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https://www.readbyqxmd.com/read/28944968/pediatric-vaccine-strain-herpes-zoster-a-case-series
#1
Sean Dreyer, Peera Hemarajata, Marcia Hogeling, Gregory P Henderson
BACKGROUND/OBJECTIVES: Herpes zoster (HZ) is caused by reactivation of the varicella zoster virus (VZV), and typically causes a painful, vesicular, dermatomal rash in adults over the age of fifty. However, HZ has been known to present in immunocompetent pediatric patients, which account for under 1% of total cases. Pediatric cases are typically caused by natural infection with VZV, but among vaccinated children up to half of cases can be due to vaccine-strain VZV. We present two such cases of vaccine-strain HZ in pediatric patients...
September 25, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28942229/surgical-experience-of-laparoscopic-retroperitoneal-triple-neurectomy-for-a-patient-with-chronic-neuropathic-inguinodynia
#2
Masato Narita, Shunpei Jikihara, Hiroaki Hata, Ryo Matsusue, Takashi Yamaguchi, Tetsushi Otani, Iwao Ikai
BACKGROUND: Neuropathic inguinodynia following inguinal hernia repair sometimes becomes a disabling disease. We report a case of successful surgical treatment of chronic refractory neuropathic pain after inguinal hernia by laparoscopic retroperitoneal triple neurectomy. CASE PRESENTATION: A seventy-year-old male who underwent right-side inguinal hernia repair using the Lichtenstein method revisited our hospital with inguinodynia 16 months after surgery. After a thorough assessment, the patient was diagnosed with neuropathic pain based on the following: 1) dermatomal mapping suggested ilioinguinal and iliohypogastric nerve problems, 2) pain was evoked by specific movement, 3) the site of maximum pain was slightly changed at every physical examination, and 4) no evidence of recurrence or meshoma was observed on MRI...
September 15, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28898500/offset-analgesia-the-role-of-peripheral-and-central-mechanisms
#3
D Ligato, K K Petersen, C D Mørch, L Arendt-Nielsen
BACKGROUND: Offset Analgesia (OA) can be evoked by a three-heat-stimulus train (T1-T2-T3), with T1 (5 s) and T3 (20 s) having the same temperature (e.g. 48 °C) and T2 (5 s) being slightly higher (1-3 °C). OA is defined as a disproportional pain reduction caused by the slight temperature decrease from T2 to T3. As the pain modulatory mechanisms behind OA are still poorly understood, the current study aimed to investigate the role of peripheral and central mechanisms by applying heat stimuli to the same location and to different unilateral and bilateral locations...
September 12, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28891826/injection-volume-and-anesthetic-effect-in-serratus-plane-block
#4
Tatsuya Kunigo, Takeshi Murouchi, Shuji Yamamoto, Michiaki Yamakage
BACKGROUND AND OBJECTIVES: Serratus plane block is performed for analgesia of the anterior chest wall. However, there has been no study concerning the appropriate volume for this block. This prospective randomized controlled study assesses the dermatomal spread and analgesic effects of serratus plane block. METHODS: Ultrasound-guided serratus plane block was performed for breast cancer surgery. The patients were randomly assigned to receive 20 or 40 mL of 0.375% ropivacaine...
September 7, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28891203/effects-of-epidural-volume-extension-by-saline-injection-on-the-efficacy-and-safety-of-intrathecal-local-anaesthetics-systematic-review-with-meta-analysis-meta-regression-and-trial-sequential-analysis
#5
REVIEW
M Heesen, S Weibel, M Klimek, R Rossaint, L R Arends, P Kranke
Epidural volume extension, a modification of combined spinal-epidural anaesthesia, involves the epidural injection of saline in order to increase the spread of drugs given intrathecally. Results from individual studies have so far been contradictory and we aimed to gather the available evidence for this technique. We performed a systematic literature search for randomised, controlled trials comparing epidural volume extension after spinal injection with a control group without epidural injection in patients undergoing surgery...
September 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28878316/diagnostic-accuracy-of-standardised-qualitative-sensory-test-in-the-detection-of-lumbar-lateral-stenosis-involving-the-l5-nerve-root
#6
Jiann-Her Lin, Yi-Chen Hsieh, Yi-Chen Chen, Yun Wang, Chih-Cheng Chen, Yung-Hsiao Chiang
Misdiagnosis of symptomatic lumbar lateral stenosis (LS) may result in an unfavourable prognosis after surgical treatment. This study investigated the diagnostic accuracy of a standardised qualitative sensory test (SQST) in the detection of symptomatic LS in patients who had degenerative spinal disorders involving the L5 spinal nerve. We prospectively identified 75 patients, of which 60 met the inclusion criteria. Lateral recess stenosis at the L5 level or foraminal stenosis at the L5/S1 level on MRI was identified and graded by a neurosurgeon blinded to any clinical information...
September 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28855219/dural-ectasia-associated-with-mounier-kuhn-syndrome-a-novel-association-in-the-context-of-spinal-stenosis
#7
Gerard Anthony Sheridan, Owen Godkin, Aiden Devitt
We present the case of a patient undergoing lumbar spine decompression for stenosis with a history of Mounier-Kuhn syndrome. The patient presented with axial lumbar spine pain over 6 months with progressive radicular pain to the left L3 dermatome. MRI confirmed spinal stenosis at L3/4 level with associated dural ectasia. The patient had an uneventful spinal decompression with resolution of radicular symptoms and axial spine pain. Dural ectasia poses a significant risk when operating on the lumbosacral spine...
August 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28853336/the-percutaneous-absorption-of-soman-in-a-damaged-skin-porcine-model-and-the-evaluation-of-woundstat%C3%A2-as-a-topical-decontaminant
#8
Christopher Dalton, Charlotte Hall, Helen Lydon, John Jenner, J Kevin Chipman, John S Graham, Robert P Chilcott
PURPOSE: The aim of this study was to evaluate a candidate haemostat (WoundStat™), down-selected from previous in vitro studies, for efficacy as a potential skin decontaminant against the chemical warfare agent pinacoyl methylfluorophosphonate (Soman, GD) using an in vivo pig model. MATERIALS AND METHODS: An area of approximately 3 cm(2) was dermatomed from the dorsal ear skin to a nominal depth of 100 µm. A discrete droplet of (14)C-GD (300 µg kg(-1)) was applied directly onto the surface of the damaged skin at the centre of the dosing site...
August 30, 2017: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/28845604/herpes-zoster-and-tofacitinib-clinical-outcomes-and-the-risk-of-concomitant-therapy
#9
Kevin L Winthrop, Jeffrey R Curtis, Stephen Lindsey, Yoshiya Tanaka, Kunihiro Yamaoka, Hernan Valdez, Tomohiro Hirose, Chudy I Nduaka, Lisy Wang, Alan M Mendelsohn, Haiyun Fan, Connie Chen, Eustratios Bananis
OBJECTIVE: Patients with rheumatoid arthritis (RA) are at increased risk of herpes zoster (HZ), and the risk appears to be increased in patients treated with tofacitinib. The aim of this study was to evaluate whether concomitant treatment with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or glucocorticoids (GCs) contributes to the increased risk of HZ in RA patients treated with tofacitinib. METHODS: HZ cases were identified from the databases of 2 phase I, 9 phase II, 6 phase III, and 2 long-term extension studies of tofacitinib in RA patients...
August 28, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28831319/bilateral-ganglion-cysts-of-the-ligamentum-flavum-in-the-cervical-spine-causing-a-progressive-cervical-radiculomyelopathy-and-literature-review
#10
Juneki Kim, Jin-Gyu Choi, Byung-Chul Son
Here we report a unique case of bilateral ganglion cysts originating from the ligamentum flavum in the cervical spine. Degenerative cysts of the ligamentum flavum are rare lesions, and most had been reported in the lumbar spine. Its occurrence in the cervical spine is extremely rare: only eight have been reported. A 66-year-old male patient presented with progressive paraparesis, pain, and paresthesia in his bilateral T1 dermatomes that had lasted for three weeks. Magnetic resonance imaging of the cervical spine demonstrated a well-demarcated cystic lesion in the bilateral dorsolateral aspects of the C7/T1 segment and significant compression of the cervical cord...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28812959/periocular-manifestations-of-trigeminal-trophic-syndrome-a-case-series-and-literature-review
#11
Katherine A McVeigh, Morag Adams, Richard Harrad, Rebecca Ford
Trigeminal trophic syndrome (TTS) is a condition whereby persistent facial ulceration presents consequent to central or peripheral insult to the trigeminal nerve. Lesions are created by repetitive self-inflicted manipulation and trauma of dysaesthetic skin within the trigeminal dermatome. We discuss four cases with aetiologies varied from presumed microvascular compromise to resection of cerebral meningioma, cerebrovascular accident, and herpes zoster ophthalmicus. We discuss the management of the under-recognised associated periocular skin ulcerations that result from physical manipulation of dysesthic skin and prove to be persistent and challenging to treat...
August 16, 2017: Orbit
https://www.readbyqxmd.com/read/28801147/variability-in-split-thickness-skin-graft-depth-when-using-an-air-powered-dermatome-a-paediatric-cohort-study
#12
Craig A McBride, Margit Kempf, Roy M Kimble, Kellie Stockton
AIM: Split-thickness skin grafts (STSG) taken using calibrated powered dermatomes are assumed to yield a graft of uniform thickness, though this assumption has never been analysed statistically. This study aims to test that assumption in a paediatric population. METHOD: STSGs from a consecutive cohort of paediatric patients were analysed for mean thickness, measured from a central biopsy. All STSGs were taken from the thigh at a dialled thickness of 0.007in. Data were analysed using non-parametric methods...
August 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28764746/percutaneous-endoscopic-lumbar-discectomy-minimally-invasive-technique-for-multiple-episodes-of-lumbar-disc-herniation
#13
Kyung-Chul Choi, Jin-Sung Kim, Dong Chan Lee, Choon-Keun Park
BACKGROUNDS: Although open lumbar discectomy is a gold standard surgical technique for lumbar disc herniation (LDH), surgery-induced tissue injury may actually become a source of postsurgical pain. Percutaneous endoscopic lumbar discectomy (PELD) is introduced as a minimal invasive spinal technique for LDH. The PELD has gained popularity and shown successful results. The authors report the clinical usefulness of the PELD technique in two patients with the serial multilevel LDHs. CASE PRESENTATIONS: A 32-year-old man suffered from radicular pain at the L5 dermatome due to the down migrated soft LDH at the L4-5 level...
August 1, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28758087/severe-ulnar-nerve-injury-after-bee-venom-acupuncture-at-a-traditional-korean-medicine-clinic-a-case-report
#14
Joon Sang Park, Yoon Ghil Park, Chul Hoon Jang, Yoo Na Cho, Jung Hyun Park
This case report describes a severe nerve injury to the right ulnar nerve, caused by bee venom acupuncture. A 52-year-old right-handed man received bee venom acupuncture on the medial side of his right elbow and forearm, at a Traditional Korean Medicine (TKM) clinic. Immediately after acupuncture, the patient experienced pain and swelling on the right elbow. There was further development of weakness of the right little finger, and sensory changes on the ulnar dermatome of the right hand. The patient visited our clinic 7 days after acupuncture...
June 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28757922/earlier-treatment-improves-the-chances-of-complete-relief-from-postherpetic-neuralgia
#15
Dong Hee Kang, Su Young Kim, Hyuck Goo Kim, Jung Hyun Park, Tae Kyun Kim, Kyung Hoon Kim
BACKGROUND: As herpes zoster progresses via postherpetic neuralgia (PHN) to well-established PHN, it presents its recalcitrant nature to the treatment. At this point, the well-established PHN is fixed as a non-treatable, but manageable chronic painful neuropathic disorder. This study evaluated the incidence of complete relief from PHN according to PHN duration at their first visit, and the other factors influencing it. METHODS: A retrospective chart review was performed on patients with PHN at a university-based pain clinic over 7 years...
July 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/28757828/comparison-of-infracondylar-versus-subsartorial-approach-to-saphenous-nerve-block-a-randomized-controlled-study
#16
L Sahin, M L Eken, M Isik, O Cavus
BACKGROUND AND OBJECTIVES: Only a few different approaches are currently utilized for saphenous nerve block. Our study aimed to compare two different ultrasound (US)-guided saphenous nerve blocks and designed this study to test the hypothesis that the medial infracondylar approach has more success rate than the subsartorial approach applied in saphenous nerve blockage. METHODS: The study included 76 patients (18-65 years old) with the American Society of Anesthesiologists physical status of I-III, who were scheduled for below-knee surgery by the orthopedics clinic...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28756507/adhesive-capsulitis-of-the-shoulder-pain-intensity-and-distribution
#17
V Candela, G Giannicola, D Passaretti, T Venditto, S Gumina
PURPOSE: Papers regarding adhesive capsulitis (AC) of the shoulder focused on etiology, epidemiology, diagnosis, and treatment; until now, information on shoulder pain characteristics is still scarce. Our aim was to analyze pain intensity and distribution in patients with AC. METHODS: The study group was composed of 278 (133M-145F) consecutive patients with AC. After diagnosis, shoulder pain distribution was assessed through an upper limb pain map and pain intensity through a visual analog scale...
July 29, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28746222/the-use-of-tenoxicam-to-prevent-symptoms-of-discomfort-induced-by-vagotonia-during-uterus-manipulation-in-cesarean-sections
#18
RANDOMIZED CONTROLLED TRIAL
Shih-Hong Chen, Shiou-Sheng Chen, Ching-Tao Chang, Chi-Hsiang Huang, Shou-Zen Fan, Li-Kuei Chen
PURPOSE: Symptoms such as nausea, vomiting, tightness of the chest, bradycardia, and shoulder or abdominal discomfort, caused by vagotonia occurring during uterus manipulation, have concerned healthcare professionals for some time. Patients sometimes report these symptoms when undergoing spinal anesthesia for cesarean sections (CSs). We designed a prospective, double-blind study to investigate the effectiveness of tenoxicam in preventing these symptoms of discomfort. METHODS: A total of 105 American Society of Anesthesiologists (ASA) class I-II nulliparous pregnant women, who were scheduled for a CS, were enrolled into this prospective, double-blind study...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28746065/percutaneous-electrical-neurostimulation-of-dermatome-t6-for-short-term-weight-loss-in-overweight-and-obese-patients-effect-on-ghrelin-levels-glucose-lipid-and-hormonal-profile
#19
Jaime Ruiz-Tovar, Carolina Llavero, Walter Smith
BACKGROUND: Percutaneous electrical neurostimulation of dermatome T6 (PENS T6), associated with a low-caloric diet, has previously demonstrated to achieve a reduction in the appetite perception, inducing a better compliance of the prescribed diet and finally leading to a greater weight loss. Ghrelin has been hypothesized to be implicated in the effect of PENS T6. The aim of this study was to evaluate the effect of PENS T6 with hypocaloric diet on appetite, weight loss and dietary compliance, and its association with plasma ghrelin levels, in comparison with PENS T6 associated with normocaloric diet, transcutaneous electrical neurostimulation of T11-T12 (placebo) with hypocaloric diet, and only hypocaloric diet...
August 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28745006/nevus-of-ota-oculodermal-melanocytosis-in-a-dog
#20
Pedro Malho, Anita Shea, David Donaldson
A 5-year-old, female, spayed Rhodesian Ridgeback presented with ocular melanocytosis and skin hyperpigmentation involving the distribution of the first and second divisions of the trigeminal nerve on the right side of the face. The dermatomal pattern of the hyperpigmentation was similar to nevus of Ota or oculodermal melanocytosis reported in humans. This condition has been associated with increased risk of developing secondary glaucoma and melanoma transformation in skin, ocular, orbital tissues, and the central nervous system...
July 25, 2017: Veterinary Ophthalmology
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