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https://www.readbyqxmd.com/read/29775550/palliative-sedation-with-oral-medicines-in-an-infant-with-generalized-severe-junctional-epidermolysis-bullosa
#1
Keith P Pasichow, Meg Frizzola, Elissa G Miller
Generalized severe junctional epidermolysis bullosa is a rare mechanobullous skin disorder that is uniformly fatal. We present the case of an infant who received palliative pain management and ultimately proportionate palliative sedation. However, because of the extent of the patient's skin disease, we were unable to provide palliative medication through parenteral routes. We discuss the provision of enteral palliative sedation, including the pharmacology, and creative use of medications to achieve sufficient palliation in this difficult and unique situation...
May 18, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29774961/influence-of-caudal-epidural-analgesia-on-cortisol-concentrations-and-pain-related-behavioral-responses-in-mares-during-and-after-ovariectomy-via-colpotomy
#2
Aileen L Rowland, Kati G Glass, Sicilia T Grady, Kevin J Cummings, Katrin Hinrichs, Ashlee E Watts
OBJECTIVE: To determine the influence of epidural detomidine and morphine on serum corticosteroid concentrations and pain-related behavioral responses in mares during and after ovariectomy via colpotomy. STUDY DESIGN: Blinded prospective study. ANIMALS: Nine university-owned mares. METHODS: Five of 9 horses received caudal epidural detomidine hydrochloride (0.01 mg/kg) and morphine sulfate (0.1 mg/kg) prior to surgery...
May 18, 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29773240/perioperative-risk-factors-that-predict-complications-of-radial-forearm-free-flaps-in-oral-and-maxillofacial-reconstruction
#3
C Wang, G Fu, F Liu, L Liu, M Cao
The aim of the study was to find out what perioperative risk factors predicted complications in patients having reconstructions with radial forearm free flaps (RFFF). We organised a retrospective study of 169 patients (mean (range) age 54 (22-86) years, 100 of whom were female) who had oral and maxillofacial tumours resected, and reconstructed with RFFF, from January 2011-December 2016. We recorded predictive variables, subdivided into: personal and clinical (sex, age, weight, coexisting conditions, history of smoking, radiotherapy, and primary lesions); haemodynamic (perioperative concentrations of haemoglobin and albumin, blood loss, blood transfusion, urinary output (ml), and rate (ml/kg/hour), and infusion rates for crystalloids and colloids (ml/kg/hour, and volumes given intraoperatively and postoperatively for 24hours); and anaesthetic and surgical (American Society of Anesthesiologists(ASA) grade, visual analogue pain score (VAS), and duration of tourniquet and operation)...
May 14, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29772595/-case-report-metamizole-induced-agranulocytosis
#4
Falk A Gonnert, Winfried Meißner
Metamizole is primarily used for severe perioperative pain, acute injury and colic, and cancer pain. For other acute/chronic forms of pain and high fever, it should only be used if unresponsive to other agents. Metamizole should not be used for middle and low pain. Oral application should be preferred. A contraindication for metamizole is leukopenia. Clinical signs for agranulocytosis are fever, tonsillitis and aphthous stomatitis.
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29772368/volumetric-muscle-measurements-indicate-significant-muscle-degeneration-in-single-level-disc-herniation-patients
#5
Kaan Yaltırık, Burhan Oral Güdü, Yüksel Işık, Çiğdem Altunok, Ufuk Tipi, Başar Atalay
INTRODUCTION: There is a strong relationship between lower back pain and paraspinal muscle atrophy. In this study, we aimed to investigate the prevalence of lumbar paravertebral muscle atrophy in patients with and without single level disc herniation. MATERIALS AND METHODS: The 110 retrospectively analyzed patients in this study were divided into two groups. Group A included 55 patients with radiologically confirmed single level disc herniation with back pain and radiculopathy...
May 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29771804/preemptive-analgesia-decreases-pain-following-anorectal-surgery-a-prospective-randomized-double-blinded-placebo-controlled-trial
#6
Justin T Van Backer, Matthew R Jordan, Danielle T Leahy, Jesse S Moore, Peter Callas, Timothy Dominick, Peter A Cataldo
BACKGROUND: Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Studies in the orthopedic, urologic, and gynecologic literature support this practice, but the use of preemptive analgesia in anorectal surgery is understudied...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29771396/lyme-arthritis-of-the-pediatric-elbow-a-case-series
#7
David Gendelberg, William L Hennrikus
Most patients with untreated Lyme disease will experience joint symptoms. Owing to their resemblance in clinical presentation, Lyme arthritis and septic arthritis are often difficult to differentiate. However, their treatment is different. The elbow is rarely the first joint to present with symptoms. Therefore, Lyme disease is not commonly included in the differential diagnosis for children presenting with isolated elbow pain. The authors report 4 cases of monoarticular Lyme arthritis presenting in the elbow...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29769121/anxiety-and-depression-in-primary-sj%C3%A3-gren-s-syndrome-a-cross-sectional-study
#8
Yafei Cui, Ling Xia, Lin Li, Qian Zhao, Shengnan Chen, Zhifeng Gu
BACKGROUND: Prevalence of anxiety and depression is high in people with Primary Sjögren's syndrome (pSS). However, there are currently no known reported studies about anxiety/depression in pSS patients from China. Our aim was to compare anxiety/depression in pSS patients and healthy controls; to investigate the prevalence of anxiety and/or depression among pSS patients in China; to evaluate its relationship with the disease activity, fatigue, pain, education, ocular surface disease, oral health, swallowing disorders, employment status, European League Against Rheumatism Sjögren's Syndrome Patient Reported Index(ESSPRI) as well as to analyze potential determinants of anxiety and depression...
May 16, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29768604/-self-perceived-oral-health-status-chewing-ability-and-longevity-in-the-elderly
#9
Clarice Santana Milagres, Luísa Helena do Nascimento Tôrres, Anita Liberalesso Neri, Maria da Luz Rosário Sousa
The scope of this article is to assess the oral health conditions and self-perceived chewing ability among the elderly seniors (≥ 80 years). Data from the FIBRA multicentric study were used. The sample consisted of 2,341 individuals with no cognitive impairment, aged ≥ 65 years, between 2008 and 2009, where the elderly were subjected to data collection. Regarding the outcome, age was dichotomized into 65-79 and 80 and over. The association between longevity and the socio-demographic and behavioral variables, general and oral health and self-perceived chewing ability was assessed by Poisson regression...
May 2018: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/29768371/complex-regional-pain-syndrome-type-ii-after-cervical-transforaminal-epidural-injection-a-case-report
#10
Gi-Young Park, Dong Rak Kwon, Dae Gil Kwon
RATIONALE: We report a case of a 61-year-old patient who developed complex regional pain syndrome (CRPS) type II after a cervical transforaminal epidural steroid injection (CTESI). PATIENT CONCERNS: The patient developed sudden-onset severe pain and swelling of his upper right limb after a cervical transforaminal epidural injection. DIAGNOSES: On physical examination, the patient's symptoms and signs corresponded to the Budapest criteria for CRPS...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29768336/primary-diffuse-large-b-cell-lymphoma-in-the-maxilla-a-case-report
#11
Haixiao Zou, Haili Yang, Yuan Zou, Lang Lei, Li Song
RATIONALE: Lymphomas are the second most common non-epithelial malignant tumors in the oral and maxillofacial region. Non-Hodgkin's lymphoma (NHL) develops at extranodal sites, and cases involving the maxilla account for less than 1% of all NHLs. We describe a case of diffuse large B-cell lymphoma (DLBCL) in the maxilla, and highlight the clinical signs, symptoms, differential diagnosis, and appropriate treatment of DLBCL in the oral cavity and maxillofacial region. PATIENT CONCERNS: A 67-year-old woman was admitted to our surgical department with pain and swelling in her right upper posterior teeth for about six months...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29766152/undesired-effect-of-excessive-betamethasone-administration-during-pregnancy-a-rare-case
#12
Alireza Mirzaei, Solmaz Piri, Kaveh Gharanizadeh, Mozhdeh Zabihiyeganeh
Background: Postpartum bilateral femoral neck fracture (BFNF) is a rare condition. We here report a case of BFNF due to excessive corticosteroid consumption, twin pregnancy, immobility, and vitamin D deficiency. Case: This is a report of a 32-yr-old woman with bilateral femoral insufficiency fracture five days after emergency cesarean section due to preterm labor, twin pregnancy, and the history of a previous cesarean section at 33 wk. Antenatal repeated courses of betamethasone injections for fetal lung maturity, daily oral use of prednisolone for the history of miscarriage, immobilization, and vitamin D deficiency were the important contributing factors in her past medical history and lab investigations...
March 2018: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/29764480/a-stepped-approach-for-the-management-of-symptomatic-internal-derangement-of-the-temporomandibular-joint
#13
Candan Efeoglu, Aylin Sipahi Calis, Huseyin Koca, Esra Yuksel
BACKGROUND: Internal derangement is the clinical and pathological condition of disc displacement of the temporomandibular joint. Management of these cases involve conservative and surgical treatment options. Minimally invasive surgical procedures namely arthrocentesis and arthroscopy are promising techniques in the management of internal derangement. However patient selection algorithms, indications for minimally invasive procedures and details of the techniques should be further studied for safe and cost effective management of these cases...
May 15, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29763832/the-impact-of-a-pain-assessment-intervention-on-pain-score-and-analgesic-use-in-older-nursing-home-residents-with-severe-dementia-a-cluster-randomised-controlled-trial
#14
Hanne Marie Rostad, Inger Utne, Ellen Karine Grov, Milada Cvancarova Småstuen, Martine Puts, Liv Halvorsrud
BACKGROUND: Pain is highly prevalent in older adults, especially those in institutional settings such as nursing homes. The presence of dementia may increase the risk of underdiagnosed and undertreated pain. Pain assessment tools are not regularly used in clinical practice, however, there are indications that the regular use of pain assessments tools may influence the recognition of pain by nursing staff and thereby affect pain management. OBJECTIVES: To assess whether regular pain assessment using a pain assessment tool is associated with changes in i) pain scores and ii) analgesic use in nursing home residents with severe dementia...
April 30, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29763510/trihexyphenidyl-for-dystonia-in-cerebral-palsy
#15
REVIEW
Adrienne R Harvey, Louise B Baker, Dinah Susan Reddihough, Adam Scheinberg, Katrina Williams
BACKGROUND: Cerebral palsy occurs in up to 2.1 of every 1000 live births and encompasses a range of motor problems and movement disorders. One commonly occurring movement disorder amongst those with cerebral palsy is dystonia: sustained or intermittent involuntary muscle spasms and contractions that cause twisting, repetitive movements and abnormal postures. The involuntary contractions are often very painful and distressing and cause significant limitations to activity and participation...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29763267/top-20-research-studies-of-2017-for-primary-care-physicians
#16
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29762881/colchicine-a-microtubule-disassembling-drug-in-the-therapy-of-cardiovascular-diseases
#17
George N Chaldakov
Colchicum autumnale, from which colchicine has been isolated more than 100 years ago, has been used as a treatment for pain and swelling for thousands of years. It is one of the few drugs known from that time period whose use has survived to modernity. Over the past decades, advances in the knowledge of (i) cytoskeletal microtubules (МТ), and (ii) anti-inflammatory and anti-fibrotic effects of colchicine, a classical MT-disassembling (tubulin-targeting) agent, have led to potential new uses for this very old drug extended beyond acute gouty arthritis and familial Mediterranean fever...
May 15, 2018: Cell Biology International
https://www.readbyqxmd.com/read/29762332/extended-release-liposomal-bupivacaine-injection-exparel-for-early-postoperative-pain-control-following-palatoplasty
#18
Kristopher M Day, Narayanan M Nair, Larry A Sargent
INTRODUCTION: Liposomal bupivacaine (LB) is a long-acting local anesthetic reported to decrease postoperative pain in adults. The authors demonstrate the safe use of LB in pediatric patients with improved pain control following palatoplasty. MATERIALS AND METHODS: Retrospective patient series of all single-surgeon palatoplasty patients treated at a tertiary craniofacial center from August 2014 to December 2015 were included. All patients received 1.3% LB intraoperatively as greater palatal nerve and surgical field blocks in 2-flap V-Y pushback palatoplasty...
May 14, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29760541/laparoscopic-gastrojejunostomy-for-gastric-outlet-obstruction-in-patients-with-unresectable-hepatopancreatobiliary-cancers-a-personal-series-and-systematic-review-of-the-literature
#19
REVIEW
Alba Manuel-Vázquez, Raquel Latorre-Fragua, Carmen Ramiro-Pérez, Aylhin López-Marcano, Roberto De la Plaza-Llamas, José Manuel Ramia
The major symptoms of advanced hepatopancreatic-biliary cancer are biliary obstruction, pain and gastric outlet obstruction (GOO). For obstructive jaundice, surgical treatment should de consider in recurrent stent complications. The role of surgery for pain relief is marginal nowadays. On the last, there is no consensus for treatment of malignant GOO. Endoscopic duodenal stents are associated with shorter length of stay and faster relief to oral intake with more recurrent symptoms. Surgical gastrojejunostomy shows better long-term results and lower re-intervention rates, but there are limited data about laparoscopic approach...
May 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29760367/-pharmacological-action-and-clinical-outcome-of-newly-developed-nsaids-patch-loqoa-%C3%A2-tape
#20
Noboru Otsuka, Ikuko Yataba
Topical non-steroidal anti-inflammatory drugs (NSAIDs) patches are indispensable for the treatment of musculoskeletal diseases, while they are considered less effective than oral NSAIDs. LOQOA® tape is a tape-type patch containing esflurbiprofen (SFP) as a major active ingredient with potent cyclooxygenase inhibition and sufficient skin permeability. SFP patch (SFPP) showed higher percutaneous absorption rate, rapid pain relief, and potent anti-inflammatory efficacy comparing with existing NSAIDs patches in rat...
2018: Nihon Yakurigaku Zasshi. Folia Pharmacologica Japonica
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