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https://www.readbyqxmd.com/read/28100991/sphincter-of-oddi-dysfunction-a-perplexing-presentation
#1
Sana Ahmad Din, Iman Naimi, Mirza Beg
Sphincter of Oddi dysfunction is caused by stenosis or dyskinesia of the sphincter of Oddi, leading to blockage of bile drainage from the common bile duct. We present the case of a 16-year-old female with chronic abdominal pain who underwent laparoscopic cholecystectomy for cholelithiasis but continued to experience abdominal pain, nausea, and vomiting along with persistently elevated ALT and AST levels. Postoperative abdominal ultrasound was nondiagnostic. Esophagogastroduodenoscopy showed mild reflux esophagitis and mild chronic Helicobacter pylori-negative gastritis...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28098413/dermatomal-spread-following-posterior-transversus-abdominis-plane-block-in-pediatric-patients-our-initial-experience
#2
Maria A Hernandez, Tricia Vecchione, Karen Boretsky
INTRODUCTION: Several techniques for the transversus abdominis plane (TAP) block have been described. The extent of sensory changes using an ultrasound-guided posterior TAP block (pTAP) remains unclear in pediatric patients. The primary aim of this study was to report the extent of sensory changes achieved with pTAP; specifically the highest thoracic dermatome anesthetized. Secondary outcomes were pain scores (PS), opioid consumption, and complications. METHODS: We retrospectively reviewed the medical records of patients less than 21 years of age undergoing abdominal surgery with a unilateral or bilateral pTAP(s) for postoperative analgesia...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28097450/contemporary-thoughts-on-the-management-of-spigelian-hernia
#3
V Webber, C Low, R J E Skipworth, S Kumar, A C de Beaux, B Tulloh
BACKGROUND: Spigelian hernias are said to be a rare condition of the elderly population, usually arising below the arcuate line. Local experience has led us to challenge these commonly held beliefs. METHODS: Operations for Spigelian hernia from 2006-2016 were identified from the Edinburgh Lothian Surgical Audit computerised database and case notes were reviewed. RESULTS: One hundred and one patients underwent surgery for 107 Spigelian hernias in the 10-year period...
January 17, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28096645/peri-and-post-menopausal-women-with-complex-adnexal-masses-ascites-and-raised-ca-125-is-it-ovarian-cancer-or-tuberculosis
#4
Rashmi Bagga, Tanuja Muthyala, Subhas Chandra Saha, Shalini Gainder, Pradip Kumar Saha, Radhika Srinivasan, Arvind Rajwanshi, Nalini Gupta
Pelvic and peritoneal tuberculosis may resemble advanced ovarian cancer due to the presence of ascites, complex adnexal masses, peritoneal deposits and raised CA-125 level, especially in peri- and postmenopausal women. Other common features among women with these two conditions are abdominal pain and distension, weight loss and reduced appetite. As the treatment of pelvic-peritoneal tuberculosis is completely different from that of ovarian cancer, it is important to reach a correct diagnosis. Sometimes women with pelvic-peritoneal tuberculosis may be subjected to a laparotomy for suspected ovarian cancer which is likely to increase their morbidity...
October 2016: Journal of Mid-life Health
https://www.readbyqxmd.com/read/28096320/streptococcus-gordonii-a-rare-cause-of-prosthetic-joint-infection-in-a-total-hip-replacement
#5
Christopher Fenelon, John G Galbraith, David M Dalton, Eric Masterson
A 69-year-old female with a history of bilateral total hip replacements presented with rigors, fever and sudden onset left groin pain. A pelvic X-ray showed well-fixed implants. Blood results revealed a leucocytosis (white cell count 22.3 × 10(9) l(-1)) and elevated C-reactive protein (211 mg/l). Ultrasound-guided aspiration of her left hip grew Streptococcus gordonii No source infection could be identified apart from a new chronic sinus infection in a left upper incisor. Following a discussion with the patient a 6-week course of intravenous ceftriaxone was started and was successful in normalizing her inflammatory markers...
January 16, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28093873/diagnostic-and-management-challenges-from-childhood-puberty-through-to-transition-in-severe-insulin-resistance-due-to-insulin-receptor-mutations
#6
Christina Wei, Christine P Burren
Two Caucasian girls, both of normal weight and body mass indices, were diagnosed with type A insulin resistance (IR) in childhood. Case 1 presented with premature adrenarche aged 7 years, then by age 12 years had hirsutism, acne, acanthosis nigricans, and asymptomatic diabetes. Subsequent investigation revealed raised adiponectin (15.3 mg/L) and heterozygous p.Pro1205Leu mutation in the INSR gene encoding the insulin receptor. She experienced postprandial hypoglycaemia on metformin; acarbose was trialled and discontinued aged 16 years, as she became normoglycaemic...
January 17, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28089812/clinical-manifestations-and-outcomes-in-surgically-managed-gartner-duct-cysts-1
#7
Adela G Cope, Shannon Laughlin-Tommaso, Abimbola Famuyide, John B Gebhart, Matthew R Hopkins, Daniel M Breitkopf
STUDY OBJECTIVE: Gartner duct cysts (GDC) are rare embryological remnants of the mesonephric duct with the majority of cases discovered incidentally in asymptomatic patients. The largest prior published series evaluating surgical management of GDC included 4 patients. The present study aims to determine the manifestations and outcomes of surgically managed patients with GDC with important implications for surveillance, monitoring, and management of patients. DESIGN: Retrospective chart review DESIGN: Classification: Canadian Task Force Classification III SETTING: Tertiary care center PATIENTS: All women diagnosed with GDC from 1/1994-4/2014 at our institution were identified...
January 12, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28089807/ultrasonography-detects-ulnar-nerve-dislocation-despite-normal-electrophysiology-and-magnetic-resonance-imaging
#8
Jared M Pisapia, Zarina S Ali, Eric D Hudgins, Viviane Khoury, Gregory G Heuer, Eric L Zager
BACKGROUND: Dislocation of the ulnar nerve (UN) occurs in a subset of patients with ulnar neuropathy. Electrodiagnostic and magnetic resonance imaging (MRI) studies are performed to support the clinical diagnosis. We report the case of a patient with ulnar neuropathy with normal electrodiagnostic and MRI studies but with ultrasound (US) showing UN dislocation, which prompted successful treatment by UN submuscular transposition. CASE DESCRIPTION: A healthy 15 year-old female softball player presented with right medial elbow pain and paresthesias of the fourth and fifth digits...
January 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28086940/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-for-analgesia-following-total-knee-arthroplasty-a-prospective-feasibility-study
#9
Brian M Ilfeld, Christopher A Gilmore, Stuart A Grant, Michael P Bolognesi, Daniel J Del Gaizo, Amorn Wongsarnpigoon, Joseph W Boggs
BACKGROUND: Peripheral nerve stimulation has been used for decades to treat chronic pain but has not been used for postoperative analgesia due to multiple limitations, beginning with invasive electrode placement. With the development of small-diameter/gauge leads enabling percutaneous insertion, ultrasound guidance for accurate introduction, and stimulators small enough to be adhered to the skin, neurostimulation may now be provided in a similar manner to continuous peripheral nerve blocks...
January 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28081030/ultrasound-findings-of-young-and-traumatic-amputees-with-lower-extremity-residual-limb-pain-in-turkey
#10
Koray Aydemir, Yasin Demir, Ümüt Güzelküçük, Kutay Tezel, Bilge Yilmaz
OBJECTIVE: The current study was designed to document clinical and ultrasound (US) findings of patients with residual limb pain (RLP) after amputation and to investigate the relationship between these findings. MATERIALS AND METHODS: A chart review was performed to identify demographic and clinical data including the age (current and at the time of injury), time since amputation, gender, reason for amputation, affected limb number, side and level of limb loss, and ultrasonographic findings of young and traumatic amputees with RLP...
January 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28079582/landmark-guided-and-ultrasound-guided-approaches-for-trochanteric-bursa-injection-a-cadaveric-study
#11
Alex Mu, Philip Peng, Anne Agur
BACKGROUND: Trochanteric bursa (TB) injection with local anesthetic and corticosteroid is a treatment for patients suffering from greater trochanteric pain syndrome. Both landmark (LM)-guided and ultrasound (US)-guided methods have been used, but their accuracies have not been determined. This study examined the accuracy of these injections with cadaveric dissection. METHODS: Twenty-four hip specimens were randomized to receive TB injections with methylene blue under either LM-guided or US-guided approach...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079154/local-anesthesia-for-transrectal-ultrasound-guided-biopsy-of-the-prostate-a-meta-analysis
#12
Mingchao Li, Zhengyun Wang, Hao Li, Jun Yang, Ke Rao, Tao Wang, Shaogang Wang, Jihong Liu
A meta-analysis was performed to evaluate the efficacy of local anesthesia in alleviating pain during prostate biopsy. We searched relevant articles in PubMed and Embase. The included studies should be randomized controlled trials (RCT) using local anesthesia to alleviate pain during biopsy, which was recorded by a pain scale. Analgesic efficacy of different local anesthesia techniques were analyzed, including intrarectal local anesthesia (IRLA), periprostatic nerve block (PNB), pelvic plexus block (PPB) and intraprostatic local anesthesia (IPLA)...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28078503/efficacy-of-pulsed-nd-yag-laser-in-the-treatment-of-patients-with-knee-osteoarthritis-a-randomized-controlled-trial
#13
Mohamed Salaheldien Mohamed Alayat, Tarek Helmy Ahmed Aly, Aly Elsayed Mohamed Elsayed, Ammar Suliman Mohamed Fadil
The purpose of this study was to investigate the effects of pulsed Nd:YAG laser plus glucosamine/chondroitin sulfate (GCS) in patients with knee osteoarthritis (KOA) by examining changes in pain and knee function, as well as synovial thickness (ST) and femoral cartilage thickness (FCT). Sixty-seven male patients participated, with a mean (SD) age of 53.85 (4.39) years, weight of 84.01 (4.70) kg, height of 171.51 (3.96) cm, and BMI of 28.56 (1.22). Group 1 was treated with high-intensity laser therapy (HILT), GCS, and exercises (HILT + GCS + EX)...
January 11, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28078128/endoscopic-ultrasound-in-pancreatic-cancer-innovative-applications-beyond-the-basics
#14
REVIEW
Joseph Yoo, C Andrew Kistler, Linda Yan, Andrew Dargan, Ali A Siddiqui
Endoscopic ultrasound (EUS) has become a mainstay in assisting in the diagnosis and staging of pancreatic cancer. In addition, EUS provides a modality to treat chronic pain through celiac plexus neurolysis. Currently, there is growing data and utilization of EUS in more diverse and innovative applications aimed at providing more sophisticated diagnostic, prognostic and therapeutic options for patients with pancreatic cancer. EUS delivery of chemotherapy, viral and biological vectors and fiducial markers may eventually revolutionize the way clinicians approach the care of a patient with pancreatic cancer...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28077355/no-evidence-for-the-use-of-stem-cell-therapy-for-tendon-disorders-a-systematic-review
#15
Haiko I M F L Pas, Maarten H Moen, Hidde J Haisma, Marinus Winters
INTRODUCTION: Stem cells have emerged as a new treatment option for tendon disorders. We systematically reviewed the current evidence for stem cell therapy in tendon disorders. METHODS: Randomised and non-randomised controlled trials, cohort studies and case series with a minimum of 5 cases were searched in MEDLINE, CENTRAL, EMBASE, CINAHL, PEDro and SPORTDiscus. In addition, we searched grey literature databases and trial registers. Only human studies were included and no time or language restrictions were applied to our search...
January 11, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28076692/the-effects-of-ultrasound-guided-corticosteroid-injection-for-the-treatment-of-hemiplegic-shoulder-pain-on-depression-and-anxiety-in-patients-with-chronic-stroke
#16
Min Cheol Chang
PURPOSE: We attempted to investigate whether ultrasound (US)-guided intraarticular or subacromial bursa corticosteroid injections can potentially influence the severity of depression and anxiety in patients with chronic stroke with hemiplegic shoulder pain (HSP). METHODS: Thirty patients with chronic stroke with HSP received US-guided corticosteroid injections. Numeric rating scale (NRS) scores, passive shoulder range of motion (ROM), Beck Depression Inventory (BDI) scores, and Spielberger State-Trait Anxiety Inventory (STAI) scores were evaluated before the injection, and one and two months after the injection...
January 11, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28075090/carpal-tunnel-syndrome-diagnosis-and-management
#17
Jennifer Wipperman, Kyle Goerl
Carpal tunnel syndrome, the most common entrapment neuropathy of the upper extremity, is caused by compression of the median nerve as it travels through the carpal tunnel. Classically, patients with the condition experience pain and paresthesias in the distribution of the median nerve, which includes the palmar aspect of the thumb, index and middle fingers, and radial half of the ring finger. Additional clues include positive physical examination findings, such as the flick sign, Phalen maneuver, and median nerve compression test...
December 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/28074461/acute-appendicitis-during-pregnancy-case-series-of-20-pregnant-women
#18
İlker Murat Arer, Songül Alemdaroğlu, Hasan Yeşilağaç, Hakan Yabanoğlu
BACKGROUND: Acute appendicitis (AA) is the most common cause of acute abdomen during pregnancy. Most of the signs of appendicitis are also found during normal pregnancy period, however, and diagnosis of appendicitis during pregnancy remains challenging. The aim of the current study was to report our clinical experience of AA during pregnancy and investigate optimal management of this difficult situation. METHODS: Records of 20 pregnant women with diagnosis of AA who underwent appendectomy between 2005 and 2015 were included in this study...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28073211/an-unusual-case-of-primary-intrascrotal-lipoma
#19
Andrea Fabiani, Emanuele Principi, Alessandra Filosa, Tiziana Pieramici, Fabrizio Fioretti, Valentina Maurelli, Lucilla Servi, Gabriele Mammana
In daily clinical practice, intrascrotal lesion are commonly detected, both by clinical examination either by ultrasound scan. While 95% of testicular lesions are malignant, most paratesticular lesions are benign. Among these, intrascrotal lipomas must be take into account in differential diagnosis. When they originate from scrotal wall, they named "primary scrotal lipoma". We describe a case of a primary intrascrotal lipoma diagnosed after surgical excision in a young man presented at our Urological Department complaining a painful left scrotal mass...
December 30, 2016: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28073208/experience-of-percutaneous-access-under-ultrasound-guidance-in-renal-transplant-patients-with-allograft-lithiasis
#20
Silvano Palazzo, Ottavio Colamonico, Saverio Forte, Matteo Matera, Giuseppe Lucarelli, Pasquale Ditonno, Michele Battaglia, Pasquale Martino
OBJECTIVE: Urolithiasis of the transplanted kidney has an incidence of 0.2 to 1.7%, it increases the risk of infection in immunosuppressed patients and it can lead to ureteral obstruction that is often associated with deterioration of renal function. Urolithiasis of the transplanted kidney has different characteristics compared to the native kidney, due to the absence of innervation, which does not lead to colic pain. Percutaneous approach is an optimal choice in transplant patients. MATERIAL AND METHODS: Here we report our experience in two cadaveric transplant patients with urolithiasis...
December 30, 2016: Archivio Italiano di Urologia, Andrologia
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