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https://www.readbyqxmd.com/read/28641732/rehabilitation-of-symptomatic-atraumatic-degenerative-rotator-cuff-tears-a-clinical-commentary-on-assessment-and-management
#1
Sarah Bleichert, Genevieve Renaud, Joy MacDermid, Lyn Watson, Ken Faber, Ross Lenssen, Marie Saulnier, Paul Phillips, Tyler Evans, Jackie Sadi
STUDY DESIGN: Clinical Commentary. INTRODUCTION: Atraumatic rotator cuff (RC) disease, is one of the most common cause of shoulder pain, which encompasses a continuum from tendinopathy to full thickness cuff tears. Extrinsic, intrinsic and environmental factors have been implicated in the pathophysiology of this disorder, affecting the clinical presentation of symptoms including pain and irritability. Successful rehabilitation of symptomatic atraumatic degenerative rotator cuff (SADRC) tears must address the underlying mechanisms causing dysfunction and correct modifiable factors...
April 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28632013/task-demands-in-osces-influence-learning-strategies
#2
Alexandre Lafleur, Jonathan Laflamme, Jimmie Leppink, Luc Côté
THEORY: Models on pre-assessment learning effects confirmed that task demands stand out among the factors assessors can modify in an assessment to influence learning. However, little is known about which tasks in objective structured clinical examinations (OSCEs) improve students' cognitive and metacognitive processes. Research is needed to support OSCE designs that benefit students' metacognitive strategies when they are studying, reinforcing a hypothesis-driven approach. With that intent, hypothesis-driven physical examination (HDPE) assessments ask students to elicit and interpret findings of the physical exam to reach a diagnosis ("Examine this patient with a painful shoulder to reach a diagnosis")...
March 2, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28624001/diagnosis-and-management-of-the-venous-malformations-of-klippel-tr%C3%A3-naunay-syndrome
#3
REVIEW
S Keisin Wang, Natalie A Drucker, Alok K Gupta, Francis E Marshalleck, Michael C Dalsing
OBJECTIVE: A dearth of information exists in the literature regarding current practice in the management of Klippel-Trénaunay syndrome (KTS), a rare condition. We review and describe the etiology, diagnosis, and treatment of KTS. METHODS: Relevant data were synthesized from a Medline review using a combination of the keyterms "Klippel" and "Trénaunay." The majority of hits described singular case reports and were subsequently excluded. The remaining papers were then reviewed and included on the basis of the quality of evidence and the authors' discretion...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28622488/dizziness-unsteadiness-visual-disturbances-and-sensorimotor-control-in-traumatic-neck-pain
#4
Julia Treleaven
Synopsis There is considerable evidence to support the importance of cervical afferent dysfunction in the development of dizziness, unsteadiness, visual disturbances and altered balance, eye, and head movement control following neck trauma, especially in those with persistent symptoms. However, there are other possible causes for these symptoms and secondary adaptive changes should also be considered in the process of differential diagnosis. Understanding the nature of these symptoms and the differential diagnosis of their potential origin is important for rehabilitation...
June 16, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28620555/a-discussion-of-high-risk-hpv-in-a-6-year-old-female-survivor-of-child-sexual-abuse
#5
Connie D Cao, Lena Merjanian, Joelle Pierre, Adrian Balica
BACKGROUND: Human papilloma viruses (HPVs) cause a variety of clinical manifestations in children including skin warts, laryngeal papillomas, and condyloma acuminatum. Whereas the mode of transmission is well understood and management of HPV infection is clearly defined by guidelines in adults, less is known about the mode of transmission, natural history of disease, and appropriate management of high-risk anogenital HPV infections in children. CASE: The patient is a previously healthy 6-year-old female who presented with multiple vaginal lesions causing pain and discomfort and was diagnosed with HPV 18 positive CIN I...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28609279/to-operate-or-not-to-operate-on-women-with-deep-infiltrating-endometriosis-die-before-in-vitro-fertilization-ivf
#6
REVIEW
Márcia Mendonça Carneiro, Luciana Maria Pyramo Costa, Ivete de Ávila
Deep infiltrating endometriosis (DIE) can cause infertility and pelvic pain. There is little evidence of a clear connection between DIE and infertility, and the absolute benefits of surgery for DIE have not been established. This paper aimed to review the current literature on the effect of surgery for DIE on fertility, pregnancy, and IVF outcomes. Clinicians should bear in mind that a comprehensive clinical history is useful to identify patients at risk for endometriosis, although many women remain asymptomatic...
June 1, 2017: JBRA Assisted Reproduction
https://www.readbyqxmd.com/read/28609191/understanding-frequent-emergency-department-use-among-primary-care-patients
#7
Morgan Hardy, Alex Cho, Alissa Stavig, Marigny Bratcher, Janice Dillard, Lawrence Greenblatt, Kevin Schulman
Patients with high emergency department (ED) utilization are an important focus in population health management. This retrospective cohort study analyzed patterns of frequent ED use for 4087 patients enrolled at an academically-affiliated primary care clinic. For all ED visits (n = 4776), the chief complaints, admission rates, number of complaints per patient, and median time between return visits were assessed. Chart reviews were conducted for the 10 highest utilizers from each of the 3 leading complaints to help explain repeated ED use for the same complaints...
June 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28607896/a-survey-of-work-related-musculoskeletal-disorders-among-otolaryngologists
#8
Twinkle Dabholkar, Sujata Yardi, Yogesh G Dabholkar, Haritosh K Velankar, Gaurav Ghuge
There are increased reports of prevalence of work-related musculoskeletal disorders (WRMSDs) in surgeons performing minimal access surgeries. Due to the nature of the speciality, otolaryngologists spend their work days in performing markedly precise procedures in small workspaces i.e. the patients' ear, nose and throat. Due to this, they frequently adopt awkward neck, back and shoulder postures while using devices like otoscope, endoscope and microscope. The field of otolaryngology has barely received any attention with respect to ergonomic assessment...
June 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28607658/exploring-perceptions-of-instructors-about-childbirth-preparation-training-courses-a-qualitative-study
#9
Marzieh Otogara, Akram Karimi-Shahanjarini, Seyed Mohammad Mehdi Hazavehei, Jalal Poorolajal, Nahid Radnia, Forouzan Akrami, Fahimeh Bagheri
BACKGROUND: Childbirth preparation training courses on maternal and neonatal health increase awareness, and capability of pregnant women in overcoming fear and anxiety and managing labor pains. OBJECTIVE: To identify the affecting factors and barriers of these courses from the perspective of their instructors. METHODS: This qualitative study of the content analysis type, has been conducted on 16 certified teachers of the training courses of the Hamadan city in 2015...
April 2017: Electronic Physician
https://www.readbyqxmd.com/read/28600220/the-belgian-national-registry-on-chronic-pancreatitis-a-prospective-multi-centre-study-covering-more-than-800-patients-in-one-year
#10
M Fernandez, M Arvanitakis, C Musala, J Devière, W Van Steenbergen, V Putzeys, F Ausloos, B Bastens, P Gast, G Roeyen, F Berrevoet, I Scheers, M Delhaye, P H Deprez
BACKGROUND/OBJECTIVES: The epidemiology, natural history, complications, and therapeutic management of chronic pancreatitis (CP) are not well described at the national level. This multi-centre prospective observational study involving eight Belgian hospitals aimed to improve the understanding of these aspects of CP in Belgium. METHODS: All patients with a diagnosis of CP based on imaging were eligible for this study. Data were gathered regarding epidemiology, etiology, CP complications, and treatment modalities...
May 26, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28599034/a-prospective-randomized-controlled-two-arm-clinical-study-evaluating-the-efficacy-of-a-bioelectric-dressing-system-for-blister-management-in-us-army-ranger-recruits
#11
Greggory J Housler, Sue Cross, Vanessa Marcel, Daniel O Kennedy, Michael Husband, Andrew Register, Thomas Roberts, Seth Grubbs, Douglas Dudewicz, Nathan Setka, Curt Bay, Martin E Wendelken, Mina J Izadjoo
This study focused on a clinically relevant healthcare problem in the military: acute soft tissue wounds, or blisters. The trial was a prospective, controlled, randomized two-arm study evaluating the efficacy of a bioelectric dressing, Procellera®, applied topically two to three times per week for 2 weeks to blisters developed in Ranger trainees during training at Fort Benning, Georgia. A total of 80 US Army Ranger recruits with blister wounds below the knee were randomly assigned to one of two treatment groups (n = 40/group)...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28595831/-charcot-marie-tooth-disease-associated-with-hip-dysplasia-in-an-adolescent
#12
T Langlais, J-C Leonard, C Ursu, C Morin
Charcot-Marie-Tooth disease (CMT) is classified into hereditary motor and sensory neuropathy and can induce severe neuro-orthopaedics deformities, disabling at an early age. Hip dysplasia is present in 6% of CMT patients affecting preferentially CMT1 patients and can appear from the age of 8 years. The pathophysiological is paradoxical because we are confronted with proximal osteoarthritis deformations but genetics research brings use new trail. The main functional complaint is a hip joint pain during walking...
June 5, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28593737/influence-of-opioids-on-immune-function-in-patients-with-cancer-pain-from-bench-to-bedside
#13
REVIEW
Jason W Boland, A Graham Pockley
In patients with cancer, opioids are principally used for the management of acute surgical and chronic cancer-related pain. However, opioids have many non-analgesic effects, including direct and indirect effects on cancer cells and on anti-tumour immunity (natural killer (NK) cells, macrophages and T-cells). Direct effects on immune cells are manifested via opioid and non-opioid Toll-like receptors, whereas indirect effects are manifested via the sympathetic nervous system and hypothalamic-pituitary-adrenal axis...
June 8, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28588362/folic-acid-modulates-matrix-metalloproteinase-2-expression-alleviates-neuropathic-pain-and-improves-functional-recovery-in-spinal-cord-injured-rats
#14
Gurwattan S Miranpuri, Sivan Vadakkadath Meethal, Emmanuel Sampene, Abhishek Chopra, Seah Buttar, Carrie Nacht, Neydis Moreno, Kush Patel, Lisa Liu, Anupama Singh, Chandra K Singh, Nithya Hariharan, Bermans Iskandar, Daniel K Resnick
BACKGROUND: The molecular underpinnings of spinal cord injury (SCI) associated with neuropathic pain (NP) are unknown. Recent studies have demonstrated that matrix metalloproteinases (MMPs) such as MMP2 play a critical role in inducing NP following SCI. Promoter methylation of MMPs is known to suppress their transcription and reduce NP. In this context, it has been shown in rodents that folic acid (FA), an FDA approved dietary supplement and key methyl donor in the central nervous system (CNS), increases axonal regeneration and repair of injured CNS in part via methylation...
May 2017: Annals of Neurosciences
https://www.readbyqxmd.com/read/28585997/diagnosis-and-management-of-traumatic-patellar-instability-in-the-pediatric-patient
#15
Steven F DeFroda, Joseph A Gil, Alex Boulos, Aristides I Cruz
Instability of the patella is a common cause of knee pain and dysfunction in pediatric and adolescent patients and can be due to several factors. Although some patients will recall a specific traumatic event others may not, requiring the diagnosis to be made on the basis of physical examination and imaging. Congenital dislocation and connective tissue disorders should also be considered, even in the setting of trauma. There are radiographic parameters that may identify causes of instability such as trochlear and patellar abnormalities, and magnetic resonance imaging can identify signs of trauma such as bony edema, loose osteochondral fragments, and increased tibial tubercle-trochlear groove distance...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28579833/multiple-myeloma-in-niger-delta-nigeria-complications-and-the-outcome-of-palliative-interventions
#16
Ogbonna Collins Nwabuko, Elizabeth Eneikido Igbigbi, Innocent Ijezie Chukwuonye, Martin Anazodo Nnoli
BACKGROUND: Multiple myeloma (MM) is one of the hematological malignancies that require palliative care. This is because of the life-threatening nature and the suffering associated with the illness. The aim of this study is to bring to the fore the complications experienced by people living with MM in the Niger-Delta region of Nigeria and the outcome of various palliative interventions. METHODS: This was a 10-year multi-center retrospective study of 26 patients diagnosed and managed in three major centers in the Niger-Delta region of Nigeria from January 2003 to December 2012...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28579041/clinical-perspectives-of-digital-dermatitis-in-dairy-and-beef-cattle
#17
REVIEW
Paul J Plummer, Adam Krull
Digital dermatitis is a polybacterial disease process of dairy and beef cattle. Lesions are most commonly identified on the plantar aspect of the interdigital cleft of the hind limbs. Treponema spp are routinely present in large numbers of active lesions. Lesions are painful to the touch and can result in clinical lameness. The infectious nature generally results in endemic infection of cattle herds and management requires a comprehensive and integrated multipronged approach. This article provides current perspectives regarding management and treatment of digital dermatitis on dairy and beef cattle operations and provides a review for clinicians dealing with a clinical outbreak...
July 2017: Veterinary Clinics of North America. Food Animal Practice
https://www.readbyqxmd.com/read/28577713/a-critical-review-management-and-surgical-options-for-articular-defects-in-the-hip
#18
REVIEW
Eric C Makhni, Austin V Stone, Gift C Ukwuani, William Zuke, Tigran Garabekyan, Omer Mei-Dan, Shane J Nho
Patients with articular cartilage lesions of the hip may present with pain and symptoms that may be vague in nature and onset. Therefore, a thorough history and physical examination should be performed for every patient presenting with hip pain and/or disability. The management may be operative or nonoperative. Nonoperative management includes a trial of rest and/or activity modification, along with anti-inflammatory medications, physical therapy, and biologic injections. Operative treatment in the form of arthroscopic techniques continues to decrease morbidity and offer innovative solutions and new applications for microfracture, ACT, and AMIC...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28571808/nanoparticle-loaded-biodegradable-light-responsive-in-situ-forming-injectable-implants-for-effective-peptide-delivery-to-the-posterior-segment-of-the-eye
#19
Rohit Bisht, Jagdish K Jaiswal, Ilva D Rupenthal
Diseases affecting the posterior segment the eye, such as age-related macular degeneration (AMD), are the leading cause of blindness worldwide. Conventional dosage forms, such as eye drops, have to surmount several elimination mechanisms and complex barriers to achieve therapeutic concentrations at the target site often resulting in low anterior segment bioavailability (ca. 2-5%) with generally none of the drug reaching posterior segment tissues. Thus, frequent intravitreal injections are currently required to treat retinal conditions which have been associated with poor patient compliance due to pain, risk of infection, hemorrhages, retinal detachment and high treatment related costs...
June 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28570461/epineural-sheath-jacket-as-a-new-surgical-technique-for-neuroma-prevention-in-the-rat-sciatic-nerve-model
#20
Maria Siemionow, Adam Bobkiewicz, Joanna Cwykiel, Safak Uygur, Wojciech Francuzik
BACKGROUND: Terminal neuromas resulting from severe nerve injuries and traumatic or surgical limb amputations can become a source of pain, and significantly impair patients' quality of life. Recently, the number of patients with peripheral nerve injuries increased due to modern war conflicts, natural disasters, and traffic accidents. This study investigated the efficacy of the epineural sheath jacket (ESJ) as a novel technique for neuroma prevention in the rat sciatic nerve model. METHODS: A 20-mm segment of the right sciatic nerve was excised in 18 Lewis rats, and the animals were divided into 3 experimental groups (n = 6/group): group I-control, nerve stump without protection; group II-muscle burying group, nerve stump buried in the muscle; group III-ESJ group, nerve stump protected by ESJ...
May 31, 2017: Annals of Plastic Surgery
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