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https://www.readbyqxmd.com/read/28432164/use-of-gabapentin-in-the-treatment-of-chronic-pain-in-an-adolescent-with-sickle-cell-disease
#1
Cátia R Correia, Ana Teresa Soares, Laura Azurara, Maria João Palaré
Vaso-occlusive crises are the most common manifestation of sickle cell disease (SCD) and the main cause of hospital admission in these patients. There is emerging evidence that vaso-occlusive pain has both nociceptive and neuropathic components. However, the treatment of SCD-related pain with neuropathic drugs has not yet been systematically studied, particularly in children. We describe a 14-year-old girl with SCD and multiple hospital admissions for pain management for severe acute vaso-occlusive pain episodes...
April 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28431749/pharmacological-advances-in-the-multimodal-management-of-perioperative-analgesia
#2
M Matute Crespo, A Montero Matamala
The concept of multimodal analgesia is currently widespread in our clinical practice. The aim of multimodal analgesia is to reduce the side effects derived from the drugs or techniques used for the control of pain together with greater effectiveness (combination of multiple mechanisms of action) with the maximum efficiency, that is, to combine different pharmacodynamics (synergistic or additive effects) and pharmacokinetics, in the context of a predictable acute pain model, thus allowing a prior strategy such as the model of acute postoperative pain...
April 18, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28431714/solitary-fibrous-tumor-of-the-pleura-with-abdominal-aortic-blood-supply
#3
Kamal Addagatla, Rishi Mamtani, Robert Babkowski, Michael I Ebright
A solitary fibrous tumor of the pleura (SFTP) presenting with an aberrant arterial supply from the abdominal aorta is extremely rare, and it may be difficult to distinguish from intralobar sequestration (ILS). We report the case of a 38-year-old woman who presented with acute chest pain and was subsequently found to have a 17.5-cm intrathoracic mass. After preoperative arterial embolization of its feeding vessel, this presumed ILS was resected. However, the intraoperative findings revealed a benign SFTP. Here we discuss a unique presentation of a large SFTP radiographically mimicking an ILS, and we propose a safe management strategy for this entity...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28431539/pain-intervention-for-people-with-dementia-in-nursing-homes-pid-study-protocol-for-a-quasi-experimental-nurse-intervention
#4
Andrea Koppitz, Georg Bosshard, Geneviève Blanc, Hannele Hediger, Sheila Payne, Thomas Volken
BACKGROUND: It is estimated that 19 to 83% of people with dementia suffer from pain that is inadequately treated in the last months of life. A large number of healthcare workers who care for these people in nursing homes lack appropriate expertise and may therefore not always recognise, assess and treat pain in those with dementia who have complex problems on time, properly and efficiently. The aim of this intervention trial is to identify care needs of people with dementia suffering from pain living in a nursing home...
April 21, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28430850/trends-in-hospitalization-for-hypertensive-emergency-and-relationship-of-end-organ-damage-with-in-hospital-mortality
#5
Mahek Shah, Shantanu Patil, Brijesh Patel, Shilpkumar Arora, Nilay Patel, Lohit Garg, Sahil Agrawal, Larry Jacobs, Susan P Steigerwalt, Matthew W Martinez
BACKGROUND: There are no comprehensive guidelines on management of hypertensive emergency (HTNE) and complications. Despite advances in antihypertensive medications HTNE is accompanied with significant morbidity and mortality. METHODS: We queried the 2002-2012 nationwide inpatient sample database to identify patients with HTNE. Trends in incidence of HTNE and in-hospital mortality were analyzed. Logistic regression analysis was used to assess the relationship between end-organ complications and in-hospital mortality...
April 20, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28430721/outcomes-of-reverse-total-shoulder-arthroplasty-for-proximal-humeral-fractures-primary-arthroplasty-versus-secondary-arthroplasty-following-failed-proximal-humeral-locking-plate-fixation
#6
Emilio Sebastia-Forcada, Alejandro Lizaur-Utrilla, Román Cebrian-Gomez, Francisco A Miralles-Muñoz, Fernando A Lopez-Prats
OBJECTIVE: To compare the outcomes of reverse shoulder arthroplasty (RSA) between patients with failed proximal humeral locking plate (PHLP) fixation and those with acute fractures. DESIGN: Matched case-control study. SETTING: University hospital, level I trauma center. PATIENTS: 30 consecutive patients with fracture sequelae due to failed PHLP fixation (mean age 73) were age- and gender-matched to 30 patients with acute fracture (mean age 75)...
April 6, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#7
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28427740/a-study-of-the-incidence-and-management-of-admissions-for-cancer-related-symptoms-in-a-district-general-hospital-the-potential-role-of-an-acute-oncology-service
#8
C M Bruce, J Smith, A Price
AIMS: The non-specialist management of cancer patients is becoming increasingly complex. Acute oncology services (AOS), aiming to provide rapid access to specialist advice, have been shown to improve patient experience and reduce length of inpatient stay. The present study aimed to inform service provision in a district general hospital (DGH) by investigating cancer patients, not on active anti-cancer treatment, where the disease itself precipitated admission. This is a vulnerable group who are potentially disenfranchised of focused oncological input due to having less robust care pathways established to date...
April 17, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28426507/peripartum-anesthetic-management-of-the-opioid-tolerant-or-buprenorphine-suboxone-dependent-patient
#9
Aileen Pan, Mark Zakowski
Opioid abuse and dependence continues to rise in both the general population and pregnancy, with opioid overdose deaths having quadrupled in the last 15 years. Illicit drug use in last 30 days of pregnancy was over 4% with almost 0.6% documented maternal opiate use at time of birth. The management of the opioid-tolerant, buprenorphine-dependent or methadone-dependent patient in the peripartum period is reviewed. Options for treatment of opioid dependence, acute pain management, and perioperative multimodal analgesia are discussed...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28423852/using-the-mrc-framework-for-complex-interventions-to-develop-clinical-decision-support-a-case-study
#10
Dawn Dowding, Valentina Lichtner, S José Closs
The Medical Research Council (MRC) framework for complex interventions provides useful guidance to assist with the development and evaluation of health technology interventions such as decision support. In this paper we briefly summarise a project that focused on designing a decision support intervention to assist with the recognition, assessment and management of pain in patients with dementia in an acute hospital setting. We reflect on our experience of using the MRC framework to guide our study design, and highlight the importance of considering decision support interventions as complex interventions...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28420930/enterobius-vermicularis-in-tubo-ovarian-abscess-a-rare-and-interesting-incidental-finding-a-case-report
#11
Faryal Saleem, Faizan Malik, Saira Fatima
Enterobius vermicularis is a common intestinal nematode; however, rare extraintestinal Enterobius infections have been reported from different parts of the world. Here, we present a case of tubo-ovarian abscess in an otherwise healthy young sexually active female with no known comorbids with history of on and off lower abdominal pain for one year and high grade fever for one month. On the basis of further workup and radiological evaluation, a preoperative diagnosis of right sided tubo-ovarian abscess was made and salpingo-oophorectomy was performed laproscopically in July 2015...
April 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28420518/acute-small-bowel-obstruction-caused-by-barbed-suture-on-the-second-day-after-laparoscopic-hysterosacropexy-a-case-report-and-literature-review
#12
Hsuan Chen, Mun-Kun Hong, Dah-Ching Ding
OBJECTIVE: To report a case of small bowel obstruction caused by barbed suture applied in hysterosacropexy, and possible solutions. CASE REPORT: A 57-year-old woman underwent laparoscopic hysterosacropexy for a Stage 2 uterine prolapse, presenting with acute abdominal pain and a bowel obstruction syndrome 2 days following the surgery. Conservative treatment was given, but the symptoms did not improve and gradually became worse. Diagnostic laparoscopy was performed on the 7(th) day after the hysterosacropexy, and the volvulus was found...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28420517/ileocecal-endometriosis-diagnosis-and-management
#13
Ana López Carrasco, Alicia Hernández Gutiérrez, Paula A Hidalgo Gutiérrez, Roberto Rodríguez González, José L Marijuán Martín, Ignacio Zapardiel, Javier de Santiago García
OBJECTIVE: Ileocecal endometriosis is rare. Symptoms range from no symptoms, cramps, vomiting, to acute intestinal obstruction. Our objective was to review our cases, clarify, and resume its most appropriate management focusing on the factors to determine diagnosis. This is a retrospective study by revision of medical charts of all ileal endometriosis cases of our unit from 2006 to 2014. CASE REPORT: Seven cases were found; three (43%) had previous endometriosis laparoscopic diagnosis, four (57%) had partial bowel obstruction episodes, three (43%) had chronic pelvic pain, and one developed acute intestinal obstruction in postoperative ileostomy closure...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28419905/spontaneous-perforation-of-common-bile-duct-in-a-young-female-an-intra-operative-surprise
#14
Sudhir Kumar Mohanty, Tanmaya Mahapatra, Bharat Kumar Behera, Bidyapati Acharya, Supreet Kumar, Jyoti Ranjan Dash, Dibyasingh Meher, Malaya Ranjan Sarangi, Shiva Prasad Sahoo
INTRODUCTION: Spontaneous CBD perforation is one of the rare causes of acute abdomen in infants and extremely rare in adults. It is rarely suspected and correctly diagnosed preoperatively. PRESENTATION OF CASE: A 17year old female presented to Emergency Department with sudden onset of pain and distention of abdomen, associated with vomiting and non-passage of flatus and stool for 3days and features of generalized peritonitis. On exploration, a perforation of size 0...
April 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28419637/self-reported-prevalence-description-and-management-of-pain-in-adults-with-haemophilia-methods-demographics-and-results-from-the-pain-functional-impairment-and-quality-of-life-p-fiq-study
#15
M Witkop, A Neff, T W Buckner, M Wang, K Batt, C M Kessler, D Quon, L Boggio, M Recht, K Baumann, R Z Gut, D L Cooper, C L Kempton
INTRODUCTION: Haemophilia is characterized by frequent haemarthrosis, leading to acute/chronic joint pain. AIM: To assess self-reported prevalence, description and management of pain in adult males with mild-to-severe haemophilia and history of joint pain/bleeding. METHODS: Participants completed a pain survey and five patient-reported outcome instruments assessing pain, functional impairment and health-related quality of life (HRQoL). RESULTS: Of 381 participants enrolled, median age was 34 years; 77% had haemophilia A, 71% had severe disease and 65% were overweight/obese...
April 16, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28418691/editor-s-choice-the-organization-of-chest-pain-units-position-statement-of-the-acute-cardiovascular-care-association
#16
Marc J Claeys, Ingo Ahrens, Peter Sinnaeve, Roberto Diletti, Roberta Rossini, Patrick Goldstein, Kasia Czerwińska, Héctor Bueno, Maddalena Lettino, Thomas Münzel, Uwe Zeymer
Chest pain units are defined as organizational short stay units with specific management protocols designed to facilitate and optimize the diagnosis of patients presenting with chest pain in the emergency department. The present document is intended to standardize and facilitate the installation of chest pain units nearby to the emergency department or as an integral part of the emergency department. Recommendations on organizational structure, physical and technical requirements and on disease management are presented...
April 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28414683/recurrent-hypertriglyceridemic-pancreatitis-htgp-and-the-use-of-insulin-drip-as-treatment
#17
T Tran, N Lee
INTRODUCTION: Chronic pancreatitis by definition is a recurrent episode of acute pancreatitis and is commonly associated with alcoholism in the US. Another cause of chronic pancreatitis is hypertriglyceridemia (HTGP);, occurring in 1-5 percent of cases. The incidence of HTGP is higher in patients with diabetes and HIV, usually requiring triglyceride levels > 1000 mg/dL. CASE: A 33 year old man with uncontrolled type 1 diabetes and recurrent pancreatitis, first diagnosed 5 years prior, presented as a transfer from an outside hospital for a recurrent episode of HTGP...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414682/a-left-main-coronary-artery-thrombus-presenting-as-a-non-st-elevation-mi
#18
U Ezema, D Daberkow, T Delord, L Guidry, N R Sells
INTRODUCTION: Left main coronary artery (LMCA); thrombus with an acute myocardial infarction identified with coronary angiography is a clinically rare condition with an extremely high mortality rate. We present a case of LMCA thrombus that presented as a non-ST elevation myocardial infarction (NSTEMI);. CASE: A 45-year-old woman with a history of tobacco use and hyperlipidemia presented with a complaint of 10/10 "hard pain" across her chest radiating to her left shoulder and breast which woke her from sleep...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414680/a-rare-cause-of-abdominal-pain
#19
E M Dauchy, M Modica, N Masri
CASE: A 54 year old woman with hypothyroidism presented with right flank pain that began acutely one week prior to presentation. She was told initially she had a urinary tract infection and treatment resulted in mild symptomatic improvement. The pain returned and she presented to another Emergency Department (ED); and was told the pain was due to constipation. She returned to the ED the next day when her pain worsened and her labs were notable for WBC of 19,000/uL, BUN/Cr of 28/0.75 mg/dL, AST of 31 U/L, ALT of 92 U/L and total bilirubin of 0...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413389/a-case-of-right-atrial-obliteration-caused-by-intracardiac-extension-of-hepatocellular-carcinoma
#20
Meredith Barrett, Benjamin L Viglianti, Christopher A Hanson, Richard J Schildhouse
As the fifth most common malignancy worldwide, hepatocellular carcinoma (HCC) is a frequently encountered clinical entity. Symptomatology associated with the diagnosis includes hepatic dysfunction and pain from capsular spread. Additionally, due to its propensity for vascular spread, extrahepatic intravascular involvement can also be seen. We present a unique case of intracardiac involvement of HCC. Originally diagnosed as acute on chronic heart failure, echocardiography revealed the symptom source - tumor obliteration of the right atrium...
January 2017: Case Reports in Oncology
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