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https://www.readbyqxmd.com/read/29527373/-pantoea-agglomerans-infections-in-children-report-of-two-cases
#1
Shraddha Siwakoti, Rinku Sah, Rupa Singh Rajbhandari, Basudha Khanal
Introduction: Pantoea agglomerans, primarily an environmental and agricultural organism has been reported as both commensal and pathogen of humans. We present two case reports of P. agglomerans infections in children that involved the meninges and bloodstream. Case Presentations: A 6-month-old female baby, diagnosed as congenital hydrocephalus secondary to aqueduct stenosis with ventriculoperitoneal shunt in situ, operated 14 days back was brought to the pediatric emergency with a two-day history of high fever associated with vomiting, irritability, excessive crying, and decreased feeding...
2018: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29468376/gastric-per-oral-endoscopic-myotomy-g-poem-for-the-treatment-of-refractory-gastroparesis-early-experience
#2
Zubair Malik, Rahul Kataria, Rani Modayil, Adam C Ehrlich, Ron Schey, Henry P Parkman, Stavros N Stavropoulos
BACKGROUND: Gastric per oral endoscopic myotomy (G-POEM) of the pylorus is a technique that is recently being used to treat gastroparesis. Our aim was to report our experience in performing G-POEM for refractory gastroparesis of different etiologies and determine symptom improvement. METHODS: Thirteen patients undergoing G-POEM are reported. Pre- and post-procedure gastric emptying study (GES) and PAGI-SYM for symptom severity were obtained. Patients underwent G-POEM by creating a submucosal tunnel starting in the greater curvature of the distal antrum and extending it to the beginning of the duodenal bulb, followed by a full thickness pyloromyotomy...
February 22, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29381628/quality-of-postoperative-pain-management-after-maxillofacial-fracture-repair
#3
Andre Peisker, Winfried Meissner, Gregor F Raschke, Mina D Fahmy, Arndt Guentsch, Juliane Schiller, Stefan Schultze-Mosgau
BACKGROUND: Effective pain management is an essential component in the perioperative care of surgical patients. However, postoperative pain after maxillofacial fracture repair and its optimal therapy has not been described in detail. MATERIALS AND METHODS: In a prospective cohort study, 95 adults rated their pain on the first postoperative day after maxillofacial fracture repair using the questionnaire of the Quality Improvement in Postoperative Pain Management (QUIPS) project...
January 19, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29366615/the-evaluation-and-management-of-toxic-shock-syndrome-in-the-emergency-department-a-review-of-the-literature
#4
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Toxic shock syndrome (TSS) is a severe, toxin-mediated illness that can mimic several other diseases and is lethal if not recognized and treated appropriately. OBJECTIVE: This review provides an emergency medicine evidence-based summary of the current evaluation and treatment of TSS. DISCUSSION: The most common etiologic agents are Staphylococcus aureus and Streptococcus pyogenes. Sources of TSS include postsurgical wounds, postpartum, postabortion, burns, soft tissue injuries, pharyngitis, and focal infections...
January 20, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29205691/intravenous-immunoglobulin-in-drug-and-device-refractory-patients-with-the-symptoms-of-gastroparesis-an-open-label-study
#5
M Ashat, A Lewis, H Liaquat, A Stocker, L McElmurray, V Vedanarayanan, K Soota, T Howell, A Kedar, J Obert, T L Abell
BACKGROUND: Gastroparesis is a complex clinical entity; many aspects of which remain unknown. Although most patients have idiopathic, diabetic, or postsurgical gastroparesis, many are thought to have measurable neuromuscular abnormalities. Immunotherapy has recently been utilized to treat suspected autoimmune gastrointestinal dysmotility. METHODS: Fourteen patients with symptoms of gastroparesis (Gp) who were refractory to drug/device were selected from 443 Gp patients from 2013 to 2015 who were treated at the University of Louisville motility center...
March 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29187236/obstruction-in-the-third-portion-of-the-duodenum-due-to-a-diospyrobezoar-a-case-report
#6
Yukinori Yamagata, Kazuyuki Saito, Kosuke Hirano, Yawara Kubota, Ryuji Yoshioka, Takashi Okuyama, Emiko Takeshita, Nobumi Tagaya, Shinichi Sameshima, Tamaki Noie, Masatoshi Oya
BACKGROUND: Duodenal obstruction occurs mainly due to physical lesions such as duodenal ulcers or tumors. Obstruction due to bezoars is rare. We describe an extremely rare case of obstruction in the third portion of the duodenum caused by a diospyrobezoar 15 months after laparoscopic distal gastrectomy for early gastric cancer. CASE PRESENTATION: A 73-year-old man who underwent laparoscopic distal gastrectomy for early gastric cancer 15 months before admission experienced abdominal distension and occasional vomiting...
November 29, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29038191/obstructive-uropathy-as-initial-presentation-of-genitourinary-tuberculosis-and-masquerading-as-a-postsurgical-complication
#7
Grace Igiraneza, Theobald Hategekimana, Olivier M Manzi, Onyema Ogbuagu
A 46-year-old woman who had a recent total abdominal hysterectomy presented with a 1 month history of lower abdominal pain, 1 week of nausea and vomiting as well as decreased urinary output preceded by a year of significant unintentional weight loss. On renal imaging, she was found to have bilateral hydronephrosis and hydroureters in the setting of bilateral distal ureteric obstruction complicated with acute kidney injury and severe hyperkalaemia requiring haemodialysis. The initial concern was for ureteric injury, a known complication of abdominal hysterectomy procedures, however, a urological intervention, performed 9 months later to relieve the ureteric obstruction, revealed purulent material within the left ureter that was smear positive for acid fast bacilli...
October 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28387892/anesthesia-and-analgesia-in-breast-surgery-the-benefits-of-peripheral-nerve-block
#8
REVIEW
L Calì Cassi, F Biffoli, D Francesconi, G Petrella, O Buonomo
Breast surgery is frequently associated with postoperative pain, nausea and vomiting, that result in increased patient's suffering, prolongation of hospital stays and related costs. Thoracic paravertebral nerve block (TPVB) is a viable option to the classic multimodal analgesia in breast surgery as it enhances surgical anesthesia and postoperative analgesia. In this review, we report the results of a number of studies on the role of TPVB in breast surgery. This technique is associated with a superior control of the pain, a reduction in opioids consumption after surgery, a decrease in postoperative nausea and vomiting, and an overall decrease in length of hospital stay...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28226340/oral-oxycodone-for-acute-postoperative-pain-a-review-of-clinical-trials
#9
REVIEW
Chi Wai Cheung, Stanley Sau Ching Wong, Qiu Qiu, Xianyu Wang
BACKGROUND: Opioids are the mainstay of pain management for acute postsurgical pain. Oral oxycodone is an opioid that can provide effective acute postoperative pain relief. OBJECTIVES: To evaluate the use of oral oxycodone for acute postoperative pain management. STUDY DESIGN: This is a narrative review based on published articles searched in PubMed and Medline from 2003 to 2015 on oral oxycodone for acute postoperative pain management. METHODS: Clinical trials related to the use of oral oxycodone for acute postoperative pain management were searched via PubMed and Medline from 2003 to 2015...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28192247/comparison-of-peri-articular-liposomal-bupivacaine-and-standard-bupivacaine-for-postsurgical-analgesia-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#10
REVIEW
Xi Wang, Lin Xiao, Zhiyuan Wang, Guanghui Zhao, Jianbing Ma
OBJECTIVE: This meta-analysis aimed to compare the efficacy and safety of intraoperative peri-articular liposomal bupivacaine and standard bupivacaine in patients undergoing total knee arthroplasty. METHODS: A systematic search was performed in Medline (1966-2016.9), PubMed (1966-2016.9), Embase (1980-2016.9), ScienceDirect (1985-2016.9) and the Cochrane Library. Only high-quality studies were selected. Meta-analysis was performed using Stata 11.0 software. RESULTS: Three randomized controlled trials (RCTs) and two non-randomized controlled trials (Non-RCTs), including 1214 patients met the inclusion criteria...
March 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/27977335/fatty-acid-amide-hydrolase-morphine-interaction-influences-ventilatory-response-to-hypercapnia-and-postoperative-opioid-outcomes-in-children
#11
Vidya Chidambaran, Valentina Pilipenko, Kristie Spruance, Raja Venkatasubramanian, Jing Niu, Tsuyoshi Fukuda, Tomoyuki Mizuno, Kejian Zhang, Kenneth Kaufman, Alexander A Vinks, Lisa J Martin, Senthilkumar Sadhasivam
AIM: Fatty acid amide hydrolase (FAAH) degrades anandamide, an endogenous cannabinoid. We hypothesized that FAAH variants will predict risk of morphine-related adverse outcomes due to opioid-endocannabinoid interactions. PATIENTS & METHODS: In 101 postsurgical adolescents receiving morphine analgesia, we prospectively studied ventilatory response to 5% CO2 (HCVR), respiratory depression (RD) and vomiting. Blood was collected for genotyping and morphine pharmacokinetics...
January 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/27940680/wernicke-encephalopathy-in-adolescents-after-bariatric-surgery-case-report-and-review
#12
REVIEW
Amy Armstrong-Javors, Janey Pratt, Sigmund Kharasch
Roughly 1% of all weight loss surgery is performed in adolescents. There is strong evidence demonstrating significant postsurgical weight loss, improvement in quality of life, and reduction in comorbidities such as hypertension and diabetes. Reports of postoperative complications in adolescents are few because of the small sample size in most series. Despite vitamin supplementation, nutritional deficiencies requiring hospitalization occur occasionally after Roux-en-Y gastric bypass. Wernicke encephalopathy, a triad of ophthalmoplegia, ataxia, and altered mental status, is a serious consequence of thiamine (vitamin B1) deficiency...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/27898605/initial-results-of-a-safety-and-feasibility-study-of-auditory-brainstem-implantation-in-congenitally-deaf-children
#13
Eric P Wilkinson, Laurie S Eisenberg, Mark D Krieger, Marc S Schwartz, Margaret Winter, Jamie L Glater, Amy S Martinez, Laurel M Fisher, Robert V Shannon
OBJECTIVE: To determine the safety and feasibility of the auditory brainstem implant (ABI) in congenitally deaf children with cochlear aplasia and/or cochlear nerve deficiency. STUDY DESIGN: Phase I feasibility clinical trial of surgery in 10 children, ages 2 to 5 years, over a 3-year period. SETTING: Tertiary children's hospital and university-based pediatric speech/language/hearing center. INTERVENTION(S): ABI implantation and postsurgical programming...
February 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/27687344/dose-ranging-effect-of-systemic-diphenhydramine-on-postoperative-quality-of-recovery-after-ambulatory-laparoscopic-surgery-a-randomized-placebo-controlled-double-blinded-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
Gildasio S De Oliveira, Jane Bialek, R-J Marcus, Robert McCarthy
STUDY OBJECTIVE: Diphenhydramine is an antihistamine with previously demonstrated analgesic and antiemetic properties. However, it is unknown if the beneficial perioperative properties of diphenhydramine can translate to a better quality of postsurgical recovery. The main objective of the current investigation was to investigate dose-ranging effects of diphenhydramine on quality of recovery after surgery. SETTING: Tertiary hospital in the United States. DESIGN: A prospective, randomized, double-blind trial...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27530760/domperidone-to-treat-symptoms-of-gastroparesis-benefits-and-side-effects-from-a-large-single-center-cohort
#15
Ron Schey, Mohammed Saadi, Deena Midani, Aaron C Roberts, Rahul Parupalli, Henry P Parkman
BACKGROUND: There is increased awareness about risks and benefits of using domperidone to treat gastroparesis. AIM: To describe the outcome of treating patients with refractory gastroparesis symptoms with domperidone. METHODS: Domperidone 10 mg QID or TID was prescribed to patients with refractory gastroparesis symptoms; follow-up obtained at 2-3 months assessing symptoms and side effects. Patients filled out Patient Assessment of Upper GI Symptoms prior to treatment and at follow-up along with Clinical Patient Grading Assessment Scale (CPGAS, +7 = completely better; 0 = no change)...
December 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27186526/a-case-of-cushing-ulcer-in-an-8-month-old-patient-with-medulloblastoma
#16
Walavan Sivakumar, Heather S Spader, Eric Scaife, Robert J Bollo
The authors present the first case of a Cushing ulcer in an infant with medulloblastoma who, despite being administered stress ulcer prophylaxis, worsened after corticosteroids were initiated. An 8-month-old boy presented with progressive vomiting, lethargy, and decreased oral intake. Imaging revealed a heterogeneous fourth ventricular mass. Preoperatively, the patient was started on dexamethasone. The patient underwent an uncomplicated external ventricular drain placement and suboccipital craniotomy for resection of the lesion...
April 2016: Translational Pediatrics
https://www.readbyqxmd.com/read/27042786/reducing-opioid-adverse-events-a-safe-way-to-improve-outcomes
#17
COMPARATIVE STUDY
Jay A Redan, Tina Wells, Sandra Reeder, Steven D McCarus
INTRODUCTION: Opioids are commonly used in the postoperative period to manage postsurgical pain. However, adverse side effects of opioids include respiratory depression, urinary retention, pruritus, vomiting, nausea, constipation, and increased risk of falls. Surgical site infiltration with extended release liposomal bupivacaine is effective in the multimodal care plan of managing postsurgical patients. The purpose of the present study was to examine the possible effects of liposomal bupivacaine on postoperative opioid adverse events following open hernia repair and laparoscopic colon resection surgery...
April 2016: Surgical Technology International
https://www.readbyqxmd.com/read/26904968/the-experience-of-setting-up-a-resident-managed-acute-pain-service-a-descriptive-study
#18
Tommaso Borracci, Daniela Prencipe, Anita Masotti, Alessandra Nella, Germana Tuccinardi, Lucia Margiacchi, Gianluca Villa, Fulvio Pinelli, Stefano Romagnoli, Angelo Raffaele De Gaudio, Giovanni Zagli
BACKGROUND: The benefits of an Acute Pain Service (APS) for pain management have been widely reported, but its diffusion is still limited. There are two APS models: anesthesiologist-based and a nurse-based model. Here we describe the development of a different APS model managed by anesthesia residents, and we report the first year of activity in a tertiary Italian university hospital (Careggi University Hospital, Florence, IT). METHODS: Patients were included in the APS were those undergoing abdominal and urologic surgery causing moderate or severe postsurgical pain...
February 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/26633002/liposome-bupivacaine-for-postsurgical-analgesia-in-patients-undergoing-robotically-assisted-cardiac-surgery
#19
Husam H Balkhy, Susan Arnsdorf, Dorothy Krienbring, John Urban
OBJECTIVE: Despite the advantages of robotically assisted cardiac surgery over conventional open sternotomy, robotically assisted surgery may be associated with substantial postsurgical pain arising from multiple incisions and access ports. This single-site, retrospective chart review evaluated the impact of liposome bupivacaine compared with bupivacaine HCl on postsurgical pain management in patients undergoing robotically assisted endoscopic cardiac surgery. METHODS: Sequential patient cohorts undergoing robotically assisted cardiac surgery received either 0...
November 2015: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/26612989/a-fatal-twist-volvulus-of-the-small-intestine-in-a-46-year-old-woman
#20
Jared Klein, Kathryn Baxstrom, Stephen Donnelly, Patrick Feasel, Paul Koles
A 46-year-old woman presented to two emergency departments within 12 hours because of acute abdominal pain. Physical exam demonstrated tenderness and epigastric guarding. An ultrasound was interpreted as negative; she was discharged home. Later that evening, she was found dead. Postmortem exam revealed acute hemorrhagic necrosis of a segment of jejunum secondary to volvulus. Clinical clues suggesting presentations of small bowel volvulus are usually nonspecific; the diagnosis is typically confirmed at surgery...
2015: Case Reports in Medicine
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