Miscarriage: Keep breaking the silence
I’m heartened to see more public discourse about the pain of miscarriage. Recently, Mark Zuckerberg, the CEO of Facebook, went public on his Facebook page with the pregnancy losses that he and his partner suffered. Beyonce and Jay-Z wrote a song about their first pregnancy loss. Nicole Kidman, Mariah Carey, Celine Dion, Courteney Cox, and Brooke Shields have all publicly shared their miscarriage experiences. But all too often, I still find women and their partners suffering in silence and alone. Recently, researchers at Albert Einstein College of Medicine in New York City surveyed over, 1,000 adults in the United States to determine what the general public knows about the causes of miscarriage and its emotional effects. Their results were published earlier this year in a paper called “A National Survey on Public Perceptions of Miscarriage.” Fifteen percent of those surveyed said that they (or a partner) had experienced a miscarriage. Over half of the respondents believed that miscarriages were uncommon, even though studies show that approximately one in four pregnancies ends in miscarriage. Over three-quarters of respondents thought miscarriage resulted from stress, and over a quarter also thought that the most important causes were lifestyle choices made during pregnancy. But in fact, most miscarriages are the result of chromosomal abnormalities in the developing fetus, structural abnormalities of the uterus, or endocrine or autoimmune disorders in the moth...
Adequately treating pain and nausea following uterine artery embolization (UAE) is a continuing challenge. Superior hypogastric nerve block (SHNB) is a successful adjunct technique for decreasing pain after embolization. This letter discusses safety measures for administration of SHNB during UAE using radial artery access, including avoiding inadvertent intravascular injection, choosing the optimal anesthetic, and treating local anesthetic systemic toxicity.
A 27-year-old competitive runner presented with deep right thigh pain for 1 year. A T2-weighted hyperintense 3-cm lesion was found in the right vastus lateralis muscle on magnetic resonance imaging, indicative of a ganglion cyst (Fig 1). Corresponding ultrasound showed a well-defined, hypoechoic lesion confirming the diagnosis of ganglion cyst. This location is rare for g anglion cyst, and such lesions have been treated only by surgical excision. Ultrasound-guided aspiration and sclerosis with sodium tetradecyl sulfate was performed.
We report our experience with medial cuneiform decompressive exostectomy and superficial tendon debridement in 14 cases of recalcitrant tibilalis anterior insertional pain. We reviewed 13 patients (14 feet; 12 females, 1 male; mean age 67.9 ± 7.5; range 55 to 80 years) in whom conservative treatment had failed who had undergone debridement of the insertional tibialis anterior tendon and decompressive exostectomy of the medial cuneiform.
Plantar heel pain is a common disabling condition in adults. Biomechanical factors are important in the development of plantar heel pain. Quantitative changes in rearfoot alignment in patients with plantar heel pain have not been previously investigated. From April 2016 to March 2017, 100 patients with plantar heel pain and 100 healthy individuals were recruited. The foot posture index was used for the measurement of foot alignment. The generalized joint hypermobility condition was assessed using the Beighton scale.
PMID: 29672384 [PubMed - in process]
PMID: 29672377 [PubMed - in process]
Authors: Santonocito C, Noto A, Crimi C, Sanfilippo F Abstract The use of remifentanil in clinical practice offers several advantages and it is used for a wide range of procedures, ranging from day-surgery anesthesia to more complex procedures. Nonetheless, remifentanil has been consistently linked with development of opioid-induced hyperalgesia (OIH), which is described as a paradoxical increase in sensitivity to painful stimuli that develops after exposure to opioid treatment. The development of OIH may cause several issues, delaying recovery after surgery and preventing timely patient's discharge. Moreover, it c...
This may seem a little basic, but I’m a resident and am curious how most people dose their opioids. I generally don’t give any long acting opioids for cases without significant post op pain. For cases where they’ll need post op analgesia, I usually dose some long acting opioids at the start of GA because I think it lets me use less fentanyl and smoothes out the hemodynamics. So long as it’s a modest dose, I haven’t had anyone yet that fails to breath by the end of the surgery. Do others do... Opioid dosing under GA
ecker S Abstract Placebo and nocebo effects are intriguing phenomena in pain perception with important implications for clinical research and practice because they can alleviate or increase pain. According to current theoretical accounts, these effects can be shaped by verbal suggestions, social observational learning, and classical conditioning and are necessarily mediated by explicit expectation. In this review, we focus on the contribution of conditioning in the induction of placebo hypoalgesia and nocebo hyperalgesia and present accumulating evidence that conditioning independent from explicit expectation can ...
CONCLUSIONS: Our results may provide more deep insight into the mechanism and a promising therapeutic target. The next step is to put our emphasis on an experiment level and to verify the novel genes from 13 hub genes. PMID: 29672183 [PubMed - as supplied by publisher]