How Should We Diagnose Myocarditis, and Is its Recognition Really Clinically Relevant? ∗

Although the clinical spectrum of acute myocarditis varies from cardiogenic shock to asymptomatic electrocardiographic abnormalities during community viral outbreaks, its 3 most common clinical presentations are chest pain mimicking acute myocardial infarction, ventricular arrhythmias, and heart failure due to new-onset dilated cardiomyopathy (DCM) (1,2). Cardiac magnetic resonance (CMR) imaging has proven extremely valuable for assessment of clinically suspected myocarditis, by virtue of its ability to detect myocardial inflammation, myocardial edema, necrosis, and fibrosis (3). Several imaging sequences can accurately identify tissue characteristics associated with both acute and chronic myocarditis. Myocardial T1 (the spin-lattice longitudinal relaxation time) is shortened by increased interstitial space (e.g., scar, diffuse fibrosis, or infiltration) after administration of gadolinium-based contrast. T2-weighted (the spin-spin transversal relaxation time) mapping is used to detect myocardial edema, whereas early enhancement is felt to display capillary leakage and myocardial hyperemia. Contrast imaging with gadolinium enables detection of early capillary leakage based on T1-weighted early enhancement and accurate diagnosis of myocardial fibrosis based on late enhancement (LGE). LGE is frequently observed in patients with acute myocarditis in a pattern that is distinctive from ischemic myocardial injury (3). Recently, novel quantitative T1 and T2 m...
Source: Journal of the American College of Cardiology - Category: Cardiology Source Type: research

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Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
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Source: SafetyLit - Category: International Medicine & Public Health Tags: Economics of Injury and Safety, PTSD, Injury Outcomes Source Type: news
So I inherited a patient on actiq and fentanyl patch for>6 years. She states its the only thing that works. I told her Actiq is usually only for cancer pain and she showed me the REMS registration that says it can be used for non cancer pain. I am still planning on telling her to find another provider because I don't feel comfortable having patients on that. Is that unreasonable of me? She has been taking the medication safely for many years but I simply do not feel comfortable with... Actiq for chronic pain
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Degenerative spondylolisthesis with or without spondylolysis, multiply recurrent disk herniation, and degenerative disk disease commonly presents as back and leg pain, weakness and paresthesias. Surgical intervention, to include lumbar decompression with instrumented fusion with or without interbody fusion, is recommended to patients who are refractory to at least six weeks of nonoperative treatment, or patients with severe or progressive neurological deficits. This paper reviews the pre- and post-operative considerations, as well as the surgical technique, for a minimally invasive transforaminal lumbar interbody fusion fo...
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Surgical Technique Source Type: research
Conclusions: HRQOL metrics can accurately predict patient satisfaction with symptoms at 3 months, 2 years, and 4 years after surgical intervention for a lumbar disk herniation. Absolute outcome scores were somewhat more predictive than change scores.
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Primary Research Source Type: research
Conclusions: Paraspinal muscles evaluated with MRI were more significantly associated with the pathology of ASD compared with appendicular skeletal muscle evaluations with dual-energy x-ray absorptiometry. The present study indicates that multifidus and erector muscles significantly influenced the maintenance of the pelvic alignment. Level of Evidence: Level III.
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Primary Research Source Type: research
where is everyone getting their news as it related to pain medicine? is it a website or journal ? professional organization? SDN echo chamber? I have been using painmedicinenews.com which isn't terrible.
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
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Source: International Journal of Rheumatic Diseases - Category: Rheumatology Authors: Tags: ORIGINAL ARTICLE Source Type: research
ConclusionsIn contrast to the well ‐established association between black race and knee or hip OA, odds of hand OA are lower in black versus nonblack subjects, which is not mediated by known hand OA risk factors. Future mechanistic works are warranted to determine the mediating protective factors for hand OA among the black subject s.
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: FULL LENGTH Source Type: research
Conditions:   Pain, Acute;   Trauma Intervention:   Drug: Methoxyflurane Sponsors:   Ottawa Hospital Research Institute;   University of Ottawa Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
More News: Arrhythmia | Cardiogenic Shock | Cardiology | Cardiomyopathy | Chronic Pain | Dilated Cardiomyopathy | Electrocardiogram | Heart | Heart Attack | Heart Failure | Myocarditis | Outbreaks | Pain