The effect of continuous wound infusion of ropivacaine on postoperative pain after median sternotomy and mediastinal drain in children

ConclusionsContrary to our hypothesis, continuous ropivacaine wound infusion did not reduce morphine consumption, pain score values, or nausea and vomiting in children who underwent ASD closure with median sternotomy and mediastinal drain.
Source: Pediatric Anesthesia - Category: Anesthesiology Authors: Tags: Research Report Source Type: research

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A former resident texted me this ECG, done for epigastric pain in an 18 year old.  The pain resolved immediately with treatment for acid reflux, and in the clinician's opinion was clearly GI in origin, but he wanted to know what the strange waves in the QRS were:See the unusual notching in II, III, aVF, and V2-V4.I had no idea what they were.  They reminded me of theDelayed Activation Wave associated with circumflex acute MI.See this case: https://hqmeded-ecg.blogspot.com/2018/05/is-there-delayed-activation-wave.html.But they are clearly different from this.I put it on Facebook EKG club and this is the ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Publication date: January 2020Source: Archives of Cardiovascular Diseases Supplements, Volume 12, Issue 1Author(s): M. Drissa, H. Jamila, H. DrissaBackgroundAtrial septal defect (ASD) is one of the most common causes of congenital heart disease manifested in adulthood and a subgroup of patients may not develop symptoms until late adulthood.Aim of studyThe aim of our study was to describe clinical and likelihood picture of adults over 60 years born with an ASD type II.MethodsWe performed a retrospective analysis of adult's ASD referred to our institution from 2010 through 2018. Clinical, electrocardiographic, echocardiograp...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
AbstractMinimally invasive mitral valve (MV) repair is being increasingly performed over the last 2 decades due to the constantly growing patient demand, since it offers a shorter recovery, less restriction and faster return to normal physical activities, reduction in pain, and superior cosmetic results. However, such procedures have to be performed through small incisions which limit visualization and the freedom of movement of the surgeon, in contrast to conventional operations that are performed through a sternotomy. Therefore, special long surgical instruments are required, and visualization is usually enhanced with ad...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
This study provides a cornerstone to promote further studies and to motivate people to apply evidence-based medical care for mothers with diagnosed cardiac disease in the antenatal and postnatal periods.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
A 57-YEAR-OLD, 112 kg, 168 cm man with a history of poorly controlled type II diabetes mellitus, hypertension, hyperlipidemia, and obstructive sleep apnea presented to the authors ’ institution for evaluation of intermittent chest pain that typically lasted less than 1 minute and occurred at rest. His chest pain was not correlated with exercise nor did it substantially affect his activities of daily living. The patient also reported chronic, daily headaches that were treate d with acetaminophen-caffeine.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Diagnostic Dilemma Source Type: research
​BY GORDON MURPHY, PA-C, MPHThe patient was blue, her primary care physician noted. Quite literally, in fact.The 38-year-old woman had sought care for a recurrent urinary tract infection, and that's when her primary care physician found her pulse oximetry to be 74%. He was concerned about hypoxia and asked us to evaluate her.The patient reported taking an SSRI for anxiety and having a hormone-eluting IUD. She had previously had a Roux-en-Y gastric bypass. She said she had a headache, but had been instructed not to take NSAIDs. She said she had just finished a course of Cipro for her UTI, but continued to be symptomatic w...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
CONCLUSION: Despite the limitation due to the limited number of patients studied, we believe that future studies conducted with larger patient groups would further support our findings. KEY WORDS: Minimally invasive cardiac surgery, Pain, Mini thoracotomy, mini sternotomy, VAS Score. PMID: 30394365 [PubMed - as supplied by publisher]
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
Rationale: The clinical manifestations of VACTERL association include vertebral anomalies, anal atresia, congenital heart diseases, tracheoesophageal fistula, renal dysplasia, and limb abnormalities. The association of intrahepatic anomalies and VACTERL syndrome is a rare coincidence. VACTER syndrome and intrahepatic bile drainage anomalies might be genetically related. Patient concerns: A 12-year-old girl presented with episodic colicky abdominal pain, nausea, and vomiting for several years. The individual episodes resolved spontaneously within a few days. She had a history of VACTERL syndrome, including a butterfly ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
García-Rubira JC Abstract CASE PRESENTATION: A 70-year-old woman presented to the ED with oppressive ongoing chest pain that had lasted for 1 hour and was accompanied by intense sweating. The patient had a previous history of bronchial asthma, severe degenerative mitral regurgitation, and an ostium secundum atrial septal defect that had been treated 6 years ago with a prosthetic mechanical mitral valve, Bicarbon 25, and an atrial septal defect closure. She was being treated with ciclesonide, tiotropium bromide, olodaterol, theophylline, and warfarin, adjusted according to the international normalized ratio....
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
We present an unusual case where symptoms of headache and chest pain persisted for 3 years following the implantation of a septal occluder device for an atrial septal defect despite endothelialisation of the device. The patient was found to have nickel hypersensitivity on patch testing. Following the removal of the device the patient had complete resolution of headaches and chest pain up to 10 months post‐explantation.
Source: Australasian Journal of Dermatology - Category: Dermatology Authors: Tags: Brief Reports Source Type: research
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