How to Confirm Ankle Joint Penetration

Suspicious lacerations should be investigated, even if the X-ray is normal. A step-by-step pictorial guide. It is a busy Friday evening in the emergency department when you get called to the resuscitation bay for a 14-year-old female who was the restrained back seat passenger in a rollover motor vehicle crash. After a quick call to your significant other to ensure that your daughter is safe in bed, you proceed to evaluate this young patient. You are once again amazed by modern safety technology with the minimal amount of head, torso and abdominal trauma on this patient. After a thorough initial inspection you find that the patient has a large laceration to the lateral side of her left ankle, and swelling that suggests either a fracture or a severe sprain or dislocation. You do note that the laceration is directly over the ankle, and make a note that you will need to determine if that is an “open ankle” once you ensure there are no other life threatening emergencies. You order a set of ankle x-rays with the rest of your trauma work up and give the patient a dose of pain medications prior to shipping her off to get imaging. Once the patient return from her x-rays you are relieved to see there’s no fracture, and you wonder if this could simply be a bad sprain with an overlying laceration. Can this laceration just be irrigated and closed in the emergency department, or do you some other service to weigh in? Open ankle fractures are relatively common in trauma ce...
Source: EPMonthly.com - Category: Emergency Medicine Authors: Tags: Uncategorized Source Type: news

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Back pain (BP) is a common condition of major social importance and poorly understood pathogenesis. Combining data from the UK Biobank and CHARGE consortium cohorts allowed us to perform a very large genome-wide association study (total N = 509,070) and examine the genetic correlation and pleiotropy between BP and its clinical and psychosocial risk factors. We identified and replicated 3 BP-associated loci, including one novel region implicating SPOCK2/CHST3 genes. We provide evidence for pleiotropic effects of genetic factors underlying BP, height, and intervertebral disk problems. We also identified independent genetic c...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Diabetic neuropathy is an incapacitating complication in diabetic patients. The cellular and molecular mechanisms involved in this pathology are poorly understood. Previous studies have suggested that the loss of spinal GABAergic inhibition participate in painful diabetic neuropathy. However, the role of extrasynaptic α5 subunit-containing GABAA (α5GABAA) receptors in this process is not known. The purpose of this study was to investigate the role of α5GABAA receptors in diabetes-induced tactile allodynia, loss of rate-dependent depression (RDD) of the Hoffmann reflex (HR), and modulation of primary affer...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Nature is an important aspect of our daily lives that is too often taken for granted. Now, in our technologically-driven society, we are often shut away from nature, and the times that we are out in nature, we are unable to appreciate it in its entire splendor. It is hard to truly separate yourself from the rest of the world, considering we are always “on”, but the effects of doing so prove beneficial to your general well-being and emotional clarity. “[We] are all a part of nature. We are born in nature; our bodies are formed of nature; we live by the rules of nature,” writes Wesley P. Sc...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Brain and Behavior Depression General Research Sunlight Vitamin D Source Type: blogs
Editor ’s PerspectiveWhat We Already Know about This TopicOpioid-induced respiratory depression results in part from direct activation of μ-opioid receptors expressed in the inspiratory rhythm generator located in the ventrolateral medulla, the preBötzinger ComplexRespiratory neurons within the medulla also express nicotinic acetylcholine receptors, which are made up of five subunits, arranged symmetrically around a central poreActivation of the nicotinic acetylcholine receptor α4, α7, and β2 subunits increases respiratory rhythm, whereas activation of the nicotinic acetylcholine receptor &al...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
CONCLUSIONS: Of patients engaged in MOVE! in the VHA, 1.1% received WMM. WMM are underutilized among veterans. Additional research is needed to understand barriers to incorporating WMM into comprehensive obesity treatment plans. PMID: 31090207 [PubMed - as supplied by publisher]
Source: Obesity - Category: Eating Disorders & Weight Management Authors: Tags: Obesity (Silver Spring) Source Type: research
Anxiety and depression are known comorbidities of chronic back pain. Their psychological predictors are not well established in patients with chronic back pain qualified for neurosurgery.
Source: Pain Management Nursing - Category: Nursing Authors: Tags: Original Article Source Type: research
Patients undergoing thoracic or lumbar spine surgery often lack confidence with self-care management of symptoms contributing to disability, such as pain, lack of sleep, depression, and immobility. The purpose of this pilot study was to examine whether a targeted motivational interview, focused on evidence-based recommendations to manage postoperative symptoms related to thoracolumbar spine surgery, would improve patient confidence with self-care management of their symptom-related disability. A quasiexperimental, 1-group, pretest-posttest design was used on a convenience sample of 15 adult surgical spine patients at a lar...
Source: Journal of Neuroscience Nursing - Category: Neuroscience Tags: Article Source Type: research
AbstractObjectivesThis randomized controlled trial investigated the efficacy of cognitive functional therapy (CFT) compared with manual therapy and exercise (MT ‐EX) for people with non‐specific chronic low back pain (NSCLBP) at 3‐year follow‐up.MethodsHundred and twenty ‐one patients were randomized to CFT (n = 62) or MT‐EX (n = 59). Three‐year data were available for 30 (48.4%) participants in the CFT group, and 33 (55.9%) participants in the MT‐EX group. The primary outcomes were disability (Oswestry disability Index [ODI]) and pain intensity (numerical rating scale) and secondary out...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
You're reading These 5 Mental Health Tools Will Help You Cope with Any Difficult Situation, originally posted on Pick the Brain | Motivation and Self Improvement. If you're enjoying this, please visit our site for more inspirational articles. Though it may be a surprise for some, mental health problems are commonplace. According to the National Alliance on Mental Illness, nearly 44 million American adults deal with mental health symptoms on an annual basis. That’s nearly 20% of the country’s adult population. Thankfully, similar to physical conditions like joint pain or eczema, mental health problems can be tr...
Source: PickTheBrain | Motivation and Self Improvement - Category: Consumer Health News Authors: Tags: confidence depression featured happiness health and fitness meditation motivation psychology self confidence self improvement Uncategorized affirmations best self-improvement blogs how to be successful mental health pickthebr Source Type: blogs
A 70-something with h/o cardiomyopathy, ICD, LVH was awoken with sharp chest pain, 8/10, non-radiating.  It worsened through the morning and she was eventually brought to the hospital.An ECG was recorded:What do you think?Here is one from 3 years prior:There is a paced rhythm in all 12 leads.  The new ECG has new ST Elevation that meets the Smith modified Sgarbossa criteria in leads I, aVL, and V2.  (ST elevation at the J-point is at least 25% of the depth of the preceding S-wave).  Meeting the criteria in just one lead is very specific for OMI in paced rhythm.She was given aspirin, ticagrelor, and...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
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