An important lesson in assessing neurovascular involvement in proximal humeral fractures: the presence of neuropathic pain in a dysvascular limb
Proximal humerus fracture is a common upper limb fracture with an incidence of around 5%.12,13,20 It is often a result of a high-energy injury in the younger population; in the elderly, it is often due to a trivial fall.6,10 The proximity of the infraclavicular plexus and the brachial artery (the brachial bundle) to the fracture site can result in a variety of possible neurovascular presentations, making the injury uniquely challenging.22 Hence, clinicians should maintain a high index of suspicion for neurovascular compromise complicating even a simple proximal humerus fracture.
ARTHRITIS affects about 10 million people in the UK, including people of all ages. Taking between 50mg and 100mg of this daily supplement could help to reduce joint pain and inflammation, it ’s been claimed.
We present a case report of a patient who was admitted to the emergency department with severe substernal chest pain and shortness of breath who was diagnosed with spontaneous diaphragmatic rupture and caudate liver herniation. The caudate lobe was incarcerated, contributing to the patient's symptoms. A celiotomy was performed and the defect was repaired primarily. PMID: 29233365 [PubMed - in process]
Authors: Kaufman MB Abstract Secnidazole (Solosec) for the one-dose treatment of bacterial vaginosis; triamcinolone acetonide extended-release injection (Zilretta) for osteoarthritis knee pain; and insulin aspart injection (Fiasp), a rapidacting human insulin analogue for glycemic control in diabetes mellitus. PMID: 29234210 [PubMed]
Have you all been using multimodal anesthesia? If so, what? My current choices are listed below. In pre-op holding: Acetaminophen 975 mg PO Celebrex 400 mg PO Gabapentin 600 mg PO At the start of anesthesia: 50 mg/kg MgSO4 IV On certain cases I will add 10 mg dexamethasone to the bupivacaine for the local. Patients complained about nausea when I've used OxyContin pre-op so I stopped. I think what's made the most noticeable drop in post-op pain... Multimodal anesthesia
The objective of OA biomarker research is to identify early OA prior to the appearance of radiographic signs and the development of pain. Areas covered This review has focused on extracellular genomic material that could serve as biomarkers of OA. Recent studies have examined the expression of extracellular genomic material such as miRNA, lncRNA, snoRNA, mRNA and cell-free DNA, which are aberrantly expressed in the body fluids of OA patients. Changes in genomic content of peripheral blood mononuclear cells in OA could also function as biomarkers of OA. Expert commentary There is an unmet need for soluble biomarkers for det...
The PROspective Multicenter Imaging Study for Evaluation of chest pain (PROMISE) minimal-risk tool was recently developed to identify patients with suspected stable angina at very low risk of coronary artery disease (CAD) and clinical events. We assessed the external validity of this tool within the context of the Scottish Computed Tomography of the HEART (SCOT-HEART) multicenter randomised controlled trial of patients with suspected stable angina due to coronary disease.
We report the case of a 67-year-old woman presenting with epigastric pain. Computed tomography identified diffuse phlegmonous esophagitis. Esophagogastroduodenoscopy revealed multiple perforations in the mucosal layer of the esophagus. A large amount of pus was drained internally through the gut. The patient was treated with antibiotics and early jejunostomy feeding. Although phlegmonous esophagitis is a potentially fatal disease, the patient was successfully treated medically with only a minor complication (esophageal stricture). PMID: 29234613 [PubMed]
Study Objectives:The aim of this study was to provide a neurophysiological evaluation of the function of large and small fibers, particularly the peripheral part of the thermonociceptive Aδ pathway in patients with primary restless legs syndrome (RLS).Methods:The main evaluation was based on an analysis of the parameters of laser-evoked potentials (LEPs), N2 and P2 components, and an assessment of thermonociceptive thresholds (pain thresholds; PThs). Routine nerve conduction studies (NCS) were also performed.Results:No essential or important differences of clinical significance were observed in the parameters of larg...