What is DIOS?
Discussion Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the cystic fibrosis transmembrane receptor (CFTR). It is found in the epithelium of the bronchi, intestine, pancreatic duct and biliary tree. It regulates chloride, bicarbonate and water secretion. The heterozygous state helps prevent against secretory diarrhea, but the homozygous state causes thickened secretions in the hollow tubes of the lungs and digestive tract. There are multiple mutations (> 2000) which have been currently classified into classes depending on their protein production and activity. CF patients generally are living longer with improved morbidity because of new treatments including lung transplantation but they also are at higher risk of having gastrointestinal problems over their lifespan. Gastrointestinal problems in patients with CF include: Pancreas Second most frequent organ affected after the lung Concentrated pancreatic juice and thickened secretions can increase obstruction leading to acute or chronic injury and inflammation Pancreatic insufficiency Most (~90%) patients have exocrine pancreatic insufficiency Greasy stools, abdominal bloating, flatulence, diarrhea and poor weight gain are symptoms Treatment is pancreatic enzyme replacement therapy (PERT), proton pump inhibitors are used sometimes also Fat soluble vitamins (A, D, E, and K) can occur and usually are also supplemented Poor nutrition Patients have increased nutrition needs because of the ex...
CONCLUSIONS: Atypia remains the most significant contributor to the risk of upstaging papillary lesions to malignancy. Our research supports the practice of excising all atypical papillary lesions with selected excision of those without atypia. In our cohort, there was no association between race and risk of upstaging to malignacy. PMID: 30988233 [PubMed - as supplied by publisher]
The objective of this study was to evaluate the prevalence and intensity of postoperative pain and analgesic norms, before and after the implementation of a CPGPP. MATERIAL AND METHOD: An observational study was carried out that included 2cross-sectional studies in 2separate periods, before and after implementation of the CPGPP. Adult patients postoperated on the first day of admission in the surgery plants were included. Demographic, clinical and pharmacological variables were collected from clinical histories. The intensity of the pain was collected through individual interviews with patients. RESULTS: We include...
Conclusions: Intraperitoneal nebulization of ropivacaine reduced postoperative pain, fentanyl requirements, referred shoulder pain, PONV with earlier mobility but with no difference in duration of the hospital stay. PMID: 30987415 [PubMed - as supplied by publisher]
What is everyone's experience with buprenorphine for pain? I've only given butrans patches from 5 to 20 mcg and find that it isn't really strong enough for many patients with chronic pain. What about belbucca, and Subutex? Is the 2mg Subutex too much?
Usually I would only do Kyphos on patients with an acute/subacute MRI with edema on the fracture. I recently saw a patient with a CHRONIC compression fracture. But it is very tender. I did a literature search, apparently one can do kyphos on chronic appearing fractures. Do you all do it in practice? I didnt know that you could. Thoughts?
Conclusions The results of this meta-analysis suggest that platelet-rich plasma may provide a long-term effect in relieving pain in plantar fasciopathy patients. To Claim CME Credits Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME Objectives Upon completion of this article, the reader should be able to: (1) Compare the efficacy of whole blood (WB), platelet-rich plasma (PRP), and corticosteroid (CS) in short-term pain reduction in patients with plantar fasciopathy (PF); (2) Compare the efficacy of WB, PRP, and CS in long-term pain reduction in patients with PF;...
Conclusions Impairments in sensory and anticipatory postural control were insufficiently restored after subacute lung transplantation rehabilitation. The little sensitivity of the sensory organization test-composite score or limits of stability test scores to detect a minimal change in performance due to rehabilitation limits the clinical applicability of these tests as objective outcome measures in lung transplantation rehabilitation.
Conclusions In patients with unilateral shoulder pain, abduction strength was found to be lower both on the ipsilateral and contralateral side. The presence of tendinopathy did not affect the reduction in strength. Future research is needed to substantiate these findings.
Conclusions This study confirmed that a 9-wk progressive exercise therapy program can improve physical health and reduce the prevalence of cervical disability and low back pain in the last month in young adults with musculoskeletal pain.
Microdialysis quantifies in vivo soft-tissue biochemical concentrations via passive diffusion of interstitial molecules through a porous membrane into a dialysate. The purpose of this pilot study was to evaluate a technique to measure inflammatory cytokines associated with rotator cuff tendinopathy by inserting a microdialysis catheter into the posterior glenohumeral joint. The technique was tested in a convenience sample of six pain-free, able-bodied veterans. Complete dialysate samples were collected in two participants. Two participants' sample volumes were smaller than what was required for analysis (30 μl) and thus...
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