Occurrence and Practices for Pain, Agitation, and Delirium in Intensive Care Unit Patients.
CONCLUSION: Although pain, agitation, and delirium occurrence were similar to other studies, patients continue to suffer. A gap exists between clinical practices in these ICUs and current guidelines. Strategies that contribute to integrating guidelines into these ICUs should be developed, studied, and implemented. PMID: 31536628 [PubMed - in process]
ConclusionBand migration should be suspected in patients with a history of gastric band placement presenting with bowel or biliary obstruction. Its management depends on the location of the band as well as the expertise of the surgical team.
ConclusionMS patients with a higher disability at TN onset and with a longer interval between MS and TN onset had differing clinical features and outcomes: pain was more frequently bilateral, surgery was more frequent and anticipated, and preventive medication discontinuation due to pain remission was less common.
Publication date: Available online 18 October 2019Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Jean-Stéphane David, Kenji Inaba
Discussion: The incidence of rhabdomyosarcoma arising from endometriosis is exceedingly rare. The accuracy of diagnosing endometriosis and ruling out neoplasm requires coordinated efforts of a multidisciplinary team, involving radiologists, pathologists, oncologists, and gynecologic surgeons. PMID: 31624455 [PubMed - in process]
Publication date: Available online 18 October 2019Source: Preventive MedicineAuthor(s): Jack E. Henningfield, Judy B. Ashworth, Karen K. Gerlach, Bernie Simone, Sidney H. SchnollAbstractPain and addiction are complex disorders with many commonalities. Beneficial outcomes for both disorders can be achieved through similar principles such as individualized medication selection and dosing, comprehensive multi-modal therapies, and judicious modification of treatment as indicated by the patient's status. This is implicit in the term “medication assisted treatment” (MAT) for opioid use disorders (OUD), and is equally...
ConclusionStudents entering surgical residency from US medical schools have variable exposures to opioid related educational content and many students feel their medical education inadequately prepared them for prescribing postoperative opioids.
Authors: Sheldon RR, Weiss JB, Do WS, Forte DM, Carter PL, Eckert MJ, Sohn VY Abstract INTRODUCTION: Surgery is a known gateway to opioid use that may result in long-term morbidity. Given the paucity of evidence regarding the appropriate amount of postoperative opioid analgesia and variable prescribing education, we investigated prescribing habits before and after institution of a multimodal postoperative pain management protocol. MATERIALS AND METHODS: Laparoscopic appendectomies, laparoscopic cholecystectomies, inguinal hernia repairs, and umbilical hernia repairs performed at a tertiary military medical cent...
ConclusionA high index of suspicion should be held if pain is disproportionate to the signs or sepsis is present. To aid an early diagnosis, imaging of the breast should be performed early to avoid delay in treatment.
There has been surprisingly little attention to conceptual and methodological issues that influence the measurement of discretionary utilization at the end-of-life (DIALs), an indicator of quality care.
Making end-of-life decisions in neonates involves ethically difficult and distressing dilemmas for healthcare providers. Insight into which factors complicate or facilitate this decision-making process could be a necessary first step in formulating recommendations to aid future practice.