Ping Pong Balls in the Lungs

​"She's worried I had a heart attack."That was the answer I got from the 70ish-year-old patient pointing at his wife when I asked why he came to the emergency department. She quickly added, "He had terrible pain four days ago on the right side, and now he gets winded when he walks."I had already seen his ECG, so I assured her that it appeared normal. I was going to order a chest x-ray, however, because his lungs sounds were pretty quiet. She said he had COPD, and wanted to know if he needed an inhaler.The last time I had seen something like this was in medical school 30 years ago. At that time, I was astounded by a tuberculosis patient who had had plombage treatment. Initially performed in 1891, the extrapleural pneumolysis procedure placed lead bullets in the pleural space to collapse the diseased upper lobe. The surgery became known as plombage, coming from the Latin word plumbum meaning lead. Later, other substances such as wax, bone, gauze, and eventually, round Lucite balls were used. That patient long ago said she still had ping pong balls in her chest.This patient also seemed to have ping pong-sized balls filling his right chest. It was difficult to see any normal lung, so he was taken off to the donut of truth.What appeared to be ping pong balls were actually numerous bullae leaving precious little normal lung on the right. One must have popped days earlier because significant air was present in parts of his right thoracic cavity. The problem was...
Source: Lions and Tigers and Bears - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

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Quick question. Sorry about another salary thread but I am asking a specific question. Anybody working in private practice in NYC or within 30 min driving distance? Please feel free to post here or PM me about starting salary range. Thank you.
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
It's that time of year. How much Xmas bonus do you fork out for your staff, manager, mid levels, etc?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Publication date: Available online 14 December 2019Source: Orthopaedics &Traumatology: Surgery &ResearchAuthor(s): Alessio Bernasconi, Cecilia Iervolino, Rosa D’Alterio, François Lintz, Shelain Patel, Francesco SadileAbstractBackgroundThe role of subtalar arthroereisis (STA) for treating flexible flatfoot (FFF) in children is controversial. We hypothesized that (1) STA provided significant radiographic correction of low longitudinal arch and forefoot abduction in paediatric FFF and that (2) mid-term clinical outcomes were satisfactory and comparable to a normal population.MethodsA retrospective compara...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
We report the clinical findings, imaging features, surgery and histological analyses of primary synovial chondromatosis in glenohumeral joint, biceps tendon sheath and subcoracoid bursa in a child, aged 14. Primary synovial chondromatosis is characteristized by multiple calcified nodules in joints, tendons or bursa areas. The condition is more usual in large joints, in particular in lower extremities. It may be symptomless until the volume of chondromatosis has increased to such an extent that it results in pain, locking symptom or palpable mass. The treatment is removal of the loose bodies and potentially synovectomy, in ...
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
CONCLUSIONS: The use of this novel cartilage restoration surgical technique provides excellent clinical, functional, and MRI-based outcomes in young, active individuals with full-thickness cartilage or osteochondral defects. LEVEL OF EVIDENCE: Level IV-Therapeutic case series. PMID: 31835970 [PubMed - in process]
Source: Journal of Orthopaedic Surgery - Category: Orthopaedics Authors: Tags: J Orthop Surg (Hong Kong) Source Type: research
CONCLUSION: TPTD treatment prevented ovariectomy-induced bone loss and ovariectomy-induced mechanical hyperalgesia in hind limbs, and it suppressed CGRP and TRPV1 expressions in DRG neurons. These results suggest that TPTD is useful for the treatment of osteoporotic pain in postmenopausal women. PMID: 31833446 [PubMed - in process]
Source: Journal of Orthopaedic Surgery - Category: Orthopaedics Authors: Tags: J Orthop Surg (Hong Kong) Source Type: research
ConclusionsOral zinc therapy was found to be an adjunct in reducing burning sensation and lesion size in symptomatic OLP.
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research
ConclusionsOral complications in HSCT survivors are common and may include GVHD, dry mouth, and taste changes. All patients must be screened prior to HSCT and followed up by a dentist periodically to assess the oral health status and modify treatment, if needed.
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research
This study was designed to compare taste perception before and after successful treatment in BMS.Study DesignA retrospective study was conducted at a private oral medicine clinic. Thirty-two patients diagnosed with primary BMS, who had spatial taste testing with 4 supersaturated salt (1 M sodium chloride [NaCl]), sweet (1 M sucrose), sour (0.032 M citric acid), and bitter (0.001 M quinine hydrochloride) solutions and 50% ethanol, with self-rated pain intensity on a generalized labeled magnitude scale (gLMS) at the initial and final visits, were included in the study. Analysis was performed with Wilcoxon's signed-rank test,...
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research
Publication date: January 2020Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 129, Issue 1Author(s): Sumeia Gamal Werfalli, Mark Drangsholt, Michael Martin, Linda LerescheObjectivesBurning mouth syndrome (BMS) is a chronic pain condition. Xerostomia is a common complaint among patients with BMS. However, previous studies have reported inconsistent findings regarding salivary flow rate reduction among these patients. The aim of this study was to examine unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) flow rates, degree of mucosal hydration, and xerostomia in female patients w...
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research
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