Concussion in Combination With Whiplash-Associated Disorder May Be Missed in Primary Care: Key Recommendations for Assessment and Management.

Concussion in Combination With Whiplash-Associated Disorder May Be Missed in Primary Care: Key Recommendations for Assessment and Management. J Orthop Sports Phys Ther. 2019 Oct 14;:1-41 Authors: Rebbeck T, Evans K, Elliott JM Abstract SYNOPSIS: Whiplash and concussion may have similar presenting symptoms, biomechanical mechanisms, and neurophysiological sequelae, but neither enjoys a gold standard diagnostic test. Guidelines for whiplash and concussion are developed and implemented separately. This disparate process may contribute to misdiagnosis, delay appropriate primary care management, and impair patient outcomes. In our clinical commentary, we present 3 cases where signs and symptoms consistent with whiplash were identified in primary care. Symptoms in all cases included neck pain, headache, dizziness, and concentration deficits, raising suspicion of coexisting postconcussion syndrome. All cases were referred for specialist physical therapy. Characteristics consistent with poor recovery in both whiplash and postconcussion syndrome were confirmed, and multidisciplinary management, drawing from both whiplash and concussion guidelines, was implemented. All patients reported improvement in activities of daily living after tailored management addressing both neck and head injury-related factors, suggesting that these conditions were not mutually exclusive. Self-reported outcomes included reductions in neck disability and postconcussion symptoms of betwe...
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: J Orthop Sports Phys Ther Source Type: research

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Conclusions Although both types of flaps offer a satisfactory approach for finger reconstruction with small-to-medium defects, FDUAP flaps are more suitable for such operations because of the better sensory reconstruction and aesthetic results.
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Hand Surgery Source Type: research
This study compares the postoperative pain and opioid use in patients managed for surgery with general anesthesia (GA) with patients who were given combined epidural and general anesthesia (E/GA) with continuing postoperative epidural analgesia. Methods All patients who underwent penile inversion vaginoplasty between May of 2016 and May of 2018 under the care of single surgeon were identified retrospectively, 18 patients of which met the inclusion criteria. A retrospective chart review was conducted. Outcome measures were postoperative pain using visual analog scale, type and dosage of postoperatively administered intra...
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Reconstructive Surgery Source Type: research
Conclusions Continuous or intermittent wound infusion is safe and effective in reducing pain scores and opioid consumption in plastic surgery. Though the overall pain-lowering effect appears to be modest, ease of catheter insertion and patient satisfaction make this technique an alluring alternative to more validated approaches such as neuraxial or peripheral nerve blocks.
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Review Paper Source Type: research
Publication date: Available online 11 November 2019Source: Journal of Integrative MedicineAuthor(s): Sajjad Sadeghi, Farzaneh Ghaffari, Ghazaleh Heydarirad, Mehdi AlizadehAbstractGalen (129–199 A.D.), an ancient Greek scholar, is one of the most influential and recognized physicians and surgeons in the history of medicine. He is one of the most influential Greek scholar in Persian medicine, which has been repeatedly cited by Iranian scholars. The purpose of this article is to describe the exact position of Galen in Avicenna’s The Canon of Medicine, the most important work of Persian medicine. In The Canon of Me...
Source: Journal of Integrative Medicine - Category: Complementary Medicine Source Type: research
Publication date: Available online 11 November 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Başak Altiparmak, Melike Korkmaz Toker, Ali İhsan Uysal, Yağmur Kuşçu, Semra Gümüş DemirbilekAbstractBackground and objectivesThe primary aim of this study is to assess the effect of US-ESP on postoperative opioid consumption after laparoscopic cholecystectomy. The secondary aims are to assess the effects of ESP block on intraoperative fentanyl need and postoperative pain scores.MethodsPatients between 18–70 years old, ASA I-II were included in the study and randomly allocat...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
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Source: Topics in Pain Management - Category: Anesthesiology Tags: ARTICLE Source Type: research
Dr. Geoffrey Manley, a California neurosurgeon, is no football fan. He isn’t planning to attend a Super Bowl party this Sunday, and he doubts he’ll even turn on the TV at home as he works on other projects. But for the past four years, Manley been intimately involved in trying to prevent one of the NFL’s most dire problems: permanent brain damage as a result of untreated concussions.  In addition to his job as chief of neurosurgery at Zuckerberg San Francisco General Hospital and vice chairman of neurological surgery at the University of California, San Francisco, Manley also moonlights as an unaffil...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
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