Endovascular treatment of a rare case of haemobilia caused by both pseudoaneurysm and a giant hepatic haemangioma.
We report a case of a 50-year-old man with melena and anaemia and a clinical history of multivalvular endocarditis in which an extremely rare presence of 2 uncommon causes of haemobilia was found, such as a mycotic pseudoaneurysm and a giant hepatic haemangioma, both treated by transarterial embolization. In the management of haemobilia, TAE has been proven to be the treatment of choice because it combines a diagnostic angiography with therapeutic intervention in a minimally invasive, safe and effective way. Physician and radiologist should keep in mind also the uncommon aetiologies of haemobilia, knowing that the source o...
Source: Pain Physician - January 27, 2021 Category: Anesthesiology Authors: Federica L, Serafino S, Daniele F, Giovanni F, Stefano P, Antonio B Tags: Radiol Case Rep Source Type: research
Elderly hip fracture patients: surgical timing and factors to consider.
Abstract PURPOSE OF REVIEW: Hip fractures of the elderly population are a common trauma and numbers are increasing due to ageing societies. Although this is an ordinary low energy impact injury and surgical repair techniques show good results, the perioperative course is characterized by an unparalleled disproportionate perioperative morbidity and mortality. RECENT FINDINGS: Most studies focus on outcome-related data. Little is known on how to prevent and treat adverse sequelae, ranging from mild physical challenges to neurobiological disorders and death. SUMMARY: Although the contribution of the anaesth...
Source: Pain Physician - January 9, 2021 Category: Anesthesiology Authors: Wenk M, Frey S Tags: Curr Opin Anaesthesiol Source Type: research
The challenge of the surgical treatment of paediatric distal radius/ forearm fracture: K wire vs plate fixation - outcomes assessment.
Abstract Aim Distal radius/forearm fractures in adolescent patients remain challenging injuries to treat. Distal radius/forearm bony anatomy is not completely restored with intramedullary K wire fixation. The aim of this study was to compare radiographic and functional outcomes obtained using intramedullary K wire fixation and open reduction and internal fixation in the treatment of distal radius/ forearm fracture. Methods A total of 43 patients who presented with distal radius/ forearm fractures were enrolled and divided into two groups: 23 patients treated with K-wire (IMNK) and 20 patients treated with plate an...
Source: Pain Physician - December 20, 2020 Category: Anesthesiology Authors: Di Giacinto S, Pica G, Stasi A, Scialpi L, Tomarchio A, Galeotti A, Podvorica V, dell'Unto A, Meccariello L Tags: Med Glas (Zenica) Source Type: research
Real-world practice patterns and attitudes towards de-escalation of bone-modifying agents in patients with bone metastases from breast and prostate cancer: A physician survey.
Conclusion: Despite their extensive use and costs, questions around optimal use of BMAs still exist. Practice varies according to patient insurance coverage. However, most physicians are de-escalating BMAs. There is interest amongst clinicians in performing trials of de-escalation, especially after 2 years of treatment. PMID: 33294318 [PubMed] (Source: Pain Physician)
Source: Pain Physician - December 11, 2020 Category: Anesthesiology Authors: AlZahrani M, Clemons M, Vandermeer L, Sienkiewicz M, Awan AA, Hutton B, Pond GR, Ng TL Tags: J Bone Oncol Source Type: research
Dry Needling and Acupuncture in Treatment of Dance-Related Injuries, MD, and PT Perspectives.
Abstract Dancers frequently present to health care professionals with musculoskeletal impairments. The role of the health care practitioner, whether physician, physical therapist, or acupuncturist, is to decrease pain and restore function in the short term and to restore adaptive potential and neural connectivity in the long term. When dysfunction is treated, pain improves. Acupuncture and dry needling improve tissue perfusion by improving vasomotor control and can improve strength by removing motor inhibition. Acupuncture and dry needling are safe, complementary modalities aimed at improving the function of the d...
Source: Pain Physician - November 18, 2020 Category: Anesthesiology Authors: Blackmon AM, Elson L Tags: Phys Med Rehabil Clin N Am Source Type: research
Protein losing enteropathy and pneumatosis intestinalis in a child with COVID 19 infection.
Conclusion: COVID 19 infection has many different and mysterious presentations. GI manifestations are among important, common presentations. The acute abdomen like presentation with different complications like pneumatosis intestinalis, protein losing enteropathy are not common but knowledge about these presentations assist physician to be aware and make decision accurately. PMID: 33173753 [PubMed] (Source: Pain Physician)
Source: Pain Physician - November 13, 2020 Category: Anesthesiology Authors: Rohani P, Karimi A, Tabatabaie SR, Khalili M, Sayyari A Tags: J Pediatr Surg Case Rep Source Type: research
Publicly funded interfacility ambulance transfers for surgical and obstetrical conditions: A cross sectional analysis in an urban middle-income country setting.
ck GL Abstract INTRODUCTION: Interfacility transfers may reflect a time delay of definitive surgical care, but few studies have examined the prevalence of interfacility transfers in the urban low- and middle-income (LMIC) setting. The aim of this study was to determine the number of interfacility transfers required for surgical and obstetric conditions in an urban MIC setting to better understand access to definitive surgical care among LMIC patients. METHODS: A retrospective analysis of public interfacility transfer records was conducted from April 2015 to April 2016 in Cali, Colombia. Data were obtained fro...
Source: Pain Physician - November 11, 2020 Category: Anesthesiology Authors: Truche P, NeMoyer RE, Patiño-Franco S, Herrera-Escobar JP, Torres M, Pino LF, Peck GL Tags: PLoS One Source Type: research
COVID-19: Airway management considerations.
PMID: 33165885 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - November 11, 2020 Category: Anesthesiology Authors: Herman J, Viswanath O, Urits I Tags: Anaesthesiol Intensive Ther Source Type: research
Preferences for measurement and supplementation of magnesium, phosphate and zinc in ICUs: The international WhyTrace survey.
CONCLUSION: The practice of measuring and supplementing magnesium, phosphate and zinc differed substantially between ICUs. Our findings indicate that there is a need for high quality prospective data on frequencies of measurements, treatment goals and effects of supplementation on patient-important outcomes. PMID: 33165935 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - November 9, 2020 Category: Anesthesiology Authors: Vesterlund GK, Ostermann M, Myatra SN, Arabi YM, Sadat M, Zampieri FG, Cronhjort M, Schefold JC, Stöhr F, Buanes EA, Bäcklund M, Thormar KM, Perner A Tags: Acta Anaesthesiol Scand Source Type: research
Identifying Minimal and Meaningful Change in PROMIS ® for Rheumatoid Arthritis: Use of Multiple Methods and Perspectives.
CONCLUSIONS: PROMIS SFs and the PROMIS-29 Profile are responsive to change and generally distinguish between minimal and meaningful improvement and worsening in key RA domains. These data add to a growing body of evidence demonstrating robust psychometric properties of PROMIS and supporting use in RA care, research, and decision-making. PMID: 33166066 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - November 9, 2020 Category: Anesthesiology Authors: Bartlett SJ, Gutierrez AK, Andersen KM, Bykerk VP, Curtis JR, Haque UJ, Orbai AM, Jones MR, Bingham CO Tags: Arthritis Care Res (Hoboken) Source Type: research
Digital Symptom Checker Usage and Triage: Population-Based Descriptive Study in a Large North American Integrated Health System.
CONCLUSIONS: Users of the symptom checker chatbot were broadly representative of our patient population, though skewed towards younger and female users. Triage recommendations are comparable to those of nurse-staffed phone triage lines. While the emergence of COVID-19 increases the enthusiasm for remote medical assessment tools, it is important to take an evidence-based approach to their deployment. CLINICALTRIAL: PMID: 33170799 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - November 7, 2020 Category: Anesthesiology Authors: Morse KE, Ostberg NP, Jones VG, Chan AS Tags: J Med Internet Res Source Type: research
The Type of Intensive Care Unit Matters: Variations in Palliative Care for Critically Ill Patients with Chronic, Life-Limiting Illness.
Abstract Background: It is not clear whether use of specialty palliative care consults and "comfort measures only" (CMO) order sets differ by type of intensive care unit (ICU). A better understanding of palliative care provided to these patients may help address heterogeneity of care across ICU types. Objectives: Examine utilization of specialty palliative care consultation and CMO order sets across several different ICU types in a multihospital academic health care system. Design: Retrospective cohort study using Washington State death certificates and data from the electronic health record. Setting/Sub...
Source: Pain Physician - November 6, 2020 Category: Anesthesiology Authors: Lee JD, Jennerich AL, Engelberg RA, Downey L, Curtis JR, Khandelwal N Tags: J Palliat Med Source Type: research
Primary care physicians comprehensively manage acute pulmonary embolism without higher-level-of-care transfer: A report of two cases.
This report sets the stage for investigating the public health implications of comprehensive primary care-based PE management, including cost-savings as well as enhanced patient follow-up and patient satisfaction. PMID: 33157953 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - November 6, 2020 Category: Anesthesiology Authors: Isaacs DJ, Johnson EJ, Hofmann ER, Rangarajan S, Vinson DR Tags: Medicine (Baltimore) Source Type: research
Evaluating the intended and unintended consequences of opioid-prescribing interventions on primary care in British Columbia, Canada: protocol for a retrospective population-based cohort study.
This study has been approved by McGill University's Institutional Review Board (#A11-M55-19A), and the University of British Columbia's Research Ethics Board (#H19-03537). We will disseminate results via a combination of open access peer-reviewed journal publications, conferences, lay summaries and OpEds. PMID: 33154053 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - November 5, 2020 Category: Anesthesiology Authors: Panagiotoglou D, McCracken R, Lavergne MR, Strumpf EC, Gomes T, Fischer B, Brackett A, Johnson C, Kendall P Tags: BMJ Open Source Type: research
Severity of Chronic Pain in German Adolescent School Students - A Cross-sectional Study.
This study aimed to (1) examine the prevalence of chronic pain severity grades in school children and (2) investigate differences between pain severity grades for pain-related characteristics, including pain locations, sociodemographic characteristics, emotional functioning, insomnia, school factors and health care utilization. METHODS: This cross-sectional observational study was conducted with 2220 school students in Germany (52% female, age: M=13.0, SD=1.8, range 10-18▒y). Pain severity was assessed using the validated Chronic Pain Grades (CPG) for adolescents. Comparisons between CPG subgroups of adolescent char...
Source: Pain Physician - November 5, 2020 Category: Anesthesiology Authors: Könning A, Rosenthal N, Brown D, Stahlschmidt L, Wager J Tags: Clin J Pain Source Type: research
Why Do Some Spanish Nursing Students with Menstrual Pain Fail to Consult Healthcare Professionals?
Fernández-Martínez E Abstract Dysmenorrhea is a problem that affects a large percentage of young women worldwide. Alarmingly, the majority of these women choose to self-medicate rather than consult a healthcare professional, despite the risks involved. The present study aimed to explore the reasons why undergraduate nursing students do not consult health care professionals regarding their menstrual pain. A qualitative study was conducted using an open question: "Why didn't you consult a healthcare professional?" within the context of a research project on primary dysmenorrhea among nursing...
Source: Pain Physician - November 5, 2020 Category: Anesthesiology Authors: Ramos-Pichardo JD, Ortega-Galán ÁM, Iglesias-López MT, Abreu-Sánchez A, Fernández-Martínez E Tags: Int J Environ Res Public Health Source Type: research
A Comprehensive Review of Over the Counter Treatment for Chronic Low Back Pain.
Abstract PURPOSE OF THE REVIEW: Chronic low back pain (CLBP) is a major contributor to societal disease burden and years lived with disability. Nonspecific low back pain (LBP) is attributed to physical and psychosocial factors, including lifestyle factors, obesity, and depression. Mechanical low back pain occurs related to repeated trauma to or overuse of the spine, intervertebral disks, and surrounding tissues. This causes disc herniation, vertebral compression fractures, lumbar spondylosis, spondylolisthesis, and lumbosacral muscle strain. RECENT FINDINGS: A systematic review of relevant literature was cond...
Source: Pain Physician - November 4, 2020 Category: Anesthesiology Authors: Peck J, Urits I, Peoples S, Foster L, Malla A, Berger AA, Cornett EM, Kassem H, Herman J, Kaye AD, Viswanath O Tags: Pain Ther Source Type: research
Doctored Images: Enacting "Pain-Work" in John Berger and Jean Mohr's A Fortunate Man (1967).
Doctored Images: Enacting "Pain-Work" in John Berger and Jean Mohr's A Fortunate Man (1967). J Med Humanit. 2020 Nov 04;: Authors: Sidiki B Abstract This essay argues that Berger and Mohr's A Fortunate Man (1967) - comprising social observation and photographs of the rural practitioner, Dr. Sassall and his patients - enacts an embodied, intersubjective empathy called "pain-work." The book enacts "pain-work" through two strategies. Firstly, by conflating three ways of seeing - Berger's observation, Mohr's photography, and Sassall's medical gaze - it shows that the clinical...
Source: Pain Physician - November 4, 2020 Category: Anesthesiology Authors: Sidiki B Tags: J Med Humanit Source Type: research
Burden of illness among subgroups of patients with primary Sj ögren's syndrome and systemic involvement.
CONCLUSION: Cluster analysis using a real-world cohort of patients with pSS and systemic organ involvement highlights the heterogeneous presentation of patients with pSS and confirms the importance of pain and fatigue as well as organ involvement when determining disease burden. PMID: 33147609 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - November 4, 2020 Category: Anesthesiology Authors: Gairy K, Knight C, Anthony P, Hoskin B Tags: Rheumatology (Oxford) Source Type: research
Transcutaneous auricular vagus nerve stimulation reduces pain and fatigue in patients with systemic lupus erythematosus: a randomised, double-blind, sham-controlled pilot trial.
CONCLUSION: taVNS resulted in significantly reduced pain, fatigue and joint scores in SLE. Additional studies evaluating this intervention and its mechanisms are warranted. PMID: 33144299 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - November 3, 2020 Category: Anesthesiology Authors: Aranow C, Atish-Fregoso Y, Lesser M, Mackay M, Anderson E, Chavan S, Zanos TP, Datta-Chaudhuri T, Bouton C, Tracey KJ, Diamond B Tags: Ann Rheum Dis Source Type: research
Prospective Investigation of Factors Associated with Prescription Opioid Dose Escalation among Patients in Integrated Health Systems.
CONCLUSIONS: In this 2-year prospective cohort study, variables associated with opioid dose escalation were lower opioid dose, higher pain catastrophizing, receiving opioids from a medical specialist (rather than primary care clinician) or nurse practitioner, and having recently undergone surgery. Study findings highlight intervention points that may be helpful for reducing the likelihood of future prescription opioid dose escalation. PMID: 33145684 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - November 3, 2020 Category: Anesthesiology Authors: Morasco BJ, Smith N, Dobscha SK, Deyo RA, Hyde S, Yarborough BJ Tags: J Gen Intern Med Source Type: research
Feasibility of Implementing Opioid Stewardship Recommendations for Sinonasal Surgery.
CONCLUSION: Opioid stewardship recommendations can be instituted for sinonasal surgery, including multimodal perioperative pain management and substitution of tramadol for breakthrough pain, as a method to decrease the volume of opioids prescribed, without increasing patient phone calls or affecting the likelihood of physician recommendation Press Ganey scores. PMID: 33138720 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - November 3, 2020 Category: Anesthesiology Authors: Jordan JW, Spankovich C, Stringer SP Tags: Otolaryngol Head Neck Surg Source Type: research
Equity of African American Men in Headache in the United States: A Perspective From African American Headache Medicine Specialists (Part 1).
Abstract Migraine and severe headache affect approximately 1 in 6 U.S. adults and migraine is one of the most disabling disorders worldwide. Approximately 903,000 to 1.5 million African American (AA) men are affected by migraine in the United States. Racial disparities in headache medicine exist. In addition, there are limited headache studies that attest to the inclusion of or have robust data on AA men in headache medicine in the United States. Racial concordance between provider and patient may ameliorate some aspects of care disparities. Moreover, it has been demonstrated that diversity and inclusion particula...
Source: Pain Physician - November 3, 2020 Category: Anesthesiology Authors: Charleston L, Spears RC, Flippen C Tags: Headache Source Type: research
Physician Well-Being in Practice.
Abstract Despite a recent surge of interest in physician well-being, the discussion remains diffuse and often scattered. Lingering questions of what wellness entails, how it is personally applicable, and what can be done, remain pervasive. In this review, we focus on policy-level, institutional and personal factors that are both obstacles to wellness and interventions for potential remedy. We outline clear obstacles to physician wellness that include dehumanization in medicine, environments and cultures of negativity, barriers to wellness resources, and the effect of second victim syndrome. This is followed by pro...
Source: Pain Physician - October 22, 2020 Category: Anesthesiology Authors: Khan A, Vinson AE Tags: Anesth Analg Source Type: research
The Adult Cardiac Anesthesiology Section of STS Adult Cardiac Surgery Database: 2020 Update on Quality and Outcomes.
PMID: 33079860 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - October 22, 2020 Category: Anesthesiology Authors: Del Rio JM, Abernathy JJ, Taylor MA, Habib RH, Fernandez FG, Bollen BA, Lauer RE, Nussmeier NA, Glance LG, Petty JV, Mackensen GB, Vener DF, Kertai MD Tags: Anesth Analg Source Type: research
The Association Between Physicians' Communication and Patient-Reported Outcomes in Spine Surgery.
Abstract STUDY DESIGN: Retrospective cohort study using prospectively collected data. OBJECTIVE: Determine the association between satisfaction with physician communication and patient-reported outcomes in the inpatient spine surgery setting. SUMMARY OF BACKGROUND DATA: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys measure the patient experience of care and influence reimbursement for hospital systems and providers in the United States. It is not known whether patient satisfaction with physician communication is associated with better outcomes after spine surgery. Ther...
Source: Pain Physician - July 19, 2020 Category: Anesthesiology Authors: Rabah NM, Levin JM, Winkelman RD, Mroz TE, Steinmetz MP Tags: Spine (Phila Pa 1976) Source Type: research
Orthopedic manifestation as the presenting symptom of acute lymphoblastic leukemia.
Conclusion: The primary physician should maintain a high index of suspicion despite a normal peripheral smear. PMID: 32675920 [PubMed] (Source: Pain Physician)
Source: Pain Physician - July 19, 2020 Category: Anesthesiology Authors: Raj B K A, Singh KA, Shah H Tags: J Orthop Source Type: research
Tracheobronchopathia osteochondroplastica: rare but not to be forgotten.
We report a case of a 59-year-old male with a one-month history of pleuritic chest pain who was diagnosed with tracheobronchopathia osteochondroplastica (TO). TO is a rare benign condition characterized by protruding submucosal nodules into the tracheobronchial lumen. The disease is generally asymptomatic, with rare cases of progressive nodularity, cough, dyspnoea, and haemoptysis. Diagnosis can be made via bronchoscopic visualization of bony and cartilaginous nodules on tracheal walls. Although generally benign, the rarity of this condition makes diagnosis difficult even for trained pulmonologists and frequently predispos...
Source: Pain Physician - July 3, 2020 Category: Anesthesiology Authors: Gul F, Peterson E, Dejoy R, Eiger G, Mora Carpio A, Gupta E Tags: Respirol Case Rep Source Type: research
A Case of Unknown Primary Cancer with a Tumor Formed in the Retroperitoneum: A Case Report.
CONCLUSIONS: CUP has various disease states, and it is necessary to finish the examination immediately and shift to treatment. More effective treatment including immune checkpoint inhibitor for CUP is needed in the future. PMID: 32602104 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - July 1, 2020 Category: Anesthesiology Authors: Tsuda B, Hirabayashi K, Sakaeda S, Ishida R, Mizuno M, Yokoyama K, Terao M, Morioka T, Okamura T, Watanabe T, Niikura N Tags: Tokai J Exp Clin Med Source Type: research
Fatal accident involving a welder employed by a shipping container company, associated with the use of tramadol and antidepressant agents.
We present the case of a welder who, while working for a shipping container company, fell from height without a safety harness and subsequently died as a result of a traumatic brain injury. Post-mortem examination revealed a cardiac blood tramadol concentration of 2.83 mg/L, which is 3-4 times higher than the maximum therapeutic dose. The combined use of synthetic opioids and antidepressants may heighten the adverse neurological and psychiatric effects. A review of the literature, identified studies, including previous reports of fatalities, supported our causal hypothesis of a serotonin syndrome. This syndrome can lead to...
Source: Pain Physician - July 1, 2020 Category: Anesthesiology Authors: Sanz-Gallen P, Amigó de Bonet N, Canals ML, Martí-Amengual G Tags: Int Marit Health Source Type: research
Treatment of lower limb arterial disease by Dardik graft: It takes one to know one.
CONCLUSION: This article provide a historical review of the use, outcomes and complications of HUV. Even though it is no longer commercially available, the knowledge of this type of substitute still remains inspirational for the development of innovative vascular conduits and fundamental for the new generations of physician both in diagnostics and in the management of complications. PMID: 32571562 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - June 24, 2020 Category: Anesthesiology Authors: Borghese O, Pisani A, Sapienza P Tags: J Med Vasc Source Type: research
Efficacy of a Natural Topical Skin Ointment for Managing Split-Thickness Skin Graft Donor Sites: A Pilot Double-blind Randomized Controlled Trial.
Abstract OBJECTIVE: To evaluate the safety and efficacy of a new topical skin ointment with natural ingredients (aloe vera, honey, and peppermint) for dressing skin graft donor sites. DESIGN: A double-blind, placebo-controlled, randomized clinical trial. PATIENTS AND INTERVENTION: Researchers enrolled patients who were referred for split-thickness skin graft after burns or surgical wounds on the scalp or face area. For each patient, a thin layer of skin (depth, 0.04 mm; approximate size, less than 15 × 7 cm) was harvested from the thigh by a plastic surgeon with an electric or manual dermatome. The...
Source: Pain Physician - June 17, 2020 Category: Anesthesiology Authors: Abbasi MS, Rahmati J, Ehsani AH, Takzare A, Partoazar A, Takzaree N Tags: Adv Skin Wound Care Source Type: research
Evaluation of Ophthalmology Inpatients Consultation in a Nigerian Tertiary Eye Care Centre.
CONCLUSION: Inpatient consultations is very useful to the patient and managing physician. Although a better knowledge in the identification of common ophthalmic conditions can help to reduce the number of inpatient consults from other medical specialties. PMID: 32476114 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - June 3, 2020 Category: Anesthesiology Authors: Kayoma DH, Ukponmwan CU, Ese-Onakewhor JN Tags: West Afr J Med Source Type: research
Mesothelioma in Familial Mediterranean Fever With Colchicine Intolerance: A Case Report and Literature Review.
In conclusion, we suggest that in the presence of intolerance or resistance to colchicine, interleukin (IL)-1 inhibition could suppress peritoneal inflammation and prevent MSTs. PMID: 32477360 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - June 3, 2020 Category: Anesthesiology Authors: Talerico R, Cardillo C, De Vito F, Schinzari F, Soldato M, Giustiniani MC, Verrecchia E, Manna R Tags: Front Immunol Source Type: research
Authorized Agent-Controlled Analgesia for Pain Management in Critically Ill Adult Patients.
Abstract BACKGROUND: Patient-controlled analgesia is commonly used for adult patients requiring parenteral opioid analgesia in the postoperative setting. However, many patients are unable to use patient-controlled analgesia because of physical or cognitive limitations. Authorized agent-controlled analgesia, in which a nurse or family member activates the patient-controlled analgesia device, has been studied in the pediatric population but has received little attention in adults. OBJECTIVE: To evaluate the efficacy of authorized agent-controlled analgesia in critically ill adult patients. METHODS: A retro...
Source: Pain Physician - May 31, 2020 Category: Anesthesiology Authors: Benjenk I, Messing J, Lenihan MJ, Hernandez M, Amdur R, Sirajuddin S, Davison D, Schroeder ME, Sarani B Tags: Crit Care Nurse Source Type: research
The Impact Of Academic Medical Center Policies Restricting Direct-To-Physician Marketing On Opioid Prescribing.
We examined restrictions on gifts and meals, speaking and consulting engagements, and industry representatives' access to academic medical centers, as well as rules requiring conflict-of-interest disclosures. Bans on sales representatives were associated with a 4.7 percent reduction in the total volume of opioids prescribed and disclosure requirements with a 2.5 percent reduction, while having all four marketing restriction policies was associated with an 8.8 percent reduction. Policies that restrict direct-to-physician pharmaceutical marketing may curb opioid prescribing, but additional patient-level resear...
Source: Pain Physician - May 31, 2020 Category: Anesthesiology Authors: Eisenberg MD, Stone EM, Pittell H, McGinty EE Tags: Health Aff (Millwood) Source Type: research
Patient Perceptions of Gout Management Goals: A Cross-sectional Internet Survey.
CONCLUSIONS: Patient identification of gout symptom control and serum urate level monitoring as the most important treatment goals is informative for clinicians and guideline developers. PMID: 32453285 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - May 28, 2020 Category: Anesthesiology Authors: Singh JA, Edwards NL Tags: J Clin Rheumatol Source Type: research
Lessons learnt from delayed diagnosis of FGF-23-producing tumour-induced osteomalacia and post-operative hungry bone syndrome.
We present a 36-year-old man initially presenting with diffuse bone and joint pain who was inappropriately treated for presumed ankylosing spondylitis for 2 years. Whole-body bone scan suggested metabolic bone disease, prompting referral to our endocrine institution. He was subsequently diagnosed with persistent hypophosphataemia, inappropriately high renal tubular phosphate excretion, 1,25-dihydroxyvitamin D3 suppression, severe osteoporosis and severe osteomalacia. FGF-23 concentrations (140 ng/L) were raised 3-fold above the upper limit of normal. Initial Gallium-68 (68Ga) DOTATATE positron emission tomography...
Source: Pain Physician - May 28, 2020 Category: Anesthesiology Authors: Kumar S, Diamond T Tags: Bone Rep Source Type: research
Comparison of Silicone Sheets and Paper Tape for the Management of Postoperative Scars: A Randomized Comparative Study.
CONCLUSIONS: The silicone sheet group showed statistically significant differences in comparison with the paper tape group in terms of scar appearance as determined by the VAS. However, the differences were too small to be clinically meaningful. PMID: 32427792 [PubMed - in process] (Source: Pain Physician)
Source: Pain Physician - May 21, 2020 Category: Anesthesiology Authors: Lin YS, Ting PS, Hsu KC Tags: Adv Skin Wound Care Source Type: research
10 kHz Spinal Cord Stimulation for Combined Alleviation of Post-Laminectomy Syndrome and Chronic Abdominal Pain: A Case Report.
We describe the use of high-frequency SCS to alleviate the patient's post-laminectomy pain as well as his abdominal pain. Our case describes SCS use with multi-level lead placement targeting both post-laminectomy pain and abdominal pain. We describe a strategy that can be useful to patients with concurrent pain from more than one source. Our case also adds to the growing evidence supporting the use of SCS for treating chronic visceral pain syndromes. PMID: 32431535 [PubMed] (Source: Pain Physician)
Source: Pain Physician - May 21, 2020 Category: Anesthesiology Authors: Berger AA, Hasoon J, Urits I, Viswanath O, Gill J Tags: J Pain Res Source Type: research
Proposed Modifications in the 6-minutue Walk Test for Potential Application in Patients with mild Coronavirus Disease 2019 (COVID-19): A Step to Optimize Triage Guidelines.
PMID: 32433249 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - May 18, 2020 Category: Anesthesiology Authors: Mantha S, Tripuraneni SL, Roizen MF, Fleisher LA Tags: Anesth Analg Source Type: research
The role of clinical pharmacology in enhanced recovery after surgery protocols: a comprehensive review.
Abstract Clinical pharmacology has had an enormous impact in the development of anaesthesia practice. Improvement in drugs and the use of long-acting local anaesthetics in peri-pheral nerve blocks have reduced hospital stays and opioid consumption in both the hospital and ambulatory surgery settings. Ambulatory surgery centres are revolutionary because they provide an alternative to hospital-based outpatient services and generally provide favourable patient outcomes. Enhanced recovery after surgery (ERAS) was established in 2001 to improve patient care and increase the number of available ambulatory surgery centre...
Source: Pain Physician - May 17, 2020 Category: Anesthesiology Authors: Kaye A, Renschler J, Cramer K, Klein K, Granier A, Hart B, Kassem H, Urits I, Cornett E, Viswanath O Tags: Anaesthesiol Intensive Ther Source Type: research
Physician Attitudes and Perceptions of Complementary and Alternative Medicine (CAM): A Multicentre Italian Study.
, Danova M, Rossetti S, Amore A, Crispo A, Facchini G Abstract Purpose: Complementary and Alternative Medicine (CAM) interventions are widely used by patients with chronic disorders, including cancer, and may interact with cancer treatment. Physicians are often unaware of this, probably due to poor patient-physician communication on CAM. The purpose of this study was to evaluate physicians' knowledge, attitudes and practice patterns regarding CAM in a survey conducted in Italy. Methods: A questionnaire was administered to 438 physicians (11 Italian hospitals) who predominantly treat patients with chronic disease, ...
Source: Pain Physician - May 17, 2020 Category: Anesthesiology Authors: Berretta M, Rinaldi L, Taibi R, Tralongo P, Fulvi A, Montesarchio V, Madeddu G, Magistri P, Bimonte S, Trovò M, Gnagnarella P, Cuomo A, Cascella M, Lleshi A, Nasti G, Facchini S, Fiorica F, Di Francia R, Nunnari G, Pellicanò GF, Guglielmino A, Danova M, Tags: Front Oncol Source Type: research
The Relationship of Sleep Duration with Ethnicity and Chronic Disease in a Canadian General Population Cohort.
Abstract Study Objectives: Sleep duration is an important marker of sleep quality and overall sleep health. Both too little and too much sleep are associated with poorer health outcomes. We hypothesized that ethnicity-specific differences in sleep duration exist. Methods: This cross-sectional study utilized questionnaire data from the Ontario Health Study (OHS), a multi-ethnic population-based cohort of Canadian adult residents aged 18 to 99 years, who provided medical, socio-demographic, and sleep information. Generalised linear models were used to investigate the association of sleep duration with ethnicity...
Source: Pain Physician - May 1, 2020 Category: Anesthesiology Authors: Singh M, Hall KA, Reynolds A, Palmer LJ, Mukherjee S Tags: Nat Sci Sleep Source Type: research
Ectopic Pregnancy: Diagnosis and Management.
Abstract Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Risk factors include a history of pelvic inflammatory disease, cigarette smoking, fallopian tube surgery, previous ectopic pregnancy, and infertility. Ectopic pregnancy should be considered in any patient presenting early in pregnancy with vaginal bleeding or lower abdominal pain in whom intrauterine pregnancy has not yet been established. The definitive diagnosi...
Source: Pain Physician - May 1, 2020 Category: Anesthesiology Authors: Hendriks E, Rosenberg R, Prine L Tags: Am Fam Physician Source Type: research
Equivalent Pain Relief with Different Doses of Ibuprofen.
PMID: 32352261 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - May 1, 2020 Category: Anesthesiology Authors: Shaughnessy AF Tags: Am Fam Physician Source Type: research
Top 20 Research Studies of 2019 for Primary Care Physicians.
This article summarizes the clinical questions and bottom-line answers from the top 20 POEMs of 2019. Taking blood pressure medications at night results in a large mortality reduction over six years compared with morning dosing. Automated devices are the best way to measure blood pressure. Nonfasting lipid profiles are preferred over fasting lipid profiles, and nonfasting and fasting lipid profiles are equally effective at predicting risk. The benefit of statins for primary prevention in people 75 years and older is uncertain at best. Aspirin has no net benefit for primary prevention of cardiovascular disease and has no ef...
Source: Pain Physician - May 1, 2020 Category: Anesthesiology Authors: Ebell MH, Grad R Tags: Am Fam Physician Source Type: research
Endometrial Biopsy: Tips and Pitfalls.
Abstract Endometrial biopsy is a safe and efficient method to evaluate the endometrium for a variety of indications, most commonly abnormal uterine bleeding and postmenopausal bleeding. Endometrial biopsy is highly specific for diagnosing atypical hyperplasia and endometrial cancer in postmenopausal women. Pregnancy is the only absolute contraindication to the procedure. The biopsy is performed with an endometrial biopsy catheter that is inserted through the cervix into the uterine cavity. The catheter's piston is then drawn out to create suction. Tissue sampling occurs by rolling the catheter while moving it in a...
Source: Pain Physician - April 30, 2020 Category: Anesthesiology Authors: Williams PM, Gaddey HL Tags: Am Fam Physician Source Type: research
Topical Analgesic and Local Anesthetic Agents for Pain Associated with Chronic Leg Ulcers: A Systematic Review.
Abstract GENERAL PURPOSE: To provide information about the effectiveness of topical analgesic and local anesthetic agents for reducing pain associated with chronic leg ulcers. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:1. Distinguish adverse reactions to topical analgesics and local anesthetic agents.2. Evaluate the effectiveness of topical analgesics and local anesthetic age...
Source: Pain Physician - April 20, 2020 Category: Anesthesiology Authors: Purcell A, Buckley T, King J, Moyle W, Marshall AP Tags: Adv Skin Wound Care Source Type: research
Acute toxicity outcomes and dosimetric implications from incidental irradiation of adjacent tissues in tangent field hypofractionated breast radiotherapy.
Conclusions: For HF-WBI, doses to nTIB over the prescription predicted acute toxicities independent of breast doses. These data support inclusion of TIB as a region of interest in treatment planning and protocol design. PMID: 32214909 [PubMed] (Source: Pain Physician)
Source: Pain Physician - March 29, 2020 Category: Anesthesiology Authors: Alcorn SR, Sloan L, McNutt TR, Stinson SF, Asrari F, Croog VJ, Floreza B, Weaver A, Wright JL Tags: Rep Pract Oncol Radiother Source Type: research