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Thalamic pain alleviated by stellate ganglion block: A case report
Rationale: Thalamic pain is a distressing and treatment-resistant type of central post-stroke pain. Although stellate ganglion block is an established intervention used in pain management, its use in the treatment of thalamic pain has never been reported. Patient concerns: A 66-year-old woman presented with a 3-year history of severe intermittent lancinating pain on the right side of the face and the right hand. The pain started from the ulnar side of the right forearm after a mild ischemic stroke in bilateral basal ganglia and left thalamus. Weeks later, the pain extended to the dorsum of the finger tips and the whole pa...
Source: Medicine - February 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Clinical impact of the alpha-galactosidase A gene single nucleotide polymorphism -10C>T: A single-center observational study
Single nucleotide polymorphisms (SNPs) in the alpha-galactosidase A gene region (GLA) have been discussed as potential cause of symptoms and organ manifestations similarly to those seen in Fabry disease (FD). However, due to scarce data, clinical implications remain limited. The aim of the present study was to investigate the clinical impact of -10C>T SNP in the GLA. Prospective single-center observational study to determine the natural history and outcome of FD. Subjects initially referred to the Fabry Center for Interdisciplinary Therapy Würzburg (FAZIT) for management of suspected FD (11 women, 2 men, mean age 42 Â...
Source: Medicine - May 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Efficacy of Biofeedback for Medical Conditions: an Evidence Map
We present our findings in the form of evidence maps.ResultsWe included 16 good-quality systematic reviews examining biofeedback alone or as an adjunctive intervention. We found clear, consistent evidence across a large number of trials that biofeedback can reduce headache pain and can provide benefit as adjunctive therapy to men experiencing urinary incontinence after a prostatectomy. Consistent evidence across fewer trials suggests biofeedback may improve fecal incontinence and stroke recovery. There is insufficient evidence to draw conclusions about effects for most conditions including bruxism, labor pain, and Raynaud ...
Source: Journal of General Internal Medicine - August 13, 2019 Category: Internal Medicine Source Type: research

Medical management of critical limb ischaemia: where do we stand today?
This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - June 26, 2013 Category: Internal Medicine Authors: Matthew A. Lambert, Jill J. F. Belch Tags: Review Source Type: research

Low failure rate reported of diagnosis algorithm for suspected upper extremity deep vein thrombosis
Commentary on: Kleinjan A, Di Nisio M, Beyer-Westendorf J, et al.. Safety and feasibility of a diagnostic algorithm combining clinical probability, d-dimer testing and ultrasonography for suspected upper extremity deep venous thrombosis: a prospective management study. Ann Intern Med 2014;160:451–7. Context Upper extremity deep vein thrombosis (UEDVT) is an infrequent type of venous thromboembolism with an estimated incidence of 0.4–1 case per 10 000 persons.1 UEDVT may cause pulmonary embolism but this risk is lower than with lower extremity DVT. Accurate ruling out of UEDVT is mandatory in order to avert...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Delluc, A., Wells, P. S. Tags: EBM Diagnosis, Drugs: cardiovascular system, Pain (neurology), Stroke, Venous thromboembolism, Radiology, Pulmonary embolism, Clinical diagnostic tests, Radiology (diagnostics) Source Type: research

Psychological therapies help reduce headache and non-headache pain in children and adolescents
Commentary on: Eccleston C, Palermo TM, Williams AC, et al.. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev 2014;5:CD003968. Context Chronic and recurrent pain, especially in the head, abdomen and limbs affects up to 30% of children and adolescents.1 Pain can be severely disabling, disrupting school and social activities and if left untreated, may extend towards adulthood. Increasing evidence shows that psychological factors are pivotal in the transition from acute to chronic disabling pain. As a result, psychological interventions have been ...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Vlaeyen, J. W. S., Gatzounis, R. Tags: Palliative care, Clinical trials (epidemiology), Headache (including migraine), Pain (neurology), Stroke, Child and adolescent psychiatry, Complementary medicine Therapeutics Source Type: research

The Role of Decision Aids in Depression Care
Clarion calls about enhancing detection and management of depression in primary care have reiterated several truisms: Depression is as prevalent as many common medical disorders, treatable yet frequently undertreated, responsible for enormous occupational and social impairment as well as adverse effects on the costs, treatment outcomes, and mortality of comorbid medical diseases. Depression is second only to low back pain in years lived with disability (YLD), a metric that incorporates disease prevalence, age of onset, chronicity, and impairment. The YLDs attributable to depression exceed those accounted for by diabetes, i...
Source: JAMA Internal Medicine - September 28, 2015 Category: Internal Medicine Source Type: research

The evolving role of oral hormonal therapies and review of conjugated estrogens/bazedoxifene for the management of menopausal symptoms.
Authors: Parish SJ, Gillespie JA Abstract This review describes the evolving role of oral hormone therapy (HT) for treating menopausal symptoms and preventing osteoporosis, focusing on conjugated estrogens/bazedoxifene (CE/BZA). Estrogens alleviate hot flushes and prevent bone loss associated with menopause. In nonhysterectomized women, a progestin should be added to estrogens to reduce the risk of endometrial cancer. Use of HT declined since the Women's Health Initiative (WHI) studies showed that HT does not prevent coronary heart disease (CHD) and that conjugated estrogens/medroxyprogesterone acetate increased th...
Source: Postgraduate Medicine - February 1, 2017 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Diagnosis and treatment of hypertensive emergencies and urgencies among Italian emergency and intensive care departments. Results from an Italian survey: Progetto GEAR (Gestione dell'Emergenza e urgenza in ARea critica).
Abstract Hypertensive emergencies (HE) and urgencies (HU) are frequent causes of patients referral to Emergency Department (ED) and the approach may be different according to local clinical practice. Our aim was to explore awareness, management, treatment and counselling after discharge of HE and HU in Italy, by mean of an on-line survey. The young investigator research group of the Italian Society of Hypertension developed a 23-item questionnaire spread by e-mail invitation to the members of Italian Scientific societies in the field of Hypertension. 665 questionnaires were collected from EDs, Emergency and Urgenc...
Source: European Journal of Internal Medicine - November 1, 2019 Category: Internal Medicine Authors: Saladini F, Mancusi C, Bertacchini F, Spannella F, Maloberti A, Giavarini A, Rosticci M, Bruno RM, Pucci G, Grassi D, Pengo M, Muiesan ML Tags: Eur J Intern Med Source Type: research

Significant reduction in the visits to the emergency room department during the COVID-19 pandemic in a tertiary hospital in Greece: Indirect victims of the pandemic?
COVID-19 pandemic caused a major crisis, affecting and straining health care systems, including some very advanced ones. The pandemic may have also indirectly affected access to health care for patients with other conditions, not related to COVID-19, even in countries not overwhelmed by an outbreak. We analyzed and compared visits to the emergency room (ER) department during the same calendar period of 2019 and 2020 (from March 1 to March 31 of each year) in our hospital, a medium size, tertiary center, located in the center of Athens, which is not a referral center for COVID-19. Total ER visits were reduced by 42.3%...
Source: Medicine - December 24, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Hypertriglyceridemia-Induced Pseudo –High Anion Gap Metabolic Acidosis Manifesting as Ischemic Stroke
Hypertriglyceridemia is a metabolic disorder characterized by elevated levels of triglycerides in the bloodstream.1 The underlying causes are multifactorial and range from metabolic syndrome and genetic predisposition to lifestyle choices.1 The management of hypertriglyceridemia usually involves a combination of lifestyle modifications, control of low-density lipoprotein and high-density lipoprotein levels, and pharmacotherapy when necessary.1 The clinical presentation is predominantly asymptomatic; however, some patients present with abdominal pain, nausea, vomiting, and pancreatitis.
Source: Mayo Clinic Proceedings - September 1, 2023 Category: Internal Medicine Authors: Abdul R. Akkawi, Mason Fawcett, Abhiram Challa, Timothy Nguyen, Jennifer Jackson, Richard Muraga Tags: Letter to the editor Source Type: research