Articles: treatment.
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To assess the journey of individuals from experiencing a traumatic event through onset of symptoms, diagnosis, and treatment of posttraumatic stress disorder (PTSD). ⋯ PTSD presents heterogeneously, with an extensive journey from trauma to diagnosis with low remission rates and limited treatment options.
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The patient is a 49-year-old woman who had never used tobacco with a history of relapsing polychondritis and episcleritis. She sought treatment at our clinic for evaluation of multiple lung masses. ⋯ The autoimmune markers were notable for positive rheumatoid factor (153 IU/mL) and elevated erythrocyte sedimentation rate (97 mm/h) and C-reactive protein (65.5 mg/L). Pertinent studies with negative results included antineutrophilic cytoplasmic antibody, antinuclear antibody, cyclic citrullinated peptide antibody, Sjogren syndrome-related antigen A, and Sjogren syndrome-related antigen B tests.
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Dtsch. Med. Wochenschr. · Mar 2024
[Venous thromboembolism - was is new in the revised AWMF guideline?].
For the diagnosis of a lower-extremity deep vein thrombosis (LEDVT), venous duplex ultrasound is the method of first choice. If a qualified ultrasonography is not timely available, D-dimer testing, and limited ultrasound protocols (point-of-care ultrasound, POCUS) can contribute to therapeutic decision-making when clinical probability is low. A DOAC-based treatment regimen is preferable to a vitamin K antagonist for both acute therapy and secondary prophylaxis of venous thromboembolism (VTE). ⋯ Weight restrictions are no longer recommended for apixaban and rivaroxaban, but determination of DOAC trough and peak levels is recommended in the extremely obese and patients after bariatric surgery. In cancer-associated VTE, the direct factor Xa inhibitors are a good and safe alternative to low-molecular weight heparins (LMWH) for many patients; the adherence to oral therapy is also higher. Meaningful initial documentation and structured follow-up after LEDVT and pulmonary embolism (PE) are important in order to make an individualized risk-benefit assessment at the end of the therapy phase with regard to continued pharmacological secondary prophylaxis and to reassess patients' symptoms indicating post-thrombotic syndrome (PTS) or chronic thromboembolic pulmonary hypertension (CTEPH).
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Randomized Controlled Trial
Comparative Randomized Study between Pulsed Radiofrequency and Suprascapular Nerve Block for the Treatment of Chronic Shoulder Pain.
The primary objective of this study was to compare pain intensity after pulsed radiofrequency (RF) or suprascapular nerve block for the treatment of chronic shoulder pain. The secondary objectives were to compare the shoulder range of motion and supplementary analgesic requirement. ⋯ Pulsed RF on the suprascapular nerve promoted an analgesic effect for 12 weeks. Regarding the intensity of pain on movement and at rest, there was a trend toward a better effect with RF than with nerve blockage treatment. In both groups, there was a reduction in pain intensity without serious adverse effects.