Articles: acute-pain.
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The acute pain therapy in the setting of conventional or laparoscopic appendectomy has to be initiated by the surgeon. The success of acute pain therapy holds a direct relevance for quality of life, morbidity, chronification of pain, and economic aspects. ⋯ He becomes "part of the team". An efficient acute pain therapy always consists of a combination of non-medical procedures, technical operative aspects, and medical procedures.
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The aim of this study was to identify clinical risk factors for unfavorable pain trajectories after breast cancer surgery, to better understand the association between pain expectation, psychological distress, and acute postoperative pain. This prospective study included 563 women treated for breast cancer. Psychological data included questionnaires for depressive symptoms and anxiety. ⋯ The results confirm that acute pain after breast cancer surgery is a multidimensional phenomenon. Psychological distress, pain expectation, and the patients' report of preoperative pain in the area to be operated should be recognized before surgery. Patients having axillary clearance need more efficient analgesic approaches.
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Pediatric emergency care · May 2017
Case ReportsAcute-Onset Chest Pain in a 17-Year-Old Female Adolescent With Systemic Lupus Erythematosus.
We report the case of a 17-year-old adolescent girl with systemic lupus erythematosus with disseminated pneumococcal infection leading to purulent pericarditis with cardiac tamponade. Although pericarditis is not an uncommon entity in autoimmune diseases such as systemic lupus erythematosus, purulent pericarditis is a rare cause (<1%) of this presentation.
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Pediatric blood & cancer · May 2017
Opioid prescription practices at discharge and 30-day returns in children with sickle cell disease and pain.
Acute pain episodes in children with sickle cell disease (SCD) represent a leading cause of readmissions. We examined prescription practices at the time of discharge in children with SCD presenting with acute pain to determine their impact on 30-day emergency department (ED) revisits and readmissions. ⋯ Variability exists in opioid prescription practices after discharge in children with SCD and pain episodes. Prescription of NSAIDs only, without opioids, was an independent predictor of higher 30-day ED revisits. Formalized studies to better understand factors that influence returns, including outpatient opioid management, are warranted in this population.
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Ulus Travma Acil Cer · May 2017
Diagnostic value of appendicular Doppler ultrasonography in acute appendicitis.
Acute appendicitis is one of the most common causes of acute abdominal pain prompting emergency department (ED) visits. It is critical for the physicians to promptly and accurately diagnose acute appendicitis. The present study aimed to evaluate the diagnostic efficacy of Doppler ultrasonography (USG) in patients with acute appendicitis and compare this new method with other commonly used radio-diagnostic tools. ⋯ Doppler imaging can offer a high level of diagnostic success in patients with acute appendicitis. Appendicular Doppler USG offers a rapid and easy application without the need to expose patients to contrast medium and is superior to both USG and computed tomography. Therefore, we recommend the use of appendicular Doppler imaging as the primary radiological exam in diagnosing acute appendicitis.