Articles: acute-pain.
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Clinical trials suggest that cyclo-oxygenase-2 specific inhibitors (coxibs) are an effective treatment for acute postoperative pain. The aims of this systematic review were to examine the evidence for oral valdecoxib and injected parecoxib, and quantify efficacy and adverse effects. ⋯ Both oral valdecoxib and injected parecoxib are effective treatments for acute postoperative pain.
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A 28-year-old male with atraumatic abdominal pain and transient hypotension was assessed using bedside emergency department (ED) ultrasonography and contrast enhanced helical computed tomography (CT). Both tests revealed free intraperitoneal fluid, but neither detected a splenic defect. ⋯ His serology for typical viral causes was negative. This article discusses spontaneous splenic rupture, the role of imaging in diagnosis, and the limitations of ED ultrasound and contrast enhanced helical CT.
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Percutaneous neuromodulation therapy (PNT) is a new minimally invasive, office-based treatment for low back pain in which electrical stimulation is delivered to the paraspinal peripheral nerves. The purpose of this study was to determine the safety, tolerability, and clinical efficacy of PNT in a population of patients with subacute low back pain with radiation to the lower extremity. ⋯ For many patients with subacute radiating low back pain, PNT significantly reduced pain and self-rated disability, and improved sleep quality and activity level. PNT is safe and generally well tolerated.
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To examine age-related differences in pain, catastrophizing, and affective distress (depression and anxiety) after athletic injury and knee surgery. DESIGN AND SETTING: Participants were assessed with measures of pain intensity, pain-related catastrophizing, depression, and anxiety symptoms at 24 hours after anterior cruciate ligament (ACL) surgery. SUBJECTS: Twenty patients (10 adolescents, 10 adults) with an acute complete tear of the ACL. MEASUREMENTS: Pain was assessed by Visual Analog Scale (VAS), catastrophizing with the Pain Catastrophizing Scale (PCS), depressive symptoms with the Beck Depression Inventory (BDI), and anxiety with the state form of the State-Trait Anxiety Inventory (STAI-S). ⋯ After ACL surgery, athletic adolescents and adults differed significantly in pain, catastrophizing, and anxiety. Catastrophizing seemed to be a particularly strong factor in postoperative pain differences between adolescents and adults, with clinical-management implications. These data indicate the need for continued research into specific pain- and age-related factors during the acute postoperative period for athletes undergoing ACL surgery.
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To summarize new advances and research findings that relate to the treatment of burn victims. ⋯ The combination of innovative approaches and a dedicated burn team is expected to continue to improve survival in the next few years even in the most severe cases.