Articles: pain-management.
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Involvement of the temporomandibular joint can be shown in 40-90% of patients with rheumatoid arthritis and juvenile idiopathic arthritis (JIA), although it is often asymptomatic. Restricted jaw mobility and jaw pain can be found in approximately 20% of patients with JIA (prevalence: 70 per 100 000 persons). Early diagnosis and treatment of the underlying disease are essential for a good outcome, but uniform, consensus-based management is still lacking. ⋯ Oligosymptomatic and asymptomatic cases are common even with radiologic evidence of marked joint damage. The possibility of rheumatic involvement of the temporomandibular joint must be kept in mind so that serious complications can be avoided. Regular clinical evaluation of the temporomandibular joint is recommended, particularly for patients with juvenile idiopathic arthritis.
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Enhanced recovery after surgery suggests the use of multimodal analgesia to optimize the perioperative pain management scheme. At present, studies have shown that the application of acupuncture combined anesthesia in thoracoscopy has achieved good curative effect. However, there is no relevant systematic evaluation. Our study is the first meta-analysis of the effectiveness and safety of acupuncture combined anesthesia in pain management after thoracoscopy, in order to provide strong evidence for clinical support. ⋯ The research has been registered and approved on the INPLASY website. The registration number is INPLASY 2021120129.
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Meta Analysis
Hydromorphone vs sufentanil in patient-controlled analgesia for postoperative pain management: A meta-analysis.
Patient-controlled analgesia (PCA) is an effective method of postoperative pain, there have been many studies performed that have compared the efficacy of hydromorphone with continuous sufentanil. The purpose of this systematic review is to compare the efficacy and safety of hydromorphone and sufentanil. ⋯ Compared with sufentanil, PCA with hydromorphone was more effective in relieving pain and PCA requests 12, 24, and 48 hours after operation, and significantly reduced the incidence of adverse events, but it did not have an advantage in sedation intensity.
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A 36-year-old active duty female presented to an outside hospital emergency department for the evaluation of chest pain and weakness. Per report, comprehensive evaluation ruled out acute cardiopulmonary conditions. A computerized tomography scan revealed a large homogeneous anterior mediastinal mass. ⋯ The primary care physician referred her to an endocrinologist who initiated treatment with methimazole. The patient's GD responded well to medication therapy; the thymic mass size decreased and her exercise tolerance increased. Notably, testing for TSH levels upon initial presentation could have avoided the need for biopsy.