0
selected
-
1.
Cactus Spine Wounds: A Case Report and Short Review of the Literature.
Dieter, RA, Whitehouse, LR, Gulliver, R
Wounds : a compendium of clinical research and practice. 2017;(2):E18-E21
Abstract
INTRODUCTION Cactus plants are commonly seen in arid southwestern regions of the United States. Due to their ready availability, they have become a popular houseplant. The spines or glochidia can easily puncture the skin with only minor pressure (ie, bumping or touching the cactus). Removal of the offending spine is difficult, even with tweezers. CASE An 18-year-old woman initially self-removed the spines, and marked discomfort and intense erythematous reaction developed within 8 to 10 hours. Patient presented to the emergency room at Mercy Hospital and Trauma Center (Janesville, Wisconsin), where spine removal was unsuccessful. RESULTS Following emergency room discharge, she had difficulty walking from pain and swelling and was advised to use heat packs, take amoxicillin/clavulanic acid, and rest with her leg elevated for another 7 days along with using eye drops for eye irritation. The lesions slowly improved over the next several months. CONCLUSION The case of multiple barrel cactus spine injuries with severe pain and swelling is presented herein as well as a review of the treatment options and complications of cactus spine injuries.
-
2.
Pain Management in CKD: A Guide for Nephrology Providers.
Koncicki, HM, Unruh, M, Schell, JO
American journal of kidney diseases : the official journal of the National Kidney Foundation. 2017;(3):451-460
Abstract
Although pain is one of the most commonly experienced symptoms by patients with chronic kidney disease, it is under-recognized, the severity is underestimated, and the treatment is inadequate. Pain management is one of the general primary palliative care competencies for medical providers. This review provides nephrology providers with basic skills for pain management. These skills include recognition of types of pain (nociceptive and neuropathic) syndromes and appropriate history-taking skills. Through this history, providers can identify clinical circumstances in which specialist referral is beneficial, including those who are at high risk for addiction, at risk for adverse effects to medications, and those with complicated care needs such as patients with a limited prognosis. Management of pain begins with the development of a shared treatment plan, identification of appropriate medications, and continual follow-up and assessment of efficacy and adverse effects. Through adequate pain management, providers can positively affect the health of individual patients and the performance of health care systems.
-
3.
Treating breast cancer radiotherapy-induced moist desquamation with a traditional Chinese medicine formula: a case series pilot study.
Xiaoshan, W, Zhixi, L, Liang, L, Shuchun, L, Xia, W, Yuyi, W, Feng, L
Journal of alternative and complementary medicine (New York, N.Y.). 2014;(9):732-5
Abstract
UNLABELLED Abstract Objective: A case series is presented to investigate the efficacy and safety of Erhegao for patients with breast cancer who have radiotherapy-induced moist desquamation. METHODS Eighteen women with breast cancer who received radiotherapy and developed moist desquamation were enrolled. Erhegao cream, a Traditional Chinese Medicine formula consisting of zinc oxide powder, calamine powder, and lithospermum oil, was applied on areas of moist desquamation. Application was repeated once a day until healing. The primary end point for efficacy was the time to healing of the moist desquamation areas. A numerical rating scale was used to measure wound pain relief daily. Incidence of toxicity was also assessed. RESULTS The average time to healing of the moist desquamation area was 13.56 days. The mean pain scores on the first, third, and seventh days were 5.22, 2.94, and 0.83, respectively. Eight-three percent of patients reported pain relief after the first 3 days, and 94%, after the first week. The mean daily reduction in the pain score was 0.40. None of the patients developed clinical infections or reported any toxicity. CONCLUSIONS This formula is effective and safe, especially for pain relief, and may be an alternative treatment for radiotherapy-induced moist desquamation in patients with breast cancer. Future randomized, controlled studies are needed to better evaluate the efficacy of Erhegao cream.
-
4.
Complete resolution of sickle cell chronic pain with high dose vitamin D therapy: a case report and review of the literature.
Osunkwo, I
Journal of pediatric hematology/oncology. 2011;(7):549-51
Abstract
With age, individuals with sickle cell disease (SCD) experience daily chronic pain. Vitamin D deficiency (VDD) can result in chronic pain, osteoporosis, fractures, and muscle weakness. Several studies report a high prevalence of VDD in SCD; however, the clinical correlates have not been well described. We describe a case of SCD chronic pain associated with profound VDD, osteoporosis, and osteonecrosis. Treatment with high-dose vitamin D resulted in complete resolution of chronic pain symptoms and improvement in bone density. Randomized studies of vitamin D in SCD may help elucidate its role in the management of chronic pain and bone disease.
-
5.
Familial hypophosphatemia: an unusual presentation with low back ache, heel pain, and a limp in a young man, and literature review.
Arthur, S, Chopra, A
Clinical rheumatology. 2011;(4):585-9
Abstract
A case of young man with low back ache and heel pains who was examined in a rheumatology outpatient and diagnosed as familial hypophosphatemia (FH), probably X-linked (XL), is presented. FH is most commonly transmitted as XL. The role of PHEX gene and fibroblast growth factor 23 is also described.
-
6.
Diffuse muscoskeletal pain and proximal myopathy: do not forget hypovitaminosis D.
Fabbriciani, G, Pirro, M, Leli, C, Cecchetti, A, Callarelli, L, Rinonapoli, G, Scarponi, AM, Mannarino, E
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases. 2010;(1):34-7
Abstract
A 20-year-old vegetarian man was admitted to our hospital complaining of muscle weakness and gait disturbances of 4 years duration. For the past 5 years, he had major depression and had confined himself at home. He exhibited tenderness upon palpation of the chest, sternum and proximal muscles. Hypocalcemia, hypophosphatemia, vitamin D deficiency, increased levels of alkaline phosphatase, and intact parathyroid hormone were noted. An x-ray skeletal survey revealed generalized osteopenia, multiple vertebral and costal fractures, and a pelvis deformed into the shape of a triangle. A diagnosis of osteomalacia secondary to vitamin D deficiency from lack of exposure to sunlight and to inadequacy of the diet was made. The patient was started on a treatment with 20,000 IU of vitamin D3 once a week plus 1 g/d of calcium. Eight months later, gait disturbances have significantly improved and laboratory findings have all normalized.
-
7.
Issues in long-term opioid therapy: unmet needs, risks, and solutions.
Passik, SD
Mayo Clinic proceedings. 2009;(7):593-601
-
-
Free full text
-
Abstract
Both chronic pain and prescription opioid abuse are prevalent and exact a high toll on patients, physicians, and society. Health care professionals must balance aggressive treatment of chronic pain with the need to minimize the risks of opioid abuse, misuse, and diversion. A thorough, ongoing assessment can help fashion a multimodal therapeutic plan, stratify patients by risk, and identify those who may exhibit aberrant behaviors after receiving opioid therapy. Appropriate safeguards (eg, urine drug screens, pill counts) may be used when necessary. Because not all aberrant behaviors have the same origins or implications, physicians must consider a differential diagnosis and tailor therapy accordingly. Opioid formulations designed to deter and resist abuse are currently in late-stage clinical development and address some but not all aspects of inappropriate opioid use. By incorporating physical and pharmacological barriers to obtaining the euphoric effects of opioids, these novel formulations may minimize problematic opioid use. The formulations use a variety of strategies, for example, combining opioids with naltrexone or niacin or incorporating the opioid in a high-viscosity matrix designed to resist physical and chemical extraction. Nonopioid medications as well as cognitive, behavioral, and interventional techniques should be considered for all patients with chronic pain, particularly for those who are unable to safely take their opioids in a structured fashion. The aim of this article was to help physicians prescribe opioid medications safely and successfully to patients who need them. A PubMed literature search was conducted using the keywords risk management, assessment, aberrant behavior, addiction, prescription abuse, and abuse-deterrent.
-
8.
Tension-type headache as the unique pain experience of a patient with congenital insensitivity to pain.
Danziger, N, Willer, CJ
Pain. 2005;(3):478-483
Abstract
Congenital insensitivity to pain (CIP) is a rare clinical syndrome characterized by dramatic impairment of pain perception since birth and is generally caused by a hereditary sensory and autonomic neuropathy (HSAN) with loss of the small-calibre, nociceptive nerve fibres. We report the case of a 32-year-old woman with CIP and a presumptive diagnosis of HSAN type V, who experienced physical pain for the first and unique time in her life shortly after the sudden loss of her brother. This patient had sustained innumerable painless injuries during childhood, including bone fractures and severe burns. The only pain she ever felt consisted in an intense headache, which took place in a context of strong emotional overload and anxiety, 3 weeks after her younger brother died suddenly in a car accident. The description of this inaugural episode of headache fulfilled the diagnostic criteria of episodic tension-type headache. This case strongly suggests that the transcription of the grief of bereavement into physical pain may sometimes occur independently of the peripheral mechanisms of nociception and despite the lack of previous pain experience. In the light of recent experimental data showing that the same neural mechanisms that regulate physical pain may also control the expression of separation distress and the feeling of social exclusion, this unique case helps to better understand why some patients may feel physically hurt after the loss of someone they love.
-
9.
Patient centred CBT for chronic pain.
Roland, D, Prince, J, Koppe, H
Australian family physician. 2004;(5):339-44
-
10.
Gabapentin for painful legs and moving toes syndrome.
Villarejo, A, Porta-Etessam, J, Camacho, A, González De La Aleja, J, Martínez-Salio, A, Penas, M
European neurology. 2004;(3):180-1