Articles: acute-pain.
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Case Reports
An Unusual Cause of Fever, Neck Pain, and Neck Stiffness: Acute Calcific Tendinitis of the Longus Colli Muscle.
Acute calcific tendinitis (ACT) of the longus colli muscle (LCM) is an inflammatory response due to deposition of calcium hydroxyapatite crystals. It is typically correlated with whiplash and overuse injuries. A common presentation of this inflammatory response is acute but progressive neck pain. It is a rare but important cause of neck pain that should be considered on a differential diagnosis when distinguishing between life-threatening conditions and non-life-threatening causes of neck pain. ⋯ A 51-year-old woman presented to the emergency department (ED) reporting a mild sore throat that progressed to acute neck pain and stiffness. She also reported fatigue, fever, myalgias, and nausea. In the ED, the patient was tachycardic, hypertensive, and mildly febrile with normal oxygen saturation. Examination revealed meningismus and was negative for lymphadenopathy, oropharyngeal findings, and neurologic deficits. Laboratory studies were significant for leukocytosis. Computed tomography (CT) neck was obtained and was notable for calcification of the superior left longus colli muscle with prevertebral and retropharyngeal space edema along the muscle body. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: ACT of the LCM is a benign, self-limited condition that can present with features overlapping emergent causes of acute neck pain. Correct diagnosis relies on characteristic radiographic findings on CT. Fortunately, patients may be discharged home with a short course of anti-inflammatories and corticosteroids with near-complete resolution of symptoms. Emergency physicians, therefore, can rule out life-threatening causes of neck pain, while also making a definitive diagnosis and initiating effective management for this pathology.
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Role of serum CAP1 protein in the diagnosis of patients with first-time acute myocardial infarction.
The dysregulation of adenylate cyclase-associated protein 1 (CAP1) is associated with a variety of inflammatory conditions. Here, we aimed to assess the role of serum CAP1 protein in predicting acute myocardial infarction (AMI), and to explore its effect and mechanism in vascular endothelial cells injury. ELISA was utilized to detected CAP1 protein expression in serum from 70 patients with first-time AMI at 0, 6, 12, 24, 48 hours and 7 days of the onset of chest pain. ⋯ The expression of CAP1 protein was increased in supernatants of ox-LDL induced HUVEC in a dose- and time-dependent manner. CAP1 inhibited cell proliferation but promoted inflammation, and induced the activation of NF-κB pathway in vitro. To sum up, increased serum CAP1 expression might serve as a novel diagnostic biomarker for patients with first-time AMI, the mechanism might be related to its induction of NF-κB pathway activation causing abnormal proliferation and inflammation and thus mediating vascular endothelial cell injury.
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In the Emergency Department (ED), pain is one of the symptoms that are most frequently reported, making it one of the most significant issues for the emergency physician, but it is frequently under-treated. Intravenous (IV), oral (PO), and intramuscular (IM) delivery are the standard methods for administering acute pain relief. Firstly, we compared the safety and efficacy of IN analgesia to other conventional routes of analgesia to assess if IN analgesia may be an alternative for the management of acute pain in ED. ⋯ In addition, intranasal analgesia also has a rapid onset and quick absorption. Fentanyl and ketamine are two intranasal drugs that appear promising and may be taken simply and safely while providing effective pain relief. Intravenous is simple to administer, non-invasive, rapid onset, and quick absorption; it might be a viable choice in a variety of situations to reduce patient suffering or delays in pain management.
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Randomized Controlled Trial
External application of dandelion combined with borneol effectively reduced pain and facial swelling after jaw surgery.
To explore the effects of the combination of dandelion with borneol on the maxillofacial region of patients after jaw surgery in reducing the acute inflammatory reaction after surgery, the degree of facial swelling, pain, and limitation of mouth opening, and increasing patient satisfaction. ⋯ External application of dandelion combined with borneol was effective in the treatment of maxillofacial swelling and pain. This approach quickly relieved swelling, restored the limitation of mouth opening, and improved patient satisfaction.