Articles: pain-management.
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Review
Chronic Primary Pelvic Pain Syndrome in Men—Differential Diagnostic Evaluation and Treatment.
Chronic primary pelvic pain syndrome in men (CPPPSm) can be associated with urogenital pain, urinary symptoms, sexual dysfunction, and emotional disturbance. Its clinical heterogeneity and incompletely understood pathogenesis make it more difficult to treat. This article is intended to familiarize the reader with basic aspects of the manifestations, pathophysiology, diagnostic evaluation, differential diagnosis, and treatment of this condition. ⋯ The management of patients with CPPPSm should consist of a comprehensive differential diagnostic evaluation and an individually oriented treatment strategy.
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Randomized Controlled Trial
Immersive Virtual Reality for Pain Control and Anxiolysis During IV Blood Draws in Adults: A Randomized Controlled Trial.
To evaluate immersive virtual reality's (IVR) effectiveness as a distraction in reducing perceived pain and anxiety among adults undergoing intravenous (IV) blood draw. ⋯ The results of our study demonstrated that there was no significantly lower perceived pain or anxiety when using IVR compared to standard practice in adults undergoing IV blood draw.
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We report the case of a 37-year-old man presenting with pain out of proportion to the exam with hydrofluoric acid burns to his upper extremities after he spilled a wheel-stripping compound on his forearms while working at his powder coating business. His burns initially appeared mild and superficial, but over the course of several days, these evolved from simple erythema to significant partial thickness tissue destruction and ulceration. He required substantial topical, intradermal, and intravenous therapies to control the unseen burning process during his index visit to the emergency department. ⋯ Following nonoperative management, he had an uneventful recovery with full function retained in the affected extremities. Hydrofluoric acid burns require prompt treatment with calcium to neutralize the burning process, despite a potentially benign initial appearance. The emergency clinician should use an aggressive diagnostic and therapeutic approach to patients presenting with pain out of proportion to their exam, as this finding is associated with various serious underlying pathology.
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Diabetic ketoacidosis (DKA) is a serious disease entity that must be diagnosed quickly for urgent management in the intensive care unit. Keeping DKA in the differential diagnosis is important, especially in a forward deployed, resource-poor setting. The symptoms and signs of DKA are nonspecific, including fatigue, polydipsia, polyuria, weakness, weight loss, nausea, vomiting, and abdominal pain with tachycardia and tachypnea on exam. ⋯ By the time he was transferred to the emergency room, he was in severe DKA. The patient was treated in the intensive care unit and made a full recovery. He was processed for limited duty and medical board upon hospital discharge.