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Why do women choose to undergo oocyte aspiration without sedation or analgesia?

Oocyte pick-up (OPU) is a painful but essential part of fertilization (IVF) that is usually performed under sedation and analgesia (SaA). Our aim was to study that why some women decide to undergo OPU without SaA?

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Effect of different administration and dosage of dexmedetomidine in the reduction of emergence agitation in children: a meta-analysis of randomized controlled trials with sequential trial analysis.

Beneficial effects of dexmedetomidine (DEX) against emergence agitation (EA) in children remain controversial. We performed a more comprehensive meta-analysis to evaluate the protective effect of different administration routes, timing, patterns, and doses of DEX on EA in children.

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Atraumatic Fracture of the Medial Femoral Condyle of a Total Knee Arthroplasty.

The fracture of the femoral component is a rare complication of a total knee arthroplasty (TKA). This article presents a case in which a 70-year-old man underwent a left press-fit Advance Medial-Pivot Knee System TKA (MicroPort Orthopedics, Arlington, TN) in 2000. Twenty years later, he experienced a nontraumatic onset of knee pain after standing up from a lunge position. Radiographs and CT scans revealed a complete fracture of the medial condyle of the femoral component. Revision surgery was performed confirming the broken component. A cemented Triathlon Total Stabilizer (Stryker Orthopedics, Kalamazoo, MI) prosthesis was used for the revision. The authors recommend that surgeons maintain a high level of suspicion of component fracture when patients present with persistent severe knee pain and instability after a TKA.

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Preoperative Diagnosis Failure for a Rare Gastric Collision Tumor: A Case Report.

Gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors of the gastrointestinal tract (GIT), usually occur as a solitary neoplasm. Inflammatory florid polyp (IFP) is a solitary rare benign lesion of the gastrointestinal tract, mainly occur in the gastric antrum, whose atypical presentation can mimic GISTs or other malignant tumors, therefore the synchronous occurrence of GISTs and IFP is extremely rare. We had a case of a 58-year-old man that was presented with recurrent epigastric pain and recurrent melena. Upper endoscopic examination revealed a large polypoid antrum polyp measured 7 cm at greatest dimension with focal ulceration. Clinical and radiological features did not reach the definite diagnosis until histopathological evaluation with immunohistochemical analysis was performed. Surgical intervention is recommended and partial gastrectomy was done with wide resection margins. Histological examination revealed two distinct GISTs and IFP parts presenting a collision tumor that showed spindle and epitheloid cells consistent with GISTs with histological features of florid polyp showed a characteristic perivascular onion-skin arrangement of spindle cells with dense chronic inflammatory infiltrate including eosinophils and lymphocytes. Immunohistochemical studies have been done and revealed an association between GISTs and IFP. To the best of our knowledge, this is the first case of a collision tumor consisting of a GIST and an IFP arising in the stomach. In conclusion, the gastrointestinal stromal tumor is the comments mesenchymal tumor of GIT and IFP is a rare benign lesion of GIT therefore association between GIST and IFP as a collision tumor is extremely rare.

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Rare gastric neoplasm: Malignant glomus tumor of the stomach. A case report.

Glomus tumors are rare neoplasms that aris-e from neuromyoarterial canal or glomus body. They are mainly found in the peripheral soft tissue, extremities and rarely developed inside the gastrointestinal tract. In the gastrointestinal tract, the stomach is the most common site for the development of glomus tumors, and most often found in the antrum. Usually, the symptoms of gastric glomus tumors are non specific i.e (abdominal pain, GI bleeding and/or perforation) and possibly discovered incidentally during upper GI endoscopy.

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Effects of diaphragm muscle treatment in shoulder pain and mobility in subjects with rotator cuff injuries: A dataset derived from a pilot clinical trial.

The rotator cuff inflammatory or degenerative pathology is the main cause of shoulder pain. The shoulder and diaphragm muscle have a clear relation through innervation and the connection through myofascial tissue. A prospective, randomized, controlled, single-blind (assessor) pilot clinical trial was performed with a sample size of 27 subjects with rotator cuff injuries and with clinical diagnosis of myofascial pain syndrome at shoulder. The sample were divided into 3 groups of treatment (9 subjects per group):1.A direct treatment over the shoulder by ischemic compression of myofascial trigger points (MTP) (control / rotator cuff group).2.Diaphragm manual therapy techniques (diaphragm group).3.Active diaphragm mobilization by breathing exercises (breathing exercises group).The pain and range of shoulder motion were assessed before and after treatment in all the participants by inclinometry, NRS of pain in shoulder movements and pressure algometry. Methodology and full data analyzing the effect of the three interventions are presented in this article. These data could give a basis for further experiments on revealing the underlying mechanism of action of the visceral manual therapy in reducing the symptoms of shoulder pain.

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Posterior Ankle Arthroscopy for Flexor Hallucis Longus Entrapment: A Case Report.

Stenosing tenosynovitis is a chronic disorder frequently observed in finger triggering of a digit. Regarding the toes, although entrapment of the flexor hallucis longus (FHL) has already been reported in a few cases among sports players, the clinical condition is uncommon. Besides, the case without any specific causes is particularly rare.

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Inflammatory Bowel Disease Nurse-Practical Messages.

: Patients affected by inflammatory bowel diseases (IBDs) are complex patients with various problems from a clinical and psychological point of view. This complexity must be addressed by a multidisciplinary team, and an inflammatory bowel disease nurse can be the ideal professional figure to create a link between doctor and patient. The objective of this comprehensive review is to describe the figure of inflammatory bowel disease nurses and the various benefits that their introduction into a multidisciplinary team can bring, as well as a focus on how to become an inflammatory bowel disease nurse. : A search on the PubMed database was performed by associating the terms "IBD" or "inflammatory bowel disease" with the Boolean term AND to the various issues addressed: "life impact", "communication", "fistulas", "ostomy", "diet", "incontinence", "sexuality", "parenthood", "fatigue", "pain management", and "follow up appointments". Regarding the analysis of the benefits that the IBD nurse brings, the terms "IBD", "inflammatory bowel diseases", "Crohn's disease", and "ulcerative colitis" were used, associating them with the terms "benefit", "costs", "team", and "patients". Finally, regarding the focus on how to become an IBD nurse, an IBD nurse was interviewed. : An IBD nurse is a valuable nursing figure within the multidisciplinary team that takes care of patients with IBD because this nurse performs important functions from both a clinical assistance point of view (management of fistulas, ostomies, infusion of biological drugs) and an information and therapeutic education point of view (communication with patients, direct contact with patients by telephone or email). Furthermore, this nurse performs the "filter" function between doctor and patient, saving time for doctors that will be used for more outpatient visits. : The introduction of an inflammatory bowel disease nurse is therefore recommended for multidisciplinary organizations dealing with the clinical course of patients suffering from IBD.

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Ischemic Stroke as a Warning Sign of Impending Aneurysmal Rupture: A Report of Two Cases.

Ischemic stroke associated with intracranial aneurysm is rare but potentially happens because of emboli originating from aneurysm sac or aneurysmal thrombosis extension to the parent artery. We describe two patients who present subarachnoid hemorrhage (SAH) soon after ischemic stroke. Case 1. A 51-year-old woman with a history of multiple endovascular therapy for ruptured basilar top aneurysm presented with double vision. Magnetic resonance imaging (MRI) revealed infarcts in the right thalamus and left occipital cortex. Four days after ischemic stroke, she suffered from sudden onset headache, computed tomography (CT) showed diffuse SAH with intraventricular hemorrhage. Case 2. A 62-year-old man presented with right facial palsy and sensory disorder. MRI revealed an infarct in the left pons. Four days after ischemic stroke, he became comatose and CT showed diffuse SAH. Both cases develop ischemic stroke adjacent to the aneurysms and subsequently cause devasting aneurysm rupture, suggesting ischemic stroke as a warning sign of aneurysm rupture. In such cases, early treatment of the aneurysm should be considered.

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Analgesia nociception index for early detection of vagal stimulation during carotid body tumor resection: A case report.

ANI can be used for early detection of parasympathetic signals before the occurrence of bradycardia or to locate unidentified carotid structures in the head and neck region.

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