Emergency ward physicians are presented daily with patients in pain. Provisions of safe, quick pain control remains one of their major duties. Hypnosis can be used as an effective adjunct or substitute for analgesic medications when these drugs prove to be ineffective or contraindicated. Four such illustrative cases of attempted pain control are presented. The psychological foundations of pain and its assessment are discussed. The emergency ward physician can obtain facility in hypnotic techniques with only modest training.
The Australian & New Zealand Journal of Obstetrics & Gynaecology
Hypnosis can be a useful therapeutic adjunct to pharmacological analgesia or anaesthesia in obstetrics. However, it is rarely considered a primary anaesthetic technique and is seldom employed in the acute surgical setting. Few obstetricians and anaesthetists currently utilise this technique in their clinical practice.
Rectus sheath haematoma (RSH) is a well-documented but uncommon clinical condition. It is usually a self-limiting condition but can present as a life-threatening emergency. RSH after non-contact vigorous exercise is unknown. Two such cases secondary to yoga and laughter therapy sessions, respectively, are reported. One of them required surgical intervention, whereas the other was successfully treated conservatively.
Rectus sheath hematoma is a relatively rare condition but a significant cause of acute abdominal pain. The acute abdominal pain associated with rectus sheath hematoma can mimic several conditions, such as appendicitis, intestinal problems (obstruction, perforation, hernia, malignancy), and gynecologic disease (ovarian cyst, torsion, tubo-ovarian abscess, ectopic pregnancy). Correct diagnosis and subsequent treatment depends on careful history taking and appropriate use of diagnostic tools to avoid unnecessary laparotomy.
"Religious" stigmata describe body marks and sores that reflect the crucifixion wounds of Christ (hands and wrists, feet, flank, back, shoulders, forehead) and which are transferred to an individual through fervent prayer. "Non-religious" stigmata usually describe spontaneous episodes of bleeding with no identifiable cause outside any religious context. Irrespective of the setting in which they occur, such lesions are extremely striking.
A two-stage augmentation mammaplasty was performed on 231 patients (462 implants) over a period of 3 years. Two hundred and sixteen of the cavities (47 percent) were found to have hematomas at the time of the second surgical stage. After removal of the hematomas and completion of the second stage, only 41 breast (9 percent) developed capsular contracture. Treatment of the 41 with Diapulse therapy, massage, and closed capsulotomy completely eliminated all capsular contracture. The period of observation has ranged from 3 months to 2 1/2 years.
The authors began to use 1-desamino-8-D-arginine vasopressin (DDAVP) Desmopressin Acetate routinely in their facelift patients who had a relatively high risk of bleeding, either from Von Willebrand factor deficiency, platelet dysfunction, aspirin intake, or ease of ecchymosis. Based on their observations that these patients had enhanced clotting and recovery times, they decided to undertake a prospective evaluation of the effects of Desmopressin Acetate when administered as a preoperative intravenous supplement during cosmetic facioplasty.
STUDY DESIGN: A case of symptomatic hematoma of cervical ligamentum flavum. OBJECTIVE: To report the first ligamentum flavum hematoma in the cervical spine and review the reported cases. SUMMARY OF BACKGROUND DATA: A herniated nucleus pulposis, spondylosis, epidural hematoma or abscess, neoplasm, or some pathology of the ligamentum flavum, such as hypertrophy, ossification, or calcification, are the most common causes of spinal cord and nerve root compression.
Haemophilia: The Official Journal of the World Federation of Hemophilia
Muscle haematoma represents 10-25% of bleeds in patients with severe haemophilia. There is limited consensus on diagnostic or treatment strategies and little knowledge about the natural history of muscle haematoma and optimal treatment goals. The aim of this review was to perform a systematic description of the natural history of muscle haematoma in healthy athletes, focusing on diagnosis, classification and treatment options. Publications and educational textbooks on management of sports injuries were used as data source.
Vulvar edema is associated with a variety of conditions. The edema can result from inflammatory conditions, infections, infestations, trauma, pregnancy, tumors and iatrogenic causes. At times, it is difficult to determine the cause of the vulvar edema. Treatment consists of determining the origin of the edema and giving the appropriate therapy for that diagnosis as well as the use of compression and, at times, lymphatic massage.