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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors analyze diagnostic and tactical errors in rendering prehospital emergency and outpatient care for spontaneous pneumothorax (SP). Delay in hospitalization to thoracal department threatens intrapleural complications, makes treatment more difficult and durable. SP was diagnosed as primary in 510 of 615 SP cases (576 patients). 105 SP episodes occurred in patients with bronchopulmonary diseases (secondary SP). Accurate diagnosis was made immediately or after a short examination in 431 patients, misdiagnosis took place in 194 patients (31.04%). Secondary and primary SP was missed in 39.4 and 29.4% of patients, respectively. Primary SP was mistaken for extrapulmonary affection (intercostal neuralgia, ischemic heart disease, osteochondrosis, etc), while secondary SP was misdiagnosed as progression or onset of bronchopulmonary diseases.
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PMID:[Prehospital diagnostic errors and therapeutic policy in spontaneous pneumothorax]. 949 Mar 38

Neurostimulation methods for control of chronic neuropathic pain have recently gained in popularity. The reasons for this are multifactorial. As opposed to nerve ablation, these methods are minimally invasive and reversible. The improvements in hardware design simplified implantation techniques and prolonged equipment longevity. Stimulation trials have become less invasive, allowing patients to test its effects before final implantation. Finally, the scientific evidence has shown good outcomes of neurostimulation methods for chronic neuropathic pain control. Recent research efforts have revealed new potential mechanisms of action of neurostimulation. Whereas its action was widely explained by gate control theory in the past, it seems that neuromodulation acts also by modulation of neurotransmitters in the central nervous system. Three neurostimulation methods are currently used in clinical practice: spinal cord stimulation (SCS), peripheral nerve stimulation (PNS), and deep brain stimulation (DBS). The SCS and PNS are excellent treatment choices for certain forms of neuropathic pain. The new indications for SCS are end-stage peripheral vascular disease and ischemic heart disease, whereas PNS is used for the treatment of occipital neuralgia and chronic pelvic pain. DBS is reserved for carefully selected patients in whom the other treatment modalities have failed. In a minority of patients the "tolerance" to neurostimulation develops after long-term use. Further research is needed to establish better outcome predictors to neurostimulation and possibly improve patient selection criteria.
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PMID:Stimulation methods for neuropathic pain control. 1125 47