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Emerging Trends in Pain Medication Management: Back to the Future: A Focus on Ketamine

  Providers face many challenges when faced with pain management. Pain is complex, difficult to understand and diagnose, and especially enigmatic to manage. The discovery of nonopioid agents for pain management has become particularly important considering the ongoing opioid epidemic. This review is focused on revisiting ketamine, an agent that has historically been used for […]

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Contrast-enhanced computed tomography of the abdomen in coronal view showing peripancreatic inflammatory changes consistent with acute pancreatitis.

Hypertriglyceridemia-Induced Acute Pancreatitis with Normal Pancreatic Enzymes

To the Editor: The diagnosis of acute pancreatitis requires 2 of the following 3 features: 1) abdominal pain consistent with acute pancreatitis; 2) serum lipase activity (or amylase activity) at least 3 times greater than the upper limit of normal; and 3) characteristic imaging findings of acute pancreatitis.1 Although normal serum amylase levels have been reported […]

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PET/CT images showing increased 18F-fluorodeoxyglucose uptake that was consistent with a diagnosis of polymyalgia rheumatica. (A) Shoulders (blue arrows) and peritrochanteric bursae at hip joints (green arrows). (B) Greater trochanter (red arrows) and ischial tuberosities (yellow arrows).

Polymyalgia Rheumatica with Normal Inflammatory Markers

A 70-year-old man presented with pain in his shoulders, low back, and thighs for 1 year. He had difficulties when changing clothes, taking a bath, and getting out of bed because all these body movements aggravated the pain. He also experienced morning stiffness for 1 hour. Although his weight decreased by 5 kg because of loss […]

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Gas Within the Bladder

To the Editor: An 83-year-old woman with a medical history of hypertension, chronic renal failure, and diabetes mellitus came to the emergency department of our clinic after 2 days of fever, asthenia, adynamia, and hypogastric abdominal pain associated with dysuria, polyuria, and bladder tenesmus. Her family reported that she had been increasingly fatigued in the […]

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(A) Computed tomography of the abdomen/pelvis revealed a low attenuating lesion within the right lobe of the liver measuring 5.2 × 5.0 × 5.8 cm and (B) mild pericolonic fat stranding in the sigmoid colon. (C) An abdominal ultrasound scan revealed a 5.6-cm hyperechoic area in the central liver and (D) a thick-walled gallbladder filled with stones. (E) A sonographically guided percutaneous catheter drain was placed into the right liver abscess.

Unusual Case of Fever and Abdominal Pain

Pyogenic liver abscess is an uncommon type of intra-abdominal abscess and occurs in approximately 3.6 per 100,000 hospitalized individuals.1 The incidence of pyogenic liver abscess is increasing.1 Here we present a case of Streptococcus anginosus liver abscess, secondary to acute uncomplicated sigmoid diverticulitis and acute cholecystitis. Case Report A 63-year-old man presented to our tertiary medical center with a […]

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(A) Ultrasound imaging of the patient's right shoulder, shown here in this panoramic view, revealed multiple, round, mass-type lesions with homogenous echoes (arrows) and irregularly scattered hyperechoic plaques with acoustic shadows. (B) Ultrasound-guided aspiration was performed using the direct in-plane technique. The arrowheads indicate the needle.

Big Gain, No Pain: Tumoral Calcinosis

A patient’s odd physical presentation was the result of what could be termed a mineral deposit. The 40-year-old man reported that his right shoulder had been swelling progressively for more than 6 months. His medical history was significant for chronic kidney failure, and he had been undergoing hemodialysis for the previous 10 years. He had […]

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