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Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Appendicitis-I: Introduction01:22

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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
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Acute Pancreatitis II: Clinical Manifestations and Management01:30

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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Pain01:20

Pain

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Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
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重新出现的疼痛

John D Loeser1, Jane C Ballantyne2

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概括
此摘要是机器生成的。

疼痛管理需要现代化. 区分外围疼痛和中心疼痛对于有效治疗至关重要,每种类型都需要不同的诊断和治疗策略.

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科学领域:

  • 疼痛医学 医学 疼痛医学
  • 神经学 神经学
  • 医学教育 医学教育

背景情况:

  • 近50年来,疼痛患者的管理一直落后于预期.
  • 目前的方法可能无法充分解决慢性疼痛疾病的复杂性.
  • 国际疼痛研究协会 (IASP) 的框架需要重新评估.

研究的目的:

  • 确定阻碍疼痛患者管理发展的因素.
  • 重新审视疼痛分类和诊断的基本概念.
  • 评估疼痛医生的当前教育和培训.

主要方法:

  • 进行了对现有文献的全面审查.
  • 专注于用于诊断和管理高影响性慢性疼痛的新策略.
  • 分析疼痛医学中的概念框架.

主要成果:

  • 传统的急性-慢性疼痛二分法不再被认为是有用的.
  • 疼痛应根据来源进行分类:边缘或中央处理错误.
  • 外围和中心疼痛综合征需要不同的诊断和治疗方法.

结论:

  • 对外围疼痛有效的治疗方法,包括阿片类药物,对中心疼痛无效.
  • 中心疼痛需要神经中心的治疗策略,避免专注于外围原因.
  • 疼痛医生教育必须不断发展,为临床医生提供两种疼痛类型的技能.