Caring for the patient with fibromyalgia: the rehabilitation nurse's role.

Fibromyalgia (FM) is a chronic, potentially disabling, cluster of symptoms that manifests as pain for 3 months or more and pain with pressure on 11 of 18 tender points throughout the body. Because there is no known cause, and therefore, no cure, treatment focuses on the control or relief of symptoms. Many patients are referred to rehabilitation settings for physical or exercise therapy. While exercise is helpful in the control of the pain, stiffness, fatigue, sleep disorders, and mood changes, a holistic approach to treatment is more effective. Rehabilitation nurses provide major support for patients with FM. Validation of the patients' experiences is essential for achieving quality of life. Many patients have a history of being undertreated because of a lack of credibility and invisibility of the illness. This article provides background information about FM, summarizes the FM trajectory, reviews approaches to management, and discusses the role of rehabilitation nurses in a holistic approach to care of clients with FM.     

Quantification of nuclear cardiac images: The Yale approach

Conclusion  Quantification of nuclear cardiac images provides a secondary support in reading myocardial perfusion images and improves the reproducibility in the diagnosis of cardiovascular diseases. The technology for the remote Web reading of nuclear cardiac images and the quantitative data allows for an easy and secured access to patient studies without the limitations of time and space. The recent increasing interests and applications in molecular targeted imaging have opened a new field in nuclear cardiology, and absolute image quantification of the focal tracer uptake in the myocardium is exceedingly critical for the quantitative analysis of molecular targeted images.     

Ruptured pediatric posterior cerebral artery aneurysm 9 years after the onset of Kawasaki disease: a case report

CASE REPORT: A 12-year-old boy who had a history of Kawasaki disease 9 years ago experienced a subarachnoid hemorrhage by ruptured right posterior cerebral artery aneurysm. On day 1 operation, as the aneurysm was very fragile and bled easily, two intraoperative ruptures, including a very premature rupture, were encountered. As a result, a left hemiparesis especially severe in the left hand was caused by the right anterior thalamic infarction due to the occlusion of a thalamo-perforating artery arising near the neck of the aneurysm. DISCUSSION: The histopathological examination of the intraoperative excised aneurysmal dome disclosed the thickening of the endothelial inner due to the endothelial hypertrophy and the invasion of inflammatory cells. This finding of the aneurysm was partially mimicking the finding of the coronary artery of the patients with Kawasaki disease. The combination of cerebral aneurysm and Kawasaki disease has never been reported until now, and the etiology of the aneurysm of this patient is unclear.     

Pharmacotherapy for cancer pain

The first 150 words of the full text of this article appear below. Key points Cancer pain management services must integrate withpalliative and primary care. Pain is common in cancer and usuallyoccurs in more than one site. Careful assessment and treatmentsaimed at the causes of the pain are essential. Optimal oralpharmacotherapy manages more than 75% of patients with cancerpain. If specific anti-cancer therapy, drugs, physical andpsychological treatments fail, then more invasive therapiesshould be considered early.