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https://www.readbyqxmd.com/read/28721976/screening-irritable-bowel-syndrome-patients-for-symptoms-predictive-of-crohn-s-disease-using-the-red-flag-score
#1
Mahmoud Mosli, Mutaz Bamarhul, Abdulrahman Alharbi, Sohaib Shafei, Ahmad Alharbi, Khalid Bamahfouth, Hani Jawa, Emad Aljahdali, Salim Bazaraa, Yousif Qari
BACKGROUND/AIMS: The diagnosis of inflammatory bowel disease (IBD) is often delayed due to misdiagnosing patients with irritable bowel syndrome (IBS), mostly because of the under-recognition of high-risk features. The red flag score (RFS) has been recently developed to identify patients with higher risk of IBD rather than IBS. The aim of this study is to estimate the prevalence of high-risk features, according to the RFS, among patients diagnosed with IBS who would consequently be candidates for ileocolonoscopic evaluation...
July 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28720719/introduction-of-a-new-imaging-guideline-for-suspected-renal-colic-in-the-ed-reduces-ct-urography-utilisation
#2
Gabriel Blecher, Rob Meek, Diana Egerton-Warburton, Philip McCahy
BACKGROUND: Patients presenting to the ED with suspected renal colic are frequently imaged with CT urography (CTU), which rarely alters diagnosis or management. To reduce use of CTU in this population, we instigated a new imaging and management guideline in our ED. METHODS: This was a quasi-experimental prospective study, whereby a new guideline was commenced at the intervention site (Monash Medical Centre) and the existing guideline continued at the control site (Dandenong Hospital)...
July 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28708761/most-red-flags-for-malignancy-in-low-back-pain-guidelines-lack-empirical-support-a-systematic-review
#3
Arianne P Verhagen, Aron Downie, Chris G Maher, Bart W Koes
Clinicians do not want to miss underlying serious pathology, but it is still unclear which red flags are relevant. We aimed to evaluate the origin and evidence on diagnostic accuracy of red flags for malignancy for the management of low back pain in primary care. We performed a comprehensive overview, and searched the literature using snowballing techniques and reference checking for evidence on red flags endorsed in clinical guidelines for identifying patients with higher likelihood of malignancy. We selected studies including people with low back pain without any restriction on study design...
July 11, 2017: Pain
https://www.readbyqxmd.com/read/28697094/identifying-and-assisting-sexually-exploited-and-trafficked-patients-seeking-women-s-health-care-services
#4
Erin E Tracy, Wendy Macias-Konstantopoulos
It is estimated that 21 million people are trafficked worldwide, including 11.4 million women and girls. Approximately 4.5 million are forced to do sexual labor. The exact prevalence of human trafficking is difficult to ascertain, however, given the limitations of data collection in an illegal industry. Obstetrician-gynecologists should not only be aware of the widespread nature of human trafficking, but also have the tools to assess patients for trafficking and respond to victim identifications. Patients may present with signs of physical abuse, depression, anxiety, posttraumatic stress disorder, substance use, sexually transmitted infections, pregnancy, and nonspecific somatic complaints...
July 7, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28691686/oesophageal-dysphagia-a-stepwise-approach-to-diagnosis-and-management
#5
REVIEW
Brian T Johnston
Dysphagia is a common symptom in the general population. Incidence varies depending on the specific definition used. A good medical history is vital for distinguishing true oesophageal dysphagia from oropharyngeal dysphagia or other causes. Oesophageal dysphagia is a so-called red flag alarm symptom requiring oesophagogastroduodenoscopy. However, even after investigations including oesophagogastroduodenoscopy (with biopsy), barium swallow, and oesophageal manometry, no obstructive cause may be found. This Review suggests an algorithm of history-taking and investigation to allow the causes of non-obstructive dysphagia to be identified, including functional dysphagia...
August 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28687951/approach-to-upset-stomach
#6
Rishi Bolia
An "Upset stomach" is a common problem encountered by physicians involved in the care of children. It includes, diarrhea, vomiting or abdominal pain. Though often mild and self-limiting, at times there are uncommon life-threatening conditions that require urgent care. It is important for primary physicians to recognize "alarm signs" and make a referral to the specialist at the right time. At the same time it is important to recognize what is normal and re-assure the caregivers. A detailed history and a proper systemic examination are important at presentation, looking for any "red flags"...
July 8, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28687948/role-of-hepatobiliary-scintigraphy-and-preoperative-liver-biopsy-for-exclusion-of-biliary-atresia-in-neonatal-cholestasis-syndrome
#7
Ankur Mandelia, Richa Lal, Nijagal Mutt
All diagnostic algorithms for Neonatal Cholestasis Syndrome (NCS) focus on differentiating numerous medical causes from Biliary Atresia (BA). No preoperative diagnostic algorithm has 100% diagnostic accuracy for BA and yet, timely diagnosis is crucial to optimize surgical outcome. Markers for high index of clinical suspicion for BA are: a "usually" well thriving infant with conjugated hyperbilirubinemia, raised gamma glutamyl transpeptidase, persistently "acholic" stools, firm hepatomegaly with dysmorphic, hypoplastic gall bladder...
July 8, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28685649/misdiagnosis-cns-erdheim-chester-disease-mimicking-clippers
#8
Jillian Berkman, Caleb Ford, Emily Johnson, Beth A Malow, Joseph M Aulino
Introduction Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is an inflammatory central nervous system (CNS) disorder with particular involvement of the pons. Diagnostic criteria include a range of clinical symptoms related to the underlying brainstem pathology, visible with magnetic resonance imaging (MRI). MRI findings include the appearance of punctuate and curvilinear gadolinium enhancement 'peppering' the pons. We discuss a patient presenting with clinical and radiographic characteristics of CLIPPERS who was diagnosed with Erdheim-Chester disease (ECD)...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28682046/upper-gastrointestinal-conditions-nonmalignant-conditions-of-the-esophagus
#9
David S Estores, Ku-Lang Chang
Eosinophilic esophagitis (EE) is an allergic disorder of the esophagus. This diagnosis requires the presence of specific symptoms and a significantly elevated number of eosinophils in the esophageal lining as determined by endoscopic biopsies. Symptoms tend to be nonspecific among patients younger than 15 years. Among adults, dysphagia is the most common symptom. Comanagement with a gastroenterology subspecialist is essential, particularly for EE patients with a stricture. EE is commonly misdiagnosed as gastroesophageal reflux disease (GERD)...
July 2017: FP Essentials
https://www.readbyqxmd.com/read/28674366/m-protein-negative-myeloma-mimicking-lumbar-disc-herniation
#10
Yusuke Hirota, Shingo Suzuki, Yota Katsuyama, Tohru Iseki, Masatomi Ikusaka
A 60-year-old man was referred to us with high levels of aspartate aminotransferase and lactate dehydrogenase (LDH). He did not complain of any symptoms; however, he had been diagnosed with lumbar disc herniation, even though his back pain improved only to half of its previous level with pregabalin. Thus, we asked about the red flag of back pain and confirmed that he had involuntary body weight loss, which led us to diagnose truly non-secretory multiple myeloma, a variant of multiple myeloma that is associated with M-protein negativity and a normal serum free light chain level...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28667760/agree-ii-assessments-of-recent-acne-treatment-guidelines-how-well-do-they-reveal-trustworthiness-as-defined-by-the-institute-of-medicine-iom-criteria
#11
E A Eady, A M Layton, J Sprakel, B W M Arents, Z Fedorowicz, E J van Zuuren
BACKGROUND: Up-to-date, trustworthy guidelines are a widely relied-upon means of promoting excellent patient care. OBJECTIVES: To determine the quality of recently published acne treatment guidelines by utilizing the Appraisal of Guidelines for Research and Evaluation (AGREE) II Reporting Checklist, the US Institute of Medicine's (IOM) criteria of trustworthiness, Lenzer et al's red flags and CheckUp. METHODS: Systematic searches were conducted in bibliographic databases, guideline depositories and using Google(™) to identify acne treatment guidelines published since 2013...
July 1, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28665055/plagiarism-in-the-context-of-education-and-evolving-detection-strategies
#12
REVIEW
Armen Yuri Gasparyan, Bekaidar Nurmashev, Bakhytzhan Seksenbayev, Vladimir I Trukhachev, Elena I Kostyukova, George D Kitas
Plagiarism may take place in any scientific journals despite currently employed anti-plagiarism tools. The absence of widely acceptable definitions of research misconduct and reliance solely on similarity checks do not allow journal editors to prevent most complex cases of recycling of scientific information and wasteful, or 'predatory,' publishing. This article analyses Scopus-based publication activity and evidence on poor writing, lack of related training, emerging anti-plagiarism strategies, and new forms of massive wasting of resources by publishing largely recycled items, which evade the 'red flags' of similarity checks...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28659163/the-association-between-child-and-adolescent-emotional-disorder-and-poor-attendance-at-school-a-systematic-review-protocol
#13
Katie Finning, Darren Moore, Obioha C Ukoumunne, Emilia Danielsson-Waters, Tamsin Ford
BACKGROUND: Anxiety and depression are common in young people and are associated with a range of adverse outcomes. Research has suggested a relationship between emotional disorder and poor school attendance, and thus poor attendance may serve as a red flag for children at risk of emotional disorder. This systematic review aims to investigate the association between child and adolescent emotional disorder and poor attendance at school. METHODS: We will search electronic databases from a variety of disciplines including medicine, psychology, education and social sciences, as well as sources of grey literature, to identify any quantitative studies that investigate the relationship between emotional disorder and school attendance...
June 28, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28657811/description-of-the-case-mix-experienced-by-chiropractic-students-during-a-clinical-internship
#14
Aaron A Puhl, Christine J Reinhart, H Stephen Injeyan, Anthony Tibbles
OBJECTIVE: The primary objective of this study was to describe the case mix experienced by chiropractic students during their clinical internship at the Canadian Memorial Chiropractic College. Secondary objectives were to characterize teaching clinic patient populations, assess the similarity to previously published data for practicing chiropractors, and describe the treatment plans being recommended by interns. METHODS: A prospective, observational study was conducted using a convenience sample of 24 chiropractic interns...
June 28, 2017: Journal of Chiropractic Education
https://www.readbyqxmd.com/read/28652792/severe-atypical-herpes-zoster-as-an-initial-symptom-of-fatal-myelodysplastic-syndrome-with-refractory-anemia-and-blast-excess-raeb-ii
#15
Uwe Wollina, Gesina Hansel, Anja Baunacke, Georgi Tchernev
Herpes zoster is a common disease caused due to varicella zoster virus (VZV) infection with increasing incidence by age. If the patient has a severe, extended, or treatment-recalcitrant course of herpes zoster, this must be a red flag to search for underlying pathologies. Here, we report about a 64-year-old male patient with diabetes, who came to our emergency department because of general malaise, fever, chills, and a pronounced nuchal and facial swelling on the left side. Based on herpetiform-grouped vesicles and yellowish crusts, an impetiginized facial herpes zoster was diagnosed, and combined antiviral and antibiotic treatment was initiated...
2017: Clinical, Cosmetic and Investigational Dermatology
https://www.readbyqxmd.com/read/28644345/yield-of-endoscopy-in-pediatric-gastroparesis
#16
Tara A Altepeter, Stephen Shaffer
OBJECTIVES: The aim of the study was to quantify the diagnostic yield of upper endoscopy in children with gastroparesis and to develop a clinical model for gastroparesis using common symptoms and screening blood tests. METHODS: We retrospectively reviewed charts of 196 patients of age 4 to 18 years evaluated for gastroparesis between 2009 and 2013. All patients completed a standard solid-phase gastric emptying scan and upper endoscopy within a 12-month period. We analyzed gross and histologic endoscopy findings...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28641055/long-term-safety-evaluation-of-natalizumab-for-the-treatment-of-multiple-sclerosis
#17
Marinella Clerico, Carlo Alberto Artusi, Alessandra Di Liberto, Simona Rolla, Valentina Bardina, Pierangelo Barbero, Stefania Federica De Mercanti, Luca Durelli
Natalizumab is a humanized monoclonal antibody highly effective in relapsing-remitting multiple sclerosis (MS). Important concerns about its safety have been pointed out mainly because of the risk of progressive multifocal leukoencephalopathy (PML), caused by the opportunistic John-Cunningham virus (JCV). Areas covered: This review analyzes all the safety aspects related to the use and safety of natalizumab in MS patients. Other than PML, post-marketing, safety red-flags have been reported, as liver or haematological serious adverse events...
July 5, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28637110/guidelines-for-cauda-equina-syndrome-red-flags-and-white-flags-systematic-review-and-implications-for-triage
#18
Nicholas V Todd
INTRODUCTION: Patients with cauda equina syndrome (CES) are frequently referred late when neurological damage cannot be reversed. National Guidelines for emergency referral, imaging and treatment of CES contain symptoms and/or signs that are those of late often, irreversible CES. Referral at this stage may be too late for that patient. METHODS: Seven sources were reviewed. Advice re emergency referral/imaging/treatment were reviewed. Symptoms/signs were compared with a standard classification of CES...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28631045/-headaches
#19
REVIEW
M Michl, G M Michl
Headaches can be so severe that patients and doctors often fear life-threatening underlying cerebral pathologies. The spectrum of causes of headache is very heterogeneous and ranges from harmless situations to severe diseases, so that it is very difficult to consider all differential diagnoses simultaneously; however, a few targeted questions and physical examinations are sufficient to be able to make a better classification of the leading symptom headache. The following article serves as a quick guide for identification of patients at risk...
June 19, 2017: Der Internist
https://www.readbyqxmd.com/read/28625338/acute-diplopia-in-the-pediatric-emergency-department-a-cohort-multicenter-italian-study
#20
Umberto Raucci, Pasquale Parisi, Nicola Vanacore, Francesco La Penna, Valentina Ferro, Lucia Calistri, Claudia Bondone, Fabio Midulla, Agnese Suppiej, Raffaele Falsaperla, Duccio Maria Cordelli, Antonella Palmieri, Alberto Verrotti, Sabrina Becciani, Sonia Aguzzi, Mario Mastrangelo, Federica Pelizza, Filippo Greco, Giulia Carbonari, Ramona Tallone, Gabriella Bottone, Italo Trenta, Stefano Masi, Maria Pia Villa, Antonino Reale
BACKGROUND: Acute diplopia (AD) is an uncommon and distressing symptom of numerous ocular and neurological conditions, with potentially serious sequelaes. No data are present in pediatrics on the presentation and management of AD. AIM: This study investigated characteristics, etiology and health care utilization of the pediatric population with AD accessed to pediatric Emergency Departments (ED), trying to identify "red flags" associated with potentially life-threatening (LT) conditions...
June 3, 2017: European Journal of Paediatric Neurology: EJPN
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