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https://www.readbyqxmd.com/read/28798035/red-flags-or-red-herrings-redefining-the-role-of-red-flags-in-low-back-pain-to-reduce-overimaging
#1
EDITORIAL
Gilat L Grunau, Ben Darlow, Timothy Flynn, Kieran O'Sullivan, Peter B O'Sullivan, Bruce B Forster
No abstract text is available yet for this article.
August 10, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28793143/intraoperative-diagnosis-of-anderson-fabry-disease-in-patients-with-obstructive-hypertrophic-cardiomyopathy-undergoing-surgical-myectomy
#2
Franco Cecchi, Maria Iascone, Niccolò Maurizi, Laura Pezzoli, Irene Binaco, Elena Biagini, Maria Laura Fibbi, Iacopo Olivotto, Federico Pieruzzi, Ana Fruntelata, Lucian Dorobantu, Claudio Rapezzi, Paolo Ferrazzi
Importance: Diagnostic screening for Anderson-Fabry cardiomyopathy (AFC) is performed in the presence of specific clinical red flags in patients with hypertrophic cardiomyopathy (HCM) older than 25 years. However, left ventricular outflow tract obstruction (LVOTO) has been traditionally considered an exclusion criteria for AFC. Objective: To examine a series of patients diagnosed with HCM and severe basal LVOTO undergoing myectomy in whom the diagnosis of AFC was suspected by the cardiac surgeon intraoperatively and confirmed by histological and genetic examinations...
August 9, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28792305/be-aware-of-extremism
#3
Sarah Hammerton
It's as simple as picking up the phone and making a referral. For those who have done Prevent training, it's about recognising the red flags; the same red flags as recognising vulnerabilities in safeguarding and making a referral there. I get that we are all busy and rushed off our feet, honestly I do. But it's not about spotting a bomb, it's about spotting a vulnerability early. We do it every day.
August 9, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28783809/macroscopic-t-wave-alternans-a-red-flag-for-code-blue
#4
Peter K Moore, Katie E Raffel, Isaac R Whitman
No abstract text is available yet for this article.
August 7, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28779865/neurological-complications-of-gastrointestinal-disease
#5
Melissa Shapiro, David A Blanco
There is a growing interest in the extraintestinal manifestations of common pediatric gastrointestinal diseases, such as inflammatory bowel disease and celiac disease. This article specifically focuses on the neurological symptoms that manifest because of these disorders and their treatments. Many neurological symptoms have been reported in association with these diseases, including neuropathy, myopathy, ataxia, headache, and seizures, among others. It is currently believed that these neurological symptoms are largely overlooked by practitioners and could be a red flag for earlier diagnosis...
February 2017: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/28768455/occipital-headaches-in-children-are-they-a-red-flag
#6
Jacob Genizi, Amal Khourieh-Matar, Nurit Assaf, Irena Chistyakov, Isaac Srugo
Occipital headache is considered a risk factor for serious secondary headache pathology. The purpose of our study was to assess the etiology of occipital headaches among children visiting the emergency department. Subjects were children aged 5 to 18 years who were referred to the emergency department due to headaches during the years 2013 to 2014. A total of 314 patients with headaches were seen at our emergency department. Thirty-nine patients had occipital headaches. Viral infections were the most prevalent final diagnosis (97; 31%), followed by migraine (37; 11...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28765481/carotid-dissection-presenting-as-a-prolonged-cluster-like-headache-in-a-patient-with-episodic-cluster-headache
#7
Ahmed Mohamed Elhfnawy, László Solymosi, Claudia Sommer
We present a patient with known episodic cluster headache, who presented with cluster-like headache in the course of internal carotid artery dissection (ICAD) and discuss possible pathophysiological links between the two diseases. It is well known that cluster-like headache could be the presenting symptom of ICAD. However, ICAD occurring in a patient with a known episodic cluster headache was only once previously described. In the end of the manuscript, we propose red flags to help clinicians differentiate between primary cluster headache and cluster-like attacks masking underlying ICAD...
July 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28749111/syncope-in-pediatric-patients-a-practical-approach-to-differential-diagnosis-and-management-in-the-emergency-department-digest
#8
Colleen Fant, Ari Cohen, Michelle N Vazquez
Syncope is a condition that is often seen in the emergency department. Most syncope is benign, but it can be a symptom of a life-threatening condition. While syncope often requires an extensive workup in adults, in the pediatric population, critical questioning and simple, noninvasive testing is usually sufficient to exclude significant or life-threatening causes. For low-risk patients, resource-intensive workups are rarely diagnostic, and add significant cost to medical care. This issue will highlight critical diseases that cause syncope, identify high-risk "red flags," and enable the emergency clinician to develop a cost-effective, minimally invasive algorithm for the diagnosis and treatment of pediatric syncope...
April 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28727922/considerations-in-physical-therapy-management-of-a-non-responding-patient-with-low-back-pain
#9
Timothy J Madson
STUDY DESIGN: Case Study. BACKGROUND AND PURPOSE: Low back pain is a common condition managed by physical therapists (PT). Screening tools have been developed to assist the PT with medical screening of patients for serious disease. Sinister pathologies may present as musculoskeletal symptoms during the patient examination. It is important for the PT to frequently reevaluate their patient's response to therapeutic interventions and refer for further evaluation if they are not responding to conservative care...
July 20, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28721976/screening-irritable-bowel-syndrome-patients-for-symptoms-predictive-of-crohn-s-disease-using-the-red-flag-score
#10
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
#11
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
#12
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
#13
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...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28691686/oesophageal-dysphagia-a-stepwise-approach-to-diagnosis-and-management
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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