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Evidence-based physical diagnosis

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https://www.readbyqxmd.com/read/29764746/appropriateness-and-clinical-outcome-of-chest-computed-tomography-without-intravenous-contrast-a-study-conducted-in-pakistan
#1
Amjad Sattar, Sohail Ahmed Khan, Nauman Al-Qamari, Hatem Adel, Syed Omair Adil, Kashif Shafique
BACKGROUND: Chest computed tomography (CT), including high-resolution CT (HRCT), has become an integral part of modern healthcare. It enables the physician to arrive at a diagnosis using a noninvasive approach. Our practice has shown that various chest CT scans without intravenous (IV) contrast, including HRCT, have no proper clinical indication. For the same reason, we have assessed the appropriateness of chest CT without IV contrast based on the evidence-based American College of Radiology (ACR) appropriateness criteria...
March 28, 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29757454/non-pharmacological-interventions-for-treating-chronic-prostatitis-chronic-pelvic-pain-syndrome
#2
REVIEW
Juan Va Franco, Tarek Turk, Jae Hung Jung, Yu-Tian Xiao, Stanislav Iakhno, Virginia Garrote, Valeria Vietto
BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder in which the two main clinical features are pelvic pain and lower urinary tract symptoms. There are currently many approaches for its management, using both pharmacological and non-pharmacological interventions. The National Institute of Health - Chronic Prostatitis Symptom Index (NIH-CPSI) score is a validated measure commonly used to measure CP/CPPS symptoms. OBJECTIVES: To assess the effects of non-pharmacological therapies for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)...
May 12, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29748162/cocreated-smartphone-app-to-improve-the-quality-of-life-of-adolescents-and-young-adults-with-cancer-kr%C3%A3-ftv%C3%A3-rket-protocol-for-a-quantitative-and-qualitative-evaluation
#3
Abbey Elsbernd, Maiken Hjerming, Camilla Visler, Lisa Lyngsie Hjalgrim, Carsten Utoft Niemann, Kirsten Boisen, Helle Pappot
BACKGROUND: Adolescents and young adults with cancer face significant challenges during the course of their medical treatment and recovery from illness. Many adolescents and young adults struggle with long-term complications in the physical, psychosocial, economic, and academic domains. Mobile health (mHealth) interventions provide an innovative platform for delivering supportive care, particularly through the utilization of apps on smartphones and tablets. To create a successful mHealth intervention for adolescents and young adults, youth input and feedback is essential...
May 10, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29739303/the-utilization-of-formal-physical-therapy-after-shoulder-arthroplasty
#4
Eric R Wagner, Muriel J Solberg, Laurence D Higgins
Study Design Epidemiological retrospective database study. Background It is widely believed that structured rehabilitation programs by professional therapists help guide patients through the various recovery periods after shoulder arthroplasty, speeding up their recovery and improving their final functional gains. However, to our knowledge, there are no studies providing information about the current state of physical rehabilitation use after shoulder arthroplasty. Objectives Describe the variation in physical rehabilitation utilization after total and reverse total shoulder arthroplasty and identify differences in utilization based on type of insurance (private versus public), gender, age, region of the country, and type of replacement...
May 8, 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29732601/longitudinal-ultrasound-curriculum-incorporation-at-west-virginia-university-school-of-medicine-a-description-and-graduating-students-perceptions
#5
Joseph Minardi, Holly Ressetar, Theresa Foreman, Kristen Craig, Melinda Sharon, John Bassler, Stephen Davis, Anthony Machi, Scott Cottrell, Nicolas Denne, Norman Ferrari, Kenneth Landreth, Bruce Palmer, Gregory Schaefer, Robert Tallaksen, David Wilks, Dorian Williams
OBJECTIVES: Sonography is a clinical tool being incorporated in multiple medical specialties with evidence of improved patient care and cost. Some schools have begun implementing ultrasound curricula. We hope to build upon that foundation and provide another potential framework of incorporation. There are several barriers, including curricular space, equipment and physical space, adequate faculty, and performing assessment. METHODS: At West Virginia University, we began a longitudinal ultrasound curriculum in 2012 with incorporation of didactic and practical sessions into gross anatomy, our systems-based second-year curriculum, physical diagnosis course, and clinical rotations...
May 6, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29730605/physical-activity-and-asthma-cause-or-consequence-a-bidirectional-longitudinal-analysis
#6
Raisa Cassim, Elasma Milanzi, Jennifer J Koplin, Shyamali C Dharmage, Melissa Anne Russell
BACKGROUND: There is increasing interest in the role physical activity (PA) can play in the development and management of asthma. Understanding whether PA can have a positive effect is hindered by the potential influence of asthma on PA and a lack of relevant longitudinal data, leading to a debate on the existence and direction of these links. The aim of this study was to explore whether having asthma results in lower PA levels, and/or whether lower PA levels lead to more asthma in children and adolescents...
May 5, 2018: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/29729099/an-evidence-based-approach-to-assessing-surgical-versus-clinical-diagnosis-of-symptomatic-endometriosis
#7
REVIEW
Hugh S Taylor, G David Adamson, Michael P Diamond, Steven R Goldstein, Andrew W Horne, Stacey A Missmer, Michael C Snabes, Eric Surrey, Robert N Taylor
Challenges intrinsic to the accurate diagnosis of endometriosis contribute to an extended delay between the onset of symptoms and clinical confirmation. Intraoperative visualization, preferably with histologic verification, is considered by many professional organizations to be the gold standard by which endometriosis is diagnosed. Clinical diagnosis of symptomatic endometriosis via patient history, physical examination, and noninvasive tests is easy to perform but generally viewed as less accurate than surgical diagnosis...
May 5, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29719431/connecting-people-with-cancer-to-physical-activity-and-exercise-programs-a-pathway-to-create-accessibility-and-engagement
#8
D Santa Mina, C M Sabiston, D Au, A J Fong, L C Capozzi, D Langelier, M Chasen, J Chiarotto, J R Tomasone, J M Jones, E Chang, S N Culos-Reed
Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks ("pathways") that connect patients with exercise-related resources...
April 2018: Current Oncology
https://www.readbyqxmd.com/read/29718836/gallbladder-perforation-in-a-patient-with-alcoholic-liver-cirrhosis-and-asymptomatic-gallstones-a-case-report
#9
Xiaoju Shi, Shuo Jin, Siyuan Wang, Weijie Tao, Guangyi Wang
RATIONALE: Gallbladder perforation is a relatively uncommon complication of alcoholic liver cirrhosis and may happen with or without gallstones. PATIENT CONCERNS: Here we report a 52-year-old male patient who was diagnosed as gallbladder perforation with chronic liver cirrhosis and asymptomatic gallstones. The patient was admitted with acute and severe abdominal pain during weight-bearing physical labor. He had a history of alcoholic liver cirrhosis but no chronic abdominal pain or gallstones...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29709879/change-in-illness-perception-is-associated-with-short-term-seizure-burden-outcome-following-video-eeg-confirmation-of-psychogenic-nonepileptic-seizures
#10
David K Chen, Shirine Majmudar, Aarthi Ram, Holly C Rutherford, Melissa Fadipe, Callie B Dunn, Robert L Collins
OBJECTIVES: We aimed to evaluate whether potential changes in the patient's illness perception can significantly influence short-term seizure burden following video-electroencephalography (EEG) confirmation/explanation of psychogenic nonepileptic seizures (PNES). METHODS: Patients with PNES were dichotomized to two groups based on a five-point Symptom Attribution Scale: (a) those who prior to diagnosis perceived their seizures to be solely ("5") or mainly ("4") physical in origin (physical group) and (b) the remainder of patients with PNES (psychological group)...
April 27, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29706091/behavioral-awareness-in-the-feline-consultation-understanding-physical-and-emotional-health
#11
Debra F Horwitz, Ilona Rodan
Practical relevance: Awareness of the strong connection between observed behavior and physical and emotional health is essential for patient welfare. It is often a change in the individual's normal behavior that informs owners and veterinarians of the possibility of illness, pain and stress/distress. There is ample evidence in the feline literature that medical and behavioral health go hand in hand. In most feline cases, medical and behavioral conditions contribute concurrently to clinical signs. Clinical challenges: Our domestic cats do not express change in physiological and emotional states in a way that is easily recognized...
May 2018: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29695526/approach-to-diagnosis-of-cardiovascular-implantable-electronic-device-infection
#12
Daniel C DeSimone, M Rizwan Sohail
Device infection remains a significant challenge as clinical indications for cardiovascular implantable electronic devices (CIED) therapy continue to expand beyond prevention and treatment of cardiac arrhythmias. Patients receiving CIED therapy are now older with significant comorbidities, placing them at higher risk of complications including infection. CIED infection warrants complete device removal as retention is associated with unacceptably high risk of relapse and increased mortality. However, accurate diagnosis of CIED infections remains a significant challenge and is based on a combination of findings on physical examination, microbiological and laboratory testing, and advanced imaging such as transesophageal echocardiography or positron emission tomography...
April 25, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29688639/-children-with-attention-deficit-hyperactivity-disorder-adhd-clinical-activity-in-israel
#13
Yuval Bloch
This editorial relates to the study published in the current issue on how our current knowledge is practiced in screening, diagnosing and treating children suffering from ADHD in Israel. It seems that there is an awareness of the disorder by parents and teachers, thus there is no need for community screening. The roles of the different medical professions: pediatricians (after receiving training on ADHD), child neurologists and child psychiatrists are not clear enough and thus services are not utilized properly...
April 2018: Harefuah
https://www.readbyqxmd.com/read/29685474/the-evaluation-and-management-of-rocky-mountain-spotted-fever-in-the-emergency-department-a-review-of-the-literature
#14
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Rocky Mountain spotted fever (RMSF) is potentially deadly and can present subtly with signs and symptoms overlapping with other clinical conditions. Delayed diagnosis can be fatal. OBJECTIVE: This review provides an evidence-based summary of the current data for the evaluation and management of RMSF in the emergency department. DISCUSSION: RMSF occurs through transmission of Rickettsia rickettsii by an infected tick. Exposure in the United States occurs most commonly from April to September, and high-risk locations include wooded, shrubby, or grassy areas...
April 20, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29676493/the-physical-environment-and-patients-activities-and-care-a-comparative-case-study-at-three-newly-built-stroke-units
#15
Anna Anåker, Lena Von Koch, Christina Sjöstrand, Ann Heylighen, Marie Elf
AIM: To explore and compare the impact of the physical environment on patients' activities and care at three newly built stroke units. BACKGROUND: Receiving care in a stroke unit instead of in a general ward reduces the odds of death, dependency and institutionalized care. In stroke units, the design of the physical environment should support evidence-based care. Studies on patients' activities in relation to the design of the physical environment of stroke units are scarce...
April 20, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29668832/changes-in-physical-activity-behavior-and-c-reactive-protein-in-breast-cancer-patients
#16
Catherine M Sabiston, Carsten Wrosch, Andrée L Castonguay, Benjamin D Sylvester
Background: C-reactive protein (CRP) concentrations are associated with morbidity and mortality in breast cancer patients and moderate-vigorous physical activity (MVPA) may help regulate CRP levels. Purpose: The purpose of this prospective study was to examine intraindividual and interindividual changes in MVPA on changes in CRP levels among early posttreatment breast cancer patients. Methods: During five data collections over the first year posttreatment for breast cancer, women (N = 138, Mage = 55...
April 12, 2018: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
https://www.readbyqxmd.com/read/29667850/a-survey-of-fellowship-trained-upper-extremity-surgeons-on-treatment-of-lateral-epicondylitis
#17
Steven R Niedermeier, Nisha Crouser, Amy Speeckaert, Kanu S Goyal
BACKGROUND: The aim of the study is to investigate current management strategies for lateral epicondylitis by fellowship-trained upper extremity surgeons. METHODS: A 17-question survey of treatment approaches and outcomes related to lateral epicondylitis was sent to 3354 surgeons using the American Society for Surgery of the Hand and American Shoulder and Elbow Surgeons member databases. RESULTS: Six hundred twelve upper extremity surgeons completed the survey...
April 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29664187/exercise-interventions-and-patient-beliefs-for-people-with-hip-knee-or-hip-and-knee-osteoarthritis-a-mixed-methods-review
#18
REVIEW
Michael Hurley, Kelly Dickson, Rachel Hallett, Robert Grant, Hanan Hauari, Nicola Walsh, Claire Stansfield, Sandy Oliver
BACKGROUND: Chronic peripheral joint pain due to osteoarthritis (OA) is extremely prevalent and a major cause of physical dysfunction and psychosocial distress. Exercise is recommended to reduce joint pain and improve physical function, but the effect of exercise on psychosocial function (health beliefs, depression, anxiety and quality of life) in this population is unknown. OBJECTIVES: To improve our understanding of the complex inter-relationship between pain, psychosocial effects, physical function and exercise...
April 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29650765/prospective-cardiovascular-genetics-evaluation-in-spontaneous-coronary-artery-dissection
#19
M Ihsan Kaadan, Carolyn MacDonald, Francesca Ponzini, Jessica Duran, Kelsey Newell, Linda Pitler, Angela Lin, Ido Weinberg, Malissa J Wood, Mark E Lindsay
BACKGROUND: Previous studies describing genetics evaluation in spontaneous coronary artery dissection (SCAD) have been retrospective in nature or presented as single case reports. As part of a dedicated clinical program, we evaluated patients in cardiovascular genetics clinic to determine the role of genetically triggered vascular disease and genetic testing in SCAD. METHODS AND RESULTS: Patient data were entered prospectively into the Massachusetts General Hospital SCAD registry database from July 2013 to September 2017...
April 2018: Circulation. Genomic and precision medicine
https://www.readbyqxmd.com/read/29650740/managing-complexity-in-care-of-patients-with-intellectual-and-developmental-disabilities-natural-fit-for-the-family-physician-as-an-expert-generalist
#20
REVIEW
Elizabeth Grier, Dara Abells, Ian Casson, Meg Gemmill, Jessica Ladouceur, Amanda Lepp, Ullanda Niel, Samantha Sacks, Kyle Sue
OBJECTIVE: To delineate the factors inherent in caring for patients with intellectual and developmental disabilities (IDD) that lead to complexity and to provide perspectives and techniques mapped to the phases of the clinical encounter. SOURCES OF INFORMATION: The authors of the physical health section of the 2018 Canadian consensus guidelines on the primary care of adults with IDD consisted of family physicians, all of whom practise comprehensive family medicine with additional clinical experience in care of adults with IDD...
April 2018: Canadian Family Physician Médecin de Famille Canadien
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