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Evidence-based physical diagnosis

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https://www.readbyqxmd.com/read/27914903/cognitive-behavioural-therapy-and-short-term-psychoanalytical-psychotherapy-versus-a-brief-psychosocial-intervention-in-adolescents-with-unipolar-major-depressive-disorder-impact-a-multicentre-pragmatic-observer-blind-randomised-controlled-superiority-trial
#1
Ian M Goodyer, Shirley Reynolds, Barbara Barrett, Sarah Byford, Bernadka Dubicka, Jonathan Hill, Fiona Holland, Raphael Kelvin, Nick Midgley, Chris Roberts, Rob Senior, Mary Target, Barry Widmer, Paul Wilkinson, Peter Fonagy
BACKGROUND: Psychological treatments for adolescents with unipolar major depressive disorder are associated with diagnostic remission within 28 weeks in 65-70% of patients. We aimed to assess the medium-term effects and costs of psychological therapies on maintenance of reduced depression symptoms 12 months after treatment. METHODS: We did this multicentre, pragmatic, observer-blind, randomised controlled superiority trial (IMPACT) at 15 National Health Service child and adolescent mental health service (CAMHS) clinics in three regions in England...
November 30, 2016: Lancet Psychiatry
https://www.readbyqxmd.com/read/27911963/teaching-evidence-based-physical-diagnosis-six-bedside-lessons
#2
Steven McGee
Evidence-based physical diagnosis is an essential part of the bedside curriculum. By using the likelihood ratio, a simple measure of diagnostic accuracy, teachers can quickly adapt this approach to their bedside teaching. Six recurring themes in evidence-based physical diagnosis are fully reviewed, with examples, in this article.
December 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27910751/recent-advances-in-pharmacotherapeutic-paradigm-of-mild-to-recalcitrant-atopic-dermatitis
#3
Zahid Hussain, Shariza Sahudin, Hnin Ei Thu, Ahmad Nazrun Shuid, Syed Nasir Abbas Bukhari, Endang Kumolosasi
Atopic dermatitis (AD) is a common, chronic skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin E (IgE), T lymphocytes, and mast cells. The key factors responsible for the pathophysiology of this disease are immunological disorders and defects in epidermal barrier properties. Pruritus, intense itching, psychological stress, deprived physical and mental performance, and sleep disturbance are the hallmark features of this dermatological disorder. Preventive interventions such as educational programs, avoidance of allergens, and exclusive care toward the skin could play a partial role in suppressing the symptoms...
2016: Critical Reviews in Therapeutic Drug Carrier Systems
https://www.readbyqxmd.com/read/27908846/the-effectiveness-of-web-based-asthma-self-management-system-my-asthma-portal-map-a-pilot-randomized-controlled-trial
#4
Sara Ahmed, Pierre Ernst, Susan J Bartlett, Marie-France Valois, Tasneem Zaihra, Guy Paré, Roland Grad, Owis Eilayyan, Robert Perreault, Robyn Tamblyn
BACKGROUND: Whether Web-based technologies can improve disease self-management is uncertain. My Asthma Portal (MAP) is a Web-based self-management support system that couples evidence-based behavioral change components (self-monitoring of symptoms, physical activity, and medication adherence) with real-time monitoring, feedback, and support from a nurse case manager. OBJECTIVE: The aim of this study was to compare the impact of access to a Web-based asthma self-management patient portal linked to a case-management system (MAP) over 6 months compared with usual care on asthma control and quality of life...
December 1, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27881152/fitness-and-mobility-training-in-patients-with-intensive-care-unit-acquired-muscle-weakness-fitonicu-study-protocol-for-a-randomised-controlled-trial
#5
Jan Mehrholz, Simone Thomas, Jane H Burridge, André Schmidt, Bettina Scheffler, Ralph Schellin, Stefan Rückriem, Daniel Meißner, Katja Mehrholz, Wolfgang Sauter, Ulf Bodechtel, Bernhard Elsner
BACKGROUND: Critical illness myopathy (CIM) and polyneuropathy (CIP) are a common complication of critical illness. Both cause intensive-care-unit-acquired (ICU-acquired) muscle weakness (ICUAW) which increases morbidity and delays rehabilitation and recovery of activities of daily living such as walking ability. Focused physical rehabilitation of people with ICUAW is, therefore, of great importance at both an individual and a societal level. A recent systematic Cochrane review found no randomised controlled trials (RCT), and thus no supporting evidence, for physical rehabilitation interventions for people with defined CIP and CIM to improve activities of daily living...
November 24, 2016: Trials
https://www.readbyqxmd.com/read/27866570/the-diagnosis-and-treatment-of-peripheral-arterial-vascular-disease
#6
Holger Lawall, Peter Huppert, Christine Espinola-Klein, Gerhard Rümenapf
BACKGROUND: In peripheral arterial occlusive disease (PAOD), arterial stenosis or occlusion impairs perfusion in the territory of the distal portion of the aorta and the iliac and leg arteries. In Germany, the prevalence of PAOD rises with age, reaching 20% among persons over age 70. METHODS: This guideline was prepared by a collaboration of 22 medical specialty societies and two patient self-help organizations on the basis of pertinent publications that were retrieved by a systematic search in PubMed for articles that appeared from 2008 to April 2014, with a subsequent update to May 2015...
October 28, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/27853950/predicting-employment-in-the-mental-health-treatment-study-do-client-factors-matter
#7
Justin D Metcalfe, Robert E Drake, Gary R Bond
For people with psychiatric disabilities, demographic characteristics and measures of clinical status are often used to allocate scarce employment services. This study examined a battery of potential client predictors of competitive employment, testing the hypothesis that evidence-based supported employment would mitigate the negative effects of poor work history, uncontrolled symptoms, substance abuse, and other client factors. In a secondary analysis of 2055 unemployed Social Security Disability Insurance beneficiaries with schizophrenia or affective disorders, we examined 20 baseline client factors as predictors of competitive employment...
November 16, 2016: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/27851839/diagnosis-treatment-and-clinical-management-of-pulmonary-arterial-hypertension-in-the-contemporary-era-a-review
#8
Bradley A Maron, Nazzareno Galiè
Importance: Pulmonary arterial hypertension (PAH) is characterized by severe remodeling of the distal pulmonary arteries, increased pulmonary vascular resistance, and right ventricular dysfunction that promotes heart failure. Once regarded as largely untreatable, evidence-based decision making now guides clinical management of PAH and improves outcomes. However, misconceptions regarding the approach to PAH in the modern era are common and associated with substandard clinical care. Observations: The clinical profile of PAH has changed substantially since its original description...
November 16, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27835043/risk-factors-for-medial-tibial-stress-syndrome-in-active-individuals-an-evidence-based-review
#9
Zachary K Winkelmann, Dustin Anderson, Kenneth E Games, Lindsey E Eberman
: Reference/Citation: Hamstra-Wright KL, Bliven KC, Bay C. Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis. Br J Sports Med. 2015;49(6)362-369. CLINICAL QUESTION:  What factors put physically active individuals at risk to develop medial tibial stress syndrome (MTSS)? DATA SOURCES:  The authors performed a literature search of CINAHL, the Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE from each database's inception to July 2013...
November 1, 2016: Journal of Athletic Training
https://www.readbyqxmd.com/read/27834472/diagnosis-and-treatment-of-pain-in-plexopathy-radiculopathy-peripheral-neuropathy-and-phantom-limb-pain-evidence-and-recommendations-from-the-italian-consensus-conference-on-pain-on-neurorehabilitation
#10
Francesco Ferraro, Marco Jacopetti, Vincenza Spallone, Luca Padua, Marco Traballesi, Stefano Brunelli, Cristina Cantarella, Cristina Ciotti, Daniele Coraci, Elena Dalla Toffola, Silvia Mandrini, Giovanni Morone, Costanza Pazzaglia, Marcello Romano, Angelo Schenone, Rossella Togni, Stefano Tamburin
Pain may affect all aspects of social life and reduce the quality of life. Neuropathic pain (NP) is common in patients affected by plexopathy, radiculopathy, mononeuropathy, peripheral neuropathy. Phantom limb pain (PLP) is a painful sensation that is common after amputation, and its pathophysiological mechanisms involve changes in the peripheral and central nervous system. Given the lack of conclusive evidence and specific guidelines on these topics, the aim of the Italian Consensus Conference on Pain on Neurorehabilitation (ICCPN) was to collect evidence and offer recommendations to answer currently open questions on the assessment and treatment of NP associated with the above conditions and PLP...
November 11, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27830582/exposure-with-response-prevention-erp-for-body-dissatisfaction-in-a-group-therapy-format-an-exploratory-study
#11
Brad A Mac Neil, Pauline Leung, Vanessa Montemarano
PURPOSE: The aim of this exploratory study was to examine patient satisfaction and outcomes from exposure with response prevention (ERP) delivered in a group therapy format. The group was aimed at addressing eating disorder symptoms associated with body dissatisfaction in the later stages of outpatient treatment. METHODS: 33 adults with a DSM-5 diagnosis of an eating disorder participated in the ERP group. Participants completed pre- and post-ERP group measures of depression, anxiety, self-evaluation based on body image, restraint, eating concern, weight concern, shape concern, upward and downward appearance comparisons, and patient satisfaction...
November 9, 2016: Eating and Weight Disorders: EWD
https://www.readbyqxmd.com/read/27826450/dachslife-2015-an-investigation-of-lifestyle-associations-with-the-risk-of-intervertebral-disc-disease-in-dachshunds
#12
R M A Packer, I J Seath, D G O'Neill, S De Decker, H A Volk
BACKGROUND: Intervertebral disc disease (IVDD) represents a major problem in the Dachshund, with at a relative risk of IVDD 10-12 times higher than other breeds, and an estimated 19-24 % of Dachshunds showing clinical signs related to IVDD during their lifetime. A variety of genetic, physical and lifestyle-related risk factors for IVDD have previously been identified, with some conflicting findings. As such, advising owners and breeders regarding best-practice for IVDD prevention is challenging at present...
2016: Canine Genetics and Epidemiology
https://www.readbyqxmd.com/read/27809571/internet-gaming-disorder-investigating-the-clinical-relevance-of-a-new-phenomenon
#13
Andrew K Przybylski, Netta Weinstein, Kou Murayama
OBJECTIVE: The American Psychiatric Association (APA) identified Internet gaming disorder as a new potential psychiatric disorder and has recognized that little is known about the prevalence, validity, or cross-cultural robustness of proposed Internet gaming disorder criteria. In response to this gap in our understanding, the present study, a first for this research topic, estimated the period prevalence of this new potential psychiatric disorder using APA guidance, examined the validity of its proposed indicators, evaluated reliability cross-culturally and across genders, compared it to gold-standard research on gambling addiction and problem gaming, and estimated its impact on physical, social, and mental health...
November 4, 2016: American Journal of Psychiatry
https://www.readbyqxmd.com/read/27806447/a-general-practice-approach-to-bell-s-palsy
#14
Nga T Phan, Benedict Panizza, Benjamin Wallwork
BACKGROUND: Bell's palsy is characterised by an acute onset of unilateral, lower motor neuron weakness of the facial nerve in the absence of an identifiable cause. Establishing the correct diagnosis is imperative and choosing the correct treatment options can optimise the likelihood of recovery. OBJECTIVE: This article summarises our understanding of Bell's palsy and the evidence-based management options available for adult patients. DISCUSSION: The basic assessment should include a thorough history and physical examination as the diagnosis of Bell's palsy is based on exclusion...
November 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27797546/uncontrolled-pilot-study-of-an-acceptance-and-commitment-therapy-and-health-at-every-size-intervention-for-obese-depressed-women-accept-yourself
#15
Margit I Berman, Stephanie N Morton, Mark T Hegel
Depression and obesity frequently co-occur, but providing adequate treatment to depressed obese women is challenging because existing treatments for each problem in isolation are suboptimal, and treatments to address one problem may exacerbate the other. This study used an uncontrolled, pretreatment-to-posttreatment design, with 3-month follow-up, to evaluate the feasibility and outcome of a novel, self-acceptance-based treatment for obese women with depression, "Accept Yourself!" Accept Yourself! is an 11-week manualized, group-based intervention that integrates Health At Every Size (an evidence-based paradigm to enhance physical health) and Acceptance and Commitment Therapy (an evidence-based psychotherapy often used to treat depression and eating-related concerns) to improve the physical and mental health of obese, depressed women without encouraging weight loss...
October 31, 2016: Psychotherapy
https://www.readbyqxmd.com/read/27797235/potential-risk-factors-for-breast-cancer-in-pakistani-women
#16
Raisa Bano, Muhammad Ismail, Aamer Nadeem, Mohammad Haroon Khan, Hamid Rashid
BACKGROUND: Breast cancer is the most common female malignancy worldwide and its incidence is on the rise in Pakistan. The aim of this case-control study was to quantify the association of various risk factors with breast cancer risk among Pakistani women. MATERIALS AND METHODS: A total of 2,246 women were studied, including 1,238 women with histologically confirmed breast cancer patients and age matched control subjects (N=1008) without breast cancer and other chronic diseases...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/27789117/acute-ataxia-in-children-a-review-of-the-differential-diagnosis-and-evaluation-in-the-emergency-department
#17
REVIEW
Mauro Caffarelli, Amir A Kimia, Alcy R Torres
Acute ataxia in a pediatric patient poses a diagnostic dilemma for any physician. While the most common etiologies are benign, occasional individuals require urgent intervention. Children with stroke, toxic ingestion, infection, and neuro-inflammatory disorders frequently exhibit ataxia as an essential-if not the only-presenting feature. The available retrospective research utilize inconsistent definitions of acute ataxia, precluding the ability to pool data from these studies. No prospective data exist that report on patients presenting to the emergency department with ataxia...
December 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27760597/-clinicopathologic-characteristics-of-the-patients-in-the-elderly-lung-carcinoma
#18
Jie Chen, Xuezhi Hao, Fang Cheng, Tongtong Zhang, Puyuan Xing, Junling Li
BACKGROUND: As the prevalence of tobacco and the aging of the population, the incidence of lung cancer in the elderly rises. However, few elderly patients (older than 70 years old) with lung squamous cell carcinoma were involved into the clinical trials, which offered insufficient clinical evidence for these patients. Lung squamous cell carcinoma patients older than 80 years old were included in our study to analyze the clinical characteristics, treatment and prognostic factors, and to explore the optimal treatment choices for these patients...
October 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/27757283/diagnostic-imaging-in-a-direct-access-sports-physical-therapy-clinic-a-2-year-retrospective-practice-analysis
#19
Michael S Crowell, Erik A Dedekam, Michael R Johnson, Scott C Dembowski, Richard B Westrick, Donald L Goss
BACKGROUND: While advanced diagnostic imaging is a large contributor to the growth in health care costs, direct-access to physical therapy is associated with decreased rates of diagnostic imaging. No study has systematically evaluated with evidence-based criteria the appropriateness of advanced diagnostic imaging, including magnetic resonance imaging (MRI), when ordered by physical therapists. The primary purpose of this study was to describe the appropriateness of magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA) exams ordered by physical therapists in a direct-access sports physical therapy clinic...
October 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27754180/ed-08-4-diagnosis-and-treatment-of-hypertensive-emergency-in-children
#20
Lin Shi
According to the seventh report of Joint National Committee (JNC 7), hypertensive emergency (HE), a kind of hypertensive crisis, is defined as a sudden and abrupt elevation in blood pressure so as to cause acute target organ dysfunctions, including central nervous system, cardiovascular system or kidneys. Patients with HE require immediate reduction in markedly elevated blood pressure. Currently, there are no international guidelines for children HE, so the JNC definition is commonly used. Hypertensive emergency in children is rare but a life-threatening emergency...
September 2016: Journal of Hypertension
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