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Evidence-based physical diagnosis

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https://www.readbyqxmd.com/read/29331152/functioning-before-and-after-a-major-depressive-episode-pre-existing-vulnerability-or-scar-a-prospective-three-wave-population-based-study
#1
E H Bos, M Ten Have, S van Dorsselaer, B F Jeronimus, R de Graaf, P de Jonge
BACKGROUND: The vulnerability hypothesis suggests that impairments after remission of depressive episodes reflect a pre-existing vulnerability, while the scar hypothesis proposes that depression leaves residual impairments that confer risk of subsequent episodes. We prospectively examined vulnerability and scar effects in mental and physical functioning in a representative Dutch population sample. METHODS: Three waves were used from the Netherlands Mental Health Survey and Incidence Study-2, a population-based study with a 6-years follow-up...
January 14, 2018: Psychological Medicine
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#2
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29324620/diagnosis-and-treatment-of-vulvar-dermatoses
#3
Colleen K Stockdale, Lori Boardman
Vulvar symptoms of pain, dyspareunia, and pruritus are common and may significantly affect a woman's sense of well-being and sexual function. Despite this, vulvar symptoms are often underreported by women. When identified, however, vulvovaginal symptoms should be addressed by health care providers to optimize care. The evaluation of patients with vulvovaginal complaints begins with a thorough history and physical examination. Biopsy is indicated when concern exists for malignancy or the diagnosis is uncertain...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29324562/effectiveness-of-interventions-to-prevent-pre-frailty-and-frailty-progression-in-older-adults-a-systematic-review
#4
João Apóstolo, Richard Cooke, Elzbieta Bobrowicz-Campos, Silvina Santana, Maura Marcucci, Antonio Cano, Miriam Vollenbroek-Hutten, Federico Germini, Barbara D'Avanzo, Holly Gwyther, Carol Holland
OBJECTIVE: To summarize the best available evidence regarding the effectiveness of interventions for preventing frailty progression in older adults. INTRODUCTION: Frailty is an age-related state of decreased physiological reserves characterized by an increased risk of poor clinical outcomes. Evidence supporting the malleability of frailty, its prevention and treatment, has been presented. INCLUSION CRITERIA: The review considered studies on older adults aged 65 and over, explicitly identified as pre-frail or frail, who had been undergoing interventions focusing on the prevention of frailty progression...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29318625/consensus-document-on-dog-and-cat-allergy
#5
REVIEW
Ignacio Davila, Javier Domínguez-Ortega, Ana Mª Navarro Pulido, Alicia Alonso, Dario Antolin-Amerigo, Eloina González-Mancebo, Cristina Martin Garcia, Beatriz Nuñez-Acevedo, Nieves Prior, Marta Reche, Ana Rosado, Javier Ruiz-Hornillos, María Cesárea Sánchez, Miguel Torrecillas
The prevalence of sensitisation to dogs and cats varies by country, exposure time and predisposition to atopy. It is estimated that, 26% of European adults coming to the clinic for suspected allergy to inhalant allergens are sensitised to cats and 27% to dogs. This document is intended to be a useful tool for clinicians involved in the management of people with dog or cat allergy. It was prepared from a consensus process based on the RAND/UCLA method. Following a literature review, it proposes various recommendations concerning the diagnosis and treatment of these patients, grounded in evidence and clinical experience...
January 10, 2018: Allergy
https://www.readbyqxmd.com/read/29307223/-diagnosis-and-management-of-blunt-pancreatic-trauma
#6
Dániel Kollár, F Tamás Molnár, Péter Zsoldos, Attila Oláh
The management of thoracic and abdominal organ injuries has very thorough and extensive literature, including evidence-based protocols. Pancreatic trauma stands as an exception. Blunt or penetrating trauma of the pancreas is rather rare (less than 2% of all trauma cases, approximately 3-12% of all abdominal trauma), leading to the lack of high-level evidences regarding its treatment. Damage of the pancreas parenchyma can cause substantial morbidity and mortality, therefore it is essential to separate cases where conservative treatment suffices from those that need surgical approach...
January 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29298169/premenstrual-syndrome-evidence-based-evaluation-and-treatment
#7
Sarah M Appleton
Premenstrual dysphoric disorder (PMDD) is defined by both physical and psychiatric symptoms that impact a woman significantly during the luteal phase of her menstrual cycle. Diagnostic criteria for PMDD were firmly established in the Diagnostic and Statistical Manual of Mental Disorders V in 2013, but many patients fall short of the diagnosis while still appreciably affected by severe premenstrual symptoms. More recent and robust investigations have evaluated the efficacy of treatment ranging from serotonergic therapy to hormonal treatment as well as lifestyle and herbal remedies...
January 2, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29297205/cyclophosphamide-for-connective-tissue-disease-associated-interstitial-lung-disease
#8
REVIEW
Hayley Barnes, Anne E Holland, Glen P Westall, Nicole Sl Goh, Ian N Glaspole
BACKGROUND: Approximately one-third of individuals with interstitial lung disease (ILD) have associated connective tissue disease (CTD). The connective tissue disorders most commonly associated with ILD include scleroderma/systemic sclerosis (SSc), rheumatoid arthritis, polymyositis/dermatomyositis, and Sjögren's syndrome. Although many people with CTD-ILD do not develop progressive lung disease, a significant proportion do progress, leading to reduced physical function, decreased quality of life, and death...
January 3, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29286825/is-treatment-of-segond-fracture-necessary-with-combined-anterior-cruciate-ligament-reconstruction
#9
Heath P Melugin, Nick R Johnson, Isabella T Wu, Bruce A Levy, Michael J Stuart, Aaron J Krych
BACKGROUND: There is a paucity of clinical information to guide the treatment of a combined anterior cruciate ligament (ACL) tear and Segond fracture. PURPOSE: To compare clinical outcomes, graft failure rates, and activity levels between patients undergoing ACL reconstruction (ACLR) with and without an untreated Segond fracture at a minimum 2-year follow-up. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This study included a group of patients with a combined ACL tear/untreated Segond fracture that was matched based on age, sex, body mass index, and graft type to a control group of patients with an ACL tear and no Segond fracture...
December 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29277396/botulism-in-the-icu-nursing-care-plan
#10
G Zariquiey-Esteva, D Galeote-Cózar, P Santa-Candela, A Castanera-Duro
INTRODUCTION AND CASE EVALUATION: Botulism is a rare disease in Europe, caused by the bacterium Clostridium botulinum, notifiable, non-transmissible person-to-person and potentially fatal (between 5 and 10%) if not treated quickly. The favourable opinion of the Clinical Research Ethics Committee was obtained. We present the nursing care plan of a 49-year-old man with a diagnosis of bacterial intoxication caused by Clostridium botulinum, secondary to ingestion of beans in poor condition, who was admitted to the ICU for a total of 35 days...
December 22, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/29260023/definition-prevalence-and-predictive-factors-of-benign-multiple-sclerosis
#11
REVIEW
Tatjana Reynders, Miguel D'haeseleer, Jacques De Keyser, Guy Nagels, Marie B D'hooghe
Background: Multiple sclerosis (MS) is characterized by a great inter-individual variability in disease course and severity. Some patients experience a rather mild course, controversially called 'benign MS' (BMS). The usefulness of this entity in clinical practice remains unclear. Methods: We performed a literature search in PubMed, Web of Science and Cochrane Library databases from November 1980 to December 2015, using the following key words: benign multiple sclerosis, diagnosis, imaging, prognosis, predictive, natural history and predefined inclusion criteria...
June 2017: ENeurologicalSci
https://www.readbyqxmd.com/read/29246778/computed-tomography-whirl-sign-an-image-based-indication-for-surgery
#12
C Hobeika, I Anzoua Kouakou, C Eveno
Adhesive closed-loop small bowel obstruction can lead to volvulus and ischemia with risk of necrosis. The vital prognosis and bowel viability are highly dependent on rapid management. The physical examination is often insufficient to establish the diagnosis and computed tomography is ordered. The whirl sign provides the best imaging evidence of volvulus and can be sufficient to establish the indication for surgery.
December 12, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29240324/current-care-guideline-heart-failure
#13
(no author information available yet)
Treatment of heart failure depends on etiology, left ventricular function and severity of symptoms. Appropriate diagnosis and treatment requires close collaboration between health care providers. In heart failure with reduced ejection fraction, pharmacological treatment and device therapies are based on solid scientific evidence. Less data exist on treatment of heart failure with preserved ejection fraction, where management of underlying diseases contributing to the syndrome is the primary goal. Patient education and self-care may reduce the need for hospitalizations and improve quality of life...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29228823/current-practice-in-the-rehabilitation-of-complex-regional-pain-syndrome-a-survey-of-practitioners
#14
Caroline Miller, Mark Williams, Peter Heine, Esther Williamson, Neil O'connell
INTRODUCTION: International clinical guidelines for Complex Regional Pain Syndrome recommend a wide range and variation of rehabilitation therapies as the core treatment. It is likely that most therapists employ a range of approaches when managing people with Complex Regional Pain Syndrome but a recent Cochrane review identified little evidence relating to the effectiveness of multi-modal rehabilitation. There is need for up to date trials of rehabilitation for Complex Regional Pain Syndrome, but in order to develop a clear model of best practice that can be rigorously evaluated we need to understand current practice...
December 11, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29226163/diagnostic-accuracy-of-3-physical-examination-tests-in-the-assessment-of-hip-microinstability
#15
Daniel J Hoppe, Jeremy N Truntzer, Lauren M Shapiro, Geoffrey D Abrams, Marc R Safran
Background: Hip microinstability is a diagnosis gaining increasing interest. Physical examination tests to identify microinstability have not been objectively investigated using intraoperative confirmation of instability as a reference standard. Purpose: To determine the test characteristics and diagnostic accuracy of 3 physical examination maneuvers in the detection of hip microinstability. Study Design: Cohort study (diagnosis); Level of evidence, 2...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29220065/clinical-profile-of-patients-with-psychogenic-non-epileptic-seizures-in-puerto-rico
#16
Joashlie M Méndez-Ruiz, Alfonso Martínez-Taboas, Yeira M Valdez-Pimentel, Miguel Torres-Narváez, Marianette Colón-Laboy, Gisela G Jiménez-Colón, José Rodríguez-Gómez, Christian J González-Jiménez
OBJECTIVE: Specialized epilepsy clinics receive many cases (20%-30% of total cases) in which the patients are diagnosed with psychogenic non-epileptic seizures (PNES). In Puerto Rico, there has been a lack of research on and data about patients with PNES. This study examined the clinical profile of 34 patients with a confirmed diagnosis of PNES. METHODS: A secondary analysis of 34 clinical records of patients with PNES was conducted. The resulting profile was based on clinical interviews, the behavioral presentation of seizures, the history of traumatic experiences or abuse, and the relationship between PNES events and life stressors...
December 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/29212431/a-three-year-national-follow-up-study-on-the-development-of-community-level-cancer-rehabilitation-in-denmark
#17
Maria Kristiansen, Lis Adamsen, Karin Piil, Ida Halvorsen, Nanna Nyholm, Carsten Hendriksen
AIMS: Scandinavian cancer care policies emphasise community-level rehabilitation services, but little is known about changes in service provision over time. This follow-up study explores development in these services in Danish municipalities, focusing on availability, utilisation and organisation of services, including existing opportunities and challenges. METHODS: A national survey among all 98 Danish municipalities was conducted in 2013 (baseline) and repeated in 2016 (follow-up)...
December 1, 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/29210329/a-concise-evidence-based-physical-examination-for-diagnosis-of-acromioclavicular-joint-pathology-a-systematic-review
#18
Michael K Krill, Samuel Rosas, KiHyun Kwon, Andrew Dakkak, Benedict U Nwachukwu, Frank McCormick
OBJECTIVES: The clinical examination of the shoulder joint is an undervalued diagnostic tool for evaluating acromioclavicular joint (AC) joint pathology. Applying evidence-based clinical tests enables providers to make an accurate diagnosis and minimize costly imaging procedures and potential delays in care. The purpose of this study was to create a decision tree analysis enabling simple and accurate diagnosis of AC joint pathology. METHODS: A systematic review of the Medline, Ovid and Cochrane Review databases was performed to identify level one and two diagnostic studies evaluating clinical tests for AC joint pathology...
December 6, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/29202926/impingement-syndrome-of-the-shoulder
#19
Christina Garving, Sascha Jakob, Isabel Bauer, Rudolph Nadjar, Ulrich H Brunner
BACKGROUND: Shoulder pain is the third most common musculoskeletal complaint in orthopedic practice. It is usually due to a defect of the rotator cuff and/or an impingement syndrome. METHODS: This review is based on pertinent literature retrieved by a selective search of the Medline database. RESULTS: Patients with shoulder impingement syndrome suffer from painful entrapment of soft tissue whenever they elevate the arm. The pathological mechanism is a structural narrowing in the subacromial space...
November 10, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29202860/a-giant-popliteal-lipoblastoma-in-a-23-month-old-girl-a-case-report
#20
Shogo Hashimoto, Kazutaka Kikuta, Tetsuya Sekita, Robert Nakayama, Shinichiro Takayama, Aya Sasaki, Kaori Kameyama, Masaya Nakamura, Morio Matsumoto, Hideo Morioka
BACKGROUND: Lipoblastomas are rare benign tumors that arise from embryonic white fat and almost always occur in babies and children. Here, we report a case of a giant popliteal lipoblastoma in a 23-month-old Japanese girl that was successfully treated via complete resection. CASE PRESENTATION: Our patient was a 23-month-old Japanese girl. At 6 months of age, she presented at a nearby hospital with a mass on the popliteal side of her lower right leg. She had no symptoms and was diagnosed as having a benign adipose tumor via magnetic resonance imaging...
December 5, 2017: Journal of Medical Case Reports
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