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Evidence-based physical diagnosis

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https://www.readbyqxmd.com/read/28912993/bilateral-peritonsillar-abscess-in-an-infant-an-unusual-presentation-of-sore-throat
#1
Mariana Manzoni Seerig, Letícia Chueiri, Janaina Jacques, Maria Fernanda Piccoli Cardoso de Mello, Martin Batista Coutinho da Silva, Daniel Buffon Zatt, Rosana Cristine Otero Cunha, Andre Souza de Albuquerque Maranhão
INTRODUCTION: Peritonsillar abscess is considered a suppurative complication of acute tonsillitis. It is usually unilateral and clinically evident bilateral presentation is uncommon. The condition affects mainly children older than 10 years and young adults. Herein we present a rare case of bilateral peritonsillar abscess in an infant. PRESENTATION OF CASE: A 1-year-old boy presented with a two-day history of worsening sore throat, loss of appetite, vomiting, and fever...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28906340/contemporary-approach-to-joint-hypermobility-and-related-disorders
#2
Marco Castori, Alan Hakim
PURPOSE OF REVIEW: Joint hypermobility is a common, although largely ignored physical sign. Joint hypermobility is often asymptomatic but may be a feature of an underlying genetic disorder with systemic manifestations. The present article presents a comprehensive approach to considering joint hypermobility and clinically related issues in children and adults. RECENT FINDINGS: Ehlers-Danlos syndrome (EDS) is an umbrella term for various Mendelian connective tissue disorders sharing joint hypermobility, skin hyperextensibility, and tissue fragility...
September 12, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28891406/clinical-practice-guideline-evaluation-of-the-neck-mass-in-adults
#3
Melissa A Pynnonen, M Boyd Gillespie, Benjamin Roman, Richard M Rosenfeld, David E Tunkel, Laura Bontempo, Itzhak Brook, Davoren Ann Chick, Maria Colandrea, Sandra A Finestone, Jason C Fowler, Christopher C Griffith, Zeb Henson, Corinna Levine, Vikas Mehta, Andrew Salama, Joseph Scharpf, Deborah R Shatzkes, Wendy B Stern, Jay S Youngerman, Maureen D Corrigan
Objective Neck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise...
September 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28890877/pulmonary-hypertension-diagnosis-imaging-techniques-and-novel-therapies
#4
REVIEW
Alan B Goldberg, Wojciech Mazur, Dinesh K Kalra
Pulmonary hypertension (PH), defined as the elevation of mean pulmonary arterial pressure (mPAP) above 25 mmHg, has numerous causes, which the World Health Organization (WHO) has divided into five distinct categories based upon the underlying mechanism of action. This review will explore the pathophysiology, diagnostic testing, and treatment of PH. Identification of PH depends on a strong clinical suspicion, a detailed history, and a thorough physical exam. We review the evidence supporting experimental and clinical laboratory parameters for diagnosis and monitoring of PH...
August 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28886416/long-term-exposure-to-particulate-matter-no2-and-the-oxidative-potential-of-particulates-and-diabetes-prevalence-in-a-large-national-health-survey
#5
Maciej Strak, Nicole Janssen, Rob Beelen, Oliver Schmitz, Ilonca Vaartjes, Derek Karssenberg, Carolien van den Brink, Michiel L Bots, Martin Dijst, Bert Brunekreef, Gerard Hoek
BACKGROUND: The evidence from observational epidemiological studies of a link between long-term air pollution exposure and diabetes prevalence and incidence is currently mixed. Some studies found the strongest associations of diabetes with fine particles, other studies with nitrogen dioxide and some studies found no associations. OBJECTIVES: Our aim was to investigate associations between long-term exposure to multiple air pollutants and diabetes prevalence in a large national survey in the Netherlands...
September 5, 2017: Environment International
https://www.readbyqxmd.com/read/28877285/chondroblastic-osteosarcoma-mimicking-periapical-abscess
#6
Fernanda Paula Yamamoto-Silva, Brunno Santos de Freitas Silva, Aline Carvalho Batista, Elismauro Francisco de Mendonça, Décio Dos Santos Pinto-Júnior, Carlos Estrela
Case report: The present report describes a case of chondroblastic osteosarcoma in the periapical region of teeth #29, #30, and #31 of an 18-year-old male. Clinical history showed self-reported discomfort in the right posterior gingiva for over a month. Physical examination showed a small expansion and redness of the right mandibular buccal and lingual cortical plates, but no signs of pain or inflammation were observed. All the teeth responded positively to pulp sensibility. Periapical and panoramic radiographs showed slight periapical radiolucency in the roots of teeth #29 and #30, clear periodontal ligament space widening, and evident loss of lamina dura...
July 2017: Journal of Applied Oral Science: Revista FOB
https://www.readbyqxmd.com/read/28875581/european-guideline-for-the-diagnosis-and-treatment-of-insomnia
#7
REVIEW
Dieter Riemann, Chiara Baglioni, Claudio Bassetti, Bjørn Bjorvatn, Leja Dolenc Groselj, Jason G Ellis, Colin A Espie, Diego Garcia-Borreguero, Michaela Gjerstad, Marta Gonçalves, Elisabeth Hertenstein, Markus Jansson-Fröjmark, Poul J Jennum, Damien Leger, Christoph Nissen, Liborio Parrino, Tiina Paunio, Dirk Pevernagie, Johan Verbraecken, Hans-Günter Weeß, Adam Wichniak, Irina Zavalko, Erna S Arnardottir, Oana-Claudia Deleanu, Barbara Strazisar, Marielle Zoetmulder, Kai Spiegelhalder
This European guideline for the diagnosis and treatment of insomnia was developed by a task force of the European Sleep Research Society, with the aim of providing clinical recommendations for the management of adult patients with insomnia. The guideline is based on a systematic review of relevant meta-analyses published till June 2016. The target audience for this guideline includes all clinicians involved in the management of insomnia, and the target patient population includes adults with chronic insomnia disorder...
September 5, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28838857/value-of-physical-tests-in-diagnosing-cervical-radiculopathy-a-systematic-review
#8
REVIEW
Erik J Thoomes, Sarita van Geest, Danielle A van der Windt, Deborah Falla, Arianne P Verhagen, Bart W Koes, Marloes Thoomes-de Graaf, Barbara Kuijper, Wendy Gm Scholten-Peeters, Carmen L Vleggeert-Lankamp
Background context In clinical practice, the diagnosis of cervical radiculopathy is based on information from the patient history, physical examination and diagnostic imaging. Various physical tests may be performed, but their diagnostic accuracy is unknown. Purpose To summarize and update the evidence on diagnostic performance of tests carried out during a physical examination for the diagnosis of cervical radiculopathy. Study design Review of the accuracy of diagnostic tests. Study Sample Diagnostic studies comparing results of tests performed during a physical examination in diagnosing cervical radiculopathy with a reference standard of imaging or surgical findings...
August 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28838217/diagnosis-of-upper-quadrant-lymphedema-secondary-to-cancer-clinical-practice-guideline-from-the-oncology-section-of-the-american-physical-therapy-association
#9
REVIEW
Kimberly Levenhagen, Claire Davies, Marisa Perdomo, Kathryn Ryans, Laura Gilchrist
The Oncology Section of the American Physical Therapy Association (APTA) developed a clinical practice guideline to aid the clinician in diagnosing secondary upper quadrant cancer-related lymphedema. Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in the diagnostic process. Overall clinical practice recommendations were formulated based on the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility...
July 1, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28836098/promis-pain-interference-and-physical-function-scores-correlate-with-the-foot-and-ankle-ability-measure-faam-in-patients-with-hallux-valgus
#10
Devon C Nixon, Jeremy J McCormick, Jeffrey E Johnson, Sandra E Klein
BACKGROUND: Traditional patient-reported outcome instruments like the Foot and Ankle Ability Measure (FAAM) quantify patient disability but often are limited by responder burden and incomplete questionnaires. The Patient-Reported Outcome Measurement Information System (PROMIS) overcomes such obstacles through computer-adaptive technology and can capture outcome data from various domains including physical and psychosocial function. Prior work has compared the FAAM with PROMIS physical function; however, there is little evidence comparing the association between foot and ankle-specific tools like the FAAM with more general outcomes measures of PROMIS pain interference and depression in foot and ankle conditions...
August 23, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28814262/update-on-the-evaluation-and-management-of-brief-resolved-unexplained-events-previously-apparent-life-threatening-events
#11
Eric Zwemer, Ilene Claudius, Joel Tieder
BACKGROUND: The thirty-year-old term "apparent life-threatening event" (ALTE) is difficult to apply in clinical practice and research. The American Academy of Pediatrics now defines these events as brief resolved unexplained events (BRUEs), stratifies infants based on the risk of recurrence or of a serious underlying condition, and offers evidence-based management recommendations for infants at lower-risk. OBJECTIVE: To review recent ALTE literature as it relates to BRUEs...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28813765/bronchiolitis-in-infants-and-children
#12
Alexandra Schaller, Carl S Galloway
Bronchiolitis is among the most common illnesses in infants and children, and is the most common cause for hospitalization in infants in the U.S. This illness can be caused by many viruses, most commonly respiratory syncytial virus. It is diagnosed clinically by history and physical exam findings, with a narrow role for ancillary testing. Management is supportive, with medications demonstrating limited utility in multiple studies. Preventive measures include hand hygiene, breastfeeding, avoiding tobacco smoke exposure, and isolation precautions for hospitalized patients...
June 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28795458/a-comprehensive-review-of-sexual-health-concerns-after-cancer-treatment-and-the-biopsychosocial-treatment-options-available-to-female-patients
#13
REVIEW
Carly S Sears, John W Robinson, Lauren M Walker
The repercussions of cancer diagnosis and treatment profoundly impact the sexual wellbeing of women prior to, during, and following cancer treatment. Sexual health concerns are often under-addressed within clinical and research settings, and information tends to be limited to women with breast or gynecological cancers. In this narrative literature review, the authors critically evaluate research published between 1990 and 2016, pertaining to sexual health concerns of women diagnosed with cancer, of any type or stage, and to the psychosocial and biomedical interventions that currently exist for the treatment of sexual health-related side-effects (e...
August 10, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28780667/the-association-of-lifetime-physical-inactivity-with-head-and-neck-cancer-a-hospital-based-case-control-analysis
#14
Alexis J Platek, Rikki A Cannioto, John Lewis Etter, Jae Kim, Janine M Joseph, Nicholas R Gulati, Kristina L Schmitt, Emily Callahan, Edgar Khachatryan, Ryan Nagy, Albina Minlikeeva, J Brian Szender, Anurag K Singh, Iris Danziger, Kirsten B Moysich
Despite mounting epidemiological evidence suggesting an inverse association between recreational physical activity and cancer risk, evidence associated with head and neck cancer is scant. We conducted a case-control analysis to examine the associations of lifetime physical inactivity with the risk of head and neck squamous cell carcinoma (HNSCC). We utilized data from the Patient Epidemiology Data System at Roswell Park Cancer Institute (RPCI). Participants included 246 patients with HNSCC and 504 cancer-free controls who received medical services at RPCI between 1990 and 1998...
August 5, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28778107/-current-aspects-of-premenstrual-dysphoric-disorder-a-review
#15
Theresa Beddig, Christine Kühner
This narrative review presents current aspects of diagnosis, epidemiology, aetiology and therapy of Premenstrual Dysphoric Disorder (PMDD). PMDD is characterised by emotional, physical and behavioral changes during the premenstrual phase of the menstrual cycle associated with clinically significant distress and marked impairment of psychosocial functioning. Due to its cardinal symptoms (e. g. marked affect lability and irritability), its specific cycle-dependent course and high symptom-specific stability, PMDD has been outlined as a new diagnostic category in the chapter on depressive disorders in the fifth edition of the "Diagnostic and Statistical Handbook of Mental Disorders"...
August 4, 2017: Psychotherapie, Psychosomatik, Medizinische Psychologie
https://www.readbyqxmd.com/read/28776485/evidence-based-feedback-about-emotional-cancer-challenges-experienced-in-south-africa-a-qualitative-analysis-of-316-photovoice-interviews
#16
Lynn Barbara Edwards, Linda Estelle Greeff
This study aims to offer evidence-based feedback about the emotional challenges of cancer in South Africa. The action research photovoice methodology was used to capture accounts of cancer-related challenges via 316 face-to-face interviews with cancer patients and family members (n = 286), and oncology support and medical staff (n = 30). The photovoice contributions constituted qualitative data that were analysed according to inductive thematic analysis whereby nine themes of cancer challenges were identified and photovoice images were descriptively summarised from a phenomenological perspective...
August 4, 2017: Global Public Health
https://www.readbyqxmd.com/read/28774339/measurement-education-and-tracking-in-integrated-care-metric-use-of-a-culturally-adapted-education-tool-versus-standard-education-to-increase-engagement-in-depression-treatment-among-hispanic-patients-study-protocol-for-a-randomized-control-trial
#17
Katherine Sanchez, Brittany H Eghaneyan, Michael O Killian, Leopoldo Cabassa, Madhukar H Trivedi
BACKGROUND: Significant mental health disparities exist for Hispanic populations, especially with regard to depression treatment. Stigma and poor communication between patients and their providers result in low use of antidepressant medications and early treatment withdrawal. Cultural factors which influence treatment decisions among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking medications...
August 3, 2017: Trials
https://www.readbyqxmd.com/read/28770498/psychogenic-non-epileptic-seizures
#18
REVIEW
David K Chen, Esha Sharma, W Curt LaFrance
PURPOSE OF REVIEW: In this review, we elucidate the evaluation process involved in the diagnosis of psychogenic non-epileptic seizures (PNES). Minimum clinical criteria required to attain this diagnosis via a staged approach are delineated. The psychological underpinnings and management of PNES from the neurologists' perspective are also explored. RECENT FINDINGS: Helpful clues can be deduced from history-taking, seizure semiology, ictal/peri-ictal physical exam, and ictal/inter-ictal EEG data...
September 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28755682/the-effect-of-exercise-training-in-adults-with-multiple-sclerosis-with-severe-mobility-disability-a-systematic-review-and-future-research-directions
#19
REVIEW
Thomas Edwards, Lara A Pilutti
INTRODUCTION: There is evidence for the benefits of exercise training in persons with multiple sclerosis (MS). However, these benefits have primarily been established in individuals with mild-to-moderate disability (i.e., Expanded Disability Status Scale [EDSS] scores 1.0-5.5), rather than among those with significant mobility impairment. Further, the approaches to exercise training that have been effective in persons with mild-to-moderate MS disability may not be physically accessible for individuals with mobility limitations...
August 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28748128/diagnosis-of-upper-quadrant-lymphedema-secondary-to-cancer-clinical-practice-guideline-from-the-oncology-section-of-apta
#20
Kimberly Levenhagen, Claire Davies, Marisa Perdomo, Kathryn Ryans, Laura Gilchrist
INTRODUCTION: The Oncology Section of APTA developed a clinical practice guideline to aid the clinician in diagnosing secondary upper-quadrant cancer-related lymphedema. METHODS: Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in their diagnostic process. Overall, clinical practice recommendations were formulated on the basis of the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility...
July 2017: Rehabilitation Oncology
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