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Sean Fine, Judy Nee, Pranjal Thakuria, Brian Duff, Francis A Farraye, Samir A Shah
Inflammatory bowel disease (IBD) is primarily a disease of the gastrointestinal tract, though it can often affect other organ systems. These extraintestinal manifestations occur in a quarter to one-third of patients with Crohn's disease and ulcerative colitis. While musculoskeletal and dermatologic manifestations are the most common, it is also important to be cognizant of head, eye, ear, nose, and throat (HEENT) manifestations and educate IBD patients about them. Here we review the ocular manifestations in conjunction with the lesser-known but increasingly recognized ENT manifestations...
December 2017: Digestive Diseases and Sciences
Judith Haber, Erin Hartnett, Kenneth Allen, Donna Hallas, Caroline Dorsen, Julia Lange-Kessler, Madeleine Lloyd, Edwidge Thomas, Dorothy Wholihan
Improving oral health is a leading population health goal; however, curricula preparing health professionals have a dearth of oral health content and clinical experiences. We detail an educational and clinical innovation transitioning the traditional head, ears, eyes, nose, and throat (HEENT) examination to the addition of the teeth, gums, mucosa, tongue, and palate examination (HEENOT) for assessment, diagnosis, and treatment of oral-systemic health. Many New York University nursing, dental, and medical faculty and students have been exposed to interprofessional oral health HEENOT classroom, simulation, and clinical experiences...
March 2015: American Journal of Public Health
Yen-Nien Lin, Yen-Jung Chang, Yin-Huei Chen, Po-Yen Ko, Cheng-Li Lin, Fung-Chang Sung, Kuan-Cheng Chang, Chia-Hung Kao
AIMS/INTRODUCTION: Patients with malignancy are suggestive of having a tendency toward an association with vascular thrombosis risk. The aim of this study was to evaluate the possible relationship between malignancy and the risk of acute coronary syndrome (ACS) in Taiwan. MATERIALS AND METHODS: We used data from the National Health Insurance (NHI) system of Taiwan to assess the issue. Cox proportional hazards regression analysis was conducted to estimate the effects of malignancy on the risk of ACS...
October 2014: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Kenneth S Yew
Tinnitus, a common symptom encountered in family medicine, is defined as the perception of noise in the absence of an acoustic stimulus outside of the body. Because tinnitus is a symptom and not a disease, its underlying cause must be determined to best help patients. Although tinnitus is often idiopathic, sensorineural hearing loss is the most common identified cause. It can also be caused by other otologic, vascular, neoplastic, neurologic, pharmacologic, dental, and psychological factors. More serious causes, such as Meniere disease or vestibular schwannoma, can be excluded during the evaluation...
January 15, 2014: American Family Physician
Sameer Bakhshi, K S Padmanjali, L S Arya
A retrospective analysis was performed on febrile neutropenic episodes in patients with acute lymphoblastic leukemia (ALL) from 1992 to 2002. There were 222 febrile neutropenic episodes in 266 ALL patients with documented ANC < 500/mm(3). Of the 222 episodes, 98 (44%) had documented focus of infection; the rest were fever without focus. There were 274 different sites of infection in the 98 episodes of documented focus of infection; pulmonary infections were the commonest site of infection (27.3%) followed by HEENT (22...
June 2008: Pediatric Hematology and Oncology
Danielle Blouin, Luigi Eugene Dagnone, Robert McGraw
OBJECTIVES: In 2004, the format of the Royal College of Physicians and Surgeons of Canada certification exam in Emergency Medicine was modified to include an audiovisual session. Residents' performance on such stimuli is unknown. This study aims to determine the performance of Emergency Medicine postgraduate year 5 (PGY-5) on a novel practice examination using visual stimuli, in an effort to guide residents' preparatory study, and to help educators focus the teaching related to visual stimuli...
January 2006: CJEM
Susan Blank, Dung Le, Anna Hemnes
PRESENTING FEATURES: An 18-year-old white man was admitted to the Osler Medical Service with the chief complaint of back pain. Two weeks prior to admission, the patient developed diffuse and aching upper back pain. Over the next couple of days, he also developed severe anterior chest pain that was somewhat pleuritic in nature but diffuse and extending bilaterally into the shoulders. One week prior to admission, he developed intermittent fevers and night sweats. The patient denied any lymphadenopathy, pharyngitis, sick contacts, shortness of breath, rash, or bleeding...
July 1, 2004: American Journal of Medicine
Jonathan A Edlow
To decide which patients with headache ought to be evaluated for SAH, physicians should focus on specific elements of the patient history, such as onset, severity, and quality of the headache and associated symptoms. These questions should be asked and the responses documented for every patient with a headache. The physical examination should be compulsive with regard to vital signs, HEENT. and neurologic signs. Then, the physician should form an explicit differential diagnosis and have reasons for diagnosing migraine, tension, or sinus headache and other benign causes...
February 2003: Emergency Medicine Clinics of North America
Robert W Grow, Aimee Zaas
A 37-year-old woman presented with increasing abdominal pain and jaundice. Six weeks before admission, she developed persistent diarrhea and jaundice of the skin. She also bruised easily, and her gums bled. In the subsequent weeks, her appetite decreased, she was fatigued, and she had nausea, vomiting, and abdominal distension. She had a history of drinking 1 quart of vodka every day for 20 years, with brief periods of abstinence; she stopped consuming alcohol 11 days before admission because it no longer provided symptomatic relief...
February 1, 2003: American Journal of Medicine
C Kreis, P Gorman
The design of a functional interface for direct entry of physical exam data by physicians remains a formidable challenge for developers of clinical information systems. Many developers use a theoretical approach, basing the interface on a model of the structure of the information and of the user-system interaction that is developed with one or more clinical domain expert(s). We explored the use of empirical analysis as a basis for the design of a structured data entry (SDE) interface. A collection of physical examination data from actual trauma patients, dictated by trauma surgeons, was used for the analysis...
1997: Proceedings: a Conference of the American Medical Informatics Association
R S Kay
Studies indicate that the incidence of in-flight medical emergencies is low, yet the huge volume of air travelers create the potential for a significant number of in-flight problems. Many medical conditions are aggravated by factors in the cabin environment, such as reduced air pressure, low humidity, turbulence, and immobility. In particular, reduced cabin pressure, occurring at higher flight altitudes, produces hypoxia and expansion of body gases, which may adversely affect those with cardiac, pulmonary, gastrointestinal, head, eye, ear, nose, throat, neurological, and obstetrical disorders...
May 1994: Nurse Practitioner
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