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Medically unexplained

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https://www.readbyqxmd.com/read/29148230/personality-traits-such-as-neuroticism-and-disability-predict-psychological-distress-in-medically-unexplained-symptoms-a-three-year-experience-from-a-single-centre
#1
Vikas Menon, Balasubramanian Shanmuganathan, Jaiganesh Selvapandian Thamizh, Anand Babu Arun, Pooja Patnaik Kuppili, Siddharth Sarkar
BACKGROUND: People with medically unexplained symptoms (MUS) may have psychological co-morbidities. AIMS: Our objectives were to assess the rates and identify correlates of psychological distress in MUS. METHODS: A total of 171 subjects with MUS seeking treatment at a tertiary care facility were assessed over a 3-year period. Psychological distress was assessed using the Tamil version of General Health Questionnaire-12. Apart from socio-demographic factors, personality, coping, perceived social support and subjective disability were assessed using standard instruments...
November 17, 2017: Personality and Mental Health
https://www.readbyqxmd.com/read/29148208/comparison-of-long-term-outcome-in-anthracycline-related-versus-idiopathic-dilated-cardiomyopathy-a-single-centre-experience
#2
Alessandra Fornaro, Iacopo Olivotto, Luigi Rigacci, Mauro Ciaccheri, Benedetta Tomberli, Cecilia Ferrantini, Raffaele Coppini, Francesca Girolami, Francesco Mazzarotto, Marco Chiostri, Massimo Milli, Niccolò Marchionni, Gabriele Castelli
AIMS: Cardiac dysfunction is a severe complication of anthracycline-containing anticancer therapy. The outcome of anthracycline-induced cardiomyopathy (AICM) compared with other non-ischaemic causes of heart failure (HF), such as idiopathic dilated cardiomyopathy (IDCM), is unresolved. The aim of this study was to compare the survival of AICM patients with an IDCM cohort followed at our centre from 1990 to 2016. METHODS AND RESULTS: We included 67 patients (67% female, 50 ± 15 years) with AICM, defined as onset of otherwise unexplained left ventricular ejection fraction (LVEF) ≤50% following anthracycline therapy, and 488 IDCM patients (28% female, 55 ± 12 years)...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29141456/increased-serum-levels-of-mbdnf-in-women-with-minimal-and-mild-endometriosis-have-no-predictive-power-for-the-disease
#3
Alexandra Perricos, Kazem Ashjaei, Heinrich Husslein, Katharina Proestling, Lorenz Kuessel, Reinhard Obwegeser, Rene Wenzl, Iveta Yotova
The objective of our pilot clinical, prospective study was to determine the serum levels of mature brain-derived neurotrophic factor, in of women with endometriosis and controls and explore whether mature brain-derived neurotrophic factor is a potential biomarker for the disease. The patients were selected from the Endometriosis Marker Austria prospective cohort study conducted at the tertiary referral certified Endometriosis Center of the Medical University of Vienna. All women underwent laparoscopic surgery because there was a suspicion of endometriosis, or the women had pelvic pain, adnexal cysts, unexplained infertility, or uterine fibroids...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29141364/-effects-of-combination-therapy-with-aspirin-prednisone-and-elevit-in-patients-with-unexplained-recurrent-early-pregnancy-loss
#4
H Ou, Q Yu
Objective: To investigate the effect of triple therapy with aspirin, prednisone and Elevit in patients with unexplained recurrent early pregnancy loss. Methods: From January 1, 2013 to December 31, 2016, a total of 353 women of childbearing age were enrolled in Peking Union Medical College Hospital, including blood, urine and vaginal swabs. One hundred and fifty-five patients were observed normal results of blood test, urine test and vaginal swabs. According to the treatment regimen, 155 patients were divided into two groups, 89 patients (57...
November 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29140804/exploration-of-predictive-biomarkers-for-sudden-unexplained-cardiac-death-in-nonelderly-people-a-case-control-study-with-biochemical-parameters-related-to-heart-failure
#5
Sakai Kentaro, Iwadate Kimiharu, Matsumoto Sari, Takasu Shojiro, Kanto Yuko
Sudden unexplained cardiac death (SUCD) can occasionally occur in nonelderly patients with epilepsy, psychiatric disorders, or no medical history. This study was conducted to aim to analyze whether values of the biomarkers for heart failure are associated with the SUCD. Serum concentrations of N-terminal probrain natriuretic peptide, high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor α were analyzed in 57 nonelderly patients with SUCD who was diagnosed at medicolegal autopsy. The subjects were divided into 3 subgroups according to the medical history: (1) epilepsy, (2) psychiatric disorders, and (3) no specific medical history...
November 15, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29140276/clinical-profile-associated-with-adverse-childhood-experiences-the-advent-of-nervous-system-dysregulation
#6
Jorina Elbers, Cynthia R Rovnaghi, Brenda Golianu, Kanwaljeet J S Anand
BACKGROUND: We report the prevalence of children with multiple medical symptoms in a pediatric neurology clinic, describe their symptom profiles, and explore their association with adverse childhood experiences (ACEs). METHODS: We retrospectively reviewed 100 consecutive patients from an outpatient pediatric neurology clinic. Patients were included if they were ≥5 years old and reported ≥4 symptoms that were unexplained for ≥3-months. Symptom profiles across six functional domains were recorded: (1) executive dysfunction, (2) sleep disturbances, (3) autonomic dysregulation, (4) somatization, (5) digestive symptoms, and (6) emotional dysregulation...
November 15, 2017: Children
https://www.readbyqxmd.com/read/29132773/-maternal-deaths-due-to-sudden-death-results-from-the-french-confidential-enquiry-into-maternal-deaths-2010-2012
#7
E Morau, E Beaumont, E Verspyck
Sudden death is defined as unexpected cardiac arrest occurring less than one hour after the onset of the first symptoms. Between 2010 and 2012, 23 maternal deaths were considered as unexplained sudden deaths and three of them were not evaluated due to a lack of clinical data. In addition, 13 maternal deaths with an identified cause occurred in a clinical context of sudden death (7 cases of pulmonary embolism, 2 cases of epilepsy, and 2 cases of cardiomyopathy). The first maneuvers of resuscitation in the presence of bystanders were attempted in 8 of 22 cases (36%)...
November 10, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29110602/pharmacometabonomics-technique-to-identify-warfarin-response-using-nuclear-magnetic-resonance-spectroscopy
#8
Abdulkader Ahmad Bawadikji, Chin-Hoe Teh, Muhamad Ali Bin Sheikh Abdul Kader, Syed Azhar Syed Sulaiman, Baharudin Ibrahim
BACKGROUND: Warfarin, an anticoagulant medication, has prescribed regularly despite of its bleeding tendency for the prevention and/or treatment of various thromboembolic conditions, such as deep vein thrombosis, and complications associated with atrial fibrillation, and myocardial infarction, but because of its narrow therapeutic window have a lot of interactions with drugs and diet. METHOD: Warfarin relies on regular monitoring of International Normalized Ratio which is a standardized test to measure prothrombin time and appropriate dose adjustment...
November 3, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/29099422/the-endoscopic-and-histologic-findings-of-infants-who-have-experienced-brief-resolved-unexplained-events
#9
Chaowapong Jarasvaraparn, Maria B R Gallegos, Madhuri S Mulekar, Bin Wang, David A Gremse, Karen D Crissinger
INTRODUCTION: A brief resolved unexplained event (BRUE) describes an event associated with a change in muscle tone, color, respiration, and responsiveness that is unexplained after an appropriate examination. Some infants with higher risk BRUE may undergo endoscopy as part of their evaluation. OBJECTIVE: This retrospective study aimed to identify the endoscopic findings in infants who have experienced a higher risk BRUE. We also compared the characteristics, prenatal, natal, and postnatal risk factors between 23 infants who underwent endoscopic evaluation and 23 race-matched/sex-matched/term-matched/preterm-matched infants who did not undergo endoscopic evaluation...
November 2, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29098971/-the-prognosis-of-medically-unexplained-symptoms
#10
D J C Hanssen, H Knoop, J G M Rosmalen
- The condition where someone has physical symptoms for a number of weeks for which no clear somatic cause can be found, is known as medically unexplained symptoms (MUS).- In this article we give an overview of current insights into the prognosis of MUS.- Extensive somatic testing in patients diagnosed with MUS by a physician, rarely results in a somatic diagnosis.- In approximately half of these patients, MUS disappear spontaneously within one year.- Symptom-related characteristics - such as experiencing multiple physical symptoms simultaneously-, and psychological characteristics - such as unhelpful thoughts - are predictors of an unfavourable prognosis for MUS...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29098731/clues-for-early-detection-of-autoimmune-addison-s-disease-myths-and-realities
#11
Å B Saevik, A-K Åkerman, K Grønning, I Nermoen, S F Valland, T E Finnes, M Isaksson, P Dahlqvist, R Bergthorsdottir, O Ekwall, J Skov, B G Nedrebø, A-L Hulting, J Wahlberg, J Svartberg, C Höybye, I H Bleskestad, A P Jørgensen, O Kämpe, M Øksnes, S Bensing, E S Husebye
BACKGROUND: Early detection of autoimmune Addison's disease (AAD) is important as delay in diagnosis may result in a life-threatening adrenal crisis and death. The classical clinical picture of untreated AAD is well-described, but methodical investigations are scarce. OBJECTIVE: Perform a retrospective audit of patient records with the aim of identifying biochemical markers for early diagnosis of AAD. MATERIAL AND METHODS: A multicentre retrospective study including 272 patients diagnosed with AAD at hospitals in Norway and Sweden during 1978-2016...
November 3, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29098486/implantable-loop-recorders-in-the-real-world-a-study-of-two-canadian-centers
#12
Omar A Ibrahim, Doran Drew, Christopher J Hayes, William McIntyre, Colette M Seifer, Wilma Hopman, Benedict Glover, Adrian M Baranchuk
PURPOSE: Implantable loop recorders (ILRs) are increasingly being used for ambulatory electrocardiography. We sought to evaluate ILR indications, diagnostic yield, ILR-guided interventions, and complications in two Canadian centers. METHODS: This was a retrospective study using electronic medical records to identify ILR implants at Queen's University and the University of Manitoba. Information was collected on patient characteristics, medications, indication for implant, results of prior investigations, diagnostic outcome, and subsequent management...
November 2, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29096941/the-neuropsychophysiology-of-tingling
#13
REVIEW
Benedek T Tihanyi, Eszter Ferentzi, Florian Beissner, Ferenc Köteles
Tingling is a bodily sensation experienced under a variety of conditions from everyday experiences to experimental and therapeutic situations. It can be induced by both peripheral or afferent (external stimulation, peripheral pathology) and higher cognitive (expectation) processes. The paper summarizes the current scientific knowledge on the neurophysiological and psychological concomitants of the tingling sensation. Four possible models are identified and presented: the afferent, the attention-disclosed, the attention-evoked, and the efferent model...
October 30, 2017: Consciousness and Cognition
https://www.readbyqxmd.com/read/29090894/extension-of-the-presumptive-period-for-compensation-for-gulf-war-veterans-final-rule
#14
(no author information available yet)
The Department of Veterans Affairs (VA) is issuing this final rule to affirm its adjudication regulations regarding compensation for disabilities resulting from undiagnosed illnesses suffered by veterans who served in the Persian Gulf War. This amendment is necessary to extend the period during which disabilities associated with undiagnosed illnesses and medically unexplained chronic multi-symptom illnesses must become manifest in order for a Veteran to be eligible for compensation. The intended effect of this amendment is to provide consistency in VA adjudication policy, preserve certain rights afforded to Persian Gulf War (GW) veterans, and ensure fairness for current and future GW veterans...
October 24, 2017: Federal Register
https://www.readbyqxmd.com/read/29081456/lead-poisoning-caused-by-traditional-chinese-medicine-a-case-report-and-literature-review
#15
Guangmin Tang, Xiang Tu, Ping Feng
Traditional Chinese herbal medicine is widely used for primary health care worldwide as it mostly consists of herbs or herbal extracts known to be safe. However, owing to the intentional or unintentional addition to herbs of lead-containing bases or pastes, lead poisoning from traditional Chinese medicine (TCM) remains a serious issue. We report here a case of lead poisoning caused by long-term use of homemade TCM. A 66-year-old man was admitted for periumbilical pain and constipation. A detailed medication history revealed that the patient had been using homemade TCM for the past 8 months...
October 2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29077143/-neuromodulation-can-be-effective-in-patients-with-medically-unexplained-symptoms
#16
M van Beilen, H Tieleman
BACKGROUND: Neuromodulation may influence abnormal brain activation patterns in medically unexplained symptoms (MUS). AIM: To assess the importance and direction of future studies on patients with MUS. METHOD: We describe the results of the first studies on patients with functional neurological symptom disorder (fNSD) and chronic pain. RESULTS: Clinically relevant improvements in the health condition of a substantial number of patients with fnsd have been reported...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/29063801/-it%C3%A2-s-incredible-how-much-i%C3%A2-ve-had-to-fight-negotiating-medical-uncertainty-in-clinical-encounters
#17
Olaug S Lian, Catherine Robson
PURPOSE: Clinical encounters related to medically unexplained physical symptoms (MUPS) are associated with high levels of conflict between patients and doctors. Collaborative difficulties are fused by the medical uncertainty that dominates these consultations. The main aim of this study is to explore the interactional dynamics of clinical encounters riddled by medical uncertainty, as experienced by people living with long-term medically unexplained fatigue in Norway. METHOD: A qualitative thematic analysis of written texts from 256 study participants...
2017: International Journal of Qualitative Studies on Health and Well-being
https://www.readbyqxmd.com/read/29061608/impact-of-regional-socioeconomic-variation-on-coordination-and-cost-of-ambulatory-care-investigation-of-claims-data-from-bavaria-germany
#18
Michael Mehring, Ewan Donnachie, Antonius Schneider, Martin Tauscher, Roman Gerlach, Constanze Storr, Klaus Linde, Andreas Mielck, Werner Maier
OBJECTIVES: A considerable proportion of regional variation in healthcare use and health expenditures is to date still unexplained. The aim was to investigate regional differences in the gatekeeping role of general practitioners and to identify relevant explanatory variables at patient and district level in Bavaria, Germany. DESIGN: Retrospective routine data analysis using claims data held by the Bavarian Association of Statutory Health Insurance Physicians. PARTICIPANTS: All patients who consulted a specialist in ambulatory practice within the first quarter of 2011 (n=3 616 510)...
October 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29050952/a-research-coding-method-to-evaluate-medical-clinicians-conduct-of-behavioral-health-care-in-patients-with-unexplained-symptoms
#19
Katelyn A Grayson-Sneed, Robert C Smith
OBJECTIVE: Develop a reliable coding method of a Behavioral Health Treatment Model for patients with Medically Unexplained Symptoms (BHTM-MUS). METHODS: Two undergraduates trained for 30h coded videotaped interviews from 161 resident-simulated patient (SP) interactions. Trained on 45 videotapes, coders coded 33 (20%) of 161 study set tapes for the BHTM-MUS. Guetzkow's U, Cohen's Kappa, and percent of agreement were used to measure coders' reliability in unitizing and coding residents' skills for eliciting: education and informing (4 yes/no items), motivating (2), treatment statements (5), commitment and goals (2), negotiates plan (8), non-emotion patient-centered skills (4), and patient-centered emotional skills (8)...
October 12, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29042939/aphasic-status-epilepticus-as-the-sole-symptom-of-epilepsy-a-case-report-and-literature-review
#20
Ji-Qing Qiu, Yu Cui, Li-Chao Sun, Zhan-Peng Zhu
Aphasia is a common symptom encountered by neurologists. However, the presence of aphasia as the sole manifestation of partial status epilepticus is rare. The present study reports a case of aphasic status epilepticus in a 27-year-old right-handed female who presented after the abrupt onset of aphasia, which had persisted for 1.5 days. The patient's medical history included head trauma followed by a craniectomy and cranioplasty. Computed tomography scans revealed a lesion in the patient's left parietal lobe, and an electroencephalogram showed a spike and slow wave pattern in the left hemisphere of the brain during aphasia...
October 2017: Experimental and Therapeutic Medicine
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