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Medically unexplained

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https://www.readbyqxmd.com/read/29332632/retrospective-memory-for-symptoms-in-patients-with-medically-unexplained-symptoms
#1
Marta Walentynowicz, Katleen Bogaerts, Linda Stans, Ilse Van Diest, Filip Raes, Omer Van den Bergh
OBJECTIVE: Clinical assessment and diagnostic processes heavily rely on memory-based symptom reports. The current study investigated memory for symptoms and the peak-end effect for dyspnea in patients with medically unexplained symptoms and healthy participants. METHODS: Female patients with medically unexplained dyspnea (MUD) (n=22) and matched healthy controls (n=22) participated in two dyspnea induction trials (short, long). Dyspnea ratings were collected: (1) continuously during symptom induction (concurrent with respiratory measures), (2) immediately after the experiment, and (3) after 2weeks...
February 2018: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29329310/medication-discrepancies-across-multiple-care-transitions-a-retrospective-longitudinal-cohort-study-in-italy
#2
Marco Bonaudo, Maria Martorana, Valerio Dimonte, Alessandra D'Alfonso, Giulio Fornero, Gianfranco Politano, Maria Michela Gianino
PURPOSE: Medication discrepancies are defined as unexplained differences among regimens across different sites of care. The problem of medication discrepancies that occur during the entire care pathway from hospital admission to a local care setting discharge (namely all types of settings dedicated to formal care other than hospitals) has received little attention in the medical literature. The present study aims to (1) determine the prevalence of medication discrepancies that occur during the entire care pathway from hospital admission to local care setting discharge, (2) describe the discrepancy and medication type, and (3) identify potential risk factors for experiencing medication discrepancies in patient care transitions...
2018: PloS One
https://www.readbyqxmd.com/read/29327861/prognostic-factors-in-intrauterine-insemination-cycles
#3
Fernanda Sicchieri, Aline Bomfim Silva, Ana Carolina Japur de Sá Rosa E Silva, Paula Andrea de Albuquerque Sales Navarro, Rui Alberto Ferriani, Rosana Maria Dos Reis
OBJECTIVE: This study aimed to evaluate the clinical pregnancy rate of intrauterine insemination cycles in relation to patient age, cause of infertility, ovulation induction method, number of mature follicles and sperm with progressive motility. METHODS: This retrospective observational study included 237 intrauterine insemination cycles performed from 2011 to 2015 at the Assisted Reproduction Service of the Hospital das Clínicas of the Ribeirão Preto Medical School, University of São Paulo...
January 12, 2018: JBRA Assisted Reproduction
https://www.readbyqxmd.com/read/29327358/opioid-medication-use-in-patients-with-gastrointestinal-diagnoses-vs-unexplained-gastrointestinal-symptoms-in-the-us-veterans-health-administration
#4
G S Sayuk, N Kanuri, C P Gyawali, B M Gott, B D Nix, R A Rosenheck
BACKGROUND: While opioid prescriptions have increased alarmingly in the United States (US), their use for unexplained chronic gastrointestinal (GI) pain (eg, irritable bowel syndrome) carries an especially high risk for adverse effects and questionable benefit. AIM: To compare opioid use among US veterans with structural GI diagnoses (SGID) and those with unexplained GI symptoms or functional GI diagnoses (FGID), a group for whom opioids have no accepted role. METHODS: Veterans Health Administration (VHA) administrative data from fiscal year 2012 were used to identify veterans with diagnostic codes recorded for SGID and FGID...
January 12, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29323836/segmental-arterial-mediolysis-an-unusual-case-mistaken-to-be-a-strangulated-hernia
#5
Russell D Japikse, James E Sevenson, Perry J Pickhardt, Michael D Repplinger
INTRODUCTION: Segmental arterial mediolysis (SAM) is a rare nonatherosclerotic, noninflammatory vasculopathy causing arterial wall necrosis that leads to strictures, dissections, and aneurysms, particularly in medium-sized abdominal arteries. Awareness of SAM is important because, unlike vasculitides, immunosuppressive treatment may worsen the disease process. CASE: A 58-year-old man with multiple medical comorbidities presented with acute epigastric pain and a right incarcerated inguinal hernia that was interpreted as showing bowel strangulation on computed tomography...
August 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29320993/distribution-of-glomerular-diseases-in-taiwan-preliminary-report-of-national-renal-biopsy-registry-publication-on-behalf-of-taiwan-society-of-nephrology
#6
Hsien-Fu Chiu, Hung-Chun Chen, Kuo-Cheng Lu, Kuo-Hsiung Shu
BACKGROUND: Despite the development of biomarkers and noninvasive imaging tools, biopsy remains the only method for correctly diagnosing patients with unexplained hematuria, proteinuria and renal failure. Renal biopsy has been performed for several decades in Taiwan; however, a national data registry is still lacking until 2013. METHODS: The Renal Biopsy Registry Committee was established within the Taiwan Society of Nephrology in January 2013. A biopsy registry format, including basic demographic data, baseline clinical features, laboratory data, and clinical and pathological diagnosis was developed...
January 10, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29310389/secondary-systemic-lupus-erythematosus-after-thymoma-resection-misdiagnosed-as-medically-unexplained-dyspnoea-a-case-report
#7
Hao Liao, Wendi Pei, Junfang Liu, Kai Wang, Tingting Xu, Xin Chen
RATIONALE: Secondary systemic lupus erythematosus (SLE) is an exceedingly rare complication of thymoma resection and is difficult to diagnose because of the insidious and nonspecific clinical manifestations. A case of SLE that occurs secondary to thymoma resection is described in this report. PATIENT CONCERNS: A 43-year-old male came to our hospital with the sole symptom of dyspnea after thymoma resection initially. However, other atypical lesions of SLE occurred over time...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29308958/medically-unexplained-physical-symptoms-misunderstood-and-wrongly-treated-a-semiotic-perspective-on-chronic-pain
#8
Kari Irene H Busvold, Hilde Bondevik
Medically unexplained physical symptoms (MUPS) are a significant and increasing health issue in the western world. Chronic pain constitutes a considerable element of these symptoms, and the lack of a biomedical explanation of their cause challenges the clinical encounter. The limitations of biomedicine become evident in these encounters and expose the need for an expanded understanding of body and symptom. Semiotics, as an anti-dualistic meta-theory, closes the gap between natural science and the humanities and views the human body in an evolutionary and existential perspective...
January 8, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29295851/proteomic-profiling-for-cardiovascular-biomarker-discovery-in-orthostatic-hypotension
#9
Madeleine Johansson, Fabrizio Ricci, Nay Aung, Richard Sutton, Olle Melander, Artur Fedorowski
Orthostatic hypotension (OH) has been linked with higher incidence of cardiovascular disease, but little is known about the mechanisms behind this association. We aimed to identify cardiovascular disease biomarkers associated with OH through a proteomic profiling approach. Seven hundred seventy-eight patients with unexplained syncope or orthostatic intolerance underwent head-up tilt test and supine blood samples. Of these, 220 met diagnostic criteria of OH, and 179 demonstrated normal hemodynamic response during head-up tilt test...
January 2, 2018: Hypertension
https://www.readbyqxmd.com/read/29275789/the-2-year-course-of-medically-unexplained-physical-symptoms-mups-in-terms-of-symptom-severity-and-functional-status-results-of-the-prospects-cohort-study
#10
Nikki Claassen-van Dessel, Johannes C van der Wouden, Trynke Hoekstra, Joost Dekker, Henriëtte E van der Horst
OBJECTIVE: We assessed the 2-year course of Medically Unexplained Physical Symptoms (MUPS) in terms of symptom severity, physical functioning and mental functioning. METHODS: We used data of the PROSPECTS cohort study, consisting of 325 MUPS patients from several health care settings. Symptom severity (PHQ-15), physical functioning (RAND 36 PCS) and mental functioning (RAND 36 MCS) were assessed at baseline and 6, 12 and 24 months afterwards. We used Latent Class Growth Modeling (LCGM) to identify different course types, but as clinical usability of results was limited, we also analysed change scores and directions of change...
January 2018: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29259893/neonatal-pyknocytosis-in-a-preterm-dizygotic-twin
#11
Alberto Berardi, Eleonora Balestri, Goretta Bonacorsi, Claudio Chiossi, Giovanni Palazzi, Eugenio Spaggiari, Fabrizio Ferrari
Infantile pyknocytosis (IP) is a rare, self-limited neonatal haemolytic anaemia that may require multiple blood transfusions. Only a little more than 50 cases have been reported in the medical literature, and the great majority of them concerns term infants. The etiology of IP is not well understood; most likely it results from a transient extra-corpuscular factor, whose nature is unknown, transmitted from mother to child or, alternatively, from a deficiency of an anti-oxidative agent. We report the case of two preterm twins, one of which suffered from IP and developed severe anaemia at age 2 wk, while the other was unaffected...
November 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/29259449/analyzing-the-risk-factors-for-a-diminished-oocyte-retrieval-rate-under-controlled-ovarian-stimulation
#12
Mayumi Nakamura, Yoshiki Yamashita, Atsushi Hayashi, Natsuho Saito, Masae Yu, Masami Hayashi, Yoshito Terai, Masahide Ohmichi
Aim: To investigate which risk factors contribute to a lower oocyte retrieval ratio in women who are receiving controlled ovarian hyperstimulation. Methods: The authors retrospectively analyzed 329 in vitro fertilization (IVF) cycles under controlled ovarian hyperstimulation by using a gonadotropin-releasing hormone antagonist or agonist at Osaka Medical College, Japan. The patients were classified into five groups: advanced age, male infertility, severe endometriosis, tubal infertility, and unexplained infertility...
January 2017: Reproductive Medicine and Biology
https://www.readbyqxmd.com/read/29247119/applying-high-resolution-variant-classification-to-cardiac-arrhythmogenic-gene-testing-in-a-demographically-diverse-cohort-of-sudden-unexplained-deaths
#13
Ying Lin, Nori Williams, Dawei Wang, William Coetzee, Bo Zhou, Lucy S Eng, Sung Yon Um, Ruijun Bao, Orrin Devinsky, Thomas V McDonald, Barbara A Sampson, Yingying Tang
BACKGROUND: Genetic variant interpretation contributes to testing yield differences reported for sudden unexplained death. Adapting a high-resolution variant interpretation framework, which considers disease prevalence, reduced penetrance, genetic heterogeneity, and allelic contribution to determine the maximum tolerated allele count in gnomAD, we report an evaluation of cardiac channelopathy and cardiomyopathy genes in a large, demographically diverse sudden unexplained death cohort that underwent thorough investigation in the United States' largest medical examiner's office...
December 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/29239066/the-obesity-supine-death-syndrome-osds
#14
REVIEW
M Lemyze, A Guiot, J Mallat, D Thevenin
The obesity supine death syndrome refers to a catastrophic cascade of cardiorespiratory complications resulting from the supine positioning of a morbidly obese subject which can ultimately lead to death. It was first described in 1977 in two massively obese patients who were forced to lie down for medical procedures. But surprisingly, despite the current worldwide epidemic of obesity, very few cases have been reported yet. It can be assumed that the syndrome is poorly recognized in clinical practice and may participate in the high rate of unexplained death in morbidly obese patients...
December 13, 2017: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29237616/individual-differences-in-normal-body-temperature-longitudinal-big-data-analysis-of-patient-records
#15
Ziad Obermeyer, Jasmeet K Samra, Sendhil Mullainathan
OBJECTIVE: To estimate individual level body temperature and to correlate it with other measures of physiology and health. DESIGN: Observational cohort study. SETTING: Outpatient clinics of a large academic hospital, 2009-14. PARTICIPANTS: 35 488 patients who neither received a diagnosis for infections nor were prescribed antibiotics, in whom temperature was expected to be within normal limits. MAIN OUTCOME MEASURES: Baseline temperatures at individual level, estimated using random effects regression and controlling for ambient conditions at the time of measurement, body site, and time factors...
December 13, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29234547/testicular-cancer-presenting-as-gastric-variceal-hemorrhage
#16
Carlos Eduardo Salazar-Mejía, David Hernández-Barajas, Edio Llerena-Hernández, José Luis González-Vela, María Inés Contreras-Salcido, Adriana González-Gutiérrez, Omar David Borjas-Almaguer, Luis Alberto Pérez-Arredondo, Blanca Otilia Wimer-Castillo
Testicular cancer is the most common solid malignancy affecting males between the ages of 15 and 35. The symptomatology caused by this tumor varies according to the site of metastasis. We present the case of a 26-year-old male who arrived to the emergency department with hematemesis. He had no previous medical history. On arrival, we noted enlargement of the left scrotal sac. There was also a mass in the left scrotum which provoked displacement of the penis and right testis. The serum alpha-fetoprotein level was 17,090 ng/mL, lactate dehydrogenase was 1480 U/L, and human chorionic gonadotropin was 287...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29234512/new-models-of-care-a-liaison-psychiatry-service-for-medically-unexplained-symptoms-and-frequent-attenders-in-primary-care
#17
Janine Bestall, Najma Siddiqi, Suzanne Heywood-Everett, Charlotte Freeman, Paul Carder, Mick James, Brendan Kennedy, Angela Moulson, Allan House
Aims and method This paper describes the process of setting up and the early results from a new liaison psychiatry service in primary care for people identified as frequent general practice attenders with long-term conditions or medically unexplained symptoms. Using a rapid evidence synthesis, we identified existing service models, mechanisms to identify and refer patients, and outcomes for the service. Considering this evidence, with local contingencies we defined options and resources. We agreed a model to set up a service in three diverse general practices...
December 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/29228515/aging-and-cardiometabolic-risk-in-european-hems-pilots-an-assessment-of-occupational-old-age-limits-as-a-regulatory-risk-management-strategy
#18
Hans Bauer, Dennis Nowak, Britta Herbig
Old-age limits are imposed in some occupations in an effort to ensure public safety. In aviation, the "Age 60 Rule" limits permissible flight operations conducted by pilots aged 60 and over. Using a retrospective cohort design, we assessed this rule's validity by comparing age-related change rates of cardiometabolic incapacitation risk markers in European helicopter emergency medical service (HEMS) pilots near age 60 with those in younger pilots. Specifically, individual clinical, laboratory, and electrocardiogram (ECG)-based risk markers and an overall cardiovascular event risk score were determined from aeromedical examination records of 66 German, Austrian, Polish, and Czech HEMS pilots (average follow-up 8...
December 11, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/29222988/medically-unexplained-physical-symptoms-in-patients-attending-a-medical-outpatient-clinic-in-a-tertiary-hospital-in-north-india
#19
Mohit Sharma, Shubh Mohan Singh, Ajit Avasthi, Subhash C Varma, Aman Sharma, Vikas Suri
OBJECTIVE: Medically unexplained physical symptoms (MUPS) are commonly seen across health care settings. Earlier studies have focussed on prevalence, cost-utilization and burden. Data from India is scarce. Patients with persistent MUPS have more impairment and psychological distress. This study was designed to assess psychological morbidity, health anxiety (HA), somatic symptom load, disability, quality of life (QOL) in patients with persistent MUPS presenting to a general medical outpatient service and compare it with patients with medically explained physical symptoms (MEPS)...
December 2, 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/29206630/does-untreated-obstructive-sleep-apnea-cause-secondary-erythrocytosis
#20
Christopher D Nguyen, Jon-Erik C Holty
BACKGROUND: The current literature suggests a relationship between obstructive sleep apnea (OSA) severity and hematocrit. However, the degree that OSA contributes to clinically significant erythrocytosis is uncertain. The aim of this study is to evaluate this association in a large study sample controlling for multiple confounders. METHODS: We evaluated consecutive subjects with suspected untreated OSA using multivariate analysis to test the associations between apnea-hypopnea index (AHI) and hematocrit...
September 2017: Respiratory Medicine
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