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Medically unexplained symptoms

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https://www.readbyqxmd.com/read/28418216/adult-attachment-insecurity-is-positively-associated-with-medically-unexplained-chronic-pain
#1
L A McWilliams
BACKGROUND: Attachment insecurity (i.e. anxiety in relationships and/or discomfort in close relationships) is associated with self-reports of physical symptoms, medically unexplained symptoms and health conditions involving pain. Medically unexplained chronic pain (MUCP) may represent a particularly severe form of symptom reporting that is also characteristic of individuals with insecure attachment. This study investigated relationships between adult attachment style ratings and past-year MUCP in a sample of the general U...
April 18, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28412073/pediatric-acute-flaccid-paralysis-enterovirus-d68-associated-anterior-myelitis
#2
James A Yoder, Michael Lloyd, Luke Zabrocki, Jonathan Auten
BACKGROUND: Enteroviral infections can cause acute flaccid paralysis secondary to anterior myelitis. Magnetic resonance imaging (MRI) is important in the diagnosis of this potentially devastating pediatric disease. Before the 2014 outbreak of Enterovirus D68 (EV-D68), the virus was considered a relatively benign disease. CASE REPORT: A fully immunized 8-year-old boy was brought to the emergency department complaining of a cough, headache, neck pain, and right arm pain and weakness...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28358780/the-cure-that-lies-within-the-mind-body-connection-in-orthopaedics
#3
Erin Sullivan, Jeremy Hudson
The mind and the body are clearly intertwined in ways that are only now being discovered. In the orthopaedic world, injuries and diseases are often classified and described in a very organized, discrete fashion-The radius is fractured, the ACL or meniscus or rotator cuff is torn, the ankle is sprained, and/or the lumbar spine has a disc herniation. Although it is, in many ways, almost comforting to think about injuries or orthopaedic issues in this manner, what about the many patients who fail to fall into this classification? What about the thousands of patients with severe unexplained chronic pain or patients who just are not improving with the typical treatment algorithm...
March 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28326802/the-relationship-between-beliefs-about-emotions-and-quality-of-life-in-irritable-bowel-syndrome
#4
Hannah Bowers, Abigail Wroe, Tamar Pincus
Suppression of undesirable emotions, as well as beliefs about the unacceptability of experiencing and expressing emotions, have both been shown to be related to poorer health-related outcomes in several clinical groups. Potential models through which these variables relate have yet to be tested in those with irritable bowel syndrome (IBS) and are therefore examined in the current article. Online questionnaires were administered to people with IBS (n = 84) to test a mediation model in which beliefs about the unacceptability of emotions are associated with greater emotional suppression, which in turn relates to increased affective distress and consequently poorer quality of life...
March 22, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28295826/prevalence-types-and-associations-of-medically-unexplained-symptoms-and-signs-a-cross-sectional-study-of-1023-adults-with-intellectual-disabilities
#5
M Osugo, J Morrison, L Allan, D Kinnear, S-A Cooper
BACKGROUND: Medically unexplained symptoms and signs are common in the general population and can respond to appropriate managements. We aimed to quantify the types and prevalence of unexplained symptoms and signs experienced by adults with ID and to determine the associated factors. METHOD: In a population-based study, 1023 adults with ID aged 16 and over had a detailed health assessment, which systematically considered symptoms and signs. Descriptive data were generated on their symptoms and signs...
March 9, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28295128/medically-unexplained-physical-symptoms-mups-among-adults-in-canada-comorbidity-health-care-use-and-employment
#6
Jungwee Park, Heather Gilmour
Based on data from the 2014 Canadian Community Health Survey and the 2012 Canadian Community Health Survey-Mental Health, this study provides estimates of the prevalence of medically unexplained physical symptoms (MUPS) in the household population aged 25 or older. MUPS are examined in relation to sociodemographic characteristics, physical and mental comorbidity, health care use and unmet needs, labour force participation and productivity. In 2014, 5.5% of Canadian adults-an estimated 1.3 million - reported having chronic fatigue syndrome (1...
March 15, 2017: Health Reports
https://www.readbyqxmd.com/read/28291576/evaluating-challenges-for-improving-medically-unexplained-symptoms-in-us-military-veterans-via-provider-communication
#7
L Alison Phillips, Lisa McAndrew, Benjamin Laman-Maharg, Katharine Bloeser
OBJECTIVES: Medically unexplained symptoms (MUS) are common, with particularly high rates observed in military veterans. Effective patient-provider-communication is thought to be a key aspect of care; however there have been few empirical studies on the association between communication and outcomes for patients with MUS. We evaluate whether discussing veterans' MUS-illness representations and good interpersonal skills have the potential to promote MUS-treatment adherence and improvement...
March 6, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28289468/the-effect-of-an-educational-intervention-in-family-phisicians-on-self-rated-quality-of-life-in-patients-with-medically-unexplained-symptoms
#8
Vojislav Ivetić, Klemen Pašić, Polona Selič
INTRODUCTION: Medically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS. METHODS: In a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI...
June 1, 2017: Zdravstveno Varstvo
https://www.readbyqxmd.com/read/28287345/the-role-of-emotion-in-psychotherapeutic-change-for-medically-unexplained-symptoms
#9
Joel M Town, Victoria Lomax, Allan A Abbass, Gillian Hardy
OBJECTIVES: Evidence of the contribution of emotional processes to the emergence, maintenance, and experience of medically unexplained symptoms (MUS) suggests that clinical approaches which target these processes could be beneficial. In this study, qualitative methods were used to examine patients' perspectives and subjective experiences of emotional processes in the context of a psychotherapy assessment and treatment service for MUS provided in a hospital emergency department (ED). METHODS: Seven semi-structured interviews were conducted with ED patients presenting with MUS who received a course of intensive short-term dynamic psychotherapy treatment...
March 13, 2017: Psychotherapy Research: Journal of the Society for Psychotherapy Research
https://www.readbyqxmd.com/read/28279495/psychotherapy-for-medically-unexplained-pain-a-randomized-clinical-trial-comparing-intensive-short-term-dynamic-psychotherapy-and-cognitive-behavior-therapy
#10
Behzad Chavooshi, Mehdi Saberi, Seyed Abbas Tavallaie, Hedayat Sahraei
BACKGROUND: The efficacy of intensive short-term dynamic psychotherapy (ISTDP) for medically unexplained pain remains open to debate because of a paucity of high-quality studies. OBJECTIVES: This study sought to evaluate ISTDP as a treatment for medically unexplained pain in outpatients by comparing it with the established evidence-based cognitive-behavioral therapy (CBT) in a randomized clinical trial. METHODS: A total of 341 adults with medically unexplained pain were randomly assigned to 16 sessions of individual manualized CBT (N = 164) or ISTDP (N = 177)...
January 11, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28246082/survivorship-of-severe-medically-unexplained-symptoms-in-palliative-care
#11
Justin Dwyer, Keryn Taylor, Mark Boughey
OBJECTIVES: Patients who articulate their psychological distress primarily through physical symptoms (referred to as medically unexplained symptoms (MUS)) pose a challenge to the skills of most clinicians, including palliative care physicians. The philosophical underpinnings of palliative care with a stated focus on symptom management and care of the person in their psychosociospiritual context lend itself to the care of these patients. The aim of this study was to investigate the characteristics to improve identification of this patient group within palliative care...
February 28, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28241237/association-of-testosterone-levels-with-anemia-in-older-men-a-controlled-clinical-trial
#12
Cindy N Roy, Peter J Snyder, Alisa J Stephens-Shields, Andrew S Artz, Shalender Bhasin, Harvey J Cohen, John T Farrar, Thomas M Gill, Bret Zeldow, David Cella, Elizabeth Barrett-Connor, Jane A Cauley, Jill P Crandall, Glenn R Cunningham, Kristine E Ensrud, Cora E Lewis, Alvin M Matsumoto, Mark E Molitch, Marco Pahor, Ronald S Swerdloff, Denise Cifelli, Xiaoling Hou, Susan M Resnick, Jeremy D Walston, Stephen Anton, Shehzad Basaria, Susan J Diem, Christina Wang, Stanley L Schrier, Susan S Ellenberg
Importance: In one-third of older men with anemia, no recognized cause can be found. Objective: To determine if testosterone treatment of men 65 years or older with unequivocally low testosterone levels and unexplained anemia would increase their hemoglobin concentration. Design, Setting, and Participants: A double-blinded, placebo-controlled trial with treatment allocation by minimization using 788 men 65 years or older who have average testosterone levels of less than 275 ng/dL...
April 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28188168/metformin-associated-lactic-acidosis-treated-with-continuous-renal-replacement-therapy
#13
Akihide Nakamura, Kei Suzuki, Hiroshi Imai, Naoyuki Katayama
Metformin-associated lactic acidosis (MALA) is a rare but life-threatening complication. We report a case of MALA in a man aged 71 years who was treated with continuous renal replacement therapy (CRRT). The patient was brought to the hospital for prolonged and gradual worsening gastrointestinal symptoms. Although he received intravenous treatment, he developed catecholamine-resistant shock, and blood gas analysis revealed lactic acidosis. Bicarbonate and antibiotics for possible sepsis were initiated, but with no clear benefit...
February 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28173764/-medically-unexplained-symptoms-and-symptom-disorders-in-primary-care-prognosis-based-recognition-and-classification
#14
EDITORIAL
Marianne Rosendal, Tim C Olde Hartman, Aase Aamland, Henriette van der Horst, Peter Lucassen, Anna Budtz-Lilly, Christopher Burton
BACKGROUND: Many patients consult their GP because they experience bodily symptoms. In a substantial proportion of cases, the clinical picture does not meet the existing diagnostic criteria for diseases or disorders. This may be because symptoms are recent and evolving or because symptoms are persistent but, either by their character or the negative results of clinical investigation cannot be attributed to disease: so-called "medically unexplained symptoms" (MUS). MUS are inconsistently recognised, diagnosed and managed in primary care...
February 7, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28169588/how-do-hospital-doctors-manage-patients-with-medically-unexplained-symptoms-a-qualitative-study-of-physicians
#15
Alex Warner, Kate Walters, Kethakie Lamahewa, Marta Buszewicz
Objective Medically unexplained symptoms are a common presentation in medical practice and are associated with significant morbidity and high levels of service use. Most research exploring the attitudes and training of doctors in treating patients with unexplained symptoms has been conducted in primary care. This study aims to explore the ways in which doctors working in secondary care approach and manage patients with medically unexplained symptoms. Design A qualitative study using in-depth interviews and thematic analysis...
February 2017: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/28162191/-the-chinese-expert-consensus-on-clinical-practice-of-medically-unexplained-symptoms
#16
(no author information available yet)
"Medically unexplained symptoms" (MUS) are commonly seen in all clinical specialties. The preliminary investigations in China show a prevalence of MUS in 4.15%-18.2% of clinical patients. Based on international and national guidelines and the most advanced studies, a Chinese expert consensus on clinical practice of MUS is reached through three rounds of discussion seminars by 25 experts from various specialties including psychiatry, internal medicine, surgery, gynecology-obstetrics, otorhinolar-yngology and traditional Chinese medicine...
February 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28138200/a-review-of-psychopharmacological-interventions-post-disaster-to-prevent-psychiatric-sequelae
#17
REVIEW
Badari Birur, Suresh Bada Math, Rachel E Fargason
BACKGROUND: Disasters are mega-scale catastrophic events which cause trauma and mental health sequelae. A review of early pharmacological interventions for the prevention of psychiatric disorders following disasters is sorely needed. METHODS: A literature search of "Psychiatric Sequelae AND Disasters", "Disaster mental health/Disaster psychiatry", "Psychotropics AND Disasters", and "Drug therapy AND Disasters" yielded 213 articles, 38 of which were included in the review...
January 26, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28129956/-medically-unexplained-symptoms-care-in-internal-medicine-a-paradigm-of-doctor-patient-relationship-in-situation-of-uncertainty
#18
B Ranque, O Nardon
Medically unexplained symptoms (MUS) are extremely common in general practice as in all medical specialties, but their designation is not unambiguous and the approaches to take care of the patients differ from conventional therapeutic approaches. The difficulty is not to confirm the diagnosis, which is rapidly obvious with some experience, but to establish a genuinely human therapeutic relationship, without any technical help, which pushes the doctor to the edge of his empathy and communication skills. The discomfort or even distress regularly encountered by physicians in front of a patient with MUS shows that the foundations of the doctor-patient relationship under uncertainty are poorly mastered...
January 24, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28129738/a-novel-case-of-renal-pathergy-reaction-in-a-beh%C3%A3-et-s-disease-patient-complicated-by-iga-vasculitis
#19
Takaaki Higashihara, Akira Okada, Taiko Kusano, Kazuyoshi Ishigaki, Akira Shimizu, Hideki Takano
BACKGROUND: A pathergy reaction is defined as a hyperreactivity of the skin in response to minimal trauma, which is important in the diagnosis of Behçet's disease (BD). However, a pathergy reaction may not be restricted to the skin, and little is known about whether an invasive medical procedure can induce the reaction. Here we present a pathergy reaction induced by renal biopsy, an invasive procedure. CASE PRESENTATION: A 46-year-old man who was diagnosed with IgA vasculitis (IgAV) at the age of 38 was treated with prednisolone and mizoribine...
January 28, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28122926/negotiating-explanations-doctor-patient-communication-with-patients-with-medically-unexplained-symptoms-a-qualitative-analysis
#20
Madelon den Boeft, Daniëlle Huisman, LaKrista Morton, Peter Lucassen, Johannes C van der Wouden, Marjan J Westerman, Henriëtte E van der Horst, Christopher D Burton
BACKGROUND: Patients with medically unexplained physical symptoms (MUPS) seek explanations for their symptoms, but often find general practitioners (GPs) unable to deliver these. Different methods of explaining MUPS have been proposed. Little is known about how communication evolves around these explanations. OBJECTIVE: To examine the dialogue between GPs and patients related to explanations in a community-based clinic for MUPS. We categorized dialogue types and dialogue outcomes...
February 2017: Family Practice
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