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Medically unexplained symptoms

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https://www.readbyqxmd.com/read/28523700/balancing-medical-accuracy-and-diagnostic-consequences-diagnosing-medically-unexplained-symptoms-in-primary-care
#1
Erik B Rasmussen
Focusing on the case of medically unexplained symptoms (MUS), this article explores diagnostic classification in the absence of biomedical evidence or other strong medical warrants for diagnosis. The data are from three focus group interviews with Norwegian general practitioners (GPs) conducted in 2015, that centred on the issue of what diagnoses to use (or not) for MUS. The qualitative analysis reconstructs the logic underlying GPs' diagnostic accounts, which centred on the meaning of diagnostic categories and on anticipating how 'generalised others' would respond to those meanings (called 'diagnosing by anticipation')...
May 18, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28522975/hypoxia-and-inactivity-related-physiological-changes-constipation-inflammation-are-not-reflected-at-the-level-of-gut-metabolites-and-butyrate-producing-microbial-community-the-planhab-study
#2
Robert Šket, Nicole Treichel, Tadej Debevec, Ola Eiken, Igor Mekjavic, Michael Schloter, Marius Vital, Jenna Chandler, James M Tiedje, Boštjan Murovec, Zala Prevoršek, Blaž Stres
We explored the assembly of intestinal microbiota in healthy male participants during the run-in (5 day) and experimental phases [21-day normoxic bed rest (NBR), hypoxic bedrest (HBR)], and hypoxic ambulation (HAmb) in a strictly controlled laboratory environment, balanced fluid, and dietary intakes, controlled circadian rhythm, microbial ambiental burden, and 24/7 medical surveillance. The fraction of inspired O2 (FiO2) and partial pressure of inspired O2 (PiO2) were 0.209 and 133.1 ± 0.3 mmHg for NBR and 0...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28511823/dissociation-and-conversion-symptoms-in-dermatology
#3
Madhulika A Gupta, Branka Vujcic, Aditya K Gupta
Dissociation and conversion (defined as the somatic component of dissociation) can play an important mediating role in the exacerbation of the stress-reactive dermatoses (eg, psoriasis, idiopathic urticaria, atopic dermatitis), dermatoses that are exacerbated by excessive scratching (eg, lichen simplex chronicus, prurigo nodularis) and koebnerization, and the self-induced dermatoses (dermatitis artefacta, acne excoriée, skin picking disorder, trichotillomania, onychotillomania/onychophagia). Dissociative symptoms often coexist with obsessive-compulsive symptoms in the more severe cases of the self-induced dermatoses...
May 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/28511821/somatization-in-the-dermatology-patient-some-sociocultural-perspectives
#4
Krishna M Prasad, Geetha Desai, Santosh K Chaturvedi
Somatization in dermatology patients is a challenge to diagnose and manage. Somatization presents as medically unexplained dermatologic symptoms, which are commonly encountered in dermatology and psychiatry practices. These cutaneous symptoms are often intriguing and do not fit into any particular known dermatologic condition. Sometimes, they may evoke negative feelings in the practicing dermatologist. The dermatologic somatic symptoms might be one way of communicating psychologic distress in a culturally acceptable method...
May 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/28485682/-lumping-and-splitting-medically-unexplained-symptoms-is-there-a-role-for-a-transdiagnostic-approach
#5
Trudie Chalder, Claire Willis
No abstract text is available yet for this article.
May 9, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28483228/clinical-manifestations-of-neuroblastoma-with-head-and-neck-involvement-in-children
#6
Sameer Alvi, Omar Karadaghy, Michelle Manalang, Robert Weatherly
OBJECTIVE: The purpose of our study is to review our 15-year experience with pediatric patients who have been diagnosed with neuroblastoma, and to determine their most frequent head and neck manifestations and symptoms. STUDY DESIGN: Retrospective chart review of electronic medical record. SETTING: An academic, tertiary care pediatric hospital. SUBJECTS AND METHODS: IRB approval from the Office of Research Integrity at Children's Mercy Hospital was obtained...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28476564/global-mortality-variations-in-patients-with-heart-failure-results-from-the-international-congestive-heart-failure-inter-chf-prospective-cohort-study
#7
Hisham Dokainish, Koon Teo, Jun Zhu, Ambuj Roy, Khalid F AlHabib, Ahmed ElSayed, Lia Palileo-Villaneuva, Patricio Lopez-Jaramillo, Kamilu Karaye, Khalid Yusoff, Andres Orlandini, Karen Sliwa, Charles Mondo, Fernando Lanas, Dorairaj Prabhakaran, Amr Badr, Mohamed Elmaghawry, Albertino Damasceno, Kemi Tibazarwa, Emilie Belley-Cote, Kumar Balasubramanian, Shofiqul Islam, Magdi H Yacoub, Mark D Huffman, Karen Harkness, Alex Grinvalds, Robert McKelvie, Shrikant I Bangdiwala, Salim Yusuf
BACKGROUND: Most data on mortality and prognostic factors in patients with heart failure come from North America and Europe, with little information from other regions. Here, in the International Congestive Heart Failure (INTER-CHF) study, we aimed to measure mortality at 1 year in patients with heart failure in Africa, China, India, the Middle East, southeast Asia and South America; we also explored demographic, clinical, and socioeconomic variables associated with mortality. METHODS: We enrolled consecutive patients with heart failure (3695 [66%] clinic outpatients, 2105 [34%] hospital in patients) from 108 centres in six geographical regions...
May 3, 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28468642/the-ciprus-study-a-nurse-led-psychological-treatment-for-patients-with-undifferentiated-somatoform-disorder-in-primary-care-study-protocol-for-a-randomised-controlled-trial
#8
Kate Sitnikova, Stephanie S Leone, Lyonne N L Zonneveld, Harm W J van Marwijk, Judith E Bosmans, Johannes C van der Wouden, Henriëtte E van der Horst
BACKGROUND: Up to a third of patients presenting medically unexplained physical symptoms in primary care may have a somatoform disorder, of which undifferentiated somatoform disorder (USD) is the most common type. Psychological interventions can reduce symptoms associated with USD and improve functioning. Previous research has either been conducted in secondary care or interventions have been provided by general practitioners (GPs) or psychologists in primary care. As efficiency and cost-effectiveness are imperative in primary care, it is important to investigate whether nurse-led interventions are effective as well...
May 3, 2017: Trials
https://www.readbyqxmd.com/read/28464183/physician-satisfaction-in-treating-medically-unexplained-symptoms
#9
Simon G Brauer, John D Yoon, Farr A Curlin
OBJECTIVES: To determine whether treating conditions having medically unexplained symptoms is associated with lower physician satisfaction and higher ascribed patient responsibility, and to determine whether higher ascribed patient responsibility is associated with lower physician satisfaction in treating a given condition. METHODS: We surveyed a nationally representative sample of 1504 US primary care physicians. Respondents were asked how responsible patients are for two conditions with more-developed medical explanations (depression and anxiety) and two conditions with less-developed medical explanations (chronic back pain and fibromyalgia), and how much satisfaction they experienced in treating each condition...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28450466/improving-teaching-about-medically-unexplained-symptoms-for-newly-qualified-doctors-in-the-uk-findings-from-a-questionnaire-survey-and-expert-workshop
#10
Katherine Yon, Stephanie Habermann, Joe Rosenthal, Kate R Walters, Sarah Nettleton, Alex Warner, Kethakie Lamahewa, Marta Buszewicz
OBJECTIVES: Medically unexplained symptoms (MUS) present frequently in healthcare, can be complex and frustrating for clinicians and patients and are often associated with overinvestigation and significant costs. Doctors need to be aware of appropriate management strategies for such patients early in their training. A previous qualitative study with foundation year doctors (junior doctors in their first 2 years postqualification) indicated significant lack of knowledge about this topic and appropriate management strategies...
April 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28445267/different-clinical-presentations-of-choledochal-cyst-among-infants-and-older-children-a-10-year-retrospective-study
#11
Davoud Badebarin, Saeid Aslanabadi, Amir Teimouri-Dereshki, Masoud Jamshidi, Tuba Tarverdizadeh, Kaveh Shad, Kamyar Ghabili, Ghazal Khajir
Choledochal cyst is a rare and often benign congenital cystic dilation throughout the biliary tree. Due to the benign nature of choledochal cyst among early-diagnosed patients, the clinical assumption and diagnosis seem to be of utmost significance. Therefore, we sought to assess different clinical manifestations of choledochal cyst and relevant laboratory findings in infants and older children.Retrospectively, medical records of all patients with the diagnosis of choledochal cyst between 2005 and 2015 were reviewed...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28444695/exercise-therapy-for-chronic-fatigue-syndrome
#12
REVIEW
Lillebeth Larun, Kjetil G Brurberg, Jan Odgaard-Jensen, Jonathan R Price
BACKGROUND: Chronic fatigue syndrome (CFS) is characterised by persistent, medically unexplained fatigue, as well as symptoms such as musculoskeletal pain, sleep disturbance, headaches and impaired concentration and short-term memory. CFS presents as a common, debilitating and serious health problem. Treatment may include physical interventions, such as exercise therapy, which was last reviewed in 2004. OBJECTIVES: The objective of this review was to determine the effects of exercise therapy (ET) for patients with CFS as compared with any other intervention or control...
April 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28418216/adult-attachment-insecurity-is-positively-associated-with-medically-unexplained-chronic-pain
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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