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Medically unexplained symptoms

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https://www.readbyqxmd.com/read/29759049/klinefelter-s-syndrome-with-lupus-encephalitis-and-retroperitoneal-teratoma
#1
C Ng Wq, S E Eide, Huang J, Khor Ym
We report a case of a middle-aged male who presented with pyrexia of unknown origin, oral ulcers, rash and bicytopenia. His past medical history included unexplained proteinuria, infertility and joint pain. Initial workup showed a large retroperitoneal soft tissue mass, which has appeared stable for 10 years. He subsequently developed neuropsychiatric symptoms with imaging findings of meningoencephalitis. Concurrent investigations showed elevated ANA, anti-double-stranded DNA (dsDNA) and ESR levels, as well as low complement levels...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29751948/quantifying-positive-communication-doctor-s-language-and-patient-anxiety-in-primary-care-consultations
#2
Inge A Stortenbeker, Juul Houwen, Peter L B J Lucassen, Hugo W Stappers, Willem J J Assendelft, Sandra van Dulmen, Tim C Olde Hartman, Enny Das
OBJECTIVE: Positive communication is advocated for physicians during consultations with patients presenting medically unexplained symptoms (MUS), but studies generally focus on what is said rather than how it is said. This study quantified language use differences of general practitioners (GPs), and assessed their relation to patient anxiety. METHODS: Language use of 18 Dutch GPs during 82 consultations was compared for patients with MUS versus medically explained symptoms (MES)...
May 1, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29746257/novel-pharmacotherapy-in-hypertrophic-cardiomyopathy
#3
Gabriela Andries, Srikanth Yandrapalli, Srihari S Naidu, Julio A Panza
Hypertrophic cardiomyopathy (HCM) is an inherited disease characterized by unexplained left ventricular hypertrophy. Although it is estimated to affect 1 out of 500 people, the HCM gene carrier prevalence is much more common, probably as high as 1 in 200 people. Most affected individuals have a normal life expectancy, while some patients may develop sudden cardiac death or end-stage heart failure. Despite significant developments in the treatment of HCM with surgical, interventional, and device-based procedures, the main focus of current pharmacological therapy has not evolved from the basic objectives of relief of symptoms and improvement in functional capacity...
May 9, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29739735/effectiveness-of-a-blended-multidisciplinary-intervention-for-patients-with-moderate-medically-unexplained-physical-symptoms-parasol-protocol-for-a-cluster-randomized-clinical-trial
#4
Paula Elisabeth van Westrienen, Martijn F Pisters, Suze Aj Toonders, Marloes Gerrits, Cindy Veenhof, Niek J de Wit
BACKGROUND: Medically unexplained physical symptoms are an important health problem in primary care, with a spectrum from mild to chronic. The burden of chronic medically unexplained physical symptoms is substantial for patients, health care professionals, and society. Therefore, early identification of patients with moderate medically unexplained physical symptoms is needed in order to prevent chronicity. The preventive screening of medically unexplained physical symptoms (PRESUME) screening method was developed using data from the electronic medical record of the patients' general practitioner and demonstrated its prognostic accuracy to identify patients with moderate medically unexplained physical symptoms...
May 8, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29737197/inflammatory-bowel-disease-related-fatigue-is-correlated-with-depression-and-gender
#5
Philip Keightley, Rebecca E Reay, Paul Pavli, Jeffrey Cl Looi
OBJECTIVES: Fatigue is a common and disabling problem in inflammatory bowel disease. We sought to explore the possible determinants of inflammatory bowel disease-associated fatigue including demographic, psychological and disease variables. METHODS: Surveys were distributed to 100 patients undergoing infliximab infusion for inflammatory bowel disease in an infusion lounge, assessing attachment style (Experiences in Close Relationships Revised scale), fatigue (Functional Assessment of Chronic Illness Therapy Fatigue - Fatigue Subscore), and depression and anxiety (Hospital Anxiety and Depression Scale)...
May 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/29726743/opinion-paper-the-role-of-work-in-the-management-of-medically-unexplained-physical-symptoms
#6
Els Tobback, An Mariman, Lies Clauwaert, Lode Godderis, Stefan Heytens, Patrick Ruppol, Daniel Spooren, Rita Tytgat, Martine De Muynck, Dirk Vogelaers
OBJECTIVES: Patients with medically unexplained physical symptoms suffer from chronic fatigue and/or pain in combination with a variety of other symptoms. A flexible, biopsychosocial approach is needed for diagnostic screening and global management. It is crucial to involve the direct patient environment, including family, friends, colleagues as well as health providers, evaluation, and reintegration sector. The aim of this paper is to review the importance of work in the management of medically unexplained physical symptoms...
May 4, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29724416/acr-appropriateness-criteria-%C3%A2-breast-implant-evaluation
#7
Ana P Lourenco, Linda Moy, Paul Baron, Aarati D Didwania, Roberta M diFlorio, Samantha L Heller, Anna I Holbrook, Alana A Lewin, Tejas S Mehta, Bethany L Niell, Priscilla J Slanetz, Ashley R Stuckey, Daymen S Tuscano, Nina S Vincoff, Susan P Weinstein, Mary S Newell
Breast implant imaging varies depending on patient age, implant type, and symptoms. For asymptomatic patients (any age, any implant), imaging is not recommended. Rupture of saline implants is often clinically evident, as the saline is resorbed and there is a change in breast contour. With saline implants and equivocal clinical findings, ultrasound (US) is the examination of choice for patients less than 30 years of age, either mammography/digital breast tomosynthesis or US may be used for those 30 to 39 years of age, and mammography/digital breast tomosynthesis is used for those 40 years and older...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29720093/how-general-practitioners-understand-and-handle-medically-unexplained-symptoms-a-focus-group-study
#8
Erik Børve Rasmussen, Karin Isaksson Rø
BACKGROUND: Medically unexplained symptoms (MUS) are a common yet challenging encounter in primary care. The aim of this study was to explore how general practitioners (GPs) understand and handle MUS. METHODS: Three focus group interviews were conducted with a total of 23 GPs. Participants with varied clinical experience were purposively recruited. The data were analysed thematically, using the concept of framing as an analytical lens. RESULTS: The GPs alternated between a biomedical frame, centred on disease, and a biopsychosocial frame, centred on the sick person...
May 2, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29709954/two-cases-of-transiently-elevated-serum-cea-levels-in-severe-hypothyroidism-without-goiter
#9
Tomonori Sekizaki, Chiho Yamamoto, Hiroshi Nomoto
Carcinoembryonic antigen (CEA), the level of which is known to increase in both patients with gastrointestinal cancers and those with non-neoplastic conditions, is one of the most widely-used tumor markers. Hypothyroidism is a common endocrinological disorder in which CEA levels can rise, and is sometimes overlooked as a diagnosis in the absence of typical symptoms or thyroid enlargement. We report the cases of two patients with non-goiterous severe hypothyroidism with markedly elevated CEA levels that effectively decreased with levothyroxine replacement therapy alone...
April 27, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29706237/-pathway-to-diagnosis-and-real-life-experience-of-patients-believing-they-are-affected-by-chronic-lyme-disease
#10
E Forestier, F Gonnet, A Revil-Signorat, A C Zipper
OBJECTIVES: Chronic Lyme disease is a subject of scientific and social controversy in both Europe and the United States. The aim of our study was to analyze the pathway to diagnosis of patients believing they were affected by the disease, and to describe their real-life experience. METHOD: A qualitative study was performed with 13 patients declaring themselves to be affected by chronic Lyme disease. Interviews were analyzed by 2 general medical practice interns, supervised by a general practitioner with a diploma in socio-anthropology and an infectious diseases specialist...
April 26, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29697344/medically-unexplained-symptoms-and-the-diagnosis-of-medical-child-abuse
#11
Maxine Eichner
No abstract text is available yet for this article.
May 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29697342/treating-medically-unexplained-symptoms-empirically-ethical-implications-for-concurrent-diagnosis
#12
Lauren R Sankary, Paul J Ford
No abstract text is available yet for this article.
May 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29697338/schr%C3%A3-dinger-s-disease-and-the-ethics-of-non-diagnosis-the-problem-of-medically-unexplained-symptoms-in-contemporary-medical-practice
#13
Louise Stone
No abstract text is available yet for this article.
May 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29697337/conversion-disorder-diagnosis-and-medically-unexplained-symptoms
#14
Michael James Redinger, Parker Crutchfield, Tyler S Gibb, Peter Longstreet, Robert Strung
No abstract text is available yet for this article.
May 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29697336/the-need-for-improved-access-to-mental-health-services-for-youth-with-medically-unexplained-symptoms
#15
Kristin Canavera, Jennifer Allen, Liza-Marie Johnson
No abstract text is available yet for this article.
May 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29697335/rejecting-reality-and-substituting-one-s-own-why-bioethics-should-be-concerned-with-medically-unexplained-symptoms
#16
Mark Henderson Arnold, Ian Kerridge
No abstract text is available yet for this article.
May 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29697334/why-bioethics-should-pay-attention-to-patients-who-suffer-medically-unexplained-physical-symptoms-a-discussion-of-uncertainty-suffering-and-risk
#17
Chloë G K Atkins
No abstract text is available yet for this article.
May 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29697325/calibrating-confident-judgments-about-medically-unexplained-symptoms
#18
Abraham Schwab
No abstract text is available yet for this article.
May 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29697324/why-bioethics-should-be-concerned-with-medically-unexplained-symptoms
#19
Diane O'Leary
Biomedical diagnostic science is a great deal less successful than we've been willing to acknowledge in bioethics, and this fact has far-reaching ethical implications. In this article I consider the surprising prevalence of medically unexplained symptoms, and the term's ambiguous meaning. Then I frame central questions that remain answered in this context with respect to informed consent, autonomy, and truth-telling. Finally, I show that while considerable attention in this area is given to making sure not to provide biological care to patients without a need, comparatively little is given to the competing, ethically central task of making sure never to obstruct access to biological care for those with diagnostically confusing biological conditions...
May 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29693478/psychoeducation-against-depression-anxiety-alexithymia-and-fibromyalgia-a-pilot-study-in-primary-care-for-patients-on-sick-leave
#20
Eva O Melin, Ralph Svensson, Hans O Thulesius
OBJECTIVES: Feasibility testing of a psychoeducational method -The Affect School and Script Analyses (ASSA) - in a Swedish primary care setting. Exploring associations between psychological, and medically unexplained physical symptoms (MUPS). DESIGN: Pilot study. SETTING: Three Swedish primary care centers serving 20,000 people. INTERVENTION: 8 weekly 2-hour sessions with a 5-7 participant group led by two instructors - followed by 10 individual hour-long sessions...
June 2018: Scandinavian Journal of Primary Health Care
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