keyword
https://read.qxmd.com/read/38372873/how-to-monitor-disease-activity-of-axial-spondyloarthritis-in-clinical-practice
#1
REVIEW
Anand Kumthekar, Nirali Sanghavi, Anuya Natu, Abhijeet Danve
PURPOSE OF REVIEW: Treatment guided by periodic and quantitative data assessment results in better outcomes compared to using clinical gestalt. While validated generic as well as specific disease activity measures for axial spondyloarthritis (axSpA) are available, there is vast scope to improve their actual utilization in routine clinical practice. In this review, we discuss available disease activity measures for axSpA, describe results from the survey conducted among general rheumatologists as well as Spondyloarthritis Research and Treatment Network (SPARTAN) members about disease activity measurement in daily practice, and discuss ways to improve axSpA disease activity using technological advances...
February 19, 2024: Current Rheumatology Reports
https://read.qxmd.com/read/38322927/external-validation-of-the-bedside-score-for-the-diagnosis-of-acute-cholecystitis
#2
JOURNAL ARTICLE
Fatemeh Mahmoudzadeh, Atousa Akhgar, Hadi Mirfazaelian
UNLABELLED: Objective: Acute cholecystitis usually presents with right upper quadrant (RUQ) abdominal pain. However, there are other conditions with similar findings which make the diagnosis difficult. The objective of this study is to prospectively validate the performance of the bedside score for the diagnosis of cholecystitis in patients presenting to the emergency department (ED) with possible acute cholecystitis. STUDY DESIGN: We performed a prospective observational study of a convenience sample of patients with RUQ pain admitted to the ED of three academic hospitals...
February 15, 2024: Heliyon
https://read.qxmd.com/read/37945311/diagnosis-of-acute-aortic-syndrome-in-the-emergency-department-dashed-study-an-observational-cohort-study-of-people-attending-the-emergency-department-with-symptoms-consistent-with-acute-aortic-syndrome
#3
JOURNAL ARTICLE
Rachel McLatchie, Matthew J Reed, Nicola Freeman, Richard A Parker, Sarah Wilson, Steve Goodacre, Alicia Cowan, Jessica Boyle, Benjamin Clarke, Ellise Clarke
BACKGROUND: The diagnosis of acute aortic syndrome (AAS) is commonly delayed or missed in the ED. We describe characteristics of ED attendances with symptoms potentially associated with AAS, diagnostic performance of clinical decision tools (CDTs) and physicians and yield of CT aorta angiogram (CTA). METHODS: This was a multicentre observational cohort study of adults attending 27 UK EDs between 26 September 2022 and 30 November 2022, with potential AAS symptoms: chest, back or abdominal pain, syncope or symptoms related to malperfusion...
February 20, 2024: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/36897401/-in-god-alone-my-soul-can-find-rest-ps%C3%A2-62-2-silence-and-pain-in-the-psalms-and-their-narrativizations-in-taiz%C3%A3
#4
REVIEW
Margarethe Kelm, Katharina Opalka
BACKGROUND: A theological perspective on dealing with crises that focuses on modes of endurance and gestalt, is supported by interdisciplinary resilience research. OBJECTIVE: How can silence contribute to a productive coping with crises and pain? MATERIAL AND METHODS: Texts and practices of the Christian tradition are discussed with respect to their ways of dealing with critical and painful situations, namely a) the Psalm texts of the Old Testament, which are examined by means of exegetical methods for historical and cultural aspects of meaning and b) the practice of silence in the prayers of the Taizé community, which are examined from a narrative hermeneutical perspective...
March 10, 2023: Der Schmerz
https://read.qxmd.com/read/36857789/external-validation-of-the-chicago-chiari-outcome-scale-in-adults-with-chiari-malformation-type-i
#5
JOURNAL ARTICLE
Lukasz Antkowiak, Piotr Stogowski, Tomasz Klepinowski, Tristan Balinski, Hubert Mado, Piotr Sumislawski, Marcin Niedbala, Michalina Rucinska, Zuzanna Nowaczyk, Marta Rogalska, Damian Kocur, Anna Kasperczuk, Ryszard Sordyl, Wojciech Kloc, Wojciech Kaspera, Gertrud Kammler, Leszek Sagan, Adam Rudnik, Pawel Tabakow, Manfred Westphal, Marek Mandera
OBJECTIVE: The Chicago Chiari Outcome Scale (CCOS) serves as a standardized clinical outcome evaluation tool among patients with Chiari malformation type I (CM-I). While the reliability of this scale has been proven for pediatric patients, the literature lacks CCOS validation when used solely in adults. Therefore, this study aimed to determine the validity of the CCOS in an external cohort of adult patients. METHODS: The authors retrospectively analyzed the medical records of symptomatic patients with CM-I who underwent posterior fossa decompression between 2010 and 2018 in six neurosurgical departments...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36729157/pathophysiological-basis-clinical-assessment-investigation-and-management-of-patients-with-obstruction-defecation-syndrome
#6
REVIEW
John Bunni, Matthew J Laugharne
Obstructed defecation syndrome (ODS) is a clinical syndrome manifest as difficulty in faecal evacuation despite no mechanical obstruction. It is the final clinical pathway of a number of anatomical and physiological pathologies they can result in considerable misery to the lives of the patients it afflicts. Herein, the authors seek to breakdown the syndrome into its component parts, looking first at normal pelvic floor anatomy and physiology; followed by each pathological element; clinical features and investigation; individual management and management of the patient as a whole...
February 2, 2023: Langenbeck's Archives of Surgery
https://read.qxmd.com/read/36194215/acute-pulmonary-embolism-a-review
#7
REVIEW
Yonathan Freund, Fleur Cohen-Aubart, Ben Bloom
IMPORTANCE: Pulmonary embolism (PE) is characterized by occlusion of blood flow in a pulmonary artery, typically due to a thrombus that travels from a vein in a lower limb. The incidence of PE is approximately 60 to 120 per 100 000 people per year. Approximately 60 000 to 100 000 patients die from PE each year in the US. OBSERVATIONS: PE should be considered in patients presenting with acute chest pain, shortness of breath, or syncope. The diagnosis is determined by chest imaging...
October 4, 2022: JAMA
https://read.qxmd.com/read/35573551/the-lupus-attack-a-case-report-and-literature-review-of-myocardial-infarction-and-antiphospholipid-syndrome
#8
Abhinav Karan, Adefemi Adeyemo, Michael Omar, Kerolos Fahmi, Srinivasan Sattiraju
Acute myocardial infarction in a young patient is a nebulous entity, but in the absence of traditional cardiovascular risk factors, particular attention must be paid to thrombotic disorders and hypercoagulable states. A 28-year-old male presented with worsening substernal chest pain for 36 hours. He was recently diagnosed with systemic lupus erythematosus (SLE) with active class II lupus nephritis. With an initial electrocardiogram revealing ischemic changes, and an elevated troponin I, a concern was raised for myocardial infarction...
April 2022: Curēus
https://read.qxmd.com/read/35415123/case-report-of-a-diagnosed-septic-hip-joint-treated-with-a-2-stage-hip-arthroplasty
#9
Jesse A Raszewski, A D Hoffman, H B Bamberger, A G Manocchio
Introduction: Identifying and determining appropriate treatment of adult hip septic arthritis (SA) can be quite challenging. Although rare, the annual incidence of this diagnosis is approximately 8 cases per 100,000 patients. The timing of patient symptoms is wide spread. The presentation may be acute, subacute, or even chronic, and moreover, the disease process may be masked by an underlying etiology. Once diagnosed, SA requires rapid and aggressive treatment. Case Report: A 67-year-old patient presented with left hip pain...
November 2021: Journal of Orthopaedic Case Reports
https://read.qxmd.com/read/35105336/a-brief-gestalt-intervention-changes-ultrasound-measures-of-tongue-movement-during-breastfeeding-case-series
#10
JOURNAL ARTICLE
Pamela Sylvia Douglas, Sharon Lisa Perrella, Donna Tracy Geddes
BACKGROUND: Lactation consultants frequently advise adjustments to fit and hold (or positioning and attachment) with the aim of optimising intra-oral nipple placement. However, approaches to fit and hold vary widely, with limited evidence of benefits, and effects of fit and hold on infant tongue movement have not been examined. The aim of this preliminary study was to investigate whether a gestalt breastfeeding intervention alters tongue movement, using measurements from ultrasound imaging to determine nipple placement and intra-oral nipple and breast tissue dimensions...
February 1, 2022: BMC Pregnancy and Childbirth
https://read.qxmd.com/read/35077977/improving-triage-accuracy-through-a-modified-nurse-administered-emergency-department-assessment-of-chest-pain-score-on-patients-with-chest-pain-at-triage-edact-a-prospective-observational-study
#11
JOURNAL ARTICLE
Abigail Ling Ying Ng, Celine Hui Xian Yeo, Shi Ting Ong, Cheryl Li Yan Chua, Mary Grace Liwanagan, Kwee Kuang Lim, Daniel Wei Ping Chor, Mui Teng Chua
BACKGROUND: Chest pain triage in our emergency department (ED) prioritize patients for consultation based on unstructured nursing gestalt. The Emergency Department Assessment of Chest Pain Score (EDACS) identifies patients at low-risk for major adverse cardiac events and may provide standardization for chest pain triage in ED. METHODS: We conducted a prospective observational study, including adult patients with chief complaint of chest pain who were self-conveyed...
March 2022: International Emergency Nursing
https://read.qxmd.com/read/34975112/retrospective-application-of-the-hear-score-on-patients-evacuated-for-chest-pain-assessing-the-utility-of-point-of-care-troponin
#12
JOURNAL ARTICLE
A Kapur, S Boutin, K Lyster, J Irvine, K Sawchuk
Introduction: The HEART scoring system codifies the clinical gestalt used by physicians with 0-2 points assigned to 5 criteria (history, electrocardiography, age, risk factors and troponin). This scoring provides a prognostic tool that assists in disposition planning. The use of a truncated HEART score, minus the troponin data (HEAR score), was used for patients presenting with chest pain at one of four outpost nursing stations served by La Ronge Health Centre in northern Saskatchewan...
January 2022: Canadian Journal of Rural Medicine
https://read.qxmd.com/read/34474523/preparing-for-medical-education-after-the-covid-19-pandemic-insightology-in-medicine
#13
JOURNAL ARTICLE
Yon Ho Choe
It is necessary to reflect on the question, "How to prepare for medical education after coronavirus disease 2019 (COVID-19)?" Although we are preparing for the era of Education 4.0 in line with the 4th industrial revolution of artificial intelligence and big data, most measures are focused on the methodologies of transferring knowledge; essential innovation is not being addressed. What is fundamentally needed in medicine is insightful intelligence that can see the invisible. We should not create doctors who only prescribe antispasmodics for abdominal pain, or antiemetic drugs for vomiting...
September 2021: Korean Journal of Medical Education
https://read.qxmd.com/read/33976491/variations-in-physiological-psychomotor-and-analgesic-parameters-during-titration-of-nitrous-oxide-in-3-12-years-old-children-managed-with-inhalation-sedation
#14
EDITORIAL
Shivangi Sharma, Radhika Chopra, Shivani Mathur, Vinod Sachdev, Kunal Gupta
BACKGROUND: The present study was designed to assess variations in physiological, psychomotor parameters, and analgesic effects at various levels of nitrous oxide-oxygen analgesia in 3-12 years old children. DESIGN: One hundred children aged 3-12 years were assessed for physiological, psychomotor, and analgesic parameters at various concentrations of N2 O, i.e., baseline, 20, 40, 50, and 0% (100% O2 ). Physiological, psychomotor, and analgesic effects were assessed using a pulse oximeter, bender visual-motor Gestalt test, and response to electric pulp tester, respectively...
November 2020: International Journal of Clinical Pediatric Dentistry
https://read.qxmd.com/read/33868406/from-blocking-shots-to-blocking-gi-transit-this-professional-basketball-player-does-it-all-a-case-report-on-small-bowel-obstruction
#15
Emily L DeMaio, Richard C Jarvis, Jessica A Cohen, Courtney N Gleason
Small bowel obstructions (SBO) are a commonly encountered diagnosis within emergency departments. Typically, these patients have evident risk factors including, but not limited to, prior abdominal surgery, personal or family history of gastrointestinal disorders, femoral and inguinal hernias, or neoplasm. In this case, we describe an SBO in a female, professional athlete whose swift, severe symptom onset, rapid resolution with conservative treatment, lack of identifiable risk factors, and prompt return to high level competition without recurrence are certainly unique...
2021: Case Reports in Medicine
https://read.qxmd.com/read/33787290/prospective-validation-and-comparative-analysis-of-coronary-risk-stratification-strategies-among-emergency-department-patients-with-chest-pain
#16
JOURNAL ARTICLE
Dustin G Mark, Jie Huang, Mamata V Kene, Dana R Sax, Dale M Cotton, James S Lin, Sean C Bouvet, Uli K Chettipally, Megan L Anderson, Ian D McLachlan, Laura E Simon, Judy Shan, Adina S Rauchwerger, David R Vinson, Dustin W Ballard, Mary E Reed
Background Coronary risk stratification is recommended for emergency department patients with chest pain. Many protocols are designed as "rule-out" binary classification strategies, while others use graded-risk stratification. The comparative performance of competing approaches at varying levels of risk tolerance has not been widely reported. Methods and Results This is a prospective cohort study of adult patients with chest pain presenting between January 2018 and December 2019 to 13 medical center emergency departments within an integrated healthcare delivery system...
March 31, 2021: Journal of the American Heart Association
https://read.qxmd.com/read/33718926/comparison-of-self-reported-edacs-versus-physician-reported-edacs-for-the-triage-of-chest-pain-patients-in-the-emergency-department
#17
JOURNAL ARTICLE
Mingwei Ng, Zhenghong Liu, Jean Su Ling Tan, R Ponampalam
OBJECTIVES: Currently, there are no guidelines to help triage nurses identify high-risk emergency department chest pain patients. Patient self-reporting of Emergency Department Assessment of Chest Pain Score (EDACS) could facilitate more reliable triage compared to nursing gestalt, but this novel concept is untested. This study hypothesizes that because EDACS requires minimal clinical gestalt to derive, self-reported EDACS (S-EDACS) at triage is likely to correlate well with traditional physician-reported EDACS (P-EDACS) and have potential application as a triage tool...
April 2021: Journal of the American College of Emergency Physicians open
https://read.qxmd.com/read/32885833/evaluating-patients-who-present-with-pain-complaints-to-a-community-hospital-emergency-department-opioid-prescription-tracking-software-versus-provider-gestalt
#18
JOURNAL ARTICLE
Zach Hampton, Justin Thai, Christine Rukamp, William Zackowski, Danni Schneider, Kimberly Cunagin, Anand Gupta, Andy Little
OBJECTIVE: This study aimed to compare provider gestalt to assigned Narx score, a common prescription drug monitor-ing program (PDMP) component that gauges the patient's risk of misuse or abuse. DESIGN: This is a prospective, anonymous survey from advanced practice providers (APPs), emergency medicine resi-dents, and emergency medicine attendings. SETTING: Data from two emergency departments (EDs) within the OhioHealth network were included...
July 2020: Journal of Opioid Management
https://read.qxmd.com/read/32821562/a-case-report-on-endovascular-aortic-repair-rupture
#19
Jose Rubero, Thor S Stead, Latha Ganti
Endovascular repair of an abdominal aortic aneurysm (AAA) is a widely accepted alternative to open surgical AAA repair. A ruptured AAA is among the emergency surgeries with the highest risk of death, with an overall mortality rate close to90%. However, the classic symptom triad for ruptured AAAs of hypotension, a pulsatile mass, and abdominal/back pain is seen in only in 25% to 50% of affected patients. Thus, many present with symptoms and signs that suggest adifferent diagnosis. Recognizing uncommon presentations and limitations of imaging and interpretation, in addition to clinical gestalt, can save many lives...
July 15, 2020: Curēus
https://read.qxmd.com/read/32684379/association-of-pain-location-with-computed-tomography-abnormalities-in-emergeny-department-patients-with-abdominal-pain
#20
JOURNAL ARTICLE
Eric J Morley, Alexander Bracey, Michael Reiter, Henry C Thode, Adam J Singer
BACKGROUND: Over the last decade the usage of computed tomography (CT) imaging has risen dramatically in emergency department (ED) patients with abdominal pain. Recognizing the potential disadvantages of overuse of CT imaging, efforts are being made to reduce imaging. OBJECTIVE: We determined the operating characteristics for location of abdominal pain for the entities of acute appendicitis, diverticulitis, and intestinal obstruction. We hypothesized that patients with pain localized to the upper abdomen would be less likely to have CT abnormalities than those with lower abdominal pain...
October 2020: Journal of Emergency Medicine
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