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Interdisciplinary patient management

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C Sturm, T Witte
BACKGROUND: Approximately 10-50% of chest pains are caused by musculoskeletal disorders. The association is twice as frequent in primary care as in emergency admissions. AIM: This article provides an overview of the most important musculoskeletal causes of chest pain and on the diagnostics and therapy. METHODS: A selective search and analysis of the literature related to the topic of musculoskeletal causes of chest pain were carried out. RESULTS AND CONCLUSION: Non-inflammatory diseases, such as costochondritis and fibromyalgia are frequent causes of chest pain...
January 2017: Der Internist
Ryan S Larson
OBJECTIVE: The purpose of this report is to describe 2 patients with coronary artery disease presenting with musculoskeletal symptoms to a chiropractic clinic. CLINICAL FEATURES: A 48-year-old male new patient had thoracic spine pain aggravated by physical exertion. A 61-year-old man under routine care for low back pain experienced a secondary complaint of acute chest pain during a reevaluation. INTERVENTION AND OUTCOME: In both cases, the patients were strongly encouraged to consult their medical physician and were subsequently diagnosed with coronary artery disease...
March 2016: Journal of Chiropractic Medicine
Steven L Bokshan, J Mason DePasse, Adam E M Eltorai, E Scott Paxton, Andrew Green, Alan H Daniels
Differentiating the cause of pain and dysfunction due to cervical spine and shoulder pathology presents a difficult clinical challenge in many patients. Furthermore, the anatomic region reported to be painful may mislead the practitioner. Successfully treating these patients requires a careful and complete history and physical examination with appropriate provocative maneuvers. An evidence-based selection of clinical testing also is essential and should be tailored to the most likely underlying cause. When advanced imaging does not reveal a conclusive source of pathology, electromyography and selective injections have been shown to be useful adjuncts, although the sensitivity, specificity, and risk-reward ratio of each test must be considered...
September 2016: American Journal of Medicine
Nina Nechanicka, Pavel Barsa, Pavel Harsa
In the context of the interdisciplinary care of patients with chronic back pain, surgery is an option for those who do not benefit from conservative treatment. Psychological assessment prior to back surgery aims to identify suitable candidates for surgery and predict possible complications or poor treatment effects. The literature suggests that psychosocial factors are important outcome predictors of lumbar spinal surgery; however, there is not enough empirical evidence to show that early identification and treatment of these factors help improve surgical outcome...
September 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
R Kathryn McHugh, Roger D Weiss, Marise Cornelius, Marc O Martel, Robert N Jamison, Robert R Edwards
UNLABELLED: The risk for misuse of opioid medications is a significant challenge in the management of chronic pain. The identification of those who may be at greater risk for misusing opioids is needed to facilitate closer monitoring of high-risk subgroups, and may help to identify therapeutic targets for mitigating this risk. The aim of this study was to examine whether distress intolerance-the perceived or actual inability to manage negative emotional and somatic states-was associated with opioid misuse in those with chronic pain...
July 2016: Journal of Pain: Official Journal of the American Pain Society
Christopher M Petrilli, John Del Valle, Vineet Chopra
Each July, new graduates from premedical, medical, and residency programs, along with junior and midcareer faculty, acclimatize to their changing roles. During this month, overall efficiency, quality, and patient safety may suffer, a problem dubbed the "July effect." The many transitions that occur in teaching hospitals during July are often implicated as the root cause of this problem. The question, then, of how best to improve the team-based clinical care provided in July remains important. In this Commentary, the authors outline a model that combines the team-based care paradigm with effective leadership, followership, and communication-based strategies and propose some actionable steps...
July 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Tim C van de Grift, Renske Kroeze
PROBLEM: Grappling with complex structural health care issues requires medical professionals to have training in skills and knowledge that go beyond the basic and clinical sciences. It is also crucial for health care professionals to be able to work collaboratively. However, medical education has only limitedly institutionalized the teaching of these skills. APPROACH: In fall 2014, a one-semester crossover course called Hacking Healthcare was developed by the University of Amsterdam in cooperation with the Gerrit Rietveld Academie of Fine Arts and six health care institutions in the greater Amsterdam area...
September 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Robert Boyles, Rebecca Fowler, Derek Ramsey, Erin Burrows
BACKGROUND: Trigger point dry needling (TDN) is commonly used to treat musculoskeletal pain related to myofascial trigger points (MTrPs). To date, no systematic review of high-quality randomised controlled trials (RCTs) investigating TDN to multiple body regions exists. PURPOSE: The aim of this review is to determine the effectiveness of TDN based on high-quality RCTs for all body regions. METHODS: To ensure thorough reporting, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed as the methodological basis for this systematic review...
December 2015: Journal of Manual & Manipulative Therapy
Marco Ehrler, Cynthia Peterson, Serafin Leemann, Christof Schmid, Bernard Anklin, B Kim Humphreys
OBJECTIVE: The purpose of this study was to evaluate whether specific MRI features, such as axial location and type of herniation, are associated with outcomes of symptomatic lumbar disc herniation patients treated with spinal manipulation therapy (SMT). METHODS: MRI and treatment outcome data from 68 patients were included in this prospective outcomes study. Pain numerical rating scale (NRS) and Oswestry physical disability questionnaire (OPDQ) levels were measured at baseline...
March 2016: Journal of Manipulative and Physiological Therapeutics
Sandra Grace, Paul Orrock, Brett Vaughan, Raymond Blaich, Rosanne Coutts
BACKGROUND: Clinical reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the clinical reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand clinical reasoning in osteopathy from the perspective of osteopathic clinical educators and the extent to which it was similar or different from clinical reasoning in other health professions...
2016: Chiropractic & Manual Therapies
David M Eisenberg, Ted J Kaptchuk, Diana E Post, Andrea L Hrbek, Bonnie B O'Connor, Kamila Osypiuk, Peter M Wayne, Julie E Buring, Donald B Levy
Integrative medicine (IM) refers to the combination of conventional and "complementary" medical services (e.g., chiropractic, acupuncture, massage, mindfulness training). More than half of all medical schools in the United States and Canada have programs in IM, and more than 30 academic health centers currently deliver multidisciplinary IM care. What remains unclear, however, is the ideal delivery model (or models) whereby individuals can responsibly access IM care safely, effectively, and reproducibly in a coordinated and cost-effective way...
September 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Thomas R Frieden, Debra Houry
Deaths from prescription-opioid overdose have increased dramatically in the United States, quadrupling in the past 15 years. Efforts to improve pain management resulted in quadrupled rates of opioid prescribing, which propelled a tightly correlated epidemic of addiction, overdose, and death from..
April 21, 2016: New England Journal of Medicine
Atul Deodhar, Manish Mittal, Patrick Reilly, Yanjun Bao, Shivaji Manthena, Jaclyn Anderson, Avani Joshi
This study aimed to identify providers involved in diagnosing ankylosing spondylitis (AS) following back pain diagnosis in the USA and to identify factors leading to the delay in rheumatology referrals. The Truven Health MarketScan® US Commercial Database was searched for patients aged 18-64 years with back pain diagnosis in a non-rheumatology setting followed by AS diagnosis in any setting during January 2000-December 2012. Patients with a rheumatologist visit on or before AS diagnosis were considered referred...
July 2016: Clinical Rheumatology
Paul D Howard, William Behrns, Melanie Di Martino, Amanda DiMambro, Kristin McIntyre, Catherine Shurer
STUDY DESIGN: Systematic literature review. OBJECTIVE: To evaluate the diagnostic validity of manual examination techniques used to diagnose cervicogenic headache (CGH). BACKGROUND: Cervicogenic headache is a specific type of headache that originates from the cervical spine and is typically chronic in nature. Diagnostic criteria for CGH have been established by the International Headache Society (IHS) and are cited extensively in the literature...
September 2015: Journal of Manual & Manipulative Therapy
Louise Danielsson, Birgitta Kihlbom, Susanne Rosberg
BACKGROUND: Although the effectiveness of physical exercise for depression has been studied for many years, few studies have described patients' experiences of what exercise means to them, beyond the biological focus. Moreover, exercise as a treatment for depression is rarely explored in a physical therapy context. OBJECTIVES: The purpose of this study was to explore a physical therapy exercise intervention, as experienced by people with major depression. DESIGN: This study had an inductive approach and used qualitative content analysis...
August 2016: Physical Therapy
Shahnawaz Anwer, Ahmad Alghadir, Md Abu Shaphe, Dilshad Anwar
OBJECTIVES: This systematic review was conducted to examine the effects of exercise on spinal deformities and quality of life in patients with adolescent idiopathic scoliosis (AIS). DATA SOURCES: Electronic databases, including PubMed, CINAHL, Embase, Scopus, Cochrane Register of Controlled Trials, PEDro, and Web of Science, were searched for research articles published from the earliest available dates up to May 31, 2015, using the key words "exercise," "postural correction," "posture," "postural curve," "Cobb's angle," "quality of life," and "spinal deformities," combined with the Medical Subject Heading "scoliosis...
2015: BioMed Research International
Steven Pavia, Rebecca Fischer, Richard Roy
OBJECTIVE: The purpose of this study is to describe chiropractic treatment of 14 patients who presented with signs and symptoms of temporomandibular joint dysfunction (TMD). METHODS: This is a retrospective case series of 14 patients, including 13 adults and 1 child. The majority of these patients were undergoing chiropractic care for spine-related conditions when they presented with additional TMD signs and symptoms. They were evaluated and treated with Activator Methods International published protocols relative to the temporomandibular joint before the addition of treatment to the suprahyoid muscles...
December 2015: Journal of Chiropractic Medicine
Julia R Stobert, Peter C Emary, John A Taylor
OBJECTIVE: The purpose of this case report is to describe a patient with femoroacetabular impingement (FAI) who was initially misdiagnosed and treated for a hip flexor strain. CLINICAL FEATURES: A 36-year-old male patient presented with insidious onset of progressive anterior right hip and groin pain of 7 years' duration. He was diagnosed with a right-sided hip flexor muscle strain and was discharged from care 1 month later. The patient then returned to the office 8 years later for treatment of unrelated lower back pain...
December 2015: Journal of Chiropractic Medicine
Gary Globe, Ronald J Farabaugh, Cheryl Hawk, Craig E Morris, Greg Baker, Wayne M Whalen, Sheryl Walters, Martha Kaeser, Mark Dehen, Thomas Augat
OBJECTIVE: The purpose of this article is to provide an update of a previously published evidence-based practice guideline on chiropractic management of low back pain. METHODS: This project updated and combined 3 previous guidelines. A systematic review of articles published between October 2009 through February 2014 was conducted to update the literature published since the previous Council on Chiropractic Guidelines and Practice Parameters (CCGPP) guideline was developed...
January 2016: Journal of Manipulative and Physiological Therapeutics
M-V Corniola, M N Stienen, H Joswig, N R Smoll, K Schaller, G Hildebrandt, O P Gautschi
BACKGROUND: It is generally believed that radiological signs of lumbar degenerative disc disease (DDD) are associated with increased pain and functional impairment as well as lower health-related quality of life (HRQoL). Our aim was to assess the association of the Modic and Pfirrmann grading scales with established outcome questionnaires and the timed-up-and-go (TUG) test. METHODS: In a prospective two-center study with patients scheduled for lumbar spine surgery, visual analogue scale (VAS) for back and leg pain, Roland-Morris Disability Index, Oswestry Disability Index and HRQoL, as determined by the Short-Form (SF)-12 and the Euro-Qol, were recorded...
March 2016: Acta Neurochirurgica
2016-01-23 14:00:55
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