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Australian Journal of General Practice Nov 2023Chronic shoulder pain is a common presenting compliant in general practice. The differential diagnosis is broad and varies with patient age. (Review)
Review
BACKGROUND
Chronic shoulder pain is a common presenting compliant in general practice. The differential diagnosis is broad and varies with patient age.
OBJECTIVE
This article reviews the management of patients presenting with chronic shoulder pain. A structured approach to history and physical examination is presented, and appropriate investigations are discussed. Non-surgical and surgical treatment options are reviewed.
DISCUSSION
Many patients presenting with chronic shoulder pain can be successfully treated non-surgically. A multidisciplinary approach including physiotherapy, occupational therapy and psychology as needed will optimise care. Patients presenting with acute injuries or 'red flag' diagnoses should be urgently referred for specialist care. Referral to an orthopaedic surgeon is also recommended for patients who have failed an appropriate course of non-surgical treatment.
Topics: Humans; Shoulder Pain; Physical Therapy Modalities; General Practice; Family Practice; Physical Examination
PubMed: 37935145
DOI: 10.31128/AJGP-04-23-6790 -
Tidsskrift For Den Norske Laegeforening... Nov 2023Balanoposthitis is an inflammation of the glans penis and/or prepuce. It is a common condition with diverse aetiology. A targeted medical history and clinical...
Balanoposthitis is an inflammation of the glans penis and/or prepuce. It is a common condition with diverse aetiology. A targeted medical history and clinical examination are needed for correct diagnosis and treatment. This clinical review is a summary of the diagnostic process and treatment of balanoposthitis. The work is based on a selection of clinical guidelines and literature, as well as clinical experience from a dermatovenereology outpatient clinic.
Topics: Male; Humans; Balanitis; Penis; Inflammation; Ambulatory Care Facilities; Physical Examination
PubMed: 37938014
DOI: 10.4045/tidsskr.23.0256 -
JPMA. the Journal of the Pakistan... Aug 2023We conceptualize and define endocrine and metabolic prehabilitation as enhancement of physical, psychosocial and social health, prior to a planned medical, surgical or...
We conceptualize and define endocrine and metabolic prehabilitation as enhancement of physical, psychosocial and social health, prior to a planned medical, surgical or radiotherapeutic endocrine/metabolic intervention, in order to ensure optimal therapeutic outcomes during and after the procedure. This is similar to, but different from the process of endocrine rehabilitation, which follows endocrine therapy. All health care professionals, working as a team, should take responsibility of endocrine prehabilitation.
Topics: Humans; Preoperative Exercise; Health Personnel; Medicine; Physical Examination
PubMed: 37697776
DOI: 10.47391/JPMA.23-56 -
Musculoskeletal Science & Practice Aug 2023The concept that headaches may originate in the cervical spine has been discussed over decades and is still a matter of debate. The cervical spine has been traditionally...
INTRODUCTION
The concept that headaches may originate in the cervical spine has been discussed over decades and is still a matter of debate. The cervical spine has been traditionally linked to cervicogenic headache; however, current evidence supports the presence of cervical musculoskeletal dysfunctions also in tension-type headache.
PURPOSE
This position paper discusses the most updated clinical and evidence-based data about the cervical spine in tension-type headache.
IMPLICATIONS
Subjects with tension-type headache exhibit concomitant neck pain, cervical spine sensitivity, forward head posture, limited cervical range of motion, positive flexion-rotation test and also cervical motor control disturbances. In addition, the referred pain elicited by manual examination of the upper cervical joints and muscle trigger points reproduces the pain pattern in tension-type headache. Current data supports that the cervical spine can be also involved in tension-type headache, and not just in cervicogenic headache. Several physical therapies including upper cervical spine mobilization or manipulation, soft tissue interventions (including dry needling) and exercises targeting the cervical spine are proposed for managing tension-type headache; however, the effectiveness of these interventions depends on a proper clinical reasoning since not all will be equally effective for all individuals with tension-type headache. Based on current evidence, we propose to use the terms cervical "component" and cervical "source" when discussing about headache. In such a scenario, in cervicogenic headache the neck can be the cause (source) of the headache whereas in tension-type headache the neck will have a component on the pain pattern, but it will be not the cause since it is a primary headache.
Topics: Humans; Tension-Type Headache; Post-Traumatic Headache; Headache; Physical Examination; Cervical Vertebrae
PubMed: 37268552
DOI: 10.1016/j.msksp.2023.102780 -
Canadian Family Physician Medecin de... Aug 2023To provide family physicians with a practical evidence-based approach to the management of patients with sialadenitis. (Review)
Review
OBJECTIVE
To provide family physicians with a practical evidence-based approach to the management of patients with sialadenitis.
SOURCES OF INFORMATION
MEDLINE and PubMed databases were searched for English-language research on sialadenitis and other salivary gland disorders, as well as for relevant review articles and guidelines published between 1981 and 2021.
MAIN MESSAGE
refers to inflammation or infection of the salivary glands and is a condition that can be caused by a broad range of processes including infectious, obstructive, and autoimmune. History and physical examination play important roles in directing management, while imaging is often useful to establish a diagnosis. Red flags such as suspected abscess formation, signs of respiratory obstruction, facial paresis, and fixation of a mass to underlying tissue should prompt urgent referral to head and neck surgery or a visit to the emergency department.
CONCLUSION
Family physicians can play an important role in the diagnosis and management of sialadenitis. Prompt recognition and treatment of the condition can prevent the development of complications.
Topics: Humans; Sialadenitis; Diagnostic Imaging; Physical Examination
PubMed: 37582587
DOI: 10.46747/cfp.6908531 -
La Tunisie Medicale Jul 2023In the era of genomics, orientation in the face of hereditary neutropenia still requires, first and foremost, a good clinical and cytological analysis. The thirty... (Review)
Review
In the era of genomics, orientation in the face of hereditary neutropenia still requires, first and foremost, a good clinical and cytological analysis. The thirty responsible genes now explain 60% of congenital neutropenia. These are rare since they are only found in 1‰ of all congenital neutropenia, estimated at 1% of the population. The clinical examination looks for phenotypes associated with syndromic hereditary neutropenia and cytology will guide this etiological research thanks to the data collected from blood count and bone marrow analysis. The objective of this narrative literature review is to provide an overview of the most recent literature regarding acquired and congenital chronic neutropenia and will provide a decision tree to guide towards aetiology. This will allow a better discussion with geneticists even if the genotype-phenotype correlation is not very strong.
Topics: Child; Humans; Neutropenia; Congenital Bone Marrow Failure Syndromes; Phenotype; Physical Examination
PubMed: 38445418
DOI: No ID Found -
Ugeskrift For Laeger Jun 2023Focused cardiac ultrasound (FoCUS) is a point-of-care cardiac examination performed and interpreted by the emergency physician in the clinical context. This review... (Review)
Review
Focused cardiac ultrasound (FoCUS) is a point-of-care cardiac examination performed and interpreted by the emergency physician in the clinical context. This review summarises the current knowledge of FoCUS. The objective is to answer four predefined clinical questions: Are there any signs of pericardial effusion? Are there any signs of right ventricular dilatation? Are there any signs of reduced or hyperdynamic left ventricular function? Are there any signs of abnormal inferior vena cava? FoCUS is not a replacement for echocardiography but a useful tool in detecting cardiopulmonary pathology and haemodynamic abnormalities in the emergency setting.
Topics: Humans; Heart; Echocardiography; Emergency Medicine; Pericardial Effusion; Physical Examination
PubMed: 37381836
DOI: No ID Found -
Ugeskrift For Laeger Feb 2024Delirium in patients has well-documented adverse physical and mental outcomes. Delirium impairs patients' capacity to grasp and retain information, thus affecting their... (Review)
Review
Delirium in patients has well-documented adverse physical and mental outcomes. Delirium impairs patients' capacity to grasp and retain information, thus affecting their right to informed consent and active participation in treatment and care decisions. In Danish hospitals, delirium afflicts up to 50% of the elderly patients, yet it often goes unreported due to the absence of systematic screening. The selection of a screening tool should be contextually relevant. This review gives an overview of delirium screening instruments available in Danish, each with distinct advantages and disadvantages.
Topics: Aged; Humans; Hospitals; Informed Consent; Physical Examination; Delirium
PubMed: 38445335
DOI: 10.61409/V04230263 -
Ugeskrift For Laeger Mar 2024Atraumatic splenic rupture (AMR) is a life-threatening condition with a wide range of aetiologies, and it may present with a vague symptomatology. Therefore, AMR can be... (Review)
Review
Atraumatic splenic rupture (AMR) is a life-threatening condition with a wide range of aetiologies, and it may present with a vague symptomatology. Therefore, AMR can be diagnostically challenging. In this review, we wish to focus on the fact that guidelines only exist for traumatic splenic rupture although they may be applicable for AMR too. In addition, a stringent ABCDE approach for clinical examination may early and reliable diagnose the patients and guide further imaging examination and treatment.
Topics: Humans; Physical Examination; Rupture, Spontaneous; Splenic Rupture
PubMed: 38533862
DOI: 10.61409/V05230328 -
Ugeskrift For Laeger Dec 2023Traumatic fractures are often treated conservatively. Bone healing is a complex process and the complexities of a fracture, bone quality, treatment, and patient factors...
Traumatic fractures are often treated conservatively. Bone healing is a complex process and the complexities of a fracture, bone quality, treatment, and patient factors are all crucial. Routine X-rays and clinical follow-ups are a significant cost to society as well as exposing the patient to increased radiation and should only be performed if there is a risk of complications that may impact the treatment. It is difficult to assess on X-rays alone, whether there is sufficient bone healing and X-rays are therefore always recommended in conjunction with clinical examination.
Topics: Adult; Humans; Fractures, Bone; Radiography; Physical Examination; Fracture Healing
PubMed: 38105731
DOI: No ID Found