45-Year-Old Man With Abdominal Pain and Splenomegaly

A 45-year-old man presented to the emergency department at an outside facility with severe right upper quadrant abdominal pain, radiating to his back with deep inspiration. The pain had started the evening before, and the patient described it as dull and aching with intermittent episodes of sharp, stabbing discomfort. The pain was not associated with fever, nausea, vomiting, or diarrhea. He had no recent travel history. His medical history was notable for hypertension, type 2 diabetes mellitus, and gastroesophageal reflux disease.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Residents' clinic Source Type: research

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This study describes the long-term comorbidity profile and treatment burden among people with HIV-1 infection.Methods: This retrospective study included Medicaid claims data from patients with ≥1 antiretroviral (ARV) claim between 2016 and 2017 (most recent claim defined the index date), ≥1 HIV diagnosis within 1 year before index, age ≥18 years at first HIV diagnosis and
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Conclusion. This large systematic review of over 11,000 participants demonstrates that topical diclofenac is effective for acute pain, such as sprains and strains, with minimal AEs. The effectiveness of topical diclofenac was also demonstrated in chronic musculoskeletal pain, such as osteoarthritis, but with a higher NNT (worse) compared with acute pain. Again, the incidence of AEs was low. Formulation does play a part in effectiveness, and studies are needed to investigate this further. Studies of chronic pain outside of osteoarthritis would also be helpful. PMID: 31944135 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
CONCLUSION: According to the high percentage of patients diagnosed with vision-threatening DR in this study, an early diagnosis of this complication of diabetes seems to be important. Teleophthalmology enhances patient accessibility to the healthcare system, making early diagnosis of DR easier, with a high degree of satisfaction among patients and healthcare professionals. PMID: 31941342 [PubMed - in process]
Source: Rural and Remote Health - Category: Rural Health Tags: Rural Remote Health Source Type: research
Publication date: Available online 16 January 2020Source: American Journal of Kidney DiseasesAuthor(s): Jelmer K. Humalda, Gerald Klaassen, Hanne de Vries, Yvette Meuleman, Lara C. Verschuur, Elisabeth J.M. Straathof, Gozewijn D. Laverman, Willem Jan W. Bos, Paul J.M. van der Boog, Karin M. Vermeulen, Olivier A. Blanson Henkemans, Wilma Otten, Martin H. de Borst, Sandra van Dijk, Gerjan J. Navis, P.J.M. van der Boog, S. van Dijk, G.J. Navis, J.K. Humalda (project coordination), G. KlaassenRationale &ObjectivePatients with chronic kidney disease (CKD) are particularly sensitive to dietary sodium. We evaluated a self-man...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
PURPOSE OF REVIEW: We sought to summarize recent evidence regarding optimal blood pressure (BP) treatment targets and antihypertensive regimen intensity for nursing home (NH) residents and similar older, complex patients with hypertension. RECENT FINDINGS:...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Elder Adults Source Type: news
Need some treatmemt pearls. Any use for scs? IV ketamine? I have a very legit patient suffering from this Thx!!
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
ConclusionsMany elite and developing athletes visited pharmacies for medication supply and treatment of minor ailments. Doping regulatory agency websites were the most commonly used and trusted sources for medication information, although some athletes believed pharmacists could also contribute to their medication management. Future research should consider whether pharmacists are ready for a role in sports pharmacy.
Source: Journal of Science and Medicine in Sport - Category: Sports Medicine Source Type: research
Objective The aim of the study was to investigate the effects of the inclusion of neural mobilization into a motor control exercise program on pain, related disability, neuropathic symptoms, straight leg raise, and pressure pain threshold in lumbar radiculopathy. Design This is a randomized clinical trial. Methods Individuals with low back pain, with confirmed disc herniation, and lumbar radiculopathy were randomly assigned to receive eight sessions of either neurodynamic mobilization plus motor control exercises (n = 16) or motor control exercises alone (n = 16). Outcomes included pain, disability, neuropathic sym...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
Objective The aim of the study was to determine whether strength and range of motion deficits are present in patients with unilateral chronic neck pain at contralateral side to pain and at other regions. Design Forty-nine patients with unilateral chronic neck pain and 98 asymptomatic subjects participated in this case-control study. Range of motion and muscle strength of the cervical, shoulder, trunk, and hip regions were assessed bilaterally using inclinometer and dynamometer, respectively. Results Chronic neck pain patients demonstrated reduced cervical, shoulder, and trunk range of motion in their ipsilateral si...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
Conclusions Stabilization exercises could improve the voluntary activity of transverse abdominal muscle of mothers of children with cerebral palsy.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
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