Clinical and endoscopic evaluation in patients with gastroesophageal symptoms
CONCLUSION Male gender and hiatal hernia were associated with EE. Aged patients, smoking and hiatal herni a were related to severe EE. It is suggested that the risk factors for EE and non-EE types are different. Cohort studies are necessary to identify the exact mechanisms involved in each disease form.RESUMO CONTEXTO: A doen ça do refluxo gastroesofágico (DRGE) é uma das doenças digestivas mais comuns na prática médica e deve ser suspeitada de acordo com os seus sintomas clínicos, podendo ser classificada em esofagite erosiva (EE) de acordo com os achados de endoscopia. OBJETIVO: Avaliar os achados endoscópico s em pacientes com sintomas sugestivos de DGRE comparando fatores de risco e epidemiológicos. MÉTODOS: Resultados de endoscopias digestiva foram examinados retrospectivamente de pacientes com sintomas relacionados com DRGE como pirose, regurgitação, tosse, pigarro, globus e dor torácica. EE f oi determinada de acordo com a classificação de Los Angeles. Comparação de fatores de risco entre os grupos EE e não-EE foram feitos com análise estatística. RESULTADOS: Um total de 984 endoscopias foram examinadas e 676 endoscopias selecionadas para análise (281 com EE e 395 sem EE). A ma ioria dos pacientes era do sexo feminino 381 (56,36%) com uma idade média de 44,01±15,40 anos. Hérnia hiatal esteve presente em ...
Publication date: Available online 17 August 2019Source: Surgery (Oxford)Author(s): Tim LaneAbstractUpper tract transitional cell carcinoma is a lethal disease with half the patients dead within 5 years of diagnosis. Unlike urothelial tumours arising in the bladder, the disease is more likely to be invasive at the time of diagnosis and in part reflects the poorer prognosis. It is a biologically aggressive disease with a high chance of recurrence even after local control. Diagnosis is made by a combination of upper tract imaging, urine cytology and ureteroscopic biopsy. Organ-confined disease is amenable to radical surgery,...
ConclusionIP is a diagnosis of exclusion which should only be made after surgical and non-surgical causes have been outruled. In the absence of signs of peritonitis and evidence of gastrointestinal perforation on CT, a conservative approach is warranted, allowing patients to avoid unnecessary surgical intervention.
ConclusionOnly a few cases of penile FG have been reported. Early debridement of all necrotic tissue is the golden rule.
CONCLUSIONWe present a case of SCC in the anal canal with liver metastasis presenting as a hepatic pseudocyst.
Wanted your opinions on your management. If you have someone come in with mild pancreatitis unknown etiology (full work up normal) with no abnormal labs other than the lipase being>5000. Vitals stable. APACHE II on admission 3. And patient wants to eat the next day with pain improved despite lipase being still>5000. Would you initiate early refeeding or would you wait a while?
Question: Are we diluting the prestige and value of ACGME-accredited Pain fellowships by allowing alternative venues of interventional training? https://www.spine.org/Portals/0/Assets/Downloads/Education/ISMMFellowshipDirectory.pdf "WHAT DISTINGUISHES NASS ISMM FELLOWSHIPS FROM PAIN FELLOWSHIPS? The primary focus of NASS-recognized ISMM fellowships is the clinical assessment and treatment of patients with spine and musculoskeletal conditions. The fellowships... New NASS-approved vs ACGME-accredited Spine/Pain Fellowships?
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ConclusionOur current findings demonstrate that spinal CCL7/CCR2 modulation of GluA1-containing AMPA receptor activation via IL-18 and IL-18R over-expression is an important pathogenesis of remifentanil-induced hyperalgesia in rats.
Publication date: Available online 16 August 2019Source: NeuroImageAuthor(s): Rinaldo Livio Perri, Francesco Rossani, Francesco Di RussoAbstractA large literature indicated hypnosis as a useful tool to reduce pain perception, especially in high susceptible individuals. However, due to different methodological aspects, it was still not clear whether hypnosis modulates the early sensory processing of the stimuli or if it affects only the later stages of affective processing. In the present study, we measured the EEG activity of subjects with a medium level of hypnotizability while receiving electrical non-painful stimuli on ...
This report serves as a preliminary study and may be a surgical option for minimally invasive direct repair.