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AbdominalPain

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The impact of biological interventions for ulcerative colitis on health-related quality of life | Cochrane

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by abdominal pain, urgent bowel movements and bloody diarrhea. Treatment of UC focuses on induction of remission (treatment of symptoms of active disease) and prevention of clinical relapse (resumption of symptoms of active disease) in patients in remission (known as maintenance therapy). UC has a major impact on patients' health related quality of life (HRQL). HRQL refers to a person's physical functioning, social and emotional well-being, ability to work and freedom from disease symptoms. HRQL is significantly lower in patients with UC compared to the general population. Randomized controlled trials (RCTs) evaluating medical interventions for UC have traditionally used clinical disease activity indices which focus on subjective symptoms to define primary outcomes such as clinical remission or improvement. This focus on disease symptoms results in a failure to assess other important indicators of successful treatment such as HRQL.  
cochrane.org
about 5 years ago
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Imaging Case of the Week 171

The following x-rays are from a 30 year old with sudden onset of severe abdominal pain. What two abnormalities can be observed? One is acute and the other, an incidental pathology.  
emergucate.com
about 5 years ago
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Type I interferons for treatment of active ulcerative colitis | Cochrane

Ulcerative colitis (UC) is a long-term (chronic) inflammatory bowel disease characterized by abdominal pain, bloody diarrhea, and a need to hurry to the toilet to pass feces (fecal urgency).  
cochrane.org
about 5 years ago
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Belly ache and Rigler's Sign - INTENSIVE

Abdominal pain with an abnormal abdominal x-ray that is Rigler's sign positive.  
intensiveblog.com
about 5 years ago
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Abdo pain week 1 – a general approach – Don't Forget the Bubbles

Abdominal pain accounts for ~ 5% of all presentations to paediatric emergency departments. Surgery is only required in 1-7% of these and there is no specific diagnosis in up to 15%.  
dontforgetthebubbles.com
about 5 years ago
Sinaiem dark
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p-or-iup

A G1P0 10-week pregnant female presents to the ED with lower abdominal pain and vaginal spotting. She’s had no prenatal care. Being the highly motivated resident that you are, before even the urine is collected and the pregnancy is verified, you bring the ultrasound machine bedside and see this:  
sinaiem.org
about 5 years ago
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Interventions for preventing and treating kidney disease in Henoch-Schönlein Purpura | Cochrane

Henoch-Schönlein Purpura (HSP) causes inflammation of small blood vessels in children and affects approximately 20/100,000 children annually. Symptoms and signs include a purpuric skin rash (which comprises small spots and larger bruises), abdominal pain, gastrointestinal bleeding, joint pain and swelling, facial swelling and evidence of kidney disease with blood and protein in the urine. Kidney disease occurs in about one third of children with HSP. In the majority this is mild (small amounts of blood in the urine only) and resolves completely but a few children have persistent kidney disease that can progress to kidney failure.  
cochrane.org
about 5 years ago
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Medical Expulsion Therapy in Ureteral Colic: An Update - R.E.B.E.L. EM - Emergency Medicine Blog

Back in August 2014, we posted a review on medical expulsion therapy (MET) in patients with renal colic, but since then 2 new trials have been published, so we thought a brief review of each of these articles and updated recommendations were warranted.  
rebelem.com
about 5 years ago
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Dr. Smith's ECG Blog: Epigastric Abdominal Pain and Vomiting

Instructive ECGs in Clinical Context ----Archives, Popular Posts, and an Index of all ECGs are down the right-hand side.  
hqmeded-ecg.blogspot.com
about 5 years ago
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A patient request for some “deprescribing”

A 52 year old man with a history of type 2 diabetes for 14 years and hypertension for nine years presented to his general practitioner. He was a non-smoker with an alcohol intake of eight units a week. He had been experiencing bloating, abdominal pains, and erratic motions for more than a year. Because he drove about 12 000 miles a year for his job he found the loose motions “a real worry.” He wondered whether any of his problems might be caused by his drugs and asked if he could cut down on any if they weren’t all needed. He admitted to being afraid that his diabetic control might deteriorate and that he might need insulin, like some of his relatives who also had diabetes.  
feeds.bmj.com
about 5 years ago
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Drug treatment of adults with nausea and vomiting in primary care

A usually healthy 25 year old man presents to you as his general practitioner at 9 am. He has had fluctuating nausea with four vomits and one loose stool overnight, associated with colicky central abdominal pain. No blood was present in the vomit or stool, and he reports that his girlfriend was recently diagnosed as having “viral gastro.” He is afebrile, intermittently uncomfortable, but otherwise well, with mild epigastric tenderness but no guarding or rebound. Clinically, you believe viral gastroenteritis is the most likely cause of his symptoms, and you consider his request for treatment that will help to stop his vomiting so that he can get to his evening shift at a factory.  
feeds.bmj.com
about 5 years ago
Www.bmj
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An elderly woman with postprandial abdominal pain

An 84 year old woman presented with a five month history of central, recurrent, severe epigastric pain, which occurred about 20 minutes after eating. This was associated with nausea, occasional diarrhoea, and vomiting. She had experienced early satiety and weight loss over the last few months. Her medical history included myocardial infarction two years earlier. She also had a 40 pack year history of smoking. On examination, she was cachectic, but physical examination and digital rectal examination were otherwise unremarkable. Blood tests—including full blood count, liver functions tests, amylase, and renal function—were normal. Chest and abdominal radiographs, abdominal ultrasound, and computed tomography of the abdomen were unremarkable. Computed tomography angiography was performed (fig 1⇓).  
feeds.bmj.com
about 5 years ago
Www.bmj
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An elderly woman with chest pain and constipation

An 89 year old woman with chronic obstructive pulmonary disease presented to the emergency department with worsening shortness of breath (87% oxygen saturation in room air), retrosternal chest pain, mild abdominal pain, and subacute partial bowel obstruction over the past six days. On physical examination she was dehydrated and she had tachycardia (105 beats/min), diffusely decreased breath sounds, audible crackles at the base of the right lung, and absent breath sounds on the left side pulmonary base. Her abdomen was distended but soft overall, the epigastrium and right hypochondium were slightly tender on deep palpation, and her rectum was empty. Her blood pressure was 130/85 mm Hg. Electrocardiography and troponin (measured at admittance and checked again after six and 12 hours) excluded myocardial infarction. Laboratory studies were unremarkable except for a mild microcytic anaemia (haemoglobin 115 g/L (reference range 120-160), mean cell volume 78.6 fL (80-96). Urgent chest radiography was requested (fig 1⇓).  
feeds.bmj.com
about 5 years ago
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Lab Case 66

A 75 year old female presents to your ED with abdominal pain and nausea. She has a history of irritable bowel disease and gets recurrent abdominal pain.  
emergucate.com
about 5 years ago
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Medical Expulsion Therapy with Tamsulosin in Ureteral Colic - emdocs

emDocs post containing very useful emergency medicine information  
emdocs.net
about 5 years ago
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Ultrasound For the Win! Case: 38-year-old pregnant woman with acute right-sided abdominal pain #US4TW

Ultrasound For the Win! Case: 38-year-old pregnant woman with acute right-sided abdominal pain #US4TW by Dr. Jeff Shih  
aliem.com
about 5 years ago
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Nonsteroidal anti-inflammatory drugs are effective treatment for acute renal colic | Cochrane

Acute renal colic is the pain caused by the blockage of urine flow secondary to urinary stones. The prevalence of kidney stone is thought to be between 2% to 3%, and the incidence has been increasing in recent years due to changes in diet and lifestyle. The renal colic pain is usually a sudden intense pain located in the flank or abdominal areas. This usually happens when a urinary stone blocks the ureter (the tube connecting the kidneys to the bladder). Different types of pain killers are used to ease the discomfort. Nonsteroidal anti-inflammatory drugs (NSAIDs) and antispasmodics (treatment that suppresses muscle spasms) are used commonly to relieve pain and discomfort. This review aimed to assess the effectiveness of commonly used non-opioid pain killers in adult patients with acute renal colic pain. Fifty studies enrolling 5734 participants were included in this review. Treatments varied greatly and combining of studies was difficult. We found that overall NSAIDs were more effective than other non-opioid pain killers including antispasmodics for pain reduction and need for additional medication. We also found that the combining NSAIDs with antispasmodics did not increase the efficacy. No serious adverse effects were reported by any of the included studies.  
cochrane.org
about 5 years ago
Www.bmj
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Irritable bowel syndrome: new and emerging treatments

Irritable bowel syndrome is one of the most common gastrointestinal disorders in developed nations. It is characterized by abdominal pain, altered bowel habits, and bloating. Several non-pharmacological and pharmacological agents, which target the peripheral gastrointestinal system and central nervous system, are used to treat the syndrome. The individual and societal impact of investigating and managing the syndrome is substantial, and despite newer treatments, many patients have unmet needs. Intense research at many international sites has improved the understanding of pathophysiology of the syndrome, but developing treatments that are effective, safe, and that have tolerable side effects remains a challenge. This review briefly summarizes the currently available treatments for irritable bowel syndrome then focuses on newer non-pharmacological and pharmacological therapies and recent evidence for older treatments. Recent guidelines on the treatment of irritable bowel syndrome are also discussed.  
feeds.bmj.com
over 5 years ago
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How to Assess & Treat Common Pregnancy Complications

Case Presentation The EMS crew of Station 4 is called to the home of a pregnant female who’s complaining of abdominal pain and vaginal bleeding that began occurring after a fall. The crew learns that she slipped on a wet floor and fell on her abdomen. She advises the lead paramedic that she’s 30 weeks pregnant and that it’s her second pregnancy. During questioning, the paramedic learns that the patient has not sought prenatal care due to severe financial difficulties and lack of insurance.  
jems.com
over 5 years ago
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Lab Case 62

A 62 year old man presents to your ED by ambulance. He has had vomiting and diarrhoea for the last week and complains of abdominal pain. He is unable to keep anything down, has severe weakness with inability to stand.  
emergucate.com
over 5 years ago