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Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II | Cochrane

Complex regional pain syndrome (CRPS) is a painful and disabling condition. Most commonly it affects a person's arm and hand or leg and foot and may occur after a traumatic injury. There are two types of CRPS: CRPS I in which there is no nerve injury, and CRPS II in which there is a nerve injury. Guidelines recommend physiotherapy, which could include different kinds of exercise therapy or electrotherapy for instance, along with other medical treatments for treating the pain and disability associated with CRPS. However, we do not know how well these treatments work.  
cochrane.org
over 4 years ago
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Management of interstitial lung disease associated with connective tissue disease

The lung is a common site of complications of systemic connective tissue disease (CTD), and lung involvement can present in several ways. Interstitial lung disease (ILD) and pulmonary hypertension are the most common lung manifestations in CTD. Although it is generally thought that interstitial lung disease develops later on in CTD it is often the initial presentation (“lung dominant” CTD). ILD can be present in most types of CTD, including rheumatoid arthritis, scleroderma, systemic lupus erythematosus, polymyositis or dermatomyositis, Sjögren’s syndrome, and mixed connective tissue disease. Despite similarities in clinical and pathologic presentation, the prognosis and treatment of CTD associated ILD (CTD-ILD) can differ greatly from that of other forms of ILD, such as idiopathic pulmonary fibrosis. Pulmonary hypertension (PH) can present as a primary vasculopathy in pulmonary arterial hypertension or in association with ILD (PH-ILD). Therefore, detailed history, physical examination, targeted serologic testing, and, occasionally, lung biopsy are needed to diagnose CTD-ILD, whereas both non-invasive and invasive assessments of pulmonary hemodynamics are needed to diagnose pulmonary hypertension. Immunosuppression is the mainstay of treatment for ILD, although data from randomized controlled trials (RCTs) to support specific treatments are lacking. Furthermore, treatment strategies vary according to the clinical situation—for example, the treatment of a patient newly diagnosed as having CTD-ILD differs from that of someone with an acute exacerbation of the disease. Immunosuppression is indicated only in select cases of pulmonary arterial hypertension related to CTD; more commonly, selective pulmonary vasodilators are used. For both diseases, comorbidities such as sleep disordered breathing, symptoms of dyspnea, and cough should be evaluated and treated. Lung transplantation should be considered in patients with advanced disease but is not always feasible because of other manifestations of CTD and comorbidities. Clinical trials of novel therapies including immunosuppressive therapies are needed to inform best treatment strategies.  
feeds.bmj.com
over 4 years ago
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0
2

Management of interstitial lung disease associated with connective tissue disease

The lung is a common site of complications of systemic connective tissue disease (CTD), and lung involvement can present in several ways. Interstitial lung disease (ILD) and pulmonary hypertension are the most common lung manifestations in CTD. Although it is generally thought that interstitial lung disease develops later on in CTD it is often the initial presentation (“lung dominant” CTD). ILD can be present in most types of CTD, including rheumatoid arthritis, scleroderma, systemic lupus erythematosus, polymyositis or dermatomyositis, Sjögren’s syndrome, and mixed connective tissue disease. Despite similarities in clinical and pathologic presentation, the prognosis and treatment of CTD associated ILD (CTD-ILD) can differ greatly from that of other forms of ILD, such as idiopathic pulmonary fibrosis. Pulmonary hypertension (PH) can present as a primary vasculopathy in pulmonary arterial hypertension or in association with ILD (PH-ILD). Therefore, detailed history, physical examination, targeted serologic testing, and, occasionally, lung biopsy are needed to diagnose CTD-ILD, whereas both non-invasive and invasive assessments of pulmonary hemodynamics are needed to diagnose pulmonary hypertension. Immunosuppression is the mainstay of treatment for ILD, although data from randomized controlled trials (RCTs) to support specific treatments are lacking. Furthermore, treatment strategies vary according to the clinical situation—for example, the treatment of a patient newly diagnosed as having CTD-ILD differs from that of someone with an acute exacerbation of the disease. Immunosuppression is indicated only in select cases of pulmonary arterial hypertension related to CTD; more commonly, selective pulmonary vasodilators are used. For both diseases, comorbidities such as sleep disordered breathing, symptoms of dyspnea, and cough should be evaluated and treated. Lung transplantation should be considered in patients with advanced disease but is not always feasible because of other manifestations of CTD and comorbidities. Clinical trials of novel therapies including immunosuppressive therapies are needed to inform best treatment strategies.  
feeds.bmj.com
over 4 years ago
Www.bmj
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Management of interstitial lung disease associated with connective tissue disease

The lung is a common site of complications of systemic connective tissue disease (CTD), and lung involvement can present in several ways. Interstitial lung disease (ILD) and pulmonary hypertension are the most common lung manifestations in CTD. Although it is generally thought that interstitial lung disease develops later on in CTD it is often the initial presentation (“lung dominant” CTD). ILD can be present in most types of CTD, including rheumatoid arthritis, scleroderma, systemic lupus erythematosus, polymyositis or dermatomyositis, Sjögren’s syndrome, and mixed connective tissue disease. Despite similarities in clinical and pathologic presentation, the prognosis and treatment of CTD associated ILD (CTD-ILD) can differ greatly from that of other forms of ILD, such as idiopathic pulmonary fibrosis. Pulmonary hypertension (PH) can present as a primary vasculopathy in pulmonary arterial hypertension or in association with ILD (PH-ILD). Therefore, detailed history, physical examination, targeted serologic testing, and, occasionally, lung biopsy are needed to diagnose CTD-ILD, whereas both non-invasive and invasive assessments of pulmonary hemodynamics are needed to diagnose pulmonary hypertension. Immunosuppression is the mainstay of treatment for ILD, although data from randomized controlled trials (RCTs) to support specific treatments are lacking. Furthermore, treatment strategies vary according to the clinical situation—for example, the treatment of a patient newly diagnosed as having CTD-ILD differs from that of someone with an acute exacerbation of the disease. Immunosuppression is indicated only in select cases of pulmonary arterial hypertension related to CTD; more commonly, selective pulmonary vasodilators are used. For both diseases, comorbidities such as sleep disordered breathing, symptoms of dyspnea, and cough should be evaluated and treated. Lung transplantation should be considered in patients with advanced disease but is not always feasible because of other manifestations of CTD and comorbidities. Clinical trials of novel therapies including immunosuppressive therapies are needed to inform best treatment strategies.  
feeds.bmj.com
over 4 years ago
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Constitutional Mismatch Repair Deficiency Syndrome

The authors present an overview of constitutional mismatch repair deficiency, a syndrome which predisposes to multiple childhood cancers.  
medscape.com
over 4 years ago
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Adding an Antipsychotic Helps Treat Pain

A literature review finds that the atypical antipsychotic olanzapine has the most evidence supporting its use in various pain syndromes.  
medscape.com
over 4 years ago
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Notes from the Field: Nosocomial Outbreak of Middle East Respiratory Syndrome in a Large Tertiary Care Hospital — Riyadh, Saudi Arabia, 2015 | MMWR

The Morbidity and Mortality Weekly Report (MMWR) Series is prepared by the Centers for Disease Control and Prevention (CDC).  
cdc.gov
over 4 years ago
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VPS11 Mutation in Ashkenazi-Jewish Patients

The authors identify the loci of a mutation resulting in a syndrome of developmental delay, acquired microcephaly and hypomyelination in Ashkenazi-Jews.  
medscape.com
over 4 years ago
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Severity of Metabolic Syndrome Falls in Teens, not Prevalence

Improvements were linked to high-density lipoprotein and fasting triglyceride trends, according to a study of national data.  
medscape.com
over 4 years ago
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Defibrotide's Promise in Rare but Fatal Syndrome Post HSCT

Phase 3 data from a trial that used historical controls to assess safety and efficacy of defibrotide show that it confers survival benefits in patients with VOD and multiorgan failure after HSCT.  
medscape.com
over 4 years ago
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Better training is needed on fetal alcohol disorders, says BMA

Training programmes on the prevention, diagnosis, and management of fetal alcohol syndromes should be implemented for UK healthcare professionals and included in undergraduate curriculums to resolve a “scandalous lack of support” for the children affected, a report by the BMA has said.1  
feeds.bmj.com
over 4 years ago
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Effects of PTSD and Metabolic Syndrome on Cognitive Aging

PTSD and the metabolic syndrome frequently occur together in veterans. Does the presence of both conditions have an interactive or additive effect on cognitive performance?  
medscape.com
over 4 years ago
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More Evidence That Sitting Too Much Is Bad, Ups Diabetes Risk

A Dutch study finds that each hour spent sedentary increases the risk of type 2 diabetes by 22% and metabolic syndrome by 39%; the pattern of sedentary behavior may not play a significant role.  
medscape.com
over 4 years ago
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Asthma-COPD Overlap -- A New Clinical Entity

You know them individually, but what about together? A new review keeps clinicians up-to-date on identification and management of the asthma-COPD overlap syndrome.  
medscape.com
over 4 years ago
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ACEP 2016 Policy on Out of Hospital Analgesia & Sedation

@rfdsdoc @Gasman2857 pic.twitter.com/sTBdpEoUb4 — John Hinds (@DocJohnHinds) November 28, 2013 Out-of-Hospital Use of Analgesia and Sedation Editors' note: Ketamine officially endorsed by ACEP as prehospital sedation for acute agitation needing ultrarapid control, especially for suspected excited delirium syndrome I dont endorse midazolam as being the ideal prehospital sedative for agitation. Droperidol is superior. Haloperidol is…  
prehospitalmed.com
over 4 years ago
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Long-QT Syndrome: Damned if You Do, Damned if You Don't?

Dr Mandrola reviews a Mayo Clinic study on patients referred for possible LQTS. It reveals that many don't have the condition and unnecessary ICD implantation can lead to severe complications.  
medscape.com
over 4 years ago
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Primary aldosteronism

This is "Primary aldosteronism" by Pulsenotes on Vimeo.  
vimeo.com
over 4 years ago
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Antenatal administration of corticosteroids for women at risk of preterm birth

The administration of certain corticosteroids to women at risk of preterm birth causes a considerable reduction in the risks of complications of prematurity such as respiratory distress syndrome, intraventricular haemorrhage and perinatal death. Corticosteroid therapy should be incorporated into comprehensive maternal health care services and official guidelines for maternity care.  
apps.who.int
over 4 years ago
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Bodily Distress Syndrome: A New Diagnosis in Primary Care?

The authors discuss a new diagnostic category of bodily distress syndrome, which offers a clinically useful, evidence-based path for categorizing patients with functional disorders.  
medscape.com
over 4 years ago