P.05.21 ROLE OF THE ROME III QUESTIONNAIRE FOR IBS IN THE WORK UP OF PATIENTS REFERRED FOR SELFREPORTED MILK INTOLERANCE

2013 ◽  
Vol 45 ◽  
pp. S125
Author(s):  
F. Valiante ◽  
F. Galeazzi ◽  
M. De Bona ◽  
A. Bellumat ◽  
A. Buda ◽  
...  
Keyword(s):  
Milk Intolerance ◽  
Rome Iii ◽  
Work Up

scholarly journals General practitioner use of D-dimer in suspected venous thromboembolism: historical cohort study in one geographical region in the Netherlands

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026846 ◽  
Author(s):  
Angel M R Schols ◽  
Eline Meijs ◽  
Geert-Jan Dinant ◽  
Henri E J H Stoffers ◽  
Mariëlle M E Krekels ◽  
...  
Keyword(s):  
Cohort Study ◽  
General Practitioner ◽  
Clinical Assessment ◽  
Geographical Region ◽  
Historical Cohort ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up ◽  
D Dimer

ObjectivesTo investigate how many general practitioner (GP)-referred venous thromboembolic events (VTEs) are diagnosed during 1 year in one geographical region and to investigate the (urgent) referral pathway of VTE diagnoses, including the role of laboratory D-dimer testing.DesignHistorical cohort study.SettingGP patients of 47 general practices in a demarcated geographical region of 161 503 inhabitants in the Netherlands.ParticipantsWe analysed all 895 primary care patients in whom either the GP determined a D-dimer value or who had a diagnostic work-up for suspected VTE in a non-academic hospital during 2015.Primary and secondary outcome measuresThe primary outcomes of this study were the total number of VTEs per year and the diagnostic pathways—including the role of GP determined D-dimer testing—of patients urgently referred to secondary care for suspected VTE. Additionally, we explored the use of an age-adjusted D-dimer cut-off.ResultsThe annual VTE incidence was 0.9 per 1000 inhabitants. GPs annually ordered 5.1 D-dimer tests per 1000 inhabitants. Of 470 urgently GP-referred patients, 31.3% had a VTE. Of those urgently referred based on clinical assessment only (without D-dimer testing), 73.8% (96/130) had a VTE; based on clinical assessment and laboratory D-dimer testing yielded 15.0% (51/340) VTE. Applying age-adjusted D-dimer cut-offs to all patients aged 50 years or older resulted in a reduction of positive D-dimer results from 97.9% to 79.4%, without missing any VTE.ConclusionsAlthough D-dimer testing contributes to the diagnostic work-up of VTE, GPs have a high detection rate for VTE in patients who they urgently refer to secondary care based on clinical assessment only.

Endoluminal Graft Exclusion of a Proximal Para-Anastomotic Pseudoaneurysm following Aortobifemoral Bypass

1997 ◽  
Vol 4 (1) ◽  
pp. 88-94 ◽  
Author(s):  
Rodney A. White ◽  
Carlos E. Donayre ◽  
Irwin Walot ◽  
Eric Wilson ◽  
George Jackson ◽  
...  
Keyword(s):  
Medical Condition ◽  
Ct Scanning ◽  
Abdominal Ultrasound ◽  
Spiral Ct ◽  
Aortobifemoral Bypass ◽  
Anastomotic Pseudoaneurysm ◽  
Left Limb ◽  
Work Up ◽  
Abdominal Ultrasound Examination

Purpose: To describe a case of endoluminal graft exclusion of a proximal para-anastomotic pseudoaneurysm that occurred 17 years following aortobifemoral bypass for occlusive disease. Methods and Results: The lesion was found on abdominal ultrasound examination as part of a work-up for acute abdominal pain and upper gastrointestinal bleeding in a 67-year-old male. A 5-cm saccular pseudoaneurysm was confirmed by preintervention aortography and spiral computed tomography (CT) scanning. Because of the patient's acute symptoms and high-risk medical condition (cardiomyopathy), he was deemed a candidate for endoluminal bypass. At the time of intervention, intravascular ultrasound (IVUS) interrogation identified a 3.5-cm-long separation of the existing aortic graft from the proximal aortic stump with a large pseudoaneurysm. The lesion was isolated and repaired by placement of an aortic-to-right iliac endoluminal bypass, ligation of the left limb of the aortofemoral graft, and femorofemoral bypass to restore blood flow to the lower extremities. Spiral CT scans at 48 hours and 3 months following the procedure confirmed complete isolation of the lesion. Conclusions: This case illustrates the feasibility of endografting for repair of aortic para-anastomotic pseudoaneurysms, and it also highlights the potential role of IVUS imaging in endoluminal graft deployment.

scholarly journals Limited Role of Bone Marrow Aspiration and Biopsy in the Initial Staging Work-up of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma in Korea

Gut and Liver ◽  
2014 ◽  
Vol 8 (6) ◽  
pp. 637-642 ◽  
Author(s):  
Byung-Hoon Min ◽  
Jun Young Park ◽  
Eun Ran Kim ◽  
Yang Won Min ◽  
Jun Haeng Lee ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Gastric Mucosa ◽  
Lymphoid Tissue ◽  
Bone Marrow Aspiration ◽  
Limited Role ◽  
Work Up ◽  
Initial Staging

scholarly journals Endomyocardial Biopsy in Pediatric Myocarditis and Dilated Cardiomyopathy: A Tool in Search for a Role

2022 ◽  
Vol 9 (1) ◽  
pp. 24
Author(s):  
Mara Pilati ◽  
Micol Rebonato ◽  
Roberto Formigari ◽  
Gianfranco Butera
Keyword(s):  
Endomyocardial Biopsy ◽  
Ventricular Dysfunction ◽  
Diagnostic Technique ◽  
Left Ventricular ◽  
Severe Left Ventricular Dysfunction ◽  
Myocardial Diseases ◽  
Pediatric Heart Failure ◽  
Diagnostic Work ◽  
Work Up

Endomyocardial biopsy (EMB) is a well-known diagnostic tool for the investigation and treatment of myocardial diseases and remains the gold standard for the diagnosis of myocarditis. Due to its invasiveness, with a complication rate ranging from 1 to 15%, its role in the diagnostic work-up of pediatric heart failure is not well established. The aim of this review is to define the role of EMB as diagnostic technique in the work up of children presenting with severe left ventricular dysfunction with the support of our center experience.

Status epilepticus in the Paediatric Intensive Care Unit

2020 ◽  
pp. 179-190
Author(s):  
Justin Q.Y. Wang ◽  
Hari Krishnan
Keyword(s):  
Status Epilepticus ◽  
Paediatric Intensive Care Unit ◽  
Refractory Status Epilepticus ◽  
Refractory Status ◽  
Continuous Neuromonitoring ◽  
Quantitative Electroencephalogram ◽  
Aid Decision ◽  
Work Up ◽  
Electroencephalogram Eeg

This chapter covers pertinent issues around the management of children with status epilepticus within and outside of specialist centres. A detailed overview of the work-up of a child in status epilepticus is presented. Additionally, the potential management of patients with refractory status epilepticus and super-refractory status epilepticus is evaluated. Furthermore, the chapter focuses on strategies to aid decision-making related to the practical challenges paediatric intensivists face, such as the suitability of extubating patients at the referring hospital, the decision to transfer patients to specialist centres for ongoing management, the role of neuroimaging, and about use of quantitative electroencephalogram (EEG) as a continuous neuromonitoring modality.

Acute liver failure

2020 ◽  
pp. 89-104
Author(s):  
Andrew Jones ◽  
Akash Deep
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Organ Support ◽  
Fulminant Liver Failure ◽  
Management Of Complications ◽  
Diagnostic Work ◽  
Work Up ◽  
Paediatric Critical Care ◽  
Diagnostic Work Up

The work-up and management of patients with acute liver failure in paediatric critical care are often challenging. This chapter takes the readers through definitions, grading of severity, and diagnostic work-up of acute liver failure in children. General principles underlying the management of acute liver failure, including immediate resuscitation and retrieval; organ support, including renal replacement therapy; and the management of complications, including bleeding, are discussed. In particular, this chapter focuses on neuromonitoring and neuroprotection strategies in children with hepatic encephalopathy as a complication. The role of liver transplantation in fulminant liver failure and a brief overview of complications are also discussed.

scholarly journals A prospective study on the role of Hysterolaparoscopy in the evaluation of infertility

2019 ◽  
Vol 8 (12) ◽  
pp. 4766
Author(s):  
Pandeeswari B. ◽  
Shalini Mahana Valecha
Keyword(s):  
Age Groups ◽  
Female Infertility ◽  
Reproductive Age ◽  
Current Evidence ◽  
Secondary Infertility ◽  
Ovulatory Period ◽  
A Prospective Study ◽  
Work Up ◽  
Ovarian Syndrome

Background: Infertility affects about 10-15% of couples of reproductive age groups. The current evidence indicates a 9% prevalence of infertility with 56% of couples seeking medical care. Hysterolaparoscopy provides a comprehensive investigative procedure in which various factors causing female infertility can be assessed at one sitting.Methods: A total 100 infertile women between 20-40 years of age including primary and secondary infertility were evaluated. Patients would be investigated thoroughly for infertility and in preparation for anaesthesia. Tests include follicular study, Ultrasound pelvis. Hysterolaparoscopy was performed in the pre ovulatory period between days 6-10 of the cycle for infertility evaluation.Results: In the present study out of 100 cases for infertility evaluated, primary infertility were 57(57%) and secondary infertility were 43(43%). In our study out of 100 patients, Hysterolaparoscopy showed tuberculosis in 24 (24%) patients, remaining were endometriosis, polycystic ovarian syndrome, congestion, intra-pelvic adhesions, hydro-salpinx.Conclusions: It is concluded that while treating the causes of female infertility combined simultaneous diagnostic laparoscopy and hysteroscopy should be performed in all infertile patients as” seeing is believing” and if any pathologies found to be operable the gynaecologist can perform operative hystero-laparoscopy at that time, hence anticipating the pathologies after pre-operative work up is very important.

Thrombosis associated with ventriculoatrial shunts

2008 ◽  
Vol 2 (4) ◽  
pp. 286-291 ◽  
Author(s):  
Norka Wilkinson ◽  
Sandeep Sood ◽  
Steven D. Ham ◽  
Holly Gilmer-Hill ◽  
Patricia Fleming ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Anticoagulation Therapy ◽  
Treatment Strategies ◽  
Outcome Data ◽  
Single Center Study ◽  
Prophylactic Anticoagulation ◽  
Risk For Thrombosis ◽  
Work Up

Object In this single-center study, the authors examined the clinical characteristics, risk factors, treatment strategies, and outcomes in patients with thrombosis associated with ventriculoatrial (VA) shunts. Methods Inpatient and outpatient charts of patients who underwent treatment and follow-up in the Hematology-Oncology Division at the authors' institution and in whom thrombosis developed secondary to a VA shunt placement were reviewed. A complete thrombophilia work-up was performed in each patient, and these records were also reviewed. Treatment including medical and surgical management was noted and outcome data were recorded. Results Resolution of thrombosis was seen after anticoagulation therapy in all patients; this may be an alternative to surgical therapy. Conclusions Patients with VA shunts represent a unique group at risk for thrombosis. The duration of anticoagulation therapy must be individualized. However, larger studies are needed to evaluate the efficacy of screening for asymptomatic thrombosis and to investigate the role of prophylactic anticoagulation.

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