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  1 / 405238 MEDLINE  
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[PMID]:29505533
[Au] Autor:Asakura K; Yanai S; Nakamura S; Kawaski K; Eizuka M; Ishida K; Endo M; Sugai T; Migita K; Matsumoto T
[Ad] Endereço:Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University.
[Ti] Título:Familial Mediterranean fever mimicking Crohn disease: A case report.
[So] Source:Medicine (Baltimore);97(1):e9547, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Familial Mediterranean fever (FMF) is the most common form of autoinflammatory disease. We report a rare case of FMF with gastrointestinal lesions mimicking Crohn disease. PATIENT CONCERNS: A 21-year-old Japanese man was referred to our institution, complaining of refractory diarrhea and weight loss of 14 kg during the past two years. He had presented with recurrent fever, abdominal pain, anal fistula and stomatitis. His father and one of his brothers had ulcerative colitis. Colonoscopy revealed longitudinal ulcers in the terminal ileum and aphthous erosions in the colorectum. Esophagogastroduodenoscopy revealed multiple linear erosions in the gastric corpus and circular erosions in the duodenal second portion. Biopsy from these lesions failed to detect epithelioid cell granulomas. DIAGNOSES: Analysis of the genomic DNA revealed compound heterozygous mutations of E148Q/L110P in exon 2 of MEFV gene, suggesting a diagnosis of FMF. INTERVENTIONS: The patient was subsequently given 0.5 mg of colchicine per day. OUTCOMES: Follow-up colonoscopy 6 months later demonstrated that both the longitudinal ulcers in the terminal ileum and aphthous lesions in the colorectum had completely disappeared. LESSONS: Our case suggests that patients with FMF possibly manifest gastrointestinal lesions mimicking Crohn disease.
[Mh] Termos MeSH primário: Doença de Crohn/diagnóstico
Febre Familiar do Mediterrâneo/diagnóstico
[Mh] Termos MeSH secundário: Colonoscopia
Diagnóstico Diferencial
Seres Humanos
Masculino
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009547


  2 / 405238 MEDLINE  
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[PMID]:29472200
[Au] Autor:Davies BM; Mowforth OD; Smith EK; Kotter MR
[Ad] Endereço:Academic neurosurgery unit, Department of Clinical Neurosurgery, University of Cambridge, Cambridge, UK.
[Ti] Título:Degenerative cervical myelopathy.
[So] Source:BMJ;360:k186, 2018 02 22.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Vértebras Cervicais
Imagem por Ressonância Magnética
Doenças da Medula Espinal/diagnóstico
Doenças da Medula Espinal/terapia
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Progressão da Doença
Seres Humanos
Exame Neurológico
Encaminhamento e Consulta
Doenças da Medula Espinal/epidemiologia
Doenças da Medula Espinal/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180224
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k186


  3 / 405238 MEDLINE  
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[PMID]:29472185
[Au] Autor:Amin O; Howlett DC
[Ad] Endereço:Eastbourne District General Hospital, East Sussex Healthcare NHS Trust, Eastbourne, UK omedamin@doctors.org.uk.
[Ti] Título:Atypical chest pain in an older woman.
[So] Source:BMJ;360:k345, 2018 02 22.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Dor no Peito/diagnóstico por imagem
Embolia Pulmonar/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Anticoagulantes/uso terapêutico
Dor no Peito/tratamento farmacológico
Angiografia por Tomografia Computadorizada
Angiografia Coronária
Diagnóstico Diferencial
Feminino
Seres Humanos
Embolia Pulmonar/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180224
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k345


  4 / 405238 MEDLINE  
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[PMID]:29467161
[Au] Autor:Siontis GC; Mavridis D; Greenwood JP; Coles B; Nikolakopoulou A; Jüni P; Salanti G; Windecker S
[Ad] Endereço:Department of Cardiology, Bern University Hospital, Inselspital, Bern, Switzerland.
[Ti] Título:Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: network meta-analysis of diagnostic randomised controlled trials.
[So] Source:BMJ;360:k504, 2018 02 21.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate differences in downstream testing, coronary revascularisation, and clinical outcomes following non-invasive diagnostic modalities used to detect coronary artery disease. DESIGN: Systematic review and network meta-analysis. DATA SOURCES: Medline, Medline in process, Embase, Cochrane Library for clinical trials, PubMed, Web of Science, SCOPUS, WHO International Clinical Trials Registry Platform, and Clinicaltrials.gov. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Diagnostic randomised controlled trials comparing non-invasive diagnostic modalities in patients presenting with symptoms suggestive of low risk acute coronary syndrome or stable coronary artery disease. DATA SYNTHESIS: A random effects network meta-analysis synthesised available evidence from trials evaluating the effect of non-invasive diagnostic modalities on downstream testing and patient oriented outcomes in patients with suspected coronary artery disease. Modalities included exercise electrocardiograms, stress echocardiography, single photon emission computed tomography-myocardial perfusion imaging, real time myocardial contrast echocardiography, coronary computed tomographic angiography, and cardiovascular magnetic resonance. Unpublished outcome data were obtained from 11 trials. RESULTS: 18 trials of patients with low risk acute coronary syndrome (n=11 329) and 12 trials of those with suspected stable coronary artery disease (n=22 062) were included. Among patients with low risk acute coronary syndrome, stress echocardiography, cardiovascular magnetic resonance, and exercise electrocardiograms resulted in fewer invasive referrals for coronary angiography than coronary computed tomographic angiography (odds ratio 0.28 (95% confidence interval 0.14 to 0.57), 0.32 (0.15 to 0.71), and 0.53 (0.28 to 1.00), respectively). There was no effect on the subsequent risk of myocardial infarction, but estimates were imprecise. Heterogeneity and inconsistency were low. In patients with suspected stable coronary artery disease, an initial diagnostic strategy of stress echocardiography or single photon emission computed tomography-myocardial perfusion imaging resulted in fewer downstream tests than coronary computed tomographic angiography (0.24 (0.08 to 0.74) and 0.57 (0.37 to 0.87), respectively). However, exercise electrocardiograms yielded the highest downstream testing rate. Estimates for death and myocardial infarction were imprecise without clear discrimination between strategies. CONCLUSIONS: For patients with low risk acute coronary syndrome, an initial diagnostic strategy of stress echocardiography or cardiovascular magnetic resonance is associated with fewer referrals for invasive coronary angiography and revascularisation procedures than non-invasive anatomical testing, without apparent impact on the future risk of myocardial infarction. For suspected stable coronary artery disease, there was no clear discrimination between diagnostic strategies regarding the subsequent need for invasive coronary angiography, and differences in the risk of myocardial infarction cannot be ruled out. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registry no CRD42016049442.
[Mh] Termos MeSH primário: Doença da Artéria Coronariana/diagnóstico
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Seres Humanos
Metanálise em Rede
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180223
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k504


  5 / 405238 MEDLINE  
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[PMID]:29215340
[Au] Autor:Yakut K; Erdogan I; Varan B; Atar I
[Ad] Endereço:Department of Pediatric Cardiology, Baskent University Ankara Hospital, Ankara, Turkey.
[Ti] Título:A Report of Brugada Syndrome Presenting with Cardiac Arrest Triggered by Verapamil Intoxication.
[So] Source:Balkan Med J;34(6):576-579, 2017 12 01.
[Is] ISSN:2146-3131
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Brugada syndrome is a disease characterized by a specific electrocardiographic pattern and an increased risk of sudden cardiac death. We present this case with the updated literature to emphasise the need to consider the diagnosis of Brugada syndrome in patients admitted to the emergency ward with sudden cardiac arrest. CASE REPORT: A 16-year-old female patient was admitted to the emergency ward with complaints of weakness and abdominal pain, and she had four cardiac arrests during her evaluation period. She was referred to our clinic for permanent pacemaker implantation. She was on a temporary pace maker after having had C-reactive protein. Her physical exam was normal except for bilaterally decreased lung sounds. Lung x-ray and computed tomography, which were performed by another institution, revealed minimal pleural effusion and nothing else of significance. Blood and peritoneal fluid samples were sterile. Echocardiographic exam and cardiac enzymes were also in the normal ranges. Electrocardiographic showed incomplete right branch block in leads V1 and V2. An ajmaline test revealed specific electrocardiographic findings of the type I Brugada pattern. We proposed implanting an implantable cardioverter defibrillator to the patient as there were positive findings on the ajmaline test as well as a history of sudden cardiac arrest. After this treatment proposal, the patient's family admitted that she had taken a high dose of verapamil and thus, the encountered bradycardia was associated with verapamil overuse. The ajmaline test was repeated as it was contemplated that the previous positive ajmaline test had been associated with verapamil overuse. Implantable cardioverter defibrillator implantation was proposed again as there was a history of sudden cardiac arrest; however, the family did not consent to implantable cardioverter defibrillator, and the patient was discharged and followed up. CONCLUSION: Brugada syndrome should be considered for patients who are admitted to the emergency ward with sudden cardiac arrest though surface electrocardiographic is normal. If there is a suspicion of Brugada syndrome, repeated electrocardiographic should be performed on different occasions. Diagnosis can be clarified by upper costal electrocardiographic or by administering Na channel blockers during electrocardiographic performance.
[Mh] Termos MeSH primário: Antiarrítmicos/envenenamento
Síndrome de Brugada/induzido quimicamente
Parada Cardíaca/induzido quimicamente
Verapamil/envenenamento
[Mh] Termos MeSH secundário: Adolescente
Ajmalina/farmacologia
Síndrome de Brugada/diagnóstico
Síndrome de Brugada/fisiopatologia
Diagnóstico Diferencial
Eletrocardiografia
Feminino
Testes Genéticos
Parada Cardíaca/fisiopatologia
Seres Humanos
Fatores Desencadeantes
Bloqueadores dos Canais de Sódio/administração & dosagem
Tentativa de Suicídio
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Arrhythmia Agents); 0 (Sodium Channel Blockers); 1PON08459R (Ajmaline); CJ0O37KU29 (Verapamil)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.4274/balkanmedj.2016.1301


  6 / 405238 MEDLINE  
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[PMID]:29203744
[Au] Autor:Tkachenko PI; Dobroskok VO; Korotych NM; Kolisnyk IA
[Ad] Endereço:Higher State Educational Establishment Of Ukraine " Ukrainian Medical Stomatological Academy", Poltava, Ukraine.
[Ti] Título:Differences in clinical manifestations of odontogenic and non-odontogenic lymphadenitis.
[So] Source:Wiad Lek;70(5):930-933, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The acute suppurative lymphadenitis and its chronic forms prevail in the structure of inflammatory processes of the maxillofacial area in children. High incidence of the acute and chronic forms of lymphadenitis of both odontogenic and nonodontogenic origin is caused by the anotomophysiological peculiarities of the structure of the teeth and soft tissues in children in different age periods. THE AIM: The paper was aimed at comparison of clinical manifestations of the acute and chronic odontogenic and non-odontogenic lymphadenitis. MATERIALS AND METHODS: The results of the checkup and 5-year-period treatment of 324 children with the acute and chronic forms of the nonspecific lymphadenitis of the maxilifacial area have been used. Four study groups have been formed. The first and the second group included 16 (38,0%) and 26 (62%) children with the acute submandibular suppurative lymphadenitis of the odontogenic and nonodontogenic origin, respectively. 12 (35,3%) and 22 (64,7) individuals with chronic hyperplastic lymphadenitis have been assigned to the third and the fourth group, respectively. RESULTS: The clinical course of the acute submandibular suppurative lymphadenitis of various etiologies is different. Rapid development of the local clinical manifestations with its dramatic progressing is specific to odontogenic lymphadenitis. Its clinical course is characterized by the more apparent overall response of the body, increase of the body temperature, and these symptoms are more manifested than in nonodontogenic lymphadenitis. The clinical course of chronic hyperplastic lymphadenitis is accompanied by the enlarged regional lymph nodes of various size and shapes and dense-elastic consistency. Clinical manifestations of nonodontogenic lymphadenitis were less apparent and the overall sate was normal in both forms of lymphadenitis. CONCLUSIONS: Nonodontogenic lymphadenitis prevailed in all nosological forms of the acute and chronic nonspecific lymphadenitis.
[Mh] Termos MeSH primário: Linfadenite/diagnóstico
Cistos não Odontogênicos/diagnóstico
Cistos Odontogênicos/diagnóstico
[Mh] Termos MeSH secundário: Criança
Diagnóstico Diferencial
Feminino
Seres Humanos
Linfadenite/complicações
Masculino
Cistos não Odontogênicos/complicações
Cistos Odontogênicos/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


  7 / 405238 MEDLINE  
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[PMID]:28459249
[Au] Autor:Huff C
[Ad] Endereço:Private Practice, Lafayette, Louisiana.
[Ti] Título:A Systematic Method for" "Accurate Functional Diagnosis.
[So] Source:Compend Contin Educ Dent;38(5):308-316, 2017 May.
[Is] ISSN:2158-1797
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The "medical model" is a term coined for a set of procedures in which American physicians are trained. For dentistry, the sequentially ordered set of procedures includes: (1) immediate concerns; (2) medical/ dental histories; (3) physical examination findings; (4) ancillary tests, if needed; (5) diagnosis; (6) risk assessment; (7) prognosis without treatment; (8) treatment-plan options/informed consent; (9) treatment; (10) post-treatment assessment and verification. This case report demonstrates a diagnostic system using the medical model via linear thinking-ie, step-by-step progression-to diagnose and conservatively treat a patient with a constricted chewing pattern.
[Mh] Termos MeSH primário: Odontologia/métodos
Diagnóstico Diferencial
Erosão Dentária
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Meia-Idade
Medição de Risco
Erosão Dentária/diagnóstico
Erosão Dentária/etiologia
Erosão Dentária/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


  8 / 405238 MEDLINE  
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[PMID]:29429175
[Au] Autor:Peng Z; Wang ZX; Xie J; Wang LE; Liu Y; Gong SS
[Ad] Endereço:Department of Otorhinolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijng 100050, China.
[Ti] Título:[Middle ear teratoma in infant: report of three cases and review of the literatures].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;53(2):81-85, 2018 Feb 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To summarize the clinical characteristics and therapeutic experiences of the middle ear teratoma in infants. Three cases of middle ear teratoma, from 2012-2015 in Beijing Friendship Hospital were analyzed. The three cases all developed slowly and presented unilateral otorrhea and hearing loss. Otoscopy showed the granulation tissue in the external ear canal. Audiological changes varied according to the degree of severity. Imaging features showed the pocket-like occupancy lesions in the Eustachian tube area. The temporal bone CT showed mass with soft tissue density usually involved in the mastoid and tympanic cavity. MRI showed mixed signal intense on both T1 and T2 weighted imaging. All the three cases received neoplasm resection of the middle ear. Only one case received tympanoplasty surgery at the same time. And all the pathology results displayed mature teratoma. The follow-up time was 17 to 54 months. MRI showed complete removal of the tumor. Teratoma are rare in the head and neck neoplasm. When the infants suffer from the unilateral otorrhea, hearing loss, and granulation tissue formed in the external ear canal, it should be vigilant for teratoma. The differential diagnosis is middle ear cholesteatoma, congenital first branchial cyst or fistula, and middle ear carcinoma. Temporal bone CT combined with MRI could improve the accuracy of diagnosis. It should be totally resection as soon as possible if there is no contraindication. Postoperative follow-up and imaging examination are necessary to eliminate tumor recurrence.
[Mh] Termos MeSH primário: Neoplasias da Orelha/cirurgia
Orelha Média
Teratoma
[Mh] Termos MeSH secundário: Branquioma
Surdez/etiologia
Diagnóstico Diferencial
Neoplasias da Orelha/complicações
Neoplasias da Orelha/diagnóstico por imagem
Orelha Média/diagnóstico por imagem
Tuba Auditiva/diagnóstico por imagem
Neoplasias de Cabeça e Pescoço
Seres Humanos
Lactente
Imagem por Ressonância Magnética
Processo Mastoide/diagnóstico por imagem
Recidiva Local de Neoplasia
Otoscopia
Osso Temporal/diagnóstico por imagem
Teratoma/complicações
Teratoma/diagnóstico por imagem
Teratoma/cirurgia
Tomografia Computadorizada por Raios X
Timpanoplastia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2018.02.001


  9 / 405238 MEDLINE  
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[PMID]:28453918
[Au] Autor:Vannas MJ; Boyd S; Färkkilä MA; Arola J; Isoniemi H
[Ad] Endereço:Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki, Finland.
[Ti] Título:Value of brush cytology for optimal timing of liver transplantation in primary sclerosing cholangitis.
[So] Source:Liver Int;37(5):735-742, 2017 May.
[Is] ISSN:1478-3231
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIMS: Primary sclerosing cholangitis is associated with a high risk of cholangiocarcinoma. Here, we investigated the value of surveillance for dysplasia using brush cytology, to determine the optimal timing of liver transplantation in primary sclerosing cholangitis. We compared our preoperative findings, with the final explanted liver histopathology. METHODS: 126 consecutive patients were transplanted for primary sclerosing cholangitis from 1984 to 2012. Patients were divided into two groups: symptomatic (n=91), and asymptomatic (n=35). RESULTS: Brush cytology was available for 101 patients; 66 symptomatic and 35 asymptomatic. Suspicious cytological findings were found in nine patients (14%) in the symptomatic group and 17 (49%) in the asymptomatic group. DNA flow cytometry was available for 49 patients (25 symptomatic, 24 asymptomatic), with aneuploidy detected in six patients (24%) in the symptomatic group and 15 (63%) in the asymptomatic group. Explanted liver histology showed biliary dysplasia or cholangiocarcinoma in 11 symptomatic patients (12%) and 15 asymptomatic patients (43%). A combination of cytological and DNA flow cytometry findings resulted in a test sensitivity of 68%, with a specificity of 86%. Ten-year survival in the asymptomatic group was 91%. CONCLUSIONS: Dysplasia surveillance using brush specimens may help to select those patients likely to benefit from early liver transplantation. It remains unclear as to whether surveillance with brush cytology improves long-term survival, but there is presently no better method with which to predict transplantation timing.
[Mh] Termos MeSH primário: Sistema Biliar/patologia
Colangite Esclerosante/patologia
Colangite Esclerosante/cirurgia
Citodiagnóstico/métodos
Células Epiteliais/patologia
Transplante de Fígado
[Mh] Termos MeSH secundário: Adulto
Neoplasias dos Ductos Biliares/patologia
Carcinoma Hepatocelular/patologia
Colangiocarcinoma/patologia
Colangiopancreatografia Retrógrada Endoscópica
Diagnóstico Diferencial
Feminino
Finlândia
Seres Humanos
Estimativa de Kaplan-Meier
Neoplasias Hepáticas/patologia
Masculino
Meia-Idade
Sistema de Registros
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1111/liv.13276


  10 / 405238 MEDLINE  
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[PMID]:28452210
[Au] Autor:Talley NJ
[Ad] Endereço:Faculty of Health and Medicine, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia.
[Ti] Título:Functional Dyspepsia: Advances in Diagnosis and Therapy.
[So] Source:Gut Liver;11(3):349-357, 2017 May 15.
[Is] ISSN:2005-1212
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Functional dyspepsia (FD) is a common but under-recognized syndrome comprising bothersome recurrent postprandial fullness, early satiety, or epigastric pain/burning. Epidemiologically, there are two clinically distinct FD syndromes (although these often overlap clinically): postprandial distress syndrome (PDS; comprising early satiety or meal-related fullness) and epigastric pain syndrome. Symptoms of gastroesophageal reflux disease overlap with FD more than expected by chance; a subset has pathological acid reflux. The pretest probability of FD in a patient who presents with classical FD symptoms and no alarm features is high, approximately 0.7. Coexistent heartburn should not lead to the exclusion of FD as a diagnosis. One of the most exciting observations in FD has been the consistent finding of increased duodenal eosinophilia, notably in PDS. Small bowel homing T cells, signaling intestinal inflammation, and increased cytokines have been detected in the circulation, and elevated tumor necrosis factor-α levels have been significantly correlated with increased anxiety. Postinfectious gastroenteritis is a risk factor for FD. Therapeutic options remain limited and provide only symptomatic benefit in most cases. Only one therapy is known to change the natural history of FD- eradication. Treatment of duodenal eosinophilia is under investigation.
[Mh] Termos MeSH primário: Dispepsia/diagnóstico
Dispepsia/terapia
Período Pós-Prandial
Avaliação de Sintomas
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Duodenopatias/complicações
Duodenopatias/diagnóstico
Dispepsia/etiologia
Eosinofilia/complicações
Eosinofilia/diagnóstico
Refluxo Gastroesofágico/complicações
Refluxo Gastroesofágico/diagnóstico
Azia/complicações
Azia/diagnóstico
Infecções por Helicobacter/complicações
Infecções por Helicobacter/tratamento farmacológico
Helicobacter pylori
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.5009/gnl16055



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