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[PMID]:28457798
[Au] Autor:Tabit CE; Coplan MJ; Spencer KT; Alcain CF; Spiegel T; Vohra AS; Adelman D; Liao JK; Sanghani RM
[Ad] Endereço:Section of Cardiology, Department of Medicine, The University of Chicago Medical Center, Ill.
[Ti] Título:Cardiology Consultation in the Emergency Department Reduces Re-hospitalizations for Low-Socioeconomic Patients with Acute Decompensated Heart Failure.
[So] Source:Am J Med;130(9):1112.e17-1112.e31, 2017 Sep.
[Is] ISSN:1555-7162
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Re-hospitalization after discharge for acute decompensated heart failure is a common problem. Low-socioeconomic urban patients suffer high rates of re-hospitalization and often over-utilize the emergency department (ED) for their care. We hypothesized that early consultation with a cardiologist in the ED can reduce re-hospitalization and health care costs for low-socioeconomic urban patients with acute decompensated heart failure. METHODS: There were 392 patients treated at our center for acute decompensated heart failure who received standardized education and follow-up. Patients who returned to the ED received early consultation with a cardiologist; 392 patients who received usual care served as controls. Thirty- and 90-day re-hospitalization, ED re-visits, heart failure symptoms, mortality, and health care costs were recorded. RESULTS: Despite guideline-based education and follow-up, the rate of ED re-visits was not different between the groups. However, the rate of re-hospitalization was significantly lower in patients receiving the intervention compared with controls (odds ratio 0.592), driven by a reduction in the risk of readmission from the ED (0.56 vs 0.79, respectively). Patients receiving the intervention accumulated 14% fewer re-hospitalized days than controls and 57% lower 30-day total health care cost. Despite the reduction in health care resource consumption, mortality was unchanged. After accounting for the total cost of intervention delivery, the health care cost savings was substantially greater than the cost of intervention delivery. CONCLUSION: Early consultation with a cardiologist in the ED as an adjunct to guideline-based follow-up is associated with reduced re-hospitalization and health care cost for low-socioeconomic urban patients with acute decompensated heart failure.
[Mh] Termos MeSH primário: Cardiologia/normas
Serviço Hospitalar de Emergência/utilização
Insuficiência Cardíaca/terapia
Educação de Pacientes como Assunto/organização & administração
Readmissão do Paciente/estatística & dados numéricos
[Mh] Termos MeSH secundário: Doença Aguda
Idoso
Cardiologia/economia
Cardiologia/métodos
Estudos de Casos e Controles
Chicago
Controle de Custos/métodos
Controle de Custos/normas
Serviço Hospitalar de Emergência/economia
Serviço Hospitalar de Emergência/organização & administração
Feminino
Insuficiência Cardíaca/economia
Seres Humanos
Masculino
Meia-Idade
Estudos de Casos Organizacionais
Alta do Paciente/economia
Alta do Paciente/normas
Alta do Paciente/estatística & dados numéricos
Educação de Pacientes como Assunto/economia
Educação de Pacientes como Assunto/métodos
Readmissão do Paciente/economia
Guias de Prática Clínica como Assunto
Pontuação de Propensão
Encaminhamento e Consulta/economia
Encaminhamento e Consulta/normas
Estudos Retrospectivos
Fatores Socioeconômicos
Centros de Atenção Terciária/economia
Centros de Atenção Terciária/organização & administração
Saúde da População Urbana/economia
Saúde da População Urbana/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[St] Status: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


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[PMID]:29400043
[Au] Autor:Ruiz Y; Orive D; Coulombeau B; Perouse R
[Ti] Título:[Dysphonia in children: Retrospective and comparative study between the late 1980s and today].
[So] Source:Rev Laryngol Otol Rhinol (Bord);136(5):185-92, 2015.
[Is] ISSN:0035-1334
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Child dysphonia is a frequent pathological situation which concerns 6 to 38 percent of a school attending population. Thus it demands a specific and adapted treatment. Because of its direct consequences on social, family and school lives, parents often seek advice from a speech specialist. This study focuses on the specificities of those individuals having diagnosed child dysphonia, as well as the treatment which can be given to them. Our work covers a period of twenty years of comparative studies. We have read through dr Coulombeau's files, from 2005 to 2011, and we have made up a series of questions addressed to the speech therapists having speech impaired children in their practice. We have cross-examined these data with those of Dr Cornut's, covering a period of seven years (1985-1991). The qualitative and quantitative studies which have been carried out enabled us to highlight the fact there has been a constant background of child dysphonia and an evolution in the offered treatments. Indeed, we have realised that the number of individuals having diagnosed child dysphonia are less and less operated on. In the same time people tend to ignore the offered treatments. Though the follow-ups to a prior visit at a speech therapist have decreased for twenty years, it still remains the most common treatment. Our analysis does not focus on the effects of the given treatments on a long term basis. It thus appears that a study consisting in analysing the development of these children through adulthood would be greatly accurate.
[Mh] Termos MeSH primário: Disfonia/terapia
[Mh] Termos MeSH secundário: Disfonia/diagnóstico
Seres Humanos
Encaminhamento e Consulta/tendências
Estudos Retrospectivos
Fonoterapia/tendências
Conduta Expectante/tendências
[Pt] Tipo de publicação:COMPARATIVE STUDY; 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:180206
[St] Status:MEDLINE


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[PMID]:28466684
[Au] Autor:Spalding R; Kozlov E; Carpenter BD
[Ad] Endereço:1 Washington University in St. Louis, MO, USA.
[Ti] Título:Words Matter.
[So] Source:Int J Aging Hum Dev;85(1):123-130, 2017 06.
[Is] ISSN:1541-3535
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Palliative care consultation teams (PCCTs) provide input to other health-care providers working with patients who have life-limiting disease. This study examines whether the diction and phrasing of consultation recommendations in the electronic health record influence their implementation. We reviewed 288 verbatim PCCT recommendations that were made for 111 unique patients in a Veterans Affairs hospital and available in the electronic health record. Recommendations were coded for linguistic features, such as the presence of conditionals (e.g., "could") and tentative phrasing (e.g., "would suggest"). Each patient's subsequent treatment was followed in the medical record to determine whether PCCT recommendations were implemented. Only 57% of the consultation recommendations were eventually implemented. Recommendations that included a conditional word or phrase were significantly less likely to be implemented. In particular, recommendations that included the words "could" and "consider" were less likely to be implemented. PCCTs may enhance their effectiveness by attending to the subtle pragmatics of how they communicate with other health-care providers, particularly in electronic communication where nonverbal features of communication are unavailable.
[Mh] Termos MeSH primário: Comunicação
Registros Eletrônicos de Saúde/estatística & dados numéricos
Cuidados Paliativos/estatística & dados numéricos
Relações Profissional-Paciente
Encaminhamento e Consulta/estatística & dados numéricos
Comportamento Verbal
[Mh] Termos MeSH secundário: Seres Humanos
Assistência de Longa Duração
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1177/0091415016685328


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[PMID]:29251433
[Au] Autor:Sabapathy K; Mubekapi-Musadaidzwa C; Mulubwa C; Schaap A; Hoddinott G; Stangl A; Floyd S; Ayles H; Fidler S; Hayes R; HPTN 071 (PopART) study team
[Ad] Endereço:London School of Hygiene and Tropical Medicine, London, United Kingdom.
[Ti] Título:Predictors of timely linkage-to-ART within universal test and treat in the HPTN 071 (PopART) trial in Zambia and South Africa: findings from a nested case-control study.
[So] Source:J Int AIDS Soc;20(4), 2017 Dec.
[Is] ISSN:1758-2652
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: HPTN 071 (PopART) is a three-arm community randomized trial in Zambia and South Africa evaluating the impact of a combination HIV prevention package, including universal test and treat (UTT), on HIV incidence. This nested study examined factors associated with timely linkage-to-care and ART initiation (TLA) (i.e. within six-months of referral) in the context of UTT within the intervention communities of the HPTN 071 (PopART) trial. METHODS: Of the 7572 individuals identified as persons living with HIV (PLWH) (and not on antiretroviral treatment (ART)) during the first year of the PopART intervention provided by Community HIV-care Providers (CHiPs) through door-to-door household visits, individuals who achieved TLA (controls) and those who did not (cases), stratified by gender and community, were randomly selected to be re-contacted for interview. Standardized questionnaires were administered to explore factors potentially associated with TLA, including demographic and behavioural characteristics, and participants' opinions on HIV and related services. Odds ratios comparing cases and controls were estimated using a multi-variable logistic regression. RESULTS: Data from 705 participants (333 cases/372 controls) were analysed. There were negligible differences between cases and controls by demographic characteristics including age, marital or socio-economic position. Prior familiarity with the CHiPs encouraged TLA (aOR of being a case: 0.58, 95% CI: 0.39 to 0.86, p = 0.006). Participants who found clinics overcrowded (aOR: 1.51, 95% CI: 1.08 to 2.12, p = 0.006) or opening hours inconvenient (aOR: 1.63, 95% CI: 1.06 to 2.51, p = 0.02) were less likely to achieve TLA, as were those expressing stronger feelings of shame about having HIV (p  = 0.007). Expressing "not feeling ready" (aOR: 2.75, 95% CI: 1.89 to 4.01, p < 0.001) and preferring to wait until they felt sick (aOR: 2.00, 95% CI: 1.27 to 3.14, p = 0.02) were similarly indicative of being a case. Worrying about being seen in the clinic or about how staff treated patients was not associated with TLA. While the association was not strong, we found that the greater the number of self-reported lifetime sexual partners the more likely participants were to achieve TLA (p  = 0.06). There was some evidence that participants with HIV-positive partners on ART were less likely to be cases (aOR: 0.75, 95% CI: 0.53 to 1.06, p = 0.07). DISCUSSION: The lack of socio-demographic differences between cases and controls is encouraging for a "universal" intervention that seeks to ensure high coverage across whole communities. Making clinics more "patient-friendly" could enhance treatment uptake further. The finding that those with higher risk behaviour are more actively engaging with UTT holds promise for treatment-as-prevention.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/uso terapêutico
Intervenção Médica Precoce
Infecções por HIV/prevenção & controle
Aceitação pelo Paciente de Cuidados de Saúde
[Mh] Termos MeSH secundário: Adulto
Fármacos Anti-HIV/administração & dosagem
Estudos de Casos e Controles
Feminino
Seres Humanos
Incidência
Masculino
Meia-Idade
Ensaios Clínicos Controlados Aleatórios como Assunto
Encaminhamento e Consulta
Parceiros Sexuais
África do Sul
Zâmbia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.1002/jia2.25037


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[PMID]:28461283
[Au] Autor:Haskins BL; Davis-Martin R; Abar B; Baumann BM; Harralson T; Boudreaux ED
[Ad] Endereço:University of Massachusetts Medical School, Worcester, MA, United States.
[Ti] Título:Health Evaluation and Referral Assistant: A Randomized Controlled Trial of a Web-Based Screening, Brief Intervention, and Referral to Treatment System to Reduce Risky Alcohol Use Among Emergency Department Patients.
[So] Source:J Med Internet Res;19(5):e119, 2017 May 01.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Computer technologies hold promise for implementing alcohol screening, brief intervention, and referral to treatment (SBIRT). Questions concerning the most effective and appropriate SBIRT model remain. OBJECTIVE: The aim of this study was to evaluate the impact of a computerized SBIRT system called the Health Evaluation and Referral Assistant (HERA) on risky alcohol use treatment initiation. METHODS: Alcohol users (N=319) presenting to an emergency department (ED) were considered for enrollment. Those enrolled (n=212) were randomly assigned to the HERA, to complete a patient-administered assessment using a tablet computer, or a minimal-treatment control, and were followed for 3 months. Analyses compared alcohol treatment provider contact, treatment initiation, treatment completion, and alcohol use across condition using univariate comparisons, generalized estimating equations (GEEs), and post hoc chi-square analyses. RESULTS: HERA participants (n=212; control=115; intervention=97) did not differ between conditions on initial contact with an alcohol treatment provider, treatment initiation, treatment completion, or change in risky alcohol use behavior. Subanalyses indicated that HERA participants, who accepted a faxed referral, were more likely to initiate contact with a treatment provider and initiate treatment for risky alcohol use, but were not more likely to continue engaging in treatment, or to complete treatment and change risky alcohol use behavior over the 3-month period following the ED visit. CONCLUSIONS: The HERA promoted initial contact with an alcohol treatment provider and initiation of treatment for those who accepted the faxed referral, but it did not lead to reduced risky alcohol use behavior. Factors which may have limited the HERA's impact include lack of support for the intervention by clinical staff, the low intensity of the brief and stand-alone design of the intervention, and barriers related to patient follow-through, (eg, a lack of transportation or childcare, fees for services, or schedule conflicts). TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): NCT01153373; https://clinicaltrials.gov/ct2/show/NCT01153373 (Archived by WebCite at http://www.webcitation.org/6pHQEpuIF).
[Mh] Termos MeSH primário: Consumo de Bebidas Alcoólicas/prevenção & controle
Consumo de Bebidas Alcoólicas/terapia
Serviço Hospitalar de Emergência
Internet/utilização
Encaminhamento e Consulta
Comportamento de Redução do Risco
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.6812


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[PMID]:28465449
[Au] Autor:Geller BM; Nelson HD; Weaver DL; Frederick PD; Allison KH; Onega T; Carney PA; Tosteson ANA; Elmore JG
[Ad] Endereço:Department of Family Medicine, University of Vermont, Burlington, Vermont, USA.
[Ti] Título:Characteristics associated with requests by pathologists for second opinions on breast biopsies.
[So] Source:J Clin Pathol;70(11):947-953, 2017 Nov.
[Is] ISSN:1472-4146
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Second opinions in pathology improve patient safety by reducing diagnostic errors, leading to more appropriate clinical treatment decisions. Little objective data are available regarding the factors triggering a request for second opinion despite second opinion consultations being part of the diagnostic system of pathology. Therefore we sought to assess breast biopsy cases and interpreting pathologists characteristics associated with second opinion requests. METHODS: Collected pathologist surveys and their interpretations of 60 test set cases were used to explore the relationships between case characteristics, pathologist characteristics and case perceptions, and requests for second opinions. Data were evaluated by logistic regression and generalised estimating equations. RESULTS: 115 pathologists provided 6900 assessments; pathologists requested second opinions on 70% (4827/6900) of their assessments 36% (1731/4827) of these would not have been required by policy. All associations between case characteristics and requesting second opinions were statistically significant, including diagnostic category, breast density, biopsy type, and number of diagnoses noted per case. Exclusive of institutional policies, pathologists wanted second opinions most frequently for atypia (66%) and least frequently for invasive cancer (20%). Second opinion rates were higher when the pathologist had lower assessment confidence, in cases with higher perceived difficulty, and cases with borderline diagnoses. CONCLUSIONS: Pathologists request second opinions for challenging cases, particularly those with atypia, high breast density, core needle biopsies, or many co-existing diagnoses. Further studies should evaluate whether the case characteristics identified in this study could be used as clinical criteria to prompt system-level strategies for mandating second opinions.
[Mh] Termos MeSH primário: Biópsia
Doenças Mamárias/patologia
Mama/patologia
Patologistas
Encaminhamento e Consulta
[Mh] Termos MeSH secundário: Adulto
Idoso
Atitude do Pessoal de Saúde
Competência Clínica
Estudos Transversais
Diagnóstico Diferencial
Erros de Diagnóstico/prevenção & controle
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Variações Dependentes do Observador
Patologistas/psicologia
Valor Preditivo dos Testes
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1136/jclinpath-2016-204231


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[PMID]:28459902
[Au] Autor:Najafi N; Harrison JD; Duong J; Greenberg A; Cheng HQ
[Ad] Endereço:Division of Hospital Medicine, University of California San Francisco, San Francisco, CA.
[Ti] Título:It All Just Clicks: Development of an Inpatient E-Consult Program.
[So] Source:J Hosp Med;12(5):332-334, 2017 May.
[Is] ISSN:1553-5606
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although the use of electronic consultations (e-consults) in the outpatient setting is commonplace, there is little evidence of their use in the inpatient setting. Often, the only choice hospitalists have is between requesting a time-consuming in-person consultation or requesting an informal, undocumented "curbside" consultation. For a new, remote hospital in our healthcare system, we developed an e-consult protocol that can be used to address simple consultation questions. In the first year of the program, 143 e-consults occurred; the top 5 consultants were infectious disease, hematology, endocrinology, nephrology, and cardiology. Over the first 4 months, no safety issues were identified in chart review audits; to date, no safety issues have been identified through the hospital's incident reporting system. In surveys, hospitalists were universally pleased with the quality of e-consult recommendations, though only 43% of consultantsagreed. With appropriate care for patient selection, e-consults can be used to safely and efficiently provide subspecialty expertise to a remote inpatient site Journal of Hospital Medicine 2017;12:332-334.
[Mh] Termos MeSH primário: Hospitais Universitários/tendências
Desenvolvimento de Programas/métodos
Encaminhamento e Consulta/tendências
Telemedicina/métodos
Telemedicina/tendências
[Mh] Termos MeSH secundário: Medicina Hospitalar/métodos
Medicina Hospitalar/tendências
Médicos Hospitalares/tendências
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.12788/jhm.2740


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[PMID]:29384306
[Au] Autor:Houngnihin RA; Sossou AJ
[Ti] Título:[Understanding failure of obstetric referral to the Cotonou University gynaecology and obstetrics clinic].
[Ti] Título:Comprendre le renoncement à la référence obstétricale à la Clinique universitaire de gynécologie et d?obstétrique de Cotonou..
[So] Source:Sante Publique;29(5):719-729, 2017 Dec 05.
[Is] ISSN:0995-3914
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:INTRODUCTION: Since 2000, in the context of the Millennium development goals, Benin has reinforced its obstetric referral system in order to reduce maternal mortality. However, structural, sociocultural and economic problems continue to affect this strategy. The Cotonou University gynaecology and obstetrics clinic (CUGO), at the top of the health pyramid, is emblematic of this situation. This study was designed to elucidate the stakes involved in referral to this hospital based on analysis of the perceptions and experiences of referral personnel. METHODS: Essentially qualitative data collection was conducted by means of in-depth semi-structured interviews from July to December 2015 involving 37 people, including referred women, healthcare personnel and caregivers. RESULTS: The poor quality of information given to women concerning the reasons for referral, the fear of caesarean section, considered to be inevitable, and the difficult relationships with health workers contribute to failure to comply with referral. Rumours concerning reception, waiting times and hospitalization conditions are other factors that must be taken into account. Finally, the distance from the woman's home is a decisive element in acceptance of referral by women and their families. CONCLUSION: Referral is generally perceived as necessary in the case of complications during pregnancy, by both referred women and healthcare personnel. However, differences in points of view are observed when the woman is referred to CUGO.
[Mh] Termos MeSH primário: Serviços de Saúde Materna
Ambulatório Hospitalar
Cooperação do Paciente
Encaminhamento e Consulta
[Mh] Termos MeSH secundário: Adolescente
Adulto
Benin
Comunicação
Feminino
Seres Humanos
Educação de Pacientes como Assunto
Gravidez
Complicações na Gravidez
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.3917/spub.175.0719


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[PMID]:29368480
[Au] Autor:Mohammed Y; Qazi ZN; Shuler FD; Garabekyan T
[Ti] Título:Hip Pain in the Pre-Arthritic Patient: A Guide for the Primary Care Physician.
[So] Source:W V Med J;112(5):48-53, 2016 Sep-Oct.
[Is] ISSN:0043-3284
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Adolescents and young adults (less than 30 years of age) with pre-arthritic hip pain constitute a diagnostic dilemma for the primary care physician. The most common underlying diagnoses range from benign muscle strains/joint sprains to stress reactions, insufficiency fractures, and tears involving the articular cartilage/labrum in the setting of femoroacetabular impingement, a hip shape abnormality that is present in up to 90% of this age group. Undetected or left untreated these seemingly innocuous disorders can result in significant loss of function and, in some cases, irreversible joint damage. Despite sharing common predisposing factors, many of the above diagnoses can be identified with a focused history and physical examination. Conservative management may be safely initiated without advanced imaging, reserving orthopaedic consultation for refractory cases or more serious diagnoses. The presented focused hip clinical examination has 98% sensitivity in localizing intra-articular hip pathology and will be helpful to direct appropriate referrals. This article will serve as a guide for primary care physicians undertaking the difficult task of evaluating and treating a young patient with hip pain.
[Mh] Termos MeSH primário: Artralgia/terapia
Terapia por Exercício
Articulação do Quadril/patologia
Exame Físico
Médicos de Atenção Primária
Encaminhamento e Consulta
[Mh] Termos MeSH secundário: Adolescente
Artralgia/diagnóstico por imagem
Artralgia/etiologia
Terapia por Exercício/métodos
Impacto Femoroacetabular/complicações
Guias como Assunto
Seres Humanos
Medição da Dor
Satisfação do Paciente
Exame Físico/métodos
Modalidades de Fisioterapia
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE



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