Acute

Acute abdominal pain is one of the most common symptoms in patients presenting to the emergency department and accounts for 5 to 10% of all emergency department visits. Pathophysiological conditions that lead to surgical interventions in such patients are mainly gastrointestinal obstruction, hemorrhage, ischemia, and viscus perforation. Acute abdominal pain can be diffuse or localized (i.e., quadrant-based epigastric pain or pain in the right upper quadrant, left upper quadrant, right lower quadrant, or left lower quadrant)2,4,6 and is associated with but not limited to the following disease processes: perforated viscus, peptic ulcer disease, mesenteric ischemia, acute cholecystitis, appendicitis, diverticulitis, pancreatitis, and intraabdominal hemorrhage. The need for emergency general surgery is an independent risk factor for postoperative complications and death, indicating the severity of the condition. Therefore, timely diagnosis of acute abdominal emergencies is essential. From antiquity to modern times, medical students have been taught that the history and the physical examination are the central components in the evaluation of acute abdominal pain.

Author/s:

Selwyn O Rogers Jr, Orlando C Kirton

The Management of Posttraumatic Stress Disorder and Acute Stress Disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline

Erin Blanchette — Tue, 12 Mar 2024 16:40:40 +0000

Date Added:

March 12, 2024

Journal/Publication:

Annals of Internal Medicine

Publisher:

American College of Physicians

Publication Date:

February 27, 2024

URL:

The Management of Posttraumatic Stress Disorder and Acute Stress Disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.7326/M23-2757

Keywords

PTSD

veterans

Veterans Health

Department of Veterans Affairs

Department of Defense

antidepressants

PMID (1):

38408360

MeSH

Stress Disorders

stress disorder, post-traumatic

Veterans

antidepressive agents

cannabis

Traumatic

Acute

Cognitive Behavioral Therapy

Recommendations from the Depts of Veterans Affairs and Defense regarding diagnosis and management of PTSD and acute stress disorders. James W. Mold, MD, MPH

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Description: The U.S. Department of Veterans Affairs (VA) and Department of Defense (DoD) worked together to revise the 2017 VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. This article summarizes the 2023 clinical practice guideline (CPG) and its development process, focusing on assessments and treatments for which evidence was sufficient to support a recommendation for or against.

Methods: Subject experts from both departments developed 12 key questions and reviewed the published literature after a systematic search using the PICOTS (population, intervention, comparator, outcomes, timing of outcomes measurement, and setting) method. The evidence was then evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method. Recommendations were made after consensus was reached; they were based on quality and strength of evidence and informed by other factors, including feasibility and patient perspectives. Once the draft was peer reviewed by an external group of experts and their inputs were incorporated, the final document was completed.

Recommendations: The revised CPG includes 34 recommendations in the following 5 topic areas: assessment and diagnosis, prevention, treatment, treatment of nightmares, and treatment of posttraumatic stress disorder (PTSD) with co-occurring conditions. Six recommendations on PTSD treatment were rated as strong. The CPG recommends use of specific manualized psychotherapies over pharmacotherapy; prolonged exposure, cognitive processing therapy, or eye movement desensitization and reprocessing psychotherapy; paroxetine, sertraline, or venlafaxine; and secure video teleconferencing to deliver recommended psychotherapy when that therapy has been validated for use with video teleconferencing or when other options are unavailable. The CPG also recommends against use of benzodiazepines, cannabis, or cannabis-derived products. Providers are encouraged to use this guideline to support evidence-based, patient-centered care and shared decision making to optimize individuals' health outcomes and quality of life.

Author/s:

Paula P Schnurr, Jessica L Hamblen, Jonathan Wolf, Rachael Coller, Claire Collie, Matthew A Fuller, Paul E Holtzheimer, Ursula Kelly, Ariel J Lang, Kate McGraw, Joshua C Morganstein, Sonya B Norman, Katie Papke, Ismene Petrakis, David Riggs, James A Sall, Brian Shiner, Ilse Wiechers, Marija S Kelber

What Is Childhood Leukemia?

Erin Blanchette — Mon, 19 Feb 2024 16:59:17 +0000

Date Added:

February 19, 2024

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

February 9, 2024

URL:

What Is Childhood Leukemia?

Type:

Patient Education Materials

Format:

Article

DOI (1):

10.1001/jama.2023.24648

Keywords

PMID (1):

38334982

MeSH

Bone Marrow

Precursor Cell Lymphoblastic Leukemia-Lymphoma

Leukemia

Myeloid

Acute

A summary for patients of our current understanding of childhood leukemia. James W. Mold, MD, MPH

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Childhood leukemia is the most common type of cancer that affects children. Leukemia is a cancer of white blood cells that starts in bone marrow (the soft center part of bones), which produces blood cells. Once a leukemic cell develops, it multiplies quickly in the bone marrow and can prevent healthy blood cells from forming. Leukemic cells can spread to various parts of the body, including the fluid that surrounds the brain and spinal cord (cerebrospinal fluid) and other organs such as the liver and kidneys. The cause of childhood leukemia is usually unknown, but in some rare cases, inherited genetic factors may play a role in development of childhood leukemia.

Author/s:

Jenny Ruiz, Colleen Mathews, Erika Friehling