Isr Med Assoc J
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Musculoskeletal complaints represent the second most common reason for visits to a physician, second only to the common cold. The limited capability of medical treatment for musculoskeletal disease requires modification of communication with patients by attending to their perception of the disease. ⋯ The high level of patient satisfaction with their primary physicians' care for musculoskeletal symptoms may reflect the overall tendency of the elderly population to be satisfied with its primary care physicians. However, their high level of expectations (related to perceived efficacy of medical treatment) and their unrealistic perceptions of disease may lead to disappointment and non-compliance with their doctor's recommendations. Management of musculoskeletal disease in the elderly should address the patients' disease perceptions, as well as their therapeutic and functional needs.
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Familial Mediterranean fever is a genetic disease in which some characteristic gene mutations have been found. ⋯ This study characterizes the phenotype-genotype in specific ethnic groups of patients with FMF.
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Biography Historical Article
Hieronymus Bosch (1450-1516): paleopathology of the medieval disabled and its relation to the Bone and Joint Decade 2000-2010.
At the start of the Bone and Joint Decade 2000-2010, a paleopathologic study of the physically disabled may yield information and insight on the prevalence of crippling disorders and attitudes towards the afflicted in the past compared to today. ⋯ A correct clinical diagnosis can be reached through the collaboration of a rheumatologist, an orthopedist and a neurologist. The Bone and Joint Decade Project, calling for attention and education with respect to musculoskeletal disorders, should reduce the impact and burden of crippling diseases worldwide through early clinical diagnosis and appropriate treatment.
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The exact value of follow-up ultrasonography and computed tomography in the non-operative management of blunt splenic injuries is not yet defined. Although follow-up studies have been recommended to detect possible complications of the initial injury, evidence shows that routine follow-up CT scans usually do not affect management of these patients. ⋯ In the present series the follow-up radiological studies did not affect patient management. Follow-up imaging can be omitted in clinically stable patients with blunt splenic trauma grade I-III.
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Transfer to an emergency room and hospitalization of nursing home residents is a growing problem that is poorly defined and reported. ⋯ Treatment of selected nursing home residents admitted directly from the nursing home to an acute-care geriatric unit is feasible, medically effective, results in the safe discharge of almost all such patients and provides an alternative to transfer to an emergency room. This study suggests that quality gains and cost-effective measures may be achieved by such a project, although a randomized controlled trial is necessary to support this hypothesis.