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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vertebral fractures leading to low back pain, spinal deformity, gastroesophageal reflux disease, and cardiopulmonary dysfunctions decrease the quality of life (QOL) in patients with osteoporosis. We had investigated the change of QOL in osteoporosis patients with back pain for 6 months. The relief of the pain improved "activities of daily living" , but did not "leisure, social activities" , "health perception" , "posture, figure" , and "fall, mental factors" . The control of pain and social approach such as fall prevention program are necessary to improve the QOL in patients with vertebral fractures.
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PMID:[QOL in osteoporotic patients with vertebral fractures]. 1557 5

An interdisciplinary group of faculty from medicine, basic sciences, physical therapy, and education developed a performance assessment tool for evaluating clinical competence. This group was assembled following the revision to integrated systems-based curricula in the school of medicine and doctor of physical therapy program. The group was challenged to measure curricular outcomes through student assessment of clinical competence as defined through integration. The Integrated Standardized Patient Examination was developed as the assessment tool. This model utilizes standardized patients, who are trained to ask questions that require the students to integrate scientific knowledge and communicate this back to the patient. The student response is graded on a rubric and averaged with a history-taking portion of the examination. This model was administered to 140 first-year medical students who were randomly assigned to either an acute low back pain case or gastroesophageal reflux disease case. Clinical faculty scored the students in the treatment room, with additional faculty scoring in the monitor room. Interrater agreement was 87% for the low back pain case and 82% for the gastroesophageal reflux disease case. These results warrant further investigation of the Integrated Standardized Patient Examination for transfer to other health care professions, in particular physical therapy.
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PMID:A model for integrated assessment of clinical competence. 1794 10

Skeletal muscle metastasis is a very rare event in patients with oesophageal cancer. We herein report and discuss a case of a 65 years old man with history of gastro-esophageal reflux disease referred to our department for pyrosis associated to persistent low back pain. Oesophageal endoscopy and transesophageal endo-sonography showed a tumour localized in the lower third of the esophagus, histologically proved to be adenocarcinoma. Clinical staging procedures detected a two centimetres vascularized nodular lesion placed into right para-vertebral muscles at the level of L4 as the only sign of potential distant disease (versus a differential diagnosis of primitive sarcoma). The muscle lesion was completely removed and confirmed as secondary adenocarcinoma. Due to this evidence a chemotherapy protocol was initiated. After nine months the patient underwent transhiatal oesophagectomy. To the best of our knowledge this is the first reported case of a soft tissue metastasis from oesophageal cancer resected with radical intent.
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PMID:A case of oesophageal cancer with low back pain: the accidental finding of skeletal muscle metastasis. 2369 89

COPD is a worsening condition that leads to a pathologic degeneration of the respiratory system. It represents one of the most important causes of mortality and morbidity in the world, and it is characterized by the presence of associated comorbidity. This article analyzes gastroesophageal reflux disease (GERD) and low back pain (LBP) in patients with COPD and tries to produce anatomo-clinical considerations on the reasons of the presence of these comorbidities. The considerations of the authors are based on the anatomic functions and characteristics of the respiratory diaphragm that are not always considered, from which elements useful to comprehend the symptomatic status of the patient can be deduced, finally improving the therapeutic approach. The information contained in the article can be of help to the clinician and for physiotherapy, and to all health professionals who gravitate around the patient's care, improving the approach to the diaphragm muscle.
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PMID:Low back pain and gastroesophageal reflux in patients with COPD: the disease in the breath. 2940 70

Women often see their primary care physicians for common acute conditions during pregnancy. These conditions may be caused by pregnancy (obstetric problems) or worsened by pregnancy (obstetrically aggravated problems), or they may require special consideration during pregnancy because of maternal or fetal risks (nonobstetric problems). Primary care physicians should know the differential diagnosis for common conditions during pregnancy and recognize the important findings of obstetric and urgent nonobstetric problems. The family physician can evaluate and treat most nonobstetric problems, although obstetric problems require referral to a primary maternity care clinician. A tiered approach, including routinely looking for all-cause red flag symptoms and signs, while remaining aware of estimated gestational age, allows for high-quality care and shared decision making between the family physician and the pregnant patient. When treating common causes of nausea and epigastric pain/gastroesophageal reflux, lifestyle modifications are considered the safest and first-choice therapy, followed by well-established low-risk therapies, such as vitamin B6 (pyridoxine) and doxylamine for nausea, and antacids not containing salicylates (found in bismuth combination products) for gastroesophageal reflux. Other common conditions during pregnancy are best treated with low-risk therapies, such as using antihistamines or topical steroids for rashes, first-generation cephalosporins or amoxicillin for cystitis, and physical therapy and acetaminophen for low back pain and headaches.
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PMID:The Pregnant Patient: Managing Common Acute Medical Problems. 3115 Jan 81