Dysmenorrhea is one of the most common causes of pelvic pain. It negatively affects patients' quality of life and sometimes results in activity restriction. A history and physical examination, including a pelvic examination in patients who have had vaginal intercourse, may reveal the cause. Primary dysmenorrhea is menstrual pain in the absence of pelvic pathology. Abnormal uterine bleeding, dys...

BACKGROUND Alzheimer disease is an increasingly common condition in older people. Knowledge of life expectancy after the diagnosis of Alzheimer disease and of associations of patient characteristics with survival may help planning for future care. OBJECTIVE To investigate the course of Alzheimer disease after initial diagnosis and examine associations hypothesized to correlate with survival a...

Although the annual incidence of bacterial meningitis in the United States is declining, it remains a medical emer- gency with a potential for high morbidity and mortality. Clinical signs and symptoms are unreliable in distinguishing bacterial meningitis from the more common forms of aseptic meningitis; therefore, a lumbar puncture with cerebro- spinal fluid analysis is recommended. Empiric ant...

Introduction. Most documented rare diseases have genetic origin. Because of their low individual frequency, an initial diagnosis based on phenotypic symptoms is not always easy, as practitioners might never have been exposed to patients suffering from the relevant disease. It is thus important to develop tools that facilitate symptom-based initial diagnosis of rare diseases by clinicians. In th...

results we performed rush on 77 patients. kappa index was 0.71 (p value = 0.000), reflecting acceptable general agreement between initial impression and final diagnosis. for hypovolemic, cardiogenic and obstructive shock, the protocol had an npv above 97% yet it had a lower ppv. for shock with distributive or mixed etiology, rush showed a ppv of 100% but it had low sensitivity. subgroup analysi...

Background: To retrospectively evaluate whether quantitative information derived from spectral imaging can improve the differential diagnosis of pancreatic cystic masses including pancreatic solid pseudopapillary epithelial neoplasms (SPENs), mucin- producing cysts and pseudocysts. Materials and Methods: From June 2015 to October 2017, 56 patients (22 pseudocysts, 18 mucin-producing cysts and 1...

Neuroblastoma (NB) is considered one of the malignant tumors of the nervous system which originates from primordial neural crest cell and is known as the most common extra-cranial solid tumor in childhood. This tumor which is often intra-abdominal, metastases in various sites including the skull, long bones, liver, bone marrow and lymph nodes, but lung metastasis at initial diagnosis is rare (0...