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Trafficking in the child and adolescent: Application of SAFETY and CARE for a global crisis of exploitation 贩卖儿童和青少年:应用 "安全 "和 "关爱 "应对全球剥削危机。
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 DOI: 10.1016/j.disamonth.2024.101825
Donald E. Greydanus MD, DrHC (ATHENS) , Dena Nazer MD , Artemis Tsitsika MD , Ahsan Nazeer MD , Dr Swati Y. Bhave , Elizabeth K. Greydanus LMSW, CAADC
Human trafficking in the child and adolescent is a global public health crisis that can be divided into sex trafficking, labor trafficking and organ trafficking. This discussion considers basic terminology in this area, sociodemographic information on these victims, negative effects or repercussions from such egregious actions forced on the victims, issues of screening for healthcare providers based on specific risk factors/indicators, and information regarding screening tools as well as management principles for healthcare professionals. These trafficked persons are seen in varied practice settings such as primary care offices, emergency departments, street medicine operations, and others. Clinicians can approach these victims with targeted training that encourages these pediatric persons to feel safe in healthcare settings, empowering them to help with healing (i.e., trauma-informed care). It is important that those involved in the care of trafficked victims understand the rights of these persons who are essentially hostages that need rescuing, and thus, employ a rights-based approach in dealing with these vulnerable children and youth. Culturally-sensitive concepts of prevention are considered as well to reduce this illegal, inhumane exploitation of our children and adolescents ubiquitously existing throughout the United States and the world. Indeed, there is much that clinicians and society can do to help these unfortunate minors who often feel hopeless and trapped in chaotic circumstances.
贩运儿童和青少年是一场全球性的公共卫生危机,可分为性贩运、劳动力贩运和器官贩运。本讨论探讨了这一领域的基本术语、这些受害者的社会人口信息、强迫受害者从事此类恶劣行为的负面影响或反响、医疗保健提供者根据特定风险因素/指标进行筛查的问题、有关筛查工具的信息以及医疗保健专业人员的管理原则。这些被贩运者的就诊环境多种多样,如初级保健诊所、急诊科、街头医疗机构等。临床医生可以通过有针对性的培训来帮助这些受害者,鼓励这些儿科人员在医疗环境中感到安全,使他们有能力帮助治疗(即创伤知情护理)。重要的是,参与护理人口贩运受害者的人员应了解这些人的权利,他们基本上是需要解救的人质,因此,在处理这些弱势儿童和青少年时,应采用基于权利的方法。此外,还考虑了对文化敏感的预防概念,以减少美国乃至全世界普遍存在的对儿童和青少年的非法、不人道的剥削。事实上,临床医生和社会可以做很多事情来帮助这些不幸的未成年人,他们常常感到绝望并被困在混乱的环境中。
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引用次数: 0
Information for Readers 读者资讯
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 DOI: 10.1016/S0011-5029(25)00006-9
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引用次数: 0
C2: Editorial Board C2:编委会
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 DOI: 10.1016/S0011-5029(25)00004-5
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引用次数: 0
Gastrointestinal disorders–Clinical challenges for the primary care clinician: Conclusion 胃肠道疾病-初级保健临床医生的临床挑战:结论。
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101827
Robin B. McFee DO, MPH, FACPM, FAACT
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引用次数: 0
Gastrointestinal disorders – Clinical challenges for the primary care clinician An overview 胃肠道疾病-初级保健临床医生的临床挑战综述。
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101829
Robin McFee DO, MPH, FACPM, FAACT (Medical Director) , Jerrold B. Leikin MD, FACOEM, FACP, FACEP, FACMT, FAACT, FASAM (Senior Editor)
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引用次数: 0
C2: Editorial Board C2:编委会
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-01 DOI: 10.1016/S0011-5029(24)00161-5
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引用次数: 0
Navigating mesenteric vasculitis: A comprehensive review of literature 肠系膜血管炎导航:文献综述。
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101830
Fizza Zulfiqar MD , Muhammad Bilal MD , Yash Shah MD , Steele Morgan , Rida Fatima MD , Bryanna Singh , Sneha Annie Sebastian , Bashar Roumia , Parjanya Bhatt MD , Vinay Kumar Thallapally MD , Geetha Krishnamoorthy MD , Syed Ali Muttaqi Hussain MD
Vasculitides are diseases marked by inflammation of the blood vessel walls across various organ systems. The mesenteric vasculitis (MV) affects localized mesenteric vessels of the gastrointestinal tract. It usually occurs as part of a systemic inflammatory process but could also present in isolation. There are very few published reports of isolated mesenteric artery vasculitis. Presenting symptoms often include nausea, vomiting, diarrhea, abdominal pain, rectal bleeding, often complicating the diagnostic process. Diagnosing MV as the cause of abdominal pain can be challenging, and failure to diagnose can result in significant morbidity and mortality. A timely and accurate diagnosis of MV is essential for administering the appropriate immunosuppressive therapy and preventing unnecessary surgical interventions. This review aims to provide a comprehensive discussion of MV, including its clinical presentation, diagnostic approaches, and treatment options, with a focus on achieving early diagnosis to enhance outcomes and prevent complications. Furthermore, this review addresses the diagnostic challenges associated with MV, including the lack of specific criteria and symptom overlap with other gastrointestinal disorders such as atherosclerotic mesenteric ischemia, infections, malignancies, adverse medication effects, and other vessel occlusive processes. It also emphasizes the gaps in current literature regarding optimal diagnostic strategies and the necessity for standardized treatment protocols. By addressing these gaps and challenges, we aim to optimize patient care and improve prognosis for individuals affected by MV.
血管炎是以各器官系统血管壁发炎为特征的疾病。肠系膜血管炎(MV)影响胃肠道的局部肠系膜血管。它通常是全身炎症过程的一部分,但也可能单独出现。关于孤立性肠系膜动脉血管炎的公开报道很少。出现的症状通常包括恶心、呕吐、腹泻、腹痛和直肠出血,这往往使诊断过程复杂化。诊断腹痛的病因为 MV 可能具有挑战性,诊断失败可能导致严重的发病率和死亡率。及时准确地诊断出中风对采取适当的免疫抑制疗法和防止不必要的手术干预至关重要。本综述旨在全面讨论中风,包括其临床表现、诊断方法和治疗方案,重点是实现早期诊断以提高疗效和预防并发症。此外,本综述还探讨了与 MV 相关的诊断难题,包括缺乏特定标准和症状与其他胃肠道疾病重叠,如动脉粥样硬化性肠系膜缺血、感染、恶性肿瘤、药物不良反应和其他血管闭塞过程。报告还强调了当前文献在最佳诊断策略方面存在的不足,以及标准化治疗方案的必要性。通过解决这些差距和挑战,我们的目标是优化患者护理,改善中风患者的预后。
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引用次数: 0
Cannabinoid Hyperemesis Syndrome (CHS) - An emerging gastrointestinal disorder and clinical challenge 大麻素呕吐综合征——一种新兴的胃肠道疾病和临床挑战。
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101832
R.B. McFee DO, MPH, FACPM, FAACT
Nausea and vomiting are not uncommon symptoms resulting in emergency department (ED) or primary care visits. One of the emerging etiologies – Cannabinoid Hyperemesis Syndrome (CHS) remains significantly under-diagnosed, often resulting in unnecessary repeat ED visits and testing. This is in part due to lack of experience with and knowledge about CHS by health care professionals. Characterized by cyclic vomiting, often severe and intractable, it is frequently associated with a form of self-treatment; the compulsive need to take hot showers, and in the context of chronic cannabis use. With increased legalization and resultant accessibility to cannabis containing products, the risk of adverse events is significantly rising. Lack of clinical familiarity with the range of potential deleterious physical and mental health effects associated with cannabis leads to delays in appropriate diagnosis and effective treatment of CHS. Moreover, commonly utilized anti-emetics, such as ondansetron, and similar 5 HT drugs may not fully attenuate symptoms of CHS, and other interventions may be necessary; ultimately abstinence being the most effective long term clinical preventive approach. The objective of this review article is to assist the clinician in identifying the specific clinical characteristics of CHS, distinguishing it from other causes of CVS or nausea and vomiting, to facilitate more rapid, effective interventions. Collaboration with substance use professionals should also be considered during CHS treatment.
恶心和呕吐是不常见的症状导致急诊科(ED)或初级保健访问。新出现的病因之一-大麻素剧吐综合征(CHS)仍然明显诊断不足,经常导致不必要的重复ED访问和测试。这部分是由于卫生保健专业人员缺乏关于CHS的经验和知识。以周期性呕吐为特征,通常严重且难治性,常伴有某种形式的自我治疗;强迫性地需要洗热水澡,在长期使用大麻的情况下。随着大麻合法化程度的提高以及由此产生的含大麻产品的可及性,不良事件的风险正在显著上升。缺乏对与大麻有关的潜在有害身心健康影响范围的临床熟悉,导致对大麻中毒的适当诊断和有效治疗出现延误。此外,常用的止吐剂,如昂丹司琼和类似的5ht药物可能不能完全减轻CHS的症状,其他干预措施可能是必要的;最终,禁欲是最有效的长期临床预防方法。这篇综述文章的目的是帮助临床医生识别CHS的具体临床特征,将其与CVS或恶心和呕吐的其他原因区分开来,以促进更快速,更有效的干预。在CHS治疗期间还应考虑与物质使用专业人员合作。
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引用次数: 0
Lactose Intolerance – A practical approach, Part 2 An approach to foods 乳糖不耐症-一个实用的方法,第2部分:食物的方法。
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101824
Michael Mallary PhD, FIEEE
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引用次数: 0
Information for Readers 读者资讯
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-01 DOI: 10.1016/S0011-5029(24)00163-9
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