The painful rib syndrome consists of three features: pain in the lower chest or upper abdomen, a tender spot on the costal margin, and reproduction of the pain on pressing the tender spot. This is a common cause for referral to a general medical/gastroenterology clinic, accounting for 3% of new referrals in Lincoln. Seventy six consecutive patients were studied. The mean age was 48 years and 70...

OBJECTIVES To report and describe the management and response to treatment of patients referred to the osteoporosis clinic after prolonged use of bisphosphonate BPs) (4 years and more) with and without new fracture (any site) or any other new skeletal symptoms.  Methods: This is a single center observational retrospective cohort study conducted from January 2009 to May 2016 in a tertiary center...

BACKGROUND The referral letter plays a key role both in the communication between primary and secondary care, and in the quality of the health care process. Many studies have attempted to evaluate and improve the quality of these referral letters, but few have assessed the impact of their quality on the health care delivered to each patient. METHODS A cluster randomized trial, with the genera...

BACKGROUND Several guidelines have advocated the need for adequate cancer-related pain (CRP) management. The pain management index (PMI) has been proposed as an auditable measure of the appropriateness for analgesic therapy. OBJECTIVES To determine the adequacy of CRP management based on the PMI status and its patient-related predictors at the point of referral to a pain clinic (PC). METHOD...

The Symptom Management Clinic (SMC) at University Hospital in Cincinnati, OH, was established to meet identified needs of patients with cancer seen in an outpatient setting. The initial step in the formation of the SMC consisted of the development of a business plan and the presentation of that business plan to the hospital administration. The development of clinic procedures using the creation...

During our day-to-day practice, we, as clinicians, occasionally come across patients whose symptomatology is atypical. In major teaching hospitals, it is usually easy to consult with other specialists to optimize patient management and standard of care. Our study patients were treated by the authors between January 1998 and January 2003. In this article, the authors report on 6 different cases ...