Items in AFP with MESH term: Evidence-Based Medicine

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New Drugs: How to Decide Which Ones to Prescribe - Feature


Defending the Real Standard of Care - The Last Word


The Art and Science of Clinical Decision Making - Feature


How to Find Clinical Information Quickly at the Point of Care - Feature


Hirschsprung's Disease: Diagnosis and Management - Article

ABSTRACT: Hirschsprung's disease (congenital megacolon) is caused by the failed migration of colonic ganglion cells during gestation. Varying lengths of the distal colon are unable to relax, causing functional colonic obstruction. Hirschsprung's disease most commonly involves the rectosigmoid region of the colon but can affect the entire colon and, rarely, the small intestine. The disease usually presents in infancy, although some patients present with persistent, severe constipation later in life. Symptoms in infants include difficult bowel movements, poor feeding, poor weight gain, and progressive abdominal distention. Early diagnosis is important to prevent complications (e.g., enterocolitis, colonic rupture). A rectal suction biopsy can detect hypertrophic nerve trunks and the absence of ganglion cells in the colonic submucosa, confirming the diagnosis. Up to one third of patients develop Hirschsprung's-associated enterocolitis, a significant cause of mortality. Patients should be monitored closely for enterocolitis for years after surgical treatment of Hirschsprung's disease. With proper treatment, most patients will not have long-term adverse effects and can live normally.


Quality of Life in Older Persons with Dementia Living in Nursing Homes - FPIN's Clinical Inquiries


Differential Diagnosis of Tremor - FPIN's Clinical Inquiries


Leukotriene Receptor Antagonists for the Treatment of Allergic Skin Disorders - FPIN's Clinical Inquiries


Over-the-Counter Medications for Acute Cough Symptoms - Cochrane for Clinicians


Aspirin in Patients with Actue Ischemic Stroke - FPIN's Clinical Inquiries


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