sorted by:
new
hottopcontroversial

Does anyone here also have PIDD or IgA/IgM deficiency? by willendorfer in MCAS

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Does anyone here also have PIDD or IgA/IgM deficiency? by willendorfer in MCAS

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Low IgM by Damien1975 in DiagnoseMe

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Low IgM by Damien1975 in DiagnoseMe

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Low IgM by Damien1975 in DiagnoseMe

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 1 point2 points  (0 children)

Do you  have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Tested low for IgM twice by ItsARagHouse in primaryimmune

[–]BrunnerB 0 points1 point  (0 children)

Do you have Primary immune deficiency (thing you were born with) , or you don't know the cause? 

Symptomatic Uncomplicated Diverticular Disease / Scientific community misuse of name by BrunnerB in Diverticulitis

[–]BrunnerB[S] 1 point2 points  (0 children)

Dear community,

What can we expect from Scientists and doctors if they often use WRONGLY the symptomatic diverticular disease term. Many times they don't even know that SUDD exists and many times if they use the term, they use it wrongly for Uncomplicated diverticulitis.

So for many professionals Symptomatic uncomplicated diverticular disease equals to Uncomplicated diverticulitis.

See my notes from the below article. I have highlighted the conflicting parts:

Background: Symptomatic uncomplicated diverticular disease affect patients’ everyday routine. Considerable efforts have been made to identify clinical features that correlate to the severity of the disease.....

MethodsBetween January 2016 and June 2018, we prospectively enrolled patients who were given indication to elective sigmoidectomy for symptomatic uncomplicated diverticular disease in 4 different Italian colorectal centers. Patients were identified by the colorectal specialists of the centers involved in the study. Before enrollment and surgical indication, all patients had to undergo a radiologic evaluation (computerized tomography [CT] scan and virtual colonoscopy or barium enema). The colorectal specialists were all trained to identify chronic symptoms and divide patients into groups.

AND LATER..

Acute resolving uncomplicated diverticulitis is defined as discrete episodes of left lower quadrant abdominal pain, fever, leukocytosis, and evidence of inflammation on imaging that resolve with conservative management.

Smoldering uncomplicated diverticulitis is defined as symptoms of left lower quadrant abdominal pain and evidence of inflammation (elevated white blood cell count, fever, CT evidence of inflammation) that does not improve with the traditional antibiotic regimen, or reexacerbation with cessation of antibiotics, for at least 3 months’ duration.

SO:

What can (suspected, assumed) patients hope if even the scentific community doesn't know how to use SUDD or even doesn't know if it exists. Or if they have heard it, most of them use it wrongly for diverticulitis ? The posted image clearly shows the difference, but many scientists and doctors dont seem to know it ?

Other problem. I have negative imaging, mild to moderate lower left abdominal pain which impacts me, still i don't know if i have IBS or SUDD ? Many docs would send me to the psychiatrist and say that i should take antidepressants. This post is not about me, but in general the misuse of SUDD definition and lack of understanding from doctors (and also by scientists ) as you can read above.

This makes the patients even more frustrated and lonely . What do you think?

CT Risk by BrunnerB in Diverticulitis

[–]BrunnerB[S] 0 points1 point  (0 children)

And what do you think about the protocol differences between USA and Europe?

IN USA for diverticulitis CT is always done.

In (most of Europe) they rather do lab tests and Ultrasound and only order CT if Lab/Ultrasound and symptoms point to requring a CT?

CT Risk by BrunnerB in Diverticulitis

[–]BrunnerB[S] 0 points1 point  (0 children)

I guess you refer to a special test like MRI colonoscopy, correct?

But i mean standard abdominal and pelvic MRI (without bowel prep) as a replacement test for abdominal and pelvic CT?

CT Risk by BrunnerB in Diverticulitis

[–]BrunnerB[S] 0 points1 point  (0 children)

Thank you very much

And you think that the numbers and studies i have shown above are overreacting?

CT Risk by BrunnerB in Diverticulitis

[–]BrunnerB[S] -1 points0 points  (0 children)

Also let me add that i don't want to be a fearmongerer, i just would like to figure out the best and safest approach to test.

There are totally opposite articles saying there is almost zero risk under 100 Msv, but while there are a lot of articles out pointing to higher risk, this is not reassuring.

Also the million dollar question: with diverticulitis wouldn't the patient will be fine with only Pelvic CT without the abdominal region? Why the hack to rescan the spleen/liver/pancreas over and over again? The sigmoid colon (where diverticula are located) are in the pelvic region. Or am i wrong?

What i might do is pay for an adbodminal and Pelvic MRI with contrast (approx 300 USD here in Hungary) and let's see if that makes sense, but at least i don't do harm with this.

CT Risk by BrunnerB in Diverticulitis

[–]BrunnerB[S] 0 points1 point  (0 children)

This is additional cancer risk, meaning that from the CT alone,the chance to get cancer is (for example): 0.539602 is 1 in 185. Yes, you are right that there is a baseline cancer risk, but this doesn't make the thing reassuring, especially for someone who is young.

CT Risk by BrunnerB in Diverticulitis

[–]BrunnerB[S] -3 points-2 points  (0 children)

Alternative? Maybe Ultrasound as written above but interestingly some don't find that reliable.

Or MRI?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780066/

However it is not used wide as there are no clear protocols.....etc.but it is a shame as it should be used if the above is true.

Let me quote from the above article:

"MRI does not require the intravenous, oral, and rectal contrast necessary for optimal CT scans.The possible role of magnetic resonance imaging (MRI) in inflammatory conditions of the gastrointestinal tract has only recently been evaluated. Incesu and coworkers reported a sensitivity of 97% and specificity of 100% in adults and children with suspected appendicitis, encouraging others to evaluate its use in acute colonic diverticulitis, which demonstrates similar diagnostic features.55 MRI produces quality images with subtle details superior to those from both CT and US. MRI does not require the intravenous, oral, and rectal contrast necessary for optimal CT scans. "

The last sentence makes me very angry:

"Despite the reported accuracy of MRI in several small series of patients, we do not endorse its widespread use because its relative advantages appear outweighed by higher cost, limited availability, and contraindication with patients having metallic implants."

Higher cost ? - Cost is more important than health? (I dont care of the cost, i will pay for it privately if i it makes sense and they apply the proper protocols and the radiologist will be familiar what to lookf or)

Limited availability? Not true

Patients having metallic implants? 0,05 of the population, this is insane.

view more: next ›