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Spend most of my time working on healthcare translation efforts. Feel free to respond to me on whatever language version I have commented on, or here if you prefer.
Diagnosis is based on a medical history (symptoms) and physical examination, which can be supported by an elevation of neutrophilic white blood cells and imaging studies if needed. Histories fall into two categories, typical and atypical.
Typical appendicitis includes several hours of generalized abdominal pain that begins in the region of the umbilicus with associated anorexia, nausea, or vomiting. The pain then "localizes" into the right lower quadrant where the tenderness increases in intensity. It is possible the pain could localize to the left lower quadrant in people with situs inversus totalis. The combination of pain, anorexia, leukocytosis, and fever is classic.
Atypical histories lack this typical progression and may include pain in the right lower quadrant as an initial symptom. Irritation of the peritoneum (inside lining of the abdominal wall) can lead to increased pain on movement, or jolting, for example going over speed bumps. Atypical histories often require imaging with ultrasound or CT scanning.
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A bit about me
I'm User:Doc James, previously known as User:Jmh649. In real life I go by James Heilman. I am a Canadian ER doc. I have been editing here since July 6th, 2008.
James Heilman, MD, CCFP-EM
P.S. My spelling and grammar are poor, so thank you for correcting them. If something I write is completely unintelligible, please send me a request for clarification.
COI
I am entirely a volunteer. My work on Misplaced Pages via this account is my own and does not relate to positions I hold at UBC, Interior Health, BCEHS, or the Wikimedia Foundation. Nothing I write or do via this account reflect the official position of any of the aforementioned organization.
I do not receive payment or travel expense reimbursement from the Wikimedia Foundation or its chapters, nor do I accept payment or honoraria for any other work on the Internet. In 2011, I accepted travel expenses of approximately $1,500 from the Canadian chapter of Misplaced Pages. In 2012 and 2013, I donated more than that amount to the WMF. I accept travel expenses from some non-WMF organizations at whose events I speak, but I have never accepted any payments from pharmaceutical companies. I have no financial conflicts of interest in regard to any subject that I edit.
Please note that User:Docjames (no character space) is a different editor.
User:Fz-29 using User:Fz29bot moved reference metadata out of infoboxes in exchange for remuneration by WPMEDF.
Lucas
In June 2015, I hired a part-time assistant (User:Lucas559) to help me with medical projects, including the translation task force, the copyright detection bot, supporting students enrolled in classes on which we collaborate, and fundraising for the Wiki Project Med Foundation. In order to avoid conflicts of interest, my assistant and I did not vote on the same discussions. A discussion about the creation of the assistant position may be found here. This position ended in August 2016.
Alt accounts
In order to monitor changes to the approximately one-thousand properties on Wikidata, I have established the account User:DDDWatchingAccount.