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Diagnostic reasoning

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https://www.readbyqxmd.com/read/28342728/comparative-analysis-for-diagnostic-yield-of-small-cell-lung-cancer-by-cytology-and%C3%A2-histology-during-the-same-bronchoscopic%C3%A2-procedure
#1
Wei-Nan Li, Di-Fei Wang, Ya-Bin Zhao, Xue-Shan Qiu, En-Hua Wang, Guang-Ping Wu
BACKGROUND: Biopsy, brushing, and transbronchial needle aspiration (TBNA) are the most common methods used for the diagnosis of small cell lung cancer during the same diagnostic bronchoscopic procedure. However, it is not clear which method provides better results. PATIENTS AND METHODS: A retrospective analysis was performed of 140 patients who had undergone video bronchoscopy for diagnostic purposes. Bronchial brushings were obtained from all subjects. Biopsy specimens were also obtained from all subjects, except for 6 cases that could not be sampled; the TBNA method was used for some special lesions...
March 2, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28342334/oncogene-addiction-in-non-small-cell-lung-cancer-focus-on-ros1-inhibition
#2
REVIEW
Francesco Facchinetti, Giulio Rossi, Emilio Bria, Jean-Charles Soria, Benjamin Besse, Roberta Minari, Luc Friboulet, Marcello Tiseo
Detection of molecular aberrations driving the biology and the clinical behavior of advanced non-small cell lung cancer (NSCLC) allows the adoption of specific therapeutic strategies dramatically impacting disease courses. Among these, ROS1 rearrangements are present in 1-2% of lung adenocarcinomas. Thanks to similarities between ALK and ROS1 oncogenes, lessons inferred from ALK can be applied to ROS1-positive NSCLC; nevertheless, disparities exist between diseases mastered by these two fusion genes. In the absence of more common genetic alterations detected in NSCLC (e...
March 12, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28338760/childhood-maltreatment-and-young-adulthood-hallucinations-delusional-experiences-and-psychosis-a-longitudinal-study
#3
Amanuel Alemu Abajobir, Steve Kisely, James G Scott, Gail Williams, Alexandra Clavarino, Lane Strathearn, Jake Moses Najman
Child maltreatment is a widespread public health problem associated with a range of mental health disorders later in life. In order to effectively address these disorders, there is a need to understand more about the mental health consequences of different types of child maltreatment. This study examines the associations between prospectively substantiated child maltreatment (ages 0-14 y) and reports of hallucinations and delusional experiences at 21 years after birth. As well, we examined 12-month and lifetime psychotic disorders using data from a longitudinal birth cohort...
January 30, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/28337412/differential-involvement-of-corticospinal-tract-cst-fibers-in-umn-predominant-als-patients-with-or-without-cst-hyperintensity-a-diffusion-tensor-tractography-study
#4
Venkateswaran Rajagopalan, Erik P Pioro
Diagnosis of amyotrophic lateral sclerosis (ALS) depends on clinical evidence of combined upper motor neuron (UMN) and lower motor neuron (LMN) degeneration, although ALS patients can present with features predominantly of one or the other. Some UMN-predominant patients show hyperintense signal along the intracranial corticospinal tract (CST) on T2- and proton density (PD)-weighted images (ALS-CST +), and appear to have faster disease progression when compared to those without CST hyperintensity (ALS-CST -)...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28337006/challenges-in-x-ray-diagnosis-a-review-of-referrals-for-specialist-opinion
#5
M Dave, K Horner
The aim of this study was to determine the common reasons why a dental professional might request a second opinion on a dental radiograph from a Dental and Maxillofacial (DMF) radiologist. The study was a retrospective analysis of consecutive referrals for an opinion received by post or email by one DMF radiologist based in a UK dental hospital. The study period was from March 2009 to November 2015. Referrals came from a mixture of sources: mainly from general dental practitioners and specialists working in primary care, but with some referrals from hospital-based practitioners...
March 24, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28335509/novel-diagnostic-and-predictive-biomarkers-in-pancreatic-adenocarcinoma
#6
REVIEW
John C Chang, Madappa Kundranda
Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal disease for a multitude of reasons including very late diagnosis. This in part is due to the lack of understanding of the biological behavior of PDAC and the ineffective screening for this disease. Significant efforts have been dedicated to finding the appropriate serum and imaging biomarkers to help early detection and predict response to treatment of PDAC. Carbohydrate antigen 19-9 (CA 19-9) has been the most validated serum marker and has the highest positive predictive value as a stand-alone marker...
March 20, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28334938/clinical-and-genetic-characterization-of-leukoencephalopathies-in-adults
#7
David S Lynch, Anderson Rodrigues Brandão de Paiva, Wei Jia Zhang, Enrico Bugiardini, Fernando Freua, Leandro Tavares Lucato, Lucia Inês Macedo-Souza, Rahul Lakshmanan, Justin A Kinsella, Aine Merwick, Alexander M Rossor, Nin Bajaj, Brian Herron, Paul McMonagle, Patrick J Morrison, Deborah Hughes, Alan Pittman, Matilde Laurà, Mary M Reilly, Jason D Warren, Catherine J Mummery, Jonathan M Schott, Matthew Adams, Nick C Fox, Elaine Murphy, Indran Davagnanam, Fernando Kok, Jeremy Chataway, Henry Houlden
Leukodystrophies and genetic leukoencephalopathies are a rare group of disorders leading to progressive degeneration of cerebral white matter. They are associated with a spectrum of clinical phenotypes dominated by dementia, psychiatric changes, movement disorders and upper motor neuron signs. Mutations in at least 60 genes can lead to leukoencephalopathy with often overlapping clinical and radiological presentations. For these reasons, patients with genetic leukoencephalopathies often endure a long diagnostic odyssey before receiving a definitive diagnosis or may receive no diagnosis at all...
March 2, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28334777/clinicians-interpretations-of-point-of-care-urine-culture-versus-laboratory-culture-results-analysis-from-the-four-country-poetic-trial-of-diagnosis-of-uncomplicated-urinary-tract-infection-in-primary-care
#8
Saskia Hullegie, Mandy Wootton, Theo J M Verheij, Emma Thomas-Jones, Janine Bates, Kerenza Hood, Micaela Gal, Nick A Francis, Paul Little, Michael Moore, Carl Llor, Timothy Pickles, David Gillespie, Nigel Kirby, Curt Brugman, Christopher C Butler
Background.: Urine culture at the point of care minimises delay between obtaining the sample and agar inoculation in a microbiology laboratory, and quantification and sensitivity results can be available more rapidly in primary care. Objective.: To identify the degree to which clinicians' interpretations of a point-of-care-test (POCT) urine culture (Flexicult™ SSI-Urinary Kit) agrees with laboratory culture in women presenting to primary care with symptoms of uncomplicated urinary tract infections (UTI)...
March 1, 2017: Family Practice
https://www.readbyqxmd.com/read/28332224/monitoring-and-regulation-of-learning-in-medical-education-the-need-for-predictive-cues
#9
Anique B H de Bruin, John Dunlosky, Rodrigo B Cavalcanti
CONTEXT: Being able to accurately monitor learning activities is a key element in self-regulated learning in all settings, including medical schools. Yet students' ability to monitor their progress is often limited, leading to inefficient use of study time. Interventions that improve the accuracy of students' monitoring can optimise self-regulated learning, leading to higher achievement. This paper reviews findings from cognitive psychology and explores potential applications in medical education, as well as areas for future research...
March 23, 2017: Medical Education
https://www.readbyqxmd.com/read/28331936/ultrasound-guidance-for-difficult-lumbar-puncture-in-children-pearls-and-pitfalls
#10
REVIEW
Prakash Muthusami, Ashley James Robinson, Manohar M Shroff
Pediatric lumbar puncture can be challenging or unsuccessful for several reasons. At the same time, the excellent sonographic window into the pediatric spine provides a distinct opportunity for ultrasound-guided lumbar puncture. Minimal cerebrospinal fluid and thecal displacement by subdural or epidural hematomas are common after failed clinical attempts. Ultrasound is useful for determining a safe infraconal level for subarachnoid access. Real-time guidance increases not only the success rate but also the safety of diagnostic lumbar puncture and injections for chemotherapy and myelography...
March 22, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28331865/growth-hormone-utilization-review-in-a-pediatric-primary-care-setting
#11
Fatemeh Sayarifard, Fereshteh Bakhshi Imcheh, Shirinsadat Badri, Toktam Faghihi, Mostafa Qorbani, Mania Radfar
OBJECTIVE: One of the main problems facing public health providers and administrators in many countries is ensuring the rational use of high-cost drugs. In this regard, on-going process of medication use evaluation can be considered as a useful tool. In this study, we evaluated certain usage aspects of a highly-cost medication, that is, recombinant growth hormone (GH). METHODS: This cross-sectional study conducted from August 2012 to August 2014. Children receiving GH ± gonadotropin releasing hormone (GnRH) analogs were included in the study...
January 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28331764/how-many-of-the-biopsy-decisions-taken-at-inexperienced-breast-radiology-units-were-correct
#12
Özlem Demircioğlu, Meral Uluer, Erkin Arıbal
OBJECTIVE: In this study, we aimed to determine the need for biopsy in patients referred from other clinics for the performance of biopsy with the suspicion of breast cancer. MATERIALS AND METHODS: 112 patients were included in the study. It was decided that their biopsies be performed following examinations in other clinics and they presented to the breast radiology unit of our hospital for a second opinion. The demographic characteristics, diagnostic studies completed in the other centers, properties of lesions, decision made as a result of examinations and BI-RADS (Breast Imaging Reporting and Data Systems) categorizations were recorded on the registration forms of the study patients...
January 2017: J Breast Health (2013)
https://www.readbyqxmd.com/read/28331361/maternal-anxiety-and-its-correlation-with-pain-experience-during-chorion-villus-sampling-and-amniocentesis
#13
Katharina Klages, Sudip Kundu, Joachim Erlenwein, Michael Elsaesser, Peter Hillemanns, Alexander Scharf, Ismini Staboulidou
PURPOSE: Invasive prenatal diagnostic procedures, such as chorion villus sampling (CVS) and amniocentesis (AC), are routinely performed to exclude or diagnose fetal chromosomal abnormalities. The aim of this study was to investigate anxiety-dependent pain experience during CVS and AC and the potential factors that increase anxiety and pain levels. PATIENTS AND METHODS: During a 2-year period, women undergoing invasive procedures in three specialist centers were asked to participate in the study...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28326191/global-histone-modification-fingerprinting-in-human-cells-using-epigenetic-reverse-phase-protein-array
#14
Marina Partolina, Hazel C Thoms, Kenneth G MacLeod, Giovanny Rodriguez-Blanco, Matthew N Clarke, Anuroop V Venkatasubramani, Rima Beesoo, Vladimir Larionov, Vidushi S Neergheen-Bhujun, Bryan Serrels, Hiroshi Kimura, Neil O Carragher, Alexander Kagansky
The balance between acetylation and deacetylation of histone proteins plays a critical role in the regulation of genomic functions. Aberrations in global levels of histone modifications are linked to carcinogenesis and are currently the focus of intense scrutiny and translational research investments to develop new therapies, which can modify complex disease pathophysiology through epigenetic control. However, despite significant progress in our understanding of the molecular mechanisms of epigenetic machinery in various genomic contexts and cell types, the links between epigenetic modifications and cellular phenotypes are far from being clear...
2017: Cell Death Discovery
https://www.readbyqxmd.com/read/28325771/estimating-prevalence-trends-in-adult-gonorrhoea-and-syphilis-in-low-and-middle-income-countries-with-the-spectrum-sti-model-results-for-zimbabwe-and-morocco-from-1995-to-2016
#15
Eline L Korenromp, Guy Mahiané, Jane Rowley, Nico Nagelkerke, Laith Abu-Raddad, Francis Ndowa, Amina El-Kettani, Houssine El-Rhilani, Philippe Mayaud, R Matthew Chico, Carel Pretorius, Kendall Hecht, Teodora Wi
OBJECTIVE: To develop a tool for estimating national trends in adult prevalence of sexually transmitted infections by low- and middle-income countries, using standardised, routinely collected programme indicator data. METHODS: The Spectrum-STI model fits time trends in the prevalence of active syphilis through logistic regression on prevalence data from antenatal clinic-based surveys, routine antenatal screening and general population surveys where available, weighting data by their national coverage and representativeness...
March 21, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28324707/chemical-structure-based-predictive-model-for-the-oxidation-of-trace-organic-contaminants-by-sulfate-radical
#16
Tiantian Ye, Zongsu Wei, Richard Spinney, Chong-Jian Tang, Shuang Luo, Ruiyang Xiao, Dionysios D Dionysiou
Second-order rate constants [Formula: see text] for the reaction of sulfate radical anion (SO4(•-)) with trace organic contaminants (TrOCs) are of scientific and practical importance for assessing their environmental fate and removal efficiency in water treatment systems. Here, we developed a chemical structure-based model for predicting [Formula: see text] using 32 molecular fragment descriptors, as this type of model provides a quick estimate at low computational cost. The model was constructed using the multiple linear regression (MLR) and artificial neural network (ANN) methods...
March 6, 2017: Water Research
https://www.readbyqxmd.com/read/28323979/thyroid-cancer-following-childhood-low-dose-radiation-exposure-a-pooled-analysis-of-nine-cohorts
#17
Jay H Lubin, M Jacob Adams, Roy Shore, Erik Holmberg, Arthur B Schneider, Michael M Hawkins, Leslie L Robison, Peter D Inskip, Marie Lundell, Robert Johansson, Ruth A Kleinerman, Florent de Vathaire, Lena Damber, Siegal Sadetzki, Margaret Tucker, Ritsu Sakata, Lene H S Veiga
Context: The increased use of diagnostic and therapeutic procedures that involve radiation raises concerns about radiation effects, particularly in children and to the radio-sensitive thyroid gland. Objectives: Evaluation of relative risk (RR) trends for thyroid radiation doses <0.2 gray; evidence of a threshold dose; and possible modifiers of the dose-response, e.g., sex, age at exposure, time since exposure. Design and setting: Pooled data from nine cohort studies of childhood external radiation exposure and thyroid cancer with individualized dose estimates, ≥1,000 irradiated subjects or ≥10 thyroid cancer cases, with data limited to individuals receiving doses <0...
March 8, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28320749/sex-differences-in-percutaneous-coronary-intervention-insights-from-the-coronary-angiography-and-pci-registry-of-the-german-society-of-cardiology
#18
Tobias Heer, Matthias Hochadel, Karin Schmidt, Julinda Mehilli, Ralf Zahn, Karl-Heinz Kuck, Christian Hamm, Michael Böhm, Georg Ertl, Hans Martin Hoffmeister, Stefan Sack, Jochen Senges, Steffen Massberg, Anselm K Gitt, Uwe Zeymer
BACKGROUND: Several studies have suggested sex-related differences in diagnostic and invasive therapeutic coronary procedures. METHODS AND RESULTS: Data from consecutive patients who were enrolled in the Coronary Angiography and PCI Registry of the German Society of Cardiology were analyzed. We aimed to compare sex-related differences in in-hospital outcomes of patients undergoing percutaneous coronary intervention (PCI) for stable coronary artery disease, non-ST elevation acute coronary syndromes, ST elevation myocardial infarction, and cardiogenic shock...
March 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28319450/retinal-and-choroidal-thickness-in-adult-patients-with-familial-mediterranean-fever
#19
Tolga Bicer, Osman Celikay, Mustafa Kosker, Muhammed Yunus Alp, Cem Ozisler, Ahmet Yesilyurt, Burcu Kucuk Bicer, Canan Gurdal
PURPOSE: We aimed to evaluate changes in retinal, choroidal, ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL) thicknesses in genetically diagnosed adult patients with familial Mediterranean fever (FMF). METHODS: A total of 50 eyes of 50 genetically diagnosed patients with FMF and 50 eyes of controls were analyzed. Patients were recruited from the Genetic Diagnostic Center of Dışkapı Yıldırım Beyazıt Research and Training Hospital, Turkey. Retinal and choroidal thicknesses were obtained using spectral-domain optical coherence tomography from choroid, retina, GCC, and RNFL...
March 20, 2017: Ophthalmic Epidemiology
https://www.readbyqxmd.com/read/28316994/multiple-factors-involved-in-the-pathogenesis-of-white-matter-lesions
#20
REVIEW
Jing Lin, Dilong Wang, Linfang Lan, Yuhua Fan
White matter lesions (WMLs), also known as leukoaraiosis (LA) or white matter hyperintensities (WMHs), are characterized mainly by hyperintensities on T2-weighted or fluid-attenuated inversion recovery (FLAIR) images. With the aging of the population and the development of imaging technology, the morbidity and diagnostic rates of WMLs are increasing annually. WMLs are not a benign process. They clinically manifest as cognitive decline and the subsequent development of dementia. Although WMLs are important, their pathogenesis is still unclear...
2017: BioMed Research International
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