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Diagnostic reasoning

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https://www.readbyqxmd.com/read/28823115/identification-of-distinctive-clinical-significance-in-hospitalized-patients-with-endoscopic-duodenal-mucosal-lesions
#1
Yeji Han, Hye-Kyung Jung, Ji Young Chang, Chang Mo Moon, Seong-Eun Kim, Ki-Nam Shim, Sung-Ae Jung, Joo-Young Kim, Ji-Yun Bae, Sae-In Kim, Ji-Hyun Lee, Sanghui Park
Background/Aims: Duodenitis is not infrequent finding in patient undergoing endoscopy. However, hospitalized patients have a higher incidence of secondary duodenal mucosal lesions that might be related with inflammatory bowel disease (IBD), cytomegalovirus (CMV) infection, tuberculosis, immunologic disorders, or other rare infections. We aimed to identify clinicopathologic features of duodenal mucosal lesions in hospitalized patients. Methods: All hospitalized patients having duodenal mucosal lesions were identified by endoscopic registration data and pathologic data query from 2011 to 2014...
August 21, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28822887/the-changing-diagnostic-pathway-for-lung-cancer-patients-in-shanghai-china
#2
REVIEW
Tao Jiang, Shengxiang Ren, Xuefei Li, Chunxia Su, Caicun Zhou, Mary O'Brien
Accumulating evidence suggest that patients with advanced non-small-cell lung cancer (NSCLC) and specific genomic alterations including epidermal growth factor receptor and microtubule-associated protein-like 4 anaplastic lymphoma kinase could significantly benefit from molecular-targeted therapies compared with chemotherapy. Recently, immunotherapy based on programmed cell death 1 (PD-1) and its ligand (PD-L1) blockade prolong survival in patients with advanced NSCLC, especially in those patients with positive expression of PD-L1 and when used in the first-line setting...
August 17, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28819875/pathways-from-birth-weight-to-adhd-symptoms-through-fluid-reasoning-in-youth-with-or-without-intellectual-disability
#3
Julia E Morgan, Steve S Lee, Sandra K Loo, Joshua W Yuhan, Bruce L Baker
Although individual differences in fluid reasoning reliably mediate predictions of attention-deficit/hyperactivity disorder (ADHD) symptoms from birth weight in youth with typical cognitive development (TD), it is unknown if this indirect effect operates similarly in the development of ADHD symptoms secondary to intellectual disability (ID). Thus, we evaluated mediation by fluid reasoning in a longitudinal sample of 163 youth (45% female) with (n = 52) or without (n = 111) ID who were followed prospectively from age 5 to age 13...
August 18, 2017: Journal of Abnormal Child Psychology
https://www.readbyqxmd.com/read/28814253/pet-mr-tomographs-a-review-with-technical-radiochemical-and-clinical-perspectives
#4
Giampiero Giovacchini, Elisabetta Giovannini, Mattia Riondato, Andrea Ciarmiello
In the last decade, an increasing number of positron emission tomography / magnetic resonance (PET/MR) tomographs have been installed and many clinical studies were performed in the neurological field. Although PET/MR has many favorable properties to support the application in brain imaging, attenuation correction, and therefore accurate quantification, is a problem that still requires optimal solution. In this review we have summarized the three main methods that are currently used to correct for attenuation in PET/MR, namely atlas- or template-based methods, segmentation-based methods, and reconstruction-based methods...
August 16, 2017: Current Radiopharmaceuticals
https://www.readbyqxmd.com/read/28813753/pre-guideline-trends-associated-with-chest-radiograph-usage-for-pediatric-community-acquired-pneumonia-in-emergency-department-settings
#5
Eric W Jones, Benjamin Meyer, Aaron M Berg, Benson S Hsu
BACKGROUND: Health care spending in the U.S. totaled $3 trillion in 2014 and continues to increase rapidly. Minimizing waste through clinical guidelines is a promising strategy to reduce spending without compromising patient care. In 2011, clinical guidelines recommended against the use of chest X-ray (CXR) for diagnosis of community-acquired pneumonia (CAP) in pediatric ambulatory settings. However, use of CXR has not changed post-guideline. Thus, understanding the drivers of CXR utilization prior to guideline implementation could improve guideline adherence...
May 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28813449/influenza-virus-infections-among-patients-attending-emergency-department-according-to-main-reason-to-presenting-to-ed-a-3-year-prospective-observational-study-during-seasonal-epidemic-periods
#6
Enrique Casalino, Stephanie Antoniol, Nadhira Fidouh, Christophe Choquet, Jean-Christophe Lucet, Xavier Duval, Benoit Visseaux, Laurent Pereira
OBJECTIVE: The role of influenza virus in patients presenting at ED during seasonal-epidemic periods has not previously been specified. Our objective was to determine its frequency according to clinical presentation. METHODS: This is a prospective observational study conducted during three-consecutive seasonal Influenza epidemics (2013-2015), including patients presenting i) community-acquired pneumonia (CAP); ii) severe acute symptoms (SAS): respiratory failure (RF), hemodynamic failure (HF), cardiac failure (CF), and miscellaneous symptoms (M); iii) symptoms suggesting influenza (PSSI)...
2017: PloS One
https://www.readbyqxmd.com/read/28808508/new-onset-acute-thrombocytopenia-in-hospitalized-patients-pathophysiology-and-diagnostic-approach
#7
REVIEW
Naveed Ali, Herbert E Auerbach
Thrombocytopenia is a hematological finding commonly encountered in daily clinical practice from asymptomatic clinic patients to critically ill intensive care unit patients. A broad spectrum of etiologies and variation in clinical presentation often present a diagnostic challenge. Furthermore, concomitant presence of thrombosis and thrombocytopenia, as in cases of thrombotic thrombocytopenia, complicates the management. In hospitalized patients, new-onset thrombocytopenia is an important reason for hematology consultation...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28807616/pbear-an-oral-case-presentation-tool-to-promote-diagnostic-reasoning
#8
Cristina Carter, Nicole Akar-Ghibril, Jeff Sestokas, Gabrina Dixon, Wilhelmina Bradford, Mary Ottolini
No abstract text is available yet for this article.
August 11, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28806990/dvh-and-ntcp-based-dosimetric-comparison-of-different-longitudinal-margins-for-vmat-imrt-of-esophageal-cancer
#9
S Münch, M Oechsner, S E Combs, D Habermehl
PURPOSE: To cover the microscopic tumor spread in squamous cell carcinoma of the esophagus (SCC), longitudinal margins of 3-4 cm are used for radiotherapy (RT) protocols. However, smaller margins of 2-3 cm might be reasonable when advanced diagnostic imaging is integrated into target volume delineation. Purpose of this study was to compare the dose distribution and deposition to the organs at risk (OAR) for different longitudinal margins using a DVH- and NTCP-based approach. METHODS: Ten patients with SCC of the middle or lower third were retrospectively selected...
August 15, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28806091/sparsity-based-super-resolution-for-sem-images
#10
Shahar Tsiper, Or Dicker, Idan Kaizerman, Zeev Zohar, Mordechai Segev, Yonina C Eldar
The Scanning Electron Microscope (SEM) is an electron microscope that produces an image of a sample by scanning it with a focused beam of electrons. The electrons interact with the atoms in the sample, which emit secondary electrons that contain information about the surface topography and composition. The sample is scanned by the electron beam point by point, until an image of the surface is formed. Since its invention in 1942, the capabilities of SEMs have become paramount in the discovery and understanding of the nanometer world, and today it is extensively used for both research and in industry...
August 14, 2017: Nano Letters
https://www.readbyqxmd.com/read/28805194/-lung-cancer-and-copd-growing-clinical-problem
#11
EDITORIAL
Michal Tyl, Joanna Domagała-Kulawik
A spread of the addiction of tobacco smoking is valued on near 1 billion of people in the world, that involves growing number of morbidity and mortality by the reason of smoke related diseases. Lung cancer and chronic obstructive pulmonary disease (COPD) are the most serious and incurable diseases which are leading to a permanent disability as well as to premature death. There are factors that naturally increase the vulnerability of an individual on the coincidence of above disorders, such as pathophysiological conditions, systemic inflammation, bronchitis, emphysema, respiratory obstructive disease and precise genetic predispositions for COPD and lung cancer...
July 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28805149/contestation-instrumental-resistance-and-strategic-conformation-within-the-diagnostic-process-of-gender-dysphoria-in-portugal
#12
Ana Patrícia Hilário
This article aims to provide insights into the ways in which trans people (i.e. those whose gender identity or expression do not align with their assigned sex at birth) in Portugal make sense of the diagnosis of gender dysphoria. Drawing upon in-depth interviews with 10 trans men and 9 trans women carried out by the TRANSRIGHTS team, we identified three major themes: (a) contestation of gender dysphoria as a (mental) illness, (b) instrumental resistance to complete demedicalisation of gender dysphoria and (c) strategic conformation to gender essentialism within the diagnostic process of gender dysphoria...
September 2017: Health (London)
https://www.readbyqxmd.com/read/28804700/abridged-version-of-the-awmf-guideline-for-the-medical-clinical-diagnostics-of-indoor-mould-exposure-s2k-guideline-of-the-german-society-of-hygiene-environmental-medicine-and-preventive-medicine-ghup-in-collaboration-with-the-german-association-of-allergists
#13
Gerhard A Wiesmüller, Birger Heinzow, Ute Aurbach, Karl-Christian Bergmann, Albrecht Bufe, Walter Buzina, Oliver A Cornely, Steffen Engelhart, Guido Fischer, Thomas Gabrio, Werner Heinz, Caroline E W Herr, Jörg Kleine-Tebbe, Ludger Klimek, Martin Köberle, Herbert Lichtnecker, Thomas Lob-Corzilius, Rolf Merget, Norbert Mülleneisen, Dennis Nowak, Uta Rabe, Monika Raulf, Hans Peter Seidl, Jens-Oliver Steiß, Regine Szewszyk, Peter Thomas, Kerttu Valtanen, Julia Hurraß
This article is an abridged version of the AWMF mould guideline "Medical clinical diagnostics of indoor mould exposure" presented in April 2016 by the German Society of Hygiene, Environmental Medicine and Preventive Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin, GHUP), in collaboration with the above-mentioned scientific medical societies, German and Austrian societies, medical associations and experts. Indoor mould growth is a potential health risk, even if a quantitative and/or causal relationship between the occurrence of individual mould species and health problems has yet to be established...
2017: Allergo Journal International
https://www.readbyqxmd.com/read/28803270/costs-of-vitamin-d-testing-and-prescribing-among-children-in-primary-care
#14
Emre Basatemur, Rachael Hunter, Laura Horsfall, Alastair Sutcliffe, Greta Rait
Vitamin D has attracted considerable interest in recent years, with a marked increase in diagnosis of vitamin D deficiency seen among children in clinical practice in the UK. The economic implications of this change in diagnostic behaviour have not been explored. We performed a cohort study to examine longitudinal trends in healthcare expenditure arising from vitamin D testing and prescribing for children in primary care in England, using the electronic healthcare records of 722,525 children aged 0-17 years held in The Health Improvement Network database...
August 12, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28803163/-hirschsprung-associated-enterocolitis-observational-study-in-a-paediatric-emergency-care-unit
#15
Margarita Sellers, Clara Udaondo, Bárbara Moreno, Gonzalo Martínez-Alés, Jesús Díez, Leopoldo Martínez, María de Ceano-Vivas
INTRODUCTION: Hirschsprung-associated enterocolitis is a significant cause of morbidity and mortality in infants with Hirschsprung's disease. The fact that the symptoms are so variable and unspecific leads to a slow or incorrect diagnosis. The purpose of this study is to identify clinical factors associated with the diagnosis, as well as to evaluate the subsequent management of children with suspected Hirschsprung-associated enterocolitis in a paediatric emergency department. MATERIAL AND METHODS: A retrospective descriptive study was conducted on patients with Hirschsprung's disease who were seen in a paediatric emergency department between April 2011 and November 2015 due to clinical symptoms compatible with enterocolitis...
August 9, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28799047/-muscular-injuries-of-athletes-importance-of-ultrasound
#16
REVIEW
A Loizides, H Gruber, S Peer, M Plaikner
CLINICAL/METHODICAL ISSUE: Muscular injuries represent the most common musculoskeletal lesions. Especially in professional athletes an imaging clarification is essential in order to define the exact location of the lesion, the affected muscles, the extent and degree of the injury as well as to define possible concomitant complications. The best possible therapy can be initiated and a necessary rest period for a low risk resumption of sporting activity can be individually specified. STANDARD RADIOLOGICAL METHODS/METHODICAL INNOVATIONS: Due to technical improvements, for example mobile devices and thus increased rapid availability as well as relative cost-effectiveness compared to other modalities, the imaging evaluation of muscle injury would nowadays be unthinkable without ultrasound...
August 10, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28799045/trauma-laparoscopy-when-to-start-and-when-to-convert
#17
Oleh Matsevych, Modise Koto, Moses Balabyeki, Colleen Aldous
BACKGROUND: The use of laparoscopy for stable patients with abdominal trauma is increasing and its accuracy is nearly 100%. However, indications for laparoscopy and for conversion differ among centers. The aim of this study was to investigate indications for trauma laparoscopy and for conversion to laparotomy. METHODS: All trauma patients managed with laparoscopy over a 4-year period were retrospectively analyzed. Indications for laparoscopy, morbidity, and reasons for conversion were investigated and predictors of morbidity and conversion were sought...
August 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28796773/predictors-of-medical-student-remediation-and-their-underlying-causes-early-lessons-from-a-curriculum-change-in-the-university-of-auckland-medical-programme
#18
Brian Grainger, Jill Yielder, Papaarangi Reid, Warwick Bagg
AIMS: The purpose of this study was to identify predictors of remediation in a medical programme and assess the underlying causes and the quality of remediation provided within the context of a recent curriculum change. METHODS: A mixed methods study incorporating a retrospective cohort analysis of demographic predictors of remediation during 2013 and 2014, combined with thematic qualitative analysis of educator perspectives derived by interview on factors underlying remediation and the quality of that currently provided by the faculty...
August 11, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28795204/-entitlement-to-prophylactic-treatment-in-cases-of-genetic-predisposition-for-breast-cancer-interdisciplinary-perspectives
#19
REVIEW
Friedhelm Meier, Jens Ried, Anke Harney, Kerstin Rhiem, Silke Neusser, Anja Neumann, Jürgen Wasem, Rita Schmutzler, Stefan Huster, Peter Dabrock
Genetic tests can detect the predisposition to various diseases. The demand for gene diagnostics and corresponding prophylactic measures is increasing steadily. In the German healthcare system, however, legal uncertainties exist as to whether a mere risk of disease is reason enough to bear the costs for prophylactic measures. When medically effective prophylactic measures are available in certain cancer diseases, such as in hereditary breast cancer, the current practice of deciding in individual cases appears to be insufficient...
August 9, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28794882/interruption-of-enteral-nutrition-in-the-intensive-care-unit-a-single-center-survey
#20
Midori Uozumi, Masamitsu Sanui, Tetsuya Komuro, Yusuke Iizuka, Tadashi Kamio, Hiroshi Koyama, Hideyuki Mouri, Tomoyuki Masuyama, Kazuyuki Ono, Alan Kawarai Lefor
BACKGROUND: Interruption of enteral nutrition (EN) in the intensive care unit (ICU) occurs frequently for various reasons including feeding intolerance and the conduct of diagnostic and therapeutic procedures. However, few studies have investigated the details of EN interruption practices including reasons for and duration of interruptions. There is no standard protocol to minimize EN interruptions. METHODS: This is a retrospective review of 100 patients in the ICU staying more than 72 h and receiving EN in a 12-bed, medical/surgical ICU in a tertiary care center in 2013...
2017: Journal of Intensive Care
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