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Diagnostic reasoning

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https://www.readbyqxmd.com/read/29471142/hair-analysis-when-external-contamination-is-in-question-a-review-of-practical-approach-for-the-interpretation-of-results
#1
Lolita Tsanaclis, Maristela Andraus, John Wicks
Despite having been extensively discussed over the last decade, the differentiation between systemic exposure and external contamination still continues to be one of the limitations of hair testing for drugs. For this reason, we consider it worthwhile to re-state some basic principles in this short review. Various studies investigating a diversity of wash protocols, most using artificially contaminated hair with cocaine, have been valuable in evaluating wash efficacy and in understanding the incorporation of drugs in hair...
February 7, 2018: Forensic Science International
https://www.readbyqxmd.com/read/29470351/severe-unresolved-cholestasis-due-to-unknown-aetiology-leading-to-early-allograft-failure-within-the-first-3-months-of-liver-transplantation
#2
Roberta Angelico, Undine A Gerlach, Bridget K Gunson, Desley Neil, Hynek Mergental, John Isaac, Paolo Muiesan, Darius Mirza, M Thamara Pr Perera
BACKGROUND: Causes of severe cholestasis following liver transplantation(LT) are multi-factorial; whilst the aetiology is predictable in some, others culminate in graft/patient loss without a definitive cause identified. Severe cholestasis is usually associated with overlapped histological findings of rejection and biliary features, and diagnostic interpretation may pose a challenge. METHODS: This is 10-year retrospective analysis of patients with unexplained severe cholestasis resulting in death/graft loss within 90-days of LT...
February 20, 2018: Transplantation
https://www.readbyqxmd.com/read/29469334/-evaluation-of-elisa-kit-for-detection-of-serum-specific-igg-antibodies-against-taenia-solium-in-diagnosis-of-human-cysticercosis
#3
Chen Chuang, Chen Xing-Wang, Deng Jian-Zhong, Li Tiao-Ying
OBJECTIVE: To evaluate the ELISA kit for detection of IgG antibodies against Taenia solium cysticercus in humans, so as to provide a reference for its application in clinical practice. METHODS: The sera collected from the patients with neurocysticercosis, echinococcosis, taeniasis and healthy people, respectively, were checked by ELISA for specific IgG antibodies against T. solium cysticercus, as described in the instruction of the kit. RESULTS: Of the 30 patients with neurocysticercosis at active stage, 28 showed seropositive reaction, indicating a sensitivity of 93...
March 13, 2017: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
https://www.readbyqxmd.com/read/29466814/-dgp-interstitial-lung-disease-patient-questionnaire
#4
M Kreuter, U Ochmann, D Koschel, J Behr, F Bonella, M Claussen, U Costabel, S Jungmann, M Kolb, D Nowak, F Petermann, M Pfeiffer, M Polke, A Prasse, J Schreiber, J Wälscher, H Wirtz, D Kirsten
BACKGROUND:  Interstitial lung diseases (ILD) encompass different heterogeneous, mainly chronic diseases of the pulmonary interstitium and/or alveoli with known and unknown reasons. The diagnostic of ILD is challenging and should be performed interdisciplinary. The medical history is of major importance and therefore, in German-speaking countries the Frankfurter Bogen (published in 1985) was utilised to scrutinise the medical history of the patient. This by now more than 30-years-old questionnaire requires a revision with regard to content and language...
February 21, 2018: Pneumologie
https://www.readbyqxmd.com/read/29466319/skin-on-a-chip-transepithelial-electrical-resistance-and-extracellular-acidification-measurements-through-an-automated-air-liquid-interface
#5
Frank A Alexander, Sebastian Eggert, Joachim Wiest
Skin is a critical organ that plays a crucial role in defending the internal organs of the body. For this reason, extensive work has gone into creating artificial models of the epidermis for in vitro skin toxicity tests. These tissue models, called reconstructed human epidermis (RhE), are used by researchers in the pharmaceutical, cosmetic, and environmental arenas to evaluate skin toxicity upon exposure to xenobiotics. Here, we present a label-free solution that leverages the use of the intelligent mobile lab for in vitro diagnostics (IMOLA-IVD), a noninvasive, sensor-based platform, to monitor the transepithelial electrical resistance (TEER) of RhE models and adherent cells cultured on porous membrane inserts...
February 21, 2018: Genes
https://www.readbyqxmd.com/read/29465259/latent-tuberculosis-in-childhood-tolerability-of-two-different-therapeutic-approaches
#6
Chiara Tersigni, Elisabetta Venturini, Chiara Cordola, Paola Piccini, Leila Bianchi, Carlotta Montagnani, Sara Sollai, Elena Chiappini, Maurizio de Martino, Luisa Galli
BACKGROUND: Isoniazid monotherapy for six or nine months and the combination of isoniazid and rifampicin for three or four months are the most used regimens for treating latent tuberculosis. The main aim of this retrospective study is to evaluate the safety of latent tuberculosis treatment by analysing side effects in both regimens. RESEARCH DESIGN AND METHODS: Children with latent tuberculosis and treated with isoniazid or isoniazid and rifampicin were included...
February 21, 2018: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29463916/evaluating-feasibility-and-accuracy-of-non-invasive-tests-for-nonalcoholic-fatty-liver-disease-in-severe-and-morbid-obesity
#7
Geraldine J Ooi, Arul Earnest, William W Kemp, Paul R Burton, Cheryl Laurie, Ammar Majeed, Nathan Johnson, Catriona McLean, Stuart K Roberts, Wendy A Brown
INTRODUCTION: In obese individuals, nonalcoholic fatty liver disease (NAFLD) is common but often goes undiagnosed, and therefore untreated. The presence of significant fibrosis is a key determinant of NAFLD progression, and liver steatosis has substantial cardiovascular implications. We aimed to determine the diagnostic accuracy of common noninvasive diagnostic tests for steatosis and fibrosis in the obese. METHODS: We recruited 182 severely and morbidly obese individuals undergoing bariatric surgery (age 44 ± 12 years, body mass index 45...
January 30, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29460517/peri-implant-test-is-a-proposal-of-a-new-procedure-to-prevent-peri-implantitis-and-forensic-claims
#8
R M Gaudio, L Ottria, D Lauritano, A Palmieri, F Cura, A Tagliabue, L Tettamanti
Implant dentistry has become one of the most successful techniques for oral rehabilitation over the last 20 years. The success rate of implant oral rehabilitation is above 80% while peri-implant disease (PID) is the most important complication of implant dentistry. The main cause of PID is considered bacterial leakage at the implant-abutment connection of a two-piece implant system. Prevention and control of bacterial leakage at the implant-abutment connection is mandatory for reducing inflammation process around implants neck and achieving bone stability...
January 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29459528/-a-validation-study-of-the-improved-product-for-measuring-japanese-cypress-pollen-specific-ige-thermo-scientific-%C3%A2-immunocap-%C3%A2-immunocap-japanese-cypress-pollen-specific-ige
#9
Syuji Yonekura, Yoshitaka Okamoto, Satoshi Nakayama
BACKGROUND: Japanese cypress pollen is a major causative allergen of seasonal allergic rhinitis in Japan. Although ImmunoCAP-specific immunoglobulin E (IgE) reagent Japanese cypress pollen has been widely used as a diagnostic aid, its sensitivity requires enhancement. This study evaluated an improved version of this reagent. METHODS: Serum samples from 61 subjects who underwent Japanese cypress pollen exposure testing in an environmental challenge chamber in Chiba University were assessed using the conventional ImmunoCAPspecific IgE Japanese cypress pollen product and the improved product...
2018: Arerugī, [Allergy]
https://www.readbyqxmd.com/read/29457878/genetic-determinants-of-heart-failure-facts-and-numbers
#10
EDITORIAL
Frauke S Czepluch, Bernd Wollnik, Gerd Hasenfuß
The relevance of gene mutations leading to heart diseases and hence heart failure has become evident. The risk for and the course of heart failure depends on genomic variants and mutations underlying the so-called genetic predisposition. Genetic contribution to heart failure is highly heterogenous and complex. For any patient with a likely inherited heart failure syndrome, genetic counselling is recommended and important. In the last few years, novel sequencing technologies (named next-generation sequencing - NGS) have dramatically improved the availability of molecular testing, the efficiency of genetic analyses, and moreover reduced the cost for genetic testing...
February 19, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29452353/a-diagnostic-germ-cell-score-for-immature-testicular-tissue-at-risk-of-germ-cell-loss
#11
L Heckmann, D Langenstroth-Röwer, T Pock, J Wistuba, J-B Stukenborg, M Zitzmann, S Kliesch, S Schlatt, N Neuhaus
STUDY QUESTION: Can a systematic scoring procedure provide crucial information on the status of highly heterogeneous immature human testicular tissues in the context of cryopreservation for fertility preservation? SUMMARY ANSWER: We developed a systematic histological score as a novel diagnostic tool which differentiates the patient cohort according to the status of germ cell differentiation and number of spermatogonia (normal, diminished and absent), and which could be relevant in the fertility clinic...
February 14, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29451858/cerebrospinal-fluid-micrornas-as-diagnostic-biomarkers-in-brain-tumors
#12
REVIEW
Alena Kopkova, Jiri Sana, Pavel Fadrus, Ondrej Slaby
Cerebrospinal fluid (CSF) is a body fluid that has many important functions and is in direct contact with the extracellular environment of the central nervous system (CNS). CSF serves as both the communication channel allowing the distribution of various substances among the CNS cells and the storage facility for the waste products these cells release. For these reasons, CSF is a potential source of diagnostic biomarkers of many CNS diseases, including brain tumors. Recent studies have revealed that CSF also contains circulating microRNAs (miRNAs), short non-coding RNAs that have been described as biomarkers in many cancers...
February 16, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29451303/sex-specific-manifestation-of-genetic-risk-for-attention-deficit-hyperactivity-disorder-in-the-general-population
#13
Joanna Martin, Mark J Taylor, Mina Rydell, Lucy Riglin, Olga Eyre, Yi Lu, Sebastian Lundström, Henrik Larsson, Anita Thapar, Paul Lichtenstein
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is more commonly diagnosed in males than in females. A growing body of research suggests that females with ADHD might be underdiagnosed or receive alternative diagnoses, such as anxiety or depression. Other lines of reasoning suggest that females might be protected from developing ADHD, requiring a higher burden of genetic risk to manifest the disorder. METHODS: We tested these two hypotheses, using common variant genetic data from two population-based cohorts...
February 16, 2018: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/29448075/improving-mass-univariate-analysis-of-neuroimaging-data-by-modelling-important-unknown-covariates-application-to-epigenome-wide-association-studies
#14
Bryan Guillaume, Changqing Wang, Joann Poh, Mo Jun Shen, Mei Lyn Ong, Pei Fang Tan, Neerja Karnani, Michael Meaney, Anqi Qiu
Statistical inference on neuroimaging data is often conducted using a mass-univariate model, equivalent to fitting a linear model at every voxel with a known set of covariates. Due to the large number of linear models, it is challenging to check if the selection of covariates is appropriate and to modify this selection adequately. The use of standard diagnostics, such as residual plotting, is clearly not practical for neuroimaging data. However, the selection of covariates is crucial for linear regression to ensure valid statistical inference...
February 12, 2018: NeuroImage
https://www.readbyqxmd.com/read/29447780/nonprimary-pci-at-hospitals-without-cardiac-surgery-on-site-consistent-outcomes-for-all
#15
Matthew J Czarny, Julie M Miller, Daniel Q Naiman, Chao-Wei Hwang, Rani K Hasan, Cynthia C Lemmon, Thomas Aversano
BACKGROUND: The CPORT-E trial showed the noninferiority of nonprimary percutaneous coronary intervention (PCI) at hospitals without cardiac surgery on-site (SoS) compared with hospitals with SoS for 6-week mortality and 9-month major adverse cardiac events (MACE). However, target vessel revascularization (TVR) was increased at non-SoS hospitals. Therefore, we aimed to determine the consistency of the CPORT-E trial findings across the spectrum of enrolled patients. METHODS: Post hoc subgroup analyses of 6-week mortality and 9-month MACE, defined as the composite of death, Q-wave myocardial infarction, or TVR, were performed...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29445533/insomnia-and-cognitive-behavioural-therapy-how-to-assess-your-patient-and-why-it-should-be-a-standard-part-of-care
#16
REVIEW
Kirstie N Anderson
Hippocrates recognized the importance of asking about sleep as long ago as 400 BC when he wrote " sleep and watchfulness, both of them when immoderate, constitute disease ". Disrupted sleep for any reason has immediate and long term consequences on physical and mental health. Insomnia disorder ("immoderate watchfulness") remains the commonest sleep disorder in primary and secondary care with an estimated 5-10% of the adult population affected. While it is commonly comorbid with other physical and mental health problems, the new diagnostic classification has been helpfully simplified such that it is considered a disorder in itself...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29445508/development-of-the-japanese-version-of-the-preschool-confusion-assessment-method-for-the-icu
#17
Yujiro Matsuishi, Haruhiko Hoshino, Nobutake Shimojo, Yuki Enomoto, Takahiro Kido, Subrina Jesmin, Masahiko Sumitani, Yoshiaki Inoue
Aim: Delirium is associated with various negative clinical outcomes, such as decline in cognitive ability, increased length of hospital stay, and higher mortality. For these reasons, early diagnosis of delirium is critical. Unfortunately, there are no reliable diagnostic criteria or tool of delirium for infants and preschool-aged children in Japan. The aim of the present study was to translate a new delirium assessment tool, the Preschool Confusion Assessment Method for the Intensive Care Unit (psCAM-ICU), for accurately diagnosing clinically ill infants and preschool-aged children, from English to Japanese...
January 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29444748/aortopulmonary-collaterals-in-neonates-with-d-transposition-of-the-great-arteries-clinical-significance-early-after-arterial-switch-operation
#18
Alexandra Wipf, Martin Christmann, Susanne Navarini-Meury, Hitendu Dave, Daniel Quandt, Walter Knirsch, Oliver Kretschmar
OBJECTIVES: Purpose of this study is to evaluate the clinical significance of major aortopulmonary collateral arteries (MAPCAs) during the early postoperative course after arterial switch operation (ASO) in d-transposition of the great arteries (dTGA). METHODS: Clinical data of 98 patients with simple dTGA between January 2007 and December 2016 at the University Children's Hospital Zurich, Switzerland were analyzed retrospectively. RESULTS: 37 from 98 patients (38%) required cardiac catheterization (CC) due to an early complicated postoperative course or difficult coronary transfer due to special coronary anatomy...
February 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29444666/analysis-of-total-knee-arthroplasty-revision-causes
#19
Anne Postler, Cornelia Lützner, Franziska Beyer, Eric Tille, Jörg Lützner
BACKGROUND: The number of revision Total Knee Arthroplasty (TKA) is rising in many countries. The aim of this study was the prospective assessment of the underlying causes leading to revision TKA in a tertiary care hospital and the comparison of those reasons with previously published data. METHODS: In this study patients who had revision TKA between 2010 and 2015 were prospectively included. Revision causes were categorized using all available information from patients' records including preoperative diagnostics, intraoperative findings as well as the results of the periprosthetic tissue analysis...
February 14, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29441421/diagnostic-error-in-stroke-reasons-and-proposed-solutions
#20
REVIEW
Ekaterina Bakradze, Ava L Liberman
PURPOSE OF REVIEW: We discuss the frequency of stroke misdiagnosis and identify subgroups of stroke at high risk for specific diagnostic errors. In addition, we review common reasons for misdiagnosis and propose solutions to decrease error. RECENT FINDINGS: According to a recent report by the National Academy of Medicine, most people in the USA are likely to experience a diagnostic error during their lifetimes. Nearly half of such errors result in serious disability and death...
February 13, 2018: Current Atherosclerosis Reports
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