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Diagnostic reasoning

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https://www.readbyqxmd.com/read/28226351/-significance-and-contemplation-of-clinical-diagnosis-and-therapy-on-the-renewal-of-the-eighth-edition-of-gastric-cancer-tnm-staging-system
#1
Hongqing Xi, Kecheng Zhang, Bo Wei, Lin Chen
TNM staging is essential for clinical decision-making and prognostic prediction for patients with gastric cancer. The 7th TNM staging manual was formulated in 2009 and implemented in 2010. However, it was published that there were some deficiencies of the 7th edition of gastric cancer TNM staging system in clinical application process, and this old staging system could not meet the clinical needs. With the cooperation and promotion of the American Joint Committee on Cancer (AJCC), the International Union for Cancer Control (UICC) and the International Gastric Cancer Association (IGCA), and through the accumulation and analysis of gastric cancer big data, the 8th TNM staging system was published at the end of 2016...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28225839/-conceptual-and-methodological-issues-involved-in-the-research-field-of-diagnostic-reasoning
#2
Francisco N Di Persia
The psychopathological field is crossed by dilemmas that put in question its methodological, conceptual and philosophical filiations. Since the early works of Ey and Jaspers until recent work of Berrios it has been in question the position psychopathology has in the field of medicine in general, and in the field of psychiatry in particular, especially if it should follow the principles of natural science or if it has an autonomous position between them. This debate has led to two opposing positions facing two different models of psychopathology: the biomedical model and the socio-constructionist model...
May 2016: Vertex: Revista Argentina de Psiquiatriá
https://www.readbyqxmd.com/read/28225700/seeking-legitimacy-for-dsm-5-the-bereavement-exception-as-an-example-of-failed-process
#3
James E Sabin, Norman Daniels
In 2013 the American Psychiatric Association (APA) published the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Even before publication, DSM-5 received a torrent of criticism, most prominently over removal of the "bereavement exclusion" for the diagnosis of major depression. We argue that while the APA can claim legitimate authority for deciding scientific questions, it does not have legitimacy for resolving what is ultimately a question of ethics and public policy. We show how the "accountability for reasonableness" framework for seeking legitimacy in health policy could have been used to achieve a better resolution of the conflict than actually occurred...
February 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28224054/variant-profiling-of-evolving-prokaryotic-populations
#4
Markus Zojer, Lisa N Schuster, Frederik Schulz, Alexander Pfundner, Matthias Horn, Thomas Rattei
Genomic heterogeneity of bacterial species is observed and studied in experimental evolution experiments and clinical diagnostics, and occurs as micro-diversity of natural habitats. The challenge for genome research is to accurately capture this heterogeneity with the currently used short sequencing reads. Recent advances in NGS technologies improved the speed and coverage and thus allowed for deep sequencing of bacterial populations. This facilitates the quantitative assessment of genomic heterogeneity, including low frequency alleles or haplotypes...
2017: PeerJ
https://www.readbyqxmd.com/read/28223817/emergency-thoracic-ultrasound-and-clinical-risk-management
#5
Maria Concetta Interrigi, Francesca M Trovato, Daniela Catalano, Guglielmo M Trovato
PURPOSE: Thoracic ultrasound (TUS) has been proposed as an easy-option replacement for chest X-ray (CXR) in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. PATIENTS AND METHODS: This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28222095/delays-and-loss-to-follow-up-before-treatment-of-drug-resistant-tuberculosis-following-implementation-of-xpert-mtb-rif-in-south-africa-a-retrospective-cohort-study
#6
Helen Cox, Lindy Dickson-Hall, Norbert Ndjeka, Anja Van't Hoog, Alison Grant, Frank Cobelens, Wendy Stevens, Mark Nicol
BACKGROUND: South Africa has a large burden of rifampicin-resistant tuberculosis (RR-TB), with 18,734 patients diagnosed in 2014. The number of diagnosed patients has increased substantially with the introduction of the Xpert MTB/RIF test, used for tuberculosis (TB) diagnosis for all patients with presumptive TB. Routine aggregate data suggest a large treatment gap (pre-treatment loss to follow-up) between the numbers of patients with laboratory-confirmed RR-TB and those reported to have started second-line treatment...
February 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28220638/a-novel-clinical-framework-the-use-of-dispositions-in-clinical-practice-a-person-centred-approach
#7
Matthew Low
This paper explores a novel clinical framework that is underpinned by a specific philosophical perspective of causation and its utility in clinical practice. A dispositional theory of causation may overcome challenges that clinicians face in complex clinical presentations including those that are medically unexplained. Dispositionalism identifies causes not as regular events necessitating an effect but rather phenomena, which are highly complex, context-sensitive, and which tend toward an effect. Diagnostic uncertainty and causal explanation are significant challenges in terms of clinical reasoning, communication, and the overall therapeutic outcome...
February 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28220214/the-epidemiology-of-alcohol-use-in-izmir-turkey-drinking-pattern-impairment-and-help-seeking
#8
Halis Ulaş, Tolga Binbay, Umut Kırlı, Hayriye Elbi, Köksal Alptekin
PURPOSE: There is no report on various patterns of alcohol drinking and related impairment, help-seeking in Turkey. We investigated the 12-month prevalence and correlates of drinking patterns and alcohol use disorders in the general population of Izmir-Turkey, with further analyses on role impairment and help-seeking. METHOD: A multi-stage clustered area probability sample of adult household residents in the Izmir Metropolitan Area was assessed using the Composite International Diagnostic Interview 2...
February 20, 2017: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/28218347/breast-cancer-early-diagnosis-and-effective-treatment-by-drug-delivery-tracing
#9
Mahdiyeh Shamsi, Jalil Pirayesh Islamian
Breast cancer is the most frequent cancer in women and it is the main reason of cancer-related deaths of women worldwide. Different types of breast cancer diagnostic examinations are also available, such as mammography, MRI, biopsy, ultrasound and molecular imaging. Radionuclide-based imaging methods including SPECT and PET are useful in early diagnosis and treatment of the cancer. The radiolabeling of chemo drugs with nanoparticles should be recommended from the standpoint of an early diagnosis and effective treatment of breast cancer...
2017: Nuclear Medicine Review. Central & Eastern Europe
https://www.readbyqxmd.com/read/28217513/clinical-and-epidemiological-study-of-stress-hyperglycemia-among-medical-intensive-care-unit-patients-in-central-india
#10
Jitendra Sharma, Sachin Chittawar, Ram Singh Maniram, T N Dubey, Ambrish Singh
BACKGROUND: Stress hyperglycemia is common in patients presenting at the emergency medical ward and is associated with poor prognosis and increased risk of mortality. AIMS AND OBJECTIVE: To study and determine the prevalence and factors associated with stress hyperglycemia. MATERIALS AND METHODS: A cross-sectional observational study was performed on 536 nondiabetic patients presented to the Intensive Care Unit (ICU) at Gandhi Medical College and allied Hamidia Hospital, Bhopal, between March 31, 2015, and May 28, 2015...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28216547/mid-term-follow-up-of-school-aged-children-with-borderline-long-qt-interval
#11
Aya Miyazaki, Heima Sakaguchi, Yu Matsumura, Yosuke Hayama, Kanae Noritake, Jun Negishi, Etsuko Tsuda, Yoshihiro Miyamoto, Takeshi Aiba, Wataru Shimizu, Kengo Kusano, Isao Shiraishi, Hideo Ohuchi
BACKGROUND: There are no definitive diagnostic criteria or follow-up strategies for long QT syndrome (LQTS) in children with a borderline long QT interval (b-LQT).Methods and Results:We retrospectively evaluated the clinical course, genetic testing results, corrected QT interval (QTc), and LQTS score of 59 school-aged children (5-18 years old) with a b-LQT (400≤QTc<500 ms). Syncope, but neither aborted cardiac arrest nor sudden cardiac death, occurred in 2 patients during the follow-up (6±3...
February 18, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28213813/waiting-time-variation-in-early-intervention-psychosis-services-longitudinal-evidence-from-the-sepea-naturalistic-cohort-study
#12
James B Kirkbride, Y Hameed, L Wright, K Russell, C Knight, J Perez, P B Jones
PURPOSE: Early Intervention Psychosis [EIP] services have gained traction internationally, but are currently undergoing various forms of reconfiguration. In England, such services are now mandated to ensure 50% of accepted referrals commence care within 14 days, but no empirical evidence exists. We sought to estimate waiting times to EIP services in a large, representative epidemiological cohort in England, and investigate possible reasons for any variation. METHODS: We estimated median waiting time from referral to acceptance by EIP services and investigated whether this varied by clinical, demographic or neighbourhood-level factors, amongst 798 participants, 16-35 years old, presenting to six EIP services over 3...
February 18, 2017: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/28213195/blunt-traumatic-brain-injury-patients-a-role-for-ct-angiography-of-the-head-to-evaluate-non-traumatic-etiologies
#13
REVIEW
Ha Nguyen, Ninh Doan, Michael Gelsomino, Saman Shabani
BACKGROUND: In the setting of trauma, the etiology of intracranial hemorrhage (ICH) is frequently attributed to the physical, traumatic event. Caution should still be directed towards non-traumatic (or spontaneous) etiologies responsible for the trauma, such as hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformation, and hemorrhagic infarcts. The role for immediate CT angiography (CTA) remains controversial to evaluate for non-traumatic etiologies. METHODS: A systematic review of the available literature in Medline PubMed database...
February 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28211050/the-care-approach-to-reducing-diagnostic-errors
#14
Jess L Rush, Stephen E Helms, Eliot N Mostow
BACKGROUND: Diagnostic errors appear to be the most common, costly, and dangerous of all medical mistakes. There has been a notable increase on the focus of error prevention as part of a growing patient safety movement. However, diagnostic errors have received less attention than other types of error. Our goal is to present a short mnemonic that can act as a checklist or posted reminder to help practitioners in dermatology or any field of medicine to avoid diagnostic errors. METHODS: To meet this goal, the authors reviewed the literature and discussed errors and potential errors they have experienced over 55 years of combined practice, to create a short mnemonic...
February 16, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28210560/sinusoidal-hemangioma-of-the-breast-diagnostic-evaluation-management-and-literature-review
#15
Nikolaos S Salemis
Vascular tumors of the breast are rare and may pose a diagnostic challenge. Breast hemangioma is a very rare benign vascular neoplasm accounting for 0.4% of all breast tumors. It is most commonly detected as an incidental microscopic finding in biopsy specimens obtained for unrelated reasons. We describe here a very rare case of a sinusoidal breast hemangioma in a postmenopausal patient who presented with a palpable breast mass. A complete surgical resection was performed because the tumor exhibited atypical imaging features...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28208332/richtmyer-meshkov-instability-of-a-flat-interface-subjected-to-a-rippled-shock-wave
#16
Liyong Zou, Jinhong Liu, Shenfei Liao, Xianxu Zheng, Zhigang Zhai, Xisheng Luo
The Richtmyer-Meshkov (RM) instability of a nominally flat interface (N_{2}/SF_{6}) subjected to a rippled shock, as the counterpart of a corrugated interface interacting with a planar shock, is studied experimentally in a vertical shock tube using both schlieren photography and fog visualization diagnostics. The nonplanar incident shock wave is produced by a planar shock diffracting around a rigid cylinder, and the flat interface is created by a membraneless technique. Three different distances η (the ratio of spacing from cylinder to interface over cylinder diameter) are considered...
January 2017: Physical Review. E
https://www.readbyqxmd.com/read/28207539/role-of-coronary-angiography-for-out-of-hospital-cardiac-arrest-survivors-according-to-postreturn-of-spontaneous-circulation-on-an-electrocardiogram
#17
Tae Rim Lee, Sung Yeon Hwang, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Survivors of out-of-hospital cardiac arrest (OHCA) have high mortality and morbidity. An acute coronary event is the most common cause of sudden cardiac death. For this reason, coronary angiography is an important diagnostic and treatment strategy for patients with postcardiac arrest. This study aimed to identify the correlation between postreturn of spontaneous circulation (ROSC) on an electrocardiogram (ECG) and results of coronary angiography of OHCA survivors.We collected data from our OHCA registry from January 2010 to November 2014...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28205505/establishment-of-a-voluntary-electronic-chlamydia-trachomatis-laboratory-surveillance-system-in-germany-2008-to-2014
#18
Sandra Dudareva-Vizule, Karin Haar, Andrea Sailer, Klaus Jansen, Osamah Hamouda, Hilmar Wisplinghoff, Carsten Tiemann, Eberhard Pape, Viviane Bremer
Chlamydia trachomatis (CT) infections are not reportable in Germany and limited data on prevalence are available. CT screening has been offered free of charge to pregnant women since 1995 and to all women under 25 years since 2008. For symptomatic women and men, diagnostic testing is covered by statutory health insurance. We describe the establishment of a nationwide, laboratory-based, voluntary sentinel that electronically collects information on all performed CT tests with test results, test reason and patient information...
February 9, 2017: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/28204878/unusual-onset-of-adult-still-s-disease-due-to-a%C3%A2-systemic-reaction-to-artificial-breast-implants
#19
A Wehr, G Grieb, C Trautwein, K Streetz
In this manuscript, we report an exceptional observation study of a young woman suffering from an autoimmune syndrome induced by adjuvants (ASIA). Until today only seven cases of adult-onset Still's disease (AOSD) induced by breast implants have been published. This may be due to the fact that this illness itself is very rare; however, the reason might also be that the community is not sensitized to the case-specific symptoms. Within this article, we show for the first time highly detailed diagnostic test procedures such as PET-CT scans and specific histological staining of the breast tissue, displaying proinflammatory macrophages that are a well-known activator and booster of autoimmune diseases...
February 15, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28203277/semantics-based-plausible-reasoning-to-extend-the-knowledge-coverage-of-medical-knowledge-bases-for-improved-clinical-decision-support
#20
Hossein Mohammadhassanzadeh, William Van Woensel, Samina Raza Abidi, Syed Sibte Raza Abidi
BACKGROUND: Capturing complete medical knowledge is challenging-often due to incomplete patient Electronic Health Records (EHR), but also because of valuable, tacit medical knowledge hidden away in physicians' experiences. To extend the coverage of incomplete medical knowledge-based systems beyond their deductive closure, and thus enhance their decision-support capabilities, we argue that innovative, multi-strategy reasoning approaches should be applied. In particular, plausible reasoning mechanisms apply patterns from human thought processes, such as generalization, similarity and interpolation, based on attributional, hierarchical, and relational knowledge...
2017: BioData Mining
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