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https://www.readbyqxmd.com/read/28965174/lactate-determination-in-pleural-and-abdominal-effusions-a-quick-diagnostic-marker-of-exudate-a-pilot-study
#1
Giovanni Porta, Fabio G Numis, Valerio Rosato, Antonio Pagano, Mario Masarone, Giorgio Bosso, Claudia Serra, Luca Rinaldi, Maria C Fascione, Annalisa Amelia, Fiorella Paladino, Fernando Schiraldi
Pleural or abdominal effusions are frequent findings in ICU and Internal Medicine patients. Diagnostic gold standard to distinguish between transudate and exudate is represented by "Light's Criteria," but, unfortunately, the chemical-physical examination for their calculation is not a rapid test. Pursuing an acid-base assessment of the fluid by a blood-gas analyzer, an increase of lactate beyond the normal serum range is reported in the exudative effusions. The advantages of this test are that it is a very fast bed-side test, executable directly by the physician...
September 30, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28930762/competency-based-medical-education-in-the-internal-medicine-clerkship-a-report-from-the-alliance-for-academic-internal-medicine-undergraduate-medical-education-task-force
#2
Sara B Fazio, Cynthia H Ledford, Paul B Aronowitz, Shobhina G Chheda, John H Choe, Stephanie A Call, Scott D Gitlin, Marty Muntz, L James Nixon, Anne G Pereira, John W Ragsdale, Emily A Stewart, Karen E Hauer
As medical educators continue to redefine learning and assessment across the continuum, implementation of competency-based medical education in the undergraduate setting has become a focus of many medical schools. While standards of competency have been defined for the graduating student, there is no uniform approach for defining competency expectations for students during their core clerkship year. The authors describe the process by which an Alliance for Academic Internal Medicine task force developed a paradigm for competency-based assessment of students during their inpatient internal medicine (IM) clerkship...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28915942/development-of-a-validated-lc-ms-ms-method-for-the-quantification-of-19-endogenous-asthma-copd-potential-urinary-biomarkers
#3
Mona M Khamis, Darryl J Adamko, Anas El-Aneed
Obstructive airways inflammatory diseases sometimes show overlapping symptoms that hinder their early and correct diagnosis. Current clinical tests are tedious and are of inadequate specificity in special population such as the elderly and children. Therefore, we are developing tandem mass spectrometric (MS/MS) methods for targeted analysis of urine biomarkers. Recently, proton-nuclear magnetic resonance ((1)H-NMR) analysis proposed 50 urinary metabolites as potential diagnostic biomarkers among asthma and chronic obstructive pulmonary disease (COPD) patients...
October 9, 2017: Analytica Chimica Acta
https://www.readbyqxmd.com/read/28857266/avoiding-premature-closure-and-reaching-diagnostic-accuracy-some-key-predictive-factors
#4
Edward Krupat, Jolie Wormwood, Richard M Schwartzstein, Jeremy B Richards
CONTEXT: Early studies suggested that experienced clinicians simply generate more accurate diagnoses than those less experienced. However, more recent studies indicate that experienced clinicians may be subject to biases in formulating and confirming hypotheses that lead to inaccuracy. OBJECTIVES: The goal of this study was to identify factors associated with the ability to process information in ways that overcome premature closure and result in accurate diagnosis using a set of vignettes in which inconsistent information was introduced midway...
November 2017: Medical Education
https://www.readbyqxmd.com/read/28793969/lung-ultrasound-in-internal-medicine-a-bedside-help-to-increase-accuracy-in-the-diagnosis-of-dyspnea
#5
Tiziano Perrone, Alessia Maggi, Carmelo Sgarlata, Ilaria Palumbo, Elisa Mossolani, Sara Ferrari, Ariel Melloul, Roberta Mussinelli, Michele Boldrini, Ambra Raimondi, Aderville Cabassi, Francesco Salinaro, Stefano Perlini
BACKGROUND: Dyspnea is one of the most frequent causes of admission in Internal Medicine wards, leading to a sizeable utilization of medical resources. STUDY DESIGN AND METHODS: The role of bedside lung ultrasound (LUS) was evaluated in 130 consecutive patients (age: 81±9years), in whom blindly collected LUS results were compared with data obtained by clinical examination, medical history, blood analysis, and chest X-ray. Dyspnea etiology was classified as "cardiac" (n=80), "respiratory" (n=36) or "mixed" (n=14), according to the discharge diagnosis (congestive heart failure either alone [n=80] or associated with pneumonia [n=14], pneumonia [n=24], and obstructive disventilatory syndrome [n=12])...
August 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28777172/narcolepsy-and-other-central-hypersomnias
#6
Yves Dauvilliers, Lucie Barateau
PURPOSE OF REVIEW: This article focuses on the clinical presentation, pathophysiology, diagnosis, differential diagnosis, and management of narcolepsy type 1 and narcolepsy type 2, idiopathic hypersomnia, Kleine-Levin syndrome, and other central disorders of hypersomnolence, as defined in the International Classification of Sleep Disorders, Third Edition (ICSD-3). RECENT FINDINGS: In ICSD-3, the names of some central disorders of hypersomnolence have been changed: narcolepsy with cataplexy and narcolepsy without cataplexy have been renamed narcolepsy type 1 and narcolepsy type 2, respectively...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28702982/chronic-inflammation-therapy-combined-with-low-dose-cytokines-in-the-treatment-of-chronic-ulcers-of-lower-limbs
#7
S E Aragona, P Amori, G Mereghetti, J Lotti, T Lotti, G V L Colombo
Prevalence of chronic venous leg ulcers has increased from 55% to 75% in 10 years. We treat chronic vascular lesions according to a cyclic multiphase method that follows the instrumental and differential etiologic diagnosis of ulcers of the lower limbs. The AIMED (Anti Inflammatory Regenerative Medicine) operating model follows the diagnostic phase and is structured in 5 interconnected phases. Mare evaluation, pH control, biofilm removal and prevention and infections are approached according to the International Guidelines...
July 13, 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28497878/pharmacist-prescribing-a-cross-sectional-survey-of-the-views-of-pharmacists-in-nigeria
#8
Asa Auta, Barry Strickland-Hodge, Julia Maz, Shalkur David
OBJECTIVES: This study was carried out to: (1) explore the views of pharmacists in Nigeria on the extension of prescribing authority to them and determine their willingness to be prescribers and (2) identify the potential facilitators and barriers to introducing pharmacist prescribing in Nigeria. METHOD: An online cross-sectional survey was conducted from August to October 2014 among 775 pharmacists recruited from the Facebook group of the Pharmaceutical Society of Nigeria using a simple random technique...
May 12, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28420603/the-coags-uncomplicated-app-fulfilling-educational-gaps-around-diagnosis-and-laboratory-testing-of-coagulation-disorders
#9
Craig Kessler, Ellinor I Peerschke, Meera B Chitlur, Roshni Kulkarni, Natalia Holot, David L Cooper
BACKGROUND: Patients with coagulation disorders may present to a variety of physician specialties; however, accurate and efficient diagnosis can be challenging for physicians not specialized in hematology, due to identified gaps in knowledge around appropriate laboratory assays and interpretation of test results. Coags Uncomplicated was developed to fill this unmet educational need by increasing practical knowledge of coagulation disorders among nonexpert physicians and other health care professionals (HCPs) in a point-of-care (POC) setting...
April 18, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28405953/angioedema-in-the-emergency-department-a-practical-guide-to-differential-diagnosis-and-management
#10
REVIEW
Jonathan A Bernstein, Paolo Cremonesi, Thomas K Hoffmann, John Hollingsworth
BACKGROUND: Angioedema is a common presentation in the emergency department (ED). Airway angioedema can be fatal; therefore, prompt diagnosis and correct treatment are vital. OBJECTIVE OF THE REVIEW: Based on the findings of two expert panels attended by international experts in angioedema and emergency medicine, this review aims to provide practical guidance on the diagnosis, differentiation, and management of histamine- and bradykinin-mediated angioedema in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28399929/xanthogranulomatous-pyelonephritis-presenting-as-acute-pleuritic-chest-pain-a-case-report
#11
Justin Chow, Rameez Kabani, Kirstie Lithgow, Magdalena A Sarna
BACKGROUND: Xanthogranulomatous pyelonephritis is a rare and serious manifestation of chronic kidney inflammation that can be life-threatening if not recognized and treated appropriately, often with antibiotics and surgery. Affected patients are most commonly females in their fifth or sixth decade of life with a background of obstructive uropathy, nephrolithiasis, or recurrent urinary tract infections who present with vague nonspecific symptoms. CASE PRESENTATION: A 43-year-old woman of Russian ethnicity with a history of nephrolithiasis presented to our emergency department with new left-sided pleuritic chest pain amid a 6-week history of constitutional symptoms including fevers, night sweats, and 7 kg of weight loss...
April 12, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28360920/study-of-commercially-available-lobelia-chinensis-products-using-bar-hrm-technology
#12
Wei Sun, Song Yan, Jingjian Li, Chao Xiong, Yuhua Shi, Lan Wu, Li Xiang, Bo Deng, Wei Ma, Shilin Chen
There is an unmet need for herbal medicine identification using a fast, sensitive, and easy-to-use method that does not require complex infrastructure and well-trained technicians. For instance, the detection of adulterants in Lobelia chinensis herbal product has been challenging, since current detection technologies are not effective due to their own limits. High Resolution Melting (HRM) has emerged as a powerful new technology for clinical diagnosis, research in the food industry and in plant molecular biology, and this method has already highlighted the complexity of species identification...
2017: Frontiers in Plant Science
https://www.readbyqxmd.com/read/28161884/usefulness-of-procalcitonin-in-differentiating-candida-and-bacterial-blood-stream-infections-in-critically-ill-septic-patients-outside-the-intensive-care-unit
#13
Filippo Pieralli, Lorenzo Corbo, Arianna Torrigiani, Dario Mannini, Elisa Antonielli, Antonio Mancini, Francesco Corradi, Fabio Arena, Alberto Moggi Pignone, Alessandro Morettini, Carlo Nozzoli, Gian Maria Rossolini
We aimed to explore the role of procalcitonin (PCT) for the diagnosis of Candida spp. bloodstream infections in a population of critically ill septic patients admitted to internal medicine units. This is a retrospective case-control study considering all cases of candidemia identified in three internal medicine units, from January 1st 2012 to May 31st 2016. For each case of candidemia, two patients with bacteremic sepsis were included in the study as control cases. The end point of the study was to evaluate the diagnostic performance of PCT for the diagnosis of Candida spp...
August 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28155840/osteitis-in-the-course-of-pyodema-gangrenosum-case-raport
#14
Andrzej Kaźmierczak-Koćwin, Robert Pieczyrak, Damian Kusz, Eugeniusz Kucharz, Marcin Kusz
We present the case of a male patient admitted to the Department of Orthopaedics and Musculoskeletal Traumatology, Medical University of Silesia (MUS) in Katowice, due to a right hindfoot abscess with calcaneal infiltration and pain in the forehead and the back, with evidence of local inflammation. The patient had a history of ulcerative colitis and sclerosing cholangitis was suspected. During the hospital stay, the patient underwent calcaneal CT, surgery (resection of an inflammatory focus) and MRI of the thoracic and lumbosacral spine, which revealed inflamed spinous processes of the Th10, Th11 and Th12 vertebrae...
November 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/27895270/dicrocoelium-dendriticum-an-unusual-parasitological-diagnosis-in-a-reference-international-health-unit
#15
Zaira Moure, Francesc Zarzuela, Mateu Espasa, Diana Pou, Nuria Serre-Delcor, Begoña Treviño, Cristina Bocanegra, Israel Molina, Tomas Pumarola, Elena Sulleiro
Finding Dicrocoelium dendriticum eggs in human feces is exceptional and there are few prevalence data available. True infection occurs after accidental ingestion of ants containing metacercariae and spurious infection through the consumption of infected animal liver. Differential diagnosis between true and pseudo-infections is performed through stool examination after a diet free of liver. In addition, microscopy can help to differentiate the type of infection. We report six cases, all from sub-Saharan Africa, detection of this fluke at the Tropical Medicine Unit Vall d'Hebron-Drassanes (Barcelona, Spain)...
February 8, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27790959/igg4-related-syndrome-another-multiorgan-disease-in-the-interest-field-of-internal-medicine
#16
Antonino Tuttolomondo, Irene Simonetta, Domenico Di Raimondo, Tiziana Di Chiara, Roberta Conigliaro, Francesca Corpora, Valerio Vassallo, Antonio Pinto
BACKGROUND: IgG4-related disease is a rare, clinical and pathologic disease entity of unknown etiology. Its main features are increased serum concentrations of IgG4 > 1,35 g/l, lymphocyte and IgG4+plasma-cell infiltration within tissues, fibrosis or sclerosis. The classical presentation of IgG4-RSD is pancreatitis which is combined with the involvement of biliary ducts in 74 percent of patients. Extrapancreatic manifestations include: abdominal or mediastinal lymphadenopathy; the involvement of salivary glands and lacrimal glands, kidneys, lung, retroperitoneum...
2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27598500/-factor-analysis-and-internal-consistency-of-pedagogical-practices-questionnaire-among-health-care-teachers
#17
Cristhian Pérez V, Giulietta Vaccarezza G, César Aguilar A, Katherine Coloma N, Horacio Salgado F, Marjorie Baquedano R, Carla Chavarría R, Nancy Bastías V
BACKGROUND: Teaching practice is one of the most complex topics of the training process in medicine and other health care careers. The Teaching Practices Questionnaire (TPQ) evaluates teaching skills. AIM: To assess the factor structure and internal consistency of the Spanish version of the TPP among health care teachers. MATERIAL AND METHODS: The TPQ was answered by 315 university teachers from 13 of the 15 administrative Chilean regions, who were selected through a non-probabilistic volunteer sampling...
June 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/27503784/international-consensus-on-the-diagnosis-and-management-of-pediatric-patients-with-hereditary-angioedema-with-c1-inhibitor-deficiency
#18
H Farkas, I Martinez-Saguer, K Bork, T Bowen, T Craig, M Frank, A E Germenis, A S Grumach, A Luczay, L Varga, A Zanichelli
BACKGROUND: The consensus documents published to date on hereditary angioedema with C1 inhibitor deficiency (C1-INH-HAE) have focused on adult patients. Many of the previous recommendations have not been adapted to pediatric patients. We intended to produce consensus recommendations for the diagnosis and management of pediatric patients with C1-INH-HAE. METHODS: During an expert panel meeting that took place during the 9th C1 Inhibitor Deficiency Workshop in Budapest, 2015 (www...
February 2017: Allergy
https://www.readbyqxmd.com/read/27471547/evaluation-of-the-accuracy-of-diagnostic-scales-for-a-syndrome-in-chinese-medicine-in-the-absence-of-a-gold-standard
#19
Xiao Nan Wang, Vanessa Zhou, Qiang Liu, Ying Gao, Xiao-Hua Zhou
BACKGROUND: The concept of syndromes (zhengs) is unique to Chinese medicine (CM) and difficult to measure. Expert consensus is used as a gold standard to identify zhengs and evaluate the accuracy of existing diagnostic scales for zhengs. But, the use of expert consensus as a gold standard is problematic because the diagnosis of zhengs by expert consensus is not 100 % accurate. This study aimed to evaluate the accuracy of standardized diagnostic scales for a syndrome zhengs in the absence of a gold standard, with application to internal wind (nei feng) syndrome in ischemic stroke patients...
2016: Chinese Medicine
https://www.readbyqxmd.com/read/27365540/diagnosis-of-endometrial-factor-infertility-current-approaches-and-new-avenues-for-research
#20
REVIEW
N Katzorke, F Vilella, M Ruiz, J-S Krüssel, C Simón
Over the last decade, research to improve success rates in reproductive medicine has focused predominantly on the understanding and optimization of embryo quality. However, the emergence of personalized medicine in ovulation induction and embryology has shifted the focus to assessing the individual status of the endometrium. The endometrium is considered receptive during an individually defined period, the window of implantation (WOI), when the mother permits a blastocyst to attach and implant. This individual receptivity status can now be objectively diagnosed using the endometrial receptivity array (ERA) developed in 2011...
June 2016: Geburtshilfe und Frauenheilkunde
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