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Differential diagnosis internal medicine

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https://www.readbyqxmd.com/read/29459124/left-atrial-deformation-and-phasic-function-determined-by-two-dimensional-speckle-tracking-echocardiography-in-dogs-with-myxomatous-mitral-valve-disease
#1
D Caivano, M Rishniw, F Birettoni, V Patata, M E Giorgi, F Porciello
INTRODUCTION: Left atrial (LA) function can provide useful information in dogs with myxomatous mitral valve disease (MMVD). Recently, we have demonstrated the feasibility of measuring LA longitudinal deformation using speckle-tracking echocardiography (STE) to estimate LA function in healthy dogs. Whether LA strain and strain rate variables provide additional information about LA function and clinical cardiac status in dogs with MMVD remains unexplored. ANIMALS: Ninety-six client-owned dogs of different breeds with MMVD were prospectively enrolled...
February 16, 2018: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/29420882/multiplex-immuno-maldi-tof-ms-for-targeted-quantification-of-protein-biomarkers-and-their-proteoforms-related-to-inflammation-and-renal-dysfunction
#2
Jie Gao, Klaus Meyer, Katrin Borucki, Per Magne Ueland
Circulating proteins are widely used as biomarkers in clinical applications for the diagnosis, prediction and treatment of numerous diseases. Immunoassays are the most common technologies for quantification of protein biomarkers and exist in various formats. Traditional immunoassays offer sensitive and fast analyses, but cannot differentiate between proteoforms. Protein micro-heterogeneity, mainly due to post-translational modification, has been recognized as fingerprint for different pathologies, and knowledge about proteoforms is an important step towards personalized medicine...
February 8, 2018: Analytical Chemistry
https://www.readbyqxmd.com/read/29398045/-management-of-orbital-inflammation-in-internal-medicine-proposal-for-a-diagnostic-work-up
#3
S Abad, F Héran, C Terrada, P Bielefeld, D Sène, S Trad, D Saadoun, P Sève
Inflammatory orbitopathies relate to an inflammatory state originating within the orbit and its adnexes, except the inner ocular globe. Orbital inflammation (OI) may be either localized manifestation of a proven or like autoimmune disease, or local response from immune system against infectious, structural or tumoral antigens. We review the clinical manifestations of OI, which provide helpful clues to the diagnosis and describe the inflammatory, infectious and neoplastic conditions classically associated with OI...
February 1, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29340941/internal-medicine-residents-attitudes-toward-simulated-depressed-cardiac-patients-during-an-objective-structured-clinical-examination-a-randomized-study
#4
Kathleen Crapanzano, Dixie Fisher, Rebecca Hammarlund, Eric P Hsieh, Win May
BACKGROUND: Physician biases toward mental conditions such as depression have been shown to adversely affect medical outcomes. OBJECTIVE: To explore the relationship between residents' explicit bias toward depressed patients and their clinical skills on a cardiac case during an objective structured clinical exam (OSCE). DESIGN: Prospective parallel randomized controlled study. PARTICIPANTS: One hundred eighty-five internal medicine residents from three residency programs in two states...
January 16, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29324936/the-impact-of-lung-perfusion-scintigraphy-in-the-emergency-management-of-patients-with-suspected-pulmonary-embolism
#5
Cristina Ferrari, Alessandra Cimino, Giacomo Bianco, Francesca Iuele, Alessandra Di Palo, Margherita Fanelli, Artor Niccoli-Asabella, Giuseppe Rubini
OBJECTIVE: Pulmonary Embolism (PE) is an emergency condition that requires immediate treatment. As the symptoms and the risk factors are nonspecific, PE differential diagnosis is often required. Even if angio-CT is considered the gold standard for PE diagnosis, the frequent allergic condition and/or chronic renal failure of patients make, in most cases, not possible the use of contrast enhancement in emergency with even more increasing use of Lung Perfusion Scintigraphy (LPS), as a simple and fast examination with no preparation/contraindication...
September 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29320814/genotypic-identification-of-cystoisospora-in-immunocompromised-patients-using-tm-variation-analysis
#6
Maha M A Basyoni, Hany Ahmed Fouad Elghobary
Cystoisospora is responsible for morbidity in immunocompromised patients. PCR is sensitive for diagnosing Cystoisospora; however, it needs reevaluation for differential molecular diagnosis of cystoisosporiasis. We aimed at evaluating melting curve analysis (MCA) after real-time PCR (qPCR) in diagnosis and genotyping of Cystoisospora as an alternative to conventional PCR. We included 293 diarrheic stool samples of patients attending the Department of Clinical Oncology and Nuclear Medicine of Cairo University Hospitals, Egypt...
December 2017: Korean Journal of Parasitology
https://www.readbyqxmd.com/read/29273895/smear-campaign-misattribution-of-pancytopenia-to-a-tick-borne-illness
#7
Jessica Lee, Soraya Azzawi, Michael J Peluso, Aaron Richterman, Haiyan Ramirez Batlle, Maria A Yialamas
We report the case of a 51-year-old woman presenting with a targetoid rash and pancytopenia after a tick bite. Initial evaluation was notable for severe neutropenia on the complete blood cell count differential, a positive Lyme IgM antibody, and a peripheral blood smear demonstrating atypical lymphocytes. While her pancytopenia was initially attributed to tick-borne illness, peripheral flow cytometry showed 7% myeloblasts, and a bone marrow biopsy confirmed 60% blasts. The patient was ultimately diagnosed with acute myelogenous leukemia, in addition to early, localized Lyme disease...
December 22, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29197309/objective-structured-clinical-examination-based-teaching-of-the-musculoskeletal-examination
#8
Trishul Siddharthan, Sarita Soares, Hilary H Wang, Stephen R Holt
OBJECTIVES: Musculoskeletal complaints are the most common presenting illnesses in primary care settings, yet physicians often are underprepared to manage such complaints. We sought to create and evaluate an objective structured clinical examination (OSCE)-based musculoskeletal workshop designed to simultaneously educate medical students and internal medicine residents, enlisting volunteer medical students as standardized patients (SPs). METHODS: The setting for the study was the Yale Primary Care Residency Program...
December 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29192427/-clinical-application-evaluation-of-guidelines-for-diagnosis-and-treatment-of-internal-diseases-in-traditional-chinese-medicine
#9
Xue-Jie Han, Meng-Yu Liu, Zhi-Hua Lian, Li-Ying Wang, Nan-Nan Shi, Jun Zhao
To evaluate the applicability and clinical applications of Guidelines for Diagnosis and Treatment of Internal Diseases in Traditional Chinese Medicine, so as to provide the basis for the revision of the guidelines. This study was completed by the research and promotion base for traditional Chinese medicine(TCM) standard. The methods of applicability evaluation and application evaluation were used in the study. The questionnaires were filled out to evaluate applicability of the guideline, including doctor's familiarity with the guideline,the quality of the guideline, applicable conditions and clinical applications...
September 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29190706/elderly-emergency-patients-presenting-with-non-specific-complaints-characteristics-and-outcomes
#10
Joyce J H Wachelder, Patricia M Stassen, Laura P A M Hubens, Steffie H A Brouns, Suze L E Lambooij, Jeanne P Dieleman, Harm R Haak
BACKGROUND: Non-specific complaints (NSC) are common at the emergency department, but only a few studies have shown evidence that these complaints are associated with a poor prognosis in elderly emergency patients. OBJECTIVE: To describe patient characteristics and outcomes in a cohort of elderly emergency patients presenting with NSC. Outcomes were: patient characteristics, hospitalization, 90-day ED-return visits, and 30-day mortality. METHOD: A retrospective cohort study was conducted amongst elderly patients present to the Internal Medicine Emergency Department (ED) between 01-09-2010 and 31-08-2011...
2017: PloS One
https://www.readbyqxmd.com/read/29111463/diagnostic-validity-of-combining-history-elements-and-physical-examination-tests-for-traumatic-and-degenerative-symptomatic-meniscal-tears
#11
Simon Décary, Michel Fallaha, Pierre Frémont, Johanne Martel-Pelletier, Jean-Pierre Pelletier, Debbie Feldman, Marie-Pierre Sylvestre, Pascal-André Vendittoli, François Desmeules
BACKGROUND: Current approach to the clinical diagnosis of traumatic and degenerative symptomatic meniscal tears (SMT) propose combining history elements and physical examination tests without systematic prescription of imaging investigations, yet the evidence to support this diagnostic approach is scarce. OBJECTIVE: To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude traumatic and degenerative SMT compared to other knee disorders...
October 27, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29071870/-medication-rules-of-famous-veteran-traditional-chinese-medicine-doctor-in-treatment-of-chronic-bronchitis-based-on-implicit-structure-model
#12
Li-Ping Chen, Yong-Min Cai, Jian-Sheng Li
To explore the medication rules of famous veteran traditional Chinese medicine (TCM) doctors in treatment of chronic bronchitis, a structured medical record database for famous veteran TCM doctors in modern clinical books was established. First, Lantern 3.1.2(Kongmin light) implicit structure analysis software was used to build an implicit structure model and make an implicit interpretation. Then, SAS 9.1 was adopted to mine herb-herb, herb-symptom and herb-syndrome association rules. Through the mining, 1 274 commonly used herbs for chronic bronchitis were found, including liquorice, bitter almond, pinellia, dried tangerine or orange peel, poria cocos...
April 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29063266/congenital-absence-of-the-bilateral-internal-carotid-artery-a-review-of-the-associated-ab-normalities-from-a-newborn-status-to-the-eighth-decade-of-life
#13
REVIEW
Ljiljana Vasović, Milena Trandafilović, Slobodan Vlajković, Goran Radenković
PURPOSE: Due to the fact that the internal carotid artery (ICA) is responsible for nourishing two thirds of the brain volume, our aim was to inspect the morphofunctional consequences of the bilateral lack of this artery. METHODS: In order to examine this condition, we referred to both the library archive of our Faculty of Medicine and electronic databases of anatomical and clinical reports that included the following keywords: "absence," "aplasia," or "agenesis" in combination with "internal carotid artery," "common carotid artery," or only "carotid artery...
January 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29059494/molecular-based-diagnosis-of-multiple-sclerosis-and-its-progressive-stage
#14
Christopher Barbour, Peter Kosa, Mika Komori, Makoto Tanigawa, Ruturaj Masvekar, Tianxia Wu, Kory Johnson, Panagiotis Douvaras, Valentina Fossati, Ronald Herbst, Yue Wang, Keith Tan, Mark Greenwood, Bibiana Bielekova
OBJECTIVE: Biomarkers aid diagnosis, allow inexpensive screening of therapies, and guide selection of patient-specific therapeutic regimens in most internal medicine disciplines. In contrast, neurology lacks validated measurements of the physiological status, or dysfunction(s) of cells of the central nervous system (CNS). Accordingly, patients with chronic neurological diseases are often treated with a single disease-modifying therapy without understanding patient-specific drivers of disability...
November 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29058219/lemrg-decision-rule-generation-algorithm-for-mining-microrna-expression-data
#15
Łukasz Piątek, Jerzy W Grzymała-Busse
Recently, research on mining microRNA (or miRNA) expression data has received a lot of attention, mainly because of its role in gene regulation. However, such type of data - usually saved in the form of microarrays - are very specific, because they contain only a small number of cases (often less than 100) compared with large number of attributes (equal to several hundreds or even tens of thousand). The small number of cases available during the learning process can cause instability of the newly created classifiers...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29045276/impact-of-required-versus-self-directed-use-of-virtual-patient-cases-on-clerkship-performance-a-mixed-methods-study
#16
Sarang Kim, Laura R Willett, Wilbur J Pan, Joyce Afran, John A Walker, Judy A Shea
PURPOSE: To explore how students use and benefit from virtual patient cases (VPCs). METHOD: In academic years 2013-2014 and 2014-2015, cohorts of students in pediatrics (Peds), family medicine (FM), and internal medicine (IM) clerkships were allocated to either core required use (CRU) or self-directed use (SU) of MedU VPCs. Outcomes included number and time of case review, student perception of learning from VPCs, National Board of Medical Examiners (NBME) subject examination scores, and summative clinical ratings for medical knowledge and differential diagnoses/problem solving...
October 17, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28965174/lactate-determination-in-pleural-and-abdominal-effusions-a-quick-diagnostic-marker-of-exudate-a-pilot-study
#17
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
#18
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
#19
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
#20
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
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