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Diagnostic overshadowing

Roger L Kneebone
This paper argues for the inclusion of surgery within the canon of performance science. The world of medicine presents rich, complex but relatively under-researched sites of performance. Performative aspects of clinical practice are overshadowed by a focus on the processes and outcomes of medical care, such as diagnostic accuracy and the results of treatment. The primacy of this "clinical" viewpoint-framed by clinical professionals as the application of medical knowledge-hides resonances with performance in other domains...
2016: Frontiers in Psychology
Brenda Happell, Stephanie B Ewart, Julia Bocking, Chris Platania-Phung, Robert Stanton
AIMS AND OBJECTIVES: To ascertain the views and experiences of mental health consumers regarding the availability and quality of care and treatment received for their physical health needs. BACKGROUND: People diagnosed with mental illness have higher occurrence of physical health problems. Responsive health care services are crucial for prevention and management of physical health problems, and for reducing disparities in health between people diagnosed with mental illness and those who are not...
October 2016: Journal of Clinical Nursing
Igor Yakovenko, Cameron M Clark, David C Hodgins, Vina M Goghari
Little research has examined the association between disordered gambling and psychosis. In addition, clinicians treating schizophrenia or schizoaffective disorders rarely screen for or treat comorbid gambling problems due to diagnostic overshadowing. Thus, the effects of disordered gambling on symptoms of schizophrenia and vice versa remain largely unexplored and unidentified in research and clinical practice. The goal of the present study was to explore qualitatively the reciprocal associations between schizophrenia/schizoaffective disorder and disordered gambling through content and functional analyses from the perspective of the affected individual...
March 2016: Schizophrenia Research
Partha Pratim Chakraborty, Saumik Datta, Sayantan Ray, Rana Bhattacharjee, Subhankar Chowdhury
Neuropathic arthropathy of the shoulder is a rare disorder characterized by joint degeneration, and is associated with loss of sensory innervation. Syringomyelia is a disease in which fluid-containing cavities (syrinxes) form within the spinal cord. Here, we report a case of neuropathic arthropathy of the shoulder secondary to syringomyelia in a 40-year-old woman. X-rays of the left shoulder revealed damage to bone and joint architecture. Blood tests indicated vitamin D deficiency and secondary hyperparathyroidism...
December 16, 2015: World Journal of Clinical Cases
Kitty-Rose Foley, Julian Trollor
BACKGROUND: Adults with autism spectrum disorder (ASD) may require medical assessment and care, especially for mental health conditions. Although substantial knowledge and resources are available regarding the management of mental ill health in children with ASD, substantial gaps remain for adults with ASD. Diagnostic overshadowing, limitations of communication skills and the heterogeneous nature of this patient population can make practice in this area more challenging, and can contribute to poorer outcomes, including overprescribing of psychotropic medications...
2015: Australian Family Physician
Dominique Bourgeon
Within medical care units, administrative and managerial functions are often overshadowed by the curative or diagnostic acts. In this context, health managers must give their availability in order to legitimize their action. Compared to the medical procedures, their gift of time often remains invisible, unseen and therefore unacknowledged.
December 2014: Soins; la Revue de Référence Infirmière
Arthur S Tischler, Ronald R deKrijger
Pathologists using their routine diagnostic tools can contribute both to the care of patients with pheochromocytoma/paraganglioma and to understanding the pathobiology of the tumors. They can document details of tissue organization and cytology that are accessible only by microscopy and can characterize admixtures of cell types that are morphologically distinct or show differential expression of immunohistochemical markers. Current roles and challenges for pathologists include differential diagnosis, identifying clues to the presence of hereditary disease, and effective communication of pathology information for clinical and research purposes...
August 2015: Endocrine-related Cancer
J G M Hendriksen, J C A W Peijnenborgh, A P Aldenkamp, J S H Vles
AIM: Diagnostic overshadowing refers to the underdiagnosis of comorbid conditions in children with known neurological diagnoses. To demonstrate diagnostic overshadowing we determined the prevalence of attention deficit-hyperactivity disorders (ADHD) in a cohort of children with a wide range of neurological disabilities. METHOD: The study cohort consisted of 685 children (mean age 10.3 years, SD: 3.1; 425 boys and 260 girls) who visited a tertiary outpatient multidisciplinary clinic for neurological learning disabilities...
September 2015: European Journal of Paediatric Neurology: EJPN
Graham Naylor, Marie Öberg, Gunilla Wänström, Thomas Lunner
OBJECTIVES: There is strong evidence from other fields of health, and growing evidence in audiology, that characteristics of the process of intervention as perceived by the client (embodied narratives) can have significant effects on treatment outcomes, independent of the technical properties of the intervention itself. This phenomenon deserves examination because studies of technical interventions that fail to take account of it may reach erroneous conclusions and because clinical practice can put such effects to therapeutic use...
September 2015: Ear and Hearing
Dominique Bourgeon
Within medical care units, administrative and managerial functions are often overshadowed by the curative or diagnostic acts. In this context, health managers must give their availability in order to legitimize their action. Compared to the medical procedures, their gift of time often remains invisible, unseen and therefore unacknowledged.
December 2014: Soins; la Revue de Référence Infirmière
R Keerthi, Rohan P Raut, N Vaibhav, Abhishek Ghosh
Carcinoma ex pleomorphic adenoma (CXPA) is a carcinoma arising from a primary or recurrent benign pleomorphic adenoma. It often poses a diagnostic challenge to clinicians and pathologists. The entity is difficult to diagnose preoperatively. Pathological assessment is the gold standard for making the diagnosis. Treatment for CXPA often involves an ablative surgical procedure, which may be followed by radiotherapy. We report a case of a 65-year-old lady with a history of recurrent swelling in the left preauricular region and a history of surgery 10 years back, in the same region...
July 2014: Indian Journal of Dentistry
Connor M Kerns, Philip C Kendall, Hana Zickgraf, Martin E Franklin, Judith Miller, John Herrington
This study's objective was to examine associations between comorbid anxiety disorders and difficulties commonly attributed to both anxiety and ASD (autism spectrum disorder) including self-injury, depressive symptoms, functional communication, social skill deficits and parent stress, in a well-characterized sample of youth with ASD. Fifty-nine verbally fluent participants (7-17 years; 93% Caucasian) diagnosed with ASD and their parents completed semistructured diagnostic interviews to confirm ASD diagnosis and assess for anxiety disorders...
January 2015: Behavior Therapy
Emmanouil Grigoriou, Jessica Jo DeSabato, Dino Colo, John P Dormans
BACKGROUND: Aicardi syndrome (ACS) is a rare neurodevelopmental disorder that was classically characterized by the triad of agenesis of corpus callosum, infantile spasms, and chorioretinal lacunae. As new cases emerge and new common phenotypic features are being described in subsequent reports, new modified diagnostic criteria have been proposed that now classify the observed costovertebral abnormalities as supporting diagnostic features. To our knowledge there are no previous studies focusing and describing the scoliosis observed in children with ACS...
July 2015: Journal of Pediatric Orthopedics
Louis K Wagner
Diagnostic radiology has an image problem. In its effort to develop a better understanding of benefit-risk in medical radiology, data on potential risks associated with medical imaging have been welcomed into the medical community. As such, risk perspectives and mantras from the occupational health profession have been adopted and applied to patients. These perspectives often focus on risk with only casual, incidental, or no reference to the benefits experienced by patients. These occupational health viewpoints have accumulated over decades, have overshadowed a very limited perspective about the benefits of medical X-rays, and have become an integrated part of our profession...
October 2014: Pediatric Radiology
Kimberly E Fagen, Eglal Shalaby-Rana, Allison M Jackson
BACKGROUND: It is estimated that inflicted burn injuries in physically abused children occur with a prevalence of approximately 6-20%. Identification of burns of a nonaccidental nature is oftentimes difficult. Underlying skeletal injuries in abusive environments are often overshadowed by the acute burn injury. OBJECTIVE: We assessed the prevalence of inflicted burns and the frequency of associated skeletal injuries in a population from a large children's hospital...
March 2015: Pediatric Radiology
Alison E While, Louise L Clark
AIM: To develop and test a competency assessment tool for adult trained nurses caring for people with intellectual disabilities in hospital. BACKGROUND: The report 'Death by indifference' in 2007 highlighted inadequate care given to people with intellectual disabilities in hospital. This study sought to develop and test a competency assessment tool for adult trained nurses in the care of this patient group. METHODS: A review of the literature informed the topic guide for focus groups (n = 4) with experienced adult trained nurses, learning disability nurses and people with intellectual disabilities (n = 25)...
September 2014: Journal of Nursing Management
G V Ramesh Prasad, Michael Huang, Samuel A Silver, Ali I Al-Lawati, Lindita Rapi, Michelle M Nash, Jeffrey S Zaltzman
Metabolic syndrome (MetS) associates with cardiovascular risk post-kidney transplantation, but its ambiguity impairs understanding of its diagnostic utility relative to components. We compared five MetS definitions and the predictive value of constituent components of significant definitions for major adverse cardiovascular events (MACE) in a cohort of 1182 kidney transplant recipients. MetS definitions were adjusted for noncomponent traditional Framingham risk factors and relevant transplant-related variables...
January 2015: Transplant International: Official Journal of the European Society for Organ Transplantation
Simon D'Alton, Jada Lewis
In the search for therapeutic modifiers, frontotemporal dementia (FTD) has traditionally been overshadowed by other conditions such as Alzheimer's disease (AD). A clinically and pathologically diverse condition, FTD has been galvanized by a number of recent discoveries such as novel genetic variants in familial and sporadic forms of disease and the identification of TAR DNA binding protein of 43 kDa (TDP-43) as the defining constituent of inclusions in more than half of cases. In combination with an ever-expanding knowledge of the function and dysfunction of tau-a protein which is pathologically aggregated in the majority of the remaining cases-there exists a greater understanding of FTD than ever before...
2014: Frontiers in Aging Neuroscience
Takeshi Kubo, Yoshiharu Ohno, Hans Ulrich Kauczor, Hiroto Hatabu
Computed tomography currently accounts for the majority of radiation exposure related to medical imaging. Although technological improvement of CT scanners has reduced the radiation dose of individual examinations, the benefit was overshadowed by the rapid increase in the number of CT examinations. Radiation exposure from CT examination should be kept as low as reasonably possible for patient safety. Measures to avoid inappropriate CT examinations are needed. Principles and information on radiation dose reduction in chest CT are reviewed in this article...
October 2014: European Journal of Radiology
Anne Lise Holm, Anne Lyberg, Elisabeth Severinsson
The aim of this paper is to deepen the understanding of depressed elderly persons' lived experiences of physical health problems. Individual in-depth interviews were conducted with 15 depressed elderly persons who suffer from physical health problems. A hermeneutic analysis was performed, yielding one main theme, living with stigma, and three themes: longing to be taken seriously, being uncertain about whether the pain is physical or mental, and a sense of living in a war zone. The second theme comprised two subthemes, feeling like a stranger and feeling dizzy, while the third had one subtheme: afraid of being helpless and dependent on others...
2014: Nursing Research and Practice
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