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Differential diagnosis*

Fabian Sanchis-Gomar, Carme Perez-Quilis, Giuseppe Lippi, Gianfranco Cervellin, Roman Leischik, Herbert Löllgen, Enrique Serrano-Ostáriz, Alejandro Lucia
Atrial fibrillation (AF) is the most common heart arrhythmia, the risk of which typically increases with age. This condition is commonly associated with major cardiovascular diseases and structural heart damage, while it is rarely observed in healthy young people. However, increasing evidence indicates that paroxysmal AF can also onset in young or middle-aged and otherwise healthy endurance athletes (e.g., cyclists, runners and cross-country skiers). Here we review the topic of AF associated with strenuous endurance exercise (SEE), for example cycling, running and cross-country skiing, especially at a competitive level, and we propose the definition of a new syndrome based on the accumulating data in the literature: SEE-related AF under the acronym of 'PAFIYAMA' ('paroxysmal AF in young and middle-aged athletes')...
October 19, 2016: International Journal of Cardiology
Lise Løvereide, Peter Hagell
The 5-item Satisfaction With Life Scale (SWLS) was designed to measure general life satisfaction (LS). Here we examined the psychometric properties of the SWLS in a cohort of persons with Parkinson`s disease (PwPD) and age and gender matched individuals without PD. The SWLS was administered to PwPD and controls from the Norwegian ParkWest study at 5 and 7 years after the time of diagnosis. Data were analysed according to classical test theory (CTT) and Rasch measurement theory. CTT scaling assumptions for computation of a SWLS total score were met (corrected item-total correlations >0...
2016: PloS One
Jasper L A Vleugels, Joep E G IJspeert, Yark Hazewinkel, Manon van der Vlugt, Paul Fockens, Lianne Koens, Evelien Dekker
BACKGROUND: Optical diagnosis of diminutive (1 to 5 mm) polyps could result in a more cost-effective colonoscopy practice. Previous optical diagnosis studies did not incorporate the differentiation of sessile serrated polyps (SSPs). This study aimed to evaluate the impact of optical diagnosis of diminutive SSPs on the overall performance of endoscopic polyp differentiation in daily colonoscopy practice. METHODS: Endoscopy data were prospectively collected between 2011 and 2014 in a colonoscopy center...
October 21, 2016: Journal of Clinical Gastroenterology
Ofer Nathan Gofrit, Stephen Frank, Amichay Meirovitz, Hovav Nechushtan, Marina Orevi
AIM: Castrate-resistant prostate cancer (CRPC) often shows histological evidence of neuroendocrine differentiation (NED). To evaluate the extent of NED in patients with CRPC, we used PET/CT with Ga-[DOTA-Tyr]-octreotate (Ga-DOTA-TATE), a somatostatin analog that binds somatostatin receptor 2 with high affinity. This radiotracer is used in imaging of neuroendocrine tumors. METHODS: Twelve patients (mean age, 65 [SD, 12] years) with CRPC were studied. Their mean prostate-specific antigen level at scanning was 85...
October 21, 2016: Clinical Nuclear Medicine
Pavel Sumazin, Yidong Chen, Lisa R Treviño, Stephen F Sarabia, Oliver A Hampton, Kayuri Patel, Toni-Ann Mistretta, Barry Zorman, Patrick Thompson, Andras Heczey, Sarah Comerford, David A Wheeler, Murali Chintagumpala, Rebecka Meyers, Dinesh Rakheja, Milton J Finegold, Gail Tomlinson, D Williams Parsons, Dolores López-Terrada
Despite being the most common liver cancer in children, hepatoblastoma (HB) is a rare neoplasm. Consequently, few pre-treatment tumors have been molecularly profiled and there are no validated prognostic or therapeutic biomarkers for HB patients. We report on the first large-scale effort to profile pre-treatment HBs at diagnosis. Our analysis of 88 clinically-annotated HBs revealed three risk-stratifying molecular subtypes that are characterized by differential activation of hepatic progenitor cell markers and metabolic pathways: high-risk tumors were characterized by up-regulated NFE2L2 activity, high LIN28B, HMGA2, SALL4 and AFP expression, and high coordinated expression of oncofetal proteins and stem cell markers; while low-risk tumors had low LIN28B and let-7 expression, and high HNF1A activity...
October 24, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
M Oviedo Gutiérrez, S Amat Valero, A Gómez Farpón, C Montalvo Ávalos, L Fernández García, D C Lara Cárdenas, S Barnes Marañón, C Granell Suárez, N Vega Mata, A J López López, M González Guerrero, V Álvarez Muñoz
PURPOSE: Gastrointestinal adenomyoma is a rare benign tumor most frequently located in the stomach. The differential diagnosis is wide because of its large clinical spectrum and unspecific radiological findings. Surgical excision is both diagnostic and therapeutic. CASE REPORT: A 49-days old girl presented with nonbilious vomiting of 48 hours of evolution. Infantile hypertrofic pyloric stenosis was suspected. Ultrasound showed a nonobstructive nodular lesion in the anterior pyloric wall...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
G Alonso Ciodaro, J I Santamaría Ossorio, S Sanjuán Rodríguez
INTRODUCTION: Cecal duplications are rare, representing 0.4% of all gastrointestinal duplications, with few cases reported in the literature. CLINICAL CASE: A 48 hours-old newborn presented with bilious vomiting and abdominal distension; the ultrasound revealed a cystic mass in the right abdomen; ileocolic resection was performed with end to end anastomosis. Microscopy confirmed cecal duplication cyst. COMMENTS: In patients with intestinal obstruction, contrast enema allows differential diagnosis with other colonic pathologies in the newborn; when the cecal duplication cyst is connected to the lumen of the colon, enema reveals a filling defect, and cecal duplication can be suspected...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Jen-Fan Hang, Lei-Chi Wang, Chiung-Ru Lai
Here, we present the first cytological report of a primary splenic inflammatory pseudotumor-like follicular dendritic cell sarcoma. The 57 year-old male was incidentally found with a 2.2 cm well-demarcated splenic nodule. A sonography guided fine needle aspiration of the lesion was performed. The cytologic smears revealed loosely cohesive fragments of oval to spindle cells in a background of prominent lymphoplasmacytic infiltration. The cells showed sparse chromatin, distinct nucleoli, syncytial cell borders, and occasional cytoplasmic processes...
October 24, 2016: Diagnostic Cytopathology
Vigneshwaran Mani, Bhairav Paleja, Karima Larbi, Pavanish Kumar, Jo Ann Tay, Jie Yee Siew, Fatih Inci, ShuQi Wang, Cynthia Chee, Yee Tang Wang, Utkan Demirci, Gennaro De Libero, Amit Singhal
Access to point-of-care (POC), rapid, inexpensive, sensitive, and instrument-free tests for the diagnosis of tuberculosis (TB) remains a major challenge. Here, we report a simple and low-cost microchip-based TB ELISA (MTBE) platform for the detection of anti-mycobacterial IgG in plasma samples in less than 15 minutes. The MTBE employs a flow-less, magnet-actuated, bead-based ELISA for simultaneous detection of IgG responses against multiple mycobacterial antigens. Anti-trehalose 6,6'-dimycolate (TDM) IgG responses were the strongest predictor for differentiating active tuberculosis (ATB) from healthy controls (HC) and latent tuberculosis infections (LTBI)...
October 24, 2016: Scientific Reports
Susanna Nuvoli, Angela Spanu, Giuseppe Madeddu
As well known, the increase in life expectancy and the better physical condition of people in western countries will lead in the next 20 years to a dramatic development of neurodegenerative diseases, especially of dementia that could be considered one of the most important problems in clinical, social and economic fields for the future. Therefore, the differential diagnosis of the various types of dementia is a critical step for patients, clinicians and researchers since an accurate "in vivo" diagnosis can lead to a better patients management...
October 19, 2016: Current Alzheimer Research
Sara Maleki, Antonio Cajigas, Jason Moss, K H Ramesh, Samer Khader
We describe a case of synovial sarcoma originating from prostate gland. The diagnosis was confirmed by fluorescent in situ hybridization analysis (FISH) for SYT rearrangement on the cell block. Synovial sarcoma is a high grade soft tissue malignancy with exceedingly rare involvement of genitourinary tract. However this entity should be considered in the differential diagnosis when dealing with aspiration biopsies of particularly deep seated lesions with spindle cell or small round blue cell cytomorphology. Diagn...
October 24, 2016: Diagnostic Cytopathology
Amy E Felumlee, Angela J Marolf, Elissa K Randall, Annette M Bachand, Jessica M Quimby
Measurement of glomerular filtration rate (GFR) via gamma camera uptake of 99mTc-diethylenetriaminepentaacetic acid is a standard method for quantifying renal function. Aims of this retrospective, observer agreement study were to determine intra- and interobserver variation in GFR values for cats with chronic kidney disease and to determine whether renal insufficiency classification changed between observers. Guideline cut-points were established for the difference in repeated GFRs to differentiate changes caused by therapeutic effect vs...
October 23, 2016: Veterinary Radiology & Ultrasound
Giovanni Rizzo, Stefano Zanigni, Roberto De Blasi, Daniela Grasso, Davide Martino, Rodolfo Savica, Giancarlo Logroscino
Brain magnetic resonance (MR) represents a useful and feasible tool for the differential diagnosis of Parkinson's disease. Conventional MR may reveal secondary forms of parkinsonism and may show peculiar brain alterations of atypical parkinsonian syndromes. Furthermore, advanced MR techniques, such as morphometric-volumetric analyses, diffusion-weighted imaging, diffusion tensor imaging, tractography, proton MR spectroscopy, and iron-content sensitive imaging, have been used to obtain quantitative parameters useful to increase the diagnostic accuracy...
2016: Parkinson's Disease
Mark Benedict, Jose Costa
Papillary thyroid carcinoma is a common malignancy to affect the thyroid and is typified by a nonaggressive nature and low rates of mortality. In contrast, anaplastic thyroid carcinoma is the most aggressive thyroid malignancy with a mortality rate of nearly 90% and survival typically of only six months after the diagnosis is made. The transformation of papillary thyroid carcinoma to anaplastic thyroid carcinoma is well documented in the literature but is uncommon and in most instances is reported as a case report or small series only...
2016: Case Reports in Pathology
R M Medrano-Juarez, D Sotello, M A Orellana-Barrios, L D'Cuhna, J D Payne, K Nugent
We present a case of acute hemolytic anemia, renal failure, and Clostridium perfringens bacteremia in a patient with acute myelogenous leukemia. The high fatality of C. perfringens bacteremia requires that clinicians recognize and rapidly treat patients at risk for this infection. Although other hemolytic processes are in the differential diagnosis of these events, the presence of high fever, chills, and rapidly positive blood cultures may help narrow the diagnosis. Most cases of C. perfringens bacteremia have a concomitant coinfection, which makes broad spectrum empiric therapy essential...
2016: Case Reports in Infectious Diseases
Rayan Yousefzai, Setu Trivedi, Renuka Jain, Omar M Cheema, John D Crouch, Vinay Thohan, Bijoy K Khandheria
We present a 71-year-old male, who had had a heart transplantation 24 years prior, who came to our clinic with a low-grade fever and a new II/VI holosystolic murmur. Echocardiography showed a large mass in the right atrium with attachment near the junction of the right atrium and superior vena cava. The patient was taken to the operating room for resection of the mass. Microscopic evaluation was consistent with thrombus. Differential diagnosis of cardiac masses after cardiac transplant includes tumour, thrombus, and vegetation...
December 2015: ESC Heart Failure
Antonino Naro, Antonino Leo, Antonio Buda, Alfredo Manuli, Alessia Bramanti, Placido Bramanti, Rocco Salvatore Calabrò
Visual fixation (VF) of a target is a possible, although atypical, feature of the Unresponsive Wakefulness Syndrome (UWS). Whether VF may indicate residual awareness in these patients is debatable, since it may simply subtend a series of reflex processes. Objective tools should therefore be used to identify aware VF, which depends on the integrity of visuomotor networks encompassing frontal-parietal-occipital areas. The aim of our study was to detect residual visuomotor network functionality potentially sustaining aware VF...
October 20, 2016: Brain Research
J Lagarde, M Sarazin
Frontotemporal degeneration (FTD) in its behavioral variant (bvFTD) is probably one of the conditions that best illustrates the links between psychiatry and neurology. It is indeed admitted that between a third and half of patients with this condition, especially in early-onset forms, receive an initial diagnosis of psychiatric disorder (depression, schizophrenia, bipolar disorder) and are then referred to a psychiatric ward. BvFTD can thus be considered a neurological disorder with a psychiatric presentation...
October 20, 2016: L'Encéphale
Huanhao Zhou, Xiaojiao Ruan, Xia Shao, Xiaming Huang, Guan Fang, Xiaofeng Zheng
BACKGROUND: Diagnosis of incarcerated inguinal hernia (IIH) is not difficult, but currently, there are no diagnostic criteria that can be used to differentiate it from strangulated inguinal hernia (SIH). This research aimed to evaluate the clinical value of the neutrophil/lymphocyte ratio (NLR) in diagnosing SIH. METHODS: We retrospectively analyzed 263 patients with IIH who had undergone emergency operation. The patients were divided into two groups according to IIH severity: group A, patients with pure IIH validated during operation as having no bowel ischemia; group B, patients with SIH validated during operation as having obvious bowel ischemia, including bowel necrosis...
October 19, 2016: International Journal of Surgery
Kouichi Misaki, Naoyuki Uchiyama, Masanao Mohri, Yasuhiro Aida, Takehiro Uno, Mitsutoshi Nakada
Dural arteriovenous fistulas (DAVFs) presenting with ocular symptoms, such as exophthalmos and chemosis, are commonly situated in cavernous sinus (CS). DAVFs at the sphenoid wing with a drainage route into the superior orbital vein (SOV) should be considered as one of differential diagnosis of ocular symptoms. A 41-year-old woman presented with progressive left-sided chemosis and proptosis after left pulsating tinnitus that disappeared spontaneously. Cerebral angiography showed that the fistula was situated along the inferior edge of the superior orbital fissure on the greater sphenoid wing and drained solely into the SOV without flowing into the CS that caused ocular symptoms...
October 19, 2016: World Neurosurgery
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