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Pathology Consultation

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https://www.readbyqxmd.com/read/28548201/-morphine-induced-biliary-pain-case-report
#1
Zoltán Berger, Mario Arcos, Fernanda Matamala, Claudia Rojas
Morphine produces contraction of Oddi’s sphincter, which can be severe and of longer duration in some pathological conditions. This exaggerated response can manifest as a colicky biliary pain, frequently accompanied by a dramatic increase in hepatic enzymes. We report a 32 years old female who consulted in the emergency room for severe low abdominal pain of gynecologic origin, which was completely controlled by morphine. However, she presented a sudden epigastric colicky pain irradiating in the back, which persisted for several hours in spite of the repeated administration of analgesics...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28540038/effectiveness-of-paliperidone-depot-injection-in-seriously-violent-men-with-comorbid-schizophrenia-and-dissocial-personality-disorder-in-a-uk-high-security-hospital
#2
Anna-Marie Mortlock, Fintan Larkin, Callum C Ross, Nitin Gupta, Samrat Sengupta, Mrigendra Das
BACKGROUND: High-security hospital patients are often complex in presentation and are characterized by treatment resistance, medication nonadherence and history of violence. Paliperidone is licensed both as an oral and depot antipsychotic medication in the treatment of schizophrenia. Clinical trials have shown that paliperidone depot is well tolerated with similar efficacy to risperidone depot but with additional practical advantages. Whilst data exist for the effectiveness of paliperidone palmitate (PP), there are no studies involving patients in forensic settings or those with comorbid personality disorder...
May 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28537805/pathology-of-chronic-hypersensitivity-pneumonitis-what-is-it-what-are-the-diagnostic-criteria-why-do-we-care
#3
Andrew Churg, AnaMaria Bilawich, Joanne L Wright
CONTEXT: - Chronic hypersensitivity pneumonitis (CHP) has emerged from obscurity during the past 15 years and is now recognized as a very common form of fibrosing interstitial pneumonia but one that is frequently misdiagnosed both clinically and on surgical lung biopsy as usual interstitial pneumonia/idiopathic pulmonary fibrosis (UIP/IPF) or fibrotic nonspecific interstitial pneumonia. OBJECTIVE: - To review the pathologic features of CHP. DATA SOURCES: - Clinical, pathology, and radiology literature were used...
May 24, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28527289/-characterization-of-patients-with-skeletal-genetic-diseases-in-a-colombian-referral-center
#4
Harvy Mauricio Velasco, Lina Patricia Buelvas
INTRODUCTION: Short height in Colombia has an estimated prevalence of 10%. The 2009 Nosology and Classification of Skeletal Genetic Diseases described 456 clinical conditions using biochemical, molecular and radiological criteria for diagnosis. OBJECTIVE: To analyze demographic, epidemiological and clinical variables in a group of patients with skeletal genetic diseases referred to the Instituto de Ortopedia Infantil Roosevelt. MATERIALS AND METHODS: Patients referred between 2008 and 2014 were analyzed filtering 167 diagnoses of the International Classification of Diseases, 10th revision (ICD 10), related to skeletal genetic diseases...
June 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28524340/effectiveness-and-clinical-inertia-in-patients-with-antidiabetic-therapy
#5
Manuel Enrique Machado-Duque, Adriana Carolina Ramírez-Riveros, Jorge Enrique Machado-Alba
AIMS: To establish the effectiveness of antidiabetic therapy and the frequency of clinical inertia in the management of type 2 diabetes mellitus in Colombia. METHODS: A cross-sectional study with follow-up of patients who had been treated for at least 1 year and were receiving medical consultation for antidiabetic treatment. Effectiveness was established when haemoglobin-A1c levels were <7% and when clinical inertia was reached, which was defined as no therapeutic modifications despite not achieving management controls...
May 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28522132/salivary-pepsin-test-useful-and-simple-tool-for-the-laryngopharyngeal-reflux-diagnosis
#6
Luz Barona-Lleó, Claudia Duval, Rafael Barona-de Guzmán
INTRODUCTION AND OBJECTIVES: Laryngopharyngeal Reflux (LPR) is a disease characterized by the presence of symptoms, signs and tissue damage caused by retrograde flow of gastric contents to the upper aerodigestive tract. It represents up to 10% of otolaryngology consultations. The aim of the study is to describe the findings obtained by applying the salivary pepsin test (PEP-test) in a sample of patients with the clinical suspicion of LPR. MATERIAL AND METHODS: Our descriptive clinical study included 142 subjects with symptoms suggestive of LPR and a score above 13 on the RSI scale...
May 15, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28521835/adult-autoimmune-enteropathy-presenting-initially-with-acquired-acrodermatitis-enteropathica-a-case-report
#7
Erina Lie, Sarah Sung, Steven Hoseong Yang
BACKGROUND: Acrodermatitis enteropathica (AE) is a rare dermatitis secondary to zinc deficiency most commonly seen as an inherited disease in infants. In the last decade, increased number of reports have been published on the acquired form that presents in adulthood. Unlike its inherited counterpart, acquired AE (AAE) is often secondary to underlying pathologic or iatrogenic etiologies that interfere with nutritional absorption, such as inflammatory bowel disease or alcoholism. Various gastrointestinal pathologies have been associated with AAE, but there is currently no report on its association with adult autoimmune enteropathy (AIE), a rare gastrointestinal disorder commonly seen in infants, with limited cases reported in adults...
May 18, 2017: BMC Dermatology
https://www.readbyqxmd.com/read/28511385/intra-operative-diagnosis-of-breast-lesions-by-imprint-cytology-and-frozen-section-with-histopathological-correlation
#8
Asha Mahadevappa, Thattamparambil Gopalakrishnan Nisha, Gubbanna V Manjunath
INTRODUCTION: The most common malignant tumour among women is breast carcinoma. Early lesions of the breast including carcinoma are potentially curable if treated properly in the era of breast conservative therapy. For this purpose different diagnostic strategies are in practice. Intra operative Imprint Cytology (IC) and Frozen Section (FS) have a role in spite of the intense recognition of aspiration cytology in the following settings: inconclusive cytological/core biopsy findings; for evaluation of lumpectomy margins and intra operative nodal status...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28508991/digital-stethoscopes-compared-to-standard-auscultation-for-detecting-abnormal-paediatric-breath-sounds
#9
Ajay C Kevat, Anaath Kalirajah, Robert Roseby
Our study aimed to objectively describe the audiological characteristics of wheeze and crackles in children by using digital stethoscope (DS) auscultation, as well as assess concordance between standard auscultation and two different DS devices in their ability to detect pathological breath sounds. Twenty children were auscultated by a paediatric consultant doctor and digitally recorded using the Littman™ 3200 Digital Electronic Stethoscope and a Clinicloud™ DS with smart device. Using spectrographic analysis, we found those with clinically described wheeze had prominent periodic waveform segments spanning expiration for a period of 0...
May 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28508008/the-coracoacromial-ligament-anatomy-function-and-clinical-significance
#10
Adam Rothenberg, Gregory Gasbarro, Jesse Chlebeck, Albert Lin
The coracoacromial ligament (CAL) was first described as a pain generator by Dr Charles Neer in the early 1970s. Since that time, considerable controversy regarding CAL management during acromioplasty has persisted. This review aims to better understand the role of the CAL in shoulder physiology and pathology. Sixty-six articles from 1958 to 2016 were identified using an electronic search of PubMed, Cochrane Library, AccessMedicine, and MD Consult for case series as well as cohort and prospective studies. The authors used "coracoacromial ligament" and "coracoacromial veil" as medical subject headings (MeSH)...
April 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28506733/variant-morphology-in-upper-urinary-tract-urothelial-carcinoma-a-fourteen-year-case-series-of-biopsy-and-resection-specimens
#11
Hiroyuki Hayashi, Steven Mann, Chia-Sui Kao, David Grignon, Muhammad T Idrees
Upper urinary tract urothelial carcinoma exhibiting variant morphology, especially in higher-grade tumors, is a recognized phenomenon but has not been comparatively studied in biopsy versus resection material. We studied the morphologic patterns and clinicopathological features, and provide a comparison between biopsy and resection specimens. Consultation cases were evaluated separately to investigate for possible consultation bias. A total of 383 in-house cases from 352 patients including 314 resection specimens and 69 biopsies from 2001-2014 were reviewed from a single institution...
May 12, 2017: Human Pathology
https://www.readbyqxmd.com/read/28504491/profile-of-spontaneous-demand-for-services-among-infants-younger-than-30-days-old-at-a-children-s-tertiary-care-hospital
#12
Soledad Arbio, Nicolás Brunner, Eugenio Pierro, Susana Rodríguez, Diana Fariña
INTRODUCTION: In recent years, admission of critical newborn infants (NBIs) to the neonatal intensive care unit of Hospital Garrahan (HG) has been limited due to the hospitalization of infants younger than 30 days old through spontaneous demand for services. This is probably a multifactorial situation, and one of its causes is a lack of regionalization, which results in an inadequate use of resources or a distorted use of resources intended for more complex care. OBJECTIVE: To establish the profile of NBIs who make a spontaneous demand for services at HG and to assess the level of care required based on their medical condition...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28502218/recommendations-to-reduce-inequalities-for-lgbt-people-facing-advanced-illness-accesscare-national-qualitative-interview-study
#13
Katherine Bristowe, Matthew Hodson, Bee Wee, Kathryn Almack, Katherine Johnson, Barbara A Daveson, Jonathan Koffman, Linda McEnhill, Richard Harding
BACKGROUND: Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. AIM: To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28483364/how-to-investigate-a-child-with-excessive-growth
#14
Régis Coutant, Aurélie Donzeau, Anne Decrequy, Mathilde Louvigné, Natacha Bouhours-Nouet
The diagnostic approach to tall stature in children is based on collecting birth data (macrosomia), sizes and family puberty, a family history of constitutional or pathological tall stature, search for a delay of development, dysmorphia, disproportion, analysis of the growth velocity (normal or accelerated), general examination and assessment of puberty, and bone age. When there is a history of psychomotor retardation, a family history of pathological tall stature, or a disproportion in the clinical examination, the genetic causes of tall stature will be mentioned...
May 5, 2017: Annales D'endocrinologie
https://www.readbyqxmd.com/read/28483240/management-of-non-organic-hearing-loss-in-children-a-case-study
#15
Piotr Henryk Skarzynski, Danuta Raj-Koziak, Joanna Jadwiga Rajchel, Henryk Skarzynski
A 10 year-old girl was admitted due to the claim of progressively developing hearing loss. The impedance audiometry showed no abnormalities but it was impossible to obtain reliable outcomes during pure tone audiometry assessment. The girl was additionally sent for speech audiometry, indicating a bilateral hearing loss and objective evaluations such as distortion product otoacoustic emissions and auditory brainstem responses, which results indicated a normal hearing. On the second day, repeated subjective audiometric tests showed also normal hearing, despite constantly reported hearing loss...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28474111/ct-guided-transosseous-soft-tissue-biopsy-techniques-outcomes-and-complications-in-50-cases
#16
Monzer Chehab, Stephen Zintsmaster, Syed Zafar Jafri, Mark Richards, Anindya Roy
PURPOSE: To describe the techniques, outcomes and complications of CT-guided transosseous biopsy of soft tissue lesions via multiple different routes. MATERIALS AND METHODS: Clinical and radiologic data from all consecutive soft tissue biopsies performed via a transosseous approach between April 2009 and July 2015 were retrospectively compiled. Fifty biopsies performed in 50 patients (n = 17 males, n = 33 females) were included. Biopsies were performed using a 13-gauge biopsy needle which was advanced through the selected bone to the lesion margin followed by coaxial placement of either an 18- or 20-gauge biopsy gun...
May 4, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28465449/characteristics-associated-with-requests-by-pathologists-for-second-opinions-on-breast-biopsies
#17
Berta M Geller, Heidi D Nelson, Donald L Weaver, Paul D Frederick, Kimberly H Allison, Tracy Onega, Patricia A Carney, Anna N A Tosteson, Joann G Elmore
AIMS: Second opinions in pathology improve patient safety by reducing diagnostic errors, leading to more appropriate clinical treatment decisions. Little objective data are available regarding the factors triggering a request for second opinion despite second opinion consultations being part of the diagnostic system of pathology. Therefore we sought to assess breast biopsy cases and interpreting pathologists characteristics associated with second opinion requests. METHODS: Collected pathologist surveys and their interpretations of 60 test set cases were used to explore the relationships between case characteristics, pathologist characteristics and case perceptions, and requests for second opinions...
May 2, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28447899/the-american-college-of-surgeons-minimum-standards-for-hospitals-and-the-provision-of-high-quality-laboratory-services
#18
James R Wright
CONTEXT: - The first major project of the American College of Surgeons (Chicago, Illinois), founded in 1913, was implementing Minimum Standards for Hospitals. The 1918 standard (1) established medical staff organizations in hospitals; (2) restricted membership to licensed practitioners in good standing; (3) mandated that the medical staff work with hospital administration to develop and adopt regulations and policies governing their professional work; (4) required standardized, accessible medical records; and (5) required availability of diagnostic and therapeutic facilities...
May 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28440660/implementation-of-whole-slide-imaging-for-clinical-purposes-issues-to-consider-from-the-perspective-of-early-adopters
#19
Andrew J Evans, Mohamed E Salama, Walter H Henricks, Liron Pantanowitz
CONTEXT: - There is growing interest in the use of digital pathology, especially whole slide imaging, for diagnostic purposes. Many issues need to be considered when incorporating this technology into a clinical laboratory. The College of American Pathologists established a Digital Pathology Committee to support the development of College programs related to digital pathology. One of its many initiatives was a panel discussion entitled "Implementing Whole-Slide Imaging for Clinical Use: What to Do and What to Avoid," given for 3 years at the College's annual meetings starting in 2014...
April 25, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28437672/eosinophilic-funiculitis-initially-diagnosed-as-irreducible-inguinal-hernia-a-case-report
#20
Kohei Yamada, Akashi Ikubo, Shota Ikeda, Satoko Koga, Yasuhiro Tsuru, Hideo Kuroki, Naohiko Koya, Ryuichiro Samejima, Masashi Sakai, Masanobu Tabuchi, Seiji Yunotani, Shinichi Kido, Kazushige Nishimura, Hiroyuki Meiri
BACKGROUND: Most groin masses are first suspected to be groin hernias. More than 80% of bulging groin lesions are reportedly diagnosed as hernias by ultrasonography. Establishment of the correct diagnosis of hernia among all differential diagnoses is not easy. We herein describe a very rare case of groin eosinophilic funiculitis that presented as an irreducible groin hernia. CASE PRESENTATION: A 59-year-old man presented to our hospital with suspicion of a right groin hernia...
April 5, 2017: International Journal of Surgery Case Reports
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