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https://www.readbyqxmd.com/read/28647893/the-overdiagnosis-of-what-on-the-relationship-between-the-concepts-of-overdiagnosis-disease-and-diagnosis
#1
Bjørn Hofmann
Overdiagnosis and disease are related concepts. Widened conceptions of disease increase overdiagnosis and vice versa. This is partly because there is a close and complex relationship between disease and overdiagnosis. In order to address the problems with overdiagnosis, we may benefit from a closer understanding this relationship. Accordingly, the objective of this article is to elucidate the relationship between disease and overdiagnosis. To do so, the article starts with scrutinizing how overdiagnosis can explain the expansion of the concept of disease...
June 24, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28647843/alarming-increase-in-the-registration-of-degenerative-rotator-cuff-related-lesions-a-nationwide-epidemiological-study-investigating-244-519-patients
#2
Nina Monrad, Ann Ganestam, Thomas Kallemose, Kristoffer Weisskirchner Barfod
PURPOSE AND HYPOTHESIS: Shoulder lesions are common and a challenge to diagnose. They often result in significant disability for the patient and are an economic burden to society. From recent studies, an increasing incidence has been reported. The purpose of this study was to investigate and map the incidence of shoulder lesions in Denmark from 1996 to 2013 with focus on sex, age and geographical area. METHODS: The Danish National Patient Registry was searched retrospectively to find the number of shoulder lesions in Denmark during the period 1996-2013...
June 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28647396/testicular-cancer-the-usage-of-central-review-for-pathology-diagnosis-of-orchiectomy-specimens
#3
Saul E Harari, Daniel J Sassoon, David S Priemer, Joseph M Jacob, John N Eble, Anna Caliò, David J Grignon, Mohammed Idrees, Costantine Albany, Timothy A Masterson, Nasser H Hanna, Richard S Foster, Thomas M Ulbright, Lawrence H Einhorn, Liang Cheng
BACKGROUND: Radical orchiectomy specimens present a unique set of challenges for pathology assessment owing to their rarity and complexity. This study compares second opinion pathology reports generated at a single, large academic institution to primary reports from outside hospitals. METHODS: A database search was conducted for orchiectomy cases that were sent to our institution for management of testicular cancer from 2014 to 2015. Cases sent for consultation without a finalized diagnosis from the outside hospitals were excluded...
June 21, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28647377/establishing-rarity-in-the-context-of-orphan-medicinal-product-designation-in-the-european-union
#4
REVIEW
Stelios Tsigkos, Matthias Hoffer, Maria Sheean, Segundo Mariz, Kristina Larsson, Frauke Naumann-Winter, Laura Fregonese, Bruno Sepodes
In the European Union (EU) legislative framework for orphan medicinal product designation, establishing that a condition affects not more than five in 10 000 people is a prerequisite for applications based on rarity. Demonstrating this requirement to the Committee of Orphan Medicinal Products (COMP) can be a particularly challenging task for sponsors. Here, we identify and examine three common issues with the estimation of prevalence in orphan drug applications in the EU (the discernment between diagnosed and undiagnosed cases; the duration of the disease; and the need for an explicit contemporary conclusion) as critical factors for acceptable prevalence estimation...
June 21, 2017: Drug Discovery Today
https://www.readbyqxmd.com/read/28647164/liver-transplantation-in-new-orleans-parity-in-a-world-of-disparity
#5
Alison A Smith, Michael Darden, Zaid Al-Qurayshi, Anil S Paramesh, Mary Killackey, Emad Kandil, Geoffrey Parker, Luis Balart, Paul Friedlander, Joseph F Buell
BACKGROUND: Racial disparity in access to liver transplantation among African Americans (AA) compared to Caucasians (CA) has been well described. The aim of this investigation was to examine the presentation of AA liver transplant recipients in a socioeconomically challenged region. METHODS: 680 adult liver transplant candidates and 233 resultant recipients between 2007 and 2015 were analyzed using univariate and multivariate analyses to evaluate factors significant for transplantation...
June 21, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28645968/development-of-a-meta-algorithm-for-guiding-primary-care-encounters-for-patients-with-multimorbidity-using-evidence-based-and-case-based-guideline-development-methodology
#6
Cathleen Muche-Borowski, Dagmar Lühmann, Ingmar Schäfer, Rebekka Mundt, Hans-Otto Wagner, Martin Scherer
OBJECTIVE: The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. STUDY DESIGN: Systematic guideline development methodology including systematic evidence retrieval (guideline synopses), expert opinions and informal and formal consensus procedures...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645742/gastrointestinal-stromal-tumors-gist-presenting-in-the-liver-diagnostic-prognostic-and-therapeutic-issues
#7
Natacha Joyon, Jérôme Dumortier, Aude Aline-Fardin, Caroline Caramella, Pierre-Jean Valette, Jean-Yves Blay, Jean-Yves Scoazec, Peggy Dartigues
CONTEXT: Extra-gastrointestinal stromal tumors (E-GIST) presenting in the liver are exceedingly rare and raise difficult diagnostic and therapeutic challenges. METHODS: We report on two cases of liver E-GIST with different clinical presentations. We describe their clinical and imaging features, their histopathological and molecular characteristics, their treatment and their course. RESULTS: The first case was that of a 56-year-old male presenting with a 10-cm liver mass; the initial diagnosis, made in 1986 from a biopsy sample, was leiomyosarcoma; liver transplantation was performed in 1987; no extra-hepatic tumor was found; the course was uneventful until 1999, when tumor recurrence was diagnosed along the initial biopsy route; after reevaluation of available material, the definitive pathological diagnosis was GIST; imatinib treatment resulted in major response; the patient died of end-stage kidney disease 22 years after the initial diagnosis and 9 years after tumor recurrence...
June 20, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28645262/acute-myeloid-leukemia-and-pregnancy-clinical-experience-from-a-single-center-and-a-review-of-the-literature
#8
Nicola Stefano Fracchiolla, Mariarita Sciumè, Francesco Dambrosi, Francesca Guidotti, Manuela Wally Ossola, Giovanna Chidini, Umberto Gianelli, Daniela Merlo, Agostino Cortelezzi
BACKGROUND: Acute myeloid leukemia (AML) accounts for more than two thirds of leukemia during pregnancy and has an incidence of 1 in 75,000 to 100,000. Its clinical management remains a challenging therapeutic task both for patient and medical team, given to the therapy-attributable risks for mother and fetus and the connected counseling regarding pregnancy continuation. METHODS: We provided a review of updated literature and a comprehensive description of five maternal/fetal outcomes of AML cases diagnosed concomitantly to pregnancy and treated at our Institution from 2006 to 2012...
June 23, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28644948/traumatic-buccal-fat-pad-herniation-in-young-children-a-systematic-review-and-case-report
#9
Seon-Yeong Kim, Angenine Alfafara, Jin-Woo Kim, Sun-Jong Kim
PURPOSE: Traumatic herniation of a buccal fat pad, predominantly seen in young children, is a rare condition. Because of its rarity and clinical features that resemble tumors, clinicians are faced with challenges at the initial diagnosis. This report describes a case of buccal fat pad herniation with excellent long-term prognosis after surgical relocation and conservative treatment and presents a systematic review of the literature on its management. MATERIALS AND METHODS: Through a PubMed search, 811 articles were initially identified...
May 30, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28644402/choosing-surgery-for-neurogenic-tos-the-roles-of-physical-exam-physical-therapy-and-imaging
#10
REVIEW
David P Kuwayama, Jason R Lund, Charles O Brantigan, Natalia O Glebova
Neurogenic thoracic outlet syndrome (nTOS) is characterized by arm and hand pain, paresthesias, and sometimes weakness resulting from compression of the brachial plexus within the thoracic outlet. While it is the most common subtype of TOS, nTOS can be difficult to diagnose. Furthermore, patient selection for surgical treatment can be challenging as symptoms may be vague and ambiguous, and diagnostic studies may be equivocal. Herein, we describe some approaches to aid in identifying patients who would be expected to benefit from surgical intervention for nTOS...
June 23, 2017: Diagnostics
https://www.readbyqxmd.com/read/28642287/genetic-screening-in-sporadic-als-and-ftd
#11
EDITORIAL
Martin R Turner, Ammar Al-Chalabi, Adriano Chio, Orla Hardiman, Matthew C Kiernan, Jonathan D Rohrer, James Rowe, William Seeley, Kevin Talbot
The increasing complexity of the genetic landscape in amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) presents a significant resource and physician training challenge. At least 10% of those diagnosed with ALS or FTD are known to carry an autosomal dominant genetic mutation. There is no consensus on what constitutes a positive family history, and ascertainment is unreliable for many reasons. However, symptomatic individuals often wish to understand as much as possible about the cause of their disease, and to share this knowledge with their family...
June 22, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28641213/measurement-properties-of-screening-and-diagnostic-tools-for-autism-spectrum-adults-of-mean-normal-intelligence-a-systematic-review
#12
A Baghdadli, F Russet, L Mottron
BACKGROUND: The autism spectrum (AS) is a multifaceted neurodevelopmental variant associated with lifelong challenges. Despite the relevant importance of identifying AS in adults for epidemiological, public health, and quality of life issues, the measurement properties of the tools currently used to screen and diagnose adults without intellectual disabilities (ID) have not been assessed. OBJECTIVES: This systematic review addresses the accuracy, reliability, and validity of the reported AS screening and diagnostic tools used in adults without ID...
May 17, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/28640706/adult-glioblastoma
#13
Brian M Alexander, Timothy F Cloughesy
Glioblastoma (GBM) is a rare tumor and one of the most challenging malignancies to treat in all of oncology. Although advances have been made in the treatment of GBM, encouraging outcomes typically are not observed; patients diagnosed with these tumors generally have a dismal prognosis and poor quality of life as the disease progresses. This review summarizes the clinical presentation of GBM, diagnostic methods, evidentiary basis for the current standards of care, and investigational approaches to treat or manage GBM...
June 22, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28640705/genomic-analysis-of-childhood-brain-tumors-methods-for-genome-wide-discovery-and-precision-medicine-become-mainstream
#14
Stephen C Mack, Paul A Northcott
Recent breakthroughs in next-generation sequencing technology and complementary genomic platforms have transformed our capacity to interrogate the molecular landscapes of human cancers, including childhood brain tumors. Numerous high-throughput genomic studies have been reported for the major histologic brain tumor entities diagnosed in children, including interrogations at the level of the genome, epigenome, and transcriptome, many of which have yielded essential new insights into disease biology. The nature of these discoveries has been largely platform dependent, exemplifying the usefulness of applying different genomic and computational strategies, or integrative approaches, to address specific biologic and/or clinical questions...
June 22, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28639967/ras-positive-thyroid-nodules
#15
Trevor E Angell
PURPOSE OF REVIEW: The current review focuses on the uncertainty regarding the management of rat sarcoma viral oncogene homolog RAS-positive thyroid nodules. The application of oncogene testing has been heralded for improving risk assessment for indeterminate cytology thyroid nodules and has grown in clinical use. RAS mutations are historically considered oncogenic. However, RAS mutation detection in thyroid nodules has proven problematic, as these mutations are found in benign and malignant lesions...
July 20, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28639937/a-multicentre-randomised-controlled-trial-of-intravenous-immunoglobulin-compared-with-standard-therapy-for-the-treatment-of-transverse-myelitis-in-adults-and-children-strive
#16
Michael Absoud, Peter Brex, Olga Ciccarelli, Onyinye Diribe, Gavin Giovannoni, Jennifer Hellier, Rosemary Howe, Rachel Holland, Joanna Kelly, Paul McCrone, Caroline Murphy, Jackie Palace, Andrew Pickles, Michael Pike, Neil Robertson, Anu Jacob, Ming Lim
BACKGROUND: Transverse myelitis (TM) is an immune-mediated disorder of the spinal cord that affects adults and children and that causes motor, sensory and autonomic dysfunction. There is a prolonged recovery phase, which may continue for many years. Neuromyelitis optica (NMO) is an uncommon relapsing inflammatory central nervous system condition in which TM can be the first presenting symptom. As TM and NMO affect many patients in the prime of their working life, the disorder can impose a significant demand on health resources...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28639597/evaluation-of-75-g-glucose-load-in-non-fasting-state-diabetes-in-pregnancy-study-group-of-india-dipsi-criteria-as-a-diagnostic-test-for-gestational-diabetes-mellitus
#17
Reva Tripathi, Divya Verma, Vinod Kumar Gupta, Shakun Tyagi, M Kalaivani, Siddarth Ramji, Y M Mala
BACKGROUND & OBJECTIVES: There is no consensus regarding optimal standard for diagnosis of gestational diabetes mellitus (GDM). In this study, use of 75 g glucose load in non-fasting state [Diabetes in Pregnancy Study Group of India (DIPSI) criteria] as a diagnostic test for GDM in pregnant women was compared with different oral glucose tolerance tests (OGTTs). METHODS: This prospective study included 936 pregnant women, who underwent plasma glucose evaluation two hours after the challenge of 75 g glucose load irrespective of the timing of last meal (DIPSI criteria for GDM)...
February 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28639482/-always-looking-for-a-new-balance-toward-an-understanding-of-what-it-takes-to-continue-working-while-being-diagnosed-with-relapsing-remitting-multiple-sclerosis
#18
Hanneke van der Meide, Dennis van Gorp, Karin van der Hiele, Leo Visser
BACKGROUND: The aim of this study was to gain insight into the meaning of work in the everyday lives of people with relapsing-remitting multiple sclerosis, and the barriers and facilitators to staying in work. METHODS: Nineteen employed adults diagnosed with relapsing-remitting multiple sclerosis participated in narrative interviews. All interviews were transcribed and coded for thematic analysis. RESULTS: For people with relapsing-remitting multiple sclerosis, continuing to work was a precarious balancing act...
June 22, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28639144/rural-versus-urban-compliance-in-the-management-of-cryptorchidism-is-there-a-difference
#19
Dana Point, Chad Morley, Ali Tourchi, Sunil Reddy, Pokket Sirisreetreerux, John Gearhart, Osama Al-Omar
The authors compared the age and referral patterns of pediatric patients undergoing surgical intervention for cryptorchidism at a rural, West Virginia University, versus urban, Johns Hopkins University, tertiary center. A retrospective review of patients undergoing surgical evaluation for cryptorchidism was performed. Patients treated for reasons unrelated to cryptorchidism or referred for multiple urologic diagnoses were excluded. The patients at each institution were then divided into four groups based on their corrected gestational age at time of surgery...
June 21, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28639000/infections-in-neurocritical-care
#20
John C O'Horo, Priya Sampathkumar
Neurointensive care (NICU) patients experience complex infectious disease challenges. Central nervous system (CNS) infections are difficult to diagnose and treat, and post-neurosurgical patients are vulnerable to a unique set of healthcare-acquired infections (HAI) in addition to those typical of critically ill patients. The purpose of this review is to summarize the approach to suspected infection in the NICU and discuss management of several infectious syndromes in the NICU setting.
June 21, 2017: Neurocritical Care
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