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https://www.readbyqxmd.com/read/28432659/current-role-of-blood-and-urine-biomarkers-in-the-clinical-care-of-adults-with-congenital-heart-disease
#1
REVIEW
Saurabh Rajpal, Laith Alshawabkeh, Alexander R Opotowsky
PURPOSE OF REVIEW: There is an increasing number of adult patients with congenital heart disease (CHD). While several biomarkers have been validated and integrated into general cardiology clinical practice, these tests are often applied to adults with CHD in the absence of disease-specific validation. Although these patients are often grouped into a single population, there is heterogeneous pathophysiology, variable disease chronicity, extensive multisystem involvement, and a low event rate relative to acquired heart disease...
June 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28429200/achalasia-it-is-not-all-black-and-white
#2
REVIEW
Santosh Sanagapalli, Rami Sweis
PURPOSE OF REVIEW: This review aims to shed light on subtleties of achalasia diagnosis, including potential pitfalls that may lead to errors. Optimal methods for assessment of disease severity and the relationship between achalasia and other motility disorders will also be reviewed with an emphasis on recent findings from the literature. RECENT FINDINGS: Adjunctive testing with viscous substances or larger water volumes should be used routinely as it improves the accuracy of achalasia diagnosis...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28421710/synovial-sarcoma-metastatic-to-the-parotid-gland-a-possible-pitfall-in-salivary-gland-fine-needle-aspiration-cytology-report-of-a-case-with-immunocytochemical-and-fluorescence-in-situ-hybridization-findings
#3
Franco Fulciniti, Jessica Barizzi, Vittoria Martin, Vittorio Tarallo, Stefano Ermanni
We report one case of metastatic synovial sarcoma (SS) to the parotid gland in a 93-year-old male. The patient had undergone upper left pulmonary lobectomy with mediastinal lymphadenectomy for SS of the lung 5 years before. The cytopathologic presentation and the immunocytochemical findings on the FNA sample were suggestive of a spindle cell myoepithelioma, while a SYT rearrangement was identified by a FISH performed on a cytological smear of the lesion. The diagnosis was further confirmed also by positive immunocytochemical expression of TLE1 on a section from the obtained cell block...
April 19, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28413206/differential-diagnostic-significance-of-hbme-1-ck19-and-s100-in-various-thyroid-lesions
#4
S Palo, D S Biligi
OBJECTIVE: Due several overlapping histomorphological features and pitfalls in thyroid pathology, there is need to establish a panel of immunomarkers that would aid in proper diagnosis. This study was carried out to investigate the ability of HBME-1, CK19, and S100 in differentiating between hyperplastic, benign and malignant thyroid lesions. MATERIALS AND METHODS: Immunohistochemical analysis of 60 thyroidectomy specimens (10 hyperplastic nodules, 14 follicular adenomas and 36 malignant thyroid neoplasms) was carried out...
April 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28411397/chondrosarcoma-like-metastasis-from-a-poorly-differentiated-uterine-cervical-squamous-cell-carcinoma-a-unique-morphology-and-diagnostic-pitfall-in-cytology
#5
Shohei Ikoma, Marlo Nicolas, Jaishree Jagirdar, Maria Luisa Policarpio-Nicolas
Rare cases of metastatic squamous cell carcinoma with chondroid differentiation from esophageal primary have been reported but none from the uterine cervix. Given the rarity of this phenomenon and potential diagnostic pitfall, we present this unusual case. The patient is a 25-year-old woman who presented with shortness of breath. Computerized tomography (CT) showed several lung and pleural-based nodules. CT-guided core biopsy with touch preparations were performed on the pleural-based nodule. The touch preparations showed large, spindle-to-oval shaped cells with pleomorphic nuclei embedded in metachromatic chondroid stroma...
April 14, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28399846/palliative-sedation-challenging-the-professional-competency-of-health-care-providers-and-staff-a-qualitative-focus-group-and-personal-written-narrative-study
#6
Danièle Leboul, Régis Aubry, Jean-Michel Peter, Victor Royer, Jean-François Richard, Frédéric Guirimand
BACKGROUND: Despite recent advances in palliative medicine, sedating a terminally ill patient is regarded as an indispensable treatment to manage unbearable suffering. With the prospect of widespread use of palliative sedation, the feelings and representations of health care providers and staff (carers) regarding sedation must be carefully explored if we are to gain a better understanding of its impact and potential pitfalls. The objective of the study was to provide a comprehensive description of the opinions of carers about the use of sedation practices in palliative care units (PCU), which have become a focus of public attention following changes in legislation...
April 11, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28398699/pneumocytoma-sclerosing-hemangioma-a-potential-pitfall
#7
Erika Hissong, Rema Rao
Pneumocytoma is an uncommon benign tumor of the lung, derived from primitive respiratory epithelium, with a predilection for middle-aged females. A single, well-circumscribed mass is commonly identified on imaging, necessitating pathologic evaluation for further assessment. Fine-needle aspiration cytology is a minimally invasive and cost-effective method that can be utilized in the diagnosis of these lesions. Yet, distinction of pneumocytoma from other entities such as well-differentiated adenocarcinoma or carcinoid tumor can be quite challenging...
April 11, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28393379/surveillance-neck-sonography-after-thyroidectomy-for-papillary-thyroid-carcinoma-pitfalls-in-the-diagnosis-of-locally-recurrent-and-metastatic-disease
#8
Wynne Yuru Chua, Jill E Langer, Lisa P Jones
A sonographic examination of the neck performed 6 to 12 months after thyroid surgery in patients with differentiated thyroid cancer is strongly recommended by the American Thyroid Association and considered mandatory by the European Thyroid Association for locoregional surveillance. The aim of this article is to review the normal anatomic changes expected after thyroid surgery and the pathologic mimics of thyroid carcinoma recurrence in post-thyroidectomy patients as they appear on neck sonography. We hope to offer some pearls to increase diagnostic confidence in this setting...
April 10, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28393061/nasopharyngeal-carcinoma-with-cystic-cervical-metastasis-masquerading-as-branchial-cleft-cyst-a-potential-pitfall-in-diagnosis-and-management
#9
Lum Sai-Guan, Kong Min-Han, Ngan Kah-Wai, Mohd-Razif Mohamad-Yunus
INTRODUCTION: Most metastatic lymph nodes from head and neck malignancy are solid. Cystic nodes are found in 33% - 61% of carcinomas arise from Waldeyer's ring, of which only 1.8% - 8% originate are from the nasopharynx. Some cystic cervical metastases were initially presumed to be branchial cleft cyst. This case report aims to highlight the unusual presentation of cystic cervical metastasis secondary to nasopharyngeal carcinoma in a young adult. The histopathology, radiological features and management strategy were discussed...
March 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28392828/screening-of-wilson-s-disease-in-a-psychiatric-population-difficulties-and-pitfalls-a-preliminary-study
#10
Caroline Demily, François Parant, David Cheillan, Emmanuel Broussolle, Alice Pavec, Olivier Guillaud, Lioara Restier, Alain Lachaux, Muriel Bost
BACKGROUND: Wilson's disease (WD) is a rare autosomal-recessive, inherited disorder caused by a mutation in the copper-transporting gene ATP7B affecting the liver and nervous system. About 30% of patients with WD may initially present with psychiatric symptoms, and diagnosis can be difficult to establish. The objectives of the present preliminary study were [1] to evaluate the relevance of serum copper (Cu) and ceruloplasmin (Cp) measures in hospitalized patients with psychiatric disorders; and [2] to identify possible mutations in the ATP7B gene in patients with abnormal biological copper profile...
2017: Annals of General Psychiatry
https://www.readbyqxmd.com/read/28390079/pitfalls-of-diagnosing-urinary-tract-infection-in-infants-and-young-children
#11
Yasuhito Yamasaki, Osamu Uemura, Takuhito Nagai, Satoshi Yamakawa, Yoshiko Hibi, Masaki Yamamoto, Masaru Nakano, Katsuaki Kasahara, Zhang Bo
BACKGROUND: The objective of this study was to examine the sensitivity and specificity of pyuria-based diagnosis of urinary tract infection (UTI) in urine collected by transurethral catheterization, and the reliability of diagnosis of pyuria in urine collected in a perineal bag. The gold standard for UTI diagnosis was the presence of significant colony counts of a single organism in urine obtained in a sterile manner. METHODS: We enrolled 301 patients who underwent medical examination in our hospital for possible UTI between January 2005 and December 2009...
April 8, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28389487/what-is-the-care-pathway-of-patients-who-undergo-thyroid-surgery-in-france-and-its-potential-pitfalls-a-national-cohort
#12
Muriel Mathonnet, Anne Cuerq, Christophe Tresallet, Jean-Christophe Thalabard, Elisabeth Fery-Lemonnier, Gilles Russ, Laurence Leenhardt, Claude Bigorgne, Philippe Tuppin, Bertrand Millat, Anne Fagot-Campagna
CONTEXT: The rate of thyroid cancer is increasing in France, as well as concerns about overdiagnosis and treatment. OBJECTIVES: To examine the care pathway of patients who undergo thyroid surgery in France and detect potential pitfalls. DESIGN: A large observational study based on medical reimbursements, 2009-2011. SETTING: Data from the Sniiram (National Health Insurance Information System). PATIENTS: Patients with thyroid surgery in 2010, classified into 4 groups: thyroid cancer, benign nodule, goitre or multiple nodules, other (hyperthyroidism, head-neck cancer)...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28387003/cytomorphological-changes-induced-by-intraperitoneal-chemotherapy-present-important-diagnostic-pitfalls-in-peritoneal-fluid-cytology
#13
Y Mok, M E Nga
OBJECTIVE: Intraperitoneal chemotherapy (IP ChT) is an emerging modality in the treatment of advanced gastric adenocarcinoma with peritoneal disease. Cytological evaluation of peritoneal fluid specimens from patients undergoing IP ChT is important in clinical management. However, direct intraperitoneal exposure to chemotherapeutic agents induces cytomorphological changes in benign constituents of peritoneal fluid, presenting particular challenges to accurate cytological interpretation...
April 7, 2017: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/28385339/intracranial-multiple-myeloma-may-imitate-subdural-hemorrhage-how-to-overcome-diagnostic-limitations-and-avoid-errors-in-treatment
#14
Anna Prajsnar-Borak, Naci Balak, Harald Von Pein, Martin Glaser, Stephan Boor, Axel Stadie
BACKGROUND: Although the diagnosis of subdural hematoma is usually straightforward, occasionally it may be erroneous, leading to mistakes in the treatment. For example, leptomeningeal malignancies, even in the absence of bleeding, may clinically and radiologically mimic subdural hemorrhage. OBJECTIVE: To stress the importance of not only intuitive thinking but also in analytic thinking in appropriate and accurate treatment strategies. METHODS AND ILLUSTRATIVE CASE: In this report, the clinical and radiological pitfalls in differentiating malignant leptomeningeal infiltration and subdural hematomas are discussed...
March 27, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28381153/alk-negative-anaplastic-large-cell-lymphoma-presenting-as-an-extranodal-soft-tissue-mass-with-an-unusual-alveolar-growth-pattern
#15
Badr AbdullGaffar, Rania M Seliem
Anaplastic large cell lymphoma (ALCL) is a T-cell lymphoma which has been recognized to have a variable clinical presentation and a broad spectrum of histomorphologic features. Its variable histomorphologic appearances are sometimes diagnostically challenging for the pathologists since they can mimic sarcomas, melanomas and undifferentiated carcinomas. To our knowledge, a previous case of axillary soft-tissue mass of ALK-positive ALCL with an alveolar growth pattern has been so far reported in the literature...
March 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28375913/bell-s-palsy
#16
Stephen G Reich
PURPOSE OF REVIEW: Bell's palsy is a common outpatient problem, and while the diagnosis is usually straightforward, a number of diagnostic pitfalls can occur, and a lengthy differential diagnosis exists. Recognition and management of Bell's palsy relies on knowledge of the anatomy and function of the various motor and nonmotor components of the facial nerve. Avoiding diagnostic pitfalls relies on recognizing red flags or features atypical for Bell's palsy, suggesting an alternative cause of peripheral facial palsy...
April 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28375834/the-role-of-ultrasound-in-the-diagnosis-and-follow-up-of-large-vessel-vasculitis-an-update
#17
Giuseppe Germanò, Sara Monti, Cristina Ponte, Niccolo' Possemato, Roberto Caporali, Carlo Salvarani, Pierluigi Macchioni, Nicolò Pipitone
Large-vessel vasculitides comprise giant cell arteritis and Takayasu's arteritis. In both conditions, early changes consist of transmural inflammation of the arterial wall, while later complications include lumen changes, such as stenoses or aneurysms. Colour-Doppler sonography has the ability to depict the arterial wall as well as the lumen, and is therefore ideally suited both to diagnose early vasculitis and to monitor patients over time. In this review article, we addressed the following issues: 1) the role of colour-Doppler sonography in the diagnosis of large-vessel vasculitis and its common pitfalls; 2) whether colour-Doppler sonography can increase the yield of temporal artery biopsy in giant cell arteritis; 3) the role of colour-Doppler sonography in monitoring patients with LVV over time; and 4) how colour-Doppler sonography performs compared to other imaging techniques...
March 29, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28375650/emerging-frontiers-of-neuroengineering-a-network-science-of-brain-connectivity
#18
Danielle S Bassett, Ankit N Khambhati, Scott T Grafton
Neuroengineering is faced with unique challenges in repairing or replacing complex neural systems that are composed of many interacting parts. These interactions form intricate patterns over large spatiotemporal scales and produce emergent behaviors that are difficult to predict from individual elements. Network science provides a particularly appropriate framework in which to study and intervene in such systems by treating neural elements (cells, volumes) as nodes in a graph and neural interactions (synapses, white matter tracts) as edges in that graph...
March 27, 2017: Annual Review of Biomedical Engineering
https://www.readbyqxmd.com/read/28374498/utility-of-gata3-in-the-differential-diagnosis-of-pheochromocytoma
#19
Carmen M Perrino, Alex Ho, Christopher P Dall, Debra L Zynger
AIMS: GATA3 is a relatively new immunohistochemical marker which shows consistent nuclear expression in a variety of tumors, including breast and urothelial carcinoma. The staining pattern of GATA3 in adrenal lesions is not well established. We aim to describe the expression of GATA3 in adrenal tumors and determine if there is differential staining between pheochromocytoma and adrenal cortical carcinoma. METHODS AND RESULTS: A retrospective search was performed to identify 74 adrenal lesions which were immunohistochemically tested for GATA3 expression...
April 4, 2017: Histopathology
https://www.readbyqxmd.com/read/28367032/papillary-carcinoma-thyroid-with-anastomosing-channels-an-unusual-morphology
#20
Varsha Dalal, Manveen Kaur, Anju Bansal
Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, accounting for 70%-80% of all thyroid malignancies. It is biologically indolent and has an excellent prognosis. Variations in histopathologic patterns are known to influence prognosis and often result in a diagnostic dilemma. We report an unusual case of a 35-year-old female with papillary carcinoma of a thyroid isthmus showing anastomosing channels on histopathology, a distinctive pattern that has not been described in PTC. Similar to tumor cells, the lining cells of these channels were also positive for thyroid transcription factor 1, thyroglobulin, and cytokeratin-19 and negative for CD34 and CD31...
April 2017: Journal of Laboratory Physicians
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