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https://www.readbyqxmd.com/read/29432243/epilepsy-syndromes-in-childhood
#1
Phillip L Pearl
PURPOSE OF REVIEW: Epilepsy syndromes are an important clinical construct in pediatric epilepsy, as they encompass recognizable patterns seen in patients with epilepsies, whether of the more benign variety or associated with encephalopathy. RECENT FINDINGS: Syndromes may be organized by age of onset: neonatal, infantile, childhood, or adolescent. The assignment of a syndrome has specific implications for diagnosis, management, and prognostication. The 2010 revised classification of the epilepsies by the International League Against Epilepsy preserved the syndrome approach, while progress in genetics continues to advance our understanding of the pathophysiology and overlap of the epilepsy syndromes...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29392464/primary-progressive-aphasia-a-clinical-approach
#2
Charles R Marshall, Chris J D Hardy, Anna Volkmer, Lucy L Russell, Rebecca L Bond, Phillip D Fletcher, Camilla N Clark, Catherine J Mummery, Jonathan M Schott, Martin N Rossor, Nick C Fox, Sebastian J Crutch, Jonathan D Rohrer, Jason D Warren
The primary progressive aphasias are a heterogeneous group of focal 'language-led' dementias that pose substantial challenges for diagnosis and management. Here we present a clinical approach to the progressive aphasias, based on our experience of these disorders and directed at non-specialists. We first outline a framework for assessing language, tailored to the common presentations of progressive aphasia. We then consider the defining features of the canonical progressive nonfluent, semantic and logopenic aphasic syndromes, including 'clinical pearls' that we have found diagnostically useful and neuroanatomical and other key associations of each syndrome...
February 1, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29388753/acute-gastroenteritis-evidence-based-management-of-pediatric-patients-digest
#3
KeriAnne Brady, Kathryn H Pade
Although most cases of acute gastroenteritis require minimal medical intervention, severe dehydration and hypoglycemia may develop in cases of prolonged vomiting and diarrhea. The mainstay of treatment for mild-to-moderately dehydrated patients with acute gastroenteritis should be oral rehydration solution. Antiemetics allow for improved tolerance of oral rehydration solution, and, when used appropriately, can decrease the need for intravenous fluids and hospitalization. This issue reviews the common etiologies of acute gastroenteritis, discusses more-severe conditions that should be considered in the differential diagnosis, and provides evidence-based recommendations for management of acute gastroenteritis in patients with mild-to-moderate dehydration, severe dehydration, and hypoglycemia...
February 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29323067/modified-cajal-s-trichrome-stain-as-a-diagnostic-aid-in-the-study-of-epithelial-pathology
#4
Karpagaselvi Sanjai, Anjum Baker, Lokesh Papiah Reddy, Bhavna Pandey
BACKGROUND: Diagnosis of initial epithelial pathology maybe difficult in Squamous Cell Carcinoma (SCC), Carcinoma In Situ and other atypical epithelial malignancies, under routine Haematoxylin and Eosin (H and E) stain. The detection of minor basement membrane alterations in doubtful cases is both time consuming and confusing. AIMS: To evaluate efficacy of Modified Cajal's Trichrome Stain (CTS) in relation to Haematoxylin and Eosin for study of epithelial dysplasia, carcinoma in situ, micro invasive SCC, frank SCC, and SCC in lymph nodes...
October 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29241101/marjolin-s-ulcer-in-a-20-years-old-split-thickness-skin-graft-on-the-knee-a-case-report
#5
Iselin Saltvig, Steen H Matzen
OBJECTIVE: Marjolin's Ulcer (MU) is a rare cutaneous neoplasm arising in cikatrical tissue. Due to its typical clinical presentation as a non-healing lesion in scar tissue, the diagnosis can be delayed and even overlooked. METHODS AND RESULTS: We present the case of an elderly woman who developed an ulcerated, exophytic lesion in a split thickness skin graft (STSG) on the lateral aspect of the left knee. Histology showed a radically excised highly differentiated squamous cell carcinoma (SCC) with keratine pearls and a component of basocellular carcinoma (BCC)...
December 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29227042/ex-vivo-confocal-microscopy-features-of-cutaneous-squamous-cell-carcinoma
#6
Daniela Hartmann, Sebastian Krammer, Mario Raphael Bachmann, Leonie Mathemeier, Thomas Ruzicka, Isin Sinem Bagci, Tanja von Braunm├╝hl
BACKGROUND: Rapid microscopic evaluation of cutaneous squamous cell carcinoma (SCC), its grade of differentiation and level of invasiveness would enable better management of patients' therapy. OBJECTIVES: Analyzing specific ex-vivo confocal microscopy criteria whether they can predict diagnosis of invasive SCC vs. carcinoma in situ and poorly differentiated or undifferentiated vs. well and moderately differentiated SCC. METHODS: Ex-vivo confocal images of 102 SCCs in 57 patients were evaluated immediately after excision for the presence of predefined criteria based on confocal and histological knowledge...
December 11, 2017: Journal of Biophotonics
https://www.readbyqxmd.com/read/29219007/anthropometric-research-of-congenital-auricular-deformities-for-newborns
#7
Hui Zhao, Guanfeng Lin, Yong Hae Seong, Jin Shi, Jing Xu, Wenhua Huang
OBJECTIVE: This study aimed to get the data of Neonatal auricle for helping pediatricians and obstetricians to make definite diagnosis and individualized treatment for newborn congenital auricular deformities in China. METHODS: A total of 1500 newborns' ears were evaluated in this study. Six surface measurements were performed directly on the auricles of the subjects as follows: physiognomic ear length and breadth, morphological ear length and breadth, cephalo-auricular distance, and cephalo otic angle...
December 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29200114/neuroradiologic-pearls-for-neuro-oncology
#8
Joshua P Klein, Jorg Dietrich
PURPOSE OF REVIEW: This article reviews key principles in the identification of tumors of the central nervous system (CNS) using standard and advanced imaging modalities. This article highlights the pitfalls and pearls of the imaging evaluation of patients with cancer at time of diagnosis and during cancer therapy and discusses the challenges of the imaging evaluation of treatment-related toxicities. RECENT FINDINGS: Treatment of CNS tumors with surgery, chemotherapy, or radiation alters the imaging appearance of the tumor and can be associated with a variety of treatment-related toxicities...
December 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29154686/a-retrospective-summary-of-raptor-mortality-in-ontario-canada-1991-2014-including-the-effects-of-west-nile-virus
#9
Kathryn A Smith, G Douglas Campbell, David L Pearl, Claire M Jardine, Fernando Salgado-Bierman, Nicole M Nemeth
The causes of mortality of free-ranging raptors range from anthropogenic (e.g., trauma) to dynamic environmental conditions that may affect habitat suitability and prey availability. The province of Ontario, Canada, is vulnerable to anthropogenic and environmental changes because of its northern latitudes and expanding human populations, both of which may impact wildlife. We retrospectively evaluated diagnostic data from raptors submitted to the Ontario-Nunavut node of the Canadian Wildlife Health Cooperative (CWHC) from 1991 to 2014 (n=1,448)...
November 20, 2017: Journal of Wildlife Diseases
https://www.readbyqxmd.com/read/29131768/from-inguinal-hernias-to-spermatic-cord-lipomas-pearls-pitfalls-and-mimics-of-abdominal-and-pelvic-hernias
#10
Miguel C Cabarrus, Benjamin M Yeh, Andrew S Phelps, Jao J Ou, Spencer C Behr
Abdominal and pelvic hernias may be indolent and detected incidentally, manifest acutely with pain and distress, or cause chronic discomfort. Physical examination findings are often ambiguous and insufficient for optimal triage. Therefore, accurate anatomic delineation and identification of complications are critical for effective treatment planning. Imaging, particularly computed tomography, provides a vital understanding of the hernia's location and size, involved viscera, and severity of associated complications...
November 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29102012/editorial-commentary-you-may-not-have-seen-it-but-it-has-seen-you-diagnosis-of-long-head-biceps-tendon-and-subscapularis-pathology-in-association-with-shoulder-rotator-cuff-pathology-can-be-challenging
#11
EDITORIAL
Dan Guttmann
The shoulder can humble you. It is often challenging in determining the extent of pathology even when there is an adequate magnetic resonance imaging performed preoperatively and even during the so-called diagnostic portion of the arthroscopy. Abnormalities of the long head of the biceps tendon and the rotator cuff especially the subscapularis can be difficult to diagnose definitively. Experience can be very helpful in predicting pathology based on patterns seen before and knowing certain pearls that can make diagnosis and ultimately treatment more accurate...
November 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29095394/mri-arthroscopy-correlation-of-the-rotator-cuff-a-case-based-review
#12
Rafael A Buerba, Armin Arshi, Kim M Lee, Benjamin D Levine, Frank A Petrigliano
With significant advancements over recent decades, magnetic resonance imaging (MRI) and shoulder arthroscopy are important complementary tools in guiding orthopedic surgeons to diagnosis, decision making, and treatment of rotator cuff pathology. The objective of this article is to review the basic principles and pearls of MRI-arthroscopy correlation of the rotator cuff through an overview of our approach to reading shoulder MRI followed by a case-based review of selected conditions. By understanding and comparing the subtleties of these modalities, radiologists and clinicians can better appreciate both the utility and limitations of MRI in predicting operative findings...
December 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/29068643/diagnosis-and-management-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-digest
#13
Van Holden, Donald Slack Iii, Michael T McCurdy, Nirav G Shah, Nachi Gupta, Jeffrey Nusbaum
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a clinical diagnosis that is based on changes in dyspnea, cough, and/or sputum production in a COPD patient; however, patients presenting with an acute exacerbation may be undiagnosed or have a variety of comorbid conditions that can complicate diagnosis. This issue presents strategies and algorithms for the early use of evidence-based interventions, including appropriate use of antibiotics, bronchodilators, and corticosteroids, along with noninvasive ventilation with capnography, to minimize morbidity and mortality associated with this disease...
October 20, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29054315/cord-topographical-anatomy-and-its-role-in-evaluating-intramedullary-lesions
#14
REVIEW
James Andrew Spain, Scott Cressman, Horia Marin, Suresh C Patel, John J Corrigan, Brent Griffith
Intramedullary spinal lesions present a wide differential diagnosis including infectious, inflammatory, traumatic, ischemic, benign, or malignant neoplastic etiologies. Using knowledge of anatomy and physiology within the spinal cord, many similar appearing entities can be parsed into a prioritized differential. The purpose of this article is to review anatomy and pathophysiology of the spinal cord, with subsequent discussion of how this knowledge can be used to differentiate several similar appearing intramedullary pathologic processes...
September 18, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29053497/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-phalangeal-fracture-pearls-and-pitfalls
#15
Joshua M Abzug, Charles T Mehlman
Pediatric phalangeal fractures are extremely common, especially among toddlers and older children/adolescents involved in sporting activities. The physical examination must include an assessment for deviation and malrotation. In addition, concomitant injuries must be assessed for such as tendon and/or neurovascular injuries. Plain radiographs are typically sufficient to make the diagnosis and determine the treatment. The majority of pediatric and adolescent phalangeal fractures can be treated with immobilization...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29019749/pearls-and-pitfalls-in-diagnosing-pediatric-urinary-bladder-masses
#16
Susan C Shelmerdine, Armando J Lorenzo, Abha A Gupta, Govind B Chavhan
Urinary bladder masses are rare in children, and the associated histologic features and prognoses in this population are different from those in adults. Most children with urinary bladder masses present with lower urinary tract symptoms, which may include hematuria, dysuria, frequent urination, and urgency to urinate. However, some of these masses may be identified incidentally or involve generic symptoms such as abdominal distention. In general, pediatric bladder tumors can be divided into those that originate from the bladder epithelium, known as urothelial neoplasms, and mesenchymal bladder neoplasms, which are more prevalent...
October 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28978598/unusual-case-of-immune-related-colitis
#17
Meltiady Issa, Ioannis Milioglou
The cancer immunotherapy field has had many promising developments in recent years. Checkpoint inhibitors are good examples of that. This new class of medications comes with a new constellation of side effects that require early recognition and management. Here we present a patient with metastatic adenocarcinoma on pembrolizumab who was admitted to the hospital for colitis. This was found to be an immune-related adverse event from pembrolizumab. We discuss our work-up and approach to the diagnosis, then highlight important treatment pearls for internal medicine physicians who are increasingly taking care of such patients...
October 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28933808/pediatric-orthopedic-injuries-evidence-based-management-in-the-emergency-department-digest
#18
Jamie Lien, Kathryn H Pade
Upper and lower extremity injuries are common in children, with an overall risk of fracture estimated at just under 1 in 5 children. Pediatric bone anatomy and physiology produce age specific injury patterns and conditions that are unique to children, which can make accurate diagnosis difficult for emergency clinicians. This issue reviews the etiology and pathophysiology of child-specific fractures, as well as common injuries of the upper and lower extremities. Evidence-based recommendations for management of pediatric fractures, including appropriate diagnostic studies and treatment, are also discussed...
September 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28889930/radiologic-pearls-for-internists-a-case-based-review
#19
REVIEW
Melissa J McGettigan, Robert A Gatenby
Modern technologic advances in medical imaging and the increasing use of imaging across all disciplines in medicine have led to a striking rise in incidental findings unrelated to the original study indication. Often, these findings have no clinical relevance and will not impact the current or future health status of the patient. It is incumbent on radiologists to report these findings in a definitive and unambiguous manner. Similarly, it is essential for clinicians to restrain from further diagnostic investigation of incidental findings that are conclusive by imaging...
September 7, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28862048/a-precious-diagnostic-pearl-the-necklace-pattern-in-germ-cell-tumors-of-the-testis
#20
Justin Snow, Juan Miguel Mosquera, Theresa Scognamiglio, Brian D Robinson, Francesca Khani
Diffuse embryoma is a rare pattern of nonseminomatous germ cell tumor of the testis originally described in 1983. We report a case with this predominant pattern in an 18-year-old male with a painless palpable testicular mass. Although it is relatively common to see a diffuse embryoma pattern focally in mixed nonseminomatous germ cell tumors of the testis, it is rarely the predominant pattern and can represent a diagnostic pitfall on routine hematoxylin and eosin stain. We emphasize the importance of recognizing the individual components within the diffuse embryoma pattern, review the literature, and briefly discuss the ancillary immunohistochemical stains that may be utilized to help support the diagnosis...
August 1, 2017: International Journal of Surgical Pathology
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