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https://www.readbyqxmd.com/read/29200114/neuroradiologic-pearls-for-neuro-oncology
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28860558/development-and-validation-of-a-multivariate-predictive-model-for-rheumatoid-arthritis-mortality-using-a-machine-learning-approach
#14
José M Lezcano-Valverde, Fernando Salazar, Leticia León, Esther Toledano, Juan A Jover, Benjamín Fernandez-Gutierrez, Eduardo Soudah, Isidoro González-Álvaro, Lydia Abasolo, Luis Rodriguez-Rodriguez
We developed and independently validated a rheumatoid arthritis (RA) mortality prediction model using the machine learning method Random Survival Forests (RSF). Two independent cohorts from Madrid (Spain) were used: the Hospital Clínico San Carlos RA Cohort (HCSC-RAC; training; 1,461 patients), and the Hospital Universitario de La Princesa Early Arthritis Register Longitudinal study (PEARL; validation; 280 patients). Demographic and clinical-related variables collected during the first two years after disease diagnosis were used...
August 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28844704/gallbladder-adenomyomatosis-diagnosis-and-management
#15
N Golse, M Lewin, A Rode, M Sebagh, J-Y Mabrut
Gallbladder (GB) adenomyomatosis (ADM) is a benign, acquired anomaly, characterized by hypertrophy of the mucosal epithelium that invaginates into the interstices of a thickened muscularis forming so-called Rokitansky-Aschoff sinuses. There are three forms of ADM: segmental, fundal and more rarely, diffuse. Etiology and pathogenesis are not well understood but chronic inflammation of the GB is a necessary precursor. Prevalence of ADM in cholecystectomy specimens is estimated between 1% and 9% with a balanced sex ratio; the incidence increases after the age of 50...
October 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28836750/emergency-management-of-renal-and-genitourinary-trauma-best-practices-update-digest
#16
Whitney K Bryant, Sanjay Shewakramani, Milana Zaurova
In up to 10% of patients who experience abdominal trauma, renal and urogenital systems will be involved. In polytrauma patients with other potentially life-threatening injuries, renal and genitourinary trauma may be overlooked initially, but a delayed or missed diagnosis of these injuries may result in preventable complications. This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy...
August 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28776139/catching-the-zebra-clinical-pearls-and-pitfalls-for-the-successful-diagnosis-of-zollinger-ellison-syndrome
#17
REVIEW
Aaron H Mendelson, Mark Donowitz
Zollinger-Ellison syndrome (ZES) results from an ectopic gastrin-secreting tumor leading to peptic ulcer disease, reflux, and chronic diarrhea. While early recognition portends an excellent prognosis with >80% survival at 15 years, symptoms are often nonspecific making the diagnosis difficult to establish. Diagnosis involves a series of tests, including fasting gastrin, gastric pH, chromogranin A, and secretin stimulation. Performing these tests in the correct sequence and at the proper time is essential to avoid inaccurate results...
August 3, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28760177/physical-activity-and-diabetes-related-health-beliefs-of-marshallese-adults
#18
Holly Felix, Xiaocong Li, Brett Rowland, Christopher R Long, Karen H K Yeary, Pearl A McElfish
OBJECTIVE: We sought to improve understanding of diabetes-related health beliefs and physical activity behaviors of Marshallese adults with and without type 2 diabetes (T2D). METHODS: We used tests of comparison and regression analyses to examine data from 376 Marshallese adults collected at church-based events. RESULTS: One in 5 (20.2%) respondents had received a T2D diagnosis. About one-fourth of the respondents fell into one of 4 physical activity levels: zero times per week (28...
September 1, 2017: American Journal of Health Behavior
https://www.readbyqxmd.com/read/28754695/eastern-equine-encephalitis
#19
Daniel Berlin, Ahmed I Gilani, Amrit K Grewal, Mary Fowkes
We describe a patient who died from a fulminant presentation of encephalitis. After an exhaustive search, we found no treatable cause. Postmortem PCR analysis of brain tissue led to a diagnosis of eastern equine encephalitis. We have identified several clinical pearls that may assist others in making the diagnosis earlier in the disease course.
October 2017: Practical Neurology
https://www.readbyqxmd.com/read/28749627/acute-kidney-injury-in-pediatric-patients-diagnosis-and-management-in-the-emergency-department-digest
#20
Daniel Mohrer, Melissa Langhan, Pradip Chaudhari
Pediatric acute kidney injury is a condition that is underdiagnosed among children seen in the emergency department, and it has been associated with significant morbidity and mortality, including increased risk for chronic kidney disease. The most common etiologies in pediatric patients are now known to be due to hypovolemia, sepsis, shock, and cardiac dysfunction. This issue compares 3 classification systems for the diagnosis and staging of acute kidney injury and reviews the etiologies that lead to kidney injury in children...
May 22, 2017: Pediatric Emergency Medicine Practice
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