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https://www.readbyqxmd.com/read/28575459/intracranial-infectious-and-inflammatory-diseases-presenting-as-neurosurgical-pathologies
#1
Otto Rapalino, Mark E Mullins
There are many infectious and inflammatory processes affecting the central nervous system that can simulate other neurosurgical pathologies (e.g. tumor) and may precipitate a brain biopsy for definitive diagnosis if not suspected a priori. The challenge for the healthcare team is to recognize imaging features that support a nonsurgical pathology to avoid unnecessary interventions. This review aims to give a general overview of some common inflammatory and infectious entities that affect the central nervous system, with illustrative examples and highlighting important pearls and pitfalls...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28551900/-aortic-dissection-diagnosed-by-the-suprasternal-echocardiographic-view
#2
Shmuel Schwartzenberg, Pearl Herskovitz, Ron Brauner, Natalie Schnieder, Jacob Goerge, Sara Shimoni
Patients with suspected dissection of the thoracic aorta require immediate diagnostic evaluation so that urgent therapeutic interventions can begin. We present a case of aortic dissection with an atypical initial presentation mimicking acute pericarditis, in which the correct diagnosis was made on the basis of the suprasternal view of transthoracic echocardiography.
February 2017: Harefuah
https://www.readbyqxmd.com/read/28503985/diagnostic-and-therapeutic-management-of-a-first-unprovoked-seizure-in-children-and-adolescents-with-a-focus-on-the-revised-diagnostic-criteria-for-epilepsy
#3
Arnold J Sansevere, Jennifer Avalone, Lauren Doyle Strauss, Archana A Patel, Anna Pinto, Maya Ramachandran, Ivan Sanchez Fernandez, Ann M Bergin, Amir Kimia, Phillip L Pearl, Tobias Loddenkemper
By definition, unprovoked seizures are not precipitated by an identifiable factor, such as fever or trauma. A thorough history and physical examination are essential to caring for pediatric patients with a potential first unprovoked seizure. Differential diagnosis, EEG, neuroimaging, laboratory tests, and initiation of treatment will be reviewed. Treatment is typically initiated after 2 unprovoked seizures, or after 1 seizure in select patients with distinct epilepsy syndromes. Recent expansion of the definition of epilepsy by the ILAE allows for the diagnosis of epilepsy to be made after the first seizure if the clinical presentation and supporting diagnostic studies suggest a greater than 60% chance of a second seizure...
July 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28503347/wasting-of-extensor-digitorum-brevis-as-a-decisive-preoperative-clinical-indicator-of-lumbar-canal-stenosis-a-single-center-prospective-cohort-study
#4
S Munakomi, B M Kumar
BACKGROUND: The dilemma in managing patients with low back ache lies in differentiating radiculopathy from lumbar canal stenosis. This has a huge bearing in patients being planned for surgical intervention as underperforming leads to failed back syndrome whereas over-doing leads to instability. There still remains a loophole in clinically diagnosing lumbar canal stenosis. AIM: We opt to utilize a simple bedside clinical examination in routinely assessing patients presenting with low back ache in ruling out underlying canal stenosis...
September 2016: Annals of Medical and Health Sciences Research
https://www.readbyqxmd.com/read/28470756/differentiating-pulmonary-transfusion-reactions-using-recipient-and-transfusion-factors
#5
Nareg H Roubinian, Mark R Looney, Sheila Keating, Daryl J Kor, Clifford A Lowell, Ognjen Gajic, Rolf Hubmayr, Michael Gropper, Monique Koenigsberg, Gregory A Wilson, Michael A Matthay, Pearl Toy, Edward L Murphy
BACKGROUND: It is increasingly recognized that recipient risk factors play a prominent role in possible transfusion-related acute lung injury (pTRALI) and transfusion-associated circulatory overload (TACO). We hypothesized that both transfusion and recipient factors including natriuretic peptides could be used to distinguish TRALI from TACO and pTRALI. STUDY DESIGN AND METHODS: We performed a post hoc analysis of a case-control study of pulmonary transfusion reactions conducted at the University of California at San Francisco and Mayo Clinic, Rochester...
May 3, 2017: Transfusion
https://www.readbyqxmd.com/read/28448224/patient-characteristics-associated-with-inpatient-psychiatric-re-admissions-and-the-utility-of-the-readmit-clinical-risk-index
#6
Autumn Pearl Roque, Lillian Jeannette Findlay, Chizimuzo Okoli, Peggy El-Mallakh
In response to the problem of frequent 30-day readmissions to inpatient psychiatric facilities, Vigod and colleagues (2015) developed the READMIT clinical risk index to identify risk factors for psychiatric inpatient readmissions. The purpose of this descriptive retrospective study was to examine the effectiveness of the READMIT clinical risk index to identify patients that are at high risk for a 30-day inpatient psychiatric readmission at a state psychiatric hospital in the southeastern US. Data were extracted from the discharge summaries of patients discharged between September 2013 and December 2014...
May 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28435744/diagnosis-of-spinal-epidural-abscess-a-case-report-and-literature-review
#7
Chidinma Chima-Melton, Michelle Pearl, Marni Scheiner
INTRODUCTION: Spinal epidural abscess (SEA) is a rare but serious cause of back pain in the critical care setting. It occurs most commonly in adults in their fifth and sixth decades of life. Risk factors include diabetes mellitus, alcoholism, AIDS or other immunocompromised states, cancer, intravenous drug use, trauma and spinal surgery. The clinical presentation can be non-specific but the classical triad includes back pain, fever and neurological deficits. Magnetic resonance imaging (MRI) with gadolinium is the diagnostic imaging modality of choice...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28430674/continuous-eeg-in-pediatric-critical-care-yield-and-efficiency-of-seizure-detection
#8
Arnold J Sansevere, Elizabeth D Duncan, Mark H Libenson, Tobias Loddenkemper, Phillip L Pearl, Robert C Tasker
PURPOSE: Our goal was to define the duration of continuous EEG (cEEG) monitoring needed to adequately capture electrographic seizures and EEG status epilepticus in the pediatric intensive care unit using clinical and background EEG features. METHODS: Retrospective study of patients aged 1 month to 21 years admitted to a tertiary pediatric intensive care unit and undergoing cEEG (>3 hours). Clinical data collected included admission diagnosis, EEG background features, and time variables including time to first seizure after initiation of cEEG...
April 20, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
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
#9
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/28370895/microscopic-diagnosis-of-the-leaf-and-stem-of-piper-solmsianum-c-dc
#10
A R P Bertocco, I P Migacz, V L P Santos, C R C Franco, R Z Silva, R A Yunes, V Cechinel-Filho, J M Budel
Piper solmsianum C.DC., which is popularly known as pariparoba, is a shrub that measures 1-3 m in height and it inhabits areas with wet tropical soils. The objective of this study was to analyze the leaf and stem anatomy using light microscopy, scanning electron micrographs, and energy-dispersive X-ray spectroscopy in order to provide information for species identification. The anatomical profile showed the following main microscopic markers: hypostomatic leaf; hypodermis layer on both sides; pearl glands; biconvex midrib shape; five collateral vascular bundles in open arc with the central bundle larger than the others; circular stem shape; collateral vascular bundles arranged in two rings; sinuous sclerenchymatic sheath in the pith; secretory idioblasts; and starch grains in the mesophyll, in the ground parenchyma of the midrib, petiole, and in the stem; and six morphotypes of calcium oxalate crystals (styloids, cuneiform, tabular crystal rosettes, cuneiform crystal rosettes, elongated square dipyramids, as well as very elongated square dipyramids)...
March 30, 2017: Microscopy Research and Technique
https://www.readbyqxmd.com/read/28355672/ligamentous-reconstruction-of-the-knee-what-orthopaedic-surgeons-want-radiologists-to-know
#11
Andrew G Geeslin, Matthew G Geeslin, Robert F LaPrade
Knee ligament injuries are common, and treatment methods are continually evolving. Accurate clinical diagnosis with imaging confirmation is critical to support appropriate treatment. Several imaging pearls allow for improved recognition of injuries. Stress radiographs may be obtained to quantify knee laxity. Magnetic resonance imaging allows assessment of the complex anatomy of the knee and has excellent sensitivity and specificity for many injuries.
April 2017: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/28338084/late-neurosyphilis-and-tertiary-syphilis-in-guangdong-province-china-results-from-a-cross-sectional-study
#12
Weiming Tang, Shujie Huang, Lei Chen, Ligang Yang, Joseph D Tucker, Heping Zheng, Bin Yang
Due to challenges in diagnosis and the need for complex laboratory tests, misdiagnosis of neurosyphilis and tertiary syphilis is common in China. We validated the diagnosis and examined the treatment of late neurosyphilis and tertiary syphilis in Guangdong Province, China. A cross-sectional study was conducted to collect data from late neurosyphilis and tertiary syphilis cases reported between 2009 and 2014 in Guangdong, China. Descriptive analysis, bivariate analyses and multiple logistic regressions were performed to determine the structural factors associated with correct diagnosis and standard treatment of late neurosyphilis and tertiary syphilis...
March 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28319620/clinical-pearl-early-diagnosis-of-nail-psoriasis-and-psoriatic-arthritis
#13
Shari R Lipner, Matilde Iorizzo
No abstract text is available yet for this article.
February 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28289494/chronic-thromboembolic-pulmonary-hypertension-pearls-and-pitfalls-of-diagnosis
#14
Humna Abid Memon, C Huie Lin, Ashrith Guha
Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by chronic obstruction of major pulmonary arteries by organized thromboembolic material. Untreated CTEPH can result in pulmonary hypertension and eventually right heart failure, yet it is the only form of pulmonary hypertension that is potentially curable with surgical or catheter-based intervention. While early diagnosis is key to increasing the likelihood of successful treatment, CTEPH remains largely underdiagnosed. This article reviews the role of echocardiogram, ventilation/perfusion scan, and other available modalities in the diagnosis of CTEPH...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28281665/valuation-in-major-depression-is-intact-and-stable-in-a-non-learning-environment
#15
Dongil Chung, Kelly Kadlec, Jason A Aimone, Katherine McCurry, Brooks King-Casas, Pearl H Chiu
The clinical diagnosis and symptoms of major depressive disorder (MDD) have been closely associated with impairments in reward processing. In particular, various studies have shown blunted neural and behavioral responses to the experience of reward in depression. However, little is known about whether depression affects individuals' valuation of potential rewards during decision-making, independent from reward experience. To address this question, we used a gambling task and a model-based analytic approach to measure two types of individual sensitivity to reward values in participants with MDD: 'risk preference,' indicating how objective values are subjectively perceived, and 'inverse temperature,' determining the degree to which subjective value differences between options influence participants' choices...
March 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28205345/differential-diagnosis-of-well-differentiated-squamous-cell-carcinoma-from-non-neoplastic-oral-mucosal-lesions-new-cytopathologic-evaluation-method-dependent-on-keratinization-related-parameters-but-not-nuclear-atypism
#16
Hitoshi Hara, Tsuneo Misawa, Eri Ishii, Miki Nakagawa, Saki Koshiishi, Kenji Amemiya, Toshio Oyama, Kazuya Tominaga, Jun Cheng, Akio Tanaka, Takashi Saku
BACKGROUND: The cytology of oral squamous cell carcinoma (SCC) is challenging because oral SCC cells tend to be well differentiated and lack nuclear atypia, often resulting in a false negative diagnosis. The purpose of this study was to establish practical cytological parameters specific to oral SCCs. METHODS: We reviewed 123 cases of malignancy and 53 of non-neoplastic lesions of the oral mucosa, which had been diagnosed using both cytology and histopathology specimens...
May 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28192574/primary-care-asthma-management-inhaled-corticosteroids-and-other-clinical-pearls
#17
Zachary Marcus, Nanah Suk Park
Most children in the United States with intermittent, mild, and moderate persistent asthma are cared for by primary care practitioners (PCPs). Despite inhaled corticosteroids (ICS) being highly effective at controlling asthma symptoms, many PCPs are uncomfortable prescribing these medications. Cumbersome guidelines, increasing numbers of medication choices, and concerns regarding side effects are some of the barriers to prescribing ICS for children with asthma. This article serves as a quick-start guide for PCPs that (1) condenses the routine diagnosis and management of asthma into concise clinical tools for children who would benefit from ICS therapy and (2) provides clinical pearls to aid in the treatment of mild- to moderate-persistent asthma...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28156130/evaluation-of-various-cooling-systems-after-exercise-induced-hyperthermia
#18
RANDOMIZED CONTROLLED TRIAL
Pearl M S Tan, Eunice Y N Teo, Noreffendy B Ali, Bryan C H Ang, Iswady Iskandar, Lydia Y L Law, Jason K W Lee
CONTEXT: Rapid diagnosis and expeditious cooling of individuals with exertional heat stroke is paramount for survival. OBJECTIVE: To evaluate the efficacy of various cooling systems after exercise-induced hyperthermia. DESIGN: Crossover study. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty-two men (age = 24 ± 2 years, height = 1.76 ± 0.07 m, mass = 70.7 ± 9.5 kg) participated. INTERVENTION(S): Each participant completed a treadmill walk until body core temperature reached 39...
February 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28121084/melanoma-clinical-and-dermoscopic-diagnosis
#19
Gabriella Brancaccio, Teresa Russo, Aimilios Lallas, Elvira Moscarella, Marina Agozzino, Giuseppe Argenziano
Missing the diagnosis of a melanoma is the worst dermatologist nightmare, especially when melanomas have a non-alarming clinical appearance and imitate a completely benign lesion. The use of dermoscopy has provided an effective tool to facilitate the differential diagnosis and to increasingly allow an early diagnosis of melanoma. The aim of this article is to summarize the most recent and important clinical and dermoscopic pearls to recognize melanoma at the earliest stages of its development.
January 24, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/28100251/consensus-guideline-for-the-diagnosis-and-treatment-of-aromatic-l-amino-acid-decarboxylase-aadc-deficiency
#20
REVIEW
Tessa Wassenberg, Marta Molero-Luis, Kathrin Jeltsch, Georg F Hoffmann, Birgit Assmann, Nenad Blau, Angeles Garcia-Cazorla, Rafael Artuch, Roser Pons, Toni S Pearson, Vincenco Leuzzi, Mario Mastrangelo, Phillip L Pearl, Wang Tso Lee, Manju A Kurian, Simon Heales, Lisa Flint, Marcel Verbeek, Michèl Willemsen, Thomas Opladen
Aromatic L-amino acid decarboxylase deficiency (AADCD) is a rare, autosomal recessive neurometabolic disorder that leads to a severe combined deficiency of serotonin, dopamine, norepinephrine and epinephrine. Onset is early in life, and key clinical symptoms are hypotonia, movement disorders (oculogyric crisis, dystonia, and hypokinesia), developmental delay, and autonomic symptoms.In this consensus guideline, representatives of the International Working Group on Neurotransmitter Related Disorders (iNTD) and patient representatives evaluated all available evidence for diagnosis and treatment of AADCD and made recommendations using SIGN and GRADE methodology...
January 18, 2017: Orphanet Journal of Rare Diseases
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