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second opinion

Ying Han, Zhenyu Lu, Zhenguang Du, Qi Luo, Sheng Chen
BACKGROUND AND OBJECTIVE: Bipolar disorder is often mis-diagnosed as unipolar depression in the clinical diagnosis. The main reason is that, different from other diseases, bipolarity is the norm rather than exception in bipolar disorder diagnosis. YinYang bipolar fuzzy set captures bipolarity and has been successfully used to construct a unified inference mathematical modeling method to bipolar disorder clinical diagnosis. Nevertheless, symptoms and their interrelationships are not considered in the existing method, circumventing its ability to describe complexity of bipolar disorder...
May 2018: Computer Methods and Programs in Biomedicine
David Portehault, Simon Delacroix, Guillaume Gouget, Rémi Grosjean, Tsou-Hsi-Camille Chan-Chang
The design of inorganic nanoparticles relies strongly on the knowledge from solid-state chemistry not only for characterization techniques, but also and primarily for choosing the systems that will yield the desired properties. The range of inorganic solids reported and studied as nanoparticles is however strikingly narrow when compared to the solid-state chemistry portfolio of bulk materials. Efforts to enlarge the collection of inorganic particles are becoming increasingly important for three reasons. First, they can yield materials more performing than current ones for a range of fields including biomedicine, optics, catalysis, and energy...
March 13, 2018: Accounts of Chemical Research
Rosalyn E Maben-Feaster, R Brent Stansfield, AnneMarie Opipari, Maya M Hammoud
BACKGROUND: One-third of Americans use social media websites as a source of health care information. Twitter, a microblogging site that allows users to place 280-character posts-or tweets-on the Web, is emerging as an important social media platform for health care. However, most guidelines on medical professionalism on social media are based on expert opinion. OBJECTIVE: This study sought to examine if provider Twitter profiles with educational tweets were viewed as more professional than profiles with personal tweets or a mixture of the two, and to determine the impact of provider gender on perceptions of professionalism in an academic obstetrics and gynecology clinic...
March 12, 2018: Journal of Medical Internet Research
Shigeomi Yokoya, Akihiko Hino, Yukihiro Goto, Youichi Hashimoto, Hideki Oka
BACKGROUND: The headache preceding an intracranial aneurysm (AN) rupture is called a sentinel headache (SH), and it is characterized by a sudden, intense, and persistent headache. As subarachnoid hemorrhage (SAH) often develops within several weeks of SH, its rapid diagnosis and treatment can improve the prognosis. CASE DESCRIPTION: A 52-year-old woman with migraine in her medical history visited the outpatient clinic due to left orbital pain. There was no neurological deficit...
March 9, 2018: World Neurosurgery
Gunjan Vasant Bonde, Sarita Kumari Yadav, Sheetal Chauhan, Pooja Mittal, Gufran Ajmal, Sathish Thokala, Brahmeshwar Mishra
Breast cancer stands the second prominent cause of death among women. For its efficient treatment, Lapatinib (LAPA) was developed as a selective tyrosine kinase inhibitor of receptors, overexpressed by breast cancer cells. Various explored delivery strategies for LAPA indicated its controlled release with enhanced aqueous solubility, improved bioavailability, decreased plasma protein binding, reduced dose and toxicity to the other organs with maximized clinical efficacy, compared to its marketed tablet formulation...
March 9, 2018: Expert Opinion on Drug Delivery
R B Raffa, J V Pergolizzi, R Taylor, M H Ossipov
WHAT IS KNOWN AND OBJECTIVE: Advances in pain research have led to an understanding that many pains are driven by more than one underlying (patho)physiologic cause (ie, they are "multimechanistic") and that better pain relief is obtained with fewer adverse effects when an analgesic is correspondingly multimechanistic. At least two of the more-modern analgesics combine opioid and non-opioid mechanisms, and have become known as "atypical opioids." Less well known is that just as Nature evolved opioids, it also evolved atypical opioids, presaging modern drug discovery efforts...
March 8, 2018: Journal of Clinical Pharmacy and Therapeutics
Cori Russell, Samip Sheth, Douglas Jacoby
PURPOSE OF REVIEW: We provide an overview of our current understanding of combination lipid-lowering therapies intended for dyslipidemia treatment and cardiovascular disease prevention. First, we analyze recent statin and non-statin combination therapy guidelines and clinical studies since the publication of 2013 American College of Cardiology Cholesterol Guidelines. Second, we examine the clinical utility of non-statin agents alone and in combination in terms of LDL-C lowering and ASCVD risk reduction...
March 7, 2018: Current Atherosclerosis Reports
Takashi Kanamori, Shigeru Kusumoto, Kenji Okita, Shinya Hagiwara, Chie Kato, Takahiro Nakashima, Satsuki Murakami, Tomoko Narita, Asahi Ito, Masaki Ri, Takashi Ishida, Hirokazu Komatsu, Noriyuki Matsukawa, Shinsuke Iida
A 40-year-old female presented with a skin rash, hepatosplenomegaly, hypothyroidism, IgG-λ monoclonal gammopathy, slightly elevated serum VEGF levels, and >1-year history of weakness in the posterior cervical muscles. Based on these symptoms and her clinical course, she was suspected of having POEMS syndrome. However, because there was no sign of peripheral neuropathy (PN), the criteria for the diagnosis of POEMS syndrome were not met. Consequently, she continued follow-up and was under close observation as an outpatient...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Keiran D Clement, Andreas Luhmann, Michael Sj Wilson, Pradeep Patil
We report a case of a young woman admitted electively for laparoscopic Nissen fundoplication, and again three days post-operatively as an emergency with profuse vomiting and abdominal pain. She underwent diagnostic laparoscopy, and a small gastric perforation was found at the site of the fundoplication and this was suture-repaired. On both admissions, she was "screened" for pregnancy as per current guidelines. On the second admission, following a CT scan, she was found to have a gravid uterus with a foetus of 16-18 weeks' gestation...
January 1, 2018: Scottish Medical Journal
Andreas G Schreyer, Britta Rosenberg, René T Steinhäuser
BACKGROUND:  Because of an increasing number of boards and conferences, the number of second opinion readings of externally acquired image data is growing dramatically. In this review article we intend to give medical and legal recommendations for the documentation and interpretation of externally acquired radiological data for second opinions and board presentations based on German jurisdiction. METHOD:  Using the FAQ format as a dialog between radiologists and medical legal experts, we answer the most crucial questions regarding correct documentation and interpretation for externally acquired radiological image data based on an up-to-date literature search...
March 7, 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Nicole VanHeerwaarden, Genevieve Ferguson, Alexxa Abi-Jaoude, Andrew Johnson, Elisa Hollenberg, Gloria Chaim, Kristin Cleverley, Gunther Eysenbach, Joanna Henderson, Andrea Levinson, Janine Robb, Sarah Sharpe, Aristotle Voineskos, David Wiljer
BACKGROUND: Seventy percent of lifetime cases of mental illness emerge before the age of 24 years, but many youth are unable to access the support and services they require in a timely and appropriate way. With most youth using the internet, electronic health (eHealth) interventions are promising tools for reaching this population. Through participatory design research (PDR) engagement methods, Thought Spot, a Web- and mobile-based platform, was redeveloped to facilitate access to mental health services by transition-aged youth (aged 16-29 years) in postsecondary settings...
March 6, 2018: Journal of Medical Internet Research
K R Amlaiev, M G Gevandova, Kh T Dakhkilgova
The article presents analysis of social economic health determinants of parents of children with oncologic diseases. The evaluation of their satisfaction with accessibility of qualitative medical care was carried out. The questionnaire covered issues concerning medical social aspects of health and satisfaction with quality of medical care. the sampling included 284 parents of children with oncologic diseases receiving treatment in the profile departments of Krasnodar, Stavropol, Volgograd, Makhachkala, Grozny, Cherkessk, Nalchik and Astrakhan in August-September 2015...
July 2017: Problemy Sot︠s︡ialʹnoĭ Gigieny, Zdravookhranenii︠a︡ i Istorii Medit︠s︡iny
Irene Tuffrey-Wijne, Leopold Curfs, Ilora Finlay, Sheila Hollins
BACKGROUND: Euthanasia and assisted suicide (EAS) have been legally possible in the Netherlands since 2001, provided that statutory due care criteria are met, including: (a) voluntary and well-considered request; (b) unbearable suffering without prospect of improvement; (c) informing the patient; (d) lack of a reasonable alternative; (e) independent second physician's opinion. 'Unbearable suffering' must have a medical basis, either somatic or psychiatric, but there is no requirement of limited life expectancy...
March 5, 2018: BMC Medical Ethics
Allison M Cummins, Raechel Wight, Nicole Watts, Christine Catling
OBJECTIVE: first year midwifery students learn early in semester about situations in midwifery where a high level of emotion is expressed, such as taking a sexual history, being faced with the body image changes of pregnancy and working with women in the extreme pain of labour. Commencing students usually have not had exposure to the realities of studying and working in midwifery, and often have an idealised view of midwifery that may lead to attrition from the course. We aimed to equip students with personal and professional tools to discuss sensitive issues in midwifery and promote self-care through the development of two workshops...
February 15, 2018: Midwifery
Joseph H Friedman
Psychosis is a common problem for people treated for Parkinson's disease. The syndrome is quite stereotypic, with hallucinations being the most common, followed by delusions. While the hallucinations are usually not very bothersome, the delusions are typically paranoid in nature. Treatment is often, but not always, required. Areas covered: This article reviews the therapeutic approaches of this syndrome focusing on drug treatments used once contributory factors have been removed. This includes a review of the evidence supporting the use of clozapine and, most recently, pimavanserin, the first drug with antipsychotic efficacy that has no effect on dopamine...
March 1, 2018: Expert Opinion on Pharmacotherapy
Hamad Alyami, Jasdip Koner, Chi Huynh, David Terry, Afzal R Mohammed
The appropriate prescribing of paediatric dosage forms is paramount in providing the desired therapeutic effect alongside successful medication adherence with the paediatric population. Often it is the opinion of the healthcare practitioner that dictates which type of dosage form would be most appropriate for the paediatric patient, with liquids being both the most commonly available and most commonly used. Orally disintegrating tablets (ODTs) are an emerging dosage form which provide many benefits over traditional dosage forms for paediatric patients, such as rapid disintegration within the oral cavity, and the reduction in the risk of choking...
2018: PloS One
Cezar I Betianu, Augustin Dima, Giorgiana Pavaloiu
Extramarginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) is a non-Hodgkin lymphoma of low-grade malignancy. The most common localization is the stomach, and the common nongastric sites are salivary glands, the skin, orbits, the conjunctiva, the lung, breasts, upper airways, other gastrointestinal sites, and the liver. Primary hepatic MALT lymphoma is a rare disease and the diagnostic can be challenging. The clinical presentation is nonspecific and may range from no symptoms to end-stage liver disease...
December 2017: Radiology Case Reports
Jan Weyerstraß, Barbara Prediger, Edmund Neugebauer, Dawid Pieper
BACKGROUND AND OBJECTIVES: Although legally anchored, there are no empirical results from German second opinion programs. In this study, various aspects within a population of a second opinion program are examined. METHODS: In this study patients were analyzed who sought a second opinion in the period from August 2011 to December 2016. Differences in patient characteristics, differentiated by agreement of first and second opinion, were analyzed using multivariate logistic regression...
February 23, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Hyungkun Yoon, Dong Jae Oh, Ho-Suk Suh, Kyoung-Uk Lee, Se-Won Lim, Jun-Yeob Lee, Jong-Chul Yang, Jae-Hon Lee, Juwon Ha, Bun-Hee Lee, Seung-Gul Kang, Ho-Kyoung Yoon, Jihyun Moon, Seung-Min Bae, Youngdo Kwon, Hyun-Chung Kim, Kang Seob Oh
OBJECTIVE: The aim of the present study was to provide clinical consensus and evidence regarding initial treatment strategies for the pharmacological treatment of social anxiety disorder (SAD) in Korea. METHODS: We prepared a questionnaire to derive a consensus from clinicians regarding their preference for the pharmacological treatment of SAD in Korea. Data regarding medication regimens and psychotropic drugs used during initial treatment, the doses used, and the pharmacological treatment duration were obtained...
February 2018: Psychiatry Investigation
Akamin Raymond, Ettore Pedretti, Giuseppina Privitera, Cristina Cicero, Giacomo Biasucci
BACKGROUND: Unilateral absence of the pulmonary artery (UAPA) is a rare congenital malformation often associated with other cardiac anomalies; however it may occur as an isolated lesion. Isolated absence of the right pulmonary artery is twice more frequent than that of the left pulmonary artery. Patients with isolated UAPA are usually asymptomatic at birth; thereafter they may develop a progression of symptoms such as exercise intolerance, dyspnea, chest pain, hemoptysis and recurrent pulmonary infections...
February 20, 2018: Italian Journal of Pediatrics
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