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https://www.readbyqxmd.com/read/27902744/delirium-detection-and-impact-of-comorbid-health-conditions-in-a-post-acute-rehabilitation-hospital-setting
#1
Julija Stelmokas, Nicolette Gabel, Jennifer M Flaherty, Katherine Rayson, Kathileen Tran, Jason R Anderson, Linas A Bieliauskas
Misdiagnosis and under-detection of delirium may occur in many medical settings. This is important to address as delirium clearly increases risk of morbidity and mortality in such settings. This study assessed whether Veterans who screened positive on a delirium severity measure (Memorial Delirium Assessment Scale; MDAS) differed from those with and without corresponding medical documentation of delirium in terms of cognitive functioning, psychiatric/medical history, and medication use. A medical record review of 266 inpatients at a VA post-acute rehabilitation unit found that 10...
2016: PloS One
https://www.readbyqxmd.com/read/27901250/perception-of-stroke-symptoms-and-utilization-of-emergency-medical-services
#2
Maximiliano A Hawkes, Mauricio F Farez, Ismael L Calandri, Sebastián F Ameriso
Methods: Review of hospital records and structured telephone interviews of 100 consecutive stroke patients. Forward stepwise logistic regression was used for the statistical analysis. Results: Seventy patients (75%) arrived at the hospital 4.5 hours after stroke symptoms onset. The use of EMS did not improve arrival times. Most patients who recognized their symptoms did not use EMS (p < 0.02). Nineteen patients (20%) were initially misdiagnosed. Eighteen of them were first assessed by non-neurologist physicians (p < 0...
November 2016: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/27900095/intravenous-leiomyomatosis-with-right-atrium-extension-in-two-patients-a-case-report
#3
Lianxue Zhang, Yang Duan, Fulin Song, Junrui Xiao, Benqiang Yang
Intravenous leiomyomatosis (IVL) is a rare benign tumor of the uterus mesoderm, which can spread via the vein, from the micro-vein to the inferior vena cava, and even to the right atrium. IVL was first described this disease in 1896 and the first presented case of IVL with right atrium extension in the autopsy was described in 1907. On rare occasions, the tumors may extend into the regional and systemic veins, thus reaching the heart. This may subsequently cause intracardiac leiomyomatosis (ICL), which may lead to congestive heart failure and on occasion, sudden fatalities...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27899309/repeated-misdiagnosis-of-a-relapsed-atypical-anti-nmda-receptor-encephalitis-without-an-associated-ovarian-teratoma
#4
Weihe Zhang, Li Yan, Jinsong Jiao
We present an atypical case of relapsed anti-NMDAR encephalitis in a young female patient without an associated ovarian teratoma. She presented with recurrent seizure attacks with muscle weakness, psychosis, dyskinesia, autonomic failure and insomnia. She was first misdiagnosed as mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) then Hashimoto's encephalopathy due to diffuse cerebral lesions, elevated serum lactic acid concentration, increased amount of thyroid peroxidase and thyroglobulin antibodies in serum and diffuse lesions of the thyroid gland...
November 26, 2016: Neuroscience Letters
https://www.readbyqxmd.com/read/27895766/primary-mesenchymal-tumors-of-the-pancreas-in-a-single-center-over-15-years
#5
Hongkai Zhang, Shuangni Yu, Wenze Wang, Yin Cheng, Yu Xiao, Zhaohui Lu, Jie Chen
In total, 95% of primary tumors in the pancreas are epithelial tumors; primary mesenchymal tumors at this site are extremely rare. At present, only one comprehensive study about these rare tumors has been performed. Another retrospective analysis of these rare tumors is performed in the present study, which, to the best of our knowledge, is the first to be performed in China. In the present study, 10 patients that underwent resection for primary mesenchymal tumors of the pancreas were identified in a 15-year period at the Chinese Academy of Medical Sciences and Peking Union Medical College, which accounted for 0...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27891733/generalized-granulomatous-dermatitis-following-mycobacterium-w-mw-immunotherapy-in-lepromatous-leprosy
#6
Geeti Khullar, Tarun Narang, Uma Nahar Saikia, Sunil Dogra
Mycobacterium w (Mw) vaccine is a heat-killed suspension derived from a nonpathogenic, cultivable, atypical mycobacterium named Mycobacterium indicus pranii. Mw immunotherapy has been reported to be efficacious as an adjunct to multidrug therapy multibacillary regimen in leprosy patients with high bacillary index. Cutaneous reactions are predominant adverse effects associated with the administration of vaccines. Cutaneous adverse effects ascribed to Mw vaccine are generally limited to the site of injection...
November 28, 2016: Dermatologic Therapy
https://www.readbyqxmd.com/read/27889533/temporomandibular-joint-disorder-management-in-oral-and-maxillofacial%C3%A2-surgery
#7
Louis G Mercuri
PURPOSE: This article discusses why the management of temporomandibular joint disorder (TMD) cases leads to some oral and maxillofacial surgeons to actively avoid attracting such patients to their practices, offers some evidence-based explanations, and provides recommendations for resolution that will benefit not only the specialty but more importantly the patients it serves. MATERIALS AND METHODS: A review of the reasons some surgeons state they do not wish to manage TMD cases is presented, followed by an updated review of the TMD and orthopedic literature discussing not only the importance of a proper diagnosis but also the impact of comorbid conditions, genetics, clinical experience, and patient expectations important to achieving good TMD management outcomes...
November 4, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27889190/diagnosis-of-multiple-sclerosis-progress-and-challenges
#8
REVIEW
Wallace J Brownlee, Todd A Hardy, Franz Fazekas, David H Miller
The diagnosis of multiple sclerosis is based on neurological symptoms and signs, alongside evidence of dissemination of CNS lesions in space and time. MRI is often sufficient to confirm the diagnosis when characteristic lesions accompany a typical clinical syndrome, but in some patients, further supportive information is obtained from cerebrospinal fluid examination and neurophysiological testing. Differentiation is important from other diseases in which demyelination is a feature (eg, neuromyelitis optica spectrum disorder and acute disseminated encephalomyelitis) and from non-demyelinating disorders such as chronic small vessel disease and other inflammatory, granulomatous, infective, metabolic, and genetic causes that can mimic multiple sclerosis...
November 23, 2016: Lancet
https://www.readbyqxmd.com/read/27888430/radiation-exposure-in-diagnostic-imaging-wisdom-and-prudence-but-still-a-lot-to-understand
#9
Paolo Tomà, Vittorio Cannatà, Elisabetta Genovese, Andrea Magistrelli, Claudio Granata
Since 2000, a series of scientific articles on CT have been raising increasing concern about the risk of radiation induced cancer in children. The alarming conclusions of some of these articles had international echo through global media, provoking widespread public concern. Actually, many of these alarming scientific publications appeared to be flawed by poor study design, but their conclusions were not openly contradicted. In US and Europe pediatric radiologists had to face a huge challenge, which brought to the Image Gently campaign and the Eurosafe initiative with the aim to rebut misinformation and to support medical radiation protection...
November 25, 2016: La Radiologia Medica
https://www.readbyqxmd.com/read/27888160/preliminary-results-of-comparative-study-for-subsequent-photodynamic-therapy-versus-secondary-excision-after-primary-excision-for-treating-basal-cell-carcinoma
#10
Wenbo Bu, Mengli Zhang, Qian Zhang, Chunyu Yuan, Xu Chen, Fang Fang
Some basal cell carcinomas (BCCs) are indistinguishable from nevi based on clinical manifestations. Therefore, it is often difficult for the excision margins of the initial surgical treatment to achieve radical removal of the malignancy. This study was a comparative analysis of the clinical results of aminolevulinic acid (ALA)-photodynamic therapy (PDT) or secondary surgery after the primary excision. In total, 20 patients with preoperative clinical diagnoses of nevi underwent in situ resection. The postoperative pathological diagnoses confirmed all cases were BCC...
November 22, 2016: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/27882768/-adrenocortical-oncocytoma-presenting-as-cushing%C3%A2-s-syndrome-in-pregnancy-with-spontaneous-postpartum-uterine-rupture
#11
M Kotoulová, I Mikysková, J Dušková, J Vláčil, M Dvořák, M Halaška
OBJECTIVE: The description of rare case of the Cushings syndrome in pregnancy resulting in the spontaneous rupture of uterus. DESIGNS: A case report. SETTING: Department of Gynecology and Obstetrics, 1st Medical Faculty of Charles University and Hospital Na Bulovce. CASE REPORT: The authors report the case of a 33 year old woman, who was admitted to the clinic in 30th week of pregnancy for elevated blood pressure and hypokalemia...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27882155/clinical-value-of-diagnosing-aortico-left-ventricular-tunnel-by-echocardiography
#12
Manying Xie, Jiabao Yin, Qing Lv, Jing Wang
In order to assess the clinical value of echocardiography in the diagnosis of aortico-left ventricular tunnel (ALVT) the echocardiographic data and clinical manifestations of six patients with ALVT were analyzed in the present study. Based on the results, a comprehensive study was conducted regarding 147 cases from related documents. Six patients were confirmed with ALVT by surgery. The echocardiographic images of the patients revealed an abnormal communication beginning in the ascending aorta above the coronary arteries, bypassing the aortic valve, and ending in the left ventricle...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27878067/ultrasonography-findings-of-alloderm-%C3%A2-used-in-postmastectomy-alloplastic-breast-reconstruction-a-case-report-and-literature-review
#13
Young Seon Kim
AlloDerm(®) (LifeCell Corp.; Brancburg, NJ) is an acellular dermal matrix (ADM) that serves as an immunologically inert scaffold in plastic surgery. In breast reconstruction, it is used as a filler for lumpectomy defects and can be used to create the inferolateral portion of the tissue expander pocket or implant pocket in postmastectomy patients. However, there are limited reports of the radiologic findings of AlloDerm(®) in patients who have undergone postmastectomy reconstruction. Familiarity with the imaging features of AlloDerm(®) is essential for correct diagnosis...
July 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27875090/clinical-computed-tomographic-magnetic-resonance-imaging-and-histologic-findings-associated-with-myxomatous-neoplasia-of-the-temporomandibular-joint-in-two-dogs
#14
Arana Parslow, David P Taylor, David J Simpson
CASE DESCRIPTION A 15-year-old neutered female mixed-breed dog (dog 1) and an 11-year-old neutered female Labrador Retriever (dog 2) were examined because of unilateral exophthalmus, third eyelid protrusion, and periorbital swelling that failed to respond to antimicrobial treatment. CLINICAL FINDINGS Both dogs underwent ultrasonographic, CT, and MRI examination of the head. In both dogs, advanced imaging revealed a poorly defined, peripherally contrast-enhancing, mucous-filled cystic mass that radiated from the temporomandibular joint and infiltrated the periorbital tissues and retrobulbar space...
December 1, 2016: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/27873481/a-case-of-pulmonary-cryptococcosis-with-large-pericardial-effusion-diagnosed-using-cervical-lymph-node-biopsy
#15
Xuchun Liu, Wei Jia, Shubin Huang, Gengyun Sun
Pulmonary cryptococcosis (PC) is a relatively rare infectious disease. It mainly involves the lungs; however, in some patients, the infection could spread to other parts of the body. PC mostly occurs in patients with immune deficiencies. However, PC infections have been reported in non-immunocompromised patients. The diagnosis of PC is challenging in patients without immune deficiencies. Here, the case of a 27-year-old immunocompetent woman who was diagnosed with PC was report. She had unexplained fever and a history of close contact with poultry feathers...
November 7, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27873302/ultrasonographic-findings-can-identify-pseudoprogression-under-nivolumab-therapy
#16
K Imafuku, H Hata, S Kitamura, T Yanagi, H Shimizu
'Pseudoprogression' is often seen in patients with melanomas who are treated with immune-checkpoint inhibitors such as nivolumab or ipilimumab. We sometimes evaluate metastatic lesions by imaging tests such as CT or PET-CT. 'Pseudoprogression' usually occurs upon the initial administration, which may make it difficult for the physician to determine the disease condition. In our two cases of metastatic melanoma treated with nivolumab (anti-PD-1 antibody), we examined the ultrasonography (US) of target lesions that could be accessed from the body surface, such as those of the regional lymph node or subcutaneous metastasis...
November 22, 2016: British Journal of Dermatology
https://www.readbyqxmd.com/read/27870472/nodular-sclerosis-classical-hodgkin-lymphoma-grade-2-a-diagnostic-challenge-to-the-cytopathologists
#17
Sudha Sharma, Pranab Dey, Suvradeep Mitra, Arvind Rajwanshi, Raje Nijhawan, Radhika Srinivasan, Nalini Gupta, Ashim Das
BACKGROUND: Grade 2 nodular sclerosis classical Hodgkin lymphoma (NSCHL) is less common than grade 1 lymphoma and has a worse overall prognosis. To the best of the authors' knowledge, no study of a large series of cases has been performed until now. The objective of this study was to assess the diagnostic efficacy of cytology for grade 2 NSCHL versus grade 1 NSCHL and study the morphological features of grade 2 NSCHL in fine-needle aspiration cytology (FNAC). METHODS: Fifteen of 51 histopathology-proven cases of NSCHL (18 FNAC procedures) were grade 2, and 36 were grade 1...
November 21, 2016: Cancer
https://www.readbyqxmd.com/read/27867327/unusual-glomus-tumor-of-the-penis
#18
REVIEW
Gautam Dagur, Kelly Warren, Yimei Miao, Navjot Singh, Yiji Suh, Sardar A Khan
INTRODUCTION: Glomus tumors are benign neoplasms commonly found in subungual regions of the extremities and rarely located in the penis. Misdiagnosis of glomus tumors is common; therefore, symptoms and clinical presentations should be reviewed. OBJECTIVE: The primary objective of this review article is to emphasize the pathogenesis, pathology, clinical presentation, symptoms, diagnosis, and treatment methods of glomus tumors in order to better identify and manage the condition...
October 2016: Current Urology
https://www.readbyqxmd.com/read/27866294/renal-paratransplant-hernia-revealed-a-review-of-the-literature
#19
REVIEW
D Moris, J Bokos, M Vailas, K Kakavia, E Spartalis, A Athanasiou, D Schizas, S Vernadakis
BACKGROUND: Renal paratransplant hernia (RPH) is an uncommon variant of internal hernias developed in renal transplant recipients. The aim of this review is to meticulously present and analyze all data coming mainly from case reports or short-case studies on this very uncommon surgical entity. MATERIALS AND METHODS: The MEDLINE/PubMed database was searched for publications with the medical subject heading ''renal paratransplant hernia''. All the references from the identified articles were searched for relevant information...
November 19, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/27865246/renal-tuberculosis-presenting-as-acute-pyelonephritis-a-rarity
#20
Ajay Kumar Verma, Ashwini Kumar Mishra, Manoj Kumar, Surya Kant, Anubhuti Singh, Ajay Singh
One of the major health problems faced particularly by the developing world since ages is that of tuberculosis (TB). Genito-urinary tuberculosis (GUTB) is the second most common extrapulmonary TB, with kidney being the most frequent site of infection. Due to the diverse and atypical clinical manifestations of urinary TB, the disease is easy to misdiagnose. The diagnosis of renal TB should be suspected in a nonspecific bacterial cystitis associated with a therapeutic failure or a sterile pyuria and a past history of pulmonary TB with important radiologic findings, particularly with the help of CT scan...
July 2016: Indian Journal of Tuberculosis
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