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https://www.readbyqxmd.com/read/29149473/exploring-communication-during-the-journey-from-noticing-bodily-changes-to-a-diagnosis-of-endometrial-cancer
#1
Catherine Cook, Margaret Brunton, Tepora Pukepuke, Ai Ling Tan
AIMS AND OBJECTIVES: To understand women's perspectives about the trajectory from first bodily changes to diagnosis. BACKGROUND: With endometrial cancer, as with all gynaecological cancers, early diagnosis is key to successful outcomes. However, women do not always seek clinical advice early. Previously, this gap has been referred to as a 'delay', blamed on fear or refusal to acknowledge symptoms. METHODS: A qualitative research project which involved face-to-face interviews with 16 women who had presented with symptoms of endometrial cancer...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29149097/acute-coronary-disease-prognosis-and-prevalence-of-risk-factors-in-young-adults
#2
REVIEW
Alvaro Gudiño Gomezjurado, Bianca Pujol Freitas, Flavia Contreira Longatto, Juliana Negrisoli, Gustavo Aguiar Sousa
Acute coronary disease is a rare entity in young people and is mostly related to atherosclerotic disease. However, other causes such as myocardial bridges, coronary artery dissection and antiphospholipid syndrome may be present. The prognosis of the disease in this group of patients is favorable; although women may have a higher morbidity because diagnosis and treatment can be delayed. The goal of this review is to update the knowledge about risk factors and prognosis of young patients with an acute coronary event compared to the older population...
November 9, 2017: Medwave
https://www.readbyqxmd.com/read/29148580/ultrasound-guided-reduction-of-an-incarcerated-obturator-hernia-in-an-elderly-patient
#3
Bente M de Kok, Julien B C M Puylaert, Frank M Zijta
Obturator hernia is a rare but clinically relevant cause of intestinal obstruction, usually found in elderly, thin, multiparous women. It is difficult to diagnose, leading to diagnostic delay with a high incidence of strangulation and a high mortality rate. Surgery is the only reported treatment. We report the case of an 86-year-old woman, in whom an early diagnosis of incarcerated obturator hernia was made with subsequent reduction by compression with an ultrasound transducer. When the risk of strangulation is presumed to be low, ultrasound-guided reduction of an obturator hernia is achievable and worth considering...
November 17, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29148203/the-ins-and-outs-of-intussusception-where-best-practice-reduces-the-need-for-surgery
#4
Spencer W Beasley
Intussusception may be difficult to diagnose because the classical triad of symptoms is evident at the time of presentation in only about 20% of cases. This may lead to delays in making the correct diagnosis. The most common presenting features are colicky abdominal pain, vomiting, pallor, lethargy and listlessness. In recent years, the algorithms of management of intussusception have changed significantly: a routine plain abdominal X-ray has been replaced by ultrasonography, previously perceived contraindications to attempting an enema reduction no longer apply, gas has largely replaced barium for enema reduction, incomplete initial reduction is an indication for a delayed repeat enema if the child is stable clinically and partial reduction has been achieved, the indications for surgery have been tightened and laparoscopy affords an alternative surgical approach...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29147883/clinical-and-radiological-diagnosis-of-gallstone-ileus-a-mini-review
#5
Liisa Chang, Minna Chang, Hanna M Chang, Aina I Chang, Fuju Chang
Gallstone ileus is a rare cause of bowel obstruction, which mainly affects the elderly population. The associated mortality is estimated to be up to 30%. The presentation of gallstone ileus is notoriously non-specific, and this often contributes to the delay in diagnosis. The diagnosis of gallstone ileus relies on a radiological approach, and herein we discuss the benefits and drawbacks of the use of different modalities of radiological imaging: plain abdominal films, computed tomography, magnetic resonance imaging, and ultrasound scanning...
November 16, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29147600/osteoglophonic-dysplasia-phenotypic-and-radiological-clues
#6
Shwetha Kuthiroly, Dhanya Yesodharan, Aneesh Ghosh, Kenneth E White, Sheela Nampoothiri
Osteoglophonic dysplasia (OD) is an extremely rare, skeletal dysplasia with an autosomal dominant mode of inheritance. Rhizomelic dwarfism, craniosynostosis, impacted teeth, hypodontia or anodontia, and multiple nonossifying bone lesions are the salient features of this condition. We report a 14-year-old girl with clinical and radiological features consistent with OD. She presented with disproportionate short stature, craniosynostosis, a prominent supraorbital ridge, delayed teeth eruption, hypodontia, and multiple nonossifying bone lesions in the femur, tibia, and fibula...
December 2017: Journal of Pediatric Genetics
https://www.readbyqxmd.com/read/29147593/rapidly-progressive-disseminated-sporotrichosis-as-the-first-presentation-of-hiv-infection-in-a-patient-with-a-very-low-cd4-cell-count
#7
Isis Cristine Morávia Ribeiro de Oliveira-Esteves, Guilherme Almeida Rosa da Silva, Walter de Araujo Eyer-Silva, Rodrigo Panno Basílio-de-Oliveira, Luciana Ferreira de Araujo, Carlos José Martins, Rogério Neves-Motta, Marcelo Costa Velho Mendes de Azevedo, Dario José Hart Pontes Signorini, Jorge Francisco da Cunha Pinto, Lívia Machado Moura, Rafael Jacyntho Laterça, Diogo Raphael Garcia de Oliveira Pereira, Isabela Vieira do Lago, Fernando Raphael de Almeida Ferry
Sporotrichosis is a human and animal disease caused by species of the Sporothrix schenckii complex. It is classically acquired through traumatic inoculation of fungal elements. Most frequently, sporotrichosis presents as a fixed cutaneous or as a lymphocutaneous form. A much smaller number of cases occur as cutaneous disseminated and disseminated forms. These cases require immediate diagnosis and management to reduce morbidity and mortality. We present the case of a 34-year-old male patient in whom the first presentation of HIV infection was a rapidly progressive sporotrichosis with multiple cutaneous lesions, a high fungal burden in tissues, and pulmonary involvement...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29147571/a-surprising-treatment-response-in-a-patient-with-rare-isolated-growth-hormone-deficiency-type-ib
#8
Jordan Yardain Amar, Kimberly Borden, Elizabeth Watson, Talin Arslanian
Isolated Growth Hormone Deficiency (IGHD) is a rare cause of short stature, treated with the standard regimen of subcutaneous synthetic growth hormone (GH). Patients typically achieve a maximum height velocity in the first year of treatment, which then tapers shortly after treatment is stopped. We report a case of a 9-year-old male who presented with short stature (<3rd percentile for age and race). Basal hormone levels showed undetectable serum IGF1. Skeletal wrist age was consistent with chronologic age...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29147478/abdominal-pain-with-a-twist-a-rare-presentation-of-acute-gastric-volvulus
#9
David P Chen, Saqib Walayat, Imran L Balouch, Daniel K Martin, Teresa J Lynch
Acute gastric volvulus is a life threatening condition requiring early diagnosis and aggressive management. Diagnosis of gastric volvulus remains a challenge for clinicians due to variable, non-specific clinical presentation, which requires a high level of suspicion. It should be considered in patients presenting with chest pain and/or epigastric pain, especially in the elderly population. Endoscopic de-rotation could be initially attempted as a therapeutic modality especially in patients who cannot undergo surgery...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29147118/the-effects-of-public-education-through-short-message-service-on-the-time-from-symptom-onset-to-hospital-arrival-in-patients-with-myocardial-infarction-a-field-trial
#10
Farzaneh Saberi, Mohsen Adib-Hajbaghery, Javad Zohrehie
BACKGROUND: Patients' early hospital arrival is among the most important factors in minimizing the complications of myocardial infarction (MI). One of the measures which can reduce prehospital delay in these patients is public education. The aim of the present study was to investigate the effects of public education through Short Message Service (SMS) on the time from symptom onset to hospital arrival (or onset-to-door time) in patients with MI in Kashan, Iran. METHODS: This field trial was done on 131 patients with definite diagnosis of myocardial infarction...
May 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29146218/presentation-and-diagnosis-of-fournier-s-gangrene
#11
REVIEW
Bryan B Voelzke, Judith C Hagedorn
Necrotizing fasciitis is a severe type of necrotizing soft tissue infection involving the superficial fascia and subcutaneous tissues. Fournier's gangrene, a type of necrotizing fasciitis, affects the genitalia and/or perineum. While a rare health condition, Fournier's gangrene can result in significant morbidity and unnecessary mortality following delay in diagnosis and management. We provide a review of relevant presenting features to aid diagnosis and allow timely surgical management of this serious infectious condition...
November 13, 2017: Urology
https://www.readbyqxmd.com/read/29146215/-acute-methotrexate-related-neurotoxicity-and-pseudo-stroke-syndrome
#12
V Deneux, N Leboucq, L Saumet, S Haouy, T Akbaraly, N Sirvent
Treatment of acute lymphoblastic leukemia requires high-dose systemic and/or intrathecal methotrexate to prevent and/or treat central nervous system disorders. Acute neurotoxicity of methotrexate, of unknown etiopathogenesis, is characterized by the polymorphism of clinical manifestations, responsible for a potentially harmful diagnostic delay in these immunosuppressed patients. We describe five episodes of transient acute leukoencephalopathy mimicking a stroke, reported in the literature as "pseudo-stroke syndrome"...
November 13, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29145820/demographic-and-need-factors-of-early-delayed-and-no-mental-health-care-use-in-major-depression-a-prospective-study
#13
A M Boerema, M Ten Have, A Kleiboer, R de Graaf, J Nuyen, P Cuijpers, A T F Beekman
BACKGROUND: Despite the availability of evidence based treatments, many people with major depression receive no or delayed professional treatment, which may put them at risk for adverse outcomes. The aim of this study was to examine which demographic and need factors distinguish early, delayed and no treatment use. METHODS: Data were obtained from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). People with a diagnosis of major depression in the past 12 months were included (N = 434)...
November 16, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/29145691/-primary-intraocular-lymphoma-relevance-of-diagnostic-vitrectomy
#14
Claudia Helga Le Guin, Klaus Metz, Norbert Bornfeld
Primary intraocular lymphomas are rare tumours that can be further subdivided into primary vitreoretinal and the even rarer primary uveal lymphoma. The incidence of primary vitreoretinal lymphoma (PVRL) has increased during the last few decades. Differential diagnostic distinction between lymphoma and posterior uveitis is often difficult, so that adequate diagnosis and treatment is often delayed. This is fatal, because PVRL is often associated with primary central nervous lymphoma. To confirm the diagnosis, prior treatment of cytological or histological detection of lymphoma cells is the gold standard...
November 16, 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/29145279/osteosarcoma-in-the-coracoid-process-that-mimicked-an-osteochondroma-a-case-report
#15
Zhiping Luo, Conglin Ye, Hong-Xun Sang
RATIONALE: Osteosarcomas are the most common primary malignant bone tumors in children and young adults; these tumors often affect the metaphyses of long bones such as the proximal humerus, proximal tibia, and distal femur. In contrast, osteosarcoma of the coracoid process is extremely rare. PATIENT CONCERNS: Herein, we describe a case of osteosarcoma affecting the coracoid process in a 40-year-old woman. The patient presented with shoulder pain, weakness, and an inability to raise her left arm...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145275/asymptomatic-syringomyelia-accompanied-with-metastatic-cerebellar-and-spinal-intramedullary-lymphoma-a-case-report
#16
Jia-Jia Zhou, Jin-Feng Xu, Xu-Ning Zheng, Guo-Ping Peng
RATIONALE: Asympotamic syringomyelia accompanied with metastatic cerebellar and thoracic spinal intramedullary lymphoma is rare in clinical practice. If the intramedullary lymphoma is large enough, the patient will rapidly develop neurologic signs of spinal injury. The prognosis of this type of complication is always bad. PATIENT CONCERNS: Rapid and correct diagnosis and treatment is important for metastatic extranodal lymphoma with B cell of origin. DIAGNOSES: Syringomyelia accompanied with metastatic cerebellar and thoracic spinal intramedullary lymphoma...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145239/two-case-reports-colorectal-adenocarcinoma-in-children
#17
Chang Hoon Ahn, Soon Chul Kim
RATIONALE: Colorectal cancer in children is rare, with delayed diagnosis and advanced stage at presentation in high mortality. Early detection of colorectal cancer is, therefore, important for better prognosis. PATIENT CONCERNS: Thirteen-year-old boy presented with symptoms of melena, vomiting, and abdominal pain for 6 months. 18-year-old girl was hospitalized due to the symptoms of hematochezia, and persistent abdominal pain for 6 months. They have no chronic disease or familial history of malignancy...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145037/time-to-diagnosis-and-treatment-for-cancer-patients-in-the-netherlands-room-for-improvement
#18
Charles C W Helsper, Nicole N F van Erp, Petra P H M Peeters, Niek N J de Wit
BACKGROUND & AIM: Reducing the duration of the diagnostic cancer care pathway is intensively pursued. The aim of this study was to chart the diagnostic pathway for the five most common cancers in the Netherlands. METHODS: A retrospective cohort study using cancer patients' anonymised primary care data (free text and coded) linked to the Netherlands Cancer Registry. We determined the median duration of the following: 1. Primary care intervals (IPCs): the first cancer-related general practitioner consultation to referral, 2...
November 13, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29144824/17%C3%AE-hydroxylase-deficiency-is-an-underdiagnosed-disease-high-frequency-of-misdiagnoses-in-a-large-cohort-of-brazilian-patients
#19
Rafaela Fontenele, Marivânia Costa-Santos, Claudio E Kater
OBJECTIVE: 17α-Hydroxylase deficiency (P450c17D) is characterized by hypogonadism and mineralocorticoid hypertension. We aimed to estimate the relative incidence and spectrum of preliminary misdiagnoses in Brazilian P450c17D patients. DESIGN: Cross-sectional study. METHODS: We reviewed, updated, and analyzed data of 40 P450c17D patients (21 XY, 19 XX). RESULTS: Complete data were unavailable for two patients. Seven patients were relatives of an index case...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29144248/recognition-of-infantile-spasms-is-often-delayed-the-assist-study
#20
Shaun A Hussain, Johnson Lay, Emily Cheng, Julius Weng, Raman Sankar, Christine B Baca
OBJECTIVES: To characterize and quantify diagnostic and treatment delay among children with infantile spasms, and to estimate the developmental impact of this delay. STUDY DESIGN: In this cohort study, we surveyed the parents of 100 patients with infantile spasms about their experiences with diagnosis and treatment, and ascertained medical and sociodemographic factors potentially related to care of these infants. We specifically determined the latency to first visit an "effective provider," defined as a provider who identified infantile spasms, and prescribed an appropriate first-line treatment, namely adrenocorticotropic hormone, corticosteroids, or vigabatrin...
November 2017: Journal of Pediatrics
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