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Clinical diagnosis

B K Singleton, M Ahmed, C A Green, H Heimpel, M J Woźniak, L Ranjha, F Seeney, A Bomford, P Mehta, A Guest, R Mushens, M-J King
BACKGROUND: Bone marrow examination has been the confirmatory test for congenital dyserythropoietic anemia type II (CDAII). Occasional spherocytes on peripheral blood smear can confound the diagnosis. Since a screening test is still unavailable, we explored the feasibility of using flow cytometry as a preliminary screening method. METHODS: Thirteen monoclonal antibodies with specificities for eight erythrocyte membrane proteins were used in FACS analysis to probe the cellular features of red cells from CDAII, normal adults, hereditary spherocytosis (HS), and cord red cells...
October 26, 2016: Cytometry. Part B, Clinical Cytometry
Aakash Garg, Deepti Virmani, Sahil Agrawal, Chirag Agarwal, Abhishek Sharma, Giulio Stefanini, John B Kostis
Heart failure with a preserved ejection fraction (HFpEF) is increasingly prevalent and a leading cause of morbidity and mortality worldwide. HFpEF has a complex pathophysiology, with recent evidence suggesting that an interaction of cardiovascular and noncardiovascular comorbidities (e.g. obesity, hypertension, diabetes, coronary artery disease, and chronic kidney disease) induces an inflammatory state that eventually leads to myocardial structural and functional alterations. Current ACCF/AHA guidelines suggest incorporation of biomarkers along with clinical and imaging tools to establish the diagnosis and disease severity in heart failure (HF)...
October 27, 2016: Cardiology
Roopali Khanna, Deepchandh Raja, Pravin K Goel
Coronary cameral fistula is a rare congenital cardiac abnormality. An 18-year-old boy presented with features of right heart volume overload. Clinical examination was suggestive of hyperdynamic circulation with continuous murmur in precordium. 2D echocardiography showed dilated right coronary artery, and 3D echocardiography added information in tracing the track of the fistula which was consistent with the diagnosis of right coronary cameral fistula draining into the right ventricle. Coronary angiograms revealed an unusually dilated right coronary artery giving the appearance of an "elephant trunk" and with a fistulous tract into the right ventricle...
October 2016: Echocardiography
Shoji Nishio, Shigeo Fukunishi, Shinichi Yoshiya, David C Sing, Erik N Hansen, Thomas P Vail
The aim of this study was to examine the clinical characteristics of patients who required revision and the rate of early complications after revision for metal-on-metal total hip arthroplasty (MOM THA) and metal-on-polyethylene total hip arthroplasty (MOP THA). Matched cohorts were selected by retrospective review from a single-center database of revision THAs for failed MOM and MOP THAs from 2010 to 2014. A total of 140 hips in 140 patients comprised the study population; 39 revisions were performed for failed MOM THAs (MOM group), and 101 revisions were performed for failed MOP THAs (MOP group)...
October 25, 2016: Orthopedics
Flávia Paula Magalhães Monteiro, Thelma Leite de Araujo, Francisca Bertilia Chaves Costa, Telma Alteniza Leandro, Tahissa Frota Cavalcante, Marcos Venícios de Oliveira Lopes
Objective: to conduct the clinical validation of nursing diagnosis "Willingness for improved infant development". Method: a cross-sectional study, conducted in a Centro de Saúde da Família (Family Health Care center), with 45 healthy breastfed infants. The instrument for collecting the data was prepared based on the literature and validated by nurses. It contained the following variables: sociodemographic, gestational, and obstetrical variables; breastfed infant's nutritional profile; evaluation of the defining characteristics of the proposed nursing diagnosis...
September 2016: Revista Brasileira de Enfermagem
Joshua D Brown, Anand R Shewale, Jeffery C Talbert
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are widely used for prevention of stroke secondary to nonvalvular atrial fibrillation (NVAF). Increased use of NOACs is partially a result of simplified regimens compared with warfarin, which has been associated with poor adherence and persistence to therapy. Few studies have assessed adherence to NOACs, especially using contemporary data now that multiple NOACs are available. OBJECTIVE: To evaluate adherence to NOACs in a cohort of newly diagnosed NVAF patients who are commercially insured...
November 2016: Journal of Managed Care & Specialty Pharmacy
Tomoyuki Iwata, Kensuke Adachi, Manabu Takahashi
BACKGROUND: Peliosis hepatis is an uncommon vascular condition characterized by multiple, randomly distributed, blood-filled, and cyst-like cavities throughout the liver. The unique clinical nature consisting of an asymptomatic, benign, and incidental finding sometimes conceals itself even until autopsy. However, the exact pathomechanism remains as yet unproven. METHOD: We encountered the patient with multiple hypervascular masses in the whole liver and investigated the clinicopathological features underlying this condition...
October 25, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Gianluca Pontone, Giuseppe Muscogiuri, Daniele Andreini, Andrea I Guaricci, Marco Guglielmo, Saima Mushtaq, Andrea Baggiano, Edoardo Conte, Virginia Beltrama, Andrea Annoni, Alberto Formenti, Elisabetta Mancini, Mark G Rabbat, Mauro Pepi
The increased number of patients with coronary artery disease (CAD) in developed countries is of great clinical relevance and involves a large burden of the healthcare system. The management of these patients is focused on relieving symptoms and improving clinical outcomes. Therefore the ideal test would provide the correct diagnosis and actionable information. To this aim, several non-invasive functional imaging modalities are usually used as gatekeeper to invasive coronary angiography (ICA), but their diagnostic yield remains low with limited accuracy when compared to obstructive CAD at the time of ICA or invasive fractional flow reserve (FFR)...
December 2016: Current Treatment Options in Cardiovascular Medicine
Maurizio Ponz de Leon, Monica Pedroni, Luca Roncucci, Federica Domati, Giuseppina Rossi, Giulia Magnani, Annalisa Pezzi, Rossella Fante, Luca Reggiani Bonetti
Attenuated polyposis could be defined as a variant of familial adenomatous polyposis (FAP) in which synchronous polyps of the large bowel range between 10 and 99. We analysed all cases of attenuated polyposis observed over the last 30 years with the objectives: (A) to classify the disease according to different type and proportion of polyps; (B) To ascertain the contribution of APC and MutYH genes; (C) to discover features which could arise the suspicion of mutations; (D) To obtain indications for management and follow-up...
October 25, 2016: Familial Cancer
Manigandan Subramanyam Thyagarajan, Khalid Sharif
Space occupying liver lesions usually present with abdominal pain or abnormal physical findings, such as a palpable abdominal mass or distention. Liver lesions identified in children include benign and malignant neoplasms, inflammatory masses, cysts and metastatic lesions. Two-thirds of liver lesions in children are malignant. Hepatoblastoma accounts for two-thirds of malignant liver tumors in children. Benign lesions of the liver in children include vascular lesions, hamartomas, adenomas, and focal nodular hyperplasia...
October 25, 2016: Indian Journal of Pediatrics
Christiane Stern, Laurent Castera
Non-invasive diagnosis and quantification of hepatic steatosis rely on two different but complementary approaches: biomarkers or imaging techniques, either ultrasound-based such as liver ultrasonography and controlled attenuation parameter (CAP), or computed tomography (CT) and magnetic resonance imaging (MRI). Scores for the detection of steatosis have not gained much popularity in clinical practice so far. CAP, using the M probe, is the most promising technique but needs to be implemented with the XL probe and compared to ultrasound that, despite its limitations, remains the most widely used method...
October 25, 2016: Hepatology International
Salem A Beshyah, Ibrahim H Sherif, Farida Chentli, Amir Hamrahian, Aly B Khalil, Hussein Raef, Mohamed El-Fikki, Selim Jambart
BACKGROUND: Prolactinomas are the commonest functional tumors of the pituitary gland. There are still controversies regarding medical therapy in specific clinical situations. Patients may be managed by different specialists in the Middle East and North Africa (MENA) region and no data exist on patterns of clinical management. OBJECTIVES: To ascertain the diagnostic and therapeutic approaches to prolactinomas among relevant professionals from the MENA region. METHODS: An online survey of a large sample of physicians was conducted...
October 25, 2016: Pituitary
Katarina Novak, Davorka Vrdoljak, Igor Jelaska, Josip Anđelo Borovac
BACKGROUND: The goal of this observational cohort study was to examine gender-specific differences in the incidence of acute coronary syndrome (ACS), in-hospital complications and mortality. METHODS: A cohort of 1550 patients with the primary diagnosis of ACS were enrolled in the study over a period of 4 years. The in-hospital mortality and complications were analyzed as the main outcome measures. RESULTS: Women were significantly older compared to men (71 ± 11 years vs...
October 25, 2016: Wiener Klinische Wochenschrift
Angela Roberts Selzer, Matthew Murrell, Eugene Shostak
PURPOSE OF REVIEW: As the field of interventional pulmonology continues to expand and develop at a rapid pace, anesthesiologists are increasingly called upon to provide well tolerated anesthetic care during these procedures. These patients may not be candidates for surgical treatment and often have multiple comorbidities. It is important for anesthesiologists to familiarize themselves with these procedures and their associated risks and complications. RECENT FINDINGS: The scope of the interventional pulmonologist's practice is varied and includes both diagnostic and therapeutic procedures...
October 25, 2016: Current Opinion in Anaesthesiology
Sara Lodi, Shweta Sharma, Jens D Lundgren, Andrew N Phillips, Stephen R Cole, Roger Logan, Brian K Agan, Abdel Babiker, Hartwig Klinker, Haitao Chu, Matthew Law, James D Neaton, Miguel A Hernán
OBJECTIVE: The Strategic Timing of AntiRetroviral Treatment (START) trial found a lower risk of a composite clinical outcome in HIV-positive individuals assigned to immediate initiation of antiretroviral therapy (ART) compared with those assigned to deferred initiation. However, 30% of those assigned to deferred initiation started ART earlier than the protocol specified. To supplement the published intention-to-treat (ITT) effect estimates, here we estimate the per-protocol effect of immediate versus deferred ART initiation in START...
November 13, 2016: AIDS
Cheryl E Gariepy, Melvin B Heyman, Mark E Lowe, John F Pohl, Steven L Werlin, Michael Wilschanski, Bradley Barth, Douglas S Fishman, Steven D Freedman, Matthew J Giefer, Tanja Gonska, Ryan Himes, Sohail Z Husain, Veronique D Morinville, Chee Y Ooi, Sarah Jane Schwarzenberg, David M Troendle, Elizabeth Yen, Aliye Uc
: Acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) have been diagnosed in children at increasing rates over the past decade. However, as pediatric ARP and CP are still relatively rare conditions, little quality evidence is available on which to base the diagnosis and determination of etiology. OBJECTIVES: To review the current state of the literature regarding the etiology of these disorders and to developed a consensus among a panel of clinically active specialists caring for children with these disorders to help guide the diagnostic evaluation and identify areas most in need of future research...
October 25, 2016: Journal of Pediatric Gastroenterology and Nutrition
Jing Chen, Craig A Mullen
BACKGROUND: Pediatric cancer is rare and its symptoms are often ambiguous. The aims of this study were to investigate the time needed to make a diagnosis, assess the frequency of misdiagnosis, and to determine whether these factors affected survival. METHODS: A review of records of 364 pediatric patients diagnosed with cancer at the University of Rochester Golisano Children's Hospital between 2004 and 2012 was conducted. Data were extracted on patient and health care system-related factors and clinical outcomes...
October 25, 2016: Journal of Pediatric Hematology/oncology
Wilson Bautista-Molano, Robert B M Landewé, Cesar Serna, Rafael Valle-Oñate, Désirée van der Heijde
OBJECTIVES: To evaluate the patients' characteristics associated with the clinical decision to request SI-MRI and/or HLA-B27 in patients with SpA in daily practice. METHODS: Patients referred to a rheumatology outpatient-clinic in a national referral-centre were selected. Patients with a clinical diagnosis of SpA according to the rheumatologist were included. SI-MRI and HLA-B27 was available for patients in whom the rheumatologists had ordered these tests. Characteristics associated with ordering SI-MRI or HLA-B27 were identified with univariable analyses...
October 26, 2016: Clinical and Experimental Rheumatology
Rowayda M Amin, Mohamed Gowieda, Ahmed Bedda, Ahmed Kamel, Alaa Radwan
PURPOSE: To analyze the patterns and causes of intraocular inflammation in patients attending uveitis referral clinics in Egypt. METHODS: The study included 454 patients with uveitis examined both at the Department of Ophthalmology, Alexandria Faculty of Medicine, and tertiary uveitis referral clinics in Cairo and the International Eye Clinic in Upper Egypt, between August 2013 and March 2016. All patients had a comprehensive ocular examination and systemic work-up...
October 26, 2016: Ocular Immunology and Inflammation
A Neubert, Z Yang, C Engstrom, Y Xia, M W Strudwick, S S Chandra, J Fripp, S Crozier
PURPOSE: Magnetic resonance (MR) imaging plays a key role in investigating early degenerative disorders and traumatic injuries of the glenohumeral cartilages. Subtle morphometric and biochemical changes of potential relevance to clinical diagnosis, treatment planning, and evaluation can be assessed from measurements derived from in vivo MR segmentation of the cartilages. However, segmentation of the glenohumeral cartilages, using approaches spanning manual to automated methods, is technically challenging, due to their thin, curved structure and overlapping intensities of surrounding tissues...
October 2016: Medical Physics
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