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Emergency Medicine Practice Jul 2023Pericarditis and myocarditis represent a challenging set of diseases to diagnose and treat. These diseases typically present with chest pain and dyspnea in previously... (Review)
Review
Pericarditis and myocarditis represent a challenging set of diseases to diagnose and treat. These diseases typically present with chest pain and dyspnea in previously healthy young people, often in the weeks following a viral illness, including COVID-19. Nonetheless, the etiologies can be very diverse, including infectious, noninfectious, drug-induced, and autoimmune causes. This review focuses on the evaluation, diagnosis, and management of emergency department patients presenting with pericarditis and myocarditis and summarizes current guidelines and best-practice medical management strategies in order to avoid potential life-threatening cardiac complications.
Topics: Humans; Adolescent; Myocarditis; COVID-19; Pericarditis; Emergency Service, Hospital; Diagnosis, Differential; COVID-19 Testing
PubMed: 37352407
DOI: No ID Found -
Diagnostics (Basel, Switzerland) May 2023Thoracic outlet syndrome is an uncommon and controversial syndrome. Three different diagnoses can be made based on the compressed structure, arterial TOS, venous TOS,... (Review)
Review
Thoracic outlet syndrome is an uncommon and controversial syndrome. Three different diagnoses can be made based on the compressed structure, arterial TOS, venous TOS, and neurogenic TOS, though combinations do exist as well. Diagnosing NTOS is difficult since no specific objective diagnostic modalities exist. This has resulted in a lot of controversy in recent decades. NTOS remains a clinical diagnosis and is mostly diagnosed based on the exclusion of an extensive list of differential diagnoses. To guide the diagnosis and treatment of TOS, a group of experts published the reporting standards for TOS in 2016. However, a consensus was not reached regarding a blueprint for a daily care pathway in this document. Therefore, we constructed a care pathway based on the reporting standards for both the diagnosis and treatment of NTOS patients. This care pathway includes a multidisciplinary approach in which different diagnostic tests and additional imaging techniques are combined to diagnose NTOS or guide patients in their treatment for differential diagnoses. The aim of the present work is to discuss and explain the diagnostic part of this care pathway.
PubMed: 37175016
DOI: 10.3390/diagnostics13091625 -
Archives of Pathology & Laboratory... Mar 2020Histopathologic diagnosis of adenocarcinoma of the prostate is based on light-microscopic examination of hematoxylin-eosin-stained tissue sections. Multiple factors,... (Review)
Review
CONTEXT.—
Histopathologic diagnosis of adenocarcinoma of the prostate is based on light-microscopic examination of hematoxylin-eosin-stained tissue sections. Multiple factors, including preanalytic and analytic elements, affect the ability of the pathologist to accurately diagnose prostatic adenocarcinoma. False-negative diagnosis, that is, failure to diagnose prostatic adenocarcinoma, may have serious clinical consequences. It is important to delineate and understand those factors that may affect and cause histopathologic false-negative diagnoses of prostatic adenocarcinoma.
OBJECTIVES.—
To review common factors involved in histopathologic underdiagnosis of prostatic adenocarcinoma, including the following: (1) tissue processing and sectioning artifacts, (2) minimal adenocarcinoma, (3) deceptively benign appearing variants of acinar adenocarcinoma, (4) single cell adenocarcinoma, and (5) treatment effects.
DATA SOURCES.—
Data sources included published, peer-reviewed literature and personal experiences of the senior author.
CONCLUSIONS.—
Knowledge of the reasons for histopathologic false-negative diagnosis of adenocarcinoma of the prostate is an important component in the diagnostic assessment of prostate tissue sections. Diagnostic awareness of the histomorphologic presentations of small (minimal) adenocarcinoma; deceptively benign appearing variants including atrophic, foamy gland, microcystic, and pseudohyperplastic variants; single cell carcinoma; and treatment effects is critical for establishment of a definitive diagnosis of adenocarcinoma and the prevention of false-negative diagnoses of prostate cancer.
Topics: Adenocarcinoma; Biomarkers, Tumor; Cytodiagnosis; Diagnosis, Differential; False Negative Reactions; Humans; Male; Pancreatic Cyst; Prostatic Neoplasms; Sensitivity and Specificity
PubMed: 31729886
DOI: 10.5858/arpa.2019-0456-RA -
Clinics in Liver Disease May 2020Currently, there is no gold standard serologic or imaging modality to detect hepatic encephalopathy (HE). It is a clinical diagnosis gathered from the history and... (Review)
Review
Currently, there is no gold standard serologic or imaging modality to detect hepatic encephalopathy (HE). It is a clinical diagnosis gathered from the history and physical. Imaging is nonspecific; however, PET and MRI have shown areas of utility, but are not widely available, cost-efficient, or necessary for diagnosis. Electroencephalogram has shown promise as it can be used in conjunction with the Portal Systemic Hepatic Encephalopathy Score test to diagnose minimal HE. Further research on these techniques would need to be performed to identify strict criteria and cutoffs for diagnosing HE as well as associated sensitivities and specificities.
Topics: Ammonia; Brain; Electroencephalography; Hepatic Encephalopathy; Humans; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Positron-Emission Tomography; Tomography, X-Ray Computed
PubMed: 32245527
DOI: 10.1016/j.cld.2020.01.011 -
Ugeskrift For Laeger Apr 2024Bronchoscopy has a low risk of complications when diagnosing peripheral lung lesions suspected of malignancy, however the procedures do not always determine a diagnosis.... (Review)
Review
Bronchoscopy has a low risk of complications when diagnosing peripheral lung lesions suspected of malignancy, however the procedures do not always determine a diagnosis. Several modalities have been invented to improve the diagnostic yield, including radial endobronchial ultrasound and electromagnetic navigation, which are currently used by several departments in Denmark. Augmented fluoroscopy, CT-guided bronchoscopy and robotic bronchoscopy are not yet available in Denmark, but may improve the diagnostic work-up, as argued in this review.
Topics: Humans; Lung Neoplasms; Bronchoscopy; Fluoroscopy; Endosonography; Lung
PubMed: 38606703
DOI: 10.61409/V09230596 -
Journal Der Deutschen Dermatologischen... Sep 2019The diagnosis of cutaneous mycobacterial infections may be challenging. Owing to the broad spectrum of their clinical presentations, mycobacterioses have to be... (Review)
Review
The diagnosis of cutaneous mycobacterial infections may be challenging. Owing to the broad spectrum of their clinical presentations, mycobacterioses have to be considered as differential diagnoses to many inflammatory dermatoses. Diagnostic measures comprise histology including special staining, cultures and molecular microbiological examinations as well as the detection of cellular immune reactions of the patient by means of interferon-γ release assays and skin testing. Clinicians should know the appropriate use and combination of procedures to diagnose mycobacterioses quickly and correctly and to avoid costs and delays caused by unnecessary examinations. This mini review summarizes advantages, limitations, and pitfalls of diagnostic methods for mycobacterial skin infections.
Topics: Bacteriological Techniques; Diagnosis, Differential; Humans; Interferon-gamma Release Tests; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Physical Examination; Polymerase Chain Reaction; Skin Diseases, Bacterial; Tuberculin Test
PubMed: 31475786
DOI: 10.1111/ddg.13925 -
South Dakota Medicine : the Journal of... Sep 2022Skin findings in neonates carry a wide differential diagnosis, ranging from self-limiting rashes to something more sinister, as cutaneous changes can be an indicator of... (Review)
Review
Skin findings in neonates carry a wide differential diagnosis, ranging from self-limiting rashes to something more sinister, as cutaneous changes can be an indicator of a serious underlying infectious process. Even benign rashes can cause great concern for families and providers. Pathologic rashes pose a potential risk to the neonate's health. Therefore, it is important to diagnose skin findings and provide any necessary treatment swiftly and accurately. This article provides a concise review of neonatal dermatology with the goal to aid providers in diagnosing and managing neonatal skin conditions.
Topics: Humans; Infant, Newborn; Dermatology; Diagnosis, Differential
PubMed: 36881828
DOI: No ID Found -
Current Rheumatology Reports Oct 2021Calcium pyrophosphate deposition disease (CPPD) arises from calcium pyrophosphate deposition throughout the body, leading to different clinical syndromes that may be... (Review)
Review
PURPOSE OF REVIEW
Calcium pyrophosphate deposition disease (CPPD) arises from calcium pyrophosphate deposition throughout the body, leading to different clinical syndromes that may be diagnosed using various imaging modalities. The purpose of this review is to highlight recent updates in the imaging of CPPD.
RECENT FINDINGS
Conventional radiography remains the initial test when imaging CPPD; but musculoskeletal ultrasound and conventional computed tomography (CT) may also assist in diagnosing and characterizing CPP deposits, with increased sensitivity. Dual-energy CT is also being used to differentiate CPP crystals from other crystal deposition diseases. CPP discitis has been diagnosed with MRI, but MRI has lower sensitivity and specificity than the aforementioned imaging studies in CPPD diagnosis. Assorted imaging modalities are increasingly used to diagnose CPPD involving atypical joints, avoiding invasive procedures. Each modality has its advantages and disadvantages. Future imaging may be able to provide more utility than what is currently available.
Topics: Calcium Pyrophosphate; Chondrocalcinosis; Humans; Radiography; Tomography, X-Ray Computed; Ultrasonography
PubMed: 34623546
DOI: 10.1007/s11926-021-01044-4 -
Journal of the European Academy of... Oct 2020The male and female external genital regions are anatomical areas in which various types of skin disorders may occur. Although most of these conditions can be diagnosed... (Review)
Review
The male and female external genital regions are anatomical areas in which various types of skin disorders may occur. Although most of these conditions can be diagnosed by means of clinical examination and an accurate medical history, in most cases further investigations with time-consuming and/or invasive procedures are needed in order to reach the correct diagnosis. Dermoscopy, as a modern non-invasive tool, is able to better diagnose pigmented and non-pigmented skin tumours along with various inflammatory and infectious skin and appendage disorders. The aim of this paper was to provide a review of the use of dermoscopy in genital disorders based on published data and to include personal experience gained from real life, focusing on any possible gender difference and whether disease mucosal/semimucosal dermoscopy features may differ from those observed on the skin. In conclusion, genital dermoscopy should always be considered during clinical inspection in order to enhance the diagnosis or to rule out those conditions that may look similar but that show a different dermoscopy pattern, thus narrowing down the differential diagnoses and avoiding unnecessary invasive investigations.
Topics: Dermoscopy; Diagnosis, Differential; Female; Genitalia; Humans; Male; Skin; Skin Diseases; Skin Neoplasms
PubMed: 32531092
DOI: 10.1111/jdv.16723 -
Cancer Cytopathology Jun 2021Ocular cytology specimens are small, with limited options for a repeat biopsy. Appropriate handling of these specimens and triaging for ancillary testing can be taxing.... (Review)
Review
Ocular cytology specimens are small, with limited options for a repeat biopsy. Appropriate handling of these specimens and triaging for ancillary testing can be taxing. In this article, the author reviews a selection of potentially challenging diagnoses and current common practices and methods used in diagnosing ocular diseases by cytology. The majority of cytology specimens submitted for evaluation of ocular diseases can be divided into 3 major categories: surface epithelial corneal and conjunctival cytology samples, intraocular fluids from the anterior (aqueous fluid) or posterior (vitreous fluid) chambers of the eye, and intraocular fine-needle aspiration specimens. The clinical findings, testing, and cytologic features of ocular surface epithelial infections, inflammations and neoplasia are discussed; and challenges in processing and diagnosing intraocular infections, chronic uveitis, and vitreoretinal lymphoma are reviewed. Novel molecular testing in the cytologic diagnosis and classification of uveal melanoma also is explored. Cytology evaluation of corneal epithelial and stromal cells, anterior chamber and vitreous samples, and fine-needle aspiration biopsies can provide detailed diagnostic findings to aid in the treatment and follow-up of patients with ocular diseases.
Topics: Animals; Cytodiagnosis; Cytological Techniques; Eye Diseases; Humans
PubMed: 33136340
DOI: 10.1002/cncy.22384