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American Family Physician Aug 2020Neck pain is a common presenting symptom in the primary care setting and causes significant disability. The broad differential diagnosis requires an efficient but global... (Review)
Review
Neck pain is a common presenting symptom in the primary care setting and causes significant disability. The broad differential diagnosis requires an efficient but global assessment; therefore, emphasis is typically placed on red flags that can assist in the early recognition and treatment of more concerning diagnoses, such as traumatic injuries, infection, malignancy, vascular emergencies, and other inflammatory conditions. The critical element in appropriate diagnosis and management of these conditions is an accurate patient history. Physical examination findings complement and refine diagnostic cues from the history but often lack the specificity to be of value independently. Diagnostic tools such as imaging and electrodiagnostic tests have variable utility, especially in chronic or degenerative conditions. Treatment of mechanical or nonneuropathic neck pain includes short-term use of medications and possibly injections. However, long-term data for these interventions are limited. Acupuncture and other complementary and alternative therapies may be helpful in some cases. Advanced imaging and surgical evaluation may be warranted for patients with worsening neurologic function or persistent pain.
Topics: Adult; Aged; Aged, 80 and over; Curriculum; Diagnostic Tests, Routine; Education, Medical, Continuing; Female; Guidelines as Topic; Humans; Male; Medical History Taking; Middle Aged; Neck Pain
PubMed: 32735440
DOI: No ID Found -
Journal of Drugs in Dermatology : JDD Mar 2020The diagnosis of atopic dermatitis (AD) remains primarily a clinical diagnosis, in which several clinical signs and symptoms including pruritus, the presence and... (Review)
Review
The diagnosis of atopic dermatitis (AD) remains primarily a clinical diagnosis, in which several clinical signs and symptoms including pruritus, the presence and location of skin lesions, and a personal or family history of atopic conditions are used to facilitate a diagnosis. In recent decades, several well-established sets of criteria have been developed to aid diagnosis. With increased awareness of AD and the recent development of systemic immunomodulators to treat the condition, there exists a need to further define and consolidate the current diagnostic criteria while refining our current understanding of the clinical features of AD. We propose a novel, simplified set of criteria that comprises the clinical features generally considered to be essential for a confirmed diagnosis of AD, together with features previously regarded as having less clinical significance. It is essential, however, that any refinements to the diagnostic criteria for AD are made alongside regular updates of treatment guidelines so that these also reflect current developments. In this regard, the current guidelines in the United States are lacking and should be updated. J Drugs Dermatol. 2020;19(3): doi:10.36849/JDD.2020.4737 THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.
Topics: Decision Trees; Dermatitis, Atopic; Diagnostic Tests, Routine; Humans; Practice Guidelines as Topic
PubMed: 32550689
DOI: No ID Found -
Journal of Hospital Medicine Aug 2021
Topics: Calcium; Diagnostic Tests, Routine; Humans
PubMed: 34197298
DOI: 10.12788/jhm.3619 -
Journal of Minimally Invasive Gynecology Feb 2020To show how the evaluation for endometriosis can be included in the routine pelvic ultrasound examination.
STUDY OBJECTIVE
To show how the evaluation for endometriosis can be included in the routine pelvic ultrasound examination.
DESIGN
Stepwise narrated video demonstration of the sonographic evaluation for endometriosis in routine pelvic ultrasound following the recommended sonographic approach published in the 2016 consensus paper by the International Deep Endometriosis Analysis (IDEA) group [1].
SETTING
Endometriosis is a common and often debilitating gynecological disorder that affects 5-10% of women [2]. The prevalence is even higher among women with symptoms of endometriosis [2], which include chronic pelvic pain, acquired dysmenorrhea, dyspareunia, dyschezia, menorrhagia, abnormal bleeding, and infertility. Approximately 80% of women who have endometriosis have superficial lesions, whereas 20% have deep infiltrating endometriosis (DIE; [3]). Laparoscopy is the gold standard for diagnosing endometriosis, because it allows the diagnosis of all forms of endometriosis and often immediate removal of superficial endometriosis. The removal of DIE is considerably more complicated and usually cannot be completed unless it was diagnosed preoperatively. The technique to diagnose DIE with transvaginal ultrasound (TVUS) was first described in detail in 2009 [4]. Since then, the accuracy of TVUS for the prediction of DIE has been well established in the literature [5-7]. TVUS is widely used as a first-line investigation for women with gynecological symptoms. The inclusion of an assessment for endometriosis in the routine pelvic ultrasound allows earlier diagnosis and better surgical outcomes for all women with DIE.
INTERVENTIONS
The evaluation for endometriosis in routine pelvic ultrasound based on the IDEA consensus promotes a 4-step dynamic ultrasound approach [1]: (1) routine evaluation of uterus and adnexa with particular attention for sonographic signs of adenomyosis and the presence or absence of endometriomas; (2) evaluation of transvaginal sonographic 'soft markers' such as site-specific tenderness and ovarian mobility; (3) assessment of status of pouch of Douglas using the real-time ultrasound-based "sliding sign;" and (4) assessment of DIE nodules in the anterior and posterior compartments, which involves assessment of the bladder, vaginal vault, uterosacral ligaments, and bowel, including rectum, rectosigmoid junction, and sigmoid colon. Because 5-10% of women with DIE also have ureteric endometriosis, it is useful to assess the kidneys. Silent hydronephrosis is easily identified in 50-60% of patients with ureteric involvement. Although it is possible to identify DIE involving the ureters more directly, this requires more advanced skills, and further studies are still needed to better define the accuracy of ureteric DIE detection by TVUS [8-10].
CONCLUSION
Traditionally, only pathologies of the uterus and ovaries are assessed during a routine pelvic ultrasound. Here we demonstrate that the routine ultrasound examination can easily be extended beyond the uterus and ovaries into the posterior and anterior pelvic compartments to evaluate structural mobility and to look for deep infiltrating endometriotic nodules, wherewith women suffering from DIE can benefit from a preoperative diagnosis and subsequently, a single, well-planned procedure in the hands of a well-prepared team.
Topics: Diagnostic Techniques, Obstetrical and Gynecological; Diagnostic Tests, Routine; Endometriosis; Female; Humans; Pelvis; Peritoneal Diseases; Preoperative Care; Sensitivity and Specificity; Ultrasonography; Vagina
PubMed: 31493569
DOI: 10.1016/j.jmig.2019.08.027 -
Journal of Dentistry Jun 2021
Topics: Computer-Aided Design; Dental Prosthesis Design; Diagnostic Tests, Routine
PubMed: 34004272
DOI: 10.1016/j.jdent.2021.103693 -
Clinical Microbiology and Infection :... Oct 2020Digitalization and artificial intelligence have an important impact on the way microbiology laboratories will work in the near future. Opportunities and challenges lie... (Review)
Review
BACKGROUND
Digitalization and artificial intelligence have an important impact on the way microbiology laboratories will work in the near future. Opportunities and challenges lie ahead to digitalize the microbiological workflows. Making efficient use of big data, machine learning, and artificial intelligence in clinical microbiology requires a profound understanding of data handling aspects.
OBJECTIVE
This review article summarizes the most important concepts of digital microbiology. The article gives microbiologists, clinicians and data scientists a viewpoint and practical examples along the diagnostic process.
SOURCES
We used peer-reviewed literature identified by a PubMed search for digitalization, machine learning, artificial intelligence and microbiology.
CONTENT
We describe the opportunities and challenges of digitalization in microbiological diagnostic processes with various examples. We also provide in this context key aspects of data structure and interoperability, as well as legal aspects. Finally, we outline the way for applications in a modern microbiology laboratory.
IMPLICATIONS
We predict that digitalization and the usage of machine learning will have a profound impact on the daily routine of laboratory staff. Along the analytical process, the most important steps should be identified, where digital technologies can be applied and provide a benefit. The education of all staff involved should be adapted to prepare for the advances in digital microbiology.
Topics: Artificial Intelligence; Automation, Laboratory; Big Data; Data Analysis; Diagnostic Tests, Routine; Humans; Image Processing, Computer-Assisted
PubMed: 32603804
DOI: 10.1016/j.cmi.2020.06.023 -
Archives of Razi Institute Jan 2021Toxoplasmosis is a widespread parasitic disease caused by a protozoan parasite Toxoplasma gondii. Currently, nanotechnology has been used for the diagnosis of many...
Toxoplasmosis is a widespread parasitic disease caused by a protozoan parasite Toxoplasma gondii. Currently, nanotechnology has been used for the diagnosis of many infectious diseases. It could be due to the fact that nanoparticles play an important role in accurate and fast diagnosis. The purpose of this study was to design a Nano-enzyme linked immunosorbent assay (Nano-ELISA) kit using excreted/secreted (E/S) antigens to have higher sensitivity and specificity than those reported for the designed enzyme-linked immunosorbent assay (ELISA) kit for the diagnosis of Toxoplasmosis in mice. Firstly, the serum samples were collected from 15 infected mice with T. gondii and 15 healthy ones. Then, E/S antigens were separated from parasite tachyzoites and used for designing an ELISA kit. In addition, the mice sera were evaluated using the designed ELISA kit. Finally, the serum samples were assessed by Nano-ELISA kits designed with E/S antigen and conjugate of gold nanoparticles. The obtained results of the present study showed that the sensitivity and specificity of the designed ELISA kit were reported as 80% and 86.66%, respectively, that both improved to 93.33% in these sera with the designed Nano-ELISA kit. This finding revealed the significant improvement of sensitivity and specificity using gold nanoparticles in designing the ELISA kit. Furthermore, according to the literature, the use of E/S antigens in designing recognizable ELISA kits has been always highlighted considering the presence of numerous antigens in T. gondii. The results of this study revealed that the use of E/S antigens in the preparation of an ELISA kit was very effective. This is very important, especially in the lower titers of antibody requiring a more accurate diagnosis. On the other hand, the Nano-ELISA method designed with E/S antigens can be more sensitive and specific than ELISA for the diagnosis of Toxoplasmosis and can be the basis for further studies in this regard.
Topics: Diagnostic Tests, Routine; Enzyme-Linked Immunosorbent Assay; Sensitivity and Specificity; Toxoplasmosis
PubMed: 33403837
DOI: 10.22092/ari.2018.123028.1236 -
Der Hautarzt; Zeitschrift Fur... Aug 2019
Topics: Diagnostic Tests, Routine; Mycology
PubMed: 31384967
DOI: 10.1007/s00105-019-4450-4 -
The Journal of Urology Dec 2021
Topics: Diagnostic Tests, Routine; Humans; Magnetic Resonance Imaging
PubMed: 34496605
DOI: 10.1097/JU.0000000000002225 -
Chest May 2020
Topics: Diagnostic Tests, Routine; Humans; Hypertension, Pulmonary
PubMed: 32386642
DOI: 10.1016/j.chest.2019.11.053