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Fertility and Sterility Jul 2022Endometriosis was classically diagnosed during diagnostic laparoscopies, which used to be routinely performed up until a decade ago or so. This practice fitted with the... (Review)
Review
Endometriosis was classically diagnosed during diagnostic laparoscopies, which used to be routinely performed up until a decade ago or so. This practice fitted with the long-held belief that surgery was the gold standard for diagnosing endometriosis. Today, the abandon of routine diagnostic laparoscopies-in favor of assisted reproductive technology-first therapeutic approaches-has created a void for diagnosing endometriosis. Modern-day imaging techniques-ultrasound and magnetic resonance imaging-when used with a systematic approach have offered a reliable replacement option for diagnosing endometriosis. In infertility, endometriosis should be identified or excluded on the basis of past history or confirmation or exclusion suspicion on the basis of history and/or physical examination.
Topics: Endometriosis; Female; Humans; Infertility; Magnetic Resonance Imaging; Reproductive Techniques, Assisted; Ultrasonography
PubMed: 35568524
DOI: 10.1016/j.fertnstert.2022.03.015 -
Pediatric Emergency Care Sep 2020The aims of the study were to perform the first systematic review of pediatric syncope etiologies and to determine the most common diagnoses with credible intervals...
OBJECTIVES
The aims of the study were to perform the first systematic review of pediatric syncope etiologies and to determine the most common diagnoses with credible intervals (CredIs).
METHODS
Review was performed within Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and used Embase, Scopus, PubMed, and the Cochrane Controlled Trial databases. The following inclusion criteria for the articles were used: minimum of 10 patients, standard definition of syncope used, subjects who were 21 years or younger, and subjects who were either a consecutive retrospective group or a prospective group. No restrictions were made regarding language of the studies, but an English abstract was required. The following information was collected: purpose of the study, definition of syncope, number of patients, patient age range, inclusion/exclusion criteria, and etiologies of syncope.
RESULTS
Of the 500 articles initially identified, 11 studies met the inclusion criteria and were the basis for this review. Three thousand seven hundred patients were included, ranging in age from 3 months to 21 years. The most common etiologies identified were vasovagal (52.2%; 95% CredI, 50.6-53.9), postural orthostatic tachycardia syndrome (13.1%; 95% CredI, 12.1-14.2), and cardiac causes (4.0%; 95% CredI, 3.39-4.65). A total of 18.3% (95% CredI, 17.0-19.5) of patients were found to have syncope of unknown cause.
CONCLUSIONS
Syncope is a common pediatric complaint. Most cases seen are a result of benign causes, with only a small percentage because of serious medical conditions. In addition, most syncopal episodes in the pediatric population are diagnosed clinically or with minimally invasive testing, emphasizing the importance of a detailed history and physical examination.
Topics: Child; Diagnosis, Differential; Humans; Medical History Taking; Physical Examination; Syncope
PubMed: 32530839
DOI: 10.1097/PEC.0000000000002149 -
Polski Przeglad Chirurgiczny Mar 2021Abdominal pain requires rapid diagnosis and treatment, especially in emergency circumstances. Sometimes the diagnosis of the disease cannot be accomplished with...
INTRODUCTION
Abdominal pain requires rapid diagnosis and treatment, especially in emergency circumstances. Sometimes the diagnosis of the disease cannot be accomplished with laboratory and imaging methods, and an invasive procedure such as diagnostic laparoscopy may be required to obtain a diagnosis. Diagnostic laparoscopy is also performed therapeutically, but laparotomy is inevitable in some cases. The aim of the study is to evaluate the role of diagnostic laparoscopy in diagnosis and treatment and to retrospectively examine the factors that force the surgeon to perform a laparotomy.
MATERIAL AND METHODS
Patients over the age of 18 who underwent diagnostic laparoscopy in the general surgery clinic of Sakarya University Training and Research Hospital between January 2013 and December 2019 were retrospectively evaluated. Patients under 18 years of age and patients diagnosed before surgery were excluded. Demographic data of the patients, whether there was a conversion from laparoscopy to laparotomy, postoperative morbidity, and mortality were recorded.
RESULTS
The data of 347 patients in total were evaluated retrospectively between the specified dates. 216 of the patients were previously diagnosed, laparoscopic procedures performed for staging purposes and they were not included in the study. The remaining 131 patients were included in the study. 68 of the patients were women and 63 were men. 79.4% of the patients were diagnostic laparoscopies performed due to emergency circumstances, and 20.6% for abdominal pain evaluation. While the procedure was concluded laparoscopically in 64.9% of the patients, the operation was continued by performing laparotomy in 35.1%.
CONCLUSION
Despite the increase in the variety and frequency of use of imaging modalities, a laparoscopic intervention is an essential approach in both diagnosis and treatment when the diagnosis is doubtful, especially in emergency cases in appropriate cases.
Topics: Abdomen; Abdominal Pain; Adolescent; Adult; Female; Humans; Laparoscopy; Laparotomy; Male; Retrospective Studies
PubMed: 33949333
DOI: 10.5604/01.3001.0014.8220 -
Current Opinion in Gastroenterology Sep 2021The aim of this study was to provide practical tips to readers on how to perform deep enteroscopy efficiently. (Review)
Review
PURPOSE OF REVIEW
The aim of this study was to provide practical tips to readers on how to perform deep enteroscopy efficiently.
RECENT FINDINGS
Deep enteroscopy has revolutionized the diagnosis and management of small intestinal conditions in recent years. They are extremely valuable, but may be technically challenging to perform, regardless if it is double balloon enteroscopy, single balloon enteroscopy or spiral enteroscopy. The common issues to these procedures are repetitive motion, extended procedure duration and physical exertion during scope advancement. These situations may in turn lead to a variety of ergonomic issues that need to be addressed accordingly to prevent occupational injuries to the endoscopists and their assistants. Depending on the clinical indications, the technical approach and execution of these procedures may be carried out differently. Some guiding principles may be applied to make performing these procedures more smoothly, effectively and deeply.
SUMMARY
Careful planning and skilful manipulations are essential to performing an efficient and stress-free deep enteroscopy. There are many simple ways to improve on the ergonomics and performance of these procedures.
Topics: Double-Balloon Enteroscopy; Endoscopy, Gastrointestinal; Humans; Intestinal Diseases; Intestine, Small; Laparoscopy
PubMed: 34265795
DOI: 10.1097/MOG.0000000000000767 -
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 -
Expert Review of Gastroenterology &... 2023Screening-related colonoscopy is a vital component of screening initiatives to both diagnose and prevent colorectal cancer (CRC), with prevention being reliant upon... (Review)
Review
INTRODUCTION
Screening-related colonoscopy is a vital component of screening initiatives to both diagnose and prevent colorectal cancer (CRC), with prevention being reliant upon early and accurate detection of pre-malignant lesions. Several strategies, techniques, and interventions exist to optimize endoscopists' adenoma detection rates (ADR).
AREAS COVERED
This narrative review provides an overview of the importance of ADR and other colonoscopy quality indicators. It then summarizes the available evidence regarding the effectiveness of the following domains in terms of improving ADR: endoscopist factors, pre-procedural parameters, peri-procedural parameters, intra-procedural strategies and techniques, antispasmodics, distal attachment devices, enhanced colonoscopy technologies, enhanced optics, and artificial intelligence. These summaries are based on an electronic search of the databases Embase, PubMed, and Cochrane performed on 12 December 2022.
EXPERT OPINION
Given the prevalence and associated morbidity and mortality of CRC, the quality of screening-related colonoscopy quality is appropriately prioritized by patients, endoscopists, units, and payers alike. Endoscopists performing colonoscopy should be up to date regarding available strategies, techniques, and interventions to optimize their performance.
Topics: Humans; Artificial Intelligence; Colonoscopy; Mass Screening; Adenoma; Early Detection of Cancer; Colorectal Neoplasms
PubMed: 37158052
DOI: 10.1080/17474124.2023.2212159 -
Journal of Medical Ultrasonics (2001) Jul 2023The standard diagnostic modalities for gastrointestinal (GI) diseases have long been endoscopy and barium enema. Recently, trans-sectional imaging modalities, such as... (Review)
Review
The standard diagnostic modalities for gastrointestinal (GI) diseases have long been endoscopy and barium enema. Recently, trans-sectional imaging modalities, such as computed tomography and magnetic resonance imaging, have become increasingly utilized in daily practice. In transabdominal ultrasonography (US), the bowel sometimes interferes with the observation of abdominal organs. Additionally, the thin intestinal walls and internal gas can make structures difficult to identify. However, under optimal US equipment settings, with identification of the sonoanatomy and knowledge of the US findings of GI diseases, US can be used effectively to diagnose GI disorders. Thus, the efficacy of GIUS has been gradually recognized, and GIUS guidelines have been published by the World Federation for Ultrasound in Medicine and Biology and the European Federation of Societies for Ultrasound in Medicine and Biology. Following a systematic scanning method according to the sonoanatomy and precisely estimating the layered wall structures by employing color Doppler make diagnosing disease and evaluating the degree of inflammation possible. This review describes current GIUS practices from an equipment perspective, a procedure for systematic scanning, typical findings of the normal GI tract, and 10 diagnostic items in an attempt to help medical practitioners effectively perform GIUS and promote the use of GIUS globally.
Topics: Humans; Ultrasonography; Gastrointestinal Diseases; Tomography, X-Ray Computed; Magnetic Resonance Imaging
PubMed: 36087155
DOI: 10.1007/s10396-022-01236-0 -
Autoimmunity Reviews Jul 2021To reassess the diagnostic approach to a patient with a monoarticular disease in light of the up-to-date medical literature and to examine the practical utility of... (Review)
Review
PURPOSE
To reassess the diagnostic approach to a patient with a monoarticular disease in light of the up-to-date medical literature and to examine the practical utility of traditional and newer imaging tools in the setting of monoarthritis.
RESULTS
The monoarticular disease can represent a medical emergency on the one hand and be a diagnostic conundrum on the other. The management rules of patients with monoarthritis have been established long ago, but various pitfalls still lead physicians off the right diagnosis at times. Septic, pseudoseptic arthritis and hemarthrosis are the most common diagnoses made in patients with an acute presentation, and a decision not to perform a diagnostic arthrocentesis is the most prevalent cause of misdiagnosis in this setting. Many rheumatic and infectious diseases can present with more indolent monoarthritis; careful history and physical examination frequently provide clues to the straightforward diagnosis in some cases, but the extensive investigation is needed in others. Imaging methods become indispensable in individuals with the non-inflammatory monoarticular disease, with magnetic resonance imaging being the gold standard for diagnosing pigmented villonodular synovitis, lipoma arborescence, avascular necrosis, or neuropathic arthropathy.
CONCLUSIONS
A great variety of medical disorders can present as a monoarticular disease. The disease presentation dictates different diagnostic behavior, while knowing the available imaging methods' diagnostic potential should further shorten the diagnostic process.
Topics: Arthritis, Infectious; Diagnosis, Differential; Humans; Magnetic Resonance Imaging
PubMed: 33971340
DOI: 10.1016/j.autrev.2021.102848 -
Sensors (Basel, Switzerland) Feb 2023The health and productivity of animals, as well as farmers' financial well-being, can be significantly impacted by cattle illnesses. Accurate and timely diagnosis is... (Review)
Review
The health and productivity of animals, as well as farmers' financial well-being, can be significantly impacted by cattle illnesses. Accurate and timely diagnosis is therefore essential for effective disease management and control. In this study, we consider the development of models and algorithms for diagnosing diseases in cattle based on Sugeno's fuzzy inference. To achieve this goal, an analytical review of mathematical methods for diagnosing animal diseases and soft computing methods for solving classification problems was performed. Based on the clinical signs of diseases, an algorithm was proposed to build a knowledge base to diagnose diseases in cattle. This algorithm serves to increase the reliability of informative features. Based on the proposed algorithm, a program for diagnosing diseases in cattle was developed. Afterward, a computational experiment was performed. The results of the computational experiment are additional tools for decision-making on the diagnosis of a disease in cattle. Using the developed program, a Sugeno fuzzy logic model was built for diagnosing diseases in cattle. The analysis of the adequacy of the results obtained from the Sugeno fuzzy logic model was performed. The processes of solving several existing (model) classification and evaluation problems and comparing the results with several existing algorithms are considered. The results obtained enable it to be possible to promptly diagnose and perform certain therapeutic measures as well as reduce the time of data analysis and increase the efficiency of diagnosing cattle. The scientific novelty of this study is the creation of an algorithm for building a knowledge base and improving the algorithm for constructing the Sugeno fuzzy logic model for diagnosing diseases in cattle. The findings of this study can be widely used in veterinary medicine in solving the problems of diagnosing diseases in cattle and substantiating decision-making in intelligent systems.
Topics: Animals; Cattle; Reproducibility of Results; Algorithms; Cattle Diseases; Data Analysis; Fuzzy Logic
PubMed: 36850710
DOI: 10.3390/s23042107 -
Multiple Sclerosis and Related Disorders Mar 2022In recent years Artificial intelligence (AI) techniques are rapidly evolving into clinical practices such as diagnosis and prognosis processes, assess treatment... (Review)
Review
BACKGROUND
In recent years Artificial intelligence (AI) techniques are rapidly evolving into clinical practices such as diagnosis and prognosis processes, assess treatment effectiveness, and monitoring of diseases. The previous studies showed interesting results regarding the diagnostic efficiency of AI methods in differentiating Multiple sclerosis (MS) patients from healthy controls or other demyelinating diseases. There is a great lack of a comprehensive systematic review study on the role of AI in the diagnosis of MS. We aimed to perform a systematic review to document the performance of AI in MS diagnosis.
METHODS
A systematic search was performed using four databases including PubMed, Scopus, Web of Science, and IEEE on August 2021. All original studies which focused on deep learning or AI to analyze any modalities with the purpose of diagnosing MS were included in our study.
RESULTS
Finally, 38 studies were included in our systematic review after the abstract and full-text screening. A total of 5433 individuals were included, including 2924 cases of MS and 2509 healthy controls. Sensitivity and specificity were reported in 29 studies which ranged from 76.92 to 100 for sensitivity and 74 to 100 for specificity. Furthermore, 34 studies reported accuracy ranged 81 to 100. Among included studies, Magnetic Resonance Imaging (MRI) (20 studies), OCT (six studies), serum and cerebrospinal fluid markers (six studies), movement function (three studies), and other modalities such as breathing and evoked potential was used for detecting MS via AI.
CONCLUSION
In conclusion, diagnosis of MS based on new markers and AI is a growing field of research with MRI images, followed by images obtained from OCT, serum and CSF biomarkers, and motor associated markers. All of these results show that with advances made in AI, the way we monitor and diagnose our MS patients can change drastically.
Topics: Artificial Intelligence; Humans; Magnetic Resonance Imaging; Multiple Sclerosis
PubMed: 35180619
DOI: 10.1016/j.msard.2022.103673