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Indian Journal of Cancer 2020Cancer therapy is undergoing rapid advancements and many of the conditions that were incurable earlier can now easily be treated. Making a "correct diagnosis" is the...
Cancer therapy is undergoing rapid advancements and many of the conditions that were incurable earlier can now easily be treated. Making a "correct diagnosis" is the first step in the ladder towards treating the disease. However, once diagnosed, "breaking bad news" to the patient and his family that he/she has cancer is still a big challenge as it is a life-changing event not only for the patient but their families as well. The following article narrates an incident dealing with the significance of diagnosing the condition accurately and that of "breaking bad news". It gives an insight into the emotional ordeal that clinicians dealing with terminal-illnesses like cancer go through on a daily basis while trying to diagnose it and communicating it to the patient and his family.
Topics: Diagnosis, Differential; Humans; Male; Neoplasms
PubMed: 32445328
DOI: 10.4103/ijc.IJC_418_19 -
Progress in Neurological Surgery 2014Magnetoencephalography (MEG) is a biomedical technique which measures the magnetic fields emitted by the brain, generated by neuronal activity. Commercial whole-head MEG... (Review)
Review
Magnetoencephalography (MEG) is a biomedical technique which measures the magnetic fields emitted by the brain, generated by neuronal activity. Commercial whole-head MEG units have been available for about 15 years, but currently there are only about 20 such units operating in the USA. Here, we review the basic concepts of MEG and list some of the usual clinical indications: noninvasive localization of epileptic spikes and presurgical mapping of eloquent cortex. We then discuss using MEG to diagnose mild traumatic brain injury (mTBI; concussions). Injured brain tissues in TBI patients generate abnormal low-frequency magnetic activity (delta-waves: 1-4 Hz) that can be measured and localized by MEG. These abnormal delta-waves originate from neurons that experience deafferentation from axonal injury to the associated white matter fiber tracts, also manifested on diffusion tensor imaging as reduced fractional anisotropy. Magnetoencephalographic evaluation of abnormal delta-waves (1-4 Hz) is probably the most sensitive objective test to diagnose concussions. An automated MEG low-frequency (slow wave) source imaging method, frequency-domain vector-based spatiotemporal analysis using a L1-minimum norm (VESTAL), achieved a positive finding rate of 87% for diagnosing concussions (blast-induced plus nonblast), 100% for moderate TBI, and no false-positive diagnoses in normal controls. There were also significant correlations between the number of cortical regions generating abnormal slow waves and the total postconcussive symptom scores in TBI patients.
Topics: Animals; Brain Concussion; Brain Mapping; Diffusion Tensor Imaging; Humans; Image Processing, Computer-Assisted; Magnetoencephalography
PubMed: 24923396
DOI: 10.1159/000358768 -
Cardiovascular Journal of AfricaCritical coarctation of the aorta in neonates is a common cause of shock and death. It may be the most difficult of all forms of critical congenital heart disease to... (Review)
Review
Critical coarctation of the aorta in neonates is a common cause of shock and death. It may be the most difficult of all forms of critical congenital heart disease to diagnose because the obstruction from the coarctation does not appear until several days after birth (and after discharge from the hospital), and because there are no characteristic murmurs. Some of these patients may be detected by neonatal screening by pulse oximetry, but only a minority is so diagnosed. Older patients are usually asymptomatic but, although clinical diagnosis is easy, they are frequently undiagnosed.
Topics: Age Factors; Angioplasty, Balloon; Aortic Coarctation; Cardiac Imaging Techniques; Diagnostic Techniques, Cardiovascular; Early Diagnosis; Hemodynamics; Humans; Infant, Newborn; Neonatal Screening; Oximetry; Predictive Value of Tests; Prognosis; Stents; Vascular Surgical Procedures
PubMed: 29293259
DOI: 10.5830/CVJA-2017-053 -
Journal of Ultrasound in Medicine :... Sep 2021We report on a rare case of a prenatally diagnosed isolated facial teratoma, presenting as an avascular elongated ossified lesion arising from the inferior lateral rim... (Review)
Review
We report on a rare case of a prenatally diagnosed isolated facial teratoma, presenting as an avascular elongated ossified lesion arising from the inferior lateral rim of the orbit. There was no evidence of fetal compromise throughout the course of the pregnancy, which resulted in term delivery of a healthy neonate by elective Caesarean section. We summarize the key features, differential diagnoses, prognosis and management of fetal facial lesions.
Topics: Cesarean Section; Diagnosis, Differential; Female; Fetus; Humans; Infant, Newborn; Pregnancy; Prenatal Diagnosis; Teratoma; Ultrasonography, Prenatal
PubMed: 33174648
DOI: 10.1002/jum.15564 -
Current Opinion in Obstetrics &... Apr 2020The aim of this review is to understand why and how to improve the detection rate of the fetal anomalies in the first trimester. (Review)
Review
PURPOSE OF REVIEW
The aim of this review is to understand why and how to improve the detection rate of the fetal anomalies in the first trimester.
RECENT FINDINGS
The role of the first trimester is evolving from aneuploid and basic anatomical screening to a necessary tool to identifying early fetal malformations. In the past 20 years, several studies were conducted to assess the detection rate of anomalies in the first trimester, and despite the improvement in the diagnoses of spina bifida and cleft lip, many anomalies detectable in the first trimester are still being diagnosed in the second trimester scan. Analyzing the factors that improve the detection rate can show the reason why, even in recent years, only 50% of the anomalies are diagnosed in the first trimester.
SUMMARY
Thanks to the improvement in the ultrasound technology, the fetus can be thoroughly studied even in early gestation and it is, therefore, indispensable to increase the detection rate of the anomalies diagnosable from the first trimester. The sonographer's utmost attention should be applied to all pregnancies, not only in high-risk patients, and new protocols based on the mid trimester scan are needed to spread the concept of first trimester anatomical scan.
Topics: Congenital Abnormalities; Early Diagnosis; Female; Humans; Imaging, Three-Dimensional; Pregnancy; Pregnancy Trimester, First; Ultrasonography, Prenatal
PubMed: 32068542
DOI: 10.1097/GCO.0000000000000611 -
Current Hematologic Malignancy Reports Sep 2015Diagnosing a myelodysplastic syndrome (MDS) can be challenging. Somatic mutations are common in MDS and might have diagnostic utility in patients with idiopathic... (Review)
Review
Diagnosing a myelodysplastic syndrome (MDS) can be challenging. Somatic mutations are common in MDS and might have diagnostic utility in patients with idiopathic cytopenias of undetermined significance (ICUS). However, using mutations to diagnose MDS is complicated by several issues: (1) no gene is mutated in most cases, (2) no mutated gene is highly specific for MDS, (3) clonal hematopoiesis is common in older individuals without disease, and (4) we lack outcome data for ICUS patients with clonal cytopenias of undetermined significance (CCUS). Despite these caveats, genetic sequencing can inform the diagnosis of MDS. CCUS patients more closely resemble patients with MDS than age matched controls with somatic mutations. Genetic testing can identify alternative diagnoses in cytopenic patients and help risk stratify those with proven MDS. While we cannot include somatic mutations in the diagnostic definition of MDS now, testing to recognize CCUS will help characterize outcomes in these diagnostically challenging patients.
Topics: Bone Marrow; Chromosome Aberrations; Humans; Molecular Diagnostic Techniques; Mutation; Myelodysplastic Syndromes; Sequence Analysis, DNA
PubMed: 26126599
DOI: 10.1007/s11899-015-0270-5 -
Journal of Sport Rehabilitation Nov 2015Common injuries in high-level and recreational athletes, nonathletes, and the elderly are medial and lateral meniscus tears. Diagnosis of meniscus tears is done with... (Review)
Review
Common injuries in high-level and recreational athletes, nonathletes, and the elderly are medial and lateral meniscus tears. Diagnosis of meniscus tears is done with clinical exam, magnetic resonance imaging (MRI), and arthroscopy. The gold standard is arthroscopy, but accuracy of a clinical exam versus MRI diagnosis of meniscus tears is in question. A clinician's ability to detect a meniscus tear is beneficial to the patient from a timing standpoint. The process of obtaining an MRI and results could be lengthy, but if the meniscus tear is accurately diagnosed clinically, the patient could be suspended from athletics or specific job duties to prevent further injury. In addition, rehabilitation could be initiated immediately, resulting in better outcomes for the patient. The ability to diagnose a meniscus tear clinically could initiate the rehabilitation process much sooner than waiting for MRI testing and results. Beginning the rehabilitation phase earlier may lead to faster postoperative rehabilitation and better patient outcomes. Clinical detection of a meniscus tear will facilitate possible suspension, early treatment, and rehabilitation recommendations, but the MRI will provide more specific information about the injury, including type and location of tear. Thus, surgical decisions such as operative versus nonoperative or meniscectomy versus repair would be based on MRI results. Focused Clinical Question: Is a clinical exam as accurate as an MRI scan for diagnosing meniscus tears?
Topics: Arthroscopy; Humans; Knee Injuries; Knee Joint; Magnetic Resonance Imaging; Physical Examination; Rupture; Sensitivity and Specificity; Sports; Tibial Meniscus Injuries
PubMed: 25611122
DOI: 10.1123/jsr.2014-0182 -
Autism Research : Official Journal of... Feb 2023Despite increasing awareness for diagnosing autism spectrum disorder (ASD) and initiating treatments early in life, many children and adolescents continue to be...
Despite increasing awareness for diagnosing autism spectrum disorder (ASD) and initiating treatments early in life, many children and adolescents continue to be diagnosed at a relatively older age. Focusing on children who first received an ASD diagnosis at age six or older, this study aimed to describe the symptoms that parents reported when ASD was diagnosed, follow the patients' clinical trajectory prior to receiving the diagnosis, and describe differences in symptoms and prior diagnoses between males and females cases. We included 258 children (205 males and 53 females) who were first diagnosed with autism at age 6-18 in 2017-2018. We retrieved demographic information, neurologic and developmental symptoms, diagnoses, and medications dispensing history from the children's electronic medical charts. The data indicated that prior diagnoses of language delays and attention deficit hyperactivity disorder were common among children with a late ASD diagnosis. Two thirds of the children were prescribed one or more medications to treat psychosocial and behavioral conditions before receiving a late ASD diagnosis. Difficulties in social relationships with peers were the leading reported symptoms by parents at the time of ASD diagnosis. Across these different domains, some differences were found between males and females, including a somewhat higher cognitive level in males, who were also more likely to present aggressive behavior.
Topics: Child; Male; Female; Adolescent; Humans; Autism Spectrum Disorder; Delayed Diagnosis; Autistic Disorder; Interpersonal Relations; Parents
PubMed: 36495248
DOI: 10.1002/aur.2869 -
Acta Dermatovenerologica Croatica : ADC Jul 2022Teledermatology is a remote method of diagnosis, treatment, and follow-up of the patient with visual communication technologies. It has been a research subject for many...
Teledermatology is a remote method of diagnosis, treatment, and follow-up of the patient with visual communication technologies. It has been a research subject for many years, but its reliability has not been fully explained. With the emergence of the coronavirus disease-19 (COVID-19) pandemic in 2019, the need for teledermatology increased. This study aimed to evaluate the reliability of teledermatology. Material and Method: A total of 595 lesions of 546 patients who visited the dermatology outpatient clinic were included in the study. Two physicians evaluated the patients, one face-to-face and the other via multimedia messaging, and the diagnoses were compared with each other. Diagnoses were in total agreement if the first diagnoses were the same, in partial agreement if the second and third diagnoses were the same, and in no agreement if all diagnoses differed. The first diagnoses of Physicians 1 and 2 matched in 468 (total agreement rate: 76.8%) patients, and the second and third diagnoses matched in 44 and 8 patients, respectively (partial agreement rate: 8.7%). There was no agreement in the diagnoses of 75 patients (12.7%). In total, an agreement was reached in 520 patients (87.3%). Common diseases in dermatology practice, such as papulopustular and urticarial lesions, nails and hair diseases, infectious diseases, erythematous squamous diseases, those with pruritus, and skin malignancies, were diagnosed teledermatologically at a high rate of accuracy. In contrast, eczematous diseases, premalignant lesions, and other groups of diseases were less accurately diagnosed. In the last year, the importance of teledermatology has greatly increased with the COVID-19 pandemic. Our study shows that the store and forward (asynchronous) method of teledermatology can diagnose dermatological diseases with a high rate of accuracy.
Topics: COVID-19; COVID-19 Testing; Dermatology; Humans; Pandemics; Reproducibility of Results; Skin Diseases; Telemedicine
PubMed: 36153717
DOI: No ID Found -
Neurologic Clinics Feb 1996The process of diagnosing multiple sclerosis (MS) is much like that of analyzing evidence in a courtroom; they both rely on reason, judgement, and experience, rather... (Review)
Review
The process of diagnosing multiple sclerosis (MS) is much like that of analyzing evidence in a courtroom; they both rely on reason, judgement, and experience, rather than on any formal set of diagnostic criteria. The history, physical examination, and laboratory tests all have limitations and pitfalls that make MS one of the most difficult diseases to diagnose.
Topics: Diagnosis, Differential; Diagnostic Imaging; Diagnostic Tests, Routine; Humans; Multiple Sclerosis; Neurologic Examination; Patient Care Team
PubMed: 8676847
DOI: 10.1016/s0733-8619(05)70241-3