Diagnostic Delay in Epilepsy: the Scope of the Problem

2021 ◽  
Vol 21 (12) ◽  
Author(s):  
Jacob Pellinen ◽  
Jaqueline French ◽  
Kelly G. Knupp
Keyword(s):  
Diagnostic Delay

Hereditary Angioedema Diagnostic Delay Can Kill

2007 ◽  
Vol 41 (4) ◽  
pp. 45
Author(s):  
ROBERT FINN
Keyword(s):  
Hereditary Angioedema ◽  
Diagnostic Delay

Utility of Tolonium Chloride Rinse in the Diagnosis of Oral Cancer

2020 ◽  
Vol 26 (1) ◽  
pp. 11-17
Author(s):  
Md Kamruzzaman ◽  
Kazi Nurjahan ◽  
AS Gazi Sharifuddin ◽  
SK Ballav
Keyword(s):  
Developing Countries ◽  
Oral Cancer ◽  
Prospective Study ◽  
Diagnostic Delay ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Biopsy Report ◽  
Patient Side ◽  
Tolonium Chloride

Background: Oral cancer burden in developing countries is huge. In Bangladesh and India incidence were 10.6% and 10.4% respectively on 2018. At the same time worldwide incident was only 2%. Majority patients present at advanced stage and their survival rate is poor. Diagnostic delay from patient side and health delivery system side is significantly longer and it is more in developing countries. Like other malignancy early diagnosis can save a lot of these patient. Methods: This prospective study was carried out in Khulna Medical College Hospital from July 2017 to July 2019. Patients who will meet the criteria for this prospective study and capable and willing to give informed consent were enrolled. 20 second rinse/gargle with 10ml of 1% Tolonium chloride solution was done. Biopsy were taken from stained lesion, biopsy report were compared with TC stained lesions. Results: Out of 1650 patients in our outdoor department for various problem and only 30 cases were selected for this study according to selection criteria. Of 30 patients, 18 (60%) were male and 12 (40%) were female. The male-to-female ratio was 3:2. It was found that the sensitivity of 1% Tolonium Chloride rinse for oral precancer and cancer detection was 83.33%, whereas the specificity was 84.21%. Conclusion: Tolonium chloride rinse is a good screening test for oral cancer diagnosis with sensitivity 83.33% and specificity 84.21%. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 11-17

Surgical Case

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Ali Hameed Al-Badri
Keyword(s):  
Diagnostic Delay ◽  
Small Population ◽  
Negative Appendectomy ◽  
Time Cost ◽  
Voluntary Cough ◽  
Suspected Appendicitis ◽  
Sharp Pain ◽  
Clinical Syndromes ◽  
Negative Appendectomy Rate ◽  
Classical Symptom

Appendicitis is a common and urgentsurgical illness with protean manifestations,generous overlap with other clinical syndromes,and significant morbidity,whichincreases with diagnostic delay. No single sign,symptom,or diagnostic test accurately confirms the diagnosis ofappendiceal inflammation in all cases. The surgeon's goals are to evaluate a relatively small population of patients referred for suspected appendicitis and to minimize the negative appendectomy rate without increasing the incidence of perforation. The emergency department clinician must evaluate the larger group of patients who present to the ED with abdominal pain of all etiologies with the goal of approaching 100% sensitivity for the diagnosis in a time-,cost-,and consultation-efficient manner.IN 1886Reginald fitz, pathologist 1st described the clinical condition of A.A.Fewyears laterCharles mcBurney describe the clinical finding ofA.A.55% of patients presented with classical symptom of A.A so complication occurbecauseof atypical presentation which due to variation in app. Position, age of patient & degree of inflammation.Migrating pain 80% sensitive and specific Vomiting 50% Nausea60 -90 %Anorexia 75 % Diarrhea18 % 32 % has similar attach 90 % RLQ tenderness Marklesign 74 %Dunphy's sign (sharp pain in the RLQ elicited by a voluntary cough) may be helpful in making the clinical diagnosis of localized peritonitis. Similarly,RLQ pain in response to percussion of a remote quadrant of the abdomen,or to firm percussion of the patient's heel,suggests peritoneal Inflammation

Osteosarcoma Diagnostic Delay Associated With Alendronate-Induced Pain Relief

2012 ◽  
Vol 21 (03) ◽  
pp. 165-169 ◽  
Author(s):  
Christina J. Christina J. ◽  
William G. Ward
Keyword(s):  
Pain Relief ◽  
Diagnostic Delay

Diagnostic Delay in Breast Cancer: Correlation with Disease Stage and Prognosis

1990 ◽  
Vol 76 (6) ◽  
pp. 559-562 ◽  
Author(s):  
Simonetta Rossi ◽  
Claudia Cinini ◽  
Cinzia Di Pietro ◽  
Celestino Pio Lombardi ◽  
Antonio Crucitti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diagnostic Delay ◽  
Disease Stage

scholarly journals AB0092 ANTISYNTHETASE SYNDROME: CLINICAL PROFILE, SEROLOGIC AND TREATMENTS USED IN A COHORT OF PATIENTS FOLLOWED AT THE VIRGEN MACARENA HOSPITAL

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1075.1-1075
Author(s):  
P. Muñoz Reinoso ◽  
I. García Hernández ◽  
M. Ferrer Galván ◽  
F. J. Toyos Sáenz de Miera ◽  
L. Fernández de la Fuente Bursón ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Biological Therapy ◽  
Diagnostic Delay ◽  
Respiratory Function Tests ◽  
Mean Value ◽  
Frequent Pattern ◽  
Antisynthetase Syndrome ◽  
Antisynthetase Antibodies ◽  
Classical Triad

Background:The antisynthetase syndrome (SAS) is characterized by the presence of antisynthetase antibodies, anti-JO1, PL7 y PL12 are the most common; and the classic triad of myositis, arthritis, and diffuse interstitial lung disease (ILD)1. Most patients present incomplete forms and the severity of the ILD determines the prognosis of the disease2.Objectives:to analyze epidemiological, clinical and serological characteristics and treatments used in a cohort of patients with SAS.Methods:descriptive study of review of medical records. Data were collected from 15 patients with SAS followed in the Rheumatology and Pneumology consultations of the Virgen Macarena Hospital (Seville) in the last 10 years. The analysis was carried out using the R software.Results:15 patients were included, 8 men and 7 women. The median age was 56 years (33-77). Seven patients (47%) used to smoke. Four patients (27%) met the classical triad. All of them presented ILD and 8 patients (53%) had arthritis and / or myositis. Five (33%) had mechanic’s hands and six of them (40%) presented Raynaud. Seven (47%) suffered from dyspnea before the SAS diagnosis. The median diagnostic delay was 1 month (0-43). Seven (47%) patients had anti-JO1, 1 (7%) anti-PL7, 2 (13%) anti-PL12 and 2 (13%) patients anti-Ro52. Radiological patterns detected by HRCT were: 5 (33%) NINE, 4 (37%) NIU and 6 (40%) others. The initial treatment included mostly (66%) glucocorticoids (GC) and one or more cFAME. In maintenance, mycophenolate was used in 7 patients (47%), cyclosporine 5 (33%), cyclophosphamide in 3 cases (20%), azathioprine in 3 patients (20%) and methotrexate in 3 of them (20%). Four (37%) patients required a combination of DMARDs and 2 cases needed (13%) biological therapy, Rituximab and Tocilizumab. Changes in the mean value of the initial respiratory function tests (FVC1 and DLCO1) and during follow-up (FVC2 and DLCO2) were not relevant (FVC1 81.5% [42-110], FVC2 81% [59-115]; DLCO1 83% [10-112], DLCO2 80.5% [47-108]). Nine patients (60%) remained clinically stable and 3 patients (20%) progressed radiologically. Four patients died from ILD progression.Conclusion:In this study, the incomplete diagnosis of SAS predominated. The most detected antibody was anti-JO1. ILD is present in all cases, with NINE being the most frequent pattern so multidisciplinary management is necessary. Most used treatments were GC and FAMES combined, some cases required biological therapy.References:[1]Irazoque F, et al. Epidemiology, etiology and classification. Reumatol Clin. 2009;5:2-5.[2]Johnson C, et al. Clinical and pathologic differences in interstitial lung disease based on antisynthetase antibody type. Respir Med. 2014; 108(10):1542-8.Disclosure of Interests:None declared

scholarly journals POS1137 IDENTIFYING ADULT HYPOPHOSPHATASIA IN THE RHEUMATOLOGY UNIT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 848.1-848
Author(s):  
J. Feurstein ◽  
M. Behanova ◽  
J. Haschka ◽  
K. Roetzer ◽  
G. Uyanik ◽  
...  
Keyword(s):  
Burden Of Illness ◽  
Trabecular Bone Score ◽  
Correct Diagnosis ◽  
Diagnostic Delay ◽  
Official Journal ◽  
Mineral Density ◽  
Mineral Research ◽  
Clinical Factor ◽  
Logistic Regression Models ◽  
Rheumatology Unit

Background:The most frequent manifestation in adult Hypophosphatasia (HPP) is musculoskeletal pain.1,2 The unspecific nature of its clinical presentation may prevent correct diagnosis.3Objectives:Identifying adult hypophosphatasia in the rheumatology unit.Methods:Over a period of 10 years 9,522 patients were screened in a rheumatological outpatient unit. Serum ALP levels ≤ 40 U/l were found in 524 patients. After screening for secondary causes, 73 patients were invited for clinical evaluation. Genetic testing was performed in 23 patients with suspected HPP. Logistic regression models were used to estimate the association of each clinical factor with HPP.Results:Mutations in the ALPL gene were observed in 57% of genetically screened patients. Arthralgia, fractures and pain were the leading symptoms in HPP patients. Chondrocalcinosis (OR 29.12; 95% CI 2.02-1593.52) and dental disease (OR 8.33; 95% CI 0.93-143.40) were associated with HPP independent of BMI. Onset of symptoms in HPP was at 35.1 (14.3) years, with a mean duration from symptoms to diagnosis of 14.4 (8.1) years. Bone mineral density (BMD) and trabecular bone score (TBS) as well as bone turnover markers were not indicative for HPP.Conclusion:HPP can mimic joint diseases.4 Thus, in patients with uncertain rheumatologic complaints and low ALP, HPP should be considered as potential diagnosis.References:[1]Durrough C, Colazo JM, Simmons J, et al. Characterization of physical, functional, and cognitive performance in 15 adults with hypophosphatasia. Bone 2021;142:115695.[2]Seefried L, Kishnani PS, Moseley S, et al. Pharmacodynamics of asfotase alfa in adults with pediatric-onset hypophosphatasia. Bone 2021;142:115664.[3]Högler W, Langman C, Gomes da Silva H, et al. Diagnostic delay is common among patients with hypophosphatasia: initial findings from a longitudinal, prospective, global registry. BMC musculoskeletal disorders 2019;20(1):80.[4]Seefried L, Dahir K, Petryk A, et al. Burden of Illness in Adults With Hypophosphatasia: Data From the Global Hypophosphatasia Patient Registry. Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 2020;35(11):2171-78.Disclosure of Interests:None declared.

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