6. Time elapsed from initial presentation to diagnostic laparoscopy: factors affecting diagnostic delay in adolescents with biopsy-confirmed endometriosis

2021 ◽  
Vol 34 (2) ◽  
pp. 241-242
Author(s):  
Howard Li ◽  
Yonghee Cho ◽  
Hugh Taylor ◽  
Alla Vash-Margita
Keyword(s):  
Diagnostic Laparoscopy ◽  
Diagnostic Delay ◽  
Initial Presentation ◽  
Factors Affecting

scholarly journals Staphylococcus aureus Masking Tuberculous Joint Infection

2017 ◽  
Vol 24 (4) ◽  
pp. 41-45
Author(s):  
Mohammed A. Shaikhomer
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Functional Disability ◽  
Joint Infection ◽  
Extrapulmonary Tuberculosis ◽  
Diagnostic Delay ◽  
Clinical Manifestations ◽  
Bone Destruction ◽  
Initial Presentation ◽  
Tuberculous Arthritis

Skeletal tuberculosis accounts for around 10 percent of cases of extrapulmonary tuberculosis. Hip and knee involvement are the most commonly affected sites after spine. Clinical manifestations include swelling, pain, and loss of joint function that progress over weeks to months. In the setting of tuberculous arthritis, local soft tissue swelling, osteopenia, and bone destruction (with relative preservation of cartilage space) occur early in the disease. Subsequent findings include structural collapse, sclerotic changes, and soft tissue calcification. Delay in diagnosing tuberculous arthritis can lead to functional disability and poor outcome. Superimposed infection with another organism occurs very rarely and can lead to delay in diagnosing the condition. We present a case of tuberculous knee arthritis that was superimposed with Staphylococcus aureus infection. The low index of suspicion at the initial presentation together with the superimposed infection led to a delayed diagnosis. Our patient’s risk factor was immigration from a country endemic with tuberculosis. The case was diagnosed 32 months from initial presentation. In the presence of clinical and epidemiological risk for tuberculous arthritis, requesting the appropriate tests is crucial to avoid any diagnostic delay.

scholarly journals An in Depth Analysis of Factors Contributing to Diagnostic Delay in Myeloma: A Retrospective UK Study of Patients Journey from Primary Care to Specialist Secondary Care

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3007-3007
Author(s):  
Md Imran Hossain ◽  
Peter Hampson ◽  
Craig Nowell ◽  
Shamshad Khan ◽  
Ranjoy Sen ◽  
...  
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Blood Test ◽  
Diagnostic Delay ◽  
Initial Presentation ◽  
Test Results ◽  
Presenting Symptoms ◽  
Blood Tests ◽  
Time To Diagnosis ◽  
Gp Visits

Abstract Introduction Patients with Multiple Myeloma (MM) often have a significant delay between onset of symptoms and diagnosis of disease. As a result, a significant number of patients present via emergency routes with severe co-morbidities which affect survival rates. Timely diagnosis relies on the early recognition of symptoms and blood test results which may indicate disease. Methods We examined the medical records of 142 newly diagnosed MM patients (121 intact immunoglobulin and 21 light chains) across 2 UK Hospitals. Patients included had not previously been diagnosed with a plasma cell dyscrasia, including Monoclonal Gammopathy of Undetermined Significance (MGUS). Clinical symptoms and blood test results were examined from the time of initial presentation to the healthcare system with symptoms indicative of MM, to the point of diagnosis in order to highlight patterns of symptoms and blood tests results which may give an early indication of disease. Blood tests results recorded included globulin, calcium, creatinine, erythroid sedimentation rate and haemoglobin. Time to diagnosis from presentation with symptoms indicative of MM was also measured as well as the patient pathway from the point of presentation to the point of diagnosis. Results The median time to diagnosis from initial presentation was 77 days (range 0 - 12,986). Initial presentation was most commonly via primary care (58.1%). Urgent secondary care presentation was documented in 28.5% which included acute medical unit (15.6%), the emergency department (7.1%), and other secondary care specialities (5.7%) respectively. Multiple GP visits were common prior to haematology referral with a median of 3 visits (range 1 - 40). Initial presenting symptoms varied, but of those with data recorded (n=107) back/bone pain was the most common (58.2%) followed by anaemia (18.7%), fracture (7.5%), recurrent infection (7.5%) and renal impairment (3.7%) respectively. Interestingly, analysis of evaluable blood test results revealed a raised globulin was most often evident prior to diagnosis with 58% of patients recording an abnormal globulin a median of 140 days (range 3 - 4297) prior to diagnosis of disease. Conclusions Multiple GP visits prior to establishing a diagnosis of myeloma is very common. Inclusion of abnormal globulin to reflex electrophoresis request and serum free light chain assay may serve as a useful trigger for investigation when interpreted alongside presenting symptoms and other blood test results. Increased awareness of myeloma warning signs in primary care may reduce diagnostic delay and avoid presentation with severe co-morbidities in emergency settings. Disclosures No relevant conflicts of interest to declare.

scholarly journals Factors affecting the diagnostic delay in amyotrophic lateral sclerosis

2012 ◽  
Vol 114 (6) ◽  
pp. 550-554 ◽  
Author(s):  
Eleonora Cellura ◽  
Rossella Spataro ◽  
Alfonsa Claudia Taiello ◽  
Vincenzo La Bella
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Diagnostic Delay ◽  
Factors Affecting ◽  
Lateral Sclerosis

scholarly journals Time to Diagnosis of Early-Onset vs. “Late-Onset” Colorectal Cancer: Is there a difference?

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Kayla L. Chin ◽  
Laura E. Myers ◽  
Jessica M. Coffing ◽  
Jason Larson ◽  
Thomas F. Imperiale
Keyword(s):  
Colorectal Cancer ◽  
Early Onset ◽  
Late Onset ◽  
Initial Presentation ◽  
Published Data ◽  
Advanced Stage ◽  
Factors Affecting ◽  
Presenting Symptoms ◽  
Incidence And Mortality ◽  
Time To Diagnosis

BACKGROUND  Colorectal cancer (CRC) incidence and mortality is increasing in persons ˂ 50 years old. Intervals between symptom onset and initial presentation (presentation interval [PI]) and between initial presentation and diagnosis (diagnosis interval [DI]) are not well-quantified.  OBJECTIVE  Compare PI and DI between early-onset CRC (EOCRC) and persons >50, and identify factors affecting these intervals.    METHODS  In this retrospective VA-based case-control study, we identified EOCRC cases from an ongoing study and compared them to controls (CRC patients aged ≥ 50 years). We abstracted demographics, clinical features, CRC location and stage, PI, and DI. Mann-Whitney tests compared mean and median PI and DI.   RESULTS  Advanced stage (III-IV) CRC was more common among the 240 EOCRC patients (mean age: 45.2, 60.8% White) than in the 234 controls (mean age: 63.8, 71.8% White): 55.4% vs 43.5%; P= 0.015. PIs and DIs, respectively, were present for 153(63.8%) and 222(92.5%) of cases and for 74(31.6%) 222(94.9%) of controls. No difference was found between median PI in EOCRC and late-onset CRC patients (42 vs 60 days, P= 0.68). The EOCRC cases had a significantly shorter median DI (41 [IQR = 16-83] vs 71 days [IQR = 32-145], P<0.0001).   CONCLUSIONS  In this retrospective study, younger patients had more advanced stage CRC at diagnosis than their older counterparts. However, contrary to published data, median time to diagnosis was shorter in those < 50 years. Factors associated with the DI are forthcoming. Candidate factors include race, diagnosis year, presenting symptoms, type of initial provider, CRC stage, and CRC location. 

Progress In The Practical Application Of Automated Image Analysis To Tem Negatives

1977 ◽  
Vol 35 ◽  
pp. 214-217
Author(s):  
F. A. Heckman ◽  
E. Redman ◽  
J.E. Connolly
Keyword(s):  
Image Analysis ◽  
Image Quality ◽  
Exposure Time ◽  
Image Contrast ◽  
Automated Image Analysis ◽  
Practical Application ◽  
Factors Affecting ◽  
High Image Quality ◽  
Qualitative Evidence ◽  
Comprehensive Study

In our initial publication on this subject1) we reported results demonstrating that contrast is the most important factor in producing the high image quality required for reliable image analysis. We also listed the factors which enhance contrast in order of the experimentally determined magnitude of their effect. The two most powerful factors affecting image contrast attainable with sheet film are beam intensity and KV. At that time we had only qualitative evidence for the ranking of enhancing factors. Later we carried out the densitometric measurements which led to the results outlined below.Meaningful evaluations of the cause-effect relationships among the considerable number of variables in preparing EM negatives depend on doing things in a systematic way, varying only one parameter at a time. Unless otherwise noted, we adhered to the following procedure evolved during our comprehensive study:Philips EM-300; 30μ objective aperature; magnification 7000- 12000X, exposure time 1 second, anti-contamination device operating.

Factors affecting microstructural scale in liquid crystalline polymers

1990 ◽  
Vol 48 (4) ◽  
pp. 220-221
Author(s):  
Christine M. Dannels ◽  
Christopher Viney
Keyword(s):  
Liquid Crystalline ◽  
Liquid Crystalline Polymers ◽  
Factors Affecting ◽  
Crystalline Polymers ◽  
Thermal Expansion Coefficients ◽  
Low Thermal Expansion ◽  
Lower Viscosity ◽  
Fine Microstructure ◽  
Planar Orientation ◽  
Strength And Stiffness

Processing polymers from the liquid crystalline state offers several advantages compared to processing from conventional fluids. These include: better axial strength and stiffness in fibers, better planar orientation in films, lower viscosity during processing, low solidification shrinkage of injection moldings (thermotropic processing), and low thermal expansion coefficients. However, the compressive strength of the solid is disappointing. Previous efforts to improve this property have focussed on synthesizing stiffer molecules. The effect of microstructural scale has been overlooked, even though its relevance to the mechanical and physical properties of more traditional materials is well established. By analogy with the behavior of metals and ceramics, one would expect a fine microstructure (i..e. a high density of orientational defects) to be desirable.Also, because much microstructural detail in liquid crystalline polymers occurs on a scale close to the wavelength of light, light is scattered on passing through these materials.

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