scholarly journals Metastatic angiosarcoma of the scalp presented as posttraumatic subgaleal hematoma: The many faces of a diagnostic challenge

2021 ◽  
Vol 16 (9) ◽  
pp. 2812-2816
Author(s):  
Loai Aker ◽  
Mahir Abdulla Petkar ◽  
Sohail Jamiluddin Quazi ◽  
Renan Ibrahem Adam
Keyword(s):  
Diagnostic Challenge ◽  
Subgaleal Hematoma ◽  
The Many

Heart failure in an elderly population

2001 ◽  
Vol 11 (4) ◽  
pp. 311-321
Author(s):  
DN Carmichael ◽  
Michael Lye
Keyword(s):  
Heart Failure ◽  
Treatment Options ◽  
Clinical Syndrome ◽  
Point Of View ◽  
Diagnostic Challenge ◽  
The Common ◽  
Characteristic Features ◽  
The Many ◽  
Neuroendocrine Activation ◽  
Symptoms And Signs

Heart failure has been defined in many ways and definitions change over time. The multiplicity of definitions reflect the paucity of our understanding of the primary underlying physiology of heart failure and the many diseases for which heart failure is the common end-point. Fundamentally, heart failure represents a failure of the heart to meet the body’s requirement for blood supply for whatever reason. It is thus a clinical syndrome with characteristic features – not a single disease in its own right. The syndrome includes symptoms and signs of organ underperfusion, fluid retention and neuroendocrine activation. The syndrome arises from a range of possible causes of which ischaemic heart disease is the commonest. From the point of view of a clinician, the underlying pathology will determine treatment options and prognosis. The extensive range of possible aetiologies present a diagnostic challenge both to correctly identify the syndrome amongst all other causes of dyspnoea and to identify the aetiology, allowing optimization of treatment.

Autoimmune Limbic Encephalitis

2013 ◽  
Author(s):  
Aaron E. Miller ◽  
Teresa M. DeAngelis
Keyword(s):  
Clinical Outcomes ◽  
Diagnostic Criteria ◽  
Limbic Encephalitis ◽  
Diagnostic Challenge ◽  
Autoimmune Limbic Encephalitis ◽  
The Many ◽  
Therapeutic Responses

Limbic encephalitides can pose a diagnostic challenge in patients presenting with encephalopathy and seizures. Autoimmune etiologies can be either paraneoplastic or nonparaneoplastic. We discuss the approach to a patient with limbic encephalitis in this chapter and review proposed diagnostic criteria, the many antineuronal autoantibodies and respective neoplasms, as well as respective clinical outcomes and therapeutic responses.

Pyoderma gangrenosum underrepresentation in non-dermatological literature

Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Ashley M. Reese ◽  
Carter K. Haag ◽  
Enjae Jung ◽  
Allison C. Nauta ◽  
Robert A. Swerlick ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Differential Diagnosis ◽  
Pyoderma Gangrenosum ◽  
Trauma Surgery ◽  
Neutrophilic Dermatosis ◽  
Diagnostic Challenge ◽  
Review Articles ◽  
Necrotizing Soft Tissue Infections ◽  
The Many ◽  
Teaching Modules

AbstractBackgroundPyoderma gangrenosum (PG) is a chronic, ulcerative neutrophilic dermatosis. PG presents a diagnostic challenge, largely due to the many mimicking diseases, the lack of confirmatory laboratory or biological markers, and the absence of widely accepted diagnostic criteria. In particular, PG is often mistaken for necrotizing soft tissue infections (NSTI).MethodsWe reviewed four major textbooks each in general surgery, plastic surgery, trauma surgery, vascular surgery, emergency medicine, and dermatology. We also performed a search of review articles addressing NSTI and necrotizing fasciitis (NF).ResultsTen out of the 20 non-dermatology textbooks did not list PG anywhere, and only two listed a differential diagnosis for PG. None of the non-dermatology textbooks indicated PG in the NSTI differential diagnosis, while three of the dermatology textbooks included PG in the NSTI differential diagnosis. PG was listed in all of the dermatology textbooks. Only one of the NSTI and NF articles mentioned PG in the differential diagnosis.ConclusionsThere is an underrepresentation in major textbooks of surgery and emergency medicine and in NSTI and NF review articles when it comes to diagnosing PG. This might be leading to trainees and advanced providers in these fields being uninstructed on PG, and likely contributes to PG misdiagnosis and mismanagement. We recommend PG be included in the differential diagnosis of chronic ulcers and NSTI in non-dermatology textbooks. We also suggest adding identification and diagnosis of inflammatory mimickers of NSTI (e.g. PG) in teaching modules in surgical and emergency specialties to address this knowledge gap.

scholarly journals Valentino’s syndrome: the simulation of an appendicitis

2017 ◽  
Vol 4 (5) ◽  
pp. 1813
Author(s):  
Alberto Manuel González Chávez ◽  
Alain Arturo García Vázquez ◽  
José Manuel Gómez López ◽  
Nicolás Leyva Pavón ◽  
José Luis Lemus Gómez ◽  
...  
Keyword(s):  
Acute Abdominal Pain ◽  
Diagnostic Tools ◽  
Normal Appendix ◽  
Diagnostic Challenge ◽  
Quadrant Pain ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
The Many ◽  
Right Lower Quadrant

Acute abdominal pain is still the domain of the surgeon. Among the many differential diagnosis that should be considered, acute appendicitis must be one of the main options for the clinician. Even though we have excellent diagnostic tools nowadays, accomplishing an accurate diagnosis is not that easy. We all know that is better to perform surgery on a normal appendix than not operating an appendix that will result in complications; we also know that the diagnostic challenge will be higher in a female patient.  But, what if right lower quadrant pain is produced by a pathology that doesn’t involve that anatomical region? We present two cases that clearly explain this situation.

scholarly journals Evidence-Based Clinical Algorithm for Hypotonia Assessment: To Pardon the Errs

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Pragashnie Govender ◽  
Robin Wendy Elizabeth Joubert
Keyword(s):  
Clinical Assessment ◽  
Muscle Tone ◽  
Occupational Therapists ◽  
Evidence Based ◽  
Diagnostic Challenge ◽  
Clinical Algorithm ◽  
Professional Groups ◽  
Multiple Focus ◽  
Formed Part ◽  
The Many

Despite the many advances in diagnostics, the clinical assessment of children with hypotonia presents a diagnostic challenge for clinicians due to the current subjectivity of the initial clinical assessment. The aim of this paper is to report on an evidence-based clinical algorithm (EBCA) that was developed for the clinical assessment of hypotonia in children as part of the output of a multiphased study towards assisting clinicians in more accurate assessments. This study formed part of a larger advanced mixed methods design. The preceding phases of the study included a systematic review, a survey amongst clinicians, a consensus process (Delphi technique), and a qualitative critique with multiple focus groups. Samples were drawn from three professional groups (occupational therapists, physiotherapists, and paediatricians). Data were analysed at each stage and merged in the development of the EBCA. The EBCA followed a rigorous process of development and critique. The methods for formulating changes in the revision and development of the EBCA are presented together with a description and presentation of the final algorithm for practice. The overarching concepts that guided the development and refinement of the EBCA are described, taking into consideration knowledge translation, evidence-based practice, and the value of EBCAs in addition to recommendations for stakeholder uptake. The EBCA is envisaged to be useful in practice for clinicians who are faced with the assessment of a child that is suspected as having hypotonia via a systematic process in identifying specific characteristics that are associated with low muscle tone.

Identifying suboptimalities with factorial model comparison

2018 ◽  
Vol 41 ◽  
Author(s):  
Wei Ji Ma
Keyword(s):  
Experimental Design ◽  
Model Comparison ◽  
Process Models ◽  
Multiple Forms ◽  
Factorial Experimental Design ◽  
Factorial Model ◽  
Multiple Components ◽  
The Many

AbstractGiven the many types of suboptimality in perception, I ask how one should test for multiple forms of suboptimality at the same time – or, more generally, how one should compare process models that can differ in any or all of the multiple components. In analogy to factorial experimental design, I advocate for factorial model comparison.

Representing utility and deploying the body

2020 ◽  
Vol 43 ◽  
Author(s):  
David Spurrett
Keyword(s):  
Functional Activity ◽  
Degrees Of Freedom ◽  
The Body ◽  
Target Article ◽  
Processing Demands ◽  
The Many

Abstract Comprehensive accounts of resource-rational attempts to maximise utility shouldn't ignore the demands of constructing utility representations. This can be onerous when, as in humans, there are many rewarding modalities. Another thing best not ignored is the processing demands of making functional activity out of the many degrees of freedom of a body. The target article is almost silent on both.

The many faces of obligation

2020 ◽  
Vol 43 ◽  
Author(s):  
Michael Tomasello
Keyword(s):  
Third Party ◽  
The Many ◽  
Sense Of Obligation

Abstract My response to the commentaries focuses on four issues: (1) the diversity both within and between cultures of the many different faces of obligation; (2) the possible evolutionary roots of the sense of obligation, including possible sources that I did not consider; (3) the possible ontogenetic roots of the sense of obligation, including especially children's understanding of groups from a third-party perspective (rather than through participation, as in my account); and (4) the relation between philosophical accounts of normative phenomena in general – which are pitched as not totally empirical – and empirical accounts such as my own. I have tried to distinguish comments that argue for extensions of the theory from those that represent genuine disagreement.

Hydrogen Cyanide Polymers from the Impact of Comet P/Shoemaker-Levy 9 on Jupiter

1997 ◽  
Vol 161 ◽  
pp. 179-187
Author(s):  
Clifford N. Matthews ◽  
Rose A. Pesce-Rodriguez ◽  
Shirley A. Liebman
Keyword(s):  
Amino Acids ◽  
Solar System ◽  
Hydrogen Cyanide ◽  
Nitrogen Heterocycles ◽  
Laboratory Studies ◽  
Heterogeneous Solids ◽  
The Many ◽  
Comet Halley ◽  
The Impact ◽  
By Products

AbstractHydrogen cyanide polymers – heterogeneous solids ranging in color from yellow to orange to brown to black – may be among the organic macromolecules most readily formed within the Solar System. The non-volatile black crust of comet Halley, for example, as well as the extensive orangebrown streaks in the atmosphere of Jupiter, might consist largely of such polymers synthesized from HCN formed by photolysis of methane and ammonia, the color observed depending on the concentration of HCN involved. Laboratory studies of these ubiquitous compounds point to the presence of polyamidine structures synthesized directly from hydrogen cyanide. These would be converted by water to polypeptides which can be further hydrolyzed to α-amino acids. Black polymers and multimers with conjugated ladder structures derived from HCN could also be formed and might well be the source of the many nitrogen heterocycles, adenine included, observed after pyrolysis. The dark brown color arising from the impacts of comet P/Shoemaker-Levy 9 on Jupiter might therefore be mainly caused by the presence of HCN polymers, whether originally present, deposited by the impactor or synthesized directly from HCN. Spectroscopic detection of these predicted macromolecules and their hydrolytic and pyrolytic by-products would strengthen significantly the hypothesis that cyanide polymerization is a preferred pathway for prebiotic and extraterrestrial chemistry.

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