Clinical approach to the diagnosis of skin disease

2010 ◽  
pp. 4586-4592
Author(s):  
Vanessa Venning
Keyword(s):  
Skin Disease ◽  
Diagnostic Process ◽  
Clinical Approach ◽  
History Taking ◽  
Medical Specialities ◽  
The Impact ◽  
Careful History

As in most medical specialities, the diagnosis of skin disease relies on careful history taking, and a thorough examination, supported in some cases by appropriate investigation. Astute physicians will also be aware that management outcomes are improved by taking account of the impact of skin disease on patients’ lives, whether through discomfort, disfigurement, or disability. This section, however, is chiefly concerned with aspects of history taking and examination that inform the diagnostic process....

Clinical approach to the diagnosis of skin disease

2020 ◽  
pp. 5596-5601
Author(s):  
Vanessa Venning
Keyword(s):  
Skin Disease ◽  
Diagnostic Process ◽  
Clinical Approach ◽  
History Taking ◽  
Medical Specialties ◽  
Key Points ◽  
History Of ◽  
The Impact ◽  
Careful History

As in most medical specialties, the diagnosis of skin disease relies on careful history taking, and a thorough examination, supported in some cases by appropriate investigation. Astute physicians will also be aware that management outcomes are improved by taking account of the impact of skin disease on patients’ lives, whether through discomfort, disfigurement, or disability. This section, however, is chiefly concerned with aspects of history taking and examination that inform the diagnostic process. There are certain key points in the history of skin disease that should be specifically elicited. These should include a description of the events surrounding the onset of skin disease: when and where it started, and how it progressed.

scholarly journals Validity and Cost-Effectiveness of Pediatric Home Respiratory Polygraphy for the Diagnosis of Obstructive Sleep Apnea in Children: Rationale, Study Design, and Methodology

2021 ◽  
Vol 4 (1) ◽  
pp. 9
Author(s):  
Esther Oceja ◽  
Paula Rodríguez ◽  
María Jurado ◽  
Maria Luz Alonso ◽  
Genoveva del Río ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cost Effectiveness ◽  
Sleep Apnea ◽  
Therapeutic Interventions ◽  
Diagnostic Process ◽  
Urine Biomarkers ◽  
Obstructive Sleep ◽  
Respiratory Polygraphy ◽  
The Cost ◽  
The Impact

Obstructive sleep apnea (OSA) in children is a prevalent, albeit largely undiagnosed disease associated with a large spectrum of morbidities. Overnight in-lab polysomnography remains the gold standard diagnostic approach, but is time-consuming, inconvenient, and expensive, and not readily available in many places. Simplified Home Respiratory Polygraphy (HRP) approaches have been proposed to reduce costs and facilitate the diagnostic process. However, evidence supporting the validity of HRP is still scarce, hampering its implementation in routine clinical use. The objectives were: Primary; to establish the diagnostic and therapeutic decision validity of a simplified HRP approach compared to PSG among children at risk of OSA. Secondary: (a) Analyze the cost-effectiveness of the HRP versus in-lab PSG in evaluation and treatment of pediatric OSA; (b) Evaluate the impact of therapeutic interventions based on HRP versus PSG findings six months after treatment using sleep and health parameters and quality of life instruments; (c) Discovery and validity of the urine biomarkers to establish the diagnosis of OSA and changes after treatment.

scholarly journals SARS-CoV-2/DENV co-infection: a series of cases from the Federal District, Midwestern Brazil

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Luise Schulte ◽  
José Diego Brito-Sousa ◽  
Marcus Vinicius Guimarães Lacerda ◽  
Luciana Ansaneli Naves ◽  
Eliana Teles de Gois ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Federal District ◽  
Therapeutic Interventions ◽  
Diagnostic Process ◽  
The Novel ◽  
Prevention Measures ◽  
Laboratory Findings ◽  
Novel Coronavirus ◽  
The Impact

Abstract Background Since the novel coronavirus disease outbreak, over 179.7 million people have been infected by SARS-CoV-2 worldwide, including the population living in dengue-endemic regions, particularly Latin America and Southeast Asia, raising concern about the impact of possible co-infections. Methods Thirteen SARS-CoV-2/DENV co-infection cases reported in Midwestern Brazil between April and September of 2020 are described. Information was gathered from hospital medical records regarding the most relevant clinical and laboratory findings, diagnostic process, therapeutic interventions, together with clinician-assessed outcomes and follow-up. Results Of the 13 cases, seven patients presented Acute Undifferentiated Febrile Syndrome and six had pre-existing co-morbidities, such as diabetes, hypertension and hypopituitarism. Two patients were pregnant. The most common symptoms and clinical signs reported at first evaluation were myalgia, fever and dyspnea. In six cases, the initial diagnosis was dengue fever, which delayed the diagnosis of concomitant infections. The most frequently applied therapeutic interventions were antibiotics and analgesics. In total, four patients were hospitalized. None of them were transferred to the intensive care unit or died. Clinical improvement was verified in all patients after a maximum of 21 days. Conclusions The cases reported here highlight the challenges in differential diagnosis and the importance of considering concomitant infections, especially to improve clinical management and possible prevention measures. Failure to consider a SARS-CoV-2/DENV co-infection may impact both individual and community levels, especially in endemic areas.

The impact of electronic health records on diagnosis

Diagnosis ◽  
2017 ◽  
Vol 4 (4) ◽  
pp. 211-223 ◽  
Author(s):  
Mark L. Graber ◽  
Colene Byrne ◽  
Doug Johnston
Keyword(s):  
Safety Concern ◽  
Diagnostic Error ◽  
The United States ◽  
Unintended Consequences ◽  
Diagnostic Process ◽  
Health It ◽  
Health Care Information ◽  
Health Care Information Technology ◽  
Electronic Health ◽  
The Impact

AbstractDiagnostic error may be the largest unaddressed patient safety concern in the United States, responsible for an estimated 40,000–80,000 deaths annually. With the electronic health record (EHR) now in near universal use, the goal of this narrative review is to synthesize evidence and opinion regarding the impact of the EHR and health care information technology (health IT) on the diagnostic process and its outcomes. We consider the many ways in which the EHR and health IT facilitate diagnosis and improve the diagnostic process, and conversely the major ways in which it is problematic, including the unintended consequences that contribute to diagnostic error and sometimes patient deaths. We conclude with a summary of suggestions for improving the safety and safe use of these resources for diagnosis in the future.

scholarly journals Fluctuating Palmar Erythema in a Toddler during COVID-19 Pandemic: Do You Know the Offender?

2021 ◽  
Vol 67 (1) ◽  
Author(s):  
Prateek Kumar Panda ◽  
Indar Kumar Sharawat
Keyword(s):  
Contact Dermatitis ◽  
Atypical Presentation ◽  
Irritant Contact Dermatitis ◽  
History Taking ◽  
Hand Sanitizer ◽  
The Past ◽  
Palmar Erythema ◽  
Complete Reversal ◽  
Bright Color ◽  
Careful History

Abstract Palmar erythema in children can be due to various reasons, such as chronic liver disease, rheumatological disorders, medications, irritant contact dermatitis and atopic dermatitis. Recently, there are few reports about contact dermatitis caused by frequent, daily use of hand sanitizers during this COVID-19 pandemic. A 3-year-old toddler brought with the concern of waxing-waning bilateral palmar erythema for the past 2 weeks. The parents revealed that the child liked the bright color of a recently bought hand sanitizer bottle so much he used to wash his hands every 20–30 min throughout the day. The atypical presentation of contact dermatitis might be because the child was using the sanitizer more frequently during the daytime. The dermatitis resolved with stopping excessive use of the hand sanitizer by the toddler. Clinicians should be aware of contact dermatitis during these pandemic times. Instead of investigating them extensively, careful history taking and merely advising them to judicially utilize the sanitizer can lead to complete reversal of symptoms.

The impact of medical activity bureaucratization on professional values of personnel: analysis of international research results and data from sociological surveys of Kuzbass Medical Organizations (NII KPSSZ AND GBUZ “KKKD”)

2021 ◽  
Vol 10 (2) ◽  
pp. 15-20
Author(s):  
Ya. V. Danilchenko ◽  
A. N. Popsuyko ◽  
E. A. Batsina ◽  
D. V. Kilizhekova ◽  
D. V. Karas
Keyword(s):  
Comparative Analysis ◽  
Creative Thinking ◽  
International Study ◽  
Medical Personnel ◽  
Professional Values ◽  
Diagnostic Process ◽  
Federal State ◽  
Medical Organization ◽  
Medical Activity ◽  
The Impact

Aim. To assess the correspondence between the results of the European Social Survey (ESS) “The Impact of Medical Activity Bureaucratization on Professional Values of Personnel” and the results of sociological surveys of personnel of medical organizations such as Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases (NII KPSSZ) and Federal State Budgetary Institution “Kuzbass Clinical Cardiology Dispensary named after academician L.S. Barbarash” (GBUZ “KKKD”).Methods. Comparative analysis of the results of ESS (3271 medical workers from 29 countries were questioned) and the results of sociological surveys of the medical personnel at NII KPSSZ (204 respondents in 2017) and at GBUZ “KKKD” (385 respondents in 2021) was carried out.Results. According to the survey data of employees of NII KPSSZ the dominant values are: professionalism and conscientious attitude to work, respectful attitude to colleagues and patients, strict compliance with law and regulatory requirements. Among the main values of GBUZ “KKKD” staff the following were named: discipline and order in fulfilling responsibilities, professionalism and conscientious attitude to work, and respectful attitude to patients.Conclusion. On the basis of the comparative analysis, the authors proved the validity of the conclusions and results of an international study devoted to the problem of the influence of bureaucratization of a medical organization on the structure of personnel values in medical organizations focused only on the treatment and diagnostic process. If an institution functions as a scientific and medical organization, then its employees tend to strive for professional self-development, innovative and creative thinking, which is not consistent with the conclusions of international researchers.

Coaching skills for recovery a decade of providing coaching skills for recovery training at a healthcare NHS foundation trust

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Helen Kathryn Cyrus
Keyword(s):  
Work Practice ◽  
Clinical Approach ◽  
Personal Recovery ◽  
Content Type ◽  
Coaching Skills ◽  
The Difference ◽  
To Come ◽  
The Individual ◽  
The Impact ◽  
The Brain

Purpose Overview of coaching for recovery. The paper aims to show an overview of work that was carried out over 11 years with groups of mental health and physical staff. As the facilitator who had run this course for the duration in Nottingham, this was an excellent opportunity to be at the forefront of a brand new project. Design/methodology/approach The introduction of the skills are taught over two consecutive days followed by a further day a month later. The idea of coaching is to be enabled to find the answers in themselves by the use of powerful questions and using the technique of the grow model, combined with practice enables the brain to come up with its own answers. Using rapport and enabling effective communication to deliver the outcome. Findings Evidence from staff/clients and the purpose of the paper shows that when you step back it allows the individual patients/staff to allow the brain to process to create to come up with their solutions, which then helps them to buy into the process and creates ownership. Research limitations/implications The evidence suggests that the approach that was there prior to the course was very much a clinical approach to working with clients and treating the person, administering medication and not focussing on the inner person or personal recovery. The staff review has shown that in the clinical context change is happening from the inside out. Practical implications “Helps change culture”; “change of work practice”; “it changed staff focus – not so prescriptive”; “powerful questions let clients come to their own conclusions”; “coaching gives the ability to find half full. Helps to offer reassurance and to find one spark of hope”. Social implications This has shown that the approach is now person-centred/holistic. This has been the “difference that has made the difference”. When this paper looks at the issues from a different angle in this case a coaching approach, applying technique, knowledge and powerful questions the results have changed. The same clients, same staff and same problems but with the use of a different approach, there is the evidence of a different outcome, which speaks for itself. The coaching method is more facilitative, therefore it illicit’s a different response, and therefore, result. Originality/value The results/evidence starts with the individual attending and their commitment to the process over the two-day course. Then going away for the four weeks/six for managers and a commitment again to practice. Returning to share the impact if any with the group. This, in turn, helps to inspire and gain motivation from the feedback to go back to work invigorated to keep going.

The Importance of Skin Disease as Assessed by “Willingness-To-Pay”

2003 ◽  
Vol 7 (5) ◽  
pp. 369-371 ◽  
Author(s):  
Lauren Parks ◽  
Rajesh Balkrishnan ◽  
Line Hamel-Gariépy ◽  
Steven R. Feldman
Keyword(s):  
Willingness To Pay ◽  
Skin Disease ◽  
Skin Diseases ◽  
Medical Conditions ◽  
Monthly Basis ◽  
Related Quality ◽  
Health Related ◽  
Optimal Resource ◽  
The Impact

Background: To achieve optimal resource allocation in health care, it is necessary to value competing resource uses according to the benefit derived from those uses. Skin disease makes as great an impact as other serious medical conditions when assessed by effects on health-related quality of life. Objective: To confirm the high impact of skin disease by comparing patients' willingness to pay (WTP) to be cured or relieved from symptoms of skin and nonskin conditions. Methods: We searched the published literature on WTP to compare the impact of dermatologic conditions with the impact of other medical conditions. A total of 46 articles were identified of which 10 included information on willingness to pay for cure reported on a monthly basis. Results: WTP for skin diseases fell in the range of $125–260/month and was comparable or higher than all but one of the other identified conditions. Conclusion: Willingness to pay for relief from skin diseases is comparable to that for relief of other serious medical conditions. Skin diseases are associated with a significant adverse impact on patients' lives.

scholarly journals Barriers and Facilitators to Colorectal Cancer Diagnosis in New Zealand: A Qualitative Study

2020 ◽  
Author(s):  
Tania Blackmore ◽  
Kimberley Norman ◽  
Jacquie Kidd ◽  
Shemana Cassim ◽  
Lynne Chepulis ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
New Zealand ◽  
Help Seeking ◽  
Barriers And Facilitators ◽  
Diagnostic Process ◽  
Interpersonal Competence ◽  
Technical Competence ◽  
Positive Experience ◽  
The Impact ◽  
Diagnostic Intervals

Abstract Background: New Zealand (NZ) has high rates of colorectal cancer but low rates of early diagnosis. Due to a lack of understanding of the pre-diagnostic experience from the patient’s perspective, it is necessary to investigate potential patient and health system factors that contribute to longer diagnostic intervals. Previous qualitative studies have discussed delays using The Model of Pathways to Treatment, but this has not been explored in the NZ context. This study aimed to understand the patient experience and perception of their general practitioner (GP) through the diagnostic process in the Waikato region of NZ. In particular, we sought to investigate potential barriers and facilitators that contribute to longer diagnostic intervals.Methods: Ethical approval for this study was granted by the New Zealand Health and Disability Ethics Committee. Twenty-eight participants, diagnosed with colorectal cancer, were interviewed about their experience. Semi-structured interviews were audio recorded, transcribed verbatim and analysed thematically using The Model of Pathways to Treatment framework (intervals: appraisal, help-seeking, diagnostic).Results: Participant appraisal of symptoms was a barrier to prompt diagnosis, particularly if symptoms were normalised, intermittent, or isolated in occurrence. Successful self-management techniques also resulted in delayed help-seeking. However if symptoms worsened, disruption to work and daily routines were important facilitators to seeking a GP consultation. Participants positively appraised GPs if they showed good technical competence and were proactive in investigating symptoms. Negative GP appraisals were associated with a lack of physical examinations and misdiagnosis, and left participants feeling dehumanised during the diagnostic process. However high levels of GP interpersonal competence could override poor technical competence, resulting in an overall positive experience, even if the cancer was diagnosed at an advanced stage. Māori participants often appraised symptoms inclusive of their sociocultural environment and considered the impact of their symptoms in relation to family.Conclusions: The findings of this study highlight the importance of tailored colorectal cancer symptom communication in health campaigns, and indicate the significance of the interpersonal competence aspect of GP-patient interactions. These findings suggest that interpersonal competence be overtly displayed in all GP interactions to ensure a higher likelihood of a positive experience for the patient.

Collaborative Partnerships in Teacher Preparation

2022 ◽  
pp. 104-118
Author(s):  
Marie A. LeJeune ◽  
Jessica Dougherty ◽  
Mandy S. Olsen
Keyword(s):  
Clinical Practice ◽  
Teacher Preparation ◽  
Teacher Candidates ◽  
Clinical Approach ◽  
Collaborative Partnerships ◽  
Collaborative Approach ◽  
Public School Teachers ◽  
Preparation Programs ◽  
Collaborative Process ◽  
The Impact

This chapter presents a description of a collaborative approach to clinical induction for pre-service teachers, the benefits of a collaborative clinical approach, and the voiced experiences of public school teachers, teacher candidates, and university faculty/supervisors reflecting on the impact of professional involvement in the collaborative process. Arguments for disrupting traditional models for clinical practice are presented. Tips for other educators and education preparation programs for developing collaboration and co-teaching induction models are included.

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