Personal medical information cards

1971 ◽  
Vol 9 (5) ◽  
pp. 18-20
Keyword(s):  
Differential Diagnosis ◽  
Medical Care ◽  
Medical Information ◽  
Dental Treatment ◽  
Previous History ◽  
Prolonged Therapy ◽  
Unconscious Patient ◽  
Previous Therapy ◽  
Accident Surgery ◽  
Lack Of Knowledge

Continuity of medical care was once relatively simple and mattered less when therapies were not so specific and incisive. Today a patient on prolonged therapy could be exposed to a considerable number of potentially dangerous interactions should any physician, surgeon or anaesthetist alter the treatment when ignorant of the previous therapy. This is a particular hazard during holidays, dental treatment and accident surgery. The differential diagnosis of an unconscious patient in the hospital accident department is made more difficult by a lack of knowledge about his previous history and therapy. In the absence of authentic information mistakes are difficult to avoid.

scholarly journals Principles of diagnostics and therapy of anogenital pruritus in women

2019 ◽  
Vol 2 (26) ◽  
pp. 72-75
Author(s):  
Yu. N. Perlamutrov ◽  
Т. V. Vаsilеnkо ◽  
К. B. Olkhovskaia
Keyword(s):  
Differential Diagnosis ◽  
Medical Care ◽  
Medical Problem ◽  
Present Stage ◽  
Genital Area ◽  
Modern Treatment ◽  
Diagnostics And Therapy ◽  
Lack Of Knowledge

Anogenital itching is a serious problem for most women at one or another period of life. The multifactorial nature of dermatoses with localization in the vulva and anus, the lack of knowledge of the pathophysiology of itching, in principle, determine the problem of itching in the genital area as a relevant medical problem. Conducting a rational differential diagnosis and the use of modern treatment that can quickly jugulate a symptom will at the present stage increase the effectiveness of specialized medical care for this category of patients.

scholarly journals Machine learning approach for differentiating cytomegalovirus esophagitis from herpes simplex virus esophagitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jung Su Lee ◽  
Jihye Yun ◽  
Sungwon Ham ◽  
Hyunjung Park ◽  
Hyunsu Lee ◽  
...  
Keyword(s):  
Machine Learning ◽  
Differential Diagnosis ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Previous History ◽  
Clinical Factor ◽  
Endoscopic Images ◽  
Simplex Virus

AbstractThe endoscopic features between herpes simplex virus (HSV) and cytomegalovirus (CMV) esophagitis overlap significantly, and hence the differential diagnosis between HSV and CMV esophagitis is sometimes difficult. Therefore, we developed a machine-learning-based classifier to discriminate between CMV and HSV esophagitis. We analyzed 87 patients with HSV esophagitis and 63 patients with CMV esophagitis and developed a machine-learning-based artificial intelligence (AI) system using a total of 666 endoscopic images with HSV esophagitis and 416 endoscopic images with CMV esophagitis. In the five repeated five-fold cross-validations based on the hue–saturation–brightness color model, logistic regression with a least absolute shrinkage and selection operation showed the best performance (sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the receiver operating characteristic curve: 100%, 100%, 100%, 100%, 100%, and 1.0, respectively). Previous history of transplantation was included in classifiers as a clinical factor; the lower the performance of these classifiers, the greater the effect of including this clinical factor. Our machine-learning-based AI system for differential diagnosis between HSV and CMV esophagitis showed high accuracy, which could help clinicians with diagnoses.

Organization of immunobiological therapy for severe bronchial asthma in the Sverdlovsk region

2021 ◽  
Author(s):  
Evgeny K. Beltyukov ◽  
Valery A. Shelyakin ◽  
Veronika V. Naumova ◽  
Alexander V. Vinogradov ◽  
Olga G. Smolenskaya
Keyword(s):  
Differential Diagnosis ◽  
Targeted Therapy ◽  
Medical Care ◽  
Clinical Guidelines ◽  
Medical Insurance ◽  
Continuation Therapy ◽  
Insurance Program ◽  
Routine Medical Care ◽  
Insurance Funds ◽  
Stay Hospital

Background: Biologicals use in severe asthma (SA) is associated with problem of targeted therapy (TT) availability. Ensuring availability of biologicals can be resolved within the territorial compulsory medical insurance program (TCMIP) in day-stay or round-the-clock hospital. Aims: development and implementation of program for introduction of immunobiological therapy (IBT) for SA in Sverdlovsk Region (SR). Materials and methods: Program for introduction of IBT for SA was developed in SR in 2018 to provide patients with expensive biologicals within the TCMIP. Program includes: SA prevalence study in SR; practitioners training in differential diagnosis of SA; organization of affordable therapy for patients with SA; register of SA patients сreation and maintenance; patients selection and management of patients with SA in accordance with federal clinical guidelines. Results: Atopic phenotype in SA was detected in 5%, eosinophilic - in 2.3% of all analyzed cases of asthma (n=216). Practitioners of SR were trained in differential diagnosis of SA. The orders of the Ministry of Health of SR were issued, regulating the procedure for referring patients with SA to IBT, a list of municipal medical organizations providing IBT in a day-stay or round-the-clock hospital; approved regional register form of SA patients requiring biologicals use; ungrouping of clinical and statistical groups of day-stay hospital was carried out depending on INN and dose of biologicals; patients with SA are selected for TT and included in the regional register. Initiating of TT in round-the-clock hospital and continuation therapy in day-stay hospital provides a significant savings in compulsory medical insurance funds. Conclusions: introduction of IBT for SA in SR is carried out within framework of developed program. Principle of decentralization brings highly specialized types of medical care closer to patients and makes it possible to provide routine medical care in allergology-immunology profile in context of restrictions caused by COVID-19 pandemic.

scholarly journals The value of an integrated approach to assessing the availability of primary health care, taking into account public opinion and EMIAS data

2021 ◽  
Vol 65 (5) ◽  
pp. 411-417
Author(s):  
Sergei S. Budarin ◽  
Andrei V. Starshinin ◽  
Andrei A. Tyazhelnikov ◽  
Elena V. Kostenko ◽  
Yulia V. Elbek
Keyword(s):  
Health Care ◽  
Public Opinion ◽  
Primary Health Care ◽  
Medical Care ◽  
Medical Information ◽  
Integrated Approach ◽  
Sociological Study ◽  
Primary Health ◽  
Level 1 ◽  
Index Value

Introduction. The study of public opinion as the basis for strategic planning of the activities of medical institutions is more relevant than ever, as it allows finding ways to solve the problems of ensuring the availability and satisfaction of citizens with medical care. Purpose. Comparative assessment of the availability of primary health care based on the results of a sociological study of public opinion and data from the Unified Medical Information and Analytical System of the City of Moscow (UMIAS). Material and methods. To study public opinion, the practice of population survey was used, which was conducted through direct interviewing with filling out questionnaires of visitors to Moscow polyclinics and the method of questioning doctors based on a questionnaire developed by researchers. To analyze the data, the authors used general scientific methods of cognition, including the dialectical method, a systematic approach, logical correspondence and harmonization, detailing and generalization. As part of the study, the index value of the patient loyalty to the medical institution (MI) was calculated according to Net Promoter Score (NPS) method as the difference between the share of the “Promoters” group and the share of the “Critics” group in the total number of responses. Results and discussion. The established correlations indicate the opinions of doctors and citizens to coincide and the UMIAS data on the issue of assessing the accessibility of admission of level 1 doctors for citizens. Based on the results of a sociological survey, the number of dissatisfied patients is mainly affected by managing medical care and its availability. The study confirmed that the higher the availability of an appointment with a level 1 doctor, the lower the number of visits the doctor on duty. Conclusion. The conducted research has shown the practicality of an integrated approach to evaluating the activities of medical organizations based on the results of public opinion research and UMIAS data.

scholarly journals Factors associated with using the internet for medical information based on the doctor-patient trust model: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Fu ◽  
Tianwei Tang ◽  
Junhao Long ◽  
Bohuai Lin ◽  
Jiayue Li ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Medical Care ◽  
Medical Information ◽  
Cross Sectional Study ◽  
Behavioural Intention ◽  
Total Effect ◽  
Patient Trust ◽  
Cross Sectional ◽  
Factors Associated ◽  
Personal Trust

Abstract Background Internet medical care has been advancing steadily, especially during the coronavirus disease 2019 pandemic, the development momentum of Internet medical care in China is more vigorous. This study aimed to explore the factors associated with using the Internet for medical information, to examine the popularisation and implementation of Internet medical treatment and feasible strategies, and promote the further development of Internet medical treatment. Methods A cross-sectional study was conducted on 408 medical patients who had used online medical services. The one-way analysis of variance or independent samples t-test was used to compare the differences in the influence of demographic characteristics on behavioural intentions of different people seeking medical care. Pearson’s correlation was used to evaluate the correlation between different measurement variables. A mediation regression analysis was used to explore the mediating role of trust in Internet medical care. Results The difference in the influence of Internet medical use frequency on the behavioural intention of different participants was statistically significant (F = 3.311, P = 0.038). Among the influencing factors, personal trust propensity (r = 0.387, P < 0.01), website credibility (r = 0.662, P < 0.01), hospital credibility (r = 0.629, P < 0.01), doctor’s credibility (r = 0.746, P < 0.01), and online patient trust (r = 0.874, P < 0.01) were positively correlated with patients’ behavioural intentions. In the analysis of intermediary factors, the total effect of the credibility of the diagnosis and treatment website on the behavioural intention of patients was 0.344. The total effect of the credibility of the diagnosis and treatment hospital on the behavioural intention of patients was 0.312; the total effect of the service doctor’s credibility on the patient’s behavioural intention was 0.385; the total effect of the personal trust tendency on the patient’s behavioural intention was 0.296. Conclusions This study found defects in various factors that produce distrust in Internet medical treatment. It also reveals the positive effect of trust factors on the development and implementation of Internet medical treatment and provides some ideas for improving the use of Internet medical treatment by the masses.

Dehydration, Cramping, and Exertional Rhabdomyolysis: A Case Report with Suggestions for Recovery

2007 ◽  
Vol 16 (3) ◽  
pp. 244-259 ◽  
Author(s):  
Michelle Cleary ◽  
Daniel Ruiz ◽  
Lindsey Eberman ◽  
Israel Mitchell ◽  
Helen Binkley
Keyword(s):  
High School ◽  
Differential Diagnosis ◽  
Previous History ◽  
Football Player ◽  
Return To Play ◽  
Initial Assessment ◽  
Severe Dehydration ◽  
Exertional Rhabdomyolysis ◽  
Hospitalization Period ◽  
Return To Activity

Objective:We present a case of severe dehydration, muscle cramping, and rhabdomyolysis in a high school football player followed by a suggested program for gradual return to play.Background:A 16-year-old male football player (body mass = 69.1 kg, height = 175.3 cm) reported to the ATC after the morning session on the second day of two-a-days complaining of severe muscle cramping.Differential Diagnosis:The initial assessment included severe dehydration and exercise-induced muscle cramps. The differential diagnosis was severe dehydration, exertional rhabdomyolysis, or myositis. CK testing revealed elevated levels indicating mild rhabdomyolysis.Treatment:The emergency department administered 8 L of intravenous (IV) fluid within the 48-hr hospitalization period, followed by gradual return to activity.Uniqueness:To our knowledge, no reports of exertional rhabdomyolysis in an adolescent football player exist. In this case, a high school quarterback with a previous history of heat-related cramping succumbed to severe dehydration and exertional rhabdomyolysis during noncontact preseason practice. We provide suggestions for return to activity following exertional rhabdomyolysis.

Pitfalls in the diagnosis of insulin autoimmune syndrome (Hirata’s disease) in a hypoglycemic child: a case report and review of the literature

2019 ◽  
Vol 32 (4) ◽  
pp. 421-428 ◽  
Author(s):  
Tiago Jeronimo Dos Santos ◽  
Caroline Gouvêa Buff Passone ◽  
Marina Ybarra ◽  
Simone Sakura Ito ◽  
Milena Gurgel Teles ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Previous History ◽  
Human Leukocyte ◽  
Hyperinsulinemic Hypoglycemia ◽  
Insulin Levels ◽  
Insulin Autoimmune Syndrome ◽  
Endogenous Insulin ◽  
Autoimmune Syndrome ◽  
Insulin Autoantibody ◽  
Control Food Intake

Abstract Background Insulin autoimmune syndrome (IAS) is a rare cause of hyperinsulinemic hypoglycemia (HH) not addressed as a potential differential diagnosis in current pediatric guidelines. We present a case of IAS in a child with no previous history of autoimmune disease, no previous intake of triggering medications and absence of genetic predisposition. Case presentation A 6-year-old boy presented with recurrent HH (blood glucose of 26 mg/dL [1.4 mmol/L] and insulin of 686 μU/mL). Abdominal imaging was normal. After multiple therapeutic failures, we hypothesized misuse of exogenous insulin and factitious hypoglycemia. Council of Guardianship had the child separated from his mother, but insulin levels remained high. A chromatography test was then performed which showed high titers of endogenous insulin autoantibody (IAA) with early dissociation from the insulin molecule. The human leukocyte antigen (HLA) test showed a DRB1 *13:01/*08:02 genotype. The patient was advised to control food intake and physical activity routines. During a 5-year follow-up, hypoglycemic episodes were sparse, despite high insulin levels. Conclusions Misdiagnosis of IAS with factitious hypoglycemia may happen if IAS is not considered as a differential diagnosis, leading to potential traumatic consequences. Further efforts should be made to increase awareness of IAS as a differential diagnosis of hypoglycemia and to include it in pediatric guidelines.

scholarly journals Distant Ureteral Metastasis from Colon Adenocarcinoma: Report of a Case and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Ferakis Nikolaos ◽  
Anastasopoulos Panagiotis ◽  
Bouropoulos Konstantinos ◽  
Samaras Vassilios ◽  
Poulias Iraklis
Keyword(s):  
Rectal Cancer ◽  
Differential Diagnosis ◽  
Distant Metastasis ◽  
Toxic Megacolon ◽  
Incidental Finding ◽  
Previous History ◽  
Colon Adenocarcinoma ◽  
Review Of The Literature ◽  
Muscular Coat ◽  
History Of

Carcinomas arising from organs neighbouring the ureter can directly infiltrate the ureter. Distant ureteral metastasis from colon adenocarcinoma is extremely rare and usually an incidental finding in performed autopsies. We report a case of a right ureteral metastasis in a 65-year-old Caucasian male with a history of rectal cancer for which he had been treated 4 years before. He presented with asymptomatic moderate right hydronephrosis. The patient underwent a right nephroureterectomy. Histology of the ureter revealed transmural adenocarcinoma with infiltration of the mucosa. Infiltration of the muscular coat of the bladder was found 2 years later. Thus, cystectomy and left ureterocutaneostomy were performed. The patient died 6 months later due to toxic megacolon during chemotherapy. The differential diagnosis of ureteral adenocarcinoma, especially in patients with previous history of colon adenocarcinoma, should include the possibility of distant metastasis from the primary colonic tumor.

scholarly journals Differential Diagnostic Reasoning Method for Benign Paroxysmal Positional Vertigo Based on Dynamic Uncertain Causality Graph

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Chunling Dong ◽  
Yanjun Wang ◽  
Jing Zhou ◽  
Qin Zhang ◽  
Ningyu Wang
Keyword(s):  
Differential Diagnosis ◽  
Benign Paroxysmal Positional Vertigo ◽  
Medical Information ◽  
Graphical Representation ◽  
Diagnostic Reasoning ◽  
Clinical Observations ◽  
Positional Vertigo ◽  
Sample Data ◽  
Dynamic Uncertain Causality Graph ◽  
Paroxysmal Positional Vertigo

The accurate differentiation of the subtypes of benign paroxysmal positional vertigo (BPPV) can significantly improve the efficacy of repositioning maneuver in its treatment and thus reduce unnecessary clinical tests and inappropriate medications. In this study, attempts have been made towards developing approaches of causality modeling and diagnostic reasoning about the uncertainties that can arise from medical information. A dynamic uncertain causality graph-based differential diagnosis model for BPPV including 354 variables and 885 causality arcs is constructed. New algorithms are also proposed for differential diagnosis through logical and probabilistic inference, with an emphasis on solving the problems of intricate and confounding disease factors, incomplete clinical observations, and insufficient sample data. This study further uses vertigo cases to test the performance of the proposed method in clinical practice. The results point to high accuracy, a satisfactory discriminatory ability for BPPV, and favorable robustness regarding incomplete medical information. The underlying pathological mechanisms and causality semantics are verified using compact graphical representation and reasoning process, which enhance the interpretability of the diagnosis conclusions.

scholarly journals ALGORITHM FOR MEDICAL EXAMINATION OF ENDODONTIC TREATMENT

2020 ◽  
Vol 5 (4) ◽  
pp. 20-25
Author(s):  
A. К. Iordanishvili ◽  
E. K. Barinov ◽  
I. B. Salmanov
Keyword(s):  
Quality Control ◽  
Medical Care ◽  
Dental Treatment ◽  
Care Quality ◽  
Endodontic Treatment ◽  
Internal Quality ◽  
Dental Clinics ◽  
Quality Of Medical Care ◽  
Te Material

Evaluation (including within the framework of medico-legal examination) of the quality and efectiveness of endodontic dental treatment is a matter of current interest in the clinical dentistry.Obiectives. Te aim of the work was to develop an algorithm of medico-legal examination in case of endodontic treatment, to test this algorithm in the work of the commissions of medical care quality control in the departments of therapeutic dentistry of outpatient dental clinics.Material and methods.Te material of the study was the reports of daily activities of dental clinics of various forms of ownership (municipal, departmental, private) in 3 regions of Russia (Moscow, St. Petersburg, Rostov-on-Don), including periodic reports and reference reports, ofcial statistical reports of the activities of the examined clinics, including registration books of the work of the commissions of the quality of medical care. Tese materials were used as a source of primary statistical information. Afer grouping of the information contained in them, the main data characterizing organization, condition and quality of endodontic care were recovered taking into account nosological entities: pulpitis and periodontitis. Taking into account the medical, statistical and analytical nature of the study, the main conclusions and recommendations were formulated on the basis of a retrospective study of these materials.Results. Based on the studies carried out and recommendations of the European Endodontic Association on provision of the standard of endodontic treatment, an algorithm for medico-legal examination of endodontic treatment was proposed. Tis algorithm allows to assess the quality and efectiveness of endodontic treatment of pulpitis and periodontitis in diferent terms (immediately afer treatment, remote period)Conclusion. Te use of the developed algorithm in clinical practice in internal quality control of endodontic care has shown its efectiveness. A large number of clinical cases of insufcient quality of endodontic treatment and its low efectiveness in the remote period indicate persistence of the potential for claims from patients. 

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