scholarly journals New Strategies for Early Diagnosis and Treatment of Osteoid Osteoma of the Lesser Trochanter of Femur

2021 ◽  
Author(s):  
Xinzhu Qiu ◽  
Hongbo He ◽  
Hao Zeng ◽  
Xiaopeng Tong ◽  
Qing Liu
Keyword(s):  
Osteoid Osteoma ◽  
Clinical Manifestations ◽  
Diagnosis And Treatment ◽  
Postoperative Treatment ◽  
Joint Function ◽  
Treatment Practices ◽  
Hip Function ◽  
Baseline Characteristics ◽  
The Difference ◽  
New Strategies

Abstract Aims: Herein, we examined the efficacy of open resection in proximal femoral osteoid osteoma (OO) treatment. Besides, we analysed the causes of misdiagnosis of proximal femoral OO to provide a reference for its diagnosis and treatment.Methods: This was a retrospective study involving 29 patients with proximal femoral OO admitted into our hospital from January 2010 to January 2018. The baseline characteristics of the participants included; 21 males and 9 females, aged between 13 to 25 (mean 16.2) years old, and the course of the disease was 1 to 14 (mean 6.1) months. We used previous medical experience records of the patients to analyze for the causes of misdiagnosis. Moreover, we compared the difference between preoperative and postoperative treatment practices in alleviating pain in OO patients and restoring hip function. Follow-ups were conducted regularly, and patients advised to avoid strenuous exercises for 3 months.Results: We followed up 29 patients (21 intercortical, 2 sub-periosteal, and 6 medullary) for an average of 42.5 months. We found that 13 patients (44.8%) had been misdiagnosed of synovitis, Perthes disease, osteomyelitis, intra-articular infection, and joint tuberculosis, whose average time from symptoms to diagnosis were 9.8 months. Postoperative pain score and joint function score improved significantly compared with preoperative, and complications were rare.Conclusion: Open surgical resection constitutes an effective treatment for proximal femoral OO by accurately and completely removing the nidus. Lack of understanding, wrong choice of examination, and the complexity and diversity of clinical manifestations constitute the main reasons for the misdiagnosis of proximal femoral OO.

Misdiagnosis and treatment of proximal femoral osteoid osteoma

2020 ◽  
Author(s):  
Qing Liu ◽  
Hao Zeng ◽  
Wei Luo ◽  
Xiaopeng Tong ◽  
Zhiwei Wang ◽  
...  
Keyword(s):  
Osteoid Osteoma ◽  
Clinical Manifestations ◽  
Postoperative Treatment ◽  
Function Score ◽  
Open Resection ◽  
Joint Function ◽  
Treatment Practices ◽  
Hip Function ◽  
Baseline Characteristics ◽  
The Difference

Abstract Aims: Herein, we examined the efficacy of open resection in proximal femoral osteoid osteoma (OO) treatment. Besides, we analysed the causes of misdiagnosis of proximal femoral OO to provide a reference for its diagnosis and treatment.Methods: This was a retrospective study involving 29 patients with proximal femoral OO admitted into our hospital from January 2010 to January 2018. The baseline characteristics of the participants included; 21 males and 9 females, aged between 13 to 25 (mean 16.2) years old, and the course of the disease was 1 to 14 (mean 6.1) months. We used previous medical experience records of the patients to analyze for the causes of misdiagnosis. Moreover, we compared the difference between preoperative and postoperative treatment practices in alleviating pain in OO patients and restoring hip function. Follow-ups were conducted regularly, and patients advised to avoid strenuous exercises for 3 months.Results: We followed up 29 patients (21 intercortical, 2 sub-periosteal, and 6 medullary) for an average of 42.5 months. We found that 13 patients (44.8%) had been misdiagnosed of synovitis, Perthes disease, osteomyelitis, intra-articular infection, and joint tuberculosis, whose average time from symptoms to diagnosis were 9.8 months. Postoperative pain score and joint function score improved significantly compared with preoperative, and complications were rare.Conclusion: Open surgical resection constitutes an effective treatment for proximal femoral OO by accurately and completely removing the nidus. Lack of understanding, wrong choice of examination, and the complexity and diversity of clinical manifestations constitute the main reasons for the misdiagnosis of proximal femoral OO.

Clinical manifestations, diagnosis and treatment of HIV infection of stage 4 (severely symptomatic stage) in the practice of a health professional

2020 ◽  
pp. 27-34
Author(s):  
A. Nikitina ◽  
A. Rusanova ◽  
A. Zhilenkova
Keyword(s):  
Hiv Infection ◽  
Health Professional ◽  
Clinical Picture ◽  
Clinical Manifestations ◽  
Significant Problem ◽  
Diagnosis And Treatment ◽  
Modern World ◽  
Infected People ◽  
Stage 4 ◽  
Future Practice

HIV infection is a significant problem in the modern world, because there are more and more infected people every year. This article will consider: the clinical picture, diagnosis and treatment of this disease in different countries. Based on these data, the following conclusions will be made to help doctors in their future practice correctly approach the diagnosis and treatment of patients with this disease.

Etiologies, Clinical Manifestations, and Factors Associated with Severe Symptomatic Hyponatremia among Hospitalized Hyponatremia Patients

2020 ◽  
Vol 103 (5) ◽  
pp. 465-471
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Sectional Study ◽  
Close Attention ◽  
Cross Sectional ◽  
Factors Associated ◽  
Present Cross Sectional Study ◽  
Important Health ◽  
Baseline Characteristics

Background: Hyponatremia is associated with unfavorable outcomes in many cases. The mainstay of hyponatremia treatment depends on its symptoms and etiology. However, etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia have been rarely reported. Objective: To analyze and report etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia. Materials and Methods: In the present cross-sectional study, the authors enrolled hospitalized patients with hyponatremia who had consulted a nephrologist between October 1, 2017, and October 31, 2018. Their baseline characteristics and clinical manifestations were recorded. Etiologies were confirmed by the attending nephrology staff. Factors associated with severe symptomatic hyponatremia were evaluated using logistic regression analysis. Results: One hundred patients were included in this study. The syndrome of inappropriate antidiuresis (SIAD), hypovolemia, and hydrochlorothiazide use were the leading hyponatremia etiologies. Hyponatremia etiologies differed between patients with community-acquired hyponatremia (n=50) and those with hospital-associated hyponatremia (n=50). Patients with communityacquired hyponatremia were older, presented with a higher frequency of severe symptomatic hyponatremia, and showed lower SNa-levels. Low SNa-levels were significantly associated with severe symptomatic hyponatremia (p=0.014). Conclusion: Hyponatremia remains an important health problem. SIAD, hypovolemia, and hydrochlorothiazide use are among the leading etiologies of hyponatremia. Low SNa-levels are associated with severe symptomatic hyponatremia; thus, physicians should pay close attention to low SNa-levels in hospitalized patients. Keywords: Hyponatremia, Symptomatic Hyponatremia, Community-acquired hyponatremia, Hospital-associated hyponatremia

Characteristics of Asian Mosquito Saliva Allergens for Specific Diagnoses and Effective Therapies

2020 ◽  
Vol 21 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Soung-Hoo Jeon
Keyword(s):  
Allergic Reaction ◽  
East Asia ◽  
East Asian ◽  
Diagnosis And Treatment ◽  
Recombinant Allergens ◽  
Systemic Reactions ◽  
The Future ◽  
Mosquito Saliva ◽  
The Difference ◽  
Future Direction

An allergic reaction to mosquitoes can result in severe or abnormal local or systemic reactions such as anaphylaxis, angioedema, and general urticarial or wheezing. The aim of this review is to provide information on mosquito saliva allergens that can support the production of highly specific recombinant saliva allergens. In particular, candidate allergens of mosquitoes that are well suited to the ecology of mosquitoes that occur mainly in East Asia will be identified and introduced. By doing so, the diagnosis and treatment of patients with severe sensitivity to mosquito allergy will be improved by predicting the characteristics of East Asian mosquito allergy, presenting the future direction of production of recombinant allergens, and understanding the difference between East and West.

PETCO2 gradient: a novel prognostic parameter in cardiopulmonary exercise testing

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I.D Poveda Pinedo ◽  
I Marco Clement ◽  
O Gonzalez ◽  
I Ponz ◽  
A.M Iniesta ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Proportional Hazards ◽  
Cardiopulmonary Exercise Testing ◽  
Cox Proportional Hazards ◽  
Prognostic Parameter ◽  
Cardiopulmonary Exercise ◽  
Proportional Hazards Regression ◽  
Kaplan Meier ◽  
Baseline Characteristics ◽  
The Difference

Abstract Background Previous parameters such as peak VO2, VE/VCO2 slope and OUES have been described to be prognostic in heart failure (HF). The aim of this study was to identify further prognostic factors of cardiopulmonary exercise testing (CPET) in HF patients. Methods A retrospective analysis of HF patients who underwent CPET from January to November 2019 in a single centre was performed. PETCO2 gradient was defined by the difference between final PETCO2 and baseline PETCO2. HF events were defined as decompensated HF requiring hospital admission or IV diuretics, or decompensated HF resulting in death. Results A total of 64 HF patients were assessed by CPET, HF events occurred in 8 (12.5%) patients. Baseline characteristics are shown in table 1. Patients having HF events had a negative PETCO2 gradient while patients not having events showed a positive PETCO2 gradient (−1.5 [IQR −4.8, 2.3] vs 3 [IQR 1, 5] mmHg; p=0.004). A multivariate Cox proportional-hazards regression analysis revealed that PETCO2 gradient was an independent predictor of HF events (HR 0.74, 95% CI [0.61–0.89]; p=0.002). Kaplan-Meier curves showed a significantly higher incidence of HF events in patients having negative gradients, p=0.002 (figure 1). Conclusion PETCO2 gradient was demonstrated to be a prognostic parameter of CPET in HF patients in our study. Patients having negative gradients had worse outcomes by having more HF events. Time to first event, decompensated heart Funding Acknowledgement Type of funding source: None

scholarly journals A short review on leptospirosis: Clinical manifestations, diagnosis and treatment

2021 ◽  
Vol 11 ◽  
pp. 100741
Author(s):  
Chinju Susan Chacko ◽  
Shravya Lakshmi S ◽  
Anjali Jayakumar ◽  
Steffy Ligi Binu ◽  
Ramesh Datta Pant ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Short Review ◽  
Diagnosis And Treatment

scholarly journals A qualitative study on the experiences of southern European immigrant parents navigating the Norwegian healthcare system

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Raquel Herrero-Arias ◽  
Esperanza Diaz
Keyword(s):  
Healthcare System ◽  
Health Beliefs ◽  
Diagnostic Tests ◽  
Home Country ◽  
Healthcare Services ◽  
Diagnosis And Treatment ◽  
Immigrant Parents ◽  
Health Providers ◽  
Treatment Practices ◽  
Cultural Health Beliefs

Abstract Background Patients’ experiences with health providers and their diagnostic and treatment expectations are shaped by cultural health beliefs and previous experiences with healthcare services in home country. This study explores how Southern European immigrant parents navigate the Norwegian healthcare system, through its focus on how this group manage their expectations on diagnosis and treatment practices when these are unmet. Methods The study had a qualitative research design. Fourteen in-depth interviews and two focus group discussions with 20 Southern European immigrant parents were conducted in 2017 in three Norwegian municipalities. With the help of NVivo software, data were transcribed verbatim and coded. Following a thematic analysis approach to identify patterns in immigrants’ experiences with the Norwegian healthcare services, the codes were organized into two themes. Results The first theme includes immigrants’ expectations on diagnostic tests and medical treatment. Southern European immigrants expected more diagnostic tests and pharmacological treatment than what was deemed necessary by Norwegian health providers. Experiences with unmet expectations influenced how immigrants addressed their and their children’s healthcare needs. The second theme comprises immigrants’ experiences of seeking healthcare in Norway (attending medical consultations in the private sector, seeking immigrant healthcare providers, and navigating the healthcare through their Norwegian social networks). This category includes also the alternative solutions immigrants undertook when they were dissatisfied with the diagnosis and treatment practices they were offered in Norway (self-medication and seeking healthcare in home countries). Conclusions Cultural health beliefs and previous experiences with healthcare services from home country shaped immigrants’ expectations on diagnosis and treatment practices. This had great implications for their navigation through the healthcare system and interactions with health providers in the host country. The study suggests that successful inclusion of immigrants into the Norwegian healthcare system requires an acknowledgement of the cultural factors that influence access and use of healthcare services. Exploring immigrants’ perspectives and experiences offers important information to understand the challenges of cross-cultural healthcare and to improve communication and equitable access.

Psychiatry’s “Chemical Imbalance” Fraud: Who Killed Rebecca Riley?

2008 ◽  
Vol 10 (2) ◽  
pp. 96-108 ◽  
Author(s):  
Fred A. Baughman
Keyword(s):  
The United States ◽  
Diagnosis And Treatment ◽  
Normal Person ◽  
Organic Disease ◽  
Health Care Fraud ◽  
Department Of Health ◽  
Congressional Hearing ◽  
The Difference ◽  
Chemical Imbalance ◽  
The Brain

All physicians attend medical school and learn of (a) all things physically normal; anatomy, physiology, and chemistry, (b) all things physically abnormal; pathology, disease, and (c) how to tell the difference. Diagnosis is the first obligation of every physician to every patient, and must precede treatment. Diagnosis first asks, “Is there a physical abnormality (physical abnormality = disorder = disease), yes or no?” Patients with no abnormality (no physical abnormality = no disorder = no disease = normal) are referred to as having “no evidence or disease” (NED) or “no organic disease” (NOD). Their problems may be psychological or psychiatric, but they are not medical or surgical. In patients found to have an abnormality, diagnosis now asks, “Which disease?” Psychiatrists are the only physicians who do not perform physical diagnosis. The absence of disease is determined for them by other physicians, usually referring physicians. In 1948 the previously conjoint specialty of neuropsychiatry was divided into neurology—responsible for the diagnosis and treatment or physical/organic disease of the nervous system—and psychiatry—responsible for the treatment of emotional and psychological problems, none of them due to organic diseases. Nor did psychiatry object to this scientific division of labor at the time. However, in the 1950s, with the advent of psychotropic drugs, psychiatry, increasingly in league with the pharmaceutical industry, began referring to psychological diagnoses as disorders/diseases/chemical imbalances of the brain, albeit with no proof or science. In a congressional hearing in 1970, psychiatrists and federal officials, including the Food and Drug Administration and the Department of Health, Education, and Welfare, represented hyperkinetic disorder (HKD) to be a disorder/disease of the brain leading to the appropriation of millions of dollars for research, diagnosis and treatment into the drug treatment of school children said to have the new disease HKD. HKD became ADD, then ADHD, a disorder/disease/chemical imbalance always in need of a “chemical balancer”—a pill. Without proof of an abnormality/disorder/disease, the ADHD epidemic grew from 150,000 in 1970 to 6 million to 7 million today, the most common childhood diagnosis in the United States, a multi-billion dollar industry, and a model for all 374 DSM–IV psychological/psychiatric diagnoses—none of them actual diseases. As such, psychiatry is not a legitimate branch of medicine deserving scientific-fiscal parity; rather, collectively, it is the greatest health care fraud in history. Every time a so-called chemical imbalance is diagnosed, a patient’s right to informed consent has been abrogated. Every time a medically normal person is treated with a psychotropic chemical balancer—a pill—their first and only abnormality is the iatrogenic intoxication: poisoning.

Pulmonary edema following scorpion envenomation: Mechanisms, clinical manifestations, diagnosis and treatment

2013 ◽  
Vol 162 (2) ◽  
pp. 86-91 ◽  
Author(s):  
Mabrouk Bahloul ◽  
Anis Chaari ◽  
Hassen Dammak ◽  
Mohamed Samet ◽  
Kamilia Chtara ◽  
...  
Keyword(s):  
Pulmonary Edema ◽  
Clinical Manifestations ◽  
Diagnosis And Treatment ◽  
Scorpion Envenomation
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