scholarly journals Incidentalomas: concept, relevance and challenges for medical practice

2015 ◽  
Vol 10 (35) ◽  
pp. 1-9 ◽  
Author(s):  
María Ana Mariño
Keyword(s):  
High Resolution ◽  
Medical Practice ◽  
Incidental Finding ◽  
Diagnostic Procedures ◽  
Mesh Term ◽  
Medical Databases

Incidentaloma (which has not been included as a MeSH term neither in other medical databases or Bioportal) is a neologism used to describe an incidentally discovered mass (or abnormality) in asymptomatic persons. Incidentaloma, or incidental finding, is extremely common now and in most cases harmless, but sometimes it is not possible to exclude the possibility of real damage and in very few cases, some people can get benefit from its discovery. Therefore, most of incidentalomas represent overdiagnosis originated by the massive use of high-resolution diagnostic procedures. In many cases, incidentaloma causes anxiety, consume time and resources, and can even cause further damage to patients’ health as a result of procedures performed in the post-finding follow-up. Thus, it is important to recognize the problem to try to avoid it if possible, and learn strategies to deal with it once we stumbled upon an incidentaloma.

Dynamic and three dimensional transcranial ultrasonography of an arachnoid cyst in the cerebral convexity

2001 ◽  
Vol 94 (4) ◽  
pp. 655-659 ◽  
Author(s):  
Felix Schlachetzki ◽  
Thilo Hoelscher ◽  
Odo-Winfried Ullrich ◽  
Berthold Schalke ◽  
Ulrich Bogdahn
Keyword(s):  
High Resolution ◽  
Arachnoid Cyst ◽  
Three Dimensional ◽  
Reconstruction Algorithm ◽  
Diagnostic Procedures ◽  
Data Sets ◽  
Content Type ◽  
Tension Type Headaches ◽  
Fine Print

✓ Structural imaging of the brain, such as cerebral computerized tomography (CT) and magnetic resonance (MR) imaging, is state-of-the-art. Dynamic transcranial (dTC) ultrasonography and three-dimensional (3D) transcranial color-coded duplex (TCC) ultrasonography are complementary, noninvasive procedures with the capacity for real-time imaging, which may aid in the temporary management of space-occupying lesions. A 16-year-old woman presented with recurrent tension-type headaches. A space-occupying arachnoid cyst in the cerebral convexity was demonstrated on MR images. The patient underwent an examination for raised intracranial pressure, which was performed using a standard color-coded duplex ultrasonography system attached to a personal computer—based system for 3D data acquisition. Transcranial ultrasonography was used to identify the outer arachnoid membrane of the cyst, which undulated freely in response to rotation of the patient's head (headshake maneuver). Three-dimensional data sets were acquired and, using a multiplanar reformatting reconstruction algorithm, the authors obtained high-resolution images that corresponded to the initial MR image and a follow-up cranial CT scan. No detectable differences were observed on dTC or 3D TC ultrasonograms obtained at follow-up examinations performed 9 and 28 months later. Three-dimensional TCC and dTC ultrasonography may complement conventional diagnostic procedures such as MR and CT imaging. This report represents evidence of the high resolution and good reproducibility of 3D TC methods. Ultrasonography is a mobile and inexpensive tool and may be used to improve management and therapeutic strategies for patients with space-occupying brain lesions in selected cases.

Does Hospitalization Predict the Disease Course in Ulcerative Colitis? Prevalence and Predictors of Hospitalization and Re- Hospitalization in Ulcerative Colitis in a Population-based Inception Cohort (2000-2012)

2015 ◽  
Vol 24 (3) ◽  
pp. 287-292 ◽  
Author(s):  
Petra A. Golovics ◽  
Laszlo Lakatos ◽  
Michael D. Mandel ◽  
Barbara D. Lovasz ◽  
Zsuzsanna Vegh ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Cox Regression ◽  
Diagnostic Procedures ◽  
Population Based ◽  
Disease Course ◽  
Inception Cohort ◽  
Disease Extent ◽  
Cox Regression Analysis ◽  
Hospitalization Rates

Background & Aims: Limited data are available on the hospitalization rates in population-based studies. Since this is a very important outcome measure, the aim of this study was to analyze prospectively if early hospitalization is associated with the later disease course as well as to determine the prevalence and predictors of hospitalization and re-hospitalization in the population-based ulcerative colitis (UC) inception cohort in the Veszprem province database between 2000 and 2012. Methods: Data of 347 incident UC patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (M/F: 200/147, median age at diagnosis: 36, IQR: 26-50 years, follow-up duration: 7, IQR 4-10 years). Both in- and outpatient records were collected and comprehensively reviewed. Results: Probabilities of first UC-related hospitalization were 28.6%, 53.7% and 66.2% and of first re-hospitalization were 23.7%, 55.8% and 74.6% after 1-, 5- and 10- years of follow-up, respectively. Main UC-related causes for first hospitalization were diagnostic procedures (26.7%), disease activity (22.4%) or UC-related surgery (4.8%), but a significant percentage was unrelated to IBD (44.8%). In Kaplan-Meier and Cox-regression analysis disease extent at diagnosis (HR extensive: 1.79, p=0.02) or at last follow-up (HR: 1.56, p=0.001), need for steroids (HR: 1.98, p<0.001), azathioprine (HR: 1.55, p=0.038) and anti-TNF (HR: 2.28, p<0.001) were associated with the risk of UC-related hospitalization. Early hospitalization was not associated with a specific disease phenotype or outcome; however, 46.2% of all colectomies were performed in the year of diagnosis. Conclusion: Hospitalization and re-hospitalization rates were relatively high in this population-based UC cohort. Early hospitalization was not predictive for the later disease course.

scholarly journals Venus: key to understanding the evolution of terrestrial planets

2021 ◽  
Author(s):  
Colin F. Wilson ◽  
Thomas Widemann ◽  
Richard Ghail
Keyword(s):  
High Temperature ◽  
High Resolution ◽  
Radar Imaging ◽  
Space Science ◽  
Interior Surface ◽  
Extended Surface ◽  
Earth Like Planets ◽  
Orbital Mission

AbstractIn this paper, originally submitted in answer to ESA’s “Voyage 2050” call to shape the agency’s space science missions in the 2035–2050 timeframe, we emphasize the importance of a Venus exploration programme for the wider goal of understanding the diversity and evolution of habitable planets. Comparing the interior, surface, and atmosphere evolution of Earth, Mars, and Venus is essential to understanding what processes determined habitability of our own planet and Earth-like planets everywhere. This is particularly true in an era where we expect thousands, and then millions, of terrestrial exoplanets to be discovered. Earth and Mars have already dedicated exploration programmes, but our understanding of Venus, particularly of its geology and its history, lags behind. Multiple exploration vehicles will be needed to characterize Venus’ richly varied interior, surface, atmosphere and magnetosphere environments. Between now and 2050 we recommend that ESA launch at least two M-class missions to Venus (in order of priority): a geophysics-focussed orbiter (the currently proposed M5 EnVision orbiter – [1] – or equivalent); and an in situ atmospheric mission (such as the M3 EVE balloon mission – [2]). An in situ and orbital mission could be combined in a single L-class mission, as was argued in responses to the call for L2/L3 themes [3–5]. After these two missions, further priorities include a surface lander demonstrating the high-temperature technologies needed for extended surface missions; and/or a further orbiter with follow-up high-resolution surface radar imaging, and atmospheric and/or ionospheric investigations.

Between a logic of disruption and a logic of continuation: Negotiating the legitimacy of algorithms used in automated clinical decision-making

2021 ◽  
pp. 136345932199674
Author(s):  
Rikke Torenholt ◽  
Henriette Langstrup
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Patient Reported Outcomes ◽  
Patient Involvement ◽  
Clinical Decision Making ◽  
Diagnostic Procedures ◽  
Clinical Decision ◽  
Patient Reported ◽  
Pro Tools

In both popular and academic discussions of the use of algorithms in clinical practice, narratives often draw on the decisive potentialities of algorithms and come with the belief that algorithms will substantially transform healthcare. We suggest that this approach is associated with a logic of disruption. However, we argue that in clinical practice alongside this logic, another and less recognised logic exists, namely that of continuation: here the use of algorithms constitutes part of an established practice. Applying these logics as our analytical framing, we set out to explore how algorithms for clinical decision-making are enacted by political stakeholders, healthcare professionals, and patients, and in doing so, study how the legitimacy of delegating to an algorithm is negotiated and obtained. Empirically we draw on ethnographic fieldwork carried out in relation to attempts in Denmark to develop and implement Patient Reported Outcomes (PRO) tools – involving algorithmic sorting – in clinical practice. We follow the work within two disease areas: heart rehabilitation and breast cancer follow-up care. We show how at the political level, algorithms constitute tools for disrupting inefficient work and unsystematic patient involvement, whereas closer to the clinical practice, algorithms constitute a continuation of standardised and evidence-based diagnostic procedures and a continuation of the physicians’ expertise and authority. We argue that the co-existence of the two logics have implications as both provide a push towards the use of algorithms and how a logic of continuation may divert attention away from new issues introduced with automated digital decision-support systems.

MR imaging of ventriculus terminalis of the conus medullaris: A report of two operated patients and review of the literature

2003 ◽  
Vol 44 (4) ◽  
pp. 444-446
Author(s):  
R. Dullerud ◽  
A. Server ◽  
J. Berg-Johnsen
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Signal Intensity ◽  
Incidental Finding ◽  
Conus Medullaris ◽  
Review Of The Literature ◽  
Per Se ◽  
Specific Symptoms ◽  
Work Up

We report on 2 patients in whom a cystic dilation of the conus medullaris was incidentally found at MR imaging carried out in the work-up for sciatica. The cysts were well circumscribed and had signal intensity identical to the CSF on both T1- and T2-weighted images. There was no evidence of contrast enhancement. None of the patients had specific symptoms related to the spinal cord. At surgery, no evidence of malignancy was seen in any of the patients. A benign cystic dilation, also called dilated ventriculus terminalis, occasionally can be seen in the conus medullaris as an incidental finding at thoracolumbar MR imaging. Unless the expansion per se indicates cyst drainage, these patients may be monitored by clinical and MR follow-up, avoiding surgery in a substantial number of cases.

THE NEW ADDRESSING PROBLEM IN INTESTINAL CANDIDOSIS

2020 ◽  
pp. 010
Author(s):  
Suzana Otašević ◽  
Milan Golubović
Keyword(s):  
Saccharomyces Cerevisiae ◽  
Intestinal Mucosa ◽  
Medical Practice ◽  
Diagnostic Procedures

Herein, we discussed a new problem concerning diagnosis, treatment and monitoring of patients with intestinal candidosis. The lack of official attitude about significance of Candida overgrowth on intestinal mucosa as well as the absence of guidelines regarding its treatment and required diet, significantly complicate this problem in medical practice. Possible overgrowth of species Saccharomyces cerevisiae-bulardi from probiotics in intestines is a newly recognized problem in diagnostic procedures.

A Developing Anterior Mediastinal Mass In A Breast Cancer Patient : Thymic Hyperplasia

2021 ◽  
Vol 17 ◽  
Author(s):  
Nilgün Güldoğan ◽  
Aykut Soyder ◽  
Ebru Yılmaz ◽  
Aydan Arslan
Keyword(s):  
Breast Cancer ◽  
Cancer Patient ◽  
Cancer Patients ◽  
Mediastinal Mass ◽  
Diagnostic Procedures ◽  
Thymic Hyperplasia ◽  
Anterior Mediastinal Mass ◽  
Breast Cancer Patients ◽  
Thymus Hyperplasia

Introduction: True thymic hyperplasia following chemotherapy have been described mostly in children.There are a few cases of thymus hyperplasia have been reported in breast cancer patients . Diagnosis of this unusual entity is very crucial to pretend unnecessary surgery or interventional diagnostic procedures. Case Presentation: We report a case of thymus hyperplasia in a patient who was operated and treated with adjuvant chemotherapy for stage 2 breast cancer two years ago. In the follow-up CT scans an anterior mediastinal mass was noted. Radiologic evaluation and follow up revealed thymus enlargement. Discussion: Thymic hyperplasia following chemotherapy have been described in both children and adults, but occurs mostly in children and adolescents treated for lymphoma and several other types of tumors. Few cases are reported in literature describing thymus hyperplasia following chemotherapy in a breast cancer patient. Conclusion: Radiologists must be aware of this unusual finding in breast cancer patients treated with chemotherapy to guide the clinicians appropriately in order to avoid unnecessary surgical intervention, additional invasive diagnostic procedures, or chemotherapy.

scholarly journals TOI-150b and TOI-163b: two transiting hot Jupiters, one eccentric and one inflated, revealed by TESS near and at the edge of the JWST CVZ

2019 ◽  
Vol 490 (1) ◽  
pp. 1094-1110 ◽  
Author(s):  
Diana Kossakowski ◽  
Néstor Espinoza ◽  
Rafael Brahm ◽  
Andrés Jordán ◽  
Thomas Henning ◽  
...  
Keyword(s):  
High Resolution ◽  
Time Scale ◽  
High Resolution Spectroscopy ◽  
Spin Orbit ◽  
Eccentric Orbit ◽  
Hot Jupiters ◽  
Eclipse Observations ◽  
James Webb Space Telescope ◽  
Hot Jupiter

Abstract We present the discovery of TYC9191-519-1b (TOI-150b, TIC 271893367) and HD271181b (TOI-163b, TIC 179317684), two hot Jupiters initially detected using 30-min cadence Transiting Exoplanet Survey Satellite (TESS) photometry from Sector 1 and thoroughly characterized through follow-up photometry (CHAT, Hazelwood, LCO/CTIO, El Sauce, TRAPPIST-S), high-resolution spectroscopy (FEROS, CORALIE), and speckle imaging (Gemini/DSSI), confirming the planetary nature of the two signals. A simultaneous joint fit of photometry and radial velocity using a new fitting package juliet reveals that TOI-150b is a $1.254\pm 0.016\ \rm {R}_ \rm{J}$, massive ($2.61^{+0.19}_{-0.12}\ \rm {M}_ \rm{J}$) hot Jupiter in a 5.857-d orbit, while TOI-163b is an inflated ($R_ \rm{P}$ = $1.478^{+0.022}_{-0.029} \,\mathrm{ R}_ \rm{J}$, $M_ \rm{P}$ = $1.219\pm 0.11 \, \rm{M}_ \rm{J}$) hot Jupiter on a P = 4.231-d orbit; both planets orbit F-type stars. A particularly interesting result is that TOI-150b shows an eccentric orbit ($e=0.262^{+0.045}_{-0.037}$), which is quite uncommon among hot Jupiters. We estimate that this is consistent, however, with the circularization time-scale, which is slightly larger than the age of the system. These two hot Jupiters are both prime candidates for further characterization – in particular, both are excellent candidates for determining spin-orbit alignments via the Rossiter–McLaughlin (RM) effect and for characterizing atmospheric thermal structures using secondary eclipse observations considering they are both located closely to the James Webb Space Telescope (JWST) Continuous Viewing Zone (CVZ).

scholarly journals Solid-pseudopapillary tumors of the pancreas

2005 ◽  
Vol 62 (10) ◽  
pp. 763-767
Author(s):  
Darko Mirkovic ◽  
Aleksandar Karamarkovic
Keyword(s):  
Female Patient ◽  
Young Women ◽  
Diagnostic Procedures ◽  
Histopathological Analysis ◽  
High Grade ◽  
Pathological Characteristics ◽  
Rare Lesion ◽  
Grade Of Malignancy ◽  
Solid Pseudopapillary Tumors

Background. Solid-pseudopapillary tumors of the pancreas (SPT) is a very rare lesion. We presented the clinical and pathological characteristics of this tumor and reviewed the literature. Case report. We analyzed the treatment of the two female patients, aged 21 and 37 years, with this tumor. The first female patient had the tumor without involvement of the surrounding organs. The second female patient had the tumor with a high grade of malignancy which invaded blood vessels. We performed in both patients splenohemipancreatectomy, and then we reported the pathological characteristics of the tumors. We didn't find recidive in the observed postoperative follow-up of 4, and 6 years, respectively. Conclusion. SPT is a rare tumor of the pancreas that is diagnosed primarily in young women. The prognosis after surgical treatment was excellent. The histopathological analysis is the main procedure in establishing diagnosis, regardless the most recent diagnostic procedures.

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