scholarly journals Comparison of Clinical Diagnoses and Autopsy Findings: Six-Year Retrospective Study

2017 ◽  
Vol 141 (9) ◽  
pp. 1262-1266 ◽  
Author(s):  
Hyejong Song Marshall ◽  
Clara Milikowski
Keyword(s):  
Diagnostic Errors ◽  
Developed Countries ◽  
Body Cavity ◽  
Class I ◽  
Clinical Investigations ◽  
Time Period ◽  
Clinical Diagnoses ◽  
Impact On Survival ◽  
Unexpected Findings ◽  
The Given

Context.— The frequency of autopsies has declined in most developed countries beginning in the latter half of the 20th century. During this time period the technology of medicine made significant advances; however, it is important to regularly reevaluate the role of the autopsy to confirm suspected diagnoses and identify unsuspected findings. Objective.— To determine what portion of autopsies reveal clinically meaningful unexpected findings. Design.— Reports that included clinical histories of autopsies performed at Jackson Memorial Hospital during the 6 years between 2009 and 2014 were reviewed by 2 pathologists. Each case was classified using the Goldman Classification. Results.— In the given time period, 923 autopsies were performed; 512 patients (55.5%) were adults. A total of 334 cases were subject to review after excluding those with a short (<1 day) hospital stay, restriction to a single organ or body cavity, and cases referred from other facilities. A total of 33 of 334 cases (9.9%) were identified as class I discrepancy, where the autopsy revealed a discrepant diagnosis with a potential impact on survival or treatment. Critical findings, such as untreated infection (15 of 33 cases; 45.5%), pulmonary embolism (8 of 33 cases; 24.2%), and undiagnosed malignancy (6 of 33 cases; 18.2%), were found in these cases. Major significant findings that had not been clinically detected, whether clinically manageable or not (class I and II), were found in 65 of 334 cases (19.5%). Conclusion.— Despite intensive modern clinical investigations, autopsies continue to reveal major antemortem diagnostic errors in a significant number of cases.

Autopsy interrogation of emergency medicine dispute cases: how often are clinical diagnoses incorrect?

2017 ◽  
Vol 71 (1) ◽  
pp. 67-71 ◽  
Author(s):  
Danyang Liu ◽  
Rongchang Gan ◽  
Weidi Zhang ◽  
Wei Wang ◽  
Hexige Saiyin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Medicine ◽  
Aortic Dissection ◽  
Diagnostic Errors ◽  
Class I ◽  
Medical Disputes ◽  
Clinical Diagnoses ◽  
Major Discrepancy ◽  
The Difference ◽  
Missed Diagnoses

AimsEmergency medicine is a ‘high risk’ specialty. Some diseases develop suddenly and progress rapidly, and sudden unexpected deaths in the emergency department (ED) may cause medical disputes. We aimed to assess discrepancies between antemortem clinical diagnoses and postmortem autopsy findings concerning emergency medicine dispute cases and to figure out the most common major missed diagnoses.MethodsClinical files and autopsy reports were retrospectively analysed and interpreted. Discrepancies between clinical diagnoses and autopsy diagnoses were evaluated using modified Goldman classification as major and minor discrepancy. The difference between diagnosis groups was compared with Pearson χ2 test.ResultsOf the 117 cases included in this study, 71 of cases (58 class I and 13 class II diagnostic errors) were revealed as major discrepancies (60.7%). The most common major diagnoses were cardiovascular diseases (54 cases), followed by pulmonary diseases, infectious diseases and so on. The difference of major discrepancy between the diagnoses groups was significant (p<0.001). Aortic dissection and myocardial infarction were the most common cause of death (15 cases for each disease) and the most common missed class I diagnoses (80% and 66.7% for each), higher than the average 49.6% of all class I errors of the study patients.ConclusionsHigh major disparities between clinical diagnoses and postmortem examinations exist in emergency medical disputes cases; acute aortic dissection and myocardial infarction are the most frequently major missed diagnoses that ED clinicians should pay special attention to in practice. This study reaffirmed the necessity and usefulness of autopsy in auditing death in EDs.

Clinical Diagnoses and Autopsy Findings: A Retrospective Analysis of 252 Cases in Greece

2005 ◽  
Vol 129 (2) ◽  
pp. 210-214
Author(s):  
Chaido Spiliopoulou ◽  
Stavroula Papadodima ◽  
Nikolaos Kotakidis ◽  
Antonios Koutselinis
Keyword(s):  
Retrospective Analysis ◽  
Clinical Diagnosis ◽  
Cause Of Death ◽  
Diagnostic Errors ◽  
Postmortem Diagnosis ◽  
Autopsy Findings ◽  
Quality Of Patient Care ◽  
Clinical Diagnoses ◽  
Unexpected Findings

Abstract Context.—Despite medical and technologic advances, clinicians may misdiagnose a patient's situation and the cause of death. Autopsy may be valuable in uncovering the most frequent diagnostic pitfalls and helping clinicians to learn and to develop the medical art and science. Objective.—To compare the clinical diagnoses with postmortem findings and evaluate the frequency of diagnostic errors assessed by autopsies. Design.—Retrospective analysis of the protocols of 252 consecutive cases of adult patients autopsied in the Department of Forensic Medicine and Toxicology of Athens Medical School during the period 1999–2003. The outcome measures included concordance between diagnosis before death and at autopsy, sex, age, and length of hospitalization of the patient. Results.—In 73 cases (29%), the autopsy findings confirmed the clinical diagnosis and the cause of death suggested by the clinicians. In 45 cases (19%), the clinical diagnosis and the cause of death suggested by the clinicians were discordant with the autopsy findings. In 105 cases (42%), the autopsy requests did not include any suggestion about the cause of the patient's death. In 7 cases (3%), several diagnoses were suggested by the clinicians, and in 16 cases (6%), the comparison between clinical and postmortem diagnosis was not possible. The most frequently misdiagnosed diseases were coronary disease and pulmonary embolism. Conclusions.—It is concluded from this study that autopsies may reveal unexpected findings that are of critical importance and that a continued emphasis on autopsy evaluation is necessary to improve the quality of patient care.

The Ideology of Socialism and the Armenian Political Parties

wisdom ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. 107-113
Author(s):  
Gegham HOVHANNISYAN
Keyword(s):  
Political Parties ◽  
Political Life ◽  
The Political ◽  
Political Organizations ◽  
Social Democrats ◽  
Time Period ◽  
The Social ◽  
Political Forces ◽  
The 19Th Century ◽  
The Given

The article covers the manifestations and peculiarities of the ideology of socialism in the social-political life of Armenia at the end of the 19th century and the beginning of the 20th century. General characteristics, aims and directions of activity of the political organizations functioning in the Armenian reality within the given time-period, whose program documents feature the ideology of socialism to one degree or another, are given (Hunchakian Party, Dashnaktsutyun, Armenian Social-democrats, Specifics, Socialists-revolutionaries). The specific peculiarities of the national-political life of Armenia in the given time-period and their impact on the ideology of political forces are introduced.

Utilization of remote sensing for estimation of scale of cutting and growing of forest zones

2017 ◽  
Vol 920 (2) ◽  
pp. 57-60
Author(s):  
F.E. Guliyeva
Keyword(s):  
Remote Sensing ◽  
Fixed Time ◽  
Time Interval ◽  
Time Points ◽  
Average Value ◽  
Time Period ◽  
Remote Estimation ◽  
The Given ◽  
Forest Cutting

The study of results of relevant works on remote sensing of forests has shown that the known methods of remote estimation of forest cuts and growth don’t allow to calculate the objective average value of forests cut volume during the fixed time period. The existing mathematical estimates are not monotonous and make it possible to estimate primitively the scale of cutting by computing the ratio of data in two fixed time points. In the article the extreme properties of the considered estimates for deforestation and reforestation models are researched. The extreme features of integrated averaged values of given estimates upon limitations applied on variables, characterizing the deforestation and reforestation processes are studied. The integrated parameter, making it possible to calculate the averaged value of estimates of forest cutting, computed for all fixed time period with a fixed step is suggested. It is shown mathematically that the given estimate has a monotonous feature in regard of value of given time interval and make it possible to evaluate objectively the scales of forest cutting.

scholarly journals Infectious diseases acquired by international travellers visiting the USA†

2018 ◽  
Vol 25 (1) ◽  
Author(s):  
Rhett J Stoney ◽  
Douglas H Esposito ◽  
Phyllis Kozarsky ◽  
Davidson H Hamer ◽  
Martin P Grobusch ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Descriptive Analysis ◽  
Low Frequency ◽  
Developed Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
International Tourist ◽  
Clinical Diagnoses ◽  
The Usa ◽  
Systemic Infections

Abstract Background Estimates of travel-related illness have focused predominantly on populations from highly developed countries visiting low- or middle-income countries, yet travel to and within high-income countries is very frequent. Despite being a top international tourist destination, few sources describe the spectrum of infectious diseases acquired among travellers to the USA. Methods We performed a descriptive analysis summarizing demographic and travel characteristics, and clinical diagnoses among non-US-resident international travellers seen during or after travel to the USA at a GeoSentinel clinic from 1 January 1997 through 31 December 2016. Results There were 1222 ill non-US-resident travellers with 1393 diagnoses recorded during the 20-year analysis period. Median age was 40 (range 0–86 years); 52% were female. Patients visited from 63 countries and territories, most commonly Canada (31%), Germany (14%), France (9%) and Japan (7%). Travellers presented with a range of illnesses; skin and soft tissue infections of unspecified aetiology were the most frequently reported during travel (29 diagnoses, 14% of during-travel diagnoses); arthropod bite/sting was the most frequently reported after travel (173 diagnoses, 15% after-travel diagnoses). Lyme disease was the most frequently reported arthropod-borne disease after travel (42, 4%). Nonspecific respiratory, gastrointestinal and systemic infections were also among the most frequently reported diagnoses overall. Low-frequency illnesses (&lt;2% of cases) made up over half of diagnoses during travel and 41% of diagnoses after travel, including 13 cases of coccidioidomycosis and mosquito-borne infections like West Nile, dengue and Zika virus diseases. Conclusions International travellers to the USA acquired a diverse array of mostly cosmopolitan infectious diseases, including nonspecific respiratory, gastrointestinal, dermatologic and systemic infections comparable to what has been reported among travellers to low- and middle-income countries. Clinicians should consider the specific health risks when preparing visitors to the USA and when evaluating and treating those who become ill.

scholarly journals The Model of Sociological Education in the USSR (the Late 1950s — Early 1980s)

2021 ◽  
pp. 112-117
Author(s):  
Sergei V. Kozin ◽  
Zhanna B. Litvinova
Keyword(s):  
Sociological Research ◽  
Scientific Publications ◽  
Mutual Exchange ◽  
Research Areas ◽  
Time Period ◽  
The Given ◽  
Soviet Sociology

The article provides an analysis of foreign and Soviet scientific publications devoted to the problem of sociological education, the “revival” of Soviet sociology, as well as to the role and place of sociology among the sciences, in society and education. The given study covers the time period of the late 1950s — early 1980s and briefly describes the education of the population of the USSR at that time. Looking through the works on Soviet sociology, the authors show that sociology was introduced not only into the research areas of specific universities and laboratories, but also into many other branches and spheres of activity, as well as into the authorities’ activity. The authors of the article purposefully focus on the role of consolidation and mutual exchange of sociological research from various sociological services.

scholarly journals CULTURAL HERITAGE MONUMENT DOCUMENTATION THROUGH ADAPTIVE PARAMETRIC DESIGN PROCESS

2021 ◽  
Vol XLVI-M-1-2021 ◽  
pp. 769-776
Author(s):  
G. Tryfonos ◽  
M. Ioannides ◽  
A. G. Anastasi ◽  
V. A. Apostolou ◽  
P. P. Pieri ◽  
...  
Keyword(s):  
Cultural Heritage ◽  
Parametric Design ◽  
3D Models ◽  
Building Information Modelling ◽  
3D Data ◽  
Time Period ◽  
Building Information ◽  
Game Developers ◽  
The Given ◽  
The City

Abstract. The paper presents a novel adaptive parametric documentation, modelling and sharing methodology, which aims to achieve a continuous holistic documentation, data processing and sharing process for cultural heritage community, such as architects, engineers, archaeologists, conservators, programmers, fabricators, contest creators, game developers, scholars and common citizens. Thus, the use of advance parametric and building information modelling software allows the processing and specification of all data by creating the 3D models needed for the multidisciplinary experts. Two Cypriot case studies from the medieval time period have been chosen for the development, and evaluation of our proposed methodology in order to investigate the process of modelling and sharing all the given metadata and 3D data. The first one is the Asinou Church, a UNESCO Heritage stone monument in the Troodos Mountains with a unique interior and the Kolossi Castle, a former Crusader stronghold on the west of the city of Limassol on the island of Cyprus.

scholarly journals Clinical diagnoses vs. autopsy findings in early deceased septic patients in the intensive care: a retrospective cohort study

2020 ◽  
Author(s):  
Rob G. H. Driessen ◽  
Bartholomeus G. H. Latten ◽  
Dennis C. J. J. Bergmans ◽  
Riquette P. M. G. Hulsewe ◽  
Johanna W. M. Holtkamp ◽  
...  
Keyword(s):  
Intensive Care ◽  
Clinical Diagnosis ◽  
Causes Of Death ◽  
Early Death ◽  
Class I ◽  
Icu Patients ◽  
Icu Admission ◽  
Clinical Diagnoses ◽  
Important Diagnostic Tool ◽  
Record Review

AbstractEarly death in sepsis occurs frequently; however, specific causes are largely unknown. An autopsy can contribute to ascertain causes of death. The objective of the study was to determine discrepancies in clinical diagnosis and postmortem findings in septic intensive care unit (ICU) patients deceased within 48 h after ICU admission. All septic ICU patients who deceased within 48 h after ICU admission were identified and included. Four intensivists determined the clinical cause of death by medical record review. An autopsy was performed within 24 h of death. Clinical diagnosis and postmortem findings were compared and classified as autopsy-identified missed clinical diagnoses and autopsy-refuted diagnoses. Class I and II missed major diagnoses using the Goldman criteria were scored. Between 2012 and 2017, 1107 septic patients were admitted to ICU. Of these, 344 patients (31%) died, of which 97 patients (28%) deceased within 48 h. In 32 (33%) early deceased patients, an autopsy was agreed. There were 26 autopsy-identified missed clinical diagnoses found, mostly myocardial infarction (n = 4) and pneumonia (n = 4). In four patients (13%), a class I discrepancy was found. In fourteen patients (42%), a class II discrepancy was found. In conclusion, an autopsy is an important diagnostic tool that can identify definite causes of death. These diagnoses deviate from diagnoses established during admission in early deceased sepsis patients.

scholarly journals The Impact of Economic Freedom on Economic Growth? New European Dynamic Panel Evidence

2020 ◽  
Vol 13 (2) ◽  
pp. 26
Author(s):  
Ivana Brkić ◽  
Nikola Gradojević ◽  
Svetlana Ignjatijević
Keyword(s):  
Economic Growth ◽  
Economic Freedom ◽  
Negative Impact ◽  
Developed Countries ◽  
Dynamic Panel ◽  
Heritage Foundation ◽  
Eu Membership ◽  
Time Period ◽  
European Economies ◽  
The Impact

This paper analyzes the impact of economic freedom along with traditional economic factors on economic growth for a panel of European countries. The growth of the gross domestic product was observed over a twenty-year time period on a sample of 43 developing and developed countries. Based on a robust dynamic panel setting, we conclude that increases in economic freedom as expressed by the Index of Economic Freedom/Heritage Foundation (but not its levels) are related to economic growth. The EU membership status either had no effect or it curbed the effect of the economic freedom on growth. We also find that the subprime economic crisis of 2008–2009 exerted a negative impact on the growth of European economies.

scholarly journals Multicriteria analysis in hazards assessment in Libya

2012 ◽  
Vol 7 (2) ◽  
pp. 59-70
Author(s):  
Martina Zeleňáková ◽  
Ibrahim Gargar ◽  
Pavol Purcz
Keyword(s):  
Risk Assessment ◽  
Multicriteria Analysis ◽  
Pairwise Comparison ◽  
Developed Countries ◽  
Decision Makers ◽  
Risk Level ◽  
Analytic Hierarchy ◽  
The Given ◽  
Hierarchy Process ◽  
Developing And Developed Countries

Abstract Environmental hazards (natural and man-made) have always constituted problem in many developing and developed countries. Many applications proved that these problems could be solved through planning studies and detailed information about these prone areas. Determining time and location and size of the problem are important for decision makers for planning and management activities. It is important to know the risk represented by those hazards and take actions to protect against them. Multicriteria analysis methods - Analytic hierarchy process, Pairwise comparison, Ranking method are used to analyse which is the most dangerous hazard facing Libya country. The multicriteria analysis ends with a more or less stable ranking of the given alternatives and hence a recommendation as to which alternative(s) problems should be preferred. Regarding our problem of environmental risk assessment, the result will be a ranking or categorisation of hazards with regard to their risk level.

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