DIAGNOSTIC EVALUATION AND FOLLOW-UP OF PATIENTS WITH AMENORRHEA-GALACTORRHEA UNDER TREATMENT WITH BROMOERGOCRYPTINE (CB-154)

1975 ◽  
Vol 80 (1_Suppla) ◽  
pp. S25
Author(s):  
A. E. Schindler ◽  
E. Keller ◽  
R. Göser ◽  
E. R. Jaeger-Whitegiver
Keyword(s):  
Diagnostic Evaluation

scholarly journals Urinary steroid profiling in diagnostic evaluation of an unusual adrenal mass

2019 ◽  
Vol 2019 ◽  
Author(s):  
N F Lenders ◽  
J R Greenfield
Keyword(s):  
Sensitivity And Specificity ◽  
Serum Biochemistry ◽  
Diagnostic Evaluation ◽  
Gas Chromatography Mass Spectrometry ◽  
List Type ◽  
Steroid Profiling ◽  
Rare Tumours ◽  
Adrenal Masses ◽  
Urinary Steroid

Summary Adrenal oncocytomas are rare tumours, with only approximately 160 cases reported in the literature. We report the use of urinary steroid profiling as part of their diagnostic evaluation and prognostication. A 45-year-old woman presented with clinical features of hyperandrogenism. Serum biochemistry confirmed androgen excess and computed tomography (CT) demonstrated a 3.2 cm adrenal tumour with density 39 HU pre-contrast. Urine steroid profiling showed elevated tetrahydro-11 deoxycortisol (THS), which is associated with adrenal malignancy. Laparoscopic adrenalectomy was performed, and histopathology diagnosed adrenal oncocytoma. Serum and urinary biochemistry resolved post-operatively and remained normal at 1-year follow-up. Learning points: Differential diagnosis of adrenal masses is challenging. Current techniques for differentiating between tumour types lack sensitivity and specificity. 24-h urinary steroid profiling is a useful tool for reflecting steroid output from adrenal glands. Gas chromatography-mass spectrometry (GC-MS) of urinary steroid metabolites has sensitivity and specificity of 90% for diagnosing adrenocortical carcinoma. Adrenal oncocytoma are rare tumours. Differentiating between benign and malignant types is difficult. Data guiding prognostication and management are sparse.

Adrenal Incidentalomas: Diagnostic Evaluation and Long-Term Follow-Up

2008 ◽  
Vol 14 (3) ◽  
pp. 269-278
Author(s):  
Lucio Vilar ◽  
Maria da Conceição Freitas ◽  
Viviane Canadas ◽  
José Luciano Albuquerque ◽  
Carlos A. Botelho ◽  
...  
Keyword(s):  
Diagnostic Evaluation ◽  
Adrenal Incidentalomas ◽  
Long Term Follow Up

scholarly journals Diagnosis in children with exercise-induced respiratory symptoms: a multi-centre study

2020 ◽  
Author(s):  
Eva SL Pedersen ◽  
Cristina Ardura-Garcia ◽  
Carmen CM de Jong ◽  
Anja Jochmann ◽  
Alexander Moeller ◽  
...  
Keyword(s):  
Outpatient Clinic ◽  
Respiratory Symptoms ◽  
Final Diagnosis ◽  
Diagnostic Evaluation ◽  
Outpatient Clinics ◽  
List Type ◽  
Multi Centre Study ◽  
Dysfunctional Breathing ◽  
Exercise Induced

AbstractObjectiveExercise-induced respiratory symptoms (EIS) are common in childhood and reflect different diseases that can be difficult to diagnose. In children referred to respiratory outpatient clinics for EIS, we compared the diagnosis proposed by the referring primary care physician with the final diagnosis from the outpatient clinic and described diagnostic tests performed and treatment prescribed after the diagnostic evaluation.DesignObservational study nested in the Swiss Paediatric Airway Cohort (SPAC), which includes respiratory outpatients aged 0-16 years.PatientsWe included children with EIS as main reason for referral. Information about diagnostic investigations, final diagnosis, and treatment prescribed came from outpatient records.Results214 were referred for EIS (mean age 12 years, 99 (46%) female). The final diagnosis was asthma in 115 (54%), extrathoracic dysfunctional breathing (DB) in 35 (16%), thoracic DB in 22 (10%), asthma plus DB in 23 (11%), insufficient fitness in 10 (5%), chronic cough in 6 (3%), and other diagnoses in 3 (1%). Final diagnosis differed from referral diagnosis in 115 (54%). Spirometry, body plethysmography and measurements of exhaled nitric oxide were performed in almost all; exercise-challenge tests in a third. 91% of the children with a final diagnosis of asthma were prescribed inhaled medication and 50% of children with DB were referred to physiotherapy.ConclusionsDiagnosis given at the outpatient clinic often differed from the diagnosis suspected by the referring physician. Diagnostic evaluation, management and follow-up were inconsistent between clinics and diagnostic groups, highlighting the need for diagnostic guidelines in children seen for EIS.Mandatory statements for Archives of Disease in ChildhoodWhat is already known on this topic (2-3 statements of max 25 words)Exercise-induced symptoms are common in childhood but not easy to diagnose because different diagnoses share similar clinical presentationsOnly few studies focused on children with exercise-induced symptoms and all have included selected groups of patients with difficult-to-diagnose problemsWhat this study adds (2-3 statements of max 25 words)Exercise-induced respiratory symptoms was the main reason for referral in one fifth of the children referred to paediatric respiratory outpatient clinics.Dysfunctional breathing is an under-recognised diagnosis; it was frequently diagnosed in the outpatient clinic (in 37%) but rarely suspected by the referring physician (6%)Diagnostic evaluation, management, and follow-up were inconsistent between clinics highlighting the need for diagnostic guidelines in children seen for EIS.

scholarly journals Newer techniques in diagnostic imaging of colorectal carcinoma

2009 ◽  
Vol 56 (4) ◽  
pp. 113-119
Author(s):  
M.A. Lucic ◽  
I.S. Miucin-Vukadinovic ◽  
S.M. Lucic ◽  
K.M. Koprivek ◽  
M. Spirovski ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Carcinoma ◽  
Diagnostic Imaging ◽  
Wide Spectrum ◽  
Imaging Techniques ◽  
Diagnostic Evaluation ◽  
Diagnostic Assessment ◽  
Colorectal Malignancy ◽  
Imaging Methods

A wide spectrum of nowadays availible radiological and imaging methods in the diagnostic evaluation of patients with colorectal cancer enabled not only the improvement of primary colorectal malignancy detection, precise staging, regional involvement and metastatic spread assessment, but also the posttherapeutical estimation and follow- up. Having in mind that the exact diagnostic assessment of colorectal carcinoma by use of different imaging modalities still raises a lots of contradictories, in this report we have tried to present the possibilities of newer imaging techniques in the diagnostic evaluation of the patients with colorectal cancer.

Development and Implementation of a Postpartum Depression Screening Program in the NICU

2020 ◽  
Vol 39 (2) ◽  
pp. 75-82
Author(s):  
Angela Taylor Vaughn ◽  
Gwendolyn L. Hooper
Keyword(s):  
Data Analysis ◽  
Postpartum Depression ◽  
Screening Tool ◽  
Screening Program ◽  
Routine Screening ◽  
Diagnostic Evaluation ◽  
Depression Screening ◽  
National Organizations

Postpartum depression (PPD) is higher among NICU mothers compared to mothers without infants in the NICU. Routine screening improves early PPD identification and treatment for mothers. Key national women and infant organizations endorse facility-based policies that address PPD screening. In addition to PPD screening, the key national organizations recommend facilities providing care to women and infants develop a method of referral for maternal PPD evaluation, treatment, and follow-up. Due to the timing, onset, and maternal predisposition to PPD, the NICU is a prime setting for PPD screening. Despite recommendations, PPD screening is not routine in the NICU. This article describes the development and assessment of a PPD screening program implemented in the NICU. Data analysis of 30 NICU mothers evaluated the risk of PPD based on screening tool scores, maternal diagnostic evaluation compliance, and documentation of maternal follow-up with designated NICU staff.

Diagnostic Evaluation and Follow-Up of Patients with Atrial Fibrillation

2016 ◽  
Vol 12 (2) ◽  
pp. 179-191
Author(s):  
Patrick Dillon ◽  
Hamid Ghanbari
Keyword(s):  
Atrial Fibrillation ◽  
Diagnostic Evaluation

Long term follow-up of patients with fecal incontinence after diagnostic evaluation in the GI laboratory

2000 ◽  
Vol 118 (4) ◽  
pp. A832
Author(s):  
Christian Pehl ◽  
Guenter Marsch ◽  
Barbara Wendl ◽  
Wolfgang Schepp
Keyword(s):  
Fecal Incontinence ◽  
Diagnostic Evaluation ◽  
Long Term Follow Up

scholarly journals Electronic Trigger-Based Intervention to Reduce Delays in Diagnostic Evaluation for Cancer: A Cluster Randomized Controlled Trial

2015 ◽  
Vol 33 (31) ◽  
pp. 3560-3567 ◽  
Author(s):  
Daniel R. Murphy ◽  
Louis Wu ◽  
Eric J. Thomas ◽  
Samuel N. Forjuoh ◽  
Ashley N.D. Meyer ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Randomized Controlled Trial ◽  
Electronic Health Record ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Diagnostic Evaluation ◽  
Health Record ◽  
Randomized Controlled ◽  
Cluster Randomized

Purpose We tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer. Methods We performed a cluster randomized controlled trial of primary care providers (PCPs) at two sites to test whether triggers that prospectively identify patients with potential delays in diagnostic evaluation for lung, colorectal, or prostate cancer can reduce time to follow-up diagnostic evaluation. Intervention steps included queries of the electronic health record repository for patients with abnormal findings and lack of associated follow-up actions, manual review of triggered records, and communication of this information to PCPs via secure e-mail and, if needed, phone calls to ensure message receipt. We compared times to diagnostic evaluation and proportions of patients followed up between intervention and control cohorts based on final review at 7 months. Results We recruited 72 PCPs (36 in the intervention group and 36 in the control group) and applied the trigger to all patients under their care from April 20, 2011, to July 19, 2012. Of 10,673 patients with abnormal findings, the trigger flagged 1,256 patients (11.8%) as high risk for delayed diagnostic evaluation. Times to diagnostic evaluation were significantly lower in intervention patients compared with control patients flagged by the colorectal trigger (median, 104 v 200 days, respectively; n = 557; P < .001) and prostate trigger (40% received evaluation at 144 v 192 days, respectively; n = 157; P < .001) but not the lung trigger (median, 65 v 93 days, respectively; n = 19; P = .59). More intervention patients than control patients received diagnostic evaluation by final review (73.4% v 52.2%, respectively; relative risk, 1.41; 95% CI, 1.25 to 1.58). Conclusion Electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up. Similar interventions could improve timeliness of diagnosis of other serious conditions.

scholarly journals Diagnostic Evaluation Low Yield for Patients with a Lower-Risk Brief Resolved Unexplained Event

2021 ◽  
Vol 8 ◽  
pp. 2333794X2096758
Author(s):  
Rita Haddad ◽  
Sarah Parker ◽  
Ahmad Farooqi ◽  
Amy M. DeLaroche
Keyword(s):  
Lower Risk ◽  
Recurrent Events ◽  
Diagnostic Evaluation ◽  
Imaging Studies ◽  
American Academy Of Pediatrics ◽  
Life Threatening ◽  
Missed Diagnostic Opportunities ◽  
Ancillary Studies ◽  
Life Threatening Event

In contrast to patients with an apparent life-threatening event (ALTE), the American Academy of Pediatrics recommends very limited evaluation for patients categorized as lower-risk brief resolved unexplained event (BRUE). This retrospective review aims to explore potential missed diagnostic opportunities for patients with a lower-risk BRUE (n = 10) through comparison with a subset of patients with ALTE (n = 72). None of the patients with a lower-risk BRUE had laboratory, imaging or ancillary studies that were diagnostic. Among patients with ALTE, 5 had laboratory and 3 had imaging studies that were diagnostic. None of the patients with a lower-risk BRUE had recurrent events during hospitalization or a serious underlying diagnosis identified within the 90 day follow-up period. As recommended by the AAP, patients with a lower-risk BRUE do not need diagnostic evaluation and can be discharged home with outpatient follow-up.

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