Medicine and Health Sciences Commons^™

Lung Cancer Masquerading As Thoracolumbar Pain Detected In An Outpatient Physical Therapy Setting, Jeremiah Blankenship

Asian Journal of Physical Therapy

Study Design: Case Study. Background: This case report describes the clinical course of a patient with right low back pain (LBP) and the use of clinical evaluation findings to initiate medical referral resulting in a diagnosis of cancer presenting as mechanical low back pain. Diagnosis: A 59-year-old male with primary complaints of progressive right-sided LBP affecting his job, sleep, and daily activities was seen by a physical therapist in an outpatient setting. The components of the patient’s history and physical examination were consistent with mechanical thoracolumbar dysfunction. However, clustered examination findings suggested the possibility of a more serious underlying disease. …

Stroke Chameleon: A Case Of High Grade Glioma, Zachary T. Lowery, Mary M. Carter

South Atlantic Division GME Research Day 2024

No abstract provided.

Fluid Biomarkers In Cerebral Amyloid Angiopathy, Seyed M. Savar, Bin Ma, Eugene Hone, Farzana Jahan, Shaun Markovic, Steve Pedrini, Soudabeh Shemehsavar, Vandhana Easwaran, Kevin Taddei, Samantha Gardener, Jasmeer P. Chhatwal, Ellis S. Van Etten, Matthias J. P. Van Osch, Daniel Clarke, Anastazija Gnjec, Mark A. Van Buchem, Marieke J. H. Wermer, Graeme J. Hankey, Steven M. Greenberg, Ralph N. Martins, Hamid R. Sohrabi

Research outputs 2022 to 2026

Cerebral amyloid angiopathy (CAA) is a type of cerebrovascular disorder characterised by the accumulation of amyloid within the leptomeninges and small/medium-sized cerebral blood vessels. Typically, cerebral haemorrhages are one of the first clinical manifestations of CAA, posing a considerable challenge to the timely diagnosis of CAA as the bleedings only occur during the later disease stages. Fluid biomarkers may change prior to imaging biomarkers, and therefore, they could be the future of CAA diagnosis. Additionally, they can be used as primary outcome markers in prospective clinical trials. Among fluid biomarkers, blood-based biomarkers offer a distinct advantage over cerebrospinal fluid biomarkers …

Primary Adrenal Angiosarcoma: A Case Report And Review Of The Literature, Zunaira Naeem, Joon Yau Leong, Arianna Morton, Alaa Hrizat, Eric Shiffrin, Andrew Gomella, Peter Mccue, Mark Mann, Li Li

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Primary adrenal angiosarcoma is an extremely rare malignant tumor with challenging diagnosis. A 66-year-old woman had a 4.3 cm right adrenal mass suspicious for adrenal cortical carcinoma. Pathological examination demonstrated a hemorrhagic adrenal cyst with numerous irregularly shaped anastomosing vascular channels lined by atypical endothelial cells that had frequent atypical mitotic figures (12/10 HPF, Ki67 10%). The tumor cells were positive for CD31, ERG, and FLI-1, but negative for adrenal and other tumor lineage markers by immunohistochemistry. NGS fusion gene testing ruled out epithelioid hemangioendothelioma. Accurate diagnosis and differential inclusion are important for appropriate treatment of this rare tumor.

Educational Case: Ovarian Neoplasms: A Series Of Educational Cases To Review Malignancies Of Epithelial, Stromal, And Germ Cell Origin, Jordyn B. Tumas, Joanna Chan

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

No abstract provided.

Patterns And Implications Of Neurological Examination Findings In Autosomal Dominant Alzheimer Disease, Jonathan Vöglein, Nicolai Franzmeier, John C. Morris, Marianne Dieterich, Eric Mcdade, Mikael Simons, Oliver Preische, Anna Hofmann, Jason Hassenstab, Tammie L. Benzinger, Anne Fagan, James M. Noble, Sarah B. Berman, Neill R. Graff-Radford, Bernardino Ghetti, Martin R. Farlow, Jasmeer P. Chhatwal, Stephen Salloway, Chengjie Xiong, Celeste M. Karch, Nigel Cairns, Richard J. Perrin, Gregory Day, Ralph Martins, Raquel Sanchez-Valle, Hiroshi Mori, Hiroyuki Shimada, Takeshi Ikeuchi, Kazushi Suzuki, Peter R. Schofield, Colin L. Masters, Alison Goate, Virginia Buckles, Nick C. Fox, Patricio Chrem, Ricardo Allegri, John M. Ringman, Igor Yakushev, Christoph Laske, Mathias Jucker, Günter Höglinger, Randall L. Bateman, Adrian Danek, Johannes Levin, Dominantly Inherited Alzheimer Network

Research outputs 2022 to 2026

Introduction:

As knowledge about neurological examination findings in autosomal dominant Alzheimer disease (ADAD) is incomplete, we aimed to determine the frequency and significance of neurological examination findings in ADAD.

Methods:

Frequencies of neurological examination findings were compared between symptomatic mutation carriers and non mutation carriers from the Dominantly Inherited Alzheimer Network (DIAN) to define AD neurological examination findings. AD neurological examination findings were analyzed regarding frequency, association with and predictive value regarding cognitive decline, and association with brain atrophy in symptomatic mutation carriers.

Results:

AD neurological examination findings included abnormal deep tendon reflexes, gait disturbance, pathological cranial nerve examination findings, …

Guillain-Barré Syndrome: Recognizing Variations In Clinical Presentations, Andrew Wang, Komal Luthra

Gulf Coast Division GME Research Day 2023

No abstract provided.

Pleomorphic Dermal Sarcoma: A Clinical And Histopathologic Emulator Of Atypical Fibroxanthoma, But Different Biologic Behavior, Michael Carletti, Daniel A. Nguyen, Peter Malouf, Zachary Ingersoll, Gregory A. Hosler, Stephen E. Weis

HCA Healthcare Journal of Medicine

Pleomorphic dermal sarcoma (PDS) can clinically and histopathologically mimic atypical fibroxanthoma (AFX). However, it has a more aggressive clinical course with a higher recurrence rate and metastatic potential. This case presentation aims to report a rapidly-growing, exophytic, 4 cm tumor following a non-diagnostic shave biopsy 2 months prior and to highlight distinctive features between PDS and AFX needed to make the correct diagnosis. Like AFX, PDS occurs on the sun-damaged skin of the elderly, usually on the head and neck. Also, like AFX, PDS histopathologically consists of sheets or fascicles of epithelioid and/or spindle-shaped cells, often with multinucleation, pleomorphism, and …

Bell’S Palsy: My Journey With A Mysterious Nerve Disorder, Sneha Shah Bds

The Journal of the Michigan Dental Association

This article chronicles the personal journey of a dentist facing Bell's Palsy while pursuing licensure in the United States. Bell's Palsy, an idiopathic unilateral facial paralysis, is explored in detail, including its clinical presentation and differential diagnosis. The author shares their experiences, challenges, and treatments, shedding light on the impact of this mysterious nerve disorder on their daily life, work, and mental well-being. The article highlights the importance of early diagnosis, comprehensive evaluation, and treatment strategies for Bell's Palsy. The author's story serves as a poignant reminder for healthcare professionals to approach patients with empathy and compassion and recognize the …

Evaluation, Validation & Implementation Of A Computerized Diagnostic Decision Support System In Primary Practice, Joe Bridges

Translational Projects (Open Access)

Background: Medical diagnosis may be the most complex task attempted by humans. Studies estimate that 95% of diagnoses in outpatient care are accurate, implying that the annual rate of inaccurate diagnoses is 12 million in the US alone, with the potential for patient harm in about half. A well-researched differential might reduce inaccurate diagnoses by offering alternatives matching the patient’s symptoms. This study searched the literature for articles evaluating the diagnostic performance of commercially available computerized diagnostic decision support systems. This search led to selecting Isabel Pro, developed by Isabel Healthcare, Ltd. of Haslemere, UK.

Evaluation and Validation: …

Conditions That Mimic Attention Deficit Hyperactivity Disorder In A Pediatric Population: A Diagnostic Guide For Primary Care Providers, Elena Schatell

Capstone Showcase

This article outlines common neurobiological, developmental, psychological, and other medical diagnoses and conditions that symptomatically mimic attention deficit hyperactivity disorder (ADHD) in the pediatric population. Many of these disorders are comorbid with ADHD, but they may also be misdiagnosed as ADHD. Due to the similarity in presentation, these conditions must be included when formulating a differential diagnosis. Accurately diagnosing a child with ADHD requires a thorough evaluation and work up to rule out diagnoses on the differential.

Case Report: Disseminated Mucormycosis In An Ostensibly Immunocompetent Patient, Chad Froes, Matt Gellatly, Brian Watson

South Atlantic Division GME Research Day 2022

No abstract provided.

The Struggle Of Differential Diagnosis For Childhood Apraxia Of Speech: A Qualitative Case Study, Laken Cummins, Stephanie M. Schaaf, Megan Smetana, Jennifer Gaylord

Murray State Theses and Dissertations

This study addresses the controversial diagnosis of childhood apraxia of speech (CAS) and the struggle many clinicians face with differential diagnosis through a retrospective qualitative case study following a participant who received the diagnosis of CAS. Research questions targeted the characteristics the participant presented with, whether they were consistent or not, as well as if they were unique to CAS or evidence of a phonological disorder, and the treatment approaches that were implemented throughout the participant’s history of receiving speech-language services and the effectiveness of those approaches. These research questions were answered through the records and documents obtained from the …

Differential Diagnosis Between The Varieties Of Vasculitis Forms, Joana Hankollari, Marsida Duli, Qamil Dika, Xhenila Duli, Indrit Bimi, Daniela Dervishi

International Journal of Business and Technology

Vasculitis is an inflammation of the blood vessels. It can affect any blood vessel in the body by manifesting a variety of systemic, non-specific symptoms that make difficult the diagnosis of this pathology and especially its specific form. In front of any patient suspected of being affected by vasculitis, some questions are asked: Is the vasculitis or other pathology that camouflages, whether it is primary or secondary vasculitis, in which vessels this pathology extends, how can the diagnosis be confirmed and how can it be determined the type of vasculitis?The purpose of this study is to inform about the protocols …

Recent Advances In The Vibrational Spectroscopic Diagnosis Of Non-Small Cell Lung Cancer, Declan O'Dea, Fiona Lyng, Siobhan Nicholson, Finbar O'Connell, Aoife Maguire, Alison Malkin

Articles

Lung cancer is the leading cause of cancer deaths worldwide accounting for 1.69 million deaths in 2015. Studies have indicated a 5 year survival rate of 8%–15% in western countries, although a survival rate as low as 1% has been demonstrated for late stage diagnosis. With the advent of targeted therapies, it is imperative to accurately differentiate non-small cell lung cancer (NSCLC) subtypes in order to ensure efficacy of treatment for patients. Immunohistochemistry and molecular techniques for the diagnosis of NSCLC are increasingly part of the diagnostic algorithm and clinical work-up of lung cancer patients, however due to the limitation …

Differentiation Between Intestinal Behçet's Disease And Crohn's Disease Based On Endoscopy, Jing Fen Ye, Jian Long Guan

Turkish Journal of Medical Sciences

Differentiating intestinal Behçet's disease (BD) from Crohn's disease (CD) is highly challenging, as they often mimic each other in terms of clinical manifestations. Endoscopy is an important modality for distinguishing bowel lesions. The study was designed to identify clinical manifestations that are easily confused and to evaluate the efficacy of endoscopy for distinguishing intestinal BD from CD by several overlapping signs.Materials and methods: The data from 111 patients with intestinal BD and 81 patients with CD were retrospectively analyzed. Logistic regression was applied to establish a prediction model based on endoscopic findings for the differential diagnosis. The diagnostic efficacy of …

Complexity In Mood Disorder Diagnosis: Fmri Connectivity Networks Predicted Medication-Class Of Response In Complex Patients, E Osuch, S Gao, M Wammes, Jean Theberge, P Willimason, R J Neufeld, Y Du, J Sui, V Calhoun

Department of Medicine Publications

OBJECTIVE: This study determined the clinical utility of an fMRI classification algorithm predicting medication-class of response in patients with challenging mood diagnoses.

METHODS: Ninety-nine 16-27-year-olds underwent resting state fMRI scans in three groups-BD, MDD and healthy controls. A predictive algorithm was trained and cross-validated on the known-diagnosis patients using maximally spatially independent components (ICs), constructing a similarity matrix among subjects, partitioning the matrix in kernel space and optimizing support vector machine classifiers and IC combinations. This classifier was also applied to each of 12 new individual patients with unclear mood disorder diagnoses.

RESULTS: Classification within the known-diagnosis group was approximately …

Differential Diagnosis Of Auditory Processing Disorder In Children: A Literature Review, Jessica Glennon, Benjamin Kirby

AuD Capstone Projects - Communication Sciences and Disorders

Although there is no consensus on the definition of auditory processing disorder (APD), it is typically characterized by listening difficulties resulting from deficits in auditory perceptual processing of sounds in the central auditory nervous system. APD often co-occurs with other disabilities such as ADHD, dyslexia, and specific language impairment. Presenting symptoms can be very similar to these other disorder, complicating diagnosis. Due to the overlap of symptoms between APD and various other deficits, there are concerns that professionals in different fields are providing children with different labels for the same group of symptoms. Therefore, the aim of this literature review …

Burnout Syndrome And Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this chapter, we proposed an overview of burnout, from the introduction of the construct in the mid-1970s to the growing realization that the syndrome was better conceived of as a depressive condition. Recent studies have shown that the distinction between burnout and depression is problematic, both theoretically and empirically. The history of burnout research suggests that transdisciplinary communication and methodological standards should be strengthened to avoid the proliferation of constructs that, in fact, refer to the same phenomena. Construct proliferation, a transgression of the scientific canon of parsimony, is considered a major problem today because it undermines theory building …

Reproducible Network And Regional Topographies Of Abnormal Glucose Metabolism Associated With Progressive Supranuclear Palsy: Multivariate And Univariate Analyses In American And Chinese Patient Cohorts, J. Ge, J. Wu, S. Peng, P. Wu, J. Wang, H. Zhang, Y. Guan, D. Eidelberg, C. Zuo, Y. Ma

Journal Articles

No abstract provided.

Differential Diagnosis Between The Variety Of Vasculitis Forms, Joana Hankollari, Marsida Duli, Qamil Dika, Xhenila Duli, Indrit Bimi, Daniela Dervishi

UBT International Conference

Vasculitis is an inflammation of the blood vessels. It can affect any blood vessel in the body by manifesting a variety of systemic, non-specific symptoms that make difficult the diagnosis of this pathology and especially its specific form. In front of any patient suspected of being affected by vasculitis, some questions are asked: Is the vasculitis or other pathology that camouflages, whether it is primary or secondary vasculitis, in which vessels this pathology extends, how can the diagnosis be confirmed and how can it be determined the type of vasculitis?The purpose of this study is to inform about the protocols …

Metabolic Differentiation Of Early Lyme Disease From Southern Tick-Associated Rash Illness (Stari), C Molins, L Ashton, Gary Wormser, B Andre, A Hess, J Belisle

NYMC Faculty Publications

Lyme disease, the most commonly reported vector-borne disease in the United States, results from infection with Borrelia burgdorferi. Early clinical diagnosis of this disease is largely based on the presence of an erythematous skin lesion for individuals in high-risk regions. This, however, can be confused with other illnesses including southern tick-associated rash illness (STARI), an illness that lacks a defined etiological agent or laboratory diagnostic test, and is coprevalent with Lyme disease in portions of the eastern United States. By applying an unbiased metabolomics approach with sera retrospectively obtained from well-characterized patients, we defined biochemical and diagnostic differences between early …

Development Of 90th Percentile Norms For Ipsilateral Acoustic Reflex Thresholds: A Feasibility Study, Iris Wertheimer

Dissertations, Theses, and Capstone Projects

The acoustic reflex threshold has been well established in the literature as an involuntary bilateral contraction of the stapedius muscle in response to loud transient sounds. Additionally, the clinical utility of the acoustic reflex threshold has been established as it allows for the differential diagnosis of many different conductive, cochlear and retrocochlear pathologies. Gelfand, Schwander and Silman (1990) have established and validated 90^th percentile normative data for use with the contralateral acoustic reflex threshold. Much of the literature on the acoustic reflex threshold has focused on the contralateral acoustic reflex threshold; however, surveys have found that many clinicians are …

Is It Time To Consider The “Burnout Syndrome” A Distinct Illness?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The “burnout syndrome” has been defined as a combination of emotional exhaustion, depersonalization, and reduced personal accomplishment caused by chronic occupational stress. Although there has been increasing medical interest in burnout over the last decades, it is argued in this paper that the syndrome cannot be elevated to the status of diagnostic category, based on (1) an analysis of the genesis of the burnout construct, (2) a review of the latest literature on burnout-depression overlap, (3) a questioning of the three-dimensional structure of the burnout syndrome, and (4) a critical examination of the notion that burnout is singularized by its …

Burnout-Depression Overlap: A Review, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Whether burnout is a form of depression or a distinct phenomenon is an object of controversy. The aim of the present article was to provide an up-to-date review of the literature dedicated to the question of burnout–depression overlap. A systematic literature search was carried out in PubMed, PsycINFO, and IngentaConnect. A total of 92 studies were identified as informing the issue of burnout–depression overlap. The current state of the art suggests that the distinction between burnout and depression is conceptually fragile. It is notably unclear how the state of burnout (i.e., the end stage …

A Knowledge-Based Clinical Toxicology Consultant For Diagnosing Multiple Exposures, Joel D. Schipper, Douglas D. Dankel Ii, A. Antonio Arroyo, Jay L. Schauben

Publications

Objective: This paper presents continued research toward the development of a knowledge-based system for the diagnosis of human toxic exposures. In particular, this research focuses on the challenging task of diagnosing exposures to multiple toxins. Although only 10% of toxic exposures in the United States involve multiple toxins, multiple exposures account for more than half of all toxin-related fatalities. Using simple medical mathematics, we seek to produce a practical decision support system capable of supplying useful information to aid in the diagnosis of complex cases involving multiple unknown substances.

Methods: The system is automatically trained using data mining …

A Knowledge-Based Clinical Toxicology Consultant For Diagnosing Single Exposures, Joel D. Schipper, Douglas D. Dankel Ii, A. Antonio Arroyo, Jay L. Schauben

Publications

Objective: Every year, toxic exposures kill twelve hundred Americans. To aid in the timely diagnosis and treatment of such exposures, this research investigates the feasibility of a knowledge-based system capable of generating differential diagnoses for human exposures involving unknown toxins.

Methods: Data mining techniques automatically extract prior probabilities and likelihood ratios from a database managed by the Florida Poison Information Center. Using observed clinical effects, the trained system produces a ranked list of plausible toxic exposures. The resulting system was evaluated using 30,152 single exposure cases. In addition, the effects of two filters for refining diagnosis based on …

The Malingering Of Psychotic Disorders, Michael R. Harris M.D.

Jefferson Journal of Psychiatry

The phenomenon of malingered psychosis is examined through a review of the available literature. Possible motivations for malingering are discussed, and clinical indicators of feigned psychotic symptoms are reviewed. The methods discussed focus on the inpatient evaluation of suspected malingerers and include discussions of interview techniques and psychometric testing to supplement clinical impressions. A differential diagnosis is presented, and techniques for confronting a malingering patient are reviewed.

Detection Of Amyloid In Abdominal Fat Pad Aspirates In Early Amyloidosis: Role Of Electron Microscopy And Congo Red Stained Cell Block Sections, Sumana Devata, Parameswaran Hari, Natalia Markelova, Rongshan Li, Richard Komorowski, Vinod B. Shidham

Department of Pathology

Background: Fine-needle aspiration biopsy (FNA) of the abdominal fat pad is a minimally invasive procedure to demonstrate tissue deposits of amyloid. However, protocols to evaluate amyloid in fat pad aspirates are not standardized, especially for detecting scant amyloid in early disease.

Materials and Methods: We studied abdominal fat pad aspirates from 33 randomly selected patients in whom subsequent tissue biopsy, autopsy, and/or medical history for confirmation of amyloidosis (AL) were also available. All these cases were suspected to have early AL, but had negative results on abdominal fat pad aspirates evaluated by polarizing microscopy of Congo Red stained sections (CRPM). …

The Enigma Of Struma Ovarii, Lawrence M. Roth, Aleksander Talerman

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Since its first description in the early part of the twentieth century, struma ovarii has elicited considerable interest because of its many unique features; however, at present a number of aspects remain enigmatic. Although the typical presentation is that of a pelvic mass, unusual clinical manifestations such as hyperthyroidism, ascites, and Meigs' syndrome have been recognised. Uncommon macroscopic and especially histological patterns in struma can cause difficulties in diagnosis. Cystic strumas are challenging to diagnose both macroscopically and histologically. Proliferative changes within struma can be misdiagnosed as cancer. In regard to the occurrence of thyroid-type carcinoma in struma ovarii, precise …