Medicine and Health Sciences Commons^™

The New Diagnostic Team, Mark L. Graber, Diana Rusz, Melissa L. Jones

Articles

The National Academy of Medicine (NAM) in the recently issued report Improving Diagnosis in Health Care outlined eight major recommendations to improve the quality and safety of diagnosis. The #1 recommendation was to improve teamwork in the diagnostic process. This is a major departure from the classical approach, where the physician is solely responsible for diagnosis. In the new, patient-centric vision, the core team encompasses the patient, the physician and the associated nursing staff, with each playing an active role in the process. The expanded diagnostic team includes pathologists, radiologists, allied health professionals, medical librarians, and others. We review the …

Sacral Fractures And Associated Injuries., Ricardo Rodrigues-Pinto, Mark F. Kurd, Gregory D. Schroeder, Christopher K. Kepler, James C. Krieg, Jörg H. Holstein, Carlo Bellabarba, Reza Firoozabadi, F Cumhur Oner, Frank Kandziora, Marcel F. Dvorak, Conor P. Kleweno, Luiz R. Vialle, S. Rajasekaran, Klause J. Schnake, Alexander R. Vaccaro

Rothman Institute Faculty Papers

STUDY DESIGN: Literature review.

OBJECTIVE: The aim of this review is to describe the injuries associated with sacral fractures and to analyze their impact on patient outcome.

METHODS: A comprehensive narrative review of the literature was performed to identify the injuries associated with sacral fractures.

RESULTS: Sacral fractures are uncommon injuries that result from high-energy trauma, and that, due to their rarity, are frequently underdiagnosed and mistreated. Only 5% of sacral fractures occur in isolation. Injuries most often associated with sacral fractures include neurologic injuries (present in up to 50% of sacral fractures), pelvic ring disruptions, hip and lumbar spine …

The Peanut Allergic Patient: Diagnosis, Treatment, And Prevention, Daniel W. Hill, Jane H. Lassetter, Craig Nuttall

Faculty Publications

The prevalence of peanut allergies (PAs) continues to rise through recent decades, despite the best attempts to reverse that trend. PAs are unpredictable and can be life-threatening. Therefore, it is imperative that nurse practitioners (NPs) are fully aware of the most recent guidelines and evidence regarding diagnosis, treatment, and prevention of PAs. This article presents information on the current research in the diagnosis and treatment of PAs as well as the latest guidelines established to prevent PA development. NPs should understand this information, allowing them to provide the best care possible for their patients.

Evaluation Of Glycated Albumin (Ga) And Ga/Hba1c Ratio For Diagnosis Of Diabetes And Glycemic Control: A Comprehensive Review, Sara Yazdanpanah, Mohammad Rabiee, Mohammadreza Tahriri, Mojgan Abdolrahim, Asodollah Rajab, Hossein E. Jazayeri, Lobat Tayebi

School of Dentistry Faculty Research and Publications

Diabetes Mellitus (DM) is a group of metabolic diseases characterized by chronic high blood glucose concentrations (hyperglycemia). When it is left untreated or improperly managed, it can lead to acute complications including diabetic ketoacidosis and non-ketotic hyperosmolar coma. In addition, possible long-term complications include impotence, nerve damage, stroke, chronic kidney failure, cardiovascular disease, foot ulcers, and retinopathy. Historically, universal methods to measure glycemic control for the diagnosis of diabetes included fasting plasma glucose level (FPG), 2-h plasma glucose (2HP), and random plasma glucose. However, these measurements did not provide information about glycemic control over a long period of time. To …

Pediatric Leukemia: Diagnosis To Treatment–A Review, Samantha C. Bernard, Ehab H. Abdelsamad, Paisley A. Johnson, Daniel L. Chapman, Madhukiran Parvathaneni

Faculty Works

Leukemia is cancer of the blood and bone marrow, it is the most common cancer found in children and is found to be more than one fourth of pediatric cancers. It causes white blood cells to become abnormal and the body to become weak. This deficiency in the immune system reduces the body's ability to fight infection or simple airborne illnesses, causing extensive treatment of common pathogens and cancer treatment. The present review covers all topics, from diagnosis to treatment of pediatric leukemia, as well as the stages of growth and physiological changes throughout the process. As leukemia has a …

Ticked Off: An Analysis Of The Inadequate Diagnosis And Treatment Of Lyme Disease, Virginia P. Yoder

Senior Honors Theses

Lyme disease is the most common vector-borne disease in the United States and has a high prevalence among people in the northeast. Lyme disease can be a debilitating illness if not diagnosed early, and can lead to long-term health problems for many patients. This thesis serves as a review of scientific literature on Lyme disease, with the prevalence, symptomology, the bacterial mechanism of infection, the diagnostic process, transmission, and treatment therapies. Further research and development could lead to better primary care for those suffering with Lyme disease.

Clinician-Performed Bedside Ultrasound In Improving Diagnostic Accuracy In Patients Presenting To The Ed With Acute Dyspnea., Dimitrios Papanagnou, Michael Secko, John Gullett, Michael Stone, Shahriar Zehtabchi

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Diagnosing acute dyspnea is a critical action performed by emergency physicians (EP). It has been shown that ultrasound (US) can be incorporated into the work-up of the dyspneic patient; but there is little data demonstrating its effect on decision-making. We sought to examine the impact of a bedside, clinician-performed cardiopulmonary US protocol on the clinical impression of EPs evaluating dyspneic patients, and to measure the change in physician confidence with the leading diagnosis before and after US.

METHODS: We conducted a prospective observational study of EPs treating adult patients with undifferentiated dyspnea in an urban academic center, excluding those …

Ebola Virus - Epidemiology, Diagnosis, And Control: Threat To Humans, Lessons Learnt, And Preparedness Plans - An Update On Its 40 Year's Journey, Raj Kumar Singh, Kuldeep Dhama, Yashpal Singh Malik, Muthannan Andavar Ramakrishnan, Kumaragurubaran Karthik, Rekha Khandia, Ruchi Tiwari, Ashok Munjal, Mani Saminathan, Perumal Arumugam, Sunil Kumar Joshi

Bioelectrics Publications

Ebola virus (EBOV) is an extremely contagious pathogen and causes lethal hemorrhagic fever disease in man and animals. The recently occurred Ebola virus disease (EVD) outbreaks in the West African countries have categorized it as an international health concern. For the virus maintenance and transmission, the non-human primates and reservoir hosts like fruit bats have played a vital role. For curbing the disease timely, we need effective therapeutics/prophylactics, however, in the absence of any approved vaccine, timely diagnosis and monitoring of EBOV remains of utmost importance. The technologically advanced vaccines like a viral-vectored vaccine, DNA vaccine and virus-like particles are …

Applications Of Next-Generation Sequencing In Cancer Research And Molecular Diagnosis, Kesheng Wang, Chun Xu

Health & Biomedical Sciences Faculty Publications and Presentations

Next-generation sequencing (NGS) technologies including DNA sequencing and RNA sequencing provide “omics” approaches to reveal genomic, transcriptomic, and epigenomic landscapes of individual cancers. A variety of genomic aberrations can be screened simultaneously, such as common and rare variants, structural variations (e.g. insertions and deletions), copy-number variation, and fusion transcripts. NGS technologies together with bioinformatics analysis, which expand our knowledge, are increasingly used to simultaneously analyze multiple genes in a cost and time-effective manner and have been applied in analyzing clinical cancer samples and offering NGS-based molecular diagnosis. Therefore, NGS is increasingly valuable as a tool for diagnosis for a number …

Lactose Intolerance: An Overview Of The Facts And Their Implications, Noelle M. Yeo

Honors Theses

Lactose intolerance is often blamed for the symptoms such as bloating, diarrhea, gas, abdominal pain, and nausea, that ail many people. Patients often do not seek proper diagnosis from a physician and create their own treatment plans, severely restricting lactose intake, without professional guidance. Even those who do seek the care of a physician find that diagnosis is complicated by less-than ideal testing and confusion due to the symptoms common to many other conditions. The misconceptions and inability to confirm a diagnosis of lactose intolerance can cause nutrient deficiencies in these patients, as well as begin a pattern of unnecessary …

Differentiating Between Lactose Intolerance, Celiac Disease, And Irritable Bowel Syndrome-Diarrhea, Karlen E. (Beth) Luthy, Sophia G. Larimer, Donna S. Freeborn

Faculty Publications

The purpose of this article is to assist nurse practitioners (NPs) and other primary care providers in differentiating between lactose intolerance, celiac disease, and diarrhea-predominant irritable bowel syndrome in adults. Based on subtle characteristics gathered from the history and physical examination, the NP’s examination and approach to testing will help distinguish between the 3 conditions. NPs should use a sequential process of examination and testing to distinguish gastrointestinal disorders that share common symptoms. A best practice algorithm is provided.

The Peanut Allergic Patient: Diagnosis, Treatment, And Prevention, Daniel W. Hill, Jane Lassetter Phd, Rn, Craig Nuttall

Student Works

The prevalence of peanut allergies (PAs) continues to rise through recent decades, despite the best attempts to reverse that trend. PAs are unpredictable and can be life-threatening. Therefore, it is imperative that nurse practitioners (NPs) are fully aware of the most recent guidelines and evidence regarding diagnosis, treatment, and prevention of PAs. This article presents information on current research in diagnosis and treatment of PA, as well as the latest guidelines established to prevent PA development. NPs should understand this information, allowing them to provide the best care possible for their patients.

Evaluation Of The Parasight Platform For Malaria Diagnosis, Yochay Eshel, Arnon Houri-Yafin, Hagai Benkuzari, Natalie Lezmy, Mamta Soni, Malini Charles, Jayanthi Swaminathan, Hilda Solomon, Pavithra Sampathkumar, Zul Premji, Caroline Mbithi, Zaitun Nneka, Simon Onsongo, Daniel Maina, Sarah Levy-Schreier, Caitlin Lee Cohen, Dan Gluck, Joseph Joel Pollak, Seth J. Salpeter

Pathology, East Africa

The World Health Organization estimates that nearly 500 million malaria tests are performed annually. While microscopy and rapid diagnostic tests (RDTs) are the main diagnostic approaches, no single method is inexpensive, rapid, and highly accurate. Two recent studies from our group have demonstrated a prototype computer vision platform that meets those needs. Here we present the results from two clinical studies on the commercially available version of this technology, the Sight Diagnostics Parasight platform, which provides malaria diagnosis, species identification, and parasite quantification. We conducted a multisite trial in Chennai, India (Apollo Hospital [n = 205]), and Nairobi, Kenya …

Longitudinal Measurement And Hierarchical Classification Framework For The Prediction Of Alzheimer's Disease, Meiyan Huang, Wei Yang, Qianjin Feng, Wufan Chen, Michael Weiner, Paul Aisen, Ronald Petersen, Clifford R. Jack Jr., William Jagust, John Trojanowki, Arthur W. Toga, Laurel Beckett, Robert C. Green, Andrew Saykin, John Morris, Leslie M. Shaw, Jeffrey Kaye, Joseph Quinn, Lisa Silbert, Betty Lind, Raina Carter, Sara Dolen, Lon S. Schneider, Sonia Pawluczyk, Mauricio Beccera, Liberty Teodoro, Bryan Spann, James Brewer, Helen Vanderswag, Adam Fleisher, Charles D. Smith, Greg A. Jicha, Peter A. Hardy, Partha Sinha, Elizabeth Oates, Gary Conrad

Neurology Faculty Publications

Accurate prediction of Alzheimer’s disease (AD) is important for the early diagnosis and treatment of this condition. Mild cognitive impairment (MCI) is an early stage of AD. Therefore, patients with MCI who are at high risk of fully developing AD should be identified to accurately predict AD. However, the relationship between brain images and AD is difficult to construct because of the complex characteristics of neuroimaging data. To address this problem, we present a longitudinal measurement of MCI brain images and a hierarchical classification method for AD prediction. Longitudinal images obtained from individuals with MCI were investigated to acquire important …

Recent Advances In The Management And Understanding Of Diabetic Retinopathy, Matthew Powers, Margaret Greven, Robert Kleinman, Quan D. Nguyen, Diana V. Do

Journal Articles: Ophthalmology

Despite recent advances in the diagnosis and treatment of diabetic retinopathy, this complication remains a steadfast challenge to patients and physicians. This review summarizes recent progress in the diagnosis and management of diabetic retinopathy, including automated screening, optical coherence tomography, control of systemic risk factors, surgical techniques, laser treatment, and pharmaceutical treatment, including vascular endothelial growth factor inhibitors. Recent advances in pharmaceutical treatments, in particular, hold strong promise of halting and sometimes reversing the disease process. Clinicians nevertheless must remain vigilant in their efforts to diagnose and treat this disease early in its course.

Elimination Of Pain Improves Specificity Of Clinical Diagnostic Criteria For Adult Chronic Rhinosinusitis, Scott D. Hirsch, Evan R. Reiter, Laurence J. Dinardo, Wen Wan, Theodore A. Schuman

Otolaryngology Publications

Objective

Determine whether the elimination of pain improves accuracy of clinical diagnostic criteria for adult chronic rhinosinusitis.

Study Design

Retrospective cohort study.

Methods

History, symptoms, nasal endoscopy, and computed tomography (CT) results were analyzed for 1,186 adults referred to an academic otolaryngology clinic with presumptive diagnosis of chronic rhinosinusitis. Clinical diagnosis was rendered using the 1997 Rhinosinusitis Taskforce (RSTF) Guidelines and a modified version eliminating facial pain, ear pain, dental pain, and headache.

Results

Four hundred seventy-nine subjects (40%) met inclusion criteria. Among subjects positive by RSTF guidelines, 45% lacked objective evidence of sinonasal inflammation by CT, 48% by endoscopy, …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

Evaluation Of Glycated Albumin (Ga) And Ga/Hba1c Ratio For Diagnosis Of Diabetes And Glycemic Control: A Comprehensive Review, Sara Yazdanpanah, Mohammad Rabiee, Mohammadreza Tahriri, Mojgan Abdolrahim, Asodollah Rajab, Hossein E. Jazayeri, Lobat Tayebi

School of Dentistry Faculty Research and Publications

Diabetes Mellitus (DM) is a group of metabolic diseases characterized by chronic high blood glucose concentrations (hyperglycemia). When it is left untreated or improperly managed, it can lead to acute complications including diabetic ketoacidosis and non-ketotic hyperosmolar coma. In addition, possible long-term complications include impotence, nerve damage, stroke, chronic kidney failure, cardiovascular disease, foot ulcers, and retinopathy. Historically, universal methods to measure glycemic control for the diagnosis of diabetes included fasting plasma glucose level (FPG), 2-h plasma glucose (2HP), and random plasma glucose. However, these measurements did not provide information about glycemic control over a long period of time. To …

Detection And Management Of Familial Hypercholesterolaemia In Primary Care In Australia: Protocol For A Pragmatic Cluster Intervention Study With Pre-Post Intervention Comparisons, Diane Arnold-Reed, Tom Brett, Lakkhina Troeung, Alistair Vickery, Jacquie Garton-Smith, Damon Bell, Jing Pang, Tegan Grace, Caroline Bulsara, Iain Li, Max Bulsara, Gerald F. Watts

Medical Papers and Journal Articles

Introduction: Familial hypercholesterolaemia (FH), an autosomal dominant disorder of lipid metabolism, results in accelerated onset of atherosclerosis if left untreated. Lifelong treatment with diet, lifestyle modifications and statins enable a normal lifespan for most patients. Early diagnosis is critical. This protocol trials a primary care-based model of care (MoC) to improve detection and management of FH.

Methods and analysis: Pragmatic cluster intervention study with pre-post intervention comparisons in Australian general practices. At study baseline, current FH detection practice is assessed. Medical records over 2 years are electronically scanned using a data extraction tool (TARB-Ex) to identify patients at increased …