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Teledermatology Sites Raise Quality Concerns

Incorrect diagnoses, inappropriate treatments, lack of information about possible side effects and risks, and lack of transparency about physician credentials are among the concerns raised in a study of direct-to-consumer (DTC) teledermatology sites.  
medscape.com
over 3 years ago
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Mimics and Chameleons of Optic Neuritis

Optic neuritis is quite common, but often overdiagnosed--frequently due to confusion in terminology. What red flags should prompt reconsideration of a diagnosis?  
medscape.com
over 3 years ago
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Fetal Alcohol Syndrome – Don't Forget the Bubbles

Alcohol use is common in Australian women with surveys suggesting that around 90% of 18-45 year olds have had a drink in the last year and that around 39% of these are unaware of the health implications of drinking on the developing fetus. Fetal Alcohol Syndrome is a leading cause of preventable intellectual disability. An Australian diagnostic guide has recently been developed by the Telethon Kids Institute to help clinicians make the diagnosis of Fetal Alcohol Syndrome Disorders. In this post we cover some of the basics of Fetal Alcohol Syndrome and provide some resources for those who want to learn more.  
dontforgetthebubbles.com
over 3 years ago
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Debunking Five Myths in Peripheral Arterial Disease

Drs Leslie Cooper and Amy Pollak debunk misconceptions on the diagnosis and treatment of PAD.  
medscape.com
over 3 years ago
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The Case of the Blue/Brown-Eyed Girl

A 2-year-old girl presents with unusual pigmentation in one eye and hearing issues. Can you make the correct diagnosis?  
medscape.com
over 3 years ago
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Lyme and Other Tickborne Diseases in New Hampshire

New Hampshire continues to have one of the highest rates of Lyme disease in the nation. The state's Division of Public Health Services provides advice on diagnosis and treatment.  
medscape.com
over 3 years ago
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Traversing Transverse Myelitis - emdocs

We all place transverse myelitis on our broad differential of acute and dangerous causes of back pain in the emergency department. However, given the rarity of this condition and the rarity of when we make the diagnosis even when present, let's take a deeper look into this condition and determine what the emergency physician must know.  
emdocs.net
over 3 years ago
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Quick Rupture of Membranes and Miscarriage Tests on Horizon

Potentially practice-changing tests could provide immediate and definitive diagnoses of premature rupture of membranes or miscarriage. The developer is in talks to bring them to market.  
medscape.com
over 3 years ago
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Future of clinical coding

Clinical coding is used to classify the diagnosis and treatment of every inpatient for entry into a national data repository. The data are used for various purposes, mostly administrative. The system relies on the expertise of clinical coders, who extract data from largely unstructured notes using complex rules and a book of codes. The classification systems used in the UK are the international classification of diseases (ICD-10) for symptoms and diagnoses1 and the OPCS classification (OPCS-4) for procedures.2  
feeds.bmj.com
over 3 years ago
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Future of clinical coding

Clinical coding is used to classify the diagnosis and treatment of every inpatient for entry into a national data repository. The data are used for various purposes, mostly administrative. The system relies on the expertise of clinical coders, who extract data from largely unstructured notes using complex rules and a book of codes. The classification systems used in the UK are the international classification of diseases (ICD-10) for symptoms and diagnoses1 and the OPCS classification (OPCS-4) for procedures.2  
feeds.bmj.com
over 3 years ago
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Pneumonia Mimics: Pearls and Pitfalls - emdocs

Pneumonia is an illness frequently seen in our emergency departments.  But, are all presentations actually pneumonia?  Are we missing other illnesses that present similarly to pneumonia?  Which ones pose significant morbidity and mortality risk to our patients?  What clues are out there that will aid us in making an alternative and critical diagnosis?  
emdocs.net
over 3 years ago
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Best Practices for the Use of MRA in Stroke Diagnosis CME

The goal of this activity is to review the use of magnetic resonance angiography (MRA) in the evaluation of cerebral ischemia.  
medscape.org
over 3 years ago
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Immune Signature May Aid Prognosis, Therapy in Glioblastoma

Researchers have developed a risk 'signature' based on expression of eight immune genes related to glioblastoma, and they believe the immune system could be a target for therapy in this disease.  
medscape.com
over 3 years ago
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Diagnosing Sepsis Is Subjective and Highly Variable

What accounts for the variability in the diagnosis of severe sepsis -- and what approaches may help improve consistency?  
medscape.com
over 3 years ago
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Atrial fibrillation in women is linked to increased risk of cancer

Women with new onset atrial fibrillation may have an elevated risk of cancer, shows a study including nearly 35 000 women who were followed up for around 20 years. The researchers said in JAMA Cardiology that atrial fibrillation may be a risk marker for future cancer diagnoses.1  
feeds.bmj.com
over 3 years ago
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Diagnosis and Management of Community-Acquired Pneumonia in Adults - American Family Physician

Community-acquired pneumonia is diagnosed by clinical features (e.g., cough, fever, pleuritic chest pain) and by lung imaging, usually an infiltrate seen on chest radiography. Initial evaluation should determine the need for hospitalization versus outpatient management using validated mortality or severity prediction scores. Selected diagnostic laboratory testing, such as sputum and blood cultures, is indicated for inpatients with severe illness but is rarely useful for outpatients. Initial outpatient therapy should include a macrolide or doxycycline. For outpatients with comorbidities or who have used antibiotics within the previous three months, a respiratory fluoroquinolone (levofloxacin, gemifloxacin, or moxifloxacin), or an oral beta-lactam antibiotic plus a macrolide should be used. Inpatients not admitted to an intensive care unit should receive a respiratory fluoroquinolone, or a beta-lactam antibiotic plus a macrolide. Patients with severe community-acquired pneumonia or who are admitted to the intensive care unit should be treated with a beta-lactam antibiotic, plus azithromycin or a respiratory fluoroquinolone. Those with risk factors for Pseudomonas should be treated with a beta-lactam antibiotic (piperacillin/tazobactam, imipenem/cilastatin, meropenem, doripenem, or cefepime), plus an aminoglycoside and azithromycin or an antipseudomonal fluoroquinolone (levofloxacin or ciprofloxacin). Those with risk factors for methicillin-resistant Staphylococcus aureus should be given vancomycin or linezolid. Hospitalized patients may be switched from intravenous to oral antibiotics after they have clinical improvement and are able to tolerate oral medications, typically in the first three days. Adherence to the Infectious Diseases Society of America/American Thoracic Society guidelines for the management of community-acquired pneumonia has been shown to improve patient outcomes. Physicians should promote pneumococcal and influenza vaccination as a means to prevent community-acquired pneumonia and pneumococcal bacteremia.  
aafp.org
over 3 years ago
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Sport-Related Concussion in Youth

Read the up-to-date recommendations and guidelines for diagnosis and management of pediatric sport-related concussions.  
medscape.com
over 3 years ago
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Motor neurone disease patients 'face delays in seeing specialists' - BBC News

One in five people with motor neurone disease waits more than a year to see a brain specialist for help with diagnosis, a snapshot survey by the MND Association suggests.  
bbc.co.uk
over 3 years ago
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UMEM Educational Pearls - University of Maryland School of Medicine, Department of Emergency Medicine

Pick a category... Airway Management Cardiology Critical Care Critical Care Literature Update Dermatology Endocrine ENT Financial & Investing Gastrointestional Geriatrics Hematology/Oncology Infectious Disease International EM Med-Legal Medical Education Misc Neurology Obstetrics & Gynecology Ophthamology Orthopedics Pediatrics Pharmacology & Therapeutics Procedures Pulmonary Toxicology Trauma Urology Vascular Visual Diagnosis $('#pearl_categories').change(function(){ window.location = "/educational_pearls/search/?category=" + $(this).val() });  
umem.org
over 3 years ago
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The cardiovascular safety of methylphenidate

In the United States alone, 6.4 million children received a diagnosis of attention-deficit/hyperactivity disorder (ADHD) in 2011. Of these, 3.5 million received a stimulant drug, typically methylphenidate.1 In addition, there is off label use of stimulants for milder attention problems. The cardiac safety of stimulants, which are known to slightly raise blood pressure and accelerate the heart rate, has been hotly debated as case reports,2 and conflicting evidence has emerged over time.3  
feeds.bmj.com
over 3 years ago