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Psychosocial Aspects of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
The diagnosis of panic disorder is based on medical history, review of current medications, a complete physical examination, discussion of symptoms and concerns, and a psychiatric assessment. There is evaluation of whether panic attacks are unexpected and recurrent. The patient and physician discuss whether one or more panic attacks was followed by at least 1 month of worrying about another attack, or changing behaviors to avoid having another attack. There is evaluation of any medical disorders, such as diabetes, that may be causative, along with medications or other substances. The patient must be evaluated about the possibility of having another type of mental health disorder. Diagnostic tests include blood and urine tests, various imaging studies, and electrocardiogram.
Ante-natal care, screening and child health surveillance
Published in Jackie Musgrave, Health and Wellbeing for Babies and Children, 2022
Screening tests can help to identify a problem at a very early stage and when put interventions in place can reduce the effects of the condition. The screening can be a blood test or scan, or a series of questions. In order to confirm a diagnosis, it is usual to follow up results from a screening test with more investigations.
From Tracers to Treatment
Published in Alan Perkins, Life and Death Rays, 2021
Some patients may feel uncomfortable about the risks associated with receiving an injection of a radiopharmaceutical when undergoing a medical procedure, as they think this may be more harmful than having an X-ray. However, in general the radiation doses to patients undergoing nuclear medicine investigations are no greater than the doses from X-ray investigations. The doses received from X-ray CT examinations generally range between 2 and 18 mSv. Nuclear medicine imaging studies range from about 0.2 mSv for a lung ventilation investigation with a technetium-99m inhaled particulate to around 20 mSv for examination of the blood supply to the muscle of the heart using thallium-201-thallous chloride. An injection of 400 MBq of F-18-FDG for a PET scan results in an effective dose of around 7.6 mSv, but this will be higher if X-ray CT is also undertaken at the same time. An overriding consideration when assessing the potential harm from all medical radiation exposures is that the benefit gained from the diagnostic investigation is always greater than the radiation risk of carrying out the procedure and that the risk to the patient would be even higher if the investigation was not undertaken.
Endoscopic ultrasound with combined fine needle aspiration plus biopsy improves diagnostic yield in solid pancreatic masses
Published in Scandinavian Journal of Gastroenterology, 2022
Adalberto Gonzalez, Vaibhav Wadhwa, Harjinder Singh, Sikandar Khan, Kapil Gupta, Hong Liang, Ishtiaq Hussain, John Vargo, Sunguk Jang, Prabhleen Chahal, Amit Bhatt, Hassan Siddiki, Tolga Erim, Madhusudhan R. Sanaka
The definition of diagnostic yield we used was the percentage of lesions sampled for which a definitive tissue diagnosis was obtained. This is similar to the definition of diagnostic yield used in previous studies [20]. However, a definitive diagnosis may sometimes be unable to discern due to ambiguity of words such as ‘atypical’, ‘indeterminate’, ‘insufficient’, ‘indeterminate’ in pathology reports that make it difficult to discern what is a diagnostic yield or non-diagnostic yield. In our study, ‘non-diagnostic’, ‘indeterminate’, ‘insufficient’, or ‘intermediate’ samples were considered non-diagnostic as they did not infer definitive yields. Other studies have used the term diagnostic yield more variably. Some prospective studies such as Young Bang et al. described the diagnostic yield as ‘diagnostic sufficiency’ or the proportion of patients in whom an on-site diagnosis was established with 3 [8] or 4 [21] passes. Tian et al. [17] seemed to use diagnostic yield and accuracy interchangeably. We used a similar definition of diagnostic accuracy (sum of true positives and true negatives divided by the total number of samples) as Lee et al. [19] and other studies.
Delivery of audiological diagnoses for infants: a linguistic analysis of clinical communication
Published in International Journal of Audiology, 2022
Rebecca Kim, Catherine M. McMahon
When diagnoses are delivered in medical appointments, doctors often refer to test results and supporting information when making their diagnostic statement (Heath 1992; Slade et al. 2008). In Perakyla’s study of GPs in Finland (Peräkylä 2006) reference to the evidence occurred in cases where there was; a break between the examination and diagnosis delivery, a lack of clarity from the patient’s perspective about which examination has led to the diagnosis, and uncertainty around the diagnosis. Perakyla asserts that reference to the evidence is provided to ensure “visibility and intelligibility” (p. 233) of the diagnosis. In this study, the diagnosis was positioned directly after the assessment, minimising the inferential distance between the diagnosis and the evidence for the diagnosis. However, in all cases where a hearing loss was diagnosed the audiologists’ indirectly referred to the evidence used for their diagnostic conclusions. Given the small inferential difference, this may indicate that the audiologists were attempting to make explicit their reasoning, however when used in conjunction with hedging and evidential verbs (as seen in excerpts 9–11), this may serve to make the diagnosis appear uncertain. No direct reference was made to the evidence when normal hearing was found and these results were presented as plain assertions (Perakyla 1998).
Healthcare practices that increase the quality of care in cancer trajectories from a general practice perspective: a scoping review
Published in Scandinavian Journal of Primary Health Care, 2022
Anne Nicolaisen, Gitte Bruun Lauridsen, Peter Haastrup, Dorte Gilså Hansen, Dorte Ejg Jarbøl
It increases the quality of integrated and people-centered care, when GPs provide information and reassurance to patients regarding their referral, based on the patient’s information needs. Furthermore, inquiring about what their patients would like to know about the diagnostic testing process, encompassing referral, specialist input, and how the patient can obtain the results, also increases the quality of care [38]. To increase the integrated quality of care, GPs and patients can make an action plan together, which the patient can use in case of delays in the process [39]. An action plan is defined as an explicit and mutual agreement between GPs and patients, where the role of the GP and the responsibilities of both patients and GPs throughout the cancer trajectory are clearly defined.