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Burri, Haran. Differential diagnosis of supraventricular tachycardias. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0479.
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This chapter overviews the electrocardiographic diagnosis of various aetiologies of narrow complex tachycardia, as well as the criteria for distinguishing aberrant conduction from ventricular tachycardia in cases of wide QRS tachycardia. Clinical investigations for diagnosis of supraventricular tachycardia are also covered.
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Gandhi, Sanjay, e William R. Lewis. ECG monitoring in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0129.
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Electrocardiographic (ECG) monitoring is routinely used in hospitals for patients with a wide range of cardiac and non-cardiac diagnoses. Besides simple monitoring of heart rate and detection of life-threatening arrhythmias, the goals of ECG monitoring include detection of myocardial ischaemia, diagnosis of complex arrhythmia, and identification of a prolonged QT interval. The ECG remains a cornerstone in diagnosis and management of patients with coronary ischaemia. Over the past decade, there has been an increase in the number and complexity of electrophysiological interventions, including complex ablations, biventricular pacing, and insertion of implantable defibrillators. ECG monitoring in these patients can serve both a protective and diagnostic purpose. They detect life-threatening arrhythmias and double up as in-patient Holter monitors. Unfortunately, there are no randomized controlled trials of in-hospital cardiac monitoring—expert opinions based on clinical experience and published research in the field of electrocardiography form the basis of current guidelines.
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Drew, Barbara Jean. VALUE OF MCL(1), MCL(6), AND SELECTED LEADS IN THE DIAGNOSIS OF WIDE QRS COMPLEX TACHYCARDIA (MCL, CORONARY CARE). 1990.
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Bloom, Chloe, e Seamus Donnelly. Pulmonary sarcoidosis. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0019.
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This case of a young female with suspected pulmonary sarcoidosis demonstrates the difficulties in confirming the diagnosis and subsequently identifying the appropriate treatment. Current guidelines were developed in the 1990s, and there has been little change in the diagnostic pathway since then. However, there are new clinical tools to help differentiate from the common differential diagnosis of tuberculosis. The patient’s management can be complex, with a host of clinical parameters that can be potentially used to assess each patient’s disease activity, severity, and prognosis, and the decision to start immunosuppressive treatment is often difficult. The mainstay of treatment remains glucocorticoids, with a wide choice of possible steroid-sparing agents. However, the evidence for their use is limited. This case is particularly interesting, as the patient is a female with a young daughter who is planning imminently on continuing her family and has legitimate concerns about treatment side effects.
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Powell, Jenny. Approach to diagnosing skin disease. Editado por Patrick Davey e David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0244.
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Making a diagnosis in dermatology may seem daunting when there are 6 000 or more possibilities, and the terminology seems so complex. This chapter suggests a systematic approach to picking up clues from symptoms and signs, and understanding how to describe skin disease; this approach, together with experience (obtained through seeing patients, asking more experienced colleagues, and reading) will help with pattern recognition and, sometimes, lead to the answer. The skin has such a wide range of structural and functional varieties that disorders of the skin are not only common but also very variable. However, it is important to be able to give a patient a diagnosis. This ‘working label’ means that the patient fits into a known group not only in their typical presentation but also as a guide for response to treatment, prognosis, and, sometimes, for explanation of etiology and whether genetic or infective factors are important; that is, it is helpful in explaining the disease to the patient. Despite the complexity of the skin, making a diagnosis in dermatology is no different from making a diagnosis in other areas; it is based on taking a history, examining the patient, and performing investigations, if indicated.
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Harrop, James, e Christopher Maulucci, eds. Spinal Neurosurgery. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190887773.001.0001.
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Neurosurgery by Example: Key Cases and Fundamental Principles provides case-based, high yield content for the spine surgeon and neurosurgeons preparing for the American Board of Neurological Surgeons oral examination. It covers a wide array of spinal pathologies with their presentation, diagnosis, and treatment plans. Postoperative and complication management strategies are offered as well in order to prepare surgeons who can then provide comprehensive patient care for complex spine conditions.
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Bakan, Michael B. Gordon Peterson. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190855833.003.0009.
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Gordon Peterson—early music specialist, professional musician, and former tenured music professor—was diagnosed with Asperger’s syndrome at the age of forty-five, by which time he had suffered through decades of misdiagnoses, misguided psychiatric treatments, and despair. “For the first time ever,” he recalls, “I felt the correctness of the diagnosis.” Gordon attributes many of the hardships he has endured to being “wired all funny” with Asperger’s, but he sees the condition as the primary source of his musical talent, intellectual prowess, and fertile imagination as well. “In my mind,” he says, “there is an impossibly complex web of musical and non-musical cultural connections across time and geographic location . . . . I see a ribbon-like time line [that] stretches back from today all the way to the beginning of recorded history, and before . . . and I can walk around in it, looking at the instruments, hearing the sounds, hearing the language.” Asperger’s is “my superpower,” Gordon attests, but as the chapter chronicles, that superpower exacts a very high toll on him in terms of the anguish and turmoil it brings.
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Serdiuk, Oleksii, Viktor Burlaka, Andriy Kanishchev, Bohdan Tkach, Olga Vyglazova, Olga Yurchenko, Oleksii Moseiko et al. Психіатрія та наркологія. Інструменти вимірювання залежностей. Kharkiv National University of Internal Affairs, 2022. http://dx.doi.org/10.32631/msu2022.
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The course "Measurement of Substance Use and Abuse" is designed to introduce a wide range of instruments for measuring addictive behavior, methods of their construction and principles of application. The course introduces the ethical and legal aspects of measuring and diagnosing chemical addictions, modern approaches to the classification of behavioral disorders due to the use of chemical substances in the DSM and ICD, methodical and methodological principles of measuring addictive behavior, in particular the methods of mathematical statistics, which are the basis for the standardization and adaptation of diagnostic methods (reliability, validity, correlation and factor analysis), complex and specific tools for diagnosing and measuring addictive behavior. The course provides the most common methods of measuring and diagnosing chemical dependencies, as well as instructions for their application and interpretation of the obtained results. This course is the second in the "Addictive Behavior" educational cycle, designed to be studied after the introductory course "Addiction Research Methods". The course was created within the framework of the Ukrainian-American project "Capacity Building for Lifespan Focused Substance Use Disorder Research in Ukraine" (4D43TW009310-05) under supervision of the Addiction Center of the University of Michigan (USA) with the support of the Fogarty International Center (FIC ), National Institute of Health (NIH), National Institute on Alcohol Dependence and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA).
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Duris, Kimberly S., e Katherine M. Helm. What You Need to Know about Personality Disorders. Bloomsbury Publishing Inc, 2023. http://dx.doi.org/10.5040/9798216172567.
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This volume provides readers with all the information they need to know about personality disorders, including how to assess, treat, manage, and diagnose the varying signs and symptoms of the 10 different personality disorders currently recognized. Having a personality disorder is different than having personality quirks. Personality quirks or eccentricities are considered normal; however, when certain dominant personality traits interfere with healthy psychological functioning, a personality disorder might be the cause. This next installment in Greenwood’s Inside Diseases and Disorders series provides a complete overview of the 10 currently recognized personality disorders, as well as the myriad signs and symptoms that may lead to a diagnosis. Using the most recent scholarship and case studies, this volume aims to bring clarity to the topic of personality disorders, covering a wide range of topics from the history of assessing personality disorders to the ways in which a personality disorder may affect the family and friends of the patient.
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Lonser, Russell, e Brad Elder, eds. Surgical Neuro-Oncology. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190696696.001.0001.
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Surgical Neuro-Oncology, part of the Neurosurgery by Example series, has the overarching goal of spanning the spectrum of clinical practice and complexity within adult surgical neuro-oncology using representative cases. The presentation and discussion reflects the logic, thought process, and technical details behind surgical candidacy, planning, surgical procedure (including bail-out options, and complication avoidance/management), aftercare, evidence and outcome, and lessons learned. Authors with expert knowledge and technical skills address a wide range of complex clinical cases, which are presented as they are encountered the neurosurgical clinic, hospital emergency department, and operating room. While addressing the overall diagnosis, treatment, and outcome, the authors provide insight into how they handle each case. The books transmits experience gained from leaders to colleagues and provides a great background for maintenance of certification preparation, with each chapter providing lists that highlights elements of accurate diagnosis, successful treatment, and effective complication management. Cases included cover the spectrum of clinical diversity and complexity within surgical neuro-oncology.
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Mason, Will, e David Warwick. Bone and joint injuries of the hand. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757689.003.0005.
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The small bones and joints of the hand are vulnerable to fracture and dislocation. These same structures need to be pain-free, stable, and mobile for proper function. Careful diagnosis and meticulous management is required. This may entail early mobilization (e.g. a metacarpal neck fracture) or temporary splinting (e.g. mallet fracture), early repair (e.g. unstable thumb ulnar collateral avulsion), complex sequential and dynamic splinting (e.g. central slip rupture); percutaneous wires (e.g. Bennett’s fracture) or plate fixation (e.g. displaced index metacarpal shaft). There is often a trade-off between the mobilization required to avoid stiffness and the immobilization required to allow anatomical healing. Rigid surgical fixation with meticulous hand therapy may both contribute in certain patients.
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Evans, Charlotte, Anne Creaton, Marcus Kennedy e Terry Martin, eds. Neonatal retrieval. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198722168.003.0018.
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Infants requiring retrieval at or soon after birth, often present complex medical and retrieval challenges. Many of these infants will require significant stabilization and definitive care prior to transport and all will require careful preparation for potential in-transit deterioration. A wide spectrum of neonatal pathologies will be encountered in the retrieval setting, many of which will remain undifferentiated until further investigation at a receiving centre is performed. This chapter describes the diagnosis, acute resuscitation, and retrieval management of neonates with respiratory, cardiovascular, neurological, surgical, metabolic, and infectious pathologies as well as the approach to the undifferentiated, unwell neonate. Essential neonatal practical procedures are described, including airway procedures and vascular access, and normal laboratory results for neonates are outlined.
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Weeber, Edwin J. Angelman Syndrome. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199744312.003.0013.
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Angelman syndrome (AS) is a devastating neurological disorder with a symptom complex that includes but is not limited to severe developmental delay, profound cognitive disruption, motor coordination defects, increased propensity for seizure with a characteristic abnormal electroencephalogram, sleep disruption, behavioral difficulties, a lack of speech, and an overall happy demeanor. Although the disorder was first described in 1965 by British pediatrician Dr. Harry Angelman, because AS is clinically characterized by a wide constellation of symptoms with varying degrees of severity, it is not readily diagnosed by clinical presentation alone and misdiagnosis has commonly occurred.
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Speed,, Cathy, Jae Rhee e Fares Haddad. Injuries to the pelvis, hip, and thigh. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199533909.003.0027.
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Injuries to the musculoskeletal pelvis and thigh in sport are extremely common. Injury can occur at one or multiple sites of the bony pelvic ring, and in the soft tissues of the groin, abdominal wall, and thigh. Athletes in certain sports are particularly prone to hip injury, especially those involved in running, soccer, hockey, rugby, and dancing. Although recognized as a common region of injury, the true epidemiology is not known, as the spectrum of injury is wide, diagnosis can be complex, and injury classification is still debated in some conditions. Nevertheless, soft tissue injury and dysfunction are the most common forms of injury seen and, indeed, hamstring injury is the most frequent injury in a number of sports, including athletics, soccer, rugby union, and Australian Football League. Hamstring injuries are also the most common recurrent injury in sport....
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Lerner, Matthew D., Tamara E. Rosen, Erin Kang, Cara M. Keifer e Alan H. Gerber. Autism Spectrum Disorder. Editado por Thomas H. Ollendick, Susan W. White e Bradley A. White. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780190634841.013.15.
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Autism spectrum disorder (ASD) is a neurodevelopmental condition consisting of deficits in social communication and presentation of restricted and repetitive behaviors and interests. An increasingly large proportion of youth are diagnosed with ASD. ASD evinces a complex clinical presentation, ranging from a severe early impact on functioning to manifestations that present similarly to other (often comorbid) internalizing and externalizing conditions. In recent years, the reliability and standardization of ASD assessment has improved considerably. Likewise, there is now a fairly wide range of treatment options and prognoses, with several psychosocial interventions attaining empirically supported status and a nontrivial percentage of youth with ASD showing significant symptom reduction over time. This chapter describes ASD and reviews key empirically supported assessment and intervention practices. A case example is presented of an adolescent with ASD. Finally, challenges and future directions are described, as are implications for clinical practice for youth with ASD.
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Nizamuddin, Sarah, e Caitlin Aveyard. Airway Foreign Body Aspiration. Editado por Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi e Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0024.
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Aspiration of a foreign body is a potentially life-threatening problem that often necessitates an anesthetic for removal of the foreign body. Foreign body aspiration is most common among children aged 1 to 4 years old and has a wide variety of symptoms ranging from a mild, nagging cough to complete airway obstruction. Definitive diagnosis and treatment of foreign body aspiration involve flexible or rigid bronchoscopy. The urgency of the procedure depends on the type of object aspirated and the location of the foreign body in the airway. The appropriate anesthetic for removal of the foreign body is dependent upon the surgeon’s plan and involves several steps in decision-making: intravenous versus inhalational induction, airway maintenance (endotracheal tube vs. supraglottic airway vs. mask), spontaneous versus controlled ventilation, maintenance of anesthesia (total intravenous anesthesia vs. volatile agents). Good communication with the surgeon or proceduralist is key to a safe and effective anesthetic.
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Schirmer, Uwe, e Andreas Koster. Anaesthesia for cardiac surgery. Editado por Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0056.
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Cardiac anaesthesia continues to develop as a specialized discipline within the wide field of clinical anaesthesia. A comprehensive knowledge of cardiovascular physiology and its improved monitoring with modern invasive and non-invasive devices is the basis for the pharmacological treatment of complex cardiovascular disorders. Excellent skills in intraoperative transoesophageal echocardiography have become essential. Rapid developments in cardiopulmonary bypass techniques and surgical devices have resulted in the speedy introduction of new surgical techniques which anaesthesia has to embrace. The developments in the field of (left) ventricular assist devices are expansive. By changing the paradigm of the indication of implantation from ‘bridging to heart transplantation’ to ‘destination therapy’, particularly in the large group of elderly patients with end-stage heart failure, these complex operations are no longer restricted to the small group of heart centres performing heart transplantation. This chapter provides a comprehensive review of modern cardiac anaesthesia in the contemporary world of quickly evolving cardiac surgery. The basics of anaesthesia management for the ‘cardiac’ patient are described and principles of extracorporeal circulation as well as diagnostic and treatment strategies of disturbances of the haemostatic system are highlighted. Pharmacological strategies to treat left- and right-heart failure and strategies for temporary mechanical support are outlined. Further areas of focus are the anaesthetic implications of modern less or minimally invasive procedures such as off-pump coronary artery bypass grafting and minimally invasive valve implantation/surgery and anaesthesia for implantation of ventricular assist devices and heart transplantation.
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McInerny, Thomas K., Henry M. Adam, Deborah E. Campbell e Deepak M. Kamat, eds. American Academy of Pediatrics Textbook of Pediatric Care. American Academy of Pediatrics, 2008. http://dx.doi.org/10.1542/9781581106411.
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For more than 75 years, the American Academy of Pediatrics has been the nation’s leading and most trusted child health expert. The all-new full color AAP Textbook continues the tradition by providing a wealth of expert guidance spanning every aspect of current clinical practice and sets a new standard for one-stop pediatric references! Directed by a distinguished editorial team, and featuring contributions from experienced clinicians nationwide, the new AAP Textbook of Pediatric Care is a resource you’ll use with complete confidence. Look here for expert guidance spanning every aspect of current clinical practice. Comprehensive scope: Covers screening, pathophysiology, diagnosis, treatment, management, prevention, critical care, practice management, ethical and legal concerns and much more. Practical focus: Directly addresses day-to-day practice concerns for efficient patient problem-solving. Essential clinical guidance: Step-by-step recommendations on what to do, when and how to do it, when to admit, and when to refer. Evidence-based approach: State-of-the-art approach includes the evidence base for recommendations and lists detailed references within each chapter. Topical coverage: Highlights new priorities for 21st century practice: evidence-based medicine, environmental concerns, electronic health records, quality improvement, community-wide health approaches, confidentiality, cultural issues, and psychosocial issues.
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Eyre, Janet. Clinical approach to developmental neurology. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198569381.003.0171.
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The objectives and principles of neurological history and examination in children are the same as those in adults. This chapter therefore, will not provide an all-encompassing description of the neurological assessment of children, but highlights where the approach must differ substantially from that used in adults. Further it aims to provide a practical and useful approach to the examination of children, who may be preverbal and certainly will show less stamina for cooperation than adults. Of course as children get older, the examination can become more conventional and systematized. By adolescence the examination can be the same as the adult examination.The first and overriding factor for success is to be flexible and to make observations when the opportunity arises rather than to wait for abnormalities to arise during the course of a more systematic approach. Nonetheless a systematic approach to recording these results is essential, so as to bring together related observations made disparately in time. The history is of paramount importance in guiding the examination. Since it is unlikely that you will be able to complete a full examination, it is important to prioritize the observations needed in light of a differential diagnosis before you begin examining. Rather than rushing straight into the examination it is rewarding to gain a young child’s confidence by playing briefly with them. Also, instead of insisting on examining the child on a couch, it helps to become adept at examining young children on their parent’s or caretaker’s knee. Finally, no matter how cooperative a child is, potentially disturbing investigations should be left until last, including tendon reflexes or examination of the tongue, fundi, and ears. Otherwise all subsequent cooperation from the child may be lost after these examinations.The examination room environment is the key to a successful neurological examination and requires careful thought. There should be sufficient space to accommodate families and for the children to play. The room needs to be friendly and conducive to encouraging play. It needs to be equipped with carefully selected toys, pictures, pencils and paper, and books of interest to children over a wide age range. Observation of the child’s play whilst you are taking a history from the parents or caregivers will allow assessment of the child’s motor skills and developmental stage. Their use of play material can yield important clues to the nature of a deficit, by revealing ataxia, weakness, involuntary movements, tics, or spasticity. Play also provides an opportunity to assess the child’s behaviour, for instance their impulsivity, distractibility, and attention span. Interaction of the child with parents or caregivers can be observed also. If the child participates actively in the history taking, their understanding and contribution to the session allows you to make assessments of their language and intellectual skills.