Fundamentals of Diagnostic Error in Imaging.

Imaging plays a pivotal role in the diagnostic process for many patients. With estimates of average diagnostic error rates ranging from 3% to 5%, there are approximately 40 million diagnostic errors involving imaging annually worldwide. The potential to improve diagnostic performance and reduce patient harm by identifying and learning from these errors is substantial.

Papillary Thyroid Carcinoma Recurrence: Low Yield of Neck Ultrasound With an Undetectable Serum Thyroglobulin Level.

Objectives: To assess the yield of neck ultrasound (US) when serum thyroglobulin (Tg) is undetectable (<0.1 ng/mL) compared to elevated serum Tg in patients with differentiated papillary thyroid carcinoma (PTC) treated with thyroidectomy and radioactive iodine 131 (RAI) ablation.

Methods: A retrospective chart review was conducted from 2010 through 2015 at an academic institution evaluating US results in patients with serum Tg levels obtained within 6 months of a neck US examination after thyroidectomy and RAI.

Parent readiness to change differs for overweight child dietary and physical activity behaviors.

Parent involvement is important to help overweight children lose weight. However, parent readiness to make changes around child eating and physical activity (PA) behaviors can differ across domains. Using a cross-sectional design, our aim was to examine which factors were associated with parents being in the Action/Maintenance stage of change in each domain.

Severe cortisol deficiency associated with reversible growth hormone deficiency in two infants: what is the link?

Context: Hypoglycemia is potentially life-threatening, especially in infants, and can be due to congenital cortisol and/or GH deficiency (GHD).

Case Illustration: Two full-term infants had undetectable cortisol levels, but also low GH levels, at the time of severe hypoglycemia. GHD persisted for several months, even after cortisol replacement.

Ischemic stroke and rhabdomyolysis in a 15-year-old girl with paraganglioma due to an SDHB exon 6 (Q214X) mutation.

Background: We report a 15-year-old girl with a recent diagnosis of type 2 diabetes mellitus who presented in malignant hypertensive crisis (BP 210/120 mm Hg). Abdominal CT showed an 8.2 x 4.

Hospital-acquired pneumonia: recent advances in diagnosis, microbiology and treatment.

Nosocomial or hospital-acquired pneumonia occurs frequently, despite preventative measures and advances in diagnostic procedures and treatment of this severe infection. This article will highlight the recent literature with emphasis on significant publications and advances in the area of pneumonia pathogenesis, microbiology, diagnosis, and response to antimicrobial therapy.

Lost and found testes: the importance of the hCG stimulation test and other testicular markers to confirm a surgical declaration of anorchia.

Background: In patients with impalpable testes,laparoscopy or open surgery is considered conclusive in establishing the absence of testicular tissue.

Methods: Retrospective chart review.

Results: Over a 22-year period, 4 out of 82 patients with a diagnosis of bilateral anorchia by laparoscopy or laparotomy had persistent testicular tissue suggested by endocrine evaluations.

Hospital-acquired pneumonia: epidemiology, etiology, and treatment.

Despite improvements in diagnosis, treatment, and prevention, hospital-acquired pneumonia (HAP) remains the number one cause of nosocomial mortality. This article reviews the current knowledge regarding the incidence, epidemiology, and causes of HAP, with the appreciation that the available information is incomplete and that controversies are common, and thus the authors provide a rational approach to the initial management of HAP in immunocompetent adults. A discussion of therapy and what to do with patients who do not respond to the empiric therapy are included.

Blastomycosis as an etiology of acute lung injury.

Blastomyces dermatitidis, a dimorphic broad-based budding yeast endemic to the Mississippi River Valley region, is responsible for morbidity in humans via inhalation and dissemination. The response of acute lung injury, which produces an illness with serious morbidity and an approximately 50% mortality, uncommonly occurs. Diagnosis can be difficult, and a high index of suspicion should be maintained in endemic regions for patients with acute lung injury of uncertain etiology, especially if their condition deteriorates on broad-spectrum antimicrobial and antitubercular therapy and they have a previous insidious respiratory complaint and constitutional symptoms.

Hospital-acquired pneumonia: recent advances in diagnosis, microbiology and treatment.

Nosocomial or hospital-acquired pneumonia occurs frequently, despite preventative measures and advances in diagnostic procedures and treatment of this severe infection. This article will highlight the recent literature with emphasis on significant publications and advances in the area of pneumonia pathogenesis, microbiology, diagnosis, and response to antimicrobial therapy.

Pneumopericardium associated with face-mask continuous positive airway pressure.

This is an uncommon case of a patient who developed pneumopericardium while being treated with face-mask continuous positive airway pressure (CPAP) for hypoxic respiratory failure following a coronary artery bypass graft surgery. A pneumopericardium detected by chest radiograph resolved completely after discontinuation of face-mask CPAP. Possible mechanisms that may have been involved in this unusual complication are reviewed.

Applications of the PM3 semi-empirical method to the study of triethylenediamine.

Charcoal filters impregnated with triethylenediamine (TEDA) are known to be efficient for the collection of volatile methyl iodide, which may be released under a hypothetical loss-of-coolant accident in a nuclear generating station. The structure and thermodynamic stability of the products of the TEDA-methyl iodide reaction have thus been studied using semi-empirical techniques. The reaction of TEDA with two molecules of methyl iodide leads to a quaternization reaction at each of the nitrogens.