scholarly journals Change of differential diagnosis tactics in the process of clinical observation ofa patient

2008 ◽  
Vol 7 (2) ◽  
pp. 79-83
Author(s):  
O. V. Kalinina
Keyword(s):  
Lung Cancer ◽  
Differential Diagnosis ◽  
Clinical Observation ◽  
Clinical Symptoms

The complicated ratios of clinical symptoms of internal lesions during central lung cancer are demonstrated in the article when changes of differential diagnosis tactics were required for diagnosing that necessary keeping is priority of the clinical appraisal of the results inspection patient.

scholarly journals A false alarm of COVID-19 pneumonia in lung cancer with anti-PD-1 related pneumonitis: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ying Dai ◽  
Sha Liu ◽  
Yiruo Zhang ◽  
Xiaoqiu Li ◽  
Zhiyan Zhao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Differential Diagnosis ◽  
Clinical Symptoms ◽  
Close Contact ◽  
Ct Imaging ◽  
Imaging Features ◽  
Rt Pcr ◽  
Lung Lobe ◽  
Clinical Presentations ◽  
Novel Coronavirus

Abstract Background Pneumonitis belongs to the fatal toxicities of anti-PD-1/PD-L1 treatments. Its diagnosis is based on immunotherapeutic histories, clinical symptoms, and the computed tomography (CT) imaging. The radiological features were typically ground-glass opacities, similar to CT presentation of 2019 Novel Coronavirus (COVID-19) pneumonia. Thus, clinicians are cautious in differential diagnosis especially in COVID-19 epidemic areas. Case presentation Herein, we report a 67-year-old Han Chinese male patient presenting with dyspnea and normal body temperature on the 15th day of close contact with his son, who returned from Wuhan. He was diagnosed as advanced non-small cell lung cancer and developed pneumonitis post Sintilimab injection during COIVD-19 pandemic period. The chest CT indicated peripherally subpleural lattice opacities at the inferior right lung lobe and bilateral thoracic effusion. The swab samples were taken twice within 72 hours and real-time reverse-transcription polymerase-chain-reaction (RT-PCR) results were COVID-19 negative. The patient was thereafter treated with prednisolone and antibiotics for over 2 weeks. The suspicious lesion has almost absorbed according to CT imaging, consistent with prominently falling CRP level. The anti-PD-1 related pneumonitis mixed with bacterial infection was clinically diagnosed based on the laboratory and radiological evidences and good response to the prednisolone and antibiotics. Conclusion The anti-PD-1 related pneumonitis and COVID-19 pneumonia possess similar clinical presentations and CT imaging features. Therefore, differential diagnosis depends on the epidemiological and immunotherapy histories, RT-PCR tests. The response to glucocorticoid is still controversial but helpful for the diagnosis.

Difficulties of differential diagnosis of primary hyperaldostronism and arterial hypertension by the example of a clinical observation

2019 ◽  
Vol 17 (4) ◽  
pp. 179-181
Author(s):  
Z. A. Afanasieva ◽  
◽  
D.P. Nikulina ◽  
T. L. Sharapov ◽  
N. I. Bariev ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Arterial Hypertension ◽  
Clinical Observation

scholarly journals Prolonged SARS-CoV-2-RNA Detection from Nasopharyngeal Swabs in an Oncologic Patient: What Impact on Cancer Treatment?

2021 ◽  
Vol 28 (1) ◽  
pp. 847-852
Author(s):  
Anna Ferrari ◽  
Marco Trevenzoli ◽  
Lolita Sasset ◽  
Elisabetta Di Liso ◽  
Toni Tavian ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Clinical Symptoms ◽  
Palliative Radiotherapy ◽  
Rt Pcr ◽  
Cancer Treatments ◽  
Global Challenge ◽  
Viral Culture ◽  
Pcr Assays

The pandemic of SARS-CoV-2 is a serious global challenge affecting millions of people worldwide. Cancer patients are at risk for infection exposure and serious complications. A prompt diagnosis of SARS-CoV-2 infection is crucial for the timely adoption of isolation measures and the appropriate management of cancer treatments. In lung cancer patients the symptoms of infection 19 may resemble those exhibited by the underlying oncologic condition, possibly leading to diagnostic overlap and delays. Moreover, cancer patients might display a prolonged positivity of nasopharyngeal RT-PCR assays for SARS-CoV-2, causing long interruptions or delay of cancer treatments. However, the association between the positivity of RT-PCR assays and the patient’s infectivity remains uncertain. We describe the case of a patient with non-small cell lung cancer, and a severe ab extrinseco compression of the trachea, whose palliative radiotherapy was delayed because of the prolonged positivity of nasopharyngeal swabs for SARS-CoV-2. The patient did not show clinical symptoms suggestive of active infection, but the persistent positivity of RT-PCR assays imposed the continuation of isolation measures and the delay of radiotherapy for over two months. Finally, the negative result of SARS-CoV-2 viral culture allowed us to verify the absence of viral activity and to rule out the infectivity of the patient, who could finally continue her cancer treatment.

ELECTROENCEPHALOGRAPHIC FINDINGS IN BREATH HOLDING SPELLS

PEDIATRICS ◽  
1955 ◽  
Vol 15 (5) ◽  
pp. 595-599
Author(s):  
Niels L. Low ◽  
Erna L. Gibbs ◽  
Frederic A. Gibbs
Keyword(s):  
Differential Diagnosis ◽  
Clinical Diagnosis ◽  
Slow Wave ◽  
Clinical Observation ◽  
Seizure Activity ◽  
Breath Holding ◽  
Convulsive Disorders

After reviewing the literature on breath holding spells, it seemed desirable to determine whether any electroencephalographic abnormality is revealed by recordings during sleep in such cases. One hundred twenty-nine children between the ages of 7 months and 11½ years with breath holding spells were examined electroencephalographically while awake and during sleep. Seventy-seven of these children were boys and 52 were girls. All these children but one had normal electroencephalograms. One tracing taken during a breath holding spell is reproduced which shows slow wave but no seizure activity. The clinical diagnosis is discussed and it is concluded that the electroencephalogram in combination with the history and clinical observation is of value in the differential diagnosis between breath holding spells and convulsive disorders.

scholarly journals Pulmonary aspergilloma: A rare differential diagnosis to lung cancer after positive FDG PET scan

2014 ◽  
Vol 12 ◽  
pp. 1-3
Author(s):  
Franziska Spycher ◽  
Gregor J. Kocher ◽  
Mathias Gugger ◽  
Thomas Geiser ◽  
Sebastian R. Ott
Keyword(s):  
Lung Cancer ◽  
Differential Diagnosis ◽  
Fdg Pet ◽  
Pet Scan ◽  
Rare Differential Diagnosis ◽  
Fdg Pet Scan ◽  
Pulmonary Aspergilloma

scholarly journals A Machine Learning Method for Identifying Lung Cancer Based on Routine Blood Indices: Qualitative Feasibility Study

10.2196/13476 ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. e13476 ◽  
Author(s):  
Jiangpeng Wu ◽  
Xiangyi Zan ◽  
Liping Gao ◽  
Jianhong Zhao ◽  
Jing Fan ◽  
...  
Keyword(s):  
Machine Learning ◽  
Lung Cancer ◽  
Cross Validation ◽  
Clinical Symptoms ◽  
Machine Learning Method ◽  
Learning Method ◽  
Liquid Biopsies ◽  
Blood Indices ◽  
Routine Blood ◽  
Identification Model

Background Liquid biopsies based on blood samples have been widely accepted as a diagnostic and monitoring tool for cancers, but extremely high sensitivity is frequently needed due to the very low levels of the specially selected DNA, RNA, or protein biomarkers that are released into blood. However, routine blood indices tests are frequently ordered by physicians, as they are easy to perform and are cost effective. In addition, machine learning is broadly accepted for its ability to decipher complicated connections between multiple sets of test data and diseases. Objective The aim of this study is to discover the potential association between lung cancer and routine blood indices and thereby help clinicians and patients to identify lung cancer based on these routine tests. Methods The machine learning method known as Random Forest was adopted to build an identification model between routine blood indices and lung cancer that would determine if they were potentially linked. Ten-fold cross-validation and further tests were utilized to evaluate the reliability of the identification model. Results In total, 277 patients with 49 types of routine blood indices were included in this study, including 183 patients with lung cancer and 94 patients without lung cancer. Throughout the course of the study, there was correlation found between the combination of 19 types of routine blood indices and lung cancer. Lung cancer patients could be identified from other patients, especially those with tuberculosis (which usually has similar clinical symptoms to lung cancer), with a sensitivity, specificity and total accuracy of 96.3%, 94.97% and 95.7% for the cross-validation results, respectively. This identification method is called the routine blood indices model for lung cancer, and it promises to be of help as a tool for both clinicians and patients for the identification of lung cancer based on routine blood indices. Conclusions Lung cancer can be identified based on the combination of 19 types of routine blood indices, which implies that artificial intelligence can find the connections between a disease and the fundamental indices of blood, which could reduce the necessity of costly, elaborate blood test techniques for this purpose. It may also be possible that the combination of multiple indices obtained from routine blood tests may be connected to other diseases as well.

scholarly journals Coprostasia and pregnancy (clinical observation)

2015 ◽  
Vol 64 (4) ◽  
pp. 57-61
Author(s):  
Evgeniy Sergeevich Mikhaylin ◽  
Lada Anatol’evna Ivanova ◽  
Aleksey Gennad’evich Savitskiy ◽  
Anna Gennad’evna Minina ◽  
Larisa Pavlovna Zhibura ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Observation ◽  
Discharge Home

The article presents the case of the formation of a giant fecal stone in 34 weeks of pregnancy, which demanded the differential diagnosis of tumors originating from the pelvis. The patient was conducted multistage finger fragmentation of the fecal stone, alternating with the enema. The patient was discharge home with progressing pregnancy.

scholarly journals Rare incidence of non-secretory myeloma with talaromycosis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haiting Qin ◽  
Ye Qiu ◽  
Yanmei Huang ◽  
Mianluan Pan ◽  
Dong Lan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Marrow ◽  
Differential Diagnosis ◽  
Lymph Nodes ◽  
Clinical Symptoms ◽  
Subcutaneous Tissue ◽  
Community Acquired Pneumonia ◽  
Pathological Examination ◽  
Subcutaneous Nodules ◽  
Lung Lymph

Abstract Background Talaromyces marneffei (TM) primarily infects patients with co-morbidities that cause immunodeficiency, but non-secretory myeloma (NSMM) is rare. TSM and NSMM are associated with fever, osteolysis, and swollen lymph nodes, thereby making it difficult for clinicians to make differential diagnosis. In this case, we describe TM infection coexisting with NSMM. Case presentation We retrospectively reviewed the case of a male (without human immunodeficiency virus infection) with fever, thoracalgia, swollen lymph nodes, and subcutaneous nodules who presented to the First Affiliated Hospital of Guangxi Medical University in February 2014. Chest computed tomography revealed patchy infiltration and positron emission tomography/computed tomography showed increased metabolic activity in the lower-right lung, lymph nodes, left ninth rib, and right ilium. Pathological examination of the lung, lymph nodes, subcutaneous nodules, and bone marrow showed no malignancy, he was diagnosed with community-acquired pneumonia. His clinical symptoms did not improve after anti-bacterial, anti-Mycobacterium tuberculosis, and anti-non-M. tuberculosis treatment. Later, etiological culture and pathological examination of the subcutaneous nodule proved TM infection, and the patient was re-diagnosed with disseminated TSM, which involved the lungs, lymph nodes, skin, bone, and subcutaneous tissue. After antifungal treatment, the patient showed significant improvement, except for the pain in his bones. Imaging showed aggravated osteolysis, and bone marrow biopsy and immunohistochemistry indicated NSMM. Thus, we conclusively diagnosed the case as NSMM with TSM (involving the lungs, lymph nodes, skin, and subcutaneous tissue). His condition improved after chemotherapy, and he was symptom-free for 7 years. Conclusion TM infection is rare in individual with NSMM. Since they have clinical manifestation in common, easily causing misdiagnosis and missed diagnosis, multiple pathological examinations and tissue cultures are essential to provide a differential diagnosis.

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