RESUMO
In this episode of the AJR Podcast Series on Diagnostic Excellence and Error, Francis Deng, MD, introduces the concept of diagnostic excellence and its relevance to radiologists. Patient-centered definitions of diagnostic error and conceptualizations of the diagnostic process are discussed.
In this episode of the AJR Podcast Series on Diagnostic Excellence and Error, Francis Deng, MD, introduces the concept of diagnostic excellence and its relevance to radiologists. Patient-centered definitions of diagnostic error and conceptualizations of the diagnostic process are discussed.
Assuntos
Erros de Diagnóstico , Humanos , Erros de Diagnóstico/prevenção & controle , Radiologia/normas , Competência ClínicaRESUMO
To evaluate for differences in breast cancer screening among women with visual or hearing impairment, the 2019 National Health Interview Survey was analyzed for mammography use in the past 2 years among women age 50-74, adjusting for demographic characteristics, health care access, and comorbidities. Visual impairment was independently associated with decreased likelihood of recent mammography (odds ratio [OR], 0.71; 95% CI, 0.59-0.85; p < .001). Hearing impairment was not independently associated with mammography use (OR, 0.91; 95% CI, 0.75-1.11; p = .37).
Assuntos
Neoplasias da Mama , Mamografia , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Neoplasias da Mama/diagnóstico por imagem , Detecção Precoce de Câncer , Inquéritos e Questionários , Audição , Programas de Rastreamento/métodosAssuntos
Trombose do Corpo Cavernoso , Síndrome de Lemierre , Humanos , Síndrome de Lemierre/complicações , Síndrome de Lemierre/diagnóstico , Trombose do Corpo Cavernoso/etiologia , Trombose do Corpo Cavernoso/diagnóstico por imagem , Masculino , Imageamento por Ressonância Magnética , Fusobacterium necrophorum/isolamento & purificação , Feminino , Seio Cavernoso/patologia , Seio Cavernoso/diagnóstico por imagem , Adulto , Tomografia Computadorizada por Raios XRESUMO
Online supplemental material is available for this article.
Assuntos
Distinções e Prêmios , Publicações Periódicas como Assunto , Radiologia/educação , Políticas Editoriais , HumanosRESUMO
Background Disease severity on chest radiographs has been associated with higher risk of disease progression and adverse outcomes from coronavirus disease 2019 (COVID-19). Few studies have evaluated COVID-19-related racial and/or ethnic disparities in radiology. Purpose To evaluate whether non-White minority patients hospitalized with confirmed COVID-19 infection presented with increased severity on admission chest radiographs compared with White or non-Hispanic patients. Materials and Methods This single-institution retrospective cohort study was approved by the institutional review board. Patients hospitalized with confirmed COVID-19 infection between March 17, 2020, and April 10, 2020, were identified by using the electronic medical record (n = 326; mean age, 59 years ±17 [standard deviation]; male-to-female ratio: 188:138). The primary outcome was the severity of lung disease on admission chest radiographs, measured by using the modified Radiographic Assessment of Lung Edema (mRALE) score. The secondary outcome was a composite adverse clinical outcome of intubation, intensive care unit admission, or death. The primary exposure was the racial and/or ethnic category: White or non-Hispanic versus non-White (ie, Hispanic, Black, Asian, or other). Multivariable linear regression analyses were performed to evaluate the association between mRALE scores and race and/or ethnicity. Results Non-White patients had significantly higher mRALE scores (median score, 6.1; 95% confidence interval [CI]: 5.4, 6.7) compared with White or non-Hispanic patients (median score, 4.2; 95% CI: 3.6, 4.9) (unadjusted average difference, 1.8; 95% CI: 0.9, 2.8; P < .01). For both White (adjusted hazard ratio, 1.3; 95% CI: 1.2, 1.4; P < .001) and non-White (adjusted hazard ratio, 1.2; 95% CI: 1.1, 1.3; P < .001) patients, increasing mRALE scores were associated with a higher likelihood of experiencing composite adverse outcome with no evidence of interaction (P = .16). Multivariable linear regression analyses demonstrated that non-White patients presented with higher mRALE scores at admission chest radiography compared with White or non-Hispanic patients (adjusted average difference, 1.6; 95% CI: 0.5, 2.7; P < .01). Adjustment for hypothesized mediators revealed that the association between race and/or ethnicity and mRALE scores was mediated by limited English proficiency (P < .01). Conclusion Non-White patients hospitalized with coronavirus disease 2019 infection were more likely to have a higher severity of disease on admission chest radiographs than White or non-Hispanic patients, and increased severity was associated with worse outcomes for all patients. © RSNA, 2020 Online supplemental material is available for this article.
Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/epidemiologia , Etnicidade/estatística & dados numéricos , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Grupos Raciais/estatística & dados numéricos , Radiografia Torácica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , COVID-19 , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Radiografia , Estudos Retrospectivos , SARS-CoV-2 , Índice de Gravidade de Doença , Adulto JovemAssuntos
Neoplasias Encefálicas , Cisto Dermoide , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Humanos , Cisto Dermoide/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Tomografia Computadorizada por Raios X/métodos , Feminino , Masculino , Diagnóstico Diferencial , AdultoRESUMO
In this episode of the AJR Podcast Series on Diagnostic Excellence and Error, Francis Deng, MD, and David Newman-Toker, MD, PhD, discuss prevalence and harms of diagnostic error in medicine, the role and causes of error in diagnostic radiology, and disease-specific examples, including in patients with stroke presenting with dizziness.
RESUMO
Human pluripotent stem cells (hPSCs) have the potential to generate any human cell type, and one widely recognized goal is to make pancreatic ß cells. To this end, comparisons between differentiated cell types produced in vitro and their in vivo counterparts are essential to validate hPSC-derived cells. Genome-wide transcriptional analysis of sorted insulin-expressing (INS(+)) cells derived from three independent hPSC lines, human fetal pancreata, and adult human islets points to two major conclusions: (i) Different hPSC lines produce highly similar INS(+) cells and (ii) hPSC-derived INS(+) (hPSC-INS(+)) cells more closely resemble human fetal ß cells than adult ß cells. This study provides a direct comparison of transcriptional programs between pure hPSC-INS(+) cells and true ß cells and provides a catalog of genes whose manipulation may convert hPSC-INS(+) cells into functional ß cells.
Assuntos
Diferenciação Celular/fisiologia , Células Secretoras de Insulina/citologia , Pâncreas/citologia , Células-Tronco Pluripotentes/citologia , Adulto , Diferenciação Celular/genética , Feto/citologia , Feto/metabolismo , Citometria de Fluxo , Perfilação da Expressão Gênica , Humanos , Células Secretoras de Insulina/metabolismo , Análise em Microsséries , Células-Tronco Pluripotentes/metabolismoAssuntos
Líquido Cefalorraquidiano , Cistos/diagnóstico por imagem , Doenças Peritoneais/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Derivação Ventriculoperitoneal , Adulto , Cistos/cirurgia , Humanos , Masculino , Paracentese , Doenças Peritoneais/cirurgia , Complicações Pós-Operatórias/cirurgia , Tomografia Computadorizada por Raios XAssuntos
Infecções por Coronavirus/diagnóstico por imagem , Educação de Pós-Graduação em Medicina/métodos , Pneumonia Viral/diagnóstico por imagem , Radiologia/educação , Betacoronavirus , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Credenciamento/organização & administração , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Internato e Residência , Pandemias , SARS-CoV-2 , Gestão da Segurança/métodos , Estados UnidosRESUMO
Atypical infections of the brain and spine caused by parasites occur in immunocompetent and immunosuppressed hosts, related to exposure and more prevalently in endemic regions. In the United States, the most common parasitic infections that lead to central nervous system manifestations include cysticercosis, echinococcosis, and toxoplasmosis, with toxoplasmosis being the most common opportunistic infection affecting patients with advanced HIV/AIDS. Another rare but devastating transmittable disease is prion disease, which causes rapidly progressive spongiform encephalopathies. Familiarity and understanding of various infectious agents are a crucial aspect of diagnostic neuroradiology, and recognition of unique features can aid timely diagnosis and treatment.