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Provisional Diagnosis (provisional + diagnosis)
Selected AbstractsPanic disorder and suicidal ideation in primary careDEPRESSION AND ANXIETY, Issue 1 2006Daniel J. Pilowsky M.D., M.P.H. Abstract The purpose of this study was to ascertain whether panic disorder (PD) and suicidal ideation are associated in an inner-city primary care clinic and whether this association remains significant after controlling for commonly co-occurring psychiatric disorders. We surveyed 2,043 patients attending a primary care clinic using the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire, a screening instrument that yields provisional diagnoses of selected psychiatric disorders. We estimated the prevalence of current suicidal ideation and of common psychiatric disorders including panic disorder and major depression. A provisional diagnosis of current PD was received by 127 patients (6.2%). After adjusting for potential confounders (age, gender, major depressive disorder [MDD], generalized anxiety disorder, and substance use disorders), patients with PD were about twice as likely to present with current suicidal ideation, as compared to those without PD (adjusted odds ratio [AOR]=1.84; 95% confidence interval [CI]: 1.06,3.18; P=.03). After adjusting for PD and the above-mentioned potential confounders, patients with MDD had a sevenfold increase in the odds of suicidal ideation, as compared to those without MDD (AOR=7.00; 95% CI: 4.42,11.08; P<.0001). Primary care patients with PD are at high risk for suicidal ideation, and patients with PD and co-occurring MDD are at especially high risk. PD patients in primary care thus should be assessed routinely for suicidal ideation and depression. Depression and Anxiety 23:11,16, 2006. © 2005 Wiley-Liss, Inc. [source] Attitudes and practices of general practitioners in the diagnosis and management of attention-deficit/hyperactivity disorderJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2002KA Shaw Objective: To assess understanding of, and actual and potential roles in management of attention-deficit/hyperactivity disorder (ADHD) among GPs. Methods: A cross-sectional questionnaire survey of Queensland GPs selected randomly from the Royal Australian College of General Practitioners directory of members was carried out. Main outcome measures were knowledge levels of ADHD, current management practices, referral patterns and self-perceived information and training needs. Results: Three hundred and ninety-nine GPs returned a completed questionnaire (response rate 76%). Roles identified by GPs were: the provisional diagnosis of ADHD and referral to specialist services for confirmation of the diagnosis and initiation of management; assistance with monitoring progress once a management plan was in place; education of the child and their family regarding the disorder; and liaison with the school where necessary. Perceived barriers to increased involvement of GPs were: time and resource constraints of general practice; concerns regarding abuse and addiction liability of prescription stimulants; complex diagnostic issues associated with childhood behavioural problems; and lack of training and education regarding ADHD. Conclusions: General practitioners identify a role for themselves in ADHD care that is largely supportive in nature and involves close liaison with specialist services. [source] Alveolar capillary dysplasia with antenatal anomalies mimicking trisomy 21JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1 2001J. McGaughran Abstract: Alveolar capillary dysplasia (ACD) has been described in conjunction with a number of congenital abnormalities. The case reported here was noted in utero to have duodenal atresia and a partial atrioventricular canal defect and a provisional diagnosis of trisomy 21 was considered. A fetal blood sample showed a normal karyotype. The diagnosis of ACD was made at post-mortem following a neonatal death on the tenth day. This case further highlights the range of congenital abnormalities that may be present in cases of ACD that may mimic other conditions, including trisomy 21, on antenatal scan. However, the absence of congenital anomalies, even in the same family, would not exclude the diagnosis of ACD. [source] Diagnosis of ophthalmic tumoursACTA OPHTHALMOLOGICA, Issue 2009T KIVELÄ Purpose To summarise clinical methods used to diagnose ophthalmic tumours. Methods Personal experience of the author as a member of the European Ophthalmic Oncology Group. Results Conjunctival tumours are excised based on provisional clinical diagnosis or, if they are extensive, atypical or part of systemic disease such as lymphoma, first biopsied to obtain a histopathologic diagnosis. Useful methods to diagnose and stage conjunctival tumours are high frequency ultrasonography (US) or ultrasound biomicroscopy (UBM) to measure their thickness, in vivo confocal microscopy or impression cytology to chart their extent, and exfoliative cytology to get a provisional diagnosis. Ciliary body tumours are visualised by radical biomicroscopy, transillumination and indirect ophthalmoscopy with scleral indentation, supplemented with high frequency US or UBM. Binocular indirect ophthalmoscopy and US form the basis or diagnosing choroidal tumours. In addition to fluorescein and indocyanine green angiography in atypical cases, optical coherence tomography to detect subretinal fluid and autofluorescence to detect orange pigment are useful adjuncts in telling a small melanoma from a naevus. The mnemonic "To Find Small Ocular Melanomas" (from Thickness >2mm, subretinal Fluid, Symptoms, Orange pigment, Margin touching disc) is also useful in this respect. Clinical diagnosis of medium-sized to large melanomas is 99% accurate, whereas a fine needle or vitrectomy biopsy may be necessary to diagnose atypical tumours and is also used for cytogenetic analysis of uveal melanomas. Conclusion Conjunctival tumours are mostly diagnosed histopathologically, whereas diagnosis of uveal tumours is usually based on clinical examination. While clinical diagnosis is usually reliable, biopsy of uveal tumours is increasingly used for prognostic purposes. [source] | ||||||||||