Symptoms of Unknown Origin – The Prevalence of False Diagnosis of Disease

This study only raises the question, “How common is the error of assigning a false diagnosis of a disease?” The literature is surprisingly silent on the prevalence of false diagnoses. I can find only one dated study of the prevalence of false diagnoses in a population. In 1967, Berman and Stamm studied over 100 children in the Seattle school system that carried a diagnosis of heart disease. (2.) Rounding off the figures, only 20 percent were found to have heart disease on careful study. Eighty percent did not have heart disease. The most telling finding was the presence of severe psychological and physical disability in 75 percent of both groups. In other words, non-cardiac disease was generating more disability than true heart disease in these children. Every few years I have done a repeated literature search for similar population based studies of false diagnoses. I can find none.* The literature is silent on defining the prevalence of false diagnoses on a population basis. It is filled with many studies of false positives in testing or imaging studies but it appears silent on false diagnoses on a population basis. These questions remain unanswered: What percent of our health care system is consumed with treating non-existent disease? What amount of disability, harm, and costs comes from false diagnoses of disease? ____________________________________________________ Table 1. Forty-two “Diagnoses” Not Found among 78 Patients with Symptoms without Med...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: THCB Source Type: blogs

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This study establishes adjuvant-induced arthritis (AIA) mouse models and explores the anti-inflammatory efficacy of QAW in AIA mice. To enhance the targeting, responsiveness, and efficacy of QAW to inflammation, QAW (Q) is modified with a cell penetrating peptide (T), a matrix metalloproteases-2/9 (MMP-2/9) digestive peptide (M), and an inflammation targeting peptide-RGD (R). The designed RMTQ demonstrates enhanced delivery to cytoplasm, higher reduction of pro-inflammatory factors, and better efficacy than QAW. The anti-inflammatory efficacy of RMTQ is similar to that of DEX in this study whereas RMTQ treatment shows a hi...
Source: International Journal of Pharmaceutics - Category: Drugs & Pharmacology Source Type: research
Conclusions: In select patients, nonoperative treatment with wound care and antibiotics may be sufficient for preventing infection after GSW-related traumatic arthrotomies. Findings of randomized studies and treatment algorithms are needed to further evaluate this relatively common injury.Level of Evidence: IV. PMID: 31413691 [PubMed - in process]
Source: Iowa orthopaedic journal - Category: Orthopaedics Tags: Iowa Orthop J Source Type: research
Authors: Chang G, Buckley PS, Krieg JC Abstract Yablon originally described that late posttraumatic degenerative ankle arthritis was due to ongoing tibio-talar joint incongruity, and more importantly that anatomic reduction of the lateral malleolus was key to anatomic reduction of the ankle joint, as the talus "faithfully followed that of the lateral malleolus." Ankle fractures involving the lateral malleolus, left unreduced, can lead to malunion and posttraumatic degenerative arthritis. Treatment of this often includes a fibular osteotomy to restore length and rotation. We revisit Yablon's original princ...
Source: Iowa orthopaedic journal - Category: Orthopaedics Tags: Iowa Orthop J Source Type: research
This study assessed the effect of residual pain, age, sex, diabetes, hypertension, and depression on changes and status at one-year following arthroplasty with respect to shoulder function and overall physical and mental health status. Methods: A retrospective analysis of a prospective cohort of 140 patients tested preoperatively and one-year following shoulder arthroplasty was conducted at our tertiary hospital. Pearson's correlations and multiple regression analysis were performed to test the impact of predictors on shoulder pain and function assessed using the American Shoulder and Elbow Surgery (ASES) questionnaire...
Source: Iowa orthopaedic journal - Category: Orthopaedics Tags: Iowa Orthop J Source Type: research
Authors: Shah AS, Kalish LA, Bae DS, Peljovich AE, Cornwall R, Bauer AS, Waters PM, Treatment and Outcomes of Brachial Plexus Injuries (TOBI) Study Group Abstract Background: Microsurgical reconstruction is indicated for infants with brachial plexus birth palsy (BPBP) that demonstrate limited spontaneous neurological recovery. This investigation defines the demographic, perinatal, and physical examination characteristics leading to microsurgical reconstruction. Methods: Infants enrolled in a prospective multicenter investigation of BPBP were evaluated. Microsurgery was performed at the discretion of the treatin...
Source: Iowa orthopaedic journal - Category: Orthopaedics Tags: Iowa Orthop J Source Type: research
Authors: Safran MR, Bedi A, Byrd JWT, Guanche CA, Ilizaliturri V, Lynch TS, Martin HD, Matsuda DK, McCarthy JC, Philippon MJ, Sampson TG, Suarez-Ahedo C Abstract Hip arthroscopy is one of the most rapidly growing areas in orthopaedic surgery because of increased awareness of nonarthritic hip pathologies, advanced imaging modalities, and advanced techniques to reproducibly manage nonarthritic hip pathologies within a deep soft-tissue envelope and a constrained joint. In addition, more academic medical centers are providing residents with education on hip arthroscopy, and many hip preservation fellowships and courses...
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research
Authors: Burkhart SS Abstract In patients who have a massive rotator cuff tear without glenohumeral arthritis in whom surgery is indicated, surgeons should always attempt a complete repair. Interval slides and linked high-strength repair constructs can be used; however, despite advanced mobilization and repair techniques, some rotator cuff tears are not fully repairable. Promising early outcomes have been reported in select patients with a massive rotator cuff tear who undergo superior capsule reconstruction with the use of acellular dermal allograft. PMID: 31411430 [PubMed]
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research
Authors: Raikin SM, Parekh SG Abstract Symptomatic cavovarus foot deformity is frequently associated with neuromuscular conditions, such as Charcot-Marie-Tooth disease, which cause an imbalance between antagonistic muscle groups, thereby leading to the deformity. Avoiding complications in the treatment of patients with cavovarus foot deformity requires a detailed understanding of this imbalance between antagonistic muscle groups and the resulting three-dimensional deformity. Because of the poor outcomes reported in patients with cavovarus foot deformity who undergo nonsurgical treatment or fusion procedures, joint-...
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research
Authors: Levine B, Caccavallo P, Springer B, Meneghini RM Abstract In the current healthcare environment, the postoperative treatment of patients who undergo total knee arthroplasty (TKA) is critical to successful outcomes, patient satisfaction, and controlling costs. Preemptive analgesia and the avoidance of excessive narcotics may help improve the outcomes and satisfaction of patients who undergo TKA because it allows for a more rapid rehabilitation program and reduces overall pain. Various techniques can be used to minimize the postoperative pain routinely observed in these patients. In addition, appropriate pos...
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research
Authors: Jupiter JB, Nunez FA, Nunez F, Fernandez DL, Shin AY Abstract Although perilunate injuries represent only 5% of all carpal injuries, they compose a spectrum of devastating complex wrist injuries. Perilunate injuries result from high-energy trauma to the wrist and may be associated with multiple fractures, dislocations, and ligament injuries. Although the diagnosis of a perilunate injury is made via radiographic assessment, missed diagnosis occurs in 25% of patients with a perilunate injury. Immediate diagnosis of perilunate injuries is critical to optimize patient outcomes. Closed reduction of perilunate i...
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research
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