Diagnostic Errors ; prevention & control ; Emergency Service, Hospital ; Humans ; Severe Acute Respiratory Syndrome ; diagnosis ; World Health Organization

OBJECTIVETo reduce misdiagnosis and explore etiology of laryngeal stridor in neonates.

METHODSSixteen neonates with laryngeal stridor were reviewed. All the patients were examined with CT scan for larynx and lungs and some were examined with laryngoscopy. Laboratory examination and chromosome analysis were also done in all or some patients.

RESULTSAll the 16 neonates were diagnosed before admission as congenital simple laryngeal stridor in other hospitals. Of the 16 neonates with laryngeal stridor, 5 (31%) had thyroglossal ductal cyst, 1 (6%) neonate with cri du chat (5p(-)) syndrome, 2 (13%) neonates with Pierre-Robin syndrome and the rest 8 (50%) were suspected of congenital simple laryngeal stridor.

CONCLUSIONNeonates with laryngeal stridor are easily misdiagnosed; neonatal thyroglossal duct cyst is one of common causes. The diagnosis for a congenital simple laryngeal stridor should be carefully made excluding the possibility of related diseases. The authors recommend that laryngoscopy and CT scan for larynx should be performed in the neonates with laryngeal stridor.

Diagnostic Errors ; prevention & control ; Humans ; Infant, Newborn ; Laryngeal Diseases ; congenital ; diagnosis ; Laryngoscopy ; Larynx ; diagnostic imaging ; Lung ; diagnostic imaging ; Respiratory Sounds ; etiology ; Tomography, X-Ray Computed

Thyroid ultrasonography (US) plays a key role in the diagnosis and management of thyroid-related diseases. The aim of this article was to illustrate various pitfalls that can occur in utilizing thyroid US and techniques to prevent them. In this article, we present cases demonstrating the common pitfalls associated with US equipment, performance, normal thyroid structures, misinterpretations, and surrounding structures. Knowledge of these areas is essential to avoid misdiagnosis or improper disease management.
Adult ; Artifacts ; Diagnostic Errors/*prevention & control ; Female ; Humans ; Male ; Middle Aged ; Thyroid Diseases/*ultrasonography ; Thyroid Gland/anatomy & histology/*ultrasonography ; Ultrasonography/instrumentation

Cone-beam CT (CBCT) of Elekta can be used to analyze the setup errors in intensity modulated radiotherapy. A total of 240 patients with head and neck cancer were chosen in the period from October, 2009 to October, 2010. Their CBCT images were obtained after initial setup, and registered to the planning CT images, and then the setup errors on translational directions (X, Y, Z) and on rotational directions (U, V, W) were obtained and analyzed. The results showed that the setup errors on translational directions in Y-axis and Z-axis were larger than in X-axis, and the setup errors on rotational directions in Y-axis was much more obvious than those on the other two directions, which should be taken care during the patient daily setup. It may be concluded that the CBCT system can improve the precision for radiotherapy.
Cone-Beam Computed Tomography ; methods ; Head and Neck Neoplasms ; diagnostic imaging ; radiotherapy ; Humans ; Radiotherapy Setup Errors ; prevention & control ; statistics & numerical data ; Radiotherapy, Intensity-Modulated

OBJECTIVEDiagnosing neonatal asphyxia solely according to Apgar score may lead to misdiagnosis. The aim of this study was to explore new and more accurate diagnostic criteria for neonatal asphyxia.

METHODSTotally 10 376 live born neonates in our hospital were consecutively enrolled into the study. The following five items related to birth asphyxia, i.e., antepartum high-risk factors, Apgar scores, umbilical artery blood pH, organ injury, differential diagnosis on the causes of low Apgar score cases were examined and registered. The relationship among the first 4 items were analyzed. By differential diagnosis, the sensitivity and specificity of each index on diagnosing asphyxia and their complementary value on each other were investigated.

RESULTSThe items correlated well with each other (P < 0.01 or < 0.05) but were not entirely parallel and consistent; they could complement but could not substitute for each other. The sensitivity of antepartum high-risk factors, low Apgar scores, umbilical artery blood pH < 7.00 and organ injury was 100%, 100%, 44.44% and 100%, while the specificity was 17.99%, 98.90%, 96.05% and 96.62%, respectively. Of the 230 low Apgar score cases in this series only 50.9% coincided with asphyxia. For the 230 cases, when low Apgar score was combined with umbilical artery blood pH < 7.00, the sensitivity and specificity were 41% and 99.1% and when low Apgar score was combined with umbilical artery blood pH < 7.20, the sensitivity and specificity were 100% and 29.20%, respectively. After organ injury was added, the specificity was increased to 65.49%. When differential diagnosis was further added to exclude the other causes of low Apgar score cases, the misdiagnosis rate was minimized.

CONCLUSIONUp to now, no single accurate index for diagnosing neonatal asphyxia is available. In order to increase diagnostic bases and reduce misdiagnosis, the criteria of sole Apgar score should be replaced by multi-index diagnostic criteria. Based on the present study, a set of integrated diagnostic criteria for neonatal asphyxia is proposed: (1) prenatal high-risk factors, (2) low Apgar scores (respiratory depression must present), (3) umbilical artery blood pH < 7.00, if only pH < 7.20, the items (2) (4) (5) must be present, (4) hypoxic-ischemic organ injury (at least one organ dysfunction), (5) the other causes of low Apgar scores should be excluded. The last 4 indexes should all be met and the first one serves as reference. If multi-organ (three or more organs) dysfunction and (or) hypoxic-ischemic encephalopathy are present, severe asphyxia can be diagnosed.

Apgar Score ; Asphyxia Neonatorum ; blood ; diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; prevention & control ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Multiple Organ Failure ; Risk Factors ; Sensitivity and Specificity

OBJECTIVETo retrospectively analysis the curative effect of wrist scaphoid bone fracture,and explore the causes and preventive methods of misdiagnosis.

METHODSFrom September 2007 to September 2010,16 patients with wrist scaphoid bone fractures were treated with plaster cast and cannulated screws fixation. There were 10 males and 6 females,ranging in age from 26 to 44 years with an average of 35 years. Among them, 12 cases manifested swelling pain of radial lateral wrist, tenderness at snuffbox area, wrist pain aggravated when stretching wrist joint, thumb or forefinger; 4 cases manifested no obviously symptoms and limited movement; 9 cases were early diagnosed; 5 cases were treated by plaster cast; 4 cases were treated with cannulated screws fixation; Among 7 cases with misdiagnosis, there were 4 cases without obvious symptoms and they were dealt with activating blood to dissipate swelling and pain process in preliminary stage. Four cases were treated with plaster cast and 3 cases with cannulated screws fixation.

RESULTSAll the patients were followed up from 3 months to 39 months (averaged 21 months). Among 16 patients, 9 cases were early diagnosis, 7 cases were misdiagnosis and the rate of misdiagnosis was 43.8%. Seven cases with screws fixation were no wound infection. There was 1 case with occurred chronic pain and declining wrist mobility in both plaster cast and screw group, and both of them were misdiagnosed. According to curative effect rating criteria,these 2 cases were classified into moderate, other 14 cases were excellent.

CONCLUSIONWrist scaphoid bone fracture are easy to misdiagnose, so early diagnosis and treatment is particularly important. The main causes of misdiagnosis are nonspecific symptoms at early stage, combination with other injuries, lack of knowledge and ignorance of the further examination. Therefore, detailed inquiries and particular examination, multi-dimensional radiography and CT scan or MRI scan are the main measures for prevention.

Adult ; Bone Screws ; Casts, Surgical ; Diagnostic Errors ; prevention & control ; Female ; Fractures, Bone ; diagnosis ; surgery ; Humans ; Male ; Retrospective Studies ; Scaphoid Bone ; injuries

OBJECTIVES: Recently kudoa septempuctata in olive flounders is suggested as a cause of food poisoning, however whether kudoa septempuctata can affect human gastrointestinal systems is controversial and its pathogenecity remains unclear. In view of the field epidemiology, food poisonings caused by kudoa septempuctata should be distinguished from those caused by Staphylococcus aureus and bacillus cereus. METHODS: The statistics of food poisoning investigations published by Korea Centers for Disease Control and Prevention in 2013-2015 were reviewed. The characteristics of kudoa septempuctata food poisoning reported by Korea Centers for Disease Control and Prevention were reviewed. Information regarding clinical symptoms or epidemiology was extracted. RESULTS: Total eleven kudoa septempuctata food poisoning cases were analyzed. Food poisonings caused by kudoa septempuctata, Staphylococcus aureus and bacillus cereus have clinical and epidemiological similarities. Forty five percent of food poisoning outbreaks occurred in Korea was concluded as unknown. The food poisoning caused by Staphylococcus aureus and bacillus cereus accounted for 4.5% (50/1,092) of all food poisoning outbreaks in Korea between 2013 and 2015. CONCLUSIONS: This study suggests the possibilities of misdiagnosis in the investigations of food poisoning by Staphylococcus aureus and bacillus cereus with kudoa septempuctata.
Bacillus cereus ; Centers for Disease Control and Prevention (U.S.) ; Diagnosis, Differential* ; Diagnostic Errors ; Disease Outbreaks ; Epidemiology ; Flounder ; Food Parasitology ; Foodborne Diseases ; Humans ; Korea ; Myxozoa ; Olea ; Staphylococcus aureus

OBJECTIVES: Recently kudoa septempuctata in olive flounders is suggested as a cause of food poisoning, however whether kudoa septempuctata can affect human gastrointestinal systems is controversial and its pathogenecity remains unclear. In view of the field epidemiology, food poisonings caused by kudoa septempuctata should be distinguished from those caused by Staphylococcus aureus and bacillus cereus.METHODS: The statistics of food poisoning investigations published by Korea Centers for Disease Control and Prevention in 2013-2015 were reviewed. The characteristics of kudoa septempuctata food poisoning reported by Korea Centers for Disease Control and Prevention were reviewed. Information regarding clinical symptoms or epidemiology was extracted.RESULTS: Total eleven kudoa septempuctata food poisoning cases were analyzed. Food poisonings caused by kudoa septempuctata, Staphylococcus aureus and bacillus cereus have clinical and epidemiological similarities. Forty five percent of food poisoning outbreaks occurred in Korea was concluded as unknown. The food poisoning caused by Staphylococcus aureus and bacillus cereus accounted for 4.5% (50/1,092) of all food poisoning outbreaks in Korea between 2013 and 2015.CONCLUSIONS: This study suggests the possibilities of misdiagnosis in the investigations of food poisoning by Staphylococcus aureus and bacillus cereus with kudoa septempuctata.
Bacillus cereus ; Centers for Disease Control and Prevention (U.S.) ; Diagnosis, Differential ; Diagnostic Errors ; Disease Outbreaks ; Epidemiology ; Flounder ; Food Parasitology ; Foodborne Diseases ; Humans ; Korea ; Myxozoa ; Olea ; Staphylococcus aureus

No abstract available.
Bronchi/microbiology/pathology ; Coronavirus Infections/*microbiology/*pathology ; Delayed Diagnosis/*prevention & control ; Diagnosis, Differential ; Diagnostic Errors/*prevention & control ; False Positive Reactions ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Specimen Handling/methods ; Sputum/*cytology/*microbiology

INTRODUCTIONThe aim of this study was to investigate the role of ultrasound biomicroscopy (UBM) in imaging anterior segment foreign bodies and compare it with conventional B-scan ultrasound and computed tomography (CT).

MATERIALS AND METHODSThe charts of 18 eyes with anterior segment foreign bodies were reviewed. The rates of detection of foreign bodies using ultrasound, CT scan and UBM were compared.

RESULTSThe foreign body detection rates were 36.5% by ultrasound, 88.9% by CT scan, and 94.4% by UBM. The diagnosis of presence of a foreign body using UBM was made based on high reflective echoes causing shadowing or reverberations. In 7 eyes, UBM detected injury to the zonules, guiding the operative procedure. In the 8 eyes for which all tests were performed, rates of detection of foreign bodies were 25% (2/8) with ultrasound, 87.5% (7/8) with CT, and 100% (8/8) with UBM.

CONCLUSIONUBM is a valuable adjunct for the accurate localisation of small foreign bodies, including cilia. It offers a higher detection rate than that provided by ultrasound and CT scan.

Adolescent ; Adult ; Anterior Eye Segment ; ultrastructure ; Diagnostic Errors ; prevention & control ; Eye Foreign Bodies ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Microscopy, Acoustic ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome ; Ultrasonography ; methods ; Wounds, Penetrating ; complications