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

Although the development of the 2009 SpA classification criteria by Assessment of SpondyloArthritis international Society (ASAS) represents an important step towards a better definition of the early disease stage particularly in axial spondyloarthritis (axSpA), the specificity of the criteria has been criticized these days. As the commonest zoonotic infection worldwide, human brucellosis can mimic a large number of diseases, including SpA. This study was performed to determine the frequency of rheumatologic manifestations in patients with brucellosis and the chance of misdiagnosing them as having axSpA in central China. The results showed that clinical manifestations of axSpA could be observed in brucellosis. Over half of patients had back pain, and one fifth of the patients with back pain were less than 45 years old at onset and had the symptom for more than 3 months. Two young males were falsely classified as suffering from axSpA according to the ASAS criteria, and one with MRI proved sacroiliitis was once given Etanercept for treatment. Therefore, differential diagnosis including human brucellosis should always be kept in mind when applying the ASAS criteria, even in traditionally non-endemic areas.
Adult ; Aged ; Antirheumatic Agents ; therapeutic use ; Back Pain ; physiopathology ; Brucellosis ; diagnosis ; drug therapy ; physiopathology ; China ; Diagnosis, Differential ; Diagnostic Errors ; prevention & control ; statistics & numerical data ; Etanercept ; therapeutic use ; Female ; Humans ; Inappropriate Prescribing ; statistics & numerical data ; Male ; Middle Aged ; Practice Guidelines as Topic ; Rheumatologists ; ethics ; Sacroiliitis ; physiopathology ; Spondylarthritis ; diagnosis ; drug therapy ; physiopathology

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

Any medical diagnosis should take a multimodal approach, especially those involving tumour-like conditions, as entities that mimic neoplasms have overlapping features and may present detrimental outcomes if they are underdiagnosed. These case reports present diagnostic pitfalls resulting from overdependence on a single diagnostic parameter for three musculoskeletal neoplasm mimics: brown tumour (BT) that was mistaken for giant cell tumour (GCT), methicillin-resistant Staphylococcus aureus osteomyelitis mistaken for osteosarcoma and a pseudoaneurysm mistaken for a soft tissue sarcoma. Literature reviews revealed five reports of BT simulating GCT, four reports of osteomyelitis mimicking osteosarcoma and five reports of a pseudoaneurysm imitating a soft tissue sarcoma. Our findings highlight the therapeutic dilemmas that arise with musculoskeletal mimics, as well as the importance of thorough investigation to distinguish mimickers from true neoplasms.
Adult ; Aneurysm, False ; diagnosis ; Biopsy ; Bone Diseases ; diagnosis ; Bone Diseases, Metabolic ; diagnosis ; Bone Neoplasms ; diagnosis ; Cell Proliferation ; Diagnosis, Differential ; Diagnostic Errors ; prevention & control ; Female ; Giant Cell Tumors ; diagnosis ; Humans ; Hyperparathyroidism ; complications ; Leukocytosis ; diagnosis ; Male ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Neoplasms ; diagnosis ; microbiology ; Osteomyelitis ; diagnosis ; microbiology ; Osteosarcoma ; diagnosis ; Sarcoma ; diagnosis ; Soft Tissue Neoplasms ; diagnosis ; Tibia ; pathology

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

Some patients who have neck tumor but cannot tolerate the thermoplastic immobilization may be supported by simple cushions, and are marked on the neck skin during CT simulation. We therefore set 5 mm as the spinal cord-planning risk volume margin in the intensity-modulated radiotherapy plans in our Centre. Cone beam CT (CBCT) scans were acquired for three times, and matched with the simulation CT images in each radiotherapy. The mean and the standard deviation of the individual, the root mean-square and the standard deviation of the individual were calculated. The matched results of the third CBCT were used to calculate the spinal cord- planning risk volume margin. The results showed that the interfraction error was significantly reduced and the intrafraction error was stable by CBCT guiding. CBCT and 5 mm spinal cord-planning organ is feasible and safe without threatening volume margin to high dose radiotherapy for the patients with neck tumor and not able to tolerate thermoplastic immobilization.
Cone-Beam Computed Tomography ; Head and Neck Neoplasms ; diagnostic imaging ; radiotherapy ; Humans ; Patient Positioning ; methods ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy Setup Errors ; prevention & control ; Radiotherapy, Image-Guided ; methods ; Radiotherapy, Intensity-Modulated ; instrumentation ; methods

BACKGROUND: Preanalytical variability, including biological variability and patient preparation, is an important source of variability in laboratory testing. In this study, we assessed whether a regular light meal might bias the results of routine clinical chemistry testing. METHODS: We studied 17 healthy volunteers who consumed light meals containing a standardized amount of carbohydrates, proteins, and lipids. We collected blood for routine clinical chemistry tests before the meal and 1, 2, and 4 hr thereafter. RESULTS: One hour after the meal, triglycerides (TG), albumin (ALB), uric acid (UA), phosphatase (ALP), Ca, Fe, and Na levels significantly increased, whereas blood urea nitrogen (BUN) and P levels decreased. TG, ALB, Ca, Na, P, and total protein (TP) levels varied significantly. Two hours after the meal, TG, ALB, Ca, Fe, and Na levels remained significantly high, whereas BUN, P, UA, and total bilirubin (BT) levels decreased. Clinically significant variations were recorded for TG, ALB, ALT, Ca, Fe, Na, P, BT, and direct bilirubin (BD) levels. Four hours after the meal, TG, ALB, Ca, Fe, Na, lactate dehydrogenase (LDH), P, Mg, and K levels significantly increased, whereas UA and BT levels decreased. Clinically significant variations were observed for TG, ALB, ALT, Ca, Na, Mg, K, C-reactive protein (CRP), AST, UA, and BT levels. CONCLUSIONS: A significant variation in the clinical chemistry parameters after a regular meal shows that fasting time needs to be carefully considered when performing tests to prevent spurious results and reduce laboratory errors, especially in an emergency setting.
Adult ; Alkaline Phosphatase/blood ; *Blood Chemical Analysis ; Blood Urea Nitrogen ; C-Reactive Protein/analysis ; Diagnostic Errors/prevention & control ; Diet/*standards ; Fasting ; Female ; Humans ; Lipids/blood ; Male ; Metals/blood ; Serum Albumin/analysis ; Triglycerides/blood ; Uric Acid/blood

Radiology is an important adjunct to clinical practice, but for many clinicians, requesting X-rays was something that was learnt on the job. This article provides guidelines on when and how to request X-rays for acute conditions such as head and cervical spine trauma, suspected rib and extremity fractures, low back pain and acute abdominal pain. We also highlight what to write in the request form, in order to obtain maximum value from the examination and allow the radiologist to generate a useful, accurate report.
Ankle Injuries ; diagnostic imaging ; Cervical Vertebrae ; diagnostic imaging ; Emergency Service, Hospital ; standards ; Fractures, Bone ; diagnostic imaging ; Health Care Costs ; Hospitals ; Humans ; Medical Errors ; prevention & control ; Neck Pain ; diagnostic imaging ; Radiology ; methods ; organization & administration ; standards ; Spinal Injuries ; diagnostic imaging ; Tomography, X-Ray Computed ; X-Rays

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