جستجوی مقالات مرتبط با کلیدواژه "diagnostic delay" در نشریات گروه "پزشکی"
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Background & Objective
The aim of this study was to determine the endometriosis-associated symptoms and diagnostic delay through an online survey.
Materials & MethodsA cross-sectional study was conducted in Australia using an online web-based survey. All data were entered into and analyzed using the STATA software (version 14.1). A total of 903 respondents completed an online survey from September 2013 to October 2015.
ResultsOut of 903, 71.10% were Australians and 28.90% were Non-Australian, with a self-reported diagnosis of endometriosis confirmed by surgery. Out of the participants, 86.5% completed the online survey. Delay in diagnosis was 8.1±6.2 years. There was no difference in the age range (P = 0.35), mean age of onset of the first symptoms (P = 0.93), and delay in diagnosis (P = 0.11) between both groups. Most common endometriosis-related symptoms that all respondents had experienced in their lifetime were period pain (98.1%), fatigue (94%), bloating (90.7%), ovulation pain (88.7%), pelvic pain (87.3%), pain during and before/after sexual activity (82.7%), and heavy bleeding (82.2%). Treatments used by affected women included: pain killers (96%), hormonal medication (84.7%), surgical treatments (84.5%), and delayed fertility (37.1%).
ConclusionVast similarities in demographics and endometriosis-associated symptoms among the Australian and non-Australian women with endometriosis support the universality of the disease characteristics. Delay in diagnosis of endometriosis is a problem and the reasons for delayed diagnosis must be understood to try to shorten this delay. Besides pain, patients with endometriosis suffer from a variety of other symptoms; hence, any treatment must take into account the most prominent symptoms.
Keywords: Diagnosis, Diagnostic Delay, Endometriosis, Symptoms -
سابقه و هدفیکی از دلایلگسترش بیماری سل، تاخیر در تشخیصو درمان قطعیاین بیماری می باشد. هدف از این مطالعه ارزیابی مدت زمان تاخیر در تشخیص و درمان بیماران سل اسمیر مثبت در منطقه سیستان می باشد.مواد و روش هامطالعه حاضر به صورت مقطعی بوده که در آن 384 بیمار مسلول اسمیر مثبت در طی سال های 1395 و 1396 مورد بررسی قرار گرفتند. با مراجعه به معاونت بهداشتی زابل، اطلاعات موردنیازجمع آوری شد.یافته هادر این مطالعه میانه تاخیر در تشخیص و تاخیر در درمان بیماران مسلول ریوی اسمیر مثبت به ترتیب 31 روز و صفر روز برآورد شد. تاخیر در تشخیص در بیماران تحت درمان مجدد بیش تر از بیماران جدید بود (004/0= P). همچنین هرچه درجه مثبت بودن اسمیر خلط بیش تر بود، میزان تاخیر در تشخیص بیماران هم بیش تر بود (003/0= P). از بین سایر فاکتورهای مورد بررسی مانند سن (361/0= P)، جنس (70/0= P)، ملیت (29/0= P)، محل سکونت (90/0= P)، شغل (154/0= P) و درجه تحصیلات (298/0= P)، هیچ یک تاثیر معنی داری در تاخیر تشخیص نداشت. در خصوص عوامل مختلف در تاخیر در درمان بیماران مسلول، وضعیت شغل (015/0= P) تاثیر معنی داری داشت.استنتاجمطالعه ما نشان داد که در سال های گذشته بیش تر بیماران مسلول ریوی اسمیر مثبت دیرتر از یک ماه از شروع علایم تشخیص داده شده اند، اما درمان اکثر بیماران به موقع صورت گرفته بود. همچنین، نوع بیماری سل و درجه مثبت بودن خلط می تواند در تاخیر تشخیص نقش داشته باشد.کلید واژگان: تاخیر تشخیص, تاخیر درمان, سل, سیستانBackground and purposeDelay in diagnosis and treatment of tuberculosis (TB) patients with positive sputum is a main reason for spread of the disease. The present study aimed at investigating delayed diagnosis and treatment of patients with positive tuberculosis in Sistan, Iran.Materials and methodsThis cross sectional study was conducted among 384 patients with positive smear tuberculosis in 2016- 2017. The information was collected from the Health Department of Zabol University of Medical Sciences.ResultsThe mean days for diagnostic delay and treatment delay were 31 days and zero day, respectively. Treatment delay among patients with previous history of TB treatment was higher than that of new cases (P= 0.004). Higher degrees of smear positivity led to greater delay in diagnosis (P= 0.003). Other factors, including age (P= 0.361), gender (P= 0.70), nationality (P= 0.29), place of residence (P= 0.90), job (P= 0.154), and educational background (P= 0.298) had no significant effect on the delay in diagnosis. But, job status was found to have a significant effect on the delay in treatment of TB patients (P= 0.015).ConclusionIn this study, most of the patients with smear positive pulmonary TB were diagnosed more than one month after the onset of symptoms. But the treatment in most cases was on time. The type of TB and the degree of smear positivity could play a role in diagnostic delay.Keywords: diagnostic delay, treatment delay, tuberculosis, Sistan
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Chronic Granulomatous Disease (CGD) can be associated with several neurological complications. Abscess in the brain in patients diagnosed with CGD has been reported in several publications. Different pathogens have been linked with brain abscess development including fungal or bacterial infections. Other neurologic complications may include white matter disease and formation of a granulomatous lesion in the central nervous system. In addition to these common reports, observation of leptomeningeal, along with focal brain infiltration by pigmented, lipid-laden macrophages, fungal brain infection, Aspergillus abscess resembling a brain tumor, spinal cord infection by Aspergillus, and fungal granuloma of the brain have also been described. Physicians should be aware of Streptococcus- and Candida-induced meningitis in a selected group of CGD patients as well. Herein, we report a case of the attenuated ill-defined lesion in the right cerebellar hemisphere in a CGD patient without involvement of the sinuses or lungs.
Keywords: Gastrointestinal manifestation, Enteropathy phenotype, Common variable immunodefi-ciency, Diagnostic delay -
Enteropathy is one of the rare manifestations of common variable immunodeficiency (CVID) as a predominant antibody deficiency. Proper diagnosis of this phenotype in CVID cases is difficult and may result in inaccurate assessment or incorrect management.Further, this misdiagnosis is more probable when noninfectious diarrhea is the only manifestation of CVID. We present herein a case with such an abstruse condition who was misdiagnosed as a celiac disease leading to delayed diagnosis of her primary immunodeficiency disease. We also offer a review on enteropathy manifestation in CVID patients.
Keywords: Gastrointestinal manifestation, Enteropathy phenotype, Common variable immunodefi-ciency, Diagnostic delay -
IntroductionDespite recent advances in treatment of oral cancer, it still causes high rates of mortality and morbidity worldwide. Delays in diagnosis and treatment of these cancers greatly affect the prognosis. This study aimed to assess the treatment delay and its relation to diagnostic delay among oral cancer patients in Tehran, Iran.Materials And MethodsWe studied 100 patients with primary oral squamous cell carcinoma who were admitted to three teaching hospitals between 2004 and 2006. Treatment delay was defined as the time from diagnosis to the beginning of treatment. Diagnostic delay is considered as the time elapsed between the onset of symptoms and diagnosis.ResultsOf all the patients 53% were male with the mean age of 61.5 (SD 15.8 years; range 24-100 years) at diagnosis. The majority of tumors (61%) were at advanced stages when diagnosed (stages III or IV). The mean diagnostic delay was 7.2 months (SD 7.5) and the mean treatment delay was 33.16 days (SD 14.1). Patients who were diagnosed at earlier stages had longer treatment delays (p<0.05), and those who had longer diagnostic delay had shorter treatment delay (p<0.05).ConclusionsOur findings indicated a need for oral cancer prevention campaigns, focused on reducing the delays between the appearance of signs and symptoms, and final diagnosis and treatment to ensure better prognosis and higher quality of life for patients.Keywords: Diagnostic delay, Iran, Oral cancer, Treatment delay
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زمینه و هدفارتباط بین تاخیر در تشخیص آپاندیسیت حاد و خطر ایجاد پرفوراسیون آپاندیس هنوز به روشنی مشخص نیست. هدف این مطالعه بررسی بیماران آپاندکتومی شده از نظر تعیین فراوانی آپاندیسیت پرفوره در میان بیماران با تاخیر در تشخیص آپاندیسیت می باشد.مواد و روش هاپرونده 508 نفر از بیمارانی که در سال های 1391-1389 در بیمارستان شهید بهشتی کاشان تحت عمل آپاندکتومی قرار گرفتند، مورد بررسی قرار گرفت و سن، جنس، نوع آپاندیسیت و مدت زمانی که بیمار قبل از عمل آپاندکتومی علامت دار بوده است، ثبت شد. در نهایت داده های به دست آمده وارد نرم افزار 16SPSS شده و با آزمون آماری فیشر و کای اسکوار مورد تجزیه و تحلیل قرار گرفت.یافته هااز 508 بیمار مورد بررسی 128 بیمار (2/25%) آپاندیسیت پرفوره داشتند. میزان پرفوراسیون در گروه بدون تاخیر در تشخیص آپاندیسیت 9/28% و در گروه با تاخیر در تشخیص آپاندیسیت 1/14% بود که از نظر آماری این اختلاف معنادار بود (P valueکلید واژگان: آپاندیسیت حاد, آپاندیسیت پرفوره, آپاندکتومی, تاخیر در تشخیصIntroduction &ObjectiveThe relationship between the delay in the diagnosis of acute appendicitis and the risk of perforation is not clear yet. The aim of this study is the reviewing of appendectomy cases in order to determine the incidence of perforation due to the delay in the diagnosis.Materials and MethodsRecords of 508 patients who were operated on for acute appendicitis between years 2010-2012 in Shahid Beheshti hospital of Kashan were reviewed. Data gathered included age at the time of operation، gender، kind of appendicitis، duration of symptoms before diagnosis. Finally، the obtained data were entered into SPSS 16 software and were analyzed by using chi square، Fisher''s exact test.ResultsOut of 508 patients، 128 (25. 2%) had perforated appendicitis. The perforation rate in patients without diagnostic delay was 28. 9%، and in patients with diagnostic delay was 14. 1%. This difference was statistically significant)P-valueKeywords: Acute Appendicitis, Perforated Appendicitis, Appendectomy, Diagnostic Delay
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