Tag Archives: Diagnosis

Medicine: ‘Diabetes’ – Risks & Diagnosis (BMJ Podcast)

In this episode of the JIM Podcast, Editor-in-Chief Richard McCallum speaks with David Cistola of Texas Tech University Health Sciences Center El Paso about American Diabetes Month.

Medical: Diagnosis And Treatment Of “Parkinson’s Disease” (JAMA Podcast)

JAMA Clinical Reviews LogoMore than 6 million people worldwide have Parkinson disease. Even though it is classically associated with tremors, the disease has many manifestations and is very treatable for most patients.

Michael S. Okun, MD, from the Department of Neurology at the University of Florida, Gainesville, discusses the pathophysiology, clinical presentation, diagnosis, and treatment of Parkinson disease.

Health: Diagnosing “Essential Tremor” Movement Disorder

From a NextAvenue.org online article (01/07/20):

Essential Tremor InfographicEssential tremor is a common movement disorder — more common than tremors that come with Parkinson’s disease — and the most common neurologic condition affecting people 65 and older. It is estimated that 10 million Americans live with essential tremor, according to the International Essential Tremor Foundation.

About half of people with essential tremor inherited the condition. But the severity and affected body parts can differ from generation to generation, and researchers still haven’t pinned down the gene or genes responsible.

Tremors typically happen when people try to use their hands for a task. Activities such as shaving can be difficult’ people often need to use safety razors or electric razors to avoid cutting or nicking themselves. Also, difficulty holding a utensil makes eating a challenge for many people with essential tremor.

To read more

Medical Perspectives: “Stroke – The Doctor As Patient” (The Lancet)

From a The Lancet online article:

The Lancet NeurologyAs a consultant, I had profoundly failed to appreciate the experience of fatigue and apathy among patients. More than excessive tiredness, the fatigue was overwhelming, turning simple activities into insurmountable, exhausting challenges. It was frustrating and I fell into the trap of overexertion when I did have energy, thus exhausting myself and sabotaging the day’s recovery plan. Had staff not been so adept at encouraging me when I lacked energy and holding me back when I tried to overdo things, I would have squandered much valuable rehabilitation time. 

I was a consultant in neurological rehabilitation for acquired brain injury when, at the age of 62 years, I had a stroke. Running for a train, I experienced pain in the right side of my head and mild weakness and sensory loss in my left limbs. I thought I’d had a stroke, but I was remarkably calm. It was late and my instinct was to get home, where I went to the study. In the morning, I found myself on the floor, half-blind, half-paralysed, and terrified.
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Scans showed a large intracerebral haemorrhage in the area of the right basal ganglia. My symptoms could be explained by the damage to my brain—my medical world was in order, something to hold on to. I discussed my diagnosis and treatment with my colleagues during brief waking periods, grateful that they still saw the person I was before my stroke. Meanwhile, my wife was in the good hands of staff who treated her with sensitivity, giving her plain facts and support.

Health: “Feather Duvet Lung” Left Undiagnosed Risks Irreversible Lung Fibrosis (BMJ Case Reports)

From a British Medical Journal (BMJ) online release:

Feather Duvet LungAlthough he had no pet birds, on closer questioning he had recently acquired a duvet and pillows containing feathers. His symptoms, chest radiograph and lung function tests improved after removal of all feather bedding, and he was also started on oral corticosteroid therapy. Our case reinforces the importance of taking a meticulous exposure history and asking about domestic bedding in patients with unexplained breathlessness. Prompt recognition and cessation of antigen exposure may prevent the development of irreversible lung fibrosis.

A 43-year-old non-smoker was referred with a 3-month history of malaise, fatigue and breathlessness. Blood avian precipitins were strongly positive. Lung function testing confirmed a restrictive pattern with impaired gas transfer. A ‘ground glass’ mosaic pattern was seen on CT imaging, suggestive of hypersensitivity pneumonitis.

Feather duvet lung (FDL), is an immunologically mediated form of hypersensitivity pneumonitis (HP), also sometimes called extrinsic allergic alveolitis. FDL is caused by inhalation of organic dust from duck or goose feathers found in duvets and pillows. Antigen inhalation triggers an immunological cascade, resulting in lung parenchymal inflammation. Repeated exposure may result in irreversible lung fibrosis.

To read more: https://casereports.bmj.com/content/12/11/e231237