Gibson, Lorna; Paul, Laura; Sudlow, Cathie LM. (2017). Potentially serious incidental findings on brain and body magnetic resonance imaging conducted among apparently healthy adults: a systematic review and meta-analysis, [dataset]. http://dx.doi.org/10.7488/ds/2100 ...
A major dilemma is whether to treat incidental brain findings and, if so, how. But the evidence is insufficient on what to do with most of them, partly because of the lack of controlled trials of their treatments and partly because the availability of MRI for only 20-30 years means that the long term prognosis is unknown. For example, the risk of haemorrhage from most unruptured aneurysms seems to be low15 yet the risk of death and stroke from interventional treatment is sizeable.16 However, awareness of the presence of an unruptured intracranial aneurysm might lead to better modification of risk factors and potential benefits from interventional treatment. A randomised controlled trial is under way to address this dilemma (www.teamstudy.org). Treatment of unruptured brain arteriovenous malformations is independently associated with poor outcome in the short term,17 which has also led to an ongoing randomised controlled trial (www.arubastudy.org). Although repeated scanning has become ...
April 2016. An incidental finding is one discovered in the course of research which is beyond the aims of the study for which there is a potential health importance for the research participant.. It is the policy of the Organization that a human subjects research application which includes imaging procedures for research purposes must include the following: 1)A statement regarding whether the research imaging procedures conducted as part of the research will be of clinical quality; and,. 2)If the imaging is of clinical quality, a plan for detecting and managing the reporting of incidental findings to research participants and/or their physicians in a timely manner. The following imaging procedures are generally deemed to be of clinical quality and capable of yielding clinically significant incidental findings:. ...
In a series of deliberations, the Presidential Commission for the Study of Bioethical Issues (the Bioethics Commission) today addressed how incidental findings should be handled in the context of research, the clinic, and direct-to-consumer testing. What are the responsibilities of clinicians and researchers in seeking out and reporting incidental findings to patients? What are the responsibilities of direct-to-consumer industries in delivering results that might be sensitive to the consumer? The Members and speakers emphasized the responsibility of clinicians and researchers, and spoke of potential voluntary measures that the direct-to-consumer testing industry might take to deliver findings in an ethical manner. Discussion highlights included:. "Once you take up the ethical question of what you should do with incidental findings of the traditional sort, you, as a thinking human being, have to ask the question: what should our general rule or general practice be, since there are these ...
Dental Update is the leading dental journal for CPD (Continuing Professional Development) and education. Dental Update gives verifiable CPD and PDP management
This observer performance study assessed lesion detection in the computed tomography attenuation correction image, as would be produced for myocardial perfusion imaging over a tube current (mA) range. A static anthropomorphic chest phantom containing simulated pulmonary lesions was scanned using the four available mA values (1, 1.5, 2 and 2.5) on a GE Infinia Hawkeye 4. All other computed tomography acquisition parameters remained constant throughout. Twenty-seven cases showing zero to four lesions were produced for a free-response receiver-operating characteristic method. Image observations were completed using our novel web-based ROCView software under controlled conditions. The Jackknife alternative free-response receiver-operating characteristic (JAFROC) figure of merit was used for significance testing, wherein a difference in lesion detection performance was considered significant at P values less than 0.05. Twenty readers with varying computed tomography experience (0-24 years) evaluated ...
As clinical volumes have increased again, we will be hosting Cases for Aces once per week: Every Tuesday at 11am PST / 2 pm EST ! Follo... ...
PubMed comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
The American College of Medical Genetics and Genomics has published recommendations about reporting incidental findings in the exons of certain genes. In brief, the ACMG recommends that if DNA mutations are found in certain genes they should be reported to individuals because of their potential high medical importance.[PMID 23788249 ...
The American College of Medical Genetics and Genomics has published recommendations about reporting incidental findings in the exons of certain genes. In brief, the ACMG recommends that if DNA mutations are found in certain genes they should be reported to individuals because of their potential high medical importance.[PMID 23788249 ...
The use of brain magnetic resonance imaging (MRI) for evaluation of neurological disorders has increased in the past two decades. This has led to an increased detection of incidental findings on brain MRI. The most common of these asymptomatic abnormalities are white matter lesions that are interpreted as demyelinating based on radiological criteria. However, in the absence of associated clinical symptoms suggestive of multiple sclerosis (MS), a definite diagnosis of MS cannot be made in patients with these incidental white matter lesions. These patients are now diagnosed as radiologically isolated syndrome (RIS). The natural history and clinical approach to patients with RIS are reviewed in this article.
this means that the test was performed in a laboratory with established procedures to ensure reproducibility. In keeping with CHOP clinical guidelines, IRB SOP 903: Reporting Test Results and Incidental Findings interprets this to mean performed in a CLIA-certified lab. However, the FDA reported on July 31, 2014 that they were issuing "a final guidance on the development, review and approval or clearance of companion diagnostics, which are tests used to identify patients who will benefit from or be harmed by treatment with a certain drug" and they were intending "to publish a proposed risk-based oversight framework for laboratory developed tests (LDTs), which are designed, manufactured and used within a single laboratory going to end its enforcement discretion related to lab-developed tests." This latter action could especially impact the use of genetic tests.. ...
Incidental findings arise when clinically relevant genetic information about a research participant or patient is identified outside the scope of the original research objective or diagnostic test being performed
Purpose: Generation of incidental findings (IFs) from whole genome and exome sequencing raise several questions about the return of IFs to donors in the research setting. One important aspect that is highly understudied is whether individuals from the general public value the return of IFs and what individual characteristics are associated with these values. Methods: We used a willingness to pay (WTP) survey-an economic tool-to evaluate the values individuals place on the information provided by a genetic counseling consultation providing IFs for cancer causing genes. An online survey was administered through ResearchMatch, a national registry, in June 2015. Along with demographics, attitudinal and health-related questions, survey respondents were asked WTP questions to reveal the values for IFs information specifically for cancer causing genes. Results: The average WTP of 94 respondents was $161 (95% CI: $132-202) for a one-time IF consultation for cancer causing genes. Income was significantly
Plan: Admitted to the general internal medicine team Urgent CTB: 6 x 4.5 x 4 cm space occupying lesion in the right parietal area. Followed by MRI brain on the same day.
A Triad of Complete Dorsal Pancreatic Agenesis, Pancake Kidney and Bicornuate Uterus. An Association or an Incidental Finding: First Case in Literature, Sa
In Singular Intimacies, which the New England Journal of Medicine said captured theessence of becoming and being a doctor, Danielle Ofri led us into the hectic, constantly challenging world of big-city medicine. In Incidental Findings, shes finished her training and is learning through practice to become a more rounded healer. The book opens with a dramatic tale of the tables being turned on Dr. Ofri: Shes had to shed the precious white coat and credentials she worked so hard to earn and enter her own hospital as a patient. She experiences the realslight prick and pressure of a long needle as well as the very real sense of invasion and panic that routinely visits her patients ...
Canada Research Chair in Neuroethics Professor of Neurology National Core for Neuroethics University of British Columbia Presidential Commission for the Study of Bioethical Issues February 2011. Frontiers in Incidental Findings. Judy Illes, Ph.D. Agenda. Background Current landscape...
Objective: Cranial computed tomography (CCT) scans are frequently obtained in the evaluation of patients with mild head trauma. These scans may detect unexpected incidental findings. Advances in neuroimaging and the increase in human population, has led to increased identification of patients with incidental intracranial findings on CCT. Since incidental lesions do not usually cause any pathology, treatment is not needed. However, in some cases, they provide an early diagnosis of the pathology that may occur in the future. In this study, it is aimed to create awareness for incidental brain findings detected on CCT after mild head trauma in emergency departments.. Material and Methods: We retrospectively reviewed incidental findings on routine brain computed tomography in patients with mild head trauma who admitted between June 2012 2018 in the emergency department. The age, sex, backgrounds and anatomic localization of the lesion were evaluated. Patients without any deficits were included in the ...
The case presented was particularly challenging as the endoscopic and imagiologic appearance mimicked that of a calcified subepithelial lesion with ulcerated top, such as GIST. Most common subepithelial lesions found in the duodenum are GIST, leyomiomas, lipomas and carcinoids and EUS plays a major role in the differential diagnosis. These lesions may occasionally show calcification, usually focal or punctate.1 However, massive calcification is extremely rare (it has been described in few cases of GIST)1 and may point to an alternative diagnosis such as an impacted gallstone into the duodenal wall, particularly if found in D2. There are only three published case reports of parapapillary fistula with impaction of a gallstone into the duodenal wall.2,3. Conflicts of interest. The authors have no conflicts of interest to declare.. Disclosures. All authors have approved the manuscript and agree with its submission to GE - Portuguese Journal of Gastroenterology. All authors have nothing to ...
You need to be signed in to access email alerts. If you have an account log in with your user name and password. If you dont have an account you can just enter your email address in the email box below ...
Poonam Rani, Parul Sobti, Amita Jain Gupta, Prerna Arora, Meeta Singh, Shyama Jain, Roopal Rathi, Asmita Muthal Rathore, Filarial worm residing in ovarian papillary serous adenocarcinoma-A rare case report, Diagnostic Cytopathology, 2016, 44, 11, ...
An accidental finding has led scientists to believe that anti-inflammatory pain relievers might be able to treat bacterial infections, though the science behind it has a long path forward.
TY - JOUR. T1 - Incidental vs symptomatic renal tumours. T2 - Survival outcomes. AU - Al-Marhoon, Mohammed S.. AU - Osman, Ahmed Mosbah. AU - Kamal, Mohammed M.. AU - Shokeir, Ahmed A.. PY - 2011/3. Y1 - 2011/3. N2 - Purpose: Currently there is an increase in the incidental diagnosis of renal cell carcinoma (RCC). Our aim was to assess the survival of patients with incidental and symptomatic renal tumours who had undergone nephrectomy. Patients and methods: We retrospectively assessed 604 patients who underwent renal surgery for RCC between 1983 and 2005. Patients were divided in two groups; group 1 had incidental and group 2 had symptomatic tumours. The median follow-up was 4 and 3.3 years for groups 1 and 2, respectively. All patients had surgery in the form of radical or partial nephrectomy. Sex, age, tumour size, type of surgery, pathological characteristics and patient survival in both groups were evaluated. The statistical analysis included the log-rank, Kaplan-Meier and Cox regression ...
OBJECTIVE To evaluate trends in urine aquaporin-1 (AQP1) and perilipin 2 (PLIN2) concentrations in sufferers with very clear cell and papillary renal cell carcinoma (RCC) this analysis determined the partnership between your urine concentration of the biomarkers and tumor size, stage and grade. mainly on tumor size (levels T1 and T2), however, not with stage … Read more OBJECTIVE To evaluate trends in urine aquaporin-1 (AQP1) and perilipin 2. Read More ...
We found a high prevalence of incidental brain and head and neck abnormalities (9.4% and 36.7%, respectively) in a population of healthy young adult volunteers (18-35 years of age) when scans were retrospectively read by an experienced head and neck radiologist or neuroradiologist; 4.4% of the brain findings and 5.5% of the head and neck findings were classified as in need of referral (clinically relevant), including 2 findings classified as urgent referral. Of the 19 findings categorized as in need of referral, only 1 (skull lesion consistent with fibrous dysplasia) was actually referred at the time of the study (5.2%).. Our finding of an incidence of 36.7% of MR imaging scans with any incidental finding is quite similar to that recently reported,14 in which an incidental finding of any kind was found in 42.9% of the brain examinations. However, our prevalence rate of potentially clinically relevant incidental brain abnormalities is higher than that reported previously in a similar age group of ...
Definition of incidental in the Legal Dictionary - by Free online English dictionary and encyclopedia. What is incidental? Meaning of incidental as a legal term. What does incidental mean in law?
Primary hyperparathyroidism (PHPT) is a common incidental finding on routine biochemical testing, affecting around 1% of the population. The majority of individuals will be asymptomatic at diagnosis, with no evidence of end organ damage, and unless individuals aged , 50 years at diagnosis, they are often considered to have mild PHPT, as they do not meet published criteria for parathyroidectomy (PTX). However, there is increasing evidence that mild PHPT is associated with adverse health outcomes. Longterm observational studies describing the natural history of mild PHPT suggest that even though biochemistry may be relatively stable in the majority, bone mineral density (BMD) does decline after approximately 10 years of observation, whereas significant improvements in BMD are seen following PTX. Recent large European record linkage studies of mild PHPT demonstrate significantly increased all-cause and cardiovascular mortality, similar to rates published for patients with PHPT who meet the ...
An indolent hematologic cancer that occurs with increasing age. Usually presents with absolute lymphocytosis as an incidental finding on routine CBC or with asymptomatic lymphadenopathy. Diagnosed by CBC with differential, blood smear showing smudge cells, and flow cytometry. Variable clinical co...
Young adult female. Irregular pigmented lesion on vulva. Incidental finding on routine cervical smear. Removed for cosmetic reasons.. ...
Sellar masses typically present in one or more ways:With neurologic symptoms, such as visual impairment or headacheAs an incidental finding on magnetic resonance imaging (MRI) performed for some other reasonWith hormonal abnormalitiesThis topic will
This story could be told by many. You undergo an imaging test for a particular medical reason and then, lo and behold, another condition is discovered. We have all heard the story about a brain tumor being incidentally found - thus saving someones life. But that is a rare event. The more common incidental findings are like mine.. I often talk about unnecessary care in presentations about the Choosing Wisely campaign, including cascade effects like incidentalomas, which a systematic review found were present in 22-38 percent of common MRI and CT studies.1 In my story, I feel a sense of mistrust because I didnt have the opportunity to have the kind of conversation espoused by the Choosing Wisely campaign.. For six months, I experienced intermittent ringing in my left ear. With some hesitation, I raised the issue with my primary care physician. He ordered an MRI without much discussion with me, presented no data on how frequently vascular problems are detected from a tinnitus condition. I ...
We had a great Ambulatory Report today with the help of our own Christian Ngo and Endocrinologist Dr. Abramowitz, teaching us how to workup/manage adrenal incidentalomas: Basics: All patients: cortisol (1mg dex suppression test: am cortisol |1.8 rules out and |5 rules in). 24 hour urine cortisol is only used in patients where suspicion for…
An 82-year-old man was admitted to hospital because of asthenia, anorexia, and cough with blood-tinged sputum for the preceding 2 weeks. He had smoked one pack of cigarettes per day for 40 years but had stopped 20 years earlier. Two years before presentation a coronary angiography and echocardiography were performed for evaluation of chest pain, which revealed normal coronary arteries and normal left ventricular function. He had a history of hypertension and permanent atrial fibrillation but had been otherwise well, and there was no history of heart failure. The complete blood count, and serum values of glucose, creatinine, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, sodium, potassium, calcium, and phosphorus were normal. A chest radiograph showed a mass in the left upper lung field. A CT scan of … ...
I then had all the blood-work done. Which came back normal! However the ultrasound results show a nodule on the upper rt. lobe of my thyroid. The size is 2.4cm. When I met with the surgeon I was told a biopsy would be the next step. {needle} During that same appt. the surgeon stated "That after more review of the radiology report {from the ultrasound} That it may be better to just watch & moniter the situation. Reason being that the report indicated the nodule to be more fluid filled, like a cyst. Also he stated that most of these "attempted" biopsys; prove to be fruitless. Due to "Not Enough" actual cell material to create the sample. My concern is leaveing it go & later on finding out its some type of cancer! Have any of You had a similar diagnoisis?? Or had afluid filled nodule as well?? Please share your experience with me. Im going "crazy" trying to pool any information off the web. All the Medical sites, although informative; they are also very overwhelming. All the medical verbage is ...
Every now and then though, you get something interesting, and thats the enjoyable part about medicine sometimes. Youll get something that surprises even yourself. My last call, I was examining a chest pain rule out patient and I found an undiagnosed abdominal aortic aneurysm. It was hard to miss: it was large and in charge. And I informed the patient of the risk of rupture and such.. But what really shocked me is that shes known that it was there for months now, and in that time, shes seen doctors and no ones caught this before. I mean, its bouncing out of this patients abdomen and how can I have been the only person to catch it? Its certainly not causing the chest pain. The patients lucky that there was non-cardiac chest pain needing R/O MI so that we could find this AAA ...
The placenta succenturiata or, succenturiate placenta is a morphological abnormality of placenta having succenturiate lobe. Succenturiate lobe is one or, more small accessory placental lobe
The one thing that I learned about myself is that I place no value in praise. Ive won my fair share of awards and recognition. Today my senior told me that he really appreciated that our lists were so up to date, and on all the services hed been on, hed never had a list so well done. Im sure he meant it in a complimentary way. I couldnt have cared less. Why should I be praised for doing what Im supposed to do? Thats ridiculous. If I did something outstanding, then sure, I would like some thanks. But please, for doing what Im supposed to do, I expect nothing. Ive always believed that when someone trusts you to do something, thats sacred. That means you do it, and you do it right ...
Archives of Disease in Childhood - Fetal and Neonatal Edition Jan 2017, 102 (1) F73-F78; DOI: 10.1136/archdischild-2015-310333 ...
The clinical presentation may vary from an incidental detection on the chest radiograph to acute pneumonia as in this case or chronic fibrosis. Inflammatory markers and white cell count are raised in the cases described. The chest radiograph typically shows alveolar consolidation and ground-glass opacities.2 A CT scan of the thorax may demonstrate areas of alveolitis, consolidation and pneumatoceles.3 Bronchoscopy and bronchoalveolar lavage may be useful where the diagnosis is in doubt. Fat globules are found in the bronchoalveolar fluid and lipid-laden macrophages are noted on cytological examination. Pulmonary function testing may demonstrate bronchial hyperresponsiveness and a restrictive ventilatory defect.4. Case reports have described treatment with corticosteroids, although there are no experimental data supporting their role.5 Prophylactic antibiotics are also reported to be used in the treatment and may treat any co-existing bacterial infection. The prognosis is generally good, but one ...
All your favorite books and authors in one place!. Find and read more books youll love, and keep track of the books you want to read. Be part of the worlds largest community of book lovers on wewico.com. ...
Incidental adrenal masses seen on abdominal CT scans of low-risk patients are almost always benign and do not need any imaging follow-up, according to a large study of patients. This finding is significant because incidental adrenal lesions are seen in about 5 percent of CT examinations, study authors say.
In medicine, an incidentaloma is a tumor (-oma) found by coincidence (incidental) without clinical symptoms and suspicion. It is a common problem: up to 7% of all patients over 60 may harbor a benign growth, often of the adrenal gland, which is detected when diagnostic imaging is used for the analysis of unrelated symptoms. With the increase of "whole-body CT scanning" as part of health screening programs, the chance of finding incidentalomas is expected to increase.. ...
Yes, my own personal hell started in September 2013 after a very bad viral illness and then the twitching began-in full force and everywhere!! All new to me. I had just completed a full work up of anemia and weight loss (15 lbs over 6 weeks) with colonoscopy, gastroscopy and CT scan of the chest, abdomen and pelvis-talk about incidental findings, the radiologist reported thyroid nodules-all else was clear but this was news to me. To make a very long story short, I had an MRI-all fine apart from the usual age related changes in the lower spine, 2 EMGs (Dec 2013 and March 2014)-both fine and neurologist assured me that I DO NOT have ALS and a one year one in Dec 2014-also fine. I still twitch now and then but I am firmly convinced that if I have a terminal illness IT IS NOT ALS. The thyroid however turned out to be more than I bargained for. After 2 benign biopsies, I decided that the compression symptoms in the neck were driving me crazy so I had the right side of the thyroid removed in April ...
Neuroglial cysts of the CNS are maldevelopmental in nature. Neuroglial cysts are ependymal lined and probably arise from budding or displacement from the ventricular system. They are nowadays picked up as incidental findings, but patients can pr...
A pathological vessel dilation in the brain, termed cerebral aneurysm, bears a high risk of rupture, and is associated with a high mortality. In recent years, incidental findings of unruptured aneurysms have become more ...
Cured has to be a guarded term in dealing with any cancer.. "Old dog nodular hyperplasia" is not curable but there are no clinical signs or adverse clinical effects on liver function. It is usually an incidental finding.. Regenerative nodules remain undetected until late in the disease when they are usually not curable and the course of the disease is short, sometimes only weeks. Routine blood biochemical tests do not indicate whether fibrosis is likely to progress rapidly. However, there are special substances in the blood (acute phase proteins) that, in some types, can indicate whether a dog is more likely to survive for longer. Even so, survival is unlikely to be more than a year.. Localized cancers of liver cells and bile ducts in dogs and cats have been removed surgically and good quality life is possible for several months up to three years. Recurrence is not common. Malignant tumors spread late in the course of the disease when the primary tumor is large. Clinical effects are therefore ...
Congenital anomaly of the aortic arch is a rare and usually an incidental finding. Vascular rings constitute less than 1% of the congenital cardiovascular diseases and were first identified by Gross in 1945 [1]. Double aortic arch is the most frequent form of arch anomaly that requires surgery for tracheal or oesophageal compression [2]. Respiratory symptoms at birth or during infancy should raise the possibility of a vascular ring. The classic history in a patient with double aortic arch is noisy breathing in the first few weeks of life. Rarely, neonates may present with Acute life-threatening event (ALTE) characterized by episodes of acute apnea and cyanosis ...
The autopsy of a 88-year-old female patient revealed a lung tumour as an incidental finding. This lesion had been known about for 20 years and had apparently not changed for the last 3 years. The...
A 42-year-old woman with a large calcified cyst in the liver. This was an incidental finding. There is another similar calcified lesion anterior to the superior mesenteric artery and vein. This is hydatid disease ...