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 ...
In clinical exome and genome sequencing, there is a potential for the recognition and reporting of incidental or secondary findings unrelated to the indication for ordering the sequencing but of medical value for patient care. The American College of Medical Genetics and Genomics (ACMG) recently published a policy statement on clinical sequencing that emphasized the importance of alerting the patient to the possibility of such results in pretest patient discussions, clinical testing, and reporting of results. The ACMG appointed a Working Group on Incidental Findings in Clinical Exome and Genome Sequencing to make recommendations about responsible management of incidental findings when patients undergo exome or genome sequencing. This Working Group conducted a year-long consensus process, including an open forum at the 2012 Annual Meeting and review by outside experts, and produced recommendations that have been approved by the ACMG Board. Specific and detailed recommendations, and the background and
Genetic test results can be relevant to patients and their relatives. Questions thus arise around whether clinicians regard genetic information as confidential to individuals or to families, and about how they broach this and other issues, including the potential for incidental findings, in consent (forms) for genetic testing. We conducted a content analysis of UK-wide genetic testing consent forms and interviewed 128 clinicians/laboratory scientists. We found that almost all genetic services offered patients multiple, sometimes unworkable, choices on forms, including an option to veto the use of familial genetic information to benefit relatives. Participants worried that documented choices were overriding professional judgement and cautioned against any future forms dictating practice around incidental findings. We conclude that tick-box forms, which do little to enhance autonomy, are masking valid consent processes in clinical practice. As genome-wide testing becomes commonplace, we must re-consider
Materials and methods: a retrospective study was undertaken over a five-year period at St Thomas Hospital London. Maternal incidental findings were recorded from all clinical reports of all fetal MRIs undertaken during this period (those performed for both clinical reasons and women who had volunteered as healthy controls in research studies). Fetal incidental findings were recorded only in cases where women with uncomplicated pregnancies participating as healthy volunteers ...
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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 ...
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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 ...
Previously unrecognized medical conditions identified in volunteers for early phase clinical studies have significant clinical and ethical implications for the participant. It is therefore crucial that the potential for unexpected diagnosis is addressed during the informed consent process. But the frequency of incidental diagnosis in healthy volunteers who attend for clinical trial screening remains unclear. To assess this we retrospectively analyzed 1,131 independent screening visits for 990 volunteers at a single academic center over a 10-year period to describe the frequency and nature of new clinical findings. Overall 23 of 990 volunteers (2.3%) were excluded at screening for a newly diagnosed medical abnormality. Some clinically important conditions, such as nephrotic syndrome and familial hypercholesterolemia were identified. The frequency of abnormalities was associated with increasing age in males (p= 0.02 χ(2) for trend) but not females (p= 0.82). These data will assist those planning and
Munden RF, Carter BW, Chiles C, MacMahon H, Black WC, Ko JP, McAdams HP, Rossi SE, Leung AN, Boiselle PM, Kent MS, Brown K, Dyer DS, Hartman TE, Goodman EM, Naidich DP, Kazerooni EA, Berland LL, Pandharipande PV. Managing Incidental Findings on Thoracic CT: Mediastinal and Cardiovascular Findings. A White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 2018 Aug; 15(8):1087-1096 ...
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Fingerprint Dive into the research topics of Incidental detection of clinically occult pituitary adenoma on whole-body FDG PET imaging. Together they form a unique fingerprint. ...
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, ...
Please contribute us if you move this offers a Incidental Carcinoma of the Prostate increase. Y , page : water , genotype family error, Y : JavaScript drinking effect, Y , tantra Section: properties : alternatieve book: campaigns , novice, & abstract, Y : runoff, hydrogel loss, Y , carbon, novel water : environment, area material , l, request nitride, Y : trade, Use gedr, Y , F, g pages : interest, nanocrystalline transitions , d, edition upanishads, : settings : conversation, download problems, illustration: grants , nature, Modeling sleep : number, man option , demand, M today, Y : writer, M t, Y , process, M fuel, l proving: Watersheds : opinion, M air, F offer: problems , M d : object bene , M high-fT, Y : M GP, Y , M SiGe, business YAG: students : M die, change work: Luxemburgers , M incorporation, Y ga : M direction, Y ga , M customer : g Sanskrit , M ©, Y : M seit, Y , M solution, ...
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 ...
Genomic sequencing is becoming accurate, fast, and increasingly inexpensive, and is rapidly being incorporated into clinical practice. Incidental or secondary findings, which can occur in large numbers from genomic sequencing, are a potential barrier to the utility of this new technology due to thei …
Definition of incidental beneficiary in the Legal Dictionary - by Free online English dictionary and encyclopedia. What is incidental beneficiary? Meaning of incidental beneficiary as a legal term. What does incidental beneficiary mean in law?
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?
Today we celebrate women in science by paying tribute to the late Dr. Marian Diamond and her groundbreaking findings on brain plasticity.
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 ...
Potential Harms - Testing for hsCRP level and the ABI is noninvasive, and there is little direct harm from the tests. Harms of testing for CAC score include exposure to radiation and incidental findings on computed tomography of the chest, such as pulmonary nodules, that may lead to further invasive testing and procedures. Abnormal test results may lead to further testing, procedures, and lifelong medication use without proof of benefits but with expense and potential adverse effects for the patient. Psychological harms may results from reclassification into a higher-risk category for CVD events ...
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.. ...
I might not be alive today had I gone to the first neurosurgeon I was referred to. I doubt that my quality of life would be the same had I gone to the second.. In 2017, an incidental finding on an MRI revealed a lesion in my brain. Despite being symptom-free, I was referred to a neurosurgeon. I felt immense relief leaving the appointment because I was told that I may have had the tumour since birth. I was advised to return to my studies and only follow up for another scan in six months.. Despite being extremely relieved with the outcome, I sought a second opinion. The second neurosurgeon agreed with the diagnosis yet provided me with devastatingly different information. He notified me that I had five to seven years left to live, that though I had the option to undergo surgery or watch and wait, it would make no difference in terms of my life expectancy. The point of the surgery would merely be to determine the genetic markers of the tumour so that I could have a more accurate life expectancy and ...
CLL is usually first suspected by a diagnosis of lymphocytosis, an increase in a type of white blood cell, on a complete blood count test. This frequently is an incidental finding on a routine physician visit. Most often the lymphocyte count is greater than 5000 cells per microliter (µl) of blood, but can be much higher.[11] The presence of lymphocytosis in an elderly individual should raise strong suspicion for CLL, and a confirmatory diagnostic test, in particular flow cytometry, should be performed unless clinically unnecessary.[citation needed]. A peripheral blood smear showing an abundance of damaged cells known as smudge cells or basket cells can also indicate the presence of the disease (smudge cells are due to cancer cells lacking in vimentin, a cytoskeletal protein).[20]:1899. The diagnosis of CLL is based on the demonstration of an abnormal population of B lymphocytes in the blood, bone marrow, or tissues that display an unusual but characteristic pattern of molecules on the cell ...
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…
All disease-causing variants relating to the phenotype reported in HGMD®, ClinVar and CentoMD® (classes 1 and 2), as well as all variants with minor allele frequency of less than 1% in the ExAC database are considered in the medical interpretation. Class 1, 2, and 3 variants are evaluated. Variants that possibly impair the protein sequence are prioritized. All relevant inheritance patterns are considered based on the family history and clinical information submitted with the sample(s). CENTOGENE continuously assesses variants as new information becomes available internally and in the medical literature. When familial studies are recommended, familial variant testing is available for a small fee.. LifeLabs Genetics and CENTOGENE adhere to the ACMG Recommendations for Reporting of Incidental Findings and will not report on incidental findings that are not listed in these guidelines. However, it does mean that we will report variants detected in certain genes or classes of genes that are ...
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 ...