Clinical history

Mullins ME, Lev MH, SchelUngerhout D, Koroshetz WJ, Gonzalez RG. Influence of availability of clinical history on detection of early stroke using unenhanced CT and diffusion-weighted MR imaging. Am J Roentgenol 2002 179 223-228. 

A detailed clinical history, past medical and surgical history, medications, allergies, laboratory work-up, physical examination, and NIHSS should be obtained as quickly as possible for assessment of inclusion and exclusion criteria for lAT. Table 4.1 lists the criteria for catheter-based reperfusion therapy currently in place at the Massachusetts General Hospital (Table 4.1 see also www.acutestroke.com for updated criteria). 

The most useful tool in the diagnosis of GERD is the clinical history, including both the presenting symptoms and associated risk factors. Patients presenting with uncomplicated,... 

To determine the success of treatment, evaluate whether the treatment plan restored normal sleep patterns, reduced daytime sequelae, and improved quality of life without causing adverse effects. Schedule patients for follow-up within 3 weeks for insomnia and within 3 months for other sleep disorders. Perform a detailed clinical history to determine the patient s perception of treatment progress and symptoms along with medication effectiveness and side effects. 

Usually based on clinical history and presenting symptoms,... 

Body fluid specimens will be prepared and stained and the morphologic characteristic of the cells and the environment in which these cells are found will be examined by light microscopy. To achieve this, a representative cell sample must be obtained and adequate cell fixation is a prerequisite. Proper identification of the specimen and protection of the specimen s integrity are essential. Finally, pertinent patient clinical history is important for accurate specimen interpretation. 

Transmission in both cases was preceded by a clinical history of chronic prostatitis in the source patient. 

Further assessment of atopy in the pathogenesis of the acute byssinotic reaction necessitates purification of well characterized and standardized cotton dust antigens, and the development of an allergy specific test (HAST) to measure serum IgE antibodies to cotton dust allergens. Such developments would allow correlation of skin tests, clinical history, dust exposure, FEVj and serum IgE level with specific IgE to cotton dust allergens. 

The diagnosis of mania is made on the basis of clinical history plus a mental state examination. Key features of mania include elevated, expansive or irritable mood accompanied by hyperactivity, pressure of speech, flight of ideas, grandiosity, hyposomnia and distractibility. Such episodes may alternate with severe depression, hence the term "bipolar illness", which is clinically similar to that seen in patients with "unipolar depression". In such cases, the mood can range from sadness to profound melancholia with feelings of guilt, anxiety, apprehension and suicidal ideation accompanied by anhedonia (lack of interest in work, food, sex, etc.). 

Shreffler, W., Beyer, K., Chu, T., Burks, A., Sampson, H., Microarray immunoassay association of clinical history, in vitro IgG function, and heterogeneity of allergenic peanut epitopes, /. Allergy Clin. Immunol., 113(4), 776-782, 2004. 

The type of submission considered by DSEB to be appropriate for a PI update depends on the regulatory and clinical history of the drug in Australia and overseas, with special reference to the United Kingdom, United States, Sweden, Canada and the Netherlands. Submissions based on company sponsored clinical trials are usually required for drugs marketed for less than 5 years, whereas any of the three types of submission can be used for drugs marketed for more than 10 years. Drugs marketed between 5 and 10 years will be considered on a case by case basis, but it is generally expected that either a conventional or hybrid submission will be submitted. 

Phthalic anhydride is a direct but delayed irritant of the skin it is more severely irritating after contact with water, because of the pronounced effects of the phthalic acid that is formed. Prolonged or repeated exposure also may cause an allergic type of skin rash. Because phthalic anhydride is a known pulmonary and skin irritant, it is often difficult to differentiate between sensitization and irritation by clinical history. ... 

In another Spanish study, Crespo et al. (1995) evaluated 355 children on the basis of clinical history, skin prick tests (SPTs), and specific serum IgE to mollusks. Allergies to molluscan shellfish were noted in 10 of these children or 2.8%. However, mollusks caused 1.6% of 608 allergic reactions among this group of children. 

Clearly, some individuals with molluscan shellfish allergy are reactive to all species of molluscan shellfish. Cross-reactivity has been established by clinical history, challenge trials (in a few instances), skin prick testing, and IgE-binding studies. Most clinical studies of cross-reactivity have been limited to a few species often within one class of molluscan shellfish. However, the totality of the evidence indicates that individuals with documented reactivity to one molluscan species and evidence of IgE against that species should be counseled to avoid other molluscan shellfish species. This recommendation is especially prudent for the individual classes of molluscan shellfish gastropods, bivalves, and cephalopods. 

The effect of psychopharmacology on psychiatry has essentially been a return to the medical model where clinical history and examination lead to the formulation of a diagnosis. The diagnosis thus allows the development of prognosis, course of illness, and prediction of ultimate outcome. Most impor-... 

The selection of biochemical tests is based on the patients clinical history, the suggestions from the physician, and the experience of the laboratory. The clinical biochemical geneticist should be familiar with the clinical presentation of the different lysosomal storage disorders and their subtypes in order to be able to select the most appropriate tests and to interpret the test results. Therefore, it is strongly recommended that the diagnostic work-up of patients with sphingolipidoses be restricted to specialized laboratories with sufficient experience in diagnosing patients with these rare disorders. 

Despite its long clinical history after its discovery in 1893 (von Mering, 1893), the mechanism of action of paracetamol is not fully understood. It shows some weak inhibition of the COX isoenzymes and there is speculation on a third COX isoenzyme, COX-3, induced during the resolution phase of an inflammatory response, that might be specifically targeted by paracetamol (Willoughby et al., 2000). Furthermore, there is evidence for a possible central analgesic effect mediated indirectly by 5-HT (Courade et al., 2001). 

A 48-year-old woman developed palpitation and insomnia (52). The clinical history, physical examination, and laboratory tests supported hyperthyroidism. Since July 1994 she had been combating constipation by improper use of an iodine-containing antiseptic cream for external use only. She had inserted povidone-iodine into her rectum by means of a cannula. 

Sleepiness is a primary symptom of narcolepsy, often preceding the onset of the other well-known symptoms of the disease, namely cataplexy, sleep paralysis, and hypnagogic hallucinations (44). Evaluation of the MSLT of narcoleptic patients has demonstrated a short sleep latency (<5 min) and multiple sleep-onset REM periods (SOREMPs). The more specific finding in the MSLT of narcoleptic patients is more than 2 SOREMPs, shown to reach a specificity of 99% by Amira et al. (45), which further increased to 99.2% if 3 SOREMPs were recorded (46). On the other hand, more than one SOREMP can occur in nonnarcoleptic patients, such as those with sleep apnea, sleep deprivation, depression, periodic limb movements, circadian rhythm disruption, or withdrawal from REM-suppressing medications (5,47). Thus, the findings of the MSLT, which is always performed for suspected narcoleptic patients, must be interpreted in view of the clinical history and nocturnal PSG. 

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