Complications diagnostic

The head and neck area contains a multitude of small, complexly arranged anatomical structures intimate knowledge of normal spatial relationships and variations is necessary to plan and implement appropriate therapy. Lesions often lie near vital structures, complicating diagnostic and therapeutic procedures. Improved visualization during such procedures can therefore provide the physician with critical information, permitting innovative procedures and improved outcomes. 

Diagnostic studies should be performed to identify the source of infection, causative pathogen, and any complications (e.g., abscess, empyema, infected intravascular catheter, etc). 

More specific diagnostic tests may be warranted in patients not responding to empiric (prescription) therapy, those with complicated or alarm symptoms (e.g., weight loss or dysphagia), or those with long-standing symptoms who are at risk for Barrett s esophagus. 

Upper gastrointestinal endoscopy is the preferred diagnostic test for assessing the mucosa for esophagitis and Barrett s esophagus.1 It enables visualization and biopsy of the esophageal mucosa. Endoscopy should be considered upon initial presentation in any patient who presents with complicated symptoms and those at risk for Barrett s esophagus.1... 

Assess patient symptoms to determine if further diagnostic evaluation is necessary. Does the patient have any GERD-related complications such as difficulty swallowing, painful swallowing, or unexplained weight loss ... 

Review any available diagnostic data to determine the severity and status of the patient s SCD. When was the patient last hospitalized for SCD complications ... 

Describe the epidemiology, etiology, pathogenesis, clinical manifestations, diagnostic criteria, and complications associated with skin and soft tissue infections. 

The manifestations of and diagnostic criteria for erysipelas and cellulitis are presented in Table 70-2. Once diagnosed, cellulitis is grouped into uncomplicated or complicated presentations depending on patient characteristics and severity of... 

Review any additional diagnostic tests to determine if treatment may be needed to prevent/minimize complications (e.g., emboli, congestive heart failure). 

Bacteriuria, or bacteria in the urine, does not always represent infection. For this reason a number of quantitative diagnostic criteria have been created to identify the amount of bacteria in the urine that most likely represents true infection (hence the term significant bacteriuria ). These are shown in Table 76-1. Furthermore, UTIs are classified as lower tract or upper tract disease. Patients will present differently with upper versus lower tract disease, and upper tract disease is thought of as a much more severe infection, as patients are more likely to be admitted to the hospital with upper urinary tract disease than lower tract disease. An example of lower tract infection is cystitis. Cystitis refers to the syndrome associated with a UTI involving dysuria, frequency, urgency, and occasional suprapubic tenderness. An example of upper urinary tract disease is pyelonephritis. Pyelonephritis is an inflammation of the kidney usually due to infection. Frequently, patients with uncomplicated UTI are treated as outpatients, while those patients with complicated UTIs are treated as inpatients. 

Meteorite mineralogy (Table 6.2) is complicated and is diagnostic of the origin of the sample. Two subclasses of the stony meteorites are chosen of particular relevance to the study of the origins of life. 

Endoscopic retrograde cholangiopancreatography is the most sensitive and specific diagnostic test, but it is reserved for patients in whom the diagnosis cannot be established by imaging techniques because of the potential for complications. 

Clinical utility takes the concept a step further and shows that the patient s medical outcome is favorably influenced by knowledge of the diagnostic test. An example would be that the tight insulin control that is only possible with frequent home blood glucose monitoring has a positive impact on delay of complications of diabetes. FDA does not require that a demonstration of clinical utility be performed in support of submissions but does... 

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