Delayed diagnosis

Spiewak, R. and Dutkiewicz, J., A farmer s occupational airborne contact dermatitis masqueraded by coexisting rosacea delayed diagnosis and legal acknowledgement, Ann. Agric. Environ. Med, 11, 329, 2004. 

The apphcation should consider the consequences of incorrect or delayed diagnosis of a patient s condition or symptoms due to self-medication with the product. 

The early symptoms of pancreatic cancer tend to be nonspecific, thus delaying diagnosis in 80-90% of patients. Pain is the single most common presenting symptom ... 

Presently, ABL is not a curable disease, but the associated morbidity and premature death are preventable. Thus, early diagnosis and treatment are essential to avoid secondary neurological and ophthalmic pathologies and to provide an opportunity of a normal life for affected individuals. Initiation of treatment, after delayed diagnosis and symptomatic development, can prevent further progression of symptoms. 

In elderly people, iron deficiency is usually a sign of bleeding, and it is wiser to track down and correct the cause of the blood loss (for example gastric malignancy) than to prescribe iron, which can merely mask the problem and delay diagnosis. 

This particular form of chronic tubulo-interstitial nephritis is characterized by an important cellular infiltration of the interstitium with macrophages, T-cells but also B-cells. Furthermore, after arrest of the drug, there is improvement of the renal function in some cases [26,93]. In those in which there is a delayed diagnosis of renal damage, recovery of renal function does not occur. Instead, several of those patients needed one or another form of renal replacement therapy. An important aspect of this type of toxic nephropathy is the documented persistence of the inflammation of the renal interstitium even several months after arrest of drug intake [28]. 

In the past, radiation accidents have frequently resulted in a delayed diagnosis. In a study of four radiation accidents due to lost sources (Mit Haifa, Egypt, May 2000,... 

Twenty-four-hour collections offer little advantage, delay diagnosis, and increase the risk of losses during the collection period. PBG and porphyrins are stable in urine in the dark at 4 °C for up to 48 hours and for at least a month at -20 Specimens for ALA estimation should be promptly refrigerated. Urine specimens can be stored at 4 C in the dark for at least 2 weeks without significant loss of ALA, and frozen specimens are stable for weeks. Whereas PBG is more stable around pH 8 to 9, ALA is more stable around pH 3 to 4, although more acidic environments notably reduce ALA stability. 

Hyperosmolar hyperglycaemia (HH) is generally the fulminant result of poorly treated type 2 diabetes or delayed diagnosis of previously unknown type 2 diabetes. HH is less frequent than DKA, but mortality is higher and remains close to 15% in many centres [1,20]. As implied hyperosmolality is the primary clinical problem and there will be hyperglycaemia of >35 0 mmol/L and an effective seram osmolality of >320 mOsm/kg (Table 1). HH most often occurs in frail patients in combination with other potentially fatal conditions. Strict differentiation between DKA and HH can be difficult, because some degree of ketosis may be present in HH and because, for example, lactic acidosis, respiratory and renal failure may also be present. In practise this dilemma is mainly ornamental, since diagnostic and therapeutic efforts follow the same principles. 

Poole GV (1990) Anatomic basis for delayed diagnosis of appendicitis. South Med J 83 771-773 Powell RW, Raffensperger JG (1982) Congenital colonic atresia. J Pediatr Surg 17 166-170... 

Parajes S, Chan AO, But WM, Rose IT, Taylor AE, Dhir V, Arlt W, Krone N (2012) Delayed diagnosis of adrenal insufficiency in a patient with severe penoscrotal hypospadias due to two novel P450 side-change cleavage enzyme (CYPllAl) mutations (p.R360W p.R405X). Eur J Endocrinol 167 881-885... 

The myth that only poor inner-city minority children can be lead poisoned has resulted in the delayed diagnosis of numerous cases of lead poisoning. 

Allen GS, Moore FA, Cox CS Jr et al (1998) Delayed diagnosis of blunt duodenal injury an avoidable complication. J Am Coll Surg 187 393-399... 

Marine operator identifies rising water in a ballast tank. Delayed diagnosis of location and rate of leakage. No cause identified, man-machine interface is adequate. Information overload due to low manning (only one CCR operator). A second operator to be available witbin short notice. 

D. Stoffelen, L. De Smet and P. L. Broos, Delayed diagnosis of high-pressure injection injuries to the finger. A case report and review of the literature, Acta Orthopaed. Belg., 1994, 60, 332-333. 

Adult salicylate poisoning carries a surprisingly high morbidity and mortality in some centres and this may be related in part to delayed diagnosis and to therapy. 

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