Diagnosis, correct

Most treatment-resistant depressed patients have received inadequate therapy. Issues to be considered in patients who have not responded to treatment include the following (1) Is the diagnosis correct (2) Does the patient have a psychotic depression (3) Has the patient received an adequate dose and duration of treatment (4) Do adverse effects preclude adequate dosing (5) Has the patient been compliant with the prescribed regimen (6) Was treatment outcome measured adequately (7) Is there a coexisting or preexisting medical or psychiatric disorder (8) Was a stepwise approach to treatment used (9) Are there other factors that interfere with treatment ... 

Is the diagnosis correct (e.g., both incorrect diagnosis or subtype, such as atypical depression) ... 

Think about the necessity for drugs. Is the diagnosis correct and complete Is the drug really necessary Is there a better alternative ... 

Equipment part Problem Diagnosis Corrective action... 

Diagnosis. Correct diagnosis and treatment depend on proper identification of... 

The medical model of disease, which has served the practice of medicine well, proposes that a cause of disease - no matter what the cause or the disease - initiates a deviant process - called pathogenesis - which culminates in manifestations of the disease. The manifestations are its taxonomy and from them one initiates another process leading to diagnosis. Correct treatment depends upon diagnosis. All error in, or an absence of, diagnosis leaves manifestations naked, pathogenesis is not reversed and cause continues to initiate the disease. 

Lapse The necessary action is determined by the diagnosis correctly, but the action is not recalled at all (omission), or recalled incorrectly (commission). 

Complete and correct diagnosis of failures will account for all observed evidence. In this case, although some questions remain unanswered, it is judged that galvanic corrosion exercised the predominant influence. 

Monitoring, fault diagnosis, and implementing corrective actions... 

For critical, high consequence systems, simulators are useful to practice diagnosis and correction of errors and abnormal conditions in emergency conditions (CCPS, 1994a). 

Once you have identified the root cause of the nonconformity you can propose corrective action to prevent its recurrence. Eliminating the cause of nonconformity and preventing the recurrence of nonconformity are essentially the same thing. The key to successful diagnosis of causes is to keep asking the question why When you encounter a don t know then continue the investigation to find an answer. 

Advocates of the global approach would argue that human activities are essentially goal-directed (the cognitive view expressed in Chapter 2), and that this cannot be captured by a simple decomposition of a task into its elements. They also state that if an intention is correct (on the basis of an appropriate diagnosis of a situation), then errors of omission in skill-based actions are imlikely, because feedback will constantly provide a comparison between the expected and actual results of the task. From this perspective, the focus would be on the reliability of the cognitive rather than the action elements of the task. 

Mistakes Errors arising from a correct intentions that lead to incorrect action sequences. Such errors may arise, for example, from lack of knowledge or inappropriate diagnosis. 

Diagnosis of defects by inspection of visible causes or more sophisticated means (tracer-dye inundation to find sources and routes of leaks, infrared photography, etc.) is a prerequisite for correct repair specification. Greater skill in detailing and specifying suitable materials and methods are required in the design of flat roofs and the same applies to repairs. Here, too, durability and effectiveness are, to some extent, cost related. 

Adverse reaction means a response to a medicinal product which is noxious and unintended and which occurs at doses normaily used in man for the prophyiaxis, diagnosis or therapy of disease or for the restoration, correction or modification of physioiogical function. 

This form of myositis stands apart from the classical PM/DM syndromes on account of its distinctive clinical and histopathological features. There is no clear difference in incidence between males and females and the disorder is typically one of middle or old age. In the majority of cases, progression is slow and skin involvement is not seen, so that the main question of differential diagnosis is its distinction from chronic PM. Unlike classic PM, weakness involves distal muscles as frequently as proximal muscles. CK levels are usually only moderately raised. A common finding which leads to the correct diagnosis of this condition is its nonresponsiveness to steroid treatment or other forms of immunosuppression. 

The latest consensus on the definition and management [1] of anaphylaxis agrees on the lack of imiversally accepted diagnostic criteria and reliable laboratory biomarkers to confirm the clinical impression. Sometimes it is not feasible to obtain the samples within the optimum time frame. Moreover, in spite of a correct collection of samples, histamine and/or tryptase are within normal levels. Hence, new markers should be explored and further research into the role of selected mediators is urgently needed. Recently however, studies from animal models have shown promising results. In this chapter we will seek to review our current knowledge on confirmed or putative markers for the in vitro diagnosis of anaphylaxis. 

The correct interpretation of measured process data is essential for the satisfactory execution of many computer-aided, intelligent decision support systems that modern processing plants require. In supervisory control, detection and diagnosis of faults, adaptive control, product quality control, and recovery from large operational deviations, determining the mapping from process trends to operational conditions is the pivotal task. Plant operators skilled in the extraction of real-time patterns of process data and the identification of distinguishing features in process trends, can form a mental model on the operational status and its anticipated evolution in time. 

Glucose < 50 or > 400 (This relative contraindication is intended to prevent treatment of patients with focal deficits due to hypo- or hyperglycemia. If the deficit persists after correction of the serum glucose, or if rapid diagnosis of vascular occlusion can be made, treatment may be given.)... 

O Determining a correct and accurate diagnosis is essential prior to any consideration of pharmacotherapy. When a patient complains of paroxysmal, stereotypical spells that may be seizures, it must be determined if the spells are really seizures. Numerous other disorders, including syncope, psychogenic nonepileptic events (i.e., pseudoseizures), anxiety attacks, cardiac arrhythmias, hypoglycemia, transient ischemic... 

In patients presenting with acute adrenal crisis who have not been diagnosed previously with adrenal insufficiency, immediate treatment with injectable hydrocortisone and intravenous saline and dextrose solutions should be initiated prior to confirmation of the diagnosis because of the life-threatening nature of this condition. Determine and correct the underlying cause of the acute adrenal crisis (e.g., infection). 

The goal of treatment for GH deficiency is to correct associated clinical symptoms.34,35 In children, prompt diagnosis and early initiation of treatment are important to maximize final adult height. In adults, efforts should be made to achieve normal physiologic GH levels in an attempt to reverse the metabolic... 

Currently, the choice of therapy is based on the size, site, and morphology of lesions, as well as patient preference, treatment costs, convenience, adverse effects, and patient experience. Assuming that the diagnosis is correct, switching to alternate therapy is appropriate if there has been no response observed after three treatment cycles. A comparison of adverse effects related to treatment options maybe found in Table 77-2. 

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