Accuracy Of Provisional Diagnosis Research Articles

Paediatric head and neck malignant neoplasms: A brazilian retrospective study.

To assess the prevalence of oral and maxillofacial malignant neoplasias in children and adolescents diagnosed through biopsies sent to the Oral Pathology Laboratory at the University of Sao Paulo School of Dentistry. A retrospective analysis of anatomopathological reports on patients between 1 and 18 years old issued by the oral and maxillofacial pathology laboratory between 1997 and 2021 was performed for demographic data, lesion site, type of biopsy, diagnostic hypothesis and final diagnosis. The laboratory issued 76,194 anatomopathological reports during this period, of which 10.77% were of children and adolescents. Of this total, only 32 biopsies (32/8.204; 0.39%) were neoplasias in children and adolescents. Sarcomas were the most prevalent malignant neoplasms (19/32; 59%), followed by carcinomas (7/32; 22%), lymphomas (5/32; 16%) and ganglioneuroblastomas (1/32; 3%). Of these 32 patients, the most affected individuals were aged between 4 and 11 years old (47%), 18 (56%) were male, and the mandible was the main anatomical site involved (28%). In 41% of the cases (13/32), the diagnostic hypothesis of the biopsied lesion was mistakenly considered benign and there was no diagnostic hypothesis in 18% of the cases. Oral and maxillofacial malignant neoplasms in children and adolescents are uncommon and the accuracy of provisional diagnoses is low in these cases. Better knowledge on oral and maxillofacial malignant lesions in this population would help professionals to reduce the diagnostic time and consequently improve the patient's prognosis.

A retrospective analysis of referral patterns to a university oral medicine clinic

The aim of this study was to analyze referral patterns to a university-based oral medicine (OM) clinic and to identify access issues to OM care. A retrospective patient chart review on all OM specialists at the University of Alberta (Edmonton, Alberta, Canada) over a 1-year period was performed. Data collected included patient age and gender, referring clinician training and experience, reason and urgency of referral, provisional and final diagnosis, and the referral times. Proportions for data points were collected by using a 95% Wilson Score confidence interval. Two-sided Fisher's exact tests were performed for significant differences. In total, 924 patients were included. Dentists referred 81.4% of the cases, with the remaining cases referred by physicians. Patients traveled, on average, 55.44 km to the OM clinic, with a mean wait time of 105.5 days. White/red lesions were the most common referral reason (38%), with the tongue (21.8%) being the most common site of concern. There was no significant difference in the accuracy of provisional diagnoses between clinician types. Immune-mediated conditions were the most common final diagnosis. The referral patterns of dental and medical practitioners are similar, with mucosal lesions being the most common referral reason. In our study population, access to care was compromised by wait times and travel distances.

Effectiveness and Biocompability of Propylene Mesh in Animal Model of Nasal Septal Perforations on Rabbits

A FIVE-YEAR RETROSPECTIVE STUDY OF PROVISIONAL AND FINAL DIAGNOSIS IN BIOPSIED JAW LESIONS Elif Peker, Faruk O gutlu, Merve Cakir, Ozkan Buyuk, Elif Sibel Gultekin, Inci Rana Karaca, Department of Oral and Maxillofacial Surgery, Gazi University, Ankara, Turkey; Department of Oral Pathology, Gazi University, Ankara, Turkey Objective: The definitive diagnosis of jaw lesions is essential. However, their clinical and radiological appearance may mimic each other. The aim of the present study was to determine the accuracy of provisional diagnosis and to emphasize the importance of performing biopsy. Study Design: A retrospective analysis of 1473 lesions was made. Results: The study revealed that concordance between provisional and histopathological diagnoses of all lesions was 80.5%. Periapical granuloma, which provisionally diagnosed as radicular cyst, constitutes the overwhelming majority of the diagnostic disagreements. This data did not surprise us because of the same pathogenic process they have. Keratocystic odontogenic tumor, which diagnosed as dentigerous or radicular/residual cyst provisionally, was the other most common diagnostic disagreement. The another most common type was ameloblastoma that diagnosed provisionally as dentigerous cyst. Conclusions: The study emphasizes the diagnosis of jaw lesions should be based on clinical, radiographic, and histopathologic features.

Are Grampian General Practitioners Good Gatekeepers for Access to Emergency General Surgical Care?

Direct admission from primary care is the predominant emergency general surgical referral route in north-east Scotland. Recent primary and secondary care reconfiguration has increased resources necessary to support the current system, therefore alternative models are proposed. We seek to analyse frequency and accuracy of provisional diagnosis by general practitioners within our current admission system. Presence of referral letter, provisional diagnosis, discharge diagnosis and management were prospectively recorded for all emergency general surgical admissions to Aberdeen Royal Infirmary over three weeks. One hundred and sixty three primary care admissions: 69.3% from patient's own practice and 30.7% from the out-of-hours service. Of these patients 98.1% came with a referral letter, 86.1% including a provisional diagnosis, which was correct in 43.6% of cases. Fourteen patients (8.6%) were transferred to another ward for treatment. General practitioners provide written provisional diagnoses with most referrals, accurate in almost half of cases, with only a minority of patients requiring transfer for management of presenting problems. This is despite limited investigations, clinical isolation, restricted facilities for examination and limited time for assessment. We believe Grampian general practitioners are good gatekeepers to emergency general surgical care and support the current direct admission pathway.

Accuracy of provisional diagnoses of dyspepsia in patients undergoing first endoscopy

Accuracy of provisional diagnoses of dyspepsia in patients undergoing first endoscopy