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Case Report: The intersection of psychiatry and medicine: diagnostic and ethical insights from case studies.

The intersection of psychiatry and medicine presents unique diagnostic and ethical challenges, particularly for conditions involving significant brain-body interactions, such as psychosomatic, somatopsychic, and complex systemic disorders. This article explores the historical and contemporary issues in diagnosing such conditions, emphasizing the fragmentation of medical and psychiatric knowledge, biases in clinical guidelines, and the mismanagement of complex illnesses. Diagnostic errors often arise from insufficient integration between general medicine and psychiatry, compounded by the relian

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… While these practices may reduce perceived clinical risk, they often come at the cost of patient-centered care, leading to overdiagnosis, stigmatization, and reduced trust in the therapeutic relationship ( 79 – 81 ). …

Metastatic Spread in Prostate Cancer Patients Influencing Radiotherapy Response.

Radiotherapy and surgery are curative treatment options for localized prostate cancer (PCa) with a 5-year survival rate of nearly 100%. Once PCa cells spread into distant organs, such as bone, the overall survival rate of patients drops dramatically. The metastatic cascade and organotropism of PCa cells are regulated by different cellular subtypes, organ microenvironment, and their interactions. This cross-talk leads to pre-metastatic niche formation that releases chemo-attractive factors enforcing the formation of distant metastasis. Biological characteristics of PCa metastasis impacting on m

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… On the other hand, PSA is not solely a PCa-specific biomarker and, as such, leads to overdiagnosis and overtreatment of clinically insignificant cases, representing a significant burden for patients ( 84 ). Moreover, absolute PSA level does not always correlate with prognosis ( 85 ). …

The 2024 revised clinical guidelines on the management of thyroid tumors by the Japan Association of Endocrine Surgery.

The Japan Association of Endocrine Surgery published the first edition of the "Clinical guidelines on the management of thyroid tumors" in 2010 and the revised edition in 2018. The guideline presented herein is the English translation of the revised third edition, issued in 2024. The aim is to enhance health outcomes for patients suffering from thyroid tumors by facilitating evidence-based shared decision-making between healthcare providers and patients, as well as standardizing the management of thyroid tumors. The focus is on adult patients with thyroid tumors, addressing clinically signific

Mapping the research trends and hotspots on solid pulmonary nodules from 2000-2024: insights from bibliometric analysis.

BackgroundDue to extensive low-dose computed tomography (CT) screening, the detection rate of solid pulmonary nodules (PNs) is constantly rising. However, existing studies lack a comprehensive understanding of its emerging research trends and interdisciplinary progress, especially in terms of artificial intelligence (AI) integration and molecular characteristics. In this study, we conduct a comprehensive bibliometric analysis to clarify the current research trends and predict future research hotspots in this field, in order to improve diagnostic accuracy, reduce overtreatment, and promote inno

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… However, this interest has been hindered due to the perceived complexity and high uncertainty of the diagnostic process for SN, as well as the cautious approach towards the risks of overdiagnosis and invasive examinations. …

Prevalence and clinicopathological characteristics of de novo metastatic cancer at a major radiotherapy centre in West Africa: a cross-sectional study.

BackgroundCancer is a major public health challenge in West Africa, with a significant proportion of cancer-related deaths attributed to distant metastasis. De novo metastatic cancer (DnMC), where metastasis is detected at diagnosis, presents considerable therapeutic challenges, particularly in limited-resource settings where novel treatments are often unavailable and/or unaffordable.AimTo determine the prevalence, incidence and clinicopathological characteristics of patients diagnosed with DnMC at a major radiotherapy center in West Africa.MethodsThis was a single-institution-based quantitati

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… Overdiagnosis and overtreatment in cancer: an opportunity for improvement. JAMA. 2021;285(13):2907–2908. doi: 10.1001/jama.2013.108415. 64. Sadigh G, Goeckner HG, Kazerooni EA, et al. State legislative trends related to biomarker testing. …

The Risk of Sarcoidosis Misdiagnosis and the Harmful Effect of Corticosteroids When the Disease Picture Is Incomplete.

Sarcoidosis is a complex granulomatous disease of unknown etiology. Due to the heterogeneity of the disease, the diagnosis remains challenging in many cases, often at the physician's discretion, requiring a thorough and complex investigation. Many other granulomatous diseases have the potential to mimic sarcoidosis, whether infectious, occupational, or autoimmune diseases and starting an unnecessary corticosteroid treatment can worsen the patient's prognosis, leading to side effects that can be harder to treat than the actual disease.

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… The nonspecific symptomatology, the granulomatous-type inflammation, that is also found in other pathological conditions, the absence of specific and sensitive markers and the lack of a perfect investigation, often make the diagnosis difficult and prone to errors, both through overdiagnosis and also …

Trends in early-onset cancer incidence rates in the Nordic countries (2003-2022): a population-based study.

BACKGROUND: Increasing incidence rates of early-onset cancer at ages 20-49 years have been reported in several countries, especially for colorectal, kidney and breast cancer. We examined recent incidence trends of early-onset cancer in Denmark, Finland, Iceland, Norway, Sweden, Greenland, and the Faroe Islands across 18 major cancer sites and compared to trends at ages 50-84 years. METHODS: We utilised the NORDCAN database comprising incident cancer cases among individuals aged 20-84 years during 2003-2022. Age-standardised (Nordic population 2000) incidence rates (ASR) per 100,000 person-year

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… The increasing impact of overdiagnosis N Engl J Med 375 2016 614 617 27532827 10.1056/NEJMp1604412 41 Salinas C.A. Tsodikov A. Ishak-Howard M. Cooney K.A. …

User experiences on implementation of patient reported outcome measures (PROMs)in a Haematological outpatient clinic.

BackgroundPROMs can help healthcare professionals gain an improved understanding of patients' physical burdens, functional levels, and (health-related) quality of life throughout disease and medical treatment. The aim of this study was to investigate the barriers and potential opportunities PROMs may present in a haematological outpatient clinic from three different perspectives: patients, nurses and haematologists.MethodsThe present study synthesizes three previously published studies that separately explored the experiences of patients, nurses and haematologists when implementing PROMs. The

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… development in nursing Person-centred care Interpretive Description methodology 3 / Insider Researcher | MD, PhD Student | Haematology RCT-studies Implementation of PROMs 4 / Co-researcher and Supervisor | PhD, MD | General practitioner Evidence-based medicine Psychometrics Mixed methods Medical screening Overdiagnosis …

Mechanistic and Clinical Perspectives on Traditional Chinese Medicine in Thyroid Cancer Management.

Thyroid cancer is one of the most prevalent malignancies of the endocrine system, comprising various subtypes such as papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC), medullary thyroid carcinoma (MTC), and the aggressive anaplastic thyroid carcinoma (ATC). Despite a generally favorable prognosis for PTC, recurrence, metastasis, and resistance to conventional therapies continue to pose significant challenges. The pathogenesis of thyroid cancer involves genetic mutations in BRAF, RAS, and RET, as well as dysregulated molecular pathways such as MAPK, PI3K/Akt/mTOR, and NF-κB

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… Vaccarella S. 2024a Evolving epidemiological patterns of thyroid cancer and estimates of overdiagnosis in 2013-17 in 63 countries worldwide: A population-based study Lancet Diabetes Endocrinol. 12 824 836 10.1016/S2213-8587(24)00223-7 39389067 Li M. Wei B. Gao T. …

Albuminuria as a diagnostic criterion and a therapeutic target in heart failure and other cardiovascular disease.

The high disease burden and bidirectional relationship of chronic kidney disease (CKD), heart failure (HF) and other cardiovascular disease (CVD) necessitate the need for early diagnosis of these diseases. While current screening and detection methods are recommended by CKD and CVD guidelines, their adoption in practice is low. Urine albumin-to-creatinine ratio (uACR) is recognized as a diagnostic marker for CKD and a prognostic marker for CKD progression, HF and CVD outcomes, therefore albuminuria changes have been accepted as a surrogate outcome for kidney and cardiovascular endpoints. Furth

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… screening was cost‐effective. 107 Population‐based urine albumin‐to‐creatinine ratio screening Population‐based screening involves identifying a large population who is at risk of developing a condition and detecting the incidence of this disease; the main purpose is to primarily establish risk of overdiagnosis …

Molecular mechanisms of the preventable causes of cancer in the United States.

Annually, there are 1.6 million new cases of cancer and nearly 600,000 cancer deaths in the United States alone. The public health burden associated with these numbers has motivated enormous research efforts into understanding the root causes of cancer. These efforts have led to the recognition that between 40% and 45% of cancers are associated with preventable risk factors and, importantly, have identified specific molecular mechanisms by which these exposures modify human physiology to induce or promote cancer. The increasingly refined knowledge of these mechanisms, which we summarize here,

Designing optimal allocations for cancer screening using queuing network models.

Cancer is one of the leading causes of death, but mortality can be reduced by detecting tumors earlier so that treatment is initiated at a less aggressive stage. The tradeoff between costs associated with screening and its benefit makes the decision of whom to screen and when a challenge. To enable comparisons across screening strategies for any cancer type, we demonstrate a mathematical modeling platform based on the theory of queuing networks designed for quantifying the benefits of screening strategies. Our methodology can be used to design optimal screening protocols and to estimate their

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… For example, it is easy to incorporate the potential costs of screening such as overdiagnosis and overtreatment into this model, which might simply involve reweighting estimated sojourn times by QALY scores, but it is hard to estimate these effects without a randomized controlled trial. …

Machine Learning: A New Prospect in Multi-Omics Data Analysis of Cancer.

Cancer is defined as a large group of diseases that is associated with abnormal cell growth, uncontrollable cell division, and may tend to impinge on other tissues of the body by different mechanisms through metastasis. What makes cancer so important is that the cancer incidence rate is growing worldwide which can have major health, economic, and even social impacts on both patients and the governments. Thereby, the early cancer prognosis, diagnosis, and treatment can play a crucial role at the front line of combating cancer. The onset and progression of cancer can occur under the influence of

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… Along with other disadvantages of screening methods, overdiagnosis and subsequently overtreatment of the disease remains challenging, which may have adverse effects on patients. …

Strategies to Mitigate Cisplatin-Induced Ototoxicity: A Literature Review of Protective Agents, Mechanisms, and Clinical Gaps.

BackgroundCisplatin, a widely used chemotherapeutic agent, is associated with significant ototoxicity, leading to progressive and irreversible sensorineural hearing loss in up to 93% of patients. Cisplatin generates reactive oxygen species (ROS) in the cochlea, activating apoptotic and necroptotic pathways that result in hair cell death. Inflammatory processes and nitrative stress also contribute to cochlear damage.MethodsThis literature review was conducted to explore the mechanisms underlying cisplatin-induced ototoxicity and evaluate protective strategies, including both current and emergin

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… Rhainds M., Bussières M., L’Espérance S., Nourissat A., Coulombe M. 137 Audiologic Monitoring of Cisplatin Ototoxicity in Cancer Treatment of Adults: A Balance between Overdiagnosis and Patient Safety? BMJ Evid.-Based Med. 2018;23:A64. doi: 10.1136/bmjebm-2018-111070.137. 103. …

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Molecular Mechanisms and Biomarkers Associated with Chemotherapy-Induced AKI.

Acute kidney injury (AKI) is a life-threatening condition characterized by a rapid and transient decrease in kidney function. AKI is part of an array of conditions collectively defined as acute kidney diseases (AKD). In AKD, persistent kidney damage and dysfunction lead to chronic kidney disease (CKD) over time. A variety of insults can trigger AKI; however, chemotherapy-associated nephrotoxicity is increasingly recognized as a significant side effect of chemotherapy. New biomarkers are urgently needed to identify patients at high risk of developing chemotherapy-associated nephrotoxicity and s

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… Despite the impact of cancer overdiagnosis in correctly estimating the actual impact of cancer on patient survival [ 11 ], cancer will likely be the leading cause of death in the following decades [ 9 , 10 ]. …

Brazilian consensus recommendations on the diagnosis and treatment of light chain amyloidosis.

INTRODUCTION: Systemic immunoglobulin light chain amyloidosis is characterized by the extracellular deposition of misfolded light chains, leading to progressive dysfunction of multiple organs. Diagnosis remains a significant clinical challenge and is frequently delayed due to the presence of nonspecific symptoms, coupled with limited access to specialized diagnostic tools and expertise. Currently, no established national recommendations for the diagnosis and management of this condition exist in Brazil. METHODS: These expert recommendations were developed following a structured advisory meeti

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… In 2025, a new definition of light chain MGUS was proposed, with the aim of decreasing the overdiagnosis of monoclonal gammopathies often linked to using the standard reference intervals for serum free light chains (sFLCs) [ 12 ]. …

Radiotheranostics - Precision Medicine in Nuclear Medicine and Molecular Imaging.

'See what you treat and treat what you see, at a molecular level', could be the motto of theranostics. The concept implies diagnosis (imaging) and treatment of cells (usually cancer) using the same molecule, thus guaranteeing a targeted cytotoxic approach of the imaged tumor cells while sparing healthy tissues. As the brilliant late Sam Gambhir would say, the imaging agent acts like a 'molecular spy' and reveals where the tumoral cells are located and the extent of disease burden (diagnosis). For treatment, the same 'molecular spy' docks to the same tumor cells, this time delivering cytotoxic

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… The Increasing Impact of Overdiagnosis N Engl J Med 2016 375 614 7 27532827 10.1056/NEJMp1604412 10 Siegel RL Miller KD Fuchs HE Jemal A Cancer Statistics, 2021 CA Cancer J Clin 2021 71 7 33 33433946 10.3322/caac.21654 11 Fagin JA Wells SA Jr Biologic and Clinical Perspectives on Thyroid Cancer N Engl …

Early detection of sporadic pancreatic cancer: summative review.

Pancreatic cancer (PC) is estimated to become the second leading cause of cancer death in the United States by 2020. Early detection is the key to improving survival in PC. Addressing this urgent need, the Kenner Family Research Fund conducted the inaugural Early Detection of Sporadic Pancreatic Cancer Summit Conference in 2014 in conjunction with the 45th Anniversary Meeting of the American Pancreatic Association and Japan Pancreas Society. This seminal convening of international representatives from science, practice, and clinical research was designed to facilitate challenging interdiscipli

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… False Positive “Pseudotumors” in PC Screening Heightened surveillance can lead to the overdiagnosis and overtreatment of tumors with indolent natural histories. This remains a concern, as removal of lesions requires major surgery. …

Unpacking adiposity: a narrative critical appraisal of diverse obesity definitions.

BACKGROUND: Obesity is a complex, multifaceted chronic disease that poses a major global health challenge. Traditionally, population-level screening and follow-up have relied heavily on body mass index (BMI). Although BMI provides a simple, standardized measure for epidemiological studies, it does not account for individual variations in muscle mass, fat distribution, or metabolic health. Consequently, relying solely on weight-to-height ratios-even when supplemented with waist circumference, waist-to-hip ratio, or waist-to-height ratio-limits precise individual diagnosis and comprehensive heal

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… diseases in themselves | Product of a high-quality, broadly endorsed scientific process; explicitly moves beyond BMI as the sole diagnostic tool; distinguishes preclinical from clinical obesity, extending the obesity diagnosis to people with BMI < 30 kg/m 2 who have confirmed excess adiposity; mitigates overdiagnosis …