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Objective The etiologies of diagnostic errors among internal medicine physicians are unclear. To understand the causes and characteristics of diagnostic errors through reflection by those involved in them. Methods We conducted a cross-sectional study using a web-based questionnaire in Japan in January 2019. Over a 10-day period, a total of 2,220 participants agreed to participate in the study, of whom 687 internists were included in the final analysis. Participants were asked about their most memorable diagnostic error cases, in which the time course, situational factors, and psychosocial context could be most vividly recalled and where the participant provided care. We categorized diagnostic errors and identified contributing factors (i.e., situational factors, data collection/interpretation factors, and cognitive biases). Results Two-thirds of the identified diagnostic errors occurred in the clinic or emergency department. Errors were most frequently categorized as wrong diagnoses, followed by delayed and missed diagnoses. Errors most often involved diagnoses related to malignancy, circulatory system disorders, or infectious diseases. Situational factors were the most cited error cause, followed by data collection factors and cognitive bias. Common situational factors included limited consultation during office hours and weekends and barriers that prevented consultation with a supervisor or another department. Conclusion Internists reported situational factors as a significant cause of diagnostic errors. Other factors, such as cognitive biases, were also evident, although the difference in clinical settings may have influenced the proportions of the etiologies of the errors that were observed. Furthermore, wrong, delayed, and missed diagnoses may have distinctive associated cognitive biases.

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INTRODUCTION: Capillary (finger prick) blood sampling is commonplace in paediatric practice but this method is prone to produce spurious laboratory results. CASE PRESENTATION: A five-year-old girl presented with abdominal pain, epigastric tenderness, tachycardia and reduced oxygen saturation. A venous blood sample haemolysed, and serum amylase on a finger prick sample was reported as 2831 units/L. The working diagnosis was acute pancreatitis and respiratory tract infection. A repeat amylase 9 h later was within the normal range. The patient was known to bite her fingers and the possibility of salivary contamination was considered. Serum isoenzyme analysis confirmed presence of high salivary amylase levels with no pancreatic amylase detected. A viral respiratory tract infection and buried gastrostomy bumper were eventually thought to account for the patient's presentation. CONCLUSION: Increased awareness of the potential for salivary contamination of serum amylase in finger prick samples may prevent misdiagnoses of pancreatitis.

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Dermatoscopy is a method of in vivo evaluation of the structures within the epidermis and dermis. Currently, it may be the most precise pre-surgical method of diagnosing melanocytic lesions. Diagnostic errors may result in unnecessary removal of benign lesions or what is even worse, they can cause early and very early melanomas to be overlooked. Errors in assessment of dermatoscopy can be divided into those arising from failure to maintain proper test procedures (procedural and technical errors) and knowledge based mistakes related to the lack of sufficient familiarity and experience in dermatoscopy. The article discusses the most common mistakes made by beginner or inexperienced dermatoscopists.

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Bipolar disorders are considered by many authors as a condition of nature only affective, though frequently patients with mania present psychotic symptoms (hallucinations, disorders of thought form and psychomotor disturbances and even catatonia) that are often misdiagnosed as a schizophrenic disorder. The presence of hallucinations and other psychotic symptoms is common in the different phases of bipolar disorder and relates to the unfavorable development and chronicity of symptoms, especially when they are incongruent with mood disorders. Some authors consider them as a clinical dimension of mania, that would be the result of genetic predisposition (there are some candidate genes) of cognitive impairments, specific attention disorders or neurobiological abnormalities. This article reviews the semiotic aspects, psychopathological and etiological factors associated with the presence of hallucinations in episodes of mania and the consequences of making a wrong diagnosis.

El trastorno bipolar es considerado por muchos autores como un trastorno de índole exclusivamente anímico pero con frecuencia los pacientes con manía presentan síntomas psicóticos (alucinaciones, trastornos de la forma del pensamiento y alteraciones psicomotoras e incluso catatonia) que con frecuencia son mal diagnosticados como pertenecientes a un trastorno esquizofrénico. La presencia de alucinaciones y otros síntomas psicóticos es frecuente en las diferentes fases del trastorno bipolar y guardan relación con una evolución desfavorable y cronicidad de los síntomas, especialmente cuando son incongruentes con las alteraciones del estado de ánimo. Algunos autores las consideran como una dimensión clínica de la manía, que sería el resultado de predisposición genética (se han identificado algunos genes candidatos), de las alteraciones cognoscitivas, específicamente los trastornos de atención o de alteraciones neurobiológicas. En el presente artículo se revisan los aspectos semiológicos, psicopatológicos y etiológicos relacionados con la presentación de alucinaciones en los episodios de manía y las consecuencias de realizar un mal diagnóstico.

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The factors that separate an otolaryngology related law suit from others are manifold. The definition of standard of care, the patient's expectation of a surgical outcome and the psychological consequence that results from the surgical complications are unique to this specially. As this specially deals with one of the most sensitive part of a human body, patient's expectations of any treatment is bound to differ from that of the doctor. Unlike other fields, the definition of standard of care is constantly evolving due to continuous introduction and modification of the techniques and instruments. Statistics shows that the most common allegation in law suits relating to this branch is inadequate consent for the proposed treatment followed by wrong techniques used for operation. Negligence in postoperative care, failure to diagnose early and faulty maintenance of medical words are the other major areas that concern a doctor in a court room. The present article aims at reviewing some major problem areas and addressing the legal aspects concerning those areas.

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Objective To study wrong diagnosis in the patients with epidemic hemorrhage fever in the early stage. Method To analyze the data such as the time of making wrong diagnosis,the wrong diagnosis,the department of treatment and the hospital of treatment before the diagnosis was made and the relationship between the clinical type and making wrong diagnosis. Results Making wrong diagnosis in the patients with epidemic hemorrhage fever was common (88.97%),and it was more happened in the early stage,in the non-typical and mild patients and in the lower grade hospitals.The wrong diagnosis rate (28.95%,11/38)was lower in the Infectious disease department than in the other department (93.65%),P