Diagnosis

In rejecting PSA screening for prostate cancer, an influential federal panel has chipped a cornerstone of preventive medicine, declaring that it's not always best to catch cancer as early as possible. "At best, PSA screening may help only 1 man in 1,000 avoid death from prostate cancer," the U.S. Preventive Services Task Force said Monday. "Most prostate cancers found by PSA screening are slow growing, not life threatening, and will not cause a man any harm during his lifetime.

I'M NOT a journalist nor do I understand the process of editing the Daily News, but I know you have better sense than to write in big bold letters "A schizophrenic is missing" (City/Region, May 19). Our society is polluted because of the misunderstanding and stereotypical views of how someone is categorized with a mental illness. The schizophrenic that your article so insensitively wrote about had a full description of the person missing. You had her age, weight, height and what she was last seen wearing, but instead led off with the schizophrenic piece.

A psychiatrist who helped establish the professional criteria for diagnosing mental disorders testified yesterday that surrogate mother Mary Beth Whitehead is not suffering from a personality disorder, as other mental- health experts have asserted. Appearing on behalf of Whitehead at the Baby M trial, Dr. Donald F. Klein testified that Wynnewood psychiatrist Marshall D. Schechter improperly diagnosed Whitehead as having a "mixed personality disorder. " In his diagnosis, prepared for the baby's court-appointed guardian, Schechter said he used the criteria established in the third edition of the Diagnostic and Statistical Manual of Mental Disorders, referred to as DSM- III. Klein, a practicing psychiatrist in New York City and a medical professor at Columbia University, testified yesterday that he had been on the 19-member task force that helped write the manual.

For young Joshua Knobel, life consisted of one crisis after another as he lay in a hospital bed, vomiting hour after hour, sometimes for days. Life was hell for his parents, as well, as they watched their child suffer, and waited for his death from Fazio-Laude Disease, one of the world's rarest neurological illnesses. But Joshua Knobel, now 14, of Langhorne, Bucks County, never had fatal Fazio-Laude. Yesterday, a Philadelphia jury awarded $9.9 million to Joshua and his parents in a medical malpractice suit against a former Children's Hospital of Philadelphia neurologist who diagnosed the disease.

Given his credentials, one might presume that Jeffrey Lerner would have had an easier time finding the best medical treatment for his mother. But he bounced along like anyone else trying to gather sound answers for a grim cancer diagnosis. As a senior executive for a nonprofit health-services research group in Plymouth Meeting, Lerner could read whatever was available about malignant melanoma. Even so, his efforts did not equip him for his mother's three-year struggle with the disease.

The two men were brothers, they were friends, but they also were physician and patient. And one diagnosis made on a winter day five years ago changed everything. In December 1993, Joseph Labricciosa, a family practice physician in Springfield, Delaware County, examined his brother Robert and diagnosed a case of hemorrhoids. But he was actually suffering from rectal cancer. That first diagnosis recently culminated in a Delaware County courtroom, where a jury ordered Joseph Labricciosa to pay $8.2 million to his late brother's widow - one of the largest verdicts in recent county history, in a case that has divided a family.

Betsy Smetona of Haddon Heights quit her job last summer to stay home with her children. Her 23-year-old twins, Megan and Michael, have graduated from the Bancroft School in Haddonfield and can't be left alone. Both have autism, although in different degrees. "It's a big shock to the system when they graduate," Smetona said. "Their schooling was everything to them. It met their social and extracurricular needs. It's hard to find something in the community for Michael and Megan to do. " For the Smetonas and other New Jersey families in a similar situation, help could be on the way. Gov. Corzine signed laws in 2007 and 2008 that are now taking effect to enable early diagnosis of autism, develop screening guidelines for physicians, create a statewide patient registry, and educate emergency responders to recognize developmental disabilities.

The U.S. Attorney's Office yesterday announced that Presbyterian Medical Center in West Philadelphia had agreed to pay $535,448 to settle civil allegations by the government that it improperly obtained Medicare payments by using an inaccurate diagnosis reimbursement code for pneumonia patients from October 1992 to March 1997. The agreement, under which Presbyterian officials did not admit liability under the False Claims Act, was one of three such agreements filed by prosecutors in Philadelphia and in Chicago.

Q: I would appreciate information on fibromyalgia and polymyalgia. I've had many tests and my diagnosis has been narrowed to these conditions. Anti- inflammatories such as Advil have eased the pain, but I need some direction. A: Fibromyalgia is a common rheumatic disorder, of unknown cause, marked by muscle pain, tenderness and stiffness. The hallmark of this disease is the presence of "trigger points," localized areas of muscle or tendon that are exquisitely tender when pressed.

Tim Kerr has been hospitalized since Monday with an as-yet undiagnosed malady that is suspected to be linked to his shoulder problems. The Flyers' right wing was complaining of hot and cold flashes, soreness in his left shoulder and a general lethargy when he entered Graduate Hospital. Dr. John Gregg, the orthopedist who operated on the shoulder three times this summer, said the diagnosis was not complete, but that he expected Kerr would be "fine. " Gregg would not comment any further.

Larry Kaiser, at the helm of Temple University Health System in North Philadelphia for a year, is crafting a bold plan to steer the organization out of the financial morass of being Philadelphia's unofficial public hospital for the poor. So far, he has engineered the $83.8 million purchase of the Fox Chase Cancer Center — a deal expected to close July 1 — and overseen the opening of an outpatient facility in Oaks that is drawing suburban patients with better-paying insurance and has treated 40 percent more patients than budgeted.

Sidney Crosby will appear in his 413th National Hockey League game Monday night at Consol Energy Center. Might not seem like it, though. Not to what could be the most-energized crowd in the young arena's history. And certainly not to Crosby, who has not participated in one since being diagnosed with a concussion Jan. 6. For that reason, Penguins coach Dan Bylsma said Sunday that Crosby figures to experience the emotions and excitement of a guy competing at this level for the first time.

WASHINGTON - The doctor doesn't think your sore throat is bad enough yet to order a strep test - unaware that a dozen people across town were diagnosed with strep throat just last week. Doctors rarely know what bugs are brewing in the neighborhood until their own waiting rooms start to fill. Harvard University researchers reported Monday that getting them real-time information on nearby infections could improve patient care - for strep throat alone, potentially helping tens of thousands avoid a delayed diagnosis or getting unneeded antibiotics.

KNOXVILLE, Tenn. - Tennessee's Pat Summitt plans to coach "as long as the good Lord is willing" despite recently learning she has early onset dementia. In a statement from Summitt released by the university on Tuesday, the Hall of Fame coach said she visited with doctors at the Mayo Clinic in Rochester, Minn., after the 2010-11 basketball season ended, and early onset dementia - Alzheimer's type - was diagnosed over the summer. "I plan to continue to be your coach," Summitt said.

PARIS - Picture yourself in Barbara Lesher's shoes: 54 years old and fearing you are developing Alzheimer's disease. "I don't remember if I had a bath," said Lesher, who lives north of Harrisburg. "It took me two hours to follow a recipe. I drove to my childhood homestead the other week instead of my own home. It's really scary. " Doctors are arguing about whether to test patients for signs of the incurable disease and tell them the results. The debate raged last week at the Alzheimer's Association International Conference in France, where research on new methods - easier brain scans, an eye test, a blood test - made it clear there soon may be more such tools available.

MIAMI GARDENS, Fla. - After Sunday, the Phillies coaching staff will have a midsummer break for the first time in three years. Many of the team's players will spend the four days with family or simply relax, knowing a successful first half is complete.   Charlie Manuel is just about ready for that time to come. "We're trying to get people well," Manuel said. "I don't know how you keep them well, but we're trying to get well. " The newest concern is   Shane Victorino,   who was diagnosed with a sprained right thumb after a Tuesday appointment with hand specialist   Randall Culp   in Philadelphia.

Question: I have a good friend whose son is in school with mine. He's a bit odd and sometimes has difficulty dealing socially with the other kids, but has friends. He's very bright but seems to miss some social cues other 8-year-old boys pick up on. My professional background has given me some exposure to autism/pervasive developmental disorders, but I am no expert. I can't help thinking he's got something along these lines, but I'm not sure if I should say anything. He's been in school with teachers, school counselors, etc., who have never said anything to her (she's pretty open with her friends about her struggles with his behavior problems)

Andy Holder couldn't swim. He wasn't a bike rider. He wasn't a distance runner, either. So naturally, when Holder learned at age 36 that he had Type 1 diabetes, one of his first thoughts was, I'm going to become an ironman triathlete . "People laugh when I tell that story," said Holder, who will compete Sunday in the Philadelphia Insurance Triathlon in Fairmount Park. "But I wanted to do something extreme. I wanted to prove to myself but also to others that you shouldn't put any limits on yourself.

S UN HEE LEE WILL participate in the ovarian-cancer run/walk Sunday morning and will likely cross the finish line, no doubt feeling triumphant. She well should. Lee, who lives in University City, has been defying the odds since being diagnosed with stage IV ovarian cancer in 2007. By the time doctors discovered the reasons for her nagging cough and swollen abdomen, the cancer had spread to her chest cavity. Typically, the one-year survival rate for most patients diagnosed with late-stage ovarian is dismal - just 17 percent, according to the Annals of Medicine.

A consumer advocacy group has accused the authors of a study published in the Journal of the American Medical Association (JAMA) - including employees of Avid Radiopharmaceuticals in University City and the University of Pennsylvania - of withholding important negative information about an experimental dye meant to help diagnose Alzheimer's disease. Public Citizen says the article in the Jan. 19 issue of JAMA left out information about variability in the way doctors read brain scans of patients who had been given the imaging agent Amyvid.