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  1. Incremental yield of bronchial washing for diagnosing smear-negative pulmonary tuberculosis

    Alonso Soto

    2013-08-01

    Full Text Available OBJECTIVE To assess the increased diagnostic yield for pulmonary tuberculosis using bronchial washing cultures compared with sputum cultures. METHODS Study conducted with 61 adults in Lima, Peru, from January 2006 to December 2007. The yield of sputum cultures was compared with the yield of acid-fast bacilli smears and cultures of bronchial washing for diagnosing pulmonary tuberculosis in suspected cases of clinical tuberculosis with negative acid fast bacilli sputum smears. RESULTS Twenty seven (95%CI 32;58 of the cases were eventually diagnosed with smear-negative pulmonary tuberculosis. Bronchial washing samples detected 23 (95%CI 72;99 of the smear-negative pulmonary tuberculosis cases compared with 15 (95%CI 37;74 for sputum cultures (p = 0.02. The incremental diagnostic yield of acid fast bacilli smear and culture of bronchial washing specimens over sputum culture was 44% (95%CI 25;65. CONCLUSIONS In function of the epidemiological context and the resources available, bronchoscopy should be deployed as part of a comprehensive work up that optimizes smear-negative pulmonary tuberculosis diagnosis and minimizes risk and costs.

  2. Accuracy of bronchoalveolar lavage enzyme-linked immunospot assay to diagnose smear-negative tuberculosis: a meta-analysis

    Li, Zhenzhen; Qin, Wenzhe; Li, Lei; WU, QIN; Chen, Xuerong

    2015-01-01

    Purpose: While the bronchoalveolar lavage enzyme-linked immunospot assay (BAL-ELISPOT) shows promise for diagnosing smear-negative tuberculosis, its accuracy remains controversial. We meta-analyzed the available evidence to obtain a clearer understanding of the diagnostic accuracy. Methods: Studies of the diagnostic performance of ELI-SPOT on smear-negative tuberculosis were identified through systematic searches of the PubMed and EMBASE databases. Pooled data on sensitivity, specificity and ...

  3. Performance of the 2007 WHO algorithm to diagnose smear-negative pulmonary tuberculosis in a HIV prevalent setting.

    Helena Huerga

    Full Text Available BACKGROUND: The 2007 WHO algorithm for diagnosis of smear-negative pulmonary tuberculosis (PTB including Mycobacterium tuberculosis (MTB culture was evaluated in a HIV prevalent area of Kenya. METHODS: PTB smear-negative adult suspects were included in a prospective diagnostic study (2009-2011. In addition, program data (2008-2009 were retrospectively analysed. At the first consultation, clinical examination, chest X-ray, and sputum culture (Thin-Layer-Agar and Lowenstein-Jensen were performed. Patients not started on TB treatment were clinically re-assessed after antibiotic course. The algorithm performance was calculated using culture as reference standard. RESULTS: 380 patients were included prospectively and 406 analyzed retrospectively. Culture was positive for MTB in 17.5% (61/348 and 21.8% (72/330 of cases. Sensitivity of the clinical-radiological algorithm was 55.0% and 31.9% in the prospective study and the program data analysis, respectively. Specificity, positive and negative predictive values were 72.9%, 29.7% and 88.6% in the prospective study and 79.8%, 30.7% and 80.8% in the program data analysis. Performing culture increased the number of confirmed TB patients started on treatment by 43.3% in the prospective study and by 44.4% in the program data analysis. Median time to treatment of confirmed TB patients was 6 days in the prospective study and 27 days in the retrospective study. Inter-reader agreement for X-ray interpretation between the study clinician and a radiologist was low (Kappa coefficient = 0.11, 95%CI: 0.09-0.12. In a multivariate logistic analysis, past TB history, number of symptoms and signs at the clinical exam were independently associated with risk of overtreatment. CONCLUSION: The clinical-radiological algorithm is suboptimal to diagnose smear-negative PTB. Culture increases significantly the proportion of confirmed TB cases started on treatment. Better access to rapid MTB culture and development of new

  4. Incremental yield of bronchial washing for diagnosing smear-negative pulmonary tuberculosis

    2013-01-01

    OBJECTIVE: To assess the increased diagnostic yield for pulmonary tuberculosis using bronchial washing cultures compared with sputum cultures. METHODS: Study conducted with 61 adults in Lima, Peru, from January 2006 to December 2007. The yield of sputum cultures was compared with the yield of acid-fast bacilli smears and cultures of bronchial washing for diagnosing pulmonary tuberculosis in suspected cases of clinical tuberculosis with negative acid fast bacilli sputum smears. RESULTS: ...

  5. National guidelines not always followed when diagnosing smear-negative pulmonary tuberculosis in patients with HIV in Botswana.

    Taurayi A Tafuma

    Full Text Available BACKGROUND: Diagnosis of smear negative pulmonary tuberculosis (SNPTB is challenging, especially in patients with HIV. The Botswana National Tuberculosis Program (BNTP guidelines give guidance in diagnosing and treating SNPTB. Patients with chronic cough should be screened for TB by 3 sputum smear investigations. If negative, a chest x-ray (CXR should be performed. If negative for TB, antimicrobial treatment for other infections should be started. We investigated the clinicians' use of the guidelines in clinical practice. METHODS: Data regarding the medical history (coughing period, requested and conducted investigations concerning tuberculosis diagnosis (sputum smear or culture or CXR or alternative diagnoses (sputum microscopy or blood or sputum culture for diagnosis of other organisms, in SNPTB HIV-positive patients (outpatients and admitted patients from 2006-2009 in a district hospital in Botswana were extracted from all available hospital medical records. Additionally, a survey was done in all doctors diagnosing SNPTB in this hospital using a self-administered questionnaire with questions regarding the application of the BNTP guidelines in practice. Descriptive analyses of collected data were performed to test the compliance to the guidelines. RESULTS: Data from medical records showed that in 47.0% (132/281 of patients, TB treatment was started without microbiological results from sputum smears. Other methods to rule out or confirm PTB were used in 2.1% (6/281; and 99.6% (280/281 of SNPTB patients had received a CXR. The survey in 7 clinicians found that all always used CXR, and all clinicians requested three sputum results only sometimes. Six out of 7 clinicians started antibiotics before starting TB treatment. Reasons clinicians gave for difficulties in following the guidelines included inability of patients to produce sputum; and laboratory delays in releasing sputum results. CONCLUSION: Between 2006 and 2009 a high proportion of SNPTB

  6. Clinical and radiographic predictors in diagnosing sputum smear-negative pulmonary tuberculosis in HIV-negative patients: a cross-sectional study in China

    LI Xin-xu; JIANG Shi-wen; ZHANG Hui; JING Kuan-he; WANG Li; LI Wei-bin; LIU Xiao-qiu

    2013-01-01

    Background In county-level tuberculosis (TB) dispensaries in China,the accurate diagnosis of sputum smear-negative pulmonary tuberculosis (SNPT) needs to be improved by developing and validating clinical and radiographic predictors.Methods The study was conducted simultaneously in three counties per province in Chongqing Municipality and Liaoning Province in China between May 2005 and May 2006.A total of 432 new SNPT patients who are HIV-negative and more than 15 years old diagnosed by expert panels in county-level TB dispensaries were recruited.Their sputum samples were collected for culture before anti-TB treatment,and the treatment outcomes (changes of X-rays) were followed up at the end of the 6th month.Results Of the 432 SNPT patients,sputum culture positive (9.7%) or culture negative with good changes of X-rays at the end of the 6th month (73.6%) was validated as SNPT.Four predictive variables were associated with validated SNPT in the multivariate logistic regression model:age ≤55 years old (odds ratio (OR) 5.66; 95% CI 2.69-11.91),>60 days of cough (OR 3.73; 95% CI 1.10-12.65),≥10% of pulmonary consolidation in the lungs (OR 5.40; 95% CI 2.90-10.06),and pulmonary consolidation in the upper lobe anterior segment (OR 3.00; 95% CI 1.57-5.72).The area under the receiver operating characteristic curve of the model was 0.77 (95% CI 0.71-0.83).Conclusion Four predictors of clinical and radiological characteristics that had a good diagnostic performance of SNPT deserve to be recommended as index indicators of SNPT diagnosis in county-level TB dispensaries in China.

  7. The risk and timing of tuberculosis diagnosed in smear-negative TB suspects: a 12 month cohort study in Harare, Zimbabwe.

    Munyaradzi Dimairo

    Full Text Available BACKGROUND: Cases of smear-negative TB have increased dramatically in high prevalence HIV settings and pose considerable diagnostic and management challenges. METHODS AND FINDINGS: Between February 2006 and July 2007, a cohort study nested within a cluster-randomised trial of community-based case finding strategies for TB in Harare, Zimbabwe was undertaken. Participants who had negative sputum smears and remained symptomatic of TB were follow-up for one year with standardised investigations including HIV testing, repeat sputum smears, TB culture and chest radiography. Defaulters were actively traced to the community. The objectives were to investigate the incidence and risk factors for TB. TB was diagnosed in 218 (18.2% participants, of which 39.4% was bacteriologically confirmed. Most cases (84.2% were diagnosed within 3 months, but TB incidence remained high thereafter (111.3 per 1000 person-years, 95% CI: 86.6 to 146.3. HIV prevalence was 63.3%, and HIV-infected individuals had a 3.5-fold higher risk of tuberculosis than HIV-negative individuals. CONCLUSION: We found that diagnosis of TB was insensitive and slow, even with early radiography and culture. Until more sensitive and rapid diagnostic tests become widely available, a much more proactive and integrated approach towards prompt initiation of ART, ideally from within TB clinics and without waiting for TB to be excluded, is needed to minimise the risk and consequences of diagnostic delay.

  8. Computed tomography in predicting smear-negative pulmonary tuberculosis in AIDS patients

    FENG Feng; SHI Yu-xin; XIA Gan-lin; ZHU Ying; LU Hong-zhou; ZHANG Zhi-yong

    2013-01-01

    Background The correct diagnosis of sputum smear-negative pulmonary tuberculosis in AIDS patients is very important to their therapy.We aimed to assess the value of the computed tomography (CT) and clinical findings in predicting smearnegative pulmonary tuberculosis in AIDS patients.Methods A total of 121 AIDS patients suspected of smear-negative pulmonary tuberculosis by clinical and radiographic findings were recruited.Pulmonary tuberculosis was diagnosed in 57 (47.1%) patients.The CT and clinical predictors were selected to diagnose AIDS-related pulmonary tuberculosis through univariate and multivariate Logistic analysis.Results Multivariate analysis showed that five variables,including weight loss,presence of miliary nodules,necrotic lymph node,Iobular consolidation,tree-in-bud sign,were independent predictors of pulmonary tuberculosis in AIDS patients.Predicted scores based on the five variables were used to identify pulmonary tuberculosis.If the predicted score of 3 was taken as the ideal cut-off point in the diagnosis of AIDS-related smear-negative pulmonary tuberculosis,the sensitivity,specificity,positive predictive value,negative predictive value,and accuracy were 84.2%,81.2%,80.0%,85.2%,and 82.6%,respectively.Conclusion The prediction method based on five key factors of clinical and CT findings are useful in guiding the diagnosis of smear-negative pulmonary tuberculosis in AIDS patients.

  9. Meta-analysis to compare the accuracy of GeneXpert, MODS and the WHO 2007 algorithm for diagnosis of smear-negative pulmonary tuberculosis

    Walusimbi, Simon; Bwanga, Freddie; Costa, Ayesha; Haile, Melles; Joloba, Moses; Hoffner, Sven

    2013-01-01

    Background Smear-negative pulmonary tuberculosis (SN-PTB), which is common in HIV-infected patients, is difficult to diagnose using smear microscopy alone. In 2007, the WHO developed an algorithm to improve the diagnosis and management of smear-negative tuberculosis in HIV prevalent and resource constrained settings. Implementation of the algorithm required individuals with presumptive TB to be initially evaluated using two sputum microscopy examinations followed by clinical diagnosis that ma...

  10. DIAGNOSTIC TEST OF SPUTUM GENEXPERT MTB/RIF FOR SMEAR NEGATIVE PULMONARY TUBERCULOSIS.

    Reechaipichitkul, Wipa; Phetsuriyawong, Attawoot; Chaimanee, Prajuab; Ananta, Pimjai

    2016-05-01

    The objective of this study was to evaluate the performance of the Gene-Xpert MTB/RIF sputum test for diagnosing pulmonary tuberculosis (TB) among patients sputum acid-fast bacillus (AFB) smear negative results in Thailand, a country with a high prevalence of pulmonary tuberculosis. We studied 151 patients who presented to Srinagarind Hospital, Khon Kaen, Thailand with a 2 week or more history of fever and/or cough and an abnormal chest radiograph between 2010 and 2014; these patients had at least 2 negative sputum AFB smear results. Of these, 76 were diagnosed as having either confirmed or probable pulmonary TB: the 32 confirmed cases were those with a positive sputum culture for Mycobacterium tuberculosis (MTB) and the 44 probable case were those with clinical and radiographic findings consistent with TB and who had a response to anti-TB therapy. Seventy-five cases were diagnosed as not having pulmonary TB. Of the 32 patients with a positive sputum culture for MTB, 26 had a positive GeneXpert MTB/RIF sputum test. Compared to sputum culture for MTB the GeneXpert MTB/ RIF test gave a sensitivity of 83.9% (95% CI: 66.3-94.5) and a specificity of 92.1% (95% CI: 83.6-97), a positive predictive value (PPV) of 81.3% (95% CI: 63.6-92.8) and a negative predictive value (NPV) of 93.3% (95% CI: 85.1-97.8). The GeneXpert MTB/RIF test had a fair sensitivity and specificity for diagnosing smear negative pulmonary TB. It may be useful for diagnosing pulmonary TB in patients with a negative sputum AFB smear. The assay is faster than culture and can detect rifampicin resistant strains of MTB. PMID:27405129

  11. Characteristics of Patients with Smear-Negative Pulmonary Tuberculosis (TB) in a Region with High TB and HIV Prevalence

    Leandro Cruz Campos; Marcos Vinícius Vieira Rocha; Denise Maria Cunha Willers; Denise Rossato Silva

    2016-01-01

    Introduction Smear-negative pulmonary TB (SNPT) represents 30–60% of all pulmonary TB cases. The mortality of these patients can reach 25% in populations with high prevalence of HIV infection, and 10–20% of TB transmission at the population level are attributable to SNPT cases. Methods We conducted a retrospective study to evaluate epidemiological, clinical, and radiological characteristics of patients with SNPT and to compare these with patients who were diagnosed as having smear-positive pu...

  12. Whole Blood Interferon-γ Release Assay Is Insufficient for the Diagnosis of Sputum Smear Negative Pulmonary Tuberculosis

    Park, Heejin; Shin, Jung Ar; Kim, Hyung Jung; Ahn, Chul Min; CHANG, YOON SOO

    2014-01-01

    Purpose We investigated the value of an interferon-γ release assay (IGRA) for the diagnosis of active pulmonary tuberculosis (PTB) among sputum smear negative PTB suspects in an environment with intermediate burden of PTB and high Bacillus Calmette-Guérin (BCG) vaccination rate. Materials and Methods We retrospectively reviewed IGRA, medical records, chest PA and CT scan of PTB suspects seen at Gangnam Severance Hospital, Seoul, Korea from Oct. 2007 to Apr. 2013. "Active PTB" was diagnosed wh...

  13. Talus avulsion fractures: are they accurately diagnosed?

    Robinson, Karen P; Davies, Mark B

    2015-10-01

    Dorsal talus avulsion fractures occurring along the supination line of the foot can cause pain and discomfort. Examination of the foot and ankle using the Ottawa ankle rules does not include examination of the talus, an injury here is easily missed causing concern to the patient. This is a retrospective study carried out in a major trauma centre to look at the assessment and diagnosis of all patients with a dorsal talus and navicular avulsion fractures over a one year period. Nineteen patients with an isolated dorsal talus avulsion fracture and five patients with an isolated dorsal navicular fracture were included. The correct diagnosis was made in 12 of patients with isolated dorsal talus avulsion fractures, 7 patients were given an incorrect diagnosis after misreading of the radiograph. Four patients with a dorsal navicular avulsion fracture were given the correct diagnosis. If not correctly diagnosed on presentation patients can be overly concerned that a 'fracture was missed' which can lead to confusion and anxiety. Therefore these injuries need to be recognised early, promptly diagnosed, treated symptomatically and reassurance given. We recommend the routine palpation of the talus in addition to the examination set out in the Ottawa Ankle Rules and the close inspection of plain radiographs to adequately diagnose an injury in this area. PMID:26190632

  14. Evaluation of Smear Negative and Pozitive Pulmonary Tuberculosis Cases

    Fulsen Bozkus

    2014-04-01

    Full Text Available Aim: To determine the relation between radiographic involvement and tuberculin skin test (TST and Bacillus Calmette Guerin (BCG results in patients with pulmonary tuberculosis (PTB. Material and Method: In 210 patients (%42,7 female, %57,6 male, mean age:40,5 ± 16,1 with smear positive and negative PTB we retrospectively analyzed the relation between radiographic findings, TST and BCG. We separated the patients into three groups as mild, moderate and severe according to their radiologic involvement and compared the radiologic extension with tuberculin skin test results. We also compared the degree of sputum smear positivity with tuberculin skin test results. Results: According to the evaluation of radiological findings of the patients, high risk is detected in 58(67,4% patients in smear-positive group and 28(32,6% patients in smear-negative group and statistically valuable relation between smear positivity and radiological findings of the patients is seen (p:0,001. According to the results of TST of the patients, high risk is detected radiologically in 53(61,6% cases of TST-negative group, 33(38,4% cases of TST-positive group and statistically valuable relation between TST results and radiological findings of the patients is seen (p:0,001. A valuable difference between BCG results and radiological findings is not seen. Discussion: It is concluded that radiology is beneficial for diagnosis especially in cases which are without bacilli and suspicious for tuberculosis and TST is shown that it can be beneficial for determining the immunity against to mycobacterium tuberculosis.

  15. A screening system for smear-negative pulmonary tuberculosis using artificial neural networks

    João B. de O. Souza Filho

    2016-08-01

    Conclusions: In settings with a high prevalence of smear-negative PTB, the system can be useful for screening and also to aid clinical practice in expediting complementary tests for higher risk patients.

  16. Sputum smear negative pulmonary tuberculosis: sensitivity and specificity of diagnostic algorithm

    Mugusi Ferdinand M; Swai Hedwiga F; Mbwambo Jessie K

    2011-01-01

    Abstract Background The diagnosis of pulmonary tuberculosis in patients with Human Immunodeficiency Virus (HIV) is complicated by the increased presence of sputum smear negative tuberculosis. Diagnosis of smear negative pulmonary tuberculosis is made by an algorithm recommended by the National Tuberculosis and Leprosy Programme that uses symptoms, signs and laboratory results. The objective of this study is to determine the sensitivity and specificity of the tuberculosis treatment algorithm u...

  17. Antibodies against Mycobacterial Proteins as Biomarkers for HIV-Associated Smear-Negative Tuberculosis

    Siev, Michael; Wilson, Douglas; Kainth, Supreet; Kasprowicz, Victoria O.; Feintuch, Catherine M.; Jenny-Avital, Elizabeth R.; Achkar, Jacqueline M.

    2014-01-01

    Serology data are limited for patients with sputum smear-negative HIV-associated active tuberculosis (TB). We evaluated the serum antibody responses against the mycobacterial proteins MPT51, MS, and echA1 and the 38-kDa protein via enzyme-linked immunosorbent assay (ELISA) in South African (S.A.) HIV-positive (HIV+) smear-negative TB patients (n = 56), U.S. HIV+ controls with a positive tuberculin skin test (TST+; n = 21), and S.A. HIV-negative (HIV−) (n = 18) and HIV+ (n = 24) controls. TB p...

  18. Sputum smear negative pulmonary tuberculosis: sensitivity and specificity of diagnostic algorithm

    Mugusi Ferdinand M

    2011-11-01

    Full Text Available Abstract Background The diagnosis of pulmonary tuberculosis in patients with Human Immunodeficiency Virus (HIV is complicated by the increased presence of sputum smear negative tuberculosis. Diagnosis of smear negative pulmonary tuberculosis is made by an algorithm recommended by the National Tuberculosis and Leprosy Programme that uses symptoms, signs and laboratory results. The objective of this study is to determine the sensitivity and specificity of the tuberculosis treatment algorithm used for the diagnosis of sputum smear negative pulmonary tuberculosis. Methods A cross-section study with prospective enrollment of patients was conducted in Dar-es-Salaam Tanzania. For patients with sputum smear negative, sputum was sent for culture. All consenting recruited patients were counseled and tested for HIV. Patients were evaluated using the National Tuberculosis and Leprosy Programme guidelines and those fulfilling the criteria of having active pulmonary tuberculosis were started on anti tuberculosis therapy. Remaining patients were provided appropriate therapy. A chest X-ray, mantoux test, and Full Blood Picture were done for each patient. The sensitivity and specificity of the recommended algorithm was calculated. Predictors of sputum culture positive were determined using multivariate analysis. Results During the study, 467 subjects were enrolled. Of those, 318 (68.1% were HIV positive, 127 (27.2% had sputum culture positive for Mycobacteria Tuberculosis, of whom 66 (51.9% were correctly treated with anti-Tuberculosis drugs and 61 (48.1% were missed and did not get anti-Tuberculosis drugs. Of the 286 subjects with sputum culture negative, 107 (37.4% were incorrectly treated with anti-Tuberculosis drugs. The diagnostic algorithm for smear negative pulmonary tuberculosis had a sensitivity and specificity of 38.1% and 74.5% respectively. The presence of a dry cough, a high respiratory rate, a low eosinophil count, a mixed type of anaemia and

  19. Predicting smear negative pulmonary tuberculosis with classification trees and logistic regression: a cross-sectional study

    Kritski Afrânio; Chaisson Richard E; Conde Marcus; Rezende Valéria MC; Soares Sérgio; Bastos Luiz; Mello Fernanda; Ruffino-Netto Antonio; Werneck Guilherme

    2006-01-01

    Abstract Background Smear negative pulmonary tuberculosis (SNPT) accounts for 30% of pulmonary tuberculosis cases reported yearly in Brazil. This study aimed to develop a prediction model for SNPT for outpatients in areas with scarce resources. Methods The study enrolled 551 patients with clinical-radiological suspicion of SNPT, in Rio de Janeiro, Brazil. The original data was divided into two equivalent samples for generation and validation of the prediction models. Symptoms, physical signs ...

  20. TB-SA antibody test for diagnosis and monitoring treatment outcome of sputum smear negative pulmonary tuberculosis patients.

    Li, Xinxu; Xu, Hancheng; Jiang, Shiwen; Jing, Kuanhe; Wang, Li; Liu, Xiaoqiu; Li, Weibin; Zhang, Hui; Wang, Lixia

    2011-09-01

    The objectives of this study were to evaluate the suitability of the TB-SA antibody test to diagnose tuberculosis in sputum smear negative (SS-) pulmonary tuberculosis (TB) patients and its applicability for monitoring treatment outcomes in these patients. This study was conducted in three counties/districts in Chongqing Municipality, Liaoning Province, China between June 2005 and June 2007. A total of 432 SS suspected pulmonary TB patients were recruited and their blood was collected prior to treatment, at the end of 1 month of treatment, 2 months of treatment and 6 months of treatment (E6MT). The serum samples were analyzed with a TB-SA antibody test kit. Of the 432 SS suspected pulmonary TB patients, serum samples were obtained at all time points in 316 patients and analyzed. The 316 patients were divided into three groups according to sputum smear and sputum culture results and the chest X-ray results before treatment and at E6MT. Ten point four percent were SS-/culture positive (C+), 73.1% were SS-/culture negative (C-) with X-rays abnormalities, and 16.5% were SS-/C- without X-rays abnormalities. The positive rates for TB-SA antibody in the three groups were 57.6, 44.6 and 44.2%, respectively, before treatment, and 18.2, 19.1 and 26.9%, respectively, at E6MT. There was a significant decrease in TB-SA antibody positivity with treatment for all 3 groups. The TB-SA antibody test may be a useful adjunct to diagnose tuberculosis in SS- pulmonary TB patients, and may be useful for monitoring treatment outcomes of SS- pulmonary TB patients. PMID:22299440

  1. Clinico-pathological profile and treatment outcome in smear negative pulmonary tuberculosis patients at a teaching hospital

    Tuberculosis remains the single highest contributor to the world's morbidity and mortality. Early diagnosis and prompt treatment is essential to prevent its transmission. To see the treatment response of anti tuberculosis drugs in smear negative patients and study the predictors of culture positive among smear negative tuberculosis patients. Ninety four sputum smear negative patients clinically and radiologically suggestive of tuberculosis were selected. These patients were put on anti tuberculosis drugs without waiting for their culture results. They were then followed for 8 months to see their treatment outcome. A total of 94 smear negative patients were selected and given anti tuberculosis treatment. Of these 37(39%) were culture positive and 57(61%) were culture negative. Of the 37 culture positive patients 36(97%) showed clinical or radiological improvement as compared to 46(81%) out of 57 in culture negative cases. Symptoms of cough with sputum production was significantly associated with culture positivity. On x-ray chest moderate lesion with diffuse infiltration was more common finding in 64% while extensive and cavitatory lesion was seen in 24% of all cases. Association of extensive and cavitatory lesion were seen in culture positive group. Response to anti tuberculosis drugs in sputum smear negative tubercolosis suspects was found to be effective in majority of the patients. Cough, sputum and extensive cavitatory lung lesion were the predictors of culture positive cases. There is need to train physicians on the use of anti tuberculosis therapy in smear negative suspected pulmonary tuberculosis cases, especially if they have productive cough and cavitatory lung lesions. (author)

  2. Comparison of Chest X-Ray Findings of Smear Positive and Smear Negative Patients with Pulmonary Tuberculosis

    Tuberculosis is a chronic pulmonary infectious disease that has affected one-third of the people in the world. It causes nine million new cases and two million deaths per year. Chest radiography associated with Ziehl-Neelsen acid-fast staining procedure significantly helps the diagnosis of pulmonary tuberculosis (PTB). Chest radiography can help the diagnosis of tuberculosis in patients with a negative smear sample result that is mainly diagnosed with delay. In this study, chest X-ray findings of PTB were compared in two groups of smear positive and smear negative patients. In this retrospective descriptive-analytical study, 376 patients who had been confirmed with PTB were referred to Birjand Health Care Center from 2001 to 2006. Out of the 376 patients, 100 patients with a positive smear based on WHO criteria were selected. In addition, among negative smear patients, 100 were selected in whom similar demographic characteristics with positive smear patients were seen. All of them had undergone chest radiographies that were then interpreted by two expert radiologists independently. Moreover, all patients’ sputa were examined by an expert laboratory technician at the reference laboratory of the health center. The obtained data were analyzed by means of frequency distribution table and descriptive statistics using SPSS (version 15) and Chi-square statistical test. Except reticulo-nodular infiltration, the relative frequency of other radiographic findings in positive smear patients were more than negative smear patients; and only differences in calcification variables, mediastinal widening, patchy infiltration and hilar adenopathy were statistically significant (P < 0.05). Based on the results of this study, although radiographic findings are not diagnostic in PTB, they are helpful if the assessment associates with the view of clinical manifestations and sputum smears

  3. Predicting smear negative pulmonary tuberculosis with classification trees and logistic regression: a cross-sectional study

    Kritski Afrânio

    2006-02-01

    Full Text Available Abstract Background Smear negative pulmonary tuberculosis (SNPT accounts for 30% of pulmonary tuberculosis cases reported yearly in Brazil. This study aimed to develop a prediction model for SNPT for outpatients in areas with scarce resources. Methods The study enrolled 551 patients with clinical-radiological suspicion of SNPT, in Rio de Janeiro, Brazil. The original data was divided into two equivalent samples for generation and validation of the prediction models. Symptoms, physical signs and chest X-rays were used for constructing logistic regression and classification and regression tree models. From the logistic regression, we generated a clinical and radiological prediction score. The area under the receiver operator characteristic curve, sensitivity, and specificity were used to evaluate the model's performance in both generation and validation samples. Results It was possible to generate predictive models for SNPT with sensitivity ranging from 64% to 71% and specificity ranging from 58% to 76%. Conclusion The results suggest that those models might be useful as screening tools for estimating the risk of SNPT, optimizing the utilization of more expensive tests, and avoiding costs of unnecessary anti-tuberculosis treatment. Those models might be cost-effective tools in a health care network with hierarchical distribution of scarce resources.

  4. Optimizing Mycobacterial Culture in Smear-Negative, Human Immunodeficiency Virus-Infected Tuberculosis Cases.

    N A Ismail

    Full Text Available Tuberculosis (TB is a significant public health problem and the diagnosis in human immunodeficiency virus (HIV-infected individuals is challenging. The use of mycobacterial culture remains an important complementary tool and optimizing it has important benefits. We sought to determine the effect of an increase in the number of specimens evaluated, addition of nutritional supplementation to the culture medium, sputum appearance and volume on diagnostic yield and time to detection of pulmonary TB among smear-negative, HIV-infected adults.In this prospective study conducted at the Tshwane District Hospital and Academic TB Laboratory, Pretoria, South Africa we collected three sputum specimens an hour apart from presumptive TB cases at an antiretroviral treatment site. We analysed specimens from 236 patients. Specimen appearance and volume were recorded. All specimens were processed for culture using both standard and supplemented media.A single specimen identified 79% of PTB cases using standard media; the second and third specimens added 12.5% and 8.3% respectively. Media supplementation, sputum appearance and specimen volume had no effect on culture yield or contamination rates. The mean time to detection was reduced from 19.8 days in standard cultures to 11.8 days in nutrient supplemented cultures (p = 0.002. For every 1 ml increase in sputum volume, time to detection was decreased by a factor of 0.797 (p = 0.011.Use of an inexpensive culture supplement substantially reduced time to detection and could contribute to reducing treatment delay among HIV-infected cases.

  5. Diagnostic Yield of Bronchoalveolar Lavage Gene Xpert in Smear-Negative and Sputum-Scarce Pulmonary Tuberculosis

    Objective: To measure the diagnostic yield of Bronchoalveolar Lavage (BAL) gene Xpert (Xpert MTB/RIF assay), to detect Mycobacterium tuberculosis (MTB) and rifampicin resistance and compare it with that of mycobacterial cultures in a suspected case of pulmonary tuberculosis. Study Design: An analytical study. Place and Duration of Study: Department of Pulmonology, Fauji Foundation Hospital (FFH), Rawalpindi, from December 2012 to August 2013. Methodology: BAL specimens of 93 patients with suspected pulmonary tuberculosis with smear-negative or sputumscarce disease, who presented to the Department of Pulmonology, FFH, Rawalpindi were inducted. A smear-negative case was one in whom three consecutive early morning sputum samples did not reveal acid fast bacilli when examined by microscopy with Zeihl Nelson (ZN) stain. Patients who had sputum amount less than 1 ml were defined to have sputumscarce disease. The same was evaluated with ZN stain, gene Xpert and mycobacterial cultures. Sensitivity analysis was carried out using culture as the gold standard. Results: The frequency of positive mycobacterial cultures was 85 (91.4%). The sensitivity, specificity, positive predictive value and negative predictive values of BAL gene Xpert to detect Mycobacterium tuberculosis were 91.86%, 71.42%, 97.53% and 41.66% respectively. Xpert MTB/RIF assay had a sensitivity and specificity of 83.33% and 100% to detect rifampicin resistance. Conclusion: Bronchoalveolar lavage gene Xpert had a superior diagnostic yield in patients with either smear-negative or sputum-scarce pulmonary tuberculosis. Hence a positive Xpert MTB/RIF assay may be a useful adjunct to diagnosis and detection of MDR-TB in bronchoalveolar lavage specimens. (author)

  6. Predictors for MTB Culture-Positivity among HIV-Infected Smear-Negative Presumptive Tuberculosis Patients in Uganda: Application of New Tuberculosis Diagnostic Technology

    Nakiyingi, Lydia; Bareng A S Nonyane; Ssengooba, Willy; Bruce J Kirenga; Nakanjako, Damalie; Lubega, Gloria; Byakika-Kibwika, Pauline; Moses L Joloba; Ellner, Jerry J.; Susan E Dorman; Mayanja-Kizza, Harriet; Manabe, Yukari C.

    2015-01-01

    Background The existing World Health Organization diagnostic algorithms for smear-negative TB perform poorly in HIV-infected individuals. New TB diagnostics such as urine TB lipoarabinomannan (LAM) could improve the accuracy and reduce delays in TB diagnosis in HIV-infected smear-negative presumptive TB. We sought to determine predictors for MTB culture-positivity among these patients. Methods This study was nested into a prospective evaluation of HIV-infected outpatients and inpatients clini...

  7. Evaluation of rapid techniques for the detection of mycobacteria in sputum with scanty bacilli or clinically evident, smear negative cases of pulmonary and extra-pulmonary tuberculosis

    Pottathil Shinu

    2011-08-01

    Full Text Available The objective of the current study was to compare two rapid methods, the BBL Mycobacteria Growth Indicator Tube (MGIT TM and Biotec FASTPlaque TB TM (FPTB assays, with the conventional Löwenstein-Jensen (LJ media assay to diagnose mycobacterial infections from paucibacillary clinical specimens. For evaluation of the clinical utility of the BBL MGIT TM and FPTB assays, respiratory tract specimens (n = 208, with scanty bacilli or clinically evident, smear negative cases and non-respiratory tract specimens (n = 119 were analyzed and the performance of each assay was compared with LJ media. MGIT and FPTB demonstrated a greater sensitivity (95.92% and 87.68%, specificity (94.59% and 98.78%, positive predictive value (94.91% and 99.16% and negative predictive value (96.56% and 90.92%, respectively, compared to LJ culture for both respiratory tract and non-respiratory tract specimens. However, the FPTB assay was unable to detect nontuberculous mycobacteria and few Mycobacterium tuberculosis complex cases from paucibacillary clinical specimens. It is likely that the analytical sensitivity of FPTB is moderately low and may not be useful for the direct detection of tuberculosis in paucibacillary specimens. The current study concluded that MGIT was a dependable, highly efficient system for recovery of M. tuberculosis complexes and nontuberculous mycobacteria from both respiratory and non-respiratory tract specimens in combination with LJ media.

  8. Sodium Hypochlorite Sedimentation Technique: A Simple Way to Enhance Sensitivity of Ziehl-Neelsen Stain in Diagnosis of Smear Negative Pulmonary Tuberculosis

    B. V. Peerapur

    2014-07-01

    Full Text Available Background: With the looming global HIV pandemic, the problem of tuberculosis tiptoes as a perpetual companion. Smear negative pulmonary tuberculosis which pose substantially a challenge for diagnosis, hoots this combination into noxious health problem. There is, therefore, an urgent need to establish more sensitive, safe and fairly rapid methodologies that could confirm diagnosis particularly in smear negative pulmonary tuberculosis patients. Aim: This study was carried out to establish whether, 3.5% sodium hypochlorite overnight sedimentation method improves the sensitivity of Ziehl-Neelsen (ZN stain in samples declared as smear negative. Material and Methods: A total of 605 direct ZN smear negative sputum specimens were examined after concentration with 3.5% sodium hypochlorite overnight sedimentation method. Results: Forty one (6.77% samples were found to be positive when smears were repeated after performing sodium hypochlorite sedimentation technique. Sensitivity and specificity of this method was found to be 76.31% and 97.88% respectively. Conclusion: 3.5% Sodium hypochlorite sedimentation technique has the potential to improve the diagnosis in tuberculosis in smear negative pulmonary tuberculosis cases especially in resource poor countries.

  9. Diagnostic value of serum adenosine deaminase levels in sputum smear negative pulmonary tuberculosis patients in Nepalese population

    Anil Chander; Chandrika Devi Shrestha

    2012-01-01

    Objective: To assess the levels of adenosine deaminase (ADA) in serum in patients with sputum smear negative pulmonary tuberculosis (SNPTB) and to compare it with serum ADA levels in patients with non-tuberculous pulmonary disease - chronic obstructive pulmonary disease (COPD) and with healthy control group and to explore its validity as a diagnostic marker in serum in SNPTB patients.Methods:Three groups of study populations were made. Group I: SNPTB - 142 cases, Group II:non-tubercular pulmonary disease - COPD - 40 cases, Group III: healthy controls - 80 cases. Serum samples were collected and ADA assay was done by the method of Guisti and Galanti. Results: ADA levels (Mean±SD, U/L) in the three groups were as follows: Group I: 42.26±21.22, Group II: 23.31±8.22, Group III: 18.88±6.67. Difference between Group I and Group III was statistically significant (P < 0.0001). The test showed a high specificity 91.25% (95% confidence interval - CI 83.00 - 95.7) and a sensitivity of 83.10% (95% CI 76.08-88.37) in Group I. Positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and accuracy in Group I were 94.00%, 69.52%, 9.49, 0.18 and 82.43% respectively.Conclusions: Overall assessment of the use of serum ADA levels as a diagnostic biochemical marker in smear-negative pulmonary tuberculosis patients showed promising results. Studies with a larger population group are required to validate its use as a routine diagnostic test in these cases.

  10. A first insight into high prevalence of undiagnosed smear-negative pulmonary tuberculosis in Northern Ethiopian prisons: implications for greater investment and quality control.

    Fantahun Biadglegne

    Full Text Available BACKGROUND: Tuberculosis (TB transmission in prisons poses significant risks to inmates as well as the general population. Currently, there are no data on smear-negative pulmonary TB cases in prisons and by extension no data on the impact such cases have on TB incidence. This study was designed to obtain initial data on the prevalence of smear-negative cases of TB in prisons as well as preliminary risk factor analysis for such TB cases. METHODS: This cross-sectional survey was conducted in November 2013 at eight main prisons located in the state of Amhara, Ethiopia. Interviews using a structured and pretested questionnaire were done first to identify symptomatic prisoners. Three consecutive sputum samples were collected and examined using acid fast bacilli (AFB microscopy at the point of care. All smear-negative sputum samples were taken for culture and Xpert testing. Descriptive and multivariate analysis was done using SPSS version 16. RESULTS: Overall the prevalence of smear-negative pulmonary TB cases in the study prisons was 8% (16/200. Using multivariate analysis, a contact history to TB patients in prison, educational level, cough and night sweating were found to be predictors of TB positivity among smear-negative pulmonary TB cases (p ≤ 0.05. CONCLUSIONS: In the studied prisons, high prevalence of undiagnosed TB cases using AFB microscopy was documented, which is an important public health concern that urgently needs to be addressed. Furthermore, patients with night sweating, non-productive cough, a contact history with TB patients and who are illiterate merit special attention, larger studies are warranted in the future to assess the associations more precisely. Further studies are also needed to examine TB transmission dynamics by patients with smear-negative pulmonary TB in a prison setting.

  11. Diagnosis of Carrion's disease by direct blood PCR in thin blood smear negative samples.

    Juana del Valle Mendoza

    Full Text Available Bartonella bacilliformis is the etiologic agent of Carrion's disease. This disease has two well established phases, the most relevant being the so called Oroya Fever, in which B. bacilliformis infect the erythrocytes resulting in severe anemia and transient immunosuppression, with a high lethality in the absence of adequate antibiotic treatment. The presence of B. bacilliformis was studied in 113 blood samples suspected of Carrion's disease based on clinical criteria, despite the absence of a positive thin blood smear, by two different PCR techniques (using Bartonella-specific and universal 16S rRNA gene primers, and by bacterial culture. The specific 16S rRNA gene primers revealed the presence of 21 B. bacilliformis and 1 Bartonella elizabethae, while universal primers showed both the presence of 3 coinfections in which a concomitant pathogen was detected plus Bartonella, in addition to the presence of infections by other microorganisms such as Agrobacterium or Bacillus firmus. These data support the need to implement molecular tools to diagnose Carrion's disease.

  12. A First Insight into High Prevalence of Undiagnosed Smear-Negative Pulmonary Tuberculosis in Northern Ethiopian Prisons: Implications for Greater Investment and Quality Control

    Biadglegne, Fantahun; Arne C Rodloff; Sack, Ulrich

    2014-01-01

    Background Tuberculosis (TB) transmission in prisons poses significant risks to inmates as well as the general population. Currently, there are no data on smear-negative pulmonary TB cases in prisons and by extension no data on the impact such cases have on TB incidence. This study was designed to obtain initial data on the prevalence of smear-negative cases of TB in prisons as well as preliminary risk factor analysis for such TB cases. Methods This cross-sectional survey was conducted in Nov...

  13. Accurate diagnoses, evidence based drugs, and new devices (3 Ds in heart failure

    Bambang B. Siswanto

    2012-02-01

    Full Text Available Heart failure becomes main problem in cardiology because of increasing of heart failure patients, rehospitalization rate, morbidity, and mortality rate. The main causes of increasing heart failure problems are: (1 Successful treatment of acute myocardial infarction can be life saving, but its sequelae can cause heart failure. (2 Increasing life expectancy rate grows along with incidences of ageing related heart failure. (3 High prevalence of infection in Indonesia can cause rheumatic heart disease post Streptococcal beta hemolyticus infection, viral myocarditis, infective endocartitis, and tuberculoid pericarditis. (4 Many risk factors for coronary heart disease are often found in heart failure patients, for examples smoking, diabetes, hypercholesterolemia, hypertension, and obesity. Indonesia joined international multicentered registry in 2006. Acute Decompensated HEart failure REgistry is a web based international registry to record patient with acute decompensated heart failure treated in emergency room. It was found that heart failure patients in 5 big hospitals in Java and Bali island that joined this registry are younger, sicker and late to seek treatment. The median hospital length of stay was 7 days and in hospital mortality rate was 6.7%. The aim of this article is to give summary about essential things in diagnosing and treating heart failure patients. 3D (accurate diagnoses, evidence based drugs, and new devices are the most important but what to do and what not to do in dealing with heart failure is also useful for your daily practice. (Med J Indones 2012;21:52-8Keywords: Devices, diagnostic, drugs, heart failure

  14. Bronchoalveolar lavage enzyme-linked immunospot for diagnosis of smear-negative tuberculosis in HIV-infected patients.

    Adithya Cattamanchi

    Full Text Available Peripheral blood interferon-gamma release assays (IGRAs have sub-optimal sensitivity and specificity for diagnosis of active pulmonary tuberculosis (TB. However, assessment of local immune responses has been reported to improve the accuracy of TB diagnosis.We enrolled HIV-infected adults with cough ≥2 weeks' duration admitted to Mulago Hospital in Kampala, Uganda and referred for bronchoscopy following two negative sputum acid-fast bacillus smears. We performed an ELISPOT-based IGRA (T-SPOT.TB®, Oxford Immunotec, Oxford, UK using peripheral blood and bronchoalveolar lavage (BAL fluid mononuclear cells, and determined the accuracy of IGRAs using mycobacterial culture results as a reference standard.94 HIV-infected patients with paired peripheral blood and BAL IGRA results were included. The study population was young (median age 34 years [IQR 28-40 years] and had advanced HIV/AIDS (median CD4+ T-lymphocyte count 60 cells/µl [IQR 22-200 cells/µl]. The proportion of indeterminate IGRA results was higher in BAL fluid than in peripheral blood specimens (34% vs. 14%, difference 20%, 95% CI 7-33%, p = 0.002. BAL IGRA had moderate sensitivity (73%, 95% CI 50-89% but poor specificity (48%, 95% CI 32-64% for TB diagnosis. Sensitivity was similar (75%, 95% CI 57-89% and specificity was higher (78%, 95% CI 63-88% when IGRA was performed on peripheral blood.BAL IGRA performed poorly for the diagnosis of smear-negative TB in a high HIV/TB burden setting. Further studies are needed to examine reasons for the large proportion of indeterminate results and low specificity of BAL IGRA for active TB in high HIV/TB burden settings.

  15. Aetiology of pulmonary symptoms in HIV-infected smear negative recurrent PTB suspects in Kampala, Uganda: a cross-sectional study.

    Alphonse Okwera

    Full Text Available INTRODUCTION: Previously treated TB patients with pulmonary symptoms are often considered recurrent TB suspects in the resource-limited settings, where investigations are limited to microscopy and chest x-ray. Category II anti-TB drugs may be inappropriate and may expose patients to pill burden, drug toxicities and drug-drug interactions. OBJECTIVE: To determine the causes of pulmonary symptoms in HIV-infected smear negative recurrent pulmonary tuberculosis suspects at Mulago Hospital, Kampala. METHODS: Between March 2008 and December 2011, induced sputum samples of 178 consented HIV-infected smear negative recurrent TB suspects in Kampala were subjected to MGIT and LJ cultures for mycobacteria at TB Reference Laboratory, Kampala. Processed sputum samples were also tested by PCR to detect 18S rRNA gene of P.jirovecii and cultured for other bacteria. RESULTS: Bacteria, M. tuberculosis and Pneumocystis jirovecii were detected in 27%, 18% and 6.7% of patients respectively and 53.4% of the specimens had no microorganisms. S. pneumoniae, M. catarrhalis and H. influenzae were 100% susceptible to chloramphenicol and erythromycin but co-trimoxazole resistant. CONCLUSION: At least 81.5% of participants had no microbiologically-confirmed TB. However our findings call for thorough investigation of HIV-infected smear negative recurrent TB suspects to guide cost effective treatment.

  16. The Application of GeneXpert MTB/RIF for Smear-Negative TB Diagnosis as a Fee-Paying Service at a South Asian General Hospital

    Arjyal, Amit; Caws, Maxine; Prajapati, Krishna Govinda; Karkey, Abhilasha; Dongol, Sabina; Pathak, Saruna; Prajapati, Shanti; Basnyat, Buddha

    2015-01-01

    The GeneXpert MTB/RIF assay (Xpert) is a novel automated diagnostic tool for tuberculosis but its optimal placement in the healthcare system has not been determined. The objective of this study was to determine the possibility of additional case detection for pulmonary tuberculosis (PTB) by offering Xpert to smear-negative patients in a low-HIV burden setting with no Mycobacterium tuberculosis (M.tb.) culture facilities. Patients routinely presenting with symptoms suggestive of PTB with negative smears were offered single Xpert test on a fee-paying basis. Data were retrospectively reviewed to determine case detection in patients tested from February to December 2013. Symptoms associated with a positive test were analysed to determine if refinement of clinical criteria would reduce unnecessary testing. 258 smear-negative patients were included and M.tb. was detected in 55 (21.32%, n = 55/258). Using standard clinical assessment for selection, testing 5 patients detected one case of smear-negative PTB. These results demonstrate that fee-paying Xpert service in low-income setting can increase TB case confirmation substantially and further systematic studies of health economic implications should be conducted to determine optimal implementation models to increase access to Xpert in low- and middle-income countries. PMID:25949825

  17. The rapid diagnosis value of T-SPOT .TB for smear negative pulmonary tuberculosis%T-SPOT .TB在涂阴肺结核中的快速诊断价值

    黄丽美; 林健雄; 彭东东; 刘晓燕; 郭苏珊; 李耿聪

    2015-01-01

    目的:评价结核感染 T 细胞试验(T‐SPOT .TB)在涂阴肺结核病诊断上的价值。方法利用 T‐SPOT .TB、TB‐DNA、TB‐DOT 3种结核病诊断方法对112例确诊涂阴肺结核病患者和60例非结核病对照者分别进行检测。结果 T‐SPOT . TB试验检测灵敏度为88.3%,TB‐DNA、TB‐DOT的灵敏度依次为25.9%、58.9%,与T‐SPOT .TB试验相比,差异均有统计学意义(χ2=86.6,P<0.05;χ2=23.3,P<0.05);T‐SPOT .TB试验特异度为96.7%,显著高于 TB‐DOT (78.3%),差异有统计学意义(χ2=9.22,P<0.05)。结论 T‐SPOT .TB对涂阴肺结核病的敏感性和特异性都有明显的优势,可以作为涂阴肺结核病早期诊断的一种辅助检查手段,具快速准确的诊断价值。%Objective To evaluate the diagnostic value of Tuberculosis Infection in T Cell Test(T‐SPOT .TB) for smear negative pulmonary tuberculosis .Methods Separately used T‐SPOT .TB ,TB‐DNA ,TB‐DOT the three diagnostic methods for tuberculosis , separately detected with each method ,112 smear negative pulmonary tuberculosis ,and 60 non tuberculosis regarded as control group .Results The sensitivity of T‐SPOT .TB ,TB‐DNA ,TB‐DOT in proper sequence were 88 .3% ,25 .9% ,58 .9% .Contrasted to TB‐DNA and TB‐DOT ,the differences were statistically significant(X2 =86 .6 ,P<0 .01 ;X2 =23 .3 ,P<0 .01);the specificity of T‐SPOT .TB was 96 .7% ,significantly higher than TB‐DOT (78 .3% ) ,the differences were statistically significant(X2 = 9 .22 ,P<0 .05) .Conclusion T‐SPOT .TB has obvious advantages in sensitivity and specificity for smear negative pulmonary tuberculosis .It can be one auxiliary tool for smear negative pulmonary tuberculosis early diagnosis ,provided with the value of fast and accurate .

  18. How accurate can we diagnose breast lesion by fine needle aspiration cytology?

    Fine needle aspiration cytology (FNA) is performed firstly in the diagnosis of breast lesion, as the FNA is less-invasive diagnostic procedure. Depending on the results obtained by the FNA, we subsequently perform core needle biopsy or Mammotome biopsy to determine the histological finding of the breast lesion. The purpose of the study is to evaluate the accuracy and limitation of diagnosis of breast lesion by FNA. The clinical data of 528 patients who underwent an operation for the breast lesion in the Shinshu University hospital from April 2004 to March 2009 were analyzed. Of 528 breast lesions, 488 were breast cancers, and 40 benign breast lesions. Of 528 breast lesions, 94 cases were excluded because CNB or MMT was performed firstly. In these cases, some were scheduled for the preoperative chemotherapy, and others were highly suspected to be ductal carcinoma in situ (DCIS), which was expected to be difficult to be diagnosed by FNA. Two hundreds and ninety two cases of 488 (59.8%) breast cancers and 21 of 40 (52.2%) benign lesions were diagnosed by FNA, respectively. Three of 299 cases (1%) determined to be 'malignant' by FNA were diagnosed as benign in the postoperative pathological diagnosis. 40 of 40 'suspicious for malignancy,' 40 of 46 'indeterminate,' 12 of 38 'normal or benign,' and 10 of 11 'inadequate' cases were finally diagnosed as cancer, in which scirrhous carcinoma, DCIS, small papillo-tubular carcinoma and lobular carcinoma were observed. It is speculated that enough specimens for diagnosis might not be obtained from these tumors by FNA, and that diagnosis by cytology itself might be difficult for these tumors. Although FNA is useful in the diagnosis of breast lesions, some lesions are very difficult to be diagnosed by FNA alone. We have to be careful in considering the conformity of the findings of image diagnoses with the cytological findings. Furthermore, when there is a lack of conformity between them, we should not to hesitate to perform CNB

  19. Using an Educational Electronic Documentation System to Help Nursing Students Accurately Identify Nursing Diagnoses

    Pobocik, Tamara J.

    2013-01-01

    The use of technology and electronic medical records in healthcare has exponentially increased. This quantitative research project used a pretest/posttest design, and reviewed how an educational electronic documentation system helped nursing students to identify the accurate related to statement of the nursing diagnosis for the patient in the case…

  20. Decline in overall, smear-negative and HIV-positive TB incidence while smear-positive incidence stays stable in Guinea-Bissau 2004-2011

    Lemvik, G; Rudolf, F; Vieira, F;

    2014-01-01

    191. TB incidence rates increased significantly with age in both sexes, regardless of smear or HIV status. Despite a peak with unknown cause of 352 per 100 000 in 2007, the overall incidence of pulmonary TB declined over the period. The incidence of HIV infected TB cases declined significantly from...... 108 to 39 per 100 000, while the incidence of smear-positive TB cases remained stable; the overall figure was 188 per 100 000. CONCLUSIONS: Overall incidence of pulmonary TB in Guinea-Bissau has declined from 2004 to 2011. The decline was also seen in the subgroups of smear-negative and HIV......OBJECTIVE: To calculate Tuberculosis (TB) incidence rates in Guinea-Bissau over an 8-year period. METHODS: Since 2003, a surveillance system has registered all TB cases in six suburban districts of Bissau. In this population-based prospective follow-up study, 1205 cases of pulmonary TB were...

  1. Successful removal of intrathyroidal parathyroid adenoma diagnosed and accurately located preoperatively by parathyroid scintigraphy (SPECT-CT)

    We describe the case of a large intrathyroidal parathyroid adenoma in a 46-year-old woman who had a history of recently diagnosed hypercalcaemia and a 2-year history of an asymptomatic enlargement of the right lobe of the thyroid. This rare case highlights the potential difficulties that can arise in the evaluation of hyperparathyroidism, especially in cases of multinodular goiter. In some cases, including this one, even a thorough preoperative evaluation that includes radiological studies (ultrasonography and computed tomography (CT)) may not allow for a definitive preoperative diagnosis due to limited sensitivity, especially in multinodular goiter. The overlapping histological features between thyroid and parathyroid lesions can also be problematic at the time of the intraoperative frozen-section evaluation. We present a case in which, with parathyroid scintigraphy and combination of structural and functional imaging (SPECT-CT), we could accurately locate the intrathyroidal parathyroid adenoma in a patient with multinodular goiter. (author)

  2. Avaliação da utilidade diagnóstica da fibrobroncoscopia óptica na tuberculose pulmonar BAAR negativa na prática clínica de rotina Evaluation of the diagnostic utility of fiberoptic bronchoscopy for smear-negative pulmonary tuberculosis in routine clinical practice

    Alonso Soto

    2012-12-01

    Full Text Available Avaliamos o rendimento diagnóstico da fibrobroncoscopia óptica no diagnóstico de tuberculose pulmonar com baciloscopia negativa em pacientes atendidos em um hospital de referência em Lima, Peru. Dos 611 pacientes submetidos ao procedimento, 140 (23% foram diagnosticados com tuberculose com base nas amostras de LBA. Ser mais jovem e do sexo masculino foi associado a culturas positivas. Além disso, 287 pacientes realizaram baciloscopia de escarro após a broncoscopia, e os resultados aumentaram o rendimento diagnóstico em 22% em relação às amostras de LBA. Concluímos que amostras de LBA e de escarro pós-broncoscopia tiveram um bom rendimento diagnóstico nos pacientes com suspeita de tuberculose pulmonar com baciloscopia negativa.We evaluated the diagnostic yield of fiberoptic bronchoscopy for the diagnosis of smear-negative pulmonary tuberculosis in patients treated at a referral hospital in Lima, Peru. Of the 611 patients who underwent the procedure, 140 (23% were diagnosed with tuberculosis based on the analysis of BAL samples. Being young and being male were significantly associated with positive cultures. In addition, 287 patients underwent post-bronchoscopic sputum smear testing for AFB, the results of which increased the diagnostic yield by 22% over that obtained through the analysis of BAL samples alone. We conclude that the analysis of BAL samples and post-bronchoscopic sputum samples provides a high diagnostic yield in smear-negative patients suspected of having pulmonary tuberculosis.

  3. Successful removal of intrathyroidal parathyroid adenoma diagnosed and accurately located preoperatively by parathyroid scintigraphy (SPECT-CT)

    Kaushal, Dinesh Kumar; Mishra, Atul; Mittal, Naveen; Bordoloi, Jayanta K

    2010-01-01

    We describe the case of a large intrathyroidal parathyroid adenoma in a 46-year-old woman who had a history of recently diagnosed hypercalcaemia and a 2-year history of an asymptomatic enlargement of the right lobe of the thyroid. This rare case highlights the potential difficulties that can arise in the evaluation of hyperparathyroidism, especially in cases of multinodular goiter. In some cases, including this one, even a thorough preoperative evaluation that includes radiological studies (u...

  4. High IFIT1 expression predicts improved clinical outcome, and IFIT1 along with MGMT more accurately predicts prognosis in newly diagnosed glioblastoma.

    Zhang, Jin-Feng; Chen, Yao; Lin, Guo-Shi; Zhang, Jian-Dong; Tang, Wen-Long; Huang, Jian-Huang; Chen, Jin-Shou; Wang, Xing-Fu; Lin, Zhi-Xiong

    2016-06-01

    Interferon-induced protein with tetratricopeptide repeat 1 (IFIT1) plays a key role in growth suppression and apoptosis promotion in cancer cells. Interferon was reported to induce the expression of IFIT1 and inhibit the expression of O-6-methylguanine-DNA methyltransferase (MGMT).This study aimed to investigate the expression of IFIT1, the correlation between IFIT1 and MGMT, and their impact on the clinical outcome in newly diagnosed glioblastoma. The expression of IFIT1 and MGMT and their correlation were investigated in the tumor tissues from 70 patients with newly diagnosed glioblastoma. The effects on progression-free survival and overall survival were evaluated. Of 70 cases, 57 (81.4%) tissue samples showed high expression of IFIT1 by immunostaining. The χ(2) test indicated that the expression of IFIT1 and MGMT was negatively correlated (r = -0.288, P = .016). Univariate and multivariate analyses confirmed high IFIT1 expression as a favorable prognostic indicator for progression-free survival (P = .005 and .017) and overall survival (P = .001 and .001), respectively. Patients with 2 favorable factors (high IFIT1 and low MGMT) had an improved prognosis as compared with others. The results demonstrated significantly increased expression of IFIT1 in newly diagnosed glioblastoma tissue. The negative correlation between IFIT1 and MGMT expression may be triggered by interferon. High IFIT1 can be a predictive biomarker of favorable clinical outcome, and IFIT1 along with MGMT more accurately predicts prognosis in newly diagnosed glioblastoma. PMID:26980050

  5. Rapid Diagnosis of Smear-Negative Tuberculosis Using Immunology and Microbiology with Induced Sputum in HIV-Infected and Uninfected Individuals

    Breen, R A M; Hardy, G. A. D.; Perrin, F. M. R.; Lear, S; Kinloch, S.; Smith, C. J.; Cropley, I.; Janossy, G.; Lipman, M. C. I.

    2007-01-01

    Rationale and Objectives. Blood-based studies have demonstrated the potential of immunological assays to detect tuberculosis. However lung fluid sampling may prove superior as it enables simultaneous microbiological detection of mycobacteria to be performed. Until now this has only been possible using the expensive and invasive technique of broncho-alveolar lavage. We sought to evaluate an immunoassay using non-invasive induced-sputum to diagnose active tuberculosis. Methods and Results. Pros...

  6. Diagnosing Dementia--Positive Signs

    ... Navigation Bar Home Current Issue Past Issues Diagnosing Dementia—Positive Signs Past Issues / Fall 2007 Table of ... easy, affordable blood test that could accurately diagnose Alzheimer's disease (AD)—even before symptoms began to show? Researchers ...

  7. Getting Diagnosed

    ... also for those with related disorders. How is Marfan syndrome diagnosed? getting_diagnosed.jpg A Marfan diagnosis ... spinal column). Is there a genetic test for Marfan syndrome? Genetic testing can provide helpful information in ...

  8. How Is Asthma Diagnosed?

    ... page from the NHLBI on Twitter. How Is Asthma Diagnosed? Your primary care doctor will diagnose asthma ... other disease may be causing your symptoms. Diagnosing Asthma in Young Children Most children who have asthma ...

  9. Diagnosing GORD in respiratory medicine

    Chris James Timms

    2011-07-01

    Full Text Available Gastroesophageal reflux disease is increasing in prevalence and is associated with several lung diseases such as asthma and COPD. Current diagnostic methods are imperfect, being insensitive, nonspecific, expensive or invasive. An accurate diagnosis of GORD can aid effective treatment with a significant clinical impact. Novel methods such as exhaled breath condensate analysis and electronic nose technology have the potential to improve the accuracy of diagnosing GORD.

  10. Diagnosing GORD in Respiratory Medicine

    Timms, Chris J.; Yates, Deborah H; Thomas, Paul S.

    2011-01-01

    Gastroesophageal reflux disease (GORD) is increasing in prevalence and is highly associated with several lung diseases such as asthma and COPD. Current diagnostic methods are imperfect, being insensitive, non-specific, expensive, or invasive. An accurate diagnosis of GORD can aid effective treatment and have significant clinical impact. Novel methods such as exhaled breath condensate analysis and electronic nose technology have the potential to improve the accuracy of diagnosing GORD.

  11. How Is COPD Diagnosed?

    ... page from the NHLBI on Twitter. How Is COPD Diagnosed? Your doctor will diagnose COPD based on ... Rate This Content: NEXT >> Featured Video What is COPD? 05/22/2014 Describes how COPD, or chronic ...

  12. Critical thinking and accuracy of nurses' diagnoses.

    Lunney, Margaret

    2003-01-01

    Interpretations of patient data are complex and diverse, contributing to a risk of low accuracy nursing diagnoses. This risk is confirmed in research findings that accuracy of nurses' diagnoses varied widely from high to low. Highly accurate diagnoses are essential, however, to guide nursing interventions for the achievement of positive health outcomes. Development of critical thinking abilities is likely to improve accuracy of nurses' diagnoses. New views of critical thinking serve as a basis for critical thinking in nursing. Seven cognitive skills and ten habits of mind are identified as dimensions of critical thinking for use in the diagnostic process. Application of the cognitive skills of critical thinking illustrates the importance of using critical thinking for accuracy of nurses' diagnoses. Ten strategies are proposed for self-development of critical thinking abilities. PMID:14649031

  13. Differential diagnoses to MS

    Horwitz, Henrik; Friis, Tina; Modvig, Signe;

    2014-01-01

    of 643 patients were included in the study. Apart from ON, the most frequent diagnoses were tumors (n = 15), ischemic or hypertensive neuropathies (n = 13), and retinal or choroid disorders (n = 9). Six patients were diagnosed with neuromyelitis optica. Rarer causes of visual loss were infections (n...

  14. Diagnosing Sleep Disorders

    ... of this page please turn JavaScript on. Feature: Sleep Disorders Diagnosing Sleep Disorders Past Issues / Summer 2015 Table of Contents Depending ... several possible tests when trying to diagnose a sleep disorder: Sleep history and sleep log If you believe ...

  15. Diagnosing Psoriatic Arthritis

    ... to find out more! Email * Zipcode Diagnosing Psoriatic Arthritis Psoriatic arthritis can develop slowly with mild symptoms, or it ... severe. Early recognition, diagnosis and treatment of psoriatic arthritis can help prevent or limit extensive joint damage ...

  16. Diagnosing Delirium by Telephone

    Marcantonio, Edward R.; Sm,; Michaels, Mary; Resnick, Neil M.

    1998-01-01

    To determine whether delirium can be diagnosed by telephone, we interviewed 41 subjects aged 65 years or older 1 month after repair of hip fracture, first by telephone and then face-to-face. Interviews included the modified telephone Mini-Mental State Examination and the Delirium Symptom Interview. Delirium was diagnosed using the Confusion Assessment Method diagnostic algorithm, and the telephone results were compared with the face-to-face results (the “gold standard”). Of 41 subjects, 6 wer...

  17. Diagnosing gestational diabetes

    Ryan, E. A.

    2011-01-01

    The newly proposed criteria for diagnosing gestational diabetes will result in a gestational diabetes prevalence of 17.8%, doubling the numbers of pregnant women currently diagnosed. These new diagnostic criteria are based primarily on the levels of glucose associated with a 1.75-fold increased risk of giving birth to large-for-gestational age infants (LGA) in the Hyperglycemia Adverse Pregnancy Outcome (HAPO) study; they use a single OGTT. Thus, of 23,316 pregnancies, gestational diabetes wo...

  18. Diagnosing and Treating Acute Bronchitis

    ... Lung Disease Lookup > Acute Bronchitis Diagnosing and Treating Acute Bronchitis It is important to get your questions about ... Symptoms that last a few weeks How Is Acute Bronchitis Diagnosed? Healthcare providers diagnose acute bronchitis by asking ...

  19. Understanding Prostate Cancer: Newly Diagnosed

    ... Wellness PCF Spotlight Glossary African American Men Understanding Prostate Cancer Newly Diagnosed Newly Diagnosed Staging the Disease Issues ... you care about has recently been diagnosed with prostate cancer, this section will help guide you through the ...

  20. How a Stroke Is Diagnosed

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... Diagnosis » How a Stroke is Diagnosed How a Stroke is Diagnosed How a Stroke is Diagnosed Lab ...

  1. Diagnosis of Carrion’s Disease by Direct Blood PCR in Thin Blood Smear Negative Samples

    del Valle Mendoza, Juana; Silva Caso, Wilmer; Tinco Valdez, Carmen; Pons, Maria J.; del Valle, Luis J.; Oré, Verónica Casabona; Michelena, Denisse Champin; Mayra, Jorge Bazán; Gavidea, Víctor Zavaleta; Vargas, Martha; Ruiz, Joaquim

    2014-01-01

    Bartonella bacilliformis is the etiologic agent of Carrion's disease. This disease has two well established phases, the most relevant being the so called Oroya Fever, in which B. bacilliformis infect the erythrocytes resulting in severe anemia and transient immunosuppression, with a high lethality in the absence of adequate antibiotic treatment. The presence of B. bacilliformis was studied in 113 blood samples suspected of Carrion’s disease based on clinical criteria, despite the absence of a...

  2. Predictors and outcomes of mycobacteremia among HIV-infected smear- negative presumptive tuberculosis patients in Uganda

    Nakiyingi, Lydia; Ssengooba, Willy; Nakanjako, Damalie; Armstrong, Derek; Holshouser, Molly; Bruce J Kirenga; Shah, Maunank; Mayanja-Kizza, Harriet; Moses L Joloba; Ellner, Jerrold J; Susan E Dorman; Manabe, Yukari C.

    2015-01-01

    Background Sputum smear microscopy for tuberculosis (TB) diagnosis lacks sensitivity in HIV-infected symptomatic patients and increases the likelihood that mycobacterial infections particularly disseminated TB will be missed; delays in diagnosis can be fatal. Given the duration for MTB growth in blood culture, clinical predictors of MTB bacteremia may improve early diagnosis of mycobacteremia. We describe the predictors and mortality outcome of mycobacteremia among HIV-infected sputum smear-n...

  3. Optimizing Mycobacterial Culture in Smear-Negative, Human Immunodeficiency Virus-Infected Tuberculosis Cases

    Ismail, N. A.; Said, H. M.; Pinini, Z.; S.V. Omar; Beyers, N; Naidoo, P

    2015-01-01

    Introduction Tuberculosis (TB) is a significant public health problem and the diagnosis in human immunodeficiency virus (HIV)—infected individuals is challenging. The use of mycobacterial culture remains an important complementary tool and optimizing it has important benefits. We sought to determine the effect of an increase in the number of specimens evaluated, addition of nutritional supplementation to the culture medium, sputum appearance and volume on diagnostic yield and time to detectio...

  4. Being publicly diagnosed

    Konradsen, Hanne; Lillebaek, Troels; Wilcke, Jon Torgny Rostrup;

    2014-01-01

    INTRODUCTION: Tuberculosis (TB) is a disease which affects people worldwide, but there is knowledge lacking about patients' experiences in low-prevalence and high-income countries. AIM: To provide a theoretical framework for the process of being diagnosed with tuberculosis in a Danish setting. ME...

  5. Diagnosing pulmonary embolism

    Khosla Rahul

    2006-01-01

    Full Text Available Pulmonary embolism (PE is a common, treatable, highly lethal emergency, which despite advances in diagnostic testing, remains an under diagnosed killer. The mortality rate of diagnosed and treated pulmonary embolism ranges from 3-8%, but increases to about 30% in untreated pulmonary embolism. PE is a part of the spectrum of venousthromboembolic disease and most pulmonary emboli have their origin from clots in the iliac, deep femoral, or popliteal veins. Nonspecific clinical signs and symptoms with low sensitivity and specificity of routine tests such as arterial blood gas, chest roentgenogram and electrocardiogram make the diagnosis of PE very challenging for the clinician. Pulmonary angiography is the gold standard diagnostic test, but this technique is invasive, expensive, not readily available and labor intensive. Diagnostic strategies have revolved around establishing clinical probabilities based on predictive models, then ruling in or ruling out the diagnosis of PE with various tests. The aim of this article was to review the literature and present an evidence- based medicine approach to diagnosis of pulmonary embolism.

  6. How Is Muscular Dystrophy Diagnosed?

    ... Information Clinical Trials Resources and Publications How is muscular dystrophy diagnosed? Skip sharing on social media links Share this: Page Content The first step in diagnosing muscular dystrophy (MD) is a visit with a health care ...

  7. How Is Pulmonary Hypertension Diagnosed?

    ... from the NHLBI on Twitter. How Is Pulmonary Hypertension Diagnosed? Your doctor will diagnose pulmonary hypertension (PH) ... To Look for the Underlying Cause of Pulmonary Hypertension PH has many causes, so many tests may ...

  8. How Is Cystic Fibrosis Diagnosed?

    ... page from the NHLBI on Twitter. How Is Cystic Fibrosis Diagnosed? Doctors diagnose cystic fibrosis (CF) based on ... tested to see whether the baby has CF. Cystic Fibrosis Carrier Testing People who have one normal CFTR ...

  9. Ankle Fractures Often Not Diagnosed

    ... Not Diagnosed A A A | Print | Share Ankle Fractures Often Not Diagnosed Long-term complications result from ... patients: Total ankle replacements--similar to hip and knee replacements--were once reserved for geriatric patients but ...

  10. Diagnoses and interventions in podiatry.

    Zuijderduin, W.M.; Dekker, J

    1996-01-01

    In the present study a quantitative description is given of diagnoses and interventions in podiatry. Data are used from a survey on podiatry practice in The Netherlands. Data have been recorded by 36 podiatrists on 897 patients. Information was gathered on patient characteristics, the medical diagnoses, the podiatry diagnoses (impairments and disabilities), treatment goals derived from these diagnoses, and interventions. Impairments were recorded in nearly all patients. The interrelationship ...

  11. Accurate Finite Difference Algorithms

    Goodrich, John W.

    1996-01-01

    Two families of finite difference algorithms for computational aeroacoustics are presented and compared. All of the algorithms are single step explicit methods, they have the same order of accuracy in both space and time, with examples up to eleventh order, and they have multidimensional extensions. One of the algorithm families has spectral like high resolution. Propagation with high order and high resolution algorithms can produce accurate results after O(10(exp 6)) periods of propagation with eight grid points per wavelength.

  12. Diagnosable structured logic array

    Whitaker, Sterling (Inventor); Miles, Lowell (Inventor); Gambles, Jody (Inventor); Maki, Gary K. (Inventor)

    2009-01-01

    A diagnosable structured logic array and associated process is provided. A base cell structure is provided comprising a logic unit comprising a plurality of input nodes, a plurality of selection nodes, and an output node, a plurality of switches coupled to the selection nodes, where the switches comprises a plurality of input lines, a selection line and an output line, a memory cell coupled to the output node, and a test address bus and a program control bus coupled to the plurality of input lines and the selection line of the plurality of switches. A state on each of the plurality of input nodes is verifiably loaded and read from the memory cell. A trusted memory block is provided. The associated process is provided for testing and verifying a plurality of truth table inputs of the logic unit.

  13. How Is Aplastic Anemia Diagnosed?

    ... from the NHLBI on Twitter. How Is Aplastic Anemia Diagnosed? Your doctor will diagnose aplastic anemia based on your medical and family histories, a ... your primary care doctor thinks you have aplastic anemia, he or she may refer you to a ...

  14. Diagnosing sepsis - The role of laboratory medicine.

    Fan, Shu-Ling; Miller, Nancy S; Lee, John; Remick, Daniel G

    2016-09-01

    Sepsis is the host response to microbial pathogens resulting in significant morbidity and mortality. An accurate and timely diagnosis of sepsis allows prompt and appropriate treatment. This review discusses laboratory testing for sepsis because differentiating systemic inflammation from infection is challenging. Procalcitonin (PCT) is currently an FDA approved test to aid in the diagnosis of sepsis but with questionable efficacy. However, studies support the use of PCT for antibiotic de-escalation. Serial lactate measurements have been recommended for monitoring treatment efficacy as part of sepsis bundles. The 2016 sepsis consensus definitions include lactate concentrations >2mmol/L (>18mg/dL) as part of the definition of septic shock. Also included in the 2016 definitions are measuring bilirubin and creatinine to determine progression of organ failure indicating worse prognosis. Hematologic parameters, including a simple white blood cell count and differential, are frequently part of the initial sepsis diagnostic protocols. Several new biomarkers have been proposed to diagnose sepsis or to predict mortality, but they currently lack sufficient sensitivity and specificity to be considered as stand-alone testing. If sepsis is suspected, new technologies and microbiologic assays allow rapid and specific identification of pathogens. In 2016 there is no single laboratory test that accurately diagnoses sepsis. PMID:27387712

  15. How Is Polycythemia Vera Diagnosed?

    ... page from the NHLBI on Twitter. How Is Polycythemia Vera Diagnosed? Polycythemia vera (PV) may not cause signs or symptoms for ... to find out whether you have primary polycythemia (polycythemia vera) or secondary polycythemia. Your medical history and physical ...

  16. How Is Atrial Fibrillation Diagnosed?

    ... Atrial Fibrillation » How Is Atrial Fibrillation Diagnosed? Explore Atrial Fibrillation What Is... Types Other Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Related Topics Arrhythmia ...

  17. How Is Lactose Intolerance Diagnosed?

    ... Information Clinical Trials Resources and Publications How is lactose intolerance diagnosed? Skip sharing on social media links Share ... based on symptoms alone whether a person has lactose intolerance or another condition. 2 Many common health problems ...

  18. Nursing diagnoses in overweight adolescents

    Raphaela Santos do Nascimento Rodrigues; Ana Márcia Tenório de Souza Cavalcanti; Telma Marques da Silva

    2013-01-01

    This study aimed to identify nursing diagnoses in overweight adolescents from public schools, according to the International Classification for Nursing Practice. A population-based cross-sectional study that investigated the socio-demographic, behavioural and psychological characteristics of adolescents aged from 10 to 14 years. 11 nursing diagnoses were identified: "Risk of overweight", "Risk of impaired adolescent development", "Risk of insecurity in parental role performance", "Risk of the...

  19. Nursing diagnoses in overweight adolescents

    Raphaela Santos do Nascimento Rodrigues

    2013-05-01

    Full Text Available This study aimed to identify nursing diagnoses in overweight adolescents from public schools, according to the International Classification for Nursing Practice. A population-based cross-sectional study that investigated the socio-demographic, behavioural and psychological characteristics of adolescents aged from 10 to 14 years. 11 nursing diagnoses were identified: "Risk of overweight", "Risk of impaired adolescent development", "Risk of insecurity in parental role performance", "Risk of the family impaired ability to manage diet regime", "Risk of impaired ability to manage diet regime", "Risk of lack of knowledge of dietary regime", "Risk of excess food intake", "Risk of negative self-image", "Risk of low self-esteem", "Risk of impaired social well-being" and "Impaired exercise pattern". These diagnoses reflect the multifactorial nature of obesity, highlighting the need for interdisciplinary and intersectoral articulation of nursing interventions for prevention and control of overweight.

  20. Diagnosing and Treating Hantavirus Pulmonary Syndrome (HPS)

    ... CDC.gov . Hantavirus Share Compartir Diagnosing and Treating Hantavirus Pulmonary Syndrome (HPS) Diagnosing HPS Diagnosing HPS in ... is no specific treatment, cure, or vaccine for hantavirus infection. However, we do know that if infected ...

  1. [Cognitive-behavioural therapy for sexual dysfunctions: treatment, etiology and accurate diagnosing of premature ejaculation].

    Rawińska, Marta; Fijałkowska, Sylwia

    2014-01-01

    Premature ejaculation (PE) is one of the most common male sexual dysfunctions. Successful treatment of PE has been hampered by the existence of a variety of definitions and diagnostic criteria and the lack of large, long-term studies of treatment efficacy. Numerous, diverse treatment approaches with varying degrees of efficacy have been used; these include behavioral, cognitive, and sex therapy techniques, and pharmacologic management with antidepressants, phosphodiesterase-5 inhibitors, and topical anesthetics. Combining a specific pharmacologic treatment for premature ejaculation with appropriate cognitive, behavioral, and sex therapy techniques should improve the overall understanding and management of sexual dysfunction, resulting in a sustainable increase in sexual satisfaction and decrease in distress for man. The aim of this article is to raise awareness of the prevalence of PE, its symptoms, and the impact it has on both partners and to discuss the benefits of adding limited behavioral and cognitive sex therapy techniques to drug therapy. PMID:24645584

  2. Accurate diagnoses, evidence based drugs, and new devices (3 Ds) in heart failure

    Bambang B. Siswanto

    2012-01-01

    Heart failure becomes main problem in cardiology because of increasing of heart failure patients, rehospitalization rate, morbidity, and mortality rate. The main causes of increasing heart failure problems are: (1) Successful treatment of acute myocardial infarction can be life saving, but its sequelae can cause heart failure. (2) Increasing life expectancy rate grows along with incidences of ageing related heart failure. (3) High prevalence of infection in Indonesia can cause rheumatic heart...

  3. Progress in Using Brain Morphometry as a Clinical Tool for Diagnosing Psychiatric Disorders

    Haubold, Alexander; Peterson, Bradley S.; Bansal, Ravi

    2012-01-01

    Brain morphometry in recent decades has increased our understanding of the neural bases of psychiatric disorders by localizing anatomical disturbances to specific nuclei and subnuclei of the brain. At least some of these disturbances precede the overt expression of clinical symptoms and possibly are endophenotypes that could be used to diagnose an individual accurately as having a specific psychiatric disorder. More accurate diagnoses could significantly reduce the emotional and financial bur...

  4. 77 FR 42504 - Prospective Grant of Exclusive License: Development of a Diagnostic Tool for Diagnosing Benign...

    2012-07-19

    .... malignant papillary thyroid tumors. Subsequently, a 72 gene model has been developed for diagnosing less... classification system for thyroid tumors and this in turn provides a more accurate diagnostic tool for the... tumors that are typically difficult to diagnose by cytology of fine needle aspiration (FNA)...

  5. Immunological methods for diagnosing neurocysticercosis

    Kuhn, R.E.; Estrada, J.J.; Grogl, M.

    1989-01-31

    A method is described for diagnosing active human neurocysticercosis by detecting the presence of at least one Taenia solium larval antigen in cerebrospinal fluid, which comprises: contacting cerebrospinal fluid from a human to be diagnosed with a solid support, wherein the support binds with a Taenia solium larval antigen if present, contacting the support with a first antibody, wherein the first antibody binds with a larval Taenia solium antigen if present in the cerebrospinal fluid, contacting the solid support with a detectable second antibody which will bind with the first antibody, and detecting the second antibody bound to the support.

  6. Diagnoses and interventions in podiatry.

    Zuijderduin, W.M.; Dekker, J.

    1996-01-01

    In the present study a quantitative description is given of diagnoses and interventions in podiatry. Data are used from a survey on podiatry practice in The Netherlands. Data have been recorded by 36 podiatrists on 897 patients. Information was gathered on patient characteristics, the medical diagno

  7. How Is Fanconi Anemia Diagnosed?

    ... from the NHLBI on Twitter. How Is Fanconi Anemia Diagnosed? People who have Fanconi anemia (FA) are born with the disorder. They may ... questions about: Any personal or family history of anemia Any surgeries you’ve had related to the ...

  8. Advice for the Newly Diagnosed

    ... De-Risking Successes PD Therapeutics Conference Sponsored Prizes Data Science Challenge Robert A. Pritzker Prize Bachmann-Strauss Prize ... need newly-diagnosed Parkinson’s patients.) In 2011, the Food and Drug Administration (FDA) approved a specialized imaging ...

  9. How Is Bone Cancer Diagnosed?

    ... with bone cancer. Accurate diagnosis of a bone tumor often depends on combining information about its location (what bone is affected and even which part of the bone is involved), appearance on x-rays, and appearance under a microscope. ...

  10. Bronchoalveolar Lavage Enzyme-Linked Immunospot for Diagnosis of Smear-Negative Tuberculosis in HIV-Infected Patients

    Cattamanchi, Adithya; Ssewenyana, Isaac; Nabatanzi, Rose; Cecily R Miller; den Boon, Saskia; Davis, J. Lucian; Andama, Alfred; Worodria, William; Samuel D Yoo; Cao, Huyen; Huang, Laurence

    2012-01-01

    Background Peripheral blood interferon-gamma release assays (IGRAs) have sub-optimal sensitivity and specificity for diagnosis of active pulmonary tuberculosis (TB). However, assessment of local immune responses has been reported to improve the accuracy of TB diagnosis. Methods We enrolled HIV-infected adults with cough ≥2 weeks’ duration admitted to Mulago Hospital in Kampala, Uganda and referred for bronchoscopy following two negative sputum acid-fast bacillus smears. We performed an ELISPO...

  11. Diagnosing pulmonary embolism using artificial neural networks

    Pulmonary Embolism (PE), an obstruction of pulmonary blood flow to the distal lung is a life-threatening condition causing chest pain and difficulty of breathing. Hence, prompt diagnosis is necessary so to render medical attention immediately. The standard way of diagnosing PE is through Lung Scintigraphy analyzed by Nuclear Medicine physicians. An expert system using artificial neural network (ANN) is created to diagnose PE with its probability based on Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED). A set of patients who underwent lung scan due to PE formed the training group while another set of patients formed the test group. None of the training group scans was included in the test group. The training group was trained by ANN using the back propagation method and Delta Rule while the test group was used to measure the performance of the expert system. All scans were examined independently by one expert nuclear medicine physician based on PIOPED criteria. The expert system is a standalone application with user-friendly interface. It shows all the 8 standard projections of lung scan. White spots and hot spots are detected and effectively reduced in the images to warrant more accurate diagnosis. Spaces around the lung images are also removed ensuring proper alignment of the ventilation and perfusion images to the template. Likewise, the system is able to quantify the mismatched between the ventilation and perfusion images. Based on the evaluation of the test group, the system is able to match the diagnosis of the expert physician by 80 %. The expert system can be used as a temporary substitute when there are no immediate help from expert physicians. It can also be used as a teaching tool by resident doctors training in radiology or nuclear medicine and is not meant to replace the expert physicians diagnosis. (authors)

  12. Towards accurate emergency response behavior

    Nuclear reactor operator emergency response behavior has persisted as a training problem through lack of information. The industry needs an accurate definition of operator behavior in adverse stress conditions, and training methods which will produce the desired behavior. Newly assembled information from fifty years of research into human behavior in both high and low stress provides a more accurate definition of appropriate operator response, and supports training methods which will produce the needed control room behavior. The research indicates that operator response in emergencies is divided into two modes, conditioned behavior and knowledge based behavior. Methods which assure accurate conditioned behavior, and provide for the recovery of knowledge based behavior, are described in detail

  13. DIAGNOSE AND MANAGEMENT TINEA FASCIALIS

    I Pt Agus Suryantara P

    2014-01-01

    Full Text Available Fungi disease  on skin is often occur at Indonesia because it is a tropic country that has hot climate and also correlate wit bad hygiene.  Dermatofitosis is fungi disease on the keratinizing tissue and differentiate as many class such as Tinea Corporis or TineaCruris. Tinea fascialis include in this form. The diagnose this disease from anamnesis,clinical manifetation, and also test result from the tissue. Management for thistineacomprise to topical and systemic. The important one in management this disease isprevention  management include in control of skin dryness.

  14. Accurate determination of antenna directivity

    Dich, Mikael

    1997-01-01

    The derivation of a formula for accurate estimation of the total radiated power from a transmitting antenna for which the radiated power density is known in a finite number of points on the far-field sphere is presented. The main application of the formula is determination of directivity from power...

  15. How Are Obesity and Overweight Diagnosed?

    ... Information Clinical Trials Resources and Publications How are obesity & overweight diagnosed? Skip sharing on social media links ... and Blood Institute. (2012). How are overweight and obesity diagnosed? Retrieved August 8, 2012, from http://www. ...

  16. [Munchausen disease diagnosed ten years after debut].

    Mrgan, Monija; Taasti, Lena Merete

    2013-09-01

    Munchausen disease is difficult to diagnose especially because it is often an exclusion diagnosis. We present a case of skin ulcers in a young woman, who was eventually diagnosed with Munchausen disease. PMID:23992908

  17. How Is a Heart Attack Diagnosed?

    ... from the NHLBI on Twitter. How Is a Heart Attack Diagnosed? Your doctor will diagnose a heart attack ... This Content: NEXT >> Featured Video What is a heart attack? 05/22/2014 Describes how a heart attack ...

  18. How Is Alpha-1 Antitrypsin Deficiency Diagnosed?

    ... Alpha-1 Antitrypsin Deficiency Diagnosed? Alpha-1 antitrypsin (AAT) deficiency usually is diagnosed after you develop a ... related to the condition. Your doctor may suspect AAT deficiency if you have signs or symptoms of ...

  19. How Is Thrombotic Thrombocytopenic Purpura Diagnosed?

    ... Diagnosed? Your doctor will diagnosis thrombotic thrombocytopenic purpura (TTP) based on your medical history, a physical exam, and test results. If TTP is suspected or diagnosed, a hematologist will be ...

  20. Transplantvaskulopathie - Pathophysiologie, Diagnose und Therapie

    Pölzl G

    2009-01-01

    Full Text Available Die Transplantvaskulopathie (CAV ist die häufigste Todesursache im Langzeitverlauf nach Herztransplantation. Sowohl immunologische als auch nicht-immunologische Faktoren sind für die Entwicklung der meist konzentrischen, diffusen, überwiegend fibrösen Intimahyperplasie verantwortlich. Die klinische Symptomatik ist unspezifisch, regelmäßige Kontrolluntersuchungen sind daher erforderlich. Im Gegensatz zur konventionellen Koronarangiographie ermöglicht der intravaskuläre Ultraschall die frühzeitige Diagnose und Quantifizierung der Erkrankung und damit einen raschen Therapiebeginn. Dabei spielen die konsequente Einstellung kardiovaskulärer Risikofaktoren, die immunsuppressive Therapie und die Zytomegalie-Prophylaxe eine wichtige Rolle. Bei schweren Verlaufsformen kommen die perkutane Koronarintervention, seltener die Bypassoperation und in ausgewählten Fällen die Retransplantation zum Einsatz.

  1. Is one diagnosis the whole story? patients with double diagnoses.

    Kurolap, Alina; Orenstein, Naama; Kedar, Inbal; Weisz Hubshman, Monika; Tiosano, Dov; Mory, Adi; Levi, Zohar; Marom, Daphna; Cohen, Lior; Ekhilevich, Nina; Douglas, Jessica; Nowak, Catherine Bearce; Tan, Wen-Hann; Baris, Hagit N

    2016-09-01

    One of the goals of evaluating a patient in the genetics clinic is to find the diagnosis that would explain his or her clinical presentation. Sometimes the patient's diagnosis remains undefined or does not explain all of the clinical findings. As clinicians are often guided by a "single disorder" paradigm, diagnosing multiple genetic conditions in the same patient requires a heightened sense of awareness. Over the last few years, we evaluated several patients (n = 14) who were found to have more than one genetic diagnosis. In this paper, we will describe their natural history and diagnoses, and draw on the lessons learned from this phenomenon, which we expect to grow in this era of next-generation diagnostic technologies. To our knowledge, this is by far the largest series of patients with double diagnoses. Based on our findings, we strongly recommend that physicians question every diagnosis to determine whether it indeed explains all of the patients' symptoms, and consider whether they should continue the diagnostic evaluation to look for a more accurate and complete set of diagnoses. © 2016 Wiley Periodicals, Inc. PMID:27271787

  2. Diagnosing Common Benign Skin Tumors.

    Higgins, James C; Maher, Michael H; Douglas, Mark S

    2015-10-01

    Patients will experience a wide range of skin growths and changes over their lifetime. Family physicians should be able to distinguish potentially malignant from benign skin tumors. Most lesions can be diagnosed on the basis of history and clinical examination. Lesions that are suspicious for malignancy, those with changing characteristics, symptomatic lesions, and those that cause cosmetic problems may warrant medical therapy, a simple office procedure (e.g., excision, cryosurgery, laser ablation), or referral. Acrochordons are extremely common, small, and typically pedunculated benign neoplasms. Simple scissor or shave excision, electrodesiccation, or cryosurgery can be used for treatment. Sebaceous hyperplasia presents as asymptomatic, discrete, soft, pale yellow, shiny bumps on the forehead or cheeks, or near hair follicles. Except for cosmesis, they have no clinical significance. Lipomas are soft, flesh-colored nodules that are easily moveable under the overlying skin. Keratoacanthomas are rapidly growing, squamoproliferative benign tumors that resemble squamous cell carcinomas. Early simple excision is recommended. Pyogenic granuloma is a rapidly growing nodule that bleeds easily. Treatment includes laser ablation or shave excision with electrodesiccation of the base. Dermatofibromas are an idiopathic benign proliferation of fibroblasts. No treatment is required unless there is a change in size or color, bleeding, or irritation from trauma. Epidermal inclusion cysts can be treated by simple excision with removal of the cyst and cyst wall. Seborrheic keratoses and cherry angiomas generally do not require treatment. PMID:26447443

  3. Accurate Modeling of Advanced Reflectarrays

    Zhou, Min

    of the incident field, the choice of basis functions, and the technique to calculate the far-field. Based on accurate reference measurements of two offset reflectarrays carried out at the DTU-ESA Spherical NearField Antenna Test Facility, it was concluded that the three latter factors are particularly important...... to the conventional phase-only optimization technique (POT), the geometrical parameters of the array elements are directly optimized to fulfill the far-field requirements, thus maintaining a direct relation between optimization goals and optimization variables. As a result, better designs can be obtained compared...... using the GDOT to demonstrate its capabilities. To verify the accuracy of the GDOT, two offset contoured beam reflectarrays that radiate a high-gain beam on a European coverage have been designed and manufactured, and subsequently measured at the DTU-ESA Spherical Near-Field Antenna Test Facility...

  4. Accurate ab initio spin densities

    Boguslawski, Katharina; Legeza, Örs; Reiher, Markus

    2012-01-01

    We present an approach for the calculation of spin density distributions for molecules that require very large active spaces for a qualitatively correct description of their electronic structure. Our approach is based on the density-matrix renormalization group (DMRG) algorithm to calculate the spin density matrix elements as basic quantity for the spatially resolved spin density distribution. The spin density matrix elements are directly determined from the second-quantized elementary operators optimized by the DMRG algorithm. As an analytic convergence criterion for the spin density distribution, we employ our recently developed sampling-reconstruction scheme [J. Chem. Phys. 2011, 134, 224101] to build an accurate complete-active-space configuration-interaction (CASCI) wave function from the optimized matrix product states. The spin density matrix elements can then also be determined as an expectation value employing the reconstructed wave function expansion. Furthermore, the explicit reconstruction of a CA...

  5. Accurate thickness measurement of graphene

    Shearer, Cameron J.; Slattery, Ashley D.; Stapleton, Andrew J.; Shapter, Joseph G.; Gibson, Christopher T.

    2016-03-01

    Graphene has emerged as a material with a vast variety of applications. The electronic, optical and mechanical properties of graphene are strongly influenced by the number of layers present in a sample. As a result, the dimensional characterization of graphene films is crucial, especially with the continued development of new synthesis methods and applications. A number of techniques exist to determine the thickness of graphene films including optical contrast, Raman scattering and scanning probe microscopy techniques. Atomic force microscopy (AFM), in particular, is used extensively since it provides three-dimensional images that enable the measurement of the lateral dimensions of graphene films as well as the thickness, and by extension the number of layers present. However, in the literature AFM has proven to be inaccurate with a wide range of measured values for single layer graphene thickness reported (between 0.4 and 1.7 nm). This discrepancy has been attributed to tip-surface interactions, image feedback settings and surface chemistry. In this work, we use standard and carbon nanotube modified AFM probes and a relatively new AFM imaging mode known as PeakForce tapping mode to establish a protocol that will allow users to accurately determine the thickness of graphene films. In particular, the error in measuring the first layer is reduced from 0.1-1.3 nm to 0.1-0.3 nm. Furthermore, in the process we establish that the graphene-substrate adsorbate layer and imaging force, in particular the pressure the tip exerts on the surface, are crucial components in the accurate measurement of graphene using AFM. These findings can be applied to other 2D materials.

  6. Pitfalls in diagnosing diabetic foot infections.

    Peters, Edgar J

    2016-01-01

    Although the diagnosis of a diabetic foot infection is made based on clinical symptoms and signs, we also use blood laboratory, microbiological and radiological studies to make treatment decisions. All of these diagnostic studies have pitfalls that can lead to a delay in diagnosis. Such delays will likely lead to further tissue damage and to a higher chance of amputation. One of these pitfalls is that some clinicians rely on microbiological, rather than clinical data, to diagnose infection. Though subjective by nature, clinical signs predict outcome of foot infections accurately. Another pitfall is that microbiological data can be misleading. All wounds harbour microorganisms; therefore, a positive wound culture does not mean that a wound is infected. Furthermore, the outcome of cultures of wound swabs does not correlate well with culture results of tissue biopsies. Therapy guidance by wound swab will likely lead to overtreatment of non-pathogenic organisms. Genotyping might have a role in identifying previously unrecognized (combinations of) pathogens in diabetic foot infection, bacteria in sessile phenotype and non-culturable pathogens, e.g. in cases where antibiotics have already been administered. One more pitfall is that the diagnosis of osteomyelitis remains difficult. Although the result of percutaneous bone biopsy is the reference standard for osteomyelitis, some other diagnostic modalities can aid in the diagnosis. A combination of several of these diagnostic tests is probably a good strategy to achieve a higher diagnostic accuracy. Relying on a single test will likely lead to misidentification of patients with osteomyelitis with associated overtreatment and undertreatment. PMID:26813617

  7. Novel approaches in diagnosing tuberculosis

    Kolk, Arend H. J.; Dang, Ngoc A.; Kuijper, Sjoukje; Gibson, Tim; Anthony, Richard; Claassens, Mareli M.; Kaal, Erwin; Janssen, Hans-Gerd

    2011-06-01

    The WHO declared tuberculosis (TB) a global emergency. An estimated 8-9 million new cases occur each year with 2-3 million deaths. Currently, TB is diagnosed mostly by chest-X ray and staining of the mycobacteria in sputum with a detection limit of 1x104 bacteria /ml. There is an urgent need for better diagnostic tools for TB especially for developing countries. We have validated the electronic nose from TD Technology for the detection of Mycobacterium tuberculosis by headspace analysis of 284 sputum samples from TB patients. We used linear discriminant function analysis resulting in a sensitivity of 75% a specificity of 67% and an accuracy of 69%. Further research is still required to improve the results by choosing more selective sensors and sampling techniques. We used a fast gas chromatography- mass spectrometry method (GC-MS). The automated procedure is based on the injection of sputum samples which are methylated inside the GC injector using thermally assisted hydrolysis and methylation (THM-GC-MS). Hexacosanoic acid in combination with tuberculostearic acid was found to be specific for the presence of M. tuberculosis. The detection limit was similar to microscopy. We found no false positives, all microscopy and culture positive samples were also found positive with the THM-GC-MS method. The detection of ribosomal RNA from the infecting organism offers great potential since rRNA molecules outnumber chromosomal DNA by a factor 1000. It thus may possible to detect the organism without amplification of the nucleic acids (NA). We used a capture and a tagged detector probe for the direct detection of M. tuberculosis in sputum. So far the detection limit is 1x106 bacteria / ml. Currently we are testing a Lab-On-A-Chip Interferometer detection system.

  8. Pulmonale Hypertension, Pathophysiologie, Diagnose, Therapie

    Lang I

    2001-01-01

    Full Text Available Die pulmonale Hypertension (PH ist ein Syndrom, bestehend aus Atemnot bei Belastung, Brustschmerzen und Synkopen und beruht auf einer Steigerung des pulmonal-arteriellen Druckes und Erhöhung des Lungengefäßwiderstandes. Durch einen progressiven Verlauf kommt es beim Unbehandelten innerhalb von zwei bis drei Jahren nach Diagnosestellung zu Rechtsherzversagen und Tod. Die Erkrankung ist eine Lungengefäßerkrankung. In allen Schichten der Gefäßwand finden sich pathologische Veränderungen. Das Lungengefäßendothel zeigt prokoagulatorische Eigenschaften, die glatte Gefäßmuskulatur ist depolarisiert und Kalzium-überladen, die Adventitia zeigt eine Überexpression von Metalloproteinasen und Elastasen als Ausdruck eines aktiven vaskulären Remodelings. Basierend auf dem Konzept, daß Vasokonstriktion und thrombotischer Verschluß der Widerstandsgefäße der Lunge den Krankheitsprozeß beschleunigen, werden derzeit Vasodilatation und Antikoagulierung als Therapie eingesetzt. Noch vor wenigen Jahren wurde die medikamentöse Therapie der PH nur als Überbrückung zur Lungen- oder Herz-Lungen-Transplantation betrachtet. Allerdings könnten Vasodilatatoren oder Vasodilatator-Kombinationstherapien in Zukunft eine Alternative zur Lungentransplantation darstellen. Vor Beginn einer Vasodilatatortherapie wird in einem standardisierten Austestungsverfahren die individuelle Gefäßreaktivität festgestellt. Schlüssel für die Diagnostik ist die Abgrenzung der chronisch thromboembolischen pulmonalen Hypertension (CTEPH von allen anderen Formen. Die CTEPH ist die einzige PH, die durch eine pulmonale Thromboendarterektomie geheilt werden kann. Dieser Artikel bietet eine kurze aktuelle Zusammenfassung über Klassifikation der verschiedenen Formen von PH, Pathologie und Pathobiologie, Risikofaktoren, Genetik, Diagnose und Therapien.

  9. A More Accurate Fourier Transform

    Courtney, Elya

    2015-01-01

    Fourier transform methods are used to analyze functions and data sets to provide frequencies, amplitudes, and phases of underlying oscillatory components. Fast Fourier transform (FFT) methods offer speed advantages over evaluation of explicit integrals (EI) that define Fourier transforms. This paper compares frequency, amplitude, and phase accuracy of the two methods for well resolved peaks over a wide array of data sets including cosine series with and without random noise and a variety of physical data sets, including atmospheric $\\mathrm{CO_2}$ concentrations, tides, temperatures, sound waveforms, and atomic spectra. The FFT uses MIT's FFTW3 library. The EI method uses the rectangle method to compute the areas under the curve via complex math. Results support the hypothesis that EI methods are more accurate than FFT methods. Errors range from 5 to 10 times higher when determining peak frequency by FFT, 1.4 to 60 times higher for peak amplitude, and 6 to 10 times higher for phase under a peak. The ability t...

  10. Therapy of Newly Diagnosed Follicular Lymphoma

    Jason R. Westin

    2012-12-01

    Full Text Available Newly diagnosed follicular lymphoma is relatively common and can be effectively treated with several differing approaches. Although the disease is often considered incurable, it is highly responsive to therapy when indicated. This review discusses the indications for treatment, risk stratification systems, treatment options with supporting clinical trial data, and expected therapeutic outcomes in newly diagnosed follicular lymphoma.

  11. From experience: applying the risk diagnosing methodology

    Keizer, Jimme A.; Halman, Johannes I.M.; Song, Michael

    2002-01-01

    No risk, no reward. Companies must take risks to launch new products speedily and successfully. The ability to diagnose and manage risks is increasingly considered of vital importance in high-risk innovation. This article presents the Risk Diagnosing Methodology (RDM), which aims to identify and eva

  12. Can we confidently diagnose pilomatricoma with fine needle aspiration cytology?

    Wong, Yin-Ping; Masir, Noraidah; Sharifah, Noor Akmal

    2015-01-01

    Pilomatricomas can be confidently diagnosed cytologically due to their characteristic cytomorphological features. However, these lesions are rarely encountered by cytopathologists and thus pose a diagnostic dilemma to even experienced individuals, especially when the lesions are focally sampled. We describe two cases of histologically confirmed pilomatricoma. The first case is of a 13-year-old boy with posterior cervical 'lymphadenopathy', and the second one is of a 12-year-old girl with a lower cheek swelling. Both aspirates comprised predominantly atypical basal-like cells, with prominent nucleoli. 'Ghost cells' were readily identified by cell block in case two, but cell block in case one yielded no diagnostic material. In case two, pilomatricoma was accurately diagnosed pre-operatively. A cytological suspicion of a neoplastic process was raised in case one. Despite being diagnostically challenging, pilomatricoma can be diagnosed with careful observation of two unique cytological features of the lesions: (1) pathognomonic 'ghost cells' and (2) irregular, saw-toothed, loosely cohesive basaloid cells, with prominent nucleoli. The role of thorough sampling of the lesion, with multiple passes of various sites, cannot be overemphasized. PMID:25892955

  13. Validation studies of nursing diagnoses in neonatology

    Pavlína Rabasová

    2016-03-01

    Full Text Available Aim: The objective of the review was the analysis of Czech and foreign literature sources and professional periodicals to obtain a relevant comprehensive overview of validation studies of nursing diagnoses in neonatology. Design: Review. Methods: The selection criterion was studies concerning the validation of nursing diagnoses in neonatology. To obtain data from relevant sources, the licensed professional databases EBSCO, Web of Science and Scopus were utilized. The search criteria were: date of publication - unlimited; academic periodicals - full text; peer-reviewed periodicals; search language - English, Czech and Slovak. Results: A total of 788 studies were found. Only 5 studies were eligible for content analysis, dealing specifically with validation of nursing diagnoses in neonatology. The analysis of the retrieved studies suggests that authors are most often concerned with identifying the defining characteristics of nursing diagnoses applicable to both the mother (parents and the newborn. The diagnoses were validated in the domains Role Relationship; Coping/Stress tolerance; Activity/Rest, and Elimination and Exchange. Diagnoses represented were from the field of dysfunctional physical needs as well as the field of psychosocial and spiritual needs. The diagnoses were as follows: Parental role conflict (00064; Impaired parenting (00056; Grieving (00136; Ineffective breathing pattern (00032; Impaired gas exchange (00030; and Impaired spontaneous ventilation (00033. Conclusion: Validation studies enable effective planning of interventions with measurable results and support clinical nursing practice.

  14. 38 CFR 4.46 - Accurate measurement.

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Accurate measurement. 4... RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.46 Accurate measurement. Accurate measurement of the length of stumps, excursion of joints, dimensions and location of scars with respect...

  15. Prevalence of Diagnosed Cancer According to Duration of Diagnosed Diabetes and Current Insulin Use Among U.S. Adults With Diagnosed Diabetes

    Li, Chaoyang; Zhao, Guixiang; Okoro, Catherine A; Wen, Xiao-Jun; Ford, Earl S.; Balluz, Lina S

    2013-01-01

    OBJECTIVE To estimate the prevalence of diagnosed cancer according to duration of diagnosed diabetes and current insulin use among U.S. adults with diagnosed diabetes. RESEARCH DESIGN AND METHODS We analyzed data from 25,964 adults aged ≥18 years with diagnosed diabetes who participated in the 2009 Behavioral Risk Factor Surveillance System. RESULTS After adjustment for potential confounders, we found that the greater the duration of diagnosed diabetes, the higher the prevalence of diagnosed ...

  16. Diagnosing Diabetes and Learning about Prediabetes

    ... Size: A A A Listen En Español Diagnosing Diabetes and Learning About Prediabetes There are several ways ... mg/dl – 199 mg/dl Preventing Type 2 Diabetes You will not develop type 2 diabetes automatically ...

  17. How Is Breast Cancer in Men Diagnosed?

    ... disturbing. Some places will give you headphones with music to block this noise out. MRIs are also expensive, but insurance plans generally pay for them in some situations, such as once cancer is diagnosed. MRI machines are quite common, but ...

  18. How Do Health Care Providers Diagnose Endometriosis?

    ... and Publications How do health care providers diagnose endometriosis? Skip sharing on social media links Share this: ... way to be sure of the diagnosis of endometriosis. The most common surgery is called laparoscopy (pronounced ...

  19. At få en diagnose

    Olesen, Birgitte Ravn; Jansbøl, Kirsten

    I dette hæfte ligger fokus på døvblindblevnes fortællinger om at have et handicap uden at kende sin diagnose og om at håndtre at få diagnosen RP eller Usher syndrom. Det er karakteristisk for fortællingerne, at det har stor betydning - hvornår i livet, man får sin diagnose - under hvilke omstændi......I dette hæfte ligger fokus på døvblindblevnes fortællinger om at have et handicap uden at kende sin diagnose og om at håndtre at få diagnosen RP eller Usher syndrom. Det er karakteristisk for fortællingerne, at det har stor betydning - hvornår i livet, man får sin diagnose - under hvilke...

  20. How Is Chronic Lymphocytic Leukemia Diagnosed?

    ... this protein generally indicate a more advanced CLL. Bone marrow tests Blood tests are often enough to diagnose ... is called an incisional biopsy . Lumbar puncture (or spinal tap) This procedure is used to take samples ...

  1. How Are Lung Carcinoid Tumors Diagnosed?

    ... Research Get Involved Find Local ACS Learn About Cancer » Lung Carcinoid Tumor » Detailed Guide » How are lung carcinoid tumors diagnosed? Share this Page Close Push escape to close share window. Print ...

  2. How Is von Willebrand Disease Diagnosed?

    ... of your von Willebrand factor. The test helps your doctor diagnose what type of VWD you have. Platelet function test. This test measures how well your platelets are working. You may have these tests ...

  3. How Is a Heart Murmur Diagnosed?

    ... Is a Heart Murmur Diagnosed? Doctors use a stethoscope to listen to heart sounds and hear heart ... your heart or your child's heart with a stethoscope to find out whether a murmur is innocent ...

  4. Diagnosing Asthma in Very Young Children

    ... Listen Español Text Size Email Print Share Diagnosing Asthma in Babies & Toddlers Page Content Article Body One ... family with recurrent bronchitis or sinus problems. When Asthma is Not the Cause Your pediatrician will listen ...

  5. Diagnosing Infectious Mononucleosis: Avoiding the Pitfalls

    McSherry, J. A.

    1985-01-01

    Infectious mononucleosis may be diagnosed with confidence only when Hoagland's diagnostic criteria have been met. The illness must be compatible with the known clinical features of infectious mononucleosis; there should be absolute and relative lymphocytosis on differential white cell count; there should be more than 20% atypical lymphocytes and serological tests should be positive—either a Paul-Bunnell Davidsohn or a rapid slide test for heterophil antibody. Failure to diagnose this common v...

  6. Nursing diagnoses in women deprived of freedom

    Izabelle de Freitas Ferreira; Tatiane Gomes Guedes; Sheila Coelho Ramalho Vasconcelos Morais; José Cristovam Martins Vieira; Marcelle Guimarães de Mello; Francisca Márcia Pereira Linhares

    2016-01-01

    Objective: to analyze the nursing diagnoses profile of women deprived of freedom, using the International Classification for Nursing® Practice version 1.0. Methods: a descriptive study, conducted with 186 women deprived of freedom. Nursing Diagnoses were extrapolated based on the clinical data of the participants, collected through a structured form and clinical reasoning. Results: there were 44 nursing diagnostic statements, among the most common, there were: infection risk (70.9%); fluid in...

  7. Challenges in diagnosing tuberculosis in children

    Rahman, Nadia; Pedersen, Karin Kæreby; Rosenfeldt, Vibeke;

    2012-01-01

    Clinical investigations of childhood tuberculosis (TB) are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. We investigated the challenges in diagnosing TB in children in a low-incidence country.......Clinical investigations of childhood tuberculosis (TB) are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. We investigated the challenges in diagnosing TB in children in a low-incidence country....

  8. Problems with diagnosing Conversion Disorder in response to variable and unusual symptoms

    Barnum R

    2014-04-01

    Full Text Available Richard BarnumPrivate practice, Child and adolescent psychiatry, MA, USAAbstract: Conversion Disorder (CD is a diagnosis offered to explain signs and symptoms that do not correspond to recognized medical conditions. Pediatric patients with variable, vague, and multisystem complaints are at increased risk for being diagnosed with CD. Little is known about the impact of such a diagnosis. In making such diagnoses, it is likely that pediatric providers hope to encourage patients to access mental health care, but no basis exists to show that these diagnoses result in such access in any useful way. This article presents the case of a child with Ehlers-Danlos Syndrome, who had been previously (incorrectly diagnosed with CD and referred for mental health care. It offers commentary based on interviews with other pediatric patients with similar experiences – conducted in collaboration with the Ehlers-Danlos National Foundation. These cases indicate that CD diagnoses can seriously undermine patients’ trust in doctors, and can create such defensiveness that it may interfere with (especially patients’ abilities to engage with mental health services. Such interference is an important problem, if the diagnosis is accurate. But, in the (more likely event that it is not accurate, this defensiveness can interfere with both important mental health care and further ongoing necessary medical care.Keywords: somatoform disorders, dysautonomias, pain, collagen diseases, mitochondrial diseases, complex regional pain syndromes

  9. How accurately can digital images depict conventional radiographs

    The purpose of this paper is to investigate how accurately the video image of a digitized chest radiograph can depict normal anatomic configurations of thoracic organs seen on a conventional radiograph. These configurations are important to diagnosis of diseases of the chest. Chest radiographs of 50 individuals diagnosed as normal were analyzed. Three chest physicians and one radiologist reviewed 50 pairs of digitized images (digitized in 0.125-mm pixel size, 10-bit gray scale, displayed on 1,024 x 1.536, 8-bit gray scale) constructed and conventional films. The visibility of eight structures (spinal process, trachea, right and left main bronchus, anterior tip of right fourth rib, vessels behind diaphragm and cardiac shadow, and descending aorta behind heart) was graded into five levels of confidence

  10. Pancreas Cystic Lymphangioma Diagnosed with EUS-FNA

    Adam W Coe

    2012-05-01

    Full Text Available Context Endoscopic ultrasound has proved to be an invaluable tool when obtaining high quality images of the pancreas.Furthermore, fine-needle aspiration of suspected lesions can be carried out simultaneously thus providing tissue samples for cytologic diagnosis. We present two cases of a rare pancreatic lesion that were diagnosed by endoscopic ultrasound with fine-needle aspiration. Case #1 A 60-year-old asymptomatic gentleman was found to have an incidental pancreatic lesion on abdominal computed tomography scan during a cardiac workup. Patient had no personal or family medical history that would predispose him to pancreatic lesions. Endoscopic ultrasound was performed and patient was diagnosed with pancreatic cystic lymphangioma. Case #2 A 40-year-old asymptomatic gentleman with history of heavy alcohol use was found to have an incidental pancreatic lesion on computed tomography scan during a work up of chest pain. Computed tomography guided fine-needle aspiration was negative for malignancy but no other studies were performed on the fluid sample at that time. Patient was then referred to our institution after repeat computed tomography scan showed a stable lesion. Endoscopic ultrasound did not show evidence of pancreatitis and fineneedle aspiration was consistent with pancreatic cystic lymphangioma. Discussion The universally available and escalating use of computed tomography scans has led to an increased detection of incidental cystic pancreatic lesions. Pancreatic cystic lymphangiomas are a rare lesion and account for less than one percent of all pancreatic cystic lesions. These lesions are easily and accurately diagnosed by the use of endoscopic ultrasound guided fine-needle aspiration.

  11. [Nursing diagnoses of the elderly at home].

    Figueiredo, Maria do Livramento Fortes; Luz, Maria Helena Barros Araújo; de Brito, Cleidiane Maria Sales; Sousa, Suéli Nolêto Silva; da Silva, Dâmaris Rebeca Soares

    2008-01-01

    The descriptive study, with quantitative approach, that has had as objective to do the characterization of ill elderly at home attended by the ESF teams of the Satellite's District in Teresina - PI and to collect Nursing Diagnoses and it respective interventions. This descriptive study was constituted by 50 seniors interviewed at home, the results showed that most of the women in age between of 60 and 79 years were ill at home for one or five years at least. There were eight Nursing Diagnoses (ND) prevalent, in which 98% of the seniors were identified with the ND - Inadequate Control of Therapeutic Regime, and in 72% the deambulation was prejudiced with mobility's limitation and, for all diagnoses were proposed nursing interventions objectifying the conquest of autonomy and independence of these seniors. PMID:18797782

  12. Modified Kenneth Jones criteria for diagnosing tuberculous meningitis in children

    To evaluate accuracy of modified Kenneth Jones scoring criteria (MKJSC) as a screening tool to diagnose tuberculous meningitis in children. Study Design: Cross-sectional study. Place and Duration of Study: Paediatric Medicine, Unit-I, Bahawal Victoria Hospital, Bahawalpur, from May 2006 to March 2007. Methodology: A total of 100 children admitted through emergency in Paediatric Medicine, Unit-I, were included who were having fever and features suggestive of central nervous system (CNS) infection. Lumbar puncture was done in all patients after written consent. Findings of lumbar puncture were taken as gold standard for the diagnosis of TBM. MKJSC was applied on each patient and accuracy determined against the gold standard. Results: Out of 100 children, 47 were diagnosed as TBM on the basis of CSF results. All children had scored 0-7 or above according to MKJSC. A score 1-2, 3-4, 5-6 and 7 or more was obtained in 23, 25, 30 and 22 children respectively. Children who had scored 5 or more received ATT. Accuracy of MKJSC was calculated to be 91%. Conclusion: MKJSC is a simple and accurate tool to improve tuberculous meningitis case detection rate in children. (author)

  13. Atypical late-time singular regimes accurately diagnosed in stagnation-point-type solutions of 3D Euler flows

    Mulungye, Rachel M; Bustamante, Miguel D

    2015-01-01

    We revisit, both numerically and analytically, the finite-time blowup of the infinite-energy solution of 3D Euler equations of stagnation-point-type introduced by Gibbon et al. (1999). By employing the method of mapping to regular systems, presented in Bustamante (2011) and extended to the symmetry-plane case by Mulungye et al. (2015), we establish a curious property of this solution that was not observed in early studies: before but near singularity time, the blowup goes from a fast transient to a slower regime that is well resolved spectrally, even at mid-resolutions of $512^2.$ This late-time regime has an atypical spectrum: it is Gaussian rather than exponential in the wavenumbers. The analyticity-strip width decays to zero in a finite time, albeit so slowly that it remains well above the collocation-point scale for all simulation times $t < T^* - 10^{-9000}$, where $T^*$ is the singularity time. Reaching such a proximity to singularity time is not possible in the original temporal variable, because fl...

  14. Efficacy of magnetic resonance imaging in diagnosing diabetic foot osteomyelitis in the presence of ischemia.

    Fujii, Miki; Armstrong, David G; Armsrong, David G; Terashi, Hiroto

    2013-01-01

    Magnetic resonance imaging (MRI) has been recognized as the most accurate imaging modality for the detection of diabetic foot osteomyelitis. However, how accurately MRI displays the extent of diabetic foot osteomyelitis in the presence of ischemia is still unclear. We retrospectively compared the preoperative MRI findings with the results of histopathologic examinations of resected bones and studied the efficacy of MRI in the diagnosis of diabetic foot osteomyelitis of different etiologies. A total 104 bones from 18 foot ulcers in 16 diabetic patients (10 men and 6 women; age range 42 to 84 years) treated by surgical intervention from 2008 to 2012 was examined. In 8 neuropathic ulcers, 29 bones were accurately diagnosed in detail using MRI, even those with severe soft tissue infection. Of 75 bones in 10 ischemic ulcers, only 7 bones evaluated by MRI after revascularization were diagnosed accurately; the other 68 could not be diagnosed because of unclear or equivocal MRI findings. On histopathologic examination, all the bones were found to be infected through the bone cortex by the surrounding infected soft tissue, not directly by articulation. Overall, preoperative MRI is effective in the diagnosis of neuropathic ulcers, but less so of ischemic ones. PMID:24160720

  15. Bilateral segmental neurofibromatosis diagnosed during pregnancy.

    Maldonado Cid, P; Sendagorta Cudós, E; Noguera Morel, L; Beato Merino, M J

    2011-01-01

    Bilateral segmental neurofibromatosis is a rare subtype of neurofibromatosis type 1 defined by lesions affecting a single segment of the body and crossing the midline, with no systemic involvement. We present a case diagnosed during pregnancy because of the characteristic increase in size of the lesions during this period. PMID:21635828

  16. Diagnosing and treating respiratory syncytial virus bronchiolitis.

    Napierkowski, Daria B

    2016-09-22

    Respiratory syncytial virus (RSV) is one of the major causes of respiratory tract illness in children and can lead to significant infection and death. This article discusses the incidence, clinical presentation, diagnosis, current treatment, and prevention options to successfully diagnose and treat infections caused by RSV. PMID:27552683

  17. Diagnosing Functional Seizures in Children and Adolescent

    Wichaidit, Bianca Taaning; Rask, Charlotte Ulrikka; Ostergaard, John R

    2014-01-01

    Functional seizures (FS) is a condition where the child experiences seizure-like events, without abnormal electrical discharge as measured by EEG, and with high risk of misdiagnosis. Diagnosing FS contains: 1) video-EEG, 2) anamnestic evaluation, focusing on the presence of psychosocial stressors...

  18. Diagnosing risks in product-innovation projects

    Halman, J.I.M.; Keizer, J.A.

    1994-01-01

    A new method of diagnosing risks in product-innovation projects is introduced in the paper. The method is an improvement on existing risk methods used on product-innovation projects, such as potential problem analysis and failure mode and effects analysis. Technological, organizational and commercia

  19. Diagnosing Febrile Illness in a Returned Traveler

    2012-03-01

    This podcast will assist health care providers in diagnosing febrile illness in patients returning from a tropical or developing country.  Created: 3/1/2012 by National Center for Enteric, Zoonotic, and Infectious Diseases (NCEZID).   Date Released: 3/1/2012.

  20. Bordetella pertussis diagnosed by polymerase chain reaction

    Birkebaek, N H; Heron, I; Skjødt, K

    1994-01-01

    The object of this work was to test the polymerase chain reaction (PCR) for demonstration of Bordetella pertussis (BP) in nasopharyngeal secretions. The method was applied to patients with recently diagnosed pertussis, as verified by BP culture. In order to test the sensitivity and specificity of...

  1. Eating Disorder Diagnoses: Empirical Approaches to Classification

    Wonderlich, Stephen A.; Joiner, Thomas E., Jr.; Keel, Pamela K.; Williamson, Donald A.; Crosby, Ross D.

    2007-01-01

    Decisions about the classification of eating disorders have significant scientific and clinical implications. The eating disorder diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) reflect the collective wisdom of experts in the field but are frequently not supported in…

  2. Medicinalindustrien har brug for diagnoser som ADHD

    Fugl, Marie

    2008-01-01

    Det er ikke første gang, at medicinalindustriens evne til at finde nye markeder har medført nye eller bredere diagnoser. I det forrige årti så vi et parallelt forløb mellem et boom i antallet af depressionsdiagnoser og forbruget af lykkepiller. Interview med sociolog Thomas Brante. Udgivelsesdato...

  3. Two Siblings Diagnosed as Lafora Disease

    Yasemin Biçer Gömceli

    2010-03-01

    Full Text Available Lafora disease is a typical progressive myoclonic epilepsy that is characterized by autosomal recessive inheritance, myoclonic and occipital seizures, progressive dementia, ataxia, and dysarthria. Two siblings with myoclonic and generalized tonic clonic seizures, progressive dementia, ataxia and dysarthria, who were diagnosed as Lafora disease by sweat gland biopsy, are discussed.

  4. Odontogenic maxillary sinusitis diagnosed using conebeam x-ray CT

    We evaluated the usefulness of conebeam x-ray CT in the diagnosis of odontogenic maxillary sinusitis in 21 patients. Among teeth causing odontogenic maxillary sinusitis, 95% had apical lesions after root canal treatment. Most root canals were filled with filling materials incompletely. Apical lesions in inappropriately treated teeth thus caused odontogenic maxillary sinusitis. Conebeam CT involves 3-dimensional isotropic voxel image date in up to 512 frames for transaxial, coronal, and sagittal planes, so resolution in imaging on the body axis was especially high. Multiplanar reconstruction and volume rendering images at any optional plane could be obtained without interpolation. The relationship between causative teeth and the maxillary sinus could be observed and measured, and odontogenic maxillary sinusitis accurately diagnosed. In addition to the accurate diagnosis of apical lesions, maxilla, and maxillary sinus, periodontal ligament space, lamina dura, pulp cavity, root canal, canal-treated root, apical periodontitis, alveolar ostitis, marginal periodontitis of causative teeth could be observed. Metal artifacts were minimized, making conebeam CT useful in the diagnosis of periodontal tissue and causative teeth, including root-canal-treated and crown-restored teeth. (author)

  5. Laboratory Building for Accurate Determination of Plutonium

    2008-01-01

    <正>The accurate determination of plutonium is one of the most important assay techniques of nuclear fuel, also the key of the chemical measurement transfer and the base of the nuclear material balance. An

  6. Significance of eosinophils in diagnosing Hashimoto′s thyroiditis on fine-needle aspiration cytology

    Ekambaram Maheswari; Kumar Bipin; Chowdhary Nitlotpal; Siddaraju N; Kumar Surendra

    2010-01-01

    Background: Hashimoto′s thyroiditis (HT) is the most common cause of hypothyroidism in those areas of the world where iodine levels are sufficient. Fine-needle aspiration cytology (FNAC) can accurately diagnose this lesion in most of the patients. However, a small percentage of cases may be missed due to inherent limitations of this procedure. Therefore, cytologic clues to increase sensitivity of diagnosis need to be searched for. Aims: To assess whether an eosinophilic infiltration of...

  7. Neonatal goiter with congenital thyroid dysfunction in two infants diagnosed by MRI

    It is essential to diagnose thyroid dysfunction at an early stage because congenital hypothyroidism (CH) represents one of the most common preventable causes of delayed physical and psychological development, including mental retardation. US evaluates the shape of the thyroid gland. CT and scintigraphic examinations demonstrate iodine metabolism of the thyroid, but there is associated radiation exposure. We encountered two cases of congenital goiter, in which MRI was very helpful in confirming thyroid dysfunction and was very useful in making an accurate diagnosis. (orig.)

  8. Neonatal goiter with congenital thyroid dysfunction in two infants diagnosed by MRI

    Kondoh, Mutsuko [Department of Radiology, St. Marianna University, Seibu Hospital, Kanagawa (Japan); Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa-ken 216-8511 (Japan); Miyazaki, Osamu; Imanishi, Yoshimasa; Hayakawa, Minako [Department of Radiology, St. Marianna University, Seibu Hospital, Kanagawa (Japan); Aikyou, Miho; Doi, Hiromi [Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa (Japan)

    2004-07-01

    It is essential to diagnose thyroid dysfunction at an early stage because congenital hypothyroidism (CH) represents one of the most common preventable causes of delayed physical and psychological development, including mental retardation. US evaluates the shape of the thyroid gland. CT and scintigraphic examinations demonstrate iodine metabolism of the thyroid, but there is associated radiation exposure. We encountered two cases of congenital goiter, in which MRI was very helpful in confirming thyroid dysfunction and was very useful in making an accurate diagnosis. (orig.)

  9. Reliability of clinical ICD-10 schizophrenia diagnoses

    Jakobsen, Klaus D; Frederiksen, Julie N; Hansen, Thomas;

    2005-01-01

    Concern has been expressed as to the reliability of clinical ICD-10 diagnosis of schizophrenia. This study was designed to assess the diagnostic reliability of the clinical ICD-10 diagnosis of schizophrenia in a random sample of Danish in- and outpatients with a history of psychosis. A sample of...... was seen between OPCRIT-derived ICD-10 and DSM-IV diagnoses (kappa=0.87). Thus, this study demonstrates high reliability of the clinical diagnosis of schizophrenia and even more so of the diagnosis of schizophrenia-spectrum disorder....... 100 subjects was assessed using the operational criteria OPCRIT checklist for psychotic and affective illness. The most recent principal and clinical ICD-10 diagnosis was compared with diagnoses generated by the OPCRIT instrument. Data documented very high sensitivity (93%) and positive predictive...

  10. An Appropriate Indicator for Diagnosing Gestational Diabetes

    Jui-Hung Sun; Lai-Chu See; Tsung-Hong Chiu; T’sang-T’ang Hsieh; Miau-Ju Huang

    2005-01-01

    Background: This study was intended to simplify the diagnostic procedure for gestationaldiabetes mellitus (GDM) through using a single plasma glucose level, after a100 g oral glucose tolerance test (OGTT), as the most appropriate indicatorfor diagnosing GDM in pregnant women with a positive 50 g, 1-hour oralglucose challenge test (GCT) in Northern Taiwan.Methods: A total of 973 native Taipei metropolitan pregnant women with a positiveGCT, who underwent a 100 g, 3-hour OGTT were retrospectivel...

  11. Eosinophilic Pancreatitis Diagnosed With Endoscopic Ultrasound

    Kakodkar, Samir; Omar, Hina; Cabrera, Julio; Chi, Kenneth

    2015-01-01

    Eosinophilic pancreatitis (EP) is a rare clinical entity, and few cases have been reported. It usually presents on imaging as a pancreatic mass leading to common bile duct obstruction and jaundice. Since it can mimic a malignancy, eosinophilic pancreatitis is often diagnosed after “false positive” pancreatic resections. To our knowledge, we report the only known case of EP in which the diagnosis was made by fine needle aspiration and core biopsy of the pancreas during EUS, sparing the patient...

  12. Diagnosing dementia: do we get it right?

    Homer, A. C.; Honavar, M; Lantos, P L; Hastie, I R; Kellett, J M; Millard, P H

    1988-01-01

    To find out whether the diagnosis of dementia agreed with findings at necropsy a detailed assessment of 27 elderly patients (mean age 82 (range 70-94] presenting with dementia was conducted at a combined department of geriatric medicine and psychiatry for the elderly. On the basis of the results the cause of the dementia was diagnosed clinically. Neuropathological examinations were performed after death. The clinical diagnosis made during life was not supported by the findings at necropsy in ...

  13. Measuring Money Mismanagement Among Dually Diagnosed Clients

    Black, Ryan A.; Rounsaville, Bruce J.; Rosenheck, Robert A; Conrad, Kendon J.; Ball, Samuel A.; Rosen, Marc I.

    2008-01-01

    Clients dually diagnosed with psychiatric and substance abuse disorders may be adversely affected if they mismanage their Social Security or public support benefits. Assistance managing funds, including assignment of a representative payee, is available but there are no objective assessments of money mismanagement. In this study, a Structured Clinical Interview for Money Mismanagement was administered twice at one-week intervals to 46 clients receiving disability payments and was compared to ...

  14. Best waveform score for diagnosing keratoconus

    Allan Luz; Bruno Machado Fontes; Bernardo Lopes; Isaac Ramos; Fernando Faria Correia; Paulo Schor; Renato Ambrósio Jr.

    2013-01-01

    PURPOSE: To test whether corneal hysteresis (CH) and corneal resistance factor (CRF) can discriminate between keratoconus and normal eyes and to evaluate whether the averages of two consecutive measurements perform differently from the one with the best waveform score (WS) for diagnosing keratoconus. METHODS: ORA measurements for one eye per individual were selected randomly from 53 normal patients and from 27 patients with keratoconus. Two groups were considered the average (CH-Avg, CRF-Avg)...

  15. An Appropriate Indicator for Diagnosing Gestational Diabetes

    Jui-Hung Sun

    2005-12-01

    Full Text Available Background: This study was intended to simplify the diagnostic procedure for gestationaldiabetes mellitus (GDM through using a single plasma glucose level, after a100 g oral glucose tolerance test (OGTT, as the most appropriate indicatorfor diagnosing GDM in pregnant women with a positive 50 g, 1-hour oralglucose challenge test (GCT in Northern Taiwan.Methods: A total of 973 native Taipei metropolitan pregnant women with a positiveGCT, who underwent a 100 g, 3-hour OGTT were retrospectively surveyed.GDM was defined according to the standards of National Diabetes DataGroup. Plasma glucose levels, obtained 1 hour following a GCT and at multipletiming following a 100 g oral glucose load, were used to plot receiveroperative characteristic curves to determine the most appropriate indicatorfor diagnosing GDM.Results: In the 973 pregnant women with a positive GCT, a 2-hour plasma glucoselevel above 165 mg/dl revealed a sensitivity and specificity of 91.2% and90.3%, respectively.Conclusions: To simplify the diagnostic procedure for GDM, we suggest that a 2-hourplasma glucose level above 165 mg/dl after a 100 g OGTT might be anappropriate indicator for diagnosing GDM in women with a positive GCT.

  16. Invariant Image Watermarking Using Accurate Zernike Moments

    Ismail A. Ismail

    2010-01-01

    Full Text Available problem statement: Digital image watermarking is the most popular method for image authentication, copyright protection and content description. Zernike moments are the most widely used moments in image processing and pattern recognition. The magnitudes of Zernike moments are rotation invariant so they can be used just as a watermark signal or be further modified to carry embedded data. The computed Zernike moments in Cartesian coordinate are not accurate due to geometrical and numerical error. Approach: In this study, we employed a robust image-watermarking algorithm using accurate Zernike moments. These moments are computed in polar coordinate, where both approximation and geometric errors are removed. Accurate Zernike moments are used in image watermarking and proved to be robust against different kind of geometric attacks. The performance of the proposed algorithm is evaluated using standard images. Results: Experimental results show that, accurate Zernike moments achieve higher degree of robustness than those approximated ones against rotation, scaling, flipping, shearing and affine transformation. Conclusion: By computing accurate Zernike moments, the embedded bits watermark can be extracted at low error rate.

  17. Sulfasalazine and temozolomide with radiation therapy for newly diagnosed glioblastoma

    Satoru Takeuchi

    2014-01-01

    Full Text Available Background: A recent phase 1/2 clinical trial argued for caution for the use of sulfasalazine in progressive glioblastoma (GBM. However, the study enrolled patients with recurrent or progressive high-grade glioma indicating that patients recruited probably had severe disease. Thus, the study may not accurately reflect the effectiveness of sulfasalazine for GBM and we hypothesized that earlier sulfasalazine administration may lead to anticancer effects. Aim: The aim of this study was to investigate whether sulfasalazine can improve the outcomes of patients with newly diagnosed GBM. Subjects and Methods: A total of 12 patients were treated with temozolomide and sulfasalazine with radiation therapy after surgery. Twelve patients with primary GBM treated with temozolomide and radiation therapy formed the control group. Progression-free survival (PFS, overall survival (OS and seizure-free survival (SFS curves were obtained using the Kaplan-Meier method. The survival curves were compared using the log-rank test. Results: The median OS, PFS and SFS did not differ between the groups. Grade 3 or 4 adverse events occurred over the duration of the study in nine (75% patients. The median SFS was 12 months in nine patients who received sulfasalazine administration for more than 21 days, which was strongly but not significantly longer than the 3 months observed in the control group (P = 0.078. Conclusions: Sulfasalazine treatment with temozolomide plus radiotherapy for newly diagnosed primary GBM is associated with a high rate of discontinuation due to hematologic toxic effects. This treatment may have no effect on OS or PFS, although it may improve seizure control if an adequate dose can be administered.

  18. The Diagnostic Accuracy of Urine-Based Xpert MTB/RIF in HIV-Infected Hospitalized Patients Who Are Smear-Negative or Sputum Scarce

    Peter, Jonathan G.; Theron, Grant; Muchinga, Tapuwa E.; Govender, Ureshnie; Dheda, Keertan

    2012-01-01

    Background Hospitals in sub-Saharan Africa are inundated with HIV-infected patients and tuberculosis (TB) is the commonest opportunistic infection in this sub-group. Up to one third of TB-HIV co-infected patients fail to produce a sputum sample (sputum scarce) and diagnosis is thus often delayed or missed. We investigated the sensitivity of urine-based methods (Xpert MTB/RIF, LAM strip test and LAM ELISA) in such patients. Methodology/Principal Findings 281 HIV-infected hospitalised patients ...

  19. Best waveform score for diagnosing keratoconus

    Allan Luz

    2013-12-01

    Full Text Available PURPOSE: To test whether corneal hysteresis (CH and corneal resistance factor (CRF can discriminate between keratoconus and normal eyes and to evaluate whether the averages of two consecutive measurements perform differently from the one with the best waveform score (WS for diagnosing keratoconus. METHODS: ORA measurements for one eye per individual were selected randomly from 53 normal patients and from 27 patients with keratoconus. Two groups were considered the average (CH-Avg, CRF-Avg and best waveform score (CH-WS, CRF-WS groups. The Mann-Whitney U-test was used to evaluate whether the variables had similar distributions in the Normal and Keratoconus groups. Receiver operating characteristics (ROC curves were calculated for each parameter to assess the efficacy for diagnosing keratoconus and the same obtained for each variable were compared pairwise using the Hanley-McNeil test. RESULTS: The CH-Avg, CRF-Avg, CH-WS and CRF-WS differed significantly between the normal and keratoconus groups (p<0.001. The areas under the ROC curve (AUROC for CH-Avg, CRF-Avg, CH-WS, and CRF-WS were 0.824, 0.873, 0.891, and 0.931, respectively. CH-WS and CRF-WS had significantly better AUROCs than CH-Avg and CRF-Avg, respectively (p=0.001 and 0.002. CONCLUSION: The analysis of the biomechanical properties of the cornea through the ORA method has proved to be an important aid in the diagnosis of keratoconus, regardless of the method used. The best waveform score (WS measurements were superior to the average of consecutive ORA measurements for diagnosing keratoconus.

  20. Neuroimaging differential diagnoses to abusive head trauma

    Trauma is the most common cause of death in childhood, and abusive head trauma is the most common cause of traumatic death and morbidity in infants younger than 1 year. The main differential diagnosis of abusive head trauma is accidental traumatic brain injury, which is usually witnessed. This paper also discusses more uncommon diagnoses such as congenital and acquired disorders of hemostasis, cerebral arteriovenous malformations and metabolic diseases, all of which are extremely rare. Diagnostic imaging including CT and MRI is very important for the distinction of non-accidental from accidental traumatic injury. (orig.)

  1. Neuroimaging differential diagnoses to abusive head trauma

    Girard, Nadine [AP-HM Timone 2, Department of Neuroradiology, Marseille cedex 05 (France); Aix Marseille University, UMR CNRS 7339, Marseille (France); Brunel, Herve; Dory-Lautrec, Philippe [AP-HM Timone 2, Department of Neuroradiology, Marseille cedex 05 (France); Chabrol, Brigitte [AP-HM Timone, Department of Pediatric Neurology, Marseille (France)

    2016-05-15

    Trauma is the most common cause of death in childhood, and abusive head trauma is the most common cause of traumatic death and morbidity in infants younger than 1 year. The main differential diagnosis of abusive head trauma is accidental traumatic brain injury, which is usually witnessed. This paper also discusses more uncommon diagnoses such as congenital and acquired disorders of hemostasis, cerebral arteriovenous malformations and metabolic diseases, all of which are extremely rare. Diagnostic imaging including CT and MRI is very important for the distinction of non-accidental from accidental traumatic injury. (orig.)

  2. Accuracy of Ultrasonography in Diagnosing Acute Appendicitis

    Parisa Javidi Parsijani; Nima Pourhabibi Zarandi; Shahram Paydar; Hamidreza Abbasi; Shahram Bolandparvaz

    2013-01-01

    Objectives: To evaluate the accuracy of sonography in diagnosing acute appendicitis in patients with Alvarado score 4–7.Methods: This is a retrospective cross-sectional study being performed in Namazee hospital affiliated with Shiraz University of Medical sciences during a one year period from 9/2007 to 9/2008. We evaluated all patients with Alvarado score 4-7 and divided them in two groups: those with Ultrasound study prior to surgery and those without any imaging modalities for diagnosis of...

  3. Diagnosing risks in product-innovation projects

    Halman, JIM Joop; Keizer, JA Jimme

    1994-01-01

    A new method of diagnosing risks in product-innovation projects is introduced in the paper. The method is an improvement on existing risk methods used on product-innovation projects, such as potential problem analysis and failure mode and effects analysis. Technological, organizational and commercial risks are identified and assessed on an individual basis. These risks are mapped in a risk topography which is used as an input for the drawing up of a risk-management plan. The method has been d...

  4. Psychotherapy Techniques for Patients Diagnosed with Schizophrenia.

    Lotterman, Andrew C

    2016-01-01

    The paper describes how standard psychotherapy techniques need to be modified to suit the specialized needs of patients diagnosed with schizophrenia. Patients with psychosis often have lost their ability to use words to describe their inner states. As a result, traditional forms of psychotherapy which depend so crucially on the use of language are compromised. The goal of treatment at the start is to help the patient recover his ability to use language to describe his inner life. Eventually, this enables the patient to make use of more traditional forms of psychodynamic treatment. PMID:27052606

  5. Computer Assisted Diagnoses for Red Eye (CADRE)

    Muhammad Zubair Asghar; Abdur Rashid Khan; Muhammad Junaid Asghar

    2009-01-01

    This paper introduces an expert System (ES) named as “CADRE-Computer Assisted Diagnoses for Red Eye. Mostly the remote areas of the population are deprived of the facilities of having experts in eye disease. So it is the need of the day to store the expertise of Eye specialists in computers through using ES technology. This ES is a rule-based Expert System that assists in red-eye diagnosis and treatment. The knowledge acquired from literature review and human experts of the specific domain wa...

  6. Benign intracranial hypertension diagnosed with bilateral papilloedema

    K. C. Phillips

    2013-12-01

    Full Text Available This article presents a case of benign intracranial hypertension (BIH diagnosed from the presence of papilloedema. This potentially sight-threatening condition particularly affects younger obese females and can be idiopathic, caused by adverse reaction to certain prescription medications or by systemic disease. Prompt treatment is essentialto avoid optic atrophy and low energy diet and exercise forms part of long-term treatment to avoid relapse. Optometrists can play a critical primary health care role in the detection of papilloedema and referring appropriately.

  7. Accurate atomic data for industrial plasma applications

    Griesmann, U.; Bridges, J.M.; Roberts, J.R.; Wiese, W.L.; Fuhr, J.R. [National Inst. of Standards and Technology, Gaithersburg, MD (United States)

    1997-12-31

    Reliable branching fraction, transition probability and transition wavelength data for radiative dipole transitions of atoms and ions in plasma are important in many industrial applications. Optical plasma diagnostics and modeling of the radiation transport in electrical discharge plasmas (e.g. in electrical lighting) depend on accurate basic atomic data. NIST has an ongoing experimental research program to provide accurate atomic data for radiative transitions. The new NIST UV-vis-IR high resolution Fourier transform spectrometer has become an excellent tool for accurate and efficient measurements of numerous transition wavelengths and branching fractions in a wide wavelength range. Recently, the authors have also begun to employ photon counting techniques for very accurate measurements of branching fractions of weaker spectral lines with the intent to improve the overall accuracy for experimental branching fractions to better than 5%. They have now completed their studies of transition probabilities of Ne I and Ne II. The results agree well with recent calculations and for the first time provide reliable transition probabilities for many weak intercombination lines.

  8. More accurate picture of human body organs

    Computerized tomography and nucler magnetic resonance tomography (NMRT) are revolutionary contributions to radiodiagnosis because they allow to obtain a more accurate image of human body organs. The principles are described of both methods. Attention is mainly devoted to NMRT which has clinically only been used for three years. It does not burden the organism with ionizing radiation. (Ha)

  9. Hospital-diagnosed dementia and suicide

    Erlangsen, Annette; Zarit, Steven H; Conwell, Yeates

    2008-01-01

    OBJECTIVE: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. DESIGN: Event-history analysis using time-varying covariates. SETTING: Population-based record linkage. PARTICIPANTS: All individual...... for older adults. Preventive measures should focus on suicidal ideation after initial diagnosis but also acknowledge that suicides can occur well after a dementia diagnosis has been established....... who are aged 70 or older with dementia have a threefold higher risk than persons with no dementia. The time shortly after diagnosis is associated with an elevated suicide risk. The risk among persons with dementia remains significant when controlling for mood disorders. As many as 26% of the men...... and 14% of the women who died by suicide died within the first 3 months after being diagnosed whereas 38% of the men and 41% of the women died more than 3 years after initial dementia diagnosis. CONCLUSIONS: Dementia, determined during hospitalization, was associated with an elevated risk of suicide...

  10. Diagnosing faults in autonomous robot plan execution

    Lam, Raymond K.; Doshi, Rajkumar S.; Atkinson, David J.; Lawson, Denise M.

    1989-01-01

    A major requirement for an autonomous robot is the capability to diagnose faults during plan execution in an uncertain environment. Many diagnostic researches concentrate only on hardware failures within an autonomous robot. Taking a different approach, the implementation of a Telerobot Diagnostic System that addresses, in addition to the hardware failures, failures caused by unexpected event changes in the environment or failures due to plan errors, is described. One feature of the system is the utilization of task-plan knowledge and context information to deduce fault symptoms. This forward deduction provides valuable information on past activities and the current expectations of a robotic event, both of which can guide the plan-execution inference process. The inference process adopts a model-based technique to recreate the plan-execution process and to confirm fault-source hypotheses. This technique allows the system to diagnose multiple faults due to either unexpected plan failures or hardware errors. This research initiates a major effort to investigate relationships between hardware faults and plan errors, relationships which were not addressed in the past. The results of this research will provide a clear understanding of how to generate a better task planner for an autonomous robot and how to recover the robot from faults in a critical environment.

  11. How Do Health Care Providers Diagnose Cushing's Syndrome?

    ... and Publications How do health care providers diagnose Cushing’s syndrome? Skip sharing on social media links Share this: Page Content Diagnosing Cushing’s syndrome can be complex and difficult. This syndrome is ...

  12. How Do Health Care Providers Diagnose Turner Syndrome?

    ... and Publications How do health care providers diagnose Turner syndrome? Skip sharing on social media links Share this: ... the X chromosomes is partially or completely missing. Turner syndrome also can be diagnosed during pregnancy by testing ...

  13. How Do Health Care Providers Diagnose Spina Bifida?

    ... and Publications How do health care providers diagnose spina bifida? Skip sharing on social media links Share this: Page Content Doctors diagnose spina bifida before or after the infant is born. Spina ...

  14. Time trend in diagnosing dementia in secondary care

    Phung, Thien Kieu Thi; Waltoft, Berit Lindum; Kessing, Lars Vedel;

    2010-01-01

    To study the trend of diagnosing dementia in the secondary health care sector over time, we conducted a nationwide longitudinal study of the incidence and prevalence of registered dementia diagnoses in the Danish national hospital registers.......To study the trend of diagnosing dementia in the secondary health care sector over time, we conducted a nationwide longitudinal study of the incidence and prevalence of registered dementia diagnoses in the Danish national hospital registers....

  15. Application of Laser Induced Plasma Spectroscopy on Breast Cancer Diagnoses

    Abd-Alfattah, A.; Eldakrouri, A. A.; Emam, H.; Azzouz, I. M.

    2013-03-01

    Worldwide, millions of breast cancer cases appear each year. It ranked as the first malignant tumors in Egypt. Breast cancer patients are at increased risk of developing malignant melanoma and cancers of the ovary, endometrium, colon, thyroid, and salivary glands because of similar hormonal and genetic factors. Therefore, early diagnosis by a quick and accurate method may have a great affect on healing. In this work, we investigate the feasibility of using LIPS as a simple, technique to diagnose breast cancer by measuring the concentration of trace elements in breast tissues. The accuracy of LIPS measurements was confirmed by carrying out another elemental analysis via atomic absorption spectroscopy (AAS) technique. The results obtained via these two techniques showed that the concentration of Ca, Cu, Fe, Zn and Mn in the malignant tissue cells are significantly enhanced. A voting algorithm was built for instantaneous decision of the diagnostic technique (normal or malignant). This study instigates developing a new diagnostic tool with potential use in vivo.

  16. Feedback about more accurate versus less accurate trials: differential effects on self-confidence and activation.

    Badami, Rokhsareh; VaezMousavi, Mohammad; Wulf, Gabriele; Namazizadeh, Mahdi

    2012-06-01

    One purpose of the present study was to examine whether self-confidence or anxiety would be differentially affected byfeedback from more accurate rather than less accurate trials. The second purpose was to determine whether arousal variations (activation) would predict performance. On day 1, participants performed a golf putting task under one of two conditions: one group received feedback on the most accurate trials, whereas another group received feedback on the least accurate trials. On day 2, participants completed an anxiety questionnaire and performed a retention test. Shin conductance level, as a measure of arousal, was determined. The results indicated that feedback about more accurate trials resulted in more effective learning as well as increased self-confidence. Also, activation was a predictor of performance. PMID:22808705

  17. Accurate guitar tuning by cochlear implant musicians.

    Thomas Lu

    Full Text Available Modern cochlear implant (CI users understand speech but find difficulty in music appreciation due to poor pitch perception. Still, some deaf musicians continue to perform with their CI. Here we show unexpected results that CI musicians can reliably tune a guitar by CI alone and, under controlled conditions, match simultaneously presented tones to <0.5 Hz. One subject had normal contralateral hearing and produced more accurate tuning with CI than his normal ear. To understand these counterintuitive findings, we presented tones sequentially and found that tuning error was larger at ∼ 30 Hz for both subjects. A third subject, a non-musician CI user with normal contralateral hearing, showed similar trends in performance between CI and normal hearing ears but with less precision. This difference, along with electric analysis, showed that accurate tuning was achieved by listening to beats rather than discriminating pitch, effectively turning a spectral task into a temporal discrimination task.

  18. Accurate guitar tuning by cochlear implant musicians.

    Lu, Thomas; Huang, Juan; Zeng, Fan-Gang

    2014-01-01

    Modern cochlear implant (CI) users understand speech but find difficulty in music appreciation due to poor pitch perception. Still, some deaf musicians continue to perform with their CI. Here we show unexpected results that CI musicians can reliably tune a guitar by CI alone and, under controlled conditions, match simultaneously presented tones to <0.5 Hz. One subject had normal contralateral hearing and produced more accurate tuning with CI than his normal ear. To understand these counterintuitive findings, we presented tones sequentially and found that tuning error was larger at ∼ 30 Hz for both subjects. A third subject, a non-musician CI user with normal contralateral hearing, showed similar trends in performance between CI and normal hearing ears but with less precision. This difference, along with electric analysis, showed that accurate tuning was achieved by listening to beats rather than discriminating pitch, effectively turning a spectral task into a temporal discrimination task. PMID:24651081

  19. How Accurate is inv(A)*b?

    Druinsky, Alex

    2012-01-01

    Several widely-used textbooks lead the reader to believe that solving a linear system of equations Ax = b by multiplying the vector b by a computed inverse inv(A) is inaccurate. Virtually all other textbooks on numerical analysis and numerical linear algebra advise against using computed inverses without stating whether this is accurate or not. In fact, under reasonable assumptions on how the inverse is computed, x = inv(A)*b is as accurate as the solution computed by the best backward-stable solvers. This fact is not new, but obviously obscure. We review the literature on the accuracy of this computation and present a self-contained numerical analysis of it.

  20. Accurate, reproducible measurement of blood pressure.

    Campbell, N. R.; Chockalingam, A; Fodor, J. G.; McKay, D. W.

    1990-01-01

    The diagnosis of mild hypertension and the treatment of hypertension require accurate measurement of blood pressure. Blood pressure readings are altered by various factors that influence the patient, the techniques used and the accuracy of the sphygmomanometer. The variability of readings can be reduced if informed patients prepare in advance by emptying their bladder and bowel, by avoiding over-the-counter vasoactive drugs the day of measurement and by avoiding exposure to cold, caffeine con...

  1. Accurate Finite Difference Methods for Option Pricing

    Persson, Jonas

    2006-01-01

    Stock options are priced numerically using space- and time-adaptive finite difference methods. European options on one and several underlying assets are considered. These are priced with adaptive numerical algorithms including a second order method and a more accurate method. For American options we use the adaptive technique to price options on one stock with and without stochastic volatility. In all these methods emphasis is put on the control of errors to fulfill predefined tolerance level...

  2. Towards accurate modeling of moving contact lines

    Holmgren, Hanna

    2015-01-01

    The present thesis treats the numerical simulation of immiscible incompressible two-phase flows with moving contact lines. The conventional Navier–Stokes equations combined with a no-slip boundary condition leads to a non-integrable stress singularity at the contact line. The singularity in the model can be avoided by allowing the contact line to slip. Implementing slip conditions in an accurate way is not straight-forward and different regularization techniques exist where ad-hoc procedures ...

  3. Accurate variational forms for multiskyrmion configurations

    Jackson, A.D.; Weiss, C.; Wirzba, A.; Lande, A.

    1989-04-17

    Simple variational forms are suggested for the fields of a single skyrmion on a hypersphere, S/sub 3/(L), and of a face-centered cubic array of skyrmions in flat space, R/sub 3/. The resulting energies are accurate at the level of 0.2%. These approximate field configurations provide a useful alternative to brute-force solutions of the corresponding Euler equations.

  4. Efficient Accurate Context-Sensitive Anomaly Detection

    2007-01-01

    For program behavior-based anomaly detection, the only way to ensure accurate monitoring is to construct an efficient and precise program behavior model. A new program behavior-based anomaly detection model,called combined pushdown automaton (CPDA) model was proposed, which is based on static binary executable analysis. The CPDA model incorporates the optimized call stack walk and code instrumentation technique to gain complete context information. Thereby the proposed method can detect more attacks, while retaining good performance.

  5. Accurate phase-shift velocimetry in rock

    Shukla, Matsyendra Nath; Vallatos, Antoine; Phoenix, Vernon R.; Holmes, William M.

    2016-06-01

    Spatially resolved Pulsed Field Gradient (PFG) velocimetry techniques can provide precious information concerning flow through opaque systems, including rocks. This velocimetry data is used to enhance flow models in a wide range of systems, from oil behaviour in reservoir rocks to contaminant transport in aquifers. Phase-shift velocimetry is the fastest way to produce velocity maps but critical issues have been reported when studying flow through rocks and porous media, leading to inaccurate results. Combining PFG measurements for flow through Bentheimer sandstone with simulations, we demonstrate that asymmetries in the molecular displacement distributions within each voxel are the main source of phase-shift velocimetry errors. We show that when flow-related average molecular displacements are negligible compared to self-diffusion ones, symmetric displacement distributions can be obtained while phase measurement noise is minimised. We elaborate a complete method for the production of accurate phase-shift velocimetry maps in rocks and low porosity media and demonstrate its validity for a range of flow rates. This development of accurate phase-shift velocimetry now enables more rapid and accurate velocity analysis, potentially helping to inform both industrial applications and theoretical models.

  6. Ultrasonic findings in diagnosing renal colic

    Lee, Myung Jin; Kim, Mee Hyun; Lee, Young Joong; Yoon, Jong Sup [Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    1986-04-15

    To determine diagnostic values of ultrasonography in evaluation of renal colic, ultrasonographic study of 35 patients in whom renal colic was clinically suspected was undertaken. The sonographic criterion for a positive finding consisted of visualization of urinary tract calculus with posterior acoustic shadowing, with or without ureterectasis. Renal colic was correctly diagnosed by ultrasonography in 28 patients of 33 patients with proven ureteric stone, for an accuracy of 85%. Of the 33 patients with proven ureteric stone, there were 3 cases with ureteropelvic junction stone, 4 cases with abdominal ureter stone, 4 cases with iliac ureter stone, 4 cases with pelvic ureter stone and 18 cases with ureterovesical junction stone. The results show that ultrasonography in an effective initial screening test when renal colic is clinically suspected.

  7. No real-time prognoses without diagnoses

    ECN is developing a 'problem oriented user guide' for a PC-based computer programme for real-time prognoses. This programme, infoREM, calculates the potential consequences of a nuclear accident from reported radioactive releases to the atmosphere and weather forecasts. This user guide will help the staff of the local and national co-ordination centres to use InfoREM to perform the necessary calculations with the data available during a nuclear accident. In particular, the guide will help them to critically diagnose the results calculated before using these when implementing monitoring plans and countermeasures. This paper discusses an instruction set for performing 'simple prognoses' as an example for the methodology of the user guide. This set has been developed by ECN for the monitoring and decontamination teams of the fire brigades. In addition, the structure of infoREM is discussed. (orig.)

  8. A case of thoracogastropagus diagnosed before delivery.

    Hayashi, M; Tomobe, K; Yaoi, Y

    1998-01-01

    The subject was a 29-year-old pregnant woman whose fetuses were a conjoined twin. We diagnosed the fetuses as a conjoined twin by ultrasonography at the 12th week of gestation. The patient and her family wanted living infants and hoped that they were separated surgically. We consulted with the doctors of pediatric surgery and cardiovascular surgery departments. At the 18th week of gestation, the fetuses died in utero and they were delivered transvaginally by labor induction. Both infants were female with 430 g in total body weight and both of them were 21 cm in length. Pathological findings were thoracogastro-pagus with a single heart, a single pair of liver and a single small intestine. PMID:9704294

  9. Nichtinvasive Diagnose der Leberfibrose bei chronischen Hepatopathien

    Stauber R

    2009-01-01

    Full Text Available Die Beurteilung der Leberfibrose ist bedeutsam für die Prognose, Therapieindikation und Verlaufskontrolle bei chronisch-progredienten Hepatopathien. Referenztest (Goldstandard ist derzeit die histologische Beurteilung von Leberbiopsaten. Da die Leberbiopsie jedoch ein gewisses Risiko birgt, sind zuverlässige nicht-invasive Fibrosetests sehr wünschenswert. Der vorliegende Artikel soll eine Übersicht über die wichtigsten nicht-invasiven Fibrosetests und deren diagnostische Aussagekraft hinsichtlich signifikanter Fibrose bzw. Zirrhose bei verschiedenen Lebererkrankungen bieten. Die meisten Studien wurden bei chronischer Hepatitis C durchgeführt, aber auch bei nicht-alkoholischer Fettlebererkrankung gewinnt diese Fragestellung an Bedeutung. Anhand der vorliegenden Daten ist die Aussagekraft einfacher (auf Routinelaborwerten basierender Fibrosetests hinsichtlich signifikanter Fibrose offenbar ähnlich wie diejenige der komplexeren Biomarker. Die Ultraschall-Elastographie (Fibroscan ™ erscheint jedoch als überlegene Methode zur Diagnose von Zirrhose bzw. eventuell auch von klinisch-signifikanter portaler Hypertonie.

  10. Excess mortality in patients diagnosed with hypothyroidism

    Thvilum, Marianne; Brandt, Frans; Pedersen, Dorthe Almind;

    2013-01-01

    Background: Although hypothyroidism is associated with increased morbidity, an association with increased mortality is still debated. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism influences mortality. Methods: In an observational cohort study from...... January 1, 1978 until December 31, 2008 using record-linkage data from nationwide Danish health registers, 3587 singletons and 682 twins diagnosed with hypothyroidism were identified. Hypothyroid individuals were matched 1:4 with nonhypothyroid controls with respect to age and gender and followed over a...... mean period of 5.6 years (range 0-30 years). The hazard ratio (HR) for mortality was calculated using Cox regression analyses. Comorbidity was evaluated using the Charlson score (CS). Results: In singletons with hypothyroidism, the mortality risk was increased (HR 1.52; 95% confidence interval [CI]: 1...

  11. Automated diagnostic kiosk for diagnosing diseases

    Regan, John Frederick; Birch, James Michael

    2014-02-11

    An automated and autonomous diagnostic apparatus that is capable of dispensing collection vials and collections kits to users interesting in collecting a biological sample and submitting their collected sample contained within a collection vial into the apparatus for automated diagnostic services. The user communicates with the apparatus through a touch-screen monitor. A user is able to enter personnel information into the apparatus including medical history, insurance information, co-payment, and answer a series of questions regarding their illness, which is used to determine the assay most likely to yield a positive result. Remotely-located physicians can communicate with users of the apparatus using video tele-medicine and request specific assays to be performed. The apparatus archives submitted samples for additional testing. Users may receive their assay results electronically. Users may allow the uploading of their diagnoses into a central databank for disease surveillance purposes.

  12. Alternative diagnoses at paediatric appendicitis MRI

    As the utilization of MRI in the assessment for paediatric appendicitis increases in clinical practice, it is important to recognize alternative diagnoses as the cause of abdominal pain. The purpose of this review is to share our institution's experience using MRI in the evaluation of 510 paediatric patients presenting with suspected appendicitis over a 30 month interval (July 2011 to December 2013). An alternative diagnosis was documented in 98/510 (19.2%) patients; adnexal pathology (6.3%, n = 32), enteritis–colitis (6.3%, n = 32), and mesenteric adenitis (2.2%, n = 11) comprised the majority of cases. These common entities and other less frequent illustrative cases obtained during our overall institutional experience with MRI for suspected appendicitis are reviewed

  13. Optical coherence tomography for diagnosing periodontal disease

    Colston, Bill W., Jr.; Everett, Matthew J.; Da Silva, Luiz B.; Otis, Linda L.; Nathel, Howard

    1997-05-01

    We have, in this preliminary study, investigated the use of optical coherence tomography for diagnosis of periodontal disease. We took in vitro OCT images of the dental and periodontal tissues from a young pig and compared them to histological sections. These images distinguish tooth and soft tissue relationships that are important in diagnosing and assessing periodontal disease. We have imaged the attachment of gingiva to the tooth surface and located the cemento-enamel junction. This junction is an important reference point for defining attachment level in the diagnosis of periodontal disease. the boundary between enamel and dentin is also visible for most of the length of the anatomical crown, allowing quantitation of enamel thickness and character.

  14. Editorial: Testing and Diagnosing Social Science Literacy

    Birgit Weber

    2011-10-01

    Full Text Available A year ago the Journal of Social Science Education 4/2010 invites to debate the foundation of social science literacy. What are the competences, and ‘what are’ the contents, and individual needs to understand the relations, systems and orders of society, economy and politics? What helps to make autonomously found decisions and responsible judgements in individual and social life? What kind of abilities are needed for autonomous action within ones own life in order to participate within the given frames of society, economy and politics, in shaping them or in creating new rules. Search and discussion of the relevant concepts and competences in the domain of social science education are going on. Nevertheless the research on testing and diagnosing social science literacy is carried as well – despite the absence of a consensus on content.

  15. Postnatal Treatment in Antenatally Diagnosed Meconium Peritonitis.

    Ionescu, S; Andrei, B; Oancea, M; Licsandru, E; Ivanov, M; Marcu, V; Popa-Stanila, R; Mocanu, M

    2015-01-01

    Meconium peritonitis is a rare prenatal disease with an increased rate of morbidity and mortality in the neonatal period. Distinctive features revealed by prenatal and postnatal ultrasoundmay be present: abdominal calcifications, ascites, polyhydramnios, meconium pseudocyst, echogenic mass and dilated bowel or intestinal obstruction. Establishing clear postnatal treatment and prognosis is difficult because of the heterogeneity of the results obtained by ultrasound. The aim of the study is to determine how prenatal diagnosis of meconium peritonitis is associated with perinatal management and further evolution. Clinical results are different depending on the presence of antenatal diagnosis of meconium peritonitis and its form, which can be mild or severe. Surgical treatment and management of meconium peritonitis depend on the clinical presentation of the newborn. Meconium peritonitis diagnosed prenatally differs from that of the newborn, not only concerning the mortality rates but also through reduced morbidity and overall better prognosis. PMID:26713828

  16. Discrete event systems diagnosis and diagnosability

    Sayed-Mouchaweh, Moamar

    2014-01-01

    Discrete Event Systems: Diagnosis and Diagnosability addresses the problem of fault diagnosis of Discrete Event Systems (DES). This book provides the basic techniques and approaches necessary for the design of an efficient fault diagnosis system for a wide range of modern engineering applications. The different techniques and approaches are classified according to several criteria such as: modeling tools (Automata, Petri nets) that is used to construct the model; the information (qualitative based on events occurrences and/or states outputs, quantitative based on signal processing and data analysis) that is needed to analyze and achieve the diagnosis; the decision structure (centralized, decentralized) that is required to achieve the diagnosis. The goal of this classification is to select the efficient method to achieve the fault diagnosis according to the application constraints. This book focuses on the centralized and decentralized event based diagnosis approaches using formal language and automata as mode...

  17. Diagnosing chronic thromboembolic pulmonary hypertension: current perspectives

    Hadinnapola C

    2014-09-01

    Full Text Available Charaka Hadinnapola, Deepa Gopalan, David P Jenkins Papworth Hospital National Health Service Foundation Trust, Papworth Everard, Cambridge, United Kingdom Abstract: Chronic thromboembolic pulmonary hypertension is a rare and relatively poorly understood disease. It remains underdiagnosed and is often not recognized in primary and secondary care, as its symptoms are nonspecific and there are few clinical signs until late in the disease process. However, pulmonary endarterectomy (PEA offers a potential cure for patients with this type of pulmonary hypertension; therefore, it is important that they are identified and diagnosed in a timely manner. PEA is associated with a 2.2%–5% risk of significant morbidity and mortality, even in experienced PEA centers. Therefore, once chronic thromboembolic pulmonary hypertension is diagnosed, further assessment of operability and patient selection is crucial. Assessment of operability involves determining the distribution and burden of chronic thromboembolic disease, assessing pulmonary hemodynamics, and assessing the functional impairment of the patient. Ventilation perfusion scintigraphy is of value in screening for the presence of chronic thromboembolic disease. However, computer tomography pulmonary angiography and magnetic resonance pulmonary angiography are now increasingly used to image the vascular occlusions directly. This allows assessment of the surgically accessible disease burden. Some centers still advocate conventional selective pulmonary angiography for the latter. Right-heart catheterization remains the gold standard for assessing pulmonary hemodynamics. Higher pulmonary vascular resistances are associated with poorer outcomes as well as increased risks at the time of surgery. This is in part because of the presence of more distal chronic thromboembolic material and distal pulmonary artery remodeling. However, in experienced centers, these patients are being operated on safely and with good

  18. Juvenile myoclonic epilepsy: Under-diagnosed syndrome

    Božić Ksenija

    2011-01-01

    Full Text Available Introduction. Juvenile myoclonic epilepsy is an idiopathic, hereditary form of epilepsy. Although juvenile myoclonic epilepsy is a well defined clinical syndrome, attempts at diagnosing it commonly fail. Etiopathogenesis. The exact cause of juvenile myoclonic epilepsy remains unknown. Clinical, morphological and metabolic data suggest a preferential role for frontal regions in this syndrome. Several major genes for juvenile myoclonic epilepsy have been identified, but these genes account for only a small proportions of juvenile myoclonic epilepsy cases, suggesting multifactorial or complex inheritance in most. Clinical Manifestations. Juvenile myoclonic epilepsy is characterized by the triad of myoclonic jerks on awakening (all patients, generalized tonic-clonic seizures (>90% of patients and typical absences (about one third of patients. Seizures have an age-related onset, circadian distribution and are frequently precipitated by sleep deprivation, fatigue and alcohol intake. Intelligence is normal. Diagnosis. Juvenile myoclonic epilepsy diagnosis is based upon clinical criteria and typical electroencephalographic findings (generalized pattern of spikes and/or polyspikes and waves. All other tests are normal. Treatment and Prognosis. Both medical treatment and counselling are important in the management of juvenile myoclonic epilepsy. Mono-therapy with valproate is the preferred treatment. Some of the newer antiepileptic drugs have been suggested as possible alternatives. Juvenile myoclonic epilepsy has a good prognosis. Lifelong treatment is usually considered necessary in vast majority of patients due to the increased risk of relapse if treatment is discontinued. Conclusion. Juvenile myoclonic epilepsy is a common, although under-diagnosed epileptic syndrome. The clinician should study the occurrence of myoclonic jerks and should consider atypical presentations.

  19. Causes and outcome of prenatally diagnosed hydronephrosis

    Ahmadzadeh Ali

    2009-01-01

    Full Text Available Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with ultrasonography (U/S. Hydronephrosis may be obstructive or non-obstructive; obstructive lesions are more harmful to the developing kidneys. The aim of the study was to evaluate the causes of renal pelvic dilatation and the outcome of postnatal treatment in infants with hydronephrosis diagnosed prenatally with U/S. We prospectively studied 67 (60 males newborns with hydronephrosis diagnosed prenatally and confirmed postnatally with U/S from Sept. 2005 to Oct. 2007. The patients were allocated to three groups based on the mea-surement of the anteroposterior renal pelvic diameter (APRPD in transverse plane: mild (6-9.9 mm, moderate (10-14.9 mm and severe (> 15 mm hydronephrosis. Voiding cystourethrography (VCUG was obtained in all of the patients to rule out vesicoureteral reflux (VUR. In cases with negative VUR, Diethylenetriamine-pentaacetic acid (DTPA scan with diuretic renography was performed to detect ureteropelvic joint obstruction (UPJO. Twenty two cases (32.8% had mild, 20 (29.9% had moderate, and 25 (37.3% had severe hydronephrosis. The causes of hydroneph-rosis were VUR (40.2%, UPJO (32.8%, posterior urethral valves (PUVs (13.4 %, and transient hydronephrosis (13.4 %. The lesion was obstructive in 37 (55.2% infants. Totally, 33 (49.2% patients with hydronephrosis (9 mild, 9 moderate, and 15 severe subsequently developed com-plications such as UTI and renal insufficiency, or required surgery. Associated abnormalities were observed in 15 (22.4% patients. We conclude that every newborn with any degree of hydro-nephrosis should be assessed postnatally for specific diagnosis and treatment.

  20. Causes and outcome of prenatally diagnosed hydronephrosis

    Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with ultrasonography (U/S). Hydronephrosis may be obstructive or nonobstructive; obstructive lesions are more harmful to the developing kidneys. The aim of the study was to evaluate the causes of renal pelvic dilatation and the outcome of postnatal treatment in infants with hydronephrosis diagnosed prenatally with U/S. We prospectively studied 67 (60 males) newborns with hydronephrosis diagnosed prenatally and confirmed postnatally with U/S from Sept. 2005 to Oct. 2007. The patients were allocated to three groups based on the mea-surement of the anteroposterior renal pelvic diameter (APRPD) in transverse plane: mild (6-9.9 mm), moderate (10-14.9 mm) and severe (> 15 mm) hydronephrosis. Voiding cystourethrography (VCUG) was obtained in all of the patients to rule out vesicoureteral reflux (VUR). In cases with negative VUR, Diethylenetriamine-pentaacetic acid (DTPA) scan with diuretic renography was performed to detect ureteropelvic joint obstruction (UPJO). Twenty two cases (32.8%) had mild, 20 (29.9%) had moderate, and 25 (37.3%) had severe hydronephrosis. The causes of hydronephrosis were VUR (40.2%), UPJO (32.8%), posterior urethral valves (PUVs) (13.4 %), and transient hydronephrosis (13.4 %). The lesion was obstructive in 37 (55.2%) infants. Totally, 33 (49.2%) patients with hydronephrosis (9 mild, 9 moderate, and 15 severe) subsequently developed complications such as UTI and renal insufficiency, or required surgery. Associated abnormalities were observed in 15 (22.4%) patients. We conclude that every newborn with any degree of hydronephrosis should be assessed postnatally for specific diagnosis and treatment. (author)

  1. High Frequency QRS ECG Accurately Detects Cardiomyopathy

    Schlegel, Todd T.; Arenare, Brian; Poulin, Gregory; Moser, Daniel R.; Delgado, Reynolds

    2005-01-01

    High frequency (HF, 150-250 Hz) analysis over the entire QRS interval of the ECG is more sensitive than conventional ECG for detecting myocardial ischemia. However, the accuracy of HF QRS ECG for detecting cardiomyopathy is unknown. We obtained simultaneous resting conventional and HF QRS 12-lead ECGs in 66 patients with cardiomyopathy (EF = 23.2 plus or minus 6.l%, mean plus or minus SD) and in 66 age- and gender-matched healthy controls using PC-based ECG software recently developed at NASA. The single most accurate ECG parameter for detecting cardiomyopathy was an HF QRS morphological score that takes into consideration the total number and severity of reduced amplitude zones (RAZs) present plus the clustering of RAZs together in contiguous leads. This RAZ score had an area under the receiver operator curve (ROC) of 0.91, and was 88% sensitive, 82% specific and 85% accurate for identifying cardiomyopathy at optimum score cut-off of 140 points. Although conventional ECG parameters such as the QRS and QTc intervals were also significantly longer in patients than controls (P less than 0.001, BBBs excluded), these conventional parameters were less accurate (area under the ROC = 0.77 and 0.77, respectively) than HF QRS morphological parameters for identifying underlying cardiomyopathy. The total amplitude of the HF QRS complexes, as measured by summed root mean square voltages (RMSVs), also differed between patients and controls (33.8 plus or minus 11.5 vs. 41.5 plus or minus 13.6 mV, respectively, P less than 0.003), but this parameter was even less accurate in distinguishing the two groups (area under ROC = 0.67) than the HF QRS morphologic and conventional ECG parameters. Diagnostic accuracy was optimal (86%) when the RAZ score from the HF QRS ECG and the QTc interval from the conventional ECG were used simultaneously with cut-offs of greater than or equal to 40 points and greater than or equal to 445 ms, respectively. In conclusion 12-lead HF QRS ECG employing

  2. Infrequent detection of Pneumocystis jirovecii by PCR in oral wash specimens from TB patients with or without HIV and healthy contacts in Tanzania

    Friis Henrik; Range Nyagosya; Changalucha John; Faurholt-Jepsen Daniel; Kidola Jeremiah; Praygod George; Jensen Andreas V; Jensen Lotte; Helweg-Larsen Jannik; Jensen Jorgen S; Andersen Aase B

    2010-01-01

    Abstract Background In tuberculosis (TB) endemic parts of the world, patients with pulmonary symptoms are managed as "smear-negative TB patients" if they do not improve on a two-week presumptive, broad-spectrum course of antibiotic treatment even if they are TB microscopy smear negative. These patients are frequently HIV positive and have a higher mortality than smear-positive TB patients. Lack of access to diagnose Pneumocystis jirovecii pneumonia might be a contributing reason. We therefore...

  3. Percutaneous transluminal biopsy using 7F forceps for diagnosing malignant biliary obstruction

    Bahn, Young Eun; Kim, Young Hwan; An, Eun Jung; Kim, See Hyung [Keimyung Univ. College of Medicine, Daegu (Korea, Republic of)

    2012-07-15

    To evaluate the usefulness of the percutaneous transluminal biopsy using 7-F forceps for diagnosing malignant biliary obstruction. One hundred and seven consecutive patients with obstructive jaundice underwent transluminal forceps biopsy. The lesions involved the common bile duct (n = 33), common hepatic duct (n = 13), hilum (n = 17), right or left intrahepatic bile duct (n = 32), multiple sites (extra and intrahepatic ducts, n = 7), or anastomotic sites (n = 5). In each patient, an average of three specimens was taken with 7F biopsy forceps through a transhepatic biliary drainage tract. The final diagnosis was confirmed with pathologic findings, or a clinical and radiologic follow up. The final diagnoses showed malignancies in 75 patients and benign biliary obstructions in 32 patients. Pathologic classifications of malignancies established by forceps biopsy included 67 adenocarcinomas, 1 adenosquamous cell carcinoma, and 1 hepatocelluar carcinoma. There were 6 false-negative diagnoses. The diagnostic performance of transluminal forceps biopsy in malignant biliary obstruction had a sensitivity of 92%, specificity of 100%, positive predictive value of 100%, a negative predictive value of 84.2%, and an accuracy of 94.2%. Percutaneous transluminal forceps biopsy is a safe procedure that is easy to perform through a transhepatic biliary drainage tract. It is a highly accurate technique for diagnosing malignant biliary obstructions.

  4. Significance of eosinophils in diagnosing Hashimoto′s thyroiditis on fine-needle aspiration cytology

    Ekambaram Maheswari

    2010-07-01

    Full Text Available Background: Hashimoto′s thyroiditis (HT is the most common cause of hypothyroidism in those areas of the world where iodine levels are sufficient. Fine-needle aspiration cytology (FNAC can accurately diagnose this lesion in most of the patients. However, a small percentage of cases may be missed due to inherent limitations of this procedure. Therefore, cytologic clues to increase sensitivity of diagnosis need to be searched for. Aims: To assess whether an eosinophilic infiltration of the thyroid gland has a higher association with HT than colloid goiter. Materials and Methods: The study was a case-control study. Smears obtained by FNAC of 50 case, each of HT (which served as cases and colloid goiter (which served as controls were observed. The number of eosinophils and neutrophils per high-power field (HPF was counted in all the smears. The eosinophil-neutrophil ratio in the smears, diagnosed as HT, was then compared with that of colloid goiter using unpaired t-test. Results: Smears diagnosed as HT was found to have a significantly higher eosinophil-neutrophil ratio than smears diagnosed as colloid goiter (P value 0.0001. Conclusion: Eosinophilic infiltration of the thyroid gland has higher association with Hashimoto thyroiditis.

  5. Percutaneous transluminal biopsy using 7F forceps for diagnosing malignant biliary obstruction

    To evaluate the usefulness of the percutaneous transluminal biopsy using 7-F forceps for diagnosing malignant biliary obstruction. One hundred and seven consecutive patients with obstructive jaundice underwent transluminal forceps biopsy. The lesions involved the common bile duct (n = 33), common hepatic duct (n = 13), hilum (n = 17), right or left intrahepatic bile duct (n = 32), multiple sites (extra and intrahepatic ducts, n = 7), or anastomotic sites (n = 5). In each patient, an average of three specimens was taken with 7F biopsy forceps through a transhepatic biliary drainage tract. The final diagnosis was confirmed with pathologic findings, or a clinical and radiologic follow up. The final diagnoses showed malignancies in 75 patients and benign biliary obstructions in 32 patients. Pathologic classifications of malignancies established by forceps biopsy included 67 adenocarcinomas, 1 adenosquamous cell carcinoma, and 1 hepatocelluar carcinoma. There were 6 false-negative diagnoses. The diagnostic performance of transluminal forceps biopsy in malignant biliary obstruction had a sensitivity of 92%, specificity of 100%, positive predictive value of 100%, a negative predictive value of 84.2%, and an accuracy of 94.2%. Percutaneous transluminal forceps biopsy is a safe procedure that is easy to perform through a transhepatic biliary drainage tract. It is a highly accurate technique for diagnosing malignant biliary obstructions

  6. Accurate diagnosis is essential for amebiasis

    2004-01-01

    @@ Amebiasis is one of the three most common causes of death from parasitic disease, and Entamoeba histolytica is the most widely distributed parasites in the world. Particularly, Entamoeba histolytica infection in the developing countries is a significant health problem in amebiasis-endemic areas with a significant impact on infant mortality[1]. In recent years a world wide increase in the number of patients with amebiasis has refocused attention on this important infection. On the other hand, improving the quality of parasitological methods and widespread use of accurate tecniques have improved our knowledge about the disease.

  7. Investigations on Accurate Analysis of Microstrip Reflectarrays

    Zhou, Min; Sørensen, S. B.; Kim, Oleksiy S.;

    2011-01-01

    An investigation on accurate analysis of microstrip reflectarrays is presented. Sources of error in reflectarray analysis are examined and solutions to these issues are proposed. The focus is on two sources of error, namely the determination of the equivalent currents to calculate the radiation...... pattern, and the inaccurate mutual coupling between array elements due to the lack of periodicity. To serve as reference, two offset reflectarray antennas have been designed, manufactured and measured at the DTUESA Spherical Near-Field Antenna Test Facility. Comparisons of simulated and measured data are...

  8. Niche Genetic Algorithm with Accurate Optimization Performance

    LIU Jian-hua; YAN De-kun

    2005-01-01

    Based on crowding mechanism, a novel niche genetic algorithm was proposed which can record evolutionary direction dynamically during evolution. After evolution, the solutions's precision can be greatly improved by means of the local searching along the recorded direction. Simulation shows that this algorithm can not only keep population diversity but also find accurate solutions. Although using this method has to take more time compared with the standard GA, it is really worth applying to some cases that have to meet a demand for high solution precision.

  9. How accurately can we calculate thermal systems?

    The objective was to determine how accurately simple reactor lattice integral parameters can be determined, considering user input, differences in the methods, source data and the data processing procedures and assumptions. Three simple square lattice test cases with different fuel to moderator ratios were defined. The effect of the thermal scattering models were shown to be important and much bigger than the spread in the results. Nevertheless, differences of up to 0.4% in the K-eff calculated by continuous energy Monte Carlo codes were observed even when the same source data were used. (author)

  10. Splenic abscess diagnosed with the aid of abdominal computerized tomography: report of 2 cases

    Two patients with splenic abscess successfully diagnosed and treated are described. The first case, a diabetic, developed a pyogenic abscess caused by klebsiella, while the other suffered a splenic infarct complicated by splenic abscess. Although relatively easy to treat, solitary abscess of the spleen is a potentially lethal condition due to diagnostic difficulties. In both present instances the final diagnosis was easily achieved before surgery by the aid of computerized tomography (CT). This investigation seems to be more accurate than 99Tcsup(m)-sulphur colloid scan and ultrasound scan, which failed in both cases to diagnose splenic abscess clearly. The use of this investigation is suggested in every suspected case and will no doubt, confirm the diagnosis at an early stage of the disease. Splenectomy with antibiotic cover will usually result in cure. (author)

  11. Do trigeminal autonomic cephalalgias represent primary diagnoses or points on a continuum?

    Charleston, Larry

    2015-06-01

    The question of whether the trigeminal autonomic cephalalgias (TACs) represent primary diagnoses or points on a continuum has been debatable for a number of years. Patients with TACs may present with similar clinical characteristics, and occasionally, TACS respond to similar treatments. Prima facie, these disorders may seem to be intimately related. However, due to the current evidence, it would be challenging to accurately conclude whether they represent different primary headache diagnoses or the same primary headache disorder represented by different points on the same continuum. Ultimately, the TACs may utilize similar pathways and activate nociceptive responses that result in similar clinical phenotypes but "original and initiating" etiology may differ, and these disorders may not be points on the same continuum. This paper seeks to provide a brief comparison of TACs via diagnostic criteria, secondary causes, brief overview of pathophysiology, and the use of some key treatments and their mechanism of actions to illustrate the TAC similarities and differences. PMID:26021755

  12. Accurate determination of characteristic relative permeability curves

    Krause, Michael H.; Benson, Sally M.

    2015-09-01

    A recently developed technique to accurately characterize sub-core scale heterogeneity is applied to investigate the factors responsible for flowrate-dependent effective relative permeability curves measured on core samples in the laboratory. The dependency of laboratory measured relative permeability on flowrate has long been both supported and challenged by a number of investigators. Studies have shown that this apparent flowrate dependency is a result of both sub-core scale heterogeneity and outlet boundary effects. However this has only been demonstrated numerically for highly simplified models of porous media. In this paper, flowrate dependency of effective relative permeability is demonstrated using two rock cores, a Berea Sandstone and a heterogeneous sandstone from the Otway Basin Pilot Project in Australia. Numerical simulations of steady-state coreflooding experiments are conducted at a number of injection rates using a single set of input characteristic relative permeability curves. Effective relative permeability is then calculated from the simulation data using standard interpretation methods for calculating relative permeability from steady-state tests. Results show that simplified approaches may be used to determine flowrate-independent characteristic relative permeability provided flow rate is sufficiently high, and the core heterogeneity is relatively low. It is also shown that characteristic relative permeability can be determined at any typical flowrate, and even for geologically complex models, when using accurate three-dimensional models.

  13. Accurate radiative transfer calculations for layered media.

    Selden, Adrian C

    2016-07-01

    Simple yet accurate results for radiative transfer in layered media with discontinuous refractive index are obtained by the method of K-integrals. These are certain weighted integrals applied to the angular intensity distribution at the refracting boundaries. The radiative intensity is expressed as the sum of the asymptotic angular intensity distribution valid in the depth of the scattering medium and a transient term valid near the boundary. Integrated boundary equations are obtained, yielding simple linear equations for the intensity coefficients, enabling the angular emission intensity and the diffuse reflectance (albedo) and transmittance of the scattering layer to be calculated without solving the radiative transfer equation directly. Examples are given of half-space, slab, interface, and double-layer calculations, and extensions to multilayer systems are indicated. The K-integral method is orders of magnitude more accurate than diffusion theory and can be applied to layered scattering media with a wide range of scattering albedos, with potential applications to biomedical and ocean optics. PMID:27409700

  14. Accurate basis set truncation for wavefunction embedding

    Barnes, Taylor A.; Goodpaster, Jason D.; Manby, Frederick R.; Miller, Thomas F.

    2013-07-01

    Density functional theory (DFT) provides a formally exact framework for performing embedded subsystem electronic structure calculations, including DFT-in-DFT and wavefunction theory-in-DFT descriptions. In the interest of efficiency, it is desirable to truncate the atomic orbital basis set in which the subsystem calculation is performed, thus avoiding high-order scaling with respect to the size of the MO virtual space. In this study, we extend a recently introduced projection-based embedding method [F. R. Manby, M. Stella, J. D. Goodpaster, and T. F. Miller III, J. Chem. Theory Comput. 8, 2564 (2012)], 10.1021/ct300544e to allow for the systematic and accurate truncation of the embedded subsystem basis set. The approach is applied to both covalently and non-covalently bound test cases, including water clusters and polypeptide chains, and it is demonstrated that errors associated with basis set truncation are controllable to well within chemical accuracy. Furthermore, we show that this approach allows for switching between accurate projection-based embedding and DFT embedding with approximate kinetic energy (KE) functionals; in this sense, the approach provides a means of systematically improving upon the use of approximate KE functionals in DFT embedding.

  15. Accurate pose estimation for forensic identification

    Merckx, Gert; Hermans, Jeroen; Vandermeulen, Dirk

    2010-04-01

    In forensic authentication, one aims to identify the perpetrator among a series of suspects or distractors. A fundamental problem in any recognition system that aims for identification of subjects in a natural scene is the lack of constrains on viewing and imaging conditions. In forensic applications, identification proves even more challenging, since most surveillance footage is of abysmal quality. In this context, robust methods for pose estimation are paramount. In this paper we will therefore present a new pose estimation strategy for very low quality footage. Our approach uses 3D-2D registration of a textured 3D face model with the surveillance image to obtain accurate far field pose alignment. Starting from an inaccurate initial estimate, the technique uses novel similarity measures based on the monogenic signal to guide a pose optimization process. We will illustrate the descriptive strength of the introduced similarity measures by using them directly as a recognition metric. Through validation, using both real and synthetic surveillance footage, our pose estimation method is shown to be accurate, and robust to lighting changes and image degradation.

  16. Accurate shear measurement with faint sources

    Zhang, Jun; Foucaud, Sebastien [Center for Astronomy and Astrophysics, Department of Physics and Astronomy, Shanghai Jiao Tong University, 955 Jianchuan road, Shanghai, 200240 (China); Luo, Wentao, E-mail: betajzhang@sjtu.edu.cn, E-mail: walt@shao.ac.cn, E-mail: foucaud@sjtu.edu.cn [Key Laboratory for Research in Galaxies and Cosmology, Shanghai Astronomical Observatory, Nandan Road 80, Shanghai, 200030 (China)

    2015-01-01

    For cosmic shear to become an accurate cosmological probe, systematic errors in the shear measurement method must be unambiguously identified and corrected for. Previous work of this series has demonstrated that cosmic shears can be measured accurately in Fourier space in the presence of background noise and finite pixel size, without assumptions on the morphologies of galaxy and PSF. The remaining major source of error is source Poisson noise, due to the finiteness of source photon number. This problem is particularly important for faint galaxies in space-based weak lensing measurements, and for ground-based images of short exposure times. In this work, we propose a simple and rigorous way of removing the shear bias from the source Poisson noise. Our noise treatment can be generalized for images made of multiple exposures through MultiDrizzle. This is demonstrated with the SDSS and COSMOS/ACS data. With a large ensemble of mock galaxy images of unrestricted morphologies, we show that our shear measurement method can achieve sub-percent level accuracy even for images of signal-to-noise ratio less than 5 in general, making it the most promising technique for cosmic shear measurement in the ongoing and upcoming large scale galaxy surveys.

  17. Diagnosing clostridial enteric disease in poultry.

    Cooper, Kerry K; Songer, J Glenn; Uzal, Francisco A

    2013-05-01

    The world's poultry industry has grown into a multibillion-dollar business, the success of which hinges on healthy intestinal tracts, which result in effective feed conversion. Enteric disease in poultry can have devastating economic effects on producers, due to high mortality rates and poor feed efficiency. Clostridia are considered to be among the most important agents of enteric disease in poultry. Diagnosis of enteric diseases produced by clostridia is usually challenging, mainly because many clostridial species can be normal inhabitants of the gut, making it difficult to determine their role in virulence. The most common clostridial enteric disease in poultry is necrotic enteritis, caused by Clostridium perfringens, which typically occurs in broiler chickens but has also been diagnosed in various avian species including turkeys, waterfowl, and ostriches. Diagnosis is based on clinical and pathological findings. Negative culture and toxin detection results may be used to rule out this disease, but isolation of C. perfringens and/or detection of its alpha toxin are of little value to confirm the disease because both are often found in the intestine of healthy birds. Ulcerative enteritis, caused by Clostridium colinum, is the other major clostridial enteric disease of poultry. Diagnosis of ulcerative enteritis is by documentation of typical pathological findings, coupled with isolation of C. colinum from the intestine of affected birds. Other clostridial enteric diseases include infections produced by Clostridium difficile, Clostridium fallax, and Clostridium baratii. PMID:23572451

  18. Computer Assisted Diagnoses for Red Eye (CADRE

    Muhammad Zubair Asghar

    2009-11-01

    Full Text Available This paper introduces an expert System (ES named as “CADRE-Computer Assisted Diagnoses for Red Eye. Mostly the remote areas of the population are deprived of the facilities of having experts in eye disease. So it is the need of the day to store the expertise of Eye specialists in computers through using ES technology. This ES is a rule-based Expert System that assists in red-eye diagnosis and treatment. The knowledge acquired from literature review and human experts of the specific domain was used as a base for analysis, diagnosis and recommendations. CADRE evaluates the risk factors of 20 eye diseases and works just like an ophthalmologist, which will be useful for students, doctors and researchers as well as to patients. This expert system (ES was developed through using ESTA, VISUAL BASIC, MS-EXCEL, Seagate Crystal Reports and Image Styler. This ES is not limited to the Red-eye diseases but can be extended to all types of eye-diseases.

  19. Using saccades to diagnose covert hepatic encephalopathy.

    Cunniffe, Nicholas; Munby, Henry; Chan, Shona; Saatci, Defne; Edison, Eric; Carpenter, R H S; Massey, Dunecan

    2015-06-01

    Covert Hepatic Encephalopathy (CHE), previously known as Minimal Hepatic Encephalopathy, is a subtle cognitive defect found in 30-70 % of cirrhosis patients. It has been linked to poor quality of life, impaired fitness to drive, and increased mortality: treatment is possible. Despite its clinical significance, diagnosis relies on psychometric tests that have proved unsuitable for use in a clinical setting. We investigated whether measurement of saccadic latency distributions might be a viable alternative. We collected data on 35 cirrhosis patients at Addenbrooke's Hospital, Cambridge, with no evidence of clinically overt encephalopathy, and 36 age-matched healthy controls. Performance on standard psychometric tests was evaluated to determine those patients with CHE as defined by the World Congress of Gastroenterology. We then compared visually-evoked saccades between those with CHE and those without, as well as reviewing blood test results and correlating saccadic latencies with biochemical parameters and prognostic scores. Cirrhosis patients have significantly longer median saccadic latencies than healthy controls. Those with CHE had significantly prolonged saccadic latencies when compared with those without CHE. Analysis of a cirrhosis patient's saccades can diagnose CHE with a sensitivity of 75 % and a specificity of 75 %. We concluded that analysis of a cirrhosis patient's saccadic latency distributions is a fast and objective measure that can be used as a diagnostic tool for CHE. This improved early diagnosis could direct avoidance of high-risk activities such as driving, and better inform treatment strategies. PMID:25586511

  20. Diagnosing SWOT through Importance-performance Analysis

    Alagirisamy Kamatchi Subbiah Sukumaran

    2015-03-01

    Full Text Available The aim of the study is to evaluate the performance of the firms surveyed against the importance of the opportunities, threats, strengths and weaknesses applicable to those firms using Importance-Performance analysis. Firms optimize their Strengths, Weaknesses, Opportunities and Threats with the help of SWOT analysis. Martilla and James (1977 popularized the Importance-Performance analysis through their study titled with the same name. Importance-Performance analysis can be used to evaluate the performance against the intention or plan formulated by business or non-business firms. This method is widely used in consumer satisfaction studies and competitor analysis. Quite often right decisions can be taken if the information is presented in a comprehensive and understandable manner and in these contexts, Importance-Performance measure scores well. To the best of the author’s knowledge, Importance-Performance Analysis is used for the first time in the study to diagnose the strengths, weaknesses, opportunities and threats applicable to a firm.

  1. Fetal MRI clues to diagnose cloacal malformations

    Prenatal US detection of cloacal malformations is challenging and rarely confirms this diagnosis. To define the prenatal MRI findings in cloacal malformations. We performed a retrospective study of patients with cloacal malformations who had pre- and post-natal assessment at our institution. Fetal MRI was obtained in six singleton pregnancies between 26 and 32 weeks of gestation. Imaging analysis was focused on the distal bowel, the urinary system and the genital tract and compared with postnatal clinical, radiological and surgical diagnoses. The distal bowel was dilated and did not extend below the bladder in five fetuses. They had a long common cloacal channel (3.5-6 cm) and a rectum located over the bladder base. Only one fetus with a posterior cloacal variant had a normal rectum. Three fetuses had increased T2 signal in the bowel and two increased T1/decreased T2 signal bladder content. All had renal anomalies, four had abnormal bladders and two had hydrocolpos. Assessment of the anorectal signal and pelvic anatomy during the third trimester helps to detect cloacal malformations in the fetus. The specificity for this diagnosis was highly increased when bowel fluid or bladder meconium content was identified. (orig.)

  2. PET in diagnosing exocrine pancreatic cancer

    Despite dramatic improvements in diagnostic imaging (ultrasonography, in particular endoscopic ultrasound, CT, MRI) treatment results of pancreatic cancer are still poor. Due to the lack of early symptoms, most tumors are diagnosed at an advanced stage of disease which excludes curative surgical treatment. FDG-PET has been shown to be effective in detecting pancreatic cancer as well as differentiating benign from malignant pancreatic tumors. Results might be further improved by applying quantitative analyses, in particular kinetic modelling of FDG metabolism. Nevertheless false negative as well as false positive findings may occur. Small lesions (lymphnode or liver metastases < 1 cm) might be missed, furthermore hyperglycemia often present in patients with pancreatic disease might reduce tumor uptake and subsequently tumor detectability by PET. False positive findings were reported in active pancreatitis and some benign tumors. Although PET proved to be superior to CT or ERCP in detecting cancer, clinical relevance of PET is limited due to the absence of therapeutic consequences to be derived from PET. As a consequence PET should only be used in patients with equivocal findings of morphological imaging (CT, ERCP) who are potential candidates for surgical treatment. (orig.)

  3. Vitamin C nutriture in newly diagnosed diabetes.

    Shim, Jae Eun; Paik, Hee Young; Shin, Chan Soo; Park, Kyong Soo; Lee, Hong Kyu

    2010-01-01

    This study was performed to investigate the relationship between serum L-ascorbic acid, vitamin C intake, and diabetes in a nested case-control study. A cross-sectional survey of diet and health was conducted in 2,048 adults with an age of 30 y or older in Yonchon County, Korea. An oral glucose tolerance test was administered to all participants. One hundred cases of newly diagnosed diabetes were identified. Two healthy controls for each case matched with age, gender, drinking status, and smoking status were selected among the survey participants. L-Ascorbic acid levels were analyzed in fasting serum samples and one 24-h dietary recall was performed. Dietary vitamin C intake of persons with diabetes was 50.1±47.6 mg/d and that of controls was 55.1±41.1 mg/d. People with diabetes (22.3±16.8 µmol/L) have lower serum ascorbic acid levels than their controls (26.3±17.0 µmol/L) and the difference was significant by paired t-test (pnutritional status of vitamin C, further investigation of association between serum ascorbic acid level and diabetes and smoking by the level of vitamin C consumption is warranted. PMID:20924142

  4. Radionuclide methods of diagnosing anthracycline - induced cardiotoxity

    Anthracycline chemotherapeutic agents play an important role in tumor treatment owing to their high therapeutic efficiency but at the same time they cause lesions to healthy tissues and organs among which cardiotoxity is the most significant. Radionuclide diagnostic methods are widely used in diagnosing heart damage against the background of therapy with anthracyclines. Radionuclide ventriculography is implemented in practice as a routine procedure for serial evaluation of LVFI (left ventricular filling index) and regional myocardial kinetics monitoring. The obtained results are used for individual assessment of the cumulative dose of the anthracycline antineoplastic agent administered. However, the method has low prognostic value regarding the severity of myocardial impairment on account of its late positiveness. Researches along these lines are focused on radiopharmaceuticals accumulating in the myocardial cell and mirroring its perfusion, innervation and vitality, such as 111In-antimyosin, 123I-MIBG and 99mTc-MIBI. Investigations using the aforementioned radiopharmaceuticals disclose the mechanisms of myocardial cell damage under the effect of anthracyclines, becoming positive before clinical manifestation of cardiotoxicity. Their implementation in the routine practice lags behind because of insufficient studies on the issue

  5. Diagnosing Beijing 2020: Mapping the Ungovernable City

    Robin Visser

    2014-07-01

    Full Text Available Beijing Municipality, characterised by the ‘off-ground’ architecture distinguishing neo-liberal privatisation, is attempting to mitigate the damaging effects of rampant development on the social fabric, cultural heritage, and the environment by adopting sustainable urban planning. I argue that the sustainability rhetoric in the Beijing Municipality 2020 Plans functions in part as strategic metaphors masking unnamed, imminent threats to governance. In this article I diagnose four Beijing plans (Beijing 2006-2015 ‘Rail Transit Plan’ for Compact City, Beijing 2005-2020 ‘Underground Space Plan’ for Alternative Space, Beijing 2006-2020 ‘Undeveloped Area Plan’ for Ecological Responsibility, and Beijing 2006-2010 ‘Low-income Housing Plan’ for Affordability and Liveability. A diagrammatics of the plans illuminates not so much a mapping of Beijing’s future as the forms of spontaneity preoccupying the nation at this historical juncture. The Beijing 2020 plan, as city mapping more generally, discloses the imminence of ungovernable city. The fact that citizens are demanding greater authority over Beijing governance suggests that radical alterations to its urban fabric and quality of life have incited the imminent sociability that is the city.

  6. Diagnoses of corticobasal syndrome and corticobasal degeneration.

    Shimohata, Takayoshi; Aiba, Ikuko; Nishizawa, Masatoyo

    2016-03-30

    Experts use the term corticobasal syndrome (CBS) for patients with a clinical diagnosis of corticobasal degeneration (CBD), and reserve CBD for those whose conditions have been diagnosed on the basis of neuropathological analyses. Several studies demonstrated that patients with CBD may also present with progressive supranuclear syndrome (PSPS), aphasia, Alzheimer disease-like dementia or behavioral change, suggesting that CBS is merely one of the presenting phenotypes of CBD. Although previous CBD diagnostic criteria reflected only CBS, the international consortium proposed new diagnostic criteria for CBD in 2013 (Armstrong's criteria). The new criteria include 4 CBD subtypes; CBS, frontal behavioral-spatial syndrome (FBS), nonfluent/agrammatic variant of primary progressive aphasia (naPPA),and PSPS. These subtypes were combined to create 2 sets of criteria: more specific clinical research criteria for probable CBD (cr-CBD) and broader criteria for possible CBD that are more inclusive but have a higher chance to detect other tau-based pathologies (p-CBD). Two studies have already revealed that the sensitivity and specificity of the criteria were not high. Because therapeutic interventions that target abnormally-phosphorylated tau have started, further refinement of the criteria is needed via biomarker researches with prospective study designs. PMID:26876110

  7. Diagnosing Anomalous Network Performance with Confidence

    Settlemyer, Bradley W [ORNL; Hodson, Stephen W [ORNL; Kuehn, Jeffery A [ORNL; Poole, Stephen W [ORNL

    2011-04-01

    Variability in network performance is a major obstacle in effectively analyzing the throughput of modern high performance computer systems. High performance interconnec- tion networks offer excellent best-case network latencies; how- ever, highly parallel applications running on parallel machines typically require consistently high levels of performance to adequately leverage the massive amounts of available computing power. Performance analysts have usually quantified network performance using traditional summary statistics that assume the observational data is sampled from a normal distribution. In our examinations of network performance, we have found this method of analysis often provides too little data to under- stand anomalous network performance. Our tool, Confidence, instead uses an empirically derived probability distribution to characterize network performance. In this paper we describe several instances where the Confidence toolkit allowed us to understand and diagnose network performance anomalies that we could not adequately explore with the simple summary statis- tics provided by traditional measurement tools. In particular, we examine a multi-modal performance scenario encountered with an Infiniband interconnection network and we explore the performance repeatability on the custom Cray SeaStar2 interconnection network after a set of software and driver updates.

  8. Accurate valence band width of diamond

    An accurate width is determined for the valence band of diamond by imaging photoelectron momentum distributions for a variety of initial- and final-state energies. The experimental result of 23.0±0.2 eV2 agrees well with first-principles quasiparticle calculations (23.0 and 22.88 eV) and significantly exceeds the local-density-functional width, 21.5±0.2 eV2. This difference quantifies effects of creating an excited hole state (with associated many-body effects) in a band measurement vs studying ground-state properties treated by local-density-functional calculations. copyright 1997 The American Physical Society

  9. Toward Accurate and Quantitative Comparative Metagenomics.

    Nayfach, Stephen; Pollard, Katherine S

    2016-08-25

    Shotgun metagenomics and computational analysis are used to compare the taxonomic and functional profiles of microbial communities. Leveraging this approach to understand roles of microbes in human biology and other environments requires quantitative data summaries whose values are comparable across samples and studies. Comparability is currently hampered by the use of abundance statistics that do not estimate a meaningful parameter of the microbial community and biases introduced by experimental protocols and data-cleaning approaches. Addressing these challenges, along with improving study design, data access, metadata standardization, and analysis tools, will enable accurate comparative metagenomics. We envision a future in which microbiome studies are replicable and new metagenomes are easily and rapidly integrated with existing data. Only then can the potential of metagenomics for predictive ecological modeling, well-powered association studies, and effective microbiome medicine be fully realized. PMID:27565341

  10. Accurate Telescope Mount Positioning with MEMS Accelerometers

    Mészáros, László; Pál, András; Csépány, Gergely

    2014-01-01

    This paper describes the advantages and challenges of applying microelectromechanical accelerometer systems (MEMS accelerometers) in order to attain precise, accurate and stateless positioning of telescope mounts. This provides a completely independent method from other forms of electronic, optical, mechanical or magnetic feedback or real-time astrometry. Our goal is to reach the sub-arcminute range which is well smaller than the field-of-view of conventional imaging telescope systems. Here we present how this sub-arcminute accuracy can be achieved with very cheap MEMS sensors and we also detail how our procedures can be extended in order to attain even finer measurements. In addition, our paper discusses how can a complete system design be implemented in order to be a part of a telescope control system.

  11. Accurate estimation of indoor travel times

    Prentow, Thor Siiger; Blunck, Henrik; Stisen, Allan;

    2014-01-01

    the InTraTime method for accurately estimating indoor travel times via mining of historical and real-time indoor position traces. The method learns during operation both travel routes, travel times and their respective likelihood---both for routes traveled as well as for sub-routes thereof. InTraTime...... allows to specify temporal and other query parameters, such as time-of-day, day-of-week or the identity of the traveling individual. As input the method is designed to take generic position traces and is thus interoperable with a variety of indoor positioning systems. The method's advantages include...... a minimal-effort setup and self-improving operations due to unsupervised learning---as it is able to adapt implicitly to factors influencing indoor travel times such as elevators, rotating doors or changes in building layout. We evaluate and compare the proposed InTraTime method to indoor adaptions...

  12. Accurate sky background modelling for ESO facilities

    Full text: Ground-based measurements like e.g. high resolution spectroscopy are heavily influenced by several physical processes. Amongst others, line absorption/ emission, air glow by OH molecules, and scattering of photons within the earth's atmosphere make observations in particular from facilities like the future European extremely large telescope a challenge. Additionally, emission from unresolved extrasolar objects, the zodiacal light, the moon and even thermal emission from the telescope and the instrument contribute significantly to the broad band background over a wide wavelength range. In our talk we review these influences and give an overview on how they can be accurately modeled for increasing the overall precision of spectroscopic and imaging measurements. (author)

  13. The value of double balloon enteroscopy in diagnosing blue rubber bleb naevus syndrome: a case report.

    O'Kelly, Fardod

    2010-01-01

    Blue rubber bleb naevus syndrome is a rare vascular disorder associated with multiple gastrointestinal haemangiomas that have the potential for life-threatening haemorrhage. These may be difficult to diagnose, and have classically been described using computed tomographic studies and\\/or mesenteric angiography. Resected surgical specimens of these lesions, especially in the small bowel, have often been extensive and poorly localized. The recent advent and progressive development of double balloon enteroscopy has allowed the direct visualization and marking of these enteric lesions and serves as a valuable adjunct not only in diagnosis but also planning prior to surgery to allow accurate estimate of the extent of resection.

  14. Accurate Weather Forecasting for Radio Astronomy

    Maddalena, Ronald J.

    2010-01-01

    The NRAO Green Bank Telescope routinely observes at wavelengths from 3 mm to 1 m. As with all mm-wave telescopes, observing conditions depend upon the variable atmospheric water content. The site provides over 100 days/yr when opacities are low enough for good observing at 3 mm, but winds on the open-air structure reduce the time suitable for 3-mm observing where pointing is critical. Thus, to maximum productivity the observing wavelength needs to match weather conditions. For 6 years the telescope has used a dynamic scheduling system (recently upgraded; www.gb.nrao.edu/DSS) that requires accurate multi-day forecasts for winds and opacities. Since opacity forecasts are not provided by the National Weather Services (NWS), I have developed an automated system that takes available forecasts, derives forecasted opacities, and deploys the results on the web in user-friendly graphical overviews (www.gb.nrao.edu/ rmaddale/Weather). The system relies on the "North American Mesoscale" models, which are updated by the NWS every 6 hrs, have a 12 km horizontal resolution, 1 hr temporal resolution, run to 84 hrs, and have 60 vertical layers that extend to 20 km. Each forecast consists of a time series of ground conditions, cloud coverage, etc, and, most importantly, temperature, pressure, humidity as a function of height. I use the Liebe's MWP model (Radio Science, 20, 1069, 1985) to determine the absorption in each layer for each hour for 30 observing wavelengths. Radiative transfer provides, for each hour and wavelength, the total opacity and the radio brightness of the atmosphere, which contributes substantially at some wavelengths to Tsys and the observational noise. Comparisons of measured and forecasted Tsys at 22.2 and 44 GHz imply that the forecasted opacities are good to about 0.01 Nepers, which is sufficient for forecasting and accurate calibration. Reliability is high out to 2 days and degrades slowly for longer-range forecasts.

  15. Generator maintenance electrical testing. The importance of trending and accurate interpretation. A case study

    In today's rapidly changing Power Generation Industry it is more critical than ever to acquire and maintain accurate records of previous and current electrical test data. Evaluation and trending of this data is essential to insuring the reliable operation of the machine in the ever changing world of extended maintenance outages and maintenance budget reductions. This paper presents a case study of a unique problem that had initiated in as early as 1990 and was not properly diagnosed and corrected until 2004, at which time it had propagated to a condition of eminent failure. (author)

  16. Diagnosing delayed ettringite formation in concrete structures

    There has been a number of cases involving deteriorated concrete structures in North America where there has been considerable controversy surrounding the respective contributions of alkali-silica reaction (ASR) and delayed ettringite formation (DEF) to the observed damage. The problem arises because the macroscopic symptoms of distress are not unequivocal and microscopical examinations of field samples often reveal evidence of both processes making it difficult to separate the individual contributions. This paper presents the results of an investigation of a number of concrete columns carrying a raised expressway in North America; prior studies had implicated both DEF and ASR as possible causes of deterioration. Although the columns were not deliberately heat-cured, it is estimated that the peak internal temperature would have exceeded 70 deg. C and perhaps even 80 deg. C, in some cases. The forensic investigation included scanning electron microscopy with energy-dispersive X-ray analysis and expansion testing of cores extracted from the structure. Small-diameter cores stored in limewater expanded significantly (0.3 to 1.3%) and on the basis of supplementary tests on laboratory-produced concrete specimens it was concluded that expansion under such conditions is caused by DEF as the conditions of the test will not sustain ASR. In at least one column, DEF was diagnosed as the sole contributory cause of damage with no evidence of any contribution from ASR or any other deterioration process. In other cases, both ASR and DEF were observed to have contributed to the apparent damage. Of the columns examined, only concrete containing fly ash appeared to be undamaged. The results of this study confirm that, under certain conditions, the process of DEF (acting in isolation of other processes) can result in significant deterioration of cast-in-place reinforced concrete structures

  17. Incarcerated diaphragmatic hernia--differential diagnoses.

    Bukvić, Nado; Versić, Ana Bosak; Bacić, Giordano; Gusić, Nadomir; Nikolić, Harry; Bukvić, Frane

    2014-12-01

    The incarceration of diaphragmatic hernia is very rare. We present a case of a four-year-old girl who developed the incarceration of left-sided diaphragmatic hernia, who, until then, was completely asymptomatic. This incarceration of the hernia represented a surgical emergency presenting as obstructive ileus and a severe respiratory distress which developed from what appeared to be full health. During a brief pre-operative examination a number of differential diagnoses were suggested. Along with the laboratory blood analysis (complete blood count and acid-base balance) a plain thoracic and abdominal radiography was done (babygram). After that, through an inserted nasal-gastric tube, barium meal of the upper gastrointestinal tract was done, showing abdominal organs in the left half of the thorax and a significant shift of the mediastinum to the right. With an urgent upper medial laparotomy we accessed the abdominal cavity and made the correct diagnosis. An opening was shown in the rear part of the left hemi-diaphragm with thickened and edematous edges, approx. 6 cm in diameter with incarcerated content. The incarcerated abdominal organs (stomach, transversal colon, small intestine and spleen) gradually moved into the abdominal cavity. The opening was closed with nonresorptive sutures (TiCron) size 2-0 with aprevious control and ventilated expansion of the well-developed left lung. In postoperative course the acid-base balance quickly recovered, as well as the general state of the patient and radiography showed a good expansion and lucency of the lung parenchyma and a return of the mediastinum into the middle part of the thorax. PMID:25842758

  18. Semistructured Interview for Seizure Classification: Agreement with Physicians’ Diagnoses

    Ottman, Ruth; Hauser, W. Allen; Stallone, Lillian

    1990-01-01

    A semi-structured interview was developed for classification of seizures in accordance with the 1981 International League Against Epilepsy (ILAE) criteria. The interview was administered over the telephone by trained lay interviewers. Interview-based diagnoses for 50 patients were compared with independent diagnoses by neurologists who also use the ILAE system for seizure classification. Interview diagnoses agreed with those of physicians for broad seizure-type classifications (i.e., partial ...

  19. Dressing up nursing diagnoses: a critical-thinking strategy.

    Sedlak, C A; Ludwick, R

    1996-01-01

    Teaching nursing diagnoses to beginning students who have no clinical experiences challenges educators to use their creative energies in developing strategies that facilitate students' critical-thinking skills. Dressing Up Nursing Diagnoses is a fun and creative classroom teaching strategy you can use during the Halloween season to help beginning students formulate nursing diagnoses. Two nurse educators describe their successful experiences with this unique teaching strategy. PMID:8718155

  20. Approaching system equilibrium with accurate or not accurate feedback information in a two-route system

    Zhao, Xiao-mei; Xie, Dong-fan; Li, Qi

    2015-02-01

    With the development of intelligent transport system, advanced information feedback strategies have been developed to reduce traffic congestion and enhance the capacity. However, previous strategies provide accurate information to travelers and our simulation results show that accurate information brings negative effects, especially in delay case. Because travelers prefer to the best condition route with accurate information, and delayed information cannot reflect current traffic condition but past. Then travelers make wrong routing decisions, causing the decrease of the capacity and the increase of oscillations and the system deviating from the equilibrium. To avoid the negative effect, bounded rationality is taken into account by introducing a boundedly rational threshold BR. When difference between two routes is less than the BR, routes have equal probability to be chosen. The bounded rationality is helpful to improve the efficiency in terms of capacity, oscillation and the gap deviating from the system equilibrium.

  1. Effiziente Diagnose von verteilten Funktionen automobiler Steuergeräte

    Kohl, Jens

    2013-01-01

    In der Dissertation wird eine Methodik vorgestellt mit dem Ziel, die Effizienz der automobilen Diagnose zu erhöhen. Hierzu gehört die Beherrschung der zunehmenden Komplexität der Diagnose bei gleichzeitiger Senkung ihrer Kostenfaktoren. Somit wird der Zielkonflikt zwischen Kosten und Güte der Diagnose bewältigt. Grundlage für den Ansatz ist eine Analyse der gegenwärtigen Diagnose auf Kosten- und Qualitätspotentiale. Es handelt sich um einen formalen, modellbasierten Diagnoseansatz, der für al...

  2. Accurate fission data for nuclear safety

    Solders, A; Jokinen, A; Kolhinen, V S; Lantz, M; Mattera, A; Penttila, H; Pomp, S; Rakopoulos, V; Rinta-Antila, S

    2013-01-01

    The Accurate fission data for nuclear safety (AlFONS) project aims at high precision measurements of fission yields, using the renewed IGISOL mass separator facility in combination with a new high current light ion cyclotron at the University of Jyvaskyla. The 30 MeV proton beam will be used to create fast and thermal neutron spectra for the study of neutron induced fission yields. Thanks to a series of mass separating elements, culminating with the JYFLTRAP Penning trap, it is possible to achieve a mass resolving power in the order of a few hundred thousands. In this paper we present the experimental setup and the design of a neutron converter target for IGISOL. The goal is to have a flexible design. For studies of exotic nuclei far from stability a high neutron flux (10^12 neutrons/s) at energies 1 - 30 MeV is desired while for reactor applications neutron spectra that resembles those of thermal and fast nuclear reactors are preferred. It is also desirable to be able to produce (semi-)monoenergetic neutrons...

  3. Fast and Provably Accurate Bilateral Filtering.

    Chaudhury, Kunal N; Dabhade, Swapnil D

    2016-06-01

    The bilateral filter is a non-linear filter that uses a range filter along with a spatial filter to perform edge-preserving smoothing of images. A direct computation of the bilateral filter requires O(S) operations per pixel, where S is the size of the support of the spatial filter. In this paper, we present a fast and provably accurate algorithm for approximating the bilateral filter when the range kernel is Gaussian. In particular, for box and Gaussian spatial filters, the proposed algorithm can cut down the complexity to O(1) per pixel for any arbitrary S . The algorithm has a simple implementation involving N+1 spatial filterings, where N is the approximation order. We give a detailed analysis of the filtering accuracy that can be achieved by the proposed approximation in relation to the target bilateral filter. This allows us to estimate the order N required to obtain a given accuracy. We also present comprehensive numerical results to demonstrate that the proposed algorithm is competitive with the state-of-the-art methods in terms of speed and accuracy. PMID:27093722

  4. Accurate adiabatic correction in the hydrogen molecule

    Pachucki, Krzysztof, E-mail: krp@fuw.edu.pl [Faculty of Physics, University of Warsaw, Pasteura 5, 02-093 Warsaw (Poland); Komasa, Jacek, E-mail: komasa@man.poznan.pl [Faculty of Chemistry, Adam Mickiewicz University, Umultowska 89b, 61-614 Poznań (Poland)

    2014-12-14

    A new formalism for the accurate treatment of adiabatic effects in the hydrogen molecule is presented, in which the electronic wave function is expanded in the James-Coolidge basis functions. Systematic increase in the size of the basis set permits estimation of the accuracy. Numerical results for the adiabatic correction to the Born-Oppenheimer interaction energy reveal a relative precision of 10{sup −12} at an arbitrary internuclear distance. Such calculations have been performed for 88 internuclear distances in the range of 0 < R ⩽ 12 bohrs to construct the adiabatic correction potential and to solve the nuclear Schrödinger equation. Finally, the adiabatic correction to the dissociation energies of all rovibrational levels in H{sub 2}, HD, HT, D{sub 2}, DT, and T{sub 2} has been determined. For the ground state of H{sub 2} the estimated precision is 3 × 10{sup −7} cm{sup −1}, which is almost three orders of magnitude higher than that of the best previous result. The achieved accuracy removes the adiabatic contribution from the overall error budget of the present day theoretical predictions for the rovibrational levels.

  5. Clinical analysis of 135 newly diagnosed patients with Hodgkin lymphoma

    周佳丽

    2014-01-01

    Objective To investigate the clinical characteristics,therapeutic effects,long-term survival and prognostic factors of the newly diagnosed patients with Hodgkin lymphoma(HL).Methods One hundred and thirty five newly diagnosed HL patients in West China hospital from January 1,2000 to December 31,2010 were analyzed retrospectively.Software SPSS18.0 was applied to deter-

  6. Collective Thomson scattering capabilities to diagnose fusion plasmas

    Korsholm, Søren Bang; Bindslev, Henrik; Furtula, Vedran;

    2010-01-01

    Collective Thomson scattering (CTS) is a versatile technique for diagnosing fusion plasmas. In particular, experiments on diagnosing the ion temperature and fast ion velocity distribution have been executed on a number of fusion devices. In this article the main aim is to describe the technique...

  7. Diagnosing cardiac disease during pregnancy: imaging modalities.

    Ntusi, Ntobeko A; Samuels, Petronella; Moosa, Sulaiman; Mocumbi, Ana O

    2016-01-01

    Pregnant women with known or suspected cardiovascular disease (CVD) often require cardiovascular imaging during pregnancy. The accepted maximum limit of ionising radiation exposure to the foetus during pregnancy is a cumulative dose of 5 rad. Concerns related to imaging modalities that involve ionising radiation include teratogenesis, mutagenesis and childhood malignancy. Importantly, no single imaging study approaches this cautionary dose of 5 rad (50 mSv or 50 mGy). Diagnostic imaging procedures that may be used in pregnancy include chest radiography, fluoroscopy, echocardiography, invasive angiography, cardiovascular computed tomography, computed tomographic pulmonary angiography, cardiovascular magnetic resonance (CMR) and nuclear techniques. Echocardiography and CMR appear to be completely safe in pregnancy and are not associated with any adverse foetal effects, provided there are no general contra-indications to MR imaging. Concerns related to safety of imaging tests must be balanced against the importance of accurate diagnosis and thorough assessment of the pathological condition. Decisions about imaging in pregnancy are premised on understanding the physiology of pregnancy, understanding basic concepts of ionising radiation, the clinical manifestations of existent CVD in pregnancy and features of new CVD. The cardiologist/physician must understand the indications for and limitations of, and the potential harmful effects of each test during pregnancy. Current evidence suggests that a single cardiovascular radiological study during pregnancy is safe and should be undertaken at all times when clinically justified. In this article, the different imaging modalities are reviewed in terms of how they work, how safe they are and what their clinical utility in pregnancy is. Furthermore, the safety of contrast agents in pregnancy is also reviewed. PMID:27213857

  8. Accurate paleointensities - the multi-method approach

    de Groot, Lennart

    2016-04-01

    The accuracy of models describing rapid changes in the geomagnetic field over the past millennia critically depends on the availability of reliable paleointensity estimates. Over the past decade methods to derive paleointensities from lavas (the only recorder of the geomagnetic field that is available all over the globe and through geologic times) have seen significant improvements and various alternative techniques were proposed. The 'classical' Thellier-style approach was optimized and selection criteria were defined in the 'Standard Paleointensity Definitions' (Paterson et al, 2014). The Multispecimen approach was validated and the importance of additional tests and criteria to assess Multispecimen results must be emphasized. Recently, a non-heating, relative paleointensity technique was proposed -the pseudo-Thellier protocol- which shows great potential in both accuracy and efficiency, but currently lacks a solid theoretical underpinning. Here I present work using all three of the aforementioned paleointensity methods on suites of young lavas taken from the volcanic islands of Hawaii, La Palma, Gran Canaria, Tenerife, and Terceira. Many of the sampled cooling units are <100 years old, the actual field strength at the time of cooling is therefore reasonably well known. Rather intuitively, flows that produce coherent results from two or more different paleointensity methods yield the most accurate estimates of the paleofield. Furthermore, the results for some flows pass the selection criteria for one method, but fail in other techniques. Scrutinizing and combing all acceptable results yielded reliable paleointensity estimates for 60-70% of all sampled cooling units - an exceptionally high success rate. This 'multi-method paleointensity approach' therefore has high potential to provide the much-needed paleointensities to improve geomagnetic field models for the Holocene.

  9. Towards Accurate Application Characterization for Exascale (APEX)

    Hammond, Simon David [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States)

    2015-09-01

    Sandia National Laboratories has been engaged in hardware and software codesign activities for a number of years, indeed, it might be argued that prototyping of clusters as far back as the CPLANT machines and many large capability resources including ASCI Red and RedStorm were examples of codesigned solutions. As the research supporting our codesign activities has moved closer to investigating on-node runtime behavior a nature hunger has grown for detailed analysis of both hardware and algorithm performance from the perspective of low-level operations. The Application Characterization for Exascale (APEX) LDRD was a project concieved of addressing some of these concerns. Primarily the research was to intended to focus on generating accurate and reproducible low-level performance metrics using tools that could scale to production-class code bases. Along side this research was an advocacy and analysis role associated with evaluating tools for production use, working with leading industry vendors to develop and refine solutions required by our code teams and to directly engage with production code developers to form a context for the application analysis and a bridge to the research community within Sandia. On each of these accounts significant progress has been made, particularly, as this report will cover, in the low-level analysis of operations for important classes of algorithms. This report summarizes the development of a collection of tools under the APEX research program and leaves to other SAND and L2 milestone reports the description of codesign progress with Sandia’s production users/developers.

  10. Accurate hydrocarbon estimates attained with radioactive isotope

    To make accurate economic evaluations of new discoveries, an oil company needs to know how much gas and oil a reservoir contains. The porous rocks of these reservoirs are not completely filled with gas or oil, but contain a mixture of gas, oil and water. It is extremely important to know what volume percentage of this water--called connate water--is contained in the reservoir rock. The percentage of connate water can be calculated from electrical resistivity measurements made downhole. The accuracy of this method can be improved if a pure sample of connate water can be analyzed or if the chemistry of the water can be determined by conventional logging methods. Because of the similarity of the mud filtrate--the water in a water-based drilling fluid--and the connate water, this is not always possible. If the oil company cannot distinguish between connate water and mud filtrate, its oil-in-place calculations could be incorrect by ten percent or more. It is clear that unless an oil company can be sure that a sample of connate water is pure, or at the very least knows exactly how much mud filtrate it contains, its assessment of the reservoir's water content--and consequently its oil or gas content--will be distorted. The oil companies have opted for the Repeat Formation Tester (RFT) method. Label the drilling fluid with small doses of tritium--a radioactive isotope of hydrogen--and it will be easy to detect and quantify in the sample