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Sample records for accurately diagnose smear-negative

  1. Clinical and radiographic factors do not accurately diagnose smear-negative tuberculosis in HIV-infected inpatients in Uganda: a cross-sectional study.

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    J Lucian Davis

    Full Text Available BACKGROUND: Although World Health Organization guidelines recommend clinical judgment and chest radiography for diagnosing tuberculosis in HIV-infected adults with unexplained cough and negative sputum smears for acid-fast bacilli, the diagnostic performance of this approach is unknown. Therefore, we sought to assess the accuracy of symptoms, physical signs, and radiographic findings for diagnosing tuberculosis in this population in a low-income country with a high incidence of tuberculosis. METHODOLOGY: We performed a cross-sectional study enrolling consecutive HIV-infected inpatients with unexplained cough and negative sputum smears for acid-fast bacilli at Mulago Hospital in Kampala, Uganda. Trained medical officers prospectively collected data on standard symptoms and signs of systemic respiratory illness, and two radiologists interpreted chest radiographs in a standardized fashion. We calculated positive- and negative-likelihood ratios of these factors for diagnosing pulmonary tuberculosis (defined when mycobacterial cultures of sputum or bronchoalveolar lavage fluid were positive. We used both conventional and novel regression techniques to develop multivariable prediction models for pulmonary tuberculosis. PRINCIPAL FINDINGS: Among 202 enrolled HIV-infected adults with negative sputum smears for acid-fast bacilli, 72 (36% had culture-positive pulmonary tuberculosis. No single factor, including respiratory symptoms, physical findings, CD4+ T-cell count, or chest radiographic abnormalities, substantially increased or decreased the likelihood of pulmonary tuberculosis. After exhaustive testing, we were also unable to identify any combination of factors which reliably predicted bacteriologically confirmed tuberculosis. CONCLUSIONS AND SIGNIFICANCE: Clinical and radiographic criteria did not help diagnose smear-negative pulmonary tuberculosis among HIV-infected patients with unexplained cough in a low-income setting. Enhanced diagnostic

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

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    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.

  3. Diagnosing sputum/smear-negative pulmonary tuberculosis: Does fibre-optic bronchoscopy play a significant role?

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    Bachh Arshad

    2010-01-01

    Full Text Available Background : Diagnosis of sputum/smear-negative pulmonary tuberculosis patients can be both challenging and time consuming with many patients being put on empirical anti-tubercular treatment. Fibreoptic bronchoscopy may provide a confirmative and early diagnosis in such patients. Aims: To assess the role of fibreoptic bronchoscopy in the diagnosis of sputum /smear-negative pulmonary tuberculosis. Materials and Methods: The study was conducted on 75 suspected sputum / smear-negative pulmonary tuberculosis cases attending Pulmonary Medicine Department of Mamata Medical College and Hospital, Khammam, AP. Fibreoptic bronchoscopy was performed; culture of sputum and bronchial washings for Mycobacterium tuberculosis was done by BACTEC method. Results: A final diagnosis of sputum /smear-negative pulmonary tuberculosis was made in 60 patients. Bronchial washings smear for acid-fast bacilli (AFB was positive in 21 patients while culture of bronchial washings was positive in 39 patients. In 29 patients, smear or culture of bronchial washing alone contributed to the final diagnosis. Total yield of bronchoscopy in diagnosis of sputum smear negative pulmonary tuberculosis was 83.33% (50/60; bronchoscopy was the only diagnostic method in 66% cases (40/60 with bronchial washings being the only diagnostic method in 48.33%. Bronchial washings smear for AFB and histopathological evidence of caseating granuloma made immediate diagnosis possible in 48.33% (29/60 patients. Conclusion: Our study suggests that fibreoptic bronchoscopy can provide excellent material for diagnosis of suspected cases of Pulmonary Tuberculosis in whom smears of expectorated sputum do not reveal mycobacteria.

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

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    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

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

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    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.

  6. Evaluation of the Xpert ® MTB/Rif test, microscopic observation drug susceptibility test and nitrate reductase assay, for rapid and accurate diagnosis of smear-negative tuberculosis in HIV patients

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    Simon Walusimbi

    2013-01-01

    Full Text Available Diagnosis of smear-negative tuberculosis (TB, which is frequently seen in HIV-infected patients, is a challenge without conventional culture methods. Since 2007, the WHO (World Health Organization has endorsed new or improved tests for increased and rapid diagnosis of TB. This study was undertaken in an effort to evaluate the accuracy of two rapid culture methods: the Microscopic Observation Drug Susceptibility assay (MODS and Nitrate Reductase Assay (NRA, and the molecular based test Xpert ® MTB/Rif (Xpert, for diagnosis of smear-negative TB in HIV patients using the mycobacteria growth indicator tube (MGIT in the BACTECTM MGITTM 960 system as the reference test. 430 smear-negative patients with presumptive TB were enrolled in a cross-sectional study at a tertiary care facility in Uganda. Their sputum was tested on MODS, NRA, Xpert and MGIT. Of the 430 patients, 373 had complete results to compute test accuracy. Mycobacterium tuberculosis (MTB was detected in 43 patients by MGIT. The sensitivity and specificity were 24.4% and 98.1% for MODS, 41.5% and 92% for NRA, 48.8% and 95.1% for Xpert, respectively. The low sensitivity of the tests implies that additional diagnostics such as chest X-ray and conventional liquid culture methods might still be needed to detect TB in smear-negative HIV patients. The high specificity of the tests is useful to confirm TB in HIV patients with symptoms suggestive of TB.

  7. Tuberculosis transmission by patients with smear-negative pulmonary tuberculosis in a large cohort in the Netherlands.

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    Tostmann, A.; Kik, S.V.; Kalisvaart, N.A.; Sebek, M.M.; Verver, S.; Boeree, M.J.; Soolingen, D. van

    2008-01-01

    BACKGROUND: Sputum smear microscopy is commonly used for diagnosing tuberculosis (TB). Although patients with sputum smear-negative TB are less infectious than patients with smear-positive TB, they also contribute to TB transmission. The objective of this study was to determine the proportion of TB

  8. Microscopic examination and smear negative pulmonary tuberculosis in Ethiopia.

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    Keflie, Tibebe Seyoum; Ameni, Gobena

    2014-01-01

    Tuberculosis causes illness among millions of people each year and ranks as the second leading cause of death from infectious disease worldwide. The aim of this study was to investigate the detection rate of microscopic examination and estimate risk of transmission of TB by smear negative pulmonary TB patients. A cross-sectional study and retrospective data analysis on TB were undertaken in Northwest Shewa, Ethiopia. Microscopic examination, bacterial culture and PCR were performed. The statistical analysis was made by using STATA software version 10. A total of 92 suspected TB cases was included in the study. Of these, 27.17% (25/92) were positive for microscopic examination and 51% (47/92) for culture. The sensitivity and specificity of microscopic examination with 95% CI were 48.94% (34.08% to 63.93%) and 95.56% (84.82 to 99.33%), respectively. The positive and negative predictive values were 92% (73.93% to 98.78%) and 64.18% (51.53% to 75.53%), respectively. Of 8150 pulmonary TB cases in the retrospective study, 58.9% was smear negative. The proportion of TB-HIV co-infection was 28.66% (96/335). The sensitivity of microscopic examination was 48.94% which was very low. The poor sensitivity of this test together with the advent of HIV/AIDS elevated the prevalence of smear negative pulmonary TB. This in turn increased the risk of TB transmission.

  9. Utility of high-resolution computed tomography for predicting risk of sputum smear-negative pulmonary tuberculosis

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    Nakanishi, Masanori [Departments of Respiratory Medicine, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki Eiheizi-cho, Fukui 910-1193 (Japan)], E-mail: mnakanishi@nifty.ne.jp; Demura, Yoshiki; Ameshima, Shingo [Departments of Respiratory Medicine, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki Eiheizi-cho, Fukui 910-1193 (Japan); Kosaka, Nobuyuki [Departments of Radiology, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki Eiheizi-cho, Fukui 910-1193 (Japan); Chiba, Yukio [Department of Respiratory Medicine, National Hospital Organization, Fukui Hospital, Tsuruga, Fukui 914-0195 (Japan); Nishikawa, Satoshi [Department of Radiology, National Hospital Organization, Fukui Hospital, Tsuruga, Fukui 914-0195 (Japan); Itoh, Harumi [Departments of Radiology, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki Eiheizi-cho, Fukui 910-1193 (Japan); Ishizaki, Takeshi [Departments of Respiratory Medicine, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki Eiheizi-cho, Fukui 910-1193 (Japan)

    2010-03-15

    Background: To diagnose sputum smear-negative pulmonary tuberculosis (PTB) is difficult and the ability of high-resolution computed tomography (HRCT) for diagnosing PTB has remained unclear in the sputum smear-negative setting. We retrospectively investigated whether or not this imaging modality can predict risk for sputum smear-negative PTB. Methods: We used HRCT to examine the findings of 116 patients with suspected PTB despite negative sputum smears for acid-fast bacilli (AFB). We investigated their clinical features and HRCT-findings to predict the risk for PTB by multivariate analysis and a combination of HRCT findings by stepwise regression analysis. We then designed provisional HRCT diagnostic criteria based on these results to rank the risk of PTB and blinded observers assessed the validity and reliability of these criteria. Results: A positive tuberculin skin test alone among clinical laboratory findings was significantly associated with an increase of risk of PTB. Multivariate regression analysis showed that large nodules, tree-in-bud appearance, lobular consolidation and the main lesion being located in S1, S2, and S6 were significantly associated with an increased risk of PTB. Stepwise regression analysis showed that coexistence of the above 4 factors was most significantly associated with an increase in the risk for PTB. Ranking of the results using our HRCT diagnostic criteria by blinded observers revealed good utility and agreement for predicting PTB risk. Conclusions: Even in the sputum smear-negative setting, HRCT can predict the risk of PTB with good reproducibility and can select patients having a high probability of PTB.

  10. Clinical diagnostic performance of the simultaneous amplification and testing methods for detection of the Mycobacterium tuberculosis complex for smear-negative or sputum-scarce pulmonary tuberculosis in China

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    Fan Lin; Zhang Qing; Cheng Liping; Liu Zhibing; Ji Xiaobing; Cui Zhenling; Ju Jingliang

    2014-01-01

    Background Early detection of pulmonary tuberculosis (PTB) is a big challenge in smear negative and sputum scarce patients in China.Simultaneous amplification and testing methods for detection of the Mycobactedum tuberculosis (MTB) complex (SAT-TB assay) is a novel molecular technique established in our hospital.This method has a high sensitivity and specificity in the lab.In this study,the clinical diagnostic performance of this method in smear-negative or sputum-scarce PTB suspects was investigated and evaluated.Methods Two hundred smear negative and 80 sputum-scarce patients were recruited in this study.Samples that included sputum or bronchial washing fluid were collected and sent for both bacteria culture and SAT-TB assay.Diagnosis for these patients was based on the comprehensive evaluation of chestX-ray/CT study,histology examination,lab results,and treatment response.Sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) for each diagnostic test were investigated and calculated using confirmed tuberculosis (TB) and non-TB cases.The time required for detection of MTB was also measured for each method.Results Ninety-two patients (33%) were diagnosed as definitive TB,112 patients (40%) were probable PTB,and 76 (27%) were non-TB.The sensitivity,specificity,PPV,and NPV of SAT-TB in smear-negative PTB suspects were 93% (95% CI,84%-98%),98% (95% CI,90%-100%),98% (95% Cl,91%-100%),and 93% (95% CI,83%-98%).In sputum scarce PTB suspects,the sensitivity,specificity,PPV,and NPV of the SAT-TB assay on bronchial washing fiuids were 90% (95%Cl,74%-98%),100% (95% Cl,85%-100%),100% (95% Cl,88%-100%),and 88% (95% CI,69%-97%).The accuracy of the SAT-TB assay is consistent with the bacteria culture assay.The median time required for detecting MTB in the SAT-TB assay was 0.5 day,which was much faster than bacteria culture (28 days).Conclusions The SAT-TB assay is a fast

  11. Evaluation of Smear Negative and Pozitive Pulmonary Tuberculosis Cases

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    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.

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

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    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.

  13. Accurate Completion of Medical Report on Diagnosing Death.

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    Savić, Slobodan; Alempijević, Djordje; Andjelić, Sladjana

    2015-01-01

    Diagnosing death and issuing a Death Diagnosing Form (DDF) represents an activity that carries a great deal of public responsibility for medical professionals of the Emergency Medical Services (EMS) and is perpetually exposed to the control of the general public. Diagnosing death is necessary so as to confirm true, to exclude apparent death and consequentially to avoid burying a person alive, i.e. apparently dead. These expert-methodological guidelines based on the most up-to-date and medically based evidence have the goal of helping the physicians of the EMS in accurately filling out a medical report on diagnosing death. If the outcome of applied cardiopulmonary resuscitation measures is negative or when the person is found dead, the physician is under obligation to diagnose death and correctly fill out the DDF. It is also recommended to perform electrocardiography (EKG) and record asystole in at least two leads. In the process of diagnostics and treatment, it is a moral obligation of each Belgrade EMS physician to apply all available achievements and knowledge of modern medicine acquired from extensive international studies, which have been indeed the major theoretical basis for the creation of these expert-methodological guidelines. Those acting differently do so in accordance with their conscience and risk professional, and even criminal sanctions.

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

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    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.

  15. 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

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    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.

  16. Usefulness of interferon-γ release assay for the diagnosis of sputum smear-negative pulmonary and extra-pulmonary TB in Zhejiang Province, China.

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    Ji, Lei; Lou, Yong-Liang; Wu, Zhong-Xiu; Jiang, Jin-Qin; Fan, Xing-Li; Wang, Li-Fang; Liu, Xiao-Xiang; Du, Peng; Yan, Jie; Sun, Ai-Hua

    2017-09-01

    Quick diagnosis of smear-negative pulmonary tuberculosis (TB) and extra-pulmonary TB are urgently needed in clinical diagnosis. Our research aims to investigate the usefulness of the interferon-γ release assay (IGRA) for the diagnosis of smear-negative pulmonary and extra-pulmonary TB. We performed TB antibody and TB-IGRA tests on 389 pulmonary TB patients (including 120 smear-positive pulmonary TB patients and 269 smear-negative pulmonary TB patients), 113 extra-pulmonary TB patients, 81 patients with other pulmonary diseases and 100 healthy controls. Blood samples for the TB-Ab test and the TB-IGRA were collected, processed, and interpreted according to the manufacturer's protocol. The detection ratio of smear-positive pulmonary TB patients and smear-negative pulmonary TB patients were 90.8% (109 of 120) and 89.6% (241 of 269), respectively. There was no statistically significant difference of its performance between these two sample sets (P > 0.05). The detection ratio of positive TB patients and extra-pulmonary TB patients were 90.0% (350 of 389) and 87.6% (99 of 113), respectively, which was not significantly different (P > 0.05). In this work, the total detection ratio using TB-IGRA was 89.4%, therefore TB-IGRA has diagnostic values in smear-negative pulmonary TB and extra-pulmonary TB diagnosis.

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

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    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.

  18. p16 Immunohistochemistry Interpretation by Nonpathologists as an Accurate Method for Diagnosing Cervical Precancer and Cancer.

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    Liao, Guang-Dong; Kang, Le-Ni; Chen, Wen; Zhang, Xun; Liu, Xiao-Yang; Zhao, Fang-Hui; Stoler, Mark H; Mills, Anne; Xi, Ming-Rong; Qiao, You-Lin; Castle, Philip E

    2015-07-01

    We conducted a pilot study of whether nonpathologists could accurately diagnose cervical precancer in biopsies using only a basic light microscope, evaluating p16 immunohistochemistry (p16 IHC) of biopsies, and video-based training for both. Using biopsies collected as part of a screening study conducted in rural China, we randomly selected 50 biopsies with a precancerous diagnosis of cervical intraepithelial neoplasia grade 2 (CIN2) or more severe (CIN2+) and 50 biopsies with diagnosis of CIN less severe than CIN2, and stained them for p16 using a commercial IHC kit. Twelve nonpathologists of varying educational backgrounds living in Beijing, China received video training and were assigned one of 4 sets of 25 CIN2+ and 25 CIN less severe than CIN2 for evaluation. A pathologist reviewed all 100 cases. The mean sensitivity and specificity of the p16 IHC staining scored by the nonpathologists were 91.7% and 94.1%, respectively, compared to scoring by the pathologist. The readers and the pathologist agreed on p16 IHC scoring for 42 (84%) of the 50 slides of CIN less severe than CIN2 and 37 (74%) of the 50 CIN2+ slides. The mean sensitivity and specificity for consensus CIN2+ of p16 IHC as scored by the readers were 88% and 87%, respectively, versus an overall sensitivity and specificity by the pathologist of 96% and 92%, respectively. We demonstrated that nonpathologists can accurately diagnose CIN2+ using p16 IHC alone.

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

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    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.

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

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    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 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. PMID:24651298

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

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    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.

  2. A novel method for diagnosis of smear-negative tuberculosis patients by combining a random unbiased Phi29 amplification with a specific real-time PCR.

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    Pang, Yu; Lu, Jie; Yang, Jian; Wang, Yufeng; Cohen, Chad; Ni, Xin; Zhao, Yanlin

    2015-07-01

    In this study, we develop a novel method for diagnosis of smear-negative tuberculosis patients by performing a random unbiased Phi29 amplification prior to the use of a specific real-time PCR. The limit of detection (LOD) of the conventional real-time PCR was 100 colony-forming units (CFU) of MTB genome/reaction, while the REPLI real-time PCR assay could detect 0.4 CFU/reaction. In comparison with the conventional real-time PCR, REPLI real-time PCR shows better sensitivity for the detection of smear-negative tuberculosis (P = 0.015).

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

    Directory of Open Access Journals (Sweden)

    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

  4. Xpert(®) MTB/RIF for smear-negative presumptive TB: impact on case notification in DR Congo.

    Science.gov (United States)

    Mbonze, N B; Tabala, M; Wenzi, L K; Bakoko, B; Brouwer, M; Creswell, J; Van Rie, A; Behets, F; Yotebieng, M

    2016-02-01

    The impact of Xpert(®) MTB/RIF as a follow-on diagnostic test after smear microscopy on tuberculosis (TB) notification has not yet been well defined. Quasi-experimental design with 86 evaluation and 49 control clinics in Kinshasa, Democratic Republic of Congo. Smear microscopy was supported at all 135 clinics, Xpert was placed in 15 evaluation clinics and a sputum transport system was implemented for 25 satellite clinics. The number of cases notified before and during the project (July 2012-June 2013) was obtained from the National TB Program. Of 27,147 presumptive TB cases presenting in clinics with access to Xpert, 5922 (21.8%) were smear-positive. Of 18,636 individuals with ⩾ 3 negative microscopy results, 6920 (37.1%) underwent Xpert testing, 991 (14.3%) of whom tested positive. The number of bacteriologically positive cases increased equally in evaluation clinics (15.1%, 95%CI -2.3 to 32.6) and control clinics (13.6%, 95%CI 2.6-29.3), for a difference in increase of 1.5% (95%CI -28.8 to 31.8). There was no difference in the change in smear-negative cases (-42.4%, 95%CI -111.5 to 26.6), nor in all types of TB notified (-6.1%, 95%CI -32.5 to 20.4) between the evaluation and control clinics. In part due to a restrictive algorithm, Xpert as follow-on to smear microscopy did not increase the overall number of TB notifications, nor the number of bacteriologically positive cases.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Prevalence of melioidosis in patients with suspected pulmonary tuberculosis and sputum smear negative for acid-fast bacilli in northeast Thailand.

    Science.gov (United States)

    Suntornsut, Pornpan; Kasemsupat, Kriangsak; Silairatana, Santi; Wongsuvan, Gumphol; Jutrakul, Yaowaruk; Wuthiekanun, Vanaporn; Day, Nicholas P J; Peacock, Sharon J; Limmathurotsakul, Direk

    2013-11-01

    The clinical and radiological features of pulmonary melioidosis can mimic tuberculosis. We prospectively evaluated 118 patients with suspected pulmonary tuberculosis who were acid-fast bacilli (AFB) smear negative at Udon Thani Hospital, northeast Thailand. Culture of residual sputum from AFB testing was positive for Burkholderia pseudomallei in three patients (2.5%; 95% confidence interval [CI] 0.5-7.3%). We propose that in melioidosis-endemic areas, residual sputum from AFB testing should be routinely cultured for B. pseudomallei.

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

    Directory of Open Access Journals (Sweden)

    Poojan Shrestha

    2015-01-01

    Full Text Available 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.

  8. Rapid detection of Mycobacterium tuberculosis complex and rifampin resistance in smear-negative clinical samples by use of an integrated real-time PCR method.

    Science.gov (United States)

    Moure, Raquel; Muñoz, Laura; Torres, Miriam; Santin, Miguel; Martín, Rogelio; Alcaide, Fernando

    2011-03-01

    Sixty-four of 85 (75.3%) smear-negative respiratory (n = 78) and nonrespiratory (n = 7) samples with positive cultures of Mycobacterium tuberculosis complex (MTC) were detected by the GeneXpert system using the Xpert MTB/RIF assay (GX). In addition, GX found rpoB mutations in all six of the rifampin-resistant strains detected. The test was negative in 20 culture-negative and 20 nontuberculous culture-positive samples (100% specificity). GX offers high potential for the diagnosis of tuberculosis due to its capacity for direct detection of MTC, its rapidity, and its simplicity.

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

    Science.gov (United States)

    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…

  10. Nucleic acid amplification tests for diagnosis of smear-negative TB in a high HIV-prevalence setting: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    J Lucian Davis

    Full Text Available Nucleic acid amplification tests are sensitive for identifying Mycobacterium tuberculosis in populations with positive sputum smears for acid-fast bacilli, but less sensitive in sputum-smear-negative populations. Few studies have evaluated the clinical impact of these tests in low-income countries with high burdens of TB and HIV.We prospectively enrolled 211 consecutive adults with cough ≥2 weeks and negative sputum smears at Mulago Hospital in Kampala, Uganda. We tested a single early-morning sputum specimen for Mycobacterium tuberculosis DNA using two nucleic acid amplification tests: a novel in-house polymerase chain reaction targeting the mycobacterial secA1 gene, and the commercial Amplified® Mycobacterium tuberculosis Direct (MTD test (Gen-Probe Inc, San Diego, CA. We calculated the diagnostic accuracy of these index tests in reference to a primary microbiologic gold standard (positive mycobacterial culture of sputum or bronchoalveolar lavage fluid, and measured their likely clinical impact on additional tuberculosis cases detected among those not prescribed initial TB treatment.Of 211 patients enrolled, 170 (81% were HIV-seropositive, with median CD4+ T-cell count 78 cells/µL (interquartile range 29-203. Among HIV-seropositive patients, 94 (55% reported taking co-trimoxazole prophylaxis and 29 (17% reported taking antiretroviral therapy. Seventy-five patients (36% had culture-confirmed TB. Sensitivity of MTD was 39% (95% CI 28-51 and that of secA1 was 24% (95% CI 15-35. Both tests had specificities of 95% (95% CI 90-98. The MTD test correctly identified 18 (24% TB patients not treated at discharge and led to a 72% relative increase in the smear-negative case detection rate.The secA1 and MTD nucleic acid amplification tests had moderate sensitivity and high specificity for TB in a predominantly HIV-seropositive population with negative sputum smears. Although newer, more sensitive nucleic acid assays may enhance detection of

  11. Effectiveness of an integrated real-time PCR method for detection of the Mycobacterium tuberculosis complex in smear-negative extrapulmonary samples in an area of low tuberculosis prevalence.

    Science.gov (United States)

    Moure, Raquel; Martín, Rogelio; Alcaide, Fernando

    2012-02-01

    Early extrapulmonary tuberculosis (EPTB) diagnosis is particularly difficult. Among 108 smear-negative extrapulmonary samples showing a positive culture for Mycobacterium tuberculosis complex (43 body fluids and 65 nonliquid specimens), 63 (58.3%) were positive with the Xpert MTB/RIF assay (GX). GX sensitivity was quite low for samples from sterile locations (especially for pleural fluids: 26.9%) but high for some nonliquid samples, like abscess aspirates (76.5%). In summary, GX may be a useful tool to be considered for EPTB diagnosis.

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

    Science.gov (United States)

    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.

  13. Kinesiographic recordings of jaw movements are not accurate to detect magnetic resonance-diagnosed temporomandibular joint (TMJ) effusion and disk displacement: findings from a validation study.

    Science.gov (United States)

    Manfredini, Daniele; Favero, Lorenzo; Federzoni, Elvis; Cocilovo, Francesco; Guarda-Nardini, Luca

    2012-10-01

    The aim of this study was to perform a validation study assessing the correlation between magnetic resonance (MR) findings of temporomandibular joint (TMJ) disk displacement and effusion and some parameters drawn from kinesiographic (KG) recordings of jaw motion, i.e., deflection, deviations, incisures. Thirty-one patients with TMJ disorders underwent a kinesiographic recording in the same day in which the MR was performed. Regression analysis was performed to assess the correlation between the MR and KG findings. MR findings were not correlated with KG parameters (P > .05). The accuracy of all KG variables for diagnosing MR-detected signs was low. KG deflection ranged from 38.7% to 54.8%, KG deviation from 42% to 54.8%, and KG incisures from 9.6% to 71%. Specificity and positive predictive values were far from acceptable levels for all KG variables. The findings do not support the usefulness of jaw-tracking devices in dental practices that diagnose and manage temporomandibular disorders. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Integrating trans-abdominal ultrasonography with fecal steroid metabolite monitoring to accurately diagnose pregnancy and predict the timing of parturition in the red panda (Ailurus fulgens styani).

    Science.gov (United States)

    Curry, Erin; Browning, Lissa J; Reinhart, Paul; Roth, Terri L

    2017-02-23

    Red pandas (Ailurus fulgens styani) exhibit a variable gestation length and may experience a pseudopregnancy indistinguishable from true pregnancy; therefore, it is not possible to deduce an individual's true pregnancy status and parturition date based on breeding dates or fecal progesterone excretion patterns alone. The goal of this study was to evaluate the use of transabdominal ultrasonography for pregnancy diagnosis in red pandas. Two to three females were monitored over 4 consecutive years, generating a total of seven profiles (four pregnancies, two pseudopregnancies, and one lost pregnancy). Fecal samples were collected and assayed for progesterone (P4) and estrogen conjugate (EC) to characterize patterns associated with breeding activity and parturition events. Animals were trained for voluntary transabdominal ultrasound and examinations were performed weekly. Breeding behaviors and fecal EC data suggest that the estrus cycle of this species is 11-12 days in length. Fecal steroid metabolite analyses also revealed that neither P4 nor EC concentrations were suitable indicators of pregnancy in this species; however, a secondary increase in P4 occurred 69-71 days prior to parturition in all pregnant females, presumably coinciding with embryo implantation. Using ultrasonography, embryos were detected as early as 62 days post-breeding/50 days pre-partum and serial measurements of uterine lumen diameter were documented throughout four pregnancies. Advances in reproductive diagnostics, such as the implementation of ultrasonography, may facilitate improved husbandry of pregnant females and allow for the accurate prediction of parturition. © 2017 Wiley Periodicals, Inc.

  15. Allele Specific Locked Nucleic Acid Quantitative PCR (ASLNAqPCR): An Accurate and Cost-Effective Assay to Diagnose and Quantify KRAS and BRAF Mutation

    Science.gov (United States)

    Morandi, Luca; de Biase, Dario; Visani, Michela; Cesari, Valentina; De Maglio, Giovanna; Pizzolitto, Stefano; Pession, Annalisa; Tallini, Giovanni

    2012-01-01

    The use of tyrosine kinase inhibitors (TKIs) requires the testing for hot spot mutations of the molecular effectors downstream the membrane-bound tyrosine kinases since their wild type status is expected for response to TKI therapy. We report a novel assay that we have called Allele Specific Locked Nucleic Acid quantitative PCR (ASLNAqPCR). The assay uses LNA-modified allele specific primers and LNA-modified beacon probes to increase sensitivity, specificity and to accurately quantify mutations. We designed primers specific for codon 12/13 KRAS mutations and BRAF V600E, and validated the assay with 300 routine samples from a variety of sources, including cytology specimens. All were analyzed by ASLNAqPCR and Sanger sequencing. Discordant cases were pyrosequenced. ASLNAqPCR correctly identified BRAF and KRAS mutations in all discordant cases and all had a mutated/wild type DNA ratio below the analytical sensitivity of the Sanger method. ASLNAqPCR was 100% specific with greater accuracy, positive and negative predictive values compared with Sanger sequencing. The analytical sensitivity of ASLNAqPCR is 0.1%, allowing quantification of mutated DNA in small neoplastic cell clones. ASLNAqPCR can be performed in any laboratory with real-time PCR equipment, is very cost-effective and can easily be adapted to detect hot spot mutations in other oncogenes. PMID:22558339

  16. Diagnosing MS

    Science.gov (United States)

    ... a Local Support Group Ask an MS Navigator Edward M. Dowd Personal Advocate Program Connect with Peers ... Symptoms & Diagnosis Diagnosing MS Possible MS Clinically Isolated Syndrome (CIS) Newly Diagnosed Diagnosing Tools Other Conditions to ...

  17. Diagnosing Dementia--Positive Signs

    Science.gov (United States)

    ... 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 ...

  18. Diagnostic value of Xpert MTB/RIF for smear-negative pulmonary tuberculosis using bronchoalveolar lavage fluid%支气管肺泡灌洗液行Xpert MTB/RIF检测对涂阴肺结核的诊断价值

    Institute of Scientific and Technical Information of China (English)

    高春景; 朱述阳

    2016-01-01

    目的:评价支气管肺泡灌洗液行Xpert MTB/RIF检测对涂阴肺结核的诊断价值。方法选取从2014年11月至2015年12月徐州市传染病医院收治的3次痰涂片阴性的可疑肺结核患者110例,对所有患者行支气管镜检查进行刷检及收集BALF,进行涂片镜检找抗酸杆菌、结核分枝杆菌培养及Xpert MTB/RIF检测,同时进行诊断。分别以BALF的罗氏培养结果及临床诊断标准作为肺结核诊断的阳性标准,计算Xpert MTB/RIF 诊断涂阴肺结核的敏感度、特异度、阳性预测值及阴性预测值。结果以BALF培养阳性结果作为判断肺结核的阳性标准,BALF行Xpert MTB/RIF检测对诊断涂阴肺结核的敏感度、特异度、阳性预测值、阴性预测值分别为100%、97.4%、97.8%、100%。以临床诊断标准为诊断肺结核的阳性标准, BALF 行 Xpert MTB/RIF检测对诊断涂阴肺结核的敏感度、特异度、阳性预测值、阴性预测值分别为81.9%、97.4%、98.3%、74.0%。以DST结果为金标准,Xpert MTB/RIF检测利福平耐药的敏感度、特异度分别为75.0%、96.0%。结论 BALF行Xpert MTB/RIF检测在涂阴肺结核中的敏感度、特异度均较高,且检测快速并能判断是否利福平耐药,对涂阴肺结核的快速诊断及治疗具有较大的应用价值。%Objective To evaluate the diagnostic value of Xpert MTB/RIF for smear-negative pulmonar tu-berculosis using bronchoalveolar lavage fluid. Methods From November 2014 to December 2015 in Xuzhou infec-tious disease hospital, we screened 110 suspected PTB patients with 3 consecutive negative sputum smears, bushed and obtained their BLAF specimen by brochchoscopy. BALF was tested by smear microscopy for acid fast bacilli, my-cobacterium tuberculosis culture and Xpert MTB/RIF assay. The sensitivity, specificity, PPV and NPV for Xpert MTB/RIF test were respectively calculated using culture results and? clinical diagnostic criteria as reference stand

  19. Diagnostic value of enzyme-linked immunospot assay in patients with sputum-acid-fast-bacilli-smear negative tuberculosis%酶联免疫斑点法检测在涂阴肺结核患者的诊断价值

    Institute of Scientific and Technical Information of China (English)

    刘琳; 董迎华; 吴雪琼; 王兰; 阳幼荣; 张俊仙; 梁艳; 王仲元; 安慧茹; 王涛

    2015-01-01

    Objective To study the diagnostic value of enzyme-linked immunospot assay (ELISPOT) for antigens specific interferon-γ in mycobacterium tuberculosis in bronchoalveolar lavage fluid (BALF)for sputum-acid-fast-bacilli-smear negative tuberculosis. Methods The ELISPOT tests were tested in 32 cases of sputum-acid-fast-bacilli-smear negative tuberculosis,and in 30 cases of nontuberculosis with other pulmonary diseases. Receiver operating characteristic (ROC) curve of ELISPOT in peripheral blood and in BALF were drawn,area under curve (AUC) was calculated and their diagnostic value was compared by AUC. BALF in sputum-acid-fast-bacilli-smear negative tuberculosis was also detected by acid fast stain, mycobacterium tuberculosis culture, nucleic acid amplification technique. Results In the tuberculosis group and nontuberculosis group, the ELISPOT sensitivity and specificity were 84.4% and 90.0% in peripheral blood, 90.6%and 96.7%in BALF, but the difference was not statistically significant (P>0.05). The AUC of ROC was 0.936 in BALF and 0.872 in peripheral blood. The positive rate of ELISPOT in BALF of the 32 patients with sputum-acid-fast-bacilli-smear negative tuberculosis (90.6%) was higher than acid fast stain (15.6%), mycobacterium tuberculosis culture (34.4%), mycobacterium tuberculosis nucleic acid amplification fluorescence detection (31.3%). The difference was statistically significant (P= 0.000). Conclusion Detecting T lymphocytes which secrete tuberculosis antigens specific interferon-γby ELISPOT in BALF is sensitive, specific and fast. It will become an auxiliary diagnostic method in sputum of AFB smear-negative tuberculosis.%目的:评价肺泡灌洗液酶联免疫斑点试验(ELISPOT)在痰涂片抗酸杆菌阴性(涂阴)肺结核患者的诊断价值。方法应用ELISPOT检测32例涂阴肺结核患者、30例非结核肺部疾病患者外周血和肺泡灌洗液中分泌结核抗原特异性干扰素的T淋巴细胞水平;绘制受试者工作

  20. CT平扫能否准确诊断脑静脉窦血栓?%Is it possible to accurately diagnose cerebral venous sinus thrombosis on non-contrast CT?

    Institute of Scientific and Technical Information of China (English)

    关键; 林玲; 黄展坤; 初建平; 杨智云

    2015-01-01

    Objective To investigate the efficacy of non-contrast CT for diagnosing cerebral venous sinus thrombosis (CVST). Methods 35 patients with CVST and 40 volunteers without CVST underwent non-contrast CT. .The two groups were matched by age and gender..Two radiologists blindly reviewed all CT examinations in consensus..Another experienced radiologist measured the CT values of cerebral venous..Independent samples t test was performed to compare the two groups,.and receiver operating characteristics ( ROC ) curve analysis was performed to obtain the critical CT value of venous sinus for differential diagnosis . . We calculated sensitivity,.specificity and reliability of 4 variables for diagnosis of CVST including the threshold CT value of venous sinus,history of systemic lupus erythematosis, nephropathy, or pregnancy, symptoms of headache and/or spasm, venous infarct and/or scalp swelling on CT. The readers graded the variables from 1 to 3 points and the sum of each variable in both groups were compared using the Chi-square test and Fisher exact test. Results The CT attenuation of thrombosed venous sinus was significantly higher than that of normal (P<0.001). The best threshold value for diagnosing CVST was 68HU (Youden index=0.886). The best single indicator was the CT threshold value with specificity of 93% and reliability score of 3 ,.followed by venous infarct and/or scalp swelling with specificity of 77% and reliability score of 2. .There was no significant difference in the history of associated disorders (1 score) or symptoms (1 score) between the two groups. The total score of 5 or more is highly correlated with CVST in follow-up with 88.6%sensitivity,.100%specificity and 94.7%reliability..Conclusion Together with the relevant history and symptoms , it is possible to make an accurate diagnosis of CVST on non-contrast CT.%目的:脑静脉窦血栓(CVST)临床表现多样,急诊准确诊断仍有一定困难,而 CT 平扫是急诊首选的影像检查,

  1. Newly Diagnosed

    Science.gov (United States)

    ... Sites Podcasts QR Codes RSS Feeds Social Bookmarking Social Network Sites Text Messaging Twitter Video Games Video Sharing ... in care is similar to that of HIV-negative individuals. Additional Resources AIDSinfo – Just Diagnosed: Next ...

  2. Application of Fluorescent Real-time PCR and BACTEC MGIT 960 Rapid Cultivation System in Diagnosis of Sputum Smear-negative Pulmonary Tuberculosis Without History of Antituberculous Treatment%实时荧光PCR与BACTEC MGIT960快速培养在初治痰涂片阴性未受抗结核治疗的肺结核诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    蔡常辉; 梁连辉; 曾桂云; 王锦萍

    2012-01-01

    目的:探讨实时荧光PCR与BACTEC MGIT 960分枝杆菌快速培养(快速培养法)准确诊断初治痰涂片阴性(涂阴)且未经受抗结核治疗的肺结核可能性.方法:实验组:368份临床诊断活动性肺结核患者的初治涂片阴性痰标本;对照组:55份非结核性肺部疾病患者的痰液标本.用FQ-PCR技术、快速培养法及改良罗氏培养参考法对两组标本进行分析,观察指标为TB-DNA和结核菌阳性率.结果:实验组和对照标本中FQ-PCR技术、快速培养法和改良罗氏培养参考法检测的TB-DNA或结核菌阳性率分别为:16.85%、23.37%、22.01%和1%、0%、0%.三种方法分别平均耗时3h、9.6d和28d.以改良罗氏培养参考法为参照,FQ-PCR法和快速培养法的敏感性分别为69.1%和100%;特异性分别为91.2%和98.6%.结论:FQ-PCR和快速培养法均能提高初治涂阴肺结核患者的早期确诊率,但FQ-PCR的敏感性尚需进一步提高.%Objective To study on the possibility to improve the rapid diagnosis rate of smear negative pulmonary tuberculosis without history of antituberculous treatment by the fluorescent real-time PCR ( FQ-PCR) and BACTEC MGIT 960 branch bacili rapid detection system (fast cultivation method).Methods The experimental group: 368 sputum samples from patients with smear negative active pulmonary tuberculosis without history of antituberculous treatment g the control group g 55 sputum samples from patients with pulmonary diseases other than tuberculosis.The positive rates of TB-DNA or Mycobacterium tuberculosis were detected using FQ-PCR, fast cultivation or modified Roche reference method.Results The positive rates of TB-DNA or tuberculosis bacterium of the experimental and control groups detecting by FQ-PCR technology, fast cultivation or modified Roche reference method were 16.85% , 23.37% , 22.01% and 1% , 0% , 0% , respectively.The average time-consuming were 3 hours, 9.8 days and 28 days.When the modified Roche reference method was

  3. How Are Arrhythmias Diagnosed?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Are Arrhythmias Diagnosed? Arrhythmias can be hard to diagnose, especially the types ... symptoms every once in a while. Doctors diagnose arrhythmias based on medical and family histories, a physical ...

  4. Diagnosing GORD in respiratory medicine

    Directory of Open Access Journals (Sweden)

    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.

  5. How Is COPD Diagnosed?

    Science.gov (United States)

    ... 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 ...

  6. How Is Atherosclerosis Diagnosed?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is Atherosclerosis Diagnosed? Your doctor will diagnose atherosclerosis based on ... Rate This Content: NEXT >> Featured Video What is atherosclerosis? 05/22/2014 Describes how the build-up ...

  7. How Are Thalassemias Diagnosed?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Are Thalassemias Diagnosed? Doctors diagnose thalassemias using blood tests , including a complete blood count ( ... in a sample of blood. People who have thalassemias have fewer healthy red blood cells and less ...

  8. How Is Sarcoidosis Diagnosed?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is Sarcoidosis Diagnosed? Your doctor will diagnose sarcoidosis based on ... Content: NEXT >> Featured Video Living With and Managing Sarcoidosis 05/18/2011 This video—presented by the ...

  9. Diagnosing Tic Disorders

    Science.gov (United States)

    ... Other Websites Information For... Media Policy Makers Diagnosing Tic Disorders Language: English Español (Spanish) Recommend on Facebook ... or postviral encephalitis). Persistent (Chronic) Motor or Vocal Tic Disorder For a person to be diagnosed with ...

  10. How Is Vasculitis Diagnosed?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is Vasculitis Diagnosed? Your doctor will diagnose vasculitis based on your signs and symptoms, your medical ... results. Specialists Involved Depending on the type of vasculitis you have and the organs affected, your doctor ...

  11. April 2015 Phonenix pulmonary journal club: endo-bronchial ultrasound in diagnosing tuberculosis

    Directory of Open Access Journals (Sweden)

    Mathew M

    2015-04-01

    Full Text Available No abstract available. Article truncated after 150 words. Lin SM, Chung FT, Huang CD, Liu WT, Kuo CH, Wang CH, Lee KY, Liu CY, Lin HC, Kuo HP. Diagnostic value of endobronchial ultrasonography for pulmonary tuberculosis. J Thorac Cardiovasc Surg. 2009;138(1:179-84. The diagnosis of tuberculosis in patients with inability to produce sputum or in patients that remain acid-fast bacilli (AFB smear negative with high index of clinical suspicion remains a challenge and often results in treatment delay. This study examined the role in using endobronchial ultrasound (EBUS to locate parenchymal infiltrates to allow for more accurate sampling of bronchial lavage fluid and transbronchial biopsies. The study examined 121 patients divided into 2 groups, 73 patients received EBUS guided bronchoscopy and 48 pts received conventional bronchoscopy with bronchoalveolar lavage (BAL and transbronchial biopsies. It should be noted that patients undergoing transbronchial biopsies in the non-EBUS group appeared to have biopsies done without the use of fluoroscopy. The results showed ...

  12. Differential diagnoses to MS

    DEFF Research Database (Denmark)

    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 = 5...

  13. How Is Raynaud's Diagnosed?

    Science.gov (United States)

    ... diagnose primary Raynaud's (Raynaud's disease) or secondary Raynaud's (Raynaud's phenomenon) based on your medical history, a physical exam, and test results. Specialists Involved Primary care doctors and internists often diagnose and treat Raynaud's. If you have the disorder, you also may ...

  14. Diagnosing Sleep Disorders

    Science.gov (United States)

    ... 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. How Is Hemophilia Diagnosed?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is Hemophilia Diagnosed? If you or your child appears to ... have bleeding problems. However, some people who have hemophilia have no recent family history of the disease. ...

  16. Speaking Fluently And Accurately

    Institute of Scientific and Technical Information of China (English)

    JosephDeVeto

    2004-01-01

    Even after many years of study,students make frequent mistakes in English. In addition, many students still need a long time to think of what they want to say. For some reason, in spite of all the studying, students are still not quite fluent.When I teach, I use one technique that helps students not only speak more accurately, but also more fluently. That technique is dictations.

  17. How a Stroke Is Diagnosed

    Science.gov (United States)

    ... 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 ...

  18. How Is Testicular Cancer Diagnosed?

    Science.gov (United States)

    ... Cancer Early Detection, Diagnosis, and Staging How Is Testicular Cancer Diagnosed? Testicular cancer is usually found as a ... the tumor might have returned. Surgery to diagnose testicular cancer Most types of cancer are diagnosed by removing ...

  19. Diagnosing ADHD in Adolescence

    Science.gov (United States)

    Sibley, Margaret H.; Pelham, William E., Jr.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Garefino, Allison C.; Kuriyan, Aparajita B.; Babinski, Dara E.; Karch, Kathryn M.

    2012-01-01

    Objective: This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing attention-deficit/hyperactivity disorder (ADHD) to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of self- versus informant ratings, diagnostic threshold, and…

  20. Being publicly diagnosed

    DEFF Research Database (Denmark)

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

    2014-01-01

    . METHOD: A grounded theory design with field studies and qualitative interviews, following the recommendations from Glaser and Strauss. RESULT: A process of being publicly diagnosed was identified, which developed during the patient's trajectory from being on the way to becoming a patient, becoming...

  1. Diagnosing plant problems

    Science.gov (United States)

    Cheryl A. Smith

    2008-01-01

    Diagnosing Christmas tree problems can be a challenge, requiring a basic knowledge of plant culture and physiology, the effect of environmental influences on plant health, and the ability to identify the possible causes of plant problems. Developing a solution or remedy to the problem depends on a proper diagnosis, a process that requires recognition of a problem and...

  2. Innovative technologies in diagnosing acute otitis media.

    Science.gov (United States)

    Shand, Kate D; Campe, Kristin

    2016-01-01

    New guidelines for managing acute otitis media include stricter criteria for properly diagnosing the condition and ensuring an accurate diagnosis before clinicians make treatment decisions. This is key because of the increase in antibiotic-resistant pathogens. This article focuses on how clinicians can use ancillary techniques and technologies to improve diagnostic accuracy for acute otitis media. Techniques include proper cerumen removal, visualizing the tympanic membrane with the correct otoscope, pneumatic otoscopy, using a spectral gradient acoustic reflectometer, and tympanometry.

  3. Liability for Diagnosing Malingering.

    Science.gov (United States)

    Weiss, Kenneth J; Van Dell, Landon

    2017-09-01

    Malingering is a medical diagnosis, but not a psychiatric disorder. The label imputes that an evaluee has intentionally engaged in false behavior or statements. By diagnosing malingering, psychiatrists pass judgment on truthfulness. Evaluees taking exception to the label may claim that the professional has committed defamation of character (libel or slander) when the diagnosis is wrong and costs the claimant money or benefits. Clinicians may counter by claiming immunity or that the diagnosis was made in good faith. This problem has come into focus in military and veterans' contexts, where diagnoses become thresholds for benefits. Through historical and literary examples, case law, and military/veterans' claims of disability and entitlement, the authors examine the potency of the malingering label and the potential liability for professionals and institutions of making this diagnosis. © 2017 American Academy of Psychiatry and the Law.

  4. BIOACCESSIBILITY TESTS ACCURATELY ESTIMATE ...

    Science.gov (United States)

    Hazards of soil-borne Pb to wild birds may be more accurately quantified if the bioavailability of that Pb is known. To better understand the bioavailability of Pb to birds, we measured blood Pb concentrations in Japanese quail (Coturnix japonica) fed diets containing Pb-contaminated soils. Relative bioavailabilities were expressed by comparison with blood Pb concentrations in quail fed a Pb acetate reference diet. Diets containing soil from five Pb-contaminated Superfund sites had relative bioavailabilities from 33%-63%, with a mean of about 50%. Treatment of two of the soils with P significantly reduced the bioavailability of Pb. The bioaccessibility of the Pb in the test soils was then measured in six in vitro tests and regressed on bioavailability. They were: the “Relative Bioavailability Leaching Procedure” (RBALP) at pH 1.5, the same test conducted at pH 2.5, the “Ohio State University In vitro Gastrointestinal” method (OSU IVG), the “Urban Soil Bioaccessible Lead Test”, the modified “Physiologically Based Extraction Test” and the “Waterfowl Physiologically Based Extraction Test.” All regressions had positive slopes. Based on criteria of slope and coefficient of determination, the RBALP pH 2.5 and OSU IVG tests performed very well. Speciation by X-ray absorption spectroscopy demonstrated that, on average, most of the Pb in the sampled soils was sorbed to minerals (30%), bound to organic matter 24%, or present as Pb sulfate 18%. Ad

  5. Diagnosing Intermittent and Persistent Faults using Static Bayesian Networks

    Science.gov (United States)

    Megshoel, Ole Jakob

    2010-01-01

    Both intermittent and persistent faults may occur in a wide range of systems. We present in this paper the introduction of intermittent fault handling techniques into ProDiagnose, an algorithm that previously only handled persistent faults. We discuss novel algorithmic techniques as well as how our static Bayesian networks help diagnose, in an integrated manner, a range of intermittent and persistent faults. Through experiments with data from the ADAPT electrical power system test bed, generated as part of the Second International Diagnostic Competition (DXC-10), we show that this novel variant of ProDiagnose diagnoses intermittent faults accurately and quickly, while maintaining strong performance on persistent faults.

  6. Groundwater recharge: Accurately representing evapotranspiration

    CSIR Research Space (South Africa)

    Bugan, Richard DH

    2011-09-01

    Full Text Available Groundwater recharge is the basis for accurate estimation of groundwater resources, for determining the modes of water allocation and groundwater resource susceptibility to climate change. Accurate estimations of groundwater recharge with models...

  7. Diagnosable structured logic array

    Science.gov (United States)

    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.

  8. How Is Pelvic Pain Diagnosed?

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications How is pelvic pain diagnosed? Skip sharing on social media links Share ... needed to help diagnose the cause of the pelvic pain. These tests or procedures may include 1 , 2 : ...

  9. How Is Kawasaki Disease Diagnosed?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is Kawasaki Disease Diagnosed? Kawasaki disease is diagnosed based on your child's signs ... are the first to suspect a child has Kawasaki disease. Pediatricians are doctors who specialize in treating ...

  10. How Is Lactose Intolerance Diagnosed?

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications How is lactose intolerance diagnosed? Skip sharing on social media links ... people think that they or their children are lactose intolerant without being tested or diagnosed. 1 As ...

  11. Diagnosing oceanic nutrient deficiency

    Science.gov (United States)

    Moore, C. Mark

    2016-11-01

    The supply of a range of nutrient elements to surface waters is an important driver of oceanic production and the subsequent linked cycling of the nutrients and carbon. Relative deficiencies of different nutrients with respect to biological requirements, within both surface and internal water masses, can be both a key indicator and driver of the potential for these nutrients to become limiting for the production of new organic material in the upper ocean. The availability of high-quality, full-depth and global-scale datasets on the concentrations of a wide range of both macro- and micro-nutrients produced through the international GEOTRACES programme provides the potential for estimation of multi-element deficiencies at unprecedented scales. Resultant coherent large-scale patterns in diagnosed deficiency can be linked to the interacting physical-chemical-biological processes which drive upper ocean nutrient biogeochemistry. Calculations of ranked deficiencies across multiple elements further highlight important remaining uncertainties in the stoichiometric plasticity of nutrient ratios within oceanic microbial systems and caveats with regards to linkages to upper ocean nutrient limitation. This article is part of the themed issue 'Biological and climatic impacts of ocean trace element chemistry'.

  12. Diagnosing mucopolysaccharidosis IVA.

    Science.gov (United States)

    Wood, Timothy C; Harvey, Katie; Beck, Michael; Burin, Maira Graeff; Chien, Yin-Hsiu; Church, Heather J; D'Almeida, Vânia; van Diggelen, Otto P; Fietz, Michael; Giugliani, Roberto; Harmatz, Paul; Hawley, Sara M; Hwu, Wuh-Liang; Ketteridge, David; Lukacs, Zoltan; Miller, Nicole; Pasquali, Marzia; Schenone, Andrea; Thompson, Jerry N; Tylee, Karen; Yu, Chunli; Hendriksz, Christian J

    2013-03-01

    Mucopolysaccharidosis IVA (MPS IVA; Morquio A syndrome) is an autosomal recessive lysosomal storage disorder resulting from a deficiency of N-acetylgalactosamine-6-sulfate sulfatase (GALNS) activity. Diagnosis can be challenging and requires agreement of clinical, radiographic, and laboratory findings. A group of biochemical genetics laboratory directors and clinicians involved in the diagnosis of MPS IVA, convened by BioMarin Pharmaceutical Inc., met to develop recommendations for diagnosis. The following conclusions were reached. Due to the wide variation and subtleties of radiographic findings, imaging of multiple body regions is recommended. Urinary glycosaminoglycan analysis is particularly problematic for MPS IVA and it is strongly recommended to proceed to enzyme activity testing even if urine appears normal when there is clinical suspicion of MPS IVA. Enzyme activity testing of GALNS is essential in diagnosing MPS IVA. Additional analyses to confirm sample integrity and rule out MPS IVB, multiple sulfatase deficiency, and mucolipidoses types II/III are critical as part of enzyme activity testing. Leukocytes or cultured dermal fibroblasts are strongly recommended for enzyme activity testing to confirm screening results. Molecular testing may also be used to confirm the diagnosis in many patients. However, two known or probable causative mutations may not be identified in all cases of MPS IVA. A diagnostic testing algorithm is presented which attempts to streamline this complex testing process.

  13. Diagnosing bipolar disorder in children and adolescents.

    Science.gov (United States)

    Chang, Kiki D

    2009-11-01

    Pediatric-onset bipolar disorder is common but often difficult to diagnose in younger patients. Clinicians should be sure to establish the presence of a full manic episode to make the diagnosis of bipolar I disorder. Because adult criteria are used for children and adolescents, clinicians also should be aware of developmental norms that can help to make an accurate diagnosis. Bipolar disorder NOS and other disorders in children and adolescents may be prodromal states for bipolar disorder, especially in the presence of a positive family history. Copyright 2009 Physicians Postgraduate Press, Inc.

  14. Diagnosing patients with longstanding shoulder joint pain

    DEFF Research Database (Denmark)

    Nørregaard, J; Krogsgaard, M R; Lorenzen, T

    2002-01-01

    lesion also showed poor agreement. Pain during muscle contraction showed moderate agreement. The agreement of clinical diagnoses was poor and the accuracy was low in comparison with arthroscopy. Ultrasonography was accurate in full thickness supraspinatus tendon tears, but inaccurate for partial tears...... were "blindly" examined by two trained doctors using several clinical tests. In all patients an ultrasonographic examination was performed, and in 42 (49%) an arthroscopy. RESULTS: Tests for impingement showed poor to moderate agreement. Tenderness of muscles, muscle weakness, and tests for labral...

  15. MR imaging of the forefoot: Morton neuroma and differential diagnoses.

    Science.gov (United States)

    Zanetti, Marco; Weishaupt, Dominik

    2005-09-01

    Magnetic resonance (MR) imaging of Morton neuromas is highly accurate. Morton neuromas are more conspicuous when the patient is prone positioned and the foot is plantar flexed than in the supine position with the toes pointing upward. MR imaging of Morton neuromas has a large influence on the diagnostic thinking and treatment plan of orthopedic foot surgeons. The most common differential diagnoses include intermetatarsal bursitis, stress fractures, and stress reactions. Some diagnoses (nodules associated with rheumatoid arthritis, synovial cyst, soft tissue chondroma, and plantar fibromatosis) are rare and can be diagnosed with histologic correlation only.

  16. NNLOPS accurate associated HW production

    CERN Document Server

    Astill, William; Re, Emanuele; Zanderighi, Giulia

    2016-01-01

    We present a next-to-next-to-leading order accurate description of associated HW production consistently matched to a parton shower. The method is based on reweighting events obtained with the HW plus one jet NLO accurate calculation implemented in POWHEG, extended with the MiNLO procedure, to reproduce NNLO accurate Born distributions. Since the Born kinematics is more complex than the cases treated before, we use a parametrization of the Collins-Soper angles to reduce the number of variables required for the reweighting. We present phenomenological results at 13 TeV, with cuts suggested by the Higgs Cross Section Working Group.

  17. How Is Aplastic Anemia Diagnosed?

    Science.gov (United States)

    ... 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 ...

  18. BET 2: Can procalcitonin accurately diagnose serious bacterial infection in emergency department patients with SIRS?

    Science.gov (United States)

    Wilson, Joel; Baskerville, Jerry; Zarabi, Sahar

    2017-09-01

    A shortcut review was carried out to establish whether serum procalcitonin levels can be used to identify serious bacterial infection in ED patients with undifferentiated SIRS. 14 papers presented the best evidence to answer the clinical question. The review concludes that raised procalcitonin levels are associated with bacteraemia; however, there are no clinical management studies addressing this question in ED patients with SIRS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. How to diagnose cardiac tamponade

    NARCIS (Netherlands)

    van Steijn, JHM; Sleijfer, DT; van der Graaf, WTA; van der Sluis, A; Nieboer, P

    2002-01-01

    Malignant pericardial effusion is a potentially fatal complication of malignancy unless recognised and treated promptly. Patients with this condition are often difficult to diagnose. Physical examination, chest radiography and electrocardiography have poor diagnostic values in identification of pati

  20. How Is Stomach Cancer Diagnosed?

    Science.gov (United States)

    ... Cancer Early Detection, Diagnosis, and Staging How Is Stomach Cancer Diagnosed? Stomach cancers are usually found when ... Ask Your Doctor About Stomach Cancer? More In Stomach Cancer About Stomach Cancer Causes, Risk Factors, and ...

  1. How Is Marfan Syndrome Diagnosed?

    Science.gov (United States)

    ... common in many people. Doctors use a scoring system based on the number and type of Ghent criteria present to diagnose Marfan syndrome. Talk ... National Institutes of Health Department of Health and Human Services USA.gov

  2. How Is Thyroid Cancer Diagnosed?

    Science.gov (United States)

    ... Cancer Early Detection, Diagnosis, and Staging Tests for Thyroid Cancer Thyroid cancer may be diagnosed after a person ... Health Care Team About Thyroid Cancer? More In Thyroid Cancer About Thyroid Cancer Causes, Risk Factors, and Prevention ...

  3. How Is Ovarian Cancer Diagnosed?

    Science.gov (United States)

    ... Cancer Early Detection, Diagnosis, and Staging How Is Ovarian Cancer Diagnosed? If you have symptoms of ovarian cancer ... Ask Your Doctor About Ovarian Cancer? More In Ovarian Cancer About Ovarian Cancer Causes, Risk Factors, and Prevention ...

  4. How to diagnose cardiac tamponade

    NARCIS (Netherlands)

    van Steijn, JHM; Sleijfer, DT; van der Graaf, WTA; van der Sluis, A; Nieboer, P

    Malignant pericardial effusion is a potentially fatal complication of malignancy unless recognised and treated promptly. Patients with this condition are often difficult to diagnose. Physical examination, chest radiography and electrocardiography have poor diagnostic values in identification of

  5. Diagnosing breast cancer by using Raman spectroscopy

    Science.gov (United States)

    Haka, Abigail S.; Shafer-Peltier, Karen E.; Fitzmaurice, Maryann; Crowe, Joseph; Dasari, Ramachandra R.; Feld, Michael S.

    2005-08-01

    We employ Raman spectroscopy to diagnose benign and malignant lesions in human breast tissue based on chemical composition. In this study, 130 Raman spectra are acquired from ex vivo samples of human breast tissue (normal, fibrocystic change, fibroadenoma, and infiltrating carcinoma) from 58 patients. Data are fit by using a linear combination model in which nine basis spectra represent the morphologic and chemical features of breast tissue. The resulting fit coefficients provide insight into the chemical/morphological makeup of the tissue and are used to develop diagnostic algorithms. The fit coefficients for fat and collagen are the key parameters in the resulting diagnostic algorithm, which classifies samples according to their specific pathological diagnoses, attaining 94% sensitivity and 96% specificity for distinguishing cancerous tissues from normal and benign tissues. The excellent results demonstrate that Raman spectroscopy has the potential to be applied in vivo to accurately classify breast lesions, thereby reducing the number of excisional breast biopsies that are performed. Author contributions: M.F., J.C., R.R.D., and M.S.F. designed research; A.S.H. and K.E.S.-P. performed research; A.S.H. and M.F. analyzed data; and A.S.H. wrote the paper.This paper was submitted directly (Track II) to the PNAS office.Abbreviations: DEH, ductal epithelial hyperplasia; ROC, receiver operating characteristic; N/C, nuclear-to-cytoplasm.

  6. Nursing diagnoses in overweight adolescents

    Directory of Open Access Journals (Sweden)

    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.

  7. Challenges in diagnosing hepatic encephalopathy.

    Science.gov (United States)

    Weissenborn, K

    2015-02-01

    The term "hepatic encephalopathy" (HE) covers the neuropsychiatric syndrome associated with acute, chronic and acute-on-chronic liver disease (CLD). This paper deals with clinical features and diagnosis of HE in patients with liver cirrhosis and portal hypertension or porto-systemic shunts. The possible impact of concomitant disorders and the cirrhosis underlying liver disease upon brain function is described emphasizing the need of a detailed diagnostic work up of every individual case before diagnosing HE. Currently used methods for diagnosing minimal or covert hepatic encephalopathy are compared with regard to their sensitivity and specificity for diagnosing HE against the background of a multitude of concomitant disorders and diseases that could contribute to brain dysfunction.

  8. Rapid Urine LAM Testing Improves Diagnosis of Expectorated Smear-Negative Pulmonary Tuberculosis in an HIV-endemic Region.

    Science.gov (United States)

    Drain, Paul K; Gounder, Lilishia; Sahid, Faieza; Moosa, Mahomed-Yunus S

    2016-02-11

    We sought to determine if urine lipoarabinomannan (LAM) would improve diagnosis of pulmonary TB. We enrolled consecutive adults presenting with ≥2 TB-related symptoms, obtained one induced sputum sample for smear microscopy (AFB) and mycobacterial culture, and performed urine LAM testing (Determine(TM) TB LAM, Alere). We used culture-confirmed pulmonary TB as the gold standard, and compared accuracy with area under receiver operating characteristic curves (AUROC). Among 90 participants, 82 of 88 tested (93%) were HIV-infected with a median CD4 168/mm(3) (IQR 89-256/mm(3)). Diagnostic sensitivities of urine LAM and sputum AFB were 42.1% (95% CI 29.1-55.9%) and 21.1% (95% CI 11.4-33.9%), and increased to 52.6% (95% CI 39.0-66.0%) when combined. Sensitivity of LAM increased significantly among participants with a lower Karnofsky Performance score, anemia, hypoalbuminemia, and higher C-reactive protein. Combining LAM with AFB had an AUROC = 0.68 (95% CI 0.59-0.77), significantly better than AFB alone (AUROC=0.58; 95% CI 0.51-0.64). The combination of LAM and AFB was significantly better than AFB alone among patients with Karnofsky Performance score ≤90, hemoglobin ≤10 g/dL, albumin ≤25 g/L, C-reactive protein ≥25 mg/L, or CD4 <200/mm(3). Urine LAM testing may be most beneficial among patients with functional impairment, elevated inflammatory markers, or greater immunosuppression.

  9. Comparison of clinical and microbiological profiles in smear-positive and smear-negative cases of suspected microbial keratitis

    Directory of Open Access Journals (Sweden)

    Sharma Savitri

    2007-01-01

    Full Text Available Purpose: To examine the hypothesis that initial smear examination results have a significant bearing on the management and outcome of suspected microbial keratitis. Materials and Methods: One hundred and seventy consecutive patients with suspected microbial keratitis were included in a prospective nonrandomized comparative study and their detailed clinical and microbiological data (smears and cultures of corneal scrapings were captured on a predesigned corneal ulcer database. Patients were divided into two groups: Group 1 included 68 patients with corneal scrapings negative in smears while Group 2 included 102 patients with corneal scrapings positive in smears. The two groups were compared for their clinico-microbiological profile, management and clinical outcome. The outcome was noted at three months. Fisher′s exact test was applied for statistical analysis. Results: Cultures were sterile in 57.3% of patients in Group 1 compared to 17.6% in Group 2. Scrapings that grew S. pneumoniae , gram-negative organisms, fungi and Acanthamoeba were more often positive in smears (18.6%, 11.8%, 19.6% and 2.9% respectively. While data on duration of prior treatment was not available, prior medication made no significant difference to smear results. More (79.3% patients of Group 1 had small infiltrate size (< 25 mm[[2

  10. High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus.

    Science.gov (United States)

    Rusovich, V; Kumar, A M V; Skrahina, A; Hurevich, H; Astrauko, A; de Colombani, P; Tayler-Smith, K; Dara, M; Zachariah, R

    2014-12-21

    Contexte : Le Belarus (Europe de l'Est) est confronté à une épidémie de tuberculose multirésistante (TB-MDR). En 2012, les patients atteints de tuberculose pulmonaire (TBP) à frottis positif ont bénéficié en priorité de diagnostics moléculaires pour confirmer une TB-MDR, tandis que les patients atteints de TBP à frottis négatif (SN-PTB) ont bénéficié de méthodes conventionnelles qui retardaient souvent le diagnostic de TB-MDR de 2 à 4 mois.Objectif : Déterminer la proportion de TB-MDR parmi les patients SN-PTB enregistrés en 2012, ainsi que les facteurs cliniques et démographiques associés.Schéma : Etude de cohorte rétrospective basée sur des données émanant de tout le pays grâce au registre électronique national de la TB.Résultats : Sur 5377 cas de TB enregistrés, 2960 (55%) étaient des SN-PTB. Parmi ces derniers, 1639 (55%) avaient une culture positive, dont 768 (47%) avaient une TB-MDR : 33% (363/1084) nouveaux cas et 73% (405/555) patients déjà traités préalablement. La notion de traitement antérieur, l'âge, la région, la résidence en milieu urbain, le statut à l'égard du virus de l'immunodéficience humaine et le fait d'être retraité étaient indépendamment associés à la TB-MDR.Conclusion : Près de la moitié des patients SN-PTB à culture positive ont une TB-MDR, et dans les cas de retraitement, on arrive à plus de sept patients sur dix. La décision politique nationale d'extension des diagnostics moléculaires rapides à tous les patients TBP, y compris les patients SN-PTB, semble donc justifiée. Il est nécessaire de prendre des mesures afin d'assurer la mise en œuvre de cette priorité urgente, en raison des implications d'un diagnostic retardé à la fois pour les patients et en termes de santé publique.

  11. Immunological methods for diagnosing neurocysticercosis

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. How Is Fanconi Anemia Diagnosed?

    Science.gov (United States)

    ... 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 ...

  13. Efficient and accurate fragmentation methods.

    Science.gov (United States)

    Pruitt, Spencer R; Bertoni, Colleen; Brorsen, Kurt R; Gordon, Mark S

    2014-09-16

    Conspectus Three novel fragmentation methods that are available in the electronic structure program GAMESS (general atomic and molecular electronic structure system) are discussed in this Account. The fragment molecular orbital (FMO) method can be combined with any electronic structure method to perform accurate calculations on large molecular species with no reliance on capping atoms or empirical parameters. The FMO method is highly scalable and can take advantage of massively parallel computer systems. For example, the method has been shown to scale nearly linearly on up to 131 000 processor cores for calculations on large water clusters. There have been many applications of the FMO method to large molecular clusters, to biomolecules (e.g., proteins), and to materials that are used as heterogeneous catalysts. The effective fragment potential (EFP) method is a model potential approach that is fully derived from first principles and has no empirically fitted parameters. Consequently, an EFP can be generated for any molecule by a simple preparatory GAMESS calculation. The EFP method provides accurate descriptions of all types of intermolecular interactions, including Coulombic interactions, polarization/induction, exchange repulsion, dispersion, and charge transfer. The EFP method has been applied successfully to the study of liquid water, π-stacking in substituted benzenes and in DNA base pairs, solvent effects on positive and negative ions, electronic spectra and dynamics, non-adiabatic phenomena in electronic excited states, and nonlinear excited state properties. The effective fragment molecular orbital (EFMO) method is a merger of the FMO and EFP methods, in which interfragment interactions are described by the EFP potential, rather than the less accurate electrostatic potential. The use of EFP in this manner facilitates the use of a smaller value for the distance cut-off (Rcut). Rcut determines the distance at which EFP interactions replace fully quantum

  14. Accurate determination of antenna directivity

    DEFF Research Database (Denmark)

    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......-pattern measurements. The derivation is based on the theory of spherical wave expansion of electromagnetic fields, which also establishes a simple criterion for the required number of samples of the power density. An array antenna consisting of Hertzian dipoles is used to test the accuracy and rate of convergence...

  15. Attitudes of primary care team to diagnosing dementia.

    Science.gov (United States)

    Thomas, Hywel

    2010-04-01

    Healthcare professionals in primary care are gatekeepers to specialist services and are important in terms of ensuring access to community support and appropriate referral for the sizable number of older people with mental health problems. This literature review explores the role of primary care professionals, particularly GPs and practice nurses, in diagnosing and managing patients with dementia. It recommends that education and training are required to raise awareness of the importance of accurate diagnosis and management in primary care.

  16. Accurate ab initio spin densities

    CERN Document Server

    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...

  17. The Accurate Particle Tracer Code

    CERN Document Server

    Wang, Yulei; Qin, Hong; Yu, Zhi

    2016-01-01

    The Accurate Particle Tracer (APT) code is designed for large-scale particle simulations on dynamical systems. Based on a large variety of advanced geometric algorithms, APT possesses long-term numerical accuracy and stability, which are critical for solving multi-scale and non-linear problems. Under the well-designed integrated and modularized framework, APT serves as a universal platform for researchers from different fields, such as plasma physics, accelerator physics, space science, fusion energy research, computational mathematics, software engineering, and high-performance computation. The APT code consists of seven main modules, including the I/O module, the initialization module, the particle pusher module, the parallelization module, the field configuration module, the external force-field module, and the extendible module. The I/O module, supported by Lua and Hdf5 projects, provides a user-friendly interface for both numerical simulation and data analysis. A series of new geometric numerical methods...

  18. Accurate Modeling of Advanced Reflectarrays

    DEFF Research Database (Denmark)

    Zhou, Min

    Analysis and optimization methods for the design of advanced printed re ectarrays have been investigated, and the study is focused on developing an accurate and efficient simulation tool. For the analysis, a good compromise between accuracy and efficiency can be obtained using the spectral domain...... to the POT. The GDOT can optimize for the size as well as the orientation and position of arbitrarily shaped array elements. Both co- and cross-polar radiation can be optimized for multiple frequencies, dual polarization, and several feed illuminations. Several contoured beam reflectarrays have been designed...... 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...

  19. Accurate thickness measurement of graphene

    Science.gov (United States)

    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.

  20. Accurate thickness measurement of graphene.

    Science.gov (United States)

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

    2016-03-29

    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.

  1. A More Accurate Fourier Transform

    CERN Document Server

    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...

  2. Diagnosability issues in multiprocessor systems

    Energy Technology Data Exchange (ETDEWEB)

    Raghavan, V.

    1989-01-01

    In a seminal paper on fault diagnosis, Preparata, Metze, and Chien introduced a graph-theoretical model. Barsi, Grandoni, and Maestrini relaxed some constraints in this model to create a different model for fault diagnosis. Both these models have become the subject of intense research in the past two decades. A major open problem for these models is the question of sequential t-diagnosability-Given an arbitrary system of units and that there are no more than t faulty units in it, can we always identify at least one faulty unit The author shows that this problem is co-NP complete in both models. Recent research has shown that there are polynomial time algorithms to find the maximum number of faulty units a system can withstand and still identify all of them from a single collection of test results. He presents improved algorithms to solve this problem in both models. Using the letters n,m, and {tau} to denote the number of units, the number of tests, and the maximum number of faulty units respectively, our results can be summarized as follows: in the model of Barsi, Grandoni, and Maestrini, the algorithm has a time complexity of O(n{tau}{sup 2}/log{tau}) improving on the currently known O(n{tau}{sup 2}); in the model of Preparata, Metze, and Chien, the algorithm has a complexity of O(n{tau}{sup 2.5}) improving on the currently known O(mn{sup 1.5}). He also presents related results in the latter model, which suggest the possibility of reducing the complexity even further. Finally, he develops a general scheme for characterizing diagnosable systems. Using this scheme, he solves the open problem of characterizing t/s and sequentially t-diagnosable systems. The characterizations are then used to rederive some known results.

  3. How to diagnose acute appendicitis

    DEFF Research Database (Denmark)

    Mostbeck, Gerhard; Adam, E Jane; Nielsen, Michael Bachmann;

    2016-01-01

    Acute appendicitis (AA) is a common abdominal emergency with a lifetime prevalence of about 7 %. As the clinical diagnosis of AA remains a challenge to emergency physicians and surgeons, imaging modalities have gained major importance in the diagnostic work-up of patients with suspected AA in order...... appendicitis (AA). • Primary US for AA diagnosis will decrease ionizing radiation and cost. • Sensitivity of US to diagnose AA is lower than of CT/MRI. • Non-visualization of the appendix should lead to clinical reassessment. • Complementary MRI or CT may be performed if diagnosis remains unclear....

  4. Distal DVT: worth diagnosing? Yes.

    Science.gov (United States)

    Schellong, S M

    2007-07-01

    Much of the argument for or against diagnosis of distal deep vain thrombosis (DVT) depends on the extra effort that has to be spent on it. This review presents the data on ultrasound of paired calf veins and calf muscle veins (distal ultrasound) in terms of protocols, feasibility, reliability and expected findings. In summary, provided there is adequate and anatomically sound training of sonographers, distal ultrasound is a valid, 4-minute procedure, which can easily be added to the examination of proximal veins. The second part of the review refers to the pathophysiology of ascending DVT, which is the most common type. Adequate patient care in terms of benefit, harm and cost includes a single non-invasive examination followed by risk adopted treatment allocation. This concept ideally should be valid for any type of DVT. The data extending this concept to distal DVT can only be derived from studies that look closely at this entity (i.e. in fact diagnose distal DVT). Even before these data are available, diagnosing distal DVT at least doubles the number of symptomatic patients in which signs and symptoms can be ascribed to a definitive diagnosis, which in itself is a benefit for patient care.

  5. Peptidomic Identification of Serum Peptides Diagnosing Preeclampsia.

    Directory of Open Access Journals (Sweden)

    Qiaojun Wen

    Full Text Available We sought to identify serological markers capable of diagnosing preeclampsia (PE. We performed serum peptide analysis (liquid chromatography mass spectrometry of 62 unique samples from 31 PE patients and 31 healthy pregnant controls, with two-thirds used as a training set and the other third as a testing set. Differential serum peptide profiling identified 52 significant serum peptides, and a 19-peptide panel collectively discriminating PE in training sets (n = 21 PE, n = 21 control; specificity = 85.7% and sensitivity = 100% and testing sets (n = 10 PE, n = 10 control; specificity = 80% and sensitivity = 100%. The panel peptides were derived from 6 different protein precursors: 13 from fibrinogen alpha (FGA, 1 from alpha-1-antitrypsin (A1AT, 1 from apolipoprotein L1 (APO-L1, 1 from inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4, 2 from kininogen-1 (KNG1, and 1 from thymosin beta-4 (TMSB4. We concluded that serum peptides can accurately discriminate active PE. Measurement of a 19-peptide panel could be performed quickly and in a quantitative mass spectrometric platform available in clinical laboratories. This serum peptide panel quantification could provide clinical utility in predicting PE or differential diagnosis of PE from confounding chronic hypertension.

  6. Paraphilic diagnoses in DSM-5.

    Science.gov (United States)

    Krueger, Richard B; Kaplan, Meg S

    2012-01-01

    The DSM-5 has been under revision since 1999 and is scheduled for publication in 2013. This article will review the major proposed modifications of the Paraphilias. The information reviewed was obtained from PubMed, PsychInfo, the DSM-5.org website and other sources and reviewed. Pedohebephilia, Hypersexual Disorder and Paraphilic Coercive Disorder are new proposed diagnoses. Paraphilias have been assigned their own chapter in DSM- 5 and a distinction has been made between Paraphilias and Paraphilic Disorders. Victim numbers have been included in diagnosis of paraphilias that involve victims and remission and severity measures have been added to all paraphilias. Transvestic Disorder can apply to males or females, Fetishistic Disorder now includes partialism, and Sexual Masochism Disorder has Asphyxiophilia as a specifier. This study is based on a literature review and influenced by the knowledge and biases of the authors. The Paraphilic Disorders Section of the DSM-5 represents a significant departure from DSMIV-TR.

  7. Diagnosing Coronary Heart Disease using Ensemble Machine Learning

    Directory of Open Access Journals (Sweden)

    Kathleen H. Miao

    2016-10-01

    Full Text Available Globally, heart disease is the leading cause of death for both men and women. One in every four people is afflicted with and dies of heart disease. Early and accurate diagnoses of heart disease thus are crucial in improving the chances of long-term survival for patients and saving millions of lives. In this research, an advanced ensemble machine learning technology, utilizing an adaptive Boosting algorithm, is developed for accurate coronary heart disease diagnosis and outcome predictions. The developed ensemble learning classification and prediction models were applied to 4 different data sets for coronary heart disease diagnosis, including patients diagnosed with heart disease from Cleveland Clinic Foundation (CCF, Hungarian Institute of Cardiology (HIC, Long Beach Medical Center (LBMC, and Switzerland University Hospital (SUH. The testing results showed that the developed ensemble learning classification and prediction models achieved model accuracies of 80.14% for CCF, 89.12% for HIC, 77.78% for LBMC, and 96.72% for SUH, exceeding the accuracies of previously published research. Therefore, coronary heart disease diagnoses derived from the developed ensemble learning classification and prediction models are reliable and clinically useful, and can aid patients globally, especially those from developing countries and areas where there are few heart disease diagnostic specialists.

  8. 38 CFR 4.46 - Accurate measurement.

    Science.gov (United States)

    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...

  9. [Left pulmonary agenesis diagnosed late].

    Science.gov (United States)

    Deleanu, Oana; Pătraşcu, Natalia; Nebunoiu, Ana-Maria; Vintilă, V; Ulmeanu, Ruxandra; Mihălţan, F D

    2010-01-01

    We present the case of a 51 years old female-patient, with severe dextroscoliosis, having like unique symptom progressive dyspnea. The blood samples reveals polycythemia, the radiological exam shows the opacification of 2/3 of the left thorax, the absence of the lung structure in the other 1/3, the deviation of the mediastinum, and dextroscoliosis; the computed tomography reveals the absence of the left lung artery and the left airways, compensatory hyperinflation of the right lung and dilatation of the trunk and right pulmonary artery; the bronchoscopy does not visualize the carina or the left main bronchus, typical for pulmonary agenesis. Echocardiography confirmed the absence of left pulmonary artery and shows mild pulmonary hypertension (systolic pressure in the pulmonary artery of 33 mmHg) with dilatation of the right cavities, but good cinetics. We face a case of pulmonary agenesis lately diagnosed, with modest functional cardiologic implications, limited therapeutic options and good survival, justified by the late appearance of the pulmonary hypertension of low severity and without worsening in time.

  10. Lung ultrasonography to diagnose pneumothorax of the newborn.

    Science.gov (United States)

    Liu, Jing; Chi, Jing-Han; Ren, Xiao-Ling; Li, Jie; Chen, Ya-Juan; Lu, Zu-Lin; Liu, Ying; Fu, Wei; Xia, Rong-Ming

    2017-09-01

    To explore the reliability and accuracy of lung ultrasound for diagnosing neonatal pneumothorax. This study was divided into two phases. (1) In the first phase, from January 2013 to June 2015, 40 patients with confirmed pneumothorax had lung ultrasound examinations performed to identify the sonographic characteristics of neonatal pneumothorax. (2) In the second phase, from July 2015 to August 2016, lung ultrasound was undertaken on 50 newborn infants with severe lung disease who were suspected of having pneumothorax, to evaluate the sonographic accuracy and reliability to diagnose pneumothorax. (1) The main ultrasonic manifestations of pneumothorax are as follows: ① lung sliding disappearance, which was observed in all patients (100%); ② the existence of the pleural line and the A-line, which was also observed in all patients (100%); ③ the lung point, which was found in 75% of the infants with mild-moderate pneumothorax but not found to exist in 25% of the severe pneumothorax patients; ④ the absence of B-lines in the area of the pneumothorax (100% of the pneumothorax patients); and ⑤ no lung consolidation existed in the area of the pneumothorax (100% of the pneumothorax patients). (2) The accuracy and reliability of the lung sonographic signs of lung sliding disappearance as well as the existence of the pleural line and the A-line in diagnosing pneumothorax were as follows: 100% sensitivity, 100% specificity, 100% positive predictive value, and 100% negative predictive value. When the lung point exists, the diagnosis is mild-moderate pneumothorax, whereas if no lung point exists, the diagnosis is severe pneumothorax. Lung ultrasound is accurate and reliable in diagnosing and ruling out neonatal pneumothorax and, in our study, was found to be as accurate as chest X-ray. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. HIV Trends in the United States: Diagnoses and Estimated Incidence

    Science.gov (United States)

    Song, Ruiguang; Tang, Tian; An, Qian; Prejean, Joseph; Dietz, Patricia; Hernandez, Angela L; Green, Timothy; Harris, Norma; McCray, Eugene; Mermin, Jonathan

    2017-01-01

    Background The best indicator of the impact of human immunodeficiency virus (HIV) prevention programs is the incidence of infection; however, HIV is a chronic infection and HIV diagnoses may include infections that occurred years before diagnosis. Alternative methods to estimate incidence use diagnoses, stage of disease, and laboratory assays of infection recency. Using a consistent, accurate method would allow for timely interpretation of HIV trends. Objective The objective of our study was to assess the recent progress toward reducing HIV infections in the United States overall and among selected population segments with available incidence estimation methods. Methods Data on cases of HIV infection reported to national surveillance for 2008-2013 were used to compare trends in HIV diagnoses, unadjusted and adjusted for reporting delay, and model-based incidence for the US population aged ≥13 years. Incidence was estimated using a biomarker for recency of infection (stratified extrapolation approach) and 2 back-calculation models (CD4 and Bayesian hierarchical models). HIV testing trends were determined from behavioral surveys for persons aged ≥18 years. Analyses were stratified by sex, race or ethnicity (black, Hispanic or Latino, and white), and transmission category (men who have sex with men, MSM). Results On average, HIV diagnoses decreased 4.0% per year from 48,309 in 2008 to 39,270 in 2013 (P<.001). Adjusting for reporting delays, diagnoses decreased 3.1% per year (P<.001). The CD4 model estimated an annual decrease in incidence of 4.6% (P<.001) and the Bayesian hierarchical model 2.6% (P<.001); the stratified extrapolation approach estimated a stable incidence. During these years, overall, the percentage of persons who ever had received an HIV test or had had a test within the past year remained stable; among MSM testing increased. For women, all 3 incidence models corroborated the decreasing trend in HIV diagnoses, and HIV diagnoses and 2 incidence

  12. Sixty-five thousand shades of gray: importance of color in surgical pathology diagnoses.

    Science.gov (United States)

    Campbell, W Scott; Talmon, Geoffrey A; Foster, Kirk W; Lele, Subodh M; Kozel, Jessica A; West, William W

    2015-12-01

    Digital whole slide imaging (WSI) is a diagnostic modality that has gained acceptance as a tool for use in some areas of surgical pathology such as remote consultations. Accurate control of color representation of digitally rendered images of histologic sections is considered an important parameter of WSI. Currently, professional societies, physicians, and other stakeholders are in the process of establishing clinical guidelines outlining the use of these devices, which include color integrity and color calibration of scanners and viewing devices. Although color is a component of surgical pathology diagnoses, it was posited that pathologists could accurately diagnose surgical specimens without color. To test this hypothesis, 5 pathologists were presented breast biopsy specimens from 20 patients consisting of 22 separate tissue specimens and WSI of 158 hematoxylin and eosin-stained slides imaged at ×20. No special stains were included. The pathologists reviewed each case using a 16-bit grayscale monitor and rendered a diagnosis for each case. Diagnoses were compared to the original light microscopy diagnoses and scored for concordance. A 92.7% concordance was observed. Discordant diagnoses represented well-known areas of diagnostic disagreement in breast pathology as well as known limitations of WSI. The research demonstrated that surgical pathologists did not rely primarily on color to render accurate diagnoses of breast biopsy cases but rather used architectural features of tissue and cellular morphology to reach a diagnostic conclusion. This research did not suggest that color is an unimportant factor in pathology diagnosis, but its importance may be overstated.

  13. Novel approaches in diagnosing tuberculosis

    Science.gov (United States)

    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.

  14. Are Pediatricians Diagnosing Obese Children?

    Science.gov (United States)

    Thomas, Katharine; Urrego, Fernando

    2017-01-01

    Background: Pediatric obesity is the most prevalent nutritional disorder in American children. The detrimental social, psychological, and physiological effects of obesity call for pediatricians to address this health concern. The literature demonstrates that clinicians are underreporting the diagnosis of obesity in the pediatric setting. The primary purpose of this study was to determine if pediatricians at one pediatrics clinic in the Ochsner Health System are documenting the presence of an overweight or obese body mass index (BMI) as a diagnosis in the medical record. A secondary purpose of this study was to determine the demographics of all pediatric patients in the Ochsner Health System to be used for program development. Methods: A retrospective medical record review was conducted. Records from April 1, 2012 to April 1, 2016, were reviewed for the presence of the diagnosis of BMI classified as obese or overweight. Results: We analyzed a total of 175,066 records in this study. Of these records, 1.32% documented a diagnosis of obesity, and 0.5% documented a BMI score indicating overweight. The percentages of patient visits that met the Centers for Disease Control and Prevention criteria to be classified as obese or overweight were 28.66% and 30.41%, respectively. The majority of our pediatric patients were male (51.76%), white (43.31%), and 5-12 years old (43.80%). Conclusion: This study demonstrates that pediatricians at Ochsner Health Center for Children are not diagnosing patients who have unhealthy BMI scores as overweight or obese. Interventions are needed to increase the identification of children who may benefit from receiving resources that encourage a healthy lifestyle and optimal weight maintenance. PMID:28331453

  15. Diagnosing bilectal children with SLI: Determination of identification accuracy.

    Science.gov (United States)

    Theodorou, Eleni; Kambanaros, Maria; Grohmann, Kleanthes K

    2016-01-01

    Very little is known about diagnosing specific language impairment (SLI) in children who are exposed daily to a dialect (community language) and a standard variety (school instruction). The research reported here examines the specificity and sensitivity of language tests used so far to evaluate language performance in the context of diglossia (Cyprus). Sixteen children with SLI aged 5-9 years and 22 age-matched typically developing children were examined on a range of language tests modified to include dialectal differences. Properties of each test were evaluated through logistic regression analysis in order to identify children with SLI. The analysis revealed that many of the tests used are sufficiently accurate concerning sensitivity and specificity levels. Furthermore, a combination of tests is proposed as a good tool for diagnostic purposes. Speech and language therapists as well as researchers can now rely on an accurate diagnostic procedure within a practice-based evidence framework.

  16. Sequential Window Diagnoser for Discrete-Event Systems Under Unreliable Observations

    Energy Technology Data Exchange (ETDEWEB)

    Wen-Chiao Lin; Humberto E. Garcia; David Thorsley; Tae-Sic Yoo

    2009-09-01

    This paper addresses the issue of counting the occurrence of special events in the framework of partiallyobserved discrete-event dynamical systems (DEDS). Developed diagnosers referred to as sequential window diagnosers (SWDs) utilize the stochastic diagnoser probability transition matrices developed in [9] along with a resetting mechanism that allows on-line monitoring of special event occurrences. To illustrate their performance, the SWDs are applied to detect and count the occurrence of special events in a particular DEDS. Results show that SWDs are able to accurately track the number of times special events occur.

  17. Challenges in diagnosing narcolepsy without cataplexy: a consensus statement.

    Science.gov (United States)

    Baumann, Christian R; Mignot, Emmanuel; Lammers, Gert Jan; Overeem, Sebastiaan; Arnulf, Isabelle; Rye, David; Dauvilliers, Yves; Honda, Makoto; Owens, Judith A; Plazzi, Giuseppe; Scammell, Thomas E

    2014-06-01

    Diagnosing narcolepsy without cataplexy is often a challenge as the symptoms are nonspecific, current diagnostic tests are limited, and there are no useful biomarkers. In this report, we review the clinical and physiological aspects of narcolepsy without cataplexy, the limitations of available diagnostic procedures, and the differential diagnoses, and we propose an approach for more accurate diagnosis of narcolepsy without cataplexy. A group of clinician-scientists experienced in narcolepsy reviewed the literature and convened to discuss current diagnostic tools, and to map out directions for research that should lead to a better understanding and more accurate diagnosis of narcolepsy without cataplexy. To aid in the identification of narcolepsy without cataplexy, we review key indicators of narcolepsy and present a diagnostic algorithm. A detailed clinical history is mainly helpful to rule out other possible causes of chronic sleepiness. The multiple sleep latency test remains the most important measure, and prior sleep deprivation, shift work, or circadian disorders should be excluded by actigraphy or sleep logs. A short REM sleep latency (≤ 15 minutes) on polysomnography can aid in the diagnosis of narcolepsy without cataplexy, although sensitivity is low. Finally, measurement of hypocretin levels can helpful, as levels are low to intermediate in 10% to 30% of narcolepsy without cataplexy patients.

  18. From experience: applying the risk diagnosing methodology

    NARCIS (Netherlands)

    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

  19. De dokter en de diagnose-verzamelaar

    NARCIS (Netherlands)

    Geersing, Geert-Jan

    2015-01-01

    In the course of the medical curriculum, medical students are trained to recognise diagnoses. They classify these in their minds, together with detailed information on laboratory and imaging tests, as collections of diagnoses. The downside of this could be overdiagnosis. This paper describes some of

  20. From experience: applying the risk diagnosing methodology

    NARCIS (Netherlands)

    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

  1. Reliability of clinical ICD-10 schizophrenia diagnoses

    DEFF Research Database (Denmark)

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

    2005-01-01

    value (87%) of ICD-10 schizophrenia and an overall good agreement between clinical and OPCRIT-derived diagnoses (kappa=0.60). An even higher positive predictive value was obtained when diagnoses were amalgamated into a diagnostic entity of schizophrenia-spectrum disorders (98%). Near perfect agreement...

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

    Science.gov (United States)

    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.

  3. Concoradance of clinical and neurophysiologic diagnoses of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Martić Vesna

    2015-01-01

    Full Text Available Introduction/Aim. Clinical presentation and neurophysiological examination are crucial in diagnosing carpal tunnel syndrome (CTS. The aim of this study was to determine sensitivity and specificity of clinical examination for diagnosing of CTS in relation to neurophysiological evaluation. Methods. The sample included 181 patients referred to the neurologist for further diagnosis of pain and parestesias in the arm (81 women and 100 men mean age 42 ± 14 years and 52 ± 16 years, respectively. All the patients were neurophysiologicly tested. Results. Out of 181 patients, clinical findings were considered positive for CTS in 37 patients. The neurophysiological findings for CTS were positive in 60 patients. Both clinical and neurophysiological findings were positive in 31 patients and both findings were negative in 115 patients (sensitivity 0,51; specificity 0,95. Conclusion. Low sensitivity and high specificity suggest that it is easier to exclude rather than to accurately diagnose CTS based on clinical examination alone. Thus, there is the need for neurophysiological evaluation of patients with complains in the arm.

  4. Laboratory Building for Accurate Determination of Plutonium

    Institute of Scientific and Technical Information of China (English)

    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

  5. Establishing magnetic resonance imaging as an accurate and reliable tool to diagnose and monitor esophageal cancer in a rat model.

    Directory of Open Access Journals (Sweden)

    Juliann E Kosovec

    Full Text Available OBJECTIVE: To assess the reliability of magnetic resonance imaging (MRI for detection of esophageal cancer in the Levrat model of end-to-side esophagojejunostomy. BACKGROUND: The Levrat model has proven utility in terms of its ability to replicate Barrett's carcinogenesis by inducing gastroduodenoesophageal reflux (GDER. Due to lack of data on the utility of non-invasive methods for detection of esophageal cancer, treatment efficacy studies have been limited, as adenocarcinoma histology has only been validated post-mortem. It would therefore be of great value if the validity and reliability of MRI could be established in this setting. METHODS: Chronic GDER reflux was induced in 19 male Sprague-Dawley rats using the modified Levrat model. At 40 weeks post-surgery, all animals underwent endoscopy, MRI scanning, and post-mortem histological analysis of the esophagus and anastomosis. With post-mortem histology serving as the gold standard, assessment of presence of esophageal cancer was made by five esophageal specialists and five radiologists on endoscopy and MRI, respectively. RESULTS: The accuracy of MRI and endoscopic analysis to correctly identify cancer vs. no cancer was 85.3% and 50.5%, respectively. ROC curves demonstrated that MRI rating had an AUC of 0.966 (p<0.001 and endoscopy rating had an AUC of 0.534 (p = 0.804. The sensitivity and specificity of MRI for identifying cancer vs. no-cancer was 89.1% and 80% respectively, as compared to 45.5% and 57.5% for endoscopy. False positive rates of MRI and endoscopy were 20% and 42.5%, respectively. CONCLUSIONS: MRI is a more reliable diagnostic method than endoscopy in the Levrat model. The non-invasiveness of the tool and its potential to volumetrically quantify the size and number of tumors likely makes it even more useful in evaluating novel agents and their efficacy in treatment studies of esophageal cancer.

  6. Cardiopulmonary exercise testing is more accurate than ECG-stress testing in diagnosing myocardial ischemia in subjects with chest pain.

    Science.gov (United States)

    Belardinelli, Romualdo; Lacalaprice, Francesca; Tiano, Luca; Muçai, Andi; Perna, Gian Piero

    2014-06-15

    Cardiopulmonary exercise stress testing (CPET) is used to grade the severity of heart failure and to assess its prognosis. However it is unknown whether CPET may improve diagnostic accuracy of standard ECG stress testing to identify or exclude obstructive coronary artery disease (O-CAD) in patients with chest pain. We prospectively studied 1265 consecutive subjects (55 ± 8 years, 156 women) who were evaluated with ECG stress testing (ET) for chest pain. No one had a documented O-CAD. All patients performed an incremental CPET with ECG recordings on an electronically braked cycle ergometer. Of 1265 patients, 73 had a positive CPET and 1192 had a negative CPET. Seventy-three patients with a positive CPET and 71 patients with a negative CPET agreed to undergo nuclear SPECT imaging and coronary angiography. Follow-up lasted 48 ± 7 months. As compared with ET, sensitivity, specificity, PPV and NPV were all improved significantly (ET: 48%, 55%, 33%, 95%; CPET: 88%, 98%, 73%, 99%, respectively, PVO2>91% of predicted VO2 max and absence of VO2-related signs of myocardial ischemia had no evidence of O-CAD in 100% of cases. Cardiac events occurred in 32 patients with a positive CPET and 8 patients with a negative CPET (log rank 18.2, P<0.0001). In patients with chest pain, CPET showed a better diagnostic and predictive accuracy than traditional ET to detect/exclude myocardial ischemia. Its use should be encouraged among physicians as a first line diagnostic tool in clinical practice. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Understanding the Code: keeping accurate records.

    Science.gov (United States)

    Griffith, Richard

    2015-10-01

    In his continuing series looking at the legal and professional implications of the Nursing and Midwifery Council's revised Code of Conduct, Richard Griffith discusses the elements of accurate record keeping under Standard 10 of the Code. This article considers the importance of accurate record keeping for the safety of patients and protection of district nurses. The legal implications of records are explained along with how district nurses should write records to ensure these legal requirements are met.

  8. Prevalence and Incidence of Diagnosed Chronic Rhinosinusitis in Alberta, Canada.

    Science.gov (United States)

    Xu, Yuan; Quan, Hude; Faris, Peter; Garies, Stephanie; Liu, Mingfu; Bird, Ceris; Kukec, Edward; Dean, Stafford; Rudmik, Luke

    2016-11-01

    Reported prevalence rates of chronic rhinosinusitis (CRS) range from 1% to 12% worldwide. To facilitate appropriate health service delivery and resource allocation, it is important to improve the estimated burden of CRS to the health care system. To assess the prevalence and incidence of diagnosed CRS in Alberta, Canada, from the perspective of the health care system and to evaluate the 10-year temporal trend and geographic variation of diagnosed CRS. From provincial-wide physicians' claim data, a CRS cohort was identified using a validated case definition. The population at the midpoint (2008-2009) of the study period (2 925 930) was used as the reference. The crude as well as age- and sex-standardized incidence and prevalence rates were calculated. The age-specific incidence and prevalence by sex were also assessed in each study year. Small-area variation analysis was conducted using extremal quotient, weighted coefficient of variation, χ2 statistic, systematic component of variation, and empirical Bayes variance estimate. Of the 2 925 930 individuals in the study at midpoint (2008-2009), 1 451 261 (49.6%) were women, and the mean (SD) age was 45 (17) years. From fiscal year 2004-2005 to fiscal year 2013-2014, the mean age- and sex-standardized incidence of diagnosed CRS was 2.5 (range, 2.3-2.7) per 1000 population. The estimated prevalence based on age-specific incidence varied between 18.8 (95% CI, 18.7-18.9) and 23.3 (95% CI, 23.1-23.5) per 1000 population during 2004-2005 to 2013-2014, and no obvious growing trend was found. There was high geographic variation in the diagnosed incidence and prevalence of CRS (mean systematic component of variation, 19.4 and 12.3, respectively). Although the incidence and prevalence rates of diagnosed CRS were lower compared with earlier published estimates obtained from population-based survey analysis, outcomes from this study may more accurately reflect the disease burden of CRS to the health care system. Given

  9. Diagnosing Asthma in Very Young Children

    Science.gov (United States)

    ... 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 ...

  10. How Are Pelvic Floor Disorders Diagnosed?

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications How are pelvic floor disorders diagnosed? Skip sharing on social media links ... fee ). This test is used to evaluate the pelvic floor and rectum while the patient is having a ...

  11. How Are Overweight and Obesity Diagnosed?

    Science.gov (United States)

    ... body mass index (BMI) and possibly a high waist circumference, and tests to rule out other medical conditions. ... diagnosed as obese if you have a large waist circumference that suggests increased amounts of fat in your ...

  12. How Are Soft Tissue Sarcomas Diagnosed?

    Science.gov (United States)

    ... type of cancer or a benign disease. Several types of biopsies are used to diagnose sarcomas. Doctors experienced with ... But if FNA results suggest a sarcoma, another type of biopsy will usually be done to remove enough tissue ...

  13. How Are Obesity and Overweight Diagnosed?

    Science.gov (United States)

    ... Clinical Trials Resources and Publications How are obesity & overweight diagnosed? Skip sharing on social media links Share ... common way to determine if a person is overweight or obese is to calculate body mass index ( ...

  14. Challenges in diagnosing tuberculosis in children

    DEFF Research Database (Denmark)

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

    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....

  15. Accurate tracking control in LOM application

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    The fabrication of accurate prototype from CAD model directly in short time depends on the accurate tracking control and reference trajectory planning in (Laminated Object Manufacture) LOM application. An improvement on contour accuracy is acquired by the introduction of a tracking controller and a trajectory generation policy. A model of the X-Y positioning system of LOM machine is developed as the design basis of tracking controller. The ZPETC (Zero Phase Error Tracking Controller) is used to eliminate single axis following error, thus reduce the contour error. The simulation is developed on a Maltab model based on a retrofitted LOM machine and the satisfied result is acquired.

  16. The puzzling unidimensionality of DSM-5 substance use disorder diagnoses

    Directory of Open Access Journals (Sweden)

    Robert J MacCoun

    2013-11-01

    Full Text Available There is a perennial expert debate about the criteria to be included or excluded for the DSM diagnoses of substance use dependence. Yet analysts routinely report evidence for the unidimensionality of the resulting checklist. If in fact the checklist is unidimensional, the experts are wrong that the criteria are distinct, so either the experts are mistaken or the reported unidimensionality is spurious. I argue for the latter position, and suggest that the traditional reflexive measurement model is inappropriate for the DSM; a formative measurement model would be a more accurate characterization of the institutional process by which the checklist is created, and a network or causal model would be a more appropriate foundation for a scientifically grounded diagnostic system.

  17. Fast and accurate methods for phylogenomic analyses

    Directory of Open Access Journals (Sweden)

    Warnow Tandy

    2011-10-01

    Full Text Available Abstract Background Species phylogenies are not estimated directly, but rather through phylogenetic analyses of different gene datasets. However, true gene trees can differ from the true species tree (and hence from one another due to biological processes such as horizontal gene transfer, incomplete lineage sorting, and gene duplication and loss, so that no single gene tree is a reliable estimate of the species tree. Several methods have been developed to estimate species trees from estimated gene trees, differing according to the specific algorithmic technique used and the biological model used to explain differences between species and gene trees. Relatively little is known about the relative performance of these methods. Results We report on a study evaluating several different methods for estimating species trees from sequence datasets, simulating sequence evolution under a complex model including indels (insertions and deletions, substitutions, and incomplete lineage sorting. The most important finding of our study is that some fast and simple methods are nearly as accurate as the most accurate methods, which employ sophisticated statistical methods and are computationally quite intensive. We also observe that methods that explicitly consider errors in the estimated gene trees produce more accurate trees than methods that assume the estimated gene trees are correct. Conclusions Our study shows that highly accurate estimations of species trees are achievable, even when gene trees differ from each other and from the species tree, and that these estimations can be obtained using fairly simple and computationally tractable methods.

  18. Accurate Switched-Voltage voltage averaging circuit

    OpenAIRE

    金光, 一幸; 松本, 寛樹

    2006-01-01

    Abstract ###This paper proposes an accurate Switched-Voltage (SV) voltage averaging circuit. It is presented ###to compensated for NMOS missmatch error at MOS differential type voltage averaging circuit. ###The proposed circuit consists of a voltage averaging and a SV sample/hold (S/H) circuit. It can ###operate using nonoverlapping three phase clocks. Performance of this circuit is verified by PSpice ###simulations.

  19. Accurate overlaying for mobile augmented reality

    NARCIS (Netherlands)

    Pasman, W; van der Schaaf, A; Lagendijk, RL; Jansen, F.W.

    1999-01-01

    Mobile augmented reality requires accurate alignment of virtual information with objects visible in the real world. We describe a system for mobile communications to be developed to meet these strict alignment criteria using a combination of computer vision. inertial tracking and low-latency renderi

  20. Accurate overlaying for mobile augmented reality

    NARCIS (Netherlands)

    Pasman, W; van der Schaaf, A; Lagendijk, RL; Jansen, F.W.

    1999-01-01

    Mobile augmented reality requires accurate alignment of virtual information with objects visible in the real world. We describe a system for mobile communications to be developed to meet these strict alignment criteria using a combination of computer vision. inertial tracking and low-latency

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

    Directory of Open Access Journals (Sweden)

    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

  2. Diagnosing tuberculosis with a novel support vector machine-based artificial immune recognition system.

    Science.gov (United States)

    Saybani, Mahmoud Reza; Shamshirband, Shahaboddin; Golzari Hormozi, Shahram; Wah, Teh Ying; Aghabozorgi, Saeed; Pourhoseingholi, Mohamad Amin; Olariu, Teodora

    2015-04-01

    Tuberculosis (TB) is a major global health problem, which has been ranked as the second leading cause of death from an infectious disease worldwide. Diagnosis based on cultured specimens is the reference standard, however results take weeks to process. Scientists are looking for early detection strategies, which remain the cornerstone of tuberculosis control. Consequently there is a need to develop an expert system that helps medical professionals to accurately and quickly diagnose the disease. Artificial Immune Recognition System (AIRS) has been used successfully for diagnosing various diseases. However, little effort has been undertaken to improve its classification accuracy. In order to increase the classification accuracy of AIRS, this study introduces a new hybrid system that incorporates a support vector machine into AIRS for diagnosing tuberculosis. Patient epacris reports obtained from the Pasteur laboratory of Iran were used as the benchmark data set, with the sample size of 175 (114 positive samples for TB and 60 samples in the negative group). The strategy of this study was to ensure representativeness, thus it was important to have an adequate number of instances for both TB and non-TB cases. The classification performance was measured through 10-fold cross-validation, Root Mean Squared Error (RMSE), sensitivity and specificity, Youden's Index, and Area Under the Curve (AUC). Statistical analysis was done using the Waikato Environment for Knowledge Analysis (WEKA), a machine learning program for windows. With an accuracy of 100%, sensitivity of 100%, specificity of 100%, Youden's Index of 1, Area Under the Curve of 1, and RMSE of 0, the proposed method was able to successfully classify tuberculosis patients. There have been many researches that aimed at diagnosing tuberculosis faster and more accurately. Our results described a model for diagnosing tuberculosis with 100% sensitivity and 100% specificity. This model can be used as an additional tool for

  3. Pulmonary mycoses diagnosed using exfoliative cytology: infection or colonization?

    Science.gov (United States)

    Singh, Lavleen; Jain, Deepali; Madan, Karan; Mathur, Sandeep R; Chatterjee, Priti; Guleria, Randeep; Iyer, Venkateswaran K

    2013-01-01

    Flexible bronchoscopy with exfoliative cytology is an important tool for the diagnosis of pulmonary fungal infections. The question of colonization versus true fungal infection is of critical importance. A 5-year retrospective analysis of all cases of pulmonary fungal infection diagnosed using exfoliative cytology was performed. Clinical, radiological, bronchoscopy and histopathology findings were recorded. A total of 69 cases of mycoses were retrieved. The most common fungal organism identified was Aspergillus followed by Candida and Pneumocystis. Most cases of Aspergillus and Candida in cytological specimens presented as a pulmonary mass or endobronchial growth and were diagnosed as carcinomas in biopsy specimens, thus representing colonization. All cases of Pneumocystis with bilateral ground glass infiltrates and cryptococcosis with parenchymal mass lesion in radiology represented true infection. Histoplasma was identified in pleural fluid from a known case of lung carcinoma. Aspergillus and Candida species are the most common fungal organisms. Most of these represent colonization of malignant growths. However, true fungal infections may also present as mass lesions and may masquerade malignancy clinically. Fluid cytological examination is an important diagnostic modality for pulmonary mycoses; however, it is important to correlate results with clinical, bronchoscopy and biopsy findings for accurate diagnosis and appropriate management.

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

    Science.gov (United States)

    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.

  5. Transition-Aged Youths With Dual Diagnoses.

    Science.gov (United States)

    Kalinyak, Christopher M; Gary, Faye A; Killion, Cheryl M; Suresky, M Jane

    2016-03-01

    The current study provides an overview of the research knowledge about unique problems encountered by transition-aged youths with dual diagnoses. A description of the considerable physical and emotional changes experienced by transition-aged youths provides a foundation for exploring the pressures and challenges compounded by mental health issues and substance abuse. Programs that provide intensive support throughout the transition years pay valuable dividends. However, transition-aged youths with dual diagnoses of mental disorders and substance abuse find themselves faced with limited or nonexistent options. There is a confusing lack of continuity and consistency of supports and services, which complicates the already perplexing circumstances that beleaguer the lives of young adults with dual diagnoses. Copyright 2016, SLACK Incorporated.

  6. Pulmonary embolus diagnosed by endobronchial ultrasound

    Directory of Open Access Journals (Sweden)

    Justin M. Segraves

    2015-01-01

    Full Text Available Endobronchial ultrasound (EBUS imaging is commonly used to evaluate and aid in biopsy of mediastinal lymph nodes. Pulmonary arteries are readily viewable with this type of imaging modality. We present a case report of a pulmonary embolism (PE diagnosed by EBUS. Our patient had no smoking history and presented with respiratory and constitutional symptoms, urinary retention, and leg weakness suspicious for malignancy with metastasis to spine. Chest computed tomography (CT was suggestive of lung carcinoma and specifically showed no PE. EBUS with TBNA was requested for tissue diagnosis. A mobile filling defect consistent with a PE was observed and reported to primary team. Follow-up chest CT showed an acute PE which confirmed the diagnosis originally made by EBUS. Bronchoscopists should be aware of potential to diagnose a PE while performing EBUS. Additionally, there may be a role in using EBUS specifically to diagnose a PE in the right patient population.

  7. Anterior diffuse scleritis diagnosed as conjunctivitis

    Directory of Open Access Journals (Sweden)

    K. P. Mashige

    2012-12-01

    Full Text Available This article presents a case of anterior diffuse scleritis that initially was diagnosed as conjunctivitis. Anterior diffuse scleritis (ADS is a potentially vision-threatening inflammation of the sclera whose etiology may include autoimmune and systemic conditions such as rheumatoid arthritis and tuberculosis. The signs and symptoms of ADS include pain, tearing, tenderness, redness, painful sensitivity to light and decreased visual acuity. Ocular and physical examinations including blood tests to rule out underlying causes are important. Medications such as corticosteroids, non-steroidal anti-inflam-matory drugs and possibly immune-suppressants are used in the management of ADS. If care is not taken, ADS can be mis-diagnosed as conjunctivitis because the redness is similar in both conditions. Such mis-diagnosis can be sight-threatening and therefore it is essential that primary eye care practitioners are cautious in all diagnoses of red eye conditions. (S Afr Optom 2012 71(1 51-54

  8. Reliability of clinical ICD-10 schizophrenia diagnoses

    DEFF Research Database (Denmark)

    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...... value (87%) of ICD-10 schizophrenia and an overall good agreement between clinical and OPCRIT-derived diagnoses (kappa=0.60). An even higher positive predictive value was obtained when diagnoses were amalgamated into a diagnostic entity of schizophrenia-spectrum disorders (98%). Near perfect agreement...... 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....

  9. Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors.

    Science.gov (United States)

    Song, In Hye; Song, Joon Seon; Sung, Chang Ohk; Roh, Jong-Lyel; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon; Lee, Jeong Hyun; Baek, Jung Hwan; Cho, Kyung-Ja

    2015-03-01

    Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.

  10. Accurate diagnosis of CHD by Paediatricians with Expertise in Cardiology.

    Science.gov (United States)

    Jacob, Hannah C; Massey, Hannah; Yates, Robert W M; Kelsall, A Wilfred

    2017-08-01

    Introduction Paediatricians with Expertise in Cardiology assess children with a full history, examination, and often perform an echocardiogram. A minority are then referred to an outreach clinic run jointly with a visiting paediatric cardiologist. The accuracy of the echocardiography diagnosis made by the Paediatrician with Expertise in Cardiology is unknown. Materials and methods We conducted a retrospective review of clinic letters for children seen in the outreach clinic for the first time between March, 2004 and March, 2011. Children with CHD diagnosed antenatally or elsewhere were excluded. We recorded the echocardiography diagnosis made by the paediatric cardiologist and previously by the Paediatrician with Expertise in Cardiology. The Paediatrician with Expertise in Cardiology referred 317/3145 (10%) children seen in the local cardiac clinics to the outreach clinic over this period, and among them 296 were eligible for inclusion. Their median age was 1.5 years (range 1 month-15.1 years). For 244 (82%) children, there was complete diagnostic agreement between the Paediatrician with Expertise in Cardiology and the paediatric cardiologist. For 29 (10%) children, the main diagnosis was identical with additional findings made by the paediatric cardiologist. The abnormality had resolved in 17 (6%) cases by the time of clinic attendance. In six (2%) patients, the paediatric cardiologist made a different diagnosis. In total, 138 (47%) patients underwent a surgical or catheter intervention. Discussion Paediatricians with Expertise in Cardiology can make accurate diagnoses of CHD in children referred to their clinics. This can allow effective triage of children attending the outreach clinic, making best use of limited specialist resources.

  11. Aggression, ADHD symptoms, and dysphoria in children and adolescents diagnosed with bipolar disorder and ADHD.

    Science.gov (United States)

    Doerfler, Leonard A; Connor, Daniel F; Toscano, Peter F

    2011-06-01

    This study had two objectives: (1) examine characteristics of aggression in children and adolescents diagnosed with bipolar disorder and (2) determine whether the CBCL pediatric bipolar disorder profile differentiated youngsters with bipolar disorder from youngsters with ADHD. Children and adolescents referred to a pediatric psychopharmacology clinic were systematically evaluated for psychopathology using a psychiatrist-administered diagnostic interview, parent- and teacher-report rating scales assessing the child's behavior, and child-completed self-report scales. In this sample, 27 children and adolescents were diagnosed with bipolar disorder and 249 youngsters were diagnosed with ADHD without co-occurring bipolar disorder. These two groups were compared to determine whether there were significant differences on various measures of psychopathology. Youngsters diagnosed with bipolar disorder were more verbally aggressive and exhibited higher levels of reactive aggression than youngsters with ADHD without co-occurring bipolar disorder. Youngsters with bipolar disorder also reported higher levels of depressive symptoms than youngsters with ADHD without bipolar disorder. The CBCL pediatric bipolar disorder profile did not accurately identify youngsters diagnosed with bipolar disorder. The present findings present a picture of manic youngsters as verbally aggressive and argumentative, who respond with anger when frustrated. Youngsters diagnosed with bipolar disorder and ADHD exhibited significant levels of impulsive behavior and attention problems, but youngsters with bipolar disorder also exhibited significant levels of aggressive behavior and dysphoric mood. Finally, the CBCL pediatric bipolar disorder profile did not accurately identify youngsters who were diagnosed with bipolar disorder. Copyright © 2010 Elsevier B.V. All rights reserved.

  12. How Is Idiopathic Pulmonary Fibrosis Diagnosed?

    Science.gov (United States)

    ... sent to a laboratory, where its oxygen and carbon dioxide levels are measured. This test is more accurate than ... a more precise measure of the oxygen and carbon dioxide levels in your blood. Your doctor also may ask ...

  13. Accurate estimation of indoor travel times

    DEFF Research Database (Denmark)

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

    2014-01-01

    The ability to accurately estimate indoor travel times is crucial for enabling improvements within application areas such as indoor navigation, logistics for mobile workers, and facility management. In this paper, we study the challenges inherent in indoor travel time estimation, and we propose...... 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...

  14. Accurate colorimetric feedback for RGB LED clusters

    Science.gov (United States)

    Man, Kwong; Ashdown, Ian

    2006-08-01

    We present an empirical model of LED emission spectra that is applicable to both InGaN and AlInGaP high-flux LEDs, and which accurately predicts their relative spectral power distributions over a wide range of LED junction temperatures. We further demonstrate with laboratory measurements that changes in LED spectral power distribution with temperature can be accurately predicted with first- or second-order equations. This provides the basis for a real-time colorimetric feedback system for RGB LED clusters that can maintain the chromaticity of white light at constant intensity to within +/-0.003 Δuv over a range of 45 degrees Celsius, and to within 0.01 Δuv when dimmed over an intensity range of 10:1.

  15. Accurate guitar tuning by cochlear implant musicians.

    Directory of Open Access Journals (Sweden)

    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.

  16. Synthesizing Accurate Floating-Point Formulas

    OpenAIRE

    Ioualalen, Arnault; Martel, Matthieu

    2013-01-01

    International audience; Many critical embedded systems perform floating-point computations yet their accuracy is difficult to assert and strongly depends on how formulas are written in programs. In this article, we focus on the synthesis of accurate formulas mathematically equal to the original formulas occurring in source codes. In general, an expression may be rewritten in many ways. To avoid any combinatorial explosion, we use an intermediate representation, called APEG, enabling us to rep...

  17. Efficient Accurate Context-Sensitive Anomaly Detection

    Institute of Scientific and Technical Information of China (English)

    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.

  18. Accurate Control of Josephson Phase Qubits

    Science.gov (United States)

    2016-04-14

    61 ~1986!. 23 K. Kraus, States, Effects, and Operations: Fundamental Notions of Quantum Theory, Lecture Notes in Physics , Vol. 190 ~Springer-Verlag... PHYSICAL REVIEW B 68, 224518 ~2003!Accurate control of Josephson phase qubits Matthias Steffen,1,2,* John M. Martinis,3 and Isaac L. Chuang1 1Center...for Bits and Atoms and Department of Physics , MIT, Cambridge, Massachusetts 02139, USA 2Solid State and Photonics Laboratory, Stanford University

  19. On accurate determination of contact angle

    Science.gov (United States)

    Concus, P.; Finn, R.

    1992-01-01

    Methods are proposed that exploit a microgravity environment to obtain highly accurate measurement of contact angle. These methods, which are based on our earlier mathematical results, do not require detailed measurement of a liquid free-surface, as they incorporate discontinuous or nearly-discontinuous behavior of the liquid bulk in certain container geometries. Physical testing is planned in the forthcoming IML-2 space flight and in related preparatory ground-based experiments.

  20. Accurate guitar tuning by cochlear implant musicians.

    Science.gov (United States)

    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 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.

  1. Accurate integration of forced and damped oscillators

    OpenAIRE

    García Alonso, Fernando Luis; Cortés Molina, Mónica; Villacampa, Yolanda; Reyes Perales, José Antonio

    2016-01-01

    The new methods accurately integrate forced and damped oscillators. A family of analytical functions is introduced known as T-functions which are dependent on three parameters. The solution is expressed as a series of T-functions calculating their coefficients by means of recurrences which involve the perturbation function. In the T-functions series method the perturbation parameter is the factor in the local truncation error. Furthermore, this method is zero-stable and convergent. An applica...

  2. Diagnosing breast cancer using Raman spectroscopy: prospective analysis

    Science.gov (United States)

    Haka, Abigail S.; Volynskaya, Zoya; Gardecki, Joseph A.; Nazemi, Jon; Shenk, Robert; Wang, Nancy; Dasari, Ramachandra R.; Fitzmaurice, Maryann; Feld, Michael S.

    2009-01-01

    We present the first prospective test of Raman spectroscopy in diagnosing normal, benign, and malignant human breast tissues. Prospective testing of spectral diagnostic algorithms allows clinicians to accurately assess the diagnostic information contained in, and any bias of, the spectroscopic measurement. In previous work, we developed an accurate, internally validated algorithm for breast cancer diagnosis based on analysis of Raman spectra acquired from fresh-frozen in vitro tissue samples. We currently evaluate the performance of this algorithm prospectively on a large ex vivo clinical data set that closely mimics the in vivo environment. Spectroscopic data were collected from freshly excised surgical specimens, and 129 tissue sites from 21 patients were examined. Prospective application of the algorithm to the clinical data set resulted in a sensitivity of 83%, a specificity of 93%, a positive predictive value of 36%, and a negative predictive value of 99% for distinguishing cancerous from normal and benign tissues. The performance of the algorithm in different patient populations is discussed. Sources of bias in the in vitro calibration and ex vivo prospective data sets, including disease prevalence and disease spectrum, are examined and analytical methods for comparison provided. PMID:19895125

  3. Accurate structural correlations from maximum likelihood superpositions.

    Directory of Open Access Journals (Sweden)

    Douglas L Theobald

    2008-02-01

    Full Text Available The cores of globular proteins are densely packed, resulting in complicated networks of structural interactions. These interactions in turn give rise to dynamic structural correlations over a wide range of time scales. Accurate analysis of these complex correlations is crucial for understanding biomolecular mechanisms and for relating structure to function. Here we report a highly accurate technique for inferring the major modes of structural correlation in macromolecules using likelihood-based statistical analysis of sets of structures. This method is generally applicable to any ensemble of related molecules, including families of nuclear magnetic resonance (NMR models, different crystal forms of a protein, and structural alignments of homologous proteins, as well as molecular dynamics trajectories. Dominant modes of structural correlation are determined using principal components analysis (PCA of the maximum likelihood estimate of the correlation matrix. The correlations we identify are inherently independent of the statistical uncertainty and dynamic heterogeneity associated with the structural coordinates. We additionally present an easily interpretable method ("PCA plots" for displaying these positional correlations by color-coding them onto a macromolecular structure. Maximum likelihood PCA of structural superpositions, and the structural PCA plots that illustrate the results, will facilitate the accurate determination of dynamic structural correlations analyzed in diverse fields of structural biology.

  4. Accurate finite element modeling of acoustic waves

    Science.gov (United States)

    Idesman, A.; Pham, D.

    2014-07-01

    In the paper we suggest an accurate finite element approach for the modeling of acoustic waves under a suddenly applied load. We consider the standard linear elements and the linear elements with reduced dispersion for the space discretization as well as the explicit central-difference method for time integration. The analytical study of the numerical dispersion shows that the most accurate results can be obtained with the time increments close to the stability limit. However, even in this case and the use of the linear elements with reduced dispersion, mesh refinement leads to divergent numerical results for acoustic waves under a suddenly applied load. This is explained by large spurious high-frequency oscillations. For the quantification and the suppression of spurious oscillations, we have modified and applied a two-stage time-integration technique that includes the stage of basic computations and the filtering stage. This technique allows accurate convergent results at mesh refinement as well as significantly reduces the numerical anisotropy of solutions. We should mention that the approach suggested is very general and can be equally applied to any loading as well as for any space-discretization technique and any explicit or implicit time-integration method.

  5. Remembering and diagnosing clients: Does experience matter?

    NARCIS (Netherlands)

    Witteman, C.L.M.; Tollenaar, M.S.

    2012-01-01

    Experienced mental health clinicians often do not outperform novices in diagnostic decision making. In this paper we look for an explanation of this phenomenon by testing differences in memory processes. In two studies we aimed to look at differences in accuracy of diagnoses in relation to free reca

  6. Fighting to be heard: contested diagnoses

    NARCIS (Netherlands)

    C. Trundle; I. Singh; C. Bröer

    2014-01-01

    This chapter explores how diagnoses can become sites of contest, rather than of agreement. Conflict can arise when illness refuses to yield the level of proof that epidemiology, clinical medicine, and toxicology require, or its existence is doubted within mainstream medicine. Other forms of contest

  7. How Do Health Care Providers Diagnose Vaginitis?

    Science.gov (United States)

    ... the treatments? Are there complications? Does it affect pregnancy? How is it prevented? NICHD Research Information Clinical Trials Resources and Publications How do health care providers diagnose vaginitis? Skip sharing on social media links Share this: Page Content To find out ...

  8. How Is von Willebrand Disease Diagnosed?

    Science.gov (United States)

    ... may not be diagnosed unless they have heavy bleeding after surgery or some other trauma. On the other hand, ... following the injury. Any prolonged, heavy, or repeated bleeding that required medical care after surgery or dental extractions. Any bruising with little or ...

  9. Diagnosing Febrile Illness in a Returned Traveler

    Centers for Disease Control (CDC) Podcasts

    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.

  10. Eating Disorder Diagnoses: Empirical Approaches to Classification

    Science.gov (United States)

    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…

  11. Bordetella pertussis diagnosed by polymerase chain reaction

    DEFF Research Database (Denmark)

    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...

  12. Appendiceal endometriosis differentially diagnosed from acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Gastón Astroza; Victor Faundes; René Nanjarí; Marcelo Fleiderman; Carlos Rodriguez

    2010-01-01

    @@ Endometriosis is a common disease in premenopausal women involving pelvic organs specially. However endometriosis that affects the appendix is rarely seen except appendiceal endometriosis that mimics acute appendicitis. In a patient with acute appendicitis we diagnosed and operated on, histopathological examination of the appendix revealed appendiceal endometriosis which caused symptoms.

  13. Two Siblings Diagnosed as Lafora Disease

    Directory of Open Access Journals (Sweden)

    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.

  14. Fighting to be heard: contested diagnoses

    NARCIS (Netherlands)

    Trundle, C.; Singh, I.; Bröer, C.; Goldstein Jutel, A.; Dew, K.

    2014-01-01

    This chapter explores how diagnoses can become sites of contest, rather than of agreement. Conflict can arise when illness refuses to yield the level of proof that epidemiology, clinical medicine, and toxicology require, or its existence is doubted within mainstream medicine. Other forms of contest

  15. Medicinalindustrien har brug for diagnoser som ADHD

    DEFF Research Database (Denmark)

    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...

  16. The natural history of prenatally diagnosed conjoined twins.

    Science.gov (United States)

    Mackenzie, Tippi C; Crombleholme, Timothy M; Johnson, Mark P; Schnaufer, Louise; Flake, Alan W; Hedrick, Holly L; Howell, Lori J; Adzick, N Scott

    2002-03-01

    Accurate prenatal diagnosis of complex anatomic connections and associated anomalies has only been possible recently with the use of ultrasonography, echocardiography, and fetal magnetic resonance imaging (MRI). To assess the impact of improved antenatal diagnosis in the management and outcome of conjoined twins, the authors reviewed their experience with 14 cases. A retrospective review of prenatally diagnosed conjoined twins referred to our institution from 1996 to present was conducted. In 14 sets of conjoined twins, there were 10 thoracoomphalopagus, 2 dicephalus tribrachius dipus, 1 ischiopagus, and 1 ischioomphalopagus. The earliest age at diagnosis was 9 weeks' gestation (range, 9 to 29; mean, 20). Prenatal imaging with ultrasonography, echocardiography, and ultrafast fetal MRI accurately defined the shared anatomy in all cases. Associated anomalies included cardiac malformations (11 of 14), congenital diaphragmatic hernia (4 of 14), abdominal wall defects (2 of 14), and imperforate anus (2 of 14). Three sets of twins underwent therapeutic abortion, 1 set of twins died in utero, and 10 were delivered via cesarean section at a mean gestational age of 34 weeks. There were 5 individual survivors in the series after separation (18%). In one case, in which a twin with a normal heart perfused the cotwin with a rudimentary heart, the ex utero intrapartum treatment procedure (EXIT) was utilized because of concern that the normal twin would suffer immediate cardiac decompensation at birth. This EXIT-to-separation strategy allowed prompt control of the airway and circulation before clamping the umbilical cord and optimized control over a potentially emergent situation, leading to survival of the normal cotwin. In 2 sets of twins in which each twin had a normal heart, tissue expanders were inserted before separation. Advances in prenatal diagnosis allow detailed, accurate evaluations of conjoined twins. Careful prenatal studies may uncover cases in which emergent

  17. Determinants of the accuracy of nursing diagnoses: influence of ready knowledge, knowledge sources, disposition toward critical thinking, and reasoning skills.

    Science.gov (United States)

    Paans, Wolter; Sermeus, Walter; Nieweg, Roos; van der Schans, Cees

    2010-01-01

    The purpose of this study was to determine how knowledge sources, ready knowledge, and disposition toward critical thinking and reasoning skills influence the accuracy of student nurses' diagnoses. A randomized controlled trial was conducted to determine the influence of knowledge sources. We used the following questionnaires: (a) knowledge inventory, (b) California Critical Thinking Disposition Inventory, and (c) Health Science Reasoning Test (HSRT). The use of knowledge sources had very little influence on the accuracy of nursing diagnoses. Accuracy was significantly related to the analysis domain of the HSRT. Students were unable to operationalize knowledge sources to derive accurate diagnoses and did not effectively use reasoning skills. Copyright 2010 Elsevier Inc. All rights reserved.

  18. Biosurveillance Using Clinical Diagnoses and Social Media Indicators in Military Populations

    Energy Technology Data Exchange (ETDEWEB)

    Corley, Courtney D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Volkova, Svitlana [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rounds, Jeremiah [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Charles-Smith, Lauren E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Harrison, Joshua J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Mendoza, Joshua A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Han, Keith S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2017-02-23

    U.S. military influenza surveillance uses electronic reporting of clinical diagnoses to monitor health of military personnel and detect naturally occurring and bioterrorism-related epidemics. While accurate, these systems lack in timeliness. More recently, researchers have used novel data sources to detect influenza in real time and capture nontraditional populations. With data-mining techniques, military social media users are identified and influenza-related discourse is integrated along with medical data into a comprehensive disease model. By leveraging heterogeneous data streams and developing dashboard biosurveillance analytics, the researchers hope to increase the speed at which outbreaks are detected and provide accurate disease forecasting among military personnel.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... identified between January 2004 and December 2011. Incidence rates were calculated using census data from the Bandim Health and Demographic Surveillance System (HDSS). RESULTS: The overall incidence of pulmonary TB was 279 per 100 000 person-years of observation; the male incidence being 385, and the female...... 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...

  20. Accurate measurement of unsteady state fluid temperature

    Science.gov (United States)

    Jaremkiewicz, Magdalena

    2017-03-01

    In this paper, two accurate methods for determining the transient fluid temperature were presented. Measurements were conducted for boiling water since its temperature is known. At the beginning the thermometers are at the ambient temperature and next they are immediately immersed into saturated water. The measurements were carried out with two thermometers of different construction but with the same housing outer diameter equal to 15 mm. One of them is a K-type industrial thermometer widely available commercially. The temperature indicated by the thermometer was corrected considering the thermometers as the first or second order inertia devices. The new design of a thermometer was proposed and also used to measure the temperature of boiling water. Its characteristic feature is a cylinder-shaped housing with the sheath thermocouple located in its center. The temperature of the fluid was determined based on measurements taken in the axis of the solid cylindrical element (housing) using the inverse space marching method. Measurements of the transient temperature of the air flowing through the wind tunnel using the same thermometers were also carried out. The proposed measurement technique provides more accurate results compared with measurements using industrial thermometers in conjunction with simple temperature correction using the inertial thermometer model of the first or second order. By comparing the results, it was demonstrated that the new thermometer allows obtaining the fluid temperature much faster and with higher accuracy in comparison to the industrial thermometer. Accurate measurements of the fast changing fluid temperature are possible due to the low inertia thermometer and fast space marching method applied for solving the inverse heat conduction problem.

  1. New law requires 'medically accurate' lesson plans.

    Science.gov (United States)

    1999-09-17

    The California Legislature has passed a bill requiring all textbooks and materials used to teach about AIDS be medically accurate and objective. Statements made within the curriculum must be supported by research conducted in compliance with scientific methods, and published in peer-reviewed journals. Some of the current lesson plans were found to contain scientifically unsupported and biased information. In addition, the bill requires material to be "free of racial, ethnic, or gender biases." The legislation is supported by a wide range of interests, but opposed by the California Right to Life Education Fund, because they believe it discredits abstinence-only material.

  2. Accurate diagnosis is essential for amebiasis

    Institute of Scientific and Technical Information of China (English)

    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.

  3. The first accurate description of an aurora

    Science.gov (United States)

    Schröder, Wilfried

    2006-12-01

    As technology has advanced, the scientific study of auroral phenomena has increased by leaps and bounds. A look back at the earliest descriptions of aurorae offers an interesting look into how medieval scholars viewed the subjects that we study.Although there are earlier fragmentary references in the literature, the first accurate description of the aurora borealis appears to be that published by the German Catholic scholar Konrad von Megenberg (1309-1374) in his book Das Buch der Natur (The Book of Nature). The book was written between 1349 and 1350.

  4. Niche Genetic Algorithm with Accurate Optimization Performance

    Institute of Scientific and Technical Information of China (English)

    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.

  5. Universality: Accurate Checks in Dyson's Hierarchical Model

    Science.gov (United States)

    Godina, J. J.; Meurice, Y.; Oktay, M. B.

    2003-06-01

    In this talk we present high-accuracy calculations of the susceptibility near βc for Dyson's hierarchical model in D = 3. Using linear fitting, we estimate the leading (γ) and subleading (Δ) exponents. Independent estimates are obtained by calculating the first two eigenvalues of the linearized renormalization group transformation. We found γ = 1.29914073 ± 10 -8 and, Δ = 0.4259469 ± 10-7 independently of the choice of local integration measure (Ising or Landau-Ginzburg). After a suitable rescaling, the approximate fixed points for a large class of local measure coincide accurately with a fixed point constructed by Koch and Wittwer.

  6. Misdiagnostic analysis of clinically diagnosed severe acute respiratory syndrome after following up 197 convalescent patients

    Institute of Scientific and Technical Information of China (English)

    LIU You-ning; TIAN Qing; HU Hong; XIE Li-xin; FAN Bao-xing; XU Hong-min; CHEN Wei-jun

    2005-01-01

    @@ The severe acute respiratory syndrome (SARS) is an emerging and highly contagious infection caused by a newly discovered strain of coronavirus.1 Since the clinical case definition of SARS is similar to other severe atypical pneumonias, specific laboratory tests that can accurately diagnose SARS-associated coronavirus (SARS-CoV) infection are important. However, published data are insufficient to investigate whether clinically diagnosed SARS patients may include some non-SARS pneumonia. Therefore, we aimed to determine clinical and laboratory features to differentiate SARS patients from non-SARS pneumonias that could reduce misdiagnosis of SARS. A retrospective analysis of clinical and laboratory characteristics after the initial onset of SARS, as well as its convalescent-phase, was examined from clinically diagnosed 197 SARS patients.

  7. Impact of 18F-FDG PET/CT Staging in Newly Diagnosed Classical Hodgkin Lymphoma

    DEFF Research Database (Denmark)

    El-Galaly, Tarec Christoffer; Hutchings, Martin; Mylam, Karen Juul

    2013-01-01

    F-18-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is a highly accurate staging method in classical Hodgkin lymphoma (cHL). We retrospectively compared the staging results obtained in two large cohorts of patients with cHL diagnosed before (n = 324) and after (n = 406......%, p Hodgkin Study Group (GHSG) risk classification (early, intermediate, advanced disease) predicted outcome in PET...

  8. Hospital-diagnosed dementia and suicide

    DEFF Research Database (Denmark)

    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 individuals...... aged 50+ living in Denmark (N=2,474,767) during January 1, 1990 through December 31, 2000. MEASUREMENTS: Outcome of interest is suicide. Relative risks are calculated based on person-days spent in each stratum. RESULTS: A total of 18,648,875 person-years were observed during the 11-year study period....... During this period, 136 persons who previously had been diagnosed with dementia died by suicide. Men and women aged 50-69 years with hospital presentations of dementia have a relative suicide risk of 8.5 (95% confidence interval: 6.3-11.3) and 10.8 (95% confidence interval: 7.4-15.7), respectively. Those...

  9. Accurate Stellar Parameters for Exoplanet Host Stars

    Science.gov (United States)

    Brewer, John Michael; Fischer, Debra; Basu, Sarbani; Valenti, Jeff A.

    2015-01-01

    A large impedement to our understanding of planet formation is obtaining a clear picture of planet radii and densities. Although determining precise ratios between planet and stellar host are relatively easy, determining accurate stellar parameters is still a difficult and costly undertaking. High resolution spectral analysis has traditionally yielded precise values for some stellar parameters but stars in common between catalogs from different authors or analyzed using different techniques often show offsets far in excess of their uncertainties. Most analyses now use some external constraint, when available, to break observed degeneracies between surface gravity, effective temperature, and metallicity which can otherwise lead to correlated errors in results. However, these external constraints are impossible to obtain for all stars and can require more costly observations than the initial high resolution spectra. We demonstrate that these discrepencies can be mitigated by use of a larger line list that has carefully tuned atomic line data. We use an iterative modeling technique that does not require external constraints. We compare the surface gravity obtained with our spectral synthesis modeling to asteroseismically determined values for 42 Kepler stars. Our analysis agrees well with only a 0.048 dex offset and an rms scatter of 0.05 dex. Such accurate stellar gravities can reduce the primary source of uncertainty in radii by almost an order of magnitude over unconstrained spectral analysis.

  10. Accurate pose estimation for forensic identification

    Science.gov (United States)

    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.

  11. Accurate pattern registration for integrated circuit tomography

    Energy Technology Data Exchange (ETDEWEB)

    Levine, Zachary H.; Grantham, Steven; Neogi, Suneeta; Frigo, Sean P.; McNulty, Ian; Retsch, Cornelia C.; Wang, Yuxin; Lucatorto, Thomas B.

    2001-07-15

    As part of an effort to develop high resolution microtomography for engineered structures, a two-level copper integrated circuit interconnect was imaged using 1.83 keV x rays at 14 angles employing a full-field Fresnel zone plate microscope. A major requirement for high resolution microtomography is the accurate registration of the reference axes in each of the many views needed for a reconstruction. A reconstruction with 100 nm resolution would require registration accuracy of 30 nm or better. This work demonstrates that even images that have strong interference fringes can be used to obtain accurate fiducials through the use of Radon transforms. We show that we are able to locate the coordinates of the rectilinear circuit patterns to 28 nm. The procedure is validated by agreement between an x-ray parallax measurement of 1.41{+-}0.17 {mu}m and a measurement of 1.58{+-}0.08 {mu}m from a scanning electron microscope image of a cross section.

  12. Accurate basis set truncation for wavefunction embedding

    Science.gov (United States)

    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.

  13. How Accurately can we Calculate Thermal Systems?

    Energy Technology Data Exchange (ETDEWEB)

    Cullen, D; Blomquist, R N; Dean, C; Heinrichs, D; Kalugin, M A; Lee, M; Lee, Y; MacFarlan, R; Nagaya, Y; Trkov, A

    2004-04-20

    I would like to determine how accurately a variety of neutron transport code packages (code and cross section libraries) can calculate simple integral parameters, such as K{sub eff}, for systems that are sensitive to thermal neutron scattering. Since we will only consider theoretical systems, we cannot really determine absolute accuracy compared to any real system. Therefore rather than accuracy, it would be more precise to say that I would like to determine the spread in answers that we obtain from a variety of code packages. This spread should serve as an excellent indicator of how accurately we can really model and calculate such systems today. Hopefully, eventually this will lead to improvements in both our codes and the thermal scattering models that they use in the future. In order to accomplish this I propose a number of extremely simple systems that involve thermal neutron scattering that can be easily modeled and calculated by a variety of neutron transport codes. These are theoretical systems designed to emphasize the effects of thermal scattering, since that is what we are interested in studying. I have attempted to keep these systems very simple, and yet at the same time they include most, if not all, of the important thermal scattering effects encountered in a large, water-moderated, uranium fueled thermal system, i.e., our typical thermal reactors.

  14. Accurate taxonomic assignment of short pyrosequencing reads.

    Science.gov (United States)

    Clemente, José C; Jansson, Jesper; Valiente, Gabriel

    2010-01-01

    Ambiguities in the taxonomy dependent assignment of pyrosequencing reads are usually resolved by mapping each read to the lowest common ancestor in a reference taxonomy of all those sequences that match the read. This conservative approach has the drawback of mapping a read to a possibly large clade that may also contain many sequences not matching the read. A more accurate taxonomic assignment of short reads can be made by mapping each read to the node in the reference taxonomy that provides the best precision and recall. We show that given a suffix array for the sequences in the reference taxonomy, a short read can be mapped to the node of the reference taxonomy with the best combined value of precision and recall in time linear in the size of the taxonomy subtree rooted at the lowest common ancestor of the matching sequences. An accurate taxonomic assignment of short reads can thus be made with about the same efficiency as when mapping each read to the lowest common ancestor of all matching sequences in a reference taxonomy. We demonstrate the effectiveness of our approach on several metagenomic datasets of marine and gut microbiota.

  15. Accurate determination of characteristic relative permeability curves

    Science.gov (United States)

    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.

  16. Incarcerated Diaphragmatic Hernia – Differential Diagnoses

    OpenAIRE

    Bukvić, Nado; Bosak Veršić, Ana; Bačić, Giordano; Gusić, Nadomir; Nikolić, Harry; Bukvić, Frane

    2014-01-01

    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 sugges...

  17. Fuzzy expert system for diagnosing diabetic neuropathy.

    Science.gov (United States)

    Rahmani Katigari, Meysam; Ayatollahi, Haleh; Malek, Mojtaba; Kamkar Haghighi, Mehran

    2017-02-15

    To design a fuzzy expert system to help detect and diagnose the severity of diabetic neuropathy. The research was completed in 2014 and consisted of two main phases. In the first phase, the diagnostic parameters were determined based on the literature review and by investigating specialists' perspectives (n = 8). In the second phase, 244 medical records related to the patients who were visited in an endocrinology and metabolism research centre during the first six months of 2014 and were primarily diagnosed with diabetic neuropathy, were used to test the sensitivity, specificity, and accuracy of the fuzzy expert system. The final diagnostic parameters included the duration of diabetes, the score of a symptom examination based on the Michigan questionnaire, the score of a sign examination based on the Michigan questionnaire, the glycolysis haemoglobin level, fasting blood sugar, blood creatinine, and albuminuria. The output variable was the severity of diabetic neuropathy which was shown as a number between zero and 10, had been divided into four categories: absence of the disease, (the degree of severity) mild, moderate, and severe. The interface of the system was designed by ASP.Net (Active Server Pages Network Enabled Technology) and the system function was tested in terms of sensitivity (true positive rate) (89%), specificity (true negative rate) (98%), and accuracy (a proportion of true results, both positive and negative) (93%). The system designed in this study can help specialists and general practitioners to diagnose the disease more quickly to improve the quality of care for patients.

  18. Test Differences in Diagnosing Reading Comprehension Deficits

    Science.gov (United States)

    Keenan, Janice M.; Meenan, Chelsea E.

    2012-01-01

    We examined the implications of test differences for defining and diagnosing comprehension deficits using reading comprehension tests. We had 995 children complete the Gray Oral Reading Test-3, the Qualitative Reading Inventory-3, the Woodcock-Johnson Passage Comprehension-3, and the Peabody Individual Achievement Test, and compared which children were identified by each test as being in the lowest 10%. Although a child who performs so poorly might be expected to do poorly on all tests, we found that the average overlap between tests in diagnosing comprehension difficulties was only 43%. Consistency in diagnosis was greater for younger children, when comprehension deficits are due to weaker decoding skills, than for older children. Inconsistencies between tests were just as evident when identifying the top performers. The different children identified as having a comprehension deficit by each test were compared on four profile variables - word decoding skill, IQ, ADHD symptoms, and working memory skill – to understand the nature of the different deficits assessed by each test. Theoretical and practical implications of these test differences in defining and diagnosing comprehension deficits are discussed. PMID:22442251

  19. Pulmonary Artery Leiomyosarcoma Diagnosed without Delay

    Directory of Open Access Journals (Sweden)

    Motohisa Yamasaki

    2011-05-01

    Full Text Available A 63-year-old female presented with abnormal lung shadows but had, apart from this, few symptoms. Computed tomography (CT revealed multiple nodules and blockage of the pulmonary artery. She was immediately diagnosed with pulmonary artery sarcoma based on a careful differential diagnosis and underwent surgery. Her tumor was pathologically diagnosed as leiomyosarcoma (i.e. intimal sarcoma. Pulmonary artery sarcoma can be easily confounded with thromboembolism in a clinical setting and some cases are diagnosed post mortem only. In our case, clinical prediction scores (Wells score, Geneva score, and revised Geneva score for the pulmonary embolism showed low probability. Moreover, chest CT showed uncommon findings for pulmonary thromboembolism, as the nodules were too big for thrombi. Because surgical resection can provide the only hope of long-term survival in cases of pulmonary artery sarcoma, clinicians should consider this possibility in the differential diagnosis of pulmonary embolism. Clinical prediction scores and CT findings might help to reach the correct diagnosis of pulmonary artery sarcoma.

  20. The quality of severe mental disorder diagnoses in a national health registry as compared to research diagnoses based on structured interview.

    Science.gov (United States)

    Nesvåg, Ragnar; Jönsson, Erik G; Bakken, Inger Johanne; Knudsen, Gun Peggy; Bjella, Thomas D; Reichborn-Kjennerud, Ted; Melle, Ingrid; Andreassen, Ole A

    2017-03-14

    .0% for bipolar disorder. When compared to research-based diagnoses, clinical diagnoses of schizophrenia and bipolar disorder in the NPR are accurate and consistent, with minimal diagnostic overlap between the two disorders.

  1. Accurate Telescope Mount Positioning with MEMS Accelerometers

    Science.gov (United States)

    Mészáros, L.; Jaskó, A.; Pál, A.; Csépány, G.

    2014-08-01

    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.

  2. Apparatus for accurately measuring high temperatures

    Science.gov (United States)

    Smith, D.D.

    The present invention is a thermometer used for measuring furnace temperatures in the range of about 1800/sup 0/ to 2700/sup 0/C. The thermometer comprises a broadband multicolor thermal radiation sensor positioned to be in optical alignment with the end of a blackbody sight tube extending into the furnace. A valve-shutter arrangement is positioned between the radiation sensor and the sight tube and a chamber for containing a charge of high pressure gas is positioned between the valve-shutter arrangement and the radiation sensor. A momentary opening of the valve shutter arrangement allows a pulse of the high gas to purge the sight tube of air-borne thermal radiation contaminants which permits the radiation sensor to accurately measure the thermal radiation emanating from the end of the sight tube.

  3. Toward Accurate and Quantitative Comparative Metagenomics

    Science.gov (United States)

    Nayfach, Stephen; Pollard, Katherine S.

    2016-01-01

    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

  4. Accurate renormalization group analyses in neutrino sector

    Energy Technology Data Exchange (ETDEWEB)

    Haba, Naoyuki [Graduate School of Science and Engineering, Shimane University, Matsue 690-8504 (Japan); Kaneta, Kunio [Kavli IPMU (WPI), The University of Tokyo, Kashiwa, Chiba 277-8568 (Japan); Takahashi, Ryo [Graduate School of Science and Engineering, Shimane University, Matsue 690-8504 (Japan); Yamaguchi, Yuya [Department of Physics, Faculty of Science, Hokkaido University, Sapporo 060-0810 (Japan)

    2014-08-15

    We investigate accurate renormalization group analyses in neutrino sector between ν-oscillation and seesaw energy scales. We consider decoupling effects of top quark and Higgs boson on the renormalization group equations of light neutrino mass matrix. Since the decoupling effects are given in the standard model scale and independent of high energy physics, our method can basically apply to any models beyond the standard model. We find that the decoupling effects of Higgs boson are negligible, while those of top quark are not. Particularly, the decoupling effects of top quark affect neutrino mass eigenvalues, which are important for analyzing predictions such as mass squared differences and neutrinoless double beta decay in an underlying theory existing at high energy scale.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Accurate Weather Forecasting for Radio Astronomy

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  8. Fuzzy expert system for diagnosing diabetic neuropathy

    Science.gov (United States)

    Rahmani Katigari, Meysam; Ayatollahi, Haleh; Malek, Mojtaba; Kamkar Haghighi, Mehran

    2017-01-01

    AIM To design a fuzzy expert system to help detect and diagnose the severity of diabetic neuropathy. METHODS The research was completed in 2014 and consisted of two main phases. In the first phase, the diagnostic parameters were determined based on the literature review and by investigating specialists’ perspectives (n = 8). In the second phase, 244 medical records related to the patients who were visited in an endocrinology and metabolism research centre during the first six months of 2014 and were primarily diagnosed with diabetic neuropathy, were used to test the sensitivity, specificity, and accuracy of the fuzzy expert system. RESULTS The final diagnostic parameters included the duration of diabetes, the score of a symptom examination based on the Michigan questionnaire, the score of a sign examination based on the Michigan questionnaire, the glycolysis haemoglobin level, fasting blood sugar, blood creatinine, and albuminuria. The output variable was the severity of diabetic neuropathy which was shown as a number between zero and 10, had been divided into four categories: absence of the disease, (the degree of severity) mild, moderate, and severe. The interface of the system was designed by ASP.Net (Active Server Pages Network Enabled Technology) and the system function was tested in terms of sensitivity (true positive rate) (89%), specificity (true negative rate) (98%), and accuracy (a proportion of true results, both positive and negative) (93%). CONCLUSION The system designed in this study can help specialists and general practitioners to diagnose the disease more quickly to improve the quality of care for patients. PMID:28265346

  9. Best waveform score for diagnosing keratoconus

    Directory of Open Access Journals (Sweden)

    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.

  10. Diagnosing Functional Seizures in Children and Adolescent

    DEFF Research Database (Denmark)

    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......, psychiatric co-morbidity and functional symptoms other than FS, and 3) evaluation of seizure characteristics such as long duration, seizure initiation during wakefulness and in the presence of witnesses asynchronous movements, and no incontinence, tongue bite and injury related to the event....

  11. Neuroimaging differential diagnoses to abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  12. Patient specific modelling in diagnosing depression

    DEFF Research Database (Denmark)

    Ottesen, Johnny T.

    2015-01-01

    Depression is a very common disease. Approximately 10% of people in the Western world experience severe depression during their lifetime and many more experience a mild form of depression. It is commonly believed that depression is caused by malfunctions in the biological system constituted...... diagnoses more precise and to offer individual treatment plans and drug design. Efficient and reliable methods for parameter estimation are crucial. Presently we are investigating how well the Metropolis-Hastings Algorithm of the Bayesian Markov Chain Monte Carlo (MCMC) method for estimating the parameters...

  13. Trisomy 9 Mosaicism Diagnosed In Utero

    Directory of Open Access Journals (Sweden)

    Hironori Takahashi

    2010-01-01

    Full Text Available We present three cases of trisomy 9 mosaicism diagnosed by amniocentesis with ongoing pregnancies after referral to our center due to fetal abnormalities. Two cases were associated with severe fetal growth restriction (FGR, each of which resulted in an intrauterine fetal demise (IUFD in the third trimester. The other case involved mild FGR with a congenital diaphragmatic hernia and resulted in a live birth with severe development delay. A major prenatal finding of trisomy 9 mosaicism is FGR. Fetuses with trisomy 9 mosaicism can rarely survive in the case of severe FGR.

  14. Accurate lineshape spectroscopy and the Boltzmann constant.

    Science.gov (United States)

    Truong, G-W; Anstie, J D; May, E F; Stace, T M; Luiten, A N

    2015-10-14

    Spectroscopy has an illustrious history delivering serendipitous discoveries and providing a stringent testbed for new physical predictions, including applications from trace materials detection, to understanding the atmospheres of stars and planets, and even constraining cosmological models. Reaching fundamental-noise limits permits optimal extraction of spectroscopic information from an absorption measurement. Here, we demonstrate a quantum-limited spectrometer that delivers high-precision measurements of the absorption lineshape. These measurements yield a very accurate measurement of the excited-state (6P1/2) hyperfine splitting in Cs, and reveals a breakdown in the well-known Voigt spectral profile. We develop a theoretical model that accounts for this breakdown, explaining the observations to within the shot-noise limit. Our model enables us to infer the thermal velocity dispersion of the Cs vapour with an uncertainty of 35 p.p.m. within an hour. This allows us to determine a value for Boltzmann's constant with a precision of 6 p.p.m., and an uncertainty of 71 p.p.m.

  15. MEMS accelerometers in accurate mount positioning systems

    Science.gov (United States)

    Mészáros, László; Pál, András.; Jaskó, Attila

    2014-07-01

    In order to attain precise, accurate and stateless positioning of telescope mounts we apply microelectromechanical accelerometer systems (also known as MEMS accelerometers). In common practice, feedback from the mount position is provided by electronic, optical or magneto-mechanical systems or via real-time astrometric solution based on the acquired images. Hence, MEMS-based systems are completely independent from these mechanisms. Our goal is to investigate the advantages and challenges of applying such devices and to reach the sub-arcminute range { that is well smaller than the field-of-view of conventional imaging telescope systems. We present how this sub-arcminute accuracy can be achieved with very cheap MEMS sensors. Basically, these sensors yield raw output within an accuracy of a few degrees. We show what kind of calibration procedures could exploit spherical and cylindrical constraints between accelerometer output channels in order to achieve the previously mentioned accuracy level. We also demonstrate how can our implementation be inserted in a telescope control system. Although this attainable precision is less than both the resolution of telescope mount drive mechanics and the accuracy of astrometric solutions, the independent nature of attitude determination could significantly increase the reliability of autonomous or remotely operated astronomical observations.

  16. Does a pneumotach accurately characterize voice function?

    Science.gov (United States)

    Walters, Gage; Krane, Michael

    2016-11-01

    A study is presented which addresses how a pneumotach might adversely affect clinical measurements of voice function. A pneumotach is a device, typically a mask, worn over the mouth, in order to measure time-varying glottal volume flow. By measuring the time-varying difference in pressure across a known aerodynamic resistance element in the mask, the glottal volume flow waveform is estimated. Because it adds aerodynamic resistance to the vocal system, there is some concern that using a pneumotach may not accurately portray the behavior of the voice. To test this hypothesis, experiments were performed in a simplified airway model with the principal dimensions of an adult human upper airway. A compliant constriction, fabricated from silicone rubber, modeled the vocal folds. Variations of transglottal pressure, time-averaged volume flow, model vocal fold vibration amplitude, and radiated sound with subglottal pressure were performed, with and without the pneumotach in place, and differences noted. Acknowledge support of NIH Grant 2R01DC005642-10A1.

  17. Towards Accurate Modeling of Moving Contact Lines

    CERN Document Server

    Holmgren, Hanna

    2015-01-01

    A main challenge in numerical simulations of moving contact line problems is that the adherence, or no-slip boundary condition leads to a non-integrable stress singularity at the contact line. In this report we perform the first steps in developing the macroscopic part of an accurate multiscale model for a moving contact line problem in two space dimensions. We assume that a micro model has been used to determine a relation between the contact angle and the contact line velocity. An intermediate region is introduced where an analytical expression for the velocity exists. This expression is used to implement boundary conditions for the moving contact line at a macroscopic scale, along a fictitious boundary located a small distance away from the physical boundary. Model problems where the shape of the interface is constant thought the simulation are introduced. For these problems, experiments show that the errors in the resulting contact line velocities converge with the grid size $h$ at a rate of convergence $...

  18. Accurate upper body rehabilitation system using kinect.

    Science.gov (United States)

    Sinha, Sanjana; Bhowmick, Brojeshwar; Chakravarty, Kingshuk; Sinha, Aniruddha; Das, Abhijit

    2016-08-01

    The growing importance of Kinect as a tool for clinical assessment and rehabilitation is due to its portability, low cost and markerless system for human motion capture. However, the accuracy of Kinect in measuring three-dimensional body joint center locations often fails to meet clinical standards of accuracy when compared to marker-based motion capture systems such as Vicon. The length of the body segment connecting any two joints, measured as the distance between three-dimensional Kinect skeleton joint coordinates, has been observed to vary with time. The orientation of the line connecting adjoining Kinect skeletal coordinates has also been seen to differ from the actual orientation of the physical body segment. Hence we have proposed an optimization method that utilizes Kinect Depth and RGB information to search for the joint center location that satisfies constraints on body segment length and as well as orientation. An experimental study have been carried out on ten healthy participants performing upper body range of motion exercises. The results report 72% reduction in body segment length variance and 2° improvement in Range of Motion (ROM) angle hence enabling to more accurate measurements for upper limb exercises.

  19. Fast and accurate exhaled breath ammonia measurement.

    Science.gov (United States)

    Solga, Steven F; Mudalel, Matthew L; Spacek, Lisa A; Risby, Terence H

    2014-06-11

    This exhaled breath ammonia method uses a fast and highly sensitive spectroscopic method known as quartz enhanced photoacoustic spectroscopy (QEPAS) that uses a quantum cascade based laser. The monitor is coupled to a sampler that measures mouth pressure and carbon dioxide. The system is temperature controlled and specifically designed to address the reactivity of this compound. The sampler provides immediate feedback to the subject and the technician on the quality of the breath effort. Together with the quick response time of the monitor, this system is capable of accurately measuring exhaled breath ammonia representative of deep lung systemic levels. Because the system is easy to use and produces real time results, it has enabled experiments to identify factors that influence measurements. For example, mouth rinse and oral pH reproducibly and significantly affect results and therefore must be controlled. Temperature and mode of breathing are other examples. As our understanding of these factors evolves, error is reduced, and clinical studies become more meaningful. This system is very reliable and individual measurements are inexpensive. The sampler is relatively inexpensive and quite portable, but the monitor is neither. This limits options for some clinical studies and provides rational for future innovations.

  20. Noninvasive hemoglobin monitoring: how accurate is enough?

    Science.gov (United States)

    Rice, Mark J; Gravenstein, Nikolaus; Morey, Timothy E

    2013-10-01

    Evaluating the accuracy of medical devices has traditionally been a blend of statistical analyses, at times without contextualizing the clinical application. There have been a number of recent publications on the accuracy of a continuous noninvasive hemoglobin measurement device, the Masimo Radical-7 Pulse Co-oximeter, focusing on the traditional statistical metrics of bias and precision. In this review, which contains material presented at the Innovations and Applications of Monitoring Perfusion, Oxygenation, and Ventilation (IAMPOV) Symposium at Yale University in 2012, we critically investigated these metrics as applied to the new technology, exploring what is required of a noninvasive hemoglobin monitor and whether the conventional statistics adequately answer our questions about clinical accuracy. We discuss the glucose error grid, well known in the glucose monitoring literature, and describe an analogous version for hemoglobin monitoring. This hemoglobin error grid can be used to evaluate the required clinical accuracy (±g/dL) of a hemoglobin measurement device to provide more conclusive evidence on whether to transfuse an individual patient. The important decision to transfuse a patient usually requires both an accurate hemoglobin measurement and a physiologic reason to elect transfusion. It is our opinion that the published accuracy data of the Masimo Radical-7 is not good enough to make the transfusion decision.

  1. Accurate free energy calculation along optimized paths.

    Science.gov (United States)

    Chen, Changjun; Xiao, Yi

    2010-05-01

    The path-based methods of free energy calculation, such as thermodynamic integration and free energy perturbation, are simple in theory, but difficult in practice because in most cases smooth paths do not exist, especially for large molecules. In this article, we present a novel method to build the transition path of a peptide. We use harmonic potentials to restrain its nonhydrogen atom dihedrals in the initial state and set the equilibrium angles of the potentials as those in the final state. Through a series of steps of geometrical optimization, we can construct a smooth and short path from the initial state to the final state. This path can be used to calculate free energy difference. To validate this method, we apply it to a small 10-ALA peptide and find that the calculated free energy changes in helix-helix and helix-hairpin transitions are both self-convergent and cross-convergent. We also calculate the free energy differences between different stable states of beta-hairpin trpzip2, and the results show that this method is more efficient than the conventional molecular dynamics method in accurate free energy calculation.

  2. Accurate fission data for nuclear safety

    CERN Document Server

    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.

    Science.gov (United States)

    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.

  4. Accurate thermoplasmonic simulation of metallic nanoparticles

    Science.gov (United States)

    Yu, Da-Miao; Liu, Yan-Nan; Tian, Fa-Lin; Pan, Xiao-Min; Sheng, Xin-Qing

    2017-01-01

    Thermoplasmonics leads to enhanced heat generation due to the localized surface plasmon resonances. The measurement of heat generation is fundamentally a complicated task, which necessitates the development of theoretical simulation techniques. In this paper, an efficient and accurate numerical scheme is proposed for applications with complex metallic nanostructures. Light absorption and temperature increase are, respectively, obtained by solving the volume integral equation (VIE) and the steady-state heat diffusion equation through the method of moments (MoM). Previously, methods based on surface integral equations (SIEs) were utilized to obtain light absorption. However, computing light absorption from the equivalent current is as expensive as O(NsNv), where Ns and Nv, respectively, denote the number of surface and volumetric unknowns. Our approach reduces the cost to O(Nv) by using VIE. The accuracy, efficiency and capability of the proposed scheme are validated by multiple simulations. The simulations show that our proposed method is more efficient than the approach based on SIEs under comparable accuracy, especially for the case where many incidents are of interest. The simulations also indicate that the temperature profile can be tuned by several factors, such as the geometry configuration of array, beam direction, and light wavelength.

  5. Diagnosing faults in autonomous robot plan execution

    Science.gov (United States)

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

    1988-01-01

    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.

  6. Imaging tests for accurate diagnosis of acute biliary pancreatitis.

    Science.gov (United States)

    Şurlin, Valeriu; Săftoiu, Adrian; Dumitrescu, Daniela

    2014-11-28

    Gallstones represent the most frequent aetiology of acute pancreatitis in many statistics all over the world, estimated between 40%-60%. Accurate diagnosis of acute biliary pancreatitis (ABP) is of outmost importance because clearance of lithiasis [gallbladder and common bile duct (CBD)] rules out recurrences. Confirmation of biliary lithiasis is done by imaging. The sensitivity of the ultrasonography (US) in the detection of gallstones is over 95% in uncomplicated cases, but in ABP, sensitivity for gallstone detection is lower, being less than 80% due to the ileus and bowel distension. Sensitivity of transabdominal ultrasonography (TUS) for choledocolithiasis varies between 50%-80%, but the specificity is high, reaching 95%. Diameter of the bile duct may be orientative for diagnosis. Endoscopic ultrasonography (EUS) seems to be a more effective tool to diagnose ABP rather than endoscopic retrograde cholangiopancreatography (ERCP), which should be performed only for therapeutic purposes. As the sensitivity and specificity of computerized tomography are lower as compared to state-of-the-art magnetic resonance cholangiopancreatography (MRCP) or EUS, especially for small stones and small diameter of CBD, the later techniques are nowadays preferred for the evaluation of ABP patients. ERCP has the highest accuracy for the diagnosis of choledocholithiasis and is used as a reference standard in many studies, especially after sphincterotomy and balloon extraction of CBD stones. Laparoscopic ultrasonography is a useful tool for the intraoperative diagnosis of choledocholithiasis. Routine exploration of the CBD in cases of patients scheduled for cholecystectomy after an attack of ABP was not proven useful. A significant rate of the so-called idiopathic pancreatitis is actually caused by microlithiasis and/or biliary sludge. In conclusion, the general algorithm for CBD stone detection starts with anamnesis, serum biochemistry and then TUS, followed by EUS or MRCP. In the end

  7. ULTRASONOGRAPHY, AN EFFECTIVE TOOL IN DIAGNOSING PLANTAR FASCIITIS: A SYSTEMATIC REVIEW OF DIAGNOSTIC TRIALS

    Science.gov (United States)

    Wyland, Matthew; Applequist, Lee; Bolowsky, Erin; Klingensmith, Heather; Virag, Isaac

    2016-01-01

    Background Plantar fasciitis (PF) is the most common cause of heel pain that affects 10% of the general population, whether living an athletic or sedentary lifestyle. The most frequent mechanism of injury is an inflammatory response that is caused by repetitive micro trauma. Many techniques are available to diagnose PF, including the use of ultrasonography (US). Purpose The purpose of this study is to systematically review and appraise previously published articles published between the years 2000 and 2015 that evaluated the effectiveness of using US in the process of diagnosing PF, as compared to alternative diagnostic methods. Methods A total of eight databases were searched to systematically review scholarly (peer reviewed) diagnostic and intervention articles pertaining to the ability of US to diagnose PF. Results Using specific key words the preliminary search yielded 264 articles, 10 of which were deemed relevant for inclusion in the study. Two raters independently scored each article using the 15 point modified QUADAS scale. Discussion Six studies compared the diagnostic efficacy of US to another diagnostic technique to diagnose PF, and four studies focused on comparing baseline assessment of plantar fascia before subsequent intervention. The most notable US outcomes measured were plantar fascia thickness, enthesopathy, and hypoechogenicity. Conclusion US was found to be accurate and reliable compared to alternative reference standards like MRI in the diagnosis of PF. The general advantages of US (e.g. cost efficient, ease of administration, non-invasive, limited contraindications) make it a superior diagnostic modality in the diagnosis of PF. US should be considered in rehabilitation clinics to effectively diagnose PF and to accurately monitor improvement in the disease process following rehabilitation interventions. Level of Evidence 1A PMID:27757279

  8. Xanthogranuloma of the sellar region diagnosed by frozen section

    Science.gov (United States)

    Ji, Kun; Zhang, Liyan; Wang, Liwei

    2016-01-01

    Abstract Xanthogranuloma (XG) of the sellar region is uncommon and is difficult to diagnose based on intraoperative frozen sections. This study is a case presentation and review of the literature, highlighting the need to explore underlying diseases in order to guarantee an accurate patient diagnosis. Herein, we presented the case of a 43-year-old woman who was afflicted with xanthogranuloma of the sellar region; the patient had a history of headache and lengthened menstrual cycles over the 6 months prior to presentation. Endocrinology tests revealed that the patient’s levels of prolactin were high and the MRI of the patient showed a clearly defined sellar mass. As a result, the patient was considered to have prolactinoma prior to undergoing surgery. The tumor was completely removed using a transsphenoidal approach, and intraoperative frozen section revealed histology similar to xanthogranuloma. When the tumor was removed by surgical operation, the patient’s visual field defects and headache were relieved. Although intraoperative frozen section should provide some guidance with regard to the diagnosis, a pathological study is conducted to confirm the actual diagnosis. PMID:28352831

  9. Xanthogranuloma of the sellar region diagnosed by frozen section

    Directory of Open Access Journals (Sweden)

    Ji Kun

    2016-01-01

    Full Text Available Xanthogranuloma (XG of the sellar region is uncommon and is difficult to diagnose based on intraoperative frozen sections. This study is a case presentation and review of the literature, highlighting the need to explore underlying diseases in order to guarantee an accurate patient diagnosis. Herein, we presented the case of a 43-year-old woman who was afflicted with xanthogranuloma of the sellar region; the patient had a history of headache and lengthened menstrual cycles over the 6 months prior to presentation. Endocrinology tests revealed that the patient’s levels of prolactin were high and the MRI of the patient showed a clearly defined sellar mass. As a result, the patient was considered to have prolactinoma prior to undergoing surgery. The tumor was completely removed using a transsphenoidal approach, and intraoperative frozen section revealed histology similar to xanthogranuloma. When the tumor was removed by surgical operation, the patient’s visual field defects and headache were relieved. Although intraoperative frozen section should provide some guidance with regard to the diagnosis, a pathological study is conducted to confirm the actual diagnosis.

  10. Role of multiplex polymerase chain reaction in diagnosing tubercular meningitis

    Directory of Open Access Journals (Sweden)

    Anupam Berwal

    2017-01-01

    Full Text Available Tuberculous meningitis (TBM is one of the most serious manifestations of extrapulmonary tuberculosis. Timely and accurate diagnosis provides a favorable prognosis in patients with TBM. The study evaluated the use of multiplex polymerase chain reaction (PCR in the diagnosis of TBM. A study was conducted on 74 patients clinically suspected with TBM. The cerebrospinal fluid (CSF specimens were processed for smear microscopy, middle brook 7H9 culture, and multiplex PCR using primers directed against IS6110 gene and 38 kD protein for detection of Mycobacterium tuberculosis. The results were analyzed to assess the role of multiplex PCR in the diagnosis of TBM. A total of 26 (35.1% patients were diagnosed with TBM. Microscopy was negative in all while culture was positive in two cases only. Comparing with clinical diagnosis and CSF adenosine deaminase levels of ≥10 U/L, multiplex PCR showed sensitivity, specificity, positive predictive value, and negative predictive value of 71.4%, 89.6%, 83.3%, and 81.2%, respectively, in the diagnosis of TBM.

  11. Accurate paleointensities - the multi-method approach

    Science.gov (United States)

    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.

  12. Towards Accurate Application Characterization for Exascale (APEX)

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Optimizing cell arrays for accurate functional genomics

    Directory of Open Access Journals (Sweden)

    Fengler Sven

    2012-07-01

    Full Text Available Abstract Background Cellular responses emerge from a complex network of dynamic biochemical reactions. In order to investigate them is necessary to develop methods that allow perturbing a high number of gene products in a flexible and fast way. Cell arrays (CA enable such experiments on microscope slides via reverse transfection of cellular colonies growing on spotted genetic material. In contrast to multi-well plates, CA are susceptible to contamination among neighboring spots hindering accurate quantification in cell-based screening projects. Here we have developed a quality control protocol for quantifying and minimizing contamination in CA. Results We imaged checkered CA that express two distinct fluorescent proteins and segmented images into single cells to quantify the transfection efficiency and interspot contamination. Compared with standard procedures, we measured a 3-fold reduction of contaminants when arrays containing HeLa cells were washed shortly after cell seeding. We proved that nucleic acid uptake during cell seeding rather than migration among neighboring spots was the major source of contamination. Arrays of MCF7 cells developed without the washing step showed 7-fold lower percentage of contaminant cells, demonstrating that contamination is dependent on specific cell properties. Conclusions Previously published methodological works have focused on achieving high transfection rate in densely packed CA. Here, we focused in an equally important parameter: The interspot contamination. The presented quality control is essential for estimating the rate of contamination, a major source of false positives and negatives in current microscopy based functional genomics screenings. We have demonstrated that a washing step after seeding enhances CA quality for HeLA but is not necessary for MCF7. The described method provides a way to find optimal seeding protocols for cell lines intended to be used for the first time in CA.

  14. Important Nearby Galaxies without Accurate Distances

    Science.gov (United States)

    McQuinn, Kristen

    2014-10-01

    The Spitzer Infrared Nearby Galaxies Survey (SINGS) and its offspring programs (e.g., THINGS, HERACLES, KINGFISH) have resulted in a fundamental change in our view of star formation and the ISM in galaxies, and together they represent the most complete multi-wavelength data set yet assembled for a large sample of nearby galaxies. These great investments of observing time have been dedicated to the goal of understanding the interstellar medium, the star formation process, and, more generally, galactic evolution at the present epoch. Nearby galaxies provide the basis for which we interpret the distant universe, and the SINGS sample represents the best studied nearby galaxies.Accurate distances are fundamental to interpreting observations of galaxies. Surprisingly, many of the SINGS spiral galaxies have numerous distance estimates resulting in confusion. We can rectify this situation for 8 of the SINGS spiral galaxies within 10 Mpc at a very low cost through measurements of the tip of the red giant branch. The proposed observations will provide an accuracy of better than 0.1 in distance modulus. Our sample includes such well known galaxies as M51 (the Whirlpool), M63 (the Sunflower), M104 (the Sombrero), and M74 (the archetypal grand design spiral).We are also proposing coordinated parallel WFC3 UV observations of the central regions of the galaxies, rich with high-mass UV-bright stars. As a secondary science goal we will compare the resolved UV stellar populations with integrated UV emission measurements used in calibrating star formation rates. Our observations will complement the growing HST UV atlas of high resolution images of nearby galaxies.

  15. How flatbed scanners upset accurate film dosimetry.

    Science.gov (United States)

    van Battum, L J; Huizenga, H; Verdaasdonk, R M; Heukelom, S

    2016-01-21

    Film is an excellent dosimeter for verification of dose distributions due to its high spatial resolution. Irradiated film can be digitized with low-cost, transmission, flatbed scanners. However, a disadvantage is their lateral scan effect (LSE): a scanner readout change over its lateral scan axis. Although anisotropic light scattering was presented as the origin of the LSE, this paper presents an alternative cause. Hereto, LSE for two flatbed scanners (Epson 1680 Expression Pro and Epson 10000XL), and Gafchromic film (EBT, EBT2, EBT3) was investigated, focused on three effects: cross talk, optical path length and polarization. Cross talk was examined using triangular sheets of various optical densities. The optical path length effect was studied using absorptive and reflective neutral density filters with well-defined optical characteristics (OD range 0.2-2.0). Linear polarizer sheets were used to investigate light polarization on the CCD signal in absence and presence of (un)irradiated Gafchromic film. Film dose values ranged between 0.2 to 9 Gy, i.e. an optical density range between 0.25 to 1.1. Measurements were performed in the scanner's transmission mode, with red-green-blue channels. LSE was found to depend on scanner construction and film type. Its magnitude depends on dose: for 9 Gy increasing up to 14% at maximum lateral position. Cross talk was only significant in high contrast regions, up to 2% for very small fields. The optical path length effect introduced by film on the scanner causes 3% for pixels in the extreme lateral position. Light polarization due to film and the scanner's optical mirror system is the main contributor, different in magnitude for the red, green and blue channel. We concluded that any Gafchromic EBT type film scanned with a flatbed scanner will face these optical effects. Accurate dosimetry requires correction of LSE, therefore, determination of the LSE per color channel and dose delivered to the film.

  16. Excess mortality in patients diagnosed with hypothyroidism

    DEFF Research Database (Denmark)

    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...

  17. Postnatal Treatment in Antenatally Diagnosed Meconium Peritonitis.

    Science.gov (United States)

    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. Celsius.

  18. Optical coherence tomography for diagnosing periodontal disease

    Science.gov (United States)

    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.

  19. Diagnosing Myocardial Contusion after Blunt Chest Trauma

    Directory of Open Access Journals (Sweden)

    Zahra Alborzi

    2016-10-01

    Full Text Available A myocardial contusion refers to a bruise of the cardiac muscle, the severity of which can vary depending on the severity of the injury and when the injury occurs. It is a major cause of rapid death which happens after blunt chest trauma and should be suspected at triage in the emergency department. We demonstrated that suspected myocardial contusion patients who have normal electrocardiograms (ECGs and biomarker tests can be safely discharged. However, if the test results are abnormal, the next steps should be echocardiography and more advanced measures. Diagnosing myocardial contusion is very difficult because of its nonspecific symptoms. If a myocardial contusion happens, cardiogenic shock or arrhythmia must be anticipated, and the patient must be carefully monitored.

  20. Clinically and electrophysiologically diagnosed botulinum intoxication.

    Science.gov (United States)

    Kotan, Dilcan; Aygul, Recep; Ceylan, Mustafa; Yilikoglu, Yalcin

    2013-01-03

    In this case report, clinical and electrophysiological findings of 43-year-old female patient who developed Clostridium botulinum intoxication after consumption of home-made canned food are presented. Following the sudden onset of severe nausea and vomiting, diplopia, blurred vision, bilateral ptosis, weakness, speech and swallowing difficulties have developed and the patient declared that she has just tasted the canned beans after she had rinsed them several times. The case, where serological tests cannot be performed, was diagnosed clinically and treated with antitoxin immediately. During follow-up, consecutive nerve stimulation was performed and significant incremental response was observed. There was an improvement in symptoms within 2 weeks, and in 5 or 6 weeks the symptoms had disappeared completely. Electrodiagnostic studies revealed that the findings turned to normal. The case showed that immediate antitoxin treatment is life-saving even the diagnosis of botulinum intoxication is based on clinical findings.

  1. Ein mehrstufiger Algorithmus zur Diagnose seltener Genodermatosen.

    Science.gov (United States)

    Tantcheva-Poór, Iliana; Oji, Vinzenz; Has, Cristina

    2016-10-01

    Jüngste Fortschritte der Genforschung haben ihren Weg in die klinische Dermatologie gefunden. Nahezu ein Drittel aller Erbkrankheiten zeigt charakteristische Hautveränderungen. Zudem können Proben menschlicher Haut als Untersuchungsmaterial zur Detektion genetischer Mosaike und der zu Grunde liegenden Defekte eingesetzt werden. Die Diagnose von Genodermatosen bleibt jedoch aufgrund ihrer unterschiedlich ausgeprägten und überlappenden Phänotypen sowie ihrer Seltenheit und Vielzahl neuer Informationen wegen eine Herausforderung für die Kliniker. Um das Interesse für dieses, sich schnell entwickelnde Feld der Dermatologie zu wecken und den Blick für einige seltene Erbkrankheiten zu schärfen, stellen wir in der hiesigen Übersicht einen Algorithmus für die Diagnostik und Evaluierung von Patienten mit fraglichen Genodermatosen vor.

  2. Preoperatively diagnosed mucocele of the appendix.

    Science.gov (United States)

    Rojnoveanu, Gh; Ghidirim, Gh; Mishin, I; Vozian, M; Mishina, A

    2014-01-01

    Mucocele of the appendix is an infrequent entity, characterized by distension of the lumen due to accumulation of mucoid substance and is rarely diagnosed preoperatively. If untreated, mucocele may rupture producing a potentially fatal entity known as pseudomyxoma peritonei. The type of surgical treatment is related to the dimensions and the histology of the mucocele. Appendectomy is used for simple mucocele or for cystadenoma. Right hemi-colectomy is recommended for cystadeno carcinoma. In this paper, we report a case of an asymptomatic 37-year-old woman in whom mucocele was found on a routine ultrasound examination and preoperative computed tomography scan. Surgery revealed a big appendix measuring 84 mm in length and 40 mm in diameter. The final pathologic diagnosis was simple mucocele. Celsius.

  3. Outcome of prenatally diagnosed trisomy 6 mosaicism.

    Science.gov (United States)

    Wallerstein, Robert; Oh, Tracey; Durcan, Judy; Abdelhak, Yaakov; Clachko, Mark; Aviv, Hana

    2002-08-01

    We report the prenatal diagnosis of trisomy 6 mosaicism via amniocentesis, in which trisomy 6 cells were identified in three of five culture vessels with 33% (5/15) of colonies showing trisomic cells. The pregnancy was electively terminated and examination revealed minor abnormalities (shortening of the femurs, micrognathia, posterior malrotation of the ears, and bilateral camptomelia of the second digit of the hands and fifth digits of the feet). Cytogenetic analysis of the placenta showed trisomy 6 in 100% of 20 cells studied. Karyotype was 46,XX in 100 cells examined from fetal skin. There are relatively few prenatally diagnosed cases of mosaic trisomy 6 at amniocentesis. Confined placental mosaicism (CPM) has been postulated in other cases where follow-up cytogenetic studies were not available. The present case differs from those previously reported, as it appears to represent CPM of chromosome 6 with phenotypic effects to the fetus.

  4. Bordetella pertussis diagnosed by polymerase chain reaction

    DEFF Research Database (Denmark)

    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...... in 25 patients in whose nasopharyngeal secretions BP had been demonstrated after 4-7 days of culture. The detection limit of PCR in aqueous solution was 1-2 BP bacteria per reaction tube. PCR was 100% specific for BP, showing no response with other Bordetella species or other bacteria known to colonize...... of PCR for the diagnosis of BP, we used known concentrations of BP, Bordetella parapertussis and Bordetella bronchiseptica in aqueous solutions. PCR was furthermore carried out on species of bacteria that might be isolated from the nasopharynx. The applicability of PCR to patient specimens was tested...

  5. Automated diagnostic kiosk for diagnosing diseases

    Science.gov (United States)

    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.

  6. Diagnosing ancient Diphyllobothriasis from Chinchorro mummies

    Directory of Open Access Journals (Sweden)

    Karl Reinhard

    2003-01-01

    Full Text Available Diphyllobothrium pacificum has been reported as a human parasite from coprolites and skeletons in Peru and Chile. Our analysis of Chinchorro mummies from Chile provides the oldest evidence of D. pacificum directly associated with human mummies. These mummies date between 4,000 and 5,000 years ago. The basis for our diagnosis is presented. We find that the size of the eggs in the mummies is smaller than other discoveries of D. pacificum. We suggest that this is due to the peculiar circumstances of preservation of parasite eggs within mummies and the release of immature eggs into the intestinal tract as the tapeworms decompose after the death of the host. This information is important to consider when making diagnoses from mummies.

  7. Discrete event systems diagnosis and diagnosability

    CERN Document Server

    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...

  8. Gastroesophageal reflux diagnosed by occlusal splint tintion.

    Science.gov (United States)

    Cebrián-Carretero, José Luis; López-Arcas-Calleja, José María

    2006-01-01

    The gastroesophageal reflux (GER) disease is a very frequent digestive disorder, mainly characterised by the reflux of the gastric acidic content to the esophage in abnormal quantities. There are different situations that favour this situation but almost in all of them rely an incompetence of the esophagic sphincter. The clinical consequences are many, including oral manifestations. Among all of them the most frequent is the esophagitis followed by symptoms at the pharynx or larynx and finally, the oral cavity. At this level fundamentally we will find enamel and oral mucosa erosions. We report the case of a patient who was indirectly diagnosed of her esophague disease by the observation of the alterations in the occlusal splint induced by the gastric reflux. We review the literature concerning the above topic and its possible association with the miofascial syndrome.

  9. How Do Health Care Providers Diagnose Spina Bifida?

    Science.gov (United States)

    ... 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 ...

  10. How Do Health Care Providers Diagnose Neural Tube Defects?

    Science.gov (United States)

    ... and Publications How do health care providers diagnose neural tube defects? Skip sharing on social media links Share this: Page Content Neural tube defects are usually diagnosed before the infant is ...

  11. My Child Has Been Diagnosed with ADHD - Now What?

    Science.gov (United States)

    ... for Parents My Child Has Been Diagnosed with ADHD - Now What? When their child is diagnosed with ... Services Among Children Ages 2-5 Years with ADHD (Healthcare Claims Data) Learn more Medicaid policies to ...

  12. Comparison of radiological measures for diagnosing flatfoot

    Energy Technology Data Exchange (ETDEWEB)

    Lo, Huan-Chu (Department of Radiology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan (China); Diagnostic Radiology, National Defense Medical Center, Taipei, Taiwan (China)), Email: huanchu_lo@126.com; Chu, Wencheng; Wu, Weikai; Hsieh, Hsin; Chou, Chiehping; Sun, Shaoen; Chou, Pinya; Liao, Chenhui; Guan, Xiaoyun; Li, Shuchee (Department of Radiology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan (China))

    2012-03-15

    Background. In the Taiwanese military, flatfoot is indicated by a calcaneal-fifth metatarsal angle (arch angle) =165 deg . However, the arch angle is not always easily defined. Purpose. To assess correlations between the arch angle and other radiographic measures and thus identify an alternative radiographic measure for diagnosing flatfoot. Material and Methods Eighty-seven male Taiwanese military recruits were studied (median age 22 years, interquartile range 20-23 years). Lateral, weight-bearing radiographs were taken. Five radiographic measurements, including the calcaneal-fifth metatarsal angle (arch angle), medial arch angle (MAA), calcaneal pitch angle (CP), talus angle (TA), and talar-first metatarsal angle (TFM) were made. Correlations between the arch angle and all other measures were determined. A cut-off value for predicting flatfoot (arch angle >=165 deg ) was determined for each measure using the Youden index and receiver-operating characteristic (ROC) curves were generated for each measure to assess diagnostic accuracy. Results. All measures were significantly correlated with arch angle (P < 0.05); however, the strongest correlation was for CP (rho = -0.905, P < 0.001). CP was associated with the highest area under the ROC (0.988 vs. 0.711-0.912 for the other measures). Further, CP (cut-off <12.3 deg ) had the highest sensitivity (92.0%), positive predictive value (76.7%), and negative predictive value (96.5%). TFM (>9.5 deg ) had the highest specificity (90.3% vs. 88.75 for CP <12.3 deg ). Conclusion. CP is inversely correlated with arch angle in Taiwanese male military recruits. CP < 12.3 deg is a significant predictor of flatfoot. Assessment of CP may be used as an alternative means of diagnosing flatfoot when the arch angle is not easily defined

  13. Diagnosing chronic thromboembolic pulmonary hypertension: current perspectives

    Directory of Open Access Journals (Sweden)

    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

  14. Causes and outcome of prenatally diagnosed hydronephrosis

    Directory of Open Access Journals (Sweden)

    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.

  15. An automated method for accurate vessel segmentation

    Science.gov (United States)

    Yang, Xin; Liu, Chaoyue; Le Minh, Hung; Wang, Zhiwei; Chien, Aichi; (Tim Cheng, Kwang-Ting

    2017-05-01

    Vessel segmentation is a critical task for various medical applications, such as diagnosis assistance of diabetic retinopathy, quantification of cerebral aneurysm’s growth, and guiding surgery in neurosurgical procedures. Despite technology advances in image segmentation, existing methods still suffer from low accuracy for vessel segmentation in the two challenging while common scenarios in clinical usage: (1) regions with a low signal-to-noise-ratio (SNR), and (2) at vessel boundaries disturbed by adjacent non-vessel pixels. In this paper, we present an automated system which can achieve highly accurate vessel segmentation for both 2D and 3D images even under these challenging scenarios. Three key contributions achieved by our system are: (1) a progressive contrast enhancement method to adaptively enhance contrast of challenging pixels that were otherwise indistinguishable, (2) a boundary refinement method to effectively improve segmentation accuracy at vessel borders based on Canny edge detection, and (3) a content-aware region-of-interests (ROI) adjustment method to automatically determine the locations and sizes of ROIs which contain ambiguous pixels and demand further verification. Extensive evaluation of our method is conducted on both 2D and 3D datasets. On a public 2D retinal dataset (named DRIVE (Staal 2004 IEEE Trans. Med. Imaging 23 501-9)) and our 2D clinical cerebral dataset, our approach achieves superior performance to the state-of-the-art methods including a vesselness based method (Frangi 1998 Int. Conf. on Medical Image Computing and Computer-Assisted Intervention) and an optimally oriented flux (OOF) based method (Law and Chung 2008 European Conf. on Computer Vision). An evaluation on 11 clinical 3D CTA cerebral datasets shows that our method can achieve 94% average accuracy with respect to the manual segmentation reference, which is 23% to 33% better than the five baseline methods (Yushkevich 2006 Neuroimage 31 1116-28; Law and Chung 2008

  16. Queer diagnoses revisited: The past and future of homosexuality and gender diagnoses in DSM and ICD.

    Science.gov (United States)

    Drescher, Jack

    2015-01-01

    The American Psychiatric Association (APA) recently completed a several year process of revising the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). During that time, there were objections raised to retaining DSM's gender identity disorder diagnoses and calls to remove them, just as homosexuality had been removed from DSM-II in 1973. At the conclusion of the DSM-5 revision process, the gender diagnoses were retained, albeit in altered form and bearing the new name of 'gender dysphoria'. The author of this paper was a member of the DSM-5 Workgroup on Sexual and Gender Identity Disorders and presently serves on the WHO Working Group on Sexual Disorders and Sexual Health. Both groups faced similar tasks: reconciling patients' needs for access to care with the stigma of being given a psychiatric diagnosis. The differing nature of the two diagnostic manuals led to two different outcomes. As background, this paper updates the history of homosexuality and the gender diagnoses in the DSM and in the International Statistical Classification of Diseases and Related Health Problems (ICD) as well as what is expected to happen to the homosexuality and gender diagnoses following the current ICD-11 revision process.

  17. Time trend in diagnosing dementia in secondary care

    DEFF Research Database (Denmark)

    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....

  18. Diagnosing Aircraft Icing Potential from Satellite Cloud Retrievals

    Science.gov (United States)

    Smith, William L., Jr.; Minnis, Patrick; Fleeger, Cecilia; Spangenberg, Douglas

    2013-01-01

    The threat for aircraft icing in clouds is a significant hazard that routinely impacts aviation operations. Accurate diagnoses and forecasts of aircraft icing conditions requires identifying the location and vertical distribution of clouds with super-cooled liquid water (SLW) droplets, as well as the characteristics of the droplet size distribution. Traditional forecasting methods rely on guidance from numerical models and conventional observations, neither of which currently resolve cloud properties adequately on the optimal scales needed for aviation. Satellite imagers provide measurements over large areas with high spatial resolution that can be interpreted to identify the locations and characteristics of clouds, including features associated with adverse weather and storms. This paper describes new techniques for interpreting cloud products derived from satellite data to infer the flight icing threat to aircraft. For unobscured low clouds, the icing threat is determined using empirical relationships developed from correlations between satellite imager retrievals of liquid water path and droplet size with icing conditions reported by pilots (PIREPS). For deep ice over water cloud systems, ice and liquid water content (IWC and LWC) profiles are derived by using the imager cloud properties to constrain climatological information on cloud vertical structure and water phase obtained apriori from radar and lidar observations, and from cloud model analyses. Retrievals of the SLW content embedded within overlapping clouds are mapped to the icing threat using guidance from an airfoil modeling study. Compared to PIREPS and ground-based icing remote sensing datasets, the satellite icing detection and intensity accuracies are approximately 90% and 70%, respectively, and found to be similar for both low level and deep ice over water cloud systems. The satellite-derived icing boundaries capture the reported altitudes over 90% of the time. Satellite analyses corresponding to

  19. Molecular evidence for central nervous system involvement in children with newly diagnosed acute lymphoblastic leukemia.

    Science.gov (United States)

    Januszkiewicz, D A; Nowak, J S

    1995-01-01

    Central nervous system (CNS) involvement in children with newly diagnosed acute lymphoblastic leukemia (ALL) would have profound implication for the prognosis and accurate stratification of CNS prophylactic therapy. Using PCR technique with specific primers for V, D and J segments of TCRD gene, the pattern of TCRD gene rearrangements in bone marrow lymphoblasts and in cells from cerebrospinal fluid (CSF) have been investigated. The study involved 21 children at the time of diagnosis with B-lineage ALL. In nine of 21 patients incomplete TCRDVD gene rearrangement has been found in CSF cells, which was identical to that observed in bone marrow of the same children. It can be concluded that at least in 43 per cent of all analysed cases, there were signs of CNS involvement in newly diagnosed ALL patients.

  20. Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors

    Directory of Open Access Journals (Sweden)

    In Hye Song

    2015-03-01

    Full Text Available Background: Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. Methods: We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. Results: Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. Conclusions: We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.

  1. Fetal MRI clues to diagnose cloacal malformations

    Energy Technology Data Exchange (ETDEWEB)

    Calvo-Garcia, Maria A.; Kline-Fath, Beth M.; Patel, Manish N.; Kraus, Steven [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); Levitt, Marc A.; Pena, Alberto [Cincinnati Children' s Hospital Medical Center, Colorectal Center for Children, Pediatric Surgery, Cincinnati, OH (United States); Lim, Foong-Yen; Crombleholme, Timothy M. [Cincinnati Children' s Hospital Medical Center, Fetal Care Center of Cincinnati, Pediatric Surgery, Cincinnati, OH (United States); Linam, Leann E. [Arkansas Children' s Hospital, Department of Radiology, Little Rock, AR (United States)

    2011-09-15

    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. Diagnosing Mitochondrial Disorder without Sophisticated Means

    Directory of Open Access Journals (Sweden)

    Josef Finsterer

    2015-10-01

    Full Text Available Mitochondrial disorders (MIDs require biochemical or genetic investigations for being diagnosed. In some cases, however, the diagnosis can be suspected upon the syndromic phenotype or upon clinical presentation and family history, as in the following case. The patient was a 74-year-old male admitted for worsening of pre-existing left-sided ptosis and ophthalmoparesis after a birthday party. The history was positive for arterial hypertension, hypertrophic cardiomyopathy with systolic dysfunction, diabetes-type 2, mild renal insufficiency, thyroiditis, and polyneuropathy. Instrumental investigations additionally revealed hepatopathy, hyperlipidemia, hyperuricemia, bifascicular block, white matter lesions, and subacute stroke. Systolic dysfunction resolved upon adequate cardiac treatment. On hospital day 11 the patient suddenly developed asystole. He was successfully resuscitated but died a few hours later from acute myocardial infarction. Surprisingly, a more extensive family history was positive for myopathy (patient, brother, daughter, neuropathy (patient, hypoacusis (patient, Parkinson syndrome (mother, spasticity (son, diabetes (patient, son, renal failure (patient, and generalized atherosclerosis (patient. The individual and family history was strongly suggestive of an MID. In conclusion, individual and family history may strongly suggest MID. Phenotypic variability may be high between family members affected by an MID. MID may be associated with an increasing atherosclerotic risk lastly resulting in coronary heart disease and death.

  3. Computer Assisted Diagnoses for Red Eye (CADRE

    Directory of Open Access Journals (Sweden)

    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.

  4. Diagnosing Beijing 2020: Mapping the Ungovernable City

    Directory of Open Access Journals (Sweden)

    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.

  5. Diagnosing young onset dementia can be challenging.

    Science.gov (United States)

    Ahmed, Samrah; Baker, Ian; Butler, Christopher R

    2016-05-01

    Although the risk of developing dementia increases with age, onset can be as early as the third or fourth decade of life. Genetic influences play a more important role in younger than in older people with dementia, so young onset dementia may cluster in families. Diagnosing young onset dementia is challenging. The range of possible presenting features is broad, encompassing behavioural, cognitive, psychiatric and neurological domains, and symptoms are often subtle initially. Frequently the complaints are misattributed to stress or depression, and the patient is falsely reassured that they are too young to have dementia. The most common causes of young onset dementia are early onset forms of adult neurodegenerative conditions and alcohol. Vascular dementia is the second most common cause of young onset dementia after Alzheimer's disease. Conventional vascular risk factors may be absent and diagnosis relies on imaging evidence of cerebrovascular disease. Obtaining a detailed history remains the most important part of the workup and usually requires corroboration by a third party. Undertaking a basic neurological examination is also important. Those with suspected young onset dementia should be referred to a neurology-led cognitive disorders clinic where available as the differenti diagnosis is considerably broader tha in older adults and requires specialist investigation.

  6. Diagnosing SWOT through Importance-performance Analysis

    Directory of Open Access Journals (Sweden)

    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.

  7. Intramuscular and intermuscular lipoma: neglected diagnoses.

    Science.gov (United States)

    Fletcher, C D; Martin-Bates, E

    1988-03-01

    Fifty-four cases of lipoma arising either within or between skeletal muscles are presented. Of these, 52 were identified in a systematic review of 2478 tumours of adipose tissue diagnosed and treated in one hospital over a 25 year period. Intramuscular lipomas account for 1.8% of fatty tumours, arise predominantly in middle to late adult life and, in our series, are commonest on the trunk. They may be divided into infiltrative and well-circumscribed types, respective local recurrence rates being 19 and 0%. Intermuscular lipomas are comparatively rare, 0.3% of fatty tumours, have a similar age distribution and arise most often in the anterior abdominal wall; none of the seven cases recurred. It is important that both pathologists and surgeons appreciate the significant tendency of infiltrative intramuscular lipomas to recur. Hence, preventative surgical measures may be undertaken and worries that the lesion may be sarcomatous can be avoided. Differential diagnosis, most importantly from well-differentiated liposarcoma, is discussed.

  8. Do clinical diagnoses correlate with pathological diagnoses in cardiac transplant patients? The importance of endomyocardial biopsy

    DEFF Research Database (Denmark)

    Luk, Adriana; Metawee, Mohammed; Ahn, Eric

    2009-01-01

    . Patient records were reviewed for preoperative clinical diagnoses and other relevant data, including pretransplant endomyocardial biopsy (EMB) results, information regarding left ventricular assist devices and, finally, evidence of disease recurrence in the grafted heart. RESULTS: A shift......, arrhythmogenic right ventricle dysplasia (100%), cardiac sarcoidosis (83%) and iron overload toxicity- associated cardiomyopathy (100%) had been misdiagnosed in pretransplantation investigations. Investigations before transplantation did not include an EMB. Of all 296 patients, 51 patients (17%) were...

  9. Contrast-enhanced ultrasonography to diagnose complicated acute cholecystitis.

    Science.gov (United States)

    Sagrini, Elisabetta; Pecorelli, Anna; Pettinari, Irene; Cucchetti, Alessandro; Stefanini, Federico; Bolondi, Luigi; Piscaglia, Fabio

    2016-02-01

    Gangrenous cholecystitis and perforation are severe complications of acute cholecystitis, which have a challenging preoperative diagnosis. Early identification allows better surgical management. Contrast-enhanced computed tomography (ceCT) is the current diagnostic gold standard. Contrast-enhanced ultrasonography (CEUS) is a promising tool for the diagnosis of gallbladder perforation, but data from the literature concerning efficacy are sparse. The aim of the study was to evaluate CEUS findings in pathologically proven complicated cholecystitis (gangrenous, perforated gallbladder, pericholecystic abscess). A total of 8 patients submitted to preoperative CEUS, and with subsequent proven acute complicated cholecystitis at surgical inspection and pathological analysis, were retrospectively identified. The final diagnosis was gangrenous/phlegmonous cholecystitis (n. 2), phlegmonous/ulcerative changes plus pericholecystic abscess (n. 2), perforated plus pericholecystic abscess (n. 3), or perforated plus pericholecystic biliary collection (n. 1). Conventional US findings revealed irregularly thickened gallbladder walls in all 8 patients, with vaguely defined walls in 7 patients, four of whom also had striated wall thickening. CEUS revealed irregular enhancing gallbladder walls in all patients. A distinct wall defect was seen in six patients, confirmed as gangrenous/phlegmonous cholecystitis at pathology in all six, and in four as perforation at macroscopic surgical inspection. CEUS is a non-invasive easily repeatable technique that can be performed at the bedside, and is able to accurately diagnose complicated/perforated cholecystitis. Despite the limited sample size in the present case series, CEUS appears as a promising tool for the management of patients with the clinical possibility of having an acute complicated cholecystitis.

  10. Validation of spontaneous abortion diagnoses in the Danish National Registry of Patients

    DEFF Research Database (Denmark)

    Lohse, Sarah Rytter; Farkas, Dóra Körmendiné; Lohse, Nicolai;

    2010-01-01

    PURPOSE: The purpose of this study is to validate the diagnosis of spontaneous abortion (SA) recorded in the Danish National Registry of Patients (DNRP). METHODS: We randomly selected patients registered in the DNRP with a diagnosis of SA between 1980 and 2008 from hospitals in the county of North...... the three patients with available data who did not fulfill the criteria for SA, one had an induced abortion and two had threatened abortion but did not miscarry. CONCLUSION: Registration of SA in the DNRP accurately reflects the diagnoses recorded in medical charts. The DNRP is a suitable source of data...

  11. Learning to Diagnose Cirrhosis with Liver Capsule Guided Ultrasound Image Classification

    Directory of Open Access Journals (Sweden)

    Xiang Liu

    2017-01-01

    Full Text Available This paper proposes a computer-aided cirrhosis diagnosis system to diagnose cirrhosis based on ultrasound images. We first propose a method to extract a liver capsule on an ultrasound image, then, based on the extracted liver capsule, we fine-tune a deep convolutional neural network (CNN model to extract features from the image patches cropped around the liver capsules. Finally, a trained support vector machine (SVM classifier is applied to classify the sample into normal or abnormal cases. Experimental results show that the proposed method can effectively extract the liver capsules and accurately classify the ultrasound images.

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

    LENUS (Irish Health Repository)

    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.

  13. Understanding and diagnosing shift work disorder.

    Science.gov (United States)

    Thorpy, Michael

    2011-09-01

    A significant proportion of the workforce in industrialized countries (16%) are employed as shift workers. These workers may be susceptible to shift work disorder (SWD), a circadian rhythm sleep disorder, particularly those who work at night or on early-morning shifts. Shift work disorder remains an underdiagnosed and undertreated problem among this population. Patients with SWD have difficulty initiating sleep and waking up. Often, these patients have excessive sleepiness during their work shift. Shift work disorder has been associated with decreased productivity, impaired safety, diminished quality of life, and adverse effects on health. Several tools have been validated to assess excessive daytime sleepiness and are often used to assess excessive nighttime sleepiness, such as that experienced in patients with SWD, including the Epworth Sleepiness Scale and the Multiple Sleep Latency Test. The criteria for diagnosing SWD as established by the American Academy of Sleep Medicine (AASM) and published in the International Classification of Sleep Disorders-Second Edition (ICSD-2) were most recently updated in 2005 and thus do not contain newer agents approved for use in patients with SWD. The symptoms of SWD can be treated using behavioral, prescription, and nonprescription therapies. Current treatment guidelines suggest nonpharmacologic interventions, such as exercise and exposure to light. In addition, medications that contain melatonin or caffeine may have clinical benefits in some patients with SWD. However, modafinil and armodafinil are approved by the US Food and Drug Administration to improve wakefulness in patients with excessive sleepiness associated with SWD, and recent data suggest a clinical benefit. The use of these therapies can significantly improve sleep, performance, and quality of life for patients with SWD.

  14. Can intramuscular glucose levels diagnose compartment syndrome?

    Science.gov (United States)

    Doro, Christopher J; Sitzman, Thomas J; O'Toole, Robert V

    2014-02-01

    Compartment syndrome is difficult to diagnose, particularly in patients who are not able to undergo adequate clinical examination. Current methods rely on pressure measurements within the compartment, have high false-positive rates, and do not reliably indicate presence of muscle ischemia. We hypothesized that measurement of intramuscular glucose and oxygen can identify compartment syndrome with high sensitivity and specificity. Compartment syndrome was created in 12 anesthetized adult mixed-sex beagles, in the craniolateral compartment of a lower leg, by infusion of lactated Ringer's solution with normal serum concentration of glucose. The contralateral leg served as a control. Hydrostatic pressure, oxygen tension, and glucose concentration were recorded with commercially available probes. Compartment syndrome was maintained for 8 hours, and the animals were recovered. Two weeks later, compartment and control legs underwent muscle biopsy. Specimens were reviewed by a blinded pathologist. Within 15 minutes of creating compartment syndrome, glucose concentration and oxygen tension in the experimental limb were significantly lower than in the control limb (glucose, p = 0.02; oxygen, p = 0.007; two-tailed t test). Intramuscular glucose concentration of less than 97 mg/dL was 100% sensitive (95% confidence interval [CI], 73-100%) and 75% specific (95% CI, 40-94%) for the presence of compartment syndrome. Partial pressure of oxygen less than 30 mm Hg was 100% sensitive (95% CI, 72-100%) and 100% specific (95% CI, 69-100%) for the presence of compartment syndrome. Pathology confirmed compartment syndrome in all experimental limbs. Our results show that intramuscular glucose concentration and partial pressure of oxygen rapidly identify muscle ischemia with high sensitivity and specificity after experimentally created compartment syndrome in this animal model.

  15. Shave Biopsy Is a Safe and Accurate Method for the Initial Evaluation of Melanoma

    Science.gov (United States)

    Zager, Jonathan S; Hochwald, Steven N; Marzban, Suroosh S; Francois, Rony; Law, Kimberly M; Davis, Ashley H; Messina, Jane L; Vincek, Vladimir; Mitchell, Christina; Church, Ann; Copeland, Edward M; Sondak, Vernon K; Grobmyer, Stephen R

    2015-01-01

    BACKGROUND Shave biopsy of cutaneous lesions is simple, efficient, and commonly used clinically. However, this technique has been criticized for its potential to hamper accurate diagnosis and microstaging of melanoma, thereby complicating treatment decision-making. STUDY DESIGN We retrospectively analyzed a consecutive series of patients referred to the University of Florida Shands Cancer Center or to the Moffitt Cancer Center for treatment of primary cutaneous melanoma, initially diagnosed on shave biopsy to have Breslow depth biopsy in T-staging and the potential impact on definitive surgical treatment and outcomes. RESULTS Six hundred patients undergoing shave biopsy were diagnosed with melanoma from extremity (42%), trunk (37%), and head or neck (21%). Mean (± SEM) Breslow thickness was 0.73 ± 0.02 mm; 6.2% of lesions were ulcerated. At the time of wide excision, residual melanoma was found in 133 (22%), resulting in T-stage upstaging for 18 patients (3%). Recommendations for additional wide excision or sentinel lymph node biopsy changed in 12 of 600 (2%) and 8 of 600 patients (1.3%), respectively. Locoregional recurrence occurred in 10 (1.7%) patients and distant recurrence in 4 (0.7%) patients. CONCLUSIONS These data challenge the surgical dogma that full-thickness excisional biopsy of suspicious cutaneous lesions is the only method that can lead to accurate diagnosis. Data obtained on shave biopsy of melanoma are reliable and accurate in the overwhelming majority of cases (97%). The use of shave biopsy does not complicate or compromise management of the overwhelming majority of patients with malignant melanoma. PMID:21463767

  16. Ductal carcinoma in situ and atypical ductal hyperplasia of the breast diagnosed at stereotactic core biopsy.

    Science.gov (United States)

    Méndez, I; Andreu, F J; Sáez, E; Sentís, M; Jurado, I; Cabezuelo, M A; Castañer, E; Gallardo, X; Díaz-Ruiz, M J; López, E; Marco, V

    2001-01-01

    Stereotactic core needle biopsy (SCNB) allows specific histopathologic diagnoses to be made without surgery and has been demonstrated to be an accurate, cost-effective method of diagnosing breast disease, particularly nonpalpable lesions. However, recent studies have concluded that the diagnosis of atypical ductal hyperplasia (ADH) by means of SCNB has resulted in nearly equal odds that a coexisting malignant lesion will be missed. Furthermore, others have concluded that SCNB diagnosed as DCIS cannot reliably indicate the absence of tumor invasion in surgical excision. Between 1993 and 1998, 1,221 consecutive SCNB of mammographically identified lesions were performed using a 14-gauge automated device with an average of 5.3 cores obtained per lesion. ADH was identified in 19 (1.6%) lesions and DCIS in 89 (7.3%). Surgical biopsy was performed in 89 of these patients and histopathologic results from SCNB and surgical biopsies were reviewed and correlated. In 12 cases of ADH diagnosed by SCNB, surgical biopsy showed ADH in 8 (67%) cases and DCIS in the other 4 (33%) cases. In 77 cases of DCIS diagnosed by SCNB, a surgical biopsy showed DCIS in 55 (71%) cases, 6 more cases (8%) had DCIS with focal microinvasion, and 15 (19%) had invasive ductal carcinoma. In one case no residual tumor was found at surgery. In the author's patient population, the diagnosis of ADH at SCNB indicates high probability of DCIS or residual ADH in the surgical biopsy. The diagnosis of DCIS at SCNB is confirmed in the majority of surgical biopsies; however, a significant number of cases may show microinvasion or invasive carcinoma.

  17. Accurate Jones Matrix of the Practical Faraday Rotator

    Institute of Scientific and Technical Information of China (English)

    王林斗; 祝昇翔; 李玉峰; 邢文烈; 魏景芝

    2003-01-01

    The Jones matrix of practical Faraday rotators is often used in the engineering calculation of non-reciprocal optical field. Nevertheless, only the approximate Jones matrix of practical Faraday rotators has been presented by now. Based on the theory of polarized light, this paper presents the accurate Jones matrix of practical Faraday rotators. In addition, an experiment has been carried out to verify the validity of the accurate Jones matrix. This matrix accurately describes the optical characteristics of practical Faraday rotators, including rotation, loss and depolarization of the polarized light. The accurate Jones matrix can be used to obtain the accurate results for the practical Faraday rotator to transform the polarized light, which paves the way for the accurate analysis and calculation of practical Faraday rotators in relevant engineering applications.

  18. Biomimetic Approach for Accurate, Real-Time Aerodynamic Coefficients Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aerodynamic and structural reliability and efficiency depends critically on the ability to accurately assess the aerodynamic loads and moments for each lifting...

  19. Use of infrared thermal imaging to diagnose health of Ammopiptanthus mongolicus in northwestern China

    Institute of Scientific and Technical Information of China (English)

    Weijie Yuan; Yi Yu; Yongde Yue; Ji Wang; Fengchun Zhang; Xiaohong Dang

    2015-01-01

    Population of the rare and endangered species Ammopiptanthus mongolicus (Maxim.) Cheng f. declined rapidly in China’s arid region and Central Asia. There is an urgent need to protect this species, which is particularly important in maintaining biodiversity throughout the arid region of northwestern China. By analyzing the infrared thermal images based on plant-transpiration transfer coef-ficient (hat) and photosynthetic parameters, we made quantitative and accurate diagnoses of the plant growth and health status of A. mongolicus. Using an LI-COR6400 photosynthesis system, we measured the net photosynthetic rate (Pn), stomatal conductance (Gs), and transpiration rate (Tr). Infrared thermal images obtained in the field were processed by ENVI4.8 software to calculate surface tem-peratures of the plant subjects. We found that the plant transpiration transfer coefficient of A. mongolicus was in the order of old plants [young plants [intermediate-aged plants. Declining health levels of young, intermediate, and old plants were divided into three categories:\\0.4, 0.4–0.7, and [0.7. The coefficient showed a significant negative correlation with Tr, Gs, and Pn, indicating that they can simultaneously reflect the state of plant growth. By estab-lishing hat and photosynthetic parameters in regression model Y=a-blnx, we can accurately diagnose plant growth and decline of plant health conditions.

  20. Myopericarditis in acquired immunodeficiency syndrome diagnosed by gallium scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Cregler, L.L.; Sosa, I.; Ducey, S.; Abbey, L. (Bronx VA Medical Center, NY (USA))

    1990-07-01

    Myocarditis is among the cardiac complications of acquired immunodeficiency syndrome and, yet, is often not discovered until autopsy. Gallium scintigraphy has been employed in diagnosing this entity, but few data are available about its diagnostic accuracy and value. Here, the authors report two cases of myopericarditis as diagnosed by gallium scan.

  1. Quality of life in children with undiagnosed and diagnosed asthma

    NARCIS (Netherlands)

    van Gent, R.; van Essen, L.E.; Rovers, M.M.; Kimpen, J.L.; van der Ent, C.K.; de Meer, G.

    2007-01-01

    This study describes the impact of undiagnosed and diagnosed asthma on quality of life in schoolchildren aged 7-10 years and their caregivers in a cross-sectional community-based study. Diagnosed asthma was defined as the parents' confirmation of a physician's diagnosis of asthma. Undiagnosed asthma

  2. Quality of life in children with undiagnosed and diagnosed asthma

    NARCIS (Netherlands)

    van Gent, R.; van Essen, L.E.; Rovers, M.M.; Kimpen, J.L.; van der Ent, C.K.; de Meer, G.

    This study describes the impact of undiagnosed and diagnosed asthma on quality of life in schoolchildren aged 7-10 years and their caregivers in a cross-sectional community-based study. Diagnosed asthma was defined as the parents' confirmation of a physician's diagnosis of asthma. Undiagnosed asthma

  3. Quality of life in children with undiagnosed and diagnosed asthma

    NARCIS (Netherlands)

    van Gent, R.; van Essen, L.E.; Rovers, M.M.; Kimpen, J.L.; van der Ent, C.K.; de Meer, G.

    2007-01-01

    This study describes the impact of undiagnosed and diagnosed asthma on quality of life in schoolchildren aged 7-10 years and their caregivers in a cross-sectional community-based study. Diagnosed asthma was defined as the parents' confirmation of a physician's diagnosis of asthma. Undiagnosed asthma

  4. Diagnosability Analysis Considering Causal Interpretations for Differential Constraints

    OpenAIRE

    2012-01-01

    This paper is focused on structural approaches to study diagnosability properties given a system model taking into account, both simultaneously or separately, integral and differential causal interpretations for differential constraints. We develop a model characterization and corresponding algorithms, for studying system diagnosability using a structural decomposition that avoids generating the full set of system analytical redundancy relations. Simultaneous application of integral and diffe...

  5. TBI-ROC Part Nine: Diagnosing TBI and Psychiatric Disorders

    Science.gov (United States)

    Elias, Eileen; Weider, Katie; Mustafa, Ruman

    2011-01-01

    This article is the ninth of a multi-part series on traumatic brain injury (TBI). It focuses on the process of diagnosing TBI and psychiatric disorders. Diagnosing traumatic brain injury can be challenging. It can be difficult differentiating TBI and psychiatric symptoms, as both have similar symptoms (e.g., memory problems, emotional outbursts,…

  6. Collective Thomson scattering capabilities to diagnose fusion plasmas

    DEFF Research Database (Denmark)

    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. PREVALENCE OF DIABETIC RETINOPATHY IN PATIENTS WITH NEWLY DIAGNOSED TYPE II DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    A. Bostak

    2006-11-01

    Full Text Available Diabetic retinopathy is a common complication of type II diabetes mellitus and carries with it the threat of blindness. Accurate information regarding the incidence of diabetic retinopathy and associated risk factors is important in the prevention of its development and of the visual impairment caused by this complication. This study was designed to determine the prevalence of diabetic retinopathy in newly diagnosed patients with type II diabetes mellitus. We have also evaluated the association of diabetic retinopathy with clinical and biochemical variables. In a cross-sectional study, 152 consecutive patients with newly diagnosed type II diabetes mellitus were referred from two outpatient clinics in Tehran for ophthalmologic exam to detect retinopathy. Indirect ophthalmoscopy was performed and data regarding risk factors were extracted from routine medical records. Chi square and Mann Whitney U tests were used to analyze the data. The overall prevalence of diabetic retinopathy was 13.8 %( 21 cases: three cases with microaneurysm only, 10 with mild, 5 with moderate and 2 with severe non proliferative diabetic retinopathy. Only one patient had advanced proliferative retinopathy. The prevalence of diabetic retinopathy was positively associated with age, duration of disease, fasting plasma glucose, HbA1c, and systolic blood pressure. Diabetic retinopathy is common in newly diagnosed type II diabetes mellitus patients. Ophthalmologic consultation is essential at the time of diagnosis for all patients.

  8. Spontaneous Rupture of Pyometra Causing Peritonitis in Elderly Female Diagnosed on Dynamic Transvaginal Ultrasound

    Directory of Open Access Journals (Sweden)

    Sharad M. Malvadkar

    2016-01-01

    Full Text Available Pyometra is collection of pus within the uterine cavity and is usually associated with underlying gynaecological malignancy or other benign causes. Spontaneous rupture of pyometra is a rare complication. We report a case of a 65-year-old female who presented with acute abdomen and was diagnosed with a ruptured uterus secondary to pyometra and consequent peritonitis on dynamic transvaginal sonography (TVS which was later confirmed on contrast enhanced computed tomography (CECT. An emergency laparotomy was performed and about 800 cc of pus was drained from the peritoneal cavity. A rent was found in the anterior uterine wall and hence hysterectomy was performed. Histopathology revealed mixed inflammatory cell infiltrate with no evidence of malignancy. There are only 31 cases of ruptured pyometra reported till date, most of which were definitively diagnosed only on laparotomy. In only two of these cases the preoperative diagnosis was made on CECT. We report this case, as the correct and definitive diagnosis was made preoperatively on dynamic TVS. To our knowledge, this is the first case report revealing spontaneous ruptured pyometra being diagnosed preoperatively on dynamic TVS. This report is aimed at giving emphasis on the use of simple dynamic TVS for accurate diagnosis of rare spontaneous ruptured pyometra causing peritonitis.

  9. Spontaneous Rupture of Pyometra Causing Peritonitis in Elderly Female Diagnosed on Dynamic Transvaginal Ultrasound.

    Science.gov (United States)

    Malvadkar, Sharad M; Malvadkar, Madhuri S; Domkundwar, Shilpa V; Mohd, Shariq

    2016-01-01

    Pyometra is collection of pus within the uterine cavity and is usually associated with underlying gynaecological malignancy or other benign causes. Spontaneous rupture of pyometra is a rare complication. We report a case of a 65-year-old female who presented with acute abdomen and was diagnosed with a ruptured uterus secondary to pyometra and consequent peritonitis on dynamic transvaginal sonography (TVS) which was later confirmed on contrast enhanced computed tomography (CECT). An emergency laparotomy was performed and about 800 cc of pus was drained from the peritoneal cavity. A rent was found in the anterior uterine wall and hence hysterectomy was performed. Histopathology revealed mixed inflammatory cell infiltrate with no evidence of malignancy. There are only 31 cases of ruptured pyometra reported till date, most of which were definitively diagnosed only on laparotomy. In only two of these cases the preoperative diagnosis was made on CECT. We report this case, as the correct and definitive diagnosis was made preoperatively on dynamic TVS. To our knowledge, this is the first case report revealing spontaneous ruptured pyometra being diagnosed preoperatively on dynamic TVS. This report is aimed at giving emphasis on the use of simple dynamic TVS for accurate diagnosis of rare spontaneous ruptured pyometra causing peritonitis.

  10. An update of 77 cases diagnosed as oral hemangiomas based on GLUT-1 positivity.

    Science.gov (United States)

    da Silva Filho, Tiago João; de Oliveira, Denise Hélen Imaculada Pereira; Brasil, Veruska Lima Moura; Nonaka, Cassiano Francisco Weege; da Silveira, Éricka Janine Dantas; Queiroz, Lélia Maria Guedes

    2017-08-01

    To evaluate cases diagnosed as "oral hemangiomas" based on the immunohistochemical expression of human glucose transporter protein (GLUT-1) and on histopathological features, and to investigate whether the classification proposed by the ISSVA was used correctly to classify these lesions. All cases stored in the archives of an Oral Pathology Service and diagnosed as "oral hemangiomas" were reviewed. Seventy-seven cases were analyzed regarding the expression of GLUT-1. GLUT-1(+) specimens were classified as true infantile hemangioma (IH) and GLUT-1(-) specimens were reclassified based on their histopathological features. The nomenclature of these lesions was evaluated and some cases were reclassified. Only 26 (33.8%) of the specimens were indeed IHs. Among the GLUT-1(-) specimens, 20 (26.0%) were reclassified as pyogenic granulomas (PGs) and 31 (40.2%) as vascular malformations. Considering the previously applied nomenclature, only 47.5% of the cases initially diagnosed as "hemangiomas" were IHs. In the group of "capillary hemangiomas", most cases (56.2%) were PGs. Among the three "cellular hemangiomas", two were PGs and one was IH. Most (88.8%) "cavernous hemangiomas" were vascular malformations. Careful and parameterized review of cases of vascular anomalies is necessary using auxiliary tools such as GLUT-1, since the exclusive use of histopathological findings might be insufficient to differentiate some anomalies. Accurate clinical examination and the use of biomarkers such as GLUT-1 are essential for the diagnosis. Copyright © 2017. Published by Elsevier Inc.

  11. Clinical value of CT three-dimensional imaging in diagnosing gastrointestinal tract diseases

    Institute of Scientific and Technical Information of China (English)

    Shao-Yin Duan; Dan-Tong Zhang; Qing-Chi Lin; Yan-Huan Wu

    2006-01-01

    AIM: To discuss the clinical value of CT three-dimensional (3-D) imaging in diagnosing gastrointestinal tract diseases.METHODS: Three-D imaging findings of 52 patients were retrospectively analyzed. Three-D imaging methods included shaded surface display (SSD), volume rendering (VR), virtual endoscopy (VE) and multiplanar reformatting (MPR). The diagnosis results of CT 3-D were evaluated by comparison with those of endoscopy and/or surgical finding.RESULTS: Fifty-two patients with gastrointestinal tract diseases were diagnosed by CT 3-D imaging, of whom 50 cases were correctly diagnosed and 2 were misdiagnosed. There were 33 cases of gastric diseases (27 with carcinoma, 5 with peptic ulcer and 1 with leiomyoma) and 19 large intestinal diseases (10 with colon carcinoma, 2 with carcinoma of the rectum, 5 with colon polypus and 2 with tuberculosis of the ileocecal junction). Twenty-two cases with prominent lesions (9 with subsequent hollow lesions), 20 with stenosis of cavity (8 with concomitant prominent lesions) and 10 with hollow lesions (5 with concomitant prominent lesions) were shown in 3-D images. The minimal lesion shown was 1.0 cm × 0.8 cm × 0.5 cm.CONCLUSION: CT 3-D imaging, a non-invasive examination without pain, can display clearly and directly the lesions of gastrointestinal tract with accurate location and high diagnosis accuracy. It is an important complementary technique to endoscopy.

  12. Speed-of-sound compensated photoacoustic tomography for accurate imaging

    CERN Document Server

    Jose, Jithin; Steenbergen, Wiendelt; Slump, Cornelis H; van Leeuwen, Ton G; Manohar, Srirang

    2012-01-01

    In most photoacoustic (PA) measurements, variations in speed-of-sound (SOS) of the subject are neglected under the assumption of acoustic homogeneity. Biological tissue with spatially heterogeneous SOS cannot be accurately reconstructed under this assumption. We present experimental and image reconstruction methods with which 2-D SOS distributions can be accurately acquired and reconstructed, and with which the SOS map can be used subsequently to reconstruct highly accurate PA tomograms. We begin with a 2-D iterative reconstruction approach in an ultrasound transmission tomography (UTT) setting, which uses ray refracted paths instead of straight ray paths to recover accurate SOS images of the subject. Subsequently, we use the SOS distribution in a new 2-D iterative approach, where refraction of rays originating from PA sources are accounted for in accurately retrieving the distribution of these sources. Both the SOS reconstruction and SOS-compensated PA reconstruction methods utilize the Eikonal equation to m...

  13. Nursing diagnoses identified in children with acute respiration infection

    Directory of Open Access Journals (Sweden)

    Flávia Paula Magalhães Monteiro

    2006-08-01

    Full Text Available A cross-sectional study developed with 78 children with until five years old, bearers of acute respiration infection interned in pediatric hospital of the periphery of a great city, with the purpose to identify the nursing diagnoses presented by these children. The number of nursing diagnoses, defining characteristics, related factors and risk factors identified and other numerical variables were analyzed based in theirs central tendency and dispersion measures. It was identified a total of 26 nursing diagnoses, 43 related factors, 14 risk factors e 67 defining characteristics. In average, It was found 5,32 nursing diagnoses; 4,10 related factors; 2,03 risk factors and 7,33 defining characteristics. The nursing diagnoses with the biggest proportion were: Ineffective Breathing Pattern, Risk for delayed growth, Ineffective protection and Altered oral mucous membrane. We concluded that children with acute respiration infection present a complex diagnostic frame including human responses of multiples domains.

  14. Ethical dilemma and moral distress: proposed new NANDA diagnoses.

    Science.gov (United States)

    Kopala, Beverly; Burkhart, Lisa

    2005-01-01

    To propose two NANDA diagnoses--ethical dilemma and moral distress--and to distinguish between the NANDA diagnosis decisional conflict and the proposed nursing diagnosis of ethical dilemma. Journal articles, books, and focus group research findings. Moral/ethical situations exist in health care. Nurses' experiences of ethical dilemmas and moral distress are extrapolated to the types and categories of ethical dilemmas and moral distress that patients experience and are used as the basis for development of two new nursing diagnoses. The two proposed NANDA diagnoses fill a void in current standardized terminology. It is important that nurses have the ability to diagnose ethical or moral situations in health care. Currently, NANDA does not offer a means to document this important phenomenon. The creation of two sets of nursing diagnoses, ethical dilemma and moral distress, will enable nurses to recognize and track nursing care related to ethical or moral situations.

  15. Nursing diagnoses in patients with chronic venous ulcer: observational study

    Directory of Open Access Journals (Sweden)

    Glycia de Almeida Nogueira

    2015-06-01

    Full Text Available This study aimed to analyze nursing diagnoses in people with chronic venous ulcer. An observational, descriptive, quantitative research conducted in an ambulatory specialized in wound treatment, with a non-probabilistic sample of 20 patients.  Data collection was performed in an institutional form denominated Assessment Protocol for Clients with Tissue Lesions. Diagnoses were established by consensus among four researchers with experience in nursing diagnoses and wound treatments. From data analysis, 16 diagnoses were identified, with 100% of participants presenting: Impaired tissue integrity, Ineffective peripheral tissue perfusion, Risk of infection, Impaired physical mobility and Ineffective health self-control. These diagnoses are found in Safety/Protection, Activity/Rest and Health promotion domains, which from the clinical practice stand point should be priority focuses in nursing intervention and assessment.

  16. A Fast Test to Diagnose Flu

    Energy Technology Data Exchange (ETDEWEB)

    Hazi, A U

    2007-02-12

    People with flu-like symptoms who seek treatment at a medical clinic or hospital often must wait several hours before being examined, possibly exposing many people to an infectious virus. If a patient appears to need more than the routine fluids-and-rest prescription, effective diagnosis requires tests that must be sent to a laboratory. Hours or days may pass before results are available to the doctor, who in the meantime must make an educated guess about the patient's illness. The lengthy diagnostic process places a heavy burden on medical laboratories and can result in improper use of antibiotics or a costly hospital stay. A faster testing method may soon be available. An assay developed by a team of Livermore scientists can diagnose influenza and other respiratory viruses in about two hours once a sample has been taken. Unlike other systems that operate this quickly, the new device, called FluIDx (and pronounced ''fluidics''), can differentiate five types of respiratory viruses, including influenza. FluIDx can analyze samples at the point of patient care--in hospital emergency departments and clinics--allowing medical providers to quickly determine how best to treat a patient, saving time and potentially thousands of dollars per patient. The FluIDx project, which is led by Livermore chemist Mary McBride of the Physics and Advanced Technologies Directorate, received funding from the National Institute of Allergy and Infectious Diseases and the Laboratory Directed Research and Development (LDRD) Program. To test the system and make it as useful as possible, the team worked closely with the Emergency Department staff at the University of California (UC) at Davis Medical Center in Sacramento. Flu kills more than 35,000 people every year in the US. The 2003 outbreak of severe acute respiratory syndrome and the ongoing concern about a possible bird flu pandemic show the need for a fast, reliable test that can differentiate seasonal flu from a

  17. A Fast Test to Diagnose Flu

    Energy Technology Data Exchange (ETDEWEB)

    Hazi, A U

    2007-02-12

    People with flu-like symptoms who seek treatment at a medical clinic or hospital often must wait several hours before being examined, possibly exposing many people to an infectious virus. If a patient appears to need more than the routine fluids-and-rest prescription, effective diagnosis requires tests that must be sent to a laboratory. Hours or days may pass before results are available to the doctor, who in the meantime must make an educated guess about the patient's illness. The lengthy diagnostic process places a heavy burden on medical laboratories and can result in improper use of antibiotics or a costly hospital stay. A faster testing method may soon be available. An assay developed by a team of Livermore scientists can diagnose influenza and other respiratory viruses in about two hours once a sample has been taken. Unlike other systems that operate this quickly, the new device, called FluIDx (and pronounced ''fluidics''), can differentiate five types of respiratory viruses, including influenza. FluIDx can analyze samples at the point of patient care--in hospital emergency departments and clinics--allowing medical providers to quickly determine how best to treat a patient, saving time and potentially thousands of dollars per patient. The FluIDx project, which is led by Livermore chemist Mary McBride of the Physics and Advanced Technologies Directorate, received funding from the National Institute of Allergy and Infectious Diseases and the Laboratory Directed Research and Development (LDRD) Program. To test the system and make it as useful as possible, the team worked closely with the Emergency Department staff at the University of California (UC) at Davis Medical Center in Sacramento. Flu kills more than 35,000 people every year in the US. The 2003 outbreak of severe acute respiratory syndrome and the ongoing concern about a possible bird flu pandemic show the need for a fast, reliable test that can differentiate seasonal flu from a

  18. Depression diagnoses following the identification of bipolar disorder: costly incongruent diagnoses

    Directory of Open Access Journals (Sweden)

    Schultz Jennifer F

    2010-06-01

    Full Text Available Abstract Background Previous research has documented that the symptoms of bipolar disorder are often mistaken for unipolar depression prior to a patient's first bipolar diagnosis. The assumption has been that once a patient receives a bipolar diagnosis they will no longer be given a misdiagnosis of depression. The objectives of this study were 1 to assess the rate of subsequent unipolar depression diagnosis in individuals with a history of bipolar disorder and 2 to assess the increased cost associated with this potential misdiagnosis. Methods This study utilized a retrospective cohort design using administrative claims data from 2002 and 2003. Patient inclusion criteria for the study were 1 at least 2 bipolar diagnoses in 2002, 2 continuous enrollment during 2002 and 2003, 3 a pharmacy benefit, and 4 age 18 to 64. Patients with at least 2 unipolar depression diagnoses in 2003 were categorized as having an incongruent diagnosis of unipolar depression. We used propensity scoring to control for selection bias. Utilization was evaluated using negative binomial models. We evaluated cost differences between patient cohorts using generalized linear models. Results Of the 7981 patients who met all inclusion criteria for the analysis, 17.5% (1400 had an incongruent depression diagnosis (IDD. After controlling for background differences, individuals who received an IDD had higher rates of inpatient and outpatient psychiatric utilization and cost, on average, an additional $1641 per year compared to individuals without an IDD. Conclusions A strikingly high proportion of bipolar patients are given the differential diagnosis of unipolar depression after being identified as having bipolar disorder. Individuals with an IDD had increased acute psychiatric care services, suggesting higher levels of relapses, and were at risk for inappropriate treatment, as antidepressant therapy without a concomitant mood-stabilizing medication is contraindicated in bipolar

  19. Adult colocolic intussusception diagnosed by ultrasonography: a case report

    Directory of Open Access Journals (Sweden)

    Benazzouz Moustapha

    2011-07-01

    Full Text Available Abstract Introduction Intussusception is highly uncommon in adults and accounts for only 5% of all reported cases. It is more commonly secondary to an identifiable bowel lesion in 90% of cases, whereas 10% have no discernable cause. Diagnosis is difficult due to non-specific symptoms of the disease. Diagnostic imaging plays an important role in the diagnosis of the condition. Sonography and computed tomography are the most commonly used imaging techniques. In adults, intussusception usually requires treatment by surgical resection of the affected bowel. Case presentation A 35-year-old Moroccan woman presented with a five-month history of intermittent abdominal pain and one episode of bleeding from the rectum. At physical examination an abdominal mass was noted. Abdominal sonography revealed a 6.3 × 8.5 cm midline mass in her upper abdomen that was tender. In transverse section, the mass had the multiple concentric rings of hypoechoic and echogenic layers associated with the sonographic appearance of intussusception. In longitudinal section, the mass had the sonographic aspect of multiple parallel lines, giving the so-called "sandwich appearance". A corresponding contrast-enhanced abdominal computed tomography scan also demonstrated the intussusception. Surgery confirmed a colocolic intussusception with a large, firm, indurated mass as the lead point. A right hemicolectomy was undertaken because of concern about possible malignancy. The resected ascending colon was then opened up, to find a protruding tumor of the ascending colon that was acting as the lead point. It measured 7.6 × 6.9 × 2.4 cm. Pathology diagnosed an infiltrating, differentiated adenocarcinoma of the ascending colon invading through the muscularis propria. No lymphovascular invasion was seen. Our patient has recovered well. Conclusion Intussusception is relatively rare in the adult population, and this, along with the vague clinical features, makes diagnosis difficult

  20. Diagnosing norovirus-associated infectious intestinal disease using viral load

    Directory of Open Access Journals (Sweden)

    Tam Clarence C

    2009-05-01

    Full Text Available Abstract Background Reverse transcription-polymerase chain reaction (RT-PCR is the main method for laboratory diagnosis of norovirus-associated infectious intestinal disease (IID. However, up to 16% of healthy individuals in the community, with no recent history of IID, may be RT-PCR positive; so it is unclear whether norovirus is actually the cause of illness in an IID case when they are RT-PCR positive. It is important to identify the pathogen causing illness in sporadic IID cases, for clinical management and for community based incidence studies. The aim of this study was to investigate how faecal viral load can be used to determine when norovirus is the most likely cause of illness in an IID case. Methods Real-time RT-PCR was used to determine the viral load in faecal specimens collected from 589 IID cases and 159 healthy controls, who were infected with genogroup II noroviruses. Cycle threshold (Ct values from the real-time RT-PCR were used as a proxy measure of viral load. Receiver-operating characteristic (ROC analysis was used to identify a cut-off in viral load for attributing illness to norovirus in IID cases. Results One hundred and sixty-nine IID cases and 159 controls met the inclusion criteria for the ROC analysis. The optimal Ct value cut-off for attributing IID to norovirus was 31. The same cut-off was selected when using healthy controls, or IID cases who were positive by culture for bacterial pathogens, as the reference negative group. This alternative reference negative group can be identified amongst specimens routinely received in clinical virology laboratories. Conclusion We demonstrated that ROC analysis can be used to select a cut-off for a norovirus real time RT-PCR assay, to aid clinical interpretation and diagnose when norovirus is the cause of IID. Specimens routinely received for diagnosis in clinical virology laboratories can be used to select an appropriate cut-off. Individual laboratories can use this method to

  1. Histological examination of ulcer margin for diagnosing Helicobacter pylori infection in patients with gastric ulcers.

    Science.gov (United States)

    Lin, Ming-Hui; Cheng, Hao-Tsai; Chuang, Wen-Yu; Yu, Li-Kuang; Tsou, Yung-Kuan; Lee, Mu-Shien

    2013-02-01

    Biopsy of ulcer margin is routinely performed to exclude malignancy in patients with gastric ulcers, but its utility in diagnosing Helicobacter pylori infection has not yet been fully studied. A cohort of 50 patients with gastric ulcer was prospectively examined. Three tests including histology, rapid urease test, and urea breath test were performed in all patients for diagnosing H pylori infection. Six biopsied specimens from the margin of the gastric ulcer and 1 each specimen from antrum and body of non-ulcer part were obtained for histology using hematoxylin-eosin (H&E) stain. The criterion used for defining H pylori infection was a positive result in at least 2 of the 3 tests. H pylori infection was diagnosed in 27 (54%) of the patients. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the histological examination of the ulcer margin were 92.6%, 95.7%, 96.2%, 91.7%, and 94%, respectively. The addition of 1 specimen from the antrum or body or a combination of the 2 specimens did not increase the diagnostic yields of those for histological examination of ulcer margin alone. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the rapid urease test were 96.3%, 100%, 100%, 95.8%, and 98%, respectively, and the corresponding values for the urea breath test were 88.9%, 87%, 88.9%, 87%, and 88%. We performed Giemsa stain for the 3 patients with false-negative and false-positive results of histological examination of ulcer margin using H&E stain, and all were positive for H pylori infection. In conclusion, histological examination of the ulcer margin using hematoxylin-eosin stain was quite accurate and useful for diagnosing H pylori infection in patients with gastric ulcers. A special stain is required when the diagnosis of H pylori infection is questionable on routine H&E staining.

  2. CT-MPR invaluable in diagnosing odontogenic maxillary sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Aoki, Hideaki; Shimazu, Kaoru; Kamada, Morito; Shiroyama, Akihiro; Mouri, Daisuke; Yamashita, Masashi; Kawasaki, Yasunori; Koseki, Takakazu; Mouri, Manabu [Osaka Dental Univ. (Japan)

    2001-08-01

    In everyday examination, it is usual to encounter odontogenic maxillary sinusitis patients. Odontogenic maxillary sinusitis is generally best diagnosed by dental X-ray imaging. Many medical facilities not having a dental X-ray unit use coronal computed tomography (CT) images to diagnose odontogenic maxillary sinusitis. Coronal CT imaging causes artifacts, however due to dental prosthesises. Computed tomography-Multiplanar reformation (CT-MPR) imaging has proved useful in evaluating the paranasal sinus because it is not influenced by dental prosthesises. We evaluated the usefulness of CT-MPR for diagnosing odontogenic maxillary sinusitis by retrospectively analyzing 16 patients, with the following results. We couldn't diagnose all cases of odontogenic maxillary sinusitis in posteroanterior and Waters projection images. Panoramic radiography is needed to diagnose odontogenic maxillary sinusitis. Dental X-ray imaging missed some cases, but all cases were diagnosed by CT-MPR imaging, giving a 100% diagnosestic rate. CT-MPR imaging is thus at least as valuable or better than dental X-ray imaging in diagnosing odontogenic maxillary sinusitis. (author)

  3. Realization of Quadrature Signal Generator Using Accurate Magnitude Integrator

    DEFF Research Database (Denmark)

    Xin, Zhen; Yoon, Changwoo; Zhao, Rende

    2016-01-01

    -signal parameters, espically when a fast resonse is required for usages such as grid synchronization. As a result, the parameters design of the SOGI-QSG becomes complicated. Theoretical analysis shows that it is caused by the inaccurate magnitude-integration characteristic of the SOGI-QSG. To solve this problem......, an Accurate-Magnitude-Integrator based QSG (AMI-QSG) is proposed. The AMI has an accurate magnitude-integration characteristic for the sinusoidal signal, which makes the AMI-QSG possess an accurate First-Order-System (FOS) characteristic in terms of magnitude than the SOGI-QSG. The parameter design process...

  4. Fabricating an Accurate Implant Master Cast: A Technique Report.

    Science.gov (United States)

    Balshi, Thomas J; Wolfinger, Glenn J; Alfano, Stephen G; Cacovean, Jeannine N; Balshi, Stephen F

    2015-12-01

    The technique for fabricating an accurate implant master cast following the 12-week healing period after Teeth in a Day® dental implant surgery is detailed. The clinical, functional, and esthetic details captured during the final master impression are vital to creating an accurate master cast. This technique uses the properties of the all-acrylic resin interim prosthesis to capture these details. This impression captures the relationship between the remodeled soft tissue and the interim prosthesis. This provides the laboratory technician with an accurate orientation of the implant replicas in the master cast with which a passive fitting restoration can be fabricated.

  5. Intertester reliability of shoulder complaints diagnoses in primary health care

    Science.gov (United States)

    Storheil, Benny; Klouman, Elise; Holmvik, Stian; Emaus, Nina; Fleten, Nils

    2016-01-01

    Objective Shoulder complaints are frequently encountered in general practice, but precise diagnosing is challenging. This study investigated agreement of shoulder complaints diagnoses between clinicians in a primary health care setting. Design Cross-sectional study. Setting Four primary health care clinicians used patients’ history and functional examination of the shoulder by selective tissue tension techniques (STTs), to diagnose shoulder complaints. Subjects 62 patients, aged 18–75 years. Main outcome measure Reliability of diagnoses was assessed by observed intertester agreement and Cohen’s kappa. A total of 372 diagnostic pairs were available for intertester comparisons. Results Six diagnoses were assigned by all clinicians; supraspinatus-, infraspinatus-, subscapularis-tendinopathies; chronic subacromial bursitis; glenohumeral capsulitis, and acromioclavicular joint lesion. The observed agreement on these diagnoses ranged from 0.84 for glenohumeral capsulitis to 0.97 for acromioclavicular joint lesion. Kappa scores were 0.46 (95% CI 0.33, 0.58) for chronic subacromial bursitis; 0.53 (95% CI 0.34, 0.68), 0.59 (95% CI 0.47, 0.70), and 0.68 (95% CI 0.53, 0.82) for infraspinatus -, supraspinatus -, and subscapularis-tendinopathy, respectively. For glenohumeral capsulitis and acromioclavicular lesion kappa scores were 0.66 (95% CI 0.57, 0.73) and 0.78 (95% CI 0.61, 0.90). Kappa scores were higher for individual diagnoses than for individual tests, except for limitation in passive abduction (0.70, 95% CI 0.62, 0.78) and passive lateral rotation (0.66, 95% CI 0.57, 0.73). Conclusions Although experienced clinicians showed substantial intertester agreement, precise diagnoses of shoulder complaints in primary health care remain a challenge. The present results call for further research on refined diagnoses of shoulder complaints. Key Points Based on medical history and a systematic functional examination by selective tissue tension techniques (STTs), we

  6. An in situ method for diagnosing phase shifting interferometry

    Science.gov (United States)

    Shao, J.; Ma, D.; Zhang, H.; Xie, Y.

    2016-05-01

    Current diagnosing phase shifting interferometry is a time and funds consuming process. Hence a brief and effective method is necessary to satisfy the real-time testing. In this paper, mathematical solutions for errors were deduced from the difference of intensity patterns. Based on the diversity of error distributions, an effective method for distinguishing and diagnosing the error sources is proposed and verified by an elaborative designed simulation. In the actual comparison experiment, vibration, phase-shift error and intensity fluctuation were imposed to demonstrate this method. The results showed that this method can be applied into the real-time measurement and provide an in situ diagnosing technique.

  7. Highly Accurate Sensor for High-Purity Oxygen Determination Project

    Data.gov (United States)

    National Aeronautics and Space Administration — In this STTR effort, Los Gatos Research (LGR) and the University of Wisconsin (UW) propose to develop a highly-accurate sensor for high-purity oxygen determination....

  8. Multi-objective optimization of inverse planning for accurate radiotherapy

    Institute of Scientific and Technical Information of China (English)

    曹瑞芬; 吴宜灿; 裴曦; 景佳; 李国丽; 程梦云; 李贵; 胡丽琴

    2011-01-01

    The multi-objective optimization of inverse planning based on the Pareto solution set, according to the multi-objective character of inverse planning in accurate radiotherapy, was studied in this paper. Firstly, the clinical requirements of a treatment pl

  9. Accurate backgrounds to Higgs production at the LHC

    CERN Document Server

    Kauer, N

    2007-01-01

    Corrections of 10-30% for backgrounds to the H --> WW --> l^+l^-\\sla{p}_T search in vector boson and gluon fusion at the LHC are reviewed to make the case for precise and accurate theoretical background predictions.

  10. ACCURATE ESTIMATES OF CHARACTERISTIC EXPONENTS FOR SECOND ORDER DIFFERENTIAL EQUATION

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    In this paper, a second order linear differential equation is considered, and an accurate estimate method of characteristic exponent for it is presented. Finally, we give some examples to verify the feasibility of our result.

  11. Controlling Hay Fever Symptoms with Accurate Pollen Counts

    Science.gov (United States)

    ... counts Share | Controlling Hay Fever Symptoms with Accurate Pollen Counts This article has been reviewed by Thanai ... rhinitis known as hay fever is caused by pollen carried in the air during different times of ...

  12. Digital system accurately controls velocity of electromechanical drive

    Science.gov (United States)

    Nichols, G. B.

    1965-01-01

    Digital circuit accurately regulates electromechanical drive mechanism velocity. The gain and phase characteristics of digital circuits are relatively unimportant. Control accuracy depends only on the stability of the input signal frequency.

  13. Mass spectrometry based protein identification with accurate statistical significance assignment

    OpenAIRE

    Alves, Gelio; Yu, Yi-Kuo

    2014-01-01

    Motivation: Assigning statistical significance accurately has become increasingly important as meta data of many types, often assembled in hierarchies, are constructed and combined for further biological analyses. Statistical inaccuracy of meta data at any level may propagate to downstream analyses, undermining the validity of scientific conclusions thus drawn. From the perspective of mass spectrometry based proteomics, even though accurate statistics for peptide identification can now be ach...

  14. Cornelia de Lange syndrome: To diagnose or not to diagnose in utero?

    Science.gov (United States)

    Avagliano, Laura; Bulfamante, Gaetano Pietro; Massa, Valentina

    2017-06-01

    Cornelia de Lange syndrome (CdLS) is an inherited condition with a wide spectrum of phenotypic anomalies, consisting mainly of growth impairment, multi-organ abnormalities, and neurocognitive delay. Clinical diagnostic criteria after birth are well defined, whereas when to suspect the syndrome during intrauterine life still remains undefined. This review summarizes the main possible prenatal findings in CdLS, suggesting that a skilled ultrasound scan in cases of intrauterine growth restriction associated with other fetal abnormalities may improve the chance of prenatal diagnosis of CdLS, especially in families known to be at high risk. We propose that, following a sequence of detailed scans and examinations, CdLS affected fetuses could be diagnosed in utero, when one or more conditions (among them, intrauterine growth restriction, limb defects, facial abnormalities, diaphragmatic hernia, and heart diseases) are detected, and possibly confirmed by specific molecular testing. Birth Defects Research 109:771-777, 2017. © 2017 The Authors. Birth Defects Research Published by Wiley Periodicals, Inc. © 2017 The Authors. Birth Defects Research Published by Wiley Periodicals, Inc.

  15. How Do Health Care Providers Diagnose Klinefelter Syndrome?

    Science.gov (United States)

    ... and Publications How do health care providers diagnose Klinefelter syndrome (KS)? Skip sharing on social media links Share ... in 166 boys, adolescents and adults with nonmosaic Klinefelter syndrome: A Copenhagen experience. Acta Paediatrica , Jun;100(6), ...

  16. How Do Health Care Providers Diagnose Polycystic Ovary Syndrome (PCOS)?

    Science.gov (United States)

    ... of high androgens, such as excess body or facial hair More than 12 cysts of a specific size on one or both of the ovaries (as detected by ultrasound) Some women diagnosed with PCOS have the first two symptoms ...

  17. Just Diagnosed: Next Steps After Testing Positive for HIV

    Science.gov (United States)

    HIV Treatment Just Diagnosed: Next Steps After Testing Positive for HIV (Last updated 3/13/2017; last reviewed 3/ ... is the next step after testing positive for HIV? Testing positive for HIV often leaves a person ...

  18. [Whose borderline is it? Reconsidering diagnosing borderline personality].

    Science.gov (United States)

    Gil, Tsvi E

    2008-11-01

    The present article critically discusses diagnosing borderline personality, demonstrating ideas raised with a treated case. In contrast to routine diagnoses made by psychiatrists according to common diagnosing systems (such as the American DSM or the WHO's ICD), we wonder whether this diagnosis reflects a medico-social construct, which is associated to the female status in masculine (or even patriarch) society, and probably associated even to the context of a woman diagnosed by a psychiatric system. In the context of critically viewing aetiological hypotheses to borderline personality (presented in our former article as a personality constellated around complex and prolonged trauma) in this article we suggest viewing borderline behaviours and symptoms as manifestations of coping and survival of a woman-victim in abusing surroundings.

  19. How Do Health Care Providers Diagnose Bacterial Vaginosis (BV)?

    Science.gov (United States)

    ... and Publications How do health care providers diagnose bacterial vaginosis (BV)? Skip sharing on social media links Share ... menstruating. Centers for Disease Control and Prevention. (2010). Bacterial vaginosis: CDC fact sheet . Retrieved May 10, 2012, from ...

  20. First Case of Zika-Linked Glaucoma Diagnosed in Infant

    Science.gov (United States)

    ... gov/news/fullstory_162294.html First Case of Zika-Linked Glaucoma Diagnosed in Infant Brazilian baby developed ... who developed glaucoma after being exposed to the Zika virus while in the womb has been reported ...

  1. Validity of stroke diagnoses in a National Register of Patients

    DEFF Research Database (Denmark)

    Krarup, Lars-Henrik; Boysen, Gudrun; Janjua, Huma;

    2007-01-01

    Many registers containing routine medical information have been developed for research and surveillance purposes. In epidemiological research assessment of endpoints is often conducted via registers. In the present study we validated stroke and transient ischemic attack (TIA) diagnoses...

  2. PHACE syndrome in antenatally diagnosed posterior fossa anomaly

    Directory of Open Access Journals (Sweden)

    Seema Pavaman Sindgikar

    2014-01-01

    Full Text Available PHACE is a neurocutaneous syndrome, an acronym to describe patients with facial segmental hemangiomas and other malformations. We describe a newborn antenatally diagnosed to have posterior fossa anomaly and subsequently as PHACE syndrome.

  3. An Event-based Approach to Hybrid Systems Diagnosability

    Data.gov (United States)

    National Aeronautics and Space Administration — Diagnosability is an important issue in the design of diagnostic systems, because it helps identify whether sufficient information is available to distinguish all...

  4. Follow-up of prenatally diagnosed unilateral hydronephrosis

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Lenz, K; Rabol, A

    1996-01-01

    Based on previous experience with prenatally diagnosed unilateral hydronephrosis, we found that the primary indications for surgical intervention should be symptoms or functional impairment of the hydronephrotic kidney. Nonoperative management of neonates without symptoms and with normal function...

  5. Implications Of Using External Consultants In Diagnosing And ...

    African Journals Online (AJOL)

    The process of diagnosing need for the change, the problems/issues to be ... Some practical examples of the diagnosis by external consultants are also presented. ... Gaining co-operation from the client organization and the avoidance of ...

  6. Concomitant HIV infection in newly diagnosed multiple myeloma ...

    African Journals Online (AJOL)

    HIV-positive MM patients with unusual clinical presentations and aggressive ... fatigue, weight loss, bone marrow plasmacytosis, renal insufficiency ... cell transplantation. ... HIV was newly diagnosed during the work-up of MM in eight cases.

  7. Pathologic diagnoses of appendectomy specimens: a 10-year review.

    African Journals Online (AJOL)

    Pathologic diagnoses of appendectomy specimens: a 10-year review. ... Annals of Biomedical Sciences ... Materials and methods: Records of resected appendices with a clinical diagnosis of acute appendicitis submitted to histopathology ...

  8. Accuracy of Veterans Affairs Databases for Diagnoses of Chronic Diseases

    OpenAIRE

    Singh, Jasvinder A.

    2009-01-01

    Introduction Epidemiologic studies usually use database diagnoses or patient self-report to identify disease cohorts, but no previous research has examined the extent to which self-report of chronic disease agrees with database diagnoses in a Veterans Affairs (VA) health care setting. Methods All veterans who had a medical care visit from October 1, 1996, through May 31, 1998, at any of the Veterans Integrated Service Network 13 facilities were surveyed about physician diagnosis of chronic ob...

  9. Validity of stroke diagnoses in a National Register of Patients

    DEFF Research Database (Denmark)

    Krarup, Lars-Henrik; Boysen, Gudrun; Janjua, Huma;

    2007-01-01

    Many registers containing routine medical information have been developed for research and surveillance purposes. In epidemiological research assessment of endpoints is often conducted via registers. In the present study we validated stroke and transient ischemic attack (TIA) diagnoses in the Dan......Many registers containing routine medical information have been developed for research and surveillance purposes. In epidemiological research assessment of endpoints is often conducted via registers. In the present study we validated stroke and transient ischemic attack (TIA) diagnoses...

  10. A 65-year-old woman diagnosed with PHACE syndrome.

    Science.gov (United States)

    Burch, Ezra A; Garzon, Maria C; Parikh, Anuraag; Meyers, Philip M

    2013-01-01

    PHACE syndrome is characterized by the association between infantile hemangioma and varied but characteristic systemic manifestations, including cerebrovascular and cardiac abnormalities. The disorder has primarily been diagnosed in children, with little information available regarding long-term outcomes in affected individuals. We report the oldest known individual with PHACE syndrome in the medical literature, a 65-year-old woman who was diagnosed after a transient ischemic attack.

  11. An accurate assay for HCV based on real-time fluorescence detection of isothermal RNA amplification.

    Science.gov (United States)

    Wu, Xuping; Wang, Jianfang; Song, Jinyun; Li, Jiayan; Yang, Yongfeng

    2016-09-01

    Hepatitis C virus (HCV) is one of the common reasons of liver fibrosis and hepatocellular carcinoma (HCC). Early, rapid and accurate HCV RNA detection is important to prevent and control liver disease. A simultaneous amplification and testing (SAT) assay, which is based on isothermal amplification of RNA and real-time fluorescence detection, was designed to optimize routine HCV RNA detection. In this study, HCV RNA and an internal control (IC) were amplified and analyzed simultaneously by SAT assay and detection of fluorescence using routine real-time PCR equipment. The assay detected as few as 10 copies of HCV RNA transcripts. We tested 705 serum samples with SAT, among which 96.4% (680/705) showed consistent results compared with routine real-time PCR. About 92% (23/25) discordant samples were confirmed to be same results as SAT-HCV by using a second real-time PCR. The sensitivity and specificity of SAT-HCV assay were 99.6% (461/463) and 100% (242/242), respectively. In conclusion, the SAT assay is an accurate test with a high specificity and sensitivity which may increase the detection rate of HCV. It is therefore a promising tool to diagnose HCV infection.

  12. Intraocular lens power estimation by accurate ray tracing for eyes underwent previous refractive surgeries

    Science.gov (United States)

    Yang, Que; Wang, Shanshan; Wang, Kai; Zhang, Chunyu; Zhang, Lu; Meng, Qingyu; Zhu, Qiudong

    2015-08-01

    For normal eyes without history of any ocular surgery, traditional equations for calculating intraocular lens (IOL) power, such as SRK-T, Holladay, Higis, SRK-II, et al., all were relativley accurate. However, for eyes underwent refractive surgeries, such as LASIK, or eyes diagnosed as keratoconus, these equations may cause significant postoperative refractive error, which may cause poor satisfaction after cataract surgery. Although some methods have been carried out to solve this problem, such as Hagis-L equation[1], or using preoperative data (data before LASIK) to estimate K value[2], no precise equations were available for these eyes. Here, we introduced a novel intraocular lens power estimation method by accurate ray tracing with optical design software ZEMAX. Instead of using traditional regression formula, we adopted the exact measured corneal elevation distribution, central corneal thickness, anterior chamber depth, axial length, and estimated effective lens plane as the input parameters. The calculation of intraocular lens power for a patient with keratoconus and another LASIK postoperative patient met very well with their visual capacity after cataract surgery.

  13. Development of anatomically and dielectrically accurate breast phantoms for microwave imaging applications

    Science.gov (United States)

    O'Halloran, M.; Lohfeld, S.; Ruvio, G.; Browne, J.; Krewer, F.; Ribeiro, C. O.; Inacio Pita, V. C.; Conceicao, R. C.; Jones, E.; Glavin, M.

    2014-05-01

    Breast cancer is one of the most common cancers in women. In the United States alone, it accounts for 31% of new cancer cases, and is second only to lung cancer as the leading cause of deaths in American women. More than 184,000 new cases of breast cancer are diagnosed each year resulting in approximately 41,000 deaths. Early detection and intervention is one of the most significant factors in improving the survival rates and quality of life experienced by breast cancer sufferers, since this is the time when treatment is most effective. One of the most promising breast imaging modalities is microwave imaging. The physical basis of active microwave imaging is the dielectric contrast between normal and malignant breast tissue that exists at microwave frequencies. The dielectric contrast is mainly due to the increased water content present in the cancerous tissue. Microwave imaging is non-ionizing, does not require breast compression, is less invasive than X-ray mammography, and is potentially low cost. While several prototype microwave breast imaging systems are currently in various stages of development, the design and fabrication of anatomically and dielectrically representative breast phantoms to evaluate these systems is often problematic. While some existing phantoms are composed of dielectrically representative materials, they rarely accurately represent the shape and size of a typical breast. Conversely, several phantoms have been developed to accurately model the shape of the human breast, but have inappropriate dielectric properties. This study will brie y review existing phantoms before describing the development of a more accurate and practical breast phantom for the evaluation of microwave breast imaging systems.

  14. The accurate assessment and physiotherapeutic treatment of rotator cuff myofascial Pain Syndrome: A case report

    Directory of Open Access Journals (Sweden)

    B. B. Barker

    2011-02-01

    Full Text Available Management  of  patients  with  rotator  cuff  myofascial  pain syndrome varies  and  successful  intervention  is  dependent  on accurate assessment. The aim of this case report is to show the importance of accurate assessment  and  clinical  reasoning  in  the  physiotherapeutic management  of a  patient  suffering  from  ante-cubital  and  anterior shoulder  pain.  The  patient was  referred  for  physiotherapy  after proving refractory  to  treatment  with  non-steroidal anti-inflammatory medication. The physiotherapist diagnosed a rotator cuff myofascial pain syndrome and treatment proceeded on that basis. Treatment consisted of twitch-obtaining dry needling, myofascial release and exercise therapy.  The result was a change in the harryman rotator cuff functional Assessment Scale score from 22/52 to 43/52 over eight treatments. Strength was regained and subjective pain report on the visual rating scale was improved to 1/10. The case study highlights the importance of accurate assessment and consideration of alternative myofascial sources for pain even in circumstances which initially seem trauma related. Precise diagnosis of the cause - in this case rotator cuff myofascial pain syndrome – will result in effective treatment being administered.

  15. Nonexposure Accurate Location K-Anonymity Algorithm in LBS

    Directory of Open Access Journals (Sweden)

    Jinying Jia

    2014-01-01

    Full Text Available This paper tackles location privacy protection in current location-based services (LBS where mobile users have to report their exact location information to an LBS provider in order to obtain their desired services. Location cloaking has been proposed and well studied to protect user privacy. It blurs the user’s accurate coordinate and replaces it with a well-shaped cloaked region. However, to obtain such an anonymous spatial region (ASR, nearly all existent cloaking algorithms require knowing the accurate locations of all users. Therefore, location cloaking without exposing the user’s accurate location to any party is urgently needed. In this paper, we present such two nonexposure accurate location cloaking algorithms. They are designed for K-anonymity, and cloaking is performed based on the identifications (IDs of the grid areas which were reported by all the users, instead of directly on their accurate coordinates. Experimental results show that our algorithms are more secure than the existent cloaking algorithms, need not have all the users reporting their locations all the time, and can generate smaller ASR.

  16. Nonexposure accurate location K-anonymity algorithm in LBS.

    Science.gov (United States)

    Jia, Jinying; Zhang, Fengli

    2014-01-01

    This paper tackles location privacy protection in current location-based services (LBS) where mobile users have to report their exact location information to an LBS provider in order to obtain their desired services. Location cloaking has been proposed and well studied to protect user privacy. It blurs the user's accurate coordinate and replaces it with a well-shaped cloaked region. However, to obtain such an anonymous spatial region (ASR), nearly all existent cloaking algorithms require knowing the accurate locations of all users. Therefore, location cloaking without exposing the user's accurate location to any party is urgently needed. In this paper, we present such two nonexposure accurate location cloaking algorithms. They are designed for K-anonymity, and cloaking is performed based on the identifications (IDs) of the grid areas which were reported by all the users, instead of directly on their accurate coordinates. Experimental results show that our algorithms are more secure than the existent cloaking algorithms, need not have all the users reporting their locations all the time, and can generate smaller ASR.

  17. Liver shear-wave velocity and serum fibrosis markers to diagnose hepatic fibrosis in patients with chronic viral hepatitis B

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Jian Xue; Ji, Yong Hao; Zhao Junzhi; Zhang, Yao Ren; Dun, Guo Liang; Ning, Bo [Dept. of Ultrasonography, Baoji Central Hospital, Baoji (China); Ai, Hong [Dept. of Ultrasonography, The First Affiliated Hospital of Medical College, Xi' an Jiaotong University, Xi' an (China)

    2016-06-15

    To compare several noninvasive indices of fibrosis in chronic viral hepatitis B, including liver shear-wave velocity (SWV), hyaluronic acid (HA), collagen type IV (CIV), procollagen type III (PCIII), and laminin (LN). Acoustic radiation force impulse (ARFI) was performed in 157 patients with chronic viral hepatitis B and in 30 healthy volunteers to measure hepatic SWV (m/s) in a prospective study. Serum markers were acquired on the morning of the same day of the ARFI evaluation. Receiver operating characteristic (ROC) analysis was performed to evaluate and compare the accuracies of SWV and serum markers using METAVIR scoring from liver biopsy as a reference standard. The most accurate test for diagnosing fibrosis F ≥ 1 was SWV with the area under the ROC curve (AUC) of 0.913, followed by LN (0.744), HA (0.701), CIV (0.690), and PCIII (0.524). The best test for diagnosing F ≥ 2 was SWV (AUC of 0.851), followed by CIV (0.671), HA (0.668), LN (0.562), and PCIII (0.550). The best test for diagnosing F ≥ 3 was SWV (0.854), followed by CIV (0.693), HA (0.675), PCIII (0.591), and LN (0.548). The best test for diagnosing F = 4 was SWV (0.965), followed by CIV (0.804), PCIII (0.752), HA (0.744), and LN (0.662). SWV combined with HA and CIV did not improve diagnostic accuracy (AUC = 0.931 for F ≥ 1, 0.863 for F ≥ 2, 0.855 for F ≥ 3, 0.960 for F = 4). The performance of SWV in diagnosing liver fibrosis is superior to that of serum markers. However, the combination of SWV, HA, and CIV does not increase the accuracy of diagnosing liver fibrosis and cirrhosis.

  18. Accurate level set method for simulations of liquid atomization☆

    Institute of Scientific and Technical Information of China (English)

    Changxiao Shao; Kun Luo; Jianshan Yang; Song Chen; Jianren Fan

    2015-01-01

    Computational fluid dynamics is an efficient numerical approach for spray atomization study, but it is chal enging to accurately capture the gas–liquid interface. In this work, an accurate conservative level set method is intro-duced to accurately track the gas–liquid interfaces in liquid atomization. To validate the capability of this method, binary drop collision and drop impacting on liquid film are investigated. The results are in good agreement with experiment observations. In addition, primary atomization (swirling sheet atomization) is studied using this method. To the swirling sheet atomization, it is found that Rayleigh–Taylor instability in the azimuthal direction causes the primary breakup of liquid sheet and complex vortex structures are clustered around the rim of the liq-uid sheet. The effects of central gas velocity and liquid–gas density ratio on atomization are also investigated. This work lays a solid foundation for further studying the mechanism of spray atomization.

  19. Highly Accurate Measurement of the Electron Orbital Magnetic Moment

    CERN Document Server

    Awobode, A M

    2015-01-01

    We propose to accurately determine the orbital magnetic moment of the electron by measuring, in a Magneto-Optical or Ion trap, the ratio of the Lande g-factors in two atomic states. From the measurement of (gJ1/gJ2), the quantity A, which depends on the corrections to the electron g-factors can be extracted, if the states are LS coupled. Given that highly accurate values of the correction to the spin g-factor are currently available, accurate values of the correction to the orbital g-factor may also be determined. At present, (-1.8 +/- 0.4) x 10-4 has been determined as a correction to the electron orbital g-factor, by using earlier measurements of the ratio gJ1/gJ2, made on the Indium 2P1/2 and 2P3/2 states.

  20. Simple and accurate analytical calculation of shortest path lengths

    CERN Document Server

    Melnik, Sergey

    2016-01-01

    We present an analytical approach to calculating the distribution of shortest paths lengths (also called intervertex distances, or geodesic paths) between nodes in unweighted undirected networks. We obtain very accurate results for synthetic random networks with specified degree distribution (the so-called configuration model networks). Our method allows us to accurately predict the distribution of shortest path lengths on real-world networks using their degree distribution, or joint degree-degree distribution. Compared to some other methods, our approach is simpler and yields more accurate results. In order to obtain the analytical results, we use the analogy between an infection reaching a node in $n$ discrete time steps (i.e., as in the susceptible-infected epidemic model) and that node being at a distance $n$ from the source of the infection.

  1. Accurate Fiber Length Measurement Using Time-of-Flight Technique

    Science.gov (United States)

    Terra, Osama; Hussein, Hatem

    2016-06-01

    Fiber artifacts of very well-measured length are required for the calibration of optical time domain reflectometers (OTDR). In this paper accurate length measurement of different fiber lengths using the time-of-flight technique is performed. A setup is proposed to measure accurately lengths from 1 to 40 km at 1,550 and 1,310 nm using high-speed electro-optic modulator and photodetector. This setup offers traceability to the SI unit of time, the second (and hence to meter by definition), by locking the time interval counter to the Global Positioning System (GPS)-disciplined quartz oscillator. Additionally, the length of a recirculating loop artifact is measured and compared with the measurement made for the same fiber by the National Physical Laboratory of United Kingdom (NPL). Finally, a method is proposed to relatively correct the fiber refractive index to allow accurate fiber length measurement.

  2. Accurate nuclear radii and binding energies from a chiral interaction

    CERN Document Server

    Ekstrom, A; Wendt, K A; Hagen, G; Papenbrock, T; Carlsson, B D; Forssen, C; Hjorth-Jensen, M; Navratil, P; Nazarewicz, W

    2015-01-01

    The accurate reproduction of nuclear radii and binding energies is a long-standing challenge in nuclear theory. To address this problem two-nucleon and three-nucleon forces from chiral effective field theory are optimized simultaneously to low-energy nucleon-nucleon scattering data, as well as binding energies and radii of few-nucleon systems and selected isotopes of carbon and oxygen. Coupled-cluster calculations based on this interaction, named NNLOsat, yield accurate binding energies and radii of nuclei up to 40Ca, and are consistent with the empirical saturation point of symmetric nuclear matter. In addition, the low-lying collective 3- states in 16O and 40Ca are described accurately, while spectra for selected p- and sd-shell nuclei are in reasonable agreement with experiment.

  3. Accurate reconstruction of digital holography using frequency domain zero padding

    Science.gov (United States)

    Shin, Jun Geun; Kim, Ju Wan; Lee, Jae Hwi; Lee, Byeong Ha

    2017-04-01

    We propose an image reconstruction method of digital holography for getting more accurate reconstruction. Digital holography provides both the light amplitude and the phase of a specimen through recording the interferogram. Since the Fresenl diffraction can be efficiently implemented by the Fourier transform, zero padding technique can be applied to obtain more accurate information. In this work, we report the method of frequency domain zero padding (FDZP). Both in computer-simulation and in experiment made with a USAF 1951 resolution chart and target, the FDZD gave the more accurate rconstruction images. Even though, the FDZD asks more processing time, with the help of graphics processing unit (GPU), it can find good applications in digital holography for 3-D profile imaging.

  4. Memory conformity affects inaccurate memories more than accurate memories.

    Science.gov (United States)

    Wright, Daniel B; Villalba, Daniella K

    2012-01-01

    After controlling for initial confidence, inaccurate memories were shown to be more easily distorted than accurate memories. In two experiments groups of participants viewed 50 stimuli and were then presented with these stimuli plus 50 fillers. During this test phase participants reported their confidence that each stimulus was originally shown. This was followed by computer-generated responses from a bogus participant. After being exposed to this response participants again rated the confidence of their memory. The computer-generated responses systematically distorted participants' responses. Memory distortion depended on initial memory confidence, with uncertain memories being more malleable than confident memories. This effect was moderated by whether the participant's memory was initially accurate or inaccurate. Inaccurate memories were more malleable than accurate memories. The data were consistent with a model describing two types of memory (i.e., recollective and non-recollective memories), which differ in how susceptible these memories are to memory distortion.

  5. Case report of clival tuberculoma. Difficult to diagnose by means of a CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Ichikawa, F.; Tachibana, S.; Miyasaka, Y.; Suwa, T.; Iida, H.; Kan, S.; Matsuda, Y.

    1987-02-01

    A patient with tuberculoma at the skull base was reported. Twenty-two years old, she had complained for ten years of amenorrhea, headache, and visual disturbance. On neurological examination, bitemporal hemianopsia, bilateral sixth nerve palsy, and recent right-side facial palsy were demonstrated. On radiological examination, a destructive lesion was found at the clivus. CT and MRI demonstrated, a space-taking lesion expanding to the floor of the third ventricle anteriorly, to the cerebello-pontine angle superiorly, and to the epipharynx inferiorly, and a marked swelling of the cerebellum, though no confirmative diagnosis could be obtained without a biopsy of the epipharyngeal tumor. The histological examination revealed that the tumor was tuberculoma. Medical treatment with INH, RFP, and steroids was effective. Although tuberculoma involving the skull base is very rare and rather difficult to diagnose, the authors would like to stress that early accurate diagnosis is very important because the lesion is curable with appropriate medical treatment.

  6. The Challenges of Diagnosing and Following Wilson Disease in the Presence of Proteinuria

    Science.gov (United States)

    Khan, Soofia; Schilsky, Michael; Silber, Gary; Morgenstern, Bruce

    2016-01-01

    The coexistence of Wilson disease with Alport syndrome has not previously been reported. The diagnosis of Wilson disease and its ongoing monitoring is challenging when associated with an underlying renal disease such as Alport syndrome. Proteinuria can lead to low ceruloplasmin since it is among serum proteins inappropriately filtered by the damaged glomerulus, and can also lead to increased urinary loss of heavy metals such as zinc and copper. Elevated transaminases may be attributed to dyslipidemia or drug induced hepatotoxicity. The accurate diagnosis of Wilson disease is essential for targeted therapy and improved prognosis. We describe a patient with a diagnosis of Alport syndrome who has had chronic elevation of transaminases eventually diagnosed with Wilson disease based on liver histology and genetics. PMID:27437191

  7. The Challenges of Diagnosing and Following Wilson Disease in the Presence of Proteinuria.

    Science.gov (United States)

    Khan, Soofia; Schilsky, Michael; Silber, Gary; Morgenstern, Bruce; Miloh, Tamir

    2016-06-01

    The coexistence of Wilson disease with Alport syndrome has not previously been reported. The diagnosis of Wilson disease and its ongoing monitoring is challenging when associated with an underlying renal disease such as Alport syndrome. Proteinuria can lead to low ceruloplasmin since it is among serum proteins inappropriately filtered by the damaged glomerulus, and can also lead to increased urinary loss of heavy metals such as zinc and copper. Elevated transaminases may be attributed to dyslipidemia or drug induced hepatotoxicity. The accurate diagnosis of Wilson disease is essential for targeted therapy and improved prognosis. We describe a patient with a diagnosis of Alport syndrome who has had chronic elevation of transaminases eventually diagnosed with Wilson disease based on liver histology and genetics.

  8. An easy method for diagnosing macro-aspartate aminotransferase: a case series.

    Science.gov (United States)

    Beşer, Omer Faruk; Laçinel, Sibel; Gülcü, Didem; Kutlu, Tufan; Cullu Çokuğraş, Fügen; Erkan, Tülay

    2014-10-01

    Macro-aspartate transaminase (macro-AST) must be considered when the aspartate transaminase (AST) level is chronically high without any liver, cardiac, or muscle disease. Many specialized laboratory techniques have been recommended for diagnosing macro-AST, including the polyethylene glycol immune precipitate technique, which is simple. This study presents a considerably easier method based on the studies of Davidson and Watson and Castiella et al. Our method is based on the decrease in the plasma AST level after storage of the macroenzyme at 2-8 °C for 5 days, and has the advantages of low cost, reliability, and practicality at any health center. In our eight cases of macro-AST, the AST activity at day 6 had decreased by more than 50% from day 1. This method is practical for primary healthcare facilities because of its easy application and accurate results, and obviated the need for unnecessary tests after diagnosis.

  9. Endoscopic and biopsy diagnoses of superficial, nonampullary, duodenal adenocarcinomas

    Science.gov (United States)

    Kakushima, Naomi; Kanemoto, Hideyuki; Sasaki, Keiko; Kawata, Noboru; Tanaka, Masaki; Takizawa, Kohei; Imai, Kenichiro; Hotta, Kinichi; Matsubayashi, Hiroyuki; Ono, Hiroyuki

    2015-01-01

    AIM: To investigate the accuracy of endoscopic or biopsy diagnoses of superficial nonampullary duodenal epithelial tumors (NADETs). METHODS: Clinicopathological data were reviewed for 84 superficial NADETs from 74 patients who underwent surgery or endoscopic resection between September 2002 and August 2014 at a single prefectural cancer center. Superficial NADETs were defined as lesions confined to the mucosa or submucosa. Demographic and clinicopathological data were retrieved from charts, endoscopic and pathologic reports. Endoscopic reports included endoscopic diagnosis, location, gross type, diameter, color, and presence or absence of biopsy. Endoscopic diagnoses were made by an endoscopist in charge of the examination before biopsy specimens were obtained. Endoscopic images were obtained using routine, front-view, high-resolution video endoscopy, and chromoendoscopy with indigocarmine was performed for all lesions. Endoscopic images were reviewed by at least two endoscopists to assess endoscopic findings indicative of carcinoma. Preoperative diagnoses based on endoscopy and biopsy findings were compared with histological diagnoses of resected specimens. Sensitivity, specificity, and accuracy were assessed for endoscopic diagnosis and biopsy diagnosis. RESULTS: The majority (81%) of the lesions were located in the second portion of the duodenum. The median lesion diameter was 14.5 mm according to final histology. Surgery was performed for 49 lesions from 39 patients, and 35 lesions from 35 patients were endoscopically resected. Final histology confirmed 65 carcinomas, 15 adenomas, and 3 hyperplasias. A final diagnosis of duodenal carcinoma was made for 91% (52/57) of the lesions diagnosed as carcinoma by endoscopy and 93% (42/45) of the lesions diagnosed as carcinoma by biopsy. The sensitivity, specificity, and accuracy of endoscopic diagnoses were 80%, 72%, and 78%, respectively, whereas those of biopsy diagnoses were 72%, 80%, and 74%, respectively

  10. Accurate torque-speed performance prediction for brushless dc motors

    Science.gov (United States)

    Gipper, Patrick D.

    Desirable characteristics of the brushless dc motor (BLDCM) have resulted in their application for electrohydrostatic (EH) and electromechanical (EM) actuation systems. But to effectively apply the BLDCM requires accurate prediction of performance. The minimum necessary performance characteristics are motor torque versus speed, peak and average supply current and efficiency. BLDCM nonlinear simulation software specifically adapted for torque-speed prediction is presented. The capability of the software to quickly and accurately predict performance has been verified on fractional to integral HP motor sizes, and is presented. Additionally, the capability of torque-speed prediction with commutation angle advance is demonstrated.

  11. Accurate analysis of planar metamaterials using the RLC theory

    DEFF Research Database (Denmark)

    Malureanu, Radu; Lavrinenko, Andrei

    2008-01-01

    In this work we will present an accurate description of metallic pads response using RLC theory. In order to calculate such response we take into account several factors including the mutual inductances, precise formula for determining the capacitance and also the pads’ resistance considering...... the variation of permittivity due to small thicknesses. Even if complex, such strategy gives accurate results and we believe that, after more refinement, can be used to completely calculate a complex metallic structure placed on a substrate in a far faster manner than full simulations programs do....

  12. Method of accurate grinding for single enveloping TI worm

    Institute of Scientific and Technical Information of China (English)

    SUN; Yuehai; ZHENG; Huijiang; BI; Qingzhen; WANG; Shuren

    2005-01-01

    TI worm drive consists of involute helical gear and its enveloping Hourglass worm. Accurate grinding for TI worm is the key manufacture technology for TI worm gearing being popularized and applied. According to the theory of gear mesh, the equations of tooth surface of worm drive are gained, and the equation of the axial section profile of grinding wheel that can accurately grind TI worm is extracted. Simultaneously,the relation of position and motion between TI worm and grinding wheel are expounded.The method for precisely grinding single enveloping TI worm is obtained.

  13. Dedifferentiated Liposarcoma in the Spermatic Cord Finally Diagnosed at 7th Resection of Recurrence: A Case Report and Bibliographic Consideration

    Directory of Open Access Journals (Sweden)

    Kento Morozumi

    2017-08-01

    Full Text Available Liposarcoma in the spermatic cord is infrequent, and accurate diagnosis of histopathological subtype is often difficult in spite of the importance of differential diagnosis for adequate treatment. A 54-year-old man underwent left-sided high orchiectomy with inguinal lymphadenectomy for a spermatic cord tumor in July 2006. The initial histopathological report diagnosed leiomyosarcoma in the spermatic cord. He then underwent surgeries for repeated recurrences a further 6 times between July 2008 and May 2014. Pathological finding at the 7th resection of the recurrent tumor was osteosarcoma, which was uncommon in the spermatic cord. With a thorough overview of all specimens, the histopathological diagnosis was finally confirmed as dedifferentiated liposarcoma because of a biphasic pattern in the specimen of high orchiectomy at the first resection. A biphasic pattern represents high-grade sarcoma like osteosarcoma and well-differentiated liposarcoma, and is characteristic of dedifferentiated liposarcoma. Although the dedifferentiated type is one of poor prognosis, the diagnosing of liposarcoma histopathologically was found to be difficult throughout this case. In this report we discuss the accurate histopathological diagnosis of liposarcoma in the spermatic cord in order to prevent repeated recurrences based on a review of the literature, as well as the difficulty in recognizing dedifferentiated liposarcoma macroscopically and morphologically. Our experience suggests that, after much difficulty, accurate histopathological diagnosis of liposarcoma in the spermatic cord is still clinically challenging.

  14. Physicians' diagnoses compared with algorithmic differentiation of causes of jaundice.

    Science.gov (United States)

    Boom, R; Chavez-Oest, J; Gonzalez, C; Cantu, M A; Rivero, F; Reyes, A; Aguilar, E; Santamaria, J

    1988-01-01

    Clinical data were collected in 194 cases of jaundiced patients treated at the "Adolfo Lopez Mateos" ISSSTE Hospital in Mexico City from July 1985 to July 1986. A copy of the clinical history of each patient was given to each of four physicians--one recently graduated from medical school, another in his first year of gastroenterology, and two others who were experienced gastroenterologists. The same clinical data were processed by a computer set up to use a modified Danish COMIC algorithm. All physicians and the computer technician were blinded to the "gold standard" pathologic diagnoses, with which their diagnoses were compared. Accuracy rates of the physicians in distinguishing intrahepatic (medical) from extrahepatic (surgical) jaundice were 78%, 86%, 86%, and 91%, and the accuracy of computer-assisted diagnoses was 96%. Chi-squared analysis of the diagnoses of three of the physicians and those of the computer showed significant differences (p between 0.1 and 0.01). For the diagnoses of the remaining physician, however, no significant difference was found after chi-squared continuity correction.

  15. Vaccination Coverage Among Adults With Diagnosed Diabetes: United States, 2015.

    Science.gov (United States)

    Villarroel, Maria A; Vahratian, Anjel

    2016-12-01

    Data from the National Health Interview Survey •Among adults aged 18 and over with diagnosed diabetes, 61.6% had an influenza vaccine in the past year. •A total of 52.6% of adults with diagnosed diabetes had a pneumococcal vaccine and 17.1% had the 3-dose vaccination schedule for hepatitis B at some point in the past. •Among adults aged 60 and over with diagnosed diabetes, 27.2% had ever had a shingles vaccine. •Among those with diagnosed diabetes, the vaccination coverage for influenza, pneumococcal, and shingles was lowest among poor adults, increased with age, and varied by race and ethnicity. •Hepatitis B vaccination coverage was lowest among poor adults, and it decreased with age. Persons with diabetes are at an increased risk for complications from vaccine-preventable infections (1-3). Several vaccines are recommended for adults with diabetes, including annual vaccination for influenza and at least a one-time dose of pneumococcal vaccine, regardless of age; a shingles vaccine starting at age 60; and a hepatitis B vaccine soon after diabetes diagnosis among those aged 19-59, and based on clinical discretion thereafter (4). This report describes the receipt of select vaccinations among adults with diagnosed diabetes by sex, age, race and ethnicity, and poverty status. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  16. Child Development: New Diagnoses for the NANDA International.

    Science.gov (United States)

    Souza, Juliana Martins de; Cruz, Diná de Almeida Lopes Monteiro da; Veríssimo, Maria De La Ó Ramallo

    2016-12-15

    The paper proposes new diagnoses on child development (CD) for NANDA International. The study followed the recommended steps of Developmental Processes for NANDA International Nursing Diagnoses. It was a secondary analysis study on the findings of a concept analysis study on CD. A proposal of labels and components of three diagnoses: "Delayed child development," "Risk for delayed child development," and "Readiness for enhanced child development." The proposed diagnoses represent all the complexity of CD. The proposed diagnoses can support nurses in the development of a comprehensive care plan on the health of children. OBJETIVO: propor novos diagnósticos de enfermagem para a NANDA-International que abordem o desenvolvimento infantil. MÉTODO: Este estudo seguiu as etapas recomendadas para o desenvolvimento de diagnósticos de enfermagem da NANDA-International. Foi realizado a partir dos resultados da análise de conceito do termo desenvolvimento infantil. Propostos os títulos e os componentes de três diagnósticos: "Atraso no desenvolvimento infantil," "Risco de atraso no desenvolvimento infantil," e "Disposição para desenvolvimento infantil melhorado." CONCLUSÕES: Os diagnósticos propostos contemplam toda a complexidade do desenvolvimento infantil. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Os novos diagnósticos podem subsidiar o enfermeiro na elaboração de um plano de cuidados integrais à saúde da criança. © 2016 NANDA International, Inc.

  17. Refractory coeliac disease in a country with a high prevalence of clinically-diagnosed coeliac disease.

    Science.gov (United States)

    Ilus, T; Kaukinen, K; Virta, L J; Huhtala, H; Mäki, M; Kurppa, K; Heikkinen, M; Heikura, M; Hirsi, E; Jantunen, K; Moilanen, V; Nielsen, C; Puhto, M; Pölkki, H; Vihriälä, I; Collin, P

    2014-02-01

    Refractory coeliac disease (RCD) is thought to be a rare disorder, but the accurate prevalence is unknown. We aimed to identify the prevalence of and the risk factors for developing RCD in a Finnish population where the clinical detection rate of coeliac disease is high. The study involved 11 hospital districts in Finland where the number of treated RCD patients (n = 44), clinically diagnosed coeliac disease patients (n = 12 243) and adult inhabitants (n = 1.7 million) was known. Clinical characteristics at diagnosis of coeliac disease between the RCD patients and patients with uncomplicated disease were compared. The prevalence of RCD was 0.31% among diagnosed coeliac disease patients and 0.002% in the general population. Of the enrolled 44 RCD patients, 68% had type I and 23% type II; in 9% the type was undetermined. Comparing 886 patients with uncomplicated coeliac disease with these 44 patients that developed RCD later in life, the latter were significantly older (median 56 vs 44 years, P coeliac disease. Patients with evolving RCD had more severe symptoms at the diagnosis of coeliac disease, including weight loss in 36% (vs. 16%, P = 0.001) and diarrhoea in 54% (vs. 38%, P = 0.050). Refractory coeliac disease is very rare in the general population. Patients of male gender, older age, severe symptoms or seronegativity at the diagnosis of coeliac disease are at risk of future refractory coeliac disease and should be followed up carefully. © 2014 John Wiley & Sons Ltd.

  18. Paracoccidioidomycosis in southern Rio Grande do Sul: a retrospective study of histopathologically diagnosed cases

    Directory of Open Access Journals (Sweden)

    Silvana Pereira de Souza

    2014-01-01

    Full Text Available Paracoccidioidomycosis (PCM is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis and is endemic to Brazil. The aim of this study was to perform a retrospective analysis of the PCM cases in the countryside south of Rio Grande do Sul, Brazil. The files from four histopathology laboratories located in the city of Pelotas were obtained, and all of the epidemiological and clinical data from the PCM diagnosed cases were collected for analysis. A total of 123 PCM cases diagnosed between 1966 and 2009 were selected. Of these patients, 104 (84.5% were male, and 17 were female. The patients ranged from 02 to 92 years of age. Fifty-two cases (41.9% were obtained from the oral pathology laboratory, and the remaining 71 cases (58.1% were obtained from the three general pathology laboratories. Of all of the patients studied, 65.2% lived in rural zones and worked in agriculture or other related fields. Data on the evolution of this disease was available for 43 cases, and the time frame ranged from 20 to 2920 days (mean = 572.3 days. An accurate diagnosis performed in less than 30 days only occurred in 21% of the cases. PCM is endemic to the countryside of Rio Grande do Sul. Therefore, it is recommended that PCM be included as a differential diagnosis, mainly for individuals between 30 and 60 years of age, living in rural zones and who have respiratory signs and associated-oropharyngeal lesions.

  19. The role of polysomnography in diagnosing and treating obstructive sleep apnea in pediatric patients.

    Science.gov (United States)

    Church, Gwynne D

    2012-01-01

    Obstructive sleep apnea in children is associated with serious neurocognitive and cardiovascular morbidity, systemic inflammation, and increased health care use, yet remains underdiagnosed. Although the prevalence of obstructive sleep apnea is 1-3% in the pediatric population, the prevalence of primary snoring (PS) is estimated to be 3-12%. The challenge for pediatricians is to differentiate PS from obstructive sleep apnea in a cost-effective, reliable, and accurate manner before recommending invasive or intrusive therapies, such as surgery or continuous positive airway pressure. The validity of polysomnography as the gold standard for diagnosing obstructive sleep apnea has been challenged, primarily related to concerns that abnormalities on polysomnography do not correlate well with adverse outcomes, that those abnormalities have statistical more than clinical significance, and that performing polysomnograms on all children who snore is a practical impossibility. The aim of this article is to review the clinical utility of diagnostic tests other than polysomnography to diagnose obstructive sleep apnea, to highlight the limitations and strengths of polysomnography, to underscore the threshold levels of abnormalities detected on polysomnography that correlate with morbidity, and to discuss what the practical implications are for treatment.

  20. Issues related to diagnosing oral lichen planus among oral pathologists in South India: A pilot survey.

    Science.gov (United States)

    Sanketh, D Sharathkumar; Srinivasan, Samuel Raj; Patil, Shankargouda; Ranganathan, Kannan

    2016-10-26

    In the present study, we simulated clinical scenarios by explicitly describing the history and clinical and histological features of hypothetical patients presenting with oral lichen planus (OLP), oral lichenoid lesion, and epithelial dysplasia in a self-designed questionnaire. By doing so, we aimed to elicit a diagnosis from oral pathologists and trainees, analyze their responses, appraise issues, and propose solutions regarding the diagnosis of OLP. The questionnaire was distributed to 100 oral pathologists and trainees in South India. Six questions were designed to assess awareness of the diagnostic aspects of OLP. Ten questions were hypothetical clinical scenarios (HCS) devised to evaluate respondents' knowledge of diagnostic guidelines and the criteria used by the respondents to render a diagnosis. There were 60 of 100 responses to the questionnaire. More than half the respondents were aware of the World Health Organization and modified guidelines of OLP. We observed considerable variations in diagnoses for the HCS. Our study illustrates the ambiguity in rendering an accurate diagnosis, despite adequate guidelines. Based on the responses for the HCS, we hypothesized that changes in the distribution (unilateral or bilateral) and clinical characteristic of OLP, and habits of patients, have a significant bearing on the clinical and final diagnoses of the lesion. © 2016 John Wiley & Sons Australia, Ltd.

  1. Diagnosing lysosomal storage diseases in a Brazilian non-newborn population by tandem mass spectrometry

    Directory of Open Access Journals (Sweden)

    Guilherme Dotto Brand

    2013-11-01

    Full Text Available OBJECTIVES: High-throughput mass spectrometry methods have been developed to screen newborns for lysosomal storage disorders, allowing the implementation of newborn screening pilot studies in North America and Europe. It is currently feasible to diagnose Pompe, Fabry, Gaucher, Krabbe, and Niemann-Pick A/B diseases, as well as mucopolysaccharidosis I, by tandem mass spectrometry in dried blood spots, which offers considerable technical advantages compared with standard methodologies. We aimed to investigate whether the mass spectrometry methodology for lysosomal storage disease screening, originally developed for newborns, can also discriminate between affected patients and controls of various ages. METHODS: A total of 205 control individuals were grouped according to age and subjected to mass spectrometry quantification of lysosomal α-glucosidase, β-glucocerebrosidase, α-galactosidase, acid sphingomyelinase, galactocerebrosidase, and α−L-iduronidase activities. Additionally, 13 affected patients were analyzed. RESULTS: The median activities for each enzyme and each age group were determined. Enzyme activities were significantly lower in individuals aged older than 18 years compared with those in newborns. Affected patients presented enzymatic activities corresponding to less than 20% of the age-matched controls. CONCLUSIONS: Our data indicate that the mass spectrometry methodology can be used for the screening of lysosomal storage diseases in non-newborn patients. However, for some diseases, such as Fabry and mucopolysaccharidosis I, a combination of biochemical and clinical data may be necessary to achieve accurate diagnoses.

  2. Dual-Energy Subtraction Imaging for Diagnosing Vocal Cord Paralysis with Flat Panel Detector Radiography

    Energy Technology Data Exchange (ETDEWEB)

    Machida, Haruhiko; Yoda, Keiko; Arai, Yasuko [Tokyo Women' s Medical University Medical Center East, Tokyo (Japan)] (and others)

    2010-06-15

    To investigate the clinical feasibility of dual energy subtraction (DES) imaging to improve the delineation of the vocal cord and diagnostic accuracy of vocal cord paralysis as compared with the anterior-posterior view of flat panel detector (FPD) neck radiography. For 122 consecutive patients who underwent both a flexible laryngoscopy and conventional/DES FPD radiography, three blinded readers retrospectively graded the radiographs during phonation and inspiration on a scale of 1 (poor) to 5 (excellent) for the delineation of the vocal cord, and in consensus, reviewed the diagnostic accuracy of vocal cord paralysis employing the laryngoscopy as the reference. We compared vocal cord delineation scores and accuracy of vocal cord paralysis diagnosis by both conventional and DES techniques using ({kappa}statistics and assessing the area under the receiver operating characteristic curve (AUC). Vocal cord delineation scores by DES (mean, 4.2 {+-} 0.4) were significantly higher than those by conventional imaging (mean, 3.3 {+-} 0.5) (p < 0.0001). Sensitivity for diagnosing vocal cord paralysis by the conventional technique was 25%, whereas the specificity was 94%. Sensitivity by DES was 75%, whereas the specificity was 96%. The diagnostic accuracy by DES was significantly superior (({kappa}= 0.60, AUC = 0.909) to that by conventional technique ({kappa}= 0.18, AUC = 0.852) (p = 0.038). Dual energy subtraction is a superior method compared to the conventional FPD radiography for delineating the vocal cord and accurately diagnosing vocal cord paralysis.

  3. A Study on Test Technology to Diagnose the Power Apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Kim, K. H.; Kang, Y. S.; Jeon, Y. K.; Lee, W. Y.; Kang, D. S.; Kyu, H. S.; Sun, J. H.; Jo, K. H. [Korea Electrotechnology Research Institute (Korea, Republic of); Jung, J. S.; Mun, Y. T.; Lee, K. H.; Jung, E. H.; Kim, J. H. [Korea Water Resources Corporation (Korea, Republic of)

    1997-02-01

    In this study, we have educated KOWACO(Korea Water Resources Corporation) specialists about the insulation diagnostic technology and trained them the insulation diagnostic test and estimation method of power apparatus. The main results of this study are as follows; A. Education of basic high-voltage engineering. B. Research of insulation characteristic and deterioration mechanism in power apparatus C. Discussion on high-voltage test standard specifications. D. Study on insulation deterioration diagnostics in power apparatus. E. Field testing of insulation diagnosis in power apparatus. F. Engineering of insulation diagnostic testing apparatus to diagnose power apparatus. KOWACO specialists are able to diagnose insulation diagnostic test of power apparatus through this study. As they have instruments to diagnose power apparatus, they can do the test and estimation of the power apparatus insulation diagnosis. (author). refs., figs., tabs.

  4. DIAGNOSING THE READINES OF TECHNICAL UNIVERSITY STUDENTS FOR RESEARCH ACTIVITIES

    Directory of Open Access Journals (Sweden)

    M. A. Fedorova

    2014-01-01

    Full Text Available The paper is devoted to the technique designed for diagnosing the technical university student’s readiness for research activities that is closely related to the research competence structure. Based on the survey results and literature analysis, the authors considered ten primary components of the readiness in question, and analyzed each component along with the corresponding weight value, mean value, and probability density. Consequently, the high level of academic knowledge and motivation for research activity were singled out as the priority components. The paper describes the linear mathematical model, developed for diagnosing student’s readiness for research activities, and presents the minimum, maximum and threshold values of diagnostic assessments, and the relating indicators. The given model can be used as the basic one for developing a test software product for students and research supervisors diagnosing the readiness for research activity

  5. Development of terahertz otoscope for diagnosing otitis media (Conference Presentation)

    Science.gov (United States)

    Jeon, Tae-In; Ji, Young Bin; Bark, Hyeon Sang; Noh, Sam Kyu; Oh, Seung Jae

    2017-03-01

    A novel terahertz (THz) otoscope is designed and fabricated to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical diagnostics. The inclusion of indium tin oxide (ITO) glass in the THz otoscope allows physicians to diagnose OM with both THz and conventional optical diagnostics. To determine THz diagnostics for OM, we observed reflection signals from samples behind a thin dielectric film and found that the presence of water behind the membrane could be distinguished based on THz pulse shape. We verified the potential of this tool for diagnosing OM using mouse skin tissue and a human tympanic membrane samples prior to clinical application. The presence of water absorbed by the human membrane was easily distinguished based on differences in pulse shapes and peak-to-peak amplitudes of reflected THz pulses. The potential for early OM diagnosis using the THz otoscope was confirmed by alteration of THz pulse depending on water absorption level.

  6. Sigmoid-vaginal fistula during bevacizumab treatment diagnosed by fistulography.

    Science.gov (United States)

    Hayashi, C; Takada, S; Kasuga, A; Shinya, K; Watanabe, M; Kano, H; Takayama, T

    2016-12-01

    There have been several reports describing rectovaginal fistula development after bevacizumab treatment, and these fistulas were diagnosed by CT scan or colonoscopy. We report a case of sigmoid-vaginal fistula diagnosed by fistulography. The case is a 53-year-old woman who was treated for chronic myelogenous leukaemia and gynaecological cancers 8 years previously. At 52 years of age, she was diagnosed with colon cancer and had a partial colectomy performed. One year after surgery, colon cancer recurred, and she was treated with anticancer agents, including bevacizumab. During chemotherapy, she complained of a foul smelling discharge from the vagina. Fistulography revealed a sigmoid-vaginal fistula. This is the first report of vaginal fistulography performed on a patient who was treated with bevacizumab. Fistulography may be useful for detecting sigmoid-vaginal fistula. © 2016 John Wiley & Sons Ltd.

  7. Psychiatric Diagnoses in Individuals with Non-Syndromic Oral Clefts

    DEFF Research Database (Denmark)

    Pedersen, Dorthe Almind; Wehby, George L; Murray, Jeffrey C

    2016-01-01

    found no increased risk of mood disorders and anxiety-related disorders. CONCLUSION: Individuals with non-syndromic OC had significantly higher risk of psychiatric diagnoses compared with individuals without OC. However, the elevated risk was observed for individuals with CLP and CP......BACKGROUND: The aim of this study was to investigate the risk of psychiatric diagnoses in individuals with non-syndromic oral clefts (OC) compared with individuals without OC, including ages from 1 to 76 years. METHODS: Linking four Danish nationwide registers, we investigated the risk...... of psychiatric diagnoses at Danish psychiatric hospitals during the period 1969-2012 for individuals born with non-syndromic OC in Denmark 1936-2009 compared with a cohort of 10 individuals without OC per individual with OC, matched by sex and birth year. The sample included 8,568 individuals with OC, observed...

  8. Verification of Opacity and Diagnosability for Pushdown Systems

    Directory of Open Access Journals (Sweden)

    Koichi Kobayashi

    2013-01-01

    Full Text Available In control theory of discrete event systems (DESs, one of the challenging topics is the extension of theory of finite-state DESs to that of infinite-state DESs. In this paper, we discuss verification of opacity and diagnosability for infinite-state DESs modeled by pushdown automata (called here pushdown systems. First, we discuss opacity of pushdown systems and prove that opacity of pushdown systems is in general undecidable. In addition, a decidable class is clarified. Next, in diagnosability, we prove that under a certain assumption, which is different from the assumption in the existing result, diagnosability of pushdown systems is decidable. Furthermore, a necessary condition and a sufficient condition using finite-state approximations are derived. Finally, as one of the applications, we consider data integration using XML (Extensible Markup Language. The obtained result is useful for developing control theory of infinite-state DESs.

  9. Urinary incontinence nursing diagnoses in patients with stroke

    Directory of Open Access Journals (Sweden)

    Telma Alteniza Leandro

    2015-12-01

    Full Text Available Abstract OBJECTIVE Identifying the prevalence of Stress urinary incontinence (SUI, Urge urinary incontinence (UUI, Functional urinary incontinence (FUI, Overflow urinary incontinence (OUI and Reflex urinary incontinence (RUI nursing diagnoses and their defining characteristics in stroke patients. METHOD A cross-sectional study with 156 patients treated in a neurological clinic. Data were collected through interviews and forwarded to nurses for diagnostic inference. RESULTS 92.3% of the patients had at least one of the studied diagnoses; OUI showed the highest prevalence (72.4%, followed by FUI (53.2%, RUI (50.0%, UUI (41.0% and SUI (37.8%. Overdistended bladder and reports of inability to reach the toilet in time to avoid urine loss were the most prevalent defining characteristics. A statistically significant association of the defining characteristics with the studied diagnosis was verified. CONCLUSION The five incontinence diagnoses were identified in the evaluated patients, with different prevalence.

  10. Prevalence of nursing diagnoses in an intensive care unit

    Directory of Open Access Journals (Sweden)

    Vinicia de Holanda Cabral

    2017-01-01

    Full Text Available To identify the main nursing diagnostic titles used in the care of critically ill patients hospitalized in an Intensive Care Unit, verifying the presence thereof in the diagnoses of NANDA International’s Taxonomy II. Methods: descriptive and documental study, in which 69 medical records of patients aged over 18 years were consulted. Results: 22 nursing diagnostic titles were found; the most frequent was risk for infection (99.0%, risk for skin integrity (75.0% and risk for aspiration (61.0%. Most diagnoses were in the domains safety/ protection (43.0% and activity/rest (26.5%. Conclusions: authors identified the main nursing diagnostic titles used in the care of critically ill patients admitted to the Intensive Care Unit and the presence thereof in the diagnoses of NANDA International’s Taxonomy II.

  11. Accurate Period Approximation for Any Simple Pendulum Amplitude

    Institute of Scientific and Technical Information of China (English)

    XUE De-Sheng; ZHOU Zhao; GAO Mei-Zhen

    2012-01-01

    Accurate approximate analytical formulae of the pendulum period composed of a few elementary functions for any amplitude are constructed.Based on an approximation of the elliptic integral,two new logarithmic formulae for large amplitude close to 180° are obtained.Considering the trigonometric function modulation results from the dependence of relative error on the amplitude,we realize accurate approximation period expressions for any amplitude between 0 and 180°.A relative error less than 0.02% is achieved for any amplitude.This kind of modulation is also effective for other large-amplitude logarithmic approximation expressions.%Accurate approximate analytical formulae of the pendulum period composed of a few elementary functions for any amplitude are constructed. Based on an approximation of the elliptic integral, two new logarithmic formulae for large amplitude close to 180° are obtained. Considering the trigonometric function modulation results from the dependence of relative error on the amplitude, we realize accurate approximation period expressions for any amplitude between 0 and 180°. A relative error less than 0.02% is achieved for any amplitude. This kind of modulation is also effective for other large-amplitude logarithmic approximation expressions.

  12. On accurate boundary conditions for a shape sensitivity equation method

    Science.gov (United States)

    Duvigneau, R.; Pelletier, D.

    2006-01-01

    This paper studies the application of the continuous sensitivity equation method (CSEM) for the Navier-Stokes equations in the particular case of shape parameters. Boundary conditions for shape parameters involve flow derivatives at the boundary. Thus, accurate flow gradients are critical to the success of the CSEM. A new approach is presented to extract accurate flow derivatives at the boundary. High order Taylor series expansions are used on layered patches in conjunction with a constrained least-squares procedure to evaluate accurate first and second derivatives of the flow variables at the boundary, required for Dirichlet and Neumann sensitivity boundary conditions. The flow and sensitivity fields are solved using an adaptive finite-element method. The proposed methodology is first verified on a problem with a closed form solution obtained by the Method of Manufactured Solutions. The ability of the proposed method to provide accurate sensitivity fields for realistic problems is then demonstrated. The flow and sensitivity fields for a NACA 0012 airfoil are used for fast evaluation of the nearby flow over an airfoil of different thickness (NACA 0015).

  13. A Simple and Accurate Method for Measuring Enzyme Activity.

    Science.gov (United States)

    Yip, Din-Yan

    1997-01-01

    Presents methods commonly used for investigating enzyme activity using catalase and presents a new method for measuring catalase activity that is more reliable and accurate. Provides results that are readily reproduced and quantified. Can also be used for investigations of enzyme properties such as the effects of temperature, pH, inhibitors,…

  14. The value of accurate A/R information.

    Science.gov (United States)

    Freeman, G; Allcorn, S

    1985-01-01

    The understanding and management of an accounts receivable system in a medical group practice is particularly important to administrators in today's economy. As the authors explain, an accurate information system can provide the medical group with valuable information regarding its financial condition and cash flow collections status, as well as help plan for future funding needs.

  15. Technique to accurately quantify collagen content in hyperconfluent cell culture.

    Science.gov (United States)

    See, Eugene Yong-Shun; Toh, Siew Lok; Goh, James Cho Hong

    2008-12-01

    Tissue engineering aims to regenerate tissues that can successfully take over the functions of the native tissue when it is damaged or diseased. In most tissues, collagen makes up the bulk component of the extracellular matrix, thus, there is great emphasis on its accurate quantification in tissue engineering. It has already been reported that pepsin digestion is able to solubilize the collagen deposited within the cell layer for accurate quantification of collagen content in cultures, but this method has drawbacks when cultured cells are hyperconfluent. In this condition, Pepsin digestion will result in fragments of the cell layers that cannot be completely resolved. These fragments of the undigested cell sheet are visible to the naked eye, which can bias the final results. To the best of our knowledge, there has been no reported method to accurately quantify the collagen content in hyperconfluent cell sheet. Therefore, this study aims to illustrate that sonication is able to aid pepsin digestion of hyperconfluent cell layers of fibroblasts and bone marrow mesenchymal stem cells, to solubilize all the collagen for accurate quantification purposes.

  16. A Simple and Accurate Method for Measuring Enzyme Activity.

    Science.gov (United States)

    Yip, Din-Yan

    1997-01-01

    Presents methods commonly used for investigating enzyme activity using catalase and presents a new method for measuring catalase activity that is more reliable and accurate. Provides results that are readily reproduced and quantified. Can also be used for investigations of enzyme properties such as the effects of temperature, pH, inhibitors,…

  17. On a more accurate Hardy-Mulholland-type inequality

    Directory of Open Access Journals (Sweden)

    Bicheng Yang

    2016-03-01

    Full Text Available Abstract By using weight coefficients, technique of real analysis, and Hermite-Hadamard’s inequality, we give a more accurate Hardy-Mulholland-type inequality with multiparameters and a best possible constant factor related to the beta function. The equivalent forms, the reverses, the operator expressions, and some particular cases are also considered.

  18. Improved fingercode alignment for accurate and compact fingerprint recognition

    CSIR Research Space (South Africa)

    Brown, Dane

    2016-05-01

    Full Text Available The traditional texture-based fingerprint recognition system known as FingerCode is improved in this work. Texture-based fingerprint recognition methods are generally more accurate than other methods, but at the disadvantage of increased storage...

  19. Accurate analysis of planar metamaterials using the RLC theory

    DEFF Research Database (Denmark)

    Malureanu, Radu; Lavrinenko, Andrei

    2008-01-01

    In this work we will present an accurate description of metallic pads response using RLC theory. In order to calculate such response we take into account several factors including the mutual inductances, precise formula for determining the capacitance and also the pads’ resistance considering the...

  20. $H_{2}^{+}$ ion in strong magnetic field an accurate calculation

    CERN Document Server

    López, J C; Turbiner, A V

    1997-01-01

    Using a unique trial function we perform an accurate calculation of the ground state $1\\sigma_g$ of the hydrogenic molecular ion $H^+_2$ in a constant uniform magnetic field ranging $0-10^{13}$ G. We show that this trial function also makes it possible to study the negative parity ground state $1\\sigma_u$.

  1. BIOACCESSIBILITY TESTS ACCURATELY ESTIMATE BIOAVAILABILITY OF LEAD TO QUAIL

    Science.gov (United States)

    Hazards of soil-borne Pb to wild birds may be more accurately quantified if the bioavailability of that Pb is known. To better understand the bioavailability of Pb to birds, we measured blood Pb concentrations in Japanese quail (Coturnix japonica) fed diets containing Pb-contami...

  2. Accurate and Simple Calibration of DLP Projector Systems

    DEFF Research Database (Denmark)

    Wilm, Jakob; Olesen, Oline Vinter; Larsen, Rasmus

    2014-01-01

    Much work has been devoted to the calibration of optical cameras, and accurate and simple methods are now available which require only a small number of calibration targets. The problem of obtaining these parameters for light projectors has not been studied as extensively and most current methods...

  3. Accurate segmentation of dense nanoparticles by partially discrete electron tomography

    Energy Technology Data Exchange (ETDEWEB)

    Roelandts, T., E-mail: tom.roelandts@ua.ac.be [IBBT-Vision Lab University of Antwerp, Universiteitsplein 1, 2610 Wilrijk (Belgium); Batenburg, K.J. [IBBT-Vision Lab University of Antwerp, Universiteitsplein 1, 2610 Wilrijk (Belgium); Centrum Wiskunde and Informatica, Science Park 123, 1098 XG Amsterdam (Netherlands); Biermans, E. [EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp (Belgium); Kuebel, C. [Institute of Nanotechnology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany); Bals, S. [EMAT, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp (Belgium); Sijbers, J. [IBBT-Vision Lab University of Antwerp, Universiteitsplein 1, 2610 Wilrijk (Belgium)

    2012-03-15

    Accurate segmentation of nanoparticles within various matrix materials is a difficult problem in electron tomography. Due to artifacts related to image series acquisition and reconstruction, global thresholding of reconstructions computed by established algorithms, such as weighted backprojection or SIRT, may result in unreliable and subjective segmentations. In this paper, we introduce the Partially Discrete Algebraic Reconstruction Technique (PDART) for computing accurate segmentations of dense nanoparticles of constant composition. The particles are segmented directly by the reconstruction algorithm, while the surrounding regions are reconstructed using continuously varying gray levels. As no properties are assumed for the other compositions of the sample, the technique can be applied to any sample where dense nanoparticles must be segmented, regardless of the surrounding compositions. For both experimental and simulated data, it is shown that PDART yields significantly more accurate segmentations than those obtained by optimal global thresholding of the SIRT reconstruction. -- Highlights: Black-Right-Pointing-Pointer We present a novel reconstruction method for partially discrete electron tomography. Black-Right-Pointing-Pointer It accurately segments dense nanoparticles directly during reconstruction. Black-Right-Pointing-Pointer The gray level to use for the nanoparticles is determined objectively. Black-Right-Pointing-Pointer The method expands the set of samples for which discrete tomography can be applied.

  4. Fast, Accurate and Detailed NoC Simulations

    NARCIS (Netherlands)

    Wolkotte, P.T.; Hölzenspies, P.K.F.; Smit, G.J.M.; Kellenberger, P.

    2007-01-01

    Network-on-Chip (NoC) architectures have a wide variety of parameters that can be adapted to the designer's requirements. Fast exploration of this parameter space is only possible at a high-level and several methods have been proposed. Cycle and bit accurate simulation is necessary when the actual r

  5. Novel multi-beam radiometers for accurate ocean surveillance

    DEFF Research Database (Denmark)

    Cappellin, C.; Pontoppidan, K.; Nielsen, P. H.

    2014-01-01

    Novel antenna architectures for real aperture multi-beam radiometers providing high resolution and high sensitivity for accurate sea surface temperature (SST) and ocean vector wind (OVW) measurements are investigated. On the basis of the radiometer requirements set for future SST/OVW missions...

  6. Practical schemes for accurate forces in quantum Monte Carlo

    NARCIS (Netherlands)

    Moroni, S.; Saccani, S.; Filippi, Claudia

    2014-01-01

    While the computation of interatomic forces has become a well-established practice within variational Monte Carlo (VMC), the use of the more accurate Fixed-Node Diffusion Monte Carlo (DMC) method is still largely limited to the computation of total energies on structures obtained at a lower level of

  7. Accurate eye center location through invariant isocentric patterns

    NARCIS (Netherlands)

    Valenti, R.; Gevers, T.

    2012-01-01

    Locating the center of the eyes allows for valuable information to be captured and used in a wide range of applications. Accurate eye center location can be determined using commercial eye-gaze trackers, but additional constraints and expensive hardware make these existing solutions unattractive and

  8. Creating a Culture of Accurate and Precise Data.

    Science.gov (United States)

    Bergren, Martha Dewey; Maughan, Erin D; Johnson, Kathleen H; Wolfe, Linda C; Watts, H Estelle S; Cole, Marjorie

    2017-01-01

    There are many stakeholders for school health data. Each one has a stake in the quality and accuracy of the health data collected and reported in schools. The joint NASN and NASSNC national school nurse data set initiative, Step Up & Be Counted!, heightens the need to assure accurate and precise data. The use of a standardized terminology allows the data on school health care delivered in local schools to be aggregated for use at the local, state, and national levels. The use of uniform terminology demands that data elements be defined and that accurate and reliable data are entered into the database. Barriers to accurate data are misunderstanding of accurate data needs, student caseloads that exceed the national recommendations, lack of electronic student health records, and electronic student health records that do not collect the indicators using the standardized terminology or definitions. The quality of the data that school nurses report and share has an impact at the personal, district, state, and national levels and influences the confidence and quality of the decisions made using that data.

  9. Modeling Battery Behavior for Accurate State-of-Charge Indication

    NARCIS (Netherlands)

    Pop, V.; Bergveld, H.J.; Veld, op het J.H.G.; Regtien, P.P.L.; Danilov, D.; Notten, P.H.L.

    2006-01-01

    Li-ion is the most commonly used battery chemistry in portable applications nowadays. Accurate state-of-charge (SOC) and remaining run-time indication for portable devices is important for the user's convenience and to prolong the lifetime of batteries. A new SOC indication system, combining the ele

  10. Compact and Accurate Turbocharger Modelling for Engine Control

    DEFF Research Database (Denmark)

    Sorenson, Spencer C; Hendricks, Elbert; Magnússon, Sigurjón

    2005-01-01

    (Engine Control Unit) as a table. This method uses a great deal of memory space and often requires on-line interpolation and thus a large amount of CPU time. In this paper a more compact, accurate and rapid method of dealing with the compressor modelling problem is presented and is applicable to all...

  11. Speed-of-sound compensated photoacoustic tomography for accurate imaging

    NARCIS (Netherlands)

    Jose, J.; Willemink, G.H.; Steenbergen, W.; Leeuwen, van A.G.J.M.; Manohar, S.

    2012-01-01

    Purpose: In most photoacoustic (PA) tomographic reconstructions, variations in speed-of-sound (SOS) of the subject are neglected under the assumption of acoustic homogeneity. Biological tissue with spatially heterogeneous SOS cannot be accurately reconstructed under this assumption. The authors pres

  12. BIOACCESSIBILITY TESTS ACCURATELY ESTIMATE BIOAVAILABILITY OF LEAD TO QUAIL

    Science.gov (United States)

    Hazards of soil-borne Pb to wild birds may be more accurately quantified if the bioavailability of that Pb is known. To better understand the bioavailability of Pb to birds, we measured blood Pb concentrations in Japanese quail (Coturnix japonica) fed diets containing Pb-contami...

  13. Quantifying Accurate Calorie Estimation Using the "Think Aloud" Method

    Science.gov (United States)

    Holmstrup, Michael E.; Stearns-Bruening, Kay; Rozelle, Jeffrey

    2013-01-01

    Objective: Clients often have limited time in a nutrition education setting. An improved understanding of the strategies used to accurately estimate calories may help to identify areas of focused instruction to improve nutrition knowledge. Methods: A "Think Aloud" exercise was recorded during the estimation of calories in a standard dinner meal…

  14. Dynamic weighing for accurate fertilizer application and monitoring

    NARCIS (Netherlands)

    Bergeijk, van J.; Goense, D.; Willigenburg, van L.G.; Speelman, L.

    2001-01-01

    The mass flow of fertilizer spreaders must be calibrated for the different types of fertilizers used. To obtain accurate fertilizer application manual calibration of actual mass flow must be repeated frequently. Automatic calibration is possible by measurement of the actual mass flow, based on

  15. A Self-Instructional Device for Conditioning Accurate Prosody.

    Science.gov (United States)

    Buiten, Roger; Lane, Harlan

    1965-01-01

    A self-instructional device for conditioning accurate prosody in second-language learning is described in this article. The Speech Auto-Instructional Device (SAID) is electro-mechanical and performs three functions: SAID (1) presents to the student tape-recorded pattern sentences that are considered standards in prosodic performance; (2) processes…

  16. Bioaccessibility tests accurately estimate bioavailability of lead to quail

    Science.gov (United States)

    Hazards of soil-borne Pb to wild birds may be more accurately quantified if the bioavailability of that Pb is known. To better understand the bioavailability of Pb, we incorporated Pb-contaminated soils or Pb acetate into diets for Japanese quail (Coturnix japonica), fed the quail for 15 days, and ...

  17. Practical schemes for accurate forces in quantum Monte Carlo

    NARCIS (Netherlands)

    Moroni, S.; Saccani, S.; Filippi, C.

    2014-01-01

    While the computation of interatomic forces has become a well-established practice within variational Monte Carlo (VMC), the use of the more accurate Fixed-Node Diffusion Monte Carlo (DMC) method is still largely limited to the computation of total energies on structures obtained at a lower level of

  18. Fast and Accurate Residential Fire Detection Using Wireless Sensor Networks

    NARCIS (Netherlands)

    Bahrepour, M.; Meratnia, Nirvana; Havinga, Paul J.M.

    2010-01-01

    Prompt and accurate residential fire detection is important for on-time fire extinguishing and consequently reducing damages and life losses. To detect fire sensors are needed to measure the environmental parameters and algorithms are required to decide about occurrence of fire. Recently, wireless

  19. Psychiatric diagnoses are not mental processes: Wittgenstein on conceptual confusion.

    Science.gov (United States)

    Rosenman, Stephen; Nasti, Julian

    2012-11-01

    Empirical explanation and treatment repeatedly fail for psychiatric diagnoses. Diagnosis is mired in conceptual confusion that is illuminated by Ludwig Wittgenstein's later critique of philosophy (Philosophical Investigations). This paper examines conceptual confusions in the foundation of psychiatric diagnosis from some of Wittgenstein's important critical viewpoints. Diagnostic terms are words whose meanings are given by usages not definitions. Diagnoses, by Wittgenstein's analogy with 'games', have various and evolving usages that are connected by family relationships, and no essence or core phenomenon connects them. Their usages will change according to the demands and contexts in which they are employed. Diagnoses, like many psychological terms, such as 'reading' or 'understanding', are concepts that refer not to fixed behavioural or mental states but to complex apprehensions of the relationship of a variety of behavioural phenomena with the world. A diagnosis is a sort of concept that cannot be located in or explained by a mental process. A diagnosis is an exercise in language and its usage changes according to the context and the needs it addresses. Diagnoses have important uses but they are irreducibly heterogeneous and cannot be identified with or connected to particular mental processes or even with a unity of phenomena that can be addressed empirically. This makes understandable not only the repeated failure of empirical science to replicate or illuminate genetic, neurophysiologic, psychic or social processes underlying diagnoses but also the emptiness of a succession of explanatory theories and treatment effects that cannot be repeated or stubbornly regress to the mean. Attempts to fix the meanings of diagnoses to allow empirical explanation will and should fail as there is no foundation on which a fixed meaning can be built and it can only be done at the cost of the relevance and usefulness of diagnosis.

  20. Utility of Fine Needle Aspiration Cytology in Diagnosing Bone Tumors

    Directory of Open Access Journals (Sweden)

    Sonal Mahajan

    2015-01-01

    Results: A total of 36 cases were studied, of which diagnostic material was adequately obtained in 32 cases (88.88%. The sensitivity (92.85% and specificity (94.44% of FNAC were high, with an accuracy of 93.75%, which is similar to findings in other studies. Conclusion: FNAC plays a vital role in diagnosing bone tumors. It is a rapid, easy, cheap, and minimum invasive outpatient department procedure. However histopathology is still important in diagnosing bone tumors that are unclear or undiagnosed on FNAC since histopathology gives a complete architectural pattern of tissue.

  1. Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia

    DEFF Research Database (Denmark)

    Saglio, Giuseppe; Kim, Dong-Wook; Issaragrisil, Surapol

    2010-01-01

    Nilotinib has been shown to be a more potent inhibitor of BCR-ABL than imatinib. We evaluated the efficacy and safety of nilotinib, as compared with imatinib, in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia (CML) in the chronic phase.......Nilotinib has been shown to be a more potent inhibitor of BCR-ABL than imatinib. We evaluated the efficacy and safety of nilotinib, as compared with imatinib, in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia (CML) in the chronic phase....

  2. Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang [Gachon University of Medicine and Science, Incheon (Korea, Republic of)

    2009-12-15

    Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

  3. Recent advances in diagnosing pathogenic equine gastrointestinal helminths

    DEFF Research Database (Denmark)

    Andersen, Ulla Vestergaard; Howe, D. K.; Olsen, Susanne Nautrup

    2013-01-01

    the needs for reliable and practical diagnostic tools for detection of major parasites infecting equines. The current, widely used coprological techniques are important and useful, but they do have considerable limitations as they are incapable of diagnosing the pathogenic migrating stages. Species...... for diagnosing A. perfoliata infection, but interpretation is complicated by the fact that horses not harbouring tapeworms can maintain elevated antibody titres. Recent work with a coproantigen ELISA has shown promise for reliable detection of current A. perfoliata infection. Perhaps most remarkable is the fact...

  4. On the importance of having accurate data for astrophysical modelling

    Science.gov (United States)

    Lique, Francois

    2016-06-01

    The Herschel telescope and the ALMA and NOEMA interferometers have opened new windows of observation for wavelengths ranging from far infrared to sub-millimeter with spatial and spectral resolutions previously unmatched. To make the most of these observations, an accurate knowledge of the physical and chemical processes occurring in the interstellar and circumstellar media is essential.In this presentation, I will discuss what are the current needs of astrophysics in terms of molecular data and I will show that accurate molecular data are crucial for the proper determination of the physical conditions in molecular clouds.First, I will focus on collisional excitation studies that are needed for molecular lines modelling beyond the Local Thermodynamic Equilibrium (LTE) approach. In particular, I will show how new collisional data for the HCN and HNC isomers, two tracers of star forming conditions, have allowed solving the problem of their respective abundance in cold molecular clouds. I will also present the last collisional data that have been computed in order to analyse new highly resolved observations provided by the ALMA interferometer.Then, I will present the calculation of accurate rate constants for the F+H2 → HF+H and Cl+H2 ↔ HCl+H reactions, which have allowed a more accurate determination of the physical conditions in diffuse molecular clouds. I will also present the recent work on the ortho-para-H2 conversion due to hydrogen exchange that allow more accurate determination of the ortho-to-para-H2 ratio in the universe and that imply a significant revision of the cooling mechanism in astrophysical media.

  5. Sample Size Requirements for Studies of Treatment Effects on Beta-Cell Function in Newly Diagnosed Type 1 Diabetes

    OpenAIRE

    John M Lachin; McGee, Paula L.; Greenbaum, Carla J.; Jerry Palmer; Mark D Pescovitz; Peter Gottlieb; Jay Skyler

    2011-01-01

    Preservation of β-cell function as measured by stimulated C-peptide has recently been accepted as a therapeutic target for subjects with newly diagnosed type 1 diabetes. In recently completed studies conducted by the Type 1 Diabetes Trial Network (TrialNet), repeated 2-hour Mixed Meal Tolerance Tests (MMTT) were obtained for up to 24 months from 156 subjects with up to 3 months duration of type 1 diabetes at the time of study enrollment. These data provide the information needed to more accur...

  6. DNA barcode data accurately assign higher spider taxa

    Directory of Open Access Journals (Sweden)

    Jonathan A. Coddington

    2016-07-01

    Full Text Available The use of unique DNA sequences as a method for taxonomic identification is no longer fundamentally controversial, even though debate continues on the best markers, methods, and technology to use. Although both existing databanks such as GenBank and BOLD, as well as reference taxonomies, are imperfect, in best case scenarios “barcodes” (whether single or multiple, organelle or nuclear, loci clearly are an increasingly fast and inexpensive method of identification, especially as compared to manual identification of unknowns by increasingly rare expert taxonomists. Because most species on Earth are undescribed, a complete reference database at the species level is impractical in the near term. The question therefore arises whether unidentified species can, using DNA barcodes, be accurately assigned to more inclusive groups such as genera and families—taxonomic ranks of putatively monophyletic groups for which the global inventory is more complete and stable. We used a carefully chosen test library of CO1 sequences from 49 families, 313 genera, and 816 species of spiders to assess the accuracy of genus and family-level assignment. We used BLAST queries of each sequence against the entire library and got the top ten hits. The percent sequence identity was reported from these hits (PIdent, range 75–100%. Accurate assignment of higher taxa (PIdent above which errors totaled less than 5% occurred for genera at PIdent values >95 and families at PIdent values ≥ 91, suggesting these as heuristic thresholds for accurate generic and familial identifications in spiders. Accuracy of identification increases with numbers of species/genus and genera/family in the library; above five genera per family and fifteen species per genus all higher taxon assignments were correct. We propose that using percent sequence identity between conventional barcode sequences may be a feasible and reasonably accurate method to identify animals to family/genus. However

  7. The need for accurate redshifts in supernova cosmology

    CERN Document Server

    Calcino, Josh

    2016-01-01

    Recent papers have shown that a small systematic redshift shift ($\\Delta z\\sim 10^{-5}$) in measurements of type Ia supernovae can cause a significant bias ($\\sim$1\\%) in the recovery of cosmological parameters. Such a redshift shift could be caused, for example, by a gravitational redshift due to the density of our local environment. The sensitivity of supernova data to redshift shifts means supernovae make excellent probes of inhomogeneities. We therefore invert the analysis, and try to diagnose the nature of our local gravitational environment by fitting for $\\Delta z$ as an extra free parameter alongside the usual cosmological parameters.

  8. Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia

    DEFF Research Database (Denmark)

    Saglio, Giuseppe; Kim, Dong-Wook; Issaragrisil, Surapol

    2010-01-01

    Nilotinib has been shown to be a more potent inhibitor of BCR-ABL than imatinib. We evaluated the efficacy and safety of nilotinib, as compared with imatinib, in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia (CML) in the chronic phase....

  9. Two Cases of True Uterine Artery Aneurysms Diagnosed during Pregnancy

    DEFF Research Database (Denmark)

    Schlütter, Jacob Mørup; Johansen, Gry; Helmig, Rikke Bek;

    2016-01-01

    We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the fir...... masses, vague bladder symptoms or radiating pelvic pain. The diagnosis is readily made by color Doppler imaging. Elective Caesarean section should be the preferred mode of delivery to avoid rupture of the aneurysm during labor.......We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the first...... case labor was induced at 37 + 4 weeks of gestation. However, due to sudden fetal distress and maternal abdominal pain, an emergency Caesarean section was performed during labor, and 3 liters of intra-peritoneal blood were encountered upon laparotomy, secondary to a ruptured uterine artery aneurysm...

  10. Neuralgisk amyotrofi - en overset diagnose ved akutte skuldersmerter

    DEFF Research Database (Denmark)

    Jürgensen, Louise; Fagerberg, Christina; Kibæk, Maria;

    2016-01-01

    Neuralgic amyotrophy (NA) is characterized by sudden onset of severe pain in the shoulder/upper arm and muscle amyotrophy. Up to 60% of patients with NA are misdiagnosed as having shoulder joint pathology or cervical pathology. We report a case of a 13-year-old girl diagnosed with the hereditary ...

  11. Diagnoses and visit length in complementary and mainstream medicine.

    NARCIS (Netherlands)

    Heiligers, P.J.M.; Groot, J. de; Koster, D.; Dulmen, S. van

    2010-01-01

    BACKGROUND: The demand for complementary medicine (CM) is growing worldwide and so is the supply. So far, there is not much insight in the activities in Dutch CM practices nor in how these activities differ from mainstream general practice. Comparisons on diagnoses and visit length can offer an

  12. Hereditary spherocytosis diagnosed with the eosin-5'-maleimide binding test.

    Science.gov (United States)

    Watanabe, Toru; Ono, Hiroyuki; Tajima, Iwao; Ishigaki, Hidetoshi; Hakamata, Akio; Shirai, Masami; Endoh, Akira; Hongo, Teruaki

    2014-06-01

    We describe three cases of hereditary spherocytosis (HS) diagnosed using the eosin-5'-maleimide (EMA) binding test and discuss the relevance of the EMA binding test. In Japan, this test is not widely used because the prevalence of HS is low. This test is a valuable screening test for the diagnosis of HS.

  13. A Narrative Approach to Supporting Students Diagnosed with Learning Disabilities

    Science.gov (United States)

    Lambie, Glenn W.; Milsom, Amy

    2010-01-01

    Students diagnosed with learning disabilities experience many challenges that school counselors may address through narrative therapy. Narrative therapy is a postmodern, social constructionist approach based on the theoretical construct that individuals create their notions of truth and meaning of life through interpretive stories. This article…

  14. Carnivore’s atopic dermatitis diagnose and therapy

    Directory of Open Access Journals (Sweden)

    Solcan, Gh.

    2008-06-01

    Full Text Available Atopy is defined as a type I hypersensitisation reaction, due to the genetic predisposition of some individuals to produce specific IgE and/or IgGd excessively after the contact with different aeroallergens inhaled and/or transdermal or digestively absorbed. The paper reveals the main methods of diagnose and therapy of the carnivore’s atopy.

  15. Nursing diagnoses, interventions and outcomes for institutionalized patients with dementia

    Directory of Open Access Journals (Sweden)

    Paula,Escalada-Hernández

    2015-04-01

    Full Text Available Aim: To describe the most frequent NANDA-I nursing diagnoses and the associated NIC in-terventions and NOC outcomes used in nursing care plans for a sample of institutionalized patients with dementia. Methods: Descriptive analyses were performed based on a subsample from a multicentric and cross-sectional study. Data were obtained retrospectively from the electronic patient records and included socio-demografic details, NANDA-I, NIC and NOC labels and the HoNOS scale. Results: In total, 108 patients diagnosed with dementia were included. The nine most prevalent NANDA-I nursing diagnoses and the NOC outcomes and NIC interventions linked to them were presented. According to HoNOS scale, the most common problems among elders with dementia were cognitive problems and problems with activities of daily living, with relationships and related to physical illness or disability. Conclusions: Thisstudy identified patterns of nursing care for institutionalized patients with dementia where the most prevalent nursing diagnoses, interventions and outcomes addressed a wide range of functional, psychosocial and physiological care needs.

  16. Injury Patterns among Individuals Diagnosed with Infantile Autism during Childhood

    DEFF Research Database (Denmark)

    Mouridsen, Svend-Erik; Rich, Bente; Isager, Torben

    2016-01-01

    Background: To date, injury risk among people with infantile autism (IA) has been a relatively poorly researched issue.Objective:The purpose of our study was to compare the prevalence and types of injuries in a clinical sample of 118 patients diagnosed with IA during childhood with those of 336 age...

  17. COMORBIDITY DIAGNOSES IN ALCOHOL DEPENDENT PATIENTS: DIFFERENCES AND DILEMMAS

    Directory of Open Access Journals (Sweden)

    Maja Rus-Makovec

    2002-11-01

    Full Text Available Background. In the presented study we followed the diagnostic procedures of comorbidity in alcohol dependent patients of in-patient treatment. The aim of the study was to evaluate the incidence of dual/triple diagnoses with alcohol dependent patients and to incorporate the diagnostic procedures in rutine work and in treatment planning.Material and methods. We were following the basic parameters of treatment of 469 patients (366 male, 102 female from July 1999 to July 2001. The diagnostic criteria according to ICD-10 were applied after at least four weeks of sobriety.Results. The most frequent additional diagnoses found were nicotine dependency, depressive and personal disorders. Main gender differences were found in diagnosis of depressive disorders and in dependency or abuse of prescripted drugs. Comparison of our results with literature data showed the greatest differences in diagnoses of cognitive, depressive, anxious data and dependency of other psychoactive substances.Conclusions. The comparison between the two time periods shows that stuff sensibility to diagnostic procedures of comorbidity states influences the frequency of diagnostic categories. The literature data review leads to impression of inconsistent diagnosing regarding the context and phylosophy of treatment context, stuff education and patient population.

  18. [Research into new methods for diagnosing, treating and preventing tuberculosis

    NARCIS (Netherlands)

    Borgdorff, M.W.; Kolk, A.; Soolingen, D. van; Meer, J.W.M. van der; Ottenhoff, T.H.

    2003-01-01

    Tuberculosis control requires improved diagnostics, drugs, and vaccines. Their development is facilitated by progress in immunology, molecular biology, and genomics. In addition to sputum smear and culture, amplification techniques can already be used to diagnose tuberculosis and antigen-detection t

  19. Weight and Height in Children Newly Diagnosed With Cancer

    NARCIS (Netherlands)

    Brinksma, Aeltsje; Roodbol, Petrie F.; Sulkers, Esther; Hooimeijer, H. Louise; Sauer, Pieter J. J.; van Sonderen, Eric; de Bont, Eveline S. J. M.; Tissing, Wim J. E.

    2015-01-01

    Background. Although weight loss and lack of linear growth occur in children with cancer, growth history is not included in research that aims to determine nutritional status in children newly diagnosed with cancer. Therefore, this study aimed to determine weight loss and lack of linear growth in th

  20. Continuous lenalidomide treatment for newly diagnosed multiple myeloma

    DEFF Research Database (Denmark)

    Palumbo, Antonio; Hajek, Roman; Delforge, Michel

    2012-01-01

    Lenalidomide has tumoricidal and immunomodulatory activity against multiple myeloma. This double-blind, multicenter, randomized study compared melphalan-prednisone-lenalidomide induction followed by lenalidomide maintenance (MPR-R) with melphalan-prednisone-lenalidomide (MPR) or melphalan......-prednisone (MP) followed by placebo in patients 65 years of age or older with newly diagnosed multiple myeloma....

  1. 381 Developing of a Computerized Brain Diagnosing System for ...

    African Journals Online (AJOL)

    User

    (Pp. 381-396). Ogunsanwo O. D. - Department of Computer Science, Gate way ICT ... computerized brain diagnosing system that would be used in carrying out the .... on Artificial Intelligence (AI) technology are being built into photocopiers, ..... This aspect explores the techniques use for the design of interface, menus and.

  2. Psychosocial and Moral Development of PTSD-Diagnosed Combat Veterans

    Science.gov (United States)

    Taylor, John G.; Baker, Stanley B.

    2007-01-01

    Two related studies were conducted in order to investigate whether psychosocial and moral development appeared to have been disrupted and arrested in veterans diagnosed as having posttraumatic stress disorder (PTSD). Study 1 was devoted to developing a measure of late adolescence, early adulthood, and adulthood stages of psychosocial…

  3. Challenges in Diagnosing Narcolepsy without Cataplexy: A Consensus Statement

    NARCIS (Netherlands)

    Baumann, C.R.; Mignot, E.; Lammers, G.J.; Overeem, S.; Arnulf, I.; Rye, D.; Dauvilliers, Y.; Honda, M.; Owens, J.A.; Plazzi, G.; Scammell, T.E.

    2014-01-01

    BACKGROUND: Diagnosing narcolepsy without cataplexy is often a challenge as the symptoms are nonspecific, current diagnostic tests are limited, and there are no useful biomarkers. In this report, we review the clinical and physiological aspects of narcolepsy without cataplexy, the limitations of ava

  4. Bone histomorphometry in children with newly diagnosed acute lymphoblastic leukemia

    NARCIS (Netherlands)

    Leeuw, JA; Koudstaal, J; Wiersema-Buist, J; Kamps, WA; Timens, W

    2003-01-01

    The objective of this study was to obtain insight into bone formation and resorption in children with newly diagnosed untreated acute lymphoblastic leukemia (ALL). In 23 consecutive children with ALL, a bone biopsy was taken from the crista iliaca posterior under ketamine anesthesia, together with t

  5. Self-Management of Initiations by Students Diagnosed with Autism

    Science.gov (United States)

    Newman, B.; Eyck, P. T.

    2005-01-01

    During prebaseline observations, three students diagnosed with autism were unable to make social initiations to another individual. The ability to make initiations would be considered a "pivotal response" in that it would allow an individual to come into contact with a wide variety of social reinforcement. A multiple-baseline design was…

  6. An Expert System for Diagnosing Children's Multiplication Errors.

    Science.gov (United States)

    Attisha, M.; Yazdani, M.

    1984-01-01

    Describes a microcomputer-based system for diagnosing children's multiplication errors which incorporates the knowledge base of all known systematic multiplication errors, and utilizes a modular approach to cope with the program's complexity. Each module's function, how the programs interact, and the design of pupil-machine interaction are…

  7. Challenges in Diagnosing Narcolepsy without Cataplexy: A Consensus Statement

    NARCIS (Netherlands)

    Baumann, C.R.; Mignot, E.; Lammers, G.J.; Overeem, S.; Arnulf, I.; Rye, D.; Dauvilliers, Y.; Honda, M.; Owens, J.A.; Plazzi, G.; Scammell, T.E.

    2014-01-01

    BACKGROUND: Diagnosing narcolepsy without cataplexy is often a challenge as the symptoms are nonspecific, current diagnostic tests are limited, and there are no useful biomarkers. In this report, we review the clinical and physiological aspects of narcolepsy without cataplexy, the limitations of

  8. Lymphogranuloma venereum proctitis: A differential diagnose to inflammatory bowel disease

    DEFF Research Database (Denmark)

    Høie, Sverre; Knudsen, Lene Surland; Gerstoft, Jan

    2011-01-01

    , relapses of GI-symptoms or extended information concerning sexual habits, LGV was suspected and diagnosed. All patients responded with remission of GI-symptoms and endoscopic findings after oral treatment with doxycycline. Conclusion. Due to similarities between LGV and IBD, LGV should be considered...

  9. Impaired Sertoli cell function in males diagnosed with Noonan syndrome.

    NARCIS (Netherlands)

    Marcus, K.A.; Sweep, C.G.J.; Burgt, I van der; Noordam, C.

    2008-01-01

    In order to study male gonadal function in Noonan syndrome, clinical and laboratory data, including inhibin B, were gathered in nine pubertal males diagnosed with Noonan syndrome. Bilateral testicular maldescent was observed in four, and unilateral cryptorchidism occurred in two. Puberty was delayed

  10. Death Concerns among Individuals Newly Diagnosed with Lung Cancer

    Science.gov (United States)

    Lehto, Rebecca; Therrien, Barbara

    2010-01-01

    Confronting the reality of death is an important challenge for individuals facing life-threatening illness such as lung cancer, the leading cause of cancer death. Few studies, however, document the nature of death-related concerns in individuals newly diagnosed with lung cancer. The aims of this exploratory study were to examine unsolicited…

  11. Maternal and fetal Doppler velocimetry in women diagnosed with ...

    African Journals Online (AJOL)

    2016-03-16

    Mar 16, 2016 ... Aim: This study aimed to investigate maternal and fetal Doppler flow parameters in term pregnant women diagnosed with fear of ... [3] A strong association was found between FOC ... and it includes 33 items about women's cognitive appraisal .... acute emotional reactivity during pregnancy can influence.

  12. Purported medical diagnoses of Pharaoh Tutankhamun, c. 1325 BC-.

    Science.gov (United States)

    Rühli, F J; Ikram, S

    2014-02-01

    King Tutankhamun is one of the most famous rulers of antiquity,thus it is not surprising that a plethora of scientific studies have put forth possible medical diagnoses and causes of his death. Diseases(autologous or infectious), metabolic disorders, trauma (possibly even murder-related), or tumorous conditions have been postulated, frequently only based on secondary data sources. The aim of this article is to critically review all these diagnoses. Since the initial examination of the mummy in the mid 1920s by Howard Carter and others, several dozens of medical diagnoses based on various levels of evidence have been proposed. While some studies did not support any sign of a major disease, others suggested diseases whose existence cannot be proven with the little tissue that is preserved for study. In the last c. five years new examinations of the mummy were performed by computed tomography and ancient DNA analyses,now allowing not only to exclude certain diagnoses that had been postulated earlier, but also to arrive at new theories with a higher degree of certainty concerning the state of health and the early death of this most famous ruler.

  13. Syntax of Emotional Narratives of Persons Diagnosed with Antisocial Personality

    Science.gov (United States)

    Gawda, Barbara

    2010-01-01

    The aim of this study was to show some specificity of syntax of narratives created by persons diagnosed with antisocial personality. The author attempted to verify and supplement information that persons with antisocial personality have an incapacity for emotional language. Scores of 60 prisoners with high antisocial tendencies, 40 prisoners with…

  14. Increased gluconeogenesis in youth with newly diagnosed type 2 diabetes

    Science.gov (United States)

    The role of increased gluconeogenesis as an important contributor to fasting hyperglycaemia at diabetes onset is not known. We evaluated the contribution of gluconeogenesis and glycogenolysis to fasting hyperglycaemia in newly diagnosed youths with type 2 diabetes following an overnight fast. Basal ...

  15. The Emotional Lexicon of Individuals Diagnosed with Antisocial Personality Disorder

    Science.gov (United States)

    Gawda, Barbara

    2013-01-01

    This study investigated the specific emotional lexicons in narratives created by persons diagnosed with antisocial personality disorder (ASPD) to test the hypothesis that individuals with ASPD exhibit deficiencies in emotional language. Study participants consisted of 60 prison inmates with ASPD, 40 prison inmates without ASPD, and 60 men without…

  16. Quality of life of elderly persons with newly diagnosed cancer

    DEFF Research Database (Denmark)

    Esbensen, B A; Osterlind, K; Roer, O

    2004-01-01

    The aim was to investigate quality of life (QoL) in elderly persons newly diagnosed with cancer (65+ years) in relation to age, contact with the health-care system, ability to perform activities of daily living (ADL), hope, social network and support, and to identify which factors were associated...

  17. Prevalence of intestinal parasites in newly diagnosed HIV/AIDS ...

    African Journals Online (AJOL)

    O.A. Obateru

    2016-05-06

    May 6, 2016 ... patients. Methods: This hospital-based cross-sectional study was carried out from December 2010 to June. 2011. ... phages, and defect in the production of immunoglobulin A ... result is immunosuppression.7 There have been reports of the ... parasites in newly diagnosed treatment naıve adult HIV/AIDS.

  18. Weight and Height in Children Newly Diagnosed With Cancer

    NARCIS (Netherlands)

    Brinksma, Aeltsje; Roodbol, Petrie F.; Sulkers, Esther; Hooimeijer, H. Louise; Sauer, Pieter J. J.; van Sonderen, Eric; de Bont, Eveline S. J. M.; Tissing, Wim J. E.

    2015-01-01

    Background. Although weight loss and lack of linear growth occur in children with cancer, growth history is not included in research that aims to determine nutritional status in children newly diagnosed with cancer. Therefore, this study aimed to determine weight loss and lack of linear growth in th

  19. Nursing diagnoses in patients with immune-bullous dermatosis

    Directory of Open Access Journals (Sweden)

    Euzeli da Silva Brandão

    Full Text Available ABSTRACT Objective: identify nursing diagnoses in patients with immune-bullous dermatosis. Method: a quantitative and descriptive research, carried out in three institutions located in Rio de Janeiro and Mato Grosso do Sul, Brazil, using the Client Assessment Protocol in Dermatology during a nursing consultation. Simple descriptive statistics was used for data analysis. Results: 14 subjects participated in the study, nine with a diagnosis of pemphigus vulgaris, pemphigus two and three of bullous pemphigoid. The age ranged between 27 and 82 years, predominantly females (11. 14 nursing diagnoses were discussed and identified from a clinical rationale in all study participants, representing the most common human responses in this sample. The application of the Assessment Protocol in Dermatology facilitated the comprehensive assessment, in addition to providing the identification of diagnostics according to the North American Nursing Diagnosis Association International. Conclusion: the nursing diagnoses presented confirm the necessity of interdisciplinary work during the care for this clientele. For better description of the phenomena related to the client in question, it is suggested the inclusion of two risk factors related in three diagnoses of this taxonomy. It is worth noting the contribution of the findings for the care, education and research in nursing in dermatology.

  20. Nursing diagnoses in patients with immune-bullous dermatosis 1

    Science.gov (United States)

    Brandão, Euzeli da Silva; dos Santos, Iraci; Lanzillotti, Regina Serrão; Ferreira, Adriano Menis; Gamba, Mônica Antar; Azulay-Abulafia, Luna

    2016-01-01

    ABSTRACT Objective: identify nursing diagnoses in patients with immune-bullous dermatosis. Method: a quantitative and descriptive research, carried out in three institutions located in Rio de Janeiro and Mato Grosso do Sul, Brazil, using the Client Assessment Protocol in Dermatology during a nursing consultation. Simple descriptive statistics was used for data analysis. Results: 14 subjects participated in the study, nine with a diagnosis of pemphigus vulgaris, pemphigus two and three of bullous pemphigoid. The age ranged between 27 and 82 years, predominantly females (11). 14 nursing diagnoses were discussed and identified from a clinical rationale in all study participants, representing the most common human responses in this sample. The application of the Assessment Protocol in Dermatology facilitated the comprehensive assessment, in addition to providing the identification of diagnostics according to the North American Nursing Diagnosis Association International. Conclusion: the nursing diagnoses presented confirm the necessity of interdisciplinary work during the care for this clientele. For better description of the phenomena related to the client in question, it is suggested the inclusion of two risk factors related in three diagnoses of this taxonomy. It is worth noting the contribution of the findings for the care, education and research in nursing in dermatology. PMID:27533274

  1. Asthma in elite athletes: pathogenesis, diagnosis, differential diagnoses, and treatment

    DEFF Research Database (Denmark)

    Pedersen, Lars; Elers, Jimmi; Backer, Vibeke

    2011-01-01

    measurements, such as the eucapnic voluntary hyperpnea test or exercise test. When considering that not all respiratory symptoms are due to asthma, other diagnoses should be considered. Certain regulations apply to elite athletes who require asthma medication for asthma. Knowledge of these regulations...

  2. Laparoscopy can be used to diagnose peritoneal tuberculosis

    DEFF Research Database (Denmark)

    Ferløv Schwensen, Jakob; Bulut, Mustafa; Nordholm-Carstensen, Andreas

    2014-01-01

    and widespread pale nodules were found throughout the peritoneum. Consequently, the patient was diagnosed with peritoneal tuberculosis. This case demonstrates that atypical manifestations of tuberculosis exist in Denmark and that laparoscopy with biopsy can be performed to obtain the diagnosis when suspecting...... peritoneal tuberculosis....

  3. Laryngeal chondrosarcoma diagnosed by core-needle biopsy.

    Science.gov (United States)

    Miyamaru, Satoru; Haba, Koichi

    2014-01-01

    We report a case of chondrosarcoma of the larynx, diagnosed by a percutaneous core-needle biopsy (CNB). Cartilaginous tumors of the larynx are usually diagnosed by biopsy with direct laryngomicroscopy under general anesthesia. However, patients find it difficult to undergo a biopsy under general anesthesia, for physical, economic, and social reasons. Instead, we can readily detect and sample tumors of the larynx using ultrasound under local anesthesia with reduced stress. Concerning needle-puncture biopsies, including fine-needle aspiration cytology (FNAC) and CNB, some studies have reported needle track dissemination, a possible complication in patients with malignant tumors. Thus, in the head and neck region, we generally use FNAC for biopsies, not CNB. However, it can be difficult to diagnose bone tumors by cytology alone. Regarding primary bone tumors, only one study has reported needle track dissemination by CNB, in osteosarcoma of the femur. Additionally, this complication has not been reported before with chondrosarcoma anywhere in the body. To our knowledge, this is the first report concerning chondrosarcoma of the larynx diagnosed by percutaneous CNB. We recommend CNB as a useful and safe diagnostic technique for primary bone tumors in the head and neck region.

  4. Accurate parameter estimation for unbalanced three-phase system.

    Science.gov (United States)

    Chen, Yuan; So, Hing Cheung

    2014-01-01

    Smart grid is an intelligent power generation and control console in modern electricity networks, where the unbalanced three-phase power system is the commonly used model. Here, parameter estimation for this system is addressed. After converting the three-phase waveforms into a pair of orthogonal signals via the α β-transformation, the nonlinear least squares (NLS) estimator is developed for accurately finding the frequency, phase, and voltage parameters. The estimator is realized by the Newton-Raphson scheme, whose global convergence is studied in this paper. Computer simulations show that the mean square error performance of NLS method can attain the Cramér-Rao lower bound. Moreover, our proposal provides more accurate frequency estimation when compared with the complex least mean square (CLMS) and augmented CLMS.

  5. Symmetric Uniformly Accurate Gauss-Runge-Kutta Method

    Directory of Open Access Journals (Sweden)

    Dauda G. YAKUBU

    2007-08-01

    Full Text Available Symmetric methods are particularly attractive for solving stiff ordinary differential equations. In this paper by the selection of Gauss-points for both interpolation and collocation, we derive high order symmetric single-step Gauss-Runge-Kutta collocation method for accurate solution of ordinary differential equations. The resulting symmetric method with continuous coefficients is evaluated for the proposed block method for accurate solution of ordinary differential equations. More interestingly, the block method is self-starting with adequate absolute stability interval that is capable of producing simultaneously dense approximation to the solution of ordinary differential equations at a block of points. The use of this method leads to a maximal gain in efficiency as well as in minimal function evaluation per step.

  6. Accurate measurement of the helical twisting power of chiral dopants

    Science.gov (United States)

    Kosa, Tamas; Bodnar, Volodymyr; Taheri, Bahman; Palffy-Muhoray, Peter

    2002-03-01

    We propose a method for the accurate determination of the helical twisting power (HTP) of chiral dopants. In the usual Cano-wedge method, the wedge angle is determined from the far-field separation of laser beams reflected from the windows of the test cell. Here we propose to use an optical fiber based spectrometer to accurately measure the cell thickness. Knowing the cell thickness at the positions of the disclination lines allows determination of the HTP. We show that this extension of the Cano-wedge method greatly increases the accuracy with which the HTP is determined. We show the usefulness of this method by determining the HTP of ZLI811 in a variety of hosts with negative dielectric anisotropy.

  7. Accurate multireference study of Si3 electronic manifold

    CERN Document Server

    Goncalves, Cayo Emilio Monteiro; Braga, Joao Pedro

    2016-01-01

    Since it has been shown that the silicon trimer has a highly multi-reference character, accurate multi-reference configuration interaction calculations are performed to elucidate its electronic manifold. Emphasis is given to the long range part of the potential, aiming to understand the atom-diatom collisions dynamical aspects, to describe conical intersections and important saddle points along the reactive path. Potential energy surface main features analysis are performed for benchmarking, and highly accurate values for structures, vibrational constants and energy gaps are reported, as well as the unpublished spin-orbit coupling magnitude. The results predict that inter-system crossings will play an important role in dynamical simulations, specially in triplet state quenching, making the problem of constructing a precise potential energy surface more complicated and multi-layer dependent. The ground state is predicted to be the singlet one, but since the singlet-triplet gap is rather small (2.448 kJ/mol) bo...

  8. Efficient and Accurate Robustness Estimation for Large Complex Networks

    CERN Document Server

    Wandelt, Sebastian

    2016-01-01

    Robustness estimation is critical for the design and maintenance of resilient networks, one of the global challenges of the 21st century. Existing studies exploit network metrics to generate attack strategies, which simulate intentional attacks in a network, and compute a metric-induced robustness estimation. While some metrics are easy to compute, e.g. degree centrality, other, more accurate, metrics require considerable computation efforts, e.g. betweennes centrality. We propose a new algorithm for estimating the robustness of a network in sub-quadratic time, i.e., significantly faster than betweenness centrality. Experiments on real-world networks and random networks show that our algorithm estimates the robustness of networks close to or even better than betweenness centrality, while being orders of magnitudes faster. Our work contributes towards scalable, yet accurate methods for robustness estimation of large complex networks.

  9. Accurate speed and slip measurement of induction motors

    Energy Technology Data Exchange (ETDEWEB)

    Ho, S.Y.S.; Langman, R. [Tasmania Univ., Hobart, TAS (Australia)

    1996-03-01

    Two alternative hardware circuits, for the accurate measurement of low slip in cage induction motors, are discussed. Both circuits compare the periods of the fundamental of the supply frequency and pulses from a shaft-connected toothed-wheel. The better of the two achieves accuracy to 0.5 percent of slip over the range 0.1 to 0.005, or better than 0.001 percent of speed over the range. This method is considered useful for slip measurement of motors supplied by either constant frequency mains of variable speed controllers with PMW waveforms. It is demonstrated that accurate slip measurement supports the conclusions of work previously done on the detection of broken rotor bars. (author). 1 tab., 6 figs., 13 refs.

  10. An Accurate Link Correlation Estimator for Improving Wireless Protocol Performance

    Directory of Open Access Journals (Sweden)

    Zhiwei Zhao

    2015-02-01

    Full Text Available Wireless link correlation has shown significant impact on the performance of various sensor network protocols. Many works have been devoted to exploiting link correlation for protocol improvements. However, the effectiveness of these designs heavily relies on the accuracy of link correlation measurement. In this paper, we investigate state-of-the-art link correlation measurement and analyze the limitations of existing works. We then propose a novel lightweight and accurate link correlation estimation (LACE approach based on the reasoning of link correlation formation. LACE combines both long-term and short-term link behaviors for link correlation estimation. We implement LACE as a stand-alone interface in TinyOS and incorporate it into both routing and flooding protocols. Simulation and testbed results show that LACE: (1 achieves more accurate and lightweight link correlation measurements than the state-of-the-art work; and (2 greatly improves the performance of protocols exploiting link correlation.

  11. A fast and accurate method for echocardiography strain rate imaging

    Science.gov (United States)

    Tavakoli, Vahid; Sahba, Nima; Hajebi, Nima; Nambakhsh, Mohammad Saleh

    2009-02-01

    Recently Strain and strain rate imaging have proved their superiority with respect to classical motion estimation methods in myocardial evaluation as a novel technique for quantitative analysis of myocardial function. Here in this paper, we propose a novel strain rate imaging algorithm using a new optical flow technique which is more rapid and accurate than the previous correlation-based methods. The new method presumes a spatiotemporal constancy of intensity and Magnitude of the image. Moreover the method makes use of the spline moment in a multiresolution approach. Moreover cardiac central point is obtained using a combination of center of mass and endocardial tracking. It is proved that the proposed method helps overcome the intensity variations of ultrasound texture while preserving the ability of motion estimation technique for different motions and orientations. Evaluation is performed on simulated, phantom (a contractile rubber balloon) and real sequences and proves that this technique is more accurate and faster than the previous methods.

  12. Accurate analysis of arbitrarily-shaped helical groove waveguide

    Institute of Scientific and Technical Information of China (English)

    Liu Hong-Tao; Wei Yan-Yu; Gong Yu-Bin; Yue Ling-Na; Wang Wen-Xiang

    2006-01-01

    This paper presents a theory on accurately analysing the dispersion relation and the interaction impedance of electromagnetic waves propagating through a helical groove waveguide with arbitrary groove shape, in which the complex groove profile is synthesized by a series of rectangular steps. By introducing the influence of high-order evanescent modes on the connection of any two neighbouring steps by an equivalent susceptance under a modified admittance matching condition, the assumption of the neglecting discontinuity capacitance in previously published analysis is avoided, and the accurate dispersion equation is obtained by means of a combination of field-matching method and admittancematching technique. The validity of this theory is proved by comparison between the measurements and the numerical calculations for two kinds of helical groove waveguides with different groove shapes.

  13. An Accurate Link Correlation Estimator for Improving Wireless Protocol Performance

    Science.gov (United States)

    Zhao, Zhiwei; Xu, Xianghua; Dong, Wei; Bu, Jiajun

    2015-01-01

    Wireless link correlation has shown significant impact on the performance of various sensor network protocols. Many works have been devoted to exploiting link correlation for protocol improvements. However, the effectiveness of these designs heavily relies on the accuracy of link correlation measurement. In this paper, we investigate state-of-the-art link correlation measurement and analyze the limitations of existing works. We then propose a novel lightweight and accurate link correlation estimation (LACE) approach based on the reasoning of link correlation formation. LACE combines both long-term and short-term link behaviors for link correlation estimation. We implement LACE as a stand-alone interface in TinyOS and incorporate it into both routing and flooding protocols. Simulation and testbed results show that LACE: (1) achieves more accurate and lightweight link correlation measurements than the state-of-the-art work; and (2) greatly improves the performance of protocols exploiting link correlation. PMID:25686314

  14. Multimodal Spatial Calibration for Accurately Registering EEG Sensor Positions

    Directory of Open Access Journals (Sweden)

    Jianhua Zhang

    2014-01-01

    Full Text Available This paper proposes a fast and accurate calibration method to calibrate multiple multimodal sensors using a novel photogrammetry system for fast localization of EEG sensors. The EEG sensors are placed on human head and multimodal sensors are installed around the head to simultaneously obtain all EEG sensor positions. A multiple views’ calibration process is implemented to obtain the transformations of multiple views. We first develop an efficient local repair algorithm to improve the depth map, and then a special calibration body is designed. Based on them, accurate and robust calibration results can be achieved. We evaluate the proposed method by corners of a chessboard calibration plate. Experimental results demonstrate that the proposed method can achieve good performance, which can be further applied to EEG source localization applications on human brain.

  15. Library preparation for highly accurate population sequencing of RNA viruses

    Science.gov (United States)

    Acevedo, Ashley; Andino, Raul

    2015-01-01

    Circular resequencing (CirSeq) is a novel technique for efficient and highly accurate next-generation sequencing (NGS) of RNA virus populations. The foundation of this approach is the circularization of fragmented viral RNAs, which are then redundantly encoded into tandem repeats by ‘rolling-circle’ reverse transcription. When sequenced, the redundant copies within each read are aligned to derive a consensus sequence of their initial RNA template. This process yields sequencing data with error rates far below the variant frequencies observed for RNA viruses, facilitating ultra-rare variant detection and accurate measurement of low-frequency variants. Although library preparation takes ~5 d, the high-quality data generated by CirSeq simplifies downstream data analysis, making this approach substantially more tractable for experimentalists. PMID:24967624

  16. FIXED-WING MICRO AERIAL VEHICLE FOR ACCURATE CORRIDOR MAPPING

    Directory of Open Access Journals (Sweden)

    M. Rehak

    2015-08-01

    Full Text Available In this study we present a Micro Aerial Vehicle (MAV equipped with precise position and attitude sensors that together with a pre-calibrated camera enables accurate corridor mapping. The design of the platform is based on widely available model components to which we integrate an open-source autopilot, customized mass-market camera and navigation sensors. We adapt the concepts of system calibration from larger mapping platforms to MAV and evaluate them practically for their achievable accuracy. We present case studies for accurate mapping without ground control points: first for a block configuration, later for a narrow corridor. We evaluate the mapping accuracy with respect to checkpoints and digital terrain model. We show that while it is possible to achieve pixel (3-5 cm mapping accuracy in both cases, precise aerial position control is sufficient for block configuration, the precise position and attitude control is required for corridor mapping.

  17. The FLUKA code: An accurate simulation tool for particle therapy

    CERN Document Server

    Battistoni, Giuseppe; Böhlen, Till T; Cerutti, Francesco; Chin, Mary Pik Wai; Dos Santos Augusto, Ricardo M; Ferrari, Alfredo; Garcia Ortega, Pablo; Kozlowska, Wioletta S; Magro, Giuseppe; Mairani, Andrea; Parodi, Katia; Sala, Paola R; Schoofs, Philippe; Tessonnier, Thomas; Vlachoudis, Vasilis

    2016-01-01

    Monte Carlo (MC) codes are increasingly spreading in the hadrontherapy community due to their detailed description of radiation transport and interaction with matter. The suitability of a MC code for application to hadrontherapy demands accurate and reliable physical models capable of handling all components of the expected radiation field. This becomes extremely important for correctly performing not only physical but also biologically-based dose calculations, especially in cases where ions heavier than protons are involved. In addition, accurate prediction of emerging secondary radiation is of utmost importance in innovative areas of research aiming at in-vivo treatment verification. This contribution will address the recent developments of the FLUKA MC code and its practical applications in this field. Refinements of the FLUKA nuclear models in the therapeutic energy interval lead to an improved description of the mixed radiation field as shown in the presented benchmarks against experimental data with bot...

  18. Profile of nursing diagnoses in patients with respiratory disorders

    Directory of Open Access Journals (Sweden)

    Naftale Alves dos Santos

    2015-04-01

    Full Text Available Objective. Identify the profile of nursing diagnoses in patients with respiratory disorders. Methodology. A descriptive and cross-sectional study involving 38 patients with respiratory problems, of referral hospitals, in a city in northeastern Brazil, in the period from August to October, 2012. Data collection was performed using a form and diagnostic inference was made according with the Taxonomy II of NANDA I. Results. The average age of the patients was 46 years and males predominated (60.5%. The most frequent nursing diagnoses were: Risk for infection (97.3%, Acute pain (68.4%, Poor knowledge (68.4%, Sedentary lifestyle (65.7%, Ineffective airway clearance (65.7%, Risk-prone health behavior (63.1%, Activity intolerance (52.6% and Disturbed sleep pattern (33.3%. Evaluated patients exhibited an average of 8.6 nursing diagnoses (SD = 2.8. With respect to the defining characteristics and related factors the average per person was 7.2 and 9.3, respectively. Conclusion. In this group of patients the most frequent diagnoses were the domain activity/rest. Knowledge of nursing diagnoses profile presented by people with respiratory disorders is important, because it is part of the Nursing Process and nurses who take care of such patients should exercise them in their care practice. Knowledge of the mains nursing diagnosis presented by patients with respiratory disorders are important for the practice of nurses who care for these patients, because it allows the choice of responses to problems of their clientele.

  19. Commentary: the problem of agreement on diagnoses in criminal cases.

    Science.gov (United States)

    Patterson, Raymond F

    2010-01-01

    The authors present an important two-part study as they strive to provide an empirical analysis of psychiatric diagnoses in criminal case reports in Australia. In the first part, they compare the level of agreement or correlation of diagnoses between pairs of experts who prepared reports for either the prosecution or defense with other reports prepared for the same and opposing sides and by profession (i.e., psychiatrists and/or psychologists). In the second part, they compare the level of agreement or correlation between experts retained by either the prosecution or defense and treating practitioners. Psychiatric diagnoses are fundamental requirements that may affect the adjudication of criminal and civil cases. Both parts of the study focus on criminal cases and are very exciting in that they review not only the correlation of agreements in these areas but also address indirectly the concept of the so-called hired gun. The development of specialized expertise in the evaluation and assessment of defendants by designated opinion or expert witnesses has progressed over time. The nexus between psychiatry and the law (i.e., forensic psychiatry) has included the presentation of psychiatric diagnosis to the courts and the necessity for the expert or treating practitioner to address legal questions raised by the court. This study makes important steps in the direction of examining and analyzing the role of psychiatric diagnosis according to the responsibilities of the evaluator (i.e., as independent examiner or treating practitioner), as well as the possible influence of professional training and experience on differences in diagnoses between two evaluators. It is anticipated that there will be further work in these areas to address not only diagnoses but forensic recommendations and opinions.

  20. Correspondence Between NANDA International Nursing Diagnoses and Outcomes as Proposed by the Nursing Outcomes Classification.

    Science.gov (United States)

    de Carvalho, Emilia Campos; Eduardo, Aline Helena Appoloni; Romanzini, Adilson; Simão, Talita Prado; Zamarioli, Cristina Mara; Garbuio, Danielle Cristina; Herdman, Tracy Heather

    2016-04-05

    The accurate identification of the nursing diagnoses and the corresponding measurement of their indicators will depend on the elements in the standardized language systems. To analyze the correspondence between elements of four NANDA-I nursing diagnoses and outcomes suggested by the nursing outcomes classification (NOC) for the resolution of these diagnoses. A methodological study consisting of cross-mapping was performed in the first stage between definitions, defining characteristics (DCs), and related factors (RFs) of impaired oral mucous membrane, impaired tissue integrity, spiritual distress, and delayed surgical recovery and outcome definitions and indicators to measure results of diagnoses resolution and an analysis of its relevance by experts in the second stage. It found partial correspondence between outcome indicators, DCs, RFs, and definitions. The data evidence the relevance of this review for a reliable application of these taxonomies and demonstrated partial correspondence between concepts analyzed. A identificação precisa dos diagnósticos de enfermagem e a medida correspondente dos seus indicadores dependerá dos elementos nos sistemas de linguagem padronizados. Foi analisar a correspondência entre os elementos de quatro NANDA-I diagnósticos de enfermagem e os resultados sugeridos pelo NOC para a resolução destes diagnósticos. MÉTODO: um estudo metodológico que consiste em cross-mapping foi realizado em uma primeira fase entre as definições, características definidoras e fatores relacionados de Mucosa oral prejudicada, Integridade tissular prejudicada, Sofrimento espiritual e Recuperação cirúrgica retardada e as definições dos resultados indicados para a resolução destes diagnósticos; na segunda fase, foi realizada uma análise desta concordância por especialistas. RESULTADOS: correspondência parcial entre as definições dos diagnósticos e dos resultados, características definidoras e fatores relacionados. CONCLUSÃO: Os

  1. Automated morphometry provides accurate and reproducible virtual staging of liver fibrosis in chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    Paul Calès

    2015-01-01

    morphometric scores provide reproducible and accurate diagnoses of fibrosis stages via "virtual expert pathologist."

  2. A robust and accurate formulation of molecular and colloidal electrostatics

    Science.gov (United States)

    Sun, Qiang; Klaseboer, Evert; Chan, Derek Y. C.

    2016-08-01

    This paper presents a re-formulation of the boundary integral method for the Debye-Hückel model of molecular and colloidal electrostatics that removes the mathematical singularities that have to date been accepted as an intrinsic part of the conventional boundary integral equation method. The essence of the present boundary regularized integral equation formulation consists of subtracting a known solution from the conventional boundary integral method in such a way as to cancel out the singularities associated with the Green's function. This approach better reflects the non-singular physical behavior of the systems on boundaries with the benefits of the following: (i) the surface integrals can be evaluated accurately using quadrature without any need to devise special numerical integration procedures, (ii) being able to use quadratic or spline function surface elements to represent the surface more accurately and the variation of the functions within each element is represented to a consistent level of precision by appropriate interpolation functions, (iii) being able to calculate electric fields, even at boundaries, accurately and directly from the potential without having to solve hypersingular integral equations and this imparts high precision in calculating the Maxwell stress tensor and consequently, intermolecular or colloidal forces, (iv) a reliable way to handle geometric configurations in which different parts of the boundary can be very close together without being affected by numerical instabilities, therefore potentials, fields, and forces between surfaces can be found accurately at surface separations down to near contact, and (v) having the simplicity of a formulation that does not require complex algorithms to handle singularities will result in significant savings in coding effort and in the reduction of opportunities for coding errors. These advantages are illustrated using examples drawn from molecular and colloidal electrostatics.

  3. Accurate Method for Determining Adhesion of Cantilever Beams

    Energy Technology Data Exchange (ETDEWEB)

    Michalske, T.A.; de Boer, M.P.

    1999-01-08

    Using surface micromachined samples, we demonstrate the accurate measurement of cantilever beam adhesion by using test structures which are adhered over long attachment lengths. We show that this configuration has a deep energy well, such that a fracture equilibrium is easily reached. When compared to the commonly used method of determining the shortest attached beam, the present method is much less sensitive to variations in surface topography or to details of capillary drying.

  4. Accurate and Simple Calibration of DLP Projector Systems

    OpenAIRE

    Wilm, Jakob; Olesen, Oline Vinter; Larsen, Rasmus

    2014-01-01

    Much work has been devoted to the calibration of optical cameras, and accurate and simple methods are now available which require only a small number of calibration targets. The problem of obtaining these parameters for light projectors has not been studied as extensively and most current methods require a camera and involve feature extraction from a known projected pattern. In this work we present a novel calibration technique for DLP Projector systems based on phase shifting profilometry pr...

  5. Accurate Insertion Loss Measurements of the Juno Patch Array Antennas

    Science.gov (United States)

    Chamberlain, Neil; Chen, Jacqueline; Hodges, Richard; Demas, John

    2010-01-01

    This paper describes two independent methods for estimating the insertion loss of patch array antennas that were developed for the Juno Microwave Radiometer instrument. One method is based principally on pattern measurements while the other method is based solely on network analyzer measurements. The methods are accurate to within 0.1 dB for the measured antennas and show good agreement (to within 0.1dB) of separate radiometric measurements.

  6. The highly accurate anteriolateral portal for injecting the knee

    Directory of Open Access Journals (Sweden)

    Chavez-Chiang Colbert E

    2011-03-01

    Full Text Available Abstract Background The extended knee lateral midpatellar portal for intraarticular injection of the knee is accurate but is not practical for all patients. We hypothesized that a modified anteriolateral portal where the synovial membrane of the medial femoral condyle is the target would be highly accurate and effective for intraarticular injection of the knee. Methods 83 subjects with non-effusive osteoarthritis of the knee were randomized to intraarticular injection using the modified anteriolateral bent knee versus the standard lateral midpatellar portal. After hydrodissection of the synovial membrane with lidocaine using a mechanical syringe (reciprocating procedure device, 80 mg of triamcinolone acetonide were injected into the knee with a 2.0-in (5.1-cm 21-gauge needle. Baseline pain, procedural pain, and pain at outcome (2 weeks and 6 months were determined with the 10 cm Visual Analogue Pain Score (VAS. The accuracy of needle placement was determined by sonographic imaging. Results The lateral midpatellar and anteriolateral portals resulted in equivalent clinical outcomes including procedural pain (VAS midpatellar: 4.6 ± 3.1 cm; anteriolateral: 4.8 ± 3.2 cm; p = 0.77, pain at outcome (VAS midpatellar: 2.6 ± 2.8 cm; anteriolateral: 1.7 ± 2.3 cm; p = 0.11, responders (midpatellar: 45%; anteriolateral: 56%; p = 0.33, duration of therapeutic effect (midpatellar: 3.9 ± 2.4 months; anteriolateral: 4.1 ± 2.2 months; p = 0.69, and time to next procedure (midpatellar: 7.3 ± 3.3 months; anteriolateral: 7.7 ± 3.7 months; p = 0.71. The anteriolateral portal was 97% accurate by real-time ultrasound imaging. Conclusion The modified anteriolateral bent knee portal is an effective, accurate, and equivalent alternative to the standard lateral midpatellar portal for intraarticular injection of the knee. Trial Registration ClinicalTrials.gov: NCT00651625

  7. Accurate quantum state estimation via "Keeping the experimentalist honest"

    CERN Document Server

    Blume-Kohout, R; Blume-Kohout, Robin; Hayden, Patrick

    2006-01-01

    In this article, we derive a unique procedure for quantum state estimation from a simple, self-evident principle: an experimentalist's estimate of the quantum state generated by an apparatus should be constrained by honesty. A skeptical observer should subject the estimate to a test that guarantees that a self-interested experimentalist will report the true state as accurately as possible. We also find a non-asymptotic, operational interpretation of the quantum relative entropy function.

  8. Are Predictive Energy Expenditure Equations in Ventilated Surgery Patients Accurate?

    Science.gov (United States)

    Tignanelli, Christopher J; Andrews, Allan G; Sieloff, Kurt M; Pleva, Melissa R; Reichert, Heidi A; Wooley, Jennifer A; Napolitano, Lena M; Cherry-Bukowiec, Jill R

    2017-01-01

    While indirect calorimetry (IC) is the gold standard used to calculate specific calorie needs in the critically ill, predictive equations are frequently utilized at many institutions for various reasons. Prior studies suggest these equations frequently misjudge actual resting energy expenditure (REE) in medical and mixed intensive care unit (ICU) patients; however, their utility for surgical ICU (SICU) patients has not been fully evaluated. Therefore, the objective of this study was to compare the REE measured by IC with REE calculated using specific calorie goals or predictive equations for nutritional support in ventilated adult SICU patients. A retrospective review of prospectively collected data was performed on all adults (n = 419, 18-91 years) mechanically ventilated for >24 hours, with an Fio2 ≤ 60%, who met IC screening criteria. Caloric needs were estimated using Harris-Benedict equations (HBEs), and 20, 25, and 30 kcal/kg/d with actual (ABW), adjusted (ADJ), and ideal body (IBW) weights. The REE was measured using IC. The estimated REE was considered accurate when within ±10% of the measured REE by IC. The HBE, 20, 25, and 30 kcal/kg/d estimates of REE were found to be inaccurate regardless of age, gender, or weight. The HBE and 20 kcal/kg/d underestimated REE, while 25 and 30 kcal/kg/d overestimated REE. Of the methods studied, those found to most often accurately estimate REE were the HBE using ABW, which was accurate 35% of the time, and 25 kcal/kg/d ADJ, which was accurate 34% of the time. This difference was not statistically significant. Using HBE, 20, 25, or 30 kcal/kg/d to estimate daily caloric requirements in critically ill surgical patients is inaccurate compared to REE measured by IC. In SICU patients with nutrition requirements essential to recovery, IC measurement should be performed to guide clinicians in determining goal caloric requirements.

  9. Interactive Isogeometric Volume Visualization with Pixel-Accurate Geometry

    OpenAIRE

    Fuchs, Franz G.; Hjelmervik, Jon M.

    2014-01-01

    A recent development, called isogeometric analysis, provides a unified approach for design, analysis and optimization of functional products in industry. Traditional volume rendering methods for inspecting the results from the numerical simulations cannot be applied directly to isogeometric models. We present a novel approach for interactive visualization of isogeometric analysis results, ensuring correct, i.e., pixel-accurate geometry of the volume including its bounding surfaces. The entire...

  10. A multiple more accurate Hardy-Littlewood-Polya inequality

    Directory of Open Access Journals (Sweden)

    Qiliang Huang

    2012-11-01

    Full Text Available By introducing multi-parameters and conjugate exponents and using Euler-Maclaurin’s summation formula, we estimate the weight coefficient and prove a multiple more accurate Hardy-Littlewood-Polya (H-L-P inequality, which is an extension of some earlier published results. We also prove that the constant factor in the new inequality is the best possible, and obtain its equivalent forms.

  11. A highly accurate method to solve Fisher’s equation

    Indian Academy of Sciences (India)

    Mehdi Bastani; Davod Khojasteh Salkuyeh

    2012-03-01

    In this study, we present a new and very accurate numerical method to approximate the Fisher’s-type equations. Firstly, the spatial derivative in the proposed equation is approximated by a sixth-order compact finite difference (CFD6) scheme. Secondly, we solve the obtained system of differential equations using a third-order total variation diminishing Runge–Kutta (TVD-RK3) scheme. Numerical examples are given to illustrate the efficiency of the proposed method.

  12. Accurate and simple calibration of DLP projector systems

    Science.gov (United States)

    Wilm, Jakob; Olesen, Oline V.; Larsen, Rasmus

    2014-03-01

    Much work has been devoted to the calibration of optical cameras, and accurate and simple methods are now available which require only a small number of calibration targets. The problem of obtaining these parameters for light projectors has not been studied as extensively and most current methods require a camera and involve feature extraction from a known projected pattern. In this work we present a novel calibration technique for DLP Projector systems based on phase shifting profilometry projection onto a printed calibration target. In contrast to most current methods, the one presented here does not rely on an initial camera calibration, and so does not carry over the error into projector calibration. A radial interpolation scheme is used to convert features coordinates into projector space, thereby allowing for a very accurate procedure. This allows for highly accurate determination of parameters including lens distortion. Our implementation acquires printed planar calibration scenes in less than 1s. This makes our method both fast and convenient. We evaluate our method in terms of reprojection errors and structured light image reconstruction quality.

  13. Accurate modelling of unsteady flows in collapsible tubes.

    Science.gov (United States)

    Marchandise, Emilie; Flaud, Patrice

    2010-01-01

    The context of this paper is the development of a general and efficient numerical haemodynamic tool to help clinicians and researchers in understanding of physiological flow phenomena. We propose an accurate one-dimensional Runge-Kutta discontinuous Galerkin (RK-DG) method coupled with lumped parameter models for the boundary conditions. The suggested model has already been successfully applied to haemodynamics in arteries and is now extended for the flow in collapsible tubes such as veins. The main difference with cardiovascular simulations is that the flow may become supercritical and elastic jumps may appear with the numerical consequence that scheme may not remain monotone if no limiting procedure is introduced. We show that our second-order RK-DG method equipped with an approximate Roe's Riemann solver and a slope-limiting procedure allows us to capture elastic jumps accurately. Moreover, this paper demonstrates that the complex physics associated with such flows is more accurately modelled than with traditional methods such as finite difference methods or finite volumes. We present various benchmark problems that show the flexibility and applicability of the numerical method. Our solutions are compared with analytical solutions when they are available and with solutions obtained using other numerical methods. Finally, to illustrate the clinical interest, we study the emptying process in a calf vein squeezed by contracting skeletal muscle in a normal and pathological subject. We compare our results with experimental simulations and discuss the sensitivity to parameters of our model.

  14. BASIC: A Simple and Accurate Modular DNA Assembly Method.

    Science.gov (United States)

    Storch, Marko; Casini, Arturo; Mackrow, Ben; Ellis, Tom; Baldwin, Geoff S

    2017-01-01

    Biopart Assembly Standard for Idempotent Cloning (BASIC) is a simple, accurate, and robust DNA assembly method. The method is based on linker-mediated DNA assembly and provides highly accurate DNA assembly with 99 % correct assemblies for four parts and 90 % correct assemblies for seven parts [1]. The BASIC standard defines a single entry vector for all parts flanked by the same prefix and suffix sequences and its idempotent nature means that the assembled construct is returned in the same format. Once a part has been adapted into the BASIC format it can be placed at any position within a BASIC assembly without the need for reformatting. This allows laboratories to grow comprehensive and universal part libraries and to share them efficiently. The modularity within the BASIC framework is further extended by the possibility of encoding ribosomal binding sites (RBS) and peptide linker sequences directly on the linkers used for assembly. This makes BASIC a highly versatile library construction method for combinatorial part assembly including the construction of promoter, RBS, gene variant, and protein-tag libraries. In comparison with other DNA assembly standards and methods, BASIC offers a simple robust protocol; it relies on a single entry vector, provides for easy hierarchical assembly, and is highly accurate for up to seven parts per assembly round [2].

  15. Discrete sensors distribution for accurate plantar pressure analyses.

    Science.gov (United States)

    Claverie, Laetitia; Ille, Anne; Moretto, Pierre

    2016-12-01

    The aim of this study was to determine the distribution of discrete sensors under the footprint for accurate plantar pressure analyses. For this purpose, two different sensor layouts have been tested and compared, to determine which was the most accurate to monitor plantar pressure with wireless devices in research and/or clinical practice. Ten healthy volunteers participated in the study (age range: 23-58 years). The barycenter of pressures (BoP) determined from the plantar pressure system (W-inshoe®) was compared to the center of pressures (CoP) determined from a force platform (AMTI) in the medial-lateral (ML) and anterior-posterior (AP) directions. Then, the vertical ground reaction force (vGRF) obtained from both W-inshoe® and force platform was compared for both layouts for each subject. The BoP and vGRF determined from the plantar pressure system data showed good correlation (SCC) with those determined from the force platform data, notably for the second sensor organization (ML SCC= 0.95; AP SCC=0.99; vGRF SCC=0.91). The study demonstrates that an adjusted placement of removable sensors is key to accurate plantar pressure analyses. These results are promising for a plantar pressure recording outside clinical or laboratory settings, for long time monitoring, real time feedback or for whatever activity requiring a low-cost system. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  16. Accurate thermoelastic tensor and acoustic velocities of NaCl

    Energy Technology Data Exchange (ETDEWEB)

    Marcondes, Michel L., E-mail: michel@if.usp.br [Physics Institute, University of Sao Paulo, Sao Paulo, 05508-090 (Brazil); Chemical Engineering and Material Science, University of Minnesota, Minneapolis, 55455 (United States); Shukla, Gaurav, E-mail: shukla@physics.umn.edu [School of Physics and Astronomy, University of Minnesota, Minneapolis, 55455 (United States); Minnesota supercomputer Institute, University of Minnesota, Minneapolis, 55455 (United States); Silveira, Pedro da [Chemical Engineering and Material Science, University of Minnesota, Minneapolis, 55455 (United States); Wentzcovitch, Renata M., E-mail: wentz002@umn.edu [Chemical Engineering and Material Science, University of Minnesota, Minneapolis, 55455 (United States); Minnesota supercomputer Institute, University of Minnesota, Minneapolis, 55455 (United States)

    2015-12-15

    Despite the importance of thermoelastic properties of minerals in geology and geophysics, their measurement at high pressures and temperatures are still challenging. Thus, ab initio calculations are an essential tool for predicting these properties at extreme conditions. Owing to the approximate description of the exchange-correlation energy, approximations used in calculations of vibrational effects, and numerical/methodological approximations, these methods produce systematic deviations. Hybrid schemes combining experimental data and theoretical results have emerged as a way to reconcile available information and offer more reliable predictions at experimentally inaccessible thermodynamics conditions. Here we introduce a method to improve the calculated thermoelastic tensor by using highly accurate thermal equation of state (EoS). The corrective scheme is general, applicable to crystalline solids with any symmetry, and can produce accurate results at conditions where experimental data may not exist. We apply it to rock-salt-type NaCl, a material whose structural properties have been challenging to describe accurately by standard ab initio methods and whose acoustic/seismic properties are important for the gas and oil industry.

  17. Is bioelectrical impedance accurate for use in large epidemiological studies?

    Directory of Open Access Journals (Sweden)

    Merchant Anwar T

    2008-09-01

    Full Text Available Abstract Percentage of body fat is strongly associated with the risk of several chronic diseases but its accurate measurement is difficult. Bioelectrical impedance analysis (BIA is a relatively simple, quick and non-invasive technique, to measure body composition. It measures body fat accurately in controlled clinical conditions but its performance in the field is inconsistent. In large epidemiologic studies simpler surrogate techniques such as body mass index (BMI, waist circumference, and waist-hip ratio are frequently used instead of BIA to measure body fatness. We reviewed the rationale, theory, and technique of recently developed systems such as foot (or hand-to-foot BIA measurement, and the elements that could influence its results in large epidemiologic studies. BIA results are influenced by factors such as the environment, ethnicity, phase of menstrual cycle, and underlying medical conditions. We concluded that BIA measurements validated for specific ethnic groups, populations and conditions can accurately measure body fat in those populations, but not others and suggest that for large epdiemiological studies with diverse populations BIA may not be the appropriate choice for body composition measurement unless specific calibration equations are developed for different groups participating in the study.

  18. Accurate genome relative abundance estimation based on shotgun metagenomic reads.

    Directory of Open Access Journals (Sweden)

    Li C Xia

    Full Text Available Accurate estimation of microbial community composition based on metagenomic sequencing data is fundamental for subsequent metagenomics analysis. Prevalent estimation methods are mainly based on directly summarizing alignment results or its variants; often result in biased and/or unstable estimates. We have developed a unified probabilistic framework (named GRAMMy by explicitly modeling read assignment ambiguities, genome size biases and read distributions along the genomes. Maximum likelihood method is employed to compute Genome Relative Abundance of microbial communities using the Mixture Model theory (GRAMMy. GRAMMy has been demonstrated to give estimates that are accurate and robust across both simulated and real read benchmark datasets. We applied GRAMMy to a collection of 34 metagenomic read sets from four metagenomics projects and identified 99 frequent species (minimally 0.5% abundant in at least 50% of the data-sets in the human gut samples. Our results show substantial improvements over previous studies, such as adjusting the over-estimated abundance for Bacteroides species for human gut samples, by providing a new reference-based strategy for metagenomic sample comparisons. GRAMMy can be used flexibly with many read assignment tools (mapping, alignment or composition-based even with low-sensitivity mapping results from huge short-read datasets. It will be increasingly useful as an accurate and robust tool for abundance estimation with the growing size of read sets and the expanding database of reference genomes.

  19. An accurate metric for the spacetime around neutron stars

    CERN Document Server

    Pappas, George

    2016-01-01

    The problem of having an accurate description of the spacetime around neutron stars is of great astrophysical interest. For astrophysical applications, one needs to have a metric that captures all the properties of the spacetime around a neutron star. Furthermore, an accurate appropriately parameterised metric, i.e., a metric that is given in terms of parameters that are directly related to the physical structure of the neutron star, could be used to solve the inverse problem, which is to infer the properties of the structure of a neutron star from astrophysical observations. In this work we present such an approximate stationary and axisymmetric metric for the exterior of neutron stars, which is constructed using the Ernst formalism and is parameterised by the relativistic multipole moments of the central object. This metric is given in terms of an expansion on the Weyl-Papapetrou coordinates with the multipole moments as free parameters and is shown to be extremely accurate in capturing the physical propert...

  20. [Spectroscopy technique and ruminant methane emissions accurate inspecting].

    Science.gov (United States)

    Shang, Zhan-Huan; Guo, Xu-Sheng; Long, Rui-Jun

    2009-03-01

    The increase in atmospheric CH4 concentration, on the one hand through the radiation process, will directly cause climate change, and on the other hand, cause a lot of changes in atmospheric chemical processes, indirectly causing climate change. The rapid growth of atmospheric methane has gained attention of governments and scientists. All countries in the world now deal with global climate change as an important task of reducing emissions of greenhouse gases, but the need for monitoring the concentration of methane gas, in particular precision monitoring, can be scientifically formulated to provide a scientific basis for emission reduction measures. So far, CH4 gas emissions of different animal production systems have received extensive research. The methane emission by ruminant reported in the literature is only estimation. This is due to the various factors that affect the methane production in ruminant, there are various variables associated with the techniques for measuring methane production, the techniques currently developed to measure methane are unable to accurately determine the dynamics of methane emission by ruminant, and therefore there is an urgent need to develop an accurate method for this purpose. Currently, spectroscopy technique has been used and is relatively a more accurate and reliable method. Various spectroscopy techniques such as modified infrared spectroscopy methane measuring system, laser and near-infrared sensory system are able to achieve the objective of determining the dynamic methane emission by both domestic and grazing ruminant. Therefore spectroscopy technique is an important methane measuring technique, and contributes to proposing reduction methods of methane.

  1. ACE-I Angioedema: Accurate Clinical Diagnosis May Prevent Epinephrine-Induced Harm

    Directory of Open Access Journals (Sweden)

    R. Mason Curtis

    2016-06-01

    Full Text Available Introduction: Upper airway angioedema is a life-threatening emergency department (ED presentation with increasing incidence. Angiotensin-converting enzyme inhibitor induced angioedema (AAE is a non-mast cell mediated etiology of angioedema. Accurate diagnosis by clinical examination can optimize patient management and reduce morbidity from inappropriate treatment with epinephrine. The aim of this study is to describe the incidence of angioedema subtypes and the management of AAE. We evaluate the appropriateness of treatments and highlight preventable iatrogenic morbidity. Methods: We conducted a retrospective chart review of consecutive angioedema patients presenting to two tertiary care EDs between July 2007 and March 2012. Results: Of 1,702 medical records screened, 527 were included. The cause of angioedema was identified in 48.8% (n=257 of cases. The most common identifiable etiology was AAE (33.1%, n=85, with a 60.0% male predominance. The most common AAE management strategies included diphenhydramine (63.5%, n=54, corticosteroids (50.6%, n=43 and ranitidine (31.8%, n=27. Epinephrine was administered in 21.2% (n=18 of AAE patients, five of whom received repeated doses. Four AAE patients required admission (4.7% and one required endotracheal intubation. Epinephrine induced morbidity in two patients, causing myocardial ischemia or dysrhythmia shortly after administration. Conclusion: AAE is the most common identifiable etiology of angioedema and can be accurately diagnosed by physical examination. It is easily confused with anaphylaxis and mismanaged with antihistamines, corticosteroids and epinephrine. There is little physiologic rationale for epinephrine use in AAE and much risk. Improved clinical differentiation of mast cell and non-mast cell mediated angioedema can optimize patient management.

  2. The non-compressibility ratio for accurate diagnosis of lower extremity deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Caecilia Marliana

    2014-08-01

    Full Text Available Background Accurate identification of patients with deep vein thrombosis (DVT is critical, as untreated cases can be fatal. It is well established that the specificity of the clinical signs and symptoms of DVT is low. Therefore, clinicians rely on additional tests to make this diagnosis. There are three modalities for DVT diagnosis; clinical scoring, laboratory investigations, and radiology. The objective of this study was to determine the correlation of plasma D-dimer concentration with the ultrasonographic non-compressibility ratio in patients with DVT in the lower extremities. Methods This research was a cross-sectional observational study. The sample comprised 25 subjects over 30 years of age with clinically diagnosed DVT in the lower extremities. In all subjects, D-dimer determination using latex enhanced turbidimetric test was performed, as well as ultrasonographic non-compressibility ratio assessment of the lower extremities. Data were analyzed using Pearson’s correlation at significance level of 0.05. Results Mean plasma D-dimer concentration was 2953.00 ± 2054.44 mg/L. The highest mean non-compressibility ratio (59.96 ± 35.98% was found in the superficial femoral vein and the lowest mean non-compressibility ratio (42.68 ± 33.71% in the common femoral vein. There was a moderately significant correlation between plasma D-dimer level and non-compressibility ratio in the popliteal vein (r=0.582; p=0.037. In the other veins of the lower extremities, no significant correlation was found. Conclusion The sonographic non-compressibility ratio is an objective test for quick and accurate diagnosis of lower extremity DVT and for evaluation of DVT severity.

  3. Exploring Rural Disparities in Medical Diagnoses Among Veterans With Transgender-related Diagnoses Utilizing Veterans Health Administration Care.

    Science.gov (United States)

    Bukowski, Leigh A; Blosnich, John; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Gordon, Adam J

    2017-09-01

    Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses. This study used a retrospective review of The Department of Veterans Affairs (VA) administrative data for transgender patients who received VA care from 1997 through 2014. Transgender patients were defined as individuals that had a lifetime diagnosis of any of 4 International Classification of Diseases-9 diagnosis codes associated with transgender status. Independent multivariable logistic regression models were used to explore associations of rural status with medical conditions. Veterans with transgender-related diagnoses residing in small/isolated rural towns had increased odds of tobacco use disorder (adjusted odds ratio=1.39; 95% confidence intervals, 1.09-1.78) and posttraumatic stress disorder (adjusted odds ratio=1.33; 95% confidence intervals, 1.03-1.71) compared with their urban transgender peers. Urban/rural status was not significantly associated with other medical conditions of interest. This study contributes the first empirical investigations of how place of residence is associated with medical diagnoses among veterans with transgender-related diagnoses. The importance of place as a determinant of health is increasingly clear, but for veterans with transgender-related diagnoses this line of research is currently limited. The addition of self-reported sex identity data within VA electronic health records is one way to advance this line of research.

  4. Diagnoses and visit length in complementary and mainstream medicine

    Directory of Open Access Journals (Sweden)

    de Groot Judith

    2010-01-01

    Full Text Available Abstract Background The demand for complementary medicine (CM is growing worldwide and so is the supply. So far, there is not much insight in the activities in Dutch CM practices nor in how these activities differ from mainstream general practice. Comparisons on diagnoses and visit length can offer an impression of how Dutch CM practices operate. Methods Three groups of regularly trained physicians specialized in CM participated in this study: 16 homeopathic physicians, 13 physician acupuncturists and 11 naturopathy physicians. Every CM physician was asked to include a maximum of 75 new patients within a period of six months. For each patient an inclusion registration form had to be completed and the activities during a maximum of five repeat visits were subsequently registered. Registrations included patient characteristics, diagnoses and visit length. These data could be compared with similar data from general practitioners (GPs participating in the second Dutch national study in general practice (DNSGP-2. Differences between CM practices and between CM and mainstream GP data were tested using multilevel regression analysis. Results The CM physicians registered activities in a total of 5919 visits in 1839 patients. In all types of CM practices general problems (as coded in the ICPC were diagnosed more often than in mainstream general practice, especially fatigue, allergic reactions and infections. Psychological problems and problems with the nervous system were also diagnosed more frequently. In addition, each type of CM physician encountered specific health problems: in acupuncture problems with the musculoskeletal system prevailed, in homeopathy skin problems and in naturopathy gastrointestinal problems. Comparisons in visit length revealed that CM physicians spent at least twice as much time with patients compared to mainstream GPs. Conclusions CM physicians differed from mainstream GPs in diagnoses, partly related to general and partly to

  5. Perturbations in the Lipid Profile of Individuals with Newly Diagnosed Type 1 Diabetes Mellitus: Lipidomics Analysis of a Diabetes Antibody Standardization Program Sample Subset

    Energy Technology Data Exchange (ETDEWEB)

    Sorensen, Christina M.; Ding, Jie; Zhang, Qibin; Alquier, Thierry; Zhao, Rui; Mueller, Patricia W.; Smith, Richard D.; Metz, Thomas O.

    2010-08-01

    Objectives: To characterize the lipid profile of individuals with newly diagnosed type 1 diabetes mellitus using LC-MS-based lipidomics and the accurate mass and time (AMT) tag approach. Design and methods: Lipids were extracted from plasma and sera of 10 subjects from the Diabetes Antibody Standardization Program (years 2000-2005) and 10 non-diabetic subjects and analyzed by capillary liquid chromatography coupled with a hybrid ion-trap-Fourier transform ion cyclotron resonance mass spectrometer. Lipids were identified and quantified using the AMT tag approach. Results: Five hundred sixty lipid features differentiated (q < 0.05) diabetic from healthy individuals in a partial least-squares analysis, characterizing of individuals with recently diagnosed type 1 diabetes mellitus. Conclusions: A lipid profile associated with newly diagnosed type 1 diabetes may aid in further characterization of biochemical pathways involved in lipid regulation or mobilization and lipotoxicity of pancreatic beta-cells.

  6. Diagnosing Diabetic Foot Osteomyelitis in Patients Without Signs of Soft Tissue Infection by Coupling Hybrid 67Ga SPECT/CT With Bedside Percutaneous Bone Puncture

    OpenAIRE

    Aslangul, Elisabeth; M’Bemba, Jocelyne; Caillat-Vigneron, Nadine; Coignard, Sophie; Larger, Etienne; Boitard, Christian; Lipsky, Benjamin A.

    2013-01-01

    OBJECTIVE Successful treatment of osteomyelitis is more likely with accurate diagnosis and identification of the causative pathogens. This typically requires obtaining a specimen of bone, usually by image-guided biopsy. We sought to develop a simpler bedside method for definitively diagnosing osteomyelitis. RESEARCH DESIGN AND METHODS Over 2 years, we enrolled consecutive patients presenting to our diabetic foot clinic with a foot ulcer and clinically suspected osteomyelitis but without soft ...

  7. Dilatation and curettage is more accurate than endometrial aspiration biopsy in early-stage endometrial cancer patients treated with high dose oral progestin and levonorgestrel intrauterine system.

    Science.gov (United States)

    Kim, Da Hee; Seong, Seok Ju; Kim, Mi Kyoung; Bae, Hyo Sook; Kim, Mi La; Yun, Bo Seong; Jung, Yong Wook; Shim, Jeong Yun

    2017-01-01

    To determine whether less invasive endometrial (EM) aspiration biopsy is adequately accurate for evaluating treatment outcomes compared to the dilatation and curettage (D&C) biopsy in early-stage endometrial cancer (EC) patients treated with high dose oral progestin and levonorgestrel intrauterine system (LNG-IUS). We conducted a prospective observational study with patients younger than 40 years who were diagnosed with clinical stage IA, The International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid adenocarcinoma and sought to maintain their fertility. The patients were treated with medroxyprogesterone acetate 500 mg/day and LNG-IUS. Treatment responses were evaluated every 3 months. EM aspiration biopsy was conducted after LNG-IUS removal followed D&C. The tissue samples were histologically compared. The diagnostic concordance rate of the two tests was examined with κ statistics. Twenty-eight pairs of EM samples were obtained from five patients. The diagnostic concordance rate of D&C and EM aspiration biopsy was 39.3% (κ value=0.26). Of the seven samples diagnosed as normal with D&C, three (42.8%) were diagnosed as normal by using EM aspiration biopsy. Of the eight samples diagnosed with endometrioid adenocarcinoma by using D&C, three (37.5%) were diagnosed with endometrioid adenocarcinoma by using EM aspiration biopsy. Of the 13 complex EM hyperplasia samples diagnosed with the D&C, five (38.5%) were diagnosed with EM hyperplasia by using EM aspiration biopsy. Of the samples obtained through EM aspiration, 46.4% were insufficient for histological evaluation. To evaluate the treatment responses of patients with early-stage EC treated with high dose oral progestin and LNG-IUS, D&C should be conducted after LNG-IUS removal.

  8. Dilatation and curettage is more accurate than endometrial aspiration biopsy in early-stage endometrial cancer patients treated with high dose oral progestin and levonorgestrel intrauterine system

    Science.gov (United States)

    2017-01-01

    Objective To determine whether less invasive endometrial (EM) aspiration biopsy is adequately accurate for evaluating treatment outcomes compared to the dilatation and curettage (D&C) biopsy in early-stage endometrial cancer (EC) patients treated with high dose oral progestin and levonorgestrel intrauterine system (LNG-IUS). Methods We conducted a prospective observational study with patients younger than 40 years who were diagnosed with clinical stage IA, The International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid adenocarcinoma and sought to maintain their fertility. The patients were treated with medroxyprogesterone acetate 500 mg/day and LNG-IUS. Treatment responses were evaluated every 3 months. EM aspiration biopsy was conducted after LNG-IUS removal followed D&C. The tissue samples were histologically compared. The diagnostic concordance rate of the two tests was examined with κ statistics. Results Twenty-eight pairs of EM samples were obtained from five patients. The diagnostic concordance rate of D&C and EM aspiration biopsy was 39.3% (κ value=0.26). Of the seven samples diagnosed as normal with D&C, three (42.8%) were diagnosed as normal by using EM aspiration biopsy. Of the eight samples diagnosed with endometrioid adenocarcinoma by using D&C, three (37.5%) were diagnosed with endometrioid adenocarcinoma by using EM aspiration biopsy. Of the 13 complex EM hyperplasia samples diagnosed with the D&C, five (38.5%) were diagnosed with EM hyperplasia by using EM aspiration biopsy. Of the samples obtained through EM aspiration, 46.4% were insufficient for histological evaluation. Conclusion To evaluate the treatment responses of patients with early-stage EC treated with high dose oral progestin and LNG-IUS, D&C should be conducted after LNG-IUS removal. PMID:27670255

  9. New method for diagnosing cast compactness based on laser ultrasonography

    Directory of Open Access Journals (Sweden)

    P. Swornowski

    2010-01-01

    Full Text Available Technologically advanced materials, such as alloys of aluminum, nickel or titanium are currently used increasingly often in significantly loaded components utilized in the aviation industry, among others in the construction of jet turbine engine blades. The article presents a method for diagnosing the condition of the inside of cast blades with the use of laser ultrasonography. The inspection is based on finding hidden flaws with a size of between 10 and 30μm. Laser ultrasonography offers a number of improvements over the non-destructive methods used so far, e.g. the possibility to diagnose the cast on a selected depth, high signal-to-noise ratio and good sensitivity. The article includes a brief overview of non-destructive inspection methods used in foundry engineering and sample results of inspecting the inner structure of a turbo jet engine blade using the method described in the article.

  10. A new gauge-invariant method for diagnosing eddy diffusivities

    CERN Document Server

    Mak, Julian; Marshall, David P

    2015-01-01

    Coarse resolution numerical ocean models must typically include a parameterisation for mesoscale turbulence. A common recipe for such parameterisations is to invoke down-gradient mixing, or diffusion, of some tracer quantity, such as potential vorticity or buoyancy. However, it is well known that eddy fluxes include large rotational components which necessarily do not lead to any mixing; eddy diffusivities diagnosed from unfiltered fluxes are thus contaminated by the presence of these rotational components. Here a new methodology is applied whereby eddy diffusivities are diagnosed directly from the eddy force function. The eddy force function depends only upon flux divergences, is independent of any rotational flux components, and is inherently non-local and smooth. A one-shot inversion procedure is applied, minimising the mis-match between parameterised force functions and force functions derived from eddy resolving calculations. This enables diffusivities associated with the eddy potential vorticity and buo...

  11. Diagnosing, special education and ‘learnification’ in Danish schools

    DEFF Research Database (Denmark)

    Hamre, Bjørn

    2016-01-01

    This article focuses on a discussion of diagnosing, special education, and ‘learnification’ in a Danish school context in which the increasing use of diagnosis is analysed as resulting from the ideas of normality that are associated with the construction of the pupil as a learner. I argue...... that diagnosis in schools can be seen as the shadow side of the articulation and management of learning through schools’ requirements for pupils. This article is based on my analysis of files produced by educational psychologists. Learning and diagnosis, I argue, constitute two different, but parallel, ways...... of looking at being a pupil in school, each of which represents conceptions of deviance and normality. The article’s methodological point of departure draws on a Foucauldian-influenced analysis of diagnosing and learning in education....

  12. Nursing diagnoses and adaptation problems among chronic renal patients

    Directory of Open Access Journals (Sweden)

    Cecília Maria Farias de Queiroz Frazão

    2015-04-01

    Full Text Available Objective. To identify similarities between NANDA International nursing diagnoses and Roy’s adaptation model among chronic renal patients undergoing hemodialysis. Methodology. Cross-sectional and descriptive study with 178 individuals selected, through consecutive convenience sampling, in a dialysis center located in the Northeast of Brazil. The study was conducted between October 2011 and February 2012. Data collection instruments included an interview form and a physical assessment. Results. Similarity was found between 20 nursing diagnoses and 22 adaptation problems. Roy’s adaptation modes that presented these relationships were: physiological, self-conception and role function. Conclusion. There are similarities between the two typologies. Furthermore, the use of the nursing process from the perspective of a theory inherent to the field supports care delivery and strengthens scientific knowledge in the profession.

  13. Fully diagnosing the spatial properties of X-ray lasers

    Institute of Scientific and Technical Information of China (English)

    杨军; 孙今人; 王韬; 范滇元; 王世绩

    2001-01-01

    Based on the moiré effect and the Fresnel diffraction theory, a novel technique for diagnosing the beam properties is presented and analyzed, which is especially suitable for X-ray lasers. The method makes it possible, in a one-shot experimental measurement, to determine the beam quality factor M2, the effective radius of curvature, the beam width, the far-field divergence, and the waist location and radius as well as the spatial coherence and its evolution. Numerical simulation proves the validity of the method. Note that the novel moiré technique opens an efficient road, for the first time, to fully diagnose the spatial properties of X-ray lasers.

  14. Quality of life of elderly persons with newly diagnosed cancer

    DEFF Research Database (Denmark)

    Esbensen, B A; Osterlind, K; Roer, O

    2004-01-01

    The aim was to investigate quality of life (QoL) in elderly persons newly diagnosed with cancer (65+ years) in relation to age, contact with the health-care system, ability to perform activities of daily living (ADL), hope, social network and support, and to identify which factors were associated...... with low QoL. The sample consisted of 101 patients (75 women and 26 men) newly diagnosed with cancer. EORTC QLQ-C30, Nowotny's Hope Scale, Katz ADL and the Interview Schedule for Social Interaction (ISSI) were used. The analysis was carried out in four age groups and revealed no significant differences...... in QoL. Compared with the other age groups, those of a high age (80+ years) more often lived alone, used more home-help service and had a smaller social network. Factors associated with low QoL were 'no other incomes than retirement pension', 'low level of hope' and 'lung cancer'. In addition, 'being...

  15. A case of Ramsay Hunt syndrome diagnosed after kidney transplantation

    Directory of Open Access Journals (Sweden)

    Yoo Min Park

    2015-12-01

    Full Text Available We report the first case of Ramsay Hunt syndrome (RHS diagnosed after kidney transplantation in Korea. RHS is a disease caused by latent varicella-zoster characterized to involve geniculate ganglion of the seventh cranial nerve. Patients who have undergone kidney transplantation can be easily affected by viral infections because of their immune-compromised status. A 35-year-old man with hypertensive end-stage renal disease underwent kidney transplantation. Two months after surgery, the recipient was diagnosed with RHS and treated with antivirals and steroids. However, after using the antiviral agents for the recommended duration, facial paralysis occurred as a new presentation and he required further treatment. Otalgia and periauricular vesicles improved, but the facial palsy remained.

  16. APPLICATION OF POLYMERASE CHAIN REACTION FOR DIAGNOSING AMEBIC LIVER ABSCESS

    Institute of Scientific and Technical Information of China (English)

    郭增柱; 王正仪; 安亦军; 祝宏

    1996-01-01

    Polymerase chain reaction (PCR) has been applied in diagnosing amebic liver infection by detecting pathogenic Entamoeba histolytica DNA in liver aspirates. Oligonucleotide primers found to he specific for the gene encoding the 30 kDa molecule of this pathogenic ameba were used in the test. Liver aspirates obtained from 23 patients with amebic liver abscess substantiated by typical clinical rnanifastation or with very high titres of anti-E histtolytica antibodies by ELISA were found to he positive by PCR. Fourteen controlsamples (3 cases of bacterial liver abscess, I of liver cancer and 10 of other abscess) were all found to be negative to this reaction. The results suggested PCR to he a specific and sensitive tool for diagnosing amebic liver abscess infections.

  17. Cholecystocolonic fistula mimicking acute cholecystitis diagnosed unequivocally by computed tomography.

    Science.gov (United States)

    Chick, Jeffrey Forris Beecham; Chauhan, Nikunj Rashmikant; Paulson, Vera Ashley; Adduci, Alexander J

    2013-12-01

    Cholecystocolonic fistula is an uncommon potential complication of cholecystitis found intraoperatively in 0.06-0.14 % of patients undergoing cholecystectomy and 0.1-0.5 % of autopsy series. Although cholecystocolonic fistula is the second most common cholecystoenteric fistula, second only to cholecystoduodenal fistula, it is diagnosed preoperatively in only 7.9 % of patients. Failure to preoperatively diagnose cholecystocolonic fistula places surgeons in precarious positions, as they may be forced to convert a seemingly routine cholecystectomy to a more sophisticated procedure coupled with adhesiolysis, colonic suturing, or colonic resection. We report a young patient who presented to the emergency department with complaints indicative of acute cholecystitis; however, preoperative ultrasound was suggestive of a cholecystoenteric fistula. Computed tomography and pathology were pathognomonic with clear visualization of the cholecystocolonic fistulous tract.

  18. Insulin Oedema in Newly Diagnosed Type 1 Diabetes Mellitus

    Science.gov (United States)

    Çetinkaya, Semra; Yılmaz Ağladıoğlu, Sebahat; Peltek Kendirici, Havva Nur; Bilgili, Hatice; Yıldırım, Nurdan; Aycan, Zehra

    2010-01-01

    Despite the essential role of insulin in the management of patients with insulin deficiency, insulin use can lead to adverse effects such as hypoglycaemia and weight gain. Rarely, crucial fluid retention can occur with insulin therapy, resulting in an oedematous condition. Peripheral or generalised oedema is an extremely rare complication of insulin therapy in the absence of heart, liver or renal involvement. It has been reported in newly diagnosed type 1 diabetes, in poorly controlled type 2 diabetes following the initiation of insulin therapy, and in underweight patients on large doses of insulin. The oedema occurs shortly after the initiation of intensive insulin therapy. We describe two adolescent girls with newly diagnosed type 1 diabetes, who presented with oedema of the lower extremities approximately one week after the initiation of insulin treatment; other causes of oedema were excluded. Spontaneous recovery was observed in both patients. Conflict of interest:None declared. PMID:21274337

  19. Psychiatric diagnoses in a group of astronaut applicants

    Science.gov (United States)

    Santy, Patricia A.; Faulk, Dean M.; Holland, Al W.

    1991-01-01

    Between 1959 and 1987, the psychiatric evaluation of astronaut candidates evolved from a 30-h intensive examination evaluating applicants for psychopathology, and studying their performance under stress, to a 2-h clinical interview whose structure and contents were determined by the individual examiner. Evaluations done during these years applied both psychiatric (or, 'select-out') criteria and psychological (or, 'select-in') criteria. In an attempt to more rigorously define the psychiatric, 'select-out' component, a standardized, semistructured clinical interview was developed to identify the presence or history of psychiatric disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 3rd Ed. ('DSM-III'). A total of 117 astronaut applicants underwent this clinical interview as part of a comprehensive medical evaluation during a recent astronaut selection. Of the 117 applicants, 9 (7.7 percent) met DSM-III criteria for a variety of Axis I and Axis II diagnoses, including V-code diagnoses.

  20. Frequency of nursing diagnoses in a surgical clinic

    Directory of Open Access Journals (Sweden)

    Andreza Cavalcanti Vasconcelos

    2015-12-01

    Full Text Available Objective: to identify the frequency of Nursing Diagnoses of patients in a surgical clinic. Methods: cross-sectional study, performed with 99 patients in the postoperative of general surgery. Data were collected through a questionnaire validated according to domains of NANDA International, including physical and laboratory examination. Results: 17 nursing diagnoses were found; eight had a frequency higher than 50.0% (infection risk, impaired tissue integrity, constipation risk, anxiety, bleeding risk, acute pain, delayed surgical recovery, dysfunctional gastrointestinal motility. It was observed in all patients the Nursing Diagnostics: risk of infection, impaired tissue integrity and risk of constipation. Conclusion: the frequency of the most prevalent diagnosis is inserted in the domains safety/protection and nutrition, which determines the need to redirect nursing care, prioritizing the patient's clinic.