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Sample records for boy differential diagnosis

  1. [Cluster headache differential diagnosis].

    Science.gov (United States)

    Guégan-Massardier, Evelyne; Laubier, Cécile

    2015-11-01

    Cluster headache is characterized by disabling stereotyped headache. Early diagnosis allows appropriate treatment, unfortunately diagnostic errors are frequent. The main differential diagnoses are other primary or essential headaches. Migraine, more frequent and whose diagnosis is carried by excess, trigeminal neuralgia or other trigemino-autonomic cephalgia. Vascular or tumoral underlying condition can mimic cluster headache, neck and brain imaging is recommended, ideally MRI.

  2. Differential diagnosis of tonsillolith

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    Luisa Schertel Cassiano

    2010-07-01

    Full Text Available Introduction:Tonsillolith is a rare type of dystrophic calcification in the palatine tonsils or in the peritonsilar region, which can mimics several intraosseous radiopaque lesions when evaluated by two-dimensional or overlapping images.This may lead to an erroneous diagnosis and to invasive and unnecessary procedures.This study reports a case of tonsillolith that was wrongly diagnosed as an odontoma. Case report: A patient with primary diagnosis of odontoma in the mandibular ramus was referred to surgical treatment of this lesion. Conclusion: Computed tomography (CT scans are fundamentally important to establish differential diagnosis and appropriate treatment for the patient.

  3. Reading ability and differential cognitive profiles of girls and boys.

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    Kirchner-Nebot, T; Amador-Campos, J A

    1999-12-01

    To compare the differential cognitive and stylistic profiles of Spanish-speaking girls and boys and the relation between these profiles with subjects' reading scores 50 girls and 50 boys, 8 years old, were assessed on a reading test, the Children's Embedded Figures Test, and the Intellectual Test (Escala Diferencial del Rendimiento Intelectual). Analysis showed differential cognitive profiles for the two sexes. While girls used single, essentially verbal strategies for the reading activity, boys with high reading scores used verbal and perceptual strategies. In general, for girls verbal intelligence scores had correlated the highest with reading scores and lowest with independence on the Children's Embedded Figures Test. For boys the two tests contribute to the explained variance of reading scores. Curiously for scores in reading letters, reading strategies of the two groups seemed inverted.

  4. Differential diagnosis diphtheria adults

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    Yu. I. Liashenko

    2010-01-01

    Full Text Available A total of 1,824 human cases of diphtheria, treated at the Clinical Infectious Diseases Hospital SP Botkin (St. Petersburg during 1993, as well as 19 deaths in 1994. It is known that early diagnosis of infectious diseases, especially diphtheria, contributes to the favorable outcome of the disease. The diagnosis of diphtheria at the prehospital stage is always difficult. Presented in detail the differential diagnosis of the disease, clinically similar to diphtheria: Lacunal angina, angina Simanovsky, infectious mononucleosis, angina Ludwig’s angina Dugue, syphilis, non-infectious with clinical «masks» of diphtheria and other. Diphtheria epidemic of 1993–1994 in Russia and, in particular, in St. Petersburg, showed that the late admission of patients with diphtheria infection in hospitals, usually associated with irregular differential diagnosis of this dangerous disease.

  5. [Differential diagnosis of hoarseness].

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    Voigt-Zimmermann, S; Lampe, K; Arens, C

    2014-04-01

    Hoarseness can be the leading symptom of dysphonia. In combination with impaired vocal performance and subjective voice-related discomfort, it can represent an individually different handicap for patients and lead to limited participation in social and professional life. Since the reasons for dysphonia may be not only functional but also organic with a potentially poor prognosis, hoarseness must be clarified using differential diagnosis. In addition to the knowledge of possible diseases, pathogenesis, and treatment options for dysphonia, the differential diagnostic approach requires profound knowledge of the various diagnostic methods, and of the interpretation of the results in particular. The etiology of dysphonia is very diverse and rarely monocausal. Therefore, a team-based and interdisciplinary differential diagnostic approach is recommended.

  6. Differential diagnosis of hyponatraemia.

    LENUS (Irish Health Repository)

    Thompson, Chris

    2012-03-01

    The appropriate management of hyponatraemia is reliant on the accurate identification of the underlying cause of the hyponatraemia. In the light of evidence which has shown that the use of a clinical algorithm appears to improve accuracy in the differential diagnosis of hyponatraemia, the European Hyponatraemia Network considered the use of two algorithms. One was developed from a nephrologist\\'s view of hyponatraemia, while the other reflected the approach of an endocrinologist. Both of these algorithms concurred on the importance of assessing effective blood volume status and the measurement of urine sodium concentration in the diagnostic process. To demonstrate the importance of accurate diagnosis to the correct treatment of hyponatraemia, special consideration was given to hyponatraemia in neurosurgical patients. The differentiation between the syndrome of inappropriate antidiuretic hormone secretion (SIADH), acute adrenocorticotropic hormone (ACTH) deficiency, fluid overload and cerebral salt-wasting syndrome was discussed. In patients with SIADH, fluid restriction has been the mainstay of treatment despite the absence of an evidence base for its use. An approach to using fluid restriction to raise serum tonicity in patients with SIADH and to identify patients who are likely to be recalcitrant to fluid restriction was also suggested.

  7. Neurofibromatoses: part 1 ? diagnosis and differential diagnosis

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    Luiz Oswaldo Carneiro Rodrigues

    2014-03-01

    Full Text Available Neurofibromatoses (NF are a group of genetic multiple tumor growing predisposition diseases: neurofibromatosis type 1 (NF1, neurofibromatosis type 2 (NF2 and schwannomatosis (SCH, which have in common the neural origin of tumors and cutaneous signs. They affect nearly 80 thousand of Brazilians. In recent years, the increased scientific knowledge on NF has allowed better clinical management and reduced complication morbidity, resulting in higher quality of life for NF patients. In most cases, neurology, psychiatry, dermatology, clinical geneticists, oncology and internal medicine specialists are able to make the differential diagnosis between NF and other diseases and to identify major NF complications. Nevertheless, due to its great variability in phenotype expression, progressive course, multiple organs involvement and unpredictable natural evolution, NF often requires the support of neurofibromatoses specialists for proper treatment and genetic counseling. This Part 1 offers step-by-step guidelines for NF differential diagnosis. Part 2 will present the NF clinical management.

  8. Differential diagnosis of feline pruritus.

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    Foil, C S

    1988-09-01

    Pruritic skin diseases in the cat are best approached in a problem-oriented fashion. The presentations of pruritic skin disease in the cat include miliary dermatitis, pruritus of the head, scaling and crusting dermatoses, alopecia, erythroderma and exfoliation, eosinophilic granuloma complex, macular and pustular eruptions, and pruritic nodular dermatoses. There is a specific differential diagnosis for each presentation. A rational diagnostic plan, based on the likelihood of each disease in the differential diagnosis, may be formulated for each presentation of pruritus in the cat.

  9. Factors influencing the probability of a diagnosis of autism spectrum disorder in girls versus boys.

    Science.gov (United States)

    Duvekot, Jorieke; van der Ende, Jan; Verhulst, Frank C; Slappendel, Geerte; van Daalen, Emma; Maras, Athanasios; Greaves-Lord, Kirstin

    2016-12-09

    In order to shed more light on why referred girls are less likely to be diagnosed with autism spectrum disorder than boys, this study examined whether behavioral characteristics influence the probability of an autism spectrum disorder diagnosis differently in girls versus boys derived from a multicenter sample of consecutively referred children aged 2.5-10 years. Based on information from the short version of the Developmental, Dimensional and Diagnostic Interview and the Autism Diagnostic Observation Schedule, 130 children (106 boys and 24 girls) received a diagnosis of autism spectrum disorder according to Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) criteria and 101 children (61 boys and 40 girls) did not. Higher overall levels of parent-reported repetitive and restricted behavior symptoms were less predictive of an autism spectrum disorder diagnosis in girls than in boys (odds ratio interaction = 0.41, 95% confidence interval = 0.18-0.92, p = 0.03). In contrast, higher overall levels of parent-reported emotional and behavioral problems increased the probability of an autism spectrum disorder diagnosis more in girls than in boys (odds ratio interaction = 2.44, 95% confidence interval = 1.13-5.29, p = 0.02). No differences were found between girls and boys in the prediction of an autism spectrum disorder diagnosis by overall autistic impairment, sensory symptoms, and cognitive functioning. These findings provide insight into possible explanations for the assumed underidentification of autism spectrum disorder in girls in the clinic.

  10. [Differential diagnosis "vertigo and dizziness"].

    Science.gov (United States)

    Plontke, S K; Walther, L E

    2014-08-01

    Vertigo and dizziness are symptoms of interdisciplinary dimension. However, the differentiation and classification of vertigo syndromes also require experience and multidisciplinary knowledge. Since the clinical syndrome is subjective, a detailed analysis of the complaints underlying is required. International disease definitions are an indispensable tool in the differential diagnosis of vertigo syndromes today. With simple diagnostic tools eye movement disorders and nystagmus can be examined and assigned to specific vestibular disorders today. Screening tests (e.g. head impulse test) are now an important instrument in the investigation of patients with vertigo syndromes in case of emergency. With objective diagnostic methods (caloric irrigation, video head impulse test, vestibular evoked myogenic potentials) the degree of functional impairment of the five vestibular receptors can be assessed quantitatively. Furthermore, in vestibulopathies, a receptor and side-specific diagnostic assessment can be performed even with regard to dynamic aspects.

  11. [Differential diagnosis in potency disorders].

    Science.gov (United States)

    Kockott, G; Dittmar, F

    1976-12-02

    Disorders of sexual libido are seldom organic, in general they are of psychological origin. It is, however, difficult to obtain a differential diagnosis. One of the first diagnostic considerations must be the establishment of primary or secondary libidinal dificit, or indeed, whether there is no libido at all. In cases of libido disorders with primary libido dificit, depression, organic disease, or side effects of pharmaca may be the cause. Libido disorders in the presence of functional libido, however, must be regarded as primarily psychologically caused. An exception are libido problems in the presence of diabetes mellitus and peripheral vasculatory defeciencies. In these cases libido is either totally absent or appears only secondarily. The symptomatology of libido disorders in the presence of depression, diabetes melitus, and peripheral vasculatory disturbancies, as well as psychologically caused erectile and ejaculatory difficulties are discussed in detail. These groups are compared with respect to libido and behavior involving erection, ejaculation, anxiety and avoidance.

  12. Differential diagnosis of leg ulcers.

    Science.gov (United States)

    Pannier, F; Rabe, E

    2013-03-01

    Leg and foot ulcers are symptoms of very different diseases. The aim of this paper is to demonstrate the differential diagnosis of leg ulcers. The majority of leg ulcers occur in the lower leg or foot. In non-venous ulcers the localization in the foot area is more frequent. The most frequent underlying disease is chronic venous disease. In 354 leg ulcers, Koerber found 75.25% venous leg ulcers, 3.66% arterial leg ulcers, 14.66% ulcers of mixed venous and arterial origin and 13.5% vasculitic ulcers. In the Swedish population of Skaraborg, Nelzen found a venous origin in 54% of the ulcer patients. Each leg ulcer needs a clinical and anamnestic evaluation. Duplex ultrasound is the basic diagnostic tool to exclude vascular anomalies especially chronic venous and arterial occlusive disease. Skin biopsies help to find a correct diagnosis in unclear or non-healing cases. In conclusion, chronic venous disease is the most frequent cause of leg ulcerations. Because 25% of the population have varicose veins or other chronic venous disease the coincidence of pathological venous findings and ulceration is very frequent even in non-venous ulcerations. Leg ulcers without the symptoms of chronic venous disease should be considered as non-venous.

  13. Transitional cell carcinoma of the bladder in children: radiologic appearance and differential diagnosis.

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    Quillin, S P; McAlister, W H

    1991-01-01

    Primary epithelial tumors of the bladder are rare in children. We report a case of transitional cell carcinoma (TCCa) of the bladder in a 10-year-old boy who was evaluated with intravenous urography, ultrasonography, and computed tomography (CT). The radiographic appearance and a differential diagnosis are discussed. The literature of TCCa of the bladder in children is reviewed.

  14. Differential diagnosis of disseminated periventricular calcifications

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    Rieger, P.; Piepgras, U.

    1986-08-01

    Juvenile disseminated periventricular calcifications may occur in tuberous sclerosis, toxoplasmosis, cytomegaly, and in tuberculous meningitis. Cysticercosis, by contrast, does not result in corresponding intracerebral foci until an older age. Differential diagnosis is no problem if clinical findings are typical (tuberous sclerosis) or if serological verification is positive. However, any unclear clinical diagnosis can often be secured by CT.

  15. POLYMYOSITIS/DERMATOMIOSITIS: DIFFERENTIAL DIAGNOSIS

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    O. A. Antelava

    2016-01-01

    Full Text Available The lecture considers the problem of rare systemic connective tissue diseases, such as idiopathic inflammatory myopathies (IIMs. It underlines the clinical and immunological heterogeneity of their subtypes, which defines therapeutic tactics and prognosis. The diagnostic criteria for IIMs are given. A differential diagnostic algorithm based on the exclusion of phenotypically similar forms of myopathies of different genesis is proposed. 

  16. Pulmonary edema: radiographic differential diagnosis

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    Yoo, Dong Soo; Choi, Young Hi; Kim, Seung Cheol; An, Ji Hyun; Lee, Jee Young; Park, Hee Hong [Dankook Univ. College of Medicine, Chonan (Korea, Republic of)

    1997-04-01

    To evaluate the feasibility of using chest radiography to differentiate between three different etiologies of pulmonary edema. Plain chest radiographs of 77 patients, who were clinically confirmed as having pulmonary edema, were retrospectively reviewed. The patients were classified into three groups : group 1 (cardiogenic edema : n = 35), group 2 (renal pulmonary edema : n = 16) and group 3 (permeability edema : n = 26). We analyzed the radiologic findings of air bronchogram, heart size, peribronchial cuffing, septal line, pleural effusion, vascular pedicle width, pulmonary blood flow distribution and distribution of pulmonary edema. In a search for radiologic findings which would help in the differentiation of these three etiologies, each finding was assessed. Cardiogenic and renal pulmonary edema showed overlapping radiologic findings, except for pulmonary blood flow distribution. In cardiogenic pulmonary edema (n=35), cardiomegaly (n=29), peribronchial cuffing (n=29), inverted pulmonary blood flow distribution (n=21) and basal distribution of edema (n=20) were common. In renal pulmonary edema (n=16), cardiomegaly (n=15), balanced blood flow distribution (n=12), and central (n=9) or basal distribution of edema (n=7) were common. Permeability edema (n=26) showed different findings. Air bronchogram (n=25), normal blood flow distribution (n=14) and peripheral distribution of edema (n=21) were frequent findings, while cardiomegaly (n=7), peribronchial cuffing (n=7) and septal line (n=5) were observed in only a few cases. On plain chest radiograph, permeability edema can be differentiated from cardiogenic or renal pulmonary edema. The radiographic findings which most reliably differentiated these two etiologies were air bronchogram, distribution of pulmonary edema, peribronchial cuffing and heart size. Only blood flow distribution was useful for radiographic differentiation of cardiogenic and renal edema.

  17. [Differential diagnosis of abdominal pain].

    Science.gov (United States)

    Frei, Pascal

    2015-09-02

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain.

  18. The Reactive–Proactive Aggression Questionnaire: Differential Correlates of Reactive and Proactive Aggression in Adolescent Boys

    OpenAIRE

    Raine, Adrian; Dodge, Kenneth; Loeber, Rolf; GATZKE-KOPP, LISA; Lynam, Don; Reynolds, Chandra; Stouthamer-Loeber, Magda; Liu, Jianghong

    2006-01-01

    This study reports the development of the Reactive–Proactive Aggression Questionnaire (RPQ), and the differential correlates of these two forms of aggression. Antisocial, psychosocial and personality measures were obtained at ages 7 and 16 years in schoolboys, while the RPQ was administered to 334 of the boys at age 16 years. Confirmatory factor analysis indicated a significant fit for a two-factor proactive–reactive model that replicated from one independent subsample to another. Proactive a...

  19. Differential diagnosis of myelitis; Differenzialdiagnostik der Myelitis

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    Langner, Soenke [Universitaetsmedizin Greifswald (Germany). Inst. fuer Diagnostische Radiologie und Neuroradiologie

    2016-09-15

    Acute transverse Myelitis is an inflammatory myelopathy characterized by rapid onset of bilateral neurological symptoms. There is a vast array of differential diagnoses and the underlying pathology often cannot be identified on clinical examination alone. Therefore neuroimaging has a central role in narrowing the differential diagnosis. This review aims to provide a summary of common causes of non-traumatic myelopathies, many of which may have similar radiological appearance.

  20. DIFFERENTIAL DIAGNOSIS OF NORMOCALCEMIC HYPERPARATHYROIDISM

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    N. A. Kravchun

    2015-01-01

    Full Text Available Objective: to describe a case of normocalcemic hyperparathyroidism.Materials and methods. A female patient aged 51 years sought medical advice for complaints of spinal column and bone pains, periodic dizziness, and hand numbness. The patient underwent clinical and biochemical blood tests, determination of the blood levels of calcium, phosphorus, parathyroid hormone, concentrations of total vitamin D, calciuria, electrocardiography, thyroid ultrasonography, and neck computed tomography.Results. Based on her complaints, examination evidence, evaluation of the clinical presentations of the disease, and objective and instrumental examination findings, the patient was diagnosed with left parathyroid adenoma and primary hyperparathyroidism; stage II hypertensive disease, grade I, a moderate risk; retinal angiopathy of both eyes; stage I dyscirculatory encephalopathy with liquor and venous dyscirculation and moderate vestibular ataxia; urolithiasis; kidney stones; and spondylosis mainly involving the lumbar spine. The diagnostic determinants for verifying the diagnosis were the results of neck computed tomography, namely: the signs of space-occupying lesion in the projection of the left parathyroid gland; the blood level of parathyroid hormone 118.6 pg/ml (normal value (N 9.5–75.0 pg/ml; total vitamin D 21.64 nmol/l (N 75–250 nmol/l; and calcium 2.48 mmol/l (N 2.15–2.50 mmol/l. The history of urolithiasis, repeated lithotripsy, as well as spondylosis with lumboischalgia was an absolute indication for surgical treatment.Conclusion. The practical interest in this case is due to the complexity of diagnosing normocalcemic hyperparathyroidism after vitamin D deficiency. The early stages of primary hyperparathyroidism are asymptomatic and frequently give rise to irreversible renal complications, causing renal failure and, as a consequence, disability. This clinical case demonstrates the importance of routinely determining vitamin D concentrations

  1. Diagnosis and Differential Diagnosis in Behcet’s Disease

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    Osman Köse

    2009-12-01

    Full Text Available The diagnosis of Behcet’s disease is made on the basis of the criteria proposed by the International Study group for Behcet’s disease in 1990. According to the criteria, recurrent oral ulceration must be present as well as at least two of the following: Recurrent genital ulceration, eye lesions, skin lesions and a positive pathergy test. Acute/chronic oral ulcers and genital ulcers should be regarded in the differential diagnosis of Behcet’s disease. We discussed the details of different dermatologic diseases especially of prominent with oral and genital ulcers in this article.

  2. Pyknodysostosis: Oral findings and differential diagnosis

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    Soares L

    2008-05-01

    Full Text Available Pyknodysostosis is a rare, genetic, autosomal recessive condition characterized by short stature, generalized bone sclerosis, and oral manifestations such as maxillary atresia and an increase of the mandibular angle. The main purpose of this article was to report a case of pyknodysostosis, describing the characteristic orofacial findings of the disease and discussing the differential diagnosis.

  3. Prostatic paracoccidioidomycosis: differential diagnosis of prostate cancer

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    Daniel Lima Lopes

    2009-02-01

    Full Text Available Symptomatic prostatic paracoccidioidomycosis (PCM is a very rare condition; however, it may express as a typical benign prostatic hyperplasia or a simulating prostatic adenocarcinoma. This case report presents PCM mimicking prostatic adenocarcinoma. The purpose of this paper is to call the general physician's attention to this important differential diagnosis.

  4. Differential Diagnosis and Treatment of Career Indecision.

    Science.gov (United States)

    Fuqua, Dale R.; Hartman, Bruce W.

    1983-01-01

    Discusses the need for a better diagnostic approach to career indecision. Suggests a model for differential diagnosis and treatment containing three career indecision types or perspectives, i.e., developmental tasks, acute situational reactions, and chronic psychological concerns. Discusses problems of diagnostic measurement. (WAS)

  5. DIFFERENTIAL DIAGNOSIS OF LONG TERM TONGUE ULCERS

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    Hegde Nidarsh D.

    2012-08-01

    Full Text Available Oral ulcers is a very common disorder of the oral mucosa. Patients with signs or symptoms of oral ulcers are sometimes referred to gastroenterology clinics, however, in most instances the ulcers does not reflect gastrointestinal disease, some with a chronic non- healing ulcer are advised biopsy. Indeed, a spectrum of disorders can give rise to oral mucosal ulcers ranging from minor local trauma to significant local disease such as malignancy or systemic illness. Lesions of the tongue have a broad differential diagnosis ranging from benign idiopathic processes to infections, cancers, and infiltrative disorders. This article will focus on common ulcerative disorders of the tongue in aspects of their clinical features and differential diagnosis, two case reports with the diagnosis and conservative management for long-term chronic ulcers. The two cases which are reported in this article had a differential diagnosis of Squamous cell carcinoma of the tongue. The clinical picture was craterlike lesion, having a velvety-red base and a rolled, indurated border and most important painless in both cases. Removal of the irritant which was the tooth, rehabilitation of the oral mucosa by lubrication with Cocus Nucifera resulted in the healing of the ulcers. Functional components of Cocus Nucifera are Squaline, tocopherol, phytosterols and other sterols which are all plant steroids.

  6. Psoriatic arthritis and psoriasis: differential diagnosis.

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    Napolitano, Maddalena; Caso, Francesco; Scarpa, Raffaele; Megna, Matteo; Patrì, Angela; Balato, Nicola; Costa, Luisa

    2016-08-01

    Psoriasis frequency ranges from 1 to 3 % in white population, and arthritis occurs in 10-40 % of psoriasis patients, representing a relevant health issue. Psoriatic arthritis (PsA) is an inflammatory arthropathy, associated with psoriasis, in which ocular-, intestinal-, metabolic-, and cardiovascular-related manifestations can variably coexist. In order to favor early PsA and psoriasis diagnosis, it is crucial to rule out other conditions that can resemble the disease and delay appropriate therapeutic approach. Therefore, the aim of this review is to focus on PsA and psoriasis differential diagnosis.

  7. [Differential diagnosis of Graves' orbitopathy. Case report].

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    Erdei, Annamária; Steiber, Zita; Gazdag, Annamária; Bodor, Miklós; Berta, Eszter; Szász, Róbert; Szántó, Antónia; Ujhelyi, Bernadett; Barna, Sándor; Berényi, Ervin; Nagy, V Endre

    2016-02-21

    Graves' orbitopathy is the extrathyroidal manifestation of Graves' disease, which is the most common cause of exophthalmos. As eye symptoms usually coincide with the development of thyrotoxicosis, the diagnosis of the disease is rarely difficult. The aim of the authors was to summarize the differential diagnosis of Graves' orbitopathy based on literature review and presentation of their own four problematic cases on this topic. They conclude that symptoms similar to endocrine orbitopathy are present in other disorders. Endocrinologists need to be aware of these other conditions to avoid treatment failures.

  8. Cervicogenic headache: Differential diagnosis and treatment

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    Aleksey Nikolayevich Barinov

    2012-01-01

    Full Text Available The paper discusses the issues of differential diagnosis of cervicocranialgia with tension headache and migraine with concomitant cervical myofascial syndrome. It considers the basic mechanisms of the pathogenesis of these nosological entities and common approaches to their treatment. The mechanisms of pathogenetic action of myorelaxants are shown in cervicocranialgia and myofascial pain syndromes. Methods for mini-invasive therapy for cervicogenic headache and other musculoskeletal disorders are presented.

  9. The Diagnosis and Treatment of Multiple Factitious Oral Ulcers in a 6-Year-Old Boy

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    Gonçalves, Priscilla Santana Pinto; Mendez, Daniela Alejandra Cusicanqui; Damante, José Humberto; Rios, Daniela

    2017-01-01

    Factitious ulcers are characterized by self-inflicted lesions with multifactorial origin. These lesions are frequently found in head, neck, and hands. This report shows a 6-year-old boy diagnosed with factitious oral ulcers that occurred after the self-biting of buccal vestibule and nail-scratching of gingival tissue. Clinically, a significant swelling was observed, hard on palpation, located at the right lower third of the face, next to the posterior area of the mandible. In the intraoral examination, ulcers at different healing stages were noted on the swelling area. During the anamnesis, the father reported a change in his familial structure that triggers psychological stress, providing the clues to the presumptive diagnosis of factitious oral ulcers. We prescribed the topical use of Gingilone® three times a day to control the local pain and inflammation. At 7-day follow-up, we noticed the reduction of extraoral swelling and the initial healing of the ulcers. The presumptive diagnosis was confirmed at 30-day follow-up, with the lasting remission of oral lesions. The treatments of factitious oral ulcers should be individually tailored for each patient, focused on a multidisciplinary approach, including psychotherapy and periodic clinical control. To the best of our knowledge, gaps of evidence lead to the lack of standardized clinical protocols on this issue. PMID:28293440

  10. Mialgias: Approaches to differential diagnosis, treatment

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    Nadezhda Aleksandrovna Shostak

    2013-01-01

    Full Text Available Differential diagnosis in muscle pains often presents great difficulties so all existing signs of the disease should be carefully considered to make its diagnosis and to prescribe adequate therapy. The paper considers the causes of muscle pains, laboratory and instrumental studies (immunological tests, determination of the level of specific muscular enzymes, primarily creatine phosphokinase – CPK, etc., and the main reasons for enhanced plasma CPK activity. It also describes acute and chronic mialgias associated with enhanced plasma CPK activity, as well as diseases in which mialgias are related to the normal level of CPK, myofascial syndrome (MFS and fibromyalgia (FM in particular. The characteristic features of MFS are given in its diagnostic criteria. It is stated that a differential diagnosis should be made between MFS and major muscle pain-associated abnormalities, such as polymyalgia rheumatica, FM, etc. Diagnosticcriteria for polymyalgia rheumatica are given. A MFS treatment algorithm is presented. Local exposure methods applied to altered musculoligamentous structures in combination with myorelaxants and non-steroidal anti-inflammatory drugs assume paramount importance in MFS.

  11. Gender-Differentiated Parenting Revisited: Meta-Analysis Reveals Very Few Differences in Parental Control of Boys and Girls.

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    Joyce J Endendijk

    Full Text Available Although various theories describe mechanisms leading to differential parenting of boys and girls, there is no consensus about the extent to which parents do treat their sons and daughters differently. The last meta-analyses on the subject were conducted more than fifteen years ago, and changes in gender-specific child rearing in the past decade are quite plausible. In the current set of meta-analyses, based on 126 observational studies (15,034 families, we examined mothers' and fathers' differential use of autonomy-supportive and controlling strategies with boys and girls, and the role of moderators related to the decade in which the study was conducted, the observational context, and sample characteristics. Databases of Web of Science, ERIC, PsychInfo, Online Contents, Picarta, and Proquest were searched for studies examining differences in observed parental control of boys and girls between the ages of 0 and 18 years. Few differences were found in parents' use of control with boys and girls. Parents were slightly more controlling with boys than with girls, but the effect size was negligible (d = 0.08. The effect was larger, but still small, in normative groups and in samples with younger children. No overall effect for gender-differentiated autonomy-supportive strategies was found (d = 0.03. A significant effect of time emerged: studies published in the 1970s and 1980s reported more autonomy-supportive strategies with boys than toward girls, but from 1990 onwards parents showed somewhat more autonomy-supportive strategies with girls than toward boys. Taking into account parents' gender stereotypes might uncover subgroups of families where gender-differentiated control is salient, but based on our systematic review of the currently available large data base we conclude that in general the differences between parenting of boys versus girls are minimal.

  12. Gender-Differentiated Parenting Revisited: Meta-Analysis Reveals Very Few Differences in Parental Control of Boys and Girls

    Science.gov (United States)

    Endendijk, Joyce J.; Groeneveld, Marleen G.; Bakermans-Kranenburg, Marian J.; Mesman, Judi

    2016-01-01

    Although various theories describe mechanisms leading to differential parenting of boys and girls, there is no consensus about the extent to which parents do treat their sons and daughters differently. The last meta-analyses on the subject were conducted more than fifteen years ago, and changes in gender-specific child rearing in the past decade are quite plausible. In the current set of meta-analyses, based on 126 observational studies (15,034 families), we examined mothers’ and fathers’ differential use of autonomy-supportive and controlling strategies with boys and girls, and the role of moderators related to the decade in which the study was conducted, the observational context, and sample characteristics. Databases of Web of Science, ERIC, PsychInfo, Online Contents, Picarta, and Proquest were searched for studies examining differences in observed parental control of boys and girls between the ages of 0 and 18 years. Few differences were found in parents’ use of control with boys and girls. Parents were slightly more controlling with boys than with girls, but the effect size was negligible (d = 0.08). The effect was larger, but still small, in normative groups and in samples with younger children. No overall effect for gender-differentiated autonomy-supportive strategies was found (d = 0.03). A significant effect of time emerged: studies published in the 1970s and 1980s reported more autonomy-supportive strategies with boys than toward girls, but from 1990 onwards parents showed somewhat more autonomy-supportive strategies with girls than toward boys. Taking into account parents’ gender stereotypes might uncover subgroups of families where gender-differentiated control is salient, but based on our systematic review of the currently available large data base we conclude that in general the differences between parenting of boys versus girls are minimal. PMID:27416099

  13. Classification and Differential Diagnosis of Diabetic Nephropathy

    Science.gov (United States)

    2017-01-01

    Diabetic nephropathy (DN) is a major cause of end-stage renal disease throughout the world in both developed and developing countries. This review briefly introduces the characteristic pathological changes of DN and Tervaert pathological classification, which divides DN into four classifications according to glomerular lesions, along with a separate scoring system for tubular, interstitial, and vascular lesions. Given the heterogeneity of the renal lesions and the complex mechanism underlying diabetic nephropathy, Tervaert classification has both significance and controversies in the guidance of diagnosis and prognosis. Applications and evaluations using Tervaert classification and indications for renal biopsy are summarized in this review according to recent studies. Meanwhile, differential diagnosis with another nodular glomerulopathy and the situation that a typical DN superimposed with a nondiabetic renal disease (NDRD) are discussed and concluded in this review. PMID:28316995

  14. Classification and Differential Diagnosis of Diabetic Nephropathy

    Directory of Open Access Journals (Sweden)

    Chenyang Qi

    2017-01-01

    Full Text Available Diabetic nephropathy (DN is a major cause of end-stage renal disease throughout the world in both developed and developing countries. This review briefly introduces the characteristic pathological changes of DN and Tervaert pathological classification, which divides DN into four classifications according to glomerular lesions, along with a separate scoring system for tubular, interstitial, and vascular lesions. Given the heterogeneity of the renal lesions and the complex mechanism underlying diabetic nephropathy, Tervaert classification has both significance and controversies in the guidance of diagnosis and prognosis. Applications and evaluations using Tervaert classification and indications for renal biopsy are summarized in this review according to recent studies. Meanwhile, differential diagnosis with another nodular glomerulopathy and the situation that a typical DN superimposed with a nondiabetic renal disease (NDRD are discussed and concluded in this review.

  15. Differential diagnosis and the suspension of judgment.

    Science.gov (United States)

    Kennedy, Ashley Graham

    2013-10-01

    In this paper I argue that ethics and evidence are intricately intertwined within the clinical practice of differential diagnosis. Too often, when a disease is difficult to diagnose, a physician will dismiss it as being "not real" or "all in the patient's head." This is both an ethical and an evidential problem. In the paper my aim is two-fold. First, via the examination of two case studies (late-stage Lyme disease and Addison's disease), I try to elucidate why this kind of dismissal takes place. Then, I propose a potential solution to the problem. I argue that instead of dismissing a patient's illness as "not real," physicians ought to exercise a compassionate suspension of judgment when a diagnosis cannot be immediately made. I argue that suspending judgment has methodological, epistemic, and ethical virtues and therefore should always be preferred to patient dismissal in the clinical setting.

  16. [Cat Scratch Disease as a differential diagnosis in a patient with swelling in the groin].

    Science.gov (United States)

    Makki, Ahmad; Murra, May; Sommer, Thorbjørn

    2014-08-11

    at Scratch Disease is caused by the bacteria Bartonella henselae and presents in patients exposed to a scratch/bite from cats. We present a case with a 12-year-old boy with an enlarged inguinal lymph node, initially suspected to be a femoral hernia by ultrasonography. Histologic examination of an inguinal lymph node showed necrosis and B. henselae infection. It is important with a thorough anamnesis including any history of animal bites/scratch and it should be kept in mind as a differential diagnosis in patients with swelling in the groin, despite the rare diagnosis of this disease.

  17. [Facial and eye pain - Neurological differential diagnosis].

    Science.gov (United States)

    Kastrup, O; Diener, H-C; Gaul, C

    2011-12-01

    Head and facial pain are common in neurological practice and the pain often arises in the orbit or is referred into the eye. This is due to the autonomic innervation of the eye and orbit. There are acute and chronic pain syndromes. This review gives an overview of the differential diagnosis and treatment. Idiopathic headache syndromes, such as migraine and cluster headache are the most frequent and are often debilitating conditions. Trigemino-autonomic cephalalgias (SUNCT and SUNA) have to be taken into account, as well as trigeminal neuralgia. Trigemino-autonomic headache after eye operations can be puzzling and often responds well to triptans. Every new facial pain not fitting these categories must be considered symptomatic and a thorough investigation is mandatory including magnetic resonance imaging. Infiltrative and neoplastic conditions frequently lead to orbital pain. As a differential diagnosis Tolosa-Hunt syndrome and Raeder syndrome are inflammatory conditions sometimes mimicking neoplasms. Infections, such as herpes zoster ophthalmicus are extremely painful and require rapid therapy. It is important to consider carotid artery dissection as a cause for acute eye and neck pain in conjunction with Horner's syndrome and bear in mind that vascular oculomotor palsy is often painful. All of the above named conditions should be diagnosed by a neurologist with special experience in pain syndromes and many require an interdisciplinary approach.

  18. [Differential infratentorial brain tumor diagnosis in children].

    Science.gov (United States)

    Warmuth-Metz, M; Kühl, J; Rutkowski, S; Krauss, J; Solymosi, L

    2003-11-01

    With the exception of the first year of life, infratentorial brain tumors are more frequent in the first decade than tumors in the supratentorial compartment. In particular these are cerebellar low-grade astrocytomas, medulloblastomas, brainstem gliomas and ependymomas of the fourth ventricle. The morphology on MRI and CT and the mode of dissemination permit differential diagnosis in many cases. To allow correct stratification into different treatments in possibly disseminating malignant brain tumors, knowledge of the status of dissemination is essential, and therefore not only cranial but also spinal MRI is indispensable for staging. If the spinal MRI is performed in the immediate postoperative period, knowledge of the normal non-specific purely postoperative changes, often seen as enhancement in the subdural spinal spaces, is necessary in order to avoid misinterpretation as meningial seeding. The differential diagnosis of pediatric infratentorial brain tumors and the morphology of subdural enhancement are illustrated with typical images. The natural history of the most frequent tumors and its importance for treatment decisions is discussed in light of the literature.

  19. Psoriasis: epidemiology, natural history, and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Basko-Plluska JL

    2012-09-01

    Full Text Available Juliana L Basko-Plluska, Vesna Petronic-RosicDepartment of Medicine, Section of Dermatology, University of Chicago, Chicago, IL, USAAbstract: Psoriasis is a chronic, immune-mediated, inflammatory disease which affects primarily the skin and joints. It occurs worldwide, but its prevalence varies considerably between different regions of the world. Genetic susceptibility as well as environmental factors play an important role in determining the development and prognosis of psoriasis. Genome-wide association studies have identified many genetic loci as potential psoriasis susceptibility regions, including PSORS1 through PSORS7. Histocompatibility antigen (HLA studies have also identified several HLA antigens, with HLA-Cw6 being the most frequently associated antigen. Epidemiological studies identified several modifiable risk factors that may predispose individuals to developing psoriasis or exacerbate pre-existing disease. These include smoking, obesity, alcohol consumption, diet, infections, medications and stressful life events. The exact mechanism by which they trigger psoriasis remains to be elucidated; however, existing data suggest that they are linked through Th1-mediated immunological pathways. The natural history of psoriasis varies depending on the clinical subtype as well as special circumstances, including pregnancy and HIV infection. In general, psoriasis is a chronic disease with intermittent remissions and exacerbations. The differential diagnosis is vast and includes many other immune-mediated, inflammatory disorders.Keywords: psoriasis, epidemiology, natural history, differential diagnosis

  20. [Histopathological differential diagnosis of primary liver tumors].

    Science.gov (United States)

    Honsová, E

    2014-03-01

    The most common primary hepatic malignancy is hepatocellular carcinoma, which constitutes 80-85% of all malignant epithelial neoplasms originating in the liver. The second most common primary hepatic malignancy is cholangiocellular carcinoma. In recent years, remarkable progress has been made in elucidating the molecular pathology of hepatic tumors. Advances in our understanding of molecular subtypes have led to a creation of a new classification system of hepatocellular adenomas, with important genotype-phenotype correlations and easy application to routine diagnostic practice. In the field of early hepatic neoplasia, a consensus on the definition of dysplastic nodules and early hepatocellular carcinoma has been reached. Immunohistochemical detection of glypican-3 and stromal invasion are used for the differential diagnosis. A lot of problems still exist in the category of mixed hepatocellular and cholangiocellular carcinoma. Although this category is recognized in the WHO classification, confusing terminology has been generated to describe tumors with morphological features of both HCC and CC. We further specify problems and pitfalls of the differential histopathological diagnosis of liver malignant tumors.

  1. Lymphangioleiomyomatosis: differential diagnosis and optimal management

    Directory of Open Access Journals (Sweden)

    Xu KF

    2014-08-01

    Full Text Available Kai-Feng Xu,1 Bee Hong Lo2 1Department of Respiratory Medicine, Peking Union Medical College Hospital, Beijing, People's Republic of China; 2Developmental Pediatrician, PECAT, Children's Hospital Westmead, Sydney, NSW, Australia Abstract: Lymphangioleiomyomatosis (LAM is an uncommon disease presented as diffuse thin-walled cystic changes in the lung. The main differential diagnoses include pulmonary Langerhans' histiocytosis (PLCH, Birt-Hogg-Dubé syndrome (BHD, lymphoid interstitial pneumonia (LIP, and amyloidosis. A combination of clinical, radiological, and pathological approaches as well as genetic testing will clarify the diagnosis in most cases. LAM is a disease almost exclusively in women. Dyspnea, pneumothorax, and hemoptysis are common presentations in LAM patients. LAM is also a lymphatic disorder affecting lymphatic vessels and lymph nodes. Chylothorax, chylous ascites, and lymphangiomyomas are frequently seen. LAM can present sporadically as a single entity or as part of tuberous sclerosis complex (TSC. Angiomyolipoma (AML is a characteristic extra-pulmonary lesion, either found in association with sporadic or TSC-related LAM. High-risk populations should be screened for LAM, including adult women with TSC and female patients with spontaneous pneumothorax, AMLs in the kidney, and diffuse cystic lung diseases. Definitive diagnosis of LAM is based on a high level of clinical suspicion on presentation supported by pathological findings or by a distinct feature, such as a history of TSC, AMLs in the kidney, chylothorax, or chylous ascites. Vascular endothelial growth factor-D (VEGF-D in serum is a noninvasive and reliable diagnostic biomarker. In experienced centers, trans-bronchial lung biopsy (TBLB provides a convenient and safe way to obtain lung specimens for diagnostic purposes. An effective treatment for LAM is now available, namely using a mechanistic target of rapamycin (mTOR inhibitor such as sirolimus. Efficacy of sirolimus has

  2. Diagnosis, Differential Diagnosis, and Epidemiology of Primary Sclerosing Cholangitis.

    Science.gov (United States)

    Ponsioen, Cyriel Y

    2015-01-01

    According to recent guidelines, primary sclerosing cholangitis (PSC) is diagnosed when a patient has a cholestatic liver enzyme profile, characteristic bile duct changes on imaging, and when secondary causes of sclerosing cholangitis are excluded. In patients with a clinical suspicion but normal cholangiography, a liver biopsy is indicated to establish a diagnosis of small duct PSC. Several other disease entities such as IgG4-associated cholangitis (IAC), cholangiocarcinoma (CCA), and secondary causes of sclerosing cholangitis such as choledocholithiasis, AIDS-cholangiopathy, ischemia, surgical bile duct trauma, or mast cell cholangiopathy can mimic PSC. IAC can be differentiated from PSC by applying the HISORt criteria including the serum IgG4 level. In cases where serum IgG4 is less than 2 × ULN, the ratio of IgG4/IgG1 >0.24 is indicative for IAC. Choledocholithiasis with recurrent cholangitis as a cause of sclerosing cholangitis can pose a conundrum, since PSC itself is associated with an increased prevalence of gallstones. The epidemiology of PSC worldwide has been poorly described. Incidence and prevalence rates vary from 0-1.3 and 0-16.2 per 100,000 inhabitants respectively. However, these figures are not based on population-based cohorts. A recent large population-based cohort from the Netherlands reported an incidence of 0.5 and a prevalence of 6/100,000. Approximately 10% fulfil the criteria for small duct PSC. At diagnosis of PSC, concurrent inflammatory bowel disease (IBD), primarily ulcerative colitis or Crohn's colitis is present in 50%, but increasing to 80%, 10 years or more after diagnosis. Conversely, 3% of IBD patients will develop PSC. PSC predisposes to malignancy. The estimated cumulative risk of developing CCA after 30 years is 20%. For colorectal carcinoma in PSC/colitis patients, the estimated cumulative risk at 30 years is 13%.

  3. Challenges in the Diagnosis and Management of Acquired Nontraumatic Urethral Strictures in Boys in Yaoundé, Cameroon

    Science.gov (United States)

    Mouafo Tambo, F. F.; Fossi kamga, G.; Kamadjou, C.; Mbouche, L.; Nwaha Makon, A. S.; Birraux, J.; Andze, O. G.; Angwafo, F. F.; Mure, P. Y.

    2016-01-01

    Introduction. Urethral strictures in boys denote narrowing of the urethra which can be congenital or acquired. In case of acquired strictures, the etiology is iatrogenic or traumatic and rarely infectious or inflammatory. The aim of this study was to highlight the diagnostic and therapeutic difficulties of acquired nontraumatic urethral strictures in boys in Yaoundé, Cameroon. Methodology. The authors report five cases of nontraumatic urethral strictures managed at the Pediatric Surgery Department of the YGOPH over a two-year period (November 2012–November 2014). In order to confirm the diagnosis of urethral stricture, all patients were assessed with both cystourethrography and urethrocystoscopy. Results. In all the cases the urethra was inflammatory with either a single or multiple strictures. The surgical management included internal urethrotomy (n = 1), urethral dilatation (n = 1), vesicostomy (n = 2), and urethral catheterization (n = 3). With a median follow-up of 8.2 months (4–16 months) all patients remained symptoms-free. Conclusion. The authors report the difficulties encountered in the diagnosis and management of nontraumatic urethral strictures in boys at a tertiary hospital in Yaoundé, Cameroon. The existence of an inflammatory etiology of urethral strictures in boys deserves to be considered. PMID:27239364

  4. Current differential diagnosis of hypereosinophilic syndrome

    Directory of Open Access Journals (Sweden)

    Dinić-Uzurov Vera

    2007-01-01

    syndrome is a subcategory of idiopathic eosinophilia. If the differential diagnosis of hypereosinophilia fails to resolve the etiology succesfully, the diagnosis of idiopathic HES remains.

  5. Gender-Differentiated parenting revisited : Meta-analysis reveals very few differences in parental control of boys and girls

    NARCIS (Netherlands)

    Endendijk, Joyce J.; Groeneveld, Marleen G.; Bakermans-Kranenburg, Marian J.; Mesman, Judi

    2016-01-01

    Although various theories describe mechanisms leading to differential parenting of boys and girls, there is no consensus about the extent to which parents do treat their sons and daughters differently. The last meta-analyses on the subject were conducted more than fifteen years ago, and changes in g

  6. The Wolf Boy: Reactive Attachment Disorder in an Adolescent Boy

    OpenAIRE

    Swain, James E.; Leckman, James F.; Volkmar, Fred R.

    2005-01-01

    An adolescent boy presented with episodic wolf-like aggressive behaviors, for which his rural community planned an exorcism. Admission to a tertiary care hospital revealed an adolescent suffering an array of severe psychiatric symptoms, which best fit the diagnosis of reactive attachment disorder (RAD). The differential diagnosis included delusional disorder, mood problems, anxiety, schizophrenia, and “feral child” syndrome. Nosology and pathophysiology as well as pharmacological and psychoso...

  7. [Etiology, diagnosis, differential diagnosis and therapy of vocal fold paralysis].

    Science.gov (United States)

    Reiter, R; Hoffmann, T K; Rotter, N; Pickhard, A; Scheithauer, M O; Brosch, S

    2014-03-01

    Etiology of vocal fold paralysis is broad: e. g. iatrogenic/traumatic, associated with neoplasms or with systemic diseases. The cause of idiopathic paralysis is unknown. The main symptom of unilateral vocal fold paralysis is hoarseness because of a remaining glottic gap during phonation. Patients with bilateral vocal fold paralysis typically have no impairment of the voice but dyspnea. Examination of patients with an idopathic vocal fold paralysis is a CT of the vagal nerve and recurrent laryngeal nerve from skull base to neck and mediastinum. Serological tests are not obligatory. Differential diagnosis of vocal fold immobility is vocal fold paralysis/neurological causes and arthrogene causes such as arytenoid subluxation, interarytenoid adhesion and vocal fold fixation in laryngeal carcinomas. Voice therapy is a promising approach for patients with unilateral vocal fold paralysis, but not all patients benefit sufficiently. Temporary vocal fold augmentation by injection medialization results in satisfactory voice quality that is comparable with a thyroplasty. Patients with bilateral vocal fold immobility show typically dyspnea requiring immediate therapy such as temporary tracheotomy or reversible laterofixation of the paralyzed vocal chord. If the paralysis persists a definitive enlargement of the glottic airway by eg. arytenoidectomy needs to be performed.

  8. The role of bone marrow pathology in diagnosis and differential diagnosis of refractory cytopenia of children

    Institute of Scientific and Technical Information of China (English)

    李占琦

    2013-01-01

    Objective To explore the diagnosis and differential diagnosis of refractory cytopenia of children(RCC) according to WHO classification,and discuss the relationship between the cytology reviewed by hematologists and histology reviewed by pathologists. Methods

  9. Familial Case of Cherubism from South India: Differential Diagnosis and Report of 2 Cases

    Directory of Open Access Journals (Sweden)

    Varun Muthuraman

    2014-01-01

    Full Text Available Cherubism is a rare familial multilocular cystic lesion of the jaws. The condition clinically appears as a bilateral symmetric swelling of the cheeks in children and is the primary reason for referral. It is a rare lesion of the jaws that has a dominant pattern of inheritance. We report two cases of cherubism, that of a boy and his mother suggestive of a strong familial incidence. A variety of lesions of the jaw mimic this condition and hence the differential diagnosis has been emphasised.

  10. Autism Diagnosis and Screening: Factors to Consider in Differential Diagnosis

    Science.gov (United States)

    Matson, Johnny L.; Beighley, Jennifer; Turygin, Nicole

    2012-01-01

    There has been an exponential growth in assessment methods to diagnose disorders on the autism spectrum. Many reasons for this trend exist and include advancing knowledge on how to make a diagnosis, the heterogeneity of the spectrum, the realization that different methods may be needed based on age and intellectual disability. Other factors…

  11. Vascular anomalies: differential diagnosis and mimickers.

    Science.gov (United States)

    Garzon, Maria C; Weitz, Nicole; Powell, Julie

    2016-09-01

    Vascular anomalies are very common in children and encompass a wide spectrum of diseases. Many vascular anomalies can be mistaken for infantile hemangioma (IH). In addition, there is a variety of rare disorders including benign and malignant tumors that may mimic IH and other types of vascular anomalies. Understanding the clinical features, natural history, and typical clinical course of different types of vascular anomalies is essential in order to make the correct diagnosis and guide management. Radiologic imaging plays an important role in establishing the diagnosis; and when the diagnosis remains in doubt, a biopsy performed by a surgical specialist with expertise may prove to be lifesaving.

  12. Differential diagnosis of ambiguous genitalia in Chines e patients

    Institute of Scientific and Technical Information of China (English)

    田秦杰; 葛秦生

    2002-01-01

    Objective: To study the etiology and differential diagnos is of ambiguous genitalia.Methods: One hundred and five cases of ambiguous genitalia with disorders of sexual differentiation were analyzed based on clinical characterist ics and basic research. Results: Ambiguous genitalia are closely related to the functio n of androgen. It could be classified into 3 groups: androgen excess, androgen d eficiency and failure of gonadal differentiation. Differential diagnosis depends on clinical manifestations, chromosome examination, serum hormone determination s, final gonadal pathology, receptor study etc.Conclusion: Ambiguous genitalia are related to abnormal androgen ic effect and early correct etiological diagnosis is the key to its management.

  13. [Differential diagnosis of pancreatic head cancer].

    Science.gov (United States)

    Kubyshkin, V A; Vishnevskiĭ, V A; Aĭrapetian, A T; Karmazanovskiĭ, G G; Kuntsevich, G I; Starkov, Iu G

    2000-01-01

    The results of clinical, instrumental and laboratory examinations were analyzed for 99 patients. 59 of them had pancreatic head cancer, 40--chronic pseudotumorous pancreatitis. The importance of complex ultrasonic diagnosis in detection of pancreatic diseases (98%), in true diagnosis of unresectable tumors (96.7%), and also in determination of bile ducts lesion level in obstructive jaundice is shown. It was revealed that spiral computed tomography (SCT) had an advantage over computed tomography in diagnosis of pancreatic tumors and in assessment of their resectability. Sensitivity of combined use of US, SCT and tumor marker CA 19-9 in pancreatic cancer diagnosis increases to 95.2%. High diagnostic value of laparoscopy with laparoscopic ultrasonic examination as a method of final assessment of tumor resectability is shown.

  14. [Eosinophilic pancreatitis and autoimmune pancreatitis: comparison, differential diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    Mauro Turrin

    2017-03-01

    Here we discuss the importance of hypereosinophilia in EP and IgG increase in type 1 AIP (included in IgG-related systemic diseases. Differential diagnosis with pancreatic neoplasms and therapy schedules are discussed as well.

  15. Diagnosis and differential diagnosis of MSA: boundary issues.

    Science.gov (United States)

    Kim, Han-Joon; Jeon, Beom S; Jellinger, Kurt A

    2015-08-01

    Because the progression of multiple system atrophy (MSA) is usually rapid and there still is no effective cause-related therapy, early and accurate diagnosis is important for the proper management of patients as well as the development of neuroprotective agents. However, despite the progression in the field of MSA research in the past few years, the diagnosis of MSA in clinical practice still relies largely on clinical features and there are limitations in terms of sensitivity and specificity, especially in the early course of the disease. Furthermore, recent pathological, clinical, and neuroimaging studies have shown that (1) MSA can present with a wider range of clinical and pathological features than previously thought, including features considered atypical for MSA; thus, MSA can be misdiagnosed as other diseases, and conversely, disorders with other etiologies and pathologies can be clinically misdiagnosed as MSA; and (2) several investigations may help to improve the diagnosis of MSA in clinical practice. These aspects should be taken into consideration when revising the current diagnostic criteria. This is especially true given that disease-modifying treatments for MSA are under investigation.

  16. Surface primary bone tumors: Systematic approach and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Mendez Diaz, Cristina; Soler Fernandez, Rafaela; Rodriguez Garcia, Esther; Fernandez Armendariz, Pablo; Diaz Angulo, Carolina [Complejo Hospitalario Universitario A Coruna, Department of Radiology, A Coruna (Spain)

    2015-09-15

    Surface primary bone tumors may appear similar to their intramedullary counterpart, but because they are rare, they may pose diagnostic challenges when showing different characteristics compared to their intramedullary counterpart. It is important for radiologists to recognize the imaging findings for various uncommon surface primary bone tumors, which may help to reduce the differential diagnosis or to lead to a specific diagnosis. Radiography is typically used for first-line imaging. If necessary, it is followed by CT or MRI for evaluation and characterization of surface bone tumors. The aim of this article is to review the imaging findings and differential diagnosis for surface primary bone tumors. (orig.)

  17. Tuberculous and brucellosis meningitis differential diagnosis

    DEFF Research Database (Denmark)

    Erdem, Hakan; Senbayrak, Seniha; Gencer, Serap

    2015-01-01

    BACKGROUND: The Thwaites and Lancet scoring systems have been used in the rapid diagnosis of tuberculous meningitis (TBM). However, brucellar meningoencephalitis (BME) has similar characteristics with TBM. The ultimate aim of this study is to infer data to see if BME should be included in the dif...

  18. [Differential diagnosis of chronic myeloic leucemia in infancy (author's transl)].

    Science.gov (United States)

    Binder, C; Pichler, E; Radaskiewicz, T; Scheibenreiter, S

    1976-01-01

    A 3 months old girl presented with significant enlargement of liver, spleen and lymphnodes, with moderate anemia, thrombopenia and leucocytosis. In the differential count there was a shift to the left and an increase of monocyte-like cells (35%). Differential diagnosis included leucemoid reaction, infectious mononucleosis, myelo-proliferative disorder with a missing C chromosome and chronic myeloid leucemia. Clinical symptoms, cytochemistry and caryotype of bone marrow cells suggested infantile chronic myeloic leucemia and normal ALP index and possibly normal HbF. Treatment with 6-mercaptopurine was followed by partial remission. The therapeutic consequences of exact differential diagnosis are discussed.

  19. Testicular torsion: diagnosis, differential diagnosis, and treatment in children; Hodentorsion: Diagnose, Differenzialdiagnose und Therapie im Kindesalter

    Energy Technology Data Exchange (ETDEWEB)

    Guenther, P. [Chirurgische Universitaetsklinik Heidelberg (Germany)., Abt. Kinderchirurgie; Schenk, J.P. [Universitaetsklinikum Heidelberg (Germany). Paediatrische Radiologie

    2006-07-15

    Acute scrotum represents an emergency situation although testicular torsion is present in less than 20% of the cases. Sonography has meanwhile become the definitive modality for diagnosis. Its increasing use before surgical intervention has led to technical improvements in ultrasound diagnostics and critical assessment of ultrasound criteria to exclude testicular torsion as well as standardization of examination procedures. Central arterial and venous perfusion shown to be bilaterally equal on Doppler sonography is the most important criterion for excluding torsion. This article discusses other criteria such as the ''resistance index,'' comparison of parenchymal structure of both testes, evidence for spermatic cord torsion, or differences between the sides in perfusion of the testicular parenchyma and highlights the difficulties involved in partial and intermittent testicular torsion. Alternative investigative methods and the significance of sonography in the differential diagnosis of other underlying causes are addressed. In summary, the combination of interpreting B-mode imaging, color Doppler, and power Doppler sonography and analyzing Doppler flow curves after clinical examination results in successful and conclusive evaluation of the testes in cases of acute scrotum in boys. (orig.) [German] Das akute Skrotum ist eine Notfallsituation, wobei in weniger als 20% der Faelle eine Hodentorsion vorliegt. Inzwischen hat sich die Sonographie zur entscheidenden diagnostischen Untersuchungsmodalitaet entwickelt deren zunehmende Anwendung zu technischen Fortschritten der Ultraschalldiagnostik, zu einer kritischen Bewertung von Ultraschallkriterien zum Ausschluss einer Hodentorsion und zu einer Standardisierung der Untersuchungsablaeufe gefuehrt hat. Die in der Dopplersonographie dargestellte seitengleiche zentrale arterielle und venoese Perfusion ist hierbei das wichtigste Kriterium zum Ausschluss einer Torsion. Weitere Kriterien wie &apos

  20. Differential diagnosis of small bowel occlusions

    Directory of Open Access Journals (Sweden)

    Paolo Ghiringhelli

    2009-06-01

    Full Text Available Hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome, is a common autosomal dominant syndrome characterized by early age at onset, and microsatellite instability (MSI. Patients with Lynch syndrome have a markedly increased risk of colorectal cancer. We report a case of a 28-year-old male with Lynch syndrome; the case allows to describe clinical manifestations and diagnostic criteria of this syndrome, and to underline the importance of genetics in the diagnosis of this disease.

  1. THE DIFFERENTIATIVE DIAGNOSIS OF RENAL CYSTS

    Directory of Open Access Journals (Sweden)

    A. V. Seregin

    2014-07-01

    Full Text Available  Despite the progress of diagnostic possibilities, the interpretation of renal cysts is still difficult and may have false negative results. So far there is no algorithm of renal cysts patients examination and treatment. Further diagnostic process improvement and an exact knowledge of the possibilities of each method are needed. The main factor for choosing the right tactics of treatment and giving the prognosis of the disease is not only the diagnosis, but also the exact gradation of the renal cysts according to the Bosniak classification. 

  2. Syndromal versus contextualized personality assessment: differentiating environmental and dispositional determinants of boys' aggression.

    Science.gov (United States)

    Wright, J C; Lindgren, K P; Zakriski, A L

    2001-12-01

    Two studies examined how "syndromal" approaches to assessment confound differences between individuals in the person and situation variables that contribute to their behavior. In a field study, a widely used instrument was found to be sensitive to the base rates of boys' aggression but, as expected, did not discriminate between boys who were similar in their behavior base rates but different in their social environments and how they responded to them. A laboratory experiment replicated this finding and demonstrated that social observers discriminated between targets on the basis of their functional properties even though syndrome scores did not. The results clarify how syndromal methods can obscure situational factors, conflict with people's social knowledge, and reinforce the view that syndromes exist "in the individual" rather than in person-environment interactions. Implications for developing more contextually sensitive instruments are discussed.

  3. Diagnosis and differential diagnosis value of magnetic resonance imaging in autoimmune pancreatitis

    Institute of Scientific and Technical Information of China (English)

    汪建华

    2014-01-01

    Objective To investigate the diagnosis and differential diagnosis value of multi-sequences magnetic resonance imaging(MRI)in autoimmune pancreatitis(AIP).Methods The MRI data of twelve AIP patients were retrospectively analyzed.The sequences of MRI included T1-weighted imaging,T2-weighted imaging,magnetic resonance cholangiopancreatography(MRCP),diffusionweighted imaging(DWI)and dynamic enhancement ima-

  4. Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis.

    Science.gov (United States)

    Gillberg, I Carina; Helles, Adam; Billstedt, Eva; Gillberg, Christopher

    2016-01-01

    We examined comorbid psychiatric and neurodevelopmental disorders in fifty adult males (mean age 30 years) with Asperger syndrome (AS) diagnosed in childhood and followed up prospectively for almost two decades (13-26 years). Only three of the 50 men had never met criteria for an additional psychiatric/neurodevelopmental diagnosis and more than half had ongoing comorbidity (most commonly either ADHD or depression or both). Any psychiatric comorbidity increased the risk of poorer outcome. The minority of the AS group who no longer met criteria for a full diagnosis of an autism spectrum disorder were usually free of current psychiatric comorbidity. The high rate of psychiatric/neurodevelopmental comorbidities underscores the need for a full psychiatric/neurodevelopmental assessment at follow-up of males with AS.

  5. Cervical spondylosis: recognition, differential diagnosis, and management.

    Science.gov (United States)

    Voorhies, R M

    2001-04-01

    In contemporary clinical practice, the prevalence of neck pain in the general population is approximately 15%. The challenge for the primary care specialist is to be able to recognize the more serious disorders that require early referral. Additionally, it is important to have the confidence to institute specific treatment for nonurgent conditions in order to avoid unnecessary referral of patients with generally self-limiting conditions.CERVICAL SPONDYLOSIS IS A GENERAL AND NONSPECIFIC TERM THAT ENCOMPASSES A BROAD SPECTRUM OF AFFLICTIONS BUT, FOR PURPOSES OF CLARITY, CAN BE ORGANIZED INTO THREE CLINICAL SYNDROMES: Type I Syndrome (Cervical Radiculopathy); Type II Syndrome (Cervical Myelopathy); and Type III Syndrome (Axial Joint Pain). It is important to remember that shoulder problems can masquerade as cervical problems, and vice versa (e.g. adhesive capsulitis, recurrent anterior subluxation, impingement syndrome, rotator cuff tear, etc.). A number of management options, including pharmaceutical, physical therapy, and psychological therapies, are available once a diagnosis has been made.

  6. Differential diagnosis and treatment of vestibular vertigo

    Directory of Open Access Journals (Sweden)

    Vladimir Anatolyevich Parfenov

    2010-01-01

    Full Text Available Vertigo is a common complaint that leads patients to visit physicians of various specialties. Diseases resulting in vestibular vertigo are very diverse and may be caused by lesion of both the central parts of the vestibular system and the peripheral vestibular apparatus. In many cases, its diagnosis can be made from complaints and a history of disease and special bedside tests requiring no sophisticated equipment. Management of vestibular vertigo should aim at treating the underlying disease; vestibular dilators as symptomatic therapy can be effective for several days. Vestibular exercises the efficiency of which can be enhanced by betahistine and other drugs accelerating vestibular compensation should be further needed. Data on the efficacy of betaver (betahistine in patients with vestibular vertigo are given.

  7. Problems in differential diagnosis of diabetes types.

    Science.gov (United States)

    Małecki, Maciej; Skupień, Jan

    2008-01-01

    Diabetes mellitus is a group of diseases characterized by chronic increase of glucose level. The last years brought progress in understanding the multiplicity of its forms, as well as, its complex pathogenesis. In 1999, a classification of diabetes based on the etiology of individual types, was proposed by the Experts Committee of the World Health Organization, and is now commonly accepted. Etiologic classification in the last decade was gradually extended with the progress of knowledge, in particular, with successes of researchers in the field of genetics. Monogenic forms of diabetes such as MODY, mitochondrial diabetes, neonatal diabetes and lipoatrophic diabetes, discovered over a dozen years ago, are characterized by unique clinical features and possibility of applying a tailored treatment, assuring optimal correction of genetically conditioned metabolic defect. The differential diagnostics of types of the diseases is playing an increasing role in diabetology, as it enables selection of optimal treatment methods, as well as, the assessment of prognosis referring to the diabetes course and complications occurence. In this article, a review of problems associated with the differential diagnostics of diabetes and its practical clinical application was made.

  8. The Haglund syndrome: initial and differential diagnosis.

    Science.gov (United States)

    Pavlov, H; Heneghan, M A; Hersh, A; Goldman, A B; Vigorita, V

    1982-07-01

    Haglund syndrome is a common cause of posterior heel pain, characterized clinically by a painful soft-tissue swelling at the level of the achilles tendon insertion. On the lateral heel radiograph the syndrome is characterized by a prominent calcaneal bursal projection, retrocalcaneal bursitis, thickening of the Achilles tendon, and a convexity of the superficial soft tissues at the level of the Achilles tendon insertion, a "pump-bump." An objective method for evaluating prominence of the bursal projection is measurement using the parallel pitch lines. This measurement helps to identify patients with Haglund syndrome and patients predisposed to develop this condition, and also to differentiate local causes of posterior heel pain from systemic causes. The parallel pitch line measurement was determined in 10 symptomatic feet and 78 control feet and the results were analyzed statistically.

  9. Lennox-Gastaut syndrome: a consensus approach to differential diagnosis.

    Science.gov (United States)

    Bourgeois, Blaise F D; Douglass, Laurie M; Sankar, Raman

    2014-09-01

    Lennox-Gastaut syndrome (LGS) is a severe epileptic encephalopathy that shares many features and characteristics of other treatment-resistant childhood epilepsies. Accurate and early diagnosis is essential to both prognosis and overall patient management. However, accurate diagnosis of LGS can be clinically challenging. This article summarizes key characteristics of LGS and areas of overlap with other childhood epilepsies. Drawing upon input from a committee of established LGS experts convened in June 2012 in Chicago, Illinois, the authors highlight key diagnostic tests for making the differential diagnosis and propose a diagnostic scheme for people with suspected LGS.

  10. Pulmonary alveolar microlithiasis. A case report with a discussion of differential diagnosis.

    Science.gov (United States)

    Saputo, V; Zocchi, M; Mancosu, M; Bonaldi, U; Croce, P

    1979-01-01

    The rare disease of pulmonary alveolar microlithiasis is characterized by innumerable microscopic stones, mainly of tribasic calcium phosphate, within the pulmonary alveoli. In a 13-year-old boy an earlier radiological examination showed diffuse lung opacity. The main differential diagnoses taken into consideration were sarcoidosis, idiopathic hemosiderosis, diffuse interstitial fibrosis and alveolar proteinosis. The correct diagnosis was made after a lung biopsy which showed intra-alveolar microliths. The radiological findings are in agreement with the reports in the literature. The specific X-ray features of pulmonary alveolar microlithiasis are calcified opacities, nodules, hilifugal trabeculations and pleural striae. These radiological signs are sufficiently diagnostic to restrict lung biopsy to particularly difficult cases. The disease is resistant to all therapeutic measures.

  11. Delayed puberty and hypogonadotropic hypogonadism. Differential diagnosis and treatment

    NARCIS (Netherlands)

    Snoep, Marinus Cornelis

    1978-01-01

    This thesis describes a method enabling a prospecrive differential diagnosis to be made berween delayed puberty (DP) and hypogonadotropic hypogonadism (HH). The influence of androgen administration on the gonadal feedback sysrem of patients with delayed puberty was also studied. ... Zie: Summary

  12. Abdominal migraine in the differential diagnosis of acute abdominal pain.

    Science.gov (United States)

    Cervellin, Gianfranco; Lippi, Giuseppe

    2015-06-01

    Although traditionally regarded as a specific pediatric disease, abdominal migraine may also be observed in adults. Unfortunately, however, this condition is frequently overlooked in the differential diagnosis of abdominal pain in the emergency department (ED). A 30-year-old woman presented to our ED complaining of abdominal pain and vomiting, lasting for 12 hours. The pain was periumbilical, continuous, and not associated with fever or diarrhea. The physical examination and the results of conventional blood tests were normal. The patient was treated with intravenous ketoprofen, metoclopramide, and ranitidine, obtaining a prompt relief of symptoms. She had a history of similar episodes in the last 15 years, with several ED visits, blood test examinations, ultrasonography of the abdomen, and upper gastrointestinal endoscopies. Celiac disease, porphyry, sickle cell disease, and inflammatory bowel disease were all excluded. In July 2012, she became pregnant, and she delivered a healthy baby on April 2013. Until November 2014, she has remained asymptomatic. Based on the clinical characteristics of the abdominal pain episodes, the exclusion of any alternative diagnosis, and the relief of symptoms during and after pregnancy, a final diagnosis of abdominal migraine could be established. A skilled emergency physician should always consider abdominal migraine in the differential diagnosis of patients admitted to the ED with abdominal pain, especially when the attacks are recurrent and no alternative diagnosis can be clearly established.

  13. Magnetic resonance imaging differential diagnosis of brainstem lesions in children

    Institute of Scientific and Technical Information of China (English)

    Carlo Cosimo Quattrocchi; Yuri Errante; Maria Camilla Rossi Espagnet; Stefania Galassi; Sabino Walter Della Sala; Bruno Bernardi; Giuseppe Fariello; Daniela Longo

    2016-01-01

    Differential diagnosis of brainstem lesions,either isolated or in association with cerebellar and supra-tentorial lesions,can be challenging. Knowledge of the structural organization is crucial for the differential diagnosis and establishment of prognosis of pathologies with involvement of the brainstem. Familiarity with the location of the lesions in the brainstem is essential,especially in the pediatric population. Magnetic resonance imaging(MRI) is the most sensitive and specific imaging technique for diagnosing disorders of the posterior fossa and,particularly,the brainstem. High magnetic static field MRI allows detailed visualization of the morphology,signal intensity and metabolic content of the brainstem nuclei,together with visualization of the normal development and myelination. In this pictorial essay we review the brainstem pathology in pediatric patients and consider the MR imaging patterns that may help the radiologist to differentiate among vascular,toxico-metabolic,infectiveinflammatory,degenerative and neoplastic processes. Helpful MR tips can guide the differential diagnosis: These include the location and morphology of lesions,the brainstem vascularization territories,gray and white matter distribution and tissue selective vulnerability.

  14. Liver biopsy interpretation in the differential diagnosis of autoimmune liver disease in children

    Directory of Open Access Journals (Sweden)

    Clara Gerosa

    2013-06-01

    Full Text Available Autoimmune liver disease  (AILD represents a group of complex inflammatory liver diseases, all characterized by an aberrant autoreactivity against hepatocytes and/or biliary structures. AILD may be subclassified into four major diseases: autoimmune hepatitis (AIH, primary biliary cirrhosis (PBC, primary sclerosing cholangitis (PSC, and autoimmune cholangitis (AIC. Recently a new entity frequently associated with autoimmune pancreatitis and defined IgG4-related cholangitis (IgG4-RC,  has been added to the spectrum of AILD. The most frequent autoimmune liver diseases  of the AILD spectrum occurring in children and in young adults are  AIH  and PSC, overlap syndrome between AIH and PSC, also defined as autoimmune sclerosing cholangitis (ASC, representing a frequent finding in pediatric patients. Here,  the morphological findings that may help liver pathologists in the differential diagnosis of AILD in pediatric patients are reviewed, underlying the frequency in liver biopsy interpretation of complex cases in which a precise diagnosis may remain controversial, due to overlap of hepatocytic and bile duct cell lesions. Among the multiple morphological changes typical of AILD,  the detection of an high number of plasma cell clusters in the portal and periportal regions is generally considered one of the main clue for the diagnosis of AIH. The recent report in a 13-year old  boy of IgG4-associated cholangitis, induces  pathologists when detecting a huge number of plasmacells, to consider the differential diagnosis between AIH and IgG4-RC.Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research

  15. Meniere's disease: Still a mystery disease with difficult differential diagnosis.

    Science.gov (United States)

    Vassiliou, A; Vlastarakos, P V; Maragoudakis, P; Candiloros, D; Nikolopoulos, T P

    2011-01-01

    One hundred and forty-six years after its first description, the differential diagnosis of Meniere's disease remains very challenging. The aim of the present study is to review the current knowledge on the advantages and disadvantages of the new diagnostic methods for Meniere's disease. The importance of accurate diagnosis for primary healthcare systems is also discussed. An extensive search of the literature was performed in Medline and other available database sources. Information from electronic links and related books were also included. Controlled clinical studies, prospective cohort studies, retrospective cohort studies, cross-sectional studies, case reports, written guidelines, systematic reviews, and books were selected. The typical clinical triad of symptoms from the vestibular and cochlear systems (recurrent vertigo, fluctuating sensorineural hearing loss and tinnitus) is usually the key for clinical diagnosis. Glycerol dehydration test and electrocochleography are the main diagnostic tests in current practice, while vestibular evoked myogenic potentials may be used in disease staging. Imagine techniques are not specific enough to set alone the diagnosis of Meniere's disease, although they may be necessary to exclude other pathologies. Recently developed 3D MRI protocols can delineate the perilymphatic/endolymphatic spaces of the inner ear and aid diagnosis. Meniere's disease is a continuous problem for the patients and affects their quality of life. Taking into account the frequent nature of the disease in certain countries, efforts for reliable diagnosis, prompt referral, and successful management are undoubtedly cost-effective for healthcare systems.

  16. Oral angioleiomyoma: a case report and considerations on differential diagnosis

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Galvão Barboza

    2013-12-01

    Full Text Available Angioleiomyomas are benign mesenchymal tumors derived from smooth muscle, which rarely occur in the oral cavity. We report a case of an angioleiomyoma occurring in the maxillary gingiva. The lesion was painless, with a lobulated surface, fibrous in consistency, and firm upon palpation. Microscopic examination showed an encapsulated tumor mass composed of large vascular channels of varying calibers, surrounded by thick walls of irregularly arranged, spindle-shaped cells, which were immunopositive for smooth-muscle actin. It is sometimes difficult to differentiate an angioleiomyoma from other spindle-cell tumors, thus we emphasize its histological differential diagnosis.

  17. Infective endocarditis: the specific features of its course, the criteria for diagnosis, differential diagnosis (part II

    Directory of Open Access Journals (Sweden)

    B S Belov

    2008-01-01

    Full Text Available Infective endocarditis (IE is today characterized by polyetiology due to a wide range of pathogens. The paper describes the specific features of the clinical picture of the disease in relation to the etiological agent, which have, in some cases, a crucial role in the choice of empiric antibiotic therapy. Significant clinical polymorphism, obscure symptoms, and monosyndromic onset as guises all enhance the importance of the differential diagnosis of IE, at its early stages in particular. Basic approaches to differentiating IE from the diseases in which differentially diagnostic problems arise to the utmost are outlined.

  18. [Differential diagnosis of dissociative identity disorder (multiple personality disorder)].

    Science.gov (United States)

    Stübner, S; Völkl, G; Soyka, M

    1998-05-01

    Recently the concept of dissociative identity disorder (formerly known as multiple personality disorder) has attracted increasing public and scientific interest. However, it is rarely diagnosed in the clinical setting. the reported case of a 47-year-old woman with a history of child abuse demonstrates the problems of differential diagnosis. A number of psychopathologic symptoms pointed to a multiple personality disorder, but in the follow-up psychotic symptoms such as delusions, possible hallucinations and bizarre behavior clearly emerged. The differential diagnosis of dissociative identity disorder includes paranoid schizophrenia, as in the case described, borderline personality disorder, hysteria, simulation and the false memory syndrome. Finally, social and cultural factors have to be considered.

  19. Pathology and differential diagnosis of chronic, noninfectious gastritis.

    Science.gov (United States)

    Polydorides, Alexandros D

    2014-03-01

    The histologic finding of chronic inflammation in an endoscopic mucosal biopsy of the stomach (chronic gastritis) is very common and usually reflects the presence of Helicobacter pylori infection. However, infectious organisms are not always present in biopsy material, and some cases of chronic gastritis do not result from H. pylori infection. Thus, the differential diagnosis of this finding is an important one for pathologists to keep in mind. This review presents the three most common and clinically significant causes of chronic, noninfectious gastritis, namely, autoimmune atrophic gastritis, lymphocytic gastritis, and gastric involvement in the setting of inflammatory bowel disease, especially Crohn disease. For each entity, a brief discussion of its etiology and pathogenesis, a review of the clinical and endoscopic features, and a description of the microscopic findings are presented in the context of the differential diagnosis of chronic gastritis with emphasis on helpful histopathologic hints and long-term sequelae.

  20. Frontal Fibrosing Alopecia: Role of Dermoscopy in Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    P. Rubegni

    2010-04-01

    Full Text Available Frontal fibrosing alopecia (FFA is more common in postmenopausal women, but it can occur in younger women. Some authors consider FFA to be a distinct frontal variant of lichen planopilaris. From a clinical point of view, this relatively uncommon condition is characterized by progressive frontotemporal recession due to inflammatory destruction of hair follicles. Dermoscopy can be very useful, as the differential diagnosis between traction alopecia, alopecia areata, FFA and cicatricial marginal alopecia may be difficult. It is not clear whether or not treatment alters the natural history of the disease – the disease stabilized with time in most of the patients with or without continuing treatment. Here we report a case of a 50-year-old woman with FFA and discuss the relevance of dermoscopy in the differential diagnosis of this disease.

  1. Endoscopic Diagnosis and Differentiation of Inflammatory Bowel Disease

    Science.gov (United States)

    Lee, Ji Min; Lee, Kang-Moon

    2016-01-01

    Patients with inflammatory bowel disease have significantly increased in recent decades in Korea. Intestinal tuberculosis (ITB) and intestinal Behcet’s disease (BD), which should be differentiated from Crohn’s disease (CD), are more frequent in Korea than in the West. Thus, the accurate diagnosis of these inflammatory diseases is problematic in Korea and clinicians should fully understand their clinical and endoscopic characteristics. Ulcerative colitis mostly presents with rectal inflammation and continuous lesions, while CD presents with discontinuous inflammatory lesions and frequently involves the ileocecal area. Involvement of fewer than four segments, a patulous ileocecal valve, transverse ulcers, and scars or pseudopolyps are more frequently seen in ITB than in CD. A few ulcers with discrete margins are a typical endoscopic finding of intestinal BD. However, the differential diagnosis is difficult in many clinical situations because typical endoscopic findings are not always observed. Therefore, clinicians should also consider symptoms and laboratory, pathological, and radiological findings, in addition to endoscopic findings. PMID:27484813

  2. Frontal Fibrosing Alopecia: Role of Dermoscopy in Differential Diagnosis

    Science.gov (United States)

    Rubegni, P.; Mandato, F.; Fimiani, M.

    2010-01-01

    Frontal fibrosing alopecia (FFA) is more common in postmenopausal women, but it can occur in younger women. Some authors consider FFA to be a distinct frontal variant of lichen planopilaris. From a clinical point of view, this relatively uncommon condition is characterized by progressive frontotemporal recession due to inflammatory destruction of hair follicles. Dermoscopy can be very useful, as the differential diagnosis between traction alopecia, alopecia areata, FFA and cicatricial marginal alopecia may be difficult. It is not clear whether or not treatment alters the natural history of the disease - the disease stabilized with time in most of the patients with or without continuing treatment. Here we report a case of a 50-year-old woman with FFA and discuss the relevance of dermoscopy in the differential diagnosis of this disease. PMID:21173926

  3. Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder

    Directory of Open Access Journals (Sweden)

    Michelle Nigri Levitan

    2013-12-01

    Full Text Available Objective: To present the most relevant findings regarding the Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder. Methods: We used the methodology proposed by the Brazilian Medical Association for the Diretrizes Project. The MEDLINE (PubMed, Scopus, Web of Science, and LILACS online databases were queried for articles published from 1980 to 2012. Searchable questions were structured using the PICO format (acronym for “patient” [or population], “intervention” [or exposure], “comparison” [or control], and “outcome”. Results: We present data on clinical manifestations and implications of panic disorder and its association with depression, drug abuse, dependence and anxiety disorders. In addition, discussions were held on the main psychiatric and clinical differential diagnoses. Conclusions: The guidelines are proposed to serve as a reference for the general practitioner and specialist to assist in and facilitate the diagnosis of panic disorder.

  4. [Anorexia nervosa as differential diagnosis in underweight patients].

    Science.gov (United States)

    Rapps, Nora; Skoda, Eva; Zipfel, Stephan

    2016-02-01

    Anorexia nervosa is a differential diagnosis in underweight patients, especially in young underweight women. Diagnostic criteria for anorexia nervosa are self-induced weight loss due to restrictive eating or purging behaviour, intense fear of gaining weight and disturbance in the way in which one`s shape is experienced, undue influence of body weight on self-evaluation and persistent lack of recognition of the seriousness of the current low body weight. Anorexia nervosa is associated with numerous medical complications.

  5. Differential diagnosis of microcalcification. Micro-cyst (blunt duct) adenosis

    Energy Technology Data Exchange (ETDEWEB)

    Lanyi, M.; Citoler, P.

    1981-03-01

    One hundred and thirty-five operations were carried out because of a finding of microcalcification in the breast. In 10% of these, the calcification was shown histologically to be within foci of micro-cyst (blunt duct) adenosis. Analysis of the radiographic appearances of the microcalcification revealed a characteristic radiographic pattern. The differential diagnosis of groups of calcification in intraduct carcinomas and in benign lesions is discussed.

  6. Pulmonary sarcoidosis: An important differential diagnosis in transbronchial lung biopsies

    Directory of Open Access Journals (Sweden)

    Qury S Mahapatra

    2014-01-01

    Full Text Available Background: Sarcoidosis is a systemic granulomatous disease of unknown etiology. Lungs and lymphatics are the principal sites affected by this disease. The disorder is often not suspected by physicians. Materials and Methods: This was a retrospective study done on 140 transbronchial lung biopsies received for histopathological examination in the Department of Pathology for 1 year in a multispeciality tertiary care hospital, in Delhi. Results: Out of 140 transbronchial lung biopsies studied, 13 cases of sarcoidosis were diagnosed histopathologically. In these patients a clinical, pathological, and radiological corelation was done. And a final diagnosis of sarcoidosis was given after excluding other granulomatous lesions. Conclusion: Transbronchial lung biopsies have become an important tool in the diagnosis of sarcoidosis in present time. Hence sarcoidosis should be considered as a differential diagnosis when dealing with granulomatous lesions in lung biopsies.

  7. Pulmonary sarcoidosis: An important differential diagnosis in transbronchial lung biopsies

    Science.gov (United States)

    Mahapatra, Qury S.; Sahai, Kavita; Rathi, K. R.; Singh, Sarvinder; Sharma, Shruti

    2014-01-01

    Background: Sarcoidosis is a systemic granulomatous disease of unknown etiology. Lungs and lymphatics are the principal sites affected by this disease. The disorder is often not suspected by physicians. Materials and Methods: This was a retrospective study done on 140 transbronchial lung biopsies received for histopathological examination in the Department of Pathology for 1 year in a multispeciality tertiary care hospital, in Delhi. Results: Out of 140 transbronchial lung biopsies studied, 13 cases of sarcoidosis were diagnosed histopathologically. In these patients a clinical, pathological, and radiological corelation was done. And a final diagnosis of sarcoidosis was given after excluding other granulomatous lesions. Conclusion: Transbronchial lung biopsies have become an important tool in the diagnosis of sarcoidosis in present time. Hence sarcoidosis should be considered as a differential diagnosis when dealing with granulomatous lesions in lung biopsies. PMID:24778476

  8. Ultrasound in differential diagnosis of periapical radiolucencies: A radiohistopathological study

    Directory of Open Access Journals (Sweden)

    Neha Khambete

    2015-01-01

    Full Text Available Objectives: To evaluate the efficacy of ultrasound in differential diagnosis of periapical radiolucencies. Materials and Methods: Ten patients aged between 19 years and 40 years with periapical lesions associated with anterior maxillary or mandibular teeth were selected and consented for the study. Pre-operative periapical radiographs were obtained. Measurements and provisional diagnoses of the apical areas were made by two specialist observers on two separate occasions. Preoperative ultrasound examinations with Doppler flowmetry were then performed and the images assessed by two specialist observers for the size, contents, vascular supply and a provisional diagnosis made as to whether the lesion was a cyst or granuloma. Endodontic surgery was performed including curettage of the apical tissues to enable histopathological investigation, which provided the gold standard diagnosis. All measurements and findings were compared and statistically analyzed. Results: Total 10 lesions were identified in 10 patients. On periapical radiographs, lesions were readily identified but observers were unable to differentiate granuloma from cyst using either modality. Where sufficient buccal cortical bone had been resorbed, ultrasound imaging was simple but underestimated the size of the lesions compared with periapical radiographs. In all cases, the ultrasound diagnosis agreed with the histopathological gold standard. Conclusion: Ultrasonography (USG can provide accurate information about the nature of intraosseous lesions of the jaws before any surgical procedure. It is proposed that USG with Doppler flowmetry can provide an additional diagnostic tool without invasive surgery, where treatment option is nonsurgical.

  9. [Several techniques proposed for the differential diagnosis of diabetic impotence].

    Science.gov (United States)

    Lavoisier, P

    1988-01-01

    The measurements of changes in penile circumference during nocturnal erection is commonly used to differentiate between organic and psychogenic impotence. Unfortunately, this measuring technique do not record variations in penile rigidity which may be insufficient to achieve coitus despite a normal circumference. We carried out a study with a penile cuff to measure penile rigidity. The validation of this penile cuff as a measurement device of penile rigidity permits us to determine the criteria of normality of penile rigidity and, subsequently, to differentiate more accurately between organic and psychogenic dysfunctions. Measurement of the bulbocavernous reflex (BCR) is widely used to diagnose underlying neurologic disorders in erectile dysfunctions. A prolonged BCR latency, more than 45 ms, or absence of a reflex response of the BC muscles during electrical stimulation of the glans penis, is considered like a sign of neurologic disease. We recorded the BCR in 90 subjects. Nineteen had abnormal BCR latencies. Furthermore, eight of these 19 subjects had normal nocturnal erections, thus confirming the diagnosis of psychogenic impotence. These results cast doubt on the validity of BCR measurements of the diagnosis of organic erectile dysfunction due to a neurologic disease. We recorded the BCR in 90 subjects. Nineteen had abnormal BCR latencies. Furthermore, eight of these 19 subjects had normal nocturnal erections, thus confirming the diagnosis of psychogenic impotence. These results cast doubt on the validity of BCR measurements for the diagnosis of organic erectile dysfunction due to a neurologic disease.

  10. Looking for "indicants" in the differential diagnosis of jaundice.

    Science.gov (United States)

    Boom, R; Gonzalez, C; Fridman, L; Ayala, J F; Realpe, J L; Morales, P; Quintero, R

    1986-01-01

    The differential diagnosis between intra- and extrahepatic causes of jaundice was studied. At the "20 Noviembre" ISSSTE Hospital in Mexico City, between January 1977 and May 1984, data were collected in 1,263 jaundiced patients. To the clinical data for 1,000 of these 1,263 patients and a new set of 105 jaundiced patients, the COMIC study group algorithm was applied. The differential diagnosis between medical and surgical causes of jaundice was correct in 90% of the cases. In 85% the algorithm could also differentiate between acute and chronic disease, or between benign and malignant causes of jaundice. The COMIC algorithm was then modified and applied to the same 1,000 cases examined previously, with 96% accuracy in distinguishing medical and surgical causes of jaundice and 94% accuracy in discriminating between acute and chronic, or benign and malignant, disease. In a new set of 105 cases of jaundiced patients the modified COMIC algorithm made the correct diagnosis between intra- and extrahepatic causes for 98% of the patients, and for 93% it was also capable of distinguishing benign from malignant and acute from chronic causes of jaundice.

  11. Exploring the differential diagnosis of hemorrhagic vesicopustules in a newborn.

    Science.gov (United States)

    Mohr, Melinda R; Sholtzow, Melissa; Bevan, Herbert E; Fisher, Randall G; Williams, Judith V

    2011-01-01

    Hemorrhagic vesicles in a newborn present a challenging differential diagnosis including both infectious and neoplastic disorders. Patients should be evaluated in an efficient manner to arrive at the correct diagnosis as quickly as possible. We present here an interesting case that outlines the methodical workup that ultimately revealed the diagnosis of congenital Langerhans cell histiocytosis. After a diagnosis of Langerhans cell histiocytosis is made, it is important to evaluate the patient thoroughly for systemic involvement. Historically, the diagnosis of congenital self-healing Langerhans cell histiocytosis was used to delineate a benign self-limited disorder limited to the skin with spontaneous resolution during the first several months of life; this disorder may also be referred to as "self-regressive Langerhans cell histiocytosis." However, some newborns with initial skin-only Langerhans cell histiocytosis progress to have multisystem disease after spontaneous resolution has occurred. For this reason, the nomenclature is changing. We suggest using the term "skin-only Langerhans cell histiocytosis." Periodic long-term follow-up is recommended to monitor for relapse or progression to systemic disease.

  12. Differential diagnosis of pain around the hip joint.

    Science.gov (United States)

    Tibor, Lisa M; Sekiya, Jon K

    2008-12-01

    The differential diagnosis of hip pain is broad and includes intra-articular pathology, extra-articular pathology, and mimickers, including the joints of the pelvic ring. With the current advancements in hip arthroscopy, more patients are being evaluated for hip pain. In recent years, our understanding of the functional anatomy around the hip has improved. In addition, because of advancements in magnetic resonance imaging, the diagnosis of soft tissue causes of hip pain has improved. All of these advances have broadened the differential diagnosis of pain around the hip joint and improved the treatment of these problems. In this review, we discuss the causes of intra-articular hip pain that can be addressed arthroscopically: labral tears, loose bodies, femoroacetabular impingement, capsular laxity, tears of the ligamentum teres, and chondral damage. Extra-articular diagnoses that can be managed arthroscopically are also discussed, including: iliopsoas tendonitis, "internal" snapping hip, "external" snapping hip, iliotibial band and greater trochanteric bursitis, and gluteal tendon injury. Finally, we discuss extra-articular causes of hip pain that are often managed nonoperatively or in an open fashion: femoral neck stress fracture, adductor strain, piriformis syndrome, sacroiliac joint pain, athletic pubalgia, "sports hernia," "Gilmore's groin," and osteitis pubis.

  13. Differential diagnosis of cystic bone tumors in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Refior, H.J.; Stuerz, H.

    1982-09-01

    Skeletal changes leading to a suspicion of the presence of a tumour frequently occur in childhood with the roentgenological manifestation of a cyst. X-ray morphology can differ depending upon the localisation and the course. In childhood, however such findings are mainly classified as tumour-like bone lesions. This group comprises, inter alia, the juvenile bone cyst, the aneurysmatic bone cyst and fibrous dysplasia. However, it is necessary to exclude by differential diagnosis - even though the main age of manifestation is after completion of growth - genuine bone tumours with cystic phenomena, such as the giant cell tumour, chondroma or chondroblastoma. Verification of the diagnosis can be effected via radiologic-diagnostic methods such as tomography and angiography as well as computerized tomography. The use of scintigraphy of the skeleton can likewise be indicated. Numerous laboratory parameters can be used in individual cases to exclude certain diagnoses. Taking these aspects into consideration, the article reviews differential diagnosis of the most frequent skeletal affections in childhood. Great emphasis is given to the ranking and importance of the individual diagnostic methods.

  14. Differential Diagnosis of Parotid Lipoma in a Breast Ca Patient

    Science.gov (United States)

    2017-01-01

    Lipomas are common benign tumors usually detected on the torso, neck, upper thighs, and upper arms. However, they are rarely found in the parotid gland region. Because of their rarity at this site, they are not often considered in the differential diagnosis of parotid tumors. This report describes a rare case of a lipoma in the superficial lobe of parotid gland. A 71-year-old female patient admitted to our department complaining about swelling and pain in the posterior area of the left mandibular region since one month. Her medical history included mastectomy after breast CA fifteen years ago. Clinical examination revealed a smooth-surfaced, soft, and painful mass, with well-defined margins in the left mandibular region. Differential diagnosis of metastasis, inflammatory neck swellings, and benign salivary gland tumors were considered for the patient. Advanced imaging methods such as ultrasonography and contrast tomography revealed that the lesion was a lipoma of parotid gland. A surgical intervention under general anesthesia was planned for the removal of the mass; however patient refused the surgical treatment. Patient was placed on six-month periodic recall. This article reviews the radiographic appearance and differential diagnoses of lipoma in this rare location.

  15. RLS, PLM, and their differential diagnosis--a video guide.

    Science.gov (United States)

    Högl, Birgit; Zucconi, Marco; Provini, Federica

    2007-01-01

    This video guide has been designed as an introduction to the full spectrum of nocturnal presentations of restless legs syndrome (RLS) and periodic limb movements (PLM), and to their differential diagnoses. The DVD consists of four sections: In the first part, clinical presentations of RLS are covered (videos 1-3). In the second part, the variety of typical and less frequent presentations of PLM are demonstrated (videos 4-14). The third part shows the clinical presentation of augmentation (videos 15-19). The last section is dedicated to the differential diagnosis of RLS and PLM and demonstrates nocturnal manifestations of other motor disorders during sleep, which must be distinguished: Epilepsy, parasomnias, and other movement disorders (of sleep) (videos 20-33). After viewing this DVD, the reader should be able to: (1) appreciate the spectrum of voluntary and unvoluntary movements seen in patients with RLS during wakefulness; (2) recognize typical PLM during sleep in subjects with RLS, and appreciate the enormous variability of clinical presentations of PLM; (3) describe specific and distinct aspects of motor activity in augmentation in patients with RLS; and (4) be aware of the most important differential diagnosis of RLS/PLM from a video or nocturnal motor activity point of view, namely, nocturnal epilepsy, parasomnias, and others.

  16. Differential diagnosis of dyscirculatory encephalopathy in outpatient practice

    Directory of Open Access Journals (Sweden)

    D V Neverovsky

    2013-01-01

    Full Text Available The differential diagnosis of dyscirculatory encephalopathy is one of the topical problems in Russian neurology. Forty-seven patients diagnosed with dyscirculatory encephalopathy and followed up in the polyclinic were examined. Only in 9 (19.2% of them, the diagnosis was confirmed. Most patients were established to have other diseases, among which there were primary depressive and/or anxiety disorders (34%, primary headache (23.4, benign paroxysmal positional vertigo (BPPV (8.5%, and Alzheimer’s disease (10.6%. The paper describes patients with migraine and BPPV, in whom the detection and treatment of these diseases have yielded a positive effect. The examination of patients diagnosed with dyscirculatory encephalopathy with investigations of their cognitive and emotional functions, otoneurological examination, and psychiatric consultation (if indicated makes it possible to identify other diseases presenting with the symptoms similar to dyscirculatory encephalopathy and to prescribe effective treatments.

  17. Headache and facial pain: differential diagnosis and treatment.

    Science.gov (United States)

    Bernstein, Jonathan A; Fox, Roger W; Martin, Vincent T; Lockey, Richard F

    2013-01-01

    Headaches affect 90% of the population sometime during their life. Most are benign and fleeting, some are serious and life-threatening, and others require ongoing medical consultation and treatment. A careful history and physical is necessary to establish a differential diagnosis and to guide the choice of testing to make an accurate diagnosis. The most common types of headaches are discussed in this review. They are divided into primary and secondary headache disorders as classified by the International Headache Society. Primary headache disorders include migraine without and with aura, cluster and tension-type headaches. Secondary headaches are those that occur as a result of some other disorder and include brain tumors, rhinosinusitis, diseases of intracranial and extracranial vasculature, and temporomandibular joint disease.

  18. [Differential diagnosis of essential adiposity and Cushings syndrome].

    Science.gov (United States)

    Kubel, M; Schwerdtner, U

    1975-04-01

    On account of the increasing number of patients with essential obesity the delimitation of the Cushing-syndrome is of actual importance. Two observations of hypercortisolism in hyperplasia of the adrenal glands are reported on and the differential-diagnostically important parameters are demonstrated. According to our opinion anamnesis and clinical findings give the possibility of making a diagnosis already on a large scale. Analyses of the hormones and special X-ray examinations only serve for the preoperative ascertainment and localisation of the endocrine defective function. With the help of literary data causes and possibilities of treatment of Cushing's syndrome are entered.

  19. Differential diagnosis of temporomandibular disorders and other orofacial pain disorders.

    Science.gov (United States)

    Okeson, Jeffrey P; de Leeuw, Reny

    2011-01-01

    There are many types of pain conditions that are felt in the orofacial structures. Most of the conditions treated by the dentist are associated with the teeth, periodontal structures, and associated mucosal tissues. This article focuses on the differential diagnosis of other common pain conditions the dentist will likely face, such as temporomandibular disorders, neuropathic pain disorders, and common headaches; and the clinical presentation of each. Controlling or reducing pain can be accomplished by controlling perpetuating factors such as parafunctional habits and by some simple behavioral modifications. Finally, this article offers some simple treatment considerations.

  20. Gender stereotype endorsement differentially predicts girls' and boys' trait-state discrepancy in math anxiety

    Directory of Open Access Journals (Sweden)

    Madeleine eBieg

    2015-09-01

    Full Text Available Mathematics is associated with anxiety for many students; an emotion linked to lower well-being and poorer learning outcomes. While findings typically show females to report higher trait math anxiety than males, no gender differences have to date been found in state (i.e., momentary math anxiety. The present diary study aimed to replicate previous findings in investigating whether levels of academic self-concept was related to this discrepancy in trait versus state anxiety measures. Additionally, mathematics-related gender stereotype endorsement (mathematics is a male domain was investigated as an additional predictor of the trait-state discrepancy. The sample included 755 German 9th and 10th graders who completed self-report measures of trait math anxiety, math self-concept, and gender stereotype endorsement, in addition to state measures of anxiety after math classes by use of a standardized diary for 2-3 weeks (Nwithin = 6207. As expected, females reported higher trait math anxiety but no gender differences were found for state math anxiety. Also in line with our assumptions, multilevel analyses showed the discrepancy between trait and state anxiety to be negatively related to students’ self-concept (i.e., a lower discrepancy for students with higher self-concepts. Furthermore, gender stereotype endorsement differentially predicted the trait-state discrepancy: When controlling for self-concept in mathematics, females who endorsed the gender stereotype of math being a male domain more strongly overestimated their trait math anxiety as compared to their state anxiety whereas this effect was not significant for males. The present findings suggest that gender stereotype endorsement plays an important role in explaining gender differences in math anxiety above and beyond academic self-concept. Implications for future research and educational practice are discussed.

  1. Gender stereotype endorsement differentially predicts girls' and boys' trait-state discrepancy in math anxiety.

    Science.gov (United States)

    Bieg, Madeleine; Goetz, Thomas; Wolter, Ilka; Hall, Nathan C

    2015-01-01

    Mathematics is associated with anxiety for many students; an emotion linked to lower well-being and poorer learning outcomes. While findings typically show females to report higher trait math anxiety than males, no gender differences have to date been found in state (i.e., momentary) math anxiety. The present diary study aimed to replicate previous findings in investigating whether levels of academic self-concept was related to this discrepancy in trait vs. state anxiety measures. Additionally, mathematics-related gender stereotype endorsement (mathematics is a male domain) was investigated as an additional predictor of the trait-state discrepancy. The sample included 755 German 9th and 10th graders who completed self-report measures of trait math anxiety, math self-concept, and gender stereotype endorsement, in addition to state measures of anxiety after math classes by use of a standardized diary for 2-3 weeks (N within = 6207). As expected, females reported higher trait math anxiety but no gender differences were found for state math anxiety. Also in line with our assumptions, multilevel analyses showed the discrepancy between trait and state anxiety to be negatively related to students' self-concept (i.e., a lower discrepancy for students with higher self-concepts). Furthermore, gender stereotype endorsement differentially predicted the trait-state discrepancy: When controlling for self-concept in mathematics, females who endorsed the gender stereotype of math being a male domain more strongly overestimated their trait math anxiety as compared to their state anxiety whereas this effect was not significant for males. The present findings suggest that gender stereotype endorsement plays an important role in explaining gender differences in math anxiety above and beyond academic self-concept. Implications for future research and educational practice are discussed.

  2. Differential diagnosis of facial acne on black skin.

    Science.gov (United States)

    Poli, Florence

    2012-11-01

    The diagnosis of acne is usually easy, but there are some pitfalls to be avoided. 'Keloid acne of the neck' and beard folliculitis are not acnes in the usual sense: both are inflammatory and fibrous reactions of the hair follicles and frizzy hair; no retentional lesions, blackheads and microcysts--are visible. Gram negative folliculitis classically occurs in acneic male subjects who have undergone extensive treatment with general antibiotics or local antiseptics, but 'de novo' cases do exist. On black skin, this condition is not exceptional, it occurs in both sexes and usually takes the nodular form. The diagnosis should be considered if there is any aggravation of acne which is resistant to classic treatment, with painful nodules on the cheeks. Treatment is based on appropriate antibiotherapy for several weeks and possibly, in a second phase, on Isotretinoin. Pityrosporum folliculitis occurs mainly on the trunk. More frequent in men than in women, it is chiefly observed in subjects living in a hot, humid climate. Demodicidosis is manifested by outbreaks of papular or papulopustular lesions of the face. On black skin the principal differential diagnosis is acne. The presence of numerous parasites is necessary for diagnosis. Clinically speaking, an important sign is when the eyelids are affected. Ivermectin is effective. Acneiform dermatitis may be induced by depigmenting preparations containing powerful dermocorticoids. It is therefore important, in cases of very inflammatory acne, to look for the other clinical signs of voluntary depigmentation. In countries where it is endemic, lepromatous leprosy should be considered. Other common dermatitis may simulate acne or else be associated with it, such as eruptive hidradenoma or molluscum contagiosum. Analysis of the different elementary lesions and the absence of retentional lesions generally enable a diagnosis to be established.

  3. Modified Calgary score in differential diagnosis between cardiac syncope and postural orthostatic tachycardia syndrome-associated syncope in children.

    Science.gov (United States)

    Yang, Jinyan; Zhu, Lulu; Chen, Stella; Li, Xueying; Zhang, Qingyou; Zhang, Fengwen; Chen, Li; Tang, Chaoshu; Du, Junbao; Jin, Hongfang

    2013-06-01

    The present study was designed to analyse the usefulness of a modified Calgary score system during differential diagnosis between cardiac syncope and postural orthostatic tachycardia syndrome-associated syncope through a large sample sized clinical investigation. The study included 213 children, including 101 boys and 112 girls, with cardiac syncope or postural orthostatic tachycardia syndrome-associated syncope in the age group of 2-19 years (mean 11.8 ± 2.9 years). A modified Calgary score was created, which was analysed to predict differential diagnoses between cardiac syncope and postural orthostatic tachycardia syndrome-associated syncope using a receiver operating characteristic curve. The median of modified Calgary scores for cardiac syncope was -5.0, which significantly differed from that of postural orthostatic tachycardia syndrome (0.0; p postural orthostatic tachycardia syndrome-associated syncope in the clinic.

  4. Intradural chordoma of the Meckel's cave: a challenging differential diagnosis.

    Science.gov (United States)

    Barresi, Valeria; Caffo, Maria; Alafaci, Concetta; Granata, Francesca; Tuccari, Giovanni

    2012-10-01

    Chordomas are midline tumors that arise from embryonic remnants of the notochord and are considered to be malignant tumors because of their tendency to invade and destroy the involved bone. Cases of intradural chordomas without bone involvement have been rarely described with a predilection for prepontine location. The absence of bony invasion renders the complete excision of these tumors more feasible and is related to their better prognosis in comparison to conventional chordomas. Herein we report the first intradural chordoma arising in the Meckel's cave. The intradural location of the lesion, outside midline structures, in the absence of bone infiltration, made the differential diagnosis versus other meningeal lesions such as chordoid meningioma challenging. The intense and strong immunohistochemical expression of pan-cytokeratins, S100, cytokeratin-19 and of the notochordal marker brachyury allowed differential diagnosis toward other tumors showing chordoid morphology. The expression of brachyury, which had not been previously analyzed in intradural chordoma, definitely links the histogenesis of this neoplasia to the notochord, similar to that of conventional chordoma. We also show that, different from conventional chordoma, intradural chordoma does not express the metallo-proteinases (MMPs) -2 and -9, which may account for its indolent biological behavior.

  5. Differential diagnosis of cervical radiculopathy and superior pulmonary sulcus tumor

    Institute of Scientific and Technical Information of China (English)

    GU Rui; KANG Ming-yang; GAO Zhong-li; ZHAO Jian-wu; WANG Jin-cheng

    2012-01-01

    Background The result would be disastrous if the superior pulmonary sulcus tumor (Pancoast tumor) was misdiagnosed as degenerative cervical spine diseases.The aim of this study was to investigate the differential diagnosis methods of cervical radiculopathy and superior pulmonary sulcus tumor.Methods Clinical manifestations,physical,and radiological findings of 10 patients,whose main complaints were radiating shoulder and arm pain and later were diagnosed with superior pulmonary sulcus tumor,were reviewed and compared with those of cervical radiculopathy.Results Superior pulmonary sulcus tumor patients have shorter mean history and fewer complaints of neck pain or limitation of neck movement.Physical examination showed almost normal cervical spine range of motion.Spurling's neck compression test was negative in all patients.Anteroposterior cervical radiographs showed the lack of pulmonary air at the top of the affected lung in all cases and first rib encroachment in one case.The diagnosis of superior pulmonary sulcus tumor can be further confirmed by CT and MRI.Conclusions By the method of combination of history,physical examination,and radiological findings,superior pulmonary sulcus tumor can be efficiently differentiated from cervical radiculopathy.Normal motion range of the cervical spine,negative Spurling's neck compression test,and the lack of pulmonary air at the top of the affected lung in anteroposterior cervical radiographs should be considerad as indications for further chest radiograph examinations.

  6. Neural network approach for differential diagnosis of interstitial lung diseases

    Science.gov (United States)

    Asada, Naoki; Doi, Kunio; MacMahon, Heber; Montner, Steven M.; Giger, Maryellen L.; Abe, Chihiro; Wu, Chris Y.

    1990-07-01

    A neural network approach was applied for the differential diagnosis of interstitial lung diseases. The neural network was designed for distinguishing between 9 types of interstitial lung diseases based on 20 items of clinical and radiographic information. A database for training and testing the neural network was created with 10 hypothetical cases for each of the 9 diseases. The performance of the neural network was evaluated by ROC analysis. The optimal parameters for the current neural network were determined by selecting those yielding the highest ROC curves. In this case the neural network consisted of one hidden layer including 6 units and was trained with 200 learning iterations. When the decision performances of the neural network chest radiologists and senior radiology residents were compared the neural network indicated high performance comparable to that of chest radiologists and superior to that of senior radiology residents. Our preliminary results suggested strongly that the neural network approach had potential utility in the computer-aided differential diagnosis of interstitial lung diseases. 1_

  7. Multivariable Discriminant Analysis for the Differential Diagnosis of Microcytic Anemia

    Directory of Open Access Journals (Sweden)

    Eloísa Urrechaga

    2013-01-01

    Full Text Available Introduction. Iron deficiency anemia and thalassemia are the most common causes of microcytic anemia. Powerful statistical computer programming enables sensitive discriminant analyses to aid in the diagnosis. We aimed at investigating the performance of the multiple discriminant analysis (MDA to the differential diagnosis of microcytic anemia. Methods. The training group was composed of 200 β-thalassemia carriers, 65 α-thalassemia carriers, 170 iron deficiency anemia (IDA, and 45 mixed cases of thalassemia and acute phase response or iron deficiency. A set of potential predictor parameters that could detect differences among groups were selected: Red Blood Cells (RBC, hemoglobin (Hb, mean cell volume (MCV, mean cell hemoglobin (MCH, and RBC distribution width (RDW. The functions obtained with MDA analysis were applied to a set of 628 consecutive patients with microcytic anemia. Results. For classifying patients into two groups (genetic anemia and acquired anemia, only one function was needed; 87.9% β-thalassemia carriers, and 83.3% α-thalassemia carriers, and 72.1% in the mixed group were correctly classified. Conclusion. Linear discriminant functions based on hemogram data can aid in differentiating between IDA and thalassemia, so samples can be efficiently selected for further analysis to confirm the presence of genetic anemia.

  8. DIFFERENTIAL DIAGNOSIS OF ORGANIC ACIDEMIA: CLINICAL AND NEUROIMAGING FINDINGS

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    Mahmoud Reza ASHRAFI

    2012-03-01

    Full Text Available Clinical differential DiagnosisThe organic acidemias are important in the differential diagnosis of metabolic and neurologic derangement in the neonate and of new-onset neurologic signs in the older child.A-Organic aciduriaSeveral disorders, not classified as primary disorders of organic acid metabolism, have a characteristic urinary organic acid profile that suggests the appropriate diagnosis.• Mevalonicaciduria, a disorder of cholesterol biosynthesis, shows mevalonic acid in the urine.• Glutaricacidemia type II, a disorder of fatty acid oxidation, has multiple organic acids in abnormal concentration in urine. These organic acids include ethylmalonic acid, glutaric acid, dicarboxylic acids, and glycine conjugates of medium chain dicarboxylic acids.• The fatty acylCoA-glycine conjugates that signal incomplete fatty acid oxidation and serves as signals to the diagnosis of MCAD defeciency and other disorders of fatty acid oxidation and transport.• Biotinidase deficiency, a disorder of biotin recycling, results in the urinary excretion of several unusual organic acids, including 3-hydroxy-isovaleric, 3-hydroxypropionic, 3-hydroxybutyric acids, and acetoacetate. Propionyl glycine may also be seen.• Mitochondrial diseases with disordered oxidative phosphorylation often demonstrate the presence of abnormal organic acids in the urine.B-AcidosisNon-genetic conditions, such as shock, sepsis, DKA, liver and kidney failure, thiamine deficiency, RTA, some drug intoxication cause acidosis- genetic conditions are include: inherited metabolic disorders of lactate and pyruvate metabolism and oxidative phosphorylation, disorders of the Krebs cycle such as fumarase deficiency.C-HyperammonemiaDisorders of the urea cycle and the hyperammonemia-hypoglycemia syndrome.Neuroimaging• A variety of MRI abnormalities have been described in the organic academia, including distinctive basal ganglia lesions in glutaricacidemia type I (GA I, white matter changes in

  9. Differential diagnosis of (inherited) amino acid metabolism or transport disorders.

    Science.gov (United States)

    Blom, W; Huijmans, J G

    1992-02-01

    Disorders of amino acid metabolism or transport are most clearly expressed in urine. Nevertheless the interpretation of abnormalities in urinary amino acid excretion remains difficult. An increase or decrease of almost every amino acid in urine can be due to various etiology. To differentiate between primary and secondary aminoacido-pathies systematic laboratory investigation is necessary. Early diagnosis of disorders of amino acid metabolism or transport is very important, because most of them can be treated, leading to the prevention of (further) clinical abnormalities. In those disorders, which cannot be treated, early diagnosis in an index-patient may prevent the birth of other siblings by means of genetic counseling and prenatal diagnosis.Primary aminoacidopathies can be due to genetically determined transport disorders and enzyme deficiencies in amino acid metabolism or degradation. Secondary aminoacidopathies are the result of abnormal or deficient nutrition, intestinal dysfunction, organ pathology or other metabolic diseases like organic acidurias.A survey of amino acid metabolism and transport abnormalities will be given, illustrated with metabolic pathways and characteristic abnormal amino acid chromatograms.

  10. Differential Diagnosis of CNS Angiostrongyliasis: A Short Review

    Science.gov (United States)

    Senthong, Vichai; Chindaprasirt, Jarin

    2013-01-01

    The diagnostic criterion for eosinophilic meningitis (EOM) is the identification of an absolute count of 10 eosinophils per ml or more than 10% of the total white blood cells in the cerebrospinal fluid (CSF) in the proper clinical context. The most common cause of EOM is Angiostrongylus cantonensis infection, termed meningitic angiostrongyliasis (MA). Neurognathostomiasis (NG) is the main parasitic disease in the differential diagnosis of meningitic angiostrongyliasis. This short review is based on articles published on Medline between 2000 and 2012 related to EOM. There are three main approaches that can be used to differentiate between MA and NG, involving clinical factors, history of larval exposure, and serological tests. MA patients presented with acute severe headache but without neurological deficit, combined with a history of eating uncooked snails or slugs. NG patients always presented with motor weakness, migratory swelling, radicular pain and had history of eating uncooked poultry or fish. Specific antigenic bands in immunoblot tests are helpful tools to differentiate the two diseases. Other causes of eosinophilic meningitis are neurocysticercosis, cerebral paragonimiasis, Toxoplasma canis, Baylisascaris, tuberculous meningitis, and cryptococcal meningitis. PMID:23901385

  11. Radiological diagnosis and differential diagnosis of headache; Radiologische Diagnostik und Differenzialdiagnostik bei Kopfschmerzen im Erwachsenenalter

    Energy Technology Data Exchange (ETDEWEB)

    Langner, S.; Kirsch, M. [University Medicine Greifswald (Germany). Inst. for Diagnostic Radiology and Neuroradiology

    2015-10-15

    Headache is very common and affects almost everyone at some point. It is one of the most common disorders that leads patients to see their physician. All different forms have the nociception via trigeminal nerve fibers in common. Beside the clinical course headaches are classified as either primary or secondary, with the latter having an identifiable structural or biochemical cause. Imaging has a low diagnostic yield in primary headache but play an important role in the differential diagnosis of secondary forms. An overview of different forms of secondary headache is given, outlining diagnostic procedures and the morphologic imaging features of each syndrome.

  12. Considering symptomatic spinal epidural lipomatosis in the differential diagnosis.

    Science.gov (United States)

    Alvarez, Adriana; Induru, Raghava; Lagman, Ruth

    2013-09-01

    Spinal epidural lipomatosis (SEL) is the abnormal accumulation of normal fat within the spinal canal. It is more frequent in those patients receiving chronic glucocorticoid therapy or in cases of endogenous hypercortisolism states. We report a case of SEL in a patient with metastatic prostate cancer with history of steroid treatment as part of his chemotherapy regimen, presenting with clinical manifestations of partial cord compression. Magnetic resonance imaging images of the lumbar spine revealed the presence of epidural tumor suspicious for metastatic disease. Operative findings were consistent with epidural lipomatosis. Spinal epidural lipomatosis is a rare condition that needs to be included in the differential diagnosis of patients with risk factors, presenting with symptomatic cord compression.

  13. Cutaneous syncytial myoepithelioma:: Clinico-pathological features and differential diagnosis.

    Science.gov (United States)

    Pizzi, Marco; Facchin, Federico; Kohlscheen, Eva; Sartore, Leonardo; Salmaso, Roberto; Bassetto, Franco

    2016-10-01

    Cutaneous syncytial myoepithelioma (CSM) is a very rare tumor belonging to the spectrum of skin myoepithelial lesions. CSM usually affects the upper extremities of young to middle aged patients and is characterized by peculiar morphological and immunohistochemical features. Unlike classic myoepithelioma, CSM is composed by a densely packed proliferation of spindled to histiocytoid cells, which are variably positive for EMA, S100, SMA, and frequently negative for cytokeratins and GFAP. The peculiar histopathology and the extreme rarity of such lesion (less than 40 cases reported in the literature) can make the diagnosis of CSM a true challenge. In the present case, we report the clinico-pathological features of a primary CSM occurring in a 38 year-old Caucasian man. The differential diagnoses of such lesion are also briefly discussed.

  14. Multimodal imaging in the differential diagnosis of soft tissue calcinosis

    Directory of Open Access Journals (Sweden)

    G. Garlaschi

    2011-11-01

    Full Text Available Soft tissue calcinosis is a common radiographic finding, which may be related to different types of pathological processes. Multimodality imaging, combined with analysis of clinical and laboratory data, plays an important role for the differential diagnosis of these conditions. Conventional radiography is considered the first line approach to soft tissue calcinosis; CT and MRI may provide further information to better characterize calcified deposits. Imaging may help to distinguish metabolic calcification, such as primary tumoral calcinosis and the secondary one (associated with acquired disorders of calcium or phosphate regulation, from dystrophic calcification, which is associated to normal blood values of phosphate. The sedimentation sign typical of tumoral calcinosis has been demonstrated by plain film radiography, CT, MRI, and, more recently, by ultrasonography. Other types of soft tissue calcinosis may have a degenerative, metaplastic or neoplastic origin, and their characterization strongly relies on multimodality imaging.

  15. Differential diagnosis and management of liver tumors in infants

    Institute of Scientific and Technical Information of China (English)

    Israel; Fernez-Pineda; Rosa; Cabello-Laureano

    2014-01-01

    During the first year of life, most of the liver neoplasms are benign in origin, but some of these histologically benign lesions may be challenging in their management. Although most hepatic hemangiomas can be safely observed until involution is documented, some patients will need treatment due to progressive hepatomegaly, hypothyroidism and/or cardiac failure. Large mesenchymal hamartomas may require extensive hepatic resection and an appropriate surgical plan is critical to obtain good results. For malignant neoplasms such as hepatoblastoma, complete surgical resection is the mainstay of curative therapy. The decision about whether to perform an upfront or delayed resection of a primary liver malignant tumor is based on many considerations, including the ease of resection, surgical expertise, tumor histology and stage, and the likely chemosensitivity of the tumor. This article reviews the initial management of the more common hepatic tumors of infancy, focusing on the differential diagnosis and treatment options.

  16. Hidradenitis suppurativa and perianal Crohn disease: differential diagnosis.

    Science.gov (United States)

    Bassas-Vila, J; González Lama, Y

    2016-09-01

    The first description of perianal fistulas and complications in Crohn disease was made 75 years ago by Penner and Crohn. Published studies have subsequently confirmed that perianal fistulas are the most common manifestations of fistulising Crohn disease. Hidradenitis suppurativa was described in 1854 by a French surgeon, Aristide Verneuil. It is a chronic, inflammatory, recurrent and debilitating disease of the pilosebaceous follicle, that usually manifests after puberty with deep, painful and inflamed lesions in the areas of the body with apocrine glands, usually the axillary, inguinal and anogenital regions. The differential diagnosis between hidradenitis suppurativa and Crohn disease can be challenging, especially when the disease is primarily perianal. When they occur simultaneously, hidradenitis suppurativa and Crohn disease show severe phenotypes and patients can respond to anti-tumour necrosis factor therapy, although adalimumab is currently the only treatment with demonstrated efficacy in hidradenitis suppurativa and Crohn disease. In addition, there is sometimes a need for different complementary surgical procedures.

  17. Imaging of the dopaminergic system in differential diagnosis of dementia

    Energy Technology Data Exchange (ETDEWEB)

    Tatsch, Klaus [University of Munich Hospital - Campus Grosshadern, Department of Nuclear Medicine, Munich (Germany)

    2008-03-15

    Neurodegenerative dementia is an increasingly common disorder with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) accounting for most cases. Due to the overlap in clinical symptoms, their differential diagnosis may be challenging. As clinical classification is not completely satisfying, there is a need to improve the diagnostic accuracy by complementary methods such as functional single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging. The latter may be helpful to address one distinct biological difference between DLB and AD, the severe nigrostriatal degeneration which occurs in DLB, but not to any significant extent in AD. Based on this principle, autoradiographic studies targeting presynaptic dopaminergic functions have consistently demonstrated the ability to distinguish DLB from AD in postmortem series. At the same time, several single-site and one multicentre study have independently confirmed - no matter what technique was used (SPECT or PET) and which presynaptic function was addressed (dopamine turnover, dopamine transporter, vesicular monoamine transporter) - significantly compromised scan results in DLB subjects, whereas AD patients maintained almost normal findings. Even more important, in vivo findings of presynaptic dopaminergic imaging correlated well with neuropathological findings at autopsy, suggesting a remarkable sensitivity of 88% and a specificity of 100% for the imaging procedure to distinguish between DLB and AD. Taken together, imaging of presynaptic dopaminergic terminal functions with SPECT and PET has currently the greatest evidence base to support its use, and therefore, may be highly recommended to help in the discrimination between DLB and AD. Compared to presynaptic functions, corresponding data targeting postsynaptic dopamine receptors are comparatively rare, less conclusive and suggest a very limited role for this purpose. This review discusses the findings of studies

  18. Ewing sarcoma versus osteomyelitis: differential diagnosis with magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Henninger, B.; Glodny, B.; Rudisch, A.; Trieb, T.; Loizides, A.; Judmaier, W.; Schocke, M.F. [Innsbruck Medical University, Department of Radiology, Innsbruck (Austria); Putzer, D. [Innsbruck Medical University, Department of Nuclear Medicine, Innsbruck (Austria)

    2013-08-15

    To find and evaluate characteristic magnetic resonance imaging (MRI) patterns for the differentiation between Ewing sarcoma and osteomyelitis. We identified 28 consecutive patients referred to our department for MRI (1.5 T) of an unclear bone lesion with clinical symptoms suggestive of Ewing sarcoma or osteomyelitis. MRI scans were re-evaluated by two experienced radiologists, typical MR imaging features were documented and a diagnostic decision between Ewing sarcoma and osteomyelitis was made. Statistical significance of the association between MRI features and the biopsy-based diagnosis was assessed using Fisher's exact test. The most clear-cut pattern for determining the correct diagnosis was the presence of a sharp and defined margin of the bone lesion, which was found in all patients with Ewing sarcoma, but in none of the patients with osteomyelitis (P < 0.0001). Contrast enhancing soft tissue was present in all cases with Ewing sarcoma and absent in 4 patients with osteomyelitis (P = 0.0103). Cortical destruction was found in all patients with Ewing sarcoma, 4 patients with osteomyelitis did not present any cortical reaction (P = 0.0103). Cystic or necrotic areas were identified in 13 patients with Ewing sarcoma and in 1 patient with osteomyelitis (P = 0.004). Interobserver reliability was very good (kappa = 1) in Ewing sarcoma and moderate (kappa = 0.6) in patients with osteomyelitis. A sharp and defined margin, optimally visualized on T1-weighted images in comparison to short tau inversion recovery (STIR) images, is the most significant feature of Ewing sarcoma in differentiating from osteomyelitis. (orig.)

  19. [Adult ADHD versus borderline personality disorder: criteria for differential diagnosis].

    Science.gov (United States)

    Witt, O; Brücher, K; Biegel, G; Petermann, F; Schmidt, S

    2014-06-01

    The present study focuses on selected symptom criteria to distinguish between attention deficit/hyperactivity disorder (ADHD) in adults and borderline personality disorder (BPD). A sample of n = 158 subjects was examined, consisting of BPD patients (n = 37), ADHD patients (n = 58), comorbid BPD/ADHD patients (n = 19), a clinical group of patients fulfilling the diagnostic criteria of a depressive disorder (DEP; n = 22) and a non-clinical control group (KG; n = 22). Selected symptom criteria were investigated by using the German scales "Skala zur Erfassung der Impulsivität und emotionalen Dysregulation der Borderline-Persönlichkeitsstörung" (IES-27), "ADHS-Screening für Erwachsene" (ADHS-LE), "Fragebogen zu dissoziativen Symptomen" (FDS) and a scale for the assessment of paranoid and dichotomous thinking (PADI). Multivariate analyses of variance revealed that BPD patients differed significantly with respect to self-mutilating behaviour, suicidality, dissociation, paranoia and dichotomy from all other groups. The same effect was found for affect regulation. Furthermore BPD patients differed significantly from ADHD patients by a more severe impulsiveness (IES-27), but not through disturbed impulse control and disinhibition overall. Regarding mean differences between ADHD and BPD patients for attentional control, ADHD patients revealed higher scores which just missed significance. For hyperactivity no significant group differences were found which is assumed to be influenced by symptom overlap like restlessness and aversive tension. The findings suggest that BPD-specific criteria, a stronger affective dysregulation and a higher tendency for autoaggressive impulsive reactions are more selective for differential diagnosis than the core symptoms of adult ADHD. Only attentional control might be a useful criterion for differential diagnosis, which should be examined in future studies.

  20. Differential diagnosis problem of pulmonary changes in ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Đurić Mirna

    2010-01-01

    Full Text Available Introduction. Inflammatory intestinal diseases are often accompanied with extraintestinal and even pulmonary manifestations. The treatment of these intestinal diseases includes sulphasalazine and mesalazine, which may have undesirable allergic and other side effects, including hypersensitive pneumonitis. Case report. Having performed colonoscopy due to abdominal pains and mushy stools, the diagnosis of ulcerous colitis was established in a 20-year old female patient and the treatment with mesalazine initiated. However, the patient developed slimy and bloody stools, slightly increased body temperature, dry cough and bilateral lung lesions. The bronchological exploration established interstitial and organizing pneumonia. Despite the treatment with antibiotics, corticosteroids and mesalazine, dry cough, fever and bloody stools persisted, accompanied with bilateral inhomogeneous lesions of the pulmonary parenchyma. Upon discontinuation of the treatment with mesalazine, clinical symptoms and pulmonary lesions disappeared. Conclusion. The differential diagnosis of pulmonary lesions in patients with ulcerous colitis may be a problem. In the reported case, pulmonary lesions were interpreted as interstitial pneumonitis accompanying ulcerous colitis. However, they are most probably a consequence of allergic response to mesalazine.

  1. CT findings and differential diagnosis of cystic neck masses

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    Lee, Ji Yeon; Lee, Kil Jun; Jeong, Seong Ki; Han, Seong Nim; Tae, Seok; Shin, Kyoung Ja; Lee, Sang Chun [Seoul Red Cross Hospital, Seoul (Korea, Republic of)

    1995-10-15

    The purpose of this study is to analyze the CT features of the cystic masses in the neck and to review differential diagnosis. We retrospectively reviewed and analyzed the CT findings of 22 histopathologically proved, cystic neck masses in regard to the location in fascial plane and relationship with adjacent organ. Of 22 cases, ten congenital cysts two ranulas, seven inflammatory lesions, and three solid tumors were included. Ten congenital cystic masses were located in typical locations as branchial cleft cyst (5) in mandibular angle, thyroglossal duct cyst (3) in visceral space embeded within the strap muscles, cystic hygroma (1) and cavernous hemangioma (1) in posterior cervical space with insinuating appearance. Two cases of ranula included one simple ranula localized in sublingual space and a plunging ranula extending to adjacent submandibular space. Seven cases of inflammatory lesions were characterized by multispatial locations and good contrast-enhancement of walls and adjacent tissue. Solid masses of low density mimicking cyst were two pleomorphic adenomas of submandibular gland and one neurilemmoma. It is considered that thorough analysis of the CT findings with attention to typical location, CT appearance, and the relationship with the adjacent structures usually leads to the correct diagnosis.

  2. Differential diagnosis of breast lesions using ultrasound elastography

    Directory of Open Access Journals (Sweden)

    Ioana Andreea Gheonea

    2011-01-01

    Full Text Available Context: The recent introduction of elastography has increased the specificity of USG and enabled early diagnosis of breast cancer. Quantitative elastography, especially with strain ratio (SR index, improves diagnostic accuracy and decreased number of biopsies. Aims: The purpose of this study was to assess the role of USG elastography in the differential diagnosis of breast lesions. Settings and Design: This prospective study was conducted in the University of Medicine and Pharmacy Research Centre of Craiova. Materials and Methods: Fifty-eight patients diagnosed with breast lesions between January 2009 and January 2010 were included in this prospective study. All the patients were examined in the supine position, and the B-mode USG image was displayed alongside the elastography strain image. For obtaining the elastography images we used a EUS Hitachi EUB 8500 ultrasound system with a 6.5-MHz linear probe. The elastography strain images were scored according to the Tsukuba elasticity score. Statistical Analysis: We performed receiver operator characteristic (ROC analysis for assessment of the role of USG elastography in the diagnosis of breast lesions. Results: We obtained a sensitivity of 86.7% and a specificity of 92.9% for elasticity score and a sensitivity of 93.3% and a specificity of 92.9% for SR (when a cutoff point of 3.67 was used. There was very good correlation between SR and elasticity score (Spearman coefficient of 0.911. Conclusions: Elastography is a fast, simple method that can complement conventional USG examination. This method has the lowest cost/efficiency ratio and it is also the most noninvasive and accessible imaging method, with an accuracy comparable to MRI.

  3. Differential diagnosis of rheumatic diseases; Differenzialdiagnose rheumatischer Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Lingg, G.; Schorn, C. [Sana-Rheumazentrum, Zentrales Roentgeninstitut, Bad Kreuznach (Germany)

    2006-05-15

    Which imaging modalities are appropriate for the Differential diagnosis of Rheumatic diseases. MRI has far most the highest sensitivity and is unequaled in its brilliant presentation of Anatomy and Pathology. But it is sometimes forgotten, that this is at least in part the result of carefully selected sequences, dedicated to the expected result. In a method totally independent of any result, this should not be the case. In contrary this method should be highly standardised and regardless what will be the findings. This is true for Plain X-ray. It will be shown, that already the outer silhouette of the soft parts with different features of swelling, and differences in density and even more - defects or appositions of the bony silhouette in the majority of cases at least will allow to classify the patient for a group of diseases and in many cases will lead to a definite diagnosis. Differential diagnoses like Rheumatoid Arthritis versus Psoriatic Arthritis or simply but not always simple - inflammatory Arthritis versus degenerative disease - are allowed to be answered definitely, not always so in MRI. The condition of the subchondral bone can give hints, how advanced and how active the disease is at present. Plain X-ray offers high specifity in the differential diagnoses of Rheumatic diseases, it is well standardised and it is a device, to use independent from any suspected findings. So it is the method of choice for questions of differential diagnosis. This is even more true, thinking of the possibility, to investigate all clinically involved regions with not to much extended efforts, whereas MRI and CT are used normally for only one region. (orig.) [German] Mit welcher oder welchen bildgebenden Methoden und in welchem Stadium lassen sich rheumatische Erkrankungen bildgebend voneinander unterscheiden. Die MRT ist in ihrer sehr hohen Sensitivitaet sowie in ihrer brillanten morphologischen Darstellung von Anatomie und Pathologie unerreicht. Diese erreicht sie

  4. Prenatal Diagnosis of Cloacal Exstrophy: A Case Report and Differential Diagnosis with a Simple Omphalocele

    Directory of Open Access Journals (Sweden)

    Ching-Yu Chou

    2015-03-01

    Full Text Available Cloacal exstrophy is a rare congenital disorder that may lead to mortality and morbidity. Although the prenatal diagnosis of cloacal exstrophy can be made by a midtrimester ultrasound, it is difficult to differentiate it from a simple omphalocele that can be corrected completely by surgery without morbidity. We reported a case with cloacal exstrophy and reviewed previous literature on differentiating it from an omphalocele. A 33-year-old, pregnant female visited our outpatient center for prenatal care at the 22nd gestational week. The midtrimester ultrasound showed fetal anomalies including a protruding mass from umbilicus, absence of bladder, ambiguous genitalia, and bilateral renal hydronephrosis. The parents received prenatal genetic counseling and decided to continue the pregnancy. A female baby was delivered at the 37th gestational week via vaginal delivery, and cloacal exstrophy without omphalocele was diagnosed. Cloacal exstrophy is a complicated congenital disorder that should be differentiated from a simple omphalocele. Prenatal counseling and postnatal care in a tertiary medical center are important for parents and the fetus, respectively.

  5. Chronic Lyme Disease and Co-infections: Differential Diagnosis.

    Science.gov (United States)

    Berghoff, Walter

    2012-01-01

    In Lyme disease concurrent infections frequently occur. The clinical and pathological impact of co-infections was first recognized in the 1990th, i.e. approximately ten years after the discovery of Lyme disease. Their pathological synergism can exacerbate Lyme disease or induce similar disease manifestations. Co-infecting agents can be transmitted together with Borrelia burgdorferi by tick bite resulting in multiple infections but a fraction of co-infections occur independently of tick bite. Clinically relevant co-infections are caused by Bartonella species, Yersinia enterocolitica, Chlamydophila pneumoniae, Chlamydia trachomatis, and Mycoplasma pneumoniae. In contrast to the USA, human granulocytic anaplasmosis (HGA) and babesiosis are not of major importance in Europe. Infections caused by these pathogens in patients not infected by Borrelia burgdorferi can result in clinical symptoms similar to those occurring in Lyme disease. This applies particularly to infections caused by Bartonella henselae, Yersinia enterocolitica, and Mycoplasma pneumoniae. Chlamydia trachomatis primarily causes polyarthritis. Chlamydophila pneumoniae not only causes arthritis but also affects the nervous system and the heart, which renders the differential diagnosis difficult. The diagnosis is even more complex when co-infections occur in association with Lyme disease. Treatment recommendations are based on individual expert opinions. In antibiotic therapy, the use of third generation cephalosporins should only be considered in cases of Lyme disease. The same applies to carbapenems, which however are used occasionally in infections caused by Yersinia enterocolitica. For the remaining infections predominantly tetracyclines and macrolides are used. Quinolones are for alternative treatment, particularly gemifloxacin. For Bartonella henselae, Chlamydia trachomatis, and Chlamydophila pneumoniae the combination with rifampicin is recommended. Erythromycin is the drug of choice for

  6. Elastofibroma dorsi – differential diagnosis in chest wall tumours

    Directory of Open Access Journals (Sweden)

    Steinau Hans-Ulrich

    2007-02-01

    Full Text Available Abstract Background Elastofibromas are benign soft tissue tumours mostly of the infrascapular region between the thoracic wall, the serratus anterior and the latissimus dorsi muscle with a prevalence of up to 24% in the elderly. The pathogenesis of the lesion is still unclear, but repetitive microtrauma by friction between the scapula and the thoracic wall may cause the reactive hyperproliferation of fibroelastic tissue. Methods We present a series of seven cases with elastofibroma dorsi with reference to clinical findings, further clinical course and functional results after resection, as well as recurrence. Data were obtained retrospectively by clinical examination, phone calls to the patients' general practitioners and charts review. Follow-up time ranged from four months to nine years and averaged 53 months. Results The patients presented with swelling of the infrascapular region or snapping scapula. In three cases, the lesion was painful. The ratio men/women was 2/5 with a mean age of 64 years. The tumor sizes ranged from 3 to 13 cm. The typical macroscopic aspect was characterized as poorly defined fibroelastic soft tissue lesion with a white and yellow cut surface caused by intermingled remnants of fatty tissue. Microscopically, the lesions consisted of broad collagenous strands and densely packed enlarged and fragmented elastic fibres with mostly round shapes. In all patients but one, postoperative seroma (which had to be punctuated occurred after resection; however, at follow-up time, no patient reported any decrease of function or sensation at the shoulder or the arm of the operated side. None of the patients experienced a relapse. Conclusion In differential diagnosis of soft tissue tumors located at this specific site, elastofibroma should be considered as likely diagnosis. Due to its benign behaviour, the tumor should be resected only in symptomatic patients.

  7. Barrio Boy.

    Science.gov (United States)

    Galarza, Ernesto

    An autobiography, "Barrio Boy" is the story of Little Ernie, a boy born in the tiny mountain village of Jalcocotan in the State of Nayarit, Mexico. Divided into 5 parts, the book offers vivid descriptions of the author's early life--his family, his friends, his surroundings, as well as events in the journey from Jalcocotan that eventually ended in…

  8. Mucins in the diagnosis and differential diagnosis of pancreatic cystic neoplasms: report of 40 cases

    Institute of Scientific and Technical Information of China (English)

    JI Yuan; TAN Yun-shan; XU Jian-fang; QI Wei-dong; LI Xiao-ping; SU-JIE Ake-su; ZHU Xiong-zeng

    2006-01-01

    @@ Cystic neoplasms of the pancreas account for 10% to 15% of all cystic pancreatic lesions.The majority (85% to 90%) of cystic lesions of the pancreas are pseudocysts. Although cystic neoplasms of the pancreas are rare, they range from benign to malignant neoplasms. The clinical challenge is the differential diagnosis and management of the cystic neoplasms, which represent 10% to 25% of primary pancreatic neoplasms. Pancreatic neoplasms and tumour like lesions with cystic features have been recently reviewed. The incidence of pancreatic cystic neoplasms reported is variable. Because there is no large, systematic study on tne cases from China comparing the incidence and biology of cystic neoplasms of pancreas to that of Western series, we reviewed all the cases of cystic neoplasms from Zhongshan Hospital over 6 years. Most of the neoplasms in our series were classified according to the recent World Health Organization (WHO)classification.1,2

  9. The Differential Diagnosis of Two Cases of Chronic Periaortitis

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    Takao Kato

    2013-01-01

    Full Text Available The imaging features of chronic periaortitis resemble those of infected aneurysms. Two illustrative cases of chronic periaortitis, in which the etiologies were caused by IgG4-related disease, are presented. The first case involved a 68-year-old man who presented with vague discomfort in his lower abdomen. The second case was a 42-year-old man who presented with a fever of 38°C and persistent, vague chest discomfort. Both cases demonstrated an increased amount of connective tissue around the aorta in computed tomography images and low intensity in the T2-weighed sequence and high intensity in the diffusion-weighed sequence, suggesting the presence of inflammation, in the magnetic resonance imaging. Negative blood cultures, elevated IgG4 levels, and pathological findings confirmed the diagnosis as chronic periaortitis due to IgG4-related disease. This is a newly recognized syndrome of unknown etiology, characterized by a fibroinflammatory condition, tumefactive lesions, and a dense lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells. Both cases were successfully treated with corticosteroids. Infected aneurysms need to be carefully differentiated from this syndrome in view of the similar imaging features.

  10. Prevalence, distribution, and differential diagnosis of nasopalatine duct cysts

    Science.gov (United States)

    CECCHETTI, F.; OTTRIA, L.; BARTULI, F.; BRAMANTI, N. E.; ARCURI, C.

    2012-01-01

    SUMMARY Introduction. Nasopalatine duct cysts (NPDCs) are the most common developmental epithelial non-odontogenic cysts of the maxillae. Their origin, however, is still a source of considerable debate. Aims. The aim of this investigation is to describe and discuss the etiology, differential diagnosis, clinic-pathological characteristics as well as to report the relative frequency and distribution of nasopalatine duct cysts in population (NPDCs) with a literature’s review on the topic. Methods The retrospective study was carried out using 36 clinical cases, with histopatological confirmation for NPDC, radiographs and oral photographs. Data included age and gender of the patient, radiographic findings, etiological factors, treatment, and prognosis of NPDC. Few surgical consideration are discussed. Results The study results report a clear male predilection with a 3:1 ratio. No statistically significant correlation was observed between the size of the lesion and patient’s gender. Lesions were usually asymptomatic. All cysts were located in the anterior maxillary midline region. Panoramic X-rays and computed tomography was used to identify the lesion. Surgical treatment was performed under local anesthesia including the dissection and removal of the cyst, adopting a usually palatine approach, with an enveloping flap from 1.4 to 2.4. Conclusions The etiology of NPDC is unclear and a male predilection was observed. Simple surgical resection is recommended, followed by clinical and radiological control to ensure correct resolution of the case. PMID:23285406

  11. Differential Diagnosis of Cardiac Malposition by Fetal Echocardiography

    Institute of Scientific and Technical Information of China (English)

    Ying WU; Feng TAO; Tao LIU; Ling ZANG; Shi-long LIU

    2009-01-01

    Objectives To explore the method and operating skill of fetal echocardiography in diagnosing cardiac malposition. Methods 91 consecutive fetuses were studied (control: 50 cases, cardiac malposition : 41 cases) between 2003 and 2008. The position of fetal heart was evaluated according to the fetal posture and the visceral situs by fetal routine scan-ning. The detailed echocardiography should be performed in the differential diagnosis of cardiac lesions when the heart was found to be abnormal position. Results In the control group, all fetuses were levocardia. 39 cases of cardiac mal-positions were detected by fetal echocardiography, included 25 fetuses with dextrocardia, 6 mesocard, 5 with levover-sion of heart, 3 common heart of conjoined twins and 2 extrathorax heart. Two of dextroversion were missed by fetal routine scanning, but found by autopsy or operation after birth. Conclusions When the abnormal visceral situs was found by fetal routine scanning, there is exceedingly high incidence of cardiac malpositions. Proficiently operating skill of fetal echocardiography is helpful to detect abnormal fetal cardiac position.

  12. The classification and differential diagnosis of orofacial pain.

    Science.gov (United States)

    Renton, Tara; Durham, Justin; Aggarwal, Vishal R

    2012-05-01

    There are currently four main pain classification systems relevant to orofacial pain (OFP): the International Association for the Study of Pain, International Classification of Headache Disorders, the American Academy of Orofacial Pain and the Research Diagnostic Criteria for Temporomandibular Disorders. Of the four, the Research Diagnostic Criteria for Temporomandibular Disorders is the most biopsychosocial system, with the remaining three focusing more on the biomedical aspects. Unsurprisingly, clinical scientists and clinicians have both reported perceived deficiencies in the published systems and have proposed further modified classifications and nomenclature for OFP. Establishing a standardized biopsychosocial classification of OFP is essential for ensuring continuity for patient care since it creates a standardized language with which to communicate healthcare information, thus enabling improved and more specific (epidemiological) research and patient care. Despite ongoing attempts, an accepted overarching classification of OFP is still a work in progress. There is an urgent need for a robust classification system for OFP. This review aims to highlight the recent debate and continued struggle to attain a consensus on a classification of OFP and highlight some recent developments that assist differential diagnosis of these conditions.

  13. Differential Diagnosis for Multiple Sclerosis-related Optic Neuritis

    Institute of Scientific and Technical Information of China (English)

    Yan Zhang; Xiaolei Liang; Shihui Wei; Hongyang Li

    2015-01-01

    Purpose:.To analyze clinical features and main causes of multiple sclerosis-related optic neuritis (MS-ON), providing evidence for the differential diagnosis of MS-ON. Methods: Clinical data were collected from 527 patients, 123 males and 404 females, diagnosed with MS-ON between June 2008 and June 2013. Visual acuity, optometry, visual field, slit-lamp microscopy, indirect ophthalmoscopy (20D), opti-cal coherence tomography (OCT) and magnetic resonance imaging (MRI) were performed. Venous blood was sampled for detection of autoimmune antibodies and Aquaporin (AQP-4). Results:.Fifty nine cases were diagnosed with neuromyelitis optica-related optic neuritis. (NMO-ON),.27 Sjogren's syn-drome-related optic neuropathy,.22 tumors,.21 anterior is-chemic optic neuropathy, 15 radiation-induced optic neuropa-thy, 14 optic neuropathy-related infection, 17 genetic eye dis-eases and 10 open angle glaucoma. Among168 MS-ON pa-tients undergoing optic nerve MRI,90 cases (53.57%) had a lesion 30 mm in two (1.19%). Conclusion:.MS-ON is more commonly misdiagnosed with NMO-ON and Sjogren's syndrome, when compared to optic neuropathy, tumors and ischemic optic neuropathy.

  14. Differential diagnosis of hyperkalemia: an update to a complex problem

    Science.gov (United States)

    Eleftheriadis, T; Leivaditis, K; Antoniadi, G; Liakopoulos, V

    2012-01-01

    Hyperkalemia is a relative common and sometimes life threatening electorlyte disorder. Although its symptomatic treatment is relatively easy, since precise therapeutic algorithms are available, its differential diagnosis is more complicated. The present review aims to unfold the differential diagnosis of hypekalemia using a pathophysiological, albeit clinically useful, approach. The basic elements of potassium homeostasis are provided, the causes of hyperkalemia are categorized and analysed and finally the required for the diferrential diagnosis laboratory tests are mentioned. PMID:23935306

  15. Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years after Initial Diagnosis

    Science.gov (United States)

    Gillberg, I. Carina; Helles, Adam; Billstedt, Eva; Gillberg, Christopher

    2016-01-01

    We examined comorbid psychiatric and neurodevelopmental disorders in fifty adult males (mean age 30 years) with Asperger syndrome (AS) diagnosed in childhood and followed up prospectively for almost two decades (13-26 years). Only three of the 50 men had "never" met criteria for an additional psychiatric/neurodevelopmental diagnosis and…

  16. [Differential diagnosis of pulmonary tuberculosis and community-acquired pneumonia].

    Science.gov (United States)

    Deĭkina, O N; Mishin, V Iu; Demikhova, O V

    2007-01-01

    The purpose of this investigation was to enhance the efficiency of differential diagnosis of pneumonia and pulmonary tuberculosis. A hundred and fifty-nine adult patients were examined. These included 78 patients with pulmonary tuberculosis and 81 with community-acquired p neumonia. The clinical features of infiltrative pulmonary tuberculosis (n = 48) and mild community-acquired pneumonia (n = 51) were compared. The course of caseous pneumonia (n = 30) was compared with that of moderate and severe community-acquired pneumonia (n = 30). Significant differences in the manifestations of the intoxication and bronchopulmonary syndrome were not found in patients with community-acquired pneumonia and infiltrative pulmonary tuberculosis. Physical studies showed that in patients with community-acquired pneumonia, moist rale (54.9%) and crepitation (11.8%) were prevalent, but in those with infiltrative tuberculosis rale was absent in 60.4% of cases and the pattern of respiration was unchanged in 79.2%. Chest X-ray studies indicated that in patients with community-acquired pneumonia, lower lobar inflammatory changes were predominant in 62.8% of cases whereas in those with infiltrative pulmonary tuberculosis the process was mainly bilateral (43.8%) with the presence of destructive changes (83.3%) and bronchogenic dissemination (66.7%). In patients with caseous pneumonia, the intoxication syndrome was more significant than in those with severe community-acquired pneumonia. Chest X-ray studies demonstrated that in patients with caseous pneumonia, specific changes were bilateral with the involvement of 2 lobes or more, with destruction and bronchogenic dissemination while in those with community-acquired pneumonia, the pulmonary processes were predominantly bilateral (76.6%) at the lower lobar site (36.7%).

  17. Differential diagnosis of myelodysplastic syndrome and aplastic anemia using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Seung Eun; Park, Jung Mi; Lee, Jae Mun; Kim, Ki Tae; Kim, Dong Wook; Kim, Chun Choo; Kim, Chun Yul; Shinn, Kyung Sub [Catholic University Medical College, Seoul (Korea, Republic of)

    1995-04-15

    To assess the patterns of myelodysplastic syndrome (MDS) and aplastic anemia (AA) on MRI of the spinal bone marrow and to find the differential points between the two groups. Fourteen patients with MDS (n=7) and AA (n=7) were studied using magnetic resonance imaging. Sagittal images from the lower thoracic and lumbar vertebral marrow were evaluated on T1-weighted and STIR images. Five distinct patterns of signal intensity of the T1-weighted and STIR images were classified. T1 and T2 relaxation times and T1 marrow/fat signal intensity ratio were measured and analyzed (t-test). The cellularity of bone marrow was evaluated on histologic slides. MDS showed homogeneously low signal intensity on T1WI and high signal intensity on STIR image, indicating hypercellular marrow, whereas AA showed relative high signal intensity on T1WI and low signal intensity on STIR image, representing fatty marrow. T1 and T2 relaxation time (T1 for MDS=750.26 msec {+-} 177.50, T1 for AA=413.21 msec {+-} 167.39 ({rho} < 0.000), T2 for MDS=91.86 msec {+-} 14.16, T2 for AA=81.44 msec {+-} 15.31 ({rho} < 0.001) and T1 marrow/fat signal intensity ratio (0.22 {+-} 0.048 in MDS, 0.30 {+-} 0.083 in AA ({rho} < 0.000) revealed statistically significant difference between the two groups. Although the marrow aspiration and needle biopsy are mandatory in hematologic disease for diagnosis, there are limited in assessing the change of total marrow mass. Therefore MRI of bone marrow might be useful in distinguishing MDS from AA because of its ability of representation of total marrow mass.

  18. Equilibrium disorders in elderly: diagnostic classification and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Alessandro Castiglione

    2013-04-01

    Full Text Available Background: Balance is primarily related to the proper functioning of three sensory input: vestibular, visual and proprioceptive. The integration of these different afferences contributes to the proper attitude of the body in static and dynamic conditions. Equilibrium disorders are common among elderly patients and are responsible for falls and fractures, leading sometimes to catastrophic outcomes, representing a serious health and social problem. Approximately one third of elderly patients at home and about 50% of institutionalized, over 75 year-old, suffer from this particular condition, with at least one fall a year and almost 50% of these with recurrent episodes. Females are more affected than males. Attempts to ascertain the underlying cause of unbalance should be done, leading then to specific treatment. Nevertheless, many elderly patients do not have a single disease but rather a multitude of medical conditions which may cause dizziness, imbalance and vertigo: effects of ageing, drugs, cardiovascular and neurological disorders, ocular and orthopaedic diseases. Aim of the study: A literature review was carried out with the intention to offer practical and useful notions for the management and treatment of equilibrium disorders. Discussion: In clinical practice, the main challenge is to distinguish between peripheral and central imbalance disorders. The data collected from history and clinical exams should be integrated with the intent to include the patient in one of the following clinical conditions: vertiginous syndrome, pre-syncope and/or syncope, neurological diseases, other conditions.Conclusions: Following the differential diagnosis, treatment mainly consists in drug administration (antiemetic and vestibular suppressor drugs and vestibular rehabilitation (physiotherapy and vestibular exercises.

  19. Differential diagnosis of neurodegenerative diseases using structural MRI data.

    Science.gov (United States)

    Koikkalainen, Juha; Rhodius-Meester, Hanneke; Tolonen, Antti; Barkhof, Frederik; Tijms, Betty; Lemstra, Afina W; Tong, Tong; Guerrero, Ricardo; Schuh, Andreas; Ledig, Christian; Rueckert, Daniel; Soininen, Hilkka; Remes, Anne M; Waldemar, Gunhild; Hasselbalch, Steen; Mecocci, Patrizia; van der Flier, Wiesje; Lötjönen, Jyrki

    2016-01-01

    Different neurodegenerative diseases can cause memory disorders and other cognitive impairments. The early detection and the stratification of patients according to the underlying disease are essential for an efficient approach to this healthcare challenge. This emphasizes the importance of differential diagnostics. Most studies compare patients and controls, or Alzheimer's disease with one other type of dementia. Such a bilateral comparison does not resemble clinical practice, where a clinician is faced with a number of different possible types of dementia. Here we studied which features in structural magnetic resonance imaging (MRI) scans could best distinguish four types of dementia, Alzheimer's disease, frontotemporal dementia, vascular dementia, and dementia with Lewy bodies, and control subjects. We extracted an extensive set of features quantifying volumetric and morphometric characteristics from T1 images, and vascular characteristics from FLAIR images. Classification was performed using a multi-class classifier based on Disease State Index methodology. The classifier provided continuous probability indices for each disease to support clinical decision making. A dataset of 504 individuals was used for evaluation. The cross-validated classification accuracy was 70.6% and balanced accuracy was 69.1% for the five disease groups using only automatically determined MRI features. Vascular dementia patients could be detected with high sensitivity (96%) using features from FLAIR images. Controls (sensitivity 82%) and Alzheimer's disease patients (sensitivity 74%) could be accurately classified using T1-based features, whereas the most difficult group was the dementia with Lewy bodies (sensitivity 32%). These results were notable better than the classification accuracies obtained with visual MRI ratings (accuracy 44.6%, balanced accuracy 51.6%). Different quantification methods provided complementary information, and consequently, the best results were obtained by

  20. ON DIFFERENTIAL DIAGNOSIS BETWEEN AUTISTIC DISORDER AND ASPERGER’S SYNDROME

    Directory of Open Access Journals (Sweden)

    Stefan Todorov

    2012-11-01

    Full Text Available The differential diagnosis between Autistic disorder (AD and Asperger’s syndrome (AS in most cases is quite difficult since most of the symptoms are clinically undistinguished. Several factors complicate the diagnosis of AS- an autism spectrum disorder (ASD. It is considered by some authors to be simply a milder version of autistic disorder. Problems in diagnosis include disagreement among diagnostic criteria, controversy over the distinction between AS and other ASD forms or even whether AS exists as a separate syndrome, and over- and under-diagnosis. Our paper is based on the diagnostic and differential diagnostic criteria of DSM-IV, ICD-10 and our clinical experience.In the process of diagnosis and differential diagnosis we, naturally, illustrate and discuss the similarities and differences between the two disorders.

  1. The ultrasonographic features of endometriomas: morphologic analysis and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Sung; Park, Chan Sup; Song, Soon Young; Lee, Eun Ja; Park, No Hyuck [College of Medicine, Kwandong Univ., Koyang (Korea, Republic of); Park, Cheol Min [College of Medicine, Korea Univ., Seoul (Korea, Republic of); Kim, Bo Hyun; Kim, Chan Kyo [College of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    2003-12-01

    To analyze the sonographic, morphologic, and internal echo patterns of endometriomas, and thus determine which ultrasonographic (US) findings assist diagnosis. One hundred and forty-seven eases of pathologically proven adnexal masses in 130 women were divided into three groups: group I, in which endometriomas were diagnosed at both preoperative US and surgery (true positive) (n=97); group II, in which endometriomas were misdiagnosed at preoperative US, and were confirmed after surgery to be other pathologic entities (false positive) (n=10); group III, in which other adnexal masses were misdiagnosed at preoperative US, but were proven after surgery to be endometriomas (false negative) (n=40). The US findings in these cases were retrospectively reviewed in terms of (a) morphologic type: unilocular, multiseptated, multilobulated, solid and cystic, or mixed; (b) internal echo pattern: homogeneous fine, anechoic, fine septation, or complex; (c) size; (d) wall thickness; (e) the presence or absence of septation; (f) wall nodularity; (g) echogenic wall foci; and (h) a solid area. In group I, the most common morphological type was unilocular cyst (n=63; 65%). In lesions most commonly emitted homogeneous fine echoes (n=76; 78%). In this group, most masses (86%) were less than 10 cm in diameter and the wall thickness in 65% of cases was less than 3 mm. Additionally, internal septation, wall nodularity, focal echogenic wall foci, and a solid area were observed at US. Group II, cases were pathologically confirmed as mucinous cystadenoma (n=3), mucinous cystadenoma with borderline malignancy, hemorrhagic cyst, functional cyst, endometrioid carcinoma, and hematoma. In group III, cases were misdiagnosed as cystadenoma (n=15), hemorrhagic cyst, teratoma, ovarian cancer, functional cyst and ectopic pregnancy at preoperative US. There were no significant differences in size or wall thickness between groups II and III, and group I. At US, groups II and III also showed internal

  2. Infectious diseases of the brain: imaging and differential diagnosis; Infektioese Hirnerkrankungen: Bildgebung und differenzialdiagnostische Aspekte

    Energy Technology Data Exchange (ETDEWEB)

    Haehnel, S.; Seitz, A. [Abt. Neuroradiologie, Neurologische Klinik, Universitaetsklinikum Heidelberg (Germany); Storch-Hagenlocher, B. [Abt. Neurologie, Neurologische Klinik, Universitaetsklinikum Heidelberg (Germany)

    2006-09-15

    Infectious diseases of the central nervous system have to be considered in differential diagnosis particularly in immunocompromised persons. Neuro-imaging, specifically advanced techniques such as diffusion weighted MRI and perfusion MRI contribute much to the differentiation of brain infections and for differentiating brain infections from other, for instance, neoplastic diseases. In this review we present the imaging criteria of the most important brains infections in adults and in pediatric patients and discuss differential diagnostic aspects in detail. (orig.)

  3. Rabies encephalomyelitis vs. ADEM: Usefulness of MR imaging in differential diagnosis

    Directory of Open Access Journals (Sweden)

    Asokan Santhoshkumar

    2012-01-01

    Full Text Available We report a case of rabies encephalomyelitis in a 12-year-old boy who had received anti-rabies vaccine 6 weeks after being bitten by a puppy. The MR (magnetic resonance imaging helped to differentiate rabies from acute disseminated encephalomyelitis (ADEM. ADEM involves the white matter predominantly, whereas rabies has a predilection for grey matter, that too of midline regions. This report emphasizes the usefulness of MRI in differentiating rabies and ADEM when encephalomyelitis occurs in a vaccinated child.

  4. Differential diagnosis of neurodegenerative diseases using structural MRI data

    Directory of Open Access Journals (Sweden)

    Juha Koikkalainen

    2016-01-01

    The results prove that automatic quantification methods and computerized decision support methods are feasible for clinical practice and provide comprehensive information that may help clinicians in the diagnosis making.

  5. The clinical assessment of intraductal ultrasonography in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis.

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To assess and compare the clinical value of intraductal ultrasonography (IDUS) in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis with conventional imaging methods. Methods: IDUS was carried out in eighteen patients with pancreatic carcinoma and chronic pancreatitis

  6. DIFFERENTIAL DIAGNOSIS OF ROSACEA AND SKIN TUBERCULOSIS AS AN EXAMPLE OF A CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    M. L. Aripova

    2014-01-01

    Full Text Available In this paper for a clinical observation of a patient with rosacea, and patients with a flat form of lupus tuberculosis presented a differential clinical diagnosis of tuberculosis of the skin.

  7. Hemichorea, parkinson's disease or somatoform disorder? A hard differential diagnosis

    Directory of Open Access Journals (Sweden)

    David Gonçalves Nordon

    2010-12-01

    Full Text Available ABSTRACT: The diagnosis of movement disorders can be quite complex, as its causes may be both organic and psychogenic. We present the case of a 62 year old woman, with a 12 year old history of movement disorder, whose treatment has been insufficient and possibly inadequate, and her diagnosis has been doubtful and not yet defined. We discuss our diagnostic methods and empirical treatments, looking for the best for our patient.

  8. Differential diagnosis of hyperkalemia: an update to a complex problem

    OpenAIRE

    2012-01-01

    Hyperkalemia is a relative common and sometimes life threatening electorlyte disorder. Although its symptomatic treatment is relatively easy, since precise therapeutic algorithms are available, its differential diagnosis is more complicated. The present review aims to unfold the differential diagnosis of hypekalemia using a pathophysiological, albeit clinically useful, approach. The basic elements of potassium homeostasis are provided, the causes of hyperkalemia are categorized and analysed a...

  9. [Desmoplastic fibroma. Differential diagnosis of a periapical lesion from endodontic failure].

    Science.gov (United States)

    Zabalegui, B; Gil, J; Zabalegui, I

    1989-01-01

    Treatment of endodontically involved teeth requires accurate diagnosis of the clinical pulpal condition to determine the primary cause of pathosis. The case presented shows the differential diagnosis between a desmoplastic fibroma and a failure of a misdiagnosed endodontic treatment. The initial direction of treatment should had never been the endodontic therapy but local surgical curettage of the lesion.

  10. Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia

    OpenAIRE

    Barcellini, W.; Fattizzo, B.

    2015-01-01

    Several hemolytic markers are available to guide the differential diagnosis and to monitor treatment of hemolytic conditions. They include increased reticulocytes, an indicator of marrow compensatory response, elevated lactate dehydrogenase, a marker of intravascular hemolysis, reduced haptoglobin, and unconjugated hyperbilirubinemia. The direct antiglobulin test is the cornerstone of autoimmune forms, and blood smear examination is fundamental in the diagnosis of congenital membrane defects ...

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

    DEFF Research Database (Denmark)

    Pedersen, Lars; Elers, Jimmi; Backer, Vibeke

    2011-01-01

    Elite athletes have a high prevalence of asthma and exercise-induced bronchoconstriction. Although respiratory symptoms can be suggestive of asthma, the diagnosis of asthma in elite athletes cannot be based solely on the presence or absence of symptoms; diagnosis should be based on objective...... 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...... is essential when treating elite athletes. This article is aimed at physicians who diagnose and treat athletes with respiratory symptoms. It focuses on the pathogenesis of asthma and exercise-induced bronchoconstriction in elite athletes and how the diagnosis can be made. Furthermore, treatment of elite...

  12. [Scintigraphic imaging in the diagnosis of failed intrathecal baclofen therapy: a case report of a 7-year-old boy with ventriculoperitoneal shunt].

    Science.gov (United States)

    Shibata, Akiko; Yamamoto, Mariko; Watanabe, Yu; Terashima, Hiroshi; Kashii, Hirofumi; Kubota, Masaya; Morota, Nobuhito

    2015-09-01

    Intrathecal baclofen (ITB) therapy is popular for the management of intractable spasticity. In 2007, the indications of ITB therapy expanded to include spasticity of children in Japan. In this report, we assessed the utility of radioisotopic scintigraphy in the diagnosis of failed ITB therapy. A 7-year-old boy with schizencephaly, hydrocephalus, and spastic quadriplegia had an ITB pump implanted. In his infancy, he had undergone ventriculoperitoneal shunt implantation. One month after the ITB operation, the ITB therapeutic effect diminished. Several examinations confirmed that the pump function was normal and catheter failure had not occurred. However, radioisotopic scintigraphy revealed that the baclofen had been washed out to blood circulation more rapidly than is typically observed. We considered two possible causes for this; obstruction of the cerebrospinal space due to kyphosis and excessive washout of celebrospinal fluid through the ventriculoperitoneal shunt. The catheter was moved to a more caudal site surgically, and his spasticity improved. The use of radioisotopic scintigraphy to identify the distribution of baclofen is an effective technique for investigation of baclofen pump system malfunction.

  13. Imaging and differential diagnosis of pediatric spinal tuberculosis

    Directory of Open Access Journals (Sweden)

    Xiao-ying Xing

    2015-03-01

    Conclusion: Pediatric spinal tuberculosis often occurs in the cervical and thoracic vertebrae with typical imaging findings. The cases with atypical manifestations should be differentiated from other diseases such as Langerhans cell histiocytosis and metastatic neoplasm.

  14. Diagnostic Accuracy of Cerebrospinal Fluid Amyloid-beta Isoforms for Early and Differential Dementia Diagnosis

    NARCIS (Netherlands)

    Struyfs, Hanne; Van Broeck, Bianca; Timmers, Maarten; Fransen, Erik; Sleegers, Kristel; Van Broeckhoven, Christine; De Deyn, Peter P.; Streffer, Johannes R.; Mercken, Marc; Engelborghs, Sebastiaan

    2015-01-01

    Background: Overlapping cerebrospinal fluid biomarkers (CSF) levels between Alzheimer's disease (AD) and non-AD patients decrease differential diagnostic accuracy of the AD core CSF biomarkers. Amyloid-beta (A beta) isoforms might improve the AD versus non-AD differential diagnosis. Objective: To de

  15. Morphological differential diagnosis of the main types of inflammatory myopathies

    Directory of Open Access Journals (Sweden)

    S. G. Radenska-Lopovok

    2012-01-01

    Full Text Available The review provides an update on the diagnosis of the main subtypes of inflammatory myopathies. Proper choice of biopsied muscle and histological methods of investigation are presented. Histochemical and immunohistochemical characteristic of tissue markers in inflammatory myopathies are given. Some dilemmas, as well as the most common errors of histological diagnostics are discussed.

  16. MRI findings and differential diagnosis in children with cerebral paragonimiasis

    Directory of Open Access Journals (Sweden)

    Zhen Zeng

    2016-06-01

    Conclusions: The clinical manifestations of cerebral paragonimiasis are nonspecific in children while the MRI findings of cerebral paragonimiasis are characteristic, including irregular hemorrhage, ring-like enhancement and disproportionately large areas of surrounding edema. Brain MRI plays an important role in the diagnosis of cerebral paragonimiasis in children.

  17. [Confusing clinical presentations and differential diagnosis of bipolar disorder].

    Science.gov (United States)

    Gorwood, P

    2004-01-01

    An early recognition of bipolar disorders may have an important impact on the prognosis of this disorder according to different mechanisms. Bipolar disorder is nevertheless not easy to detect, the diagnosis being correctly proposed after, in average more than a couple of Years and three different doctors assessments. A short delay before introducing the relevant treatment should help avoiding inappropriate treatments (prescribing, for example, neuroleptics for long periods, antidepressive drugs each time depressive symptoms occurs, absence of treatment despite mood disorders), with their associated negative impact such as mood-switching, rapid cycling or presence of chronic side-effects stigmates. Furthermore, non-treated mood disorders in bipolar disorder are longer, more stigmatizing and may be associated with an increased risk of suicidal behaviour and mortality. Lastly, compliance, an important factor regarding the long term prognosis of bipolar disorder, should be improved when there is a short delay between correct diagnosis and treatment and onset of the disorder. We therefore propose to review the literature for the different pitfalls involved in the diagnosis of bipolar disorder. Non-bipolar mood-disorders are frequently quoted as one of the alternative diagnosis. Hyperthymic temperament, side-effects of prescribed treatments and organic comorbid disorders may be involved. Bipolar disorders have a sex-ratio closer to 1 (men are thus more frequently of the bipolar type in mood-disorders), with earlier age at onset, and more frequent family history of suicidal attempts and bipolar disorder. Schizo-affective disorders are also a major concern regarding the diagnosis of bipolar disorder. This is explained by flat affects sometimes close to anhedonia, presence of a schizoïd personality in bipolar disorder, persecutive hostility that can be considered to be related to irritability rather than a schizophrenic symptom. Rapid cycling, mixed episodes and short

  18. Differential diagnosis of squamous cell carcinoma in situ using skin histopathological images.

    Science.gov (United States)

    Noroozi, Navid; Zakerolhosseini, Ali

    2016-03-01

    Differential diagnosis of squamous cell carcinoma in situ is of great importance for prognosis and decision making in the disease treatment procedure. Currently, differential diagnosis is done by pathologists based on examination of the histopathological slides under the microscope, which is time consuming and prone to inter and intra observer variability. In this paper, we have proposed an automated method for differential diagnosis of SCC in situ from actinic keratosis, which is known to be a precursor of squamous cell carcinoma. The process begins with epidermis segmentation and cornified layer removal. Then, epidermis axis is specified using the paths in its skeleton and the granular layer is removed via connected components analysis. Finally, diagnosis is done based on the classification result of intensity profiles extracted from lines perpendicular to the epidermis axis. The results of the study are in agreement with the gold standards provided by expert pathologists.

  19. Hypertrophic pachymeningitis: Current criteria for diagnosis and differentiation (Clinical case and review of literature

    Directory of Open Access Journals (Sweden)

    E. G. Mendelevich

    2015-01-01

    Full Text Available The paper describes a 44-year-old male patient with an about 6-year history of hypertrophic pachymeningitis. The major clinical symptoms were characterized by headache, exophthalmos, and blindness in one eye. The data for differential diagnosis of the disease are given. The current literature on the clinical manifestations of hypertrophic pachymeningitis, its differential diagnosis, and the results of magnetic resonance imaging (MRI is reviewed. Diagnostic difficulties at the stage of a clinical observation are due to the nonspecificity of neurological manifestations and the need for a comprehensive examination to detect a somatic disease. MRI can diagnose the disease-specific phenomenon of damage to the meninges, which calls for further careful differentiation. Clinicians must be familiar with alternative differential diagnosis, as a rapid specific therapeutic approach will help avoid long-term or irreversible neurological complications.

  20. SONOGRAPHIC PATTERNS AND DIFFERENTIAL DIAGNOSIS OF CYSTIC RENAL CARCINOMAS

    Institute of Scientific and Technical Information of China (English)

    蔡胜; 李建初; 姜玉新; 戴晴; 谭莉; 张缙熙

    2002-01-01

    Objective. To study the sonographic features and patterns of cystic renal carcinomas. Methods. Thirteen cases of cystic renal carcinoma confirmed by operation and pathology were examined by ultrasonography, and the cystic walls, septa and solid mural nodules were studied. Results. Solid mural nodules of some cases and irregular thickening of the cystic walls and septa were characteristic findings for the ultrasonic diagnosis of cystic renal carcinomas. According to their pathologic mechanisms and sonographic features, cystic renal carcinomas were classified into 3 patterns: unilocular cystic mass, multiloculated cystic mass and cystic-solid mass. Conclusions. Typical cystic renal carcinomas can be well diagnosed, while atypical cases may be misdiagnosed as benign renal cysts by ultrasonography. Color Doppler ultrasonography and needle aspiration guided by ultrasonography are helpful in the diagnosis of these atypical cases.

  1. SONOGRAPHIC PATTERNS AND DIFFERENTIAL DIAGNOSIS OF CYSTIC RENAL CARCINOMAS

    Institute of Scientific and Technical Information of China (English)

    蔡胜; 李建初; 等

    2002-01-01

    Objective:To study the sonographic features and patterns of cystic renal carcinomas.Methods:Thirteen cases of cystic renal carcinoma confirmed by operation and pathology were examined by ultrasonography,and the cystic walls,septa and solid mural nodules were studied.Results:Solid mural nodules of some cases and irregular thickening of the cystic walls and septa were characteristic findings for the ultrasonic diagnosis of cystic renal carcinomas.According to their pathologic mechanisms and sonographic features,cystic renal carcinomas were classified into 3 patterns:unilocular cystic mass,multiloculated cystic mass and cystic-solid mass.Conclusions:Typical cystic renal carcinomas can be well diagnosed,while atypical cases may be misdiagnosed as benign renal cysts by ultrasonography.Color Doppler ultrasonography and needle aspiration guided by ultrasonography are helpful in the diagnosis of these atypical cases.

  2. Tuberculosis of the calcaneus. Treatment and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Richter, R.; Koehler, G.; Michels, P.

    1981-11-01

    Eight lesions in the calcaneus have been treated surgically between 1955 and 1979; of these, six were due to tuberculosis, one to chronic osteomyelitis and the other was a cyst. The diagnosis was confirmed bacteriologically and histologically. In all cases (average age 49.1 years) the human bacillus was proved to be the cause of an haematogenous infection. The lesion was confined to the posterior part of the bone and there was no extension into the calcaneo-navicular joint. One focus extended into the ankle joint. Two patients presented with fistulae. The interval from the onset of symptoms to confirmation of the diagnosis averaged 9.1 months. Three patients had previously been treated for tuberculosis (lung, pleura, kidney) and another patient, who had a simultaneous tuberculous infection of a sternoclavicular joint had suffered from tuberculous cervical lymphadenitis at the age of nine years.

  3. Somatostatinoma syndrome: a challenging differential diagnosis among pancreatic tumors

    Directory of Open Access Journals (Sweden)

    Paula Martinez Vianna

    2013-03-01

    Full Text Available Among the neuroendocrine neoplasia, the pancreatic somatostatin-producing tumors are very rare. Usually functional, these tumors produce the somatostatinoma syndrome, which encompasses diabetes mellitus, diarrhea/steatorrhoea, and cholelithiasis. Other symptoms may include dyspepsia, weight loss, anemia, and hypochlorhydria. All theses symptoms are explained by the inhibitory actions of the somatostatin released by tumoral cells originated from pancreatic delta cells or endocrine cells of the digestive tract. The diagnosis is easy to overlook since these symptoms are commonly observed in other more common syndromes. Besides the clinical features, diagnosis is based on serum determination of somatostatin, and imaging exams, such as ultrasound, computer tomography and positron emission tomography. Pathologic examination is characterized by the positivity of immunohistochemical reaction for synaptophysin, chromogranin, and somatostatin. These tumors can be classified according to tumor size, mitotic index, neural or vascular invasion, and distant metastases. The authors describe the case of a 61-year-old female patient who sought medical care because of a 6-month history of watery diarrhea, weight loss, and depression. She was diagnosed with diabetes mellitus 3 years ago. Imaging examination revealed a tumoral mass of 4 cm in its longest axis in the topography of the head of the pancreas and calculous cholecistopathy. The patient’s clinical status was unfavorable for a surgical approach. She died after 20 days of hospitalization. The definitive diagnosis was achieved with the autopsy findings, which disclosed a pancreatic somatostatinoma.

  4. 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...... athletes with asthma, anti-doping regulations, and differential diagnoses such as exercise-induced laryngomalacia are discussed....

  5. Differential Diagnosis of Children with Suspected Childhood Apraxia of Speech

    Science.gov (United States)

    Murray, Elizabeth; McCabe, Patricia; Heard, Robert; Ballard, Kirrie J.

    2015-01-01

    Purpose: The gold standard for diagnosing childhood apraxia of speech (CAS) is expert judgment of perceptual features. The aim of this study was to identify a set of objective measures that differentiate CAS from other speech disorders. Method: Seventy-two children (4-12 years of age) diagnosed with suspected CAS by community speech-language…

  6. Patient exposure in the basic science classroom enhances differential diagnosis formation and clinical decision-making

    Directory of Open Access Journals (Sweden)

    Justin G. Peacock

    2015-02-01

    Full Text Available Purpose. The authors proposed that introducing real patients into a pathology classroom early in medical education would help integrate fundamental principles and disease pathology with clinical presentation and medical history.Methods. Three patients with different pathologies described their history and presentation without revealing their diagnosis. Students were required to submit a differential diagnosis in writing, and then were able to ask questions to arrive at the correct diagnosis. Students were surveyed on the efficacy of patient-based learning.Results. Average student scores on the differential diagnosis assignments significantly improved 32% during the course. From the survey, 72% of students felt that patient encounters should be included in the pathology course next year. Seventy-four percent felt that the differential diagnosis assignments helped them develop clinical decision-making skills. Seventy-three percent felt that the experience helped them know what questions to ask patients. Eighty-six percent felt that they obtained a better understanding of patients’ social and emotional challenges.Discussion. Having students work through the process of differential diagnosis formulation when encountering a real patient and their clinical presentation improved clinical decision-making skills and integrated fundamental concepts with disease pathology during a basic science pathology course.

  7. Patient exposure in the basic science classroom enhances differential diagnosis formation and clinical decision-making.

    Science.gov (United States)

    Peacock, Justin G; Grande, Joseph P

    2015-01-01

    Purpose. The authors proposed that introducing real patients into a pathology classroom early in medical education would help integrate fundamental principles and disease pathology with clinical presentation and medical history. Methods. Three patients with different pathologies described their history and presentation without revealing their diagnosis. Students were required to submit a differential diagnosis in writing, and then were able to ask questions to arrive at the correct diagnosis. Students were surveyed on the efficacy of patient-based learning. Results. Average student scores on the differential diagnosis assignments significantly improved 32% during the course. From the survey, 72% of students felt that patient encounters should be included in the pathology course next year. Seventy-four percent felt that the differential diagnosis assignments helped them develop clinical decision-making skills. Seventy-three percent felt that the experience helped them know what questions to ask patients. Eighty-six percent felt that they obtained a better understanding of patients' social and emotional challenges. Discussion. Having students work through the process of differential diagnosis formulation when encountering a real patient and their clinical presentation improved clinical decision-making skills and integrated fundamental concepts with disease pathology during a basic science pathology course.

  8. Classification and Differential Diagnosis of Oral and Maxillofacial Pain.

    Science.gov (United States)

    Scrivani, Steven J; Spierings, Egilius L H

    2016-08-01

    Pain in the orofacial region is a common presenting symptom. The majority of symptoms are related to dental disease and the cause can readily be established, the problem dealt with, and the pain eliminated. However, pain may persist and defy attempts at treatment. Intractable oral or facial pain can be diagnostically challenging. To make a definitive diagnosis and initiate proper treatment, a rigorous protocol for evaluation includes a thorough history and an appropriate comprehensive clinical examination and diagnostic testing, including chief complaint, history of present illness, medical history, physical examination, diagnostic studies, including imaging, and psychosocial evaluation.

  9. Isolated Cataplexy in the Differential Diagnosis of Drop Attacks: A Case of Successful Clinical Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Robert T. Egel

    2012-01-01

    Full Text Available Drop attacks are sudden spontaneous falls that are not accompanied by alteration of consciousness and are followed by immediate recovery. Cataplexy, which is usually associated with narcolepsy, is one of the causes of drop attacks. We report a patient with the rare condition of cataplexy without associated narcolepsy (isolated cataplexy. Isolated cataplexy should be included in the differential diagnosis when a patient presents with recurrent drop attacks and normal diagnostic test results.

  10. Useful MRI findings for differential diagnosis of sublingual mass lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ida, Mizue; Kurabayashi, Tohru; Yoshino, Norio; Tetumura, Akemi; Honda, Eiichi; Ohbayashi, Naoto; Sasaki, Takehito; Enomoto, Shoji; Amagasa, Teruo [Tokyo Medical and Dental Univ. (Japan). Graduate School

    2001-06-01

    The purpose of this study is to identify useful MRI findings for differentiating sublingual mass lesions. MR images of 29 patients with sublingual swelling were retrospectively reviewed. Patients were categorized into 4 groups according to their final diagnoses: cysts, benign tumors, inflammation and malignant tumors. Clinical symptoms and MRI findings of the patients in each diagnostic category were investigated. Of 29 patients, 6 had benign tumors, 6 had ranula, 6 had inflammation, 11 had malignant tumors. Eighteen patients (62%) were correctly diagnosed as one of 4 disease categories by clinical findings alone. Signal intensity of lesions compared to the muscle and the normal sublingual space (SLS) was not characteristic for any of the diagnostic categories. Only ranulas showed homogenous signal intensity within the lesion on T2 images. Hemangiomas were easily diagnosed by the characteristic contour and architecture including flow void. All lesions with ragged boundaries were either inflammatory or malignant masses. The lesions with ragged boundaries accompanied by expansion of the SLS were inflammatory masses. The lesions with smooth boundaries and a capsule-like rim were either cysts or benign tumors. Utilizing these MRI findings, 25 of 29 patients (86%) were correctly categorized into one of 4 diagnostic categories. Four lesions without a capsule-like rim confined within SLS could not be correctly categorized. These were 2 cases of inflammatory mass and 2 cases of malignant salivary gland tumor. MRI findings were efficient for differentiation of sublingual mass lesions. However, some cases of malignant salivary gland tumor originating from the sublingual gland could not be differentiated on MRI findings from cases of chronic inflammation. (author)

  11. Hyperechoic breast lesions: anatomopathological correlation and differential sonographic diagnosis*

    Science.gov (United States)

    Medeiros, Marcelo Menezes; Graziano, Luciana; de Souza, Juliana Alves; Guatelli, Camila Souza; Poli, Miriam Rosalina B.; Yoshitake, Rafael

    2016-01-01

    Hyperechoic lesions are not a frequent finding at breasts ultrasonography, and most of times are associated with benign pathologies that do not require further evaluation. However, some neoplasms such as invasive breast carcinomas and metastases may present with hyperechogenicity. Thus, the knowledge about differential diagnoses and identification of signs of lesion aggressiveness are of great relevance to avoid unnecessary procedures or underdiagnosis, and to support the correct clinical/surgical approach. On the basis of such concepts, the present essay describes and illustrates the main features of hyperechoic lesions at breast ultrasonography in different cases, with anatomopathological correlation. PMID:26929460

  12. A Case of Patch Stage of Kaposi’s Sarcoma and Discussion of the Differential Diagnosis

    Science.gov (United States)

    Kak, Ipshita; Salama, Samih; Gohla, Gabriella; Naqvi, Asghar; Alowami, Salem

    2016-01-01

    A 55 year old HIV positive male had a skin lesion biopsy which showed atypical vascular proliferation within the superficial and deep dermis with mild atypia of lining endothelial cells. A sparse lymphoplasmacytic infiltrate surrounding the irregular vascular channels was noted. Immunohistochemistry highlighted the atypical blood vessels with the vascular markers CD31, CD34 and Factor VIII. The differential diagnosis included unusual vascular or lymphatic proliferations, stasis dermatitis, kaposiform hemangioendothelioma, progressive lymphangioma and angiosarcoma with focal Kaposi’s sarcoma features. Characteristic human herpes virus-8 positive staining helped support the diagnosis of patch stage of Kaposi’s sarcoma. Herein, we discuss the case findings, differential diagnosis and characteristic histological findings associated with the patch stage of Kaposi’s sarcoma which can be an elusive diagnosis. PMID:27134709

  13. Scrotal ultrasonography in differential diagnosis of acute scrotum

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Jin; Kwon, H. J.; Jho, K. H.; Hwang, M. S.; Kim, S. Y.; Jang, J. C.; Park, B. H. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1990-12-15

    The acute scrotum is a difficult clinical challenge because of numerous etiologies including inflammatory processes, testicular torsion, trauma, and complicated tumors. As the chances of salvaging testicular function are inversely proportional to the elapsed time between onset of torsion/rupture and surgical repair of testes, prompt and accurate diagnosis is imperative. The authors underwent scrotal ultrasonography in 35 patients with acute scrotum. Ultrasonographic findings in 18 patients with acute epididymitis were enlargement of the epididymes with decreased(N=13) or mixed(n=5) echogenicity. Three patients with acute stage(within 24 hours) of testicular torsion showed enlarged testes with homogeneous and slightly decreased echogenicity:the other three patients with late stage showed enlarged epididymes and testes with diffuse mixed echogenciity

  14. [Vocal cord dysfunction. An important differential diagnosis to bronchial asthma].

    Science.gov (United States)

    Kothe, C; Schade, G; Fleischer, S; Hess, M

    2004-03-01

    Vocal cord dysfunction (VCD) is described as a functional disorder of the vocal folds which leads to an intermittent, inspiratory 'paradoxical' glottal closure. We report on three women with frequent repetitive shortness of breath attacks caused by VCD. This was diagnosed by transnasal videofiberendoscopy, with glottal closure being seen during inspiration. Because of the different etiologies, one of the patients was treated with breathing and speech therapy, another received Omeprazol for laryngopharyngeal reflux, and the third was treated by intralaryngeal botulinum toxin injections. All three patients showed a reduction in attacks. Clinically, VCD seems to mimic asthma. However, with a thorough patient history and diagnostics, especially with transnasal laryngoscopy during a (triggered) attack, a precise diagnosis seems possible.

  15. Spectrophotometric intracutaneous analysis for differential diagnosis of pigmented skin lesions

    Directory of Open Access Journals (Sweden)

    Е. V. Filonenko

    2013-01-01

    Full Text Available The non-invasive diagnosis of pigmented skin lesions by spectrophotometric intracutaneous analysis (SIA-scopy using device for dermatoscopy (SIAscope V by Astron Clinica, Ltd was approved in P.A.Herzen Moscow Cancer Research Institute. The method is based on analysis of light interaction with wavelength of 440–960 nm anf human skin, which is recorded by change of image on scan. The comparative analysis of SIA-scopy and histological data in 327 pigmented skin lesions in 147 patients showed, that SIA had high diagnostic efficiency for cutaneous melanoma: the sensitivity was 96%, specifity – 94%, diagnostic accuracy – 94%. For study of malignant potential of pigmented lesions by SIA-scopy the most informative capacity was obtained for assessment of melanin in papillary dermis, status of blood vessels and collagen fibres (SIA-scans 3, 4, 5.

  16. Differential diagnosis of pediatric tumors of the nasal cavity and paranasal sinuses: a 45-year multi-institutional review.

    Science.gov (United States)

    Holsinger, F Christopher; Hafemeister, Adam C; Hicks, M John; Sulek, Marcelle; Huh, Winston W; Friedman, Ellen M

    2010-11-01

    We conducted a retrospective case-series review to identify the various diagnoses of neoplasms of the nasal cavity and paranasal sinuses in a pediatric population. Our study group was made up of 54 children-23 boys and 31 girls, aged 8 months to 16 years (mean: 9 yr). All patients had been diagnosed with a tumor of the nasal cavity or paranasal sinuses between Jan. 1, 1955, and Dec. 31, 1999, at one of four university-based, tertiary care referral centers. We compiled data on tumoral characteristics (location, size, and histopathology), morbidity and mortality, and rates of recurrence. Lesions included adnexal neoplasm, ameloblastic fibro-odontoma, basal cell carcinoma, benign fibrous histiocytoma, blue nevus, chondrosarcoma, compound nevus, epithelioma adenoides cysticum, esthesioneuroblastoma, Ewing sarcoma, fibrosarcoma, giant cell granuloma, granulocytic sarcoma, hemangioma, hemangiopericytoma, Langerhans cell histiocytosis, lymphangioma, lymphoma, melanoma, neuroblastoma, neurofibroma, ossifying osteofibroma, osteochondroma, osteosarcoma, port wine stain, rhabdomyosarcoma, Spitz nevus, and xanthogranuloma. To the best of our knowledge, this is the largest such study of its kind to date. We believe that the large size of this study and the data on disease incidence will allow clinicians to be better informed of the differential diagnosis of neoplasms of the nasal cavity and paranasal sinuses in the pediatric population.

  17. CT-diagnosis of optic nerve lesions. Differential diagnostic criteria

    Energy Technology Data Exchange (ETDEWEB)

    Unsoeld, R.

    1982-01-01

    Computed tomograms of 166 optic nerve lesions were analyzed: 97 were mainly orbital and 69 mainly intracranial. The criteria were clinical course, size, density and delineation of the optic nerve shadow, orbital and cerebral soft tissue abnormalities, and bony changes in the optic canal. Characteristic CT features are described of individual disease entities such as optic gliomas, optic nerve sheath meningiomas, neoplastic and inflammatory infiltrations. The differential diagnostic importance of individual CT criteria is evaluated and discussed. Simultaneous visualization of orbital and intracranial soft tissue changes as well as bony changes in the optic canal allow the location and identification of the majority of optic nerve lesions based on the criteria mentioned above, and optic nerve tumors can be differentiated. In 9 patients with optic neuritis due to clinically proven encephalitis and in 17 patients with total optic atrophy, no changes in the size of the optic nerve could be found. CT evaluation of the intraorbital portion of the optic nerve requires special examination techniques. Oblique computer reformations through the optic canal provide excellent visualization of bony changes in the optic canal. The exclusion of intracranial causes of optic nerve lesions requires intravenous injection of contrast material.

  18. Tongue base schwannoma: differential diagnosis and imaging features with a case presentation

    OpenAIRE

    2016-01-01

    Schwannomas are slow growing, encapsulated neoplasms that arise from the nerve sheath. A vast majority of these benign neoplasms occur in the head and neck region, most commonly involving the 8th cranial nerve. Schwannomas arising from the base of tongue are very rare and, thus, can easily escape the list of differential diagnosis for a posterior tongue mass. A systematic approach is recommended for diagnosis of a posterior tongue mass, with neoplastic, infectious, and congenital categories. ...

  19. Observational constraints and differential diagnosis for cosmic evolutionary models

    CERN Document Server

    Wang, Deng

    2016-01-01

    In this paper, we have proposed a plotting method based on the " natural plotting rule " (NPR) which can be used to distinguish different cosmological scenarios more efficiently and obtain more useful information. By using the NPR, we have avoided the blindness to use different diagnostics when discovering that some scenarios can be hardly differentiated from each other, and develop a logical line to adopt different diagnostics. As a concrete instance, we take this method based on the NPR to distinguish several Cardassian scenarios from the base cosmology scenario, and one from the other. We place constraints on three Cardassian cosmological scenarios and their flat versions by utilizing the Type Ia supernovae (SNe Ia), baryonic acoustic oscillations (BAO), cosmic microwave background (CMB) radiation, observational Hubble parameter (OHD) data-sets as well as the single data point from the newest event GW150914, and discover that our results are more stringent than previous results for constraining the cosmolo...

  20. Differential diagnosis of neurodegenerative diseases using structural MRI data

    DEFF Research Database (Denmark)

    Koikkalainen, Juha; Rhodius-Meester, Hanneke; Tolonen, Antti;

    2016-01-01

    characteristics from T1 images, and vascular characteristics from FLAIR images. Classification was performed using a multi-class classifier based on Disease State Index methodology. The classifier provided continuous probability indices for each disease to support clinical decision making. A dataset of 504...... of differential diagnostics. Most studies compare patients and controls, or Alzheimer's disease with one other type of dementia. Such a bilateral comparison does not resemble clinical practice, where a clinician is faced with a number of different possible types of dementia. Here we studied which features...... individuals was used for evaluation. The cross-validated classification accuracy was 70.6% and balanced accuracy was 69.1% for the five disease groups using only automatically determined MRI features. Vascular dementia patients could be detected with high sensitivity (96%) using features from FLAIR images...

  1. Infectious spondylitis and its differential diagnosis; Spondylitis und ihre Differenzialdiagnosen

    Energy Technology Data Exchange (ETDEWEB)

    Erlemann, Rainer [Helios St. Johannes Klinik, Duisburg (Germany). Inst. fuer Radiologie; Hoogeveen, Anja [AKH Viersen (Germany)

    2012-06-15

    Infectious spondylitis can be diagnosed early and reliably by MRI, given that the most important diagnostic criteria are present. These criteria are bone marrow edema adjacent to two contiguous vertebral end plates, disk space of high signal intensity and enhancement of bone adjacent to two contiguous vertebral end plates and of the disk space. If not all of these criteria are present, diagnostic accuracy decreases. Erosive osteochondritis, spondylarthritis, osteoporotic fractures of two contiguous vertebral end plates, active Schmorl's nodes as well as neuropathic spine may mimic an infectious spondylitis. This paper presents typical and atypical morphologic patterns of infectious spondylitis as well as the differentiation criteria from the above mentioned diseases. (orig.)

  2. CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management

    Energy Technology Data Exchange (ETDEWEB)

    Macari, M.; Faust, M.; Liang, H.; Pachter, H.L

    2007-01-15

    Aim: To describe the imaging findings of jejunal diverticulitis as depicted at contrast-enhanced computed tomography (CT) and review the differential diagnosis and clinical management. Materials and Methods: CT and pathology databases were searched for the diagnosis of jejunal diverticulitis. Three cases were identified and the imaging and clinical findings correlated. Results: Jejunal diverticulitis presents as a focal inflammatory mass involving the proximal small bowel. A trial of medical management with antibiotics may be attempted. Surgical resection may be required if medical management is unsuccessful. Conclusion: The imaging findings at MDCT may allow a specific diagnosis of jejunal diverticulitis to be considered and may affect the clinical management of the patient.

  3. Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis

    DEFF Research Database (Denmark)

    Duer, Anne; Østergaard, M; Hørslev-Petersen, K;

    2008-01-01

    OBJECTIVES: To investigate the value in clinical practice of hand magnetic resonance imaging (MRI) and whole body bone scintigraphy in the differential diagnosis of patients with unclassified arthritis. METHODS: 41 patients with arthritis (> or = 2 swollen joints, > 6 months' duration) which...... joints of the most symptomatic hand and whole body bone scintigraphy were performed. Two rheumatologists agreed on the most likely diagnosis and the patients were treated accordingly. A final diagnosis was made by another specialist review 2 years later. RESULTS: Tentative diagnoses after MRI and bone...

  4. Overactive bladder, differential diagnosis, and clinical utility of fesoterodine

    Directory of Open Access Journals (Sweden)

    Wyndaele J-J

    2012-11-01

    Full Text Available Jean-Jacques WyndaeleDepartment of Urology, Antwerp University, Antwerp, BelgiumAbstract: Overactive bladder is a symptom syndrome with urgency, frequency and, in many cases, nocturia. Urge incontinence is not present in all. There is no direct correlation with detrusor overactivity, an objective finding during urodynamic testing where involuntary contractions can be noticed. In the pathophysiology, much more attention has been given to the afferent/sensory arm of the micturition reflex in the last decade. Anatomical and infectious causes have to be diagnosed or ruled out. Diagnosis of overactive bladder is made mostly by history-taking, but other tests can be necessary in specific patients. Treatment consists of behavioral measures, a good explanation of the condition, training, and pelvic floor physiotherapy. Drugs are often used. Until recently, antimuscarinic drugs have been the mainstay of pharmacological therapy. Fesoterodine is a newer antimuscarinic agent which is more pharmacodynamically stable then tolterodine. Fesoterodine has been extensively researched using different dosages and compared with placebo and tolterodine, in different age groups, and under different conditions. Fesoterodine is superior to placebo and to tolterodine in the short term and long term. Its safety is very acceptable.Keywords: overactive bladder, fesoterodine, incontinence, urgency, lower urinary tract

  5. Balloon Cell Urethral Melanoma: Differential Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    M. McComiskey

    2015-01-01

    Full Text Available Introduction. Primary malignant melanoma of the urethra is a rare tumour (0.2% of all melanomas that most commonly affects the meatus and distal urethra and is three times more common in women than men. Case. A 76-year-old lady presented with vaginal pain and discharge. On examination, a 4 cm mass was noted in the vagina and biopsy confirmed melanoma of a balloon type. Preoperative CT showed no distant metastases and an MRI scan of the pelvis demonstrated no associated lymphadenopathy. She underwent anterior exenterative surgery and vaginectomy also. Histology confirmed a urethral nodular malignant melanoma. Discussion. First-line treatment of melanoma is often surgical. Adjuvant treatment including chemotherapy, radiotherapy, or immunotherapy has also been reported. Even with aggressive management, malignant melanoma of the urogenital tract generally has a poor prognosis. Recurrence rates are high and the mean period between diagnosis and recurrence is 12.5 months. A 5-year survival rate of less than 20% has been reported in balloon cell melanomas along with nearly 20% developing local recurrence. Conclusion. To the best of our knowledge, this case is the first report of balloon cell melanoma arising in the urethra. The presentation and surgical management has been described and a literature review provided.

  6. SAPHO syndrome in the differential diagnosis of metastasis.

    Science.gov (United States)

    Berenguer Francés, Miguel Ángel; Lafaurie Acevedo, Alejandro; Tormo Ferrero, Vicente; Cardenal Macia, Rafael; Andreu Martínez, Francisco José

    2016-01-01

    SAPHO syndrome was proposed in the late 80s in order to group different osteoarticular manifestations with specific radiological findings such as the hyperostosis of the front part of the chest wall. Prevalence, etiology and pathogenesis of the disease are unknown, while diagnosis is made both clinically and by the specific gammagraphic image of «bull horn» in the sternoclavicular joint. The following case of a 64-year-old woman diagnosed with infiltrating ductal carcinoma of the right breast pT1N0Mx is reported. When studying the extent of the disease, a gammagraphic image of diffuse blast injury in the sterna manubrium was evidenced, which allowed the suspicion of Paget's disease or metastatic injury. Study was completed with a chest CT in which manubrium sclerosis was evidenced, suggesting metástasis. Res ults of the studies pointed out SAPHO syndrome as the most likely diagnostic option. The low tumor stage of the patient prompted the idea of possible alternative diagnoses. A deeper knowledge of this clinical condition may be crucial to avoid mistakes when classifying a subject in more advanced tumor stages, and consequently, to prevent the use of more aggressive chemotherapy and radiotherapy treatments.

  7. Differential diagnosis of sexual pain in women (La diagnosi differenziale del dolore sessuale nella donna

    Directory of Open Access Journals (Sweden)

    Giancarlo Carli, MD

    2013-09-01

    Full Text Available Dyspareunia, a pain that occurs in response to an attempted vaginalentry or to a sexual intercourse, is a clinical entity that recognizes multifactorial etiology. It may be due to organic diseases or to functional disorders suchas Hypoactive Syndrome Desire Disease (HSDD, vaginismus and provoked vulvodynia (PVD. A full history is fundamental for the diagnosis of functional syndromes. For PVD diagnosis, the gynaecologist must also have experience of syndromes of chronic widespread pain of unknownetiology such as fibromyalgia since these syndromes are frequently associated. In PVD local and diffuse hyperalgesia is associated with mechanismsof central sensitization. In PVD there is evidence suggesting local mechanisms of neuropathic nature, although local symptoms consist only in light erythema and oedema.

  8. [Anemia in workers exposed to lead: update on differential diagnosis].

    Science.gov (United States)

    Di Lorenzo, L; Soleo, L; Cassano, F; Elia, G; Schiavulli, N; Martino, M G; Corfiati, M; Bulfaro, D; Apostoli, P

    2005-01-01

    Occupational lead exposure can cause anemia at blood lead levels >50 microg/dl, as high as rarely occurs in industrialized countries nowadays. Whereas other forms of anemia are fairly probable to be found in lead exposed workers, especially in areas highly endemicfor extraoccupational anemias, such as beta thalassemia and iron deficiency anemia. The etiology of anemias has to be correctly defined in order to assess suitable therapeutical approaches and medicolegal consequences. The objective of this study is to verify in male lead exposed workers whether an accurate evaluation of hemocromocytometric parameters and of usual biological indices of lead exposure and effect on heme can differentiate the most common forms of anemia in Southern Italy. 68 workers occupationally exposed to low to moderate lead doses were studied and 59 workers of an alimentary plant have been taken as control group. On venous blood samples collected from these workers a complete hemocromocytometric test was performed and blood lead and erythrocytic zincoprotoporphyrin were determined. Anemia (Hb lead exposed workers and in a nonexposed worker. The reasoned evaluation of laboratory parameters led to identify among lead exposed workers four subjects with high probability of beta-thalassemic trait and two with lead poisoning anemia. Moreover a diagnostic algorithm was developed based on literature that seems to be able to discriminate lead poisoning from other causes of anemia in lead exposed workers in this study.

  9. Nailfold Capillaroscopy - Its Role in Diagnosis and Differential Diagnosis of Microvascular Damage in Systemic Sclerosis.

    Science.gov (United States)

    Lambova, Sevdalina; Hermann, W; Muller-Ladner, Ulf

    2013-01-01

    In the nailfold area, specific diagnostic microvascular abnormalities are easily recognized via capillaroscopic examination in systemic sclerosis (SSc). They are termed "scleroderma" type capillaroscopic pattern, which includes presence of dilated, giant capillaries, haemorrhages, avascular areas, and neoangiogenic capillaries and are observed in the majority of SSc patients (in more than 90%). LeRoy and Medsger (2001) proposed criteria for early diagnosis of SSc with inclusion of the abnormal capillaroscopic changes and suggested to prediagnose SSc prior to the development of other manifestations of the disease. It is a new era in the diagnosis of SSc. At present, an international multicenter project is performed. It aims validation of criteria for very early diagnosis of SSc (project VEDOSS (Very Early Diagnosis of Systemic Sclerosis) and is organized by European League Against Rheumatism (EULAR) Scleroderma Trials and Reasearch. Very recently the first results of the VEDOSS project were processed and new EULAR/ACR (American College of Rheumatology) classification criteria have been validated and published (2013), in which the characteristic capillaroscopic changes have been included. Our observations confirm the high frequency of the specific capillaroscopic changes of the fingers in SSc, which have been found in 97.2% of the cases from the studied patient population. We have performed for the first time capillaroscopic examinations of the toes in SSc. Interestingly,"scleroderma type" capillaroscopic pattern was also found at the toes in a high proportion of patients - 66.7%, but it is significantly less frequent as compared with fingers (97.2%, p<0.05). In our opinion, the examination of the toes of SSc patients should be considered as it suggests an additional opportunity for evaluation of the microvascular changes in these patients although the observed changes are in a lower proportion of cases. Thus, capillaroscopic examination is a cornerstone for the very

  10. Ulno-volar bayonet hand: Its differential diagnosis from Madelung's deformity

    Energy Technology Data Exchange (ETDEWEB)

    Christ, F.

    1981-04-01

    The ulno-volar bayonet hand related to the mostly hereditary multiple exostoses is compared to Madelung's forearm deformity under clinical and roentgenological view in differential diagnosis. The ulno-volar bayonet hand is considerably more seldom, basing upon dysplasia of the lower part of the ulna, less inconvenient in function, and hardly tending to the development of early arthrosis.

  11. Postpartum post-dural puncture headache: is your differential diagnosis complete?

    NARCIS (Netherlands)

    Bleeker, C.P.; Hendriks, I.M.; Booij, L.H.D.J.

    2004-01-01

    We describe a patient with an intracerebral haemorrhage following an accidental dural puncture during an attempted epidural for pain relief in labour. Anaesthetists need to include intracerebral haemorrhage in the differential diagnosis of post-dural puncture headache in the puerperium.

  12. Mixed solid and cystic acoustic neuroma: MR features and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Denys, A. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France); Duvoisin, B. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France)]|[Dept. of Radiodiagnosis, University Hospital, Lausanne (Switzerland); Fernandes, J.G. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France); Doyon, D. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France)

    1991-11-01

    We present a very rare case of combined cystic and solid acoustic neuroma investigated by magnetic resonance imaging (MRI). This case illustrates the value of MRI in the characterization of tumours in the posterior cranial fossa, particularly acoustic neuromas, and its diagnostic impact in unusual situations. The differential diagnosis of cystic and mixed lesions in the cerebellopontine angle is discussed. (orig.)

  13. Differential diagnosis in computerized tomography. 2. rev. and enl. ed.; Differenzialdiagnosen in der Computertomografie

    Energy Technology Data Exchange (ETDEWEB)

    Burgener, Francis A.; Meyers, Steven P. [Rochester Univ., NY (United States). Dept. of Imaging Sciences; Herzog, Christopher [Rotkreuzklinikum Muenchen (Germany); Zaunbauer, Wolfgang [Kantonsspital St. Gallen (Switzerland). Inst. fuer Radiologie

    2013-02-01

    The book on differential diagnosis in computerized tomography is aimed to support radiologists and physicians with experience concerning the interpretation of computerized tomography images by detailed descriptions of CT diagnoses. The book covers the following topics: intracranial indications, head and neck, spinal cord, muscle-skeleton system, thorax, abdomen and pelvis.

  14. Differential diagnosis in the pediatric radiology; Differenzialdiagnosen in der paediatrischen Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Rijn, Rick R. van [Academic Medical Center Amsterdam (Netherlands). Dept. of Radiology; Blickmann, Johan G. (eds.) [Univ. of Rocherster Medical Center, NY (United States). Dept. of Imaging Sciences URMC

    2012-11-01

    The book on differential diagnosis in the pediatric radiology covers the following issues: (1) Thorax, mediastinum, heart ad large blood vessels. (2) Abdomen and gastrointestinal tract. (3) Urogenital tract. (4) Skull, intracranial space and spinal cord. (5) Skeleton, bone joints and soft tissue. (6) Normative values.

  15. COMPUTED-TOMOGRAPHY IN DIFFERENTIAL-DIAGNOSIS OF TEMPOROMANDIBULAR-JOINT DISORDERS

    NARCIS (Netherlands)

    DEBONT, LGM; VANDERKUIJL, B; STEGENGA, B; VENCKEN, LM; BOERING, G

    1993-01-01

    Computed tomography (CT) has great potential for imaging intra- and extracapsular hard-tissue abnormality of the temporomandibular joint (TMJ). CT is not the best method of imaging disk position and form. For differential diagnosis of TMJ disorders, CT is especially successful in bony lesions. The s

  16. [The morphology and differential diagnosis of neuroglial heterotopias and related tumors].

    Science.gov (United States)

    Shelekhova, K V; Sokolova, I A; Kazakov, D V; Michal, M

    2009-01-01

    The paper reviews the data available in the literature and a clinicomorphological analysis of 15 cases of neuroglial heteropias and related tumors retrieved from the joint databases of Sikl's Department of Pathology, Pilsen, Czech Republic, and the Department of Pathology, Petrov Oncology Institute, with emphasis on the histological, immunohistochemical and ultrastructural features, as well as differential diagnosis.

  17. Cerebrospinal fluid P-tau(181P) : biomarker for improved differential dementia diagnosis

    NARCIS (Netherlands)

    Struyfs, Hanne; Niemantsverdriet, Ellis; Goossens, Joery; Fransen, Erik; Martin, Jean-Jacques; De Deyn, Peter P.; Engelborghs, Sebastiaan

    2015-01-01

    The goal of this study is to investigate the value of tau phosphorylated at threonine 181 (P-tau(181p)) in the Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarker panel for differential dementia diagnosis in autopsy confirmed AD and non-AD patients. The study population consisted of 140 aut

  18. Importance of diazepam administration during electroencephalography in the differential diagnosis of cortical visual loss.

    Science.gov (United States)

    Yis, Uluc; Topcu, Yasemin; Bayram, Erhan; Karakaya, Pakize; Cakmakci, Handan; Kurul, Semra Hiz

    2014-01-01

    A 14-year-old boy presented with acute visual loss due to cortical blindness. Two weeks after the visual symptoms, the patient developed behavioral abnormalities. Brain magnetic resonance imaging (MRI) revealed hyperintense lesions at parieto-occipital lobes on T2-weighted and fluid attenuated inversion recovery images. Sleep and awake electroencephalography (EEG) were normal, but diazepam administration revealed bilateral periodic synchronous complexes occurring every 20 to 30 seconds. Elevated measles antibody titers in cerebrospinal fluid confirmed the diagnosis of subacute sclerosing panencephalitis. We conclude that visual loss due to cortical blindness is an important finding of subacute sclerosing panencephalitis. Diazepam administration during EEG should be a part of investigation in cases with unexplained cortical blindness.

  19. Some boys' problems in education

    DEFF Research Database (Denmark)

    Jørgensen, Christian Helms

    2015-01-01

    to general education, but social and institutional processes of differentiation in the vocational schools place a significant group of students in a position where they have little chance of completing the programme. In the conclusion, some reflections are made on the effect of a recent reform of VET......The last two decades have seen an increasing political concern in the high dropout rates and low performance in education of boys compared to girls – at times in the form of a ‘moral panic’. This has also been the case in Denmark where ‘the boy problem’ in education now is placed high on the agenda...... of education policy. The purpose of this article is to examine this ‘boy problem’ in relation to the dual system of vocational education and training (VET) in Denmark. By considering the gender divisions and the value of the VET programmes on the labour market, it explores what kind of problems boys have...

  20. [Tularemia lymphadenitis. An emerging differential diagnosis of necrotizing granulomatous cervical lymphadenitis].

    Science.gov (United States)

    Strehl, J; Schoerner, C; Hartmann, A; Agaimy, A

    2014-03-01

    Tularemia is emerging as an important differential diagnosis of necrotizing granulomatous lymphadenitis, particularly in the head and neck region. The causal organism, Francisella tularensis is a Gram-negative coccoid bacterium. Tularemia usually presents with necrotizing granulomatous purulent lymphadenitis featuring multiple mostly small granulomas with geographic necrosis bordered by palisades of histiocytes. Diagnosis is mainly based on these characteristic but non-pathognomonic histological features in conjunction with negative tests for mycobacterial infections and serological confirmation of tularemia-specific antibodies or detection by polymerase chain reaction (PCR). This article describes our experiences with five patients with tularemia lymphadenitis and gives an overview of the diverse histopathological features and the differential diagnosis of this uncommon but possibly underrecognized disease.

  1. The use of expert systems on the differential diagnosis of urinary incontinence.

    Science.gov (United States)

    Lopes, Maria Helena Baena de Moraes; Marin, Heimar de Fátima; Ortega, Neli Regina Siqueira

    2009-09-01

    The differential diagnosis of urinary incontinence classes is sometimes difficult to establish. As a rule, only the results of urodynamic testing allow an accurate diagnosis. However, this exam is not always feasible, because it requires special equipment, and also trained personnel to lead and interpret the exam. Some expert systems have been developed to assist health professionals in this field. Therefore, the aims of this paper are to present the definition of Artificial Intelligence; to explain what expert system and system for decision support are and its application in the field of health and to discuss some expert systems for differential diagnosis of urinary incontinence. It is concluded that expert systems may be useful not only for teaching purposes, but also as decision support in daily clinical practice. Despite this, for several reasons, health professionals usually hesitate to use the computer expert system to support their decision making process.

  2. [Comorbid psychiatric disorders and differential diagnosis of patients with autism spectrum disorder without intellectual disability].

    Science.gov (United States)

    Strunz, Sandra; Dziobek, Isabel; Roepke, Stefan

    2014-06-01

    Autism spectrum conditions (ASC) without intellectual disability are often diagnosed late in life. Little is known about co-occurring psychiatric disorders and differential diagnosis of ASC in adulthood, particularly with regard to personality disorders. What kind of comorbid psychiatric disorders occur in ASC? Which are the most prevalent differential diagnoses in a sample of patients who seek autism specific clinical diagnostics? 118 adults who were referred with a presumed diagnosis of autistic disorder, were diagnosed with autism specific instruments and the prevalence of further psychiatric disorders was investigated. 59 (50%) fulfilled the criteria of ASC. 36% of the individuals with ASC fulfilled also criteria for a DSM-IV axis-I psychiatric disorder. Affective disorders (24%) and social phobia (14%) were the most prevalent comorbid disorders. The most frequent differential diagnoses were depression, social phobia, paranoid, avoidant and narcissistic personality disorder.

  3. Foreign Body Granuloma: A Diagnosis Not to Forget

    Directory of Open Access Journals (Sweden)

    I. El Bouchti

    2012-01-01

    The differential diagnosis for bony reaction to an unrecognised organic foreign body includes osteoid osteoma, chronic and acute osteomyelitis, tuberculosis granuloma, bone cyst, aneurysmal bone cyst, cortical fibrous defect, and neoplasm. We report the case of a boy suffering from a thorn inducing a lytic lesion of the fifth metatarsal that demonstrates the diagnosis difficulties of foreign body granuloma.

  4. The Potential of Gait Analysis to Contribute to Differential Diagnosis of Early Stage Dementia: Current Research and Future Directions

    Science.gov (United States)

    Morgan, Debra; Funk, Melanie; Crossley, Margaret; Basran, Jenny; Kirk, Andrew; Bello-Haas, Vanina Dal

    2007-01-01

    Early differential diagnosis of dementia is becoming increasingly important as new pharmacologic therapies are developed, as these treatments are not equally effective for all types of dementia. Early detection and differential diagnosis also facilitates informed family decision making and timely access to appropriate services. Information about…

  5. Sporothrix schenckii Sensu Lato identification in fragments of skin lesion cultured in NNN medium for differential diagnosis of cutaneous leishmaniasis.

    Science.gov (United States)

    Antonio, Liliane de Fátima; Pimentel, Maria Inês Fernandes; Lyra, Marcelo Rosandiski; Madeira, Maria de Fátima; Miranda, Luciana de Freitas Campos; Paes, Rodrigo Almeida; Brito-Santos, Fábio; Carvalho, Maria Helena Galdino Figueredo; Schubach, Armando de Oliveira

    2017-02-01

    Eighty-nine patients with clinical suspicion of leishmaniasis were referred for differential diagnosis. Sporothrix schenckii sensu lato was isolated in Novy-MacNeal-Nicolle + Schneider media in 98% of 64 patients with final diagnosis of sporotrichosis. This medium may be suitable for diagnosis of sporotrichosis in areas where cutaneous leishmaniasis is also endemic.

  6. [Molecular diagnosis as a strategy for differential diagnosis and at early ages of neurofibromatosis type 1 (NF1)].

    Science.gov (United States)

    Gómez, Martha; Batista, Oriana

    2015-10-01

    Neurofibromatosis type 1 (NF1), is a haploinsufficient and multisystemic disease, caused by inherited or sporadic mutations in the NF1 gene. Its incidence is one in 2,500 to 3,000 individuals, it has an autosomal dominant pattern of inheritance, high clinical variability, complete penetrance and age-dependent complications. Neurofibromin is the product of the NF1 gene and is believed to act as a tumor suppressor since the loss of its function has been associated with benign and malignant tumors in neural crest-derived tissues. Only two correlations between clinical phenotype and mutant alleles in the NF1 gene have been observed. The established criteria for disease diagnosis are very efficient in adults and children older than 3 years of age, but not for children under this age. Mutational analysis is therefore recommended to confirm the disease in young children with a negative family history. A pathogenic mutation in the NF1 should be added to the list of diagnostic criteria. Mutational analysis is also recommended for differential diagnosis and for prenatal or pre-implantation genetic diagnosis, taking into consideration the family history and the type of method to be applied. Molecular studies of this disease using different complimentary molecular techniques and bioinformatics tools have characterized NF1 gene mutations at both the DNA and mRNA levels, increasing the mutational spectrum. Consequently, about 1,289 defects have been reported to date, mainly nonsense/missense mutations, deletions and splice site defects.

  7. Second harmonic generation microscopy is a novel technique for differential diagnosis of breast fibroepithelial lesions.

    Science.gov (United States)

    Tan, Wai Jin; Yan, Jie; Xu, Shuoyu; Thike, Aye Aye; Bay, Boon Huat; Yu, Hanry; Tan, Min-Han; Tan, Puay Hoon

    2015-12-01

    Breast fibroepithelial lesions, including fibroadenomas and phyllodes tumours, are commonly encountered in clinical practice. As histological differences between these two related entities may be subtle, resulting in a challenging differential diagnosis, pathological techniques to assist the differential diagnosis of these two entities are of high interest. An accurate diagnosis at biopsy is important given corresponding implications for clinical decision-making including surgical extent and monitoring. Second harmonic generation (SHG) microscopy is a recently developed optical imaging technique capable of robust, powerful and unbiased label-free direct detection of collagen fibril structure in tissue without the use of antibodies. We constructed tissue microarrays emulating limited materials on biopsy to investigate quantitative collagen signal in fibroepithelial lesions using SHG microscopy. Archived formalin-fixed paraffin-embedded materials of 47 fibroepithelial lesions (14 fibroadenomas and 33 phyllodes tumours) were evaluated. Higher collagen signal on SHG microscopy was observed in fibroadenomas than phyllodes tumours on SHG imaging (pmicroscopy for fibroadenoma classification was 71.4% and 84.4%, respectively. To corroborate these findings, we performed immunohistochemistry on tissue array sections using collagen I and III primary antibodies. Both collagen I and III immunohistochemical expressions were also significantly higher in fibroadenomas than in phyllodes tumours (pmicroscopy is a novel imaging approach that can aid the differential diagnosis of fibroepithelial lesions.

  8. Compilation of a preliminary checklist for the differential diagnosis of neurogenic stuttering

    Directory of Open Access Journals (Sweden)

    Mariska Lundie

    2014-06-01

    Full Text Available Background: Neurogenic stuttering (NS is the most frequently occurring acquired form of stuttering in children and adults. This form of stuttering is primarily caused by neurological incidents. Owing to controversies with regard to similarities between developmental stuttering (DS and NS symptomatology, differential diagnosis is problematic. Differential diagnosis will guide the appropriate management of persons who stutter (PWS.Objectives: The aim of this study was to describe and highlight the characteristics of NS in order to compile a preliminary checklist for accurate diagnosis and intervention.Method: An explorative, applied mixed method, multiple case study research design was followed. Purposive sampling was used to select four participants. A comprehensive assessment battery was compiled for data collection.Results: The results revealed a distinct pattern of core stuttering behaviours in NS, although discrepancies existed regarding stuttering severity and frequency. It was also found that DS and NS can co-occur. The case history and the core stuttering pattern are important considerations during differential diagnosis, as these are the only consistent characteristics in people with NS.Conclusion: It is unlikely that all the symptoms of NS are present in an individual. The researchers scrutinised the findings of this study and the findings of previous literature to compile a potentially workable checklist.

  9. [Vertebrogenic chest pain--"pseudoangina pectoris": etiopathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy].

    Science.gov (United States)

    Grgić, Vjekoslav

    2007-01-01

    Vertebrogenic pain localised in the anterior thorax can imitate anginal pain ("pseudoangina pectoris"). The most common causes of vertebrogenic chest pain are segmental dysfunction and degenerative changes at the level of the lower cervical and upper middle thoracic spine. Segmental dysfunction is a source of pseudoradicular pain, and degenerative changes, before all disc hernia and dorsal osteophytes which are compressing corresponding nerve roots, are the sources of radicular pain which irradiates in the chest. Because of its similarity with angina pectoris, the intense chest pain caused by the cervical radiculopathy which is often followed by heart rhythm disorders and nonspecific changes of the ST-T-segment in ECG, is called "cervicogenic angina". The attacks of vertebrogenic chest pain are not rare even in patients with angina pectoris. Because of superimposed vertebrogenic pain, the manifestation of pain in patients with angina pectoris can be considerably changed which can be misinterpreted as unstable angina. From therapeutic aspect it is very important to distinguish vertebrogenic from anginal pain. That is, the change of cardiological therapy will not eliminate possible attacks of vertebrogenic pain in patients with angina pectoris. From the aspect of most recent understandings, the article describes etiopathogenesis, characteristics, diagnosis and therapy of vertebrogenic chest pain, and also the differences between vertebrogenic and anginal pain.

  10. Thyroid spindle epithelial tumor with thymus-like differentiation (SETTLE): is cytopathological diagnosis possible?

    Science.gov (United States)

    Kloboves-Prevodnik, Veronika; Jazbec, Janez; Us-Krasovec, Marija; Lamovec, Janez

    2002-05-01

    Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a rare tumor of the thyroid gland which occurs predominantly in children, adolescents, and young adults. It usually presents as a painless neck or thyroid mass and only exceptionally as a diffusely enlarged thyroid gland, without metastatic disease at diagnosis. We report on the case of 12-yr-old girl who had diffusely enlarged thyroid gland for about 1 yr and was initially treated for thyroiditis. Fine-needle aspiration biopsy (FNAB) was performed 8 mo after the first admission. Cytological examination of smears showed unusual morphological features. FNAB smears were cellular, with dissociated cells, naked oval nuclei, aggregates, and groups. Three main cell types were observed: spindle, epithelioid, and epithelial. These cells were uniform, cytologically bland, with few mitotic figures. The distinction between these cells was not always unequivocal. In the background of the smears abundant red extracellular material in the form of fine, dust-like granules and irregular patches were present. It was also observed in some aggregates and groups of tumor cells. Spindle and epithelioid cells were immunocytochemically diffusely pan-cytokeratin-positive. In the differential diagnosis, medullary thyroid carcinoma and SETTLE were suggested. The final histological diagnosis was SETTLE. In cases of SETTLE presented as a diffuse thyromegaly the correct diagnosis may be delayed because clinically and ultrasonographically thyroiditis is suspected. To avoid such a delay, FNAB should be used preoperatively. It can provide specific cytological diagnosis based on morphological features and certain immunocytochemical characteristics of the tumor.

  11. Use of p16 FISH for differential diagnosis of mesothelioma in smear preparations.

    Science.gov (United States)

    Nabeshima, Kazuki; Matsumoto, Shinji; Hamasaki, Makoto; Hida, Tomoyuki; Kamei, Toshiaki; Hiroshima, Kenzo; Tsujimura, Tohru; Kawahara, Kunimitsu

    2016-09-01

    Because most of malignant pleural mesothelioma (MPM) patients first present with pleural effusion, detection of mesothelioma cells on effusion smears is critical for early diagnosis. Recently, accumulating evidence indicating that the cytological diagnosis of MPM supported by ancillary techniques is as reliable as that based on histopathology has led to new guidelines for the cytopathologic diagnosis of MPM. Based on the guidelines, a combination of cytomorphological criteria and verification by ancillary techniques is required for the cytologic diagnosis of MPM. Detection of p16 homozygous deletion by fluorescence in situ hybridization (FISH) is the most reliable ancillary technique for differentiating MPM from reactive mesothelial cells (RMC) because of its relatively high sensitivity and extremely high specificity. We showed that the p16 deletion status of MPM cells in pleural effusions reflected that of the underlying invasive MPM tissues, indicating the usefulness of p16 FISH in effusion smear cytology for MPM diagnosis. Thus, for differentiating MPM from RMC, we propose to perform p16 FISH as often as possible. A positive p16 homozygous deletion supports the diagnosis of MPM. However, a negative result does not rule out the possibility of MPM. In such cases, a morphological assessment is critical. Therefore, we analyzed the morphological characteristics of p16 deletion-positive mesothelioma cells using a combination of virtual microscopy and p16 FISH, and identified three morphological characteristics useful for the differentiation, including cell-in-cell engulfment with or without hump formation, multinucleate cells, and larger berry-like cell aggregates. Diagn. Cytopathol. 2016;44:774-780. © 2016 Wiley Periodicals, Inc.

  12. Diagnosis and differential diagnosis of Graves' orbitopathy in MRI; Diagnose und Differenzialdiagnose der endokrinen Orbitopathie in der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Daubner, D.; Spieth, S.; Engellandt, K.; Kummer, R. von [Universitaetsklinikum Carl Gustav Carus, Technische Universitaet Dresden, Abteilung Neuroradiologie, Institut und Poliklinik fuer Radiologische Diagnostik, Dresden (Germany)

    2012-06-15

    Imaging of Graves' orbitopathy (GO) includes radiological and nuclear medicine procedures. Depending on the method used they provide information about the distribution and activity of the disease. Magnetic resonance imaging (MRI) is not only a helpful tool for making the diagnosis it also enables differentiation of the active and inactive forms of GO due to intramuscular edema. The modality is therefore appropriate to evaluate the disease activity and the course of therapy. The disease leads to the typical enlargement of the muscle bodies of the extraocular muscles. The inferior rectus, medial rectus and levator palpebrae muscles are mostly involved. Signal changes of the intraconal and extraconal fat tissue are possible and a bilateral manifestation is common. The differential diagnosis includes inflammatory diseases and tumors, of which orbital pseudotumor (idiopathic, unspecific orbital inflammation), ocular myositis and orbital lymphoma are the most important. The specific patterns (localization, involvement of orbital structures and signal changes) can be differentiated by MRI. (orig.) [German] Die Bildgebung der endokrinen Orbitopathie (EO) umfasst radiologische und nuklearmedizinische Verfahren, die je nach Methode Aussagen zur Verteilung und Aktivitaet der Erkrankung liefern. Die Magnetresonanztomographie (MRT) ist nicht nur zur Diagnosestellung hilfreich, sondern auch in der Lage, die aktive von der inaktiven Form anhand des intramuskulaeren Oedems zu unterscheiden. Das Verfahren eignet sich deshalb auch zur Aktivitaetsbeurteilung und zur Bewertung einer Therapie im Verlauf. Die Erkrankung fuehrt zu einer typischen Verdickung des Muskelbauchs der extraokulaeren Augenmuskeln, wobei die Mm. rectus inferior, rectus medialis und levator palpebrae am haeufigsten betroffen sind. Signalveraenderungen des intra- und extrakonalen Fettgewebes sind moeglich, und eine bilaterale Manifestation ist haeufig. Die Differenzialdiagnose umfasst neben anderen

  13. Granulomatous orchitis in a pre-pubertal school-aged child: differential diagnosis dilemmas.

    Science.gov (United States)

    Jesus, Lisieux E; Rocha, Kátia L M; Caldas, Maria L R; Fonseca, Elissa

    2012-10-01

    A 6-year-old male presented with testicular growth and persistent chronic orchiepididymitis with high inflammatory markers (C reactive protein and erythrocyte sedimentation rate). Biopsies of the testes and epididymides showed bilateral epididymal and testicular granulomata, testicular fibrosis and chronic inflammatory infiltration, and the histological diagnosis was granulomatous orchitis. The symptoms receded with oral corticosteroids. Although rare, granulomatous orchitis is a possible diagnosis in children presenting testicular enlargement. It is important to differentiate it from testicular tumors (if necessary with testicular biopsy) and to investigate its association with systemic vasculitis and infectious diseases.

  14. A Case of Relapsing-Remitting Neuroborreliosis Challenges in the Differential Diagnosis of Recurrent Myelitis

    Directory of Open Access Journals (Sweden)

    P. Albrecht

    2012-03-01

    Full Text Available We report the case of a 31-year-old woman with 4 episodes of myelitis with pleocytosis, a positive Borrelia burgdorferi serology with positive antibody indices, and full recovery each time after antibiotic and steroid treatment, suggesting neuroborreliosis. We nevertheless believe that recurrent neuroborreliosis is improbable based on the levels of the chemokine CXCL13 in cerebrospinal fluid and favor the diagnosis of post-infectious autoimmune-mediated transverse myelitis possibly triggered by an initial neuroborreliosis as the cause of the relapses observed in our patient. We demonstrate the diagnostic steps and procedures which were important in the differential diagnosis of this unusual and challenging case.

  15. Unilateral Intraparotid Swelling: A Case Report of Kimura’s Disease and Review of Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    N. W. Savage

    2013-01-01

    Full Text Available An interesting case of Kimura's disease was described in the 42-year-old patient manifesting itself as a unilateral parotid swelling, albeit the disease usually affects both parotid glands. Furthermore, first pathohistological finding was not suggestive of the disease, revealing only fatty tissue, but on the repeated biopsy together with CT the correct diagnosis was established. It should be emphasized that Kimura's disease has to be taken into account while making differential diagnosis in parotid gland swellings, especially in people of Oriental origin.

  16. CT diagnosis and differential diagnosis of otodystrophic lesions of the temporal bone

    Energy Technology Data Exchange (ETDEWEB)

    D' Archambeau, O.; Parizel, P.M.; Schepper, A.M. De (Antwerp University Hospital (Belgium). Department of Radiology); Koekelkoren, E.; Van De Heyning, P. (Antwerp University Hospital (Belgium). Department of E.N.T.)

    The purpose of this study was to assess the diagnostic and differential diagnostic value of high-resolution computed tomography in the evaluation of temporal-bone dystrophies. The study group included 55 patients with osseous abnormalities of the temporal bone in general, and the labyrinthine capsule in particular. In 27 patients the CT scan revealed evidence of otodystrophic lesions. The CT findings in patients with otosclerosis (21 patients), osteogenesis imperfecta (two patients), fibrous dysplasia (one patient). Paget's disease (one patient) and osteoporosis (two patients) are described. The CT scans of 17 patients revealed secondary osseous lesions due to metastasis (five patients), post-inflammatory changes (10 patients) or labyrinthitis ossificans (two patients). Normal variants and congenital mineralization defects were diagnosed in nine patients, Down's syndrome in two. Our results indicate the importance of high-resolution computed tomography as the primary imaging modality in evaluating osseous lesions of the temporal bone and labyrinth. (author). 14 refs.; 13 figs; 2 tabs.

  17. Fault detection and diagnosis in nonlinear systems a differential and algebraic viewpoint

    CERN Document Server

    Martinez-Guerra, Rafael

    2014-01-01

    The high reliability required in industrial processes has created the necessity of detecting abnormal conditions, called faults, while processes are operating. The term fault generically refers to any type of process degradation, or degradation in equipment performance because of changes in the process's physical characteristics, process inputs or environmental conditions. This book is about the fundamentals of fault detection and diagnosis in a variety of nonlinear systems which are represented by ordinary differential equations. The fault detection problem is approached from a differential algebraic viewpoint, using residual generators based upon high-gain nonlinear auxiliary systems (‘observers’). A prominent role is played by the type of mathematical tools that will be used, requiring knowledge of differential algebra and differential equations. Specific theorems tailored to the needs of the problem-solving procedures are developed and proved. Applications to real-world problems, both with constant an...

  18. [Piriformis muscle syndrome: etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy].

    Science.gov (United States)

    Grgić, Vjekoslav

    2013-01-01

    variations of PM and SN. In 5-6% of patients with low back pain and/or unilateral sciatica, the pain is caused by PM disorders. PS diagnosis can be made on the basis of anamnesis, clinical picture, clinical examination, EMNG, perisciatic anesthetic block of PM and radiological exams (pelvis/PM MRI; MR neurography of LS plexus and SN). PS therapy includes medicamentous therapy, physical therapy, kynesitherapy, acupuncture, therapeutic perisciatic blocks, botulinum toxin injections and surgical treatment (tenotomy of PM, neurolysis of SN).

  19. Brain MR Contribution to the Differential Diagnosis of Parkinsonian Syndromes: An Update

    Directory of Open Access Journals (Sweden)

    Giovanni Rizzo

    2016-01-01

    Full Text Available Brain magnetic resonance (MR represents a useful and feasible tool for the differential diagnosis of Parkinson’s disease. Conventional MR may reveal secondary forms of parkinsonism and may show peculiar brain alterations of atypical parkinsonian syndromes. Furthermore, advanced MR techniques, such as morphometric-volumetric analyses, diffusion-weighted imaging, diffusion tensor imaging, tractography, proton MR spectroscopy, and iron-content sensitive imaging, have been used to obtain quantitative parameters useful to increase the diagnostic accuracy. Currently, many MR studies have provided both qualitative and quantitative findings, reflecting the underlying neuropathological pattern of the different degenerative parkinsonian syndromes. Although the variability in the methods and results across the studies limits the conclusion about which technique is the best, specific radiologic phenotypes may be identified. Qualitative/quantitative MR changes in the substantia nigra do not discriminate between different parkinsonisms. In the absence of extranigral abnormalities, the diagnosis of PD is more probable, whereas basal ganglia changes (mainly in the putamen suggest the diagnosis of an atypical parkinsonian syndrome. In this context, changes in pons, middle cerebellar peduncles, and cerebellum suggest the diagnosis of MSA, in midbrain and superior cerebellar peduncles the diagnosis of PSP, and in whole cerebral hemispheres (mainly in frontoparietal cortex with asymmetric distribution the diagnosis of Corticobasal Syndrome.

  20. Meniere′s disease: Still a mystery disease with difficult differential diagnosis

    Directory of Open Access Journals (Sweden)

    Vassiliou A

    2011-01-01

    Full Text Available One hundred and forty-six years after its first description, the differential diagnosis of Meniere′s disease remains very challenging. The aim of the present study is to review the current knowledge on the advantages and disadvantages of the new diagnostic methods for Meniere′s disease. The importance of accurate diagnosis for primary healthcare systems is also discussed. An extensive search of the literature was performed in Medline and other available database sources. Information from electronic links and related books were also included. Controlled clinical studies, prospective cohort studies, retrospective cohort studies, cross-sectional studies, case reports, written guidelines, systematic reviews, and books were selected. The typical clinical triad of symptoms from the vestibular and cochlear systems (recurrent vertigo, fluctuating sensorineural hearing loss and tinnitus is usually the key for clinical diagnosis. Glycerol dehydration test and electrocochleography are the main diagnostic tests in current practice, while vestibular evoked myogenic potentials may be used in disease staging. Imagine techniques are not specific enough to set alone the diagnosis of Meniere′s disease, although they may be necessary to exclude other pathologies. Recently developed 3D MRI protocols can delineate the perilymphatic/endolymphatic spaces of the inner ear and aid diagnosis. Meniere′s disease is a continuous problem for the patients and affects their quality of life. Taking into account the frequent nature of the disease in certain countries, efforts for reliable diagnosis, prompt referral, and successful management are undoubtedly cost-effective for healthcare systems.

  1. Brain MR Contribution to the Differential Diagnosis of Parkinsonian Syndromes: An Update

    Science.gov (United States)

    De Blasi, Roberto; Grasso, Daniela; Savica, Rodolfo

    2016-01-01

    Brain magnetic resonance (MR) represents a useful and feasible tool for the differential diagnosis of Parkinson's disease. Conventional MR may reveal secondary forms of parkinsonism and may show peculiar brain alterations of atypical parkinsonian syndromes. Furthermore, advanced MR techniques, such as morphometric-volumetric analyses, diffusion-weighted imaging, diffusion tensor imaging, tractography, proton MR spectroscopy, and iron-content sensitive imaging, have been used to obtain quantitative parameters useful to increase the diagnostic accuracy. Currently, many MR studies have provided both qualitative and quantitative findings, reflecting the underlying neuropathological pattern of the different degenerative parkinsonian syndromes. Although the variability in the methods and results across the studies limits the conclusion about which technique is the best, specific radiologic phenotypes may be identified. Qualitative/quantitative MR changes in the substantia nigra do not discriminate between different parkinsonisms. In the absence of extranigral abnormalities, the diagnosis of PD is more probable, whereas basal ganglia changes (mainly in the putamen) suggest the diagnosis of an atypical parkinsonian syndrome. In this context, changes in pons, middle cerebellar peduncles, and cerebellum suggest the diagnosis of MSA, in midbrain and superior cerebellar peduncles the diagnosis of PSP, and in whole cerebral hemispheres (mainly in frontoparietal cortex with asymmetric distribution) the diagnosis of Corticobasal Syndrome. PMID:27774334

  2. Common recessive limb girdle muscular dystrophies differential diagnosis: why and how?

    Directory of Open Access Journals (Sweden)

    Ana Cotta

    2014-09-01

    Full Text Available Limb girdle muscular dystrophies are heterogeneous autosomal hereditary neuromuscular disorders. They produce dystrophic changes on muscle biopsy and they are associated with mutations in several genes involved in muscular structure and function. Detailed clinical, laboratorial, imaging, diagnostic flowchart, photographs, tables, and illustrated diagrams are presented for the differential diagnosis of common autosomal recessive limb girdle muscular dystrophy subtypes diagnosed nowadays at one reference center in Brazil. Preoperative image studies guide muscle biopsy site selection. Muscle involvement image pattern differs depending on the limb girdle muscular dystrophy subtype. Muscle involvement is conspicuous at the posterior thigh in calpainopathy and fukutin-related proteinopathy; anterior thigh in sarcoglycanopathy; whole thigh in dysferlinopathy, and telethoninopathy. The precise differential diagnosis of limb girdle muscular dystrophies is important for genetic counseling, prognostic orientation, cardiac and respiratory management. Besides that, it may probably, in the future, provide specific genetic therapies for each subtype.

  3. Common recessive limb girdle muscular dystrophies differential diagnosis: why and how?

    Science.gov (United States)

    Cotta, Ana; Carvalho, Elmano; da-Cunha-Júnior, Antonio Lopes; Paim, Júlia Filardi; Navarro, Monica M; Valicek, Jaquelin; Menezes, Miriam Melo; Nunes, Simone Vilela; Xavier Neto, Rafael; Takata, Reinaldo Issao; Vargas, Antonio Pedro

    2014-09-01

    Limb girdle muscular dystrophies are heterogeneous autosomal hereditary neuromuscular disorders. They produce dystrophic changes on muscle biopsy and they are associated with mutations in several genes involved in muscular structure and function. Detailed clinical, laboratorial, imaging, diagnostic flowchart, photographs, tables, and illustrated diagrams are presented for the differential diagnosis of common autosomal recessive limb girdle muscular dystrophy subtypes diagnosed nowadays at one reference center in Brazil. Preoperative image studies guide muscle biopsy site selection. Muscle involvement image pattern differs depending on the limb girdle muscular dystrophy subtype. Muscle involvement is conspicuous at the posterior thigh in calpainopathy and fukutin-related proteinopathy; anterior thigh in sarcoglycanopathy; whole thigh in dysferlinopathy, and telethoninopathy. The precise differential diagnosis of limb girdle muscular dystrophies is important for genetic counseling, prognostic orientation, cardiac and respiratory management. Besides that, it may probably, in the future, provide specific genetic therapies for each subtype.

  4. Clinical relevance of "bulging eyes" for the differential diagnosis of spinocerebellar ataxias

    OpenAIRE

    Adriana Moro; Renato Puppi Munhoz; Walter Oleschko Arruda; Salmo Raskin; Hélio Afonso Ghizoni Teive

    2013-01-01

    Objective To investigate the relevance of the clinical finding of bulging eyes (BE) in a large Brazilian cohort of spinocerebellar ataxias (SCA), to assess its importance in clinical differential diagnosis among SCA. Methods Three hundred sixty-nine patients from 168 Brazilian families with SCA were assessed with neurological examination and molecular genetic testing. BE was characterized by the presence of eyelid retraction. Genetically ascertained SCA3 was detected in 167 patients, SCA10 ...

  5. [The differential diagnosis of the types of trauma caused by wheeled tractors].

    Science.gov (United States)

    Zaval'niuk, A Kh

    1993-01-01

    Examinations of 23 corpses and study of 282 expert conclusions concerning the deaths of subjects aged 6 to 78 dead because of wheeled tractor injuries under agricultural conditions helped detect the specific characteristic signs of tractor injury types. Mathematical method of analysis of the characteristic features' quantitative parameters permitted the author to find statistically reliable criteria for differential diagnosis of the types of injuries inflicted by wheeled tractors. The possibility of correct conclusions of an expert using this method is at least 95%.

  6. Differential diagnosis of breast tumors on the basis of radiothermometric findings

    OpenAIRE

    V. I. Vidyukov; Ch. K. Mustafin; R. A. Kerimov; L. N. Fisher

    2016-01-01

    The paper presents a method for the differential diagnosis of breast tumors in accordance with radiothermometric findings, which is based on the authors’ developed diagnostic technique (Patent No. 2532372 dated 5 September 2014). The radiometric method was used to examine 119 patients with malignant breast tumors, 53 patients with benign breast tumors, and 60 women without breast involvement. The data were obtained in 3 institutions: the Russian Medical Academy of Postgraduate Education, the ...

  7. Granulomatous rosacea in infants. Report of three cases and discussion of the differential diagnosis.

    Science.gov (United States)

    da Costa, João Borges; Coutinho, V Sousa; de Almeida, L Soares; Gomes, M Marques

    2008-02-28

    Granulomatous rosacea is a variant of rosacea characterized by hard cutaneous papules and nodules in relatively normal-appearing skin that is rarely diagnosed in childhood. The differential diagnosis essentially includes perioral dermatitis and sarcoidosis. Despite the differences in clinical presentation and histopathology, there is similar responses to the same therapies used in rosacea. Therapeutic failure should lead to the investigation of other rare and controversial conditions, such as acne agminata.

  8. [Biphasic pulmonary blastoma with germ cell differentiation: a challenge in diagnosis and treatment].

    Science.gov (United States)

    Teixeira, Alexandra; Vieira, Claúdia; Sousa, Nuno; Begonha, Rosa; Afonso, Mariana; Amaro, Teresina; Maurício, Joaquina

    2011-12-01

    Serviço de Oncologia Médica. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal. A 27-year-old man, smoker, presented with three months history of fever. A left pulmonary mass inseparable from the heart was identified and serum alpha-fetoprotein was 4160 ng/ml. The morphologic aspects and immunohistochemistry of the biopsy specimen, in conjunction with the clinical findings were compatible with a diagnosis of pulmonary blastoma with germ cell differentiation. The tumour was considered unresectable. The patient was submitted to two cycles of primary chemotherapy with bleomycin, etoposide and cisplatin. Despite a reduction in serum alpha-fetoprotein, the tumor did not regress. Second line chemotherapy (with paclitaxel, ifosfamide and cisplatin) was instituted, but progressive disease was identified after 2 cycles. Six months after the diagnosis cerebral metastases were found and the patient died. This case illustrates a rare situation of difficult diagnosis and treatment.

  9. Differential diagnosis of nongap metabolic acidosis: value of a systematic approach.

    Science.gov (United States)

    Kraut, Jeffrey A; Madias, Nicolaos E

    2012-04-01

    Nongap metabolic acidosis is a common form of both acute and chronic metabolic acidosis. Because derangements in renal acid-base regulation are a common cause of nongap metabolic acidosis, studies to evaluate renal acidification often serve as the mainstay of differential diagnosis. However, in many cases, information obtained from the history and physical examination, evaluation of the electrolyte pattern (to determine if a nongap acidosis alone or a combined nongap and high anion gap metabolic acidosis is present), and examination of the serum potassium concentration (to characterize the disorder as hyperkalemic or hypokalemic in nature) is sufficient to make a presumptive diagnosis without more sophisticated studies. If this information proves insufficient, indirect estimates or direct measurement of urinary NH(4)(+) concentration, measurement of urine pH, and assessment of urinary HCO(3)(-) excretion can help in establishing the diagnosis. This review summarizes current information concerning the pathophysiology of this electrolyte pattern and the value and limitations of all of the diagnostic studies available. It also provides a systematic and cost-effective approach to the differential diagnosis of nongap metabolic acidosis.

  10. Differential diagnosis of rheumatic illnesses. 4. compl. rev. and enl. ed.; Differenzialdiagnose rheumatischer Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Zeidler, Henning [Rheumatologikum Hannover (Germany); Michel, Beat [UniversitaetsSpital Zuerich, Zurich (Switzerland). Rheumaklinik und Inst. fuer Physikalische Medizin

    2009-07-01

    The number of the possible differential diagnosis of rheumatic illnesses is extraordinarily high. This circumstance makes the diagnostics a difficult field with numerous pitfalls. The correct and complete diagnosis however is a condition for the correct therapy. This book facilitates this way from the symptom to the diagnosis for the reader: A detailed representation of the fundamentals (anamnesis, investigation findings, laboratory diagnostics and imaging) a detailed description of all important differential diagnosis follows. The meanwhile fourth edition of this standard work was completely revised and updated. An indispensable guide book for all persons which treat patients with rheumatic illnesses. [German] Die Zahl der moeglichen Differenzialdiagnosen rheumatischer Erkrankungen ist ausserordentlich hoch. Dieser Umstand macht die Diagnostik zu einem schwierigen Feld mit zahlreichen Fallstricken. Die korrekte und vollstaendige Diagnose ist aber Voraussetzung fuer die richtige Therapie. Dieses Buch erleichtert dem Leser diesen Weg vom Symptom zur Diagnose: Einer ausfuehrlichen Darstellung der Grundlagen (Anamnese, Untersuchungsbefund, Labordiagnostik und Bildgebung) folgt eine detaillierte Beschreibung aller wichtigen Differenzialdiagnosen. Die mittlerweile vierte Auflage dieses Standardwerks wurde komplett ueberarbeitet und aktualisiert. Ein unverzichtbarer Ratgeber fuer alle, die Patienten mit Erkrankungen aus dem rheumatologischen Formenkreis behandeln. (orig.)

  11. [Difficulties in the differential diagnosis of hyponatremia presenting with severe neuropsychiatric symptoms].

    Science.gov (United States)

    Steiner, Tamás; Oláh, Roland; Németh, Attila; Winkler, Gábor

    2013-08-04

    Hyponatremia is the most frequent eletrolyte imbalance in hospitalized geriatric patient. The accompanying signs and symptoms can run a wide range and, therefore, these patients are usually admitted to various departments, i.e. neurology and/or traumatology first. Directed laboratory investigations demonstrate severe hyponatremia. Differential diagnosis can be very difficult and complex in the clinical settings. Firstly, spurious forms of hyponatremia have to be excluded, then the underlying cause should elucidated based on the patients hydration status and serum osmolarity. Hyponatremia can be divided into hyper-, hypo- and normovolemic forms. Moreover, it can be further classified as hypo-, iso- and hyperosmolar hyponatremias. The differentiation between renal and extrarenal salt wasting forms is hinged on the urine sodium concentration. Syndrome of inappropriate antidiuretic hormone secretion is the most common cause of normovolemic, hypoosmolar forms (named also as Schwartz-Bartter syndrome). The authors aimed to shed light on the often insurmountable difficulties of the diagnosis, differential diagnosis and appropriate treatment of this very frequent electrolyte imbalance by presenting a clinical case report. Their purported aim reflects upon the wide array of ethiopathogenesis of hyponatremia: various endocrine, renal diseases, inappropriateness of antidiuretic hormone secretion as well as the role of different medications (e.g. diuretics). This fine-tuned and intricate physiology of sodium metabolism could fortuitously be overturned by these mechanisms.

  12. Serum Fragments of Tau for the Differential Diagnosis of Alzheimer's Disease

    DEFF Research Database (Denmark)

    Inekci, Dilek; Henriksen, K.; Linemann, T.

    2015-01-01

    Differential diagnosis of AD is still a challenge due to overlapping features with other types of dementia. Biomarkers for the differential diagnosis of AD can improve the diagnostic value of the disease and ensure an appropriate treatment of patients. The aim of this study was to evaluate...... the potential of two neo-epitope fragments of Tau as serum biomarkers for differential diagnosis of AD. The neo-epitope fragments of Tau were assessed in a cross-sectional cohort of subjects with AD, MCI, other dementias or subjects with non-dementia related memory complaints. The two Tau neo-epitope fragments...... were an ADAM10-generated fragment (Tau-A) and a caspase-3-generated fragment (Tau-C). The serum levels of the fragments were measured by two competitive ELISAs detecting Tau-A and Tau-C, respectively. Tau-A and Tau-C were able to separate subjects with AD and MCI from those with other dementias (p

  13. Clustering and switching during a semantic verbal fluency test contribute to differential diagnosis of cognitive impairment

    Institute of Scientific and Technical Information of China (English)

    Qianhua Zhao; Qihao Guo; Zhen Hong

    2013-01-01

    The verbal fluency test (VFT) can be dissociated into "clustering" (generating words within subcategories)and "switching" (shifting between clusters),which may be valuable in differential diagnosis.In the current study,we investigated the validity of VFT in the differential diagnosis of Alzheimer's disease (AD,n=65),vascular dementia (VaD,n =65),mild cognitive impairment (MCI,n =92),and vascular cognitive impairment without dementia (VCIND,n =76) relative to cognitively normal senior controls (NC,n =374).We found that in the NC group,the total correct score was significantly correlated with age and education; males generated more subcategories; cluster size increased with education,and subcategory and switching decreased with age.A significantly progressive advantage was observed in VFT scores in the sequence NC > MCINCIND > ADNaD,and this significantly discriminated dementia patients from the other groups.AD patients performed better in all four VFT scores than VaD patients.Subcategory and switching scores significantly distinguished AD from VaD patients (AD > VaD; mean difference,0.50 for subcategory,P <0.05; 0.71 for switching,P <0.05).MCI patients scored higher than VCIND patients,but the difference did not reach statistical significance.These results suggest that semantic VFT is useful for the detection of MCI and VCIND,and in the differential diagnosis of cognitive impairment.

  14. The Early Diagnosis of Boys and Girls in Academic Risk Using the Perceptual-Motor Diagnostic System: A Longitudinal Retrospective Study of Evidences of its Effectiveness

    Directory of Open Access Journals (Sweden)

    Emmanuel Herrera-González

    2015-09-01

    Full Text Available The main objective in this study is to evidence the efficiency of the Peques System as a useful tool to diagnose, at an early stage, possible difficulties which will affect the academic performance. In a 3-year longitudinal study, the Perceptual-Motor Diagnostic System (Peques was applied to a sample of 149 participants (77 boys and 72 girls, who were beginning preschool education. Peques classified 38 children with a high risk to lose a year at primary school level. After a three-year follow-up (first primary school level, it was determined that 23 of the 127 who remained in the study (18%, had failed the first, second or third school year. From the high-risk group diagnosed by the Peques System, an 83% indeed lost a school year. These boys and girls had difficulties in different aspects, such as their information processing capacity, motor development, corporal image, Gestalt development and corporal coordination. We concluded that Peques System was able to predict the academic failure in the primary school level, based on the perceptual-motor development reached at preschool level. Further, based on this experience it is recommended to pay special attention to perceptual-motor development, since it plays a basic role in the academic success of boys and girls.

  15. Eruptive dermal clear cell desmo-plastic mesenchymal tumors with perivascular myoid differentiation in a young boy. A clinical, histopathologic, immunohistochemical and electron microscopy study of 17 lesions.

    Science.gov (United States)

    Tomasini, Carlo; Metze, Dieter; Osella-Abate, Simona; Novelli, Mauro; Kutzner, Heinz

    2014-02-01

    Clear cell tumors of the skin are observed in a wide variety of benign and malignant conditions with different histogenesis, sharing the presence of cells with abundant clear cytoplasm. Herein, we report the clinicopathologic features of a healthy young patient affected by asymptomatic, eruptive and disseminated, benign clear cell dermal tumors since early infancy. Neither family history nor genetic testing and counseling provided further useful information. The lesions were mostly confined to the face and lower left extremity with pink teleangiectatic papules and small nodules. Over a 4-year period, a total of 16 different cutaneous lesions were biopsied and histopathologic and immunohistochemical studies carried out; an additional lesion was also removed for electron microscopy examination. Histopathology evidenced multiple perivascular growths of spindle to oval and round cells intermingled with clear/granular cells throughout the dermis, with prominent desmoplasia and numerous capillary-like vessels with focal hemangiopericytoma-like features. Immunohistochemical neoplastic cells were uniformly positive for h-caldesmon and focally smooth muscle α-actin and CD13 indicating myoid differentiation whereas the consistent diffuse cytoplasmic staining for lysosome antigen, such as CD68PG-M1 and NKI/C3 along with the ultrastructural findings supported the view of a lysosome-mediated apoptotic process. The differential diagnosis with other clear cell cutaneous neoplasms is discussed.

  16. Potential model for differential diagnosis between Crohn's disease and primary intestinal lymphoma

    Science.gov (United States)

    Zhang, Tian-Yu; Lin, Yun; Fan, Rong; Hu, Shu-Rong; Cheng, Meng-Meng; Zhang, Mao-Chen; Hong, Li-Wen; Zhou, Xiao-Lin; Wang, Zheng-Ting; Zhong, Jie

    2016-01-01

    AIM To evaluate the usefulness of different parameters to differentiate Crohn’s disease (CD) from primary intestinal lymphoma (PIL). METHODS The medical records of 85 patients with CD and 56 patients with PIL were reviewed retrospectively. Demographic, clinical, laboratory, endoscopic, and computed tomographic enterography (CTE) parameters were collected. The univariate value of each parameter was analyzed. A differentiation model was established by pooling all the valuable parameters. Diagnostic efficacy was analyzed, and a receiver operating characteristic (ROC) curve was plotted. RESULTS The demographic and clinical parameters that showed significant values for differentiating CD from PIL included age of onset, symptom duration, presence of diarrhea, abdominal mass, and perianal lesions (P 8 mm, aneurysmal dilation, stricture with proximal dilation, “comb sign”, mass showing the “sandwich sign”, and intussusceptions (P < 0.05). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the differentiation model were 91.8%, 96.4%, 93.6%, 97.5%, and 88.5%, respectively. The cutoff value was 0.5. The area under the ROC curve was 0.989. CONCLUSION The differentiation model that integrated the various parameters together may yield a high diagnostic efficacy in the differential diagnosis between CD and PIL. PMID:27895429

  17. Noninvasive differential diagnosis of dental periapical lesions in cone-beam CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Kazunori, E-mail: kazokada@sfsu.edu [Department of Computer Science, San Francisco State University, San Francisco, California 94132 (United States); Rysavy, Steven [Biomedical and Health Informatics Program, University of Washington, Seattle, Washington 98195 (United States); Flores, Arturo [Computer Science and Engineering, University of California, San Diego, California 92093 (United States); Linguraru, Marius George [Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Medical Center, Washington, DC 20010 and Departments of Radiology and Pediatrics, George Washington University, Washington, DC 20037 (United States)

    2015-04-15

    Purpose: This paper proposes a novel application of computer-aided diagnosis (CAD) to an everyday clinical dental challenge: the noninvasive differential diagnosis of periapical lesions between periapical cysts and granulomas. A histological biopsy is the most reliable method currently available for this differential diagnosis; however, this invasive procedure prevents the lesions from healing noninvasively despite a report that they may heal without surgical treatment. A CAD using cone-beam computed tomography (CBCT) offers an alternative noninvasive diagnostic tool which helps to avoid potentially unnecessary surgery and to investigate the unknown healing process and rate for the lesions. Methods: The proposed semiautomatic solution combines graph-based random walks segmentation with machine learning-based boosted classifiers and offers a robust clinical tool with minimal user interaction. As part of this CAD framework, the authors provide two novel technical contributions: (1) probabilistic extension of the random walks segmentation with likelihood ratio test and (2) LDA-AdaBoost: a new integration of weighted linear discriminant analysis to AdaBoost. Results: A dataset of 28 CBCT scans is used to validate the approach and compare it with other popular segmentation and classification methods. The results show the effectiveness of the proposed method with 94.1% correct classification rate and an improvement of the performance by comparison with the Simon’s state-of-the-art method by 17.6%. The authors also compare classification performances with two independent ground-truth sets from the histopathology and CBCT diagnoses provided by endodontic experts. Conclusions: Experimental results of the authors show that the proposed CAD system behaves in clearer agreement with the CBCT ground-truth than with histopathology, supporting the Simon’s conjecture that CBCT diagnosis can be as accurate as histopathology for differentiating the periapical lesions.

  18. Omental infarction in an obese 10-year-old boy

    Directory of Open Access Journals (Sweden)

    Katerina Kambouri

    2011-09-01

    Full Text Available Primary omental infarction (POI has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intraoperative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.

  19. Differential diagnosis of Taenia saginata and Taenia solium infections: from DNA probes to polymerase chain reaction.

    Science.gov (United States)

    González, Luis Miguel; Montero, Estrella; Sciutto, Edda; Harrison, Leslie J S; Parkhouse, R Michael E; Garate, Teresa

    2002-04-01

    The objective of this work was the rapid and easy differential diagnosis of Taenia saginata and T. solium. First, a T. saginata size-selected genomic deoxyribonucleic acid (gDNA) library was constructed in the vector lambda gt10 using the 2-4 kb fraction from the parasite DNA digested with EcoR1, under 'star' conditions. After differential screening of the library and hybridization analysis with DNA from T. saginata, T. solium, T. taeniaeformis, T. crassiceps, and Echinococcus granulosus (bovine, porcine, and human), 2 recombinant phages were selected. They were designated HDP1 and HDP2. HDP1 reacted specifically with T. saginata DNA, and HDP2 recognized DNA from both T. saginata and T. solium. The 2 DNA probes were then sequenced and further characterized. HDP1 was a repetitive sequence with a 53 bp monomeric unit repeated 24 times in direct tandem along the 1272 bp fragment, while the 3954 bp HDP2 was not a repetitive sequence. Using the sequencing data, oligonucleotides were designed and used in a polymerase chain reaction (PCR). The 2 selected oligonucleotides from probe HDP1 (PTs4F1 and PTs4R1) specifically amplified gDNA from T. saginata, but not T. solium or other related cestodes, with a sensitivity of < 10 pg of T. saginata gDNA, about the quantity of DNA in one taeniid egg. The 3 oligonucleotides selected from the HDP2 sequence (PTs7S35F1, PTs7S35F2, and PTs7S35R1) allowed the differential amplification of gDNA from T. saginata, T. solium and E. granulosus in a multiplex PCR, again with a sensitivity of < 10 pg. These diagnostic tools have immediate application in the differential diagnosis of T. solium and T. saginata in humans and in the diagnosis of dubious cysts in the slaughterhouse. We also hope to apply them to epidemiological surveys of, for example, soil and water in endemic areas.

  20. The Early Diagnosis of Boys and Girls in Academic Risk Using the Perceptual-Motor Diagnostic System: A Longitudinal Retrospective Study of Evidences of its Effectiveness

    OpenAIRE

    Emmanuel Herrera-González; Gerardo Alonso Araya-Vargas; Harry Fernández-Sagot; María Morera-Castro; Héctor Fonseca-Schmidt

    2015-01-01

    The main objective in this study is to evidence the efficiency of the Peques System as a useful tool to diagnose, at an early stage, possible difficulties which will affect the academic performance. In a 3-year longitudinal study, the Perceptual-Motor Diagnostic System (Peques) was applied to a sample of 149 participants (77 boys and 72 girls), who were beginning preschool education. Peques classified 38 children with a high risk to lose a year at primary school level. After a three-year foll...

  1. Differential Diagnosis of the pancreatic disease : significance of perivascular changes at celiac trunk and superior mesenteric artery on CT

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Ryang; Kim, Ki Whang; Yu, Jeong Sik; Kim, Ji Hyung; Kim, Dong Guk; Lee, Sung Il; Ahn, Chang Soo; Oh, Sei Jung [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine; Kim, Young Hwan [Sanggye Paik Hospital, Seoul (Korea, Republic of)

    1998-03-01

    The purpose of this paper is to classify perivascular change in the celiac trunk and SMA occurring in pancreatic disease and to evaluate its significance in differential diagnosis. In 73 patients with pancreatic disease (42, acute pancreatitis; 14, chronic pancreatitis; 17, pancreatic cancer) abdominal CT findings were retrospectively reviewed. We defined infiltration as linear or irregular density and thickening as presence of a soft tissue mantle surrounding the vessel, and statistically evaluated the usefulness of these factors for the differential diagnosis of pancreatic diseases. Thickening of the celiac trunk and SMA is a valuable finding in the differential diagnosis of pancreatic inflammatory disease and pancreatic cancer. When applied to the differential diagnosis of pancreatic disease, perivascular change should be classified as either infiltration or thickening. (author). 10 refs., 1 tab., 2 figs.

  2. The use of differential scintigraphy in the clinical diagnosis of osseous and soft tissue changes affecting the diabetic foot

    Energy Technology Data Exchange (ETDEWEB)

    Visser, H.J.; Jacobs, A.M.; Oloff, L.; Drago, J.J.

    Prompt recognition of cellulitis, osteomyelitis, diabetic osteolysis, Charcot neuroarthropathy, septic synovitis, and deep plantar abscesses in the diabetic foot is essential because the therapy is drastically different. Differential diagnosis has been greatly facilitated by recently developed scanning techniques.

  3. [Differential diagnosis between Schizotypal Personality Disorder and Autism Spectrum Disorders: a case report].

    Science.gov (United States)

    Ünver, Buket; Öner, Özgür; Yurtbaşı, Pınar

    2015-01-01

    Schizotypal personality disorder is characterized by social and interpersonal deficits marked by discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior. Inappropriate or constricted affect, reduced capacity for relationships, lack of close friends and reduced capacity for social life are the symptoms that overlap both schizotypal personality disorder and autism spectrum disorders. The making of differential diagnosis may be difficult since several symptoms are similar between these disorders. In this study, we discussed the differential diagnosis issues on the basis of an adolescent case. Odd appearance, magical thoughts, reference thoughts suggests Schizotypal Personality Disorder whereas lack of eye contact at 2 years old, a preference to be isolated and play alone and referral to a child psychiatrist at 4 years old suggest Autism Spectrum Disorders. Based on the results of psychological assessment, Wechsler Intelligence Scale for Children-Revised (WISC-R) profile is compatible with autistic children's profiles. Based on Schizotypal Personality Questionnaire, the patient's anxiety, lack of close friends, constricted affect symptoms which take place in the category of interpersonal schizotypy seems to overlap with lack of communication of Autism Spectrum Disorders. This case report indicates that, separation of autism and schizophrenia, a very important historical breakthrough in autism research, may be blurred in cases with less typical clinical pictures representing autistic and schizophrenic "spectrum" diagnosis.

  4. HE4 in the Differential Diagnosis of a Pelvic Mass: A Case Report

    Directory of Open Access Journals (Sweden)

    Luigi Frati

    2011-01-01

    Full Text Available Neoplasms of the ovary present an increasing challenge to the physician. Neoplastic ovarian cysts can resemble endometriomas in ultrasound imaging and need to be carefully considered in the differential diagnosis. We report the case of a woman with a strong family history of hereditary breast and ovarian cancer, who presented with a pelvic mass. The young girl refused oncogenetic counseling and genetic testing, even though she had a 50% a priori probability of being a BRCA1 mutation carrier. Pelvic magnetic resonance imaging (MRI and a comparative analysis of the serum concentration of HE-4 and CA125 biomarkers provided accuracy and sensitivity in the diagnosis of a benign ovarian pathology. Based on this experience, we propose that the sensitivity of a screening program based on a HE4 and CA125 assay and MRI in high risk patients with mutations in the BRCA1 and BRCA2 genes may be considered a useful pre-operative tool for the differential diagnosis of pelvic masses.

  5. Computer-aided differential diagnosis in movement disorders using MRI morphometry

    Science.gov (United States)

    Duchesne, S.; Roland, Y.; Verin, M.; Barillot, C.

    2007-03-01

    Background: Reported error rates for initial clinical diagnosis in parkinsonian disorders can reach up to 35%. Reducing this initial error rate is an important research goal. The objective of this work is to evaluate the ability of an automated MR-based classification technique in the differential diagnosis of Parkinson's disease (PD), multiple systems atrophy (MSA) and progressive supranuclear palsy (PSP). Methods: A total of 172 subjects were included in this study: 152 healthy subjects, 10 probable PD patients and 10 age-matched patients with diagnostic of either probable MSA or PSP. T1-weighted (T1w) MR images were acquired and subsequently corrected, scaled, resampled and aligned within a common referential space. Tissue transformation and deformation features were then automatically extracted. Classification of patients was performed using forward, stepwise linear discriminant analysis within a multidimensional transformation/deformation feature space built from healthy subjects data. Leave-one-out classification was used to avoid over-determination. Findings: There were no age difference between groups. Highest accuracy (agreement with long-term clinical follow-up) of 85% was achieved using a single MR-based deformation feature. Interpretation: These preliminary results demonstrate that a classification approach based on quantitative parameters of 3D brainstem morphology extracted automatically from T1w MRI has the potential to perform differential diagnosis of PD versus MSA/PSP with high accuracy.

  6. Extrahepatic bile duct atresia from the pathologist’s perspective: pathological features and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Peter Van Eyken

    2014-06-01

    Full Text Available Extrahepatic biliary atresia (EHBA refers to stenosis or atresia of the extrahepatic biliary tree. It accounts for 25-30% of cases of neonatal cholestasis. If left untreated, EHBA progresses to biliary cirrhosis and is universally fatal within the first 2 years of life. Early diagnosis is crucial since surgical treatment (Kasai procedure is the only treatment option. Histopathologic examination of liver biopsy specimens is a key element in the diagnostic work-up of infants with suspected EHBA. Pathologic diagnosis aims at excluding non-surgically correctable causes of neonatal cholestasis thereby leading to surgical exploration for confirmation of the diagnosis. All published data indicate that pathologists can diagnose EHBA with high sensitivity, high specificity and reasonable interobserver agreement. The most useful histologic features in the diagnosis of EHBA are portal tract changes including ductular proliferation and bile plugs in ducts and ductules. These lesions are not pathognomonic but can be seen in extrahepatic obstruction of any cause. Total parenteral nutrition (TPN-associated cholestasis and alpha1-antitrypsin (A1AT deficiency cannot be differentiated from EHBA without access to clinical data and may lead to false-positive diagnosis. False-negative interpretation may be caused by early age at diagnosis or by small/indequate specimens. The pathologist also plays a role in the examination of the resected fibrotic segment and of explant specimens. Histopathology can yield prognostic information, being also an indispensable tool in research for the possible pathogenesis of this disease. A well-coordinated, multidisciplinary approach is required in the assessment of suspected cases of EHBA.  Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in

  7. The differential diagnosis of Huntington's disease-like syndromes: 'red flags' for the clinician.

    Science.gov (United States)

    Martino, Davide; Stamelou, Maria; Bhatia, Kailash P

    2013-06-01

    A growing number of progressive heredodegenerative conditions mimic the presentation of Huntington's disease (HD). Differentiating among these HD-like syndromes is necessary when a patient with a combination of movement disorders, cognitive decline, behavioural abnormalities and progressive disease course proves negative to the genetic testing for HD causative mutations, that is, IT15 gene trinucleotide-repeat expansion. The differential diagnosis of HD-like syndromes is complex and may lead to unnecessary and costly investigations. We propose here a guide to this differential diagnosis focusing on a limited number of clinical features ('red flags') that can be identified through accurate clinical examination, collection of historical data and a few routine ancillary investigations. These features include the ethnic background of the patient, the involvement of the facio-bucco-lingual and cervical district by the movement disorder, the co-occurrence of cerebellar features and seizures, the presence of peculiar gait patterns and eye movement abnormalities, and an atypical progression of illness. Additional help may derive from the cognitive-behavioural presentation of the patient, as well as by a restricted number of ancillary investigations, mainly MRI and routine blood tests. These red flags should be constantly updated as the phenotypic characterisation and identification of more reliable diagnostic markers for HD-like syndromes progress over the following years.

  8. Multiparametric MR imaging in diagnosis of chronic prostatitis and its differentiation from prostate cancer

    Directory of Open Access Journals (Sweden)

    Vivek Kumar Sah

    2015-03-01

    Full Text Available Chronic prostatitis is a heterogeneous condition with high prevalence rate. Chronic prostatitis has overlap in clinical presentation with other prostate disorders and is one of the causes of high serum prostate specific antigen (PSA level. Chronic prostatitis, unlike acute prostatitis, is difficult to diagnose reliably and accurately on the clinical grounds alone. Not only this, it is also challenging to differentiate chronic prostatitis from prostate cancer with imaging modalities like TRUS and conventional MR Imaging, as the findings can mimic those of prostate cancer. Even biopsy doesn't play promising role in the diagnosis of chronic prostatitis as it has limited sensitivity and specificity. As a result of this, chronic prostatitis may be misdiagnosed as a malignant condition and end up in aggressive surgical management resulting in increased morbidity. This warrants the need of reliable diagnostic tool which has ability not only to diagnose it reliably but also to differentiate it from the prostate cancer. Recently, it is suggested that multiparametric MR Imaging of the prostate could improve the diagnostic accuracy of the prostate cancer. This review is based on the critically published literature and aims to provide an overview of multiparamateric MRI techniques in the diagnosis of chronic prostatitis and its differentiation from prostate cancer.

  9. Values of Seven Tumor Markers in Identiifcation and Diagnosis of Esophageal Carcinoma Accompanied by Neuroendocrine Differentiation

    Institute of Scientific and Technical Information of China (English)

    LIU Lian-ke; SHAO Ming-wen; MA Lan; SUN Jing; GUAN Dan; SHU Yongqian

    2015-01-01

    Objective:To explore the values of seven tumor markers in the identiifcation and diagnosis of esophageal carcinoma accompanied by neuroendocrine differentiation (E-NED). Methods:A total of 378 patients diagnosed as low differentiation of esophageal carcinoma in The First Affiliated Hospital with Nanjing Medical University from Jan., 2008 to Dec., 2013 were selected, in which there were 349 with esophageal carcinoma with no neuroendocrine differentiation (E-NNED, E-NNED group) and 29 with E-NED (E-NED group). The levels of seven tumor markers including synaptophysin (Syn), Chromogranin A (CgA), neuron-specific enolase (NSE), neural cell adhesion molecule (CD56), protein gene product 9.5 (PGP9.5), secretagogue (SCGN) and thyroid transcription factor-1 (TTF-1) of both groups were detected with histoimmunochemical method and the influences of the single and combined detection of above indexes on E-NED patients were analyzed. Results:Except TTF-1, expressions of Syn, CgA, NSE, CD56, PGP9.5 and SCGN in E-NED group were evidently higher than those in E-NNED group and the differences were significant (P Conclusion:PGP9.5 and SCGN can be used as neuroendocrine markers for the pathological diagnosis of E-NED and Syn + CD56, Syn + PGP9.5 and Syn + SCGN can all be used as combined detection.

  10. Using the Disease State Fingerprint Tool for Differential Diagnosis of Frontotemporal Dementia and Alzheimer's Disease

    Science.gov (United States)

    Muñoz-Ruiz, Miguel Ángel; Hall, Anette; Mattila, Jussi; Koikkalainen, Juha; Herukka, Sanna-Kaisa; Husso, Minna; Hänninen, Tuomo; Vanninen, Ritva; Liu, Yawu; Hallikainen, Merja; Lötjönen, Jyrki; Remes, Anne M.; Alafuzoff, Irina; Soininen, Hilkka; Hartikainen, Päivi

    2016-01-01

    Background Disease State Index (DSI) and its visualization, Disease State Fingerprint (DSF), form a computer-assisted clinical decision making tool that combines patient data and compares them with cases with known outcomes. Aims To investigate the ability of the DSI to diagnose frontotemporal dementia (FTD) and Alzheimer's disease (AD). Methods The study cohort consisted of 38 patients with FTD, 57 with AD and 22 controls. Autopsy verification of FTD with TDP-43 positive pathology was available for 14 and AD pathology for 12 cases. We utilized data from neuropsychological tests, volumetric magnetic resonance imaging, single-photon emission tomography, cerebrospinal fluid biomarkers and the APOE genotype. The DSI classification results were calculated with a combination of leave-one-out cross-validation and bootstrapping. A DSF visualization of a FTD patient is presented as an example. Results The DSI distinguishes controls from FTD (area under the receiver-operator curve, AUC = 0.99) and AD (AUC = 1.00) very well and achieves a good differential diagnosis between AD and FTD (AUC = 0.89). In subsamples of autopsy-confirmed cases (AUC = 0.97) and clinically diagnosed cases (AUC = 0.94), differential diagnosis of AD and FTD performs very well. Conclusions DSI is a promising computer-assisted biomarker approach for aiding in the diagnostic process of dementing diseases. Here, DSI separates controls from dementia and differentiates between AD and FTD. PMID:27703465

  11. Using the Disease State Fingerprint Tool for Differential Diagnosis of Frontotemporal Dementia and Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Muñoz-Ruiz

    2016-07-01

    Full Text Available Background: Disease State Index (DSI and its visualization, Disease State Fingerprint (DSF, form a computer-assisted clinical decision making tool that combines patient data and compares them with cases with known outcomes. Aims: To investigate the ability of the DSI to diagnose frontotemporal dementia (FTD and Alzheimer's disease (AD. Methods: The study cohort consisted of 38 patients with FTD, 57 with AD and 22 controls. Autopsy verification of FTD with TDP-43 positive pathology was available for 14 and AD pathology for 12 cases. We utilized data from neuropsychological tests, volumetric magnetic resonance imaging, single-photon emission tomography, cerebrospinal fluid biomarkers and the APOE genotype. The DSI classification results were calculated with a combination of leave-one-out cross-validation and bootstrapping. A DSF visualization of a FTD patient is presented as an example. Results: The DSI distinguishes controls from FTD (area under the receiver-operator curve, AUC = 0.99 and AD (AUC = 1.00 very well and achieves a good differential diagnosis between AD and FTD (AUC = 0.89. In subsamples of autopsy-confirmed cases (AUC = 0.97 and clinically diagnosed cases (AUC = 0.94, differential diagnosis of AD and FTD performs very well. Conclusions: DSI is a promising computer-assisted biomarker approach for aiding in the diagnostic process of dementing diseases. Here, DSI separates controls from dementia and differentiates between AD and FTD.

  12. Role of neuropsychological assessment in the differential diagnosis of Alzheimer's disease and vascular dementia

    Directory of Open Access Journals (Sweden)

    Érica Maria Lima Pimentel

    Full Text Available Abstract The prevalence of dementia increases significantly from the age of 65 years, doubling every five years thereafter. Alzheimer's disease (AD and vascular dementia (VaD constitute the two main dementia types. Differentiating them encompasses anamnesis, neurological examination, laboratory and neuroimaging exams and neuropsychological assessment. Neuropsychological assessment produces different findings for each dementia type, and reveals those areas most impaired as well as those most preserved. The aim of the present article was to describe the role of neuropsychology in diagnosing dementia and achieving a differential diagnosis between AD and VaD. A general overview follows of the most widely known instruments used to assess cognitive function in dementia, and the cognitive changes seen in AD and VaD. The conclusion drawn was that there is significant overlap in cognitive changes between both these dementia types, while each type has its own specific characteristics which are identifiable and quantifiable on neuropsychological assessments and provide the basis for reaching a differential diagnosis.

  13. A bilobed testicle diagnosed with ultrasound in an 18-year-old boy

    Directory of Open Access Journals (Sweden)

    Farzaneh Hekmatnia

    2016-01-01

    Full Text Available Bilobed testicle is a very rare congenital malformation with an unknown etiology. Herein, we report an 18-year-old boy presented with a right-bilobed testicle mimicking a testicular tumor. The present case highlights the importance of considering bilobed testicle as a valuable differential diagnosis of testicular mass to prevent unnecessary surgery. Furthermore, the case could provide more information about presentation and management of bilobed testicle.

  14. Brucellosis: unusual presentations in two adolescent boys

    Energy Technology Data Exchange (ETDEWEB)

    Piampiano, P.; McLeary, M.; Young, L.W. [Dept. of Radiology, Division of Pediatric Radiology, Loma Linda University Children' s Hospital, Loma Linda, CA (United States); Janner, D. [Div. of Pediatric Infectious Disease, Loma Linda University Medical Center and Children' s Hospital, Loma Linda, CA (United States)

    2000-05-01

    Two boys presented with variable signs and symptoms of infectious disease that challenged diagnosis. One of the two patients had aortic valve vegetations and lower extremity aneurysms, and the other had calvarial osteomyelitis, epidural abscess, pleural effusions, and pulmonary nodules. Only after a battery of bacterial and fungal agglutination tests was the unsuspected diagnosis made in each of brucellosis from Brucella canis. (orig.)

  15. The role of technetium-99m methoxyisobutylisonitrile scintigraphy in the differential diagnosis of cold thyroid nodules

    Energy Technology Data Exchange (ETDEWEB)

    Mezosi, E.; Bajnok, L.; Sztojka, I.; Szabo, J.; Leovey, A.; Kakuk, G.; Nagy, E. [Department of Medicine, University Medical School, Debrecen (Hungary); Gyory, F. [Department of Surgery, University Medical School, Debrecen (Hungary); Varga, J.; Galuska, L. [Nuclear Medicine Centre, University Medical School, Debrecen (Hungary)

    1999-08-01

    Various diagnostic techniques have been successfully used in the clinical management of cold nodules; however, the decision on whether to employ surgery or a conservative treatment is not always easy. This study was designed to appraise the diagnostic value of technetium-99m methoxyisobutylisonitrile (MIBI) scintigraphy in the assessment of cold nodules detected using {sup 99m}Tc-pertechnetate. Fifty-two patients were included in the study. All had already been selected for surgery, based on their clinical and laboratory findings, including fine-needle aspiration biopsy. The total number of cold nodules on {sup 99m}Tc-pertechnetate scans was 59. The thyroid scan was performed 20-40 min after i.v. injection of 400 MBq of {sup 99m}Tc-MIBI. Uptake of MIBI in thyroid nodules was compared with that in the surrounding normal thyroid tissue, and a score of between 0 and 3 was assigned to each nodule as follows: 0, cold; 1, decreased; 2, equal; 3, hot. Definitive histology revealed nodular goitre in 24 cases, adenoma in 19, thyroiditis in 1, differentiated cancer in 12, medullary cancer in 2, and anaplastic cancer in 1. None of the degenerative nodules were hot on MIBI scan, while the adenomas showed a variety of MIBI imaging patterns, most frequently the score 3 pattern. In the diagnosis of differentiated thyroid cancer the sensitivities of score 3 and score 2+3 MIBI uptake patterns were 83% (10/12) and 100%, respectively. The score 3 MIBI uptake pattern had a specificity of 100% and a positive predictive value of 100% with respect to thyroid (benign and malignant) neoplastic diseases, whereas a specificity of 72% and a positive predictive value of 43% were observed in the detection of differentiated cancer. After a cold nodule had been detected using {sup 99m}Tc-pertechnetate, a second scan with high MIBI uptake increased by 7.8 times the probability that this nodule would be a differentiated cancer. In conclusion, {sup 99m}Tc-MIBI scintigraphy is a useful method in the

  16. [Mycosis fungoides or inflammatory dermatitis: differential diagnosis between early lymphoma and inflammation in skin biopsies].

    Science.gov (United States)

    Oschlies, I; Klapper, W

    2013-05-01

    Mycosis fungoides is a cutaneous T-cell lymphoma with protracted clinical course and progression in different stages with increasing aggressiveness. The clinical picture as well as the histopathology of mycosis fungoides within the early patch and plaque phase is difficult to delineate from some inflammatory skin diseases. Thus, the diagnosis of these early stages of the lymphoma is only possible when clinical, histopathological, and molecular features are integrated into the diagnosis, especially as none of the individual disease criteria is specific. Important clues towards the diagnosis of mycosis fungoides are cytologically abnormal epidermotropic CD4-positive T-cells causing only minor epidermal alterations, the formation of Pautrier-abscesses and basal alignment of the epidermotropic T-cells. The findings of an aberrant T-cell immunophenotype of the intraepidermal lymphoid component as well as the molecular proof of T-cell clonality are important further features. In the differential diagnosis between early stage mycosis fungoides and parapsoriasis, there remains nevertheless a diagnostic and maybe also a true biological grey zone.

  17. Esthesioneuroblastoma, Neuroendocrine Carcinoma, and Sinonasal Undifferentiated Carcinoma: Differentiation in Diagnosis and Treatment

    Science.gov (United States)

    Su, Shirley Y.; Bell, Diana; Hanna, Ehab Y.

    2014-01-01

    Introduction Malignant sinonasal tumors comprise less than 1% of all neoplasms. A wide variety of tumors occurring primarily in this site can present with an undifferentiated or poorly differentiated morphology. Among them are esthesioneuroblastomas, sinonasal undifferentiated carcinomas, and neuroendocrine carcinomas. Objectives We will discuss diagnostic strategies, recent advances in immunohistochemistry and molecular diagnosis, and treatment strategies. Data Synthesis These lesions are diagnostically challenging, and up to 30% of sinonasal malignancies referred to the University of Texas MD Anderson Cancer Center are given a different diagnosis on review of pathology. Correct classification is vital, as these tumors are significantly different in biological behavior and response to treatment. The past decade has witnessed advances in diagnosis and therapeutic modalities leading to improvements in survival. However, the optimal treatment for esthesioneuroblastoma, sinonasal undifferentiated carcinoma, and neuroendocrine carcinoma remain debated. We discuss advances in immunohistochemistry and molecular diagnosis, diagnostic strategies, and treatment selection. Conclusions There are significant differences in prognosis and treatment for esthesioneuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma. Recent advances have the potential to improve oncologic outcomes but further investigation in needed. PMID:25992139

  18. Polymyositis without Beneficial Response to Steroid Therapy: Should Miyoshi Myopathy be a Differential Diagnosis?

    Science.gov (United States)

    Scalco, Renata Siciliani; Lorenzoni, Paulo José; Lynch, David S.; Martins, William Alves; Jungbluth, Heinz; Quinlivan, Ros; Becker, Jefferson; Houlden, Henry

    2017-01-01

    Patient: Male, 16 Final Diagnosis: Miyoshi myopathy Symptoms: HyperCKemia • myalgia • weakness Medication: — Clinical Procedure: — Specialty: Neurology Objective: Rare disease Background: Miyoshi myopathy (MM) is an autosomal-recessive muscle disorder caused by mutations in the DYSF gene. Clinical features and histopathological changes in dysferlinopathies may mimic inflammatory myopathies and a high degree of clinical suspicion is required to guide the genetic investigation. Case Report: We report the case of a 16-year-old male who presented with severe bilateral calf pain and elevated CK levels (15 000 IU/l) who was on prolonged steroid therapy prompted by the clinical suspicion of inflammatory myopathy. Three years into his illness, he was referred for neuromuscular evaluation presenting with untreatable muscle pain and progressive weakness. The diagnosis of “refractory polymyositis” was revisited. Targeted exome sequencing revealed homozygous pathogenic mutations in the DYSF gene, confirming a diagnosis of Miyoshi myopathy. Conclusions: Our case illustrates that severe muscle pain may be the initial feature of Miyoshi myopathy and should be considered in the differential diagnosis of inflammatory myopathies. Although the described patient reported partial clinical improvement in muscle pain, steroid treatment is not an effective therapy for dysferlinopathy patients and it did not prevent disease progression. In addition, we confirm the utility of next-generation sequencing approaches to myopathies, particularly in complex or unusual cases when muscle biopsy is not available. PMID:28053302

  19. Sclerosing cholangitis: Clinicopathologic features, imaging spectrum, and systemic approach to differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Ni Eun [Dept. of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, So Yeon; Lee, Seung Soo; Byun, Jae Ho; Kim, Hyoung Jung; Kim, Jin Hee; Lee, Moon Gyu [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-02-15

    Sclerosing cholangitis is a spectrum of chronic progressive cholestatic liver disease characterized by inflammation, fibrosis, and stricture of the bile ducts, which can be classified as primary and secondary sclerosing cholangitis. Primary sclerosing cholangitis is a chronic progressive liver disease of unknown cause. On the other hand, secondary sclerosing cholangitis has identifiable causes that include immunoglobulin G4-related sclerosing disease, recurrent pyogenic cholangitis, ischemic cholangitis, acquired immunodeficiency syndrome-related cholangitis, and eosinophilic cholangitis. In this review, we suggest a systemic approach to the differential diagnosis of sclerosing cholangitis based on the clinical and laboratory findings, as well as the typical imaging features on computed tomography and magnetic resonance (MR) imaging with MR cholangiography. Familiarity with various etiologies of sclerosing cholangitis and awareness of their typical clinical and imaging findings are essential for an accurate diagnosis and appropriate management.

  20. Differential diagnosis of isolated calf muscle vein thrombosis and gastrocnemius hematoma by high-frequency ultrasound

    Institute of Scientific and Technical Information of China (English)

    SU Li-ya; GUO Fa-jin; XU Guang; HAN Xiu-jie; SUN Chang-kun; ZHANG Zheng; JING Qing-hong

    2013-01-01

    Background Differential diagnosis of isolated calf muscle vein thrombosis (ICMVT) and gastrocnemius hematoma is essential for early identification of deep vein thrombosis (DVT).This study aimed to investigate the diagnostic value of high-frequency color Doppler ultrasound for differential diagnosis of ICMVT and gastrocnemius hematoma.Methods A retrospective case series of 35 ICMVT (M∶F,21∶14; mean age (64.5±10.6) years) and 23 gastrocnemius hematoma (M∶F,16∶7; mean age (75.4±11.8) years) patients with bilateral/unilateral lower limb pain was conducted between January 2006 and September 2012.Characteristics and the morphology of high-frequency color Doppler ultrasonography of the lower limb deep vein,great saphenous vein,calf muscles,skin,and soft tissue were examined.Results ICMVT hypoechoic signals were characterized by long,tube-like masses on longitudinal sections and oval masses on transverse sections,with apparent muscle thrombosis boundaries,distal and proximal venous connections,and,often,lower limb DVT.Gastrocnemius hematoma hypoechoic signals were characterized by large volumes,enhanced posterior hematoma echo,hyperechoic muscle boundaries,no hematoma blood flow,and no DVT,and clear differences in trauma/exercise-and oral anticoagulant-induced hematomas were readily apparent.According to the measurement,the ratio of long diameter/transverse diameter (D/T) in ICMVT patients was about less than 2.0,whereas in gastrocnemius hematoma patients the ratio was more than 2.0.Early stage isoechoic and hypoechoic signals were detected with gradually increasing ovular anechoic areas.Partial muscle fibers in the hematoma due to muscle fractures were apparent.Conclusion High-frequency color Doppler ultrasound was found to be a sensitive and reliable method for differential diagnosis of ICMVT and gastrocnemius hematoma due to trauma and exercise or prolonged oral anticoagulant use.

  1. Differential diagnosis of hyperphenylalaninaemia by a combined phenylalanine-tetrahydrobiopterin loading test.

    Science.gov (United States)

    Ponzone, A; Guardamagna, O; Spada, M; Ferraris, S; Ponzone, R; Kierat, L; Blau, N

    1993-08-01

    We describe a new fully reliable method for the differential diagnosis of tetrahydrobiopterin-dependent hyperphenylalaninaemia (HPA). The method comprises the combined phenylalanine (Phe) plus tetrahydrobiopterin (BH4) oral loading test and enables the selective screening of BH4 deficiency when pterin analysis is not available or when a clear diagnosis has not been previously made. It should be performed together with the measurement of dihydropteridine reductase (DHPR) activity in blood. The new combined loading test was performed in nine patients with primary HPA, three with classical phenylketonuria (PKU), three with DHPR deficiency, and three with 6-pyruvoyl tetrahydropterin synthase (PTPS) deficiency. Three hours after oral Phe loading (100 mg/kg body weight), synthetic BH4 was administered orally at doses of either 7.5 or 20 mg/kg body weight. Amino acid (Phe and tyrosine) and pterin (neopterin and biopterin) metabolism and kinetics were analysed. By exploiting the decrease in serum Phe 4 and 8 h after administration, a clear response was obtained with the higher BH4 dose (20 mg/kg body weight), allowing detection of all cases of BH4 deficiency, as well as differentiation of BH4 synthesis from regeneration defects. Since DHPR deficient patients who were previously shown to be non-responsive to the simple BH4 loading test gave a positive response, the combined Phe plus BH4 loading test can be used as a more reliable tool for the differential diagnosis of HPA in these patients. Moreover, it takes advantage of being performed while patients are on a Phe-restricted diet.

  2. Peripheral odontogenic fibroma: a rare gingival neoplasm with clinico-pathological differential diagnosis.

    Science.gov (United States)

    Kumar, Rajesh; Jaiswal, Shradha; Sharma, Aanchal; Andhare, Vinod; Sabir, Husain

    2015-01-01

    The peripheral odontogenic fibroma (POdF) is a rare gingival neoplasm, characterised by relatively mature collagenous fibrous tissue and varying amounts of odontogenic epithelium. It can be described as a slow growing, firmly attached, solid and smooth gingival mass which may be present asymptomatically for years, which may cause displacement of adjacent teeth. The purpose of this article is to discuss a case of POdF, occurring in the maxillary anterior region, with detailed clinico-pathological differential diagnosis to clarify characteristic features of various gingival overgrowths to enhance easy identification.

  3. Wound healing and treating wounds: Differential diagnosis and evaluation of chronic wounds.

    Science.gov (United States)

    Morton, Laurel M; Phillips, Tania J

    2016-04-01

    Wounds are an excellent example of how the field of dermatology represents a cross-section of many medical disciplines. For instance, wounds may be caused by trauma, vascular insufficiency, and underlying medical conditions, such as diabetes, hypertension, and rheumatologic and inflammatory disease. This continuing medical education article provides an overview of wound healing and the pathophysiology of chronic wounds and reviews the broad differential diagnosis of chronic wounds. It also describes the initial steps necessary in evaluating a chronic wound and determining its underlying etiology.

  4. Differential diagnosis of infections in a patient with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Paolo Ghiringhelli

    2008-12-01

    Full Text Available We describe a case of a 65-years-old patient with Chronic Obstructive Pulmonary Disease (COPD, receiving oxygen therapy and resistant to antibiotic therapy. He was admitted with high fever, productive cough, marked leukocytosis, and chest X-ray findings of infiltration and fluid levels within lung cysts. A differential diagnosis was essential to start an adequate treatment and avoid the rapid worsening of patients respiratory status. In patients with chronic pulmonary diseases under immunotherapy, micotic infections should be considered. Aspergillus fumigatus was cultured from bronchial washing fluid and we diagnosed chronic necrotizing pulmonary aspergillosis (CNPA. Oral itraconazole was started and his symptoms and laboratory data markedly improved.

  5. Nevus of ota with rare palatal involvement: a case report with emphasis on differential diagnosis.

    Science.gov (United States)

    Sharma, Gaurav; Nagpal, Archna

    2011-01-01

    Nevus of Ota, a dermal melanocytic nevus, is rare in the Indian subcontinent. It presents as a brown, blue, or gray patch on the face and is within the distribution of the ophthalmic and maxillary branches of the trigeminal nerve. The oral cavity is infrequently involved in nevus of Ota. Only 11 cases have been documented in the English literature. We report a rare case of intraoral nevus of Ota in a 22-year-old male patient. This paper focuses on the differential diagnosis of oral manifestations of nevus of Ota to assist in proper followup to avert malignant transformation.

  6. Nevus of Ota with Rare Palatal Involvement: A Case Report with Emphasis on Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Gaurav Sharma

    2011-01-01

    Full Text Available Nevus of Ota, a dermal melanocytic nevus, is rare in the Indian subcontinent. It presents as a brown, blue, or gray patch on the face and is within the distribution of the ophthalmic and maxillary branches of the trigeminal nerve. The oral cavity is infrequently involved in nevus of Ota. Only 11 cases have been documented in the English literature. We report a rare case of intraoral nevus of Ota in a 22-year-old male patient. This paper focuses on the differential diagnosis of oral manifestations of nevus of Ota to assist in proper followup to avert malignant transformation.

  7. The derivation and validation of a prediction rule for differential diagnosis of thyroid nodules

    Institute of Scientific and Technical Information of China (English)

    李拓

    2013-01-01

    Objective To set up a prediction rule for the pro-operative differential diagnosis of thyroid nodules and evaluate its clinical value.Methods All patients of thyroid nodules undergoing thyroid operations in Changzheng hospital from June,1997 to July,2012 were included in this study.They were randomly divided into the derivation cohort (2/3) and the validation cohort (1/3) .A prediction rule was developed based on the logistic regression model and the scoring system was established in accordance with assigning of the value of each variableβ

  8. Subacute Histoplasmosis with Focal Involvement of the Epiglottis: Importance of Differential Diagnosis

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    F. Ahumada

    2014-01-01

    Full Text Available Histoplasmosis is an endemic mycosis of the Americas, Africa, and Asia. In Spain, it is the most common imported endemic mycosis appearing in the literature, and its incidence is on the rise. Proper differential diagnosis of the disease must be taken into consideration by otorhinolaryngologists, as the clinical manifestations of histoplasmosis may simulate more prevalent diseases such as cancer or tuberculosis. We present the case of a Spanish patient with focal involvement of the larynx and offer a review of the relevant literature.

  9. The differential diagnosis of inflammatory joint disease in maternal-fetal microchimerism

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    Seme Youssef Reda

    2013-12-01

    Full Text Available This study aimed at making the differential diagnosis of joint disease in a case of genetic chimerism in a female multiparous donor from the Regional Blood Bank of Guarapuava-PR (Hemocentro Regional de Guarapuava-PR, who had had three pregnancies of male fetuses. The patient showed joint pain prior to the last donation. It was possible to identify fetal cells remaining in circulation 20 years after her last pregnancy. Laboratory tests for acute phase proteins revealed possible termination of immune tolerance to circulating fetal cells. Thus, a hypothesis of graft-versus-host disease was formulated to explain the joint disease manifested by the donor.

  10. Can Quantitative Muscle Strength and Functional Motor Ability Differentiate the Influence of Age and Corticosteroids in Ambulatory Boys with Duchenne Muscular Dystrophy?

    Science.gov (United States)

    Buckon, Cathleen; Sienko, Susan; Bagley, Anita; Sison-Williamson, Mitell; Fowler, Eileen; Staudt, Loretta; Heberer, Kent; McDonald, Craig M.; Sussman, Michael

    2016-01-01

    Background: In the absence of a curative treatment for Duchenne Muscular Dystrophy (DMD), corticosteroid therapy (prednisone, deflazacort) has been adopted as the standard of care, as it slows the progression of muscle weakness and enables longer retention of functional mobility. The ongoing development of novel pharmacological agents that target the genetic defect underlying DMD offer hope for a significant alteration in disease progression; however, substantiation of therapeutic efficacy has proved challenging. Identifying functional outcomes sensitive to the early, subtle changes in muscle function has confounded clinical trials. Additionally, the alterations in disease progression secondary to corticosteroid therapy are not well described making it difficult to ascertain the benefits of novel agents, often taken concurrently with corticosteroids. Objective: The purpose of this study was to examine outcome responsiveness to corticosteroid therapy and age at the onset of a natural history study of ambulatory boys with DMD. Methods: Eighty-five ambulatory boys with DMD (mean age 93 mo, range 49 to 180 mo) were recruited into this study. Fifty participants were on corticosteroid therapy, while 33 were corticosteroid naïve at the baseline assessment. Within each treatment group boys were divided in two age groups, 4 to 7 years and 8 and greater years of age. The Biodex System 3 Pro isokinetic dynamometer was used to assess muscle strength. Motor skills were assessed using the upper two dimensions (standing/walking, running & jumping) of the Gross Motor Function Measure (GMFM 88) and Timed Motor Tests (TMTs) (10-meter run, sit to stand, supine to stand, climb 4-stairs). Two way analysis of variance and Pearson correlations were used for analysis. Results: A main effect for age was seen in select lower extremity muscle groups (hip flexors, knee extensors and ankle dorsiflexors), standing dimension skills, and all TMTs with significantly greater weakness and loss of

  11. Differential diagnosis of breast tumors on the basis of radiothermometric findings

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    V. I. Vidyukov

    2016-01-01

    Full Text Available The paper presents a method for the differential diagnosis of breast tumors in accordance with radiothermometric findings, which is based on the authors’ developed diagnostic technique (Patent No. 2532372 dated 5 September 2014. The radiometric method was used to examine 119 patients with malignant breast tumors, 53 patients with benign breast tumors, and 60 women without breast involvement. The data were obtained in 3 institutions: the Russian Medical Academy of Postgraduate Education, the N.N. Blokhin Russian Cancer Research Center, and Moscow Oncology Dispensary Five. A microwave radiothermometer was used to measure core and skin temperatures in 9 symmetrical points of each breast. Using the findings as a basis, the authors proposed quantitative criteria that ensured that breast tumors should be differentially diagnosed with high specificity.

  12. [The spectrum of cystic kidney disease in adulthood: differential diagnosis and complications].

    Science.gov (United States)

    Peces, R; Costero, O

    2003-01-01

    Simple renal cysts are the most common renal masses, accounting for roughly 65 to 70% of cases. They most often occur in patients over the age of 50 as determined from post-mortem examination or renal ultrasonography. The major concern with simple renal cysts is differentiating them from more serious disorders, such as polycystic kidney disease and solid masses such as a renal carcinoma or abscess. Renal arteriovenous malformations may present with ultrasound picture mimicking simple parapelvic cyst. Ultrasound, doppler ultrasound, computed tomography and magnetic resonance imaging are effective in documenting the underlying lesions non-invasively. Arteriography may be useful to characterise vascular lesion. We report here the spectrum of cystic kidney disease in adulthood in a group of patient with different disorders. The differential diagnosis, complications and associated process are discussed.

  13. Features of the differential diagnosis of persons with gender identity disorders

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    Z.D. Novikova

    2013-10-01

    Full Text Available We presented a study of the features of gender identity in people undergoing gender, psychological and psychiatric examination to address the issue of gender reassignment. We analyze the specifics of gender identity, levels of masculinity and femininity, the similarities and differentiation within four nosological groups, which include persons with gender identity disorders (GID with transsexualism, personality disorders, diseases of the schizophrenia spectrum, and with organic mental disorders. We address the question of the differential diagnosis in the process of psychological screening of people with transsexualism and other types of GID. The analytical description of the four algorithms and their comparison are psychologically specific, qualitative research, almost impossible using statistical method of data processing. The data presented may be useful to specialists involved in the study of persons with gender identity disorders

  14. [Non-suicidal self-injury and suicide attempts: grounding of differential diagnosis].

    Science.gov (United States)

    Nitkowski, D; Petermann, F

    2010-01-01

    Three criteria for differential diagnosis of non-suicidal self-injury and suicide attempts were validated by means of more recent empirical studies. Criteria concerning motives (functions), methods of self-injury (medical severity), lifetime frequency and lifetime number of episodes were investigated. Literature research showed only a few studies concentrated on a direct comparison of non-suicidal self-injury and suicide attempts. Therefore, studies examing the relationship of suicide intent to the relevant features, are considered, too. Empirical results concerning motives (functions), methods (medical severity), lifetime frequency and number of episodes were compared to the three criteria. Except for lifetime frequency, studies support the criteria. However, in the case of motives, a more differentiated examination is needed to distinguish between non-suicidal self-injury and suicide attempts. To optimize the assessment, guidelines should be slightly modified. Because of the phenomenological overlap of non-suicidal self-injury and suicide attempts, a dimensional assessment can be helpful.

  15. Supporting Boys as Readers

    Science.gov (United States)

    Serafini, Frank

    2013-01-01

    The challenges associated with boys and reading are focused on such factors as society's lack of focus on literacy skills, parents failings to inspire reading in boys, and internal motivational factors rather than looking at the environments created for reading in and out of school. In this column, several ideas for helping boys develop a…

  16. Differential diagnosis of spall vs. cracks in the gear tooth fillet region: Experimental validation

    Science.gov (United States)

    Endo, H.; Randall, R. B.; Gosselin, C.

    2009-04-01

    This paper presents a technique to differentially diagnose two types of localized gear tooth faults: a spall and a crack in the gear tooth fillet region. These faults could have very different prognoses, but existing diagnostic techniques only detect the presence of localized tooth faults without being able to differentiate between a spall and a crack. The effects of spalls and cracks on the behaviour of gear assemblies were studied using static and dynamic simulation models. Changes in the kinematics of a pair of meshing gears due to a gear tooth fillet crack (TFC) and a tooth flank spall were compared using a static analysis model. The difference in the variation of the transmission error (TE) caused by the two faults reveals their characteristics. The effect of a tooth crack depends on the change in stiffness of the tooth while the effect of a spall is dominantly determined by the geometry of the fault. A technique has previously been proposed to detect spalls [M. EL Badaoui, J. Antoni, F. Guillet, J. Daniere, Use of the moving cepstrum integral to detect and localize tooth spalls in gears, Mechanical System and Signal Processing, 15 (5) (2001) 873-885; M. EL Badaoui, V. Cahouet, F. Guillet, J. Daniere P. Velex, Modelling and detection of localized tooth defects in geared systems, Transaction of ASME, 123 (2001) 422-430], using the cepstrum to detect a negative echo in the signal (from entry into and exit from the spall) and successfully performed differential diagnosis on the simulated vibration signals. While the result of the experimental study showed some differences from the result of the simulation study, the differential diagnosis was successfully performed based on the technique presented in this paper. Further investigation revealed non-linear gearmesh behaviour which was causing differences in the experimental and simulation model results.

  17. The differential diagnosis of children with joint hypermobility: a review of the literature

    Directory of Open Access Journals (Sweden)

    Elliott Elizabeth J

    2009-01-01

    Full Text Available Abstract Background In this study we aimed to identify and review publications relating to the diagnosis of joint hypermobility and instability and develop an evidence based approach to the diagnosis of children presenting with joint hypermobility and related symptoms. Methods We searched Medline for papers with an emphasis on the diagnosis of joint hypermobility, including Heritable Disorders of Connective Tissue (HDCT. Results 3330 papers were identified: 1534 pertained to instability of a particular joint; 1666 related to the diagnosis of Ehlers Danlos syndromes and 330 related to joint hypermobility. There are inconsistencies in the literature on joint hypermobility and how it relates to and overlaps with milder forms of HDCT. There is no reliable method of differentiating between Joint Hypermobility Syndrome, familial articular hypermobility and Ehlers-Danlos syndrome (hypermobile type, suggesting these three disorders may be different manifestations of the same spectrum of disorders. We describe our approach to children presenting with joint hypermobility and the published evidence and expert opinion on which this is based. Conclusion There is value in identifying both the underlying genetic cause of joint hypermobility in an individual child and those hypermobile children who have symptoms such as pain and fatigue and might benefit from multidisciplinary rehabilitation management. Every effort should be made to diagnose the underlying disorder responsible for joint hypermobility which may only become apparent over time. We recommend that the term "Joint Hypermobility Syndrome" is used for children with symptomatic joint hypermobility resulting from any underlying HDCT and that these children are best described using both the term Joint Hypermobility Syndrome and their HDCT diagnosis.

  18. Differential diagnosis of sarcomatoid mesothelioma from true sarcoma and sarcomatoid carcinoma using immunohistochemistry.

    Science.gov (United States)

    Kushitani, Kei; Takeshima, Yukio; Amatya, Vishwa Jeet; Furonaka, Osamu; Sakatani, Akio; Inai, Kouki

    2008-02-01

    Differentiation of sarcomatoid mesothelioma from other sarcomatoid tumors involving the pleura and other structures by light microscopy remains an important diagnostic challenge for surgical pathologists. The purpose of the present study was to investigate the utility of diagnostic immunohistochemistry for differentiating sarcomatoid mesothelioma from its histological mimics: true sarcoma and pulmonary sarcomatoid carcinoma. A total of 39 specimens of mesotheliomas with sarcomatoid components, 43 specimens of true sarcomas, and nine specimens of pulmonary sarcomatoid carcinomas were obtained from Japanese patients and examined using a 10-antibody panel (calretinin, WT1, AE1/AE3, CAM5.2, epithelial membrane antigen, desmin, alpha-smooth muscle actin, S-100 protein, CD34, and CD68). CAM5.2 had the highest sensitivity and specificity for differentiating sarcomatoid mesothelioma from true sarcoma. The combination of CAM5.2, WT1, and AE1/AE3 is recommended for routine pathological diagnosis. Accurate clinical information is necessary for differentiating sarcomatoid mesothelioma from sarcomatoid carcinoma.

  19. Differential diagnosis of pancreatic cancer from other solid tumours arising from the periampullary area on MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Suk Ki [Bundang Jesaeng General Hospital, Departments of Radiology, Daejin Medical Center, Seognam-si, Gyeonggi-do (Korea, Republic of); Kim, Jung Hoon; Joo, Ijin; Jeon, Ju Hyun; Han, Joon Koo; Choi, Byung Ihn [Seoul National University College of Medicine, Department of Radiology and Institute of Radiation Medicine, Chongno-gu, Seoul (Korea, Republic of); Shin, Kyung Sook [Chungnam National University School of Medicine, Department of Radiology, 266 Munhwa-ro, Jung-gu, Daejeon (Korea, Republic of)

    2015-10-15

    To investigate CT features and differential diagnosis of pancreatic adenocarcinoma compared to other solid tumours arising in the periampullary area. One hundred and ninety-five patients with pathologically proven, solid periampullary tumours, including pancreatic adenocarcinoma (n = 98), neuroendocrine tumours (n = 52), gastrointestinal stromal tumours (n = 31), and solid pseudopapillary neoplasms (n = 14), underwent preoperative CT. Two radiologists reviewed CT features and rated the possibility of pancreatic adenocarcinoma. Statistically common findings for pancreatic adenocarcinoma included: patient age >50 years; ill-defined margin; completely solid mass; homogeneous enhancement; hypoenhancement on arterial and venous phases; atrophy; and duct dilatation. Statistically common findings for GIST included: heterogeneous enhancement; hyperenhancement on arterial and venous phases; rim enhancement; and prominent feeding arteries. The hyperenhancement on arterial and venous phases is statistically common in NET, and heterogeneous enhancement, hypoenhancement on the arterial and venous phases are statistically common in SPN. Diagnostic performance of CT for differentiating pancreatic adenocarcinomas from other solid periampullary tumours was 0.962 and 0.977 with excellent interobserver agreement (κ = 0.824). CT is useful not only for differentiating pancreatic adenocarcinoma form other solid tumours but also for differentiating between other solid tumours, including NET, SPN, and GIST, arising in the periampullary area. (orig.)

  20. Clinical relevance of "bulging eyes" for the differential diagnosis of spinocerebellar ataxias

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    Adriana Moro

    2013-07-01

    Full Text Available Objective To investigate the relevance of the clinical finding of bulging eyes (BE in a large Brazilian cohort of spinocerebellar ataxias (SCA, to assess its importance in clinical differential diagnosis among SCA. Methods Three hundred sixty-nine patients from 168 Brazilian families with SCA were assessed with neurological examination and molecular genetic testing. BE was characterized by the presence of eyelid retraction. Genetically ascertained SCA3 was detected in 167 patients, SCA10 in 68 patients, SCA2 in 20, SCA1 in 9, SCA7 in 6, and SCA6 in 3 patients. Results BE was detected in 123 patients with SCA (33.3%, namely 109 of the 167 SCA3 patients (65.3% and in 5 of the others SCA patients (1 SCA10 patient, 2 SCA1 patients and 2 SCA2 patients. Conclusion BE was detected in the majority of patients with SCA3 (65.3% and could be used with a clinical tool for the differential diagnosis of SCA.

  1. Hypersexuality in inpatient children and adolescents: recognition, differential diagnosis, and evaluation.

    Science.gov (United States)

    El-Gabalawi, Fayez; Johnson, Robert Arnold

    2007-11-01

    We describe a 17-year-old girl with hypersexuality resulting from virilization, the latter a consequence of polycystic ovary syndrome, and we review the literature pertinent to hypersexuality in children and adults. Inappropriate sexual behavior (a common cause of disruption among children who are hospitalized for psychiatric disorders) may be caused either by hypersexuality or by simply ill-regulated behavior: a definition of hypersexuality is proposed that can be applied at the bedside (namely, sexual behaviors or fantasies that have abruptly increased in frequency by comparison with a previous baseline, are of sufficient excessiveness to disrupt expected or usual social, academic, or occupational functioning, or constitute a source of distress), so that this distinction can be made promptly, and we present a differential diagnosis for hypersexuality to direct its evaluation. Virilization does not seem to be a common cause of hypersexuality in children and adolescents, but it should not be overlooked when it does exist. The differential diagnosis of hypersexuality in adults, which we present for comparison, is much larger than it is in children.

  2. Differential diagnosis of groove pancreatic carcinomas vs. groove pancreatitis: Usefulness of the portal venous phase

    Energy Technology Data Exchange (ETDEWEB)

    Ishigami, Kousei, E-mail: Ishigamikousei@aol.co [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Tajima, Tsuyoshi; Nishie, Akihiro; Kakihara, Daisuke [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Fujita, Nobuhiro [Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Asayama, Yoshiki; Ushijima, Yasuhiro; Irie, Hiroyuki [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Nakamura, Masafumi; Takahata, Shunichi [Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Ito, Tetsuhide [Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Honda, Hiroshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan)

    2010-06-15

    Purpose: To clarify if the portal venous phase is helpful for the differential diagnosis of groove pancreatic carcinomas and groove pancreatitis. Materials and methods: MDCT and MRI of groove pancreatic carcinomas (n = 7) and groove pancreatitis (n = 15) were retrospectively reviewed by two radiologists independently. The signal intensity on T2-weighted images was subjectively assessed. The presence or absence of common bile duct (CBD) and main pancreatic duct (MPD) strictures, calcifications, and cystic lesions was evaluated. Additionally, the appearance of groove pancreatic carcinoma and that of groove pancreatitis in the portal venous phase on dynamic MDCT and MRI were compared. Results: There were no significant differences in the signal intensity on T2-weighted images and in the presence or absence of CBD and MPD strictures, calcifications, and cystic lesions between groove pancreatic carcinomas and groove pancreatitis. However, patchy focal enhancement in the portal venous phase was more commonly observed in groove pancreatitis than groove pancreatic carcinoma (Reviewers 1 and 2: 14/15 [93.3%] vs. 1/7 [14.3%], P < 0.0001). In addition, peripheral enhancement was only seen in groove pancreatic carcinomas (Reviewer 1: 4/7 [57.1%] vs. 0/15 [0%], P < 0.005, and Reviewer 2: 3/7 [42.9%] vs. 0/15 [0%], P < 0.05). Conclusion: The portal venous phase may be helpful for the differential diagnosis of groove pancreatic carcinomas and groove pancreatitis.

  3. Functional brain imaging in the dementias: role in early detection, differential diagnosis, and longitudinal studies

    Energy Technology Data Exchange (ETDEWEB)

    Devous, M.D. Sr. [Nuclear Medicine Center and Department of Radiology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX (United States)

    2002-12-01

    This review considers the role of functional brain imaging techniques in the dementias. The substantial assistance that especially single-photon emission tomography and positron emission tomography can play in the initial diagnosis of dementia and in the differential diagnosis of the specific dementing disorder is discussed. These techniques alone essentially match the sensitivity and specificity of clinical diagnoses in distinguishing Alzheimer's dementia (AD) from age-matched controls, from frontal lobe dementia and vascular dementia, and even from Lewy body dementia. Newer analytic techniques such as voxel-based correlational analyses and discriminant function analyses enhance the power of such differential diagnoses. Functional brain imaging techniques can also significantly assist in patient screening for clinical trials. The correlation of the observed deficits with specific patterns of cognitive abnormalities permits enhanced patient management and treatment planning and improved longitudinal assessment of outcome. It is also noteworthy that the classic abnormalities of temporoparietal and posterior cingulate hypoperfusion or hypometabolism appear to be present prior to symptom onset. These abnormalities predict progression to AD in the presence of the earliest of symptoms, and are present even in cognitively normal but at-risk subjects, with a severity proportional to the risk status. Even greater predictive ability for progression to AD is obtained by combining measures of perfusion or metabolism with risk factors, tau protein levels, hippocampal N-Acetyl aspartate concentrations, or hippocampal volume measures. (orig.)

  4. Neuroimaging in Parkinsonism: a study with magnetic resonance and spectroscopy as tools in the differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Vasconcellos, Luiz Felipe Rocha [1Hospital dos Servidores do Estado, Rio de Janeiro RJ (Brazil)], e-mail: luizneurol@terra.com.br; Novis, Sergio A. Pereira; Rosso, Ana Lucia Z. [Hospital Universitario Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ (Brazil); Moreira, Denise Madeira [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Inst. de Neurologia Deolindo Couto; Leite, Ana Claudia C.B. [Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ (Brazil)

    2009-03-15

    The differential diagnosis of Parkinsonism based on clinical features, sometimes may be difficult. Diagnostic tests in these cases might be useful, especially magnetic resonance imaging, a noninvasive exam, not as expensive as positron emission tomography, and provides a good basis for anatomical analysis. The magnetic resonance spectroscopy analyzes cerebral metabolism, yielding inconsistent results in parkinsonian disorders. We selected 40 individuals for magnetic resonance imaging and spectroscopy analysis, 12 with Parkinson's disease, 11 with progressive supranuclear palsy, 7 with multiple system atrophy (parkinsonian type), and 10 individuals without any psychiatric or neurological disorders (controls). Clinical scales included Hoenh and Yahr, unified Parkinson's disease rating scale and mini mental status examination. The results showed that patients with Parkinson's disease and controls presented the same aspects on neuroimaging, with few or absence of abnormalities, and supranuclear progressive palsy and multiple system atrophy showed abnormalities, some of which statistically significant. Thus, magnetic resonance imaging and spectroscopy could be useful as a tool in differential diagnosis of Parkinsonism. (author)

  5. Value of Dynamic Enhanced MR Imaging for the Differential Diagnosis between Ovarian Fibroma and Subserosal Leiomyoma

    Institute of Scientific and Technical Information of China (English)

    JunShan; XioomeiWang; JianminXu; HongliXu; XiaofengFeng; JingshanGong; RennanLing; ZibinRao

    2004-01-01

    OBJECTIVE To study the value of dynamic enhanced MR imaging in the differential diagnosis between ovarian fibroma and subserosal leiomyoma, both of which produce a intermediate to low signal intensity on T2W1. METHODS Plain and dynamic enhanced MRI results of 45 patients were analyzed, 35 cases of which were subserosal leiomyoma and 10 were ovarian fibroma. All of the tumors were verified by histologic analysis. RESULTS The 10 ovarian fibroma cases showed low signal intensities on T1W1, but 2 produced intermediate signal intensities and 8 showed low signal intensities on T2W1. There was little enhancement of the early phase and the delayed phase was long, so the enhancement index of the early phase (SI100) was low and the time to peak (TTP200) was long. Of the 35 subserosal leiomyoma cases, all showed low signal intensity on TlWl, 7 were intermediate in signal intensity and 28 generated a low signal intensity on T2W1. The enhancement of the early phase was moderate to highlyevident and the index was high. The time to peak was short (TTP200). The enhancement -time curve was different in the two groups, and the differencehad statistical sianificance (P<0.001). CONCLUSION Dynamic enhanced MR imaging was helpful in the differential diagnosis between ovarian fibroma and subserosal leiomyoma by the difference of the early phase enhancement.

  6. Multimodal EEG-MRI in the differential diagnosis of Alzheimer's disease and dementia with Lewy bodies

    Science.gov (United States)

    Colloby, Sean J.; Cromarty, Ruth A.; Peraza, Luis R.; Johnsen, Kristinn; Jóhannesson, Gísli; Bonanni, Laura; Onofrj, Marco; Barber, Robert; O'Brien, John T.; Taylor, John-Paul

    2016-01-01

    Differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) remains challenging; currently the best discriminator is striatal dopaminergic imaging. However this modality fails to identify 15–20% of DLB cases and thus other biomarkers may be useful. It is recognised electroencephalography (EEG) slowing and relative medial temporal lobe preservation are supportive features of DLB, although individually they lack diagnostic accuracy. Therefore, we investigated whether combined EEG and MRI indices could assist in the differential diagnosis of AD and DLB. Seventy two participants (21 Controls, 30 AD, 21 DLB) underwent resting EEG and 3 T MR imaging. Six EEG classifiers previously generated using support vector machine algorithms were applied to the present dataset. MRI index was derived from medial temporal atrophy (MTA) ratings. Logistic regression analysis identified EEG predictors of AD and DLB. A combined EEG-MRI model was then generated to examine whether there was an improvement in classification compared to individual modalities. For EEG, two classifiers predicted AD and DLB (model: χ2 = 22.1, df = 2, p EEG-MRI model showed greater prediction in AD and DLB (model: χ2 = 31.1, df = 3, p EEG and MRI, and may represent an alternative to dopaminergic imaging. PMID:27060340

  7. KatG protein: A novel marker for differential diagnosis of Myobacterium avium complex infection

    Directory of Open Access Journals (Sweden)

    Gupta K

    2010-01-01

    Full Text Available Purpose: Biochemical or nucleic acid based diagnostic techniques for MAC infection are unsatisfactory. This study aims to identify and evaluate M. avium secretory protein(s of diagnostic potential, so as to develop a rapid and simple method for diagnosis of MAC infection. Material and Methods: Initially, a specific protein band of ~80-85 kDa was recognised by differential immunoblotting; which was subjected to anion exchange column chromatography for purification of proteins. After fractionisation using SDS-PAGE and electroelution, blast search was carried out. Further immunoreactivity studies were done with M. avium and Mtb infected mice sera. Clinical utilisation of separated protein was evaluated by conducting indirect ELISA with serum samples from mycobacterial infected patients. Results: A specific 81.6 kDa protein, shown to be catalase-peroxidase protein (KatG by blast search was separated. Immunoreactivity studies of purified KatG proteins with mice sera confirmed it to be specific for M. avium infection. Indirect ELISA with patient samples further confirmed it to be M. avium infection specific. Conclusion: KatG protein is specifically recognised by MAC patients and can be used as a marker for simple and rapid ELISA based tests for differential diagnosis of M. avium infection.

  8. Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shirazi, P.; Konopka, L.; Crayton, J.W. [Loyola Univ. Medical Center, Maywood, IL (United States)] [and others

    1994-05-01

    Accurate diagnostic evaluation of patients with neurologic and neuropsychiatric disease is important because early treatment may halt disease progression and prevent impairment or disability. Cerebral hyperfixation of HMPAO has been ascribed to luxury perfusion following ischemic infarction. The present study sought to identify other conditions that also display radiotracer hyperfixation in order to develop a differential diagnosis of this finding on SPECT imaging. Two hundred fifty (n=250) successive cerebral SPECT images were reviewed for evidence of HMPAO hyperfixation. Hyperfixation was defined as enhanced focal perfusion surrounded by a zone of diminished or normal cerebral perfusion. All patients were scanned after intravenous injection of 25 mCi Tc-99m HMPAO. Volume-rendered and oblique images were obtained with a Trionix triple-head SPECT system using ultra high resolution fan beam collimators. Thirteen (13/250; 5%) of the patients exhibited regions of HMPAO hyperfixation. CT or MRI abnormalities were detected in 6/13 cases. Clinical diagnoses in these patients included intractable psychosis, post-traumatic stress disorder, alcohol and narcotic dependence, major depression, acute closed-head trauma, hypothyroidism, as well as subacute ischemic infarction. A wide variety of conditions may be associated with cerebral hyperfixation of HMPAO. These conditions include neurologic and psychiatric diagnoses, and extend the consideration of hyperfixation beyond ischemic infarction. Consequently, a differential diagnosis of HMPAO hyperfixation may be broader than originally considered, and this may suggest a fundamental role for local cerebral hyperperfusion. Elucidation of the fundamental mechanism(s) for cerebral hyperperfusion requires further investigation.

  9. Differential Diagnosis of Erythmato-Squamous Diseases Using Classification and Regression Tree

    Science.gov (United States)

    Maghooli, Keivan; Langarizadeh, Mostafa; Shahmoradi, Leila; Habibi-koolaee, Mahdi; Jebraeily, Mohamad; Bouraghi, Hamid

    2016-01-01

    Introduction: Differential diagnosis of Erythmato-Squamous Diseases (ESD) is a major challenge in the field of dermatology. The ESD diseases are placed into six different classes. Data mining is the process for detection of hidden patterns. In the case of ESD, data mining help us to predict the diseases. Different algorithms were developed for this purpose. Objective: we aimed to use the Classification and Regression Tree (CART) to predict differential diagnosis of ESD. Methods: we used the Cross Industry Standard Process for Data Mining (CRISP-DM) methodology. For this purpose, the dermatology data set from machine learning repository, UCI was obtained. The Clementine 12.0 software from IBM Company was used for modelling. In order to evaluation of the model we calculate the accuracy, sensitivity and specificity of the model. Results: The proposed model had an accuracy of 94.84% ( Standard Deviation: 24.42) in order to correct prediction of the ESD disease. Conclusions: Results indicated that using of this classifier could be useful. But, it would be strongly recommended that the combination of machine learning methods could be more useful in terms of prediction of ESD. PMID:28077889

  10. Best practices in the differential diagnosis and reporting of acute transfusion reactions

    Directory of Open Access Journals (Sweden)

    Hillis CM

    2016-01-01

    Full Text Available Christopher M Hillis,1–3,* Andrew W Shih,1,3,* Nancy M Heddle1,3,4 1Department of Medicine, 2Department of Oncology, 3McMaster Transfusion Research Program, McMaster University, Hamilton, 4Centre for Innovation, Canadian Blood Services, Ottawa, ON, Canada  *These authors contributed equally to this work Abstract: An acute transfusion reaction (ATR is any reaction to blood, blood components, or plasma derivatives that occurs within 24 hours of a transfusion. The frequencies of ATRs and the associated symptoms, reported by the sentinel sites of the Ontario Transfusion Transmitted Injuries Surveillance System from 2008 to 2012, illustrate an overlap in presenting symptoms. Despite this complexity, the differential diagnosis of an ATR can be determined by considering predominant signs or symptoms, such as fever, dyspnea, rash, and/or hypotension, as these signs and symptoms guide further investigations and management. Reporting of ATRs locally and to hemovigilance systems enhances the safety of the blood supply. Challenges to the development of an international transfusion reaction reporting system are discussed, including the issue of jurisdiction and issues of standardization for definitions, investigations, and reporting requirements. This review discusses a symptom-guided approach to the differential diagnosis of ATRs, the evolution of hemovigilance systems, an overview of the current Canadian system, and proposes a best practice model for hemovigilance based on a World Health Organization patient safety framework. Keywords: blood transfusion, blood components, hemovigilance

  11. Differential diagnosis of intestinal tuberculosis from Crohn′s disease and primary intestinal lymphoma in China

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    Yun-Yan Liu

    2014-01-01

    Full Text Available Background/Aims: There are many similarities and overlaps in clinical, radiological, endoscopic, and histological features among intestinal tuberculosis (ITB, Crohn′s disease (CD, and primary intestinal lymphoma (PIL, and the differential diagnosis of ITB can be very challenging for clinicians. Patients and Methods: The clinical, radiologic, endoscopic, and pathological data of 213 patients were analyzed retrospectively. According to the diagnostic criteria and exclusive criteria of ITB, CD, and PIL, 83 patients were recruited and divided into three groups, including 30 cases in the ITB group, 38 cases in the CD group, and 15 cases in the PIL group, and the medical data and statistical analysis were recorded. Results : Rural patients with abdominal pain as the first symptom and with transverse ulcer and caseating granulomas were more common in the ITB group than the CD group, whereas urban patients with stool change as the first symptom, moderate or severe anemia, thickening of intestinal wall, rectal involvement, skipping distribution, prominent lymphoid aggregates, and irregular glands were more common in CD group than ITB group (P < 0.05. Young patients (age < 30 years with fever, weakness, fatigue, abdominal mass, intestinal perforation, and emergent operation were more common in ITB group than PIL group, whereas thickening of intestinal wall, malignant lymphocytes, limited distribution, and involvement of small intestine occurred more in PIL group than ITB group (P < 0.05. Conclusion : The differential diagnosis of ITB from CD and PIL can be made by a combination of clinical manifestation, endoscopy, and pathological examinations.

  12. Prostatic Cancer: Diagnosis and Differentiation by Dynamic Contrast-Enhanced MRI

    Institute of Scientific and Technical Information of China (English)

    SHIHao; DINGHongyu; ZHANGGuangying; YANGZhenzhen

    2005-01-01

    Objective: To assess the role of dynamic contrast-enhanced MRI (DCE-MRI) in the diagnosis and differentiation of prostatic cancer (PC). Methods: Five volunteers, 36 patients with benign prostatic hyperplasia (BPH) and 13 patients with biopsy-proven prostate cancer underwent conventional MRI, DCE-MR1 and delayed enhancement MRI. The value of the signal intensity in DCE-MRI was measured and calculated to draw the time-signal intensity curve of the normal peripheral zone (PZ), the prostate cancer and the benign prostatic hyperplasia. Results: In DCE-MRI, the normal peripheral zone was enhanced mildly and slowly and the peak value was located in late phase. The enhancement of the lesions in 36 patients with the benign prostatic hyperplasia was obvious in early phase and strengthened gradually, and then turned to decrease in late phase after peak value. The lesions in 9 of 13 cases with prostate cancer were enhanced obviously in early phase and washed out rapidly, and the peak value was located in early phase, but the peak value was in mediate and late phase in the other 4 cases with diffuse lesion in the prostate on T2WI. Conclusion: In DCE-MRI, the enhancement patterns of the normal peripheral zone,the prostate cancer and the benign prostatic hyperplasia were significantly different. DCE-MRI was very useful in the diagnosis and differentiation of prostate cancer.

  13. In vitro differential diagnosis of clavus and verruca by a predictive model generated from electrical impedance.

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    Chien-Ya Hung

    Full Text Available BACKGROUND: Similar clinical appearances prevent accurate diagnosis of two common skin diseases, clavus and verruca. In this study, electrical impedance is employed as a novel tool to generate a predictive model for differentiating these two diseases. MATERIALS AND METHODS: We used 29 clavus and 28 verruca lesions. To obtain impedance parameters, a LCR-meter system was applied to measure capacitance (C, resistance (Re, impedance magnitude (Z, and phase angle (θ. These values were combined with lesion thickness (d to characterize the tissue specimens. The results from clavus and verruca were then fitted to a univariate logistic regression model with the generalized estimating equations (GEE method. In model generation, log ZSD and θSD were formulated as predictors by fitting a multiple logistic regression model with the same GEE method. The potential nonlinear effects of covariates were detected by fitting generalized additive models (GAM. Moreover, the model was validated by the goodness-of-fit (GOF assessments. RESULTS: Significant mean differences of the index d, Re, Z, and θ are found between clavus and verruca (p0.7, the adjusted generalized R2 is 0.512 (>0.3, and the p value of the Hosmer-Lemeshow GOF test is 0.350 (>0.05. CONCLUSIONS: This technique promises to provide an approved model for differential diagnosis of clavus and verruca. It could provide a rapid, relatively low-cost, safe and non-invasive screening tool in clinic use.

  14. MR Cholangiography and Dynamic Examination of Duodenal Fluid in the Differential Diagnosis between Extrahepatic Biliary Atresia and Infantile Hepatitis Syndrome

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    In order to evaluate the value of magnetic resonance cholangiography (MRC) and dynamic examination of duodenal fluid in the differential diagnosis between extrahepatic biliary atresia (EHBA) and infantile hepatitis syndrome (IHS), 52 pa tients with infantile cholestatic jaundice were examined by MRC and duodenal fluid examination. Original interpretations were compared with clinical outcome. Calculated sensitivity of duodenal fluid examination in diagnosis of EHBA was 100%, and specificity was 91.1%. Sensitivity of MRC in the diagnosis of EHBA was 94.4 % and specificity 88.24 %. The sensitivity of MRC and examination of duodenal fluid combined in diagnosis of EHBA was 94.4 % and specificity 97.06 %. We are led to conclude that MRC and dynamic examination of duodenal fluid are useful in the differential diagnosis between IHS and EHBA and the combined use of the two techniques yield better resutls.

  15. Pseudoactinomycotic Radiate Granules (PAMRAGs)- An Unusual Differential Diagnosis for Ovarian Neoplasm; A Diagnostic Dilemma.

    Science.gov (United States)

    P J, Cicy; P J, Tessy; P, Lekshmidevi; V, Letha; Poothiode, Usha

    2015-03-01

    Pseudoactinomycotic radiate granules (PAMRAGs) are rarely detected lesions in ovary. Endometrium is the usual site and a detailed search of literature yielded only two cases in the ovary. PAMRAGs must be differentiated from actinomycotic granules which are also strongly associated with the use of intrauterine contraceptive devices (IUCDs). In cases of suppurative oophoritis due to actinomycosis, a proper diagnosis and culture confirmation is mandatory to avoid further complications. This case is reported due to its rarity, unusual clinical presentation and to highlight the importance of special stains in cases of tuboovarian abscess, where PAMRAGs may cause diagnostic dilemma. Our patient was a 50 yr old female admitted with clinical diagnosis of malignant ovarian tumour. After preoperative work up, panhysterectomy, infracolic omentectomy and excision biopsy of the right inguinal lymph node were done. Peroperatively the right ovary was enlarged and adherent to the fallopian tube and pelvic wall. Gross examination revealed a right tuboovarian mass with yellowish areas of necrosis and fibrosis. Histology showed a suppurative granulomatous lesion with spherical granules having club like peripheral projections. A panel of special stains (GMS, GRAMs and AFB) done were negative. Thus, we ruled out actinomycosis and gave a diagnosis of PAMRAG.

  16. Differential Diagnosis of Two Chinese Families with Dyschromatoses by Targeted Gene Sequencing

    Institute of Scientific and Technical Information of China (English)

    Jia-Wei Liu; Asan; Jun Sun; Sergio Vano-Galvan; Feng-Xia Liu; Xiu-Xiu Wei; Dong-Lai Ma

    2016-01-01

    Background: The dyschromatoses are a group of disorders characterized by simultaneous hyperpigmented macules together with hypopigmented macules.Dyschromatosis universalis hereditaria (DUH) and dyschromatosis symmetrica hereditaria are two major types.While clinical and histological presentations are similar in these two diseases, genetic diagnosis is critical in the differential diagnosis of these entities.Methods: Three patients initially diagnosed with DUH were included.The gene test was carried out by targeted gene sequencing.All mutations detected on ADAR1 and ABCB6 genes were analyzed according to the frequency in control database, the mutation types, and the published evidence to determine the pathogenicity.Results: Family pedigree and clinical presentations were reported in 3 patients from two Chinese families.All patients have prominent cutaneous dyschromatoses involving the whole body without systemic complications.Different pathogenic genes in these patients with similar phenotype were identified: One novel mutation on ADAR1 (c.1325C>G) and one recurrent mutation in ABCB6 (c.1270T>C), which successfully distinguished two diseases with the similar phenotype.Conclusion: Targeted gene sequencing is an effective tool for genetic diagnosis in pigmentary skin diseases.

  17. Polymyositis without Beneficial Response to Steroid Therapy: Should Miyoshi Myopathy be a Differential Diagnosis?

    Science.gov (United States)

    Scalco, Renata Siciliani; Lorenzoni, Paulo José; Lynch, David S; Martins, William Alves; Jungbluth, Heinz; Quinlivan, Ros; Becker, Jefferson; Houlden, Henry

    2017-01-05

    BACKGROUND Miyoshi myopathy (MM) is an autosomal-recessive muscle disorder caused by mutations in the DYSF gene. Clinical features and histopathological changes in dysferlinopathies may mimic inflammatory myopathies and a high degree of clinical suspicion is required to guide the genetic investigation. CASE REPORT We report the case of a 16-year-old male who presented with severe bilateral calf pain and elevated CK levels (15 000 IU/l) who was on prolonged steroid therapy prompted by the clinical suspicion of inflammatory myopathy. Three years into his illness, he was referred for neuromuscular evaluation presenting with untreatable muscle pain and progressive weakness. The diagnosis of "refractory polymyositis" was revisited. Targeted exome sequencing revealed homozygous pathogenic mutations in the DYSF gene, confirming a diagnosis of Miyoshi myopathy. CONCLUSIONS Our case illustrates that severe muscle pain may be the initial feature of Miyoshi myopathy and should be considered in the differential diagnosis of inflammatory myopathies. Although the described patient reported partial clinical improvement in muscle pain, steroid treatment is not an effective therapy for dysferlinopathy patients and it did not prevent disease progression. In addition, we confirm the utility of next-generation sequencing approaches to myopathies, particularly in complex or unusual cases when muscle biopsy is not available.

  18. Differential diagnosis of atypical lipomatous tumor/well-differentiated liposarcoma and dedifferentiated liposarcoma: utility of p16 in combination with MDM2 and CDK4 immunohistochemistry.

    Science.gov (United States)

    Kammerer-Jacquet, Solène-Florence; Thierry, Sixte; Cabillic, Florian; Lannes, Morgane; Burtin, Florence; Henno, Sébastien; Dugay, Frédéric; Bouzillé, Guillaume; Rioux-Leclercq, Nathalie; Belaud-Rotureau, Marc-Antoine; Stock, Nathalie

    2017-01-01

    The differential diagnosis between atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDLPS) and dedifferentiated liposarcoma (DDLPS) from their morphologic counterparts is challenging. Currently, the diagnosis is guided by MDM2 and CDK4 immunohistochemistry (IHC) and is confirmed by the amplification of the corresponding genes. Recently, p16 IHC has been proposed as a useful diagnostic biomarker. The objective was to assess the utility of p16 IHC in the differential diagnosis of ALT/WDLPS and DDLPS. Our series included 101 tumors that were previously analyzed using fluorescence in situ hybridization for MDM2 and CDK4 amplification. We compared sensitivity and specificity of p16 IHC to MDM2 and CDK4 IHC in the differential diagnosis of ALT-WDLPS (n=19) versus benign adipocytic tumors (n=44) and DDLPS (n=18) versus mimicking sarcomas (n=20). In the differential diagnosis of ALT-WDLPS, p16 had a sensitivity of 89.5% but a specificity of 68.2%, which was impaired by false-positive lipomas with secondary changes, especially in biopsies. Likewise, in the differential diagnosis of DDLPS, p16 had a sensitivity of 94.4% and a specificity of 70%, which hampered its use as a single marker. However, adding p16 to MDM2 and/or CDK4 increased diagnostic specificity. Indeed, MDM2+/p16+ tumors were all ALT-WDLPS, and MDM2-/p16- tumors were all benign adipocytic tumors. Moreover, all MDM2+/CDK4+/p16+ tumors were DDLPS, and the MDM2-/CDK4-/p16- tumor was an undifferentiated sarcoma. Although the use of p16 as a single immunohistochemical marker is limited by its specificity, its combination with MDM2 and CDK4 IHC may help discriminate ALT-WDLPS/DDLPS.

  19. Modern representations about differential diagnosis of schizophrenia-like psychosis disorders due to psychoactive substance use

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    V. V. Chugunov

    2014-08-01

    Full Text Available In recent years in the world there is a tendency of quantity of persons who use drugs increase. Free availability of drugs of different groups for population is the main cause. Another trend associated with the consumption of drugs. All these factors led to the increased frequency of psychosis occurrence among consumers of psychoactive substances. In structure of such psychosis there are a variety of symptoms and syndromes. And since the number of drug users is quite broad in its structure - there are also persons with mental illness. This gives number of diagnostic difficulties. In this regard, the aim of the study was to trace the modern ideas of differential diagnosis of schizophrenia-like psychosis disorders due to the drug use. Materials and methods of research. In this work the content analysis of the modern representations of differential diagnosis of schizophrenia-like psychosis disorders as a result of the use of psychoactive substances was made. The problem of determination of primary and secondary nature of drug addiction in patients with psychotic disorders was indicated. Etiology and psychopathogenesis hypotheses of the addiction from psychoactive substances in the context of their correlation with endogenous mental pathology were defined. In the literature there is no clear diagnostic criteria that would allow distinguishing psychosis due to the use of drugs and endogenous psychosis, which is combined with the admission medicines. However, the attention of clinicians should be concentrated on the premorbid condition: the presence of hereditary family history, pathological behavior in childhood and adolescence. It was found that the majority of substances may cause one or more syndromes - delirium, dementia, and amnestic syndrome, delusional syndrome, hallucinatory syndrome, depressive syndrome, anxiety, and personality disorder, such disorders as schizophrenia-like psychosis disorders are not rare. Special attention was paid to the

  20. A single step multiplex immunofluorometric assay for differential diagnosis of BSE and scrapie.

    Science.gov (United States)

    Tang, Yue; Thorne, Jemma; Whatling, Kirsty; Jacobs, Jorg G; Langeveld, Jan; Sauer, Maurice J

    2010-04-30

    Although there is no evidence that the European sheep population has been infected with bovine spongiform encephalopathy (BSE), distinguishing this from scrapie is paramount, given the association between BSE exposure and the human transmissible spongiform encephalopathy (TSE), variant Creutzfeldt-Jakob disease. The capability to differentially diagnose TSEs in sheep is thus essential in order to safeguard the food chain and human health. Biochemical methods for differentiating BSE and scrapie are largely reliant on assessment by Western blot (WB) analysis of the abnormal disease associated prion protein PrP(D) following partial proteolytic digestion. WB banding patterns obtained using a panel of antibodies enable different strain specific conformations of PrP(D) to be distinguished. This approach provides a robust confirmatory test but one which is not appropriate for high throughput screening. A simple, one step, bead array flow cytometry based multiplex immunofluorometric assay has been developed which is suitable for simultaneous screening and confirmation. Using a combination of antibodies directed towards three PrP epitopes enabled differential diagnosis of scrapie and BSE. Proof of principle studies indicated a high predictive value (100%) when applied to brain samples from control animals, BSE infected cattle and sheep naturally infected with scrapie or experimentally infected with BSE.

  1. Differential sialylation of serpin A1 in the early diagnosis of Parkinson's disease dementia.

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    Sarah Jesse

    Full Text Available The prevalence of Parkinson's disease (PD increases with age. Up to 50% of PD show cognitive decline in terms of a mild cognitive impairment already in early stages that predict the development of dementia, which can occur in up to 80% of PD patients over the long term, called Parkinson's disease dementia (PDD. So far, diagnosis of PD/PDD is made according to clinical and neuropsychological examinations while laboratory data is only used for exclusion of other diseases. The aim of this study was the identification of possible biomarkers in cerebrospinal fluid (CSF of PD, PDD and controls (CON which predict the development of dementia in PD. For this, a proteomic approach optimized for CSF was performed using 18 clinically well characterized patients in a first step with subsequent validation using 84 patients. Here, we detected differentially sialylated isoforms of Serpin A1 as marker for differentiation of PD versus PDD in CSF. Performing 2D-immunoblots, all PDD patients could be identified correctly (sensitivity 100%. Ten out of 24 PD patients showed Serpin A1 isoforms in a similar pattern like PDD, indicating a specificity of 58% for the test-procedure. In control samples, no additional isoform was detected. On the basis of these results, we conclude that differentially sialylated products of Serpin A1 are an interesting biomarker to indicate the development of a dementia during the course of PD.

  2. Laser Raman detection of platelet as a non-invasive approach for early and differential diagnosis of Alzheimer's disease

    Science.gov (United States)

    Chen, P.; Tian, Q.; Baek, S. J.; Shang, X. L.; Park, A.; Liu, Z. C.; Yao, X. Q.; Wang, J. Z.; Wang, X. H.; Cheng, Y.; Peng, J.; Shen, A. G.; Hu, J. M.

    2011-07-01

    Early and differential diagnosis of Alzheimer's disease (AD) is a problem that puzzled many doctors. Reliable markers in easy-assembling samples are of considerable clinical diagnostic value. In this work, laser Raman spectroscopy (LRS) was developed a new method that potentially allows early and differential diagnosis of AD from the platelet sample. Raman spectra of platelets isolated from different ages of AD transgenic mice and non-transgenic controls were collected and analyzed. Multilayer perceptron networks (MLP) classification method was used to classify spectra and establish the diagnostic models. For differential diagnosis, spectra of platelets isolated from AD, Parkinson's disease (PD) and vascular dementia (VD) mice were also discriminated. Two notable spectral differences at 740 and 1654 cm-1 were revealed in the mean spectrum of platelets isolated from AD transgenic mice and the controls. MLP displayed a powerful ability in the classifying of early, advanced AD and the control group, and in differential diagnosis of PD and advanced AD, as well as VD and advanced AD. The results suggest that platelet detecting by LRS coupled with MLP analysis appears to be an easy and accurate method for early and differential diagnosis of AD. This technique could be rapidly promoted from laboratory to the hospital.

  3. Berardinelli-Seip syndrome in a 6-year-old boy

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    Babu Priya

    2008-01-01

    Full Text Available A 6-year-old boy presented with abnormal habitus since birth, delayed language development, history of frequent falls since 9 months, and fever since 1 week. He was found to have hyperandrogenic features, generalized paucity of fat, generalized muscular overdevelopment, and brownish pigmentation over the flexural creases. Skin biopsy demonstrated features suggestive of acanthosis nigricans with an absence of subcutaneous tissue. After further investigation, a diagnosis of Berardinelli-Seip syndrome with bilateral pneumonia and generalized tonic clonic seizures was made. Clinical features, histopathology, differential diagnosis, and prognosis of this rare disorder have been discussed.

  4. Differential protein profiling as a potential multi-marker approach for TSE diagnosis

    Directory of Open Access Journals (Sweden)

    Hogarth Caroline

    2009-11-01

    Full Text Available Abstract Background Transmissible spongiform encephalopathy describes a family of diseases affecting both man and animals. Current tests for the diagnosis of these diseases are based on the detection of an abnormal misfolded form of the host protein PrP which is found within the central nervous and lymphoreticular systems of affected animals. Recently, concern that this marker may not be as reliable as previously thought, coupled with an urgentneed for a pre-clinical live animal test, has led to the search for alternative assays for the detection of TSE disease. Methods This "proof of concept" study, examines the use of differential protein expression profiling using surface enhanced laser desorption and ionisationtime of flight mass spectrometry (SELDI-TOF for the diagnosis of TSE disease. Spectral output from all proteins selectively captured from individual murine brain homogenate samples, are compared as "profiles" in groups of infected and non-infected animals. Differential protein expression between groups is thus highlighted and statistically significant protein "peaks" used to construct a panel of disease specific markers. Studies at both terminal stages of disease and throughout the time course of disease have shown a disease specific protein profile or "disease fingerprint" which could be used to distinguish between groups of TSE infected and uninfected animals at an early time point of disease. Results Our results show many differentially expressed proteins in diseased and control animals, some at early stages of disease. Three proteins identified by SELDI-TOF analysis were verified by immunohistochemistry in brain tissue sections. We demonstrate that by combining the most statistically significant changes in expression, a panel of markers can be constructed that can distinguish between TSE diseased and normal animals. Conclusion Differential protein expression profiling has the potential to be used for the detection of disease in TSE

  5. Diagnóstico diferencial dos tremores Differential diagnosis of tremors

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    JAMES PITÁGORAS DE MATTOS

    1998-06-01

    Full Text Available Baseado na revisão da literatura, o autor refere-se aos tremores normal (fisiológico e anormal (patológico. Analisa particularmente os patológicos, dividindo-os em de repouso e de ação. Com os elementos semiológicos estabelece o diagnóstico diferencial entre os tremores parkinsoniano, essencial severo, rubral, tardio, postural, cinético e os de posição e de ação específica, entre outros.After the review of the literature the author presents the semiologic basis for the differential diagnosis of rest and action tremors. The parkinsonian, severe essential, rubral, tardive, postural, kinetic and the task or position-specific tremors are mainly analysed.

  6. Differential Diagnosis of Speech Sound Disorders in Danish-speaking Children

    DEFF Research Database (Denmark)

    Clausen, Marit Carolin; Fox-Boyer, Anette

    Danish-speaking children aged 2;6-6;7 years with suspected SSD participated in the study. The children were assessed with a picture-naming test (Clausen, 2014). An inconsistency test was administered in case a child did not exhibit a consistent pattern profile. On the basis of the children’s transcripts...... processes, which aids in deciding whether children are typical, delayed or deviant in their speech development (Dodd, 2005). To date very little is known about SSD in Danish-speaking children, both regarding accuracy of productions, as well as phonological processes and differential diagnosis. Therefor......, the aim of the study was to investigate the speech of children with SSD by means of accuracy of phoneme production as well as types of the phonological processes in a Danish-speaking population. Further, the applicability of the two different classification approaches was investigated. A total of 211...

  7. Clear cell myoepithelioma of palate with emphasis on clinical and histological differential diagnosis.

    Science.gov (United States)

    Nair, Bindu J; Vivek, Velayudhannair; Sivakumar, Trivandrum T; Joseph, Anna P; Varun, Babyamma Raghavanpillai; Mony, Vinod

    2014-03-27

    Myoepitheliomas account for less than 1% of all salivary gland tumors and mostly occur in the parotid gland and palate. A 58-year old male patient reported to the Outpatient Department of PMS College of Dental Science and Research (Kerala, India) with a slow growing painless swelling on the palate for 4 years. Pleomorphic adenoma, basal cell adenoma, myoepithelioma, cyst adenoma, lipoma, neurofibroma, neurilemmoma and leiomyoma were considered. Histopathology revealed a thinly encapsulated tumor composed mainly of sheets of clear cells mixed with cells having eosinophilic cytoplasm. Histopathological differential diagnosis included pleomorphic adenoma, oncocytoma, oncocytic hyperplasia, sebaceous adenoma, malignant salivary gland neoplasms and metastatic lesions from kidney and thyroid. Myoepitheliomas mostly occur in the parotid gland and palatal region and various histological types of myoepithelioma are described. Myoepitheliomas of the palate are rare with clear cell variant even rarer.

  8. Trichotillomania: a case report with clinical and dermatoscopic differential diagnosis with alopecia areata*

    Science.gov (United States)

    Pinto, Ana Cecília Versiani Duarte; de Andrade, Tatiana Cristina Pedro Cordeiro; de Brito, Fernanda Freitas; da Silva, Gardênia Viana; Cavalcante, Maria Lopes Lamenha Lins; Martelli, Antonio Carlos Ceribelli

    2017-01-01

    Trichotillomania is a psychodermatologic disorder characterized by uncontrollable urge to pull one's own hair. Differential diagnoses include the most common forms of alopecia such as alopecia areata. It is usually associated with depression and obsessive-compulsive disorder. Trichotillomania treatment standardization is a gap in the medical literature. Recent studies demonstrated the efficacy of N-acetylcysteine (a glutamate modulator) for the treatment of the disease. We report the clinical case of a 12-year-old female patient who received the initial diagnosis of alopecia areata, but presented with clinical and dermoscopic features of trichotillomania. She was treated with the combination of psychotropic drugs and N-acetylcysteine with good clinical response. Due to the chronic and recurring nature of trichotillomania, more studies need to be conducted for the establishment of a formal treatment algorithm. PMID:28225970

  9. Differential diagnosis of several mechanisms of destruction in patients with dust diseases of lungs

    Energy Technology Data Exchange (ETDEWEB)

    Zhumabekova, B.K.; Nikolaeva, L.N.; Milishnikova, V.V.

    1982-11-01

    In pathogenesis of lung diseases destruction of bronchial passability plays a significant role. Differential diagnosis of the mechanisms of destruction in patients ill with dust diseases was conducted with inhalation of salbutamol, stimulator of beta-adrenoreceptors of bronchi. Investigations of function of breathing included determination of ventilation characteristics, gases of blood and resistance of bronchi. Sixty patients were studied, 30 with pneumoconiosis and 30 with chronic dust bronchitis. Combination of ventilation characteristics and inhalation of salbutamol over 10, 20, 30 and 40 minute periods was used to determine mechanisms causing destruction of function of breathing. Comparisons of results of pneumotaxometry and fibroscopy show changes in mucous envelope of trachea and bronchi, inflammation and hypersecretion causing obstruction of bronchi. It is possible that these mechanisms may be combined with other changes of the tracheobronchial tree (dyskinesia, dystonia, changes in architectonics of bronchial tree and others). Further investigation of these possible mechanisms of destruction of bronchial passability is needed. (5 refs.) (In Russian)

  10. A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome

    Directory of Open Access Journals (Sweden)

    Vogel Tobias

    2006-06-01

    Full Text Available Abstract Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex. Her symptoms remained intractable from conservative treatment consisting of anti-inflammatory medication as well as physical therapy. Hence the patient was admitted to surgical resection of the ossified stylohyoid ligament complex. Afterwards she was free of any complaints and went back to work. Therefore, ossification of the stylohyoid ligament complex causing severe neck pain and movement disorder should be regarded as a rare differential diagnosis of occupational related neck pain.

  11. Recurrent eccrine hidradenoma of the breast in a male patient: problems in differential diagnosis

    Directory of Open Access Journals (Sweden)

    Maria Orsaria

    2013-04-01

    Full Text Available Introduction: Hidradenoma is an uncommon usually benign tumor of the skin that grows slowly.Case presentation: We describe a case of a 39 patient with a breast mass. Physical examination revealed a solitary, well-circumscribed tumor, measuring 1 cm by 0.7 cm. No other skin abnormalities were found. A total surgical excision was performed and histologic examination concluded to an eccrine hidradenoma with clear cells.Conclusion: Here we discuss problems in the differentiate this tumor, mainly in this not common location, from a breast primary (ductal carcinoma or adenomyoepitelioma, from a metastatic clear cell carcinoma and from other types of skin tumors. Moreover, this patient presented with a recurrence of the tumor in the same location, suggesting a locally aggressive form of this neoplasia; few reports in the literature are described as at low malignant potential, but definite criteria for this diagnosis are not well defined.

  12. Differential diagnosis of Mendelian and mitochondrial disorders in patients with suspected multiple sclerosis.

    Science.gov (United States)

    Weisfeld-Adams, James D; Katz Sand, Ilana B; Honce, Justin M; Lublin, Fred D

    2015-03-01

    Several single gene disorders share clinical and radiologic characteristics with multiple sclerosis and have the potential to be overlooked in the differential diagnostic evaluation of both adult and paediatric patients with multiple sclerosis. This group includes lysosomal storage disorders, various mitochondrial diseases, other neurometabolic disorders, and several other miscellaneous disorders. Recognition of a single-gene disorder as causal for a patient's 'multiple sclerosis-like' phenotype is critically important for accurate direction of patient management, and evokes broader genetic counselling implications for affected families. Here we review single gene disorders that have the potential to mimic multiple sclerosis, provide an overview of clinical and investigational characteristics of each disorder, and present guidelines for when clinicians should suspect an underlying heritable disorder that requires diagnostic confirmation in a patient with a definite or probable diagnosis of multiple sclerosis.

  13. Differential diagnosis of dumbbell lesions associated with spinal neural foraminal widening: Imaging features

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    Kivrak, Ali Sami [Selcuk University, Meram Medical Faculty, Department of Radiology, 42080 Konya (Turkey)], E-mail: alisamikivrak@hotmail.com; Koc, Osman; Emlik, Dilek; Kiresi, Demet; Odev, Kemal [Selcuk University, Meram Medical Faculty, Department of Radiology, 42080 Konya (Turkey); Kalkan, Erdal [Selcuk University, Meram Medical Faculty, Department of Neurosurgery, Konya (Turkey)

    2009-07-15

    Computed tomography (CT) and magnetic resonance imaging (MRI) reliably demonstrate typical features of schwannomas or neurofibromas in the vast majority of dumbbell lesions responsible for neural foraminal widening. However, a large variety of unusual lesions which are causes of neural foraminal widening can also be encountered in the spinal neural foramen. Radiologic findings can be helpful in differential diagnosis of lesions of spinal neural foramen including neoplastic lesions such as benign/malign peripheral nerve sheath tumors (PNSTs), solitary bone plasmacytoma (SBP), chondroid chordoma, superior sulcus tumor, metastasis and non-neoplastic lesions such as infectious process (tuberculosis, hydatid cyst), aneurysmal bone cyst (ABC), synovial cyst, traumatic pseudomeningocele, arachnoid cyst, vertebral artery tortuosity. In this article, we discuss CT and MRI findings of dumbbell lesions which are causes of neural foraminal widening.

  14. Differential diagnosis of breast cancer using quantitative, label-free and molecular vibrational imaging.

    Science.gov (United States)

    Yang, Yaliang; Li, Fuhai; Gao, Liang; Wang, Zhiyong; Thrall, Michael J; Shen, Steven S; Wong, Kelvin K; Wong, Stephen T C

    2011-08-01

    We present a label-free, chemically-selective, quantitative imaging strategy to identify breast cancer and differentiate its subtypes using coherent anti-Stokes Raman scattering (CARS) microscopy. Human normal breast tissue, benign proliferative, as well as in situ and invasive carcinomas, were imaged ex vivo. Simply by visualizing cellular and tissue features appearing on CARS images, cancerous lesions can be readily separated from normal tissue and benign proliferative lesion. To further distinguish cancer subtypes, quantitative disease-related features, describing the geometry and distribution of cancer cell nuclei, were extracted and applied to a computerized classification system. The results show that in situ carcinoma was successfully distinguished from invasive carcinoma, while invasive ductal carcinoma (IDC) and invasive lobular carcinoma were also distinguished from each other. Furthermore, 80% of intermediate-grade IDC and 85% of high-grade IDC were correctly distinguished from each other. The proposed quantitative CARS imaging method has the potential to enable rapid diagnosis of breast cancer.

  15. Capillaroscopy in Psoriatic and Rheumatoid Arthritis: A Useful Tool for Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Dario Graceffa

    2013-01-01

    Full Text Available Impairment of capillaries permeability and changes of microcirculation are associated with inflammatory arthritis. In order to demonstrate microvascular differences between psoriatic arthritis (PsA and rheumatoid arthritis (RA we analyzed capillaroscopic abnormalities such as megacapillaries, haemorrhages, ramifications, and avascular areas in patients affected by these two rheumatic disorders. Moreover to identify specific capillaroscopy patterns we analyzed the following parameters: venous limb diameter, arterial limb diameter, capillary loop diameter, amplitude of the capillary loop, linear density of capillaries (on 2 mm, and number of twisted capillaries (on 4 mm. Through a comparative morphometric analysis of capillaroscopy, our study demonstrated the presence of specific microvascular differences between PsA and RA providing an additional diagnostic tool for the differential diagnosis. We also suggest that capillaries structural abnormalities might reflect endothelial injury due to systemic inflammation during chronic arthritis.

  16. Immunohistochemistry applied to the differential diagnosis between ductal and lobular carcinoma of the breast.

    Science.gov (United States)

    de Deus Moura, Rafael; Wludarski, Sheila C L; Carvalho, Filomena M; Bacchi, Carlos E

    2013-01-01

    The distinction between classic lobular and ductal carcinoma, both in situ and invasive, has important therapeutic and management implications. Most ductal and lobular carcinomas are distinguished readily on hematoxylin-eosin-stained sections because of distinct histomorphologic features. In cases with ambiguous morphologic features, however, categorization in one or another type can be a challenge. Several immunohistochemical markers, including epithelial cadherin, p120, β-catenin, and low-molecular-weight and high-molecular-weight cytokeratins among others, have been introduced to help better discriminate between lobular neoplasia and ductal carcinoma. In this critical review of the literature, we comment about the usefulness and the limitations of these markers to improve the accuracy in the differential diagnosis of breast pathology.

  17. Do not overlook Weismann-Netter syndrome in differential diagnosis of skeletal dysplasias.

    Science.gov (United States)

    Caksen, H; Kurtoğlu, S

    2004-01-01

    Weismann-Netter syndrome (WNS), a rare condition, is characterized by an anterior curvature of the bones of the lower limbs, usually bilateral and symmetrical. It was first described in 1954 by Weismann-Netter and Stuhl. We report a 2-year-old girl with typical findings of WNS who was misdiagnosed as having rickets. Our purpose is to draw attention to the WNS in the differential diagnosis of skeletal dysplasias. We think that the true incidence of WNS is probably higher than previously reported; therefore, we would like to emphasize that WNS should be considered in patients who have bowed lower extremities and have been diagnosed as having syphilis or healed rickets.

  18. A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome.

    Science.gov (United States)

    Kirchhoff, Gertrud; Kirchhoff, Chlodwig; Buhmann, Sonja; Kanz, Karl-Georg; Lenz, Miriam; Vogel, Tobias; Kichhoff, Rainer Maria

    2006-06-26

    Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex. Her symptoms remained intractable from conservative treatment consisting of anti-inflammatory medication as well as physical therapy. Hence the patient was admitted to surgical resection of the ossified stylohyoid ligament complex. Afterwards she was free of any complaints and went back to work. Therefore, ossification of the stylohyoid ligament complex causing severe neck pain and movement disorder should be regarded as a rare differential diagnosis of occupational related neck pain.

  19. A review of plantar heel pain of neural origin: differential diagnosis and management.

    Science.gov (United States)

    Alshami, Ali M; Souvlis, Tina; Coppieters, Michel W

    2008-05-01

    Plantar heel pain is a symptom commonly encountered by clinicians. Several conditions such as plantar fasciitis, calcaneal fracture, rupture of the plantar fascia and atrophy of the heel fat pad may lead to plantar heel pain. Injury to the tibial nerve and its branches in the tarsal tunnel and in the foot is also a common cause. Entrapment of these nerves may play a role in both the early phases of plantar heel pain and recalcitrant cases. Although the contribution of nerve entrapment to plantar heel pain has been well documented in the literature, its pathophysiology, diagnosis and management are still controversial. Therefore, the purpose of this article was to critically review the available literature on plantar heel pain of neural origin. Possible sites of nerve entrapment, effectiveness of diagnostic clinical tests and electrodiagnostic tests, differential diagnoses for plantar heel pain, and conservative and surgical treatment will be discussed.

  20. Differential scanning calorimetry of blood plasma for clinical diagnosis and monitoring.

    Science.gov (United States)

    Garbett, Nichola C; Mekmaysy, Chongkham S; Helm, C William; Jenson, A Bennett; Chaires, Jonathan B

    2009-06-01

    Differential scanning calorimetry (DSC) provides a useful method to study the unfractionated plasma proteome. Plasma from healthy individuals yields a reproducible signature thermogram which results from the weighted sum of the thermal denaturation of the most abundant plasma proteins. Further investigation of the thermogram for healthy individuals showed it to be sensitive to ethnicity and gender. DSC analysis of plasma from diseased individuals revealed significant changes in the thermogram which are suggested to result not from changes in the concentration of the major plasma proteins but from interactions of small molecules or peptides with these proteins. Closer examination of the diseased thermograms showed a thermogram characteristic of each disease. For cervical cancer, the DSC method yields a progressively shifted thermogram as the disease advances from pre-invasive conditions to late stage cancer. Our application of the DSC method has provided a potential tool for the early diagnosis, monitoring and screening of cancer patients.

  1. Differential diagnosis of orf viruses by a single-step PCR.

    Science.gov (United States)

    Chan, Kun-Wei; Hsu, Wei-Li; Wang, Chi-Young; Yang, Cheng-Hsiung; Lin, Fong-Yuan; Chulakasian, Songkhla; Wong, Min-Liang

    2009-09-01

    The complete nucleotide sequence of the A32L gene (named after vaccinia virus, corresponding with open reading frame 108 of the orf virus and encoding an ATPase) of the orf virus was studied using samples of orf virus from infected goats, which were collected from six outbreaks in central Taiwan. DNA sequence analysis of the A32L genes of these and isolates from other countries showed sequence heterogeneity (base pair variation and deletion) in the 3'-terminal regions. This finding led to the development of a polymerase chain reaction (PCR) method for the rapid differential diagnosis of orf virus infections, and the results demonstrated that this was an easy and reliable method for genotyping of orf viruses.

  2. [Application evaluation of multi-parametric MRI in the diagnosis and differential diagnosis of early prostate cancer and prostatitis].

    Science.gov (United States)

    Li, P; Huang, Y; Li, Y; Cai, L; Ji, G H; Zheng, Y; Chen, Z Q

    2016-10-11

    Objective: To evaluate the value of multi-parametric MRI (Mp-MRI) in the diagnosis and differential diagnosis of early prostate cancer(PCa) in the peripheral zone(PZ) and low T2WI signal intensity of prostatitis. Methods: A total of 40 patients with PZ early PCa and 37 with prostatitis of hypointense T2WI signal in PZ were retrospectively analyzed, which were collected from the General Hospital of Ningxia Medical University from Janurary 2009 to June 2015, who underwent T2WI, DWI, and DCE-MRI examination and all patients were confirmed by pathology. All the data was transferred to GE Advanced Workstation AW4.3, the indexes divided into cancerous and prostatitis regions were calculated by Functool2 of signal intensity-time(SI-T) curve and ADC value, to calcuate the time to minimum(Tmax), the whole enhancment degree (SImax). ROC cure was used to determine the cutoff value for PCa detection with the ADC value. Result: On T2WI, 57.5% of PCa (23/40) showed focal nodular homogeneous low signal intensity, 70.3% of prostatitis(26/37) showed diffuse inhomogeneous low signal intensity. DCE-MRI, the distribution of curve types for malignant tumors was type Ⅰ 2.5%(1/40), typeⅡ32.5%(13/40) and type Ⅲ 65.0% (26/40). While the numbers for prostatitis was type Ⅰ 16.2%(6/37) , type Ⅱ 56.8% (21/37) and type Ⅲ 27.0% (10/37)respectively.The patterns of curve types in malignant lesions were different from benign lesions significantly(χ(2) =12.32, P<0.01). The mean values of Tmax, SImax in cancerous and prostatitis regions were (17.96±2.91)s, 1.76%±0.23% and (21.19±3.59)s, 1.53%±0.18%, respectively (t=5.37, 6.10; P<0.01). On DWI, The mean ADC values in cancerous and prostatitis regions were (0.95±0.13)×10(-3) mm(2)/s and (1.12±0.13)×10(-3) mm(2)/s, respectively (t=7.10, P<0.01). According to the ROC analysis, when the cutoff value was 1.01×10(-3) mm(2)/s, the early PCa of diagnostic sensitivity, specificity and accuracy was 79.1%, 72.7% and 76.1% respectively

  3. The many faces of hemifacial spasm: differential diagnosis of unilateral facial spasms.

    Science.gov (United States)

    Yaltho, Toby C; Jankovic, Joseph

    2011-08-01

    Hemifacial spasm is defined as unilateral, involuntary, irregular clonic or tonic movement of muscles innervated by the seventh cranial nerve. Most frequently attributed to vascular loop compression at the root exit zone of the facial nerve, there are many other etiologies of unilateral facial movements that must be considered in the differential diagnosis of hemifacial spasm. The primary purpose of this review is to draw attention to the marked heterogeneity of unilateral facial spasms and to focus on clinical characteristics of mimickers of hemifacial spasm and on atypical presentations of nonvascular cases. In addition to a comprehensive review of the literature on hemifacial spasm, medical records and videos of consecutive patients referred to the Movement Disorders Clinic at Baylor College of Medicine for hemifacial spasm between 2000 and 2010 were reviewed, and videos of illustrative cases were edited. Among 215 patients referred for evaluation of hemifacial spasm, 133 (62%) were classified as primary or idiopathic hemifacial spasm (presumably caused by vascular compression of the ipsilateral facial nerve), and 4 (2%) had hereditary hemifacial spasm. Secondary causes were found in 40 patients (19%) and included Bell's palsy (n=23, 11%), facial nerve injury (n=13, 6%), demyelination (n=2), and brain vascular insults (n=2). There were an additional 38 patients (18%) with hemifacial spasm mimickers classified as psychogenic, tics, dystonia, myoclonus, and hemimasticatory spasm. We concluded that although most cases of hemifacial spasm are idiopathic and probably caused by vascular compression of the facial nerve, other etiologies should be considered in the differential diagnosis, particularly if there are atypical features.

  4. MRI diagnosis and differential diagnosis of pineal region tumors%松果体区肿瘤的MRI诊断与鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    岑家定

    2013-01-01

    Objective To discuss the MRI diagnosis and differential diagnosis of pineal region tumors. Methods Retrospected and analysed 28 cases of pineal region tumors diagnosed with MRI data. Results 8 cases of germ cell tumor, glioma with teratoma in 5 cases, 2 cases of meningioma, 4 cases of choriocarcinoma, neuroblastoma, pinealoblastoma, arachnoid cyst and skin itching cyst in 1 cases. The diagnostic results showed that only rely on the MRI signal was difficult to accurately diagnose,combined with clinical data was still needed. Conclusion MRI examination could accurately display the pineal region tumor morphology and location, diagnosis and differential diagnosis could be combined with the source to determine the tumor tissue, effectively improved the accuracy diagnosis and differential diagnosis.%  目的探讨松果体区肿瘤的MRI诊断与鉴别诊断。方法回顾分析28例松果体区肿瘤患者MRI诊断资料。结果生殖细胞瘤8例,胶质瘤及畸胎瘤各5例,脑膜瘤2例,绒毛膜癌4例,神经母细胞瘤、松果体母细胞瘤、蛛网膜囊肿及皮痒囊肿各1例。诊断结果显示,仅依靠MRI信号难以准确诊断,还需结合临床资料,有助于准确诊断。结论 MRI检查能够准确显示松果体区肿瘤的形态以及位置,诊断与鉴别诊断可以结合肿瘤的组织学来源确定,有效提高诊断以及鉴别诊断的准确性。

  5. Rare Solid Tumors of the Pancreas as Differential Diagnosis of Pancreatic Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Sabine Kersting

    2012-05-01

    Full Text Available Context Rare solid tumors of the pancreas can be misinterpreted as primary pancreatic cancer. Objective The aim of this study was to report our experience in the treatment of patients with rare tumor lesions of the pancreas and to discuss clinical and pathological characteristics in the context of the role of surgery. Design Data from patients of our prospective data-base with rare benign and malignant tumors of the pancreas, treated in our division from January 2004 to August 2010, were analyzed retrospectively. Results One-thousand and ninety-eight patients with solid tumors of the pancreas underwent pancreatic surgery. In 19 patients (10 women, 9 men with a mean age of 57 years (range: 20-74 years rare pancreatic tumors (metastasis, solid pseudopapillary tumor, teratoma, hemangioma, accessory spleen, lymphoepithelial cyst, hamartoma, sarcoidosis, yolk sac tumor were the reason for surgical intervention. Conclusion If rare benign and malignant pancreatic tumors, intrapancreatic metastasis, as well as pancreatic malformations or other abnormalities, present themselves as solid masses of the pancreas, they constitute an important differential diagnosis to primary pancreatic neoplasia, e.g. pancreatic ductal adenocarcinoma. Clinical imaging techniques cannot always rule out malignancy, thus operative exploration often remains the treatment of choice to provide the correct diagnosis and initiate adequate surgical therapy.

  6. Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia

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    W. Barcellini

    2015-01-01

    Full Text Available Several hemolytic markers are available to guide the differential diagnosis and to monitor treatment of hemolytic conditions. They include increased reticulocytes, an indicator of marrow compensatory response, elevated lactate dehydrogenase, a marker of intravascular hemolysis, reduced haptoglobin, and unconjugated hyperbilirubinemia. The direct antiglobulin test is the cornerstone of autoimmune forms, and blood smear examination is fundamental in the diagnosis of congenital membrane defects and thrombotic microangiopathies. Marked increase of lactate dehydrogenase and hemosiderinuria are typical of intravascular hemolysis, as observed in paroxysmal nocturnal hemoglobinuria, and hyperferritinemia is associated with chronic hemolysis. Prosthetic valve replacement and stenting are also associated with intravascular and chronic hemolysis. Compensatory reticulocytosis may be inadequate/absent in case of marrow involvement, iron/vitamin deficiency, infections, or autoimmune reaction against bone marrow-precursors. Reticulocytopenia occurs in 20–40% of autoimmune hemolytic anemia cases and is a poor prognostic factor. Increased reticulocytes, lactate dehydrogenase, and bilirubin, as well as reduced haptoglobin, are observed in conditions other than hemolysis that may confound the clinical picture. Hemoglobin defines the clinical severity of hemolysis, and thrombocytopenia suggests a possible thrombotic microangiopathy or Evans’ syndrome. A comprehensive clinical and laboratory evaluation is advisable for a correct diagnostic and therapeutic workup of the different hemolytic conditions.

  7. Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia.

    Science.gov (United States)

    Barcellini, W; Fattizzo, B

    2015-01-01

    Several hemolytic markers are available to guide the differential diagnosis and to monitor treatment of hemolytic conditions. They include increased reticulocytes, an indicator of marrow compensatory response, elevated lactate dehydrogenase, a marker of intravascular hemolysis, reduced haptoglobin, and unconjugated hyperbilirubinemia. The direct antiglobulin test is the cornerstone of autoimmune forms, and blood smear examination is fundamental in the diagnosis of congenital membrane defects and thrombotic microangiopathies. Marked increase of lactate dehydrogenase and hemosiderinuria are typical of intravascular hemolysis, as observed in paroxysmal nocturnal hemoglobinuria, and hyperferritinemia is associated with chronic hemolysis. Prosthetic valve replacement and stenting are also associated with intravascular and chronic hemolysis. Compensatory reticulocytosis may be inadequate/absent in case of marrow involvement, iron/vitamin deficiency, infections, or autoimmune reaction against bone marrow-precursors. Reticulocytopenia occurs in 20-40% of autoimmune hemolytic anemia cases and is a poor prognostic factor. Increased reticulocytes, lactate dehydrogenase, and bilirubin, as well as reduced haptoglobin, are observed in conditions other than hemolysis that may confound the clinical picture. Hemoglobin defines the clinical severity of hemolysis, and thrombocytopenia suggests a possible thrombotic microangiopathy or Evans' syndrome. A comprehensive clinical and laboratory evaluation is advisable for a correct diagnostic and therapeutic workup of the different hemolytic conditions.

  8. Forefoot pain involving the metatarsal region: differential diagnosis with MR imaging.

    Science.gov (United States)

    Ashman, C J; Klecker, R J; Yu, J S

    2001-01-01

    Many disorders produce discomfort in the metatarsal region of the forefoot. These disorders include traumatic lesions of the soft tissues and bones (eg, turf toe, plantar plate disruption, sesamoiditis, stress fracture, stress response), Freiberg infraction, infection, arthritis, tendon disorders (eg, tendinosis, tenosynovitis, tendon rupture), nonneoplastic soft-tissue masses (eg, ganglia, bursitis, granuloma, Morton neuroma), and, less frequently, soft-tissue and bone neoplasms. Prior to the advent of magnetic resonance (MR) imaging, many of these disorders were not diagnosed noninvasively, and radiologic involvement in the evaluation of affected patients was limited. However, MR imaging has proved useful in detecting the numerous soft-tissue and early bone and joint processes that occur in this portion of the foot but are not depicted or as well characterized with other imaging modalities. Frequently, MR imaging allows a specific diagnosis based on the location, signal intensity characteristics, and morphologic features of the abnormality. Consequently, MR imaging is increasingly being used to evaluate patients with forefoot complaints. Radiologists should be familiar with the differential diagnosis and MR imaging features of disorders that can produce discomfort in this region.

  9. Value of ultrasound examination in differential diagnosis of pancreatic lymphoma and pancreatic cancer

    Institute of Scientific and Technical Information of China (English)

    Li Qiu; Yan Luo; Yu-Lan Peng

    2008-01-01

    AIM:To investigate the value of clinical manifestations and ultrasound examination in the differential diagnosis of pancreatic lymphoma and pancreatic cancer.METHODS:The clinical and ultrasonic characteristics of 12 cases of pancreatic lymphoma and 30 cases of pancreatic cancer were retrospectively analyzed.RESULTS:Statistically significant differences were found in the course of disease,back pain,jaundice,carcino-embryonic antigen (CEA) and CA19-9 increase,palpable abdominal lump,superficial lymph node enlargement,fever and night sweats,lesion size,bile duct expansion,pancreatic duct expansion,vascular involvement,retroperitoneal (below the renal vein level)lymph node enlargement,and intrahepatic metastasis between pancreatic lymphoma and pancreatic cancer.There were no significant differences in age of onset,gender ratio,weight loss,nausea and vomiting,lesion position,the echo of the lesion,and the blood flow of the lesion.CONCLUSION:Pancreatic lymphoma should be considered for patients with long lasting symptoms,superficial lymph node enlargement,palpable abdominal lump,fever and night sweats,relatively large lesions,and retroperitoneal (below the level of the renal vein) lymph node enlargement.A diagnosis of pancreatic cancer should be considered more likely in the patients with relatively short disease course,jaundice,back pain,CEA and CA19-9 increase,relatively small lesions,bile duct expansion,obvious pancreatic duct expansion,peripheral vascular wrapping and involvement,or intrahepatic metastases.

  10. Metastatic Renal Cell Carcinoma Presenting as a Paranasal Sinus Mass: The Importance of Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Massimo Ralli

    2017-01-01

    Full Text Available Metastases in the paranasal sinuses are rare; renal cell carcinoma is the most common cancer that metastasizes to this region. We present the case of a patient with a 4-month history of a rapidly growing mass of the nasal pyramid following a nasal trauma, associated with spontaneous epistaxis and multiple episodes of hematuria. Cranial CT scan and MRI showed an ethmoid mass extending to the choanal region, the right orbit, and the right frontal sinus with an initial intracranial extension. Patient underwent surgery with a trans-sinusal frontal approach using a bicoronal incision combined with an anterior midfacial degloving; histological exam was compatible with a metastasis of clear cell renal cell carcinoma. Following histological findings, a total body CT scan showed a solitary 6 cm mass in the upper posterior pole of the left kidney identified as the primary tumor. Although rare, metastatic renal cell carcinoma should always be suspected in patients with nasal or paranasal masses, especially if associated with symptoms suggestive of a systemic involvement such as hematuria. A correct early-stage diagnosis of metastatic RCC can considerably improve survival rate in these patients; preoperative differential diagnosis with contrast-enhanced imaging is fundamental for the correct treatment and follow-up strategy.

  11. A Review on Fat Necrosis of the Breast: The Dilemma of Differential Diagnosis with Cancer

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    Toktam Beheshtian

    2015-05-01

    Full Text Available Fat necrosis is a benign inflammatory process which can involve adipose tissue anywhere in the body. A previous history of trauma or surgery may or may not be present. Information about the clinical and radiological appearance of this lesion is very important because it can mimic breast cancer.In this article, we review the features of fat necrosis in different imaging modalities including mammography, ultrasound, and magnetic resonance imaging (MRI, and compare them with histopathologic findings; then, we try to provide a logical approach for fat necrosis management.The appearance of fat necrosis at imaging is variable from definitely benign type to highly suspicious for malignancy. The specificity of mammography is higher than that of ultrasonography; therefore, for a definite diagnosis of fat necrosis, emphasis should be mainly based on mammography rather than ultrasonography.Finally, fat necrosis is not a common disease; however, regarding unusual and atypical findings in different imaging modalities, differentiation from a cancer may be difficult, especially in patients with a previous history of malignancy. Therefore, a multimodality approach is required for a definite diagnosis.

  12. Leptin levels in the differential diagnosis between benign and malignant ascites

    Institute of Scientific and Technical Information of China (English)

    Mehmet Buyukberber; Mehmet Koruk; M Cemil Savas; Murat T Gulsen; Yavuz Pehlivan; Rukiye Deveci; Alper Sevinc; Serdar Gergerlioglu

    2007-01-01

    AIM: To evaluate the role of leptin levels in the differential diagnosis of ascites.METHODS: Ascitic leptin, TNFα and serum leptin levels were measured in 77 patients with ascites (35 with malignancies, 30 cirrhosis and 12 tuberculosis). Control serum samples were obtained from 20 healthy subjects.Leptin and TNFα levels were measured by ELISA. Body mass index (BMI) and percentage of body fat (BFM) by skin fold measurement were calculated for all patients and control groups. Peritoneal biopsy, ascites cytology and cultures or biochemical values were used for the diagnosis of patients.RESULTS: In patients with malignancies, the mean serum and ascites leptin levels and their ratios were significantly decreased compared to the other patient groups and controls. In tuberculosis peritonitis, ascitic fluid TNFα levels were significantly higher than malignant ascites and cirrhotic sterile ascites. BMI and BFM values did not distinguish between patients and controls.CONCLUSION: In patients with malignant ascites,levels of leptin and TNFα were significantly lower than in patients with tuberculous ascites.

  13. Radiological differential diagnosis of rheumatoid arthritis; Radiologische Differenzialdiagnose der rheumatoiden Arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Wick, M.C.; Klauser, A.S. [Medizinische Universitaet Innsbruck, Department Radiologie, Innsbruck (Austria)

    2012-02-15

    Establishing an early and reliable diagnosis of rheumatoid arthritis (RA) is of major importance but can be a great clinical challenge leading to direct therapeutic consequences. No single epidemiological, genetic, clinical, serological or radiological test exists which can exclusively diagnose RA. In general diagnosis of RA includes a case history, clinical signs, laboratory abnormalities and radiological examinations, viz. conventional radiography of the joints of the hands and feet. This review summarizes the most important radiological features of RA and the radiological findings of its closest differential diagnoses. (orig.) [German] Eine fruehe Diagnosestellung bei rheumatoider Arthritis (RA) stellt eine grosse klinische Herausforderung dar, da sich daraus unmittelbare therapeutische Konsequenzen ableiten. Es gibt keinen epidemiologischen, genetischen, klinischen, serologischen oder radiologischen Test, mit dessen alleiniger Anwendung die Diagnose der RA definitiv gestellt werden kann. Die Diagnose der RA erfolgt durch die Kombination von Patientenanamnese, klinischen Zeichen und serologischen Biomarkern in Zusammenschau mit der radiologischen Diagnostik, allen voran der Anwendung konventioneller Roentgenbilder der Haende und Fuesse. In diesem Uebersichtsartikel werden die wichtigsten radiologischen Merkmale zur Diagnose der RA und der diagnostisch haeufigsten Differenzialerkrankungen dargestellt. (orig.)

  14. Tendinitis of the Temporalis muscle: Differential diagnosis and treatment. A Case Report.

    Directory of Open Access Journals (Sweden)

    Veronica Iturriaga.

    2016-03-01

    Full Text Available Introduction: The temporalis muscle plays an essential role in mastication and is actively involved in the mandibular closing movement. It is covered by a fibroelastic fascia that forms its tendon. Tendinitis is a degenerative and inflammatory process, which originates in the tendon-bone junction. Signs and symptoms such as swelling, pain, tenderness on palpation, limitation of movement and mouth opening are frequently associated with other temporomandibular disorders and not with tendinitis as a causal factor. Objective: To describe a clinical case identifying the diagnostic process and management of tendinitis of the temporalis muscle. Case report: A 30-year old male patient who sought treatment after continuous squeezing pain in the zygomatic and bilateral temporal regions with increased pain during mouth opening and mandibular function. The patient referred pain in the insertion region of the tendon of the temporalis muscle. Pain was removed after using anesthesia, consequently confirming the diagnosis of tendinitis of the temporalis muscle. Primary management measures were performed and then peritendinous corticosteroids were administered. The patient did not refer spontaneous or functional pain during check-up. Conclusion: Tendinitis of the temporalis muscle is a common condition, although frequently underdiagnosed. A good differential diagnosis must be performed to avoid confusion with other common conditions such as odontogenic pain, sinusitis, arthralgia, myofascial pain and migraine. Management depends on the type of tendinitis. It usually occurs in conjunction with other types of TMD or facial pain, so it is important to know the different clinical characteristics of pathologies with similar manifestations.

  15. Lymph Node Thyroglobulin Measurement in Diagnosis of Neck Metastases of Differentiated Thyroid Carcinoma

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    Luca Giovanella

    2011-01-01

    Full Text Available Aim. Enlarged cervical lymph nodes (LNs in patients with thyroid cancer are usually assessed by fine-needle aspiration cytology (FNAC. Thyroglobulin (Tg is frequently elevated in malignant FNAC needle wash specimens (FNAC-Tg. The objectives of the study were to (1 determine an appropriate diagnostic cut-off for FNAC-Tg levels (2 compare FNAC and FNAC-Tg results in a group of 108 patients affected by differentiated thyroid carcinoma (DTC. Methods. A total of 126 consecutive FNACs were performed on enlarged LNs and the final diagnosis was confirmed by surgical pathology examination or clinical follow-up. The best FNAC-Tg cut-off level was selected by receiver operating curve analysis, and diagnostic performances of FNAC and FNAC-Tg were compared. Results. The rate of FNAC samples adequate for cytological examination was 77% in contrast FNAC-Tg available in 100% of aspirates (<.01. The sensitivity, specificity, and accuracy of FNAC were 71%, 80%, 74%, 100%, 80%, and 94%, respectively. The most appropriate cut-off value for the diagnosis of thyroid cancer metastatic LN was 1.1 ng/mL (sensitivity 100%, specificity 100%. Conclusions. The diagnostic performance of needle washout FNAC-Tg measurement with a cut-off of 1.1 ng/mL compared favorably with cytology in detecting DTC node metastases.

  16. Microarray Glycoprofiling of CA125 Improves Differential Diagnosis of Ovarian Cancer

    DEFF Research Database (Denmark)

    Chen, Kowa; Gentry-Maharaj, Aleksandra; Burnell, Matthew;

    2013-01-01

    The CA125 biomarker assay plays an important role in the diagnosis and management of primary invasive epithelial ovarian/tubal cancer (iEOC). However, a fundamental problem with CA125 is that it is not cancer-specific and may be elevated in benign gynecological conditions such as benign ovarian...... for profiling specific aberrant glycoforms, such as Neu5Aca2,6GalNAc (STn) and GalNAc (Tn), present on CA125 (MUC16) and CA15-3 (MUC1). In a blinded cohort study of patients with an elevated CA125 levels (30-500 kU/L) and a pelvic mass from the UK Ovarian Cancer Population Study (UKOPS), we measured STn-CA125......, ST-CA125 and STn-CA15-3. The combined glycoform profile was able to distinguish benign ovarian neoplasms from invasive epithelial ovarian/tubule cancer (iEOCs) with a specificity of 61.1% at 90% sensitivity. The findings suggest that microarray glycoprofiling could improve differential diagnosis...

  17. Differential diagnosis of white matter diseases in the tropics: An overview

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    Pandit Lekha

    2009-01-01

    Full Text Available In hospitals in the tropics, the availability of magnetic resonance imaging (MRI facilities in urban areas and especially in teaching institutions have resulted in white matter diseases being frequently reported in a variety of clinical settings. Unlike the west where multiple sclerosis (MS is the commonest white matter disease encountered, in the tropics, there are myriad causes for the same. Infectious and post infectious disorders probably account for the vast majority of these diseases. Human immunodeficiency virus (HIV infection tops the list of infective conditions. Central nervous system (CNS tuberculosis occasionally presents with patchy parenchymal lesions unaccompanied by meningeal involvement. Human T cell leukemia virus (HTLV infection and cystic inflammatory lesions such as neurocysticercosis are important causes to be considered in the differential diagnosis. Diagnosing post infectious demyelinating disorders is equally challenging since more than a third of cases seen in the tropics do not present with history of past infection or vaccinations. Metabolic and deficiency disorders such as Wernicke′s encephalopathy, osmotic demyelinating syndrome associated with extra pontine lesions and Vitamin B12 deficiency states can occassionaly cause confusion in diagnosis. This review considers a few important disorders which manifest with white matter changes on MRI and create diagnostic difficulties in a population in the tropics.

  18. ADHD and autism: differential diagnosis or overlapping traits? A selective review.

    Science.gov (United States)

    Taurines, Regina; Schwenck, Christina; Westerwald, Eva; Sachse, Michael; Siniatchkin, Michael; Freitag, Christine

    2012-09-01

    According to DSM-IV TR and ICD-10, a diagnosis of autism or Asperger Syndrome precludes a diagnosis of attention-deficit/hyperactivity disorder (ADHD). However, despite the different conceptualization, population-based twin studies reported symptom overlap, and a recent epidemiologically based study reported a high rate of ADHD in autism and autism spectrum disorders (ASD). In the planned revision of the DSM-IV TR, dsm5 (www.dsm5.org), the diagnoses of autistic disorder and ADHD will not be mutually exclusive any longer. This provides the basis of more differentiated studies on overlap and distinction between both disorders. This review presents data on comorbidity rates and symptom overlap and discusses common and disorder-specific risk factors, including recent proteomic studies. Neuropsychological findings in the areas of attention, reward processing, and social cognition are then compared between both disorders, as these cognitive abilities show overlapping as well as specific impairment for one of both disorders. In addition, selective brain imaging findings are reported. Therapeutic options are summarized, and new approaches are discussed. The review concludes with a prospectus on open questions for research and clinical practice.

  19. Should spinocerebellar ataxias be included in the differential diagnosis for Huntington's diseases-like syndromes?

    Science.gov (United States)

    Pedroso, José Luiz; de Freitas, Maria Eliza Thomaz; Albuquerque, Marcus Vinicius Cristino; Saraiva-Pereira, Maria Luiza; Jardim, Laura Bannach; Barsottini, Orlando G P

    2014-12-15

    In this article, we describe three patients with different spinocerebellar ataxia (SCA) subtypes presenting with unusual movement disorders predominantly characterized by choreoathetosis, which, together with their autosomal dominant pattern of inheritance, resembled the Huntington-like syndromes. From a large SCA cohort, we have observed chorea in 1/35 SCA2, 1/112 SCA3/MJD, and 1/30 SCA7 patients. Twenty-eight patients with SCA1, 11 patients with SCA6, and 3 patients with SCA10 were also evaluated, and none of them presented chorea. We provide a brief report of the three cases, with a video demonstrating chorea. Although a debate regarding the frequency of chorea in SCA patients is a fact, its occurrence, together with the autosomal dominant pattern of inheritance, clearly imposes SCA in the differentials of Huntington-like syndromes. There is some debate about what to include in a list of Huntington-like disorders, with several review articles about Huntington-like syndromes not including SCA in the differential diagnosis, except for SCA17. We believe that SCAs-at least SCA1, SCA2, SCA3/MJD, SCA7 and DRPLA-should be thought in the diagnostic workout of at least the atypical cases, such as those presented in this report.

  20. P-cadherin as myoepithelial cell marker for differential diagnosis of benign and malignant breast lesions

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    Yachika Bhatia

    2013-01-01

    Full Text Available Background: P-cadherin is cell-cell adhesion glycoprotein which can be used as a myoepithelial cell (MEC marker in the breast lesions. MEC layer is retained in most benign lesions and loss of this outer layer is hallmark of infiltrating carcinomas in the breast. Aim: To evaluate the expression of P-cadherin as MEC marker in the differential diagnosis of benign and malignant breast lesions. Materials and Methods: Immunohistochemical staining was done using P-cadherin-specific antibody on formalin fixed paraffin-embedded sections of 25 benign and 15 malignant breast lumps. Results: All 25 cases of benign breast lesions showed positive P-cadherin immunostaining, while only 4 out of 15 cases of infiltrating ductal carcinoma showed positive immunostaining for P-cadherin. In the case of benign lesions, staining index varied from 4 to 6 or 7 to 9, while in case of malignant lesions, 11 cases showed staining index from 1 to 3. Only 4 out of 15 malignant cases had staining index from 4 to 6. None of them showed index from 7 to 9. Conclusions: P-cadherin as a MEC marker can be used in differentiating benign and malignant breast lesions.

  1. Pancreatic neuroendocrine tumor and solid-pseudopapillary neoplasm: Key immunohistochemical profiles for differential diagnosis

    Science.gov (United States)

    Ohara, Yusuke; Oda, Tatsuya; Hashimoto, Shinji; Akashi, Yoshimasa; Miyamoto, Ryoichi; Enomoto, Tsuyoshi; Satomi, Kaishi; Morishita, Yukio; Ohkohchi, Nobuhiro

    2016-01-01

    AIM To reveal better diagnostic markers for differentiating neuroendocrine tumor (NET) from solid-pseudopapillary neoplasm (SPN), focusing primarily on immunohistochemical analysis. METHODS We reviewed 30 pancreatic surgical specimens of NET (24 cases) and SPN (6 cases). We carried out comprehensive immunohistochemical profiling using 9 markers: Synaptophysin, chromogranin A, pan-cytokeratin, E-cadherin, progesterone receptor, vimentin, α-1-antitrypsin, CD10, and β-catenin. RESULTS E-cadherin staining in NETs, and nuclear labeling of β-catenin in SPNs were the most sensitive and specific markers. Dot-like staining of chromogranin A might indicate the possibility of SPNs rather than NETs. The other six markers were not useful because their expression overlapped widely between NETs and SPNs. Moreover, two cases that had been initially diagnosed as NETs on the basis of their morphological features, demonstrated SPN-like immunohistochemical profiles. Careful diagnosis is crucial as we actually found two confusing cases showing disagreement between the tumor morphology and immunohistochemical profiles. CONCLUSION E-cadherin, chromogranin A, and β-catenin were the most useful markers which should be employed for differentiating between NET and SPN.

  2. Significance of ambulatory electroencephalography for differential diagnosis of epilepsy and syncope

    Institute of Scientific and Technical Information of China (English)

    Xueling Zhang; Lingli Zhang; Deyun Zhu; Lan Wei; Xuehong Wang

    2008-01-01

    BACKGROUND: Twenty-four hour ambulatory electroencephalography (AEEG) provides advantages for continuous electroencephalogram, monitoring brief loss of consciousness complicated by suspect or mild limb spasm. OBJECTIVE: To explore the significance of AEEG for differentially diagnosing epilepsy and syncope, compared to EEG. DESIGN, TIME AND SETTING: Sixty patients with brief loss of consciousness, complicated by suspect or mild limb spasm, were selected from Suqian People's Hospital between January 2006 and June 2007. PARTICIPANTS: Sixty participants comprised 34 males and 26 females, aged 13-64 years. According to clinical symptoms prior to the study, 36 patients were initially diagnosed with epilepsy and 24 with syncope. METHODS AND MAIN OUTCOME MEASURES: Abnormalities and epileptiform discharge were detected using EEG and AEEG, and the diagnostic value of the two methods for epilepsy and syncope was compared. RESULTS: A total of sixty patients were included in the final analysis. Abnormal AEEGs were observed in 37 cases (62%) and epilcptitorm discharge AEEGs in 23 cases (38%), both of which were significantly greater than EEGs [37% (22/60), 18% ( 11/60), respectively, P < 0.01, 0.05]. The detection rate of abnormal AEEG and epileptiform discharge in the epilepsy group [75% (27/36), 47% (17/36), respectively] was significantly greater than in the syncope group [42% (10/24), 25% (6/24), respectively, P < 0.01, 0.05 ]. CONCLUSION: AEEG can improve detection probability of epileptiform discharge and exhibits significant differences in the differential diagnosis of epilepsy and syncope.

  3. Desmoplastic Infantile Ganglioglioma: cytologic findings and differential diagnosis on aspiration material

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    Mariappan M Rajan

    2005-01-01

    Full Text Available Abstract Background Desmoplastic infantile ganglioglioma (DIG is a rare WHO Grade I tumor of infancy that is characterized by large volume, superficial location, invariable supratentoriality, fronto-parietal lobe predilection and morphologically, by an admixture of astroglial and neuroepithelial elements in a desmoplastic milieu. With over 50 cases described, the histologic and radiographic spectrum of DIG has been well-characterized. The superficial location of DIGs may render them greatly amenable to preoperative assessment utilizing aspiration cytology; however, the cytologic features of this rare tumor have only been reported once previously. Case Presentation We present herein cytomorphologic findings from the intraoperative aspiration of a typical case of DIG diagnosed in a 1-year-old male. As evaluated on a single liquid-based preparation, the specimen showed low cellularity and was comprised predominantly of a population of dispersed (occasionally clustered large neuronal cells with eccentrically located hyperchromatic nuclei (which were occasionally binucleated and abundant unipolar cytoplasm. Rare smaller astroglial cells were intermixed. Despite the tumor's characteristic desmoplastic histologic appearance, no stromal fragments were identified on the aspiration material. Conclusions A differential diagnosis is presented and analyzed in detail and it is concluded that when these large neuronal cells are encountered in an aspirate of a brain mass in a child, a combination of clinical, radiologic and immunohistochemical parameters can eliminate most of the differential possibilities.

  4. [The amylase-creatinine clearance ratio in the differential diagnosis of pancreatitis and gastroduodenal ulcer with hyperamylasemia].

    Science.gov (United States)

    Pezzangora, V; Della Dora, R; Pagliarini, A; Dell'Olivo, I

    1978-04-01

    The Authors followed 29 patients, hospitaled with a diagnosis of pancreatitis. They all presented the same sympotomatology and a considerable increase of the serum amylase ad urinary amylase. The examination of the ratio between the clearance of amylasis and creatinine permitted to make a differential diagnosis for 8 cases (4rd group) that were nothing but peptic ulcera. Such a diagnosis was confirmed by the radiological contrastographic examination or by the intraoperative report. So if the ratio between the clearance of amylase and creatinine is normal we must think about a pathological situation were the iperamylasemia has a pathogenetic cause different from pancreatitis.

  5. MR imaging findings of pineal germinoma: focus on differential diagnosis from other germ cell tumors

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    Kim, Hyun Jin; Lee, Ho Kyu; Kim, Jae Kyun; Shin, Ji Hoon; Choi, Choong Gon; Lee, Myung Jun; Ham, Soo Youn; Lee, Jong Hwa; Suh, Dae Chul [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-10-01

    To determine the characteristic MR imaging findings of pineal germinoma, and differential diagnosis from other germ cell tumors. MR images of patients with histopathologically proven pineal germinoma(n=3D14) and other pineal germ cell tumors(n=3D10) were retrospectively analyzed with regard to size, signal intensity and homogeneity, enhancing features, cyst formation, and multiplicity of lesions. Other pineal germ cell tumors were the mixed germ cell tumors (n=3D4), malignant teratomas (n=3D3), choriocarcinoma(n=3D1), embryonal carcinoma(n=3D1), and endodermal sinus tumor(n=3D1). Tumor markers were evaluated. On T1-weighted images, germinomas showed homogeneous(86%) or iso signal intensity (93%), while other germ cell tumors showed inhomogeneous(70%) or iso signal intensity(70%). On T2-weighted images, germinomas showed homogeneous(64%) or iso signal intensity(57%), while other germ cell tumors showed inhomogeneous(70%) or high signal intensity(80%). On Gd-DTPA enhanced images, germinomas showed homogeneous (93%) or strong enhancement (64%), while other germ cell tumors showed homogeneous(60%) or strong enhancement (70%). Cyst formation was noted in ten Patients (71%) with germinoma and in six (60%) with other germ cell tumors. Invasion on surrounding structures was seen in 11 patients (79%) with germinoma and in five (50%) with other germ cell tumors. Lesions were multiple in three patients(21%) with germinoma. Thirteen of 14 patients with germinoma had normal serum {alpha}-FP(tetoprotein) and {beta}-HCG(human chononic gonafotrophin) levels. Two of four patients with mixed germ cell tumors had elevated serum {beta}-FP and {alpha}-HCG levels; in the ther two, elevated serum {alpha}-FP or {beta}-HCG levels were noted. In the malignant teratoma and embryonal carcinoma patients, serum {alpha}-FP and {beta}-HCG levels were normal. The patient with choriocarcinoma had an elevated serum {beta}-HCG level. On T1W1, the only significant differential point (p<0.01) between

  6. Differential diagnosis of Parkinsonism using dual phase F 18 FP CIT PET imaging

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    Jin, So Young; Oh, Min Young; Ok, Seung Jun; Oh, Jung Su; Lee, Sang Ju; Chung, Sun Ju; Lee, Chong Sik; Kim, Jae Seung [Univ. of Ulsan, Seoul (Korea, Republic of)

    2012-03-15

    Dopamine transporter (DAT) imaging can demonstrate presynaptic dopaminergic neuronal loss in Parkinson's disease (PD). However, differentiating atypical parkinsonism (APD) from PD is often difficult. We investigated the usefulness of dual phase F 18 FP CIT positron emission tomography (PET) imaging in the differential diagnosis of parkinsonism. Ninety eight subjects [five normal, seven drug induced parkinsonism (DIP), five essential tremor (ET), 24 PD, 20 multiple system atrophy parkinson type (MSA-P), 13 multiple system atrophy cerebellar type (MSA-C), 13 progressive supranuclear palsy (PSP), and 11 dementia with Lewy bodies(DLB)] underwent F 18 FP CIT PET. PET images were acquired at 5 min (early phase) and 3 h (late phase) after F 18 FP CIT administration (185MBq). Regional uptake pattern of cerebral and cerebellar hemispheres was assessed on early phase images, using visual, quantitative, and statistical parametric mapping (SPM) analyses. Striatal DAT binding was normal in normal, ET, DIP, and MSA C groups, but abnormal in PD, MSA P PSP, and DLB groups. No difference was found in regional uptake on early phase images among normal DAT binding groups, except in the MSA C group. Abnormal DAT binding groups showed different regional uptake pattern on early phase images compared with PD in SPM analysis (FDR<0.05). When discriminating APD from PD, visual interpretation of the early phase image showed high diagnostic sensitivity and specificity (75.4% and 100%, respectively). Regarding the ability to distinguish specific APD, sensitivities were 81% for MSA P, 77% for MSA C, 23% for PSP, and 54.5% for DLB. Dual phase F 18 FP CIT PET imaging is useful in demonstrating striatal DAT loss in neurodegenerative parkinsonism, and also in differentiating APD, particularly MSA, from PD.

  7. Focal Myopericarditis as a Rare but Important Differential Diagnosis of Myocardial Infarction; a Case Series

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    Younes Nozari

    2016-04-01

    Full Text Available Distinguishing ST-elevation myocardial infarction (STEMI differential diagnoses is more challenging. Myopericarditis is one of these differentials that results from viral involvement of myocardium and pericardium of the heart. Myopericarditis in focal form can mimic acute STEMI in its electrocardiogram (ECG features and elevated cardiac enzymes.Myocarditis patients may face thrombolytic related complications such as intracranial bleeding, myocardial rupture, and hemorrhagic cardiac tamponade. Furthermore, re-administration of streptokinase (a common thrombolytic agent in our country is banned for at least six months of previous administration; however, it can save patients’ lives in emergency conditions such as massive pulmonary embolism. It seems that, when dealing with a young patient presenting to emergency department with acute chest pain and ST segment elevation on ECG, we should consider focal myocarditis as an important but rare differential diagnosis of STEMI. In this report, we describe three cases of focal myocarditis, primarily misdiagnosed as STEMI. Normal 0 false false false EN-US X-NONE AR-SA /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;}

  8. Boys With Long Hair

    Institute of Scientific and Technical Information of China (English)

    孙利英

    2005-01-01

    Long hair is popular among the young people.Even the boy students in high school join in this group.Some boy students would rather wear long hair,some even change their hair's color into golden,red,brown and pink.Why?

  9. Application of dual phase imaging of 11C-acetate positron emission tomography on differential diagnosis of small hepatic lesions.

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    Li Huo

    Full Text Available OBJECTIVE: Previously we observed that dual phase 11C-acetate positron emission tomography (AC-PET could be employed for differential diagnosis of liver malignancies. In this study, we prospectively evaluated the effect of dual phase AC-PET on differential diagnosis of primary hepatic lesions of 1-3 cm in size. METHODS: 33 patients having primary hepatic lesions with size of 1-3 cm in diameter undertook dual phase AC-PET scans. Procedure included an early upper-abdomen scan immediately after tracer injection and a conventional scan in 11-18 min. The standardized uptake value (SUV was calculated for tumor (SUVT and normal tissue (SUVB, from which 11C-acetate uptake ratio (as lesion against normal liver tissue, SUVT/SUVB in early imaging (R1, conventional imaging (R2, and variance between R2 and R1 (ΔR were derived. Diagnoses based on AC-PET data and histology were compared. Statistical analysis was performed with SPSS 19.0. RESULTS: 20 patients were found to have HCC and 13 patients had benign tumors. Using ΔR>0 as criterion for malignancy, the accuracy and specificity were significantly increased comparing with conventional method. The area under ROC curve (AUC for R1, R2, and ΔR were 0.417, 0.683 and 0.831 respectively. Differential diagnosis between well-differentiated HCCs and benign lesions of FNHs and hemangiomas achieved 100% correct. Strong positive correlation was also found between R1 and R2 in HCC (r2 = 0.55, P<0.001. CONCLUSIONS: Dual phase AC-PET scan is a useful procedure for differential diagnosis of well-differentiated hepatocellular carcinoma and benign lesions. The dynamic changes of 11C-acetate uptake in dual phase imaging provided key information for final diagnosis.

  10. Clinical value of diascopy and other non-invasive techniques on differential diagnosis algorithms of oral pigmentations: A systematic review

    Science.gov (United States)

    Pena-Cristóbal, Maite; Otero-Rey, Eva-María; Tomás, Inmaculada; Blanco-Carrión, Andrés

    2016-01-01

    Objectives To determine the diagnostic value of diascopy and other non-invasive clinical aids on recent differential diagnosis algorithms of oral mucosal pigmentations affecting subjects of any age. Material and Methods Data Sources: this systematic review was conducted by searching PubMed, Scopus, Dentistry & Oral Sciences Source and the Cochrane Library (2000-2015); Study Selection: two reviewers independently selected all types of English articles describing differential diagnosis algorithms of oral pigmentations and checked the references of finally included papers; Data Extraction: one reviewer performed the data extraction and quality assessment based on previously defined fields while the other reviewer checked their validity. Results Data Synthesis: eight narrative reviews and one single case report met the inclusion criteria. Diascopy was used on six algorithms (66.67%) and X-ray was included once (11.11%; 44.44% with text mentions); these were considered helpful tools in the diagnosis of intravascular and exogenous pigmentations, respectively. Surface rubbing was described once in the text (11.11%). Conclusions Diascopy was the most applied method followed by X-ray and surface rubbing. The limited scope of these procedures only makes them useful when a positive result is obtained, turning biopsy into the most recommended technique when diagnosis cannot be established on clinical grounds alone. Key words:Algorithm, differential diagnosis, flow chart, oral mucosa, oral pigmentation, systematic review. PMID:27703615

  11. Apparent diffusion coefficient measurements with diffusion-weighted imaging for differential diagnosis of soft-tissue tumor

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    Yu Zou

    2016-01-01

    Conclusion: Our results provide strong evidence that patients diagnosed with malignant soft-tissue tumors have low ADC values of DWI compared to those with benign soft-tissue tumors. Therefore, ADC measurements with DWI may be reliable in differential diagnosis of soft-tissue tumors.

  12. CONDENSING OSTEITIS OF THE CLAVICLE - MAGNETIC-RESONANCE-IMAGING AS AN ADJUNCT METHOD FOR DIFFERENTIAL-DIAGNOSIS

    NARCIS (Netherlands)

    VIERBOOM, MAC; STEINBERG, JDJ; MOOYAART, EL; VANRIJSWIJK, MH

    1992-01-01

    Condensing osteitis of the clavicle is a benign disorder leading to osteosclerosis of the medial end of the clavicle. The differential diagnosis between condensing osteitis of the clavicle and ischaemic necrosis of the medial clavicular epiphysis (Friedrich's disease), osteoid osteoma, and low grade

  13. The radiological and histopathological differential diagnosis of chordoid neoplasms in skull base

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    PAN Bin-cai

    2013-07-01

    Full Text Available Background Chordoid neoplasms refer to tumors appearing to have histological features of embryonic notochord, which is characterized by cords and lobules of neoplastic cells arranged within myxoid matrix. Because of radiological and histological similarities with myxoid matrix and overlapping immunohistochemical profile, chordoma, chordoid meningioma, chordoid glioma, and rare extraskeletal myxoid chondrosarcoma enter in the radiological and histological differential diagnosis at the site of skull base. However, there is always a great challenge for histopathologists to make an accurate diagnosis when encountering a chordoid neoplasm within or near the central nervous system. The aim of this study is to investigate and summarize the radiological, histological features and immunohistochemical profiles of chordoid neoplasms in skull base, and to find a judicious panel of immunostains to unquestionably help in diagnostically challenging cases. Methods A total of 23 cases of chordoid neoplasms in skull base, including 10 chordomas, 5 chordoid meningiomas, 3 chordoid gliomas and 5 extraskeletal myxoid chondrosarcomas, were collected from the First Affiliated Hospital, Sun Yat-sen University and Guangdong Tongjiang Hospital. MRI examination was performed on the patients before surgical treatment. Microscopical examination and immunohistochemical staining study using vimentin (Vim, pan-cytokeratin (PCK, epithelial membrane antigen (EMA, S?100 protein (S-100, glial fibrillary acidic protein (GFAP, D2-40, Galectin-3, CD3, CD20, Ki-67 were performed on the samples of cases. The clinicopathological data of the patients was also analyzed retrospectively. Results Most of chordomas were localized in the clivus with heterogeneous hyperintensity on T2WI scanning. The breakage of clivus was observed in most cases. Histologically, the tumor cells of chordoma exhibited bland nuclear features and some contained abundant vacuolated cytoplasm (the so

  14. Vibration sensor-based bearing fault diagnosis using ellipsoid-ARTMAP and differential evolution algorithms.

    Science.gov (United States)

    Liu, Chang; Wang, Guofeng; Xie, Qinglu; Zhang, Yanchao

    2014-06-16

    Effective fault classification of rolling element bearings provides an important basis for ensuring safe operation of rotating machinery. In this paper, a novel vibration sensor-based fault diagnosis method using an Ellipsoid-ARTMAP network (EAM) and a differential evolution (DE) algorithm is proposed. The original features are firstly extracted from vibration signals based on wavelet packet decomposition. Then, a minimum-redundancy maximum-relevancy algorithm is introduced to select the most prominent features so as to decrease feature dimensions. Finally, a DE-based EAM (DE-EAM) classifier is constructed to realize the fault diagnosis. The major characteristic of EAM is that the sample distribution of each category is realized by using a hyper-ellipsoid node and smoothing operation algorithm. Therefore, it can depict the decision boundary of disperse samples accurately and effectively avoid over-fitting phenomena. To optimize EAM network parameters, the DE algorithm is presented and two objectives, including both classification accuracy and nodes number, are simultaneously introduced as the fitness functions. Meanwhile, an exponential criterion is proposed to realize final selection of the optimal parameters. To prove the effectiveness of the proposed method, the vibration signals of four types of rolling element bearings under different loads were collected. Moreover, to improve the robustness of the classifier evaluation, a two-fold cross validation scheme is adopted and the order of feature samples is randomly arranged ten times within each fold. The results show that DE-EAM classifier can recognize the fault categories of the rolling element bearings reliably and accurately.

  15. Vibration Sensor-Based Bearing Fault Diagnosis Using Ellipsoid-ARTMAP and Differential Evolution Algorithms

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    Chang Liu

    2014-06-01

    Full Text Available Effective fault classification of rolling element bearings provides an important basis for ensuring safe operation of rotating machinery. In this paper, a novel vibration sensor-based fault diagnosis method using an Ellipsoid-ARTMAP network (EAM and a differential evolution (DE algorithm is proposed. The original features are firstly extracted from vibration signals based on wavelet packet decomposition. Then, a minimum-redundancy maximum-relevancy algorithm is introduced to select the most prominent features so as to decrease feature dimensions. Finally, a DE-based EAM (DE-EAM classifier is constructed to realize the fault diagnosis. The major characteristic of EAM is that the sample distribution of each category is realized by using a hyper-ellipsoid node and smoothing operation algorithm. Therefore, it can depict the decision boundary of disperse samples accurately and effectively avoid over-fitting phenomena. To optimize EAM network parameters, the DE algorithm is presented and two objectives, including both classification accuracy and nodes number, are simultaneously introduced as the fitness functions. Meanwhile, an exponential criterion is proposed to realize final selection of the optimal parameters. To prove the effectiveness of the proposed method, the vibration signals of four types of rolling element bearings under different loads were collected. Moreover, to improve the robustness of the classifier evaluation, a two-fold cross validation scheme is adopted and the order of feature samples is randomly arranged ten times within each fold. The results show that DE-EAM classifier can recognize the fault categories of the rolling element bearings reliably and accurately.

  16. Differential imaging diagnosis of a swelling after extraction in a breast cancer patient with radiotherapy and chemotherapy

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    Huh, Kyung Hoe; Huh, Min Suk [Seoul National Univ., Seoul (Korea, Republic of); An, Byung Mo; Kim, Mi Ja [Hallym Univ., Chuncheon (Korea, Republic of); Park, Kwan Soo [Inje Univ. Sanggye Paik Hospital, Seoul (Korea, Republic of)

    2006-09-15

    A 60-year-old female, who complained of delayed healing and swelling after extraction of left lower second molar during chemotherapy, visited our department. She had a history of a resection surgery of breast cancer and postoperative radiotherapy. The conventional radiographs showed diffuse primitive bone destruction in posterior mandibular body, which gave the first radiologic impression of osteonecrosis associated with radiotherapy or chemotherapy. And bone metastasis from the breast cancer was also considered in the differential diagnosis. On the enhanced computed tomography (ECT) the posterior mandibular body was occupied by a large expansible lesion showing central low attenuation with peripheral rim enhancement. Magnetic resonance images revealed that the low attenuated area on ECT did not show as high signal intensity as water on T2 weighted image and indicated solid component of a tumor. The final diagnosis was central squamous cell carcinoma. We present the diagnostic imaging features of the patient with special emphasis on the differential diagnosis.

  17. Differential diagnosis of cervical spinal cord demyelinating diseases and cervical intramedullary gliomas

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    Gui-nü HE

    2014-09-01

    Full Text Available Objective To analyze the imaging characteristics of cervical spinal cord demyelinating diseases and cervical intramedullary gliomas, so as to improve the differential diagnosis between them.  Methods A retrospective analysis was conducted using clinical and MRI data from 22 cases of cervical spinal cord demyelinating diseases and 16 cases of cervical intramedullary gliomas.  Results Clinical features in both groups included paresthesia [77.27% (17/22, 12/16], weakness of limbs [72.73% (16/22, 10/16], and dysfunction of autonomic nerve [45.45% (10/22, 4/16]. In cervical MRI, the lesions involving more than 3 vertebras were 63.64% (14/22 in demyelinating group and 15/16 in glioma group, and the average lengths of lesions were (3.41 ± 1.74 and (3.59 ± 1.28 vertebras in 2 groups. The lesions showed long T1 signal [68.18% (15/22, 7/16], equisignal T1 [31.82% (7/22, 6/16] and long T2 signal [100% (22/22, 8/15] in 2 groups. Mixed T1 and T2 signals (3/16, 6/15 could be seen in glioma group. Demyelinating lesions had unclear boundary [90.91% (20/22] with patchy and ribbon-like enhancement (13/16. Limited enlargement of spinal cord (15/16 and thickening spinal meninges (14/16 were more common in glioma group, usually with block and circular enhancement (12/16. Spinal cord involvement around central canal could be seen (14/15, and the cysts or central canal enlargement, hemorrhage and "cap sign" were showed frequently (7/16, 5/16 and 4/16.  Conclusions Although none of one single clinical or MRI feature was sufficient enough to identify cervical spinal demyelinating diseases from cervical glioma, the comprehensive analysis of multiple features could help to make differential diagnosis of these diseases. doi: 10.3969/j.issn.1672-6731.2014.09.008

  18. Determining level of endogenous serum erythropoietin for differential diagnosis of polycythemia vera and symptomatic polycythemia

    Directory of Open Access Journals (Sweden)

    Kostyukevych O.M.

    2013-06-01

    Full Text Available The article deals with determining possibility of the assessment of the level of endogenous serum erythropoietin (EPO for differential diagnosis of polycythemia vera (PV and secondary erythrocytosis (SE. The determination of subnormal level of this cytokine for the diagnosis of PV has been detected. The relation between the level of endogenous erythropoietin and iron metabolism also has been analyzed. The study involved 88 patients with PV and 119 patients with SE. Statistically significant decrease in EPO concentration level has been detected in PV patients. The mean EPO level was equal to 6.38 ± 0.84 mIU/mL and 17.98 ±2.48 mIU/mL in PV and SE patients respectively. In control group of individuals EPO concentration was equal to 9,81 ±0,58 mIU/mL, the significant difference was found between all studied groups (р<0.01. According to our data, EPO was increased in 28 SE patients (23.53%, it was not observed in control group and in group of PV patients (φ*emp = 4.355, р<0.01. The decrease of EPO level in PV patients has been detected more often than in SE patients (84.09% versus 11.76% , φ*emp = 5.218, р<0.01, it has not been observed in control group. Only 14 (15.91% PV patients had normal EPO level, in contrast 77 (64.71% SE patients demonstrated normal EPO level (φ*emp = 4.578, р<0.01. The average level of ferritin was equal to 57.41 ± 9.74 ng/mL in PV patients and 199.77 ± 14.32 ng/mL in SE patients (р<0.01. Significantly more patients with PV demonstrated decrease of ferritin level (31.81% versus 7.56%, φ*emp = 4.438, р<0.01. Patients with SE more often had raised level of EPO than PV patients (15.12% versus 4.54%, φ*emp = 2.453, р<0.01. The sensitivity of test with detecting of the reduced level of EPO for the diagnosis of PV was 84.1%, specificity - 87.4%, positive predictive value - 83.1%, negative predictive value - 88.1%. Normal range of EPO significantly (rs = 0,5494 correlated with decreased levels of serum ferritin in

  19. Development of Intelligent Method for Differential Diagnosis of Specific Language Impairment

    Science.gov (United States)

    2007-11-02

    Grant Number Program Element Number Author(s) Project Number Task Number Work Unit Number Performing Organization Name(s) and Address(es) Dept...Development in a Grammatical SLI boy: Modularity and Innateness, Journal of Neurolinguistics 10, (1997) 75-107. [8] J.P. Craiger, D.F. Goodman, R.J

  20. What is the most reliable marker in the differential diagnosis of pulmonary embolism and community-acquired pneumonia?

    Science.gov (United States)

    Ateş, Hale; Ateş, İhsan; Bozkurt, Bülent; Çelik, Hüseyin Tuğrul; Özol, Duygu; Yldrm, Zeki

    2016-04-01

    Because of similar clinical manifestations and laboratory findings, differential diagnosis of pulmonary embolism and community-acquired pneumonia (CAP) is generally difficult. Therefore, this study was conducted to find good markers for the easy, cheap, and fast differential diagnosis of pulmonary embolism and CAP. Thirty-four patients diagnosed with pulmonary embolism and 38 patients with CAP who were admitted to either emergency department or chest diseases outpatient clinic were included in this study. On admission and third day, complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate, procalcitonin (PCT), and D-dimer levels of each patient were measured. Neutrophil-to-lymphocyte ratio (NLR) was calculated using the formula NLR = neutrophil count/lymphocyte count. NLR/D-dimer and PCT/D-dimer ratios were also calculated. First day neutrophil count (P = 0.005), NLR (P = 0.002), CRP (P differential diagnosis of pulmonary embolism and CAP, CRP, PCT/D-dimer, and NLR/D-dimer were found to be independent predictive factors for the presence of CAP. Among these factors, NLR/D-dimer ratio was found to be the most sensitive (97.4%) to have the highest negative predictive value 96.7% and to be the most accurate (area under curve = 0.921) (91.7%) parameter for the differential diagnosis of pulmonary embolism and CAP. In this study, NLR/D-dimer ratio was found to be more sensitive and more selective with negative predictive value and area under curve for the differential diagnosis of pulmonary embolism and CAP compared with other laboratory tests.

  1. Kallmann综合征1例%Ultrasonography in differential diagnosis of precocious puberty in girls

    Institute of Scientific and Technical Information of China (English)

    邓大同; 朱晖; 孙莉; 章秋; 杨明功

    2011-01-01

    @@ Kallmann综合征是先天性遗传性疾病,又称为"男性特发性低促性腺激素性腺功能减退症(idiopathic hypogonadotropic hypogonadism,IHH)",发病率男性为1/l万,女性为1/5万,笔者于2010年7月27日发现1例,报道如下. 1 临床资料 患者男性,20岁.因"睾丸、阴茎小,男性第二性征不发育"入住我院.患者自幼出现嗅觉障碍,无法辨识出水与酒精的气味,无法辨识香、臭味,但可辨别水与食醋气味差别.父母非近亲结婚,两个妹妹生长发育正常.%Aim To investigate the differential diagnostic value of ulrasound with precocious puberty. Methods The uterine,ovarian follicles were measured by ultrasound. Then these indexes were compared with the normal control groups in the same age. Results The uterine indexes of girls with true-precocious puberty and pseudo-precocious puberty were significantly larger than the normal girls (P < 0.05). The volume of ovary and the largest follicle diameter, a section of the largest number of follictes in true-precocious puberty are larger than the normal girls (P < 0.05). The volume of ovary and the largest follicle diameter, a section of the largest number of follicles in pseudo-precocious puberty are similar to the normal girls(P <0.05). Conclusion Ultrasonography has great value on differential diagnosis of precocious puberty in girls.

  2. Update on laboratory tests for the diagnosis and differentiation of hereditary angioedema and acquired angioedema.

    Science.gov (United States)

    Frazer-Abel, Ashley; Giclas, Patricia C

    2011-01-01

    The importance of laboratory testing in the diagnosis of hereditary angioedema (HAE) has increased with the advent of new treatment options in recent years. It has been 50 years since HAE was linked to a decrease of C1INH (the inhibitor of complement enzyme, C1 esterase), a link that provided for the first laboratory test available for this disorder. HAE is subdivided into types that can be differentiated only by laboratory testing. The Type I form is characterized by low levels and function of C1INH in the circulation. The Type II form is characterized by normal levels of C1INH, but low function. Sample collection and handling is critical for the functional assays. The serum samples for the functional analysis must be collected, separated, and frozen at less than -60°C within 2 hours of the blood draw. Additionally some suspected Type II patients may benefit from looking closely at what method is used for the functional testing. The acquired forms of angioedema (AAE) can benefit from the same clinical testing, because most are ultimately due to decreased C1INH. Measurement of C1q levels and testing for anti-C1INH autoantibodies can help differentiate AAE from HAE. Diagnostic testing for the third hereditary form, alternately called estrogen-dependent HAE, HAE with Normal C1INH or HAE Type III, still presents challenges, and definitive testing may have to wait until there is a more complete understanding of this mixed group of patients. The next steps will include genetic analysis of C1INH and other proteins involved in HAE.

  3. Selection of Spatiotemporal Features in Breast MRI to Differentiate between Malignant and Benign Small Lesions Using Computer-Aided Diagnosis

    Directory of Open Access Journals (Sweden)

    F. Steinbruecker

    2012-01-01

    Full Text Available Automated detection and diagnosis of small lesions in breast MRI represents a challenge for the traditional computer-aided diagnosis (CAD systems. The goal of the present research was to compare and determine the optimal feature sets describing the morphology and the enhancement kinetic features for a set of small lesions and to determine their diagnostic performance. For each of the small lesions, we extracted morphological and dynamical features describing both global and local shape, and kinetics behavior. In this paper, we compare the performance of each extracted feature set for the differential diagnosis of enhancing lesions in breast MRI. Based on several simulation results, we determined the optimal feature number and tested different classification techniques. The results suggest that the computerized analysis system based on spatiotemporal features has the potential to increase the diagnostic accuracy of MRI mammography for small lesions and can be used as a basis for computer-aided diagnosis of breast cancer with MR mammography.

  4. Residual Salivary Secretion Ability May Be a Useful Marker for Differential Diagnosis in Autoimmune Diseases

    Directory of Open Access Journals (Sweden)

    Etsuko Maeshima

    2014-01-01

    Full Text Available Background. We have elucidated decreased resting salivary flow in approximately 60% of patients with autoimmune diseases not complicated by Sjögren syndrome (SjS. In this study, salivary stimulation tests using capsaicin were performed to examine residual salivary secretion ability in patients with autoimmune diseases. Materials and Methods. Fifty-eight patients were divided into three groups: patients with primary or secondary SjS (SjS group, patients with systemic sclerosis not complicated by SjS (SSc group, and patients with other autoimmune diseases (non-SjS/non-SSc group. Simple filter paper and filter paper containing capsaicin were used to evaluate salivary flow rates. Results. Resting salivary flow rates were significantly lower in the SjS and SSc groups than in the non-SjS/non-SSc group but did not differ significantly between the SjS and SSc groups. Capsaicin-stimulated salivary flow rates were significantly lower in the SjS and SSc groups than in the non-SjS/non-SSc group, but not significantly different between the SjS and SSc groups. In the non-SjS/non-SSc group, salivary flow rates increased after capsaicin stimulation to the threshold level for determination of salivary gland dysfunction, whereas no improvement was observed in the SjS and SSc groups. Conclusion. Residual salivary secretion ability may be a useful marker for differential diagnosis in autoimmune diseases.

  5. Non-functioning parathyroid adenoma: a rare differential diagnosis for vocal-cord paralysis.

    Science.gov (United States)

    Kamali, D; Sharpe, A; Nagarajan, S; Elsaify, W

    2016-07-01

    Introduction Adenomas of the parathyroid gland typically present with symptoms of hyperparathyroidism, manifested by fatigue, bone pain, abdominal pain, weakness, dyspepsia, nephrolithiasis and skeletal bone disease. Here, we describe, for the first time, a case of a non-functioning benign tumour of the parathyroid gland presenting as vocal-cord paralysis. Case History A 49-year-old male presented with a 10-week history of dysphonia and the feeling of having 'something stuck in my throat'. History-taking elicited no other associated symptoms. Flexible nasal endoscopy demonstrated paralysis of the left vocal cord. Computed tomography of the neck revealed a cystic lesion, 18mm in diameter adjacent to the oesophagus. After more rigorous tests, a neck exploration, left hemithyroidectomy, excision of the left paratracheal mass and level-VI neck dissection was undertaken, without incident to the patient or surgical team. Histology was consistent with a parathyroid adenoma. Conclusions This case emphasises the importance of including adenomatous disease of the parathyroid gland in the differential diagnosis despite normal parathyroid status as a cause of vocal cord palsy.

  6. Focal adenomyosis (intramural endometriotic cyst) in a very young patient - differential diagnosis with uterine fibromatosis

    Science.gov (United States)

    Manta, L; Suciu, N; Constantin, A; Toader, O; Popa, F

    2016-01-01

    Introduction. Adenomyosis is a widespread disease usually affecting the late reproductive years of the women’s life, which has a great impact on their fertility. The most common form is diffuse adenomyosis, while focal adenomyosis, a cystic variant, is very rare, particularly in patients younger than 30 years old. Materials and methods. We reported a rare case of a 20-year-old Caucasian woman with cystic adenomyosis who was admitted in our service with severe chronic pelvic pain, dysmenorrhea, and menorrhagia, who had received conservative surgical treatment to preserve fertility and improve her obstetrical prognosis. Results and Discussions. Although the necrobiosis of a uterine fibroid was suspected preoperatively, the extemporaneous histopathological exam revealed adenomyosis associated with fibroleiomyoma with hyaline dystrophy and multiple foci of endometriosis of cystic formation in the wall of a young woman without any risk factors. Conclusion. Although a rare lesion in young patients, cystic adenomyosis should be considered when chronic pelvic pain is exacerbated during menstruation and is associated with a uterine tumor. In young patients, the differential diagnosis should be made with uterine malformations (hematometra), necrobiosis of uterine fibroids, pelvic endometriosis. The surgical treatment should be conservative with the excision of the lesion, always taking into account fertility preservation in young patients. PMID:27453751

  7. Lower extremity vasculitis in giant cell arteritis: important differential diagnosis in patients with lower limb claudication.

    Science.gov (United States)

    Sigl, Martin; Hsu, Eric; Scheffel, Hans; Haneder, Stefan; Rümenapf, Gerhard; Amendt, Klaus

    2014-09-01

    Most patients with peripheral arterial disease suffer from arteriosclerosis, the prevalence of which increases with age. In some of these patients, however, the ischemic symptoms are not caused by stenotic arteriosclerosis, but by large vessel giant cell arteritis (LV-GCA), a disease also predominantly affecting patients of the older generation. Identifying large vessel vasculitis is a challenge for all physicians caring for patients with peripheral artery disease. The results of invasive treatment such as bypass surgery and angioplasty of inflammatory vascular lesions differ fundamentally from those of patients with atherosclerosis. Duplex ultrasound is a widely available diagnostic method for examining patients with lower limb claudication and pathological ankle-/toe- brachial index or pulse volume recording with or without exercise. Knowledge of characteristic sonographic findings suspicious about large vessel vasculitis is essential for a differential diagnosis of vasculitis versus atherosclerosis. In addition to clinical and laboratory findings, further imaging techniques, e.g. contrast-enhanced computed tomography, magnetic resonance imaging or a combination of positron emission tomography and computed tomography (PET-CT) can provide information on further vessel involvement and inflammatory activity. The present study focuses on diagnostic imaging of LV-GCA in patients presenting with claudication, illustrated by a series of cases.

  8. Comparison of real-time PCR protocols for differential laboratory diagnosis of amebiasis.

    Science.gov (United States)

    Qvarnstrom, Yvonne; James, Cleve; Xayavong, Maniphet; Holloway, Brian P; Visvesvara, Govinda S; Sriram, Rama; da Silva, Alexandre J

    2005-11-01

    Specific identification of Entamoeba spp. in clinical specimens is an important confirmatory diagnostic step in the management of patients who may be infected with Entamoeba histolytica, the species that causes clinical amebiasis. Distinct real-time PCR protocols have recently been published for identification of E. histolytica and differentiation from the morphologically identical nonpathogenic Entamoeba dispar. In this study, we compared three E. histolytica real-time PCR techniques published by December 2004. The limits of detection and efficiency of each real-time PCR assay were determined using DNA extracted from stool samples spiked with serially diluted cultured E. histolytica trophozoites. The ability of each assay to correctly distinguish E. histolytica from E. dispar was evaluated with DNA extracted from patients' stools and liver aspirates submitted for confirmatory diagnosis. Real-time PCR allowed quantitative analysis of the spiked stool samples, but major differences in detection limits and assay performance were observed among the evaluated tests. These results illustrate the usefulness of comparative evaluations of diagnostic assays.

  9. Dynamic automated synovial imaging (DASI) for differential diagnosis of rheumatoid arthritis

    Science.gov (United States)

    Grisan, E.; Raffeiner, B.; Coran, A.; Rizzo, G.; Ciprian, L.; Stramare, R.

    2014-03-01

    Inflammatory rheumatic diseases are leading causes of disability and constitute a frequent medical disorder, leading to inability to work, high comorbidity and increased mortality. The gold-standard for diagnosing and differentiating arthritis is based on patient conditions and radiographic findings, as joint erosions or decalcification. However, early signs of arthritis are joint effusion, hypervascularization and synovial hypertrophy. In particular, vascularization has been shown to correlate with arthritis' destructive behavior, more than clinical assessment. Contrast Enhanced Ultrasound (CEUS) examination of the small joints is emerging as a sensitive tool for assessing vascularization and disease activity. The evaluation of perfusion pattern rely on subjective semiquantitative scales, that are able to capture the macroscopic degree of vascularization, but are unable to detect the subtler differences in kinetics perfusion parameters that might lead to a deeper understanding of disease progression and a better management of patients. We show that after a kinetic analysis of contrast agent appearance, providing the quantitative features characterizing the perfusion pattern of the joint, it is possible to accurately discriminate RA from PSA by building a random forest classifier on the computed features. We compare its accuracy with the assessment performed by expert radiologist blinded of the diagnosis.

  10. Differential diagnosis and prognosis of T1-weighted post-gadolinium intralabyrinthine hyperintensities

    Energy Technology Data Exchange (ETDEWEB)

    Dubrulle, F.; Puech, P.; Ernst, O. [University Nord of France, Department of Radiology, CHU Lille, Huriez Hospital INSERM, Lille (France); Kohler, R. [CHU Lille, Huriez Hospital, Department of Radiology, Lille (France); Vincent, C. [CHU Lille, Department of Otology and Oto-neurosurgery, Lille (France)

    2010-11-15

    The aim of this longitudinal study is to describe the different intralabyrinthine lesions yielding high signal intensity on T1-weighted (T1W) images after intravenous gadolinium and then to analyze the follow-up of these patients. Thirty-seven patients were included and followed clinically and radiologically. A precise analysis of MR labyrinthine signals allowed exact depiction of the different lesions. Special interest is focused on the intralabyrinthine fluid signal on 3D high-resolution T2W images. The enhanced T1W labyrinthine hyperintensities correspond to two different categories: intralabyrinthine enhancement (15 intralabyrinthine schwannomas, 13 labyrinthitis, 1 inflammatory granuloma) and spontaneous T1W hyperintensities (8 intralabyrinthine hemorrhages). Hemorrhagic lesions show a substantial decrease of the intralabyrinthine fluid signal on the 3D HRT2 that evolves to ossification. In labyrinthitis, the importance of the initial labyrinthine fluid signal decrease on the 3D HRT2 is well correlated with the hearing prognosis. A meticulous analysis of inner ear lesions allows various intralabyrinthine lesions, in particular schwannomas, to be differentiated from labyrinthitis. T1W imaging without gadolinium is essential for the correct diagnosis of rapidly evolving hearing loss. In labyrinthitis and intralabyrinthine hemorrhage, 3D HRT2 brings an interesting prognostic factor for the chance of hearing recovery. (orig.)

  11. Differential diagnosis of cervical nerve compression syndrome of the external intervertebral foramen

    Institute of Scientific and Technical Information of China (English)

    WANG Jinwu; NI Weifeng; LI Qi; XU Jianguang; ZHU Haibo; ZHAO Binghui; GUO Shangchun; ZENG Bingfang

    2007-01-01

    The aim of the present research is to study the mechanism of cervical nerve compression syndrome of the external intervertebral foramen and its difierential diagnosis with cervical spondylosis.Diagnostic treatment with muscle relaxant,vasodilator,neurotrophic medicine and celecoxib (COX)-2 inhibitor were performed in 20 patients with cervical nerve compression syndrome of the external intervertebral foramen and 20 patients with cervical spondylosis confirmed by operation.Diagnostic local block therapy was performed additionally in cases showing little effect after diagnostic treatment.All the patients were followed up postoperatively for more than one year.Fifteen cases with cervical nerve compression syndrome of the external intervertebral foramen were healed by the diagnostic treatment.The other five cases had a short-term remission and there was no recurrence after diagnostic local block therapy.Diagnostic treatment led to short-term alleviation of the symptom in 20 cases with cervical spondylosis confirmed by operation,the results of which was far from satisfactory and operation was undertaken finally in all the 20 cases.The etiology of cervical nerve compression syndrome of the extemal intervertebral foramen lies in the compression of the cervical plexus,brachial plexus and cervical dorsal rami by the tendinous decussating fibers of the scalenus anticus,medius,minimus and the posterior muscles of the neck.Diagnostic treatment was propitious to differentiate cervical nerve compression syndrome of the external intervertebral foramen from cervical spondylosis.

  12. Clues in the differential diagnosis of primary vs secondary cough, exercise, and sexual headaches.

    Science.gov (United States)

    Alvarez, Rocío; Ramón, César; Pascual, Julio

    2014-10-01

    Activity-related headaches can be provoked by Valsalva maneuvers ("cough headache"), prolonged exercise ("exertional headache") and sexual excitation ("sexual headache"). These entities are a challenging diagnostic problem as can be primary or secondary and the etiologies for secondary cases differ depending on the headache type. In this paper we review the clinical clues which help us in the differential diagnosis of patients consulting due to activity-related headaches. Cough headache is the most common in terms of consultation. Primary cough headache should be suspected in patients older than 50 years, if pain does not predominate in the occipital area, if pain lasts seconds, when there are no other symptoms/signs and if indomethacin relieves the headache attacks. Almost half of cough headaches are secondary, usually to a Chiari type I malformation. Secondary cough headache should be suspected in young people, when pain is occipital and lasts longer than one minute, and especially if there are other symptoms/signs and if there is no response to indomethacin. Every patient with cough headache needs cranio-cervical MRI. Primary exercise/sexual headaches are more common than secondary, which should be suspected in women especially with one episode, when there are other symptoms/signs, in people older than 40 and if the headache lasts longer than 24 hours. These patients must have quickly a CT and then brain MRI with MRA or an angioCT to exclude space-occupying lesions or subarachnoid hemorrhage.

  13. 血尿的病因及鉴别%The etiology and differential diagnosis of hematuria

    Institute of Scientific and Technical Information of China (English)

    赵赞梅; 赵金垣; 徐希娴

    2011-01-01

    Hematuria is a common clinical symptom. Many reasons can cause red urine which is hematuria or not. For example, kidney disease, hemorrhagic disease and the abnormal of certain metabolites can cause red urine, many drugs, pesticides , heavy metals can cause hematuria. Therefore, there is a close relationship between hematuria and environmental or occupational diseases. In this review, the etiology and differential diagnosis of hematuria were briefly summarized.%血尿是临床常见的症状,其病因很多:出血性疾病、肾脏疾病、体内某些代谢物的异常增多可以引起尿色发红,许多药物、农药、重金属等均可引起血尿,因此,血尿与环境和职业因素导致的疾病关系密切.本文主要对血尿的病因和鉴别诊断进行综述.

  14. Clinical Features and Differential Diagnosis of Acute Idio-pathic Blind Spot Enlargement Syndrome

    Institute of Scientific and Technical Information of China (English)

    Xiaocui Liu; Bing Chen; Maonian Zhang; Houbin Huang

    2014-01-01

    Purpose:.To study the clinical manifestations and the diag-nostic and differential diagnostic characteristics of acute idio-pathic blind spot enlargement syndrome (AIBSES).Methods:.Six patients diagnosed with AIBSES underwent complete eye examinations including fundus photography, fundus fluorescein angiography(FFA), indocyanine green an-giography (ICGA), optical coherence tomography (OCT), electroretinogram (ERG), and visual field examinations.Results: All patients had enlarged blind spots of variable sizes and densities..Three eyes had mild swelling of the optic disc and one eye had peripapillary scarring that corresponded to the permanent field defect. Two patients who underwent FFA had fluorescein leakage of blood vessels around the optic disc and ICGA highlighted diffuse, small hypofluorescent spots scatter-ing throughout the posterior pole..OCT showed that the inner and outer segment (IS / OS).line were absent in five patients and the middle cone outer segment tip line was absent in the nasal macular area in one eye.Conclusion: AIBSES is a rare outer retinopathy. Visual field examination and OCT are the most important means of detec-tion. ICGA and FAF can determine the range of lesions earli-er, and the progress of the disease should be taken into ac-count when making a diagnosis.(Eye Science 2014; 29:143-150)

  15. Primary Synovial Sarcoma of Kidney: A Rare Differential Diagnosis of Renomegaly

    Directory of Open Access Journals (Sweden)

    Gaurang Modi

    2014-01-01

    Full Text Available Synovial sarcomas (SS are classified as subgroup of soft tissue sarcomas affecting mainly extremities of young adults. Primary SS of kidney are very rare tumours with poor prognosis. Though they have characteristic histology and immunohistochemistry (IHC due to rarity of incidence it is difficult to diagnose them. Sometimes chromosomal rearrangement studies are required to confirm the diagnosis. We are presenting a case of 41-year-old male who was referred to our cancer centre for evaluation of left renal mass. CT scan of abdomen revealed a large left renal mass encasing the aorta. Biopsy of renal mass revealed poorly differentiated sarcoma and IHC was positive for vimentin, CD99, and BCL2 and negative for AE1, epithelial membrane antigen, and leukocyte common antigen. The patient was clinically inoperable as renal mass was encasing the aorta. So he was subsequently offered palliative chemotherapy in form of ifosfamide and adriamycin. CT abdomen shows partial response after 3 cycles of chemotherapy according to RECIST criteria.

  16. Evaluation of elastic fibers pattern with orcein staining in differential diagnosis of lichen planopilaris and discoid lupus erythematosus.

    Directory of Open Access Journals (Sweden)

    Zahra Farzaneh Asadi Kani

    2014-03-01

    Full Text Available Differential diagnosis of lichen planopilaris and discoid lupus erythematosus especially in late stages is a problem for clinicians and pathologists. Our aim was to find discriminator histopathologic findings that help us to achieve definite diagnosis without using immunofluorescence study. The histopathologic findings in 77 cases of lichen planopilaris were compared with those of 26 cases of discoid lupus erythematosus with Hematoxylin & Eosin and especially staining (Alcian blue pH 2.5, Periodic Acid Shiff, Orcein. Final histopathologic diagnosis was based on histologic findings, clinicopathological correlation, past medical history and immunofluorescence studies if were applied before. Then elastic fibers pattern in dermis and follicular sheath with orcein staining were described without having information about final diagnosis. New and subtle presentations of histologic changes were assessed. We compared all histopathologic finding for each staining method. Some histologic changes such as hypergranulosis, epidermal atrophy, mucin deposition, diffuse scar and some other patterns were not specific for any diagnosis. A setting of histopathologic findings and clinicopathological correlation were needed for accurate diagnosis. We had only one specimen for the vertical section, and we had no horizontal sections. Description of elastic fibers pattern in orcein staining may be helpful in achieving a specific diagnosis, but this is not completely reliable, and we had overlap features. Finally, immunofluorescence study may be recommended for suspicious cases.

  17. Atitudes maternas diferenciais para com meninos e meninas de quatro e cinco anos Differential maternal attitudes toward four- and five-year-old boys and girls

    Directory of Open Access Journals (Sweden)

    Ebenézer A. de Oliveira

    2000-01-01

    Full Text Available Foram examinados os efeitos do sexo e da idade da criança pré-escolar sobre três atitudes maternas consideradas psicopatogênicas na literatura: irritabilidade, rejeição e intrusão. A amostra contou com 53 mães e suas crianças pré-escolares de 51 a 70 meses de idade, de níveis sócio-econômicos (NSE médio e baixo. As mães preencheram uma versão em Português do Parent Attitude Research Instrument-PARI. Correlações de ordem zero e regressões múltiplas indicaram que as mães tendem a relatar menor irritabilidade e rejeição quanto maior for a idade da criança; contudo, o mesmo não ocorreu para a intrusão materna. Independentemente da idade da criança, as mães dos meninos relataram maior intrusão do que as mães das meninas. Esses resultados se mantiveram mesmo após a inclusão do NSE na equação de regressão. Análises bivariadas também mostraram uma tendência marginal para as mães dos meninos relatarem maior rejeição do que as mães das meninas. Os resultados são discutidos à luz da literatura vigente sobre a socialização da criança pré-escolar, ressaltando elementos cognitivos e interacionais.This study examined the effects of the preschool child’s sex and age on three maternal attitudes regarded as pathogenic in the literature: Irritability, rejection, and intrusion. The sample had 53 mothers and their preschool children from 51 through 70 months of age, of both middle and low socioeconomic statuses (SES. The mothers filled out a Portuguese version of the Parent Attitude Research Instrument-PARI. Zero-order correlations and multiple regressions indicated that the older the child, the lower the levels of irritability and rejection reported by the mother; however, the same did not happen to maternal intrusion. Regardless of the child’s age, the mothers of boys reported higher intrusion than the mothers of girls. These results held even after introducing SES in the regression equation. Bivariate analyses

  18. Working with Boys.

    Science.gov (United States)

    Reay, Diane

    1990-01-01

    Describes a project involving weekly group guidance sessions with the third and fourth grade boys in a North London (England) elementary school. Evaluates the program's effectiveness in relation to racism, sexism, bullying, collaborative group process, and other matters. (DM)

  19. How I Teach Boys

    Science.gov (United States)

    Miller, Sue; Albano, Judith Baron

    1975-01-01

    The first article in a continuing series, which will be devoted to successful teaching techniques for teaching home economics to boys, offers two techniques used to teach sewing by making dashiki shirts. (EA)

  20. Case study: the use of technescan HIG to differentiate between old damage and active inflammation in arthritis in a 11-year-old-boy

    Energy Technology Data Exchange (ETDEWEB)

    Moorin, R.E.

    1997-09-01

    Full text: A {sup 99m}Tc Technescan HIG (Polyclonal Human Immunoglobulin G, `Mallinkrodt Medical`) scan was undertaken on an 11 year old boy with a nine year history of juvenile arthritis. He recently suffered in creased pain in his neck with tenderness over the right C6 dorsal facet joint. The question was posed as to whether this represented an area of old damage or new active inflammation. Whole body imaging was carried out following an IV injection of 600 MBq of {sup 99m}Tc HIG at four and 24 hours using a rectangular Millenium gamma camera. (GE Milwaukee) Both four and 24 hour images failed to show any area of focal uptake in the neck. Focal uptake was demonstrated in both knees, the right more pronounced than the left in keeping with the patient current symptoms. From this scan it was decided that the cervical problem was related to old damage. Scintigraphy with HIG labelled with either {sup 111}ln or {sup 99m}Tc is recognised as a reliable method for the detection of infection and inflammation. Recently, reports have suggested that it may be useful in detecting synovitis, identifying those joints which have current active inflammation. We conclude that this modality is a non-invasive accurate diagnostic tool which may be used to routinely monitor the status of arthritic joints. In addition, we feel that serial scanning may provide a more accurate insight into the nature of the disease progression within an individual than is available with current practices.

  1. Calgary score and modified Calgary score in the differential diagnosis between neurally mediated syncope and epilepsy in children.

    Science.gov (United States)

    Zou, Runmei; Wang, Shuo; Zhu, Liping; Wu, Lijia; Lin, Ping; Li, Fang; Xie, Zhenwu; Li, Xiaohong; Wang, Cheng

    2017-01-01

    To evaluate the value of Calgary score and modified Calgary score in differential diagnosis between neurally mediated syncope and epilepsy in children. 201 children experienced one or more episodes of loss of consciousness and diagnosed as neurally mediated syncope or epilepsy were enrolled. Calgary score, modified Calgary score and receiver-operating characteristic curve were used to explore the predictive value in differential diagnosis. There were significant differences in median Calgary score between syncope [-4.00 (-6, 1)] and epilepsy [2 (-3, 5)] (z = -11.63, P epilepsy were 91.46 and 95.80 %, suggesting a diagnosis of epilepsy. There were significant differences in median modified Calgary score between syncope [-4.00 (-6, 1)] and epilepsy [3 (-3, 6)] (z = -11.71, P epilepsy. The sensitivity and specificity of modified Calgary score and Calgary score did not show significant differences (P > 0.05). Calgary score and modified Calgary score could be used to differential diagnosis between syncope and epilepsy in children.

  2. [Intracranial chondroma arising from the skull base: two case reports featuring the image findings for differential diagnosis].

    Science.gov (United States)

    Higashida, Tetsuhiro; Sakata, Katsumi; Kanno, Hiroshi; Tanabe, Yutaka; Kawasaki, Takashi; Yamamoto, Isao

    2007-05-01

    We reported two cases of intracranial skull base chondroma and discussed the differential diagnosis and the treatment strategies. The first case was a 39-year-old male who presented with left exophtalmos, visual loss and oculomotor disturbance. MRI showed a huge tumor occupying the bilateral cavernous sinus. Partial removal of the tumor was performed through the left orbitozygomatic subtemporal approach. The second case was a 54-year-old male who presented with left hemiparesis. MRI showed a brain stem infarction with a huge tumor located at the right middle fossa. Partial removal was performed through the right orbitozygomatic subtemporal approach. In these two cases, the histopathological diagnosis of the tumors was benign chondroma and the size of residual tumors have not changed for one year without any additional therapy. Although preoperative definite diagnosis for skull base chondromas is difficult, strategies for diagnosis and treatment without any complication are essential. In our cases, chondromas showed low uptake in PET images, which might be useful for differentiation between chondromas and chordomas. The current popular surgical approach for parasellar tumors is transcranial such as the orbitozygomatic subtemporal approach. In surgical removal of skull base chondromas, it is advisable to try to confirm the diagnosis preoperatively with characteristic image findings and to consider the best approach in each case to decompress the involved nerves without any complications.

  3. Radiological diagnosis in AIDS - associated diseases: survey and differential diagnosis; AIDS-assoziierte Krankheitsbilder in der radiologischen Diagnostik: Ueberblick und Differentialdiagnose

    Energy Technology Data Exchange (ETDEWEB)

    Rademaker, J. [Beth Israel Medical Center, New York, NY (United States). Dept. of Medicine; Frahm, C. [Medizinische Univ. Luebeck (Germany). Inst. fuer Radiologische Diagnostik

    1997-03-01

    Acute manifestations of illnesses in patients with HIV-infection or AIDS will benefit from rapid diagnosis. Radiologic examinations provide substantial information to narrow the differential diagnosis. This article reviews clinically important HIV-associated diseases for the radiologist. The braod spectrum of possible manifestations is illustrated by the accompanying case reports that typify the complexity of diagnoses in this growing problem worldwide. (orig.) [Deutsch] Die oft akute Manifestation von Erkrankungen bei Patienten mit HIV-Infektion oder AIDS erfordert eine effektive Diagnostik. Radiologische Untersuchungen koennen dabei wichtige Informationen zur Einengung des diffentialdiagnostischen Spektrums geben. Die vorliegende Arbeit stellt die fuer den Radiologen wichtigsten AIDS-assoziierten Erkrankungen vor. Fallberichte demonstrieren das breite Spektrum der moeglichen Erkrankungen und illustrieren die Komplexitaet der moeglichen Befunde in diesem weltweit wachsenden Problem. (orig.)

  4. Septic Bursitis in an 8-Year-Old Boy

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    Panagiotis Kratimenos

    2014-01-01

    Full Text Available Background. The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children. Methods. We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If untreated, prepatellar bursitis can progress to patellar osteomyelitis. Results. Wound cultures grew Streptococcus pyogenes, with the infection resolving with amoxicillin. Conclusions. A high index of suspicion is necessary in children presenting with prepatellar bursitis to prevent potentially devastating sequelae of infection of the septic joint.

  5. Prenatal Diagnosis of Treacher-Collins Syndrome Using Three-Dimensional Ultrasonography and Differential Diagnosis with Other Acrofacial Dysostosis Syndromes

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    Daniela Cardoso Pereira

    2013-01-01

    Full Text Available Treacher-Collins syndrome (TCS is a rare dominant autosomal anomaly resulting from malformation or disruption of the development of the first and second branchial arches. It is characterized by micrognathia, malar hypoplasia, and malformations of the eyes and ears. The prenatal diagnosis using two-dimensional ultrasonography (2DUS is characterized by identification of facial malformations together with polyhydramnios. Three-dimensional ultrasonography (3DUS has the capacity to spatially display these facial malformations, thus making it easy for the parents to understand them. We present a case of TCS diagnosed in the 33rd week using 3DUS, with postnatal confirmation using cranial computed tomography and anatomopathological analysis.

  6. Prenatal diagnosis of treacher-collins syndrome using three-dimensional ultrasonography and differential diagnosis with other acrofacial dysostosis syndromes.

    Science.gov (United States)

    Pereira, Daniela Cardoso; Bussamra, Luiz Claudio Silva; Araujo Júnior, Edward; Drummond, Carolina Leite; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes; Aldrighi, José Mendes

    2013-01-01

    Treacher-Collins syndrome (TCS) is a rare dominant autosomal anomaly resulting from malformation or disruption of the development of the first and second branchial arches. It is characterized by micrognathia, malar hypoplasia, and malformations of the eyes and ears. The prenatal diagnosis using two-dimensional ultrasonography (2DUS) is characterized by identification of facial malformations together with polyhydramnios. Three-dimensional ultrasonography (3DUS) has the capacity to spatially display these facial malformations, thus making it easy for the parents to understand them. We present a case of TCS diagnosed in the 33rd week using 3DUS, with postnatal confirmation using cranial computed tomography and anatomopathological analysis.

  7. Esclerodermia localizada: Diagnósticos diferenciales Localized scleroderma: Differential diagnosis

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    MB Leroux

    2011-09-01

    Full Text Available La esclerodermia localizada constituye un desorden autoinmune órgano específico, que compromete sobre todo la piel. Se caracteriza por inflamación seguida de esclerosis e incluye distintas formas clínicas. La etiología de la esclerodermia localizada no ha sido establecida. El diagnóstico diferencial incluye cuadros esclerodermiformes, desencadenados por factores intrínsecos y extrínsecos que están siendo estudiados. Entre ellos se incluyen: exposición a radiaciones o tóxicos, consumo de medicamentos, infecciones y enfermedades de origen endocrino-metabólico, genético e inflamatorio. En primer lugar, se debe descartar la esclerodermia sistémica. En segundo lugar, se clasifican las entidades con predominio de esclerosis o atrofia. Por último, se incluyen algunas enfermedades en un cuadro comparativo.Localized scleroderma is an autoimmune organ specific disorder with an important skin compromise. It is an inflammatory process with several distinct clinical characteristics. The etiology of localized scleroderma has not been established yet. Differential diagnosis includes sclerodermiform onset unchained by intrinsic and extrinsic factors that are presently studied. Among them must be taking into account: exposure to radiation or toxic agents, therapeutic drugs, infections and diseases of endocrine, metabolic, genetic or inflammatory etiology. Firstly, it must be point out that systemic scleroderma must be ruled out. Secondly, disorders predominantly with sclerosis and atrophy must be classified and lastly, some other diseases are included in a comparative table.

  8. Anemia in inflammatory bowel disease: prevalence, differential diagnosis and association with clinical and laboratory variables

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    Rodrigo Andrade Alves

    Full Text Available CONTEXT AND OBJECTIVES:Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1 determine the prevalence of anemia among patients with inflammatory bowel disease; 2 investigate whether routine laboratory markers are useful for diagnosing anemia; and 3 evaluate whether any association exists between anemia and clinical/laboratory variables.DESIGN AND SETTING:Cross-sectional at a federal university.METHODS:44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid were investigated.RESULTS:Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6% and ulcerative colitis (76.7%. Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis, anemia was associated with the disease activity index.CONCLUSIONS:Most patients present iron laboratory disorders, with or without anemia, mainly due to iron deficiency. The differential diagnosis between the two most prevalent types of anemia was made based on clinical data and routine laboratory tests. In ulcerative colitis, anemia was associated with the disease activity index.

  9. Mouse rosettes and surface immunoglobulin in small lymphocytic lymphoma. Importance in immunophenotyping and differential diagnosis.

    Science.gov (United States)

    Batata, A; Shen, B

    1992-02-15

    Cell suspensions from lymphoid tissue of 82 small lymphocytic lymphoma (SLL), 8 intermediate lymphocytic lymphoma (ILL), 286 other B-non-Hodgkin's lymphoma (B-NHL), and 248 reactive lymphadenopathy (RLA) cases were analyzed to evaluate the diagnostic significance of mouse-rosette (M-rosette) assay, and surface immunoglobulin clonality (SIg) and level of expression. In SLL, 55 were M-rosette positive (67.07%) and 72 SIg positive (87.8%), with weak fluorescence in 63 and strong fluorescence in 9 cases. Of 10 SIg-negative cases, 9 were M-rosette positive; of 27 M-rosette-negative cases, 26 were SIg positive. Seven of the nine cases with strong fluorescence were M-rosette positive. In other B-NHL, 252 were M-rosette negative (88.11%) and 245 SIg positive (85.66%), with strong fluorescence in 211 and weak fluorescence in 34 cases. Thirty-two of the 34 cases with weak fluorescence were M-rosette negative. Of the RLA cases, 213 were M-rosette negative (85.89%) and 1 SIg positive (0.4%). The study demonstrated the independent expression of M-rosettes and SIg in SLL and their complementary role in diagnosis. It showed that positive results for M-rosettes and weak fluorescence are characteristic of SLL, that M-rosette negativity and strong fluorescence are characteristic of other B-NHL, and that M-rosette negativity and polyclonal SIg are characteristic of RLA. In 26 cases with paired data for CD5, M-rosettes, and SIg, a positive result for M-rosettes was superior to CD5 in differentiating SLL from other B-NHL. Intermediate lymphocytic lymphoma frequently showed weak SIg fluorescence and M-rosette negativity.

  10. Efficacy of thyroid ultrasound elastography in differential diagnosis of small thyroid nodules

    Energy Technology Data Exchange (ETDEWEB)

    Dighe, Manjiri, E-mail: dighe@u.washington.edu [Department of Radiology, Box 357115, 1959 NE Pacific Street, University of Washington, Seattle, WA 98195 (United States); Luo, Si [Department of Bioengineering, University of Washington, William H. Foege Building, N510B, 3720 15th Ave NE, Seattle, WA 98195-5061 (United States); Cuevas, Carlos, E-mail: cuevas@u.washington.edu [Department of Radiology, Box 357115, 1959 NE Pacific Street, University of Washington, Seattle, WA 98195 (United States); Kim, Yongmin, E-mail: ykim@u.washington.edu [Department of Bioengineering, University of Washington, Box 355061, Seattle, WA 98195-5061 (United States)

    2013-06-15

    Objective: To explore the efficacy of thyroid ultrasound (US) elastography in differential diagnosis of small thyroid nodules. Methods: This HIPAA-compliant study was approved by the Institutional Review Board and all patients provided written informed consent. Thirty-five patients with 38 small thyroid nodules as seen on transverse ultrasound image formed our study population. An US examination and a separate thyroid elastography examination with pulsation from the carotid artery used as the compression source were performed before fine-needle aspiration. Baseband US data were acquired for off-line elastography processing, where a semi-quantitative index for each nodule was calculated. The Kruskal–Wallis nonparametric rank sum test was used to assess equality of population means among the different types of thyroid nodules. Maximum likelihood estimation of the curve parameters for a binomial receiver operating characteristic (ROC) curve was performed. Results: Elasticity contrast index calculated with elastography was effective in distinguishing between small papillary thyroid carcinomas (PTMC, n = 8) and other lesions (n = 30) in small thyroid nodules (p = 0.0036). The area under the ROC curve for diagnosing PTMCs was 0.812 with a 95% confidence interval of 0.653–0.920. The cut-off value of ECI of 3.6 led to a sensitivity of 100% and a specificity of 60% for detecting PTMCs. Conclusion: Noninvasive evaluation of small thyroid nodules is possible using thyroid US elastography with in vivo compression to pick out the most suspicious thyroid nodules for fine-needle aspiration (FNA) and avoid FNA in benign nodules.

  11. Use of a stable copper isotope (65Cu) in the differential diagnosis of Wilson's disease.

    Science.gov (United States)

    Lyon, T D; Fell, G S; Gaffney, D; McGaw, B A; Russell, R I; Park, R H; Beattie, A D; Curry, G; Crofton, R J; Gunn, I

    1995-06-01

    1. 65Cu/63Cu stable-isotope ratios have been measured in blood serum after oral administration of the stable isotope 65Cu. The incorporation of the isotope into the plasma protein pool was followed at various times for up to 3 days. The resulting patterns of enrichment in healthy control subjects, in Wilson's disease patients and in heterozygotes for the Wilson's disease gene, were similar in appearance to those found by others using copper radioactive isotopes. After an initially high enrichment at 2 h after dosage, the Wilson's disease cases, in contrast to the control subjects, did not show a secondary rise in isotope enrichment of the plasma pool after 72 h, demonstrating a failure to incorporate copper into caeruloplasmin. The Wilson's disease heterozygotes had variable degrees of impairment of isotope incorporation, not always distinguished from those of control subjects. 2. The stability of the isotope also permits the copper tracer to be followed for a longer period. Ten healthy subjects were studied for over 40 days, allowing the biological half-time of an oral dose of copper to be determined (median 18.5 days, 95% confidence interval 14-26 days). Known heterozygotes for the Wilson's disease gene were found to have a significantly increased biological half-time for removal of copper from the plasma pool (median 43 days, 95% confidence interval 32-77 days). 3. The incorporation of 65 Cu in patients with diseases of the liver (other than Wilson's disease) was found to be similar to that in control subjects, aiding differential diagnosis.

  12. Contrast-enhanced sonography versus biopsy for the differential diagnosis of thrombosis in hepatocellular carcinoma patients

    Institute of Scientific and Technical Information of China (English)

    Paolo Sorrentino; Salvatore D'Angelo; Luciano Tarantino; Umberto Ferbo; Alessandra Bracigliano; Raffaela Vecchione

    2009-01-01

    AIM: To clarify which method has accuracy: 2nd generation contrast-enhanced ultrasound or biopsy of portal vein thrombus in the differential diagnosis of portal vein thrombosis. METHODS: One hundred and eighty-six patients with hepatocellular carcinoma and portal vein thrombosis underwent in blinded fashion a 2nd generation contrastenhanced ultrasound and biopsy of portal vein thrombus; both results were examined on the basis of the follow-up of patients compared to reference-standard. RESULTS: One hundred and eight patients completed the study. Benign thrombosis on 2nd generation contrast- enhanced ultrasound was characterised by progressive hypoenhancing of the thrombus; in malignant portal vein thrombosis there was a precocious homogeneous enhancement of the thrombus. On follow-up there were 50 of 108 patients with benign thrombosis: all were correctly diagnosed by both methods. There were 58 of 108 patients with malignant thrombosis: amongst these, 52 were correctly diagnosed by both methods, the remainder did not present malignant cells on portal vein thrombus biopsy and showed on 2nd generation contrast-enhanced ultrasound an inhomogeneous enhancement pattern. A new biopsy during the follow-up, guided to the area of thrombus that showed up on 2nd generation contrast-enhanced ultrasound, demonstrated an enhancing pattern indicating malignant cells. CONCLUSION: In patients with hepatocellular carcinoma complicated by portal vein thrombosis, 2nd generation contrast-enhanced ultrasound of portal vein thrombus is very useful in assessing the benign or malignant nature of the thrombus. Puncture biopsy of thrombus is usually accurate but presents some sampling errors, so, when pathological results are required, 2nd generation contrast-enhanced ultrasound could guide the sampling needle to the correct area of the thrombus.

  13. Voxel-based moprhometry in the differential diagnosis of posttraumatic cognitive impairments

    Directory of Open Access Journals (Sweden)

    M.M. Odinak

    2014-01-01

    Full Text Available Brain injury (BI is a major cause of cognitive impairments (CI in young people. However, many aspects of their development remain unstudied. In particular, the role of neurodegenerative and vascular processes in the occurrence of posttraumatic disorders of higher cortical functions is still unclear. Voxel-based morphometry is one of the current neuroimaging techniques. Objective: to comprehensively study a change in the volume indicators of a number of brain structures in patients with posttraumatic, vascular, and amnestic CI.Patients and methods. The investigation enrolled 123 patients who were divided into 5 groups: 1 20 examinees without CI (a control group; 2 22 patients with mild and moderate CI and a history of mild recurrent CI; 3 19 patients with moderate posttraumatic CI after severe brain contusion; 4 41 patients with moderate vascular CI; 5 21 patients with moderate amnestic CI. Before divided into the groups, all the patients underwent comprehensive neuropsychological testing, which enabled different aspects of cognitive performance to be assessed.Results. Atrophic changes were ascertained to be uncharacteristic for the patients who had sustained mild recurrent BI. At the same time, the patients with severe consequences of BI showed a significant decrease in the volume of brain regions, primarily in that of frontal and temporal lobes. A combined comprehensive assessment of the results obtained in the group analysis using SPM8 and calculating absolute volume values using MRICroN allowed one to more accurately understand the nature of neurodegenerative changes. Comparative assessment of the data obtained in the posttraumatic, vascular, and amnestic CI groups identified a number of differences in both the distribution of atrophic changes and their level, which can be of great importance for the differential diagnosis of these conditions.

  14. Heart rate circadian profile in the differential diagnosis between Parkinson disease and multiple system atrophy.

    Science.gov (United States)

    Pilleri, Manuela; Levedianos, Giorgio; Weis, Luca; Gasparoli, Elisabetta; Facchini, Silvia; Biundo, Roberta; Formento-Dojot, Patrizia; Antonini, Angelo

    2014-02-01

    Clinical diagnostic criteria indicate presence of autonomic features as the primary hallmark of Multiple System Atrophy (MSA). However involvement of the autonomic system is also a recognized feature of Parkinson's Disease (PD), yielding a broad clinical overlap between the two diseases. Laboratory assessments may help in the differential diagnosis between PD and MSA. Ambulatory Monitoring of Blood Pressure (AMBP) is a suitable tool to study the circadian rhythm of blood pressure (BP) and heart rate (HR). Different studies reported a reduction of physiological BP nocturnal dipping in PD and MSA patients, but failed to identify a distinctive pattern discriminating the two diseases. On the other hand, HR nocturnal behavior has not been exhaustively analyzed. In the present study we compared the profiles of HR circadian rhythm in 61 PD and 19 MSA patients who underwent 24 h AMBP. We found higher nocturnal HR (nHR) (71.5 beats/min ± 7.4) in MSA compared with PD (63.8 beats/min ± 9.6) as well as significantly lower nocturnal decline of HR (ndHR) in MSA (7.3% ± 8.2) vs. PD (14% ± 7.5). At a Receiver Operating Curve analysis nHR and ndHR significantly discriminated MSA from PD. nHR showed a sensitivity of 84.2% and a specificity of 62.3% (AUC 0.76; 95% IC 0.65-0.85); ndHR showed a sensitivity of 68% of and a specificity of 77% (AUC 0.72; 95% IC 0.61-0.82). According to our findings, nHR is increased and ndHR is reduced in MSA compared to PD. Moreover, these two indices discriminate between the two diseases with acceptable accuracy.

  15. The speech and vocalization patterns of boys with ADHD compared with boys with dyslexia and boys without learning disabilities.

    Science.gov (United States)

    Breznitz, Zvia

    2003-12-01

    This research study dealt with an inquiry into the speech and vocalization patterns of boys with Attention Deficit Hyperactivity Disorder (ADHD) who were not under the influence of stimulating medication, compared with the speech and vocalization patterns of boys with reading disabilities and a control group of learners without learning disabilities. The voices of 105 participants were recorded during interviews and analyzed in the laboratory using equipment that examined the temporal speech patterns and physical features of vocalization. The speech patterns were examined with a frequency examination, speech unit length duration, and correlation between the vocalization and pauses in the speech unit. The physical features of vocalization were examined with volume and frequency scales. The research results indicated that the speech and vocalization patterns of boys with ADHD were significantly different from those of boys with reading disabilities and from the boys in the control group. The results support the assumption that speech and vocalization indicators can be used as objective indicators for the diagnosis of hyperactivity syndrome with attention and concentration difficulties.

  16. The Role of Computer-aided Detection and Diagnosis System in the Differential Diagnosis of Thyroid Lesions in Ultrasonography

    Directory of Open Access Journals (Sweden)

    Tien-Chun Chang

    2015-12-01

    Full Text Available To avoid abuse of fine-needle aspiration cytology (FNAC and to save the time of a learning curve, a computer-aided detection and diagnosis (CAD system to detect suspicious lesions for FNAC from thyroid ultrasonography has been developed by the Department of Industrial Engineering, cooperative with the Department of Surgery at the National Taiwan University, Taipei, Taiwan. The purposes of this article are to introduce how to utilize the CAD system in thyroid ultrasonography, and to outline the real role of the CAD system. After marking the apparently transverse (extending across axis and longitudinal axis of the nodule appearing by ultrasonography, four parameters are calculated and displayed by the computer system automatically, which include microcalcifications, hypoechoic lesion, heterogeneity, and indistinct margin. The results are displayed by the pointers in the semilunar figures. The necessity of FNAC is dependent on the size and numbers of positive findings (pointers displayed in the right side. This CAD system is objective and easy to use. It may supply an easy method to determine the necessity for FNAC, but what we must keep in mind is that this method can reduce the necessity of FNAC, not replace FNAC for the diagnosis of thyroid cancer.

  17. Differential Diagnosis of a Severe Late Onset Ovarian Hyperstimulation Syndrome Associated with Prolonged Ascites Production – a Case Report

    Directory of Open Access Journals (Sweden)

    Ujvari E

    2005-01-01

    Full Text Available Capsule: A case of severe late onset ovarian hyperstimulation syndrome (OHSS with prolonged ascites production. Difficulties of differential diagnosis and management. Objective: This report describes a case of extremely prolonged, severe ovarian hyperstimulation syndrome. Results: 17 litres of ascites have been removed from the abdominal cavity by repeated paracenteses until the 25th week of pregnancy, which progressed after the complete resolution of symptoms to the 34th week, when cesarean section was done. Conclusion: Severe ovarian hyperstimulation syndrome can occasionally follow an unusually prolonged course. Chronic formation of abundant ascites, the presence of ovarian enlargement and elevated levels of certain tumour markers might raise the probability of ovarian cancer. Adequate differential diagnosis and management resulted in delivery of a healthy newborn.

  18. Application of T2* measurement on gradient echo T2*-weighted imaging in differential diagnosis of intracranial hemorrhage and calcification

    Institute of Scientific and Technical Information of China (English)

    LIU Lan-xiang; YI Hui-ling; HAN Hong-bin; QI Xi-ming

    2012-01-01

    Background Differential diagnosis of intracranial hemorrhage and calcification is a common problem encountered in clinical imaging diagnosis.The purpose of this study was to investigate the feasibility of T2* measurement on gradient echo (GRE) T2*-weighted imaging (T2*WI) in differential diagnosis of intracranial hemorrhage and calcification.Methods Thirty-eight hemorrhagic foci in 18 patients and 11 calcification foci in seven patients were included in this study.The diagnosis of hemorrhage and calcification was confirmed in all cases with enhanced T2* weighted angiography (ESWAN) magnetic resonance imaging (MRI) and CT respectively.The significance for the difference of T2* value between the central and peripheral areas of hemorrhage and calcification lesions was tested with univariate analysis of variance.Results The detection rate of GRE T2*WI on intracranial hemorrhage was 1.9-fold higher than that of CT,especially for the hemorrhage in the brainstem and cerebellum.However,GRE T2*WI was far less sensitive to calcification than CT.There was a significant difference in the T2* value between the central area of hemorrhage and calcification (P <0.001),though no difference in the T2* value was obtained between the peripheral area of hemorrhage and calcification (P>0.05).Conclusions Quantitative measurement of T2* value on GRE T2*WI with a single MRI examination provides a fast,convenient,and effective means in differential diagnosis between intracranial hemorrhage and calcification,which may thus reduce the medical cost and save precious time for clinical management.

  19. Differential Diagnosis of Patients with Inconclusive Parkinsonian Features Using [{sup 18}F]FP-CIT PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Eunkyung; Hwang, Yu Mi; Lee, Channyoung; Oh, Sun Young; Kim, Young Chul; Choe, Jae Gol; Park, Kun Woo [Korea Univ., Seoul (Korea, Republic of); Kim, Sujin [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2014-06-15

    It is often difficult to differentiate parkinsonism, especially when patients show uncertain parkinsonian features. We investigated the usefulness of dopamine transporter (DAT) imaging for the differential diagnosis of inconclusive parkinsonism using [{sup 18}F]FP-CIT PET. Twenty-four patients with inconclusive parkinsonian features at initial clinical evaluation and nine healthy controls were studied. Patients consisted of three subgroups: nine patients whose diagnoses were unclear concerning whether they had idiopathic Parkinson's disease or drug-induced parkinsonism ('PD/DIP'), nine patients who fulfilled neither the diagnostic criteria of PD nor of essential tremor ('PD/ET'), and six patients who were alleged to have either PD or atypical parkinsonian syndrome ('PD/APS'). Brain PET images were obtained 120 min after injection of 185 MBq [{sup 18}F]FP-CIT. Imaging results were quantified and compared with follow-up clinical diagnoses. Overall, 11 of 24 patients demonstrated abnormally decreased DAT availability on the PET scans, whereas 13 were normal. PET results could diagnose PD/DIP and PD/ET patients as having PD in six patients, DIP in seven, and ET in five; however, the diagnoses of all six PD/APS patients remained inconclusive. Among 15 patients who obtained a final follow-up diagnosis, the image-based diagnosis was congruent with the follow-up diagnosis in 11 patients. Four unsolved cases had normal DAT availability, but clinically progressed to PD during the follow-up period. [{sup 18}F]FP-CIT PET imaging is useful in the differential diagnosis of patients with inconclusive parkinsonian features, except in patients who show atypical features or who eventually progress to PD.

  20. Differential Diagnosis of Skin Ulcers in a Mycobacterium ulcerans Endemic Area: Data from a Prospective Study in Cameroon

    Science.gov (United States)

    Toutous Trellu, Laurence; Nkemenang, Patrick; Comte, Eric; Ehounou, Geneviève; Atangana, Paul; Rusch, Barbara; Njih Tabah, Earnest; Etard, Jean-François; Mueller, Yolanda K.

    2016-01-01

    Background Clinical diagnosis of Buruli ulcer (BU) due to Mycobacterium ulcerans can be challenging. We aimed to specify the differential diagnosis of skin lesions in a BU endemic area. Method We conducted a prospective diagnostic study in Akonolinga, Cameroon. Patients presenting with a skin ulcer suspect of BU were included. M. ulcerans was detected using swabs for Ziehl-Neelsen staining, PCR and culture. Skin punch biopsies were taken and reviewed by two histopathologists. Photographs of the lesions were taken and independently reviewed by two dermatologists. Final diagnosis was based on consensus, combining the results of laboratory tests and expert opinion. Results/ Discussion Between October 2011 and December 2013, 327 patients with ulcerative lesions were included. Median age was 37 years (0 to 87), 65% were males, and 19% HIV-positive. BU was considered the final diagnosis for 27% of the lesions, 85% of which had at least one positive laboratory test. Differential diagnoses were vascular lesions (22%), bacterial infections (21%), post-traumatic (8%), fistulated osteomyelitis (6%), neoplasia (5%), inflammatory lesions (3%), hemopathies and other systemic diseases (2%) and others (2%). The proportion of BU was similar between HIV-positive and HIV-negative patients (27.0% vs. 26.5%; p = 0.940). Half of children below 15 years of age were diagnosed with BU, compared to 26.8% and 13.9% among individuals 15 to 44 years of age and above, respectively (chi2 p<0.001). Children had more superficial bacterial infections (24.3%) and osteomyelitis (11.4%). Conclusion We described differential diagnosis of skin lesions in a BU endemic area, stratifying results by age and HIV-status. PMID:27074157

  1. Trigeminal Electrophysiology: a 2 × 2 matrix model for differential diagnosis between temporomandibular disorders and orofacial pain

    OpenAIRE

    Chessa Giacomo; Frisardi Gianni; Sau Gianfranco; Frisardi Flavio

    2010-01-01

    Background Pain due to temporomandibular disorders (TMDs) often has the same clinical symptoms and signs as other types of orofacial pain (OP). The possible presence of serious neurological and/or systemic organic pathologies makes differential diagnosis difficult, especially in early disease stages. In the present study, we performed a qualitative and quantitative electrophysiological evaluation of the neuromuscular responses of the trigeminal nervous system. Using the jaw jerk reflex (JJ...

  2. Basic pattern in CT of the lung and differential diagnosis; Grundmuster im CT der Lunge und ihre Differenzialdiagnose

    Energy Technology Data Exchange (ETDEWEB)

    Jacobi, V.; Thalhammer, A. [Inst. fuer Diagnostische und Interventionelle Radiologie, Univ. Frankfurt (Germany)

    2006-12-15

    Infectious, physical, chemical or other noxae elicit a limited number of reactions in lung tissue. As in the case of other organs and tissues, lung tissue has specific reactions that are often more indicative of the particular organ than the harmful agent. The resulting radiological features are usually ambiguous and therefore prevent definitive diagnosis. This complicates etiological categorization of the disease. Pathognomonic findings are rare. The same noxa can yield different radiographic features and clinical pictures for different patients. A diagnosis is generally not comprised of a single radiographic feature, but rather of a combination of a plurality of features. Although the number of possible diagnoses can be limited via radiological means, a final diagnosis is determined in conjunction with the medical history, the clinical picture, as well as lab and histopathological values. This article defines the most common pulmonary changes and also discusses differential diagnostic criteria. (orig.)

  3. A novel de novo PSTPIP1 mutation in a boy with pyogenic arthritis, pyoderma gangrenosum, acne (PAPA) syndrome.

    Science.gov (United States)

    Fathalla, Basil M; Al-Wahadneh, Adel M; Al-Mutawa, Mariam; Kambouris, Marios; El-Shanti, Hatem

    2014-01-01

    Autoinflammatory disorders are a group of Mendelian disorders characterized by seemingly unprovoked inflammatory bouts without high-titer autoantibodies or antigen-specific T-cells and are probably due to defects in the innate immunity. We here report on a 4-year-old Arabic boy with the clinical presentation of an autoinflammatory disorder, namely Pyogenic Arthritis, Pyoderma Gangrenosum and Acne (PAPA) syndrome. The presentation includes abscess formation after immunization and recurrent mono-articular acute arthritis in various joints that responded favourably to systemic glucocorticosteroids, albeit without acne or pyoderma gangrenosum. The mutation analysis of the boy identified a novel de novo mutation in PSTPIP1, the gene responsible for PAPA syndrome. We recommend that the diagnosis of PAPA syndrome should be entertained in the differential diagnosis of patients with recurrent sterile pyogenic arthritis prior to the development of pyoderma gangrenosum or acne in order to initiate a timely management of the disorder.

  4. The differential diagnosis of children with joint hypermobility: a review of the literature

    OpenAIRE

    Elliott Elizabeth J; Tofts Louise J; Munns Craig; Pacey Verity; Sillence David O

    2009-01-01

    Abstract Background In this study we aimed to identify and review publications relating to the diagnosis of joint hypermobility and instability and develop an evidence based approach to the diagnosis of children presenting with joint hypermobility and related symptoms. Methods We searched Medline for papers with an emphasis on the diagnosis of joint hypermobility, including Heritable Disorders of Connective Tissue (HDCT). Results 3330 papers were identified: 1534 pertained to instability of a...

  5. Accuracy of neuropsychological tests and the Neuropsychiatric Inventory in differential diagnosis between Frontotemporal dementia and Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Valéria Santoro Bahia

    Full Text Available Abstract The differential diagnosis between frontotemporal dementia (FTD and Alzheimer's disease (AD is sometimes difficult. Objectives: To verify the accuracy of neuropsychological tests and a behavioral disorders scale in the differential diagnosis between FTLD and AD. Methods: Retrospective data on 12 FTD patients and 12 probable AD patients were analyzed. The scores on neuropsychological tests (MMSE score, reverse digit span, delayed recall for drawings, semantic fluency of animals and the Neuropsychiatric Inventory (NPI in both groups were compared. Results: Both groups had similar performance on neuropsychological tests. All FTD patients and 50% of AD patients had neuropsychiatric abnormalities. The NPI score was 58.0±19.3 for the FTD patients, and 3.6±4.7 for the AD patients (p<0.01. Using a NPI cut-off score of 13, the sensitivity and specificity were 100% in this sample. The four most common neuropsychiatric disturbances in FTD patients were: apathy, aberrant motor behavior, disinhibition and eating abnormalities. Apathy and dysphoria/depression were the most common behavioral symptoms among the AD patients. Conclusions: In this study, NPI was found to be a useful tool for the differential diagnosis between FTD and AD. The neuropsychological tests commonly used in the medical office were unable to distinguish between the two groups.

  6. A solitary mastocytoma presenting with urticaria and angioedema in a 14-year-old boy.

    Science.gov (United States)

    Krishnan, Karthik R; Ownby, Dennis R

    2010-01-01

    Urticaria with angioedema is a common clinical presentation that often poses a challenge for allergists. The differential diagnosis for urticaria is broad, making the evaluation and pinpointing the underlying cause difficult and frustrating for both families and physicians. Certain causes of urticaria such as infections or medications are more common and easier to identify whereas less frequently seen conditions are often overlooked because of their rarity. One such condition is mastocytosis. Mastocytosis is a rare disease that very seldom presents with urticaria but may be associated with significant morbidity and mortality if not recognized in a timely manner. We are presenting a case of a 14-year-old boy who presented with urticaria and angioedema possibly caused by a solitary mastocytoma. The learning points from this case are that mastocytosis should be considered in the differential diagnosis of urticaria and solitary mastocytomas may remain active into adolescence, raising concern for systemic progression.

  7. Primary renal undifferentiated sarcoma as an infiltrative mass in a 12 year old boy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Hee; Kim, Myung Joon; Lee, Mi Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Se Hwa [Dept. of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-09-15

    Undifferentiated sarcomas are rare tumors not classified into any sarcoma subtype. Due to their rarity, imaging findings of undifferentiated sarcomas are poorly characterized. The purpose of this report was to present imaging findings of a pathologically confirmed undifferentiated sarcoma originated from the left kidney of a 12-year-old boy. The mass was infiltrative involving the renal pelvis. It mimicked massive hilar lymphadenopathy with a preserved renal contour visible by both ultrasonography and CT. Renal vein thrombosis was also observed. Although undifferentiated sarcomas are rare, they should be considered in differential diagnosis of infiltrative renal masses with renal pelvis invasion in children.

  8. Intrascrotal lipoblastoma in a ten year old boy: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Ghassan Nakib

    2013-02-01

    Full Text Available Lipoblastoma is a rare benign soft tissue tumor encountered almost exclusively in infancy and early childhood. The location of tumors varies, but most occur in the extremities, trunk, head and neck. Less frequently, lipoblastomas have been reported in the mediastinum, the retroperitoneum and the inguinal region. Only 7 cases of lipoblastoma in the scrotum have been reported so far in the English literature, with none of the patients older than 8. We report an intrascrotal lipoblastoma in a 10 year-old boy. The differential diagnosis is discussed with reference to the literature.

  9. A functionally guided approach to the morphometry of occipitotemporal regions in developmental dyslexia: evidence for differential effects in boys and girls.

    Science.gov (United States)

    Altarelli, Irene; Monzalvo, Karla; Iannuzzi, Stéphanie; Fluss, Joel; Billard, Catherine; Ramus, Franck; Dehaene-Lambertz, Ghislaine

    2013-07-03

    Developmental dyslexia is a learning disability that specifically affects reading acquisition. Cortical anomalies and gray matter volume differences in various temporal regions have been reported in dyslexic subjects compared with controls. However, consistency between studies is lacking. In the present experiments, we focused our structural analyses on the ventral occipitotemporal regions, defined by their functional response to visual categories. We applied a subject-by-subject functionally guided approach on a total of 76 participants (31 dyslexic children). Cortical thickness was estimated for each participant around his/her peak of specific functional activation to visual words, faces, or places. Results from two independent datasets showed a reduction in thickness in dyslexic children compared with controls in the region responsive to words, in the left hemisphere. Additionally, a gender-by-diagnosis interaction was observed at the same location, due to differences in girls only. To avoid the potential confound of reading level, we also contrasted dyslexic and control children matched for reading performance, and we observed a similar difference, although in a smaller extent of cortex. The present study thus provides the first account of a focal cortical thickness reduction in dyslexia in the subregion of ventral occipitotemporal cortex specifically responsive to visual words, when age, gender, and reading performance are taken into account.

  10. Primary omental actinomycosis as a differential diagnosis of acute appendicitis in children. Case report

    Directory of Open Access Journals (Sweden)

    Sergio Castañeda

    2016-09-01

    Full Text Available Actinomycosis is a chronic suppurative granulomatous inflammation caused by Actinomyces species. Abdominal actinomycosis is a rare condition, with very low incidence in childhood, and usually associated to trauma or perforation of hollow viscera. We are presenting a case of a ten-year-old boy with omental actinomycosis mimic and appendiceal infection, without a history of trauma or perforation, suggesting a hemmatogen spread. The complete resection of the affected tissue may warrant a cure in spite of a short antibiotic curse.

  11. The Problem With Boys

    Institute of Scientific and Technical Information of China (English)

    WANG HAIRONG

    2010-01-01

    @@ Pony,a 10-month-old boy,lost his first confrontation in life to a girl of the same age.The two babies'mothers met in a shopping mall recently and decided to let the two children play with each other.They put the babies down together on the floor.As soon as her feet were on the floor,the baby girl waddled toward Pony,stretching out her little hands to grab him.The boy,not yet strong enough to walk,cried at the aggressive girl.

  12. CT diagnosis and differential diagnosis in gastrointestinal stromal tumors%胃肠道间质瘤的CT诊断与鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    黄旭东; 周玉祥; 赖海辉; 廖俊杰

    2011-01-01

    目的 探讨胃肠道间质瘤(GIST)的螺旋CT征象及其诊断、鉴别诊断价值.方法 回顾性分析28例经手术病理证实为GIST患者的螺旋CT资料,分析其CT征象与肿瘤恶性程度的相关性.结果 28例患者生物学危险度:极低度2例(7.1 %),低度4例(14.3 %),中度8例(28.6 %),高度14例(50.0 %).肿块的大小、边界、密度、侵犯和/或转移、坏死或出血与肿瘤的生物学危险性之间差异密切相关(P < 0.05),而肿瘤的形态、强化程度与危险性无统计学意义(P > 0.05).结论 GIST的CT表现具有一定特征,对GIST的鉴别诊断及术后随访有重要价值,并有助于判断肿瘤的生物学危险性.%Objective To evaluate the value of multi-slice spiral CT findings in diagnosis and differential diagnosis of gastrointestinal stromal tumors.Methods The data and CT images of 28 patients pathologically confirmed with GIST were analyzed retrospectively.The relationship between CT findings and risk of tumor were compared to find the benign and malignant CT findings and the key point for differential diagnosis.Results Of the 28 GIST lesions, there were 2 with very low biological risk, 4 with low risk, 8 with moderate risk and 14 with high risk.There were significant differences between GIST lesions and the size,boundary, density, invasion or transfer, necrosis or bleeding (P < 0.05).While there were no statistical difference between the shape and enhancement of the tumor (P > 0.05).Conclusion The CT finding of GIST has some characteristics, which plays an important role in differential diagnosis and post-operative follow-up; which is helpful in risk prediction for GIST and instruction of clinic treatment.

  13. CT Diagnosis and Differential Diagnosis of Solitary Pulmonary Nodules%探讨肺内孤立结节的CT诊断及鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    陈瑞鑫; 李丽; 吴晓丽; 庞然

    2016-01-01

    Objective To study the diagnostic effect of CT diagnosis in the diagnosis of solitary pulmonary nodules.Methods The CT data of 120 patients with solitary pulmonary nodules were retrospectively analyzed. Results All patients with benign nodules were 56 cases, accounting for 46.7% of the group; malignant nodules were 64 cases, accounting for 53.3% of the group.Conclusion The diagnosis of solitary pulmonary nodules can be diagnosed by CT, which is helpful for the differentiation of benign and malignant solitary pulmonary nodules.%目的:研究分析CT诊断应用于肺内孤立结节的诊断效果。方法将我院120例肺内孤立结节患者的CT检查资料进行回顾分析。结果全部患者中良性结节患者是56例,占该组的46.7%;恶性结节病例是64例,占该组的53.3%。结论肺内孤立结节可以通过CT诊断进行确诊,这有助于良性恶性肺内孤立结节的区分。

  14. Neoplastic lesions of the temporomandibular joint (TMJ): diagnosis, differential diagnosis and intervention; Neoplasien des Temporomandibulargelenks (TMG). Diagnostik, Differenzialdiagnostik und Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Abolmaali, N.; Schedel, H.; Bergh, B. [Frankfurt Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Maeurer, J. [Radiologische Praxis am Prinzregentenplatz, Muenchen (Germany)

    2001-09-01

    Purpose. To evaluate the effectiveness of diagnostic and interventional radiological techniques for neoplastic lesions of the temporomandibular joint (TMJ). Material and methods. Modern diagnosis of the TMJ is based on the clinical use of conventional X-ray techniques, computed tomography (CT), magnetic resonance imaging (MRI) and interventional techniques like biopsies, vascular occlusion and ablation. Results. Conventional X-ray still forms the basic diagnostic procedure applied in open and closed mouth position. CT improves the diagnostic information and serves as the standard diagnostical instrument for cartaliganeous or osseous neoplastic lesions. MRI evaluates soft tissue infiltration in multiplanar techniques and high spatial resolution. Interventional vascular and ablative techniques improve the treatment of neoplastic disorders. (orig.) [German] Zielsetzung. Vorstellung der Wertigkeit bildgebender Verfahren fuer die diagnostische und interventionelle Radiologie des Temporomandibulargelenks (TMG). Material und Methodik. Die moderne Radiologie des TMG basiert auf dem Einsatz der konventionellen Roentgendiagnostik, der Computertomographie (CT) und der Magnetresonanztomographie (MRT), sowie interventioneller Verfahren wie der Biopsie, vaskulaerer Embolisationsverfahren und tumorablativer Verfahren. Ergebnisse. Als Basisdiagnostik dient die konventionelle Diagnostik in offener und geschlossener Mundposition der Erfassung von Funktionsstoerungen sowie ossaerer Destruktionen. Die CT erweitert das diagnostische Spektrum und verbessert die Differenzialdiagnostik fuer ossifizierende Prozesse. Der Einsatz der MRT erlaubt die Erfassung der Weichteilinfiltration sowie der Gelenkstrukturen. Vaskulaere interventionelle Verfahren dienen der praetherapeutischen Okklusion bzw. der palliativen Tumortherapie in Form der okklusiven Embolisation, der Chemoembolisation, oder auch der Tumorablation. (orig.)

  15. [Tuberculosis and tularemia as part of the differential diagnosis in cervical lymphadenitis].

    Science.gov (United States)

    Karagöz, Ergenekon; Ulçay, Asım; Hatipoğlu, Mustafa; Turhan, Vedat

    2014-10-01

    We have read with interest the recently published article entitled "Investigation of the presence of Mycobacterium tuberculosis in the lymph node aspirates of the suspected tularemia lymphadenitis cases" by Albayrak et al. published in Mikrobiyol Bul 2014; 48(1): 129-34. They concluded that tuberculous lymphadenitis (TCL) should be kept in mind in suspected tularemia cases and those patients should also be investigated simultaneously for the presence of TCL. With reference to data provided by the Ministry of Health in Turkey, the number of reported cases of pulmonary tuberculosis in comparison to previous years is currently on decline whereas a gradual increase in extra-pulmonary (specifically cervical TCL) cases has been observed. Besides, as one of the most common causes of cervical lymphadenitis, we are witnessing a marked increase in granulomatous infections which have been part of the evaluated cases of oropharyngeal tularemia in Turkey. In fact, differentiation of the two types of lymphadenitis can be confusing on the basis of clinical and histopathological findings. Thus, investigating the presence of M.tuberculosis in cervical lymph node aspirates of tularemia suspected cases is a vital contribution, specifically in a geographical region that is considered endemic for both diseases. We would therefore like to note the importance of this study and thank the authors for their comprehensive contribution. Contrary to what is noted in the study, cervical lymphadenitis due to acute tonsillopharyngitis unresponsive to penicillin and its derivatives, has been regarded as cervical TCL due to their histopathological appearance and have been treated unnecessarily with long-term antituberculous drugs. There are some publications from Turkey indicating the detection of Francisella tularensis antibodies and nucleic acids in the patients who were histologically diagnosed as TCL. In situations where the exact etiology of cervical lymphadenitis is not determined, treatment

  16. Differential diagnosis of gallbladder wall thickening by two phase spiral CT : gallbladder carcinoma versus cholicystitis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sun; Cho, Soon Gu; Kim, Mi Young; Woo, Je Hong; Shin, Seok Hwan; Lee, Kykung Hee; Suh, Chang Hae [Inha Univ. College of Medicine, Inchon (Korea, Republic of)

    2001-04-01

    To determine whether an analysis of two-phase CT features provides a sound basis for differential diagnosis between gallbladder carcinoma and cholecystitis. We reviewed a total of 89 cases of gallbladder carcinoma (n=35) or cholecystitis (n=54) in patients who had undergone two-phase spiral CT. For this, a GE Highspeed Advantage scanner (GE Medical Systems, Milwaukee, U . S . A .) was used. A total of 120ml of contrast material was injected at a rate of 2-3 ml/sec. Arterial and venous phase scans were obtained 35 and 65 seconds, respectively, after the initiation of contrast infusion. All cases of gallbladder carcinoma and 468 of cholecystitis (of a total of 482) were confirmed by histopathology. We reviewed the two phase spiral CT features, analyzing and assessing thickness of the lesion, the enhancement pattern seen during the arterial and the venous phase, invasion of liver, pericholecystic fat infiltration, dilatation of intrahepatic ducts, and other associated findings. Mean wall thickness was 12.6 mm in the gallbladder carcinoma group, and 7.2 mm in the cholecystitis group. The common enhancement patterns seen in gallbladder carcinoma were 1) a highly enhanced thick inner wall layer during the arterial phase which became iso attenuated with adjacent liver parenchyma during the venous phase (16/35; 45.7%) and 2) highly enhanced thick inner wall layer during both the arterial and venous phase (8/35; 22.9%). The most common enhancement pattern in cholecystitis cases was an iso attenuated thin inner wall layer during both the arterial and the venous phase (44/54; 81.5%). Findings of intrahepatic mass formation by direct invasion (9/35), lymph node enlargement (12/35), and metastasis to other organs (7/35) occurred only in cases of gallbladder carcinoma (18/35, 51.4%) than of cholecystitis (10/54, 18.5%). The incidence of pericholecystic fat infiltration and fluid collection was not significantly different between the gallbladder cancer and cholecystitis groups

  17. Validity of multiplex biomarker model of 6 genes for the differential diagnosis of thyroid nodules

    Directory of Open Access Journals (Sweden)

    Ducena Kristine

    2011-06-01

    Full Text Available Abstract Background Currently the cytological examination of fine needle aspiration (FNA biopsies is the standard technique for the pre-operative differential diagnosis of thyroid nodules. However, the results may be non-informative in ~20% of cases due to an inadequate sampling and the lack of highly specific, measurable cytological criteria, therefore ancillary biomarkers that could aid in these cases are clearly needed. The aim of our study was to evaluate the mRNA expression levels of 8 candidate marker genes as the diagnostic biomarkers for the discrimination of benign and malignant thyroid nodules and to find a combination of biomarkers with the highest diagnostic value. Materials and methods mRNA expression levels of eight candidate marker genes - BIRC5, CCND1, CDH1, CITED1, DPP4, LGALS3, MET and TFF3 was measured by real-time RT-PCR in paired nodular and surrounding normal thyroid tissue specimens of 105 consecutive patients undergoing thyroid surgery and compared between different types of thyroid lesions. Results Significant differences in the mRNA expression levels between the normal and malignant thyroid tissues and between benign and malignant nodules were found for BIRC5, CCND1, CITED1, DPP4, LGALS3, MET and TFF3, but not CDH1. On a single gene basis, relative quantity (RQ of LGALS3 had the highest diagnostic value for the discrimination of malignant and benign thyroid nodules (AUC = 0.832, P LGALS3 was RQ sum of LGALS3 and BIRC5 (AUC = 0.841, P LGALS3, BIRC5, TFF3, CCND1, MET and CITED1 that had considerably higher specificity than a single marker or two marker gene-based models (AUC = 0.895, P Conclusions This study confirmed that mRNA expression levels of 7 out of 8 candidate genes analysed have a diagnostic value for the distinction of benign and malignant thyroid nodules. The multiplex biomarker model based on 6 genes outperformed a single marker or two marker-based models and warrants feasibility studies on FNA biopsies and

  18. Multiple sclerosis: imaging, diagnostic criteria and differential diagnosis; Bildgebung, Diagnosekriterien und Differenzialdiagnose der Multiplen Sklerose

    Energy Technology Data Exchange (ETDEWEB)

    Harting, I.; Sartor, K. [Abt. Neuroradiologie, Neurologische Klinik, Universitaetsklinikum Heidelberg (Germany); Sellner, J.; Meyding-Lamade, U. [Abt. Neurologie, Neurologische Klinik, Universitaetsklinikum Heidelberg (Germany)

    2003-05-01

    Multiple sclerosis (MS) is the most common demyelinating inflammatory disease of the central nervous system (CNS), presenting with multifocal, disseminated inflammatory lesions referred to as plaques. Magnetic resonance imaging (MRI) typically depicts multiple, round to oval, circumscript lesions predominantly involving periventricular and subcortical white matter, brainstem and cerebellum. More recent investigations have demonstrated that the macroscopically visible plaques only present the tip of the iceberg: Already early in its course, MS causes neuroaxonal damage and diffusely involves the entire brain parenchyma including normal appearing white matter. These changes are reflected by strongly T{sub 1}w hypointense lesions and atrophy of early onset, by reduction of the neuronal Marker N-acetylaspartate (NAA) on spectroscopy, by a decrease of the magnetization transfer ratio (MTR), by an increased in diffusibility and decreased anisotropy on diffusion-weighted imaging (DWI). MRI imaging is an important tool in the diagnosis of MS by revealing the characteristic spatial and temporal dissemination of the cerebral and spinal manifestations of this disease. Diagnostic criteria increase the diagnostic specificity and allow better differentiation from other diseases with multifocal white matter abnormalities. (orig.) [German] Die multiple sklerose (MS) ist die haeufigste entzuendliche, demyelinisierende Erkrankung des zentralen Nervensystems (ZNS) Sie ist durch multifokale, disseminierte Entzuendungsherde, sogenannte Plaques, in den myelinhaltigen Strukturen des ZNS charakterisiert. In der Magnetresonanztomographie (MRT) sind multiple umschriebene, rundlich-ovale Laesionen der weissen Substanz charakteristisch, die bevorzugt im periventrikulaeren Marklager, an der Mark-Rindengrenze, im Hirnstamm und im Kleinhirn lokalisiert sind. Neuere Untersuchungen zeigen, dass die sichtbaren Entmarkungsherde nur die Spitze des Eisbergs sind: Bereits fruehzeitig verursacht die MS

  19. Ductal adenocarcinoma and unusual differential diagnosis; Duktales Adenokarzinom und ungewoehnliche Differenzialdiagnosen

    Energy Technology Data Exchange (ETDEWEB)

    Haage, P.; Schwartz, C.A.; Scharwaechter, C. [Universitaet Witten/Herdecke, Zentrum fuer Radiologie HELIOS Universitaetsklinikum Wuppertal, Wuppertal (Germany)

    2016-04-15

    Ductal pancreatic adenocarcinoma is by far the most common solid tumor of the pancreas. It has a very poor prognosis, especially in the more advanced stages which are no longer locally confined. Due to mostly unspecific symptoms, imaging is key in the diagnostic process. Because of the widespread use of imaging techniques, incidental findings are to a greater extent discovered in the pancreas, which subsequently entail further work-up. Ductal pancreatic adenocarcinoma can be mimicked by a large number of different lesions, such as anatomical variants, peripancreatic structures and tumors, rarer primary solid pancreatic tumors, cystic tumors, metastases or different variants of pancreatitis. Additionally, a number of precursor lesions can be differentiated. The correct classification is thus important as an early diagnosis of ductal pancreatic adenocarcinoma is relevant for the prognosis and because the possibly avoidable treatment is very invasive. All major imaging techniques are principally suitable for pancreatic imaging. In addition to sonography of the abdomen, usually the baseline diagnostic tool, computed tomography (CT) with its superior spatial resolution, magnetic resonance imaging (MRI) with its good soft tissue differentiation capabilities, possibly in combination with MR cholangiopancreatography (MRCP), endosonography with its extraordinary spatial resolution, conceivably with additional endoscopic retrograde CP or the option of direct biopsy and finally positron emission tomography CT (PET-CT) as a molecular imaging tool are all particularly useful modalities. The various techniques all have its advantages and disadvantages; depending on the individual situation they may need to be combined. (orig.) [German] Das duktale Adenokarzinom ist der weitaus haeufigste solide Tumor des Pankreas. Die Prognose ist sehr schlecht, insbesondere bei fortgeschrittenen, nicht mehr lokal begrenzten Tumoren. Bei meist unspezifischen geringen Beschwerden kommt der

  20. Combined detection of serum tumor markers for differential diagnosis of solid lesions located at the pancreatic head

    Institute of Scientific and Technical Information of China (English)

    Quan Liao; Yu-Pei Zhao; Ying-Chi Yang; Li-Jun Li; Xiao Long; Shao-Mei Han

    2007-01-01

    BACKGROUND:The differential diagnosis of solid lesions located at the pancreatic head is very important for choosing therapies and setting up surgical tactics. This study was designed to evaluate the clinical signiifcance of combined measurement of multiple serum tumor markers and the application of the receiver-operating characteristic (ROC) curves in the differential diagnosis of solid lesions located at the pancreatic head. METHODS:The serum levels of CA19-9, CA242, CA50 and carcinoembryonic antigen (CEA) in 112 patients with carcinoma of the pancreatic head and 38 patients with focal chronic pancreatitis in the pancreatic head were measured with ELISA. The sensitivity, speciifcity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of the four serum tumor markers were calculated. The ROC curves for the four serum tumor markers were constructed and the area under the curve (AUC) was calculated. RESULTS:The AUCs of CA19-9, CA242, CA50 and CEA were 0.805, 0.749, 0.738 and 0.705; the PLRs were 1.91, 3.43, 5.09 and 5.46; and the NLRs were 0.41, 0.56, 0.59 and 0.71, respectively. Combined measurements increased the diagnostic speciifcity, and parallel combined testing increased the diagnostic sensitivity. CONCLUSIONS:Combined measurement of serum tumor markers CA19-9, CA242, CA50 and CEA is valuable in differential diagnosis of solid lesions located at the pancreatic head, and CA19-9 has the best diagnostic ability. Combined measurements can increase the speciifcity of diagnosis. Evaluation with the ROC curve is better than the sensitivity or speciifcity alone and the results are more integrated and objective.

  1. Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Perani, Daniela [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, Nuclear Medicine Unit, Milan (Italy); Cerami, Chiara [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, Clinical Neuroscience Department, Milan (Italy); Caminiti, Silvia Paola [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); Santangelo, Roberto; Coppi, Elisabetta; Ferrari, Laura; Magnani, Giuseppe [San Raffaele Hospital, Department of Neurology, Milan (Italy); Pinto, Patrizia [Papa Giovanni XXIII Hospital, Department of Neurology, Bergamo (Italy); Passerini, Gabriella [Servizio di Medicina di Laboratorio OSR, Milan (Italy); Falini, Andrea [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, CERMAC - Department of Neuroradiology, Milan (Italy); Iannaccone, Sandro [San Raffaele Hospital, Clinical Neuroscience Department, Milan (Italy); Cappa, Stefano Francesco [San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); IUSS Pavia, Pavia (Italy); Comi, Giancarlo [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Hospital, Department of Neurology, Milan (Italy); Gianolli, Luigi [San Raffaele Hospital, Nuclear Medicine Unit, Milan (Italy)

    2016-03-15

    The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). We evaluated the supportive role of CSF Aβ{sub 42}, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ{sub 42} ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ{sub 42} ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role. (orig.)

  2. Unlocking Boys' Potential

    Science.gov (United States)

    Reichert, Michael C.

    2016-01-01

    Long stereotyped as not being interested in building relationships with teachers, boys actually search for--and are in need of--teachers who make meaningful connections with them, writes Reichert in this article. The author examines how school practices of the past and present have contributed to the so-called gender achievement gap and stresses…

  3. [The differential diagnosis of hysteria in the ravines of contemporary psychiatry].

    Science.gov (United States)

    Lipovetzky, Gustavo; Agrest, Martín

    2010-01-01

    The diagnosis of "hysteria" has recently become part of the history of Psychiatry. Although fully trained dynamic psychiatrists, followers of psychoanalytic theories, still make use of some clinical and theoretical production upon hysteria, for many of the young psychiatrists this term has disappeared from their scope. They only know of dissociative disorders, somatoform disorders and histrionic personality disorders, or they rather distinguish other diagnosis with which hysteria could be mistaken for. Despite the diagnosis of hysteria has been removed from the DSM, the difficulties these patients frequently imposed to physicians still prevail.

  4. Assessing significance of peripheral blood indicators for differential diagnosis and prognosis of thrombotic complications in polycythemia vera and secondary erythrocytosis

    Directory of Open Access Journals (Sweden)

    Kostiukevych O.M.

    2014-03-01

    Full Text Available The aim of the study – determining of changes in peripheral blood (PB in patients with secondary erythrocytosis (SE and polycythemia vera (PV, detection of discriminatory parameters levels of PB indicators and analyzing of their operating characteristics for differentiation of erythrocytosis and predicting of thrombotic events in patients with PV. Materials and methods. The material for the study was the results of clinical trials of 210 patients with erythrocytosis who underwent differential diagnosis between PV and SE. Results and discussion. The optimal threshold for differential diagnosis of red blood cells content between PV and SE is >6.08•1012/ L, the diagnostic value of the marker equals to the level of a good diagnostic marker (AUC=0.82; 95% CI=0.77-0.87, p 57.5% with its capacity – 0.72 (0.66-0.78, p 8.9•109/L, and the boundary of marker is consistent with a good level of efficiency (AUC=0.79, 95% CI=0.72-0.84, p287•109 /L" to differentiate erythrocytosis is 0.90 (0.86-0.94, p 55%" and "WBC >12.3•109 /L", according to the AUC (AUC=0.65; 95% CI=0.52-0.79, p=0.021 and AUC=0.66; 95% CI=0.55-0.77, p=0.003, respectively, corresponds to the average power level. Conclusion. Hemoglobin has not confirmed its value for the differential diagnosis between PV and SE. Using other parameters of PB with the aim of differentiating PV and SE is rational, but their discriminatory power levels greatly depend on the group erythrocytosis. In our cohort were obtained the following most appropriate criteria for inclusion of patients in the group of patients with PV: "WBC >8.9•109/L", "red blood cells >6.08•1012/L" and "hematocrit >57.5%". The most significant marker of general clinical blood test to differentiate between PV and SE is "platelets >287•109/L". Hematocrit over 55% and WBC over 12.3•109/L are valuable prognostic markers of thrombosis in PV patients, but their use is appropriate only in a cohort of patients with PV without

  5. The differential diagnosis of multiple sclerosis: classification and clinical features of relapsing and progressive neurological syndromes.

    Science.gov (United States)

    Trojano, M; Paolicelli, D

    2001-11-01

    In the absence of pathognomonic clinical features or a definitive laboratory test, multiple sclerosis (MS) remains ultimately a diagnosis of exclusion. Accurate diagnosis is increasingly important with available disease modifying therapy. Unfortunately the rate of misdiagnosis remains around 5%-10%, indicating that 1 in 20 patients thought to have MS has, instead, a condition resembling MS. In this review we describe conditions that may be confused with MS because they can present as lesions disseminated in time, space, or both. Conditions often confused with MS may be inflammatory (systemic lupus erythematosus, Sjögren's syndrome, vasculitis, sarcoidosis, Behçet's disease), infectious (Lyme disease, syphilis, progressive multifocal leukoencephalopathy, HTLV-1 infection, herpes zoster), genetic (lysosomal disorders, adrenoleukodystrophy, mitochondrial disorders, CADASIL), metabolic (vitamin B12 deficiency), neoplastic (CNS lymphoma) and spinal (degenerative and vascular malformations) diseases. The key to the accurate diagnosis of MS is vigilance for atypical features, suggesting the possibility of an alternative diagnosis.

  6. Differential diagnosis in pediatric radiology. Vol. 1. Skull, spine, skeleton; Differentialdiagnostik in der paediatrischen Radiologie. Bd. 1. Schaedel, Wirbelsaeule, Skelett

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    Ebel, K.D. [ed.; Willich, E. [ed.; Richter, E. [ed.; Benz-Bohm, G.; Bliesener-Harzheim, J.A.; Ebel, K.D.; Oestreich, A.E.; Reinwein, H.; Schaper, J.; Schumacher, R.; Stoever, B.

    1995-06-01

    The book presents in-depth material covering the full scope of tasks and problems of differential diagnostic radiology in children. The particular approach chosen by the authors provides information that will solve even the most difficult cases, guiding the reader on his way from radiographic findings to appropriate diagnosis. All radiographic findings have been characterized and classified and put into a tabulated system relating them to the relevant differential diagnosis. The system of reference adopted specifies a given lesion or disease by reference to the most significant diagnostic keywords obtained from anamnesis, clinical data, and further diagnostic evaluation. The tentative diagnosis is taken as the basis for further specification illustrated by the characteristic X-ray pictures and full-text descriptions. Almost all diagnoses are accompanied by a comprehensive image documentation obtained by all currently available imaging methods. (MG) [Deutsch] Das vorliegende Buch gibt einen kompletten Ueberblick ueeber die gesamte Bandbreite der Differentialdiagnostik in der Paediatrischen Radiologie und soll so auch in schwierigen Faeellen den Weg vom Roentgensymptom zur Diagnose ermoeglichen. Alle relevanten Roentgensymptome werden systematisch charakterisiert und die entsprechenden Differentialdiagnosen tabellarisch zusammengestellt. Jede Erkrankung wird durch Verweise auf die wichtigsten differentialdiagnostischen Stichworte aus Anamnese, Klinik und weiterfuehrende Diagnostik naeher eingegrenzt. Ausgehend von der Verdachtsdiagnose werden wegweisende Roentgenbefunde in Wort und Bild dargestellt. Fast alle erwaehnten Befunde werden durch Abbildungen unter Beruecksichtigung aller moderner bildgebenden Verfahren dokumentiert. (MG)

  7. The Diagnostic and Differential Diagnosis Utility of Cerebrospinal Fluid α -Synuclein Levels in Parkinson's Disease: A Meta-Analysis.

    Science.gov (United States)

    Zhou, Bo; Wen, Min; Yu, Wen-Feng; Zhang, Chun-Lin; Jiao, Ling

    2015-01-01

    Several recent studies showed that α-syn might be a potential diagnostic biomarker for PD in human cerebrospinal fluid (CSF), but the results were inconsistent. The purpose of this meta-analysis was to investigate the diagnostic and differential diagnosis efficacy of CSF α-syn in PD. Studies which measured CSF α-syn or α-syn oligomers in patients with PD and met the inclusion criteria were included in the analysis. Results of the meta-analysis indicated that mean concentration of CSF α-syn was significantly lower in PD compared to controls and significantly higher in PD compared to multiple system atrophy (MSA). No significant difference in mean concentration of CSF α-syn was found between PD and dementia with Lewy bodies (DLB). Mean concentration of CSF α-syn was slightly decreased in PD compared to progressive supranuclear palsy (PSP). Mean concentration of CSF α-syn oligomers was significantly higher in PD than control. These results support the findings that CSF α-syn may be a potential diagnostic and differential diagnosis biomarker in PD compared to control and MSA but not DLB. Furthermore, α-syn oligomer may represent a better biomarker for diagnosis of PD.

  8. 子宫腺瘤样瘤的超声诊断及鉴别诊断%Ultrasonic Diagnosis and Differential Diagnosis of Adenomatoid Tumor of Uterus

    Institute of Scientific and Technical Information of China (English)

    王薇薇

    2015-01-01

    目的:探分析子宫腺瘤样瘤的超声影像特点,探讨超声在子宫腺瘤样瘤诊断及鉴别诊断中的价值。方法选择我院在2011年6月份~2014年10月份收治85例子宫腺瘤样瘤患者作为研究对象,回顾性分析全部患者超声影像学资料,总结分析子宫腺瘤样瘤的超声图像特点。结果子宫腺瘤样瘤回声性质绝大多数为实性,其中主要为低回声,病灶位置多为肌壁间(76.2%),肿瘤直径多为1~3 cm(55/84),彩色多普勒显示病灶及内部少许或无血流信号。共有80例患者存在合并症,其中55例患者合并子宫平滑肌瘤。结论超声检查作为临床常用的辅助检查手段,对子宫腺瘤样瘤的诊断及鉴别诊断具有重要意义。%Objective To analyze the characteristics of ultrasonography of uterine adenomatoid tumor, and to explore diagnosis and differential diagnosis value of ultrasound in uterine adenomatoid tumor. Methods From 2011 June to 2014 October, 85 cases with uterine adenomatoid tumor were treated in People's Hospital of Kangping County as research object, ultrasound imaging data of all patients were analyzed retrospectively, summarized the characteristics of ultrasound image of uterine adenomatoid tumor. Results The uterine adenomatoid tumor echo property for the vast majority of solid, which mainly are low echo, most of the lesions located in the muscular wall (76.2%), tumor diameter is 1~3cm (55/84), color Doppler showed the lesions and internal little or no blood flow signal. A total of 80 patients had complications, including 55 cases with uterine leiomyoma. Conclusion Ultrasound as an auxiliary examination often used in clinic, has important signiifcance in diagnosis and differential diagnosis of uterine adenomatoid tumor.

  9. Myeloid cell nuclear differentiation antigen is expressed in a subset of marginal zone lymphomas and is useful in the differential diagnosis with follicular lymphoma.

    Science.gov (United States)

    Metcalf, Ryan A; Monabati, Ahmad; Vyas, Monika; Roncador, Giovanna; Gualco, Gabriela; Bacchi, Carlos E; Younes, Sheren F; Natkunam, Yasodha; Freud, Aharon G

    2014-08-01

    The diagnosis of marginal zone lymphomas (MZL) is challenged by the lack of specific markers that distinguish them from other low-grade non-Hodgkin B-cell lymphomas. Myeloid cell nuclear differentiation antigen (MNDA) is a nuclear protein that labels myelomonocytic cells as well as B lymphocytes that localize to the marginal zone areas of splenic white pulp. We evaluated MNDA expression in a large series of B-cell lymphomas to assess the sensitivity and specificity of this antigen for the characterization of MZL. A total of 440 tissue sections containing extramedullary B-cell lymphomas and 216 bone marrow biopsies containing atypical or neoplastic lymphoid infiltrates were stained for MNDA by immunohistochemistry. Among the extramedullary lymphoma cases, approximately 67% of nodal MZL, 61% of extranodal MZL, and 24% of splenic MZL expressed MNDA. MNDA was also infrequently expressed in other B-cell neoplasms including mantle cell lymphoma (6%), chronic lymphocytic leukemia/small lymphocytic lymphoma (13%), follicular lymphoma (FL) (4%), lymphoplasmacytic lymphoma (25%), and diffuse large B-cell lymphoma (3%). In contrast, MNDA was only expressed in 2.3% of all bone marrow biopsies involved by lymphoid infiltrates, including 2 cases of FL and one case of MZL. Collectively, these data support the inclusion of MNDA in the diagnostic evaluation of extramedullary B-cell lymphomas, particularly those in which the differential diagnosis is between low-grade FL and MZL.

  10. Early differential diagnosis between Alzheimer's disease and dementia with Lewy bodies: Comparison between (18)F-FDG PET and (123)I-IMP SPECT.

    Science.gov (United States)

    Chiba, Yuhei; Iseki, Eizo; Fujishiro, Hiroshige; Ota, Kazumi; Kasanuki, Koji; Suzuki, Masaru; Hirayasu, Yoshio; Arai, Heii; Sato, Kiyoshi

    2016-03-30

    Both (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and (123)I-iodoamphetamine (IMP) single-photon emission computed tomography (SPECT) have been used for the differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). Less information is available, however, regarding the differential diagnosis of mild cognitive impairment (MCI) due to AD and MCI due to DLB. We examined nine AD patients (AD group), nine DLB patients (DLB group), eight MCI due to AD patients (MCI-AD group), and nine MCI due to DLB patients (MCI-DLB group) with FDG PET and IMP SPECT using a well-characterized normal database and a stereotactic extraction estimation method. In the AD and DLB groups, receiver operating characteristic (ROC) analysis in the occipital regions showed significant accuracy of both FDG PET and IMP SPECT for the differential diagnosis. In the MCI-AD and MCI-DLB groups, ROC analysis showed significant accuracy of only FDG PET for the differential diagnosis. Both FDG PET and IMP SPECT would be useful for the differential diagnosis between AD and DLB. For the differential diagnosis of MCI-AD versus MCI-DLB, FDG PET would be more useful than IMP SPECT.

  11. 脑转移瘤的CT诊断与鉴别诊断%CT Diagnosis and Differential Diagnosis of Cerebral Metastasis Tumor

    Institute of Scientific and Technical Information of China (English)

    林昌能; 陈杜芳

    2013-01-01

    Objective To investigate the diagnostic value of CT on brain metastasis,and improve CT diagnosis and differential diagnosis of brain metastases.Methods Retrospective analysis of 28 cases confirmed by pathology or clinical manifestations of brain metastatic tumor CT.Results 28 cases with 102 lesions were detected;multiple in 19 cases,accounting for 68%;9 cases with single,accounted for 32%;CT plain scan was 20 cases,low,low density accounted for 71%,high density or mixed high and low density lesions in 8 cases,accounting for 29%;all cases underwent enhanced scan after scanning,density is moderate or significant changes,a ring or nodular;18 cases were peripheral edema,6 cases had mild edema;19 cases of primary tumor in lung,4 cases of primary breast cancer,2 cases of nasopharyngeal carcinoma,4 cases of gastric carcinoma. Conclusion The data show that,CT diagnosis of tumor and differential diagnosis of cerebral metastasis;extracranial tumors to find help for differential diagnosis of brain tumors,especially CT examination of the lungs is very necessary.%  目的:探讨CT对脑转移瘤的诊断价值,提高脑内转移瘤的CT诊断与鉴别诊断的认识。方法:回顾性分析28例经病理或临床确诊的脑转移瘤CT表现。结果:28例中共检出102个病灶;多发19例,占68%;单发9例,占32%;CT平扫呈等、低或等低混杂密度20例,占71%,高密度或高低混杂密度灶8例,占29%;全部病例平扫后均行增强扫描,等密度部分均有中度或明显变化,呈环状或结节样;18例有明显灶周水肿,6例有轻度水肿;19例原发灶在肺,4例原发灶为乳腺癌,2例为鼻咽癌,4例为胃癌。结论:资料表明, CT对脑内转移瘤的诊断与鉴别诊断有可靠的准确性;颅外肿瘤的查找有助于脑内肿瘤的鉴别诊断,特别是肺部的CT检查非常必要。

  12. MRI Diagnosis and Differential Diagnosis of Rare Tumors in Pineal Region%松果体区少见肿瘤MRI诊断与鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    李松涛; 汪文胜; 黄泽春

    2014-01-01

    目的探讨松果体区少见肿瘤的MRI诊断与鉴别诊断情况。方法回顾性分析我院于2007年1月至2013年7月收治的15名松果体区肿瘤患者的临床资料,总结这些患者的临床表现和MRI检查结果。结果诊断结果显示,这些患者患有松果体实质瘤、松果体细胞瘤、成熟与未成熟的畸胎瘤、胚胎发育不良性神经上皮瘤、胶质母细胞瘤、节细胞胶质瘤、神经母细胞瘤、精原细胞瘤、松果体母细胞瘤、胆脂瘤和胚胎癌等松果体区肿瘤。结论单一靠MRI检查无法明确诊断松果体区少见肿瘤, DWI及MRS等功能磁共振检查可以帮助诊断,确诊依旧需要依靠病理检查结果。%Objective To discuss the MRI diagnosis and differential diagnosis of rare tumors in pineal region. Methods Clinical data of 15 patients with pineal region tumor were retrospectively analyzed in our hospital from 2007 January to 2013 July, and their clin-ical manifestations and MRI findings were summarized. Results The diagnosis results showed that the tumors included pineal paren-chymal tumor, pineocytoma, mature or immature teratoma, dysembryoplastic neuroepithelial tumor, glioblastoma, ganglioglioma, neu-roblastoma, seminoma, pinealoblastoma, cholesteatoma and embryonal carcinoma. Conclusion Rare tumor in pineal region could not be definitely diagnosed only by MRI check;DWI and MRS functional magnetic resonance imaging examination could also contribute to its diagnosis. However, the diagnosis still depends on the pathological examination results.

  13. Differential diagnosis of tumors of the mandible and maxilla: radiological aspects; Diagnostico diferencial dos tumores da manbibula e maxila

    Energy Technology Data Exchange (ETDEWEB)

    Isberner, Rony Klaus; Nagazava, Marcio M.; Chiang, Jeng Tyng; Goncalves, Marcelo [Hospital do Cancer de Sao Paulo, SP (Brazil). Dept. de Imagem; Dib, Luciano L. [Hospital do cancer de Sao Paulo, SP (Brazil). Dept. de Estomatologia

    1999-06-01

    The radiolucent lesions of the maxilla and jaw can present similar features, such as location, proximity or dental inclusion, insufflative character and density. They are so alike that those signs frequently are not enough for the diagnosis. Among those lesions, we present follicular cysts, ameloblastomas, odontogenic keratocysts, central giant cell lesion, neurofibroma, mucoepydermoid carcinoma and hemangioma, examined with panoramic X-rays, computed tomography and in a specific case, a SPECT for the jaw, with red blood cells-{sup 99m} Tc. The objective of this work is to demonstrate in a illustrative way, the radiographic features of some of the radiolucent lesions of the maxilla and jaw, whose differential diagnosis becomes sometimes very difficult, but can be achieved through signs that are more compatible with certain lesions. (author)

  14. Differential diagnosis of acute miliary pulmonary tuberculosis from widespread-metastatic cancer for postoperative lung cancer patients: two cases

    Science.gov (United States)

    Zhao, Wei; Tian, Yuke; Peng, Feng; Long, Jianlin; Liu, Lan; Lu, You

    2017-01-01

    Pulmonary infections and lung cancer can resemble each other on radiographic images, which makes it difficult to diagnosis accurately and apply an appropriate therapy. Here we report two cases that two postoperative patients with lung adenocarcinoma developed diffuse nodules in bilateral lungs in a month which needed to be distinguished between metastatic malignancies and infectious diseases. Although there are much similarities in disease characteristics of two cases, patient in case one was diagnosed as acute miliary pulmonary tuberculosis (TB) while patient in case two was diagnosed as metastatic disease. The symptoms and pulmonary foci on CT scan of patient in case one improved distinctly after the immediate anti-TB treatment, but the disease of patient in case two progressed after chemotherapy. These findings caution us that differential diagnosis is crucial and have significance in guiding clinical work.

  15. Acute inflammatory bowel disease of the small intestine in adult: MDCT findings and criteria for differential diagnosis

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    Romano, Stefania [Department of Diagnostic Imaging, A.Cardarelli Hospital, Naples (Italy)], E-mail: stefromano@libero.it; Russo, Anna [Institute of Radiology, Second University of Naples, Naples (Italy); Daniele, Stefania; Tortora, Giovanni [Department of Diagnostic Imaging, A.Cardarelli Hospital, Naples (Italy); Maisto, Francesco [Institute of Radiology, Second University of Naples, Naples (Italy); Romano, Luigia

    2009-03-15

    Inflammatory changes of the intestine leading to acute abdomen could represent a frequent diagnostic challenge for radiologists actively involved in the emergency area. MDCT imaging findings needs to be evaluated considering the clinical history and symptoms and other abdominal findings that could be of help in differential diagnosis. Several protocols have been suggested and indicated in the imaging of patient with acute intestine. However, a CT protocol in which the precontrast scanning of the abdomen is followed by i.v. administration of contrast medium using the 45-55 s delay could be effective for an optimal visualization of the bowel wall. It is important to learn to recognize how the intestine reacts to the injury and how it 'talks', in order to become aware of the different patterns of disease manifestation related to an acute intestinal condition, for an effective diagnosis of active and acute inflammatory bowel disease.

  16. CONTRIBUTION OF THE AUDIOLOGICAL AND VESTIBULAR ASSESSMENT TO THE DIFFERENTIAL AND ETIOLOGICAL DIAGNOSIS OF PERIPHERIC VESTIBULAR SYNDROMES

    Directory of Open Access Journals (Sweden)

    Loreta Ungureanu

    2012-09-01

    Full Text Available Scope of the study: Vestibular pathology is a complex one, requiring a minute clinical evaluation, as well as numerous paraclinical investigations. The present study analyzes the contribution of the modern methods of vestibular and auditive investigation to the diagnosis of dizziness. Materials and method: The results of the investigations performed on 84 patients with peripheric vestibular syndrome, on whom a complete audiological and vestibular assessment had been also made, have been retrospectively analyzed. Results: Anamnestic data and the results of evaluation permitted classification of peripheric vestibular pathology according to topo-lesional and etiological criteria. The most frequently diagnosed diseases were: benign paroxysmal positional vertigo, Ménière syndrome and vestibular neuronitis. Conclusions: Testing of the vestibulo-ocular and vestibulo-spinal reflexes through videonystagmoscopy and, respectively, computerized dynamic posturography, besides tonal vocal audiometry and precocious auditive potentials, is especially important for a positive diagnosis and etiological differentiation of vestibular syndromes.

  17. Boys' Bodies in Early Childhood

    Science.gov (United States)

    Drummond, Murray

    2012-01-01

    This paper is based on qualitative research data from a project investigating early childhood boys' constructions of masculinities in relation to sport, health and the body. The focus group data, with 33 boys, has been collected in each of the boys' first three years at school. It is part of the data that will be collected over eight years with…

  18. The diagnosis and differential diagnosis of granulocytic sarcoma%探讨粒细胞肉瘤的诊断与鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    Xiaoli Feng; Jianming Ying; C. Cameron Yin; Ling Li; Susheng Shi; Hongtu Zhang; Yuntian Sun

    2008-01-01

    Objective: To discuss the diagnosis and differential diagnosis of granulocytic sarcoma (GS). Methods: Six cases were reported in this paper. They were assessed by pathologists. Immunohistochemistry (IHC) stain and routine hematoxylin and eosin (H&E) stain were applied. Results:All patients involved in different anatomic sites respectively including skin, lymph node, soft tissue, breast, cervix and penis. All cases were previously error diagnoses. Three of them were initially diagnosed as non-Hodgkin lymphoma (NHL). One case of cervical lymph node lesion was first considered as metastasized carcinoma by clinician. One biopsied skin sample was initially reported as Karposi's sarcoma. And one breast case was suspicious of the Iobular carcinoma with the frozen samples without antecedent clinical history information. GS was accompanied with acute myeloid leukemia (AML) in one case and with acute lymphocytic leukemia (ALL) in one case. Histopathologically, blastic, immature and differentiated variants were found in four, one and one, respectively. Immunohistochemistry (IHC) showed that myeloperoxidase (MPO) and lysozyme were both found to be positive in all cases, CD43 was found in 5 of 6 cases. Three of six cases were CD68, CD15 and LCA positive. CD34 and CD117 were positive in 1/5 and 1/6 cases, respectively. However, CD20 and CD3 were negative in all cases. Conclusion: GS was uncommon and it may be misdiagnosed easily in routine practice. Each area had its own character, but they had the common features too. It can be correctly diagnosed by combination of H&E stain, IHC stain, peripheral blood and bone marrow. MPO and Lysozyme were necessary for the nature of granulocytes. In addition, CD43, CD68 and CD15 were very helpful.

  19. A modified method for locating parapharyngeal space neoplasms on magnetic resonance images:implications for differential diagnosis

    Institute of Scientific and Technical Information of China (English)

    Xue-Wen Liu; Ling Wang; Hui Li; Rong Zhang; Zhi-Jun Geng; De-Ling Wang; Chuan-Miao Xie

    2014-01-01

    The parapharyngeal space (PPS) is an inverted pyramid-shaped deep space in the head and neck region, and a variety of tumors, such as salivary gland tumors, neurogenic tumors, nasopharyngeal carcinomas with parapharyngeal invasion, and lymphomas, can be found in this space. The differential diagnosis of PPS tumors remains challenging for radiologists. This study aimed to develop and test a modified method for locating PPS tumors on magnetic resonance (MR) images to improve preoperative differential diagnosis. The new protocol divided the PPS into three compartments: a prestyloid compartment, the carotid sheath, and the areas outside the carotid sheath. PPS tumors were located in these compartments according to the displacements of the tensor veli palatini muscle and the styloid process, with or without blood vessel separations and medial pterygoid invasion. This protocol, as wel as a more conventional protocol that is based on displacements of the internal carotid artery (ICA), was used to assess MR images captured from a series of 58 PPS tumors. The consequent distributions of PPS tumor locations determined by both methods were compared. Of al 58 tumors, our new method determined that 57 could be assigned to precise PPS compartments. Nearly all (13/14; 93%) tumors that were located in the pre-styloid compartment were salivary gland tumors. All 15 tumors within the carotid sheath were neurogenic tumors. The vast majority (18/20; 90%) of trans-spatial lesions were malignancies. However, according to the ICA-based method, 28 tumors were located in the pre-styloid compartment, and 24 were located in the post-styloid compartment, leaving 6 tumors that were difficult to locate. Lesions located in both the pre-styloid and the post-styloid compartments comprised various types of tumors. Compared with the conventional ICA-based method, our new method can help radiologists to narrow the differential diagnosis of PPS tumors to specific compartments.

  20. MRI diagnosis and differential diagnosis of pineal region tumors%松果体区肿瘤MRI诊断与鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    刘海洋; 任英红; 张劲松

    2012-01-01

    目的 分析松果体区肿瘤的MRI表现,提高临床诊断及鉴别诊断水平.方法 回顾性分析经手术及病理证实的松果体区肿瘤21例,均行MRI平扫及增强扫描.结果 本组病例包括囊肿1例,生殖细胞瘤5例,松果体细胞瘤3例,星形细胞瘤(包括多形性和间变性)3例,松果体母细胞瘤2例,原始神经外胚层肿瘤(PNET)1例,畸胎瘤2例,脑膜瘤1例,孤立性纤维瘤1例,转移瘤2例.结论 松果体区肿瘤具有一定特征性的MRI表现,结合患者临床和发病年龄、性别、部位等特点,可进一步提高其诊断准确率.%Objective To improve the diagnosis and differential diagnosis rate of pineal region tumor by analyzing the MRI findings. Methods 21 cases of pineal region neoplasms confirmed by operation and pathology were retrospectively analyzed. All the cases were performed plain and enhanced MR scan. Results Our series consisted of 1 pineal cyst ,5 pineal germinomas, 3 pinealocyto-mas, 3 astrocytomas (including pleomorphic and anaplastic) , 2 pineoblastomas, 1 primitive neuroectodermal tumor (PNET) ,2 ter-atomas, 1 meningioma, 1 solitary fibroma and 2 metastatic tumors. Conclusion Depending on their characteristics MRI findings and combining clinical features, the accuracy of diagnosis of pineal region neoplasms can be further improved.

  1. Histopathology and TB-PCR kit analysis in differentiating the diagnosis of intestinal tuberculosis and Crohn’s disease

    Institute of Scientific and Technical Information of China (English)

    Joon; Mee; Kim; Hyung; Kil; Kim; Lucia; Kim; Suk; Jin; Choi

    2010-01-01

    AIM: To compare the histopathologic features of intestinal tuberculosis (ITB) and Crohn’s disease (CD) and to identify whether polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR) would be helpful for differential diagnosis between ITB and CD.METHODS: We selected 97 patients with established diagnoses (55 cases of ITB and 42 cases of CD) who underwent colonoscopic biopsies.Microscopic features of ITB and CD were reviewed,and eight pathologic parameters were evaluated.Nine cases of acid fast bac...

  2. Torsion of an Abdominal-Wall Pedunculated Lipoma: A Rare Differential Diagnosis for Right Iliac Fossa Pain

    Directory of Open Access Journals (Sweden)

    Daniel Lee John Bunker

    2013-01-01

    Full Text Available Pedunculated lipomas arising from the peritoneal wall are a rare finding during abdominal surgery. These benign tumours of mesenchymal origin can arise anywhere in the body and are usually asymptomatic. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. To our knowledge, such a case has never been reported in the literature previously. We suggest that torsion of a pedunculated parietal lipoma is a rare differential of acute abdominal pain.

  3. Torsion of an abdominal-wall pedunculated lipoma: a rare differential diagnosis for right iliac fossa pain.

    Science.gov (United States)

    Bunker, Daniel Lee John; Ilie, Victor George; Halder, Tushar K

    2013-01-01

    Pedunculated lipomas arising from the peritoneal wall are a rare finding during abdominal surgery. These benign tumours of mesenchymal origin can arise anywhere in the body and are usually asymptomatic. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. To our knowledge, such a case has never been reported in the literature previously. We suggest that torsion of a pedunculated parietal lipoma is a rare differential of acute abdominal pain.

  4. The role of coloscopy in the differential diagnosis between idiopathic ulcerative colitis and Crohn's disease of the colon.

    Science.gov (United States)

    Banche, M; Rossini, F P; Ferrari, A; Roatta, L; Gilli, E; Cirillo, R

    1976-06-01

    The authors point out the striking significance of coloscopy in establishing a correct diagnosis of inflammatory diseases of the colon. In particular, the most valuable endoscopic features are indicated which may permit distinguishing between idiopathic ulcerative colitis and Crohn's disease of the colon. Differentiation between these two diseases cannot always be achieved by means of available diagnostic procedures other than coloscopy. Moreover, the endoscopic findings enable an assessment to be made of the extent, stage, severity and course of either disease. The authors' experience encompass 2,478 coloscopy examinations: the observed cases of idiopathic ulcerative colitis are 182, those of Crohn's disease of the colon are 104.

  5. Acute disseminated encephalomyelitis in children: differential diagnosis from multiple sclerosis on the basis of clinical course

    Directory of Open Access Journals (Sweden)

    Yun Jin Lee

    2011-06-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM is a demyelinating disease of the central nervous system (CNS that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS. Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

  6. The Bender-Gestalt Test in Differential Diagnosis of Adolescents with Learning Difficulties

    Science.gov (United States)

    Mordock, John B.; and others

    1968-01-01

    Attempt to assess efficiency of Haine and Koppitz scoring systems with Bender-Gestalt in ability to differentiate between brain-damaged and other young people in a residential treatment center did not prove useful. (Author/CJ)

  7. Eagle’s syndrome—A non-perceived differential diagnosis of temporomandibular disorder

    Directory of Open Access Journals (Sweden)

    P. Thoenissen

    2015-01-01

    Conclusion: Making use of low cost and easily accessible diagnostic workup techniques can reveal this particular cause for chronic pain restricting quality of life. Thereby differentiation from the TMD symptomatic complex is possible.

  8. Social cognition in the differential diagnosis of autism spectrum disorders and personality disorders

    NARCIS (Netherlands)

    Duijkers, J.C.L.M.; Vissers, C.Th.W.M.; Verbeeck, W.; Arntz, A.; Egger, J.I.M.

    2014-01-01

    Average intelligent patients with autism spectrum disorders (ASD) and patients with personality disorders (PD) are expected to show different problems in social cognition. Consequently, measuring social cognition may contribute to a better understanding and differentiation of ASD and PD. Therefore,

  9. 壶腹周围癌早期诊断和鉴别诊断%Eady and differential diagnosis of periampullary cancer

    Institute of Scientific and Technical Information of China (English)

    赵玉沛

    2008-01-01

    Periampullary cancer is a kind of malignant cancer of digestive tract.It arises within 2 cm of the major duodenal papilla and eomprises cancers of the ampulla,distal comliiOll bile duct,pancreas and duodenum.Their clinical features and anatomic locations are similar,as are the therapeutic approaches.However,their long-term outcomes vary.Due to the bad prognosis,it is very important to make an early,accurate diagnosis and differential diagnosis of periampullary cancer.This article summarizes some basic methods and new developments of early and differential diagnosis of poriampullary cancer.

  10. Utility of the "magnet sign" in the differential diagnosis of a firm papule in the skin.

    Science.gov (United States)

    Krakowski, Andrew C; Bennett, Lauren; Kaifi, Samar

    2014-01-01

    A symptomatic retained foreign body can be frustrating to physicians and patients alike. Herein we present a case of a retained metal ball bearing from an air gun injury. This brief communication highlights an innovative "bedside" technique that helped to confirm the diagnosis and allow for immediate and definitive management.

  11. Pompe disease is a differential diagnosis in case of reduced physical capacity and abnormal muscular fatigue

    DEFF Research Database (Denmark)

    Hansen, Julie Schjødtz; Ellingsen, Anne R; Andreasen, Caroline M;

    2014-01-01

    biopsy. Enzyme replacement therapy is now a treatment option, and a prompt diagnosis is therefore relevant. This disease should be considered in patients with unexplained fatigue and reduced physical capacity, especially in case of concurrent elevated levels of creatine kinase and liver enzymes....

  12. [The death of Fernando Pessoa. The differential diagnosis of liver colic].

    Science.gov (United States)

    Cruz, I

    1997-01-01

    A clinical review of the most probable cause of death of the poet Fernando Pessoa is made. The many times cited final diagnosis of "hepatic colic" and the limited clinical information available are considered. The spectrum of chronic alcoholism and its risks are questioned by recent advances on pathology knowledge.

  13. Differential diagnosis of lung carcinoma with three-dimensional quantitative molecular vibrational imaging

    Science.gov (United States)

    Gao, Liang; Hammoudi, Ahmad A.; Li, Fuhai; Thrall, Michael J.; Cagle, Philip T.; Chen, Yuanxin; Yang, Jian; Xia, Xiaofeng; Fan, Yubo; Massoud, Yehia; Wang, Zhiyong; Wong, Stephen T. C.

    2012-06-01

    The advent of molecularly targeted therapies requires effective identification of the various cell types of non-small cell lung carcinomas (NSCLC). Currently, cell type diagnosis is performed using small biopsies or cytology specimens that are often insufficient for molecular testing after morphologic analysis. Thus, the ability to rapidly recognize different cancer cell types, with minimal tissue consumption, would accelerate diagnosis and preserve tissue samples for subsequent molecular testing in targeted therapy. We report a label-free molecular vibrational imaging framework enabling three-dimensional (3-D) image acquisition and quantitative analysis of cellular structures for identification of NSCLC cell types. This diagnostic imaging system employs superpixel-based 3-D nuclear segmentation for extracting such disease-related features as nuclear shape, volume, and cell-cell distance. These features are used to characterize cancer cell types using machine learning. Using fresh unstained tissue samples derived from cell lines grown in a mouse model, the platform showed greater than 97% accuracy for diagnosis of NSCLC cell types within a few minutes. As an adjunct to subsequent histology tests, our novel system would allow fast delineation of cancer cell types with minimum tissue consumption, potentially facilitating on-the-spot diagnosis, while preserving specimens for additional tests. Furthermore, 3-D measurements of cellular structure permit evaluation closer to the native state of cells, creating an alternative to traditional 2-D histology specimen evaluation, potentially increasing accuracy in diagnosing cell type of lung carcinomas.

  14. Clinical and morphological approaches to the differential diagnosis of diphtheric colitis

    Directory of Open Access Journals (Sweden)

    V. A. Tsinserling

    2015-01-01

    Full Text Available Inflammatory bowel diseases is a large group of nosologic forms such as more frequent acute intestinal infection, especially dysentery, chronic inflammatory diseases such as ulcerative colitis and Cron’s disease with lesions of the bowel, antibiotics-associated and ischemic colitis. There are some difficulties in differential diagnostics of inflammatory bowel diseases despite their widespread and tendency to more frequent occurrence. On the one hand, this is largely due to similar clinical picture which is most often presented by diarrhea and abdominal pain of different degree of intensity, and, on the other hand, by the disadvantages of laboratory diagnostics techniques. The article discusses the problem of clinical and morphological aspects of the differential colitis diagnostics with more detailed characteristics of fibrinous colitis of different etiology. The morphological differential diagnostics criteria, as well as a summary table of comparative characteristics of antibiotics-associated pseudomembranous colitis, dysentery, invasive candidiasis of bowel, ulcerative colitis and ischemic colitis have been presented. The importance of an integrated approach to the differential diagnostics of inflammatory bowel diseases, based on the analysis of anamnesis, clinical-laboratory and morphological data is stressed. The algorithm for optimizing of differential diagnostics of inflammatory bowel diseases with recommendations for qualitative morphological examination has been suggested. 

  15. Repetitive transcranial magnetic stimulation induced slow wave activity modification: A possible role in disorder of consciousness differential diagnosis?

    Science.gov (United States)

    Pisani, Laura Rosa; Naro, Antonino; Leo, Antonino; Aricò, Irene; Pisani, Francesco; Silvestri, Rosalia; Bramanti, Placido; Calabrò, Rocco Salvatore

    2015-12-15

    Slow wave activity (SWA) generation depends on cortico-thalamo-cortical loops that are disrupted in patients with chronic Disorders of Consciousness (DOC), including the Unresponsive Wakefulness Syndrome (UWS) and the Minimally Conscious State (MCS). We hypothesized that the modulation of SWA by means of a repetitive transcranial magnetic stimulation (rTMS) could reveal residual patterns of connectivity, thus supporting the DOC clinical differential diagnosis. We enrolled 10 DOC individuals who underwent a 24hh polysomnography followed by a real or sham 5Hz-rTMS over left primary motor area, and a second polysomnographic recording. A preserved sleep-wake cycle, a standard temporal progression of sleep stages, and a SWA perturbation were found in all of the MCS patients and in none of the UWS individuals, only following the real-rTMS. In conclusion, our combined approach may improve the differential diagnosis between MCS patients, who show a partial preservation of cortical plasticity, and UWS individuals, who lack such properties.

  16. Differential Diagnosis of Japanese Encephalitis Virus Infections with the Inbios JE Detect™ and DEN Detect™ MAC-ELISA Kits

    Science.gov (United States)

    Johnson, Barbara W.; Goodman, Christin H.; Jee, Youngmee; Featherstone, David A.

    2016-01-01

    Japanese encephalitis virus (JEV) is the leading cause of pediatric viral neurological disease in Asia. The JEV-specific IgM antibody-capture enzyme-linked immunosorbent assay (MAC-ELISA) in cerebrospinal fluid (CSF) and serum is the recommended method of laboratory diagnosis, but specificity of JEV MAC-ELISA can be low due to cross-reactivity. To increase the specificity of the commercially available JE Detect™ MAC-ELISA (JE Detect), a differential testing algorithm was developed in which samples tested by JE Detect with positive results were subsequently tested by the DEN Detect™ MAC-ELISA (DEN Detect) kit, and results of both tests were used to make the final interpretation. The testing algorithm was evaluated with a reference panel of serum and CSF samples submitted for confirmatory testing. In serum, the false Japanese encephalitis (JE) positive rate was reduced, but sequential testing in CSF resulted in reduced JE specificity, as true JEV+ CSF samples had positive results by both JE Detect and DEN Detect and were classified as JE− (dengue virus [DENV]+). Differential diagnosis of JE by sequential testing with JE Detect and DEN Detect increased specificity for JE in serum, but more data with CSF is needed to make a final determination on the usefulness of this testing algorithm for CSF. PMID:26856911

  17. Application of Mycobacterium Leprae-specific cellular and serological tests for the differential diagnosis of leprosy from confounding dermatoses.

    Science.gov (United States)

    Freitas, Aline Araújo; Hungria, Emerith Mayra; Costa, Maurício Barcelos; Sousa, Ana Lúcia Osório Maroccolo; Castilho, Mirian Lane Oliveira; Gonçalves, Heitor Sá; Pontes, Maria Araci Andrade; Duthie, Malcolm S; Stefani, Mariane Martins Araújo

    2016-10-01

    Mycobacterium leprae-specific serological and cell-mediated-immunity/CMI test were evaluated for the differential diagnosis of multibacillary/MB, and paucibacillary/PB leprosy from other dermatoses. Whole-blood assay/WBA/IFNγ stimulated with LID-1 antigen and ELISA tests for IgG to LID-1 and IgM to PGL-I were performed. WBA/LID-1/IFNγ production was observed in 72% PB, 11% MB leprosy, 38% dermatoses, 40% healthy endemic controls/EC. The receiver operating curve/ROC for WBA/LID-1 in PB versus other dermatoses showed 72.5% sensitivity, 61.5% specificity and an area-under-the-curve/AUC=0.75; 74% positive predictive value/PPV, 59% negative predictive value/NPV. Anti PGL-I serology was positive in 67% MB, 8% PB leprosy, 6% of other dermatoses; its sensitivity for MB=66%, specificity=93%, AUC=0.89; PPV=91%, NPV=72%. Anti-LID-1 serology was positive in 87% MB, 7% PB leprosy, all other participants were seronegative; 87.5% sensitivity for MB, 100% specificity, AUC=0.97; PPV=100%, NPV=88%. In highly endemic areas anti-LID-1/PGL-I serology and WBA/LID-1-represent useful tools for the differential diagnosis of leprosy from other confounding dermatoses.

  18. A Challenging Case of Metastatic Intra-Abdominal Synovial Sarcoma with Unusual Immunophenotype and Its Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Yi-Che Changchien

    2012-01-01

    Full Text Available The primary and metastatic gastrointestinal synovial sarcoma is rare with a wide differential diagnosis. It usually expresses cytokeratins EMA, BCL2 with an occasional CD99, and S100 positivity but not desmin. We present a case of metastatic synovial sarcoma with unusual immunophenotype causing diagnostic challenges. The tumor cells showed focal cytokeratin, EMA, and, unexpectedly, desmin positivity. Additional intranuclear TLE-1 positivity and negativity for CD34 and DOG-1 were also identified. A diagnosis of monophasic synovial sarcoma was confirmed by using FISH break-apart probe. RT-PCR revealed the SYT-SSX1 fusion gene. Intra-abdominal synovial sarcoma, either primary or metastatic, with unusual desmin positivity raises the diagnostic challenge, since a wide range of differential diagnoses could show a similar immunophenotype (leiomyosarcoma, desmoid tumor, myofibroblastic tumor, and rarely GIST etc.. Typical morphology and focal cytokeratin/EMA positivity should alert to this tumor, and FISH and RT-PCR remain the gold standard for the confirmation.

  19. Clinical significance of plasma lysophosphatidic acid levels in the differential diagnosis of ovarian cancer

    Directory of Open Access Journals (Sweden)

    Yun-Jie Zhang

    2015-01-01

    Full Text Available Objective: To investigate the value of lysophosphatidic acid (LPA in the diagnosis of ovarian cancer. Materials and Methods: We first performed a hospital-based, case-control study involving 123 ovarian cancer patients and 101 benign ovarian tumor patients, and then conducted a meta-analysis with 19 case-control studies to assess the correlation between ovarian cancer and plasma LPA levels. Results: The case-control study results demonstrated that ovarian cancer patients have increased LPA and cancer antigen (CA-125 levels compared to patients with benign ovarian tumor (LPA: Ovarian cancer vs benign ovarian tumor: 5.28 ± 1.52 vs 1.82 ± 0.77 μmol/L; CA-125: Ovarian cancer vs benign ovarian tumor: 87.17 ± 45.81 vs. 14.03 ± 10.14 U/mL, which showed statistically significant differences (both P < 0.05. LPA with advanced sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of diagnosis excelled CA-125 in the diagnosis of ovarian cancer (both P < 0.05. The areas under the receiver operating characteristic (ROC curve in the diagnosis of ovarian cancer (LPA: 0.983; CA-125: 0.910 were statistically significant compared with the reference (both P < 0.001 and the difference of the areas of ROC curve between LPA and CA-125 in the diagnosis of ovarian cancer showed statistically significant difference (P < 0.05. The meta-analysis results suggested that plasma LPA levels were higher in ovarian cancer tissues than in benign tissues (standardized mean difference (SMD =2.36, 95% confidence interval (CI: 1.61-3.11, P < 0.001 and normal tissues (SMD = 2.32, 95% CI: 1.77-2.87, P < 0.001. Conclusion: LPA shows greater value in the diagnosis of ovarian cancer compared to CA-125 and may be employed as a biological index to diagnose ovarian cancer.

  20. Dermoscopy in differential diagnosis of palmar psoriasis and chronic hand eczema.

    Science.gov (United States)

    Errichetti, Enzo; Stinco, Giuseppe

    2016-04-01

    Clinical differentiation between palmar psoriasis and chronic hand eczema may sometimes be a diagnostic challenge; in such cases histopathological analysis helps to differentiate the two conditions. In the present study, palmar psoriasis and chronic hand eczema were investigated using dermoscopy and the significance of specific dermoscopic features was assessed in order to improve their non-invasive differentiation. Ten patients with biopsy-proven palmar psoriasis and 11 patients with biopsy-proven chronic hand eczema were included in the study. We found that the presence of diffuse white scales was significant in palmar psoriasis whereas the presence of yellowish scales, brownish-orange dots/globules and yellowish-orange crusts was significant in chronic hand eczema.

  1. Differential diagnosis of kidney transplant rejection and cyclosporin/tacrolimus nephropathy using urine cytology.

    Science.gov (United States)

    Kyo, Masahiro; Toki, Kiyohide; Nishimura, Kennichi; Fukunishi, Takanobu; Nagano, Shunsuke; Namba, Yukiomi; Gudat, Fred; Dalquen, Peter; Mihatsch, M J

    2002-01-01

    A total of 9000 urine samples from 69 kidney transplant recipients were studied for differential diagnoses of transplant rejection and cyclosporin/tacrolimus toxicity. New-Sternheimer and Papanicolaou staining were used to differentiate cells in urine. We also employed an immunocytochemical technique for further identification of exfoliated cells. With New-Sternheimer and Papanicolaou staining, the predominance of proximal tubular cells was useful to differentiate cyclosporin/tacrolimus toxicity from acute rejection in cases of increased serum creatinine level. During rejection episodes, an increased number of mononuclear cells and renal epithelial cells were found. Immunocytochemical analysis showed a significant increase of CD2-, CD4- CD8-, CD25- and HLA-DR-positive cells with rejection. However, there was no relationship between Banff criteria rejection grade and the increase of mononuclear cells.

  2. Unusual primary intraosseous meningioma, mimicking cranial osteoid osteoma: A radiological clue to the differential diagnosis

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Izumo

    2014-01-01

    Full Text Available Primary intraosseous meningioma of the skull is rare. We report a patient who presented with a history of an enlarging scalp mass over 30 years. Noncontrast computed tomography demonstrated a densely calcified right frontal extra-axial mass lesion. Magnetic resonance imaging of the lesion demonstrated heterogeneous hypointensity on T1-and T2-wieghted images and without evidence of gadolinium contrast enhancement. And the mass showed heterogeneous isointensity on diffusion weighted image. Preoperative diagnosis for the lesion was osteoid osteoma of the right frontoparietal bone, and total excision of the tumor was carried out. Histological examination showed intraosseous meningothelial meningioma. We should be aware of the primary intraosseous meningioma showing the classical radiological findings of cranial osteoid osteoma. The radiological clue for the accurate diagnosis is discussed.

  3. [Hepatic amyloidosis as a rare differential diagnosis of progressive liver failure].

    Science.gov (United States)

    Bettinger, Dominik; Lutz, Lisa; Schultheiß, Michael; Werner, Martin; Thimme, Robert; Neumann-Haefelin, Christoph

    2016-09-01

    Primary systemic amyloidosis is a rare disorder resulting in extracellular deposition of insoluble fibrils in different organs. Liver involvement has been reported. Since hepatic amyloidosis often presents clinically asymptomatic without specific laboratory or imaging hallmarks, diagnosis is challenging. However, cases of progressive hepatic failure due to liver amyloidosis have been reported. A 63 year old man presented with newly diagnosed ascites to our department. The patient reported occasional alcohol consumption. Viral hepatitis, genetic-metabolic causes as well as hepatic vascular disorders were excluded and ultrasound did not show any signs of liver cirrhosis or intraabdominal malignancy. Initially, alcoholic hepatitis was suspected. Due to the rapid deterioration of liver function, however, transjugular liver biopsy was performed showing light chain amyloidosis of kappa isotype. As diagnosis of hepatic amyloidosis is challenging, early liver biopsy is mandatory in patients with unexplained acute or chronic liver disease to exclude rare diseases with high mortality.

  4. Magnetic resonance imaging in the differential diagnosis of true placenta accreta: a clinical case

    Directory of Open Access Journals (Sweden)

    E. V. Tarachkova

    2016-01-01

    Full Text Available True placenta accreta is the attachment of chorionic villi to the myometrium, possibly penetrating into the thickness of the myometrium and its outside, including through the serous tunic. The main current diagnostic techniques are considered to be ultrasonography, laboratory diagnosis (elevated human chorionic gonadotropin and placental lactogen levels, and clinical data (pain and vaginal discharge. Magnetic resonance imaging is deemed to be an adjuvant technique. By using a clinical example, this paper considers the capabilities of magnetic resonance imaging to diagnose this abnormality and to choose a right treatment policy. The abnormality is compared with the conditions (trophoblastic tumor and myoma with lysis that are similar in their diagnosis and magnetic resonance pattern. The disorder in question is rather rare and its detailed consideration, determination of the capabilities of various techniques, and comparison with externally similar cases areimportant for the development of diagnostic opportunities.

  5. Periprosthetic joint infection diagnosis: a complete understanding of white blood cell count and differential.

    Science.gov (United States)

    Zmistowski, Benjamin; Restrepo, Camilo; Huang, Ronald; Hozack, William J; Parvizi, Javad

    2012-10-01

    Recent research has raised doubts regarding the utility of serum white blood cell count (WBC) for diagnosis of periprosthetic joint infection (PJI). As synovial WBC and neutrophil (PMN) percentage have been adopted as accurate markers of PJI, this study investigated the correlation of WBC in serum versus joint fluid and diagnostic value of all WBC levels for failed arthroplasty patients. 153 patients (73 PJI) undergoing revision knee arthroplasty were identified. Weak correlations between joint fluid and serum for WBC (R = 0.19), PMN count (R = 0.31), and lymphocyte count (R = -0.22) were observed. Diagnostic accuracy of PMN (93%) and WBC (93%) synovial count relative to serum was similar to synovial WBC (93%) and PMN% (95%) alone. Serum WBC analysis does little to improve the accurate diagnosis of PJI.

  6. Duodenal Duplication Cyst: A Rare Differential Diagnosis in a Neonate with Bilious Vomiting

    Science.gov (United States)

    Župančić, Božidar; Gliha, Andro; Fuenzalida, Jose Varas; Višnjić, Stjepan

    2015-01-01

    Bilious vomiting is a relevant sign in neonates that requires immediate evaluation and diagnosis. A duplication of the intestinal tract is a possible cause of obstruction if located distally to the major duodenal papilla of Vater and most of them involve the jejunum, stomach, or colon. Duodenal duplications are very rare and can have an endoscopic or surgical treatment after diagnosis. We present a case of a 16-day-old term newborn that consulted because of bilious vomiting and after evaluation with imaging and upper endoscopy, a duodenal duplication cyst was found at the level of the third portion causing compression of the intestinal lumen that required surgical resolution with duodenocystostomy. PMID:26788454

  7. The use of SD-OCT in the differential diagnosis of dots, spots and other white retinal lesions

    Directory of Open Access Journals (Sweden)

    Zaharova E

    2011-10-01

    Full Text Available Elena Zaharova1, Jerome Sherman1-31State University of New York's State College of Optometry, University Eye Center, New York, NY, USA; 2SUNY Eye Institute, New York, NY, USA; 3New York Eye Institute and Laser Center, New York, NY, USAPurpose: To demonstrate the utility of a retinal imaging technique using spectral domain optical coherence tomography (SD-OCT for creating a B-scan layer-by-layer analysis to aid in the differential diagnosis of various retinal dots, spots, and other white lesions.Design: Review.Methods: A retrospective review of imaging studies performed with SD-OCT (Topcon, 3DOCT-2000, Oakland, NJ at SUNY State College of Optometry.Results: B-scan layer-by-layer analysis and unique SD-OCT reflectivity patterns of the following retinal white lesions are reviewed in the order of their retinal layer localization: myelinated nerve fiber layer, cotton wool spot, exudates, edema residues, drusen, fundus albipunctatus, Stargardt disease, Bietti crystalline dystrophy, punctate inner choroidopathy (PIC, presumed ocular histoplasmosis syndrome (POHS, post-photocoagulation chorioretinal scarring, and osseous choristoma.Conclusion: The reviewed images demonstrate the utility of SD-OCT in the identification of the unique characteristics of the presented retinal pathologies. SD-OCT is ideal for retinal layer localization of lesions, thus enhancing the differential diagnosis of retinal dots, spots, and other white lesions. Even though true pathognomonic patterns are rare, highly suggestive findings of certain retinal abnormalities often facilitate immediate recognition and diagnosis.Keywords: SD-OCT, photoreceptor integrity line, retinal pigment epithelium, white dot syndrome, retinal pathology, imaging

  8. Immunohistochemical expression of SALL4 in hepatocellular carcinoma, a potential pitfall in the differential diagnosis of yolk sac tumors.

    Science.gov (United States)

    Gonzalez-Roibon, Nilda; Katz, Betina; Chaux, Alcides; Sharma, Rajni; Munari, Enrico; Faraj, Sheila F; Illei, Peter B; Torbenson, Michael; Netto, George J

    2013-07-01

    SALL4 is a transcription factor that serves as a marker of yolk sac tumor. Yolk sac tumor and hepatocellular carcinoma share histologic, serologic, and immunohistochemical features. Previous studies have shown lack of SALL4 expression in hepatocellular carcinoma, suggesting utility in this differential diagnosis. Sixty-nine samples of hepatocellular carcinoma were retrieved from surgical pathology archives and used to construct 9 tissue microarrays. A germ cell tumor tissue microarray containing 10 yolk sac tumors was used for comparison. Extent, intensity, and pattern of nuclear SALL4 expression were assessed in each spot. Mean percentage of expression was calculated for each tumor and used during analysis. Optimal discriminatory extent of expression cutoff was determined by receiver operating characteristic curve analysis. Other potential discriminatory markers including Hep Par1 were also evaluated. Forty-six percent (32/69) of hepatocellular carcinoma and all yolk sac tumors revealed at least focal expression of SALL4. A unique punctuate/clumped pattern of nuclear staining was present in 94% (30/32) of hepatocellular carcinoma, whereas all yolk sac tumors displayed a diffuse finely granular nuclear staining pattern. A 25% extent of SALL4 expression cutoff was found to be optimal for the distinction of yolk sac tumor from hepatocellular carcinoma yielding a sensitivity of 100%, specificity of 92.8%, and a positive predictive value of 66.6% for yolk sac tumor diagnosis. The addition of Hep Par1 increased the specificity (99%) and positive predictive value (90%). This is the first report of SALL4 expression in hepatocellular carcinoma. Our finding should be taken into consideration in the differential diagnosis of hepatocellular carcinoma and yolk sac tumor. The unique punctuate/clumped pattern seen in hepatocellular carcinoma cases could be of further discriminatory value.

  9. An Approach to Differential Diagnosis of Antiphospholipid Antibody Syndrome and Related Conditions

    OpenAIRE

    Giacomo Emmi; Elena Silvestri; Danilo Squatrito; Lucia Ciucciarelli; Anna Maria Cameli; Gentian Denas; Mario Milco D’Elios; Vittorio Pengo; Lorenzo Emmi; Domenico Prisco

    2014-01-01

    The antiphospholipid antibody syndrome is a systemic, acquired, immune-mediated disorder characterized by episodes of venous, arterial, or microcirculation thrombosis and/or pregnancy abnormalities, associated with the persistent presence of autoantibodies, confirmed at least in two occasions 12 weeks apart, directed to molecular complexes consisting of phospholipids and proteins. Antiphospholipid antibody syndrome should always be considered as a potential diagnosis especially for young pati...

  10. Polymyositis without Beneficial Response to Steroid Therapy:Should Miyoshi Myopathy be a Differential Diagnosis?

    OpenAIRE

    Scalco,Renata Siciliani; Lorenzoni,Paulo José; David S Lynch; Martins, William Alves; Jungbluth, Heinz; Quinlivan, Ros; Becker, Jefferson; Houlden, Henry

    2017-01-01

    Patient: Male, 16 Final Diagnosis: Miyoshi myopathy Symptoms: HyperCKemia • myalgia • weakness Medication: — Clinical Procedure: — Specialty: Neurology Objective: Rare disease Background: Miyoshi myopathy (MM) is an autosomal-recessive muscle disorder caused by mutations in the DYSF gene. Clinical features and histopathological changes in dysferlinopathies may mimic inflammatory myopathies and a high degree of clinical suspicion is required to guide the genetic investigation. Case Report: We ...

  11. [Pyoderma gangrenosum after intramedullary nailing of tibial shaft fracture: A differential diagnosis to necrotizing fasciitis].

    Science.gov (United States)

    Hackl, S; Merkel, P; Hungerer, S; Friederichs, J; Müller, N; Militz, M; Bühren, V

    2015-12-01

    Pyoderma gangrenosum is a rare non-infectious neutrophilic dermatitis, whereas necrotizing fasciitis is a life-threatening bacterial soft tissue infection of the fascia and adjacent skin. As in the case described here after intramedullary nailing, the clinical appearance of both diseases can be similar. Because of the completely different therapeutic approach and a worse outcome in the case of false diagnosis, pyoderma gangrenosum should always be taken into consideration before treating necrotizing fasciitis.

  12. CT differential diagnosis of tumour of the cranium with intracranial spread - a case report

    Energy Technology Data Exchange (ETDEWEB)

    Trittmacher, S.; Purmann, H.; Schmid, A.

    1988-01-01

    A report on patient presenting in the cranial computer tomogram with changes in the cranium in the left temporal region typical of a meningioma, as well as with changes in the floor of the middle cranial fossa. Correct diagnosis was obtained only by the overall assessment comprising anamnesis, laboratory findings and state of the skeletal structure: namely, a plasmacytoma involving the calotte of the cranium.

  13. Sex differentiation disorders (SDD) prenatal sonographic diagnosis, genetic and hormonal work-up.

    Science.gov (United States)

    Katorza, Eldad; Pinhas-Hamiel, Orit; Mazkereth, Ram; Gilboa, Yinon; Achiron, Reuven

    2009-09-01

    Gender is determined by the genetic, gonadal and hormonal/ phenotypic sex. Genetic sex is determined at conception. The establishment of the gonadal sex (ovary/testis) and the phenotypic sex (external and internal genitalia) is a complicated multistep process which is determined during fetal life mainly during the first trimester. Recently more genes have been found to be involved in this process. Prenatal diagnosis of fetal gender can be made using ultrasound technology, genetic and hormonal examinations. Nowadays using a vaginal and abdominal transducer for US examination recognition of external and internal genitalia of both genders is possible. The determination of gender during fetal life is important not only as a matter of curiosity; in some cases of ambiguity (for example congenital adrenal hyperplasia) prenatal treatment can change the natural history of the disease. Prenatal diagnosis can also subtype the ambiguity, and its severity can be established. In this review we describe our experience in prenatal diagnosis and establishment of the fetal gender, the subtypes of ambiguity and our suggestion for the process of diagnostic work-up.

  14. A decision tree – based method for the differential diagnosis of Aortic Stenosis from Mitral Regurgitation using heart sounds

    Science.gov (United States)

    Pavlopoulos, Sotiris A; Stasis, Antonis CH; Loukis, Euripides N

    2004-01-01

    Background New technologies like echocardiography, color Doppler, CT, and MRI provide more direct and accurate evidence of heart disease than heart auscultation. However, these modalities are costly, large in size and operationally complex and therefore are not suitable for use in rural areas, in homecare and generally in primary healthcare set-ups. Furthermore the majority of internal medicine and cardiology training programs underestimate the value of cardiac auscultation and junior clinicians are not adequately trained in this field. Therefore efficient decision support systems would be very useful for supporting clinicians to make better heart sound diagnosis. In this study a rule-based method, based on decision trees, has been developed for differential diagnosis between "clear" Aortic Stenosis (AS) and "clear" Mitral Regurgitation (MR) using heart sounds. Methods For the purposes of our experiment we used a collection of 84 heart sound signals including 41 heart sound signals with "clear" AS systolic murmur and 43 with "clear" MR systolic murmur. Signals were initially preprocessed to detect 1st and 2nd heart sounds. Next a total of 100 features were determined for every heart sound signal and relevance to the differentiation between AS and MR was estimated. The performance of fully expanded decision tree classifiers and Pruned decision tree classifiers were studied based on various training and test datasets. Similarly, pruned decision tree classifiers were used to examine their differentiation capabilities. In order to build a generalized decision support system for heart sound diagnosis, we have divided the problem into sub problems, dealing with either one morphological characteristic of the heart-sound waveform or with difficult to distinguish cases. Results Relevance analysis on the different heart sound features demonstrated that the most relevant features are the frequency features and the morphological features that describe S1, S2 and the systolic

  15. A decision tree – based method for the differential diagnosis of Aortic Stenosis from Mitral Regurgitation using heart sounds

    Directory of Open Access Journals (Sweden)

    Loukis Euripides N

    2004-06-01

    Full Text Available Abstract Background New technologies like echocardiography, color Doppler, CT, and MRI provide more direct and accurate evidence of heart disease than heart auscultation. However, these modalities are costly, large in size and operationally complex and therefore are not suitable for use in rural areas, in homecare and generally in primary healthcare set-ups. Furthermore the majority of internal medicine and cardiology training programs underestimate the value of cardiac auscultation and junior clinicians are not adequately trained in this field. Therefore efficient decision support systems would be very useful for supporting clinicians to make better heart sound diagnosis. In this study a rule-based method, based on decision trees, has been developed for differential diagnosis between "clear" Aortic Stenosis (AS and "clear" Mitral Regurgitation (MR using heart sounds. Methods For the purposes of our experiment we used a collection of 84 heart sound signals including 41 heart sound signals with "clear" AS systolic murmur and 43 with "clear" MR systolic murmur. Signals were initially preprocessed to detect 1st and 2nd heart sounds. Next a total of 100 features were determined for every heart sound signal and relevance to the differentiation between AS and MR was estimated. The performance of fully expanded decision tree classifiers and Pruned decision tree classifiers were studied based on various training and test datasets. Similarly, pruned decision tree classifiers were used to examine their differentiation capabilities. In order to build a generalized decision support system for heart sound diagnosis, we have divided the problem into sub problems, dealing with either one morphological characteristic of the heart-sound waveform or with difficult to distinguish cases. Results Relevance analysis on the different heart sound features demonstrated that the most relevant features are the frequency features and the morphological features that

  16. Is outcome of differentiated thyroid carcinoma influenced by tumor stage at diagnosis?

    NARCIS (Netherlands)

    Clement, S.C.; Kremer, L.C.; Links, T.P.; Mulder, R.L.; Ronckers, C.M.; Eck-Smit, B.L. van; Rijn, R.R. van; Pal, H.J. van der; Tissing, W.J.; Janssens, G.O.R.J.; Heuvel-Eibrink, M.M. van den; Neggers, S.J.; Dijkum, E.J. van; Peeters, R.P.; Santen, H.M. van

    2015-01-01

    BACKGROUND: There is no international consensus on surveillance strategies for differentiated thyroid carcinoma (DTC) after radiotherapy for childhood cancer. Ultrasonography could allow for early detection of DTC, however, its value is yet unclear since the prognosis of DTC is excellent. We address

  17. Is outcome of differentiated thyroid carcinoma influenced by tumor stage at diagnosis?

    NARCIS (Netherlands)

    Clement, S.C.; Kremer, L.C.M.; Links, T.P.; Mulder, R.L.; Ronckers, C.M.; van Eck-Smit, B.L.; van Rijn, R.R.; Pal van der, H.J.H.; Tissing, W.J.E.; Janssens, G.O.; van den Heuvel-Eibrink, M.M.; Neggers, S.J.; Nieveen van Dijkum, E.J.; Peeters, R.P.; van Santen, H.M.

    2015-01-01

    Background: There is no international consensus on surveillance strategies for differentiated thyroid carcinoma (DTC) after radiotherapy for childhood cancer. Ultrasonography could allow for early detection of DTC, however, its value is yet unclear since the prognosis of DTC is excellent. We address

  18. Differential diagnosis in cases of saddle-like impression of the fundus of the stomach

    Energy Technology Data Exchange (ETDEWEB)

    Hohenberg, G.; Deimer, E.; Schmidmeier, L.

    1984-01-01

    X-ray examination of the stomach sometimes shows a saddle-like impression of the region of the fundus. This phenomenon is without any clinical importance, but there are many diseases such as hiatal hernia, benign and malignant tumours, inflammatory diseases, and varices which are localised at the fundus. Differential diagnostic problems are discussed.

  19. Prospective study of differential diagnosis of hepatic tumors by pattern-based classification of contrast-enhanced sonography

    Institute of Scientific and Technical Information of China (English)

    Kazushi Numata; Tetsuo Isozaki; Manabu Morimoto; Kazuya Sugimori; Reiko Kunisaki; Toshio Morizane; Katsuaki Tanaka

    2006-01-01

    AIM: To prospectively evaluate the usefulness of a pattern-based classification of contrast-enhanced sonographic findings for differential diagnosis of hepatic tumors.METHODS: We evaluated the enhancement pattern of the contrast-enhanced sonography images in 586 patients with 586 hepatic lesions, consisting of 383 hepatocellular carcinomas, 89 metastases, and 114 hemangiomas. After injecting a galactose-palmitic acid contrast agent, lesions were scanned by contrastenhanced harmonic gray-scale sonography in three phases: arterial, portal, and late. The enhancement patterns of the initial 303 lesions were classified retrospectively, and multiple logistic regression analysis was used to identify enhancement patterns that allowed differentiation between hepatic tumors. We then used the pattern-based classification of enhancement we had retrospectively devised to prospectively diagnose 283 liver tumors.RESULTS: Seven enhancement patterns were found to be significant predictors of different hepatic tumors.The presence of homogeneous or heterogeneous enhancement both in the arterial and portal phase was the typical enhancement pattern for hepatocellular carcinoma, while the presence of peritumoral vessels in the arterial phase and ring enhancement or a perfusion defect in the portal phase was the typical enhancement pattern for metastases, and the presence of peripheral nodular enhancement both in the arterial and portal phase was the typical enhancement pattern for hemangioma. The sensitivity, specificity, and accuracy of prospective diagnosis based on the combinations of enhancement patterns, respectively, were 93.2%,96.2%, and 94.0% for hepatocellular carcinoma, 87.9%,99.6%, and 98.2% for metastasis, and 95.6%, 94.1%,and 94.3% for hemangioma.CONCLUSION: The pattern-based classification of the contrast-enhanced sonographic findings is useful for differentiating among hepatic tumors.

  20. Fetus in Fetu: Case Report and Brief Review of Literature on Embryologic Origin, Clinical Presentation, Imaging and Differential Diagnosis

    Science.gov (United States)

    Sitharama, Suhas Aithal; Jindal, Bibekanand; Vuriti, Mrudula Kumari; Naredi, Bikash Kumar; Krishnamurthy, Sriram; Subramania, Deepak Barathi

    2017-01-01

    Summary Background Fetus in fetu (FIF) is a rare entity in which a malformed diamniotic monochorionic parasitic fetal twin develops inside a normal co-twin’s body, most commonly in the abdominal cavity. FIF is differentiated from the teratoma by the presence of vertebral column often with an appropriate arrangement of other organs or limbs around it. Case Report A two-and-a-half-year-old girl presented with a painless abdominal swelling in the right hypochondrium. On imaging, a heterogenous soft tissue mass with internal calcific densities was noted in the retroperitoneum. The mass had vertebral organization, limb and pelvic bones. The presence of a fetiform teratoma was suspected and surgery revealed an encapsulated mass with an anencephalic head, spine, upper and lower limb buds. Histopathology confirmed the presence of a fetus in fetu. The postoperative period was uneventful with no evidence of recurrence. Conclusions FIF is a pediatric rarity. Cross-sectional imaging helps in differentiating it from a teratoma, meconium peritonitis and abdominal ectopic pregnancy. Surgical excision is the treatment of choice for this benign condition, which requires a follow-up only in certain cases. This case report describes a retroperitoneal fetus in fetu and discusses its clinical presentation, differential diagnosis and embryologic origin. PMID:28217238

  1. Identification of circulating microRNAs for the differential diagnosis of Parkinson’s disease and Multiple System Atrophy.

    Directory of Open Access Journals (Sweden)

    Annamaria eVallelunga

    2014-06-01

    Full Text Available Background. Parkinson's disease (PD is a progressive neurodegenerative disorder which may be misdiagnosed with atypical conditions such as Multiple System Atrophy (MSA, due to overlapping clinical features. MicroRNAs (miRNAs are small noncoding RNAs with a key role in post-transcriptional gene regulation. We hypothesized that identification of a distinct set of circulating miRNAs (cmiRNAs could distinguish patients affected by PD from MSA and healthy individuals. Results. Using TaqMan Low Density Array technology, we analysed 754 miRNAs and found 9 cmiRNAs differentially expressed in PD and MSA patients compared to healthy controls. We also validated a set of 4 differentially expressed cmiRNAs in PD and MSA patients versus controls. More specifically, miR-339-5p was downregulated, whereas miR-223*, miR-324-3p and mir-24 were upregulated in both diseases. We found cmiRNAs specifically deregulated in PD (downregulation of miR-30c and miR-148b and in MSA (upregulation of miR-148b. Finally, comparing MSA and PD, we identified 3 upregulated cmiRNAs in MSA serum (miR-24, miR-34b, miR-148b. Conclusions. Our results suggest that cmiRNA signatures discriminate PD from MSA patients and healthy controls and may be considered specific, non-invasive biomarkers for differential diagnosis.

  2. Ileitis caused by Yersinia enterocolitica - X-ray differential diagnosis of Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Lingg, G.; Hering, L.; Tanneberger, D.

    1981-12-01

    The article gives a brief description of the characteristic features of the clinical and roentgenological course and the various stages of enteritis caused by Yersinia. Basing on three cases of ileitis caused by Yersinia, the far-reaching similarity with the early changes and even the advanced stages of Crohn's diseases are demonstrated. Attention is drawn to the possibilities of differentiating between the two disease patterns.

  3. Differential diagnosis of a patient with low back and toe pain

    OpenAIRE

    Wahl, Elizabeth Cooper; Smith, David; Sesto, Mary; Boissonnault, William

    2013-01-01

    Low back pain is one of the most commonly treated conditions by outpatient orthopedic physical therapists. The management of low back pain is also responsible for a large economic burden in the United States and internationally, which highlights one of the many reasons why appropriate medical screening and referral is important in the physical therapy setting. The purpose of this case report is to describe the successful physical therapist screening and subsequent medical differential diagnos...

  4. Differential Diagnosis of Lymphadenopathy in the Neck Spaces in a CT Perfusion Study

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Sun Jung; Hong, Hyun Sook; Lee, Eun Hye; Lee, Min Hee [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Park, Jung Mi [Dept. of Nuclear Science, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2011-11-15

    To evaluate the CT perfusion parameters for differentiating between a benign and malignant lymphadenopathy in the neck spaces. Seventeen patients with cervical lymphadenopathy underwent perfusion CT. Perfusion parameters, including blood flow (BF), blood volume (BV), permeability index (PI), and mean transit time, were calculated at the regions of interest in the enlarged lymph nodes (LNs). The enlarged LNs were diagnosed by fine needle aspiration, surgical excision, and clinical follow-up. The LNs were classified as either reactive hyperplasia (n = 26), metastatic LNs (n = 11), or LNs of lymphoma (n = 14). Significant differences were found for BF, BV, and PI among the three groups (p < 0.05). Reactive hyperplasia had a significantly higher BF than metastatic LN (p < 0.0167). The LNs of lymphoma had a significantly lower BF, BV, and PI than reactive hyperplasia (p < 0.0167). No significant difference was observed between the metastatic LNs of the head and neck cancer and LNs of lymphoma for all perfusion parameters. In patients with head and neck cancer, perfusion CT is not useful for differentiating between metastatic LNs and inflammatory reactive hyperplasia. However, perfusion CT can be useful for differentiating between LNs of lymphoma and reactive hyperplasia.

  5. CT findings in differential diagnosis of pelvic inflammatory bowel mass and tuboovarian abscess

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sook Hee; Jeon, Doo Sung; Choi, Jin Ok; Chae, Soo Hyun; Lee, Kang Soo; Kim, Sung Mee; Kim, Hong Soo [Presbyterian Medical Center, Chonju (Korea, Republic of)

    1999-03-01

    To evaluate the CT findings which may help differentiate pelvic inflammatory bowel mass(IBM) from tubo-ovarian abscess(TOA). Twenty-five patients with histologically confirmed TOA(n=14), periappendiceal abscess(n=9), an abscess caused by diverticulitis(n=1), and by ulcerative colitis(n=1) were evaluated. For TOA, age distribution ranged only from the 3rd to the 5th decade, but for IBM, the range was the 2nd to 8th decade with highest frequency during the 3rd-4th decade. CT findings were retrospectively analysed for bilaterality, internal septa, anterior displacement of the mesosalpinx, and perirectal and mesenteric fat infiltration. Mesenteric fat infiltration was detected in all 11 cases of pelvic IBM, but in only two of 14 TOA cases(p<0.05). Anterior displacement of the mesosalpinx was observed in two of 11 pelvic IBM cases and in nine of 14 TOA cases(P<0.05). There were no significant difference in bilaterality, internal septa, or perirectal fat infiltration. Mesenteric fat infiltration was the most reliable finding in differentiating pelvic IBM form TOA. Anterior displacement of the mesosalpinx, and age distribution were also helpful in differentiating the two disease groups.

  6. Differential Diagnosis Tool for Parkinsonian Syndrome Using Multiple Structural Brain Measures

    Directory of Open Access Journals (Sweden)

    Miho Ota

    2013-01-01

    Full Text Available Clinical differentiation of parkinsonian syndromes such as the Parkinson variant of multiple system atrophy (MSA-P and cerebellar subtype (MSA-C from Parkinson's disease is difficult in the early stage of the disease. To identify the correlative pattern of brain changes for differentiating parkinsonian syndromes, we applied discriminant analysis techniques by magnetic resonance imaging (MRI. T1-weighted volume data and diffusion tensor images were obtained by MRI in eighteen patients with MSA-C, 12 patients with MSA-P, 21 patients with Parkinson’s disease, and 21 healthy controls. They were evaluated using voxel-based morphometry and tract-based spatial statistics, respectively. Discriminant functions derived by step wise methods resulted in correct classification rates of 0.89. When differentiating these diseases with the use of three independent variables together, the correct classification rate was the same as that obtained with step wise methods. These findings support the view that each parkinsonian syndrome has structural deviations in multiple brain areas and that a combination of structural brain measures can help to distinguish parkinsonian syndromes.

  7. C. T. criteria of the differential diagnosis in primary retroperitoneal masses

    Energy Technology Data Exchange (ETDEWEB)

    Pistolesi, G.F.; Procacci, C.; Caudana, R.; Bergamo Andreis, I.A.; Manera, V.; Recla, M.; Grasso, G.; Florio, C.

    1984-05-01

    This personal series of 44 primary retroperitoneal masses (P.R.P.M.) studied by C.T. is analyzed. The reliability of C.T. in the identification (44/44), characterization (43/44) and origin evaluation (41/44) of P.R.P.M. has been absolutely satisfactory. In particular, those criteria of C.T. diagnosis which may be utilized in the evaluation of the origin of upper abdominal masses are thoroughly described. The evaluation of the involvement (non invasive; invasive) of adjacent viscera has been achieved in 22/38 P.R.P.M. verified at operation. The evaluation of tumour resectability has been less reliable due to the high incidence of under-diagnosis (60% in our personal experience). C.T. may be used in addition as an aid to different diagnostic techniques (percutaneous guided needle biopsy) or to therapy (drainage of retroperitoneal abscesses). C.T. is absolutely necessary in the follow-up of P.R.P.M. after surgery, radiotherapy or chemotherapy.

  8. [Linear IgA bullous dermatosis: the importance of a correct differential diagnosis].

    Science.gov (United States)

    Colombo, M; Volpini, S; Orini, S; Fazi, M C; Vettore, E; Tedoldi, S; Cappellaro, E

    2008-06-01

    Linear IgA bullous dermatosis is an acquired subepidermal blistering disease which belongs to bullous autoimmune diseases, along with dermatitis herpetiformis and bullous pemphigoid. Inflammatory blisters are the main clinical characteristics and the areas of common involvement are: perioral region, abdomen, perineum, buttocks and the interior side of thighs. Essential for the diagnosis is to find by direct immunofluorescence the presence of a linear band of IgA antibodies at the level of the basement membrane. We present the case of a 5 year-old Moroccan girl which arrived at our First Aid Department for bullous dermatitis, localized mainly on the abdomen, legs and thighs. During a short stay in Morocco, a month before, the little girl was stung by an insect and developed bullous dermatitis by a residual lesion. The child was in a good state of health but blood exams showed an increase of total IgE antibodies. The girl was admitted and during her hospitalisation we made a skin biopsy which led to a diagnosis of linear IgA dermatosis. She began a steroid therapy and there was a progressive regression of the lesions. At present, she does not take medicines anymore, she feels well and is submitted to ambulatory medical follow-up.

  9. Update on celiac disease – etiology, differential diagnosis, drug targets, and management advances

    Directory of Open Access Journals (Sweden)

    Scanlon SA

    2011-12-01

    Full Text Available Samantha A Scanlon1, Joseph A Murray1,21Department of Internal Medicine, 2Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USAAbstract: Celiac disease (CD is an immune-mediated enteropathy triggered by exposure to wheat gluten and similar proteins found in rye and barley that affects genetically susceptible persons. This immune-mediated enteropathy is characterized by villous atrophy, intraepithelial lymphocytosis, and crypt hyperplasia. Once thought a disease that largely presented with malnourished children, the wide spectrum of disease activity is now better recognized and this has resulted in a shift in the presenting symptoms of most patients with CD. New advances in testing, both serologic and endoscopic, have dramatically increased the detection and diagnosis of CD. While the gluten-free diet is still the only treatment for CD, recent investigations have explored alternative approaches, including the use of altered nonimmunogenic wheat variants, enzymatic degradation of gluten, tissue transglutaminase inhibitors, induction of tolerance, and peptides to restore integrity to intestinal tight junctions.Keywords: immune-mediated enteropathy, gliadin, gluten, epidemiology, CD diagnosis, therapy

  10. Miller Fisher Syndrome: A Case Report Highlighting Heterogeneity of Clinical Features and Focused Differential Diagnosis.

    Science.gov (United States)

    Yepishin, Ilya V; Allison, Randall Z; Kaminskas, David A; Zagorski, Natalia M; Liow, Kore K

    2016-07-01

    Miller Fisher Syndrome (MFS) is a rare variant of Guillain-Barré Syndrome (GBS) that has a geographically variable incidence. It is largely a clinical diagnosis based on the cardinal clinical features of ataxia, areflexia, and opthalmoplegia, however, other neurological signs and symptoms may also be present. Serological confirmation with the anti-GQ1b antibody is available and allows for greater diagnostic certainty in the face of confounding symptoms. A self-limiting course is typical of MFS. The following case report is that of a patient who presented with generalized weakness, somatic pain, inability to walk, and diplopia following an upper respiratory illness. The patient exhibited the classic triad of ataxia, areflexia, and opthalmoplegia characteristic of MFS, but also had less typical signs and symptoms making for a more challenging diagnostic workup. Our suspected diagnosis of MFS was serologically confirmed with positive anti-GQ1b antibody titer and the patient was successfully treated with Intravenous immune globulin (IVIG).

  11. [Myocarditis in the differential diagnosis of cardiomyopathies. Endomyocardial biopsy or MRI?].

    Science.gov (United States)

    Besler, C; Schuler, G; Lurz, P

    2015-06-01

    Myocarditis is an inflammatory disease of the heart muscle commonly caused by viral pathogens. Dilated cardiomyopathy is a major long-term sequela of myocarditis and at least in part related to post-viral immune-mediated responses. Establishing a diagnosis of myocarditis represents a major challenge because of the variable clinical picture and the lack of readily available, non-invasive diagnostic tests. In recent years, cardiac magnetic resonance imaging (cMRI) has emerged as a promising additional diagnostic tool in patients with suspected myocarditis: cMRI not only provides important insights into structural and functional abnormalities of the heart but relevant tissue pathologies can also be visualized. The diagnostic accuracy of three tissue criteria, i.e. the edema ratio, early gadolinium enhancement ratio and late gadolinium enhancement, has been characterized in several studies. Endomyocardial biopsy (EMB) is widely considered to be the reference standard for diagnosis of myocarditis. Although limited by sampling error, EMB is the only diagnostic procedure that can be used to confirm myocarditis. Laboratory analyses of EMB may provide information about specific causes of myocarditis and are, at least in part, of prognostic relevance. In a subset of patients the results of EMB may guide therapeutic decision-making. Additional efforts are needed in cardiac imaging, molecular characterization of EMB and evaluation of serum biomarkers to improve the diagnostic work-up in patients with suspected myocarditis and to identify potential novel targets for a cause-specific therapy of myocarditis.

  12. Better differential diagnosis of iron deficiency anemia from beta-thalassemia trait

    Directory of Open Access Journals (Sweden)

    Fakher Rahim

    2009-09-01

    Full Text Available Objective: Iron deficiency anemia (IDA and beta-thalassemia trait (ß-TT are the most common forms of microcytic anemia. This study was conducted to compare the validity of various discrimination indices in differentiating β-TT from IDA by calculating their sensitivity, specificity and Youden's index.Methods: Totally 323 subjects (173 children and 150 adults with microcytic anemia were involved in this study. We calculated 10 discrimination indices in all patients with IDA and β-TT. We divided the patients into two different groups as younger or older than 10 years. Results: None of the indices showed sensitivity and specificity of 100% in the patients older than 10 years, and in the patients younger than 10 years, only Shine & Lal index showed sensitivity close to 90% and specificity of 100%. The most accurate discriminative index for patients younger than 10 years was Shine & Lal and for those older than 10 years it was RDW index. According to Youden's index, Shine & Lal and RBC count showed the greatest diagnostic value in patients younger than 10 years and RDW and RBC count indices in those older than 10 years. Conclusion: None of the indices was completely sensitive and specific in differentiation between β-TT and IDA. Mean and median mean cell Hb density (MCHD were very close to normal values in both IDA and β-TT patients, but in the case of mean density of Hb/liter (MDHL, we found that the mean and median were significantly higher than normal values in β-TT and lower than normal values in IDA patients. In our study, Youden's index of RBC and Shine & Lal were the highest and most reliable indices in differentiating β-TT from IDA in the patients younger than 10 years. For patients older than 10 years, the most reliable discrimination indices were RBC and RDW.

  13. FDG uptake heterogeneity evaluated by fractal analysis improves the differential diagnosis of pulmonary nodules

    Energy Technology Data Exchange (ETDEWEB)

    Miwa, Kenta, E-mail: kenta5710@gmail.com [Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550 (Japan); Division of Medical Quantum Science, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Inubushi, Masayuki, E-mail: inubushi@med.kawasaki-m.ac.jp [Department of Nuclear Medicine, Kawasaki Medical School, 577 Matsushima Kurashiki, Okayama 701-0192 (Japan); Wagatsuma, Kei, E-mail: kei1192@hotmail.co.jp [Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550 (Japan); Nagao, Michinobu, E-mail: minagao@radiol.med.kyushu-u.ac.jp [Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Murata, Taisuke, E-mail: taisuke113@gmail.com [Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550 (Japan); Koyama, Masamichi, E-mail: masamichi.koyama@jfcr.or.jp [Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550 (Japan); Koizumi, Mitsuru, E-mail: mitsuru@jfcr.or.jp [Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550 (Japan); Sasaki, Masayuki, E-mail: msasaki@hs.med.kyushu-u.ac.jp [Division of Medical Quantum Science, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)

    2014-04-15

    Purpose: The present study aimed to determine whether fractal analysis of morphological complexity and intratumoral heterogeneity of FDG uptake can help to differentiate malignant from benign pulmonary nodules. Materials and methods: We retrospectively analyzed data from 54 patients with suspected non-small cell lung cancer (NSCLC) who were examined by FDG PET/CT. Pathological assessments of biopsy specimens confirmed 35 and 19 nodules as NSCLC and inflammatory lesions, respectively. The morphological fractal dimension (m-FD), maximum standardized uptake value (SUV{sub max}) and density fractal dimension (d-FD) of target nodules were calculated from CT and PET images. Fractal dimension is a quantitative index of morphological complexity and tracer uptake heterogeneity; higher values indicate increased complexity and heterogeneity. Results: The m-FD, SUV{sub max} and d-FD significantly differed between malignant and benign pulmonary nodules (p < 0.05). Although the diagnostic ability was better for d-FD than m-FD and SUV{sub max}, the difference did not reach statistical significance. Tumor size correlated significantly with SUV{sub max} (r = 0.51, p < 0.05), but not with either m-FD or d-FD. Furthermore, m-FD combined with either SUV{sub max} or d-FD improved diagnostic accuracy to 92.6% and 94.4%, respectively. Conclusion: The d-FD of intratumoral heterogeneity of FDG uptake can help to differentially diagnose malignant and benign pulmonary nodules. The SUV{sub max} and d-FD obtained from FDG-PET images provide different types of information that are equally useful for differential diagnoses. Furthermore, the morphological complexity determined by CT combined with heterogeneous FDG uptake determined by PET improved diagnostic accuracy.

  14. Internal hemorrhoids - their typical radiological appearance and differential diagnosis to carcinoma of rectum and anus

    Energy Technology Data Exchange (ETDEWEB)

    Fiedler, V.; Koester, R.

    1984-11-01

    The main indication for colon barium enema examination is occult bleeding or bleeding noticed by the patient himself. The radiologist has to take into account all clinical details that could lead to bleeding and to document them. The most frequent causes of rectal bleeding are hemorrhoids and diverticulosis/itis which in marked cases may have a tumor-like appearance. A good double-contrast examination of the colon must not only exclude tumors, polyps or inflammatary diseases but also demonstrate other causes of bleeding. The presented paper describes typical roentgen signs and gives criteria to differentiate hemorrhoids from deeply situated cancer of the rectum or anus.

  15. False positive diagnosis on (131)iodine whole-body scintigraphy of differentiated thyroid cancers.

    Science.gov (United States)

    Triggiani, Vincenzo; Giagulli, Vito Angelo; Iovino, Michele; De Pergola, Giovanni; Licchelli, Brunella; Varraso, Antonio; Dicembrino, Franca; Valle, Guido; Guastamacchia, Edoardo

    2016-09-01

    (131)Iodine is used both to ablate any residual thyroid tissue or metastatic disease and to obtain whole-body diagnostic images after total thyroidectomy for differentiated thyroid cancer (DTC). Even though whole-body scan is highly accurate in showing thyroid residues as well as metastases of DTC, false positive results can be found, possibly leading to diagnostic errors and unnecessary treatments. This paper reviews the physiological and pathological processes involved as well as the strategy to recognize and rule out false positive radioiodine images.

  16. Progeria with post-streptococcal glomerulonephritis: a rare case report with differential diagnosis.

    Science.gov (United States)

    Sebastian, Alphy A; Ahsan, Auswaf K

    2013-02-01

    Hutchinson-Gilford progeria syndrome is a rare autosomal dominant disorder associated with skin fragility. It is characterized by craniofacial disproportion, delayed dentition, micrognathia, and plucked bird appearance. The genetic defect is mainly de nova mutation in the lamin A gene. This report describes a 16-year-old patient with classical features of progeria along with post-streptococcal glomerulonephritis. The symptoms of hepatomegaly were also present in the patient. The differential diagnoses of this lesion are also discussed in detail in this literature.

  17. The Politics of Policy in Boys' Education: Getting Boys "Right"

    Science.gov (United States)

    Weaver-Hightower, Marcus B.

    2008-01-01

    This book explores boy-focused education policy and how different educators struggle to implement or resist it in their schools. Weaver-Hightower examines masculinity politics in Australia and the United States, mapping how these politics create panic over raising and educating boys the "Right" way. Contextualizing this policy with…

  18. The use of angiogenic and antiangiogenic factors in the differential diagnosis of pre-eclampsia, antiphospholipid syndrome nephropathy and lupus nephritis.

    Science.gov (United States)

    de Jesus, G R; de Jesus, N R; Levy, R A; Klumb, E M

    2014-10-01

    Pre-eclampsia (PE) is a major cause of maternal mortality and morbidity, perinatal deaths, preterm birth and intrauterine growth restriction. Differential diagnosis with antiphospholipid syndrome (APS) nephropathy and systemic lupus erythematosus (SLE) nephritis during pregnancy is difficult, if not sometimes impossible, as all three diseases may present hypertension and proteinuria. Improvement in diagnosis of PE has also offered new paths for differential diagnosis with other conditions and the analysis of angiogenic (vascular endothelial growth factor, placental growth factor) and antiangiogenic factors (serum soluble fms-like tyrosine kinase 1, soluble endoglin) is promising for differentiation between PE, APS nephropathy and SLE nephritis. This article reviews published studies about those factors in non-pregnant and pregnant patients with APS and SLE, comparing with patterns described in PE.

  19. Tender Papule Rising on the Digit: Pacinian Neuroma Should Be Considered in Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Hyun Hee Cho, Jong Soo Hong, Se Young Park, Hyun Sun Park, Soyun Cho, Jong Hee Lee

    2012-01-01

    Full Text Available Pacinian corpuscles are sensory nerve-end organs located in the deep dermis and subcutaneous tissue of the palms or soles. Pacinian neuroma is an extremely rare feature, defined as hyperplasia or hypertrophy of Pacinian corpuscles. About half of Pacinian neuromas present with point tenderness. There have been a limited number of cases reported around the world.We observed a 45-year-old woman with an 8-month history of a tender whitish papule on her left thumb tip. Histopathologically, an enlarged hypertrophic Pacinian corpuscle in subcutaneous tissue, surrounded by numerous nerve fibers, was found. Herein, we report a case of Pacinian neuroma presenting as a tender papule on a fingertip that was clearly related to repetitive trauma at that site. This case shows that a meticulous history and histological examination can lead to an exact diagnosis and proper treatment.

  20. Lung scintigraphy in differential diagnosis of peripheral lung cancer and community-acquired pneumonia

    Science.gov (United States)

    Krivonogov, Nikolay G.; Efimova, Nataliya Y.; Zavadovsky, Konstantin W.; Lishmanov, Yuri B.

    2016-08-01

    Ventilation/perfusion lung scintigraphy was performed in 39 patients with verified diagnosis of community-acquired pneumonia (CAP) and in 14 patients with peripheral lung cancer. Ventilation/perfusion ratio, apical-basal gradients of ventilation (U/L(V)) and lung perfusion (U/L(P)), and alveolar capillary permeability of radionuclide aerosol were determined based on scintigraphy data. The study demonstrated that main signs of CAP were increases in ventilation/perfusion ratio, perfusion and ventilation gradient on a side of the diseased lung, and two-side increase in alveolar capillary permeability rate for radionuclide aerosol. Unlike this, scintigraphic signs of peripheral lung cancer comprise an increase in ventilation/perfusion ratio over 1.0 on a side of the diseased lung with its simultaneous decrease on a contralateral side, normal values of perfusion and ventilation gradients of both lungs, and delayed alveolar capillary clearance in the diseased lung compared with the intact lung.