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Sample records for clinical diagnostic application

  1. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    OpenAIRE

    Asgar Aghaei Hashjin; Dionne Kringos; Hamid Ravaghi; Jila Manoochehri; Hassan Abolghasem Gorji; Niek Klazinga

    2015-01-01

    Background Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A d...

  2. Necessity and clinical application of diagnostic CT in PET-CT scanner

    International Nuclear Information System (INIS)

    PET scanning has a definite clinical impact on diagnosis, initial staging, restaging, monitoring therapeutic effects of malignancies, and on assessment of myocardial viability. Whereas, PET scans has false positive diagnosis and false negative diagnosis of malignant lesions. It leads to reduce specifity in PET imaging. application of diagnostic CT, especially applying contrast enhanced CT scans, three dimensional technique, CTA(CT angiography), CT perfusion and CT virtual endoscopy can realize dominance complementation with PET and CT, PET-CT imaging diagnosis combines with PET and CT diagnostic technique, it improves sensitivity, specifity, and accuracy in clinical application of PET-CT scanner. (authors)

  3. A review of clinical diagnostic applications of liquid chromatography-tandem mass spectrometry.

    Science.gov (United States)

    Shushan, Bori

    2010-01-01

    Liquid chromatography coupled with tandem mass spectrometry (LC/MS/MS) technology is emerging as a complementary method to traditional methodology used for clinical applications. Enhanced specificity and high-throughput capabilities are providing significant benefits to clinical diagnostic laboratories conducting routine analyses. This technology is expected to expand rapidly as scientists focus on more complicated challenges that can be solved efficiently by adding LC/MS/MS to their arsenal of techniques. PMID:20949635

  4. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    Directory of Open Access Journals (Sweden)

    Asgar Aghaei Hashjin

    2015-10-01

    Full Text Available Background Iran has a widespread diagnostics and clinical support services (DCSS network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%, pharmacopoeia availability (92%, equipment calibration (87% and identifying responsibilities (86%. Least reported was external auditing of the DCSS (57%. The clinical chemistry and microbiology laboratories (84%, pharmacies, blood bank services (83% reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%. There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO and private-for-profit hospitals than in governmental hospitals. Conclusion There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits can be improved. Both the effectiveness of QA

  5. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    Science.gov (United States)

    Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S.

    2015-01-01

    Background: Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods: A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results: The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. Conclusion: There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA

  6. En Route to the Clinic: Diagnostic Sequencing Applications Using the Ion Torrent ( 7th Annual SFAF Meeting, 2012)

    Energy Technology Data Exchange (ETDEWEB)

    Muzny, Donna [Baylor College of Medicine

    2012-06-01

    Donna Muzny on "En route to the clinic: Diagnostic sequencing applications using the Ion Torrent" at the 2012 Sequencing, Finishing, Analysis in the Future Meeting held June 5-7, 2012 in Santa Fe, New Mexico.

  7. A compact microscope setup for multimodal nonlinear imaging in clinics and its application to disease diagnostics.

    Science.gov (United States)

    Meyer, Tobias; Baumgartl, Martin; Gottschall, Thomas; Pascher, Torbjörn; Wuttig, Andreas; Matthäus, Christian; Romeike, Bernd F M; Brehm, Bernhard R; Limpert, Jens; Tünnermann, Andreas; Guntinas-Lichius, Orlando; Dietzek, Benjamin; Schmitt, Michael; Popp, Jürgen

    2013-07-21

    The past years have seen increasing interest in nonlinear optical microscopic imaging approaches for the investigation of diseases due to the method's unique capabilities of deep tissue penetration, 3D sectioning and molecular contrast. Its application in clinical routine diagnostics, however, is hampered by large and costly equipment requiring trained staff and regular maintenance, hence it has not yet matured to a reliable tool for application in clinics. In this contribution implementing a novel compact fiber laser system into a tailored designed laser scanning microscope results in a small footprint easy to use multimodal imaging platform enabling simultaneously highly efficient generation and acquisition of second harmonic generation (SHG), two-photon excited fluorescence (TPEF) as well as coherent anti-Stokes Raman scattering (CARS) signals with optimized CARS contrast for lipid imaging for label-free investigation of tissue samples. The instrument combining a laser source and a microscope features a unique combination of the highest NIR transmission and a fourfold enlarged field of view suited for investigating large tissue specimens. Despite its small size and turnkey operation rendering daily alignment dispensable the system provides the highest flexibility, an imaging speed of 1 megapixel per second and diffraction limited spatial resolution. This is illustrated by imaging samples of squamous cell carcinoma of the head and neck (HNSCC) and an animal model of atherosclerosis allowing for a complete characterization of the tissue composition and morphology, i.e. the tissue's morphochemistry. Highly valuable information for clinical diagnostics, e.g. monitoring the disease progression at the cellular level with molecular specificity, can be retrieved. Future combination with microscopic probes for in vivo imaging or even implementation in endoscopes will allow for in vivo grading of HNSCC and characterization of plaque deposits towards the detection of high

  8. Diagnostic utility and clinical application of imaging for pleural space infections.

    Science.gov (United States)

    Heffner, John E; Klein, Jeffrey S; Hampson, Christopher

    2010-02-01

    Timely diagnosis of pleural space infections and rapid initiation of effective pleural drainage for those patients with complicated parapneumonic effusions or empyema represent keystone principles for managing patients with pneumonia. Advances in chest imaging provide opportunities to detect parapneumonic effusions with high sensitivity in patients hospitalized for pneumonia and to guide interventional therapy. Standard radiographs retain their primary role for screening patients with pneumonia for the presence of an effusion to determine the need for thoracentesis. Ultrasonography and CT scanning, however, have greater sensitivity for fluid detection and provide additional information for determining the extent and nature of pleural infection. MRI and PET scan can image pleural disease, but their role in managing parapneumonic effusions is not yet clearly defined. Effective application of chest images for patients at risk for pleural infection, however, requires a comprehensive understanding of the unique features of each modality and relative value. This review presents the diagnostic usefulness and clinical application of chest imaging studies for evaluating and managing pleural space infections in patients hospitalized for pneumonia. PMID:20133295

  9. Comparison of novel clinically applicable methodology for sensitive diagnostics of cartilage degeneration

    Directory of Open Access Journals (Sweden)

    P Kiviranta

    2007-04-01

    Full Text Available In order efficiently to target therapies intending to stop or reverse degenerative processes of articular cartilage, it would be crucial to diagnose osteoarthritis (OA earlier and more sensitively than is possible with the existing clinical methods. Unfortunately, current clinical methods for OA diagnostics are insensitive for detecting the early degenerative changes, e.g., arising from collagen network damage or proteoglycan depletion. We have recently investigated several novel quantitative biophysical methods, including ultrasound indentation, quantitative ultrasound techniques and magnetic resonance imaging, for diagnosing the degenerative changes of articular cartilage, typical for OA. In this study, the combined results of these novel diagnostic methods were compared with histological (Mankin score, MS, compositional (proteoglycan, collagen and water content and mechanical (dynamic and equilibrium moduli reference measurements of the same bovine cartilage samples. Receiver operating characteristics (ROC analysis was conducted to judge the diagnostic performance of each technique. Indentation and ultrasound techniques provided the most sensitive measures to differentiate samples of intact appearance (MS=0 from early (13 degeneration. Furthermore, these techniques were good predictors of tissue composition and mechanical properties. The specificity and sensitivity analyses revealed that the mechano-acoustic methods, when further developed for in vivo use, may provide more sensitive probes for OA diagnostics than the prevailing qualitative X-ray and arthroscopic techniques. Noninvasive quantitative MRI measurements showed slightly lower diagnostic performance than mechano-acoustic techniques. The compared methods could possibly also be used for the quantitative monitoring of success of cartilage repair.

  10. [Clinical Application of Non-invasive Diagnostic Tests for Liver Fibrosis].

    Science.gov (United States)

    Shin, Jung Woo; Park, Neung Hwa

    2016-07-25

    The diagnostic assessment of liver fibrosis is an important step in the management of patients with chronic liver diseases. Liver biopsy is considered the gold standard to assess necroinflammation and fibrosis. However, recent technical advances have introduced numerous serum biomarkers and imaging tools using elastography as noninvasive alternatives to biopsy. Serum markers can be direct or indirect markers of the fibrosis process. The elastography-based studies include transient elastography, acoustic radiation force imaging, supersonic shear wave imaging and magnetic resonance elastography. As accumulation of clinical data shows that noninvasive tests provide prognostic information of clinical relevance, non-invasive diagnostic tools have been incorporated into clinical guidelines and practice. Here, the authors review noninvasive tests for the diagnosis of liver fibrosis. PMID:27443617

  11. 76 FR 28990 - Ultra High Throughput Sequencing for Clinical Diagnostic Applications-Approaches To Assess...

    Science.gov (United States)

    2011-05-19

    ... introduction of safe and effective innovative diagnostics in public health applications. II. Meeting Overview....) Comments: FDA is holding this public meeting to discuss a number of questions regarding appropriate... validation. FDA is holding this public meeting to start discussion on approaches that can provide the...

  12. The diagnostic evaluation of fine needle aspiration cytology of thyroid and its clinical application

    Institute of Scientific and Technical Information of China (English)

    Jiayu Zhang; Jian Wang

    2012-01-01

    Objective: The aim of the study was to investigate the diagnostic value of fine needle aspiration cytology (FNAC) and its clinical application. Methods: From April 2009 to February 2011, thyroid FNAC were performed in a total of 186 patients with thyroid nodule or mass in our hospital and 78 of those 186 patients subsequently underwent thyroidectomy. The FNAC findings were compared with the results of the corresponding histological diagnosis. Results: The results of thyroid FNAC for 186 patients showed that, (1) 166 cases of benign lesions, the detection rate was 89.24% (166/186), including 96 cases of nodular colloid goiter (51.61 %), 28 cases of simple colloid goiter (15.05%), 38 cases of Hashimoto's thyroiditis (HT) (20.43%) and 4 cases of thyroid adenoma (2.15%); (2) 4 cases of suspicious malignant lesion, the detection rate was 2.15% (4/186); (3) 16 cases of malignant tumor, the detection rate was 8.60% (16/186). Seventy eight patients including malignant (16), suspicious malignant (4), HT (20) and nodular colloid goiters (38) cases diagnosed by FNAC were performed operation with thyroidectomy and the postoperative histopathologic results showed that there were 2 cases HT combined thyroid papillary carcinoma in HT 20 cases by FNAC, 15 cases of thyroid papillary carcinoma and 1 case of follicular carcinoma in 16 cases of malignant tumor by FNAC and 4 case of thyroid papillary carcinoma in 4 cases of suspicious malignant by FNAC. Conclusion: Thyroid FNAC is a valuable and reliable method for the diagnosis of the thyroid nodules or mass or even most diffuse thyroid diseases. Diagnosis of HT and thyroid papillary carcinoma can be made by thyroid FNAC. There was larger hint value for nodular colloid goiter and simple colloid goiter according to thyroid FNAC.

  13. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond;

    2014-01-01

    diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project-the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search......, assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions. CONCLUSION: The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More...

  14. Clinical applicability of various dengue diagnostic tests in resource-limited endemic settings

    OpenAIRE

    Baijayantimala Mishra; Gupta, Puneet K.; Vandana Dhiman; Sujit K Pujhari; Mirnalini Sharma; Radha K Ratho

    2014-01-01

    Introduction: Dengue is one of the most important arboviral infections caused by one of the four dengue serotypes, 1-4. Objective: To study the applicability of different diagnostic methods in diagnosis of dengue viral infection. Materials and Methods: A total of 2101 blood samples were collected for confirmation of dengue viral infection. All the samples were tested by dengue-specific IgM ELISA, of which 111 were also tested for NS1 antigen detection and 27 acute samples (≤5 days) were furth...

  15. Application of Massively Parallel Sequencing in the Clinical Diagnostic Testing of Inherited Cardiac Conditions

    Directory of Open Access Journals (Sweden)

    Ivone U. S. Leong

    2014-06-01

    Full Text Available Sudden cardiac death in people between the ages of 1–40 years is a devastating event and is frequently caused by several heritable cardiac disorders. These disorders include cardiac ion channelopathies, such as long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and Brugada syndrome and cardiomyopathies, such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy. Through careful molecular genetic evaluation of DNA from sudden death victims, the causative gene mutation can be uncovered, and the rest of the family can be screened and preventative measures implemented in at-risk individuals. The current screening approach in most diagnostic laboratories uses Sanger-based sequencing; however, this method is time consuming and labour intensive. The development of massively parallel sequencing has made it possible to produce millions of sequence reads simultaneously and is potentially an ideal approach to screen for mutations in genes that are associated with sudden cardiac death. This approach offers mutation screening at reduced cost and turnaround time. Here, we will review the current commercially available enrichment kits, massively parallel sequencing (MPS platforms, downstream data analysis and its application to sudden cardiac death in a diagnostic environment.

  16. Biofluid infrared spectro-diagnostics: pre-analytical considerations for clinical applications.

    Science.gov (United States)

    Lovergne, L; Bouzy, P; Untereiner, V; Garnotel, R; Baker, M J; Thiéfin, G; Sockalingum, G D

    2016-06-23

    Several proof-of-concept studies on the vibrational spectroscopy of biofluids have demonstrated that the methodology has promising potential as a clinical diagnostic tool. However, these studies also show that there is a lack of a standardised protocol in sample handling and preparation prior to spectroscopic analysis. One of the most important sources of analytical errors is the pre-analytical phase. For the technique to be translated into clinics, it is clear that a very strict protocol needs to be established for such biological samples. This study focuses on some of the aspects of the pre-analytical phase in the development of the high-throughput Fourier Transform Infrared (FTIR) spectroscopy of some of the most common biofluids such as serum, plasma and bile. Pre-analytical considerations that can impact either the samples (solvents, anti-coagulants, freeze-thaw cycles…) and/or spectroscopic analysis (sample preparation such as drying, deposit methods, volumes, substrates, operators dependence…) and consequently the quality and the reproducibility of spectral data will be discussed in this report.

  17. Radiation exposure and image quality in x-Ray diagnostic radiology physical principles and clinical applications

    CERN Document Server

    Aichinger, Horst; Joite-Barfuß, Sigrid; Säbel, Manfred

    2012-01-01

    The largest contribution to radiation exposure to the population as a whole arises from diagnostic X-rays. Protecting the patient from radiation is a major aim of modern health policy, and an understanding of the relationship between radiation dose and image quality is of pivotal importance in optimising medical diagnostic radiology. In this volume the data provided for exploring these concerns are partly based on X-ray spectra, measured on diagnostic X-ray tube assemblies, and are supplemented by the results of measurements on phantoms and simulation calculations.

  18. Clinical application of radionuclear diagnostic method to select treatments for circulatory diseases and its evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Yoshio; Fukuchi, Kazuki; Nonogi, Hiroshi; Miyatake, Kunio [National Cardiovascular Center, Suita, Osaka (Japan)

    1999-02-01

    Application of {sup 18}F-fluorodeoxyglucose (EDG) PET and its diagnostic significance were investigated and myocardial viability was assessed for coronary revascularization in the patients with ischemic cardial disease. Time-course changes in {sup 18}F-FDG PET image were monitored in 15 patients with acute cardiac infarction to decide the test timing for assessment of viability. In acute phase of infarction, it was found difficult to evaluate the viability of cardiac muscles based on the amount of {sup 18}F-FDG accumulated in the muscles under fasting conditions. Since {sup 18}F-FDG is also accumulated in the normal cardiac muscles under glucose loading conditions, the ratio of radioactivity in the region of infarction to that in the normal region (I/N) was used for the evaluation. The viability of cardiac muscles in the acute phase could be assessed with I/N ratio as a parameter. Next, efficacies of {sup 13}N-ammonia PET at resting state and {sup 18}F-FDG PET under glucose loading were investigated in inveterate cardiac infarction. When compared with {sup 13}N-ammonia accumulation, a greater accumulation of {sup 18}F-FDG was observed in the patient with inferior myocardial infarction, suggesting the presence of viable muscles. Thus, cardio-motility was improved by CABG on the right coronal artery. Then, motion of a regional wall was evaluated by Bull`s eye method. Significant differences in blood flow-metabolism mismatch on Bull`s eye map were found between the viability (+) group and the viability (-) group. These results suggest that Bull`s eye technique is very useful method for evaluation of regional wall motion and also, imaging under glucose loading conditions is superior to that under fasting ones. (M.N.)

  19. Applications of Microfluidics for Molecular Diagnostics

    OpenAIRE

    Jayamohan, Harikrishnan; Sant, Himanshu J.; Bruce K. Gale

    2012-01-01

    Diagnostic assays implemented in microfluidic devices have developed rapidly over the past decade and are expected to become commonplace in the next few years. Hundreds of microfluidics-based approaches towards clinical diagnostics and pathogen detection have been reported with a general theme of rapid and customizable assays that are potentially cost-effective. This chapter reviews microfluidics in molecular diagnostics based on application areas with a concise review of microfluidics in gen...

  20. Application of Molecular Diagnostics in Primary Detection of ESBL Directly from Clinical Specimens.

    Science.gov (United States)

    Sittová, Martina; Röderová, Magdaléna; Dendis, Miloš; Hricová, Kristýna; Pudová, Vendula; Horváth, Radek; Růžička, Filip; Dosoudilová, Šárka; Kolář, Milan

    2015-06-01

    The infections caused by extended-spectrum β-lactamase (ESBL)-producing organisms are associated with increased mortality. The real-time polymerase chain reaction (PCR) method, which enables detection of ESBLs directly from patients' clinical material, was developed. This study focused on blaCTX-M and blaSHV determination in endotracheal aspirates. Each sample was identified with standard microbiological procedures and simultaneously analyzed for the presence of nucleic acids, which encode CTX-M and SHV ESBL enzymes using real-time PCR. A total of 341 samples were investigated. In the set, 27 ESBL-positive samples were identified by phenotypic methods, while 60 positive samples were identified by the PCR method. Of the 60 PCR-positive samples, 58 were positive for the blaCTX-M. In two samples, the ESBL blaSHV-ESBL gene was detected. One phenotypically positive sample was PCR negative. The real-time PCR assay does not require a cultivation step and therefore enables detection of ESBL in 6 hours. The rapid method is necessary for early and adequate antimicrobial treatment. PMID:25588196

  1. Objective pain diagnostics: clinical neurophysiology.

    Science.gov (United States)

    Garcia-Larrea, L

    2012-06-01

    Neurophysiological techniques help in diagnosis, prognosis and treatment of chronic pain, and are particularly useful to determine its neuropathic origin. According to current standards, the diagnosis of definite neuropathic pain (NP) needs objective confirmation of a lesion or disease of somatosensory systems, which can be provided by neurophysiological testing. Lesions causing NP mostly concern the pain-temperature pathways, and therefore neurophysiological procedures allowing the specific testing of these pathways (i.e., A-delta and C-fibres, spino-thalamo-cortical tracts) are essential for objective diagnosis. Different techniques to stimulate selectively pain-temperature pathways are discussed. Of these, laser-evoked potentials (LEPs) appear as the easiest and most reliable neurophysiological method of assessing nociceptive function, and their coupling with autonomic responses (e.g., galvanic skin response) and psychophysics (quantitative sensory testing - QST) can still enhance their diagnostic yield. Neurophysiological techniques not exploring specifically nociception, such as standard nerve conduction velocities (NCV) and SEPs to non-noxious stimulation, should be associated to the exploration of nociceptive systems, not only because both may be simultaneously affected to different degrees, but also because some specific painful symptoms, such as paroxysmal discharges, may depend on specific alteration of highly myelinated A-beta fibres. The choice of techniques is determined after anamnesis and clinical exam, and tries to answer a number of questions: (a) is the pain-related to injury of somatosensory pathways?; (b) to what extent are different subsystems affected?; (c) are mechanisms and lesion site in accordance with imaging data?; (d) are results of use for diagnostic or therapeutic follow-up? Neuropathic pain (NP) affects more than 15 million people in Western countries, and its belated diagnosis leads to insufficient or delayed therapy. The use of

  2. MDS clinical diagnostic criteria for Parkinson's disease

    NARCIS (Netherlands)

    Postuma, R.B.; Berg, D; Stern, M.; Poewe, W.; Olanow, C.W.; Oertel, W.; Obeso, J.; Marek, K.; Litvan, I.; Lang, A.E.; Halliday, G.; Goetz, C.G.; Gasser, T.; Dubois, B.; Chan, P.; Bloem, B.R.; Adler, C.H.; Deuschl, G.

    2015-01-01

    This document presents the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (PD). The Movement Disorder Society PD Criteria are intended for use in clinical research but also may be used to guide clinical diagnosis. The benchmark for these criteria is expert clinical di

  3. Industrial applications of laser diagnostics

    CERN Document Server

    Deguchi, Yoshihiro

    2011-01-01

    Tighter regulations of harmful substances such as NOx, CO, heavy metals, particles, emissions from commercial plants and automobiles reflect a growing demand for lowering the anthropogenic burdens on the environment. It is equally important to monitor controlling factors to improve the operation of industrial machinery and plants. Among the many methods for doing this, laser diagnostics stands out. Taking a practical approach, Industrial Applications of Laser Diagnostics discusses how to apply laser diagnostics to engines, gas turbines, thermal and chemical plant systems, and disposal faciliti

  4. Symptom diagnostics based on clinical records

    NARCIS (Netherlands)

    de Jong, Marianne; Punt, Marja; de Groot, Erik; Hielkema, Tjitske; Struik, Marianne; Minderaa, Ruud B.; Hadders-Algra, Mijna

    2009-01-01

    Child psychiatric diagnoses are generally based on a clinical examination and not on standardized questionnaires. The present study assessed whether symptom diagnostics based on clinical records facilitates the use of non-standardized clinical material for research. Six hundred and eighty-five child

  5. Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome

    OpenAIRE

    Calis, M.; Akgun, K; Birtane, M; Karacan, I; Calis, H.; Tuzun, F.

    2000-01-01

    OBJECTIVE—Subacromial impingement syndrome (SIS) is a frequent cause of shoulder pain. The aim of this study was to investigate the diagnostic values of clinical diagnostic tests, in patients with SIS.
METHODS—72 female, 48 male patients with shoulder pain were included in the study. Five had bilateral shoulder pain, so 125 painful shoulders were evaluated. Details were recorded about the patients' ages and sexes, as well as characteristics of pain and related problems. Detailed physical exam...

  6. Molecular Diagnostic Applications in Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Laura Huth

    2014-06-01

    Full Text Available Colorectal cancer, a clinically diverse disease, is a leading cause of cancer-related death worldwide. Application of novel molecular diagnostic tests, which are summarized in this article, may lead to an improved survival of colorectal cancer patients.  Distinction of these applications is based on the different molecular principles found in colorectal cancer (CRC. Strategies for molecular analysis of single genes (as KRAS or TP53 as well as microarray based techniques are discussed. Moreover, in addition to the fecal occult blood testing (FOBT and colonoscopy some novel assays offer approaches for early detection of colorectal cancer like the multitarget stool DNA test or the blood-based Septin 9 DNA methylation test. Liquid biopsy analysis may also exhibit great diagnostic potential in CRC for monitoring developing resistance to treatment. These new diagnostic tools and the definition of molecular biomarkers in CRC will improve early detection and targeted therapy of colorectal cancer.

  7. Clinical PET application

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang-Moo; Hong, S. W.; Choi, C. W.; Yang, S. D.; Choi, J. S.; Kweon, O. J. et al. [Korea Cancer Center Hospital, Seoul (Korea)

    2000-12-01

    PET gives various metabolic images, and is very important, new diagnostic modality in clinical oncology. In Korea Cancer Center Hospital, PET is installed as a research tool of long-mid-term atomic research project. For the efficient use of PET for clinical and research projects, income from the patients should be managed to get the raw material, equipment, manpower, and also for the clinical PET research. 1. Support the clinical application of PET in oncology. 2. Budgetary management of income, costs for raw material, equipment, manpower, and the clinical PET research project. In this year, 1,327 cases of PET images were obtained, which resulted total income of 829,770,000won. Increased demand for {sup 18}FDG in and outside KCCH need more than 2 times production of {sup 18} in a day. Manpower should be added for the second PET operation and RI production. 10 figs., 4 tabs. (Author)

  8. Elastography as a new diagnostic tool to detect breast cancer – evaluation of research and clinical applications

    Directory of Open Access Journals (Sweden)

    Paweł Rzymski

    2011-10-01

    Full Text Available Mammography and ultrasonography are currently the most sensitive methods for detecting breast cancer,but elastography is a new diagnostic tool. Stiffness of invasive carcinomas were found to be 5-25 times largerthan that of normal adipose tissue. There are basically two types of elastography examination used in initialclinical research: conventional elastography with compression and shear wave elastography. Analysis of 20 studiesin the years 1997-2010 with 1484 malignant and 2822 benign breast lesions is presented in this paper. Theoverall sensitivity was 67-100% with specificity of 62-99% for elastography. This raises the hope of introducingthis method in the BI-RADS classification and modifying diagnostics in category 3-4.

  9. Assembling Amperometric Biosensors for Clinical Diagnostics

    Directory of Open Access Journals (Sweden)

    Claudia Marina Lagier

    2007-02-01

    Full Text Available Clinical diagnosis and disease prevention routinely require the assessment ofspecies determined by chemical analysis. Biosensor technology offers several benefits overconventional diagnostic analysis. They include simplicity of use, specificity for the targetanalyte, speed to arise to a result, capability for continuous monitoring and multiplexing,together with the potentiality of coupling to low-cost, portable instrumentation. This workfocuses on the basic lines of decisions when designing electron-transfer-based biosensorsfor clinical analysis, with emphasis on the strategies currently used to improve the deviceperformance, the present status of amperometric electrodes for biomedicine, and the trendsand challenges envisaged for the near future.

  10. Clinical PET application

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Moo; Hong, Song W.; Choi, Chang W.; Yang, Seong Dae [Korea Cancer Center Hospital, Seoul (Korea)

    1997-12-01

    PET gives various methabolic images, and is very important, new diagnostic modality in clinical oncology. In Korea Cancer Center Hospital, PET is installed as a research tool of long-mid-term atomic research project. For the efficient use of PET for clinical and research projects, income from the patients should be managed to get the raw material, equipment, manpower, and also for the clinical PET research. 1. Support the clinical application of PET in oncology. 2. Budgetary management of income, costs for raw material, equipment, manpower, and the clinical PET research project. In this year, 250 cases of PET images were obtained, which resulted total income of 180,000,000 won. 50,000,000 won was deposited for the 1998 PET clinical research. Second year PET clinical research should be managed under unified project. Increased demand for {sup 18}FDG in and outside KCCH need more than 2 times production of {sup 18}FDG in a day purchase of HPLC pump and {sup 68}Ga pin source which was delayed due to economic crisis, should be done early in 1998. (author). 2 figs., 3 tabs.

  11. Diagnostic clinical features of atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Sharma Lata

    2001-01-01

    Full Text Available Atopic dermatitis is a common disease which varies widely in clinical presentation at different ages and places. Although authors working in western countries on white races have suggested many criteria, there is no uniform set which can be used in large population studies in this part of the world. Hence keeping in mind differences in environment and ethnicity of population, the present study was carried out. Seventy- three patients of atopic dermatitis and 71 age matched controls were studied. All the subjects were examined using a set of 34 potentially useful clinical features selected from different studies, including features for evaluation of photosensitivity. Multiple regression technique was used for analysing the data. It was found that 6 clinical features were diagnostic, 1. presence of itch, 2. history of flexural involvement, 3. history of dry skin, 4. family history of atopy, 5. personal history of diagnosed asthma and 6, visible flexural dermatitis. Photosensitivity was not a significant feature.

  12. Clinical application of nuclear medical diagnostic method for adaptation deciion of treatment for circulatory disease and evaluation of its efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Yoshio; Hayashida, Kohei; Fukuchi, Kazuki [National Cardiovascular Center, Suita, Osaka (Japan)

    2000-02-01

    In this study, the conditions of patients to which cerebral revascularization through anastomosis of internal and external carotid arteries is applicable were investigated. In the first part, classification of the degree of cerebrovascular disease was attempted using positron emission tomography (PET) and in the second, cerebral blood circulation was evaluated using cerebral SPECT to consider in respect of advisability of the revascularization surgery. Since cerebral ischemia tends to be induced by enhancement of cerebral oxygen uptake, cerebral revascularization was thought to be restricted to the patients with cerebrovascular disease in stage 2. So, cerebral blood flow, cerebral blood volume and cerebral oxygen metabolism were compared among the patients in stage 1 and stage 2, and the normal control. The blood flow was decreased with the severity of disease and lowest in the patients of stage 2. There were significant differences in the oxygen metabolism and blood volume between the patient stage 1 and the control. The cerebral blood flow in patient in stage 2 was decreased to a level below the self-control range, leading to an increase in the cerebral oxygen uptake. Therefore, it was concluded that the severity of cerebrovascular disease could be estimated with cerebrocirculation index and vasodilation ability determined by cerebral SPECT. Patients of which cerebral blood flow is decreased by more than 28.0% can be regarded as the patient in stage 2. When cerebral blood volume determined by IMP-ARG method and PET method and was compared, underestimation was 34.5% for plane phantom and 11% for cranial pseudo phantom. Further classification would be made on the basis of vascular response under the conditions of Diamox loading and it was concluded that cases of which decrease in cerebral blood flow is 10% or less were applicable to cerebral revascularization. (M.N.)

  13. THE PROBLEMS OF EARLY CLINICAL DEFECTOLOGICAL DIAGNOSTICS

    Directory of Open Access Journals (Sweden)

    Aleksandar CORDIC

    1997-06-01

    Full Text Available Clinical defectological diagnostics, related to diagnostics of each individual's impairment of his cognitive and socializing abilities, has been applied in our country for a long time. Since it is a new area in the clinical defectological work and a new form of research in defectology, it poses a series of problems which have not been met so far. We shall to recognize some of them in this paper and to aim at their solution.This time we shall consider only the most prominent problems towards which we direct our interventions:· When does defectological diagnostics take part in diagnosis as treatment of impairments of the handicapped person? When does it function in the process of rehabilitation? For example, is working with a dyslexic child treatment or rehabilitation?· When does the early diagnostics reveal a problem arising from inappropriate intersection of different development courses, which can sometimes be solved without any particular treatment (early stuttering, various convulsions, and when does it reveal actual condition, such as oligophrenia or autism. Thereby we ask ourselves if early stimulative treatment of oligophrenic children or children with early childhood psychosis is treatment or rehabilitation.We tried to classify end explain the problems of diagnostics in the context of treatment and rehabilitation and to define the theoretical grounds for our standpoints.We wanted to point out the unity of the process of any impairment of the handicapped person from early childhood to the end of his life. Treatment and rehabilitation should be a united process and follow the course of development of early disorders which sometimes end up as handicaps, and sometimes, thanks to the treatment, may end up in successful socialization, for example, persons with impaired hearing or sight.We establish defectology as a complete theoretical standpoint and expert procedure which is parallel to and complementary with medicine. The only difference we

  14. Gold Nanoparticles and Nanocomposites in Clinical Diagnostics Using Electrochemical Methods

    Directory of Open Access Journals (Sweden)

    Pranjal Chandra

    2013-01-01

    Full Text Available Progress and development in clinical diagnostics certainly focus upon the advances in the nanomaterials, particularly gold nanoparticles (AuNPs that offer promise to solve the biocompatible and sensitive detection systems. This paper focuses on the recent application of AuNPs in clinical diagnosis. Various important methods of AuNPs synthesis and their application in clinical detection of various biomolecules using electrochemical detection methods have been described. AuNPs alone and in various composites are also described based on the various biosensors design recently published for the detection of cancer biomarkers, proteins, bacteria, and cancer cells. The effect of AuNPs type and size in clinical detection has also been briefly illustrated.

  15. Saliva-based biosensors: noninvasive monitoring tool for clinical diagnostics.

    Science.gov (United States)

    Malon, Radha S P; Sadir, Sahba; Balakrishnan, Malarvili; Córcoles, Emma P

    2014-01-01

    Saliva is increasingly recognised as an attractive diagnostic fluid. The presence of various disease signalling salivary biomarkers that accurately reflect normal and disease states in humans and the sampling benefits compared to blood sampling are some of the reasons for this recognition. This explains the burgeoning research field in assay developments and technological advancements for the detection of various salivary biomarkers to improve clinical diagnosis, management, and treatment. This paper reviews the significance of salivary biomarkers for clinical diagnosis and therapeutic applications, with focus on the technologies and biosensing platforms that have been reported for screening these biomarkers.

  16. Saliva-Based Biosensors: Noninvasive Monitoring Tool for Clinical Diagnostics

    Directory of Open Access Journals (Sweden)

    Radha S. P. Malon

    2014-01-01

    Full Text Available Saliva is increasingly recognised as an attractive diagnostic fluid. The presence of various disease signalling salivary biomarkers that accurately reflect normal and disease states in humans and the sampling benefits compared to blood sampling are some of the reasons for this recognition. This explains the burgeoning research field in assay developments and technological advancements for the detection of various salivary biomarkers to improve clinical diagnosis, management, and treatment. This paper reviews the significance of salivary biomarkers for clinical diagnosis and therapeutic applications, with focus on the technologies and biosensing platforms that have been reported for screening these biomarkers.

  17. Towards advanced OCT clinical applications

    Science.gov (United States)

    Kirillin, Mikhail; Panteleeva, Olga; Agrba, Pavel; Pasukhin, Mikhail; Sergeeva, Ekaterina; Plankina, Elena; Dudenkova, Varvara; Gubarkova, Ekaterina; Kiseleva, Elena; Gladkova, Natalia; Shakhova, Natalia; Vitkin, Alex

    2015-07-01

    In this paper we report on our recent achievement in application of conventional and cross-polarization OCT (CP OCT) modalities for in vivo clinical diagnostics in different medical areas including gynecology, dermatology, and stomatology. In gynecology, CP OCT was employed for diagnosing fallopian tubes and cervix; in dermatology OCT for monitoring of treatment of psoriasis, scleroderma and atopic dermatitis; and in stomatology for diagnosis of oral diseases. For all considered application, we propose and develop different image processing methods which enhance the diagnostic value of the technique. In particular, we use histogram analysis, Fourier analysis and neural networks, thus calculating different tissue characteristics as revealed by OCT's polarization evolution. These approaches enable improved OCT image quantification and increase its resultant diagnostic accuracy.

  18. Clinical Training of Medical Physicists Specializing in Diagnostic Radiology

    International Nuclear Information System (INIS)

    The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

  19. Orthogonal NGS for High Throughput Clinical Diagnostics.

    Science.gov (United States)

    Chennagiri, Niru; White, Eric J; Frieden, Alexander; Lopez, Edgardo; Lieber, Daniel S; Nikiforov, Anastasia; Ross, Tristen; Batorsky, Rebecca; Hansen, Sherry; Lip, Va; Luquette, Lovelace J; Mauceli, Evan; Margulies, David; Milos, Patrice M; Napolitano, Nichole; Nizzari, Marcia M; Yu, Timothy; Thompson, John F

    2016-04-19

    Next generation sequencing is a transformative technology for discovering and diagnosing genetic disorders. However, high-throughput sequencing remains error-prone, necessitating variant confirmation in order to meet the exacting demands of clinical diagnostic sequencing. To address this, we devised an orthogonal, dual platform approach employing complementary target capture and sequencing chemistries to improve speed and accuracy of variant calls at a genomic scale. We combined DNA selection by bait-based hybridization followed by Illumina NextSeq reversible terminator sequencing with DNA selection by amplification followed by Ion Proton semiconductor sequencing. This approach yields genomic scale orthogonal confirmation of ~95% of exome variants. Overall variant sensitivity improves as each method covers thousands of coding exons missed by the other. We conclude that orthogonal NGS offers improvements in variant calling sensitivity when two platforms are used, better specificity for variants identified on both platforms, and greatly reduces the time and expense of Sanger follow-up, thus enabling physicians to act on genomic results more quickly.

  20. Liver angioscintigraphy: clinical applications.

    Science.gov (United States)

    Dragoteanu, Mircea; Cotul, Sabin O; Pîgleşan, Cecilia; Tamaş, Stefan

    2004-03-01

    Liver angioscintigraphy (LAS) is a radio-isotope method for the investigation of liver perfusion and its alteration in various hepatic diseases. It measures the arterial and portal venous fractions of total liver blood flow. The percentage of liver blood flow supplied by hepatic artery is estimated mathematically by the hepatic perfusion index (HPI), normally between 25 % and 40 %. The decrease of portal blood flow in liver cirrhosis is compensated ("buffer" mechanisms) by increased arterial supply, with higher HPI value. For a patient with chronic liver disease, HPI over 50% suggests arterialization of hepatic perfusion, guiding the diagnose to liver cirrhosis. Splenic curve is completing the diagnostic information of the hepatic curve. Corroborated with per rectal scintigraphy and liver SPECT, LAS offers a good hemodynamic staging of chronic inflammatory liver diseases. Malignant tumors (primitive or metastases) increase the arterial supply of the liver and decrease the portal flow, HPI being over 50% (currently 65 % - 90 %). Benign tumors do not change portal/arterial liver blood flow ratio. SPECT or non-scintigraphic morphological investigations increase the diagnostic value of LAS for primitive liver tumors. Liver cancer occurring on cirrhosis is a limitative factor for LAS. Hepatic metastases increase the arterial perfusion (and HPI value) very quickly, before their size allows morphologic imaging diagnosis. LAS is therefore an early method to diagnose liver metastases being especially used in colorectal cancer. Other clinical applications of LAS are: follow up of liver toxicity of drugs, evaluation of portal vein permeability, post surgery follow up of the liver tumor patients. PMID:15054528

  1. Autoimmune diagnostics: the technology, the strategy and the clinical governance.

    Science.gov (United States)

    Bizzaro, Nicola; Tozzoli, Renato; Villalta, Danilo

    2015-02-01

    In recent years, there has been a profound change in autoimmune diagnostics. From long, tiring and inaccurate manual methods, the art of diagnostics has turned to modern, rapid and automated technology. New antibody tests have been developed, and almost all autoimmune diseases now have some specific diagnostic markers. The current need to make the most of available economic and human resources has led to the production of diagnostic algorithms and guidelines designated for optimal strategic use of the tests and to increase the diagnostic appropriateness. An important role in this scenario was assumed by the laboratory autoimmunologist, whose task is not only to govern the analytical phase, but also to help clinicians in correctly choosing the most suitable test for each clinical situation and provide consultancy support. In this review, we summarize recent advances in technology, describe the diagnostic strategies and highlight the current role of the laboratory autoimmunologist in the clinical governance of autoimmune diagnostics. PMID:25398640

  2. Applications of molecular diagnostics techniques in clinical microbiology laboratory%分子诊断技术在临床微生物学检验中的应用

    Institute of Scientific and Technical Information of China (English)

    孙长贵; 成军

    2013-01-01

    Applications of molecular diagnostics in clinical microbiology laboratory were introduced in the article,including nucleic acid hybridization,nucleic acid amplification,DNA sequencing,gene chips and mass spectrometry.Molecular diagnostic techniques provide major tools for rapid diagnosis of infectious diseases,molecular epidemiology investigation,rapid identification of microbial pathogens and the study of the pathogenicity and antibiotics resistance.The application of these new technologies,as the complement of traditional culture methods,increases sensitivity,accuracy and diagnostic efficiency of assays.%主要介绍分子诊断技术在临床微生物学检验中的应用,内容包括核酸杂交、核酸扩增、DNA测序、基因芯片和质谱技术.分子诊断技术为感染病的快速诊断、分子流行病学调查、微生物的快速鉴定、病原菌的致病性和抗生素的耐受性研究等提供了重要的检测手段.这些新技术的应用,作为传统培养法的补充,提高了检测的灵敏度、准确性和诊断效率.

  3. Better clinical decision making and reducing diagnostic error.

    Science.gov (United States)

    Croskerry, P; Nimmo, G R

    2011-06-01

    A major amount of our time working in clinical practice involves thinking and decision making. Perhaps it is because decision making is such a commonplace activity that it is assumed we can all make effective decisions. However, this is not the case and the example of diagnostic error supports this assertion. Until quite recently there has been a general nihilism about the ability to change the way that we think, but it is now becoming accepted that if we can think about, and understand, our thinking processes we can improve our decision making, including diagnosis. In this paper we review the dual process model of decision making and highlight ways in which decision making can be improved through the application of this model to our day-to-day practice and by the adoption of de-biasing strategies and critical thinking. PMID:21677922

  4. Diagnostic metagenomics: potential applications to bacterial, viral and parasitic infections

    OpenAIRE

    Pallen, M. J.

    2014-01-01

    SUMMARY The term ‘shotgun metagenomics’ is applied to the direct sequencing of DNA extracted from a sample without culture or target-specific amplification or capture. In diagnostic metagenomics, this approach is applied to clinical samples in the hope of detecting and characterizing pathogens. Here, I provide a conceptual overview, before reviewing several recent promising proof-of-principle applications of metagenomics in virus discovery, analysis of outbreaks and detection of pathogens in ...

  5. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network and orofacial pain special interest group

    NARCIS (Netherlands)

    E. Schiffman; R. Ohrbach; E. Truelove; J. Look; G. Anderson; J.P. Goulet; T. List; P. Svensson; Y. Gonzalez; F. Lobbezoo; A. Michelotti; S.L. Brooks; W. Ceusters; M. Drangsholt; D. Ettlin; C. Gaul; L.J. Goldberg; J.A. Haythornthwaite; L. Hollender; R. Jensen; M.T. John; A. De Laat; R. de Leeuw; W. Maixner; M. van der Meulen; G.M. Murray; D.R. Nixdorf; S. Palla; A. Petersson; P. Pionchon; B. Smith; C.M. Visscher; J. Zakrzewska; S.F. Dworkin

    2014-01-01

    AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.

  6. Prime time to resuscitate clinical medicine and kill diagnostic greed?

    Science.gov (United States)

    Rajasoorya, C

    2016-09-01

    Modern healthcare faces the challenges of rising costs, increasing expectations of patients and changing disease patterns. Physicians practise medicine in an era of easy availability and access to a plethora of modern and sometimes expensive diagnostic aids. The powerful utility of clinical skills cannot be underestimated nor lost. The physician has a powerful platform to encourage the rational use of tests, prevent wasteful overutilisation and ensure that tests do not cause more harm than benefit in physical, emotional or financial terms. Diagnostic skills should not be substituted by diagnostic greed. It is possible to do more for the patient rather than to the patient. PMID:27664173

  7. Real-Time Polymerase Chain Reaction: Applications in Diagnostic Microbiology

    Directory of Open Access Journals (Sweden)

    Kordo B. A. Saeed

    2013-11-01

    Full Text Available The polymerase chain reaction (PCR has revolutionized the detection of DNA and RNA. Real-Time PCR (RT-PCR is becoming the gold standard test for accurate, sensitive and fast diagnosis for a large range of infectious agents. Benefits of this procedure over conventional methods for measuring RNA include its sensitivity, high throughout and quantification. RT-PCR assays have advanced the diagnostic abilities of clinical laboratories particularly microbiology and infectious diseases. In this review we would like to briefly discuss RT-PCR in diagnostic microbiology laboratory, beginning with a general introduction to RT-PCR and its principles, setting up an RT PCR, including multiplex systems and the avoidance and remediation of contamination issues. A segment of the review would be devoted to the application of RT-PCR in clinical practice concentrating on its role in the diagnosis and treatment of infectious diseases.

  8. Diagnostic clinical features of atopic dermatitis

    OpenAIRE

    Sharma Lata

    2001-01-01

    Atopic dermatitis is a common disease which varies widely in clinical presentation at different ages and places. Although authors working in western countries on white races have suggested many criteria, there is no uniform set which can be used in large population studies in this part of the world. Hence keeping in mind differences in environment and ethnicity of population, the present study was carried out. Seventy- three patients of atopic dermatitis and 71 age matched controls were studi...

  9. Automated spectral imaging for clinical diagnostics

    Science.gov (United States)

    Breneman, John; Heffelfinger, David M.; Pettipiece, Ken; Tsai, Chris; Eden, Peter; Greene, Richard A.; Sorensen, Karen J.; Stubblebine, Will; Witney, Frank

    1998-04-01

    Bio-Rad Laboratories supplies imaging equipment for many applications in the life sciences. As part of our effort to offer more flexibility to the investigator, we are developing a microscope-based imaging spectrometer for the automated detection and analysis of either conventionally or fluorescently labeled samples. Immediate applications will include the use of fluorescence in situ hybridization (FISH) technology. The field of cytogenetics has benefited greatly from the increased sensitivity of FISH producing simplified analysis of complex chromosomal rearrangements. FISH methods for identification lends itself to automation more easily than the current cytogenetics industry standard of G- banding, however, the methods are complementary. Several technologies have been demonstrated successfully for analyzing the signals from labeled samples, including filter exchanging and interferometry. The detection system lends itself to other fluorescent applications including the display of labeled tissue sections, DNA chips, capillary electrophoresis or any other system using color as an event marker. Enhanced displays of conventionally stained specimens will also be possible.

  10. Nanophotonics for Molecular Diagnostics and Therapy Applications

    Directory of Open Access Journals (Sweden)

    João Conde

    2012-01-01

    Full Text Available Light has always fascinated mankind and since the beginning of recorded history it has been both a subject of research and a tool for investigation of other phenomena. Today, with the advent of nanotechnology, the use of light has reached its own dimension where light-matter interactions take place at wavelength and subwavelength scales and where the physical/chemical nature of nanostructures controls the interactions. This is the field of nanophotonics which allows for the exploration and manipulation of light in and around nanostructures, single molecules, and molecular complexes. What is more is the use of nanophotonics in biomolecular interactions—nanobiophotonics—has prompt for a plethora of molecular diagnostics and therapeutics making use of the remarkable nanoscale properties. In this paper, we shall focus on the uses of nanobiophotonics for molecular diagnostics involving specific sequence characterization of nucleic acids and for gene delivery systems of relevance for therapy strategies. The use of nanobiophotonics for the combined diagnostics/therapeutics (theranostics will also be addressed, with particular focus on those systems enabling the development of safer, more efficient, and specific platforms. Finally, the translation of nanophotonics for theranostics into the clinical setting will be discussed.

  11. Clinical Applications for Estetrol

    OpenAIRE

    Visser M; Coelingh Bennink HJT

    2010-01-01

    In this paper the potential clinical applications for the human fetal estrogen estetrol (E4) are presented based on recently obtained data in preclinical and clinical studies. In the past E4 has been classified as a weak estrogen due to its rather low estrogen receptor affinity. However, recent research has demonstrated that due to its favorable pharmacokinetic properties, especially the slow elimination and long half-life, E4 is an effective orally bioavailable estrogen agonist with estro...

  12. [Celiac disease : Pathogenesis, clinics, epidemiology, diagnostics, therapy].

    Science.gov (United States)

    Schuppan, Detlef

    2016-07-01

    Celiac disease is induced by the consumption of gluten containing cereals (wheat, spelt, barley, rye). With a prevalence of ~ 1 %, it is the most common non-infectious chronic inflammatory intestinal disease worldwide. It manifests in all age groups, either classically with abdominal pain, diarrhoea and growth failure or weight loss, more commonly with indirect consequences of malabsorption, such as anaemia and osteoporosis, or with associated autoimmune diseases like type 1 diabetes, autoimmune thyroiditis or dermatitis herpetiformis. The pathogenesis of celiac disease is well explored. Gluten, the cereal storage protein, is not completely digested and reaches the intestinal mucosa where it activates inflammatory T cells, which cause atrophy of the resorptive villi. This T‑cell activation requires a genetic predisposition (the molecules HLA-DQ2 or -DQ8 on antigen-presenting immune cells). Moreover, the enzyme tissue transglutaminase (TG2) which is released in the mucosa increases the immunogenicity of the gluten peptides by a deamidation reaction. The test for serum antibodies to the autoantigen TG2 is one of the best diagnostic markers in medicine, which in combination with endoscopically obtained biopsies, secures the diagnosis of celiac disease. Despite these tools celiac disease is severely underdiagnosed, with 80-90 % of those affected being undetected. The untreated condition can lead to grave complications. These include the consequences of malabsorption, cancers (especially intestinal T‑cell lymphoma), and likely also the promotion of autoimmune diseases. The therapy of celiac disease, a strict gluten-free diet, is difficult to maintain and not always effective. Alternative, supporting pharmacological therapies are urgently needed and are currently in development. PMID:27273303

  13. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for a new clinical diagnostic laboratory... SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new...

  14. Clinical Applications of Capnography

    OpenAIRE

    NIKOLOVA-TODOROVA, ZORICA

    2008-01-01

    This article gives a short review of the basic definitions of capnography and its use. The introduction gives an overview of the historical development of this procedure. Technical features of the method are presented, followed by several definitions for understanding the basic terms needed to realize the applications of capnography. The last section is a descriptive part that explains the most important clinical applications of capnography, the strengths and limitations of this method. This ...

  15. Implementation of Targeted Next Generation Sequencing in Clinical Diagnostics

    DEFF Research Database (Denmark)

    Larsen, Martin Jakob; Burton, Mark; Thomassen, Mads;

    Accurate mutation detection is essential in clinical genetic diagnostics of monogenic hereditary diseases. Targeted next generation sequencing (NGS) provides a promising and cost-effective alternative to Sanger sequencing and MLPA analysis currently used in most diagnostic laboratories. One...... advantage of targeted NGS is that multiple disease-specific genes can easily be sequenced simultaneously, which is favorable in genetic heterogeneous diseases. Prior to implementation in our diagnostic setting, we aimed to assess the sensitivity and specificity of targeted NGS by sequencing a collection......, respectively. For diagnostics, the sequencing coverage is essential, wherefore a minimum coverage of 30x per nucleotide in the coding regions was used as our primary quality criterion. For the majority of the included genes, we obtained adequate gene coverage, in which we were able to detect 100% of the known...

  16. Diagnostic Methods for Bile Acid Malabsorption in Clinical Practice

    Science.gov (United States)

    Vijayvargiya, Priya; Camilleri, Michael; Shin, Andrea; Saenger, Amy

    2013-01-01

    Altered bile acid (BA) concentrations in the colon may cause diarrhea or constipation. BA malabsorption (BAM) accounts for >25% of patients with irritable bowel syndrome (IBS) with diarrhea and chronic diarrhea in Western countries. As BAM is increasingly recognized, proper diagnostic methods are desired in clinical practice to help direct the most effective treatment course for the chronic bowel dysfunction. This review appraises the methodology, advantages and disadvantages of 4 tools that directly measure BAM: 14C-glycocholate breath and stool test, 75Selenium HomotauroCholic Acid Test (SeHCAT), 7 α-hydroxy-4-cholesten-3-one (C4) and fecal BAs. 14C-glycocholate is a laborious test no longer widely utilized. 75SeHCAT is validated, but not available in the United States. Serum C4 is a simple, accurate method that is applicable to a majority of patients, but requires further clinical validation. Fecal measurements to quantify total and individual fecal BAs are technically cumbersome and not widely available. Regrettably, none of these tests are routinely available in the U.S., and a therapeutic trial with a BA binder is used as a surrogate for diagnosis of BAM. Recent data suggest there is an advantage to studying fecal excretion of the individual BAs and their role in BAM; this may constitute a significant advantage of the fecal BA method over the other tests. Fecal BA test could become a routine addition to fecal fat measurement in patients with unexplained diarrhea. In summary, availability determines the choice of test among C4, SeHCAT and fecal BA; more widespread availability of such tests would enhance clinical management of these patients. PMID:23644387

  17. Teaching perceptual skills in clinical diagnostics using digital media

    NARCIS (Netherlands)

    Scheiter, Katharina; Jarodzka, Halszka

    2011-01-01

    Scheiter, K., & Jarodzka, H. (2011, May). Teaching perceptual skills in clinical diagnostics using digital media. Presentation at the 2nd International Conference “Research in Medical Education”: Shaping diamonds from bench to bedside, Universität Tübingen.

  18. Opportunities and challenges associated with clinical diagnostic genome sequencing: a report of the Association for Molecular Pathology.

    Science.gov (United States)

    Schrijver, Iris; Aziz, Nazneen; Farkas, Daniel H; Furtado, Manohar; Gonzalez, Andrea Ferreira; Greiner, Timothy C; Grody, Wayne W; Hambuch, Tina; Kalman, Lisa; Kant, Jeffrey A; Klein, Roger D; Leonard, Debra G B; Lubin, Ira M; Mao, Rong; Nagan, Narasimhan; Pratt, Victoria M; Sobel, Mark E; Voelkerding, Karl V; Gibson, Jane S

    2012-11-01

    This report of the Whole Genome Analysis group of the Association for Molecular Pathology illuminates the opportunities and challenges associated with clinical diagnostic genome sequencing. With the reality of clinical application of next-generation sequencing, technical aspects of molecular testing can be accomplished at greater speed and with higher volume, while much information is obtained. Although this testing is a next logical step for molecular pathology laboratories, the potential impact on the diagnostic process and clinical correlations is extraordinary and clinical interpretation will be challenging. We review the rapidly evolving technologies; provide application examples; discuss aspects of clinical utility, ethics, and consent; and address the analytic, postanalytic, and professional implications.

  19. Clinical utility of diagnostic guidelines and putative biomarkers in lymphangioleiomyomatosis

    Directory of Open Access Journals (Sweden)

    Chang William YC

    2012-04-01

    Full Text Available Abstract Background Lymphangioleiomyomatosis is a rare disease occurring almost exclusively in women. Diagnosis often requires surgical biopsy and the clinical course varies between patients with no predictors of progression. We evaluated recent diagnostic guidelines, clinical features and serum biomarkers as diagnostic and prognostic tools. Methods Serum vascular endothelial growth factor-D (VEGF-D, angiotensin converting enzyme (ACE, matrix metalloproteinases (MMP -2 and -9, clinical phenotype, thoracic and abdominal computerised tomography, lung function and quality of life were examined in a cohort of 58 patients. 32 healthy female controls had serum biomarkers measured. Results Serum VEGF-D, ACE and total MMP-2 levels were elevated in patients. VEGF-D was the strongest discriminator between patients and controls (median = 1174 vs. 332 pg/ml p  Conclusions Combining ERS criteria and serum VEGF-D reduces the need for lung biopsy in LAM. VEGF-D was associated with lymphatic disease but not lung function.

  20. Clinical Applications for Estetrol

    Directory of Open Access Journals (Sweden)

    Visser M

    2010-01-01

    Full Text Available In this paper the potential clinical applications for the human fetal estrogen estetrol (E4 are presented based on recently obtained data in preclinical and clinical studies. In the past E4 has been classified as a weak estrogen due to its rather low estrogen receptor affinity. However, recent research has demonstrated that due to its favorable pharmacokinetic properties, especially the slow elimination and long half-life, E4 is an effective orally bioavailable estrogen agonist with estrogen antagonistic effects on the breast in the presence of estradiol. Based on the pharmacokinetic properties, the pharmacological profile and the safety and efficacy results in human studies, E4 seems potentially suitable as a drug for human use in applications such as hormone replacement therapy (vaginal atrophy and vasomotor symptoms, contraception, osteoporosis and breast cancer.

  1. Clinical applications for estetrol.

    Science.gov (United States)

    Visser, Monique; Coelingh Bennink, Herjan J T

    2009-03-01

    In this paper the potential clinical applications for the human fetal estrogen estetrol (E(4)) are presented based on recently obtained data in preclinical and clinical studies. In the past E(4) has been classified as a weak estrogen due to its rather low estrogen receptor affinity. However, recent research has demonstrated that due to its favorable pharmacokinetic properties, especially the slow elimination and long half-life, E(4) is an effective orally bioavailable estrogen agonist with estrogen antagonistic effects on the breast in the presence of estradiol. Based on the pharmacokinetic properties, the pharmacological profile and the safety and efficacy results in human studies, E(4) seems potentially suitable as a drug for human use in applications such as hormone replacement therapy (vaginal atrophy and vasomotor symptoms), contraception, osteoporosis and breast cancer. PMID:19167495

  2. Translating biological parameters into clinically useful diagnostic tests.

    Science.gov (United States)

    Arfken, Cynthia L; Carney, Stuart; Boutros, Nash N

    2009-08-01

    Psychiatry has lagged behind other specialties in developing diagnostic laboratory tests for the purpose of confirming or ruling out a diagnosis. Biological research into the pathophysiology of psychiatric disorders has, however, yielded some highly replicable abnormalities that have the potential for development into clinically useful diagnostic tests. To achieve this goal, a process for systematic translation must be developed and implemented. Building on our previous work, we review a proposed process using four clearly defined steps. We conclude that biological parameters currently face challenges in their pathways to becoming diagnostic tests because of both the premature release and premature abandonment of tests. Attention to a systematic translation process aided by these principles may help to avoid these problems.

  3. Atherosclerosis and Nanotechnology: Diagnostic and Therapeutic Applications.

    Science.gov (United States)

    Kratz, Jeremy D; Chaddha, Ashish; Bhattacharjee, Somnath; Goonewardena, Sascha N

    2016-02-01

    Over the past several decades, tremendous advances have been made in the understanding, diagnosis, and treatment of coronary artery disease (CAD). However, with shifting demographics and evolving risk factors we now face new challenges that must be met in order to further advance are management of patients with CAD. In parallel with advances in our mechanistic appreciation of CAD and atherosclerosis, nanotechnology approaches have greatly expanded, offering the potential for significant improvements in our diagnostic and therapeutic management of CAD. To realize this potential we must go beyond to recognize new frontiers including knowledge gaps between understanding atherosclerosis to the translation of targeted molecular tools. This review highlights nanotechnology applications for imaging and therapeutic advancements in CAD. PMID:26809711

  4. Second Harmonic Generation Imaging Microscopy: Applications to Diseases Diagnostics

    OpenAIRE

    Campagnola, Paul

    2011-01-01

    Second Harmonic Generation microscopy has emerged as a powerful new optical imaging modality. This Feature describes its chemical and physical principles and highlights current applications in disease diagnostics.

  5. A GPA diagnostic system for aeroengine applications

    Institute of Scientific and Technical Information of China (English)

    Yi-Guang Li

    2007-01-01

    In this research,a GPA(Gas Path Analysis)diagnostic system enhanced with GPA Index is described for gas path sensor and component fault diagnosis.A method of measurement correction is used in order that the measurement data obtained at un-standard ambient and operating conditions can be used for diagnostic analysis.The developed diagnostic system has been implemented into a Cranfield University gas turbine performance and diagnostic analysis software PYTHIA for gas turbine performance degradation analysis.The developed method and software have been applied to a model aero gas turbine engine to test the effectiveness of the system.The analysis shows that the developed diagnostic system can diagnose degraded sensor and components effectively using performance deviation measured at un-standard ambient and operational conditions.Theoretically,the idea of the diagnostic approach can be applied to different gas turbine engines.

  6. Clinical Validation of Quantum Dot Barcode Diagnostic Technology.

    Science.gov (United States)

    Kim, Jisung; Biondi, Mia J; Feld, Jordan J; Chan, Warren C W

    2016-04-26

    There has been a major focus on the clinical translation of emerging technologies for diagnosing patients with infectious diseases, cancer, heart disease, and diabetes. However, most developments still remain at the academic stage where researchers use spiked target molecules to demonstrate the utility of a technology and assess the analytical performance. This approach does not account for the biological complexities and variabilities of human patient samples. As a technology matures and potentially becomes clinically viable, one important intermediate step in the translation process is to conduct a full clinical validation of the technology using a large number of patient samples. Here, we present a full detailed clinical validation of Quantum Dot (QD) barcode technology for diagnosing patients infected with Hepatitis B Virus (HBV). We further demonstrate that the detection of multiple regions of the viral genome using multiplexed QD barcodes improved clinical sensitivity from 54.9-66.7% to 80.4-90.5%, and describe how to use QD barcodes for optimal clinical diagnosis of patients. The use of QDs in biology and medicine was first introduced in 1998 but has not reached clinical care. This study describes our long-term systematic development strategy to advance QD technology to a clinically feasible product for diagnosing patients. Our "blueprint" for translating the QD barcode research concept could be adapted for other nanotechnologies, to efficiently advance diagnostic techniques discovered in the academic laboratory to patient care. PMID:27035744

  7. Clinical Evaluation on Several anti- HIV Diagnostic Reagents

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective We Joined clinical evaluation on 6 anti - HIV diagnostic reagents which was organized by National Reference Laboratory of National Center for AIDS Prevention and Control. Method 100 sera of known result and 100 sera of unknown result were detected with 6 reagents according to test procedure of the reagents. Result The crude agreement (99.5 % ) of Organon Teknika and Determine reagents were higher than that of the other reagents. No anti - HIV positive serum was detected negative with Organon Teknika and Determine reagents. The sensitivity and specificity of Organon Teknika and Determine reagents were higher than those of the other reagents. The capacity of Organon Teknika reagent to detect the mild positive serum was greater than that of the other reagent. Conclusion Organon Teknika and Determine antiHIV diagnostic reagents were qualified for anti - HIV screening test while the other 4 reagents should be improved on sensitivity and specificity.

  8. Development and application of reactor noise diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Karlsson, Joakim K.H

    1999-04-01

    A number of problems in reactor noise diagnostics have been investigated within the framework of the present thesis. The six papers presented cover three relatively different areas, namely the use of analytical calculations of the neutron noise in simple reactor models, some aspects of boiling water reactor (BWR) stability and diagnostics of core barrel motion in pressurized water reactors (PWRs). The noise induced by small vibrations of a strong absorber has been the subject of several previous investigations. For a conventional {delta}-function source model, the equations can not be linearized in the traditional manner. Thus, a new source model, which is called the {epsilon}/d model, was developed. The correct solution has been derived in the {epsilon}/d model for both 1-D and 2-D reactor models. Recently, several reactor diagnostic problems have occurred which include a control rod partially inserted into the reactor core. In order to study such problems, we have developed an analytically solvable, axially non-homogenous, 2-D reactor model. This model has also been used to study the noise induced by a rod maneuvering experiment. Comparisons of the noise with the results of different reactor kinetic approximations have yielded information on the validity of the approximations in this relatively realistic model. In case of an instability event in a BWR, the noise may consist of one or several co-existing modes of oscillation and besides the fundamental mode, a regional first azimuthal mode has been observed in e.g. the Swedish BWR Ringhals-1. In order to determine the different stability characteristics of the different modes separately, it is important to be able to decompose the noise into its mode constituents. A separation method based on factorisation of the flux has been attempted previously, but without success. The reason for the failure of the factorisation method is the presence of the local component of the noise and its axial correlation properties. In

  9. Hemicrania Continua: Functional Imaging and Clinical Features With Diagnostic Implications.

    Science.gov (United States)

    Sahler, Kristen

    2013-04-10

    This review focuses on summarizing 2 pivotal articles in the clinical and pathophysiologic understanding of hemicrania continua (HC). The first article, a functional imaging project, identifies both the dorsal rostral pons (a region associated with the generation of migraines) and the posterior hypothalamus (a region associated with the generation of cluster and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing [SUNCT]) as active during HC. The second article is a summary of the clinical features seen in a prospective cohort of HC patients that carry significant diagnostic implications. In particular, they identify a wider range of autonomic signs than what is currently included in the International Headache Society criteria (including an absence of autonomic signs in a small percentage of patients), a high frequency of migrainous features, and the presence of aggravation and/or restlessness during attacks. Wide variations in exacerbation length, frequency, pain description, and pain location (including side-switching pain) are also noted. Thus, a case is made for widening and modifying the clinical diagnostic criteria used to identify patients with HC.

  10. [The challenges of standardization in clinical diagnostic laboratories of medical organizations].

    Science.gov (United States)

    Men'shikov, V V

    2013-04-01

    The generalized data concerning the conditions of application of regulations of national standards in clinical diagnostic laboratories of medical organizations is presented. The primary information was provided by 14 regions of 6 federal administrative okrugs of Russia. The causes of challenges of application of requirements of standards are presented. They are mostly related with insufficient financial support, lacking of manpower, difficulties with reagents supply, inadequate technical maintenance of devices and absence of support of administration of medical organizations. The recommendations are formulated concerning the necessity of publishing the document of Minzdrav of Russia to determine the need in application of standards in laboratory practice.

  11. Point-of-care diagnostics for niche applications.

    Science.gov (United States)

    Cummins, Brian M; Ligler, Frances S; Walker, Glenn M

    2016-01-01

    Point-of-care or point-of-use diagnostics are analytical devices that provide clinically relevant information without the need for a core clinical laboratory. In this review we define point-of-care diagnostics as portable versions of assays performed in a traditional clinical chemistry laboratory. This review discusses five areas relevant to human and animal health where increased attention could produce significant impact: veterinary medicine, space travel, sports medicine, emergency medicine, and operating room efficiency. For each of these areas, clinical need, available commercial products, and ongoing research into new devices are highlighted. PMID:26837054

  12. Implications of caries diagnostic strategies for clinical management decisions

    DEFF Research Database (Denmark)

    Baelum, Vibeke; Hintze, Hanne; Wenzel, Ann;

    2012-01-01

    in a low-caries population. METHODS: Each of four examiners independently examined preselected contacting interproximal surfaces in 53 dental students aged 20-37 years using a visual-tactile examination and bitewing radiography. The visual-tactile examination distinguished between noncavitated......OBJECTIVES: In clinical practice, a visual-tactile caries examination is frequently supplemented by bitewing radiography. This study evaluated strategies for combining visual-tactile and radiographic caries detection methods and determined their implications for clinical management decisions......-specificity) were calculated for each diagnostic strategy. RESULTS: Visual-tactile examination provided a true-positive rate of 34.2% and a false-positive rate of 1.5% for the detection of a cavity. The combination of a visual-tactile and a radiographic examination using the lesion in dentin threshold...

  13. What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?

    DEFF Research Database (Denmark)

    Troelsen, Anders; Mechlenburg, Inger; Gelineck, John;

    2009-01-01

    BACKGROUND AND PURPOSE: An acetabular labral tear is a diagnostic challenge. Various clinical tests have been described, but little is known about their diagnostic sensitivity and specificity. We investigated the diagnostic validity of clinical tests and ultrasound as compared with MR arthrograph...

  14. Recent progress in nanomedicine: therapeutic, diagnostic and theranostic applications

    NARCIS (Netherlands)

    Rizzo, L.Y.; Theek, B.; Storm, G.; Kiessling, F.; Lammers, T.G.G.M.

    2013-01-01

    In recent years, the use of nanomedicine formulations for therapeutic and diagnostic applications has increased exponentially. Many different systems and strategies have been developed for drug targeting to pathological sites, as well as for visualizing and quantifying important (patho-) physiologic

  15. Medical diagnostic imaging systems: technology and applications

    International Nuclear Information System (INIS)

    This book attempts to assess the current status and future developments of the medical imaging industry. The first chapter contains brief descriptions, of the basic principles of various imaging modalities (radiologic, CT, nuclear, ultrasound, and thermography), and a chapter describing areas of clinical applications for each modality follows. Chapter 3 provides a profile of the industry, listing the various manufacturers of medical imaging products and their share of the market, based on 1976 to 1978 statistics. Chapter 4 describes briefly the current sources of research support (industry versus government agencies) but does not provide data either in absolute dollars or relative amounts. Chapters 5 to 14 cover a broad spectrum of advanced imaging systems by categories, including x-ray (5 and 6), CT (7 and 8), nuclear (9 and 10), ultrasound (11), thermography (12), NMR (13), and miscellaneous (14), and they may be considered the meat of the book because they provide the basis for predictions of future developments in the medical imaging industry

  16. The usefulness of the consensus clinical diagnostic criteria in Brugada syndrome

    NARCIS (Netherlands)

    Sarkozy, A.; Paparella, G.; Boussy, T.; Casado-Arroyo, R.; Yazaki, Y.; Chierchia, G.B.; Asmundis, C. de; Bayrak, F.; Namdar, M.; Richter, S.; Brugada, J.; Brugada, P.

    2013-01-01

    BACKGROUND: Consensus statements were proposed for the diagnosis of Brugada syndrome (BS). The clinical diagnostic criteria were defined as documented ventricular fibrillation or ventricular tachycardia (VT), family history of sudden cardiac death at <45 years, diagnostic ECGs of family members,

  17. Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear

    DEFF Research Database (Denmark)

    Reiman, M P; Goode, A P; Cook, C E;

    2015-01-01

    BACKGROUND: Surgery for hip femoroacetabular impingement/acetabular labral tear (FAI/ALT) is exponentially increasing despite lacking investigation of the accuracy of various diagnostic measures. Useful clinical utility of these measures is necessary to support diagnostic imaging and subsequent...

  18. Updated clinical diagnostic criteria for sporadic Creutzfeldt-Jakob disease

    Science.gov (United States)

    Kallenberg, K.; Summers, D. M.; Romero, C.; Taratuto, A.; Heinemann, U.; Breithaupt, M.; Varges, D.; Meissner, B.; Ladogana, A.; Schuur, M.; Haik, S.; Collins, S. J.; Jansen, Gerard H.; Stokin, G. B.; Pimentel, J.; Hewer, E.; Collie, D.; Smith, P.; Roberts, H.; Brandel, J. P.; van Duijn, C.; Pocchiari, M.; Begue, C.; Cras, P.; Will, R. G.; Sanchez-Juan, P.

    2009-01-01

    Several molecular subtypes of sporadic Creutzfeldt–Jakob disease have been identified and electroencephalogram and cerebrospinal fluid biomarkers have been reported to support clinical diagnosis but with variable utility according to subtype. In recent years, a series of publications have demonstrated a potentially important role for magnetic resonance imaging in the pre-mortem diagnosis of sporadic Creutzfeldt–Jakob disease. Magnetic resonance imaging signal alterations correlate with distinct sporadic Creutzfeldt–Jakob disease molecular subtypes and thus might contribute to the earlier identification of the whole spectrum of sporadic Creutzfeldt–Jakob disease cases. This multi-centre international study aimed to provide a rationale for the amendment of the clinical diagnostic criteria for sporadic Creutzfeldt–Jakob disease. Patients with sporadic Creutzfeldt–Jakob disease and fluid attenuated inversion recovery or diffusion-weight imaging were recruited from 12 countries. Patients referred as ‘suspected sporadic Creutzfeldt–Jakob disease’ but with an alternative diagnosis after thorough follow up, were analysed as controls. All magnetic resonance imaging scans were assessed for signal changes according to a standard protocol encompassing seven cortical regions, basal ganglia, thalamus and cerebellum. Magnetic resonance imaging scans were evaluated in 436 sporadic Creutzfeldt–Jakob disease patients and 141 controls. The pattern of high signal intensity with the best sensitivity and specificity in the differential diagnosis of sporadic Creutzfeldt–Jakob disease was identified. The optimum diagnostic accuracy in the differential diagnosis of rapid progressive dementia was obtained when either at least two cortical regions (temporal, parietal or occipital) or both caudate nucleus and putamen displayed a high signal in fluid attenuated inversion recovery or diffusion-weight imaging magnetic resonance imaging. Based on our analyses, magnetic

  19. Applications of laser diagnostics in energy conservation research

    Energy Technology Data Exchange (ETDEWEB)

    Hutchinson, R.A.

    1985-02-01

    During the past decade, intensive research and development has demonstrated the feasibility, checked the accuracy, and extended the sensitivity of laser diagnostics for combustion systems. Combinations of diagnostics can now provide in-situ, time-, and space-resolved measurements of temperature, velocity, and species concentration. Although these tools are powerful, they also can be exceedingly difficult to use, and their application remains largely in the hands of specialized instrument developers rather than problem-oriented researchers. This report outlines a variety of applications for existing diagnostics that may interest both instrument developers and researchers in particular fields.

  20. The application of automated deductive reasoning to power plant diagnostics

    International Nuclear Information System (INIS)

    A module which incorporates the application of deductive reasoning to diagnostics has been developed. This module is a part of a generic diagnostic expert system prototype developed for power plant operations at Combustion Engineering. This paper is one of a series of papers which will describe the activities of the project. Specifically, this paper describes the deductive reasoning module which determines and classifies root cause malfunctions. The concept of 'perfect instruments' is introduced. These instruments are imaginary instruments which bridge the gap between real world inputs and the generic diagnostic shell. The prototype, its application, and future developments are discussed

  1. Nontraditional applications in clinical pathology.

    Science.gov (United States)

    Jordan, Holly L; Register, Thomas C; Tripathi, Niraj K; Bolliger, Anne Provencher; Everds, Nancy; Zelmanovic, David; Poitout, Florence; Bounous, Denise I; Wescott, Debra; Ramaiah, Shashi K

    2014-10-01

    Most published reviews of preclinical toxicological clinical pathology focus on the fundamental aspects of hematology, clinical chemistry, coagulation, and urinalysis in routine toxicology animal species, for example, rats, mice, dogs, and nonhuman primates. The objective of this continuing education course was to present and discuss contemporary examples of nonroutine applications of clinical pathology endpoints used in the drug development setting. Area experts discussed bone turnover markers of laboratory animal species, clinical pathology of pregnant and growing laboratory animals, clinical pathology of nonroutine laboratory animal species, and unique applications of the Siemens Advia(®) hematology analyzer. This article is a summary based on a presentation given at the 31st Annual Symposium of the Society of Toxicologic Pathology, during the Continuing Education Course titled "Nontraditional Applications of Clinical Pathology in Drug Discovery and Preclinical Toxicology."

  2. Dental diagnostic clinical instrument (Canary) development using photothermal radiometry and modulated luminescence

    International Nuclear Information System (INIS)

    Since 1999, our group at the CADIFT, University of Toronto, has developed the application of Frequency Domain Photothermal Radiometry (PTR) and Luminescence (LUM) to dental caries detection. Various cases including artificial caries detection have been studied and some of the inherent advantages of the adaptation of this technique to dental diagnostics in conjunction with modulated luminescence as a dual-probe technique have been reported. Based on these studies, a portable, compact diagnostic instrument for dental clinic use has been designed, assembled and tested. A semiconductor laser, optical fibers, a thermoelectric cooled mid-IR detector, and a USB connected data acquisition card were used. Software lock-in amplifier techniques were developed to compute amplitude and phase of PTR and LUM signals. In order to achieve fast measurement and acceptable signal-to-noise ratio (SNR) for clinical application, swept sine waveforms were used. As a result sampling and stabilization time for each measurement point was reduced to a few seconds. A sophisticated software interface was designed to simultaneously record intra-oral camera images with PTR and LUM responses. Preliminary results using this instrument during clinical trials in a dental clinic showed this instrument could detect early caries both from PTR and LUM signals.

  3. Dental diagnostic clinical instrument ("Canary") development using photothermal radiometry and modulated luminescence

    Science.gov (United States)

    Jeon, R. J.; Sivagurunathan, K.; Garcia, J.; Matvienko, A.; Mandelis, A.; Abrams, S.

    2010-03-01

    Since 1999, our group at the CADIFT, University of Toronto, has developed the application of Frequency Domain Photothermal Radiometry (PTR) and Luminescence (LUM) to dental caries detection. Various cases including artificial caries detection have been studied and some of the inherent advantages of the adaptation of this technique to dental diagnostics in conjunction with modulated luminescence as a dual-probe technique have been reported. Based on these studies, a portable, compact diagnostic instrument for dental clinic use has been designed, assembled and tested. A semiconductor laser, optical fibers, a thermoelectric cooled mid-IR detector, and a USB connected data acquisition card were used. Software lock-in amplifier techniques were developed to compute amplitude and phase of PTR and LUM signals. In order to achieve fast measurement and acceptable signal-to-noise ratio (SNR) for clinical application, swept sine waveforms were used. As a result sampling and stabilization time for each measurement point was reduced to a few seconds. A sophisticated software interface was designed to simultaneously record intra-oral camera images with PTR and LUM responses. Preliminary results using this instrument during clinical trials in a dental clinic showed this instrument could detect early caries both from PTR and LUM signals.

  4. Dental diagnostic clinical instrument ('Canary') development using photothermal radiometry and modulated luminescence

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, R J; Sivagurunathan, K; Garcia, J; Matvienko, A; Mandelis, A [Center for Advanced Diffusion Wave Technologies (CADIFT), Department of Mechanical and Industrial Engineering, University of Toronto, 5 King' s College Road, Toronto, Ontario, M5S 3G8 (Canada); Abrams, S, E-mail: mandelis@mie.utoronto.c [Quantum Dental Technologies, 748 Briar Hill Avenue, Toronto, Ontario, M6B 1L3 (Canada)

    2010-03-01

    Since 1999, our group at the CADIFT, University of Toronto, has developed the application of Frequency Domain Photothermal Radiometry (PTR) and Luminescence (LUM) to dental caries detection. Various cases including artificial caries detection have been studied and some of the inherent advantages of the adaptation of this technique to dental diagnostics in conjunction with modulated luminescence as a dual-probe technique have been reported. Based on these studies, a portable, compact diagnostic instrument for dental clinic use has been designed, assembled and tested. A semiconductor laser, optical fibers, a thermoelectric cooled mid-IR detector, and a USB connected data acquisition card were used. Software lock-in amplifier techniques were developed to compute amplitude and phase of PTR and LUM signals. In order to achieve fast measurement and acceptable signal-to-noise ratio (SNR) for clinical application, swept sine waveforms were used. As a result sampling and stabilization time for each measurement point was reduced to a few seconds. A sophisticated software interface was designed to simultaneously record intra-oral camera images with PTR and LUM responses. Preliminary results using this instrument during clinical trials in a dental clinic showed this instrument could detect early caries both from PTR and LUM signals.

  5. Magnetic Nanoparticles and microNMR for Diagnostic Applications

    Directory of Open Access Journals (Sweden)

    Huilin Shao, Changwook Min, David Issadore, Monty Liong, Tae-Jong Yoon, Ralph Weissleder, Hakho Lee

    2012-01-01

    Full Text Available Sensitive and quantitative measurements of clinically relevant protein biomarkers, pathogens and cells in biological samples would be invaluable for disease diagnosis, monitoring of malignancy, and for evaluating therapy efficacy. Biosensing strategies using magnetic nanoparticles (MNPs have recently received considerable attention, since they offer unique advantages over traditional detection methods. Specifically, because biological samples have negligible magnetic background, MNPs can be used to obtain highly sensitive measurements in minimally processed samples. This review focuses on the use of MNPs for in vitro detection of cellular biomarkers based on nuclear magnetic resonance (NMR effects. This detection platform, termed diagnostic magnetic resonance (DMR, exploits MNPs as proximity sensors to modulate the spin-spin relaxation time of water molecules surrounding the molecularly-targeted nanoparticles. With new developments such as more effective MNP biosensors, advanced conjugational strategies, and highly sensitive miniaturized NMR systems, the DMR detection capabilities have been considerably improved. These developments have also enabled parallel and rapid measurements from small sample volumes and on a wide range of targets, including whole cells, proteins, DNA/mRNA, metabolites, drugs, viruses and bacteria. The DMR platform thus makes a robust and easy-to-use sensor system with broad applications in biomedicine, as well as clinical utility in point-of-care settings.

  6. Filtering Medline for a clinical discipline: diagnostic test assessment framework

    Science.gov (United States)

    Iansavichus, Arthur V; Wilczynski, Nancy L; Kastner, Monika; Baier, Leslie A; Shariff, Salimah Z; Rehman, Faisal; Weir, Matthew; McKibbon, K Ann; Haynes, R Brian

    2009-01-01

    Objective To develop and test a Medline filter that allows clinicians to search for articles within a clinical discipline, rather than searching the entire Medline database. Design Diagnostic test assessment framework with development and validation phases. Setting Sample of 4657 articles published in 2006 from 40 journals. Reviews Each article was manually reviewed, and 19.8% contained information relevant to the discipline of nephrology. The performance of 1 155 087 unique renal filters was compared with the manual review. Main outcome measures Sensitivity, specificity, precision, and accuracy of each filter. Results The best renal filters combined two to 14 terms or phrases and included the terms “kidney” with multiple endings (that is, truncation), “renal replacement therapy”, “renal dialysis”, “kidney function tests”, “renal”, “nephr” truncated, “glomerul” truncated, and “proteinuria”. These filters achieved peak sensitivities of 97.8% and specificities of 98.5%. Performance of filters remained excellent in the validation phase. Conclusions Medline can be filtered for the discipline of nephrology in a reliable manner. Storing these high performance renal filters in PubMed could help clinicians with their everyday searching. Filters can also be developed for other clinical disciplines by using similar methods. PMID:19767336

  7. Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management.

    Science.gov (United States)

    Windfuhr, Jochen P; Toepfner, Nicole; Steffen, Gregor; Waldfahrer, Frank; Berner, Reinhard

    2016-04-01

    More than 120,000 patients are treated annually in Germany to resolve repeated episodes of acute tonsillitis. Therapy is aiming at symptom regression, avoidance of complications, reduction in the number of disease-related absences in school or at work, increased cost-effectiveness and improved quality of life. The purpose of this part of the guideline is to provide clinicians in any setting with a clinically focused multi-disciplinary guidance through different conservative treatment options in order to reduce inappropriate variation in clinical care, improve clinical outcome and reduce harm. Surgical management in terms of intracapsular as well as extracapsular tonsillectomy (i.e. tonsillotomy) is the subject of part II of this guideline. To estimate the probability of tonsillitis caused by β-hemolytic streptococci, a diagnostic scoring system according to Centor or McIsaac is suggested. If therapy is considered, a positive score of ≥3 should lead to pharyngeal swab or rapid test or culture in order to identify β-hemolytic streptococci. Routinely performed blood tests for acute tonsillitis are not indicated. After acute streptococcal tonsillitis, there is no need to repeat a pharyngeal swab or any other routine blood tests, urine examinations or cardiological diagnostics such as ECG. The determination of the antistreptolysin O-titer (ASLO titer) and other antistreptococcal antibody titers do not have any value in relation to acute tonsillitis with or without pharyngitis and should not be performed. First-line therapy of β-hemolytic streptococci consists of oral penicillin. Instead of phenoxymethylpenicillin-potassium (penicillin V potassium), also phenoxymethlpenicillin-benzathine with a clearly longer half-life can be used. Oral intake for 7 days of one of both the drugs is recommended. Alternative treatment with oral cephalosporins (e.g. cefadroxil, cefalexin) is indicated only in cases of penicillin failure, frequent recurrences, and whenever a more

  8. Autoimmune liver serology: Current diagnostic and clinical challenges

    Institute of Scientific and Technical Information of China (English)

    Dimitrios P Bogdanos; Pietro Invernizzi; Ian R Mackay; Diego Vergani

    2008-01-01

    Liver-related autoantibodies are crucial for the correct diagnosis and classification of autoimmune liver diseases (AiLD), namely autoimmune hepatitis types 1 and 2 (AIH-1 and 2), primary biliary cirrhosis (PBC),and the sclerosing cholangitis variants in adults and children.AIH-1 is specified by anti-nuclear antibody (ANA) and smooth muscle antibody (SMA). AIH-2 is specified by antibody to liver kidney microsomal antigen type-1 (anti-LKM1) and anti-liver cytosol type 1 (anti-LC1).SMA,ANA and anti-LKM antibodies can be present in de-novo AIH following liver transplantation.PBC is specified by antimitochondrial antibodies (AMA) reacting with enzymes of the 2-oxo-acid dehydrogenase complexes (chiefly pyruvate dehydrogenase complex E2 subunit) and disease-specific ANA mainly reacting with nuclear pore gp210 and nuclear body sp100. Sclerosing cholangitis presents as at least two variants,first the classical primary sclerosing cholangitis (PSC) mostly affecting adult men wherein the only (and nonspecific) reactivity is an atypical perinuclear antineutrophil cytoplasmic antibody (p-ANCA),also termed perinuclear anti-neutrophil nuclear antibodies (p-ANNA) and second the childhood disease called autoimmune sclerosing cholangitis (ASC) with serological features resembling those of type 1 AIH.Liver diagnostic serology is a fast-expanding area of investigation as new purified and recombinant autoantigens,and automated technologies such as ELISAs and bead assays,become available to complement (or even compete with) traditional immunofluorescence procedures.We survey for the first time global trends in quality assurance impacting as it does on (1) manufacturers/purveyors of kits and reagents,(2) diagnostic service laboratories that fulfill clinicians'requirements, and (3) the end-user,the physician providing patient care,who must properly interpret test results in the overall clinical context.

  9. Application of Diagnostic and Formative Assessment in College English Teaching

    Institute of Scientific and Technical Information of China (English)

    张玉莲

    2008-01-01

    This report attempts to look into assessment in higher education in the UK and in Chi- na.The focus of analysis is comparison of the current state of diagnostic and formative assess- ment in the UK and in China.Also the report discusses how diagnostic and formative assessment policy or practice in the UK can be applied to China in English teaching in higher education.Fi- nally,a plan of action for 12 months about the application of diagnostic and formative assessment in College English teaching is made.

  10. Clinical Training of Medical Physicists Specializing in Diagnostic Radiology (Spanish Edition)

    International Nuclear Information System (INIS)

    The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

  11. Clinical Training of Medical Physicists Specializing in Diagnostic Radiology (French Edition)

    International Nuclear Information System (INIS)

    The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

  12. Clinical research and diagnostic efficacy studies in the oral and maxillofacial radiology literature: 1996–2005

    Science.gov (United States)

    Kim, IH; Patel, MJ; Hirt, SL; Kantor, ML

    2011-01-01

    Objectives The aim of this study was to determine the level of evidence that is published in the oral and maxillofacial radiology (OMR) literature. Methods OMR papers published in Dentomaxillofacial Radiology and Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology between 1996 and 2005 were classified using epidemiological study design and diagnostic efficacy hierarchies. The country of origin and number of authors were noted. Results Of the 725 articles, 384 could be classified with the epidemiological study design hierarchy: 155 (40%) case reports/series and 207 (54%) cross-sectional studies. The distribution of study designs was not statistically significant across time (Fisher's exact test, P = 0.06) or regions (P = 0.89). The diagnostic efficacy hierarchy was applicable to 246 articles: 71 (29%) technical efficacy and 166 (67%) diagnostic accuracy studies. The distribution of efficacy levels was not statistically significant across time (P = 0.22) but was significant across regions (P < 0.01). Authors from Japan produced 26% of the papers with a mean ± standard deviation of 5.78 ± 1.98 authors per paper (APP); American authors, 23% (3.78 ± 1.72 APP); and all others, 51% (3.76 ± 1.51 APP). Conclusion The OMR literature consisted mostly of case reports/series, cross-sectional, technical efficacy and diagnostic accuracy studies. Such studies do not provide strong evidence for clinical decision making nor do they address the impact of diagnostic imaging on patient care. More studies at the higher end of the study design and efficacy hierarchies are needed in order to make wise choices regarding clinical decisions and resource allocations. PMID:21697152

  13. Clinical, anthropometric and laboratory nutritional markers of pancreatic exocrine insufficiency: Prevalence and diagnostic use.

    Science.gov (United States)

    Lindkvist, Björn; Phillips, Mary E; Domínguez-Muñoz, J Enrique

    2015-01-01

    Pancreatic exocrine insufficiency (PEI) frequently occurs secondary to exocrine pancreatic disease (e.g. chronic pancreatitis, cystic fibrosis, cancer) or pancreatic/gastrointestinal surgery, resulting in the maldigestion of nutrients and consequently malnutrition. Pancreatic enzyme replacement therapy (PERT) is the cornerstone of PEI management. Despite its clinical relevance, the diagnosis of PEI in clinical practice is challenging, as the current gold standard test is cumbersome, and alternatives have limited availability or accuracy. There is a need for accurate and easily applicable diagnostic modalities. We review the prevalence of clinical symptoms and changes in anthropometric measurements and laboratory nutritional markers indicative of malnutrition in patients with PEI, and the relevance of these findings in diagnosing PEI and monitoring PERT efficacy. Based on limited available evidence, assessment of clinical symptoms, body weight, body mass index and other anthropometric parameters are not sensitive methods for PEI diagnosis, owing to high variability and multiple confounding factors, but appear useful in monitoring PERT efficacy. Limited evidence precludes strong recommendations but suggests that serum levels of vitamin E, magnesium, and plasma proteins, notably retinol binding protein, albumin, and prealbumin, may have diagnostic utility in PEI. Studies show that assessment of changes in these and other nutritional parameters is helpful in monitoring PERT efficacy. Further research is needed to confirm the diagnostic accuracy of these parameters for PEI. Until such data are available, a nutritional evaluation including circulating vitamin E, magnesium, retinol binding protein, albumin, and prealbumin may be used to evaluate the probability of PEI in clinical practice when reliable pancreatic function tests are not available. PMID:26243045

  14. Clinical applications of the functional connectome.

    Science.gov (United States)

    Castellanos, F Xavier; Di Martino, Adriana; Craddock, R Cameron; Mehta, Ashesh D; Milham, Michael P

    2013-10-15

    Central to the development of clinical applications of functional connectomics for neurology and psychiatry is the discovery and validation of biomarkers. Resting state fMRI (R-fMRI) is emerging as a mainstream approach for imaging-based biomarker identification, detecting variations in the functional connectome that can be attributed to clinical variables (e.g., diagnostic status). Despite growing enthusiasm, many challenges remain. Here, we assess evidence of the readiness of R-fMRI based functional connectomics to lead to clinically meaningful biomarker identification through the lens of the criteria used to evaluate clinical tests (i.e., validity, reliability, sensitivity, specificity, and applicability). We focus on current R-fMRI-based prediction efforts, and survey R-fMRI used for neurosurgical planning. We identify gaps and needs for R-fMRI-based biomarker identification, highlighting the potential of emerging conceptual, analytical and cultural innovations (e.g., the Research Domain Criteria Project (RDoC), open science initiatives, and Big Data) to address them. Additionally, we note the need to expand future efforts beyond identification of biomarkers for disease status alone to include clinical variables related to risk, expected treatment response and prognosis.

  15. The Importance of Considering Clinical Utility in the Construction of a Diagnostic Manual.

    Science.gov (United States)

    Mullins-Sweatt, Stephanie N; Lengel, Gregory J; DeShong, Hilary L

    2016-01-01

    The development of major diagnostic manuals primarily has been guided by construct validity rather than clinical utility. The purpose of this article is to summarize recent research and theory examining the importance of clinical utility when constructing and evaluating a diagnostic manual. We suggest that construct validity is a necessary but not sufficient criterion for diagnostic constructs. This article discusses components of clinical utility and how these have applied to the current and forthcoming diagnostic manuals. Implications and suggestions for future research are provided. PMID:26666967

  16. Clinical application of PET

    Energy Technology Data Exchange (ETDEWEB)

    Lomena, Francisco [Hospital Clinico Villarroel, Barcelona (Spain). Nuclear Medicine]. E-mail: flomena@clinic.ub.es; Soler, Marina [CETIR Grup Medic. Esplkugues de Llobregat, Barcelona (Spain). PET Unit

    2005-10-15

    Positron emission tomography (PET) is an imaging modality that gives information on tissue metabolism and functionalism, different from other imaging techniques like computed tomography (CT) and magnetic resonance imaging (MRI), which provide anatomical or structural information. PET has reached its development in biomedical research because of its capacity to use analogous compounds of many endogenous substance as tracers, and to measure, in vivo and in a non-invasive way, their consumption by the different organs and tissues of the mammalian body. Fluorodeoxyglucose-F 18 (FDG) PET has been proven to be a tracer adequate for clinical use in oncology and in many neurological diseases, with an excellent cost-efficiency ratio. The current PET-CT scanners can come to be the best tools for exploring patients who suffer from cancer.(author)

  17. Laser displacement meter application for milling diagnostics

    Science.gov (United States)

    Ryabov, Oleg; Mori, Kazuo; Kasashima, Nagayoshi

    1998-09-01

    This paper presents the application of a laser displacement meter for direct multi-purpose sensing of milling tool conditions. Using a laser displacement meter, a laser beam is projected onto the cutting tool and subsequently reflected. The intensity as well as the angle of the reflected beam are measured. The signals are interpreted for identification of tool geometry, tool whirling, or vibration. Signal processing and analysis depend on the application. A prototype system has been developed to demonstrate the feasibility of various applications, namely (1) tool setting evaluation, (2) in-process measurement of milling cutter geometry and detection of tool failure, (3) continuous monitoring of milling cutter deterioration, (4) detection and measurement of chatter in milling, (5) measurement of milling tool bending and (6) thermal expansion.

  18. Density dependence of line intensities and application to plasma diagnostics

    International Nuclear Information System (INIS)

    Electron density dependence of spectral lines are discussed in view of application to density diagnostics of plasmas. The dependence arises from competitive level population processes, radiative and collisional transitions from the excited states. Results of the measurement on tokamak plasmas are presented to demonstrate the usefulness of line intensity ratios for density diagnostics. Also general characteristics related to density dependence are discussed with atomic-number scaling for H-like and He-like systems to be helpful for application to higher density plasmas. (author)

  19. Pediatric DXA: clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Binkovitz, Larry A. [Columbus Children' s Hospital, Department of Radiology, Columbus, OH (United States); Sparke, Paul [Capital University, Department of Chemistry, Columbus, OH (United States); Henwood, Maria J. [Columbus Children' s Hospital, Department of Endocrinology, Columbus, OH (United States)

    2007-07-15

    Normal bone mineral accrual requires adequate dietary intake of calcium, vitamin D and other nutrients; hepatic and renal activation of vitamin D; normal hormone levels (thyroid, parathyroid, reproductive and growth hormones); and neuromuscular functioning with sufficient stress upon the skeleton to induce bone deposition. The presence of genetic or acquired diseases and the therapies that are used to treat them can also impact bone health. Since the introduction of clinical DXA in pediatrics in the early 1990s, there has been considerable investigation into the causes of low bone mineral density (BMD) in children. Pediatricians have also become aware of the role adequate bone mass accrual in childhood has in preventing osteoporotic fractures in late adulthood. Additionally, the availability of medications to improve BMD has increased with the development of bisphosphonates. These factors have led to the increased utilization of DXA in pediatrics. This review summarizes much of the previous research regarding BMD in children and is meant to assist radiologists and clinicians with DXA utilization and interpretation. (orig.)

  20. Molecular biology applications to infectious diseases diagnostic

    International Nuclear Information System (INIS)

    This project goes directed to the applications of the techniques of molecular biology in hepatitis virus.A great advance of these techniques it allows its application to the diagnose molecular and it becomes indispensable to have these fundamental tools in the field of the Health Public for the detection precocious, pursuit of the treatment, the one predicts and the evolution of the patient hepatitis bearing virus technical.Use of molecular biology to increase the handling and the control of the patients with hepatitis B and C and to detect an adult numbers of positive cases by means of the training and integration of all the countries participating.Implement the technique of PCR to identify the virus of the hepatitis B and C,implement quantification methods and genotipification for these virus

  1. Panoramic radiography and its diagnostic application

    International Nuclear Information System (INIS)

    Panoramic radiography is a term that is applied to the radiographic techniques which record is the dental arches and related structures on one or two extraoral films. It consists of two methods, one using the intraoral anode, and the other employing tomography. Because of an increase in practical application, about 10 kinds of panoramic dental X-ray units were commercially available in U.S.A.

  2. Clinical technique: techniques in the practice diagnostic laboratory: a review.

    Science.gov (United States)

    Doneley, Bob

    2015-01-01

    The need to rapidly diagnose disease in avian/exotic animal patients has led to the increased use of on-site diagnostic testing by veterinarians treating these animals. This article explores the use of on-site veterinary diagnostic testing: advantages and disadvantages of such testing; tests that are performed; type of equipment available; and the need for quality control. PMID:25421031

  3. Implementation of a companion diagnostic in the clinical laboratory

    DEFF Research Database (Denmark)

    Mancini, Irene; Pinzani, Pamela; Simi, Lisa;

    2015-01-01

    A companion diagnostic test provides information that is essential for the safe and effective use of a corresponding therapeutic product as indicated in the drug instructions. The implementation of a companion diagnostic follows the rules of a molecular test for somatic mutations in a routine cli...

  4. Clinical application of pet

    Directory of Open Access Journals (Sweden)

    Francisco Lomeña

    2005-10-01

    Full Text Available Positron emission tomography (PET is an imaging modality that gives information on tissue metabolism and functionalism, different from other imaging techniques like computed tomography (CT and magnetic resonance imaging (MRI, which provide anatomical or structural information. PET has reached its development in biomedical research because of its capacity to use analogous compounds of many endogenous substance as tracers, and to measure, in vivo and in a non-invasive way, their consumption by the different organs and tissues of the mammalian body. Fluordeoxyglucose-F18 (FDG PET has been proven to be a tracer adequate for clinical use in oncology and in many neurological diseases, with an excellent cost-efficiency ratio. The current PET-CT scanners can come to be the best tools for exploring patients who suffer from cancer.A tomografia por emissão de pósitrons (PET é uma técnica de diagnóstico por imagem que fornece informação sobre o metabolismo e funcionamento dos tecidos, diferente de outras técnicas de imagens como tomografia computadorizada (TC e ressonância magnética (RM, as quais fornecem informações estruturais ou anatômicas. O PET alcançou seu desenvolvimento em investigação biomédica devido à sua capacidade de usar traçadores análogos a muitas substâncias endógenas e de medir in vivo e de forma não invasiva seu consumo em diferentes órgãos e tecidos dos mamíferos 18Fluordesoxiglicose (FDG PET tem provado ser uma exploração de uso clínico com excelente relação custo benefício em oncologia e em muitas doenças neurológicas. Os atuais tomógrafos por PET-CT podem chegar a ser a melhor ferramenta de diagnóstico nos pacientes que sofrem de câncer.

  5. Feline genetics: clinical applications and genetic testing.

    Science.gov (United States)

    Lyons, Leslie A

    2010-11-01

    DNA testing for domestic cat diseases and appearance traits is a rapidly growing asset for veterinary medicine. Approximately 33 genes contain 50 mutations that cause feline health problems or alterations in the cat's appearance. A variety of commercial laboratories can now perform cat genetic diagnostics, allowing both the veterinary clinician and the private owner to obtain DNA test results. DNA is easily obtained from a cat via a buccal swab with a standard cotton bud or cytological brush, allowing DNA samples to be easily sent to any laboratory in the world. The DNA test results identify carriers of the traits, predict the incidence of traits from breeding programs, and influence medical prognoses and treatments. An overall goal of identifying these genetic mutations is the correction of the defect via gene therapies and designer drug therapies. Thus, genetic testing is an effective preventative medicine and a potential ultimate cure. However, genetic diagnostic tests may still be novel for many veterinary practitioners and their application in the clinical setting needs to have the same scrutiny as any other diagnostic procedure. This article will review the genetic tests for the domestic cat, potential sources of error for genetic testing, and the pros and cons of DNA results in veterinary medicine. Highlighted are genetic tests specific to the individual cat, which are a part of the cat's internal genome. PMID:21147473

  6. Feline genetics: clinical applications and genetic testing.

    Science.gov (United States)

    Lyons, Leslie A

    2010-11-01

    DNA testing for domestic cat diseases and appearance traits is a rapidly growing asset for veterinary medicine. Approximately 33 genes contain 50 mutations that cause feline health problems or alterations in the cat's appearance. A variety of commercial laboratories can now perform cat genetic diagnostics, allowing both the veterinary clinician and the private owner to obtain DNA test results. DNA is easily obtained from a cat via a buccal swab with a standard cotton bud or cytological brush, allowing DNA samples to be easily sent to any laboratory in the world. The DNA test results identify carriers of the traits, predict the incidence of traits from breeding programs, and influence medical prognoses and treatments. An overall goal of identifying these genetic mutations is the correction of the defect via gene therapies and designer drug therapies. Thus, genetic testing is an effective preventative medicine and a potential ultimate cure. However, genetic diagnostic tests may still be novel for many veterinary practitioners and their application in the clinical setting needs to have the same scrutiny as any other diagnostic procedure. This article will review the genetic tests for the domestic cat, potential sources of error for genetic testing, and the pros and cons of DNA results in veterinary medicine. Highlighted are genetic tests specific to the individual cat, which are a part of the cat's internal genome.

  7. Comparison of clinical judgment and diagnostic ultrasonography in the diagnosis of acute appendicitis

    DEFF Research Database (Denmark)

    Jahn, H; Mathiesen, F K; Neckelmann, K;

    1997-01-01

    of having acute appendicitis admitted between 0800 and midnight from June 1990 to June 1992. INTERVENTIONS: 148 Patients (67%) underwent appendicectomy and the remaining 74 patients were observed. 193 Patients (87%) had a diagnostic US examination. 21 Predictive variables were collected prospectively...... to create a scoring system. MAIN OUTCOME MEASURES: Results of surgical pathological findings, clinical outcome (observed group), diagnostic US, and values of diagnostic score. RESULTS: The decision to operate was made by a junior surgeon solely on the clinical examination, which yielded a diagnostic...

  8. Clinical instrumentation and applications of Raman spectroscopy.

    Science.gov (United States)

    Pence, Isaac; Mahadevan-Jansen, Anita

    2016-04-01

    this information in real-time, non-invasively, and in an automated manner. This review presents the various instrumentation considerations relevant to the clinical implementation of Raman spectroscopy and reviews a subset of interesting applications that have successfully demonstrated the efficacy of this technique for clinical diagnostics and monitoring in large (n ≥ 50) in vivo human studies. PMID:26999370

  9. Clinical instrumentation and applications of Raman spectroscopy.

    Science.gov (United States)

    Pence, Isaac; Mahadevan-Jansen, Anita

    2016-04-01

    this information in real-time, non-invasively, and in an automated manner. This review presents the various instrumentation considerations relevant to the clinical implementation of Raman spectroscopy and reviews a subset of interesting applications that have successfully demonstrated the efficacy of this technique for clinical diagnostics and monitoring in large (n ≥ 50) in vivo human studies.

  10. Clinical applications of SPECT-CT

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadzadehfar, Hojjat; Biersack, Hans-Juergen (eds.) [University Hospital Bonn (Germany). Dept. of Nuclear Medicine

    2014-06-01

    Covers the full spectrum of clinical applications of SPECT/CT in diagnosis of benign and malignant diseases. Includes chapters on the use of SPECT/CT for dosimetry and for therapy planning. Completely up to date. Many helpful illustrations. SPECT/CT cameras have considerably improved diagnostic accuracy in recent years. Such cameras allow direct correlation of anatomic and functional information, resulting in better localization and definition of scintigraphic findings. In addition to this anatomic referencing, CT coregistration provides superior quantification of radiotracer uptake based on the attenuation correction capabilities of CT. Useful applications of SPECT/CT have been identified not only in oncology but also in other specialties such as orthopedics and cardiology. This book covers the full spectrum of clinical applications of SPECT/CT in diagnosis and therapy planning of benign and malignant diseases. Opening chapters discuss the technology and physics of SPECT/CT and its use for dosimetry. The role of SPECT/CT in the imaging of a range of pathologic conditions is then addressed in detail. Applications covered include, among others, imaging of the thyroid, bone, and lungs, imaging of neuroendocrine tumors, cardiac scintigraphy, and sentinel node scintigraphy. Individual chapters are also devoted to therapy planning in selective internal radiation therapy of liver tumors and bremsstrahlung SPECT/CT. Readers will find this book to be an essential and up-to-date source of information on this invaluable hybrid imaging technique.

  11. The Buffer Diagnostic Prototype: A fault isolation application using CLIPS

    Science.gov (United States)

    Porter, Ken

    1994-01-01

    This paper describes problem domain characteristics and development experiences from using CLIPS 6.0 in a proof-of-concept troubleshooting application called the Buffer Diagnostic Prototype. The problem domain is a large digital communications subsystems called the real-time network (RTN), which was designed to upgrade the launch processing system used for shuttle support at KSC. The RTN enables up to 255 computers to share 50,000 data points with millisecond response times. The RTN's extensive built-in test capability but lack of any automatic fault isolation capability presents a unique opportunity for a diagnostic expert system application. The Buffer Diagnostic Prototype addresses RTN diagnosis with a multiple strategy approach. A novel technique called 'faulty causality' employs inexact qualitative models to process test results. Experimental knowledge provides a capability to recognize symptom-fault associations. The implementation utilizes rule-based and procedural programming techniques, including a goal-directed control structure and simple text-based generic user interface that may be reusable for other rapid prototyping applications. Although limited in scope, this project demonstrates a diagnostic approach that may be adapted to troubleshoot a broad range of equipment.

  12. Lubiprostone: Clinical applications beyond constipation

    Institute of Scientific and Technical Information of China (English)

    Shailendra Kapoor

    2009-01-01

    In comparison to polyethylene glycol, lubiprostone offers other advantages and is increasingly being used as an adjunctive agent in diagnostic as well as management strategies not only in gastroenterology,but in other fields. For instance, lubiprostone exerts beneficial effects in cystic fibrosis tissues. It augmernts the chloride secretion in these cells by activating non-cystic fibrosis transmembrane regulator (CFTR) secretion of chloride by afflicted respiratory epithelia.Lubiprostone also seems to improve visualization of the gastrointestinal tract during procedures such as colonoscopy. This is especially true if the lubiprostone is administered prior to bowel cleansing with agents such as polyethylene glycol electrolyte (PEG-E).Lubiprostone also enhances and stimulates contraction in colonic as well as gastric muscles and may thus further contribute as a prokinetic agent. Besides these effects, lubiprostone also causes hyperpolarization in other tissues such as uterine muscle cells. This may prove to be of significant clinical benefit in the management of uterine pathologies in the near future.

  13. Wilson's disease in children: clinical and diagnostic features

    International Nuclear Information System (INIS)

    Objective: To study the clinical and diagnostic laboratory features of Wilsons disease in children and adolescents. Design: A prospective cohort study. Place and Duration of study: The study included patients diagnosed as Wilson s disease at the Department of Pediatrics Allied Hospital, Punjab medical College, Faisalabad from May 1997 to June 2001. Patients and methods: Patients presenting with liver or suggestive neurological disease were investigated. Others were diagnosed as a result of family screening. Diagnosis of neurologic disease was made if two of the following were present: Typical neurological findings, Kayser Fleischer corneal rings and low serum ceruloplasmin (100 mu gm) free serum copper (>10 mu gm/dl). In other forms and for family screening, 24 hours. Urinary copper (> 100 mu gm), free serum copper (>10 mu gm/dl), and wherever possible liver biopsy for histopathology and cytochemical staining by rubeanic acid was also done. Results: Twenty-seven patients with a mean age of 10.2 years were diagnosed as suffering from Wilson disease. Mean age for hepatic and neurological disease was 9 years and 11.5 years respectively. Youngest patient (neurologic) was 6 years old. 48% cases presented with neurological, 41% with hepatic and 4% with skeletal manifestations while 7 % were asymptomatic. Mean duration of symptoms before diagnosis was 6.1 months. Dysarthria (84.6%), tremors (69.2%), rigidity and poor school performance and hand writing (61.5%), dysphagia (46.1%) and dystonia (38.5%), were the most common neurologic findings. Chronic liver disease was seen in 73 % while acute forms were seen in 27 % cases. Two cases presented with fulminant hepatic failure. Consanguineous marriage of the parents was found in 70 % and family history of disease was present in 65 % cases. K-F (Kayser Fleischer) rings and low serum ceruloplasmin(<20 mg/dl) was found in 85% of all patients. In non neurologic types other tests of copper metabolism were done. Elevated urinary

  14. The Application of Problem-based Learning Method in the Clinical Teaching of Diagnostic Radiology%PBL教学法在放射诊断学临床教学中的应用

    Institute of Scientific and Technical Information of China (English)

    刘敏; 蒋涛; 马展鸿; 王双坤

    2014-01-01

    以问题为导向的教学方法(problem-based learning,PBL),是以学生为中心的教学方式,广泛的应用于各种学科教学过程中,明显的提高学生的学习效率和实践技能。放射诊断学是临床医学的重要学科,传统教学模式目前已经无法充分调动学生学习的积极性,因此本研究中教师采用 PBL 教学模式,以图像存档及传输系统为工具,以临床中遇到的具体病例为中心,引导学生独立分析疾病放射学诊断思路,在教学过程中开展中英文教学,通过师生互动讨论,增加学生对放射诊断学学习的兴趣,最终提高学生放射诊断学的临床技能及英语水平。%Problem-based learning (PBL) is a teaching model focusing on the student and is widely used in multidisciplinary education. This method has been shown in improving study efficiency and practical skill. Radiation diagnostics is an important discipline of clinical medicine. The traditional teaching mode has been unable to fully arouse the enthusiasm of students learning. Teachers guide students to independently analyze disease diagnostic radiology with the tool of Picture archiving and transmission system and the center of specific cases encountered in clinicalby using PBL teaching mode.Through the interaction discussion between teachers and students, to increase students' interest in study radiologists, eventually improve the level of students in the clinical skills of radiologists and English.

  15. Clinical applications of cells labelling

    International Nuclear Information System (INIS)

    Blood cells labelled with radionuclides are reviewed and main applications are described. Red blood cell labelling by both random and specific principle. A table with most important clinical uses, 99mTc labelling of RBC are described pre tinning and in vivo reduction of Tc, in vitro labelling and administration of labelled RBC and in vivo modified technique. Labelled leucocytes with several 99mTc-complex radiopharmaceuticals by in vitro technique and specific monoclonal s for white cells(neutrofiles). Labelled platelets for clinical use and research by in vitro technique and in vivo labelling

  16. 42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.509 Reconsideration of basis for and amount of payment for a new clinical diagnostic...

  17. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory...

  18. Companion diagnostics and molecular imaging-enhanced approaches for oncology clinical trials.

    Science.gov (United States)

    Van Heertum, Ronald L; Scarimbolo, Robert; Ford, Robert; Berdougo, Eli; O'Neal, Michael

    2015-01-01

    In the era of personalized medicine, diagnostic approaches are helping pharmaceutical and biotechnology sponsors streamline the clinical trial process. Molecular assays and diagnostic imaging are routinely being used to stratify patients for treatment, monitor disease, and provide reliable early clinical phase assessments. The importance of diagnostic approaches in drug development is highlighted by the rapidly expanding global cancer diagnostics market and the emergent attention of regulatory agencies worldwide, who are beginning to offer more structured platforms and guidance for this area. In this paper, we highlight the key benefits of using companion diagnostics and diagnostic imaging with a focus on oncology clinical trials. Nuclear imaging using widely available radiopharmaceuticals in conjunction with molecular imaging of oncology targets has opened the door to more accurate disease assessment and the modernization of standard criteria for the evaluation, staging, and treatment responses of cancer patients. Furthermore, the introduction and validation of quantitative molecular imaging continues to drive and optimize the field of oncology diagnostics. Given their pivotal role in disease assessment and treatment, the validation and commercialization of diagnostic tools will continue to advance oncology clinical trials, support new oncology drugs, and promote better patient outcomes.

  19. Validity of the Research Diagnostic Criteria for Temporomandibular Disorders Axis I in clinical and research settings.

    NARCIS (Netherlands)

    Steenks, M.H.; Wijer, A. de

    2009-01-01

    The lack of standardized diagnostic criteria for defining clinical subtypes of temporomandibular disorders (TMD) was the main motive to create the Research Diagnostic Criteria for TMD (RDC/TMD), which were provided to allow standardization and replication of research into the most common forms of mu

  20. Diagnoses and Presenting Symptoms in an Infant Psychiatry Clinic: Comparison of Two Diagnostic Systems.

    Science.gov (United States)

    Frankel, Karen A.; Boyum, Lisa A.; Harmon, Robert J.

    2004-01-01

    Objective: To present data from a general infant psychiatry clinic, including range and frequency of presenting symptoms, relationship between symptoms and diagnoses, and comparison of two diagnostic systems, DSM-IV and Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3). Method: A…

  1. Protease activity measurement in milk as a diagnostic test for clinical mastitis in dairy cows

    NARCIS (Netherlands)

    Koop, G.; Werven, van T.; Roffel, S.; Hogeveen, H.; Nazmi, K.; Bikker, F.J.

    2015-01-01

    Due to the increasing use of automated milking systems, automated detection of clinical mastitis is becoming more important. Various in- or on-line diagnostic tests are in use, but generally suffer from false mastitis alerts. In this study, we explored a new diagnostic approach based on measureme

  2. Diagnostics

    DEFF Research Database (Denmark)

    Donné, A.J.H.; Costley, A.E.; Barnsley, R.;

    2007-01-01

    on ITER is a substantial challenge. Because of the harsh environment (high levels of neutron and gamma fluxes, neutron heating, particle bombardment) diagnostic system selection and design has to cope with a range of phenomena not previously encountered in diagnostic design. Extensive design and R...

  3. Widening clinical applications of the SYNTAX Score.

    Science.gov (United States)

    Farooq, Vasim; Head, Stuart J; Kappetein, Arie Pieter; Serruys, Patrick W

    2014-02-01

    The SYNTAX Score (http://www.syntaxscore.com) has established itself as an anatomical based tool for objectively determining the complexity of coronary artery disease and guiding decision-making between coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI). Since the landmark SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) Trial comparing CABG with PCI in patients with complex coronary artery disease (unprotected left main or de novo three vessel disease), numerous validation studies have confirmed the clinical validity of the SYNTAX Score for identifying higher-risk subjects and aiding decision-making between CABG and PCI in a broad range of patient types. The SYNTAX Score is now advocated in both the European and US revascularisation guidelines for decision-making between CABG and PCI as part of a SYNTAX-pioneered heart team approach. Since establishment of the SYNTAX Score, widening clinical applications of this clinical tool have emerged. The purpose of this review is to systematically examine the widening applications of tools based on the SYNTAX Score: (1) by improving the diagnostic accuracy of the SYNTAX Score by adding a functional assessment of lesions; (2) through amalgamation of the anatomical SYNTAX Score with clinical variables to enhance decision-making between CABG and PCI, culminating in the development and validation of the SYNTAX Score II, in which objective and tailored decisions can be made for the individual patient; (3) through assessment of completeness of revascularisation using the residual and post-CABG SYNTAX Scores for PCI and CABG patients, respectively. Finally, the future direction of the SYNTAX Score is covered through discussion of the ongoing development of a non-invasive, functional SYNTAX Score and review of current and planned clinical trials.

  4. Applications of Next-Generation Sequencing Technologies to Diagnostic Virology

    Directory of Open Access Journals (Sweden)

    Giorgio Palù

    2011-11-01

    Full Text Available Novel DNA sequencing techniques, referred to as “next-generation” sequencing (NGS, provide high speed and throughput that can produce an enormous volume of sequences with many possible applications in research and diagnostic settings. In this article, we provide an overview of the many applications of NGS in diagnostic virology. NGS techniques have been used for high-throughput whole viral genome sequencing, such as sequencing of new influenza viruses, for detection of viral genome variability and evolution within the host, such as investigation of human immunodeficiency virus and human hepatitis C virus quasispecies, and monitoring of low-abundance antiviral drug-resistance mutations. NGS techniques have been applied to metagenomics-based strategies for the detection of unexpected disease-associated viruses and for the discovery of novel human viruses, including cancer-related viruses. Finally, the human virome in healthy and disease conditions has been described by NGS-based metagenomics.

  5. Developing computational model-based diagnostics to analyse clinical chemistry data

    NARCIS (Netherlands)

    Schalkwijk, D.B. van; Bochove, K. van; Ommen, B. van; Freidig, A.P.; Someren, E.P. van; Greef, J. van der; Graaf, A.A. de

    2010-01-01

    This article provides methodological and technical considerations to researchers starting to develop computational model-based diagnostics using clinical chemistry data.These models are of increasing importance, since novel metabolomics and proteomics measuring technologies are able to produce large

  6. Diagnostic measure to quantify loss of clinical components in multi-lead electrocardiogram.

    Science.gov (United States)

    Tripathy, R K; Sharma, L N; Dandapat, S

    2016-03-01

    In this Letter, a novel principal component (PC)-based diagnostic measure (PCDM) is proposed to quantify loss of clinical components in the multi-lead electrocardiogram (MECG) signals. The analysis of MECG shows that, the clinical components are captured in few PCs. The proposed diagnostic measure is defined as the sum of weighted percentage root mean square difference (PRD) between the PCs of original and processed MECG signals. The values of the weight depend on the clinical importance of PCs. The PCDM is tested over MECG enhancement and a novel MECG data reduction scheme. The proposed measure is compared with weighted diagnostic distortion, wavelet energy diagnostic distortion and PRD. The qualitative evaluation is performed using Spearman rank-order correlation coefficient (SROCC) and Pearson linear correlation coefficient. The simulation result demonstrates that the PCDM performs better to quantify loss of clinical components in MECG and shows a SROCC value of 0.9686 with subjective measure. PMID:27222735

  7. Application of radionuclides for diagnostics and therapy in Australia

    International Nuclear Information System (INIS)

    Data on production and use of radionuclides for diagnostics and therapy of diseases, development of nuclear medicine in Australia are reviewed. HIFAR operation for medicine purposes is noted; characteristics of the nuclear reactor HIFAR and new nuclear reactor under construction are performed. Australian market of radionuclides for medicine and prediction of their consumption are presented. Tendency for application of cyclotron radionuclides in medicine is demonstrated

  8. Clinical applications of immunoglobulin: update

    OpenAIRE

    Marcia Cristina Zago Novaretti; Carla Luana Dinardo

    2011-01-01

    Human immunoglobulin is the most used blood product in the clinical practice. Immunoglobulin applications have increased quickly since the elucidation of its immunomodulatory and antiinflammatory properties which turned this blood product into a precious tool in the treatment of numerous diseases that present with humoral immune deficiency or that cause immune system dysfunction. Currently, the approved indications for Ig are: primary immunodeficiencies, secondary immunodeficiencies (multiple...

  9. Win on Sunday, Sell on Monday: From the Exome Sequencing of One Boy to the Delivery of Clinical Diagnostics

    Science.gov (United States)

    Tschannen, M.R.

    2011-01-01

    For several years, there have been discussions about using both Sanger and whole genome sequencing in clinical practice. In late 2009, the Medical College of Wisconsin initiated the infrastructure to streamline the delivery of current and emerging DNA technologies into state-of-the-art molecular diagnostics. The online publication of our initial case in Genetics of Medicine in late 2010 further intensified our efforts in this endeavor. However, being relatively new to the field of NextGen sequencing, we began with the addition of Sanger diagnostic sequencing to our already successful research core, which at that point had been in operation for almost ten years. This was a great undertaking, as typically, independent research laboratories performing cutting-edge science lack the financial resources and breadth of experience to launch their custom product or application to the diagnostic industry. An independent research laboratory is able to resolve these shortages by partnering with a core laboratory staffed with diagnostic expertise. Due to our lack of diagnostic experience, we quickly aligned the research core to a consortium of individuals with clinical experience to allow us to benefit from established diagnostic facilities on campus. Difficulties faced at the onset of diagnostic startup were many, including large issues such as accreditation program (CAP vs. CLIA), SOP generation and validation, competency and proficiency testing, and reimbursement, as well as smaller problems like semiannual pipette calibration, temperature monitoring, and inventory control. The purpose of this talk is to give insight into efficient ways to resolve these problems, both large and small, and transform a decade or more of research expertise into a viable diagnostic laboratory.

  10. Application of aptamers in diagnostics, drug-delivery and imaging

    Indian Academy of Sciences (India)

    CHETAN CHANDOLA; SHEETAL KALME; MARCO G CASTELEIJN; ARTO URTTI; MUNIASAMY NEERATHILINGAM

    2016-09-01

    Aptamers are small, single-stranded oligonucleotides (DNA or RNA) that bind to their target with high specificity andaffinity. Although aptamers are analogous to antibodies for a wide range of target recognition and variety ofapplications, they have significant advantages over antibodies. Since aptamers have recently emerged as a class ofbiomolecules with an application in a wide array of fields, we need to summarize the latest developments herein. Inthis review we will discuss about the latest developments in using aptamers in diagnostics, drug delivery and imaging.We begin with diagnostics, discussing the application of aptamers for the detection of infective agents itself, antigens/toxins (bacteria), biomarkers (cancer), or a combination. The ease of conjugation and labelling of aptamers makesthem a potential tool for diagnostics. Also, due to the reduced off-target effects of aptamers, their use as a potentialdrug delivery tool is emerging rapidly. Hence, we discuss their use in targeted delivery in conjugation with siRNAs,nanoparticles, liposomes, drugs and antibodies. Finally, we discuss about the conjugation strategies applicable forRNA and DNA aptamers for imaging. Their stability and self-assembly after heating makes them superior overprotein-based binding molecules in terms of labelling and conjugation strategies.

  11. Teleultrasound: Historical Perspective and Clinical Application

    Directory of Open Access Journals (Sweden)

    Adilson Cunha Ferreira

    2015-01-01

    Full Text Available The health care of patients in rural or isolated areas is challenged by the scarcity of local resources, limited patient access to doctors and hospitals, and the lack of specialized professionals. This has led to a new concept in telemedicine: teleultrasonography (or teleultrasound, which permits ultrasonographic diagnoses to be performed remotely. Telemedicine and teleultrasonography are effective in providing diagnostic imaging services to these populations and reduce health care costs by decreasing the number and duration of hospitalizations and reducing unnecessary surgical procedures. This is a narrative review to present the potential clinical applications of teleultrasonography in clinical practice. The results indicate that although barriers persist for implementing teleultrasonography in a more universal and routine way, advances in telecommunications, Internet bandwidth, and the high resolution currently available for portable ultrasonography suggest teleultrasonography applications will continue to expand. Teleultrasound appears to be a valuable addition to remote medical care for isolated populations with limited access to tertiary healthcare facilities and also a useful tool for education and training.

  12. Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation

    OpenAIRE

    Sefer Varol; Hasan Huseyin Ozdemir; Esref Akil; Demet Arslan; M. Ufuk Aluclu; Demir, Caner F.; Yavuz Yucel

    2015-01-01

    ABSTRACT Objective Facial diplegia (FD) is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS) (11), Bickerstaff’s brainstem encephalitis (1), neurosarcoidosis (1), non-Hodgkin’s Lymphoma (1), tuberculous meningitis (1) her...

  13. Interesting clinical presentation of anterior knee pain causing diagnostic dilemma.

    Science.gov (United States)

    Morgan, Samer S; Balasubramanian, S; Teanby, D

    2009-09-01

    A diverse variety of lesions may occasionally occur in the patella. In this case report, we are presenting an interesting case of anterior knee pain in middle aged gentleman. Initial investigations including Magnetic Resonance Imaging not showed any abnormality. Due to prolonged continued pain he had bone scan and MRI, which confirmed the diagnosis of Brodie's abscess. We are presenting this case of Brodie's abscess of the patella causing diagnostic dilemma because of its rarity.

  14. Liquid-based Cytology with Colposcopy in the Clinical Diagnostic Application of Cervical Lesions%液基细胞学联合阴道镜检诊断宫颈病变

    Institute of Scientific and Technical Information of China (English)

    陈宁静; 涂干卿

    2010-01-01

    目的 研究液基薄层细胞学(TCT)检查联合阴道镜检对宫颈病变诊断的价值.方法 选择1 407例患者进行TCT、阴道镜检查和活组织病理检查.结果 281例单独行阴道镜检和699例单独行TCT检查提示活检的,分别有39.50%和42.63%属CIN Ⅰ级以上病变;427例TCT检查结合阴道镜检提示活检的,有86.42%属CIN Ⅰ级以上病变.结论 TCT检查结合阴道镜检定位活检可提高宫颈病变的准确诊断率.%Objective Studying the clinical diagnostic value of liquid-based thin-layer cytology(TCT)combined colpoacopic examination for cervical lesions.Methods In May 2006~August 2007 choose the 1407 patients coming the hospital who was done cytology examination(TCT)and coiposcopy examination and biopsy.Results Among 281 cases of eolposcopy prompt biopsy 39.50% of them suffered from CIN Ⅰ.So did 42.63 % of 699 cases of TCT examinations.427 cases of TCT combined Colposcopy were prompted they need to do biopsy.86.42% of them suffered from CIN Ⅰ or above lesions.Conclusion TCT combination of colposcopy and endoscopic biopsy can increase the rate of accurate diagnosis of cervicallesions.

  15. Hyperthermia: Rational and clinical applications

    International Nuclear Information System (INIS)

    Over the past 20 years, research in the application of hyperthermia (HT), primarily as an adjuvant to radiation therapy (XRT), for the management of locally-advanced or recurrent malignancies, has waxed and waned in interest in the United States. Initial enthusiasm based on in vitro and murine tumor studies, was severely dampened by the results of early clinical trails. One initial clinical Phase III trial, however, employed applicators which were frequently unable to obtain adequate tumor heating, failed to sufficiently monitor tumor and normal tissue temperatures, and selected inappropriate tumors (based on size and depth) for therapy. Fortunately, subsequent clinical trials have benefited from the lessons learned in earlier attempts. Recently, three European-based, Phase III randomized trials enrolling large numbers of patients have demonstrated significantly improved local control rates for superficially-located metastatic melanomas, chest wall recurrences from breast cancer, and deep-seated locally-advanced tumors of the uterine cervix and urinary bladder. In addition, continued improvements in HT applicators and a better understanding of thermal dosimetry should permit further advances in trial design for the clinical use of HT as an adjuvant to XRT. This refresher course will focus on four areas: (1) a review of progress made in thermal dose descriptors with emphasis on their use in prescribing HT treatments and on the correlation of thermal and thermal dose parameters with clinical outcome, (2) tumor site-specific selection for HT studies based on sites that can be heated with currently available equipment, and tumors where improved local control will result in increased chance of patient cure or significant palliation, (3) site-specific results and examples of responses to XRT-HT, and (4) an overview of the results of eleven randomized Phase III clinical studies comparing XRT alone to XRT plus HT. It is hoped that those attending the refresher course will

  16. Clinical applications of immunoglobulin: update

    Directory of Open Access Journals (Sweden)

    Marcia Cristina Zago Novaretti

    2011-06-01

    Full Text Available Human immunoglobulin is the most used blood product in the clinical practice. Immunoglobulin applications have increased quickly since the elucidation of its immunomodulatory and antiinflammatory properties which turned this blood product into a precious tool in the treatment of numerous diseases that present with humoral immune deficiency or that cause immune system dysfunction. Currently, the approved indications for Ig are: primary immunodeficiencies, secondary immunodeficiencies (multiple myeloma or chronic lymphoid leukemia, Kawasaki syndrome, immune thrombocytopenic purpura, Guillain Barré syndrome, graft-versus-host disease following bone marrow transplantation and repeat infections in HIV children. On the other hand, there are numerous "off-label" indications of immunoglobulin, which represent 20-60% of all clinical applications of this drug. It is important to study all these indications and, above all, the scientific evidence for its use, in order to provide patients with a new therapeutic option without burdening the health system. This review results from a wide selection of papers identified in the Pubmed and Lilacs scientific electronic databases. A group of descriptors were used from human immunoglobulin to the names of each disease that immunoglobulin is clinically applied. Our main objective is to list the numerous indications of immunoglobulin, both authorized and "off-label" and to analyze these indications in the light of the most recent scientific evidence.

  17. Diagnostic application of magnetic islands rotation in JET

    Science.gov (United States)

    Buratti, P.; Alessi, E.; Baruzzo, M.; Casolari, A.; Giovannozzi, E.; Giroud, C.; Hawkes, N.; Menmuir, S.; Pucella, G.; Contributors, JET

    2016-07-01

    Measurements of the propagation frequency of magnetic islands in JET are compared with diamagnetic drift frequencies, in view of a possible diagnostic application to the determination of markers for the safety factor profile. Statistical analysis is performed for a database including many well-diagnosed plasma discharges. Propagation in the plasma frame, i.e. with subtracted E  ×  B Doppler shift, results to be in the ion diamagnetic drift direction, with values ranging from 0.8 (for islands at the q  =  2 resonant surface) to 1.8 (for more internal islands) times the ion diamagnetic drift frequency. The diagnostic potential of the assumption of island propagation at exactly the ion diamagnetic frequency is scrutinised. Rational-q locations obtained on the basis of this assumption are compared with the ones measured by equilibrium reconstruction including motional Stark effect measurements as constraints. Systematic shifts and standard deviations are determined for islands with (poloidal, toroidal) periodicity indexes of (2, 1), (3, 2), (4, 3) and (5, 3) and possible diagnostic applications are indicated.

  18. Potential applications of human saliva as diagnostic fluid.

    Science.gov (United States)

    Castagnola, M; Picciotti, P M; Messana, I; Fanali, C; Fiorita, A; Cabras, T; Calò, L; Pisano, E; Passali, G C; Iavarone, F; Paludetti, G; Scarano, E

    2011-12-01

    The use of human saliva as a diagnostic and prognostic fluid has until recently been somewhat disregarded. Although sample collection is non-invasive, physiological and genetic variations were largely responsible for its infrequent application in the past. Recently, several proteomic studies contributed to partial elucidation of the salivary proteome (more than 2400 protein components have been characterized), both in terms of composition, contributions to whole saliva and genetic/physiological variability. On this basis, is not too optimistic to believe that in the near future human saliva could become a relevant diagnostic fluid. In this review, the characterization by proteomic approaches of new salivary markers in oncology, head and neck carcinoma (oral cavity, oropharynx, larynx, and salivary glands), breast and gastric cancers, salivary gland function and disease, Sjögren syndrome, systemic sclerosis, dental and gingival pathology, systemic, psychiatric and neurological diseases, is described.

  19. PET/MRI. Methodology and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Carrio, Ignasi [Autonomous Univ. of Barcelona, Hospital Sant Pau (Spain). Dept. Medicina Nuclear; Ros, Pablo (ed.) [Univ. Hospitals Case, Medical Center, Cleveland, OH (United States). Dept. of Radiology

    2014-04-01

    Provides detailed information on the methodology and equipment of MRI-PET. Covers a wide range of clinical applications in oncology, cardiology, and neurology. Written by an international group of experts in MRI and PET. PET/MRI is an exciting novel diagnostic imaging modality that combines the precise anatomic and physiologic information provided by magnetic resonance imaging (MRI) with the molecular data obtained with positron emission tomography (PET). PET/MRI offers the promise of a simplified work flow, reduced radiation, whole-body imaging with superior soft tissue contrast, and time of flight physiologic information. It has been described as the pathway to molecular imaging in medicine. In compiling this textbook, the editors have brought together a truly international group of experts in MRI and PET. The book is divided into two parts. The first part covers methodology and equipment and comprises chapters on basic molecular medicine, development of specific contrast agents, MR attenuation and validation, quantitative MRI and PET motion correction, and technical implications for both MRI and PET. The second part of the book focuses on clinical applications in oncology, cardiology, and neurology. Imaging of major neoplasms, including lymphomas and tumors of the breast, prostate, and head and neck, is covered in individual chapters. Further chapters address functional and metabolic cardiovascular examinations and major central nervous system applications such as brain tumors and dementias. Risks, safety aspects, and healthcare costs and impacts are also discussed. This book will be of interest to all radiologists and nuclear medicine physicians who wish to learn more about the latest developments in this important emerging imaging modality and its applications.

  20. Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation

    Directory of Open Access Journals (Sweden)

    Sefer Varol

    2015-12-01

    Full Text Available ABSTRACT Objective Facial diplegia (FD is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS (11, Bickerstaff’s brainstem encephalitis (1, neurosarcoidosis (1, non-Hodgkin’s Lymphoma (1, tuberculous meningitis (1 herpes simplex reactivation (1 and idiopathic (1. In addition, two patients had developed FD during pregnancy. Conclusion Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.

  1. Clinical application of bio ceramics

    Science.gov (United States)

    Anu, Sharma; Gayatri, Sharma

    2016-05-01

    Ceramics are the inorganic crystalline material. These are used in various field such as biomedical, electrical, electronics, aerospace, automotive and optical etc. Bio ceramics are the one of the most active areas of research. Bio ceramics are the ceramics which are biocompatible. The unique properties of bio ceramics make them an attractive option for medical applications and offer some potential advantages over other materials. During the past three decades, a number of major advances have been made in the field of bio ceramics. This review focuses on the use of these materials in variety of clinical scenarios.

  2. Computer applications in clinical psychology

    CERN Document Server

    Zamoşteanu, Alina Oana

    2012-01-01

    The computer-assisted analysis is not currently a novelty, but a necessity in all areas of psychology. A number of studies that examine the limits of the computer assisted and analyzed interpretations, also its advantages. A series of studies aim to assess how the computer assisting programs are able to establish a diagnosis referring to the presence of certain mental disorders. We will present the results of one computer application in clinical psychology regarding the assessment of Theory of Mind capacity by animation.

  3. Computer applications in clinical psychology

    Directory of Open Access Journals (Sweden)

    Alina Oana Zamoşteanu

    2009-01-01

    Full Text Available The computer-assisted analysis is not currently a novelty, but a necessity in all areas of psychology. A number of studies that examine the limits of the computer assisted and analyzed interpretations, also its advantages. A series of studies aim to assess how the computer assisting programs are able to establish a diagnosis referring to the presence of certain mental disorders. We will present the results of one computer application in clinical psychology regarding the assessment of Theory of Mind capacity by animation.

  4. Application of Irwin diagnostic procedures for chronic cough

    Directory of Open Access Journals (Sweden)

    Guo-fang FENG

    2011-07-01

    Full Text Available Objective To explore the advantages and disadvantages of the diagnostic procedures suggested by the Irwin group,and summarize the experiences in diagnosis and treatment,and to beter understand the etiology,diagnosis,differential diagnosis and treatment of chronic cough.Methods Data of 118 patients,who were finally diagnosed as chronic cough according to the diagnostic procedures suggested by Irwin group in the First Affiliated Hospital of General Hospital of PLA in 2009,were retrospectivety analyzed.Results With the Irwin diagnostic procedures of chronic cough,118 patients were diagnosed definitely.The final diagnostic rate reached 100%.The duration to reach the final diagnosis was 1 day to 30 days.Of the 118 patients with chronic cough,113 were cured(96%.32 cases(27.1% were caused by asthma and related diseases(allergic rhinitis,allergic pharyngitis,cough variant asthma and eosinophilic bronchitis;28 cases(23.7% were due to upper airway cough syndrome and related diseases(chronic rhinitis,sinusitis,pharyngeal bursitis,postnasal drip syndrome,chronic laryngitis,and vocal cord polyps;23 cases(19.5% due to gastroesophageal reflux disease;14 cases(11.9% due to lower respiratory tract infection and related diseases(endobronchial tuberculosis,pulmonary tuberculosis,endotracheal mucosal adenocarcinoma,lung cancer,bronchiectasis,and pulmonary fibrosis;10 cases(8.5% due to cardiac insafficiency;6 cases(5.1% due to administration of angiotensin-converting enzyme inhibitor(ACEI-like antihypertensive agents;3 cases(2.5% were psychogenic cough,and 2 cases(1.7% were induced by other causes.Conclusions The Irwin diagnosis of chronic cough is a comprehensive and thorough procedure,and it should be used with delibcration in clinic.The etiology of chronic cough is complicated,mainly including asthma and related diseases,sinusitis and upper airway cough syndrome,and gastroesophageal reflux disease.

  5. THE HIGH DIAGNOSTIC YIELD OF A GERIATRIC OUTPATIENT CLINIC

    OpenAIRE

    Moret F.

    2012-01-01

    Objectives: To determine characteristics of older patients referred to a geriatric outpatient clinic; 2) to determine the prevalence of geriatric syndromes in this population; 3) to identify main recommendations made to referring primary care physicians. Design: Cross-sectional analysis Setting: Outpatient clinic of the service of geriatric medicine at the University of Lausanne Medical Center, Lausanne, Switzerland. Participants: Community-dwelling patients aged 65 and over referred to the c...

  6. Clinical Evaluation of Rapid Diagnostic Test Kit for Scrub Typhus with Improved Performance

    Science.gov (United States)

    2016-01-01

    Diagnosis of scrub typhus is challenging due to its more than twenty serotypes and the similar clinical symptoms with other acute febrile illnesses including leptospirosis, murine typhus and hemorrhagic fever with renal syndrome. Accuracy and rapidity of a diagnostic test to Orientia tsutsugamushi is an important step to diagnose this disease. To discriminate scrub typhus from other diseases, the improved ImmuneMed Scrub Typhus Rapid Diagnostic Test (RDT) was evaluated in Korea and Sri Lanka. The sensitivity at the base of each IgM and IgG indirect immunofluorescent assay (IFA) in Korean patients was 98.6% and 97.1%, and the specificity was 98.2% and 97.7% respectively. The sensitivity and specificity for retrospective diagnosis at the base of IFA in Sri Lanka was 92.1% and 96.1%. ImmuneMed RDT was not reactive to any serum from seventeen diseases including hemorrhagic fever with renal syndrome (n = 48), leptospirosis (n = 23), and murine typhus (n = 48). ImmuneMed RDT shows superior sensitivity (98.6% and 97.1%) compared with SD Bioline RDT (84.4% at IgM and 83.3% at IgG) in Korea. The retrospective diagnosis of ImmuneMed RDT exhibits 94.0% identity with enzyme-linked Immunosorbent assay (ELISA) using South India patient serum samples. These results suggest that this RDT can replace other diagnostic tests and is applicable for global diagnosis of scrub typhus. This rapid and accurate diagnosis will be beneficial for diagnosing and managing scrub typhus. PMID:27478327

  7. Clinical comparison of indigenous /sup 99/Tc-m radiopharmaceuticals kits with Amersham diagnostic kits

    International Nuclear Information System (INIS)

    The ultimate appropriateness of the indigenous (Pinscan) cold kits was judged by performing clinical studies with them and comparing results with Amersham's diagnostic kits (Amerscan). The scans obtained by indigenous kits was as good as those of Amershams's. This proves that the indigenous kits are of acceptable quality and be used for routine clinical studies. (author)

  8. The Application of Clinical Genetics

    Directory of Open Access Journals (Sweden)

    Maurer MH

    2012-02-01

    Full Text Available Martin H MaurerDepartment of Physiology and Pathophysiology, University of Heidelberg, Heidelberg, Germany; Mariaberg Hospital for Child and Adolescent Psychiatry, Gammertingen, GermanyIn 2012, The Application of Clinical Genetics enters its fifth year of publication. The journal has had a change of Editor-in-Chief: Dr David H Tegay stepped down and I was appointed to serve as the new Editor-in-Chief. As his successor, I thank Dr Tegay for his great work for the journal. I hope I can continue his successful editorial contributions. Moreover, I thank the many reviewers for their sustained support of the journal.The Application of Clinical Genetics is dedicated to open access publishing – as all Dove Press journals are. This means that authors will be charged for the publication process, but the acceptance of a manuscript is based solely on its scientific quality. This is what I will be responsible for as Editor-in-Chief. The team at Dove Press is a constant help with all administrative duties concerning peer reviewal, and I want to express my thanks for their prompt and reliable help. The field of clinical genetics is facing new challenges with the broad availability of large-scale screening methods for gene mutations, such as high-throughput sequencing and biochips. This means that ethical issues regarding the handling of genetic information must be addressed, both for the individual and for society.1–3 For example, sequencing of cell-free, fetal nucleic acids in the maternal blood to locate fetal aneuploidy, especially trisomy 21, may become broadly available soon, with even faster results than conventional methods such as amniocentesis.

  9. Bioinspired Composite Materials: Applications in Diagnostics and Therapeutics

    Science.gov (United States)

    Prasad, Alisha; Mahato, Kuldeep; Chandra, Pranjal; Srivastava, Ananya; Joshi, Shrikrishna N.; Maurya, Pawan Kumar

    2016-08-01

    Evolution-optimized specimens from nature with inimitable properties, and unique structure-function relationships have long served as a source of inspiration for researchers all over the world. For instance, the micro/nanostructured patterns of lotus-leaf and gecko feet helps in self-cleaning, and adhesion, respectively. Such unique properties shown by creatures are results of billions of years of adaptive transformation, that have been mimicked by applying both science and engineering concepts to design bioinspired materials. Various bioinspired composite materials have been developed based on biomimetic principles. This review presents the latest developments in bioinspired materials under various categories with emphasis on diagnostic and therapeutic applications.

  10. Optimising the diagnostic imaging process through clinical history documentation

    International Nuclear Information System (INIS)

    In the United Kingdom the 1990s were characterised by radiographer role extension including radiographic reporting and the performance of a variety of contrast examinations. In Australia where a privatised health system constrains the role of radiographers, other ways need to be found to improve professional practice and enhance patient care. One such way is for radiographers to develop knowledge and skills in clinical history taking. The paper advocates the development of a formalised approach to clinical history taking that portrays the radiographer as a professional and advocate of patient rights and welfare. The paper examines history taking approaches used by other health care professionals and proposes a clinical history template using five key areas of interview: area and type of symptoms, current history, past history, special considerations and psychosocial/occupational history. Copyright (2003) Australian Institute of Radiography

  11. Schizoaffective disorder-- the reliability of its clinical diagnostic use

    DEFF Research Database (Denmark)

    Vollmer-Larsen, Anne; Jacobsen, TB; Hemmingsen, R;

    2006-01-01

    OBJECTIVE: Patients with psychoses often suffer from affective symptoms. The originally broad concept of schizoaffective disorder (SAD) has been significantly narrowed, transformed into a convoluted set of criteria both in the ICD-10 and DSM-IV. We examined the reliability of the clinical use....... Diagnoses were allocated by OPCRIT algorithm and by consensus of two psychiatrists. RESULTS: No patients fulfilled the SAD lifetime diagnosis according to DSM-IV criteria and the raters diagnosed only six patients as possible ICD-10 SAD. CONCLUSION: A moratorium on the clinical use of the SAD diagnosis...

  12. Updated clinical diagnostic criteria for sporadic Creutzfeldt-Jakob disease

    NARCIS (Netherlands)

    I. Zerr; K. Kallenberg; D.M. Summers; C. Romero; A. Taratuto; U. Heinemann; M. Breithaupt; D. Varges; B. Meissner; A. Ladogana (Anna); M. Schuur (Maaike); S. Haik; S.J. Collins (Steven); G.H. Jansen (Gerard); G.B. Stokin; J. Pimentel; E. Hewer; D. Collie; P. Smith; H. Roberts; J.P. Brandel; P. Tikka-Kleemola (Päivi); M. Pocchiari; C. Begue; P. Cras (Patrick); R.G. Will; P. Sanchez-Juan (Pascual)

    2009-01-01

    textabstractSeveral molecular subtypes of sporadic Creutzfeldt-Jakob disease have been identified and electroencephalogram and cerebrospinal fluid biomarkers have been reported to support clinical diagnosis but with variable utility according to subtype. In recent years, a series of publications hav

  13. Clinical Utility of Machine-Learning Approaches in Schizophrenia: Improving Diagnostic Confidence for Translational Neuroimaging

    OpenAIRE

    Iwabuchi, Sarina J.; Liddle, Peter F; Palaniyappan, Lena

    2013-01-01

    Machine-learning approaches are becoming commonplace in the neuroimaging literature as potential diagnostic and prognostic tools for the study of clinical populations. However, very few studies provide clinically informative measures to aid in decision-making and resource allocation. Head-to-head comparison of neuroimaging-based multivariate classifiers is an essential first step to promote translation of these tools to clinical practice. We systematically evaluated the classifier performance...

  14. CLINICAL DIAGNOSTIC VALUE OF AUTOANTIBODIES IN THE DIAGNOSIS OF AUTOIMMUNE LIVER DISEASES

    Directory of Open Access Journals (Sweden)

    V. V. Bazarnyi

    2015-01-01

    Full Text Available We are studied the 15 patients with autoimmune liver diseases and 36 patients without autoimmune pathology found the diagnostic value of antinuclear and antimitochondrial autoantibodies (AMA-M2 tests, and antibodies to asialoglycoprotein receptor (anti-ASGPR. Based on the ROC analysis showed that the diagnostic sensitivity and diagnostic specificity of AMA-M2 was 73% and 100% and for anti-ASGPR – 60% and 77%, respectively. Therefore, the test for anti-ASGPR in autoimmune diseases of the liver showed no advantages over standart tests, and its using in clinical practice requires clarification. 

  15. Bayesian networks applied to process diagnostics. Applications in energy industry

    Energy Technology Data Exchange (ETDEWEB)

    Widarsson, Bjoern (ed.); Karlsson, Christer; Dahlquist, Erik [Maelardalen Univ., Vaesteraas (Sweden); Nielsen, Thomas D.; Jensen, Finn V. [Aalborg Univ. (Denmark)

    2004-10-01

    Uncertainty in process operation occurs frequently in heat and power industry. This makes it hard to find the occurrence of an abnormal process state from a number of process signals (measurements) or find the correct cause to an abnormality. Among several other methods, Bayesian Networks (BN) is a method to build a model which can handle uncertainty in both process signals and the process itself. The purpose of this project is to investigate the possibilities to use BN for fault detection and diagnostics in combined heat and power industries through execution of two different applications. Participants from Aalborg University represent the knowledge of BN and participants from Maelardalen University have the experience from modelling heat and power applications. The co-operation also includes two energy companies; Elsam A/S (Nordjyllandsverket) and Maelarenergi AB (Vaesteraas CHP-plant), where the two applications are made with support from the plant personnel. The project ended out in two quite different applications. At Nordjyllandsverket, an application based (due to the lack of process knowledge) on pure operation data is build with capability to detect an abnormal process state in a coal mill. Detection is made through a conflict analysis when entering process signals into a model built by analysing the operation database. The application at Maelarenergi is built with a combination of process knowledge and operation data and can detect various faults caused by the fuel. The process knowledge is used to build a causal network structure and the structure is then trained by data from the operation database. Both applications are made as off-online applications, but they are ready for being run on-line. The performance of fault detection and diagnostics are good, but a lack of abnormal process states with known cause reduces the evaluation possibilities. Advantages with combining expert knowledge of the process with operation data are the possibility to represent

  16. Evaluation of diagnostic tools for epidemiological purposes: Application to FMD

    International Nuclear Information System (INIS)

    Full text: Foot-and-mouth disease (FMD) is economically the most important disease of domestic livestock. Due to its highly infectious nature, ability to cause persistent infection and long-term effects on the animal species it affects, countries that have the disease have many trade restrictions placed upon them. The importance of laboratory information is critical for FMD control and eradication programs. In this regard and in support of the Continental Program for Eradication of FMD, implemented in 1988 in the Americas, a major challenge for the Pan American Foot-and-Mouth Disease Center (PAFMDC) as a regional OIE reference laboratory, was related to the adaptation of approaches to respond to the new demands of diagnostic precision placed to support the epidemiological transition expected in the Continent. Regions with advanced eradication campaigns needed to incorporate approaches for rapid and precise identification of the agent during an emergency, and equally important, for enabling a deeper epidemiological analysis, capable of characterizing the potential sources of infection and dissemination of the virus, either during clinical or subclinical viral circulation. Since the implementation of the eradication program there have been significant advances in the understanding of FMD epidemiology in South America. These have partly been due to the application of nucleotide sequencing methods for viral characterization and of newly developed tools for sero epidemiological monitoring of persistent viral activity, based on the use of recombinant noncapsideal antigens as serological probes to detect infection specific antibodies, regardless of vaccination condition. In the PAFMDC, a genetic sequence database of representative South American strains has been built up, which constituted the basis for the phylogenetic analysis of the viruses type O and A, responsible for the major outbreaks recorded, in regions already declared free by the OIE in the Southern Cone of

  17. Clinical and neuropathological picture of ethylmalonic aciduria - diagnostic dilemma.

    Science.gov (United States)

    Jamroz, Ewa; Paprocka, Justyna; Adamek, Dariusz; Pytel, Justyna; Szczechowska, Katarzyna; Grabska, Natalia; Malec, Michalina; Głuszkiewicz, Ewa; Daab, Michał; Wodołażski, Anatolij

    2011-01-01

    Increased ethylmalonic acid (EMA) in urine is a non-specific finding, and is observed in a number of inborn errors of metabolism, as well as in individuals who carry one of two common polymorphisms identified in the SCAD coding region. The authors present an 8-month-old girl with a suspicion of neuroinfection, although the clinical presentation led to diagnosis of ethylmalonic aciduria. From the neuropathological point of view the most remarkable changes were observed in the brain cortex, which was diffusely damaged practically in all regions of the brain. Of note, the most severe destruction was observed in the deepest regions of the sulci. The cortex of the affected regions showed no normal stratification and its structure was almost totally replaced by a form of "granulation tissue" with a markedly increased number of capillaries. To the authors' knowledge this is the first clinical report of ethylmalonic aciduria with brain autopsy findings.

  18. Bacteriophages in clinical samples can interfere with microbiological diagnostic tools.

    Science.gov (United States)

    Brown-Jaque, Maryury; Muniesa, Maite; Navarro, Ferran

    2016-09-09

    Bacteriophages are viruses that infect bacteria, and they are found everywhere their bacterial hosts are present, including the human body. To explore the presence of phages in clinical samples, we assessed 65 clinical samples (blood, ascitic fluid, urine, cerebrospinal fluid, and serum). Infectious tailed phages were detected in >45% of ascitic fluid and urine samples. Three examples of phage interference with bacterial isolation were observed. Phages prevented the confluent bacterial growth required for an antibiogram assay when the inoculum was taken from an agar plate containing lysis plaques, but not when taken from a single colony in a phage-free area. In addition, bacteria were isolated directly from ascitic fluid, but not after liquid enrichment culture of the same samples, since phage propagation lysed the bacteria. Lastly, Gram-negative bacilli observed in a urine sample did not grow on agar plates due to the high densities of infectious phages in the sample.

  19. Bacteriophages in clinical samples can interfere with microbiological diagnostic tools

    Science.gov (United States)

    Brown-Jaque, Maryury; Muniesa, Maite; Navarro, Ferran

    2016-01-01

    Bacteriophages are viruses that infect bacteria, and they are found everywhere their bacterial hosts are present, including the human body. To explore the presence of phages in clinical samples, we assessed 65 clinical samples (blood, ascitic fluid, urine, cerebrospinal fluid, and serum). Infectious tailed phages were detected in >45% of ascitic fluid and urine samples. Three examples of phage interference with bacterial isolation were observed. Phages prevented the confluent bacterial growth required for an antibiogram assay when the inoculum was taken from an agar plate containing lysis plaques, but not when taken from a single colony in a phage-free area. In addition, bacteria were isolated directly from ascitic fluid, but not after liquid enrichment culture of the same samples, since phage propagation lysed the bacteria. Lastly, Gram-negative bacilli observed in a urine sample did not grow on agar plates due to the high densities of infectious phages in the sample. PMID:27609086

  20. Clinical aspects of MR colonography as a diagnostic tool

    DEFF Research Database (Denmark)

    Achiam, Michael

    2010-01-01

    Since first described in 1997, MR colonography (MRC) has since been labelled as a promising new, non-invasive technique for examining the colon. At present time, the examination is ready to be implemented as a supplement to incomplete colonoscopy or preoperative colonic evaluation. Furthermore, MRC...... and that polypectomy might be curative. Colonoscopy remains the gold standard for full colon evaluation. However, the result of our studies can justify clinical use of MRC on selected indications, e.g. in the cases where colonoscopy is incomplete or technically difficult. Since up to 54% of all preoperative colon...... evaluations in patients with colorectal cancer and up to 17-23% of regular colonoscopies are incomplete, the clinical potential of MRC is evident. Furthermore, in our studies we have shown the insufficiency of preoperative colonic evaluation by CC. In addition, considering the invasiveness, the serious...

  1. Application of optical phase conjugation to plasma diagnostics (invited)

    Energy Technology Data Exchange (ETDEWEB)

    Jahoda, F.C.; Anderson, B.T.; Forman, P.R.; Weber, P.G.

    1985-05-01

    Several possibilities for plasma diagnostics provided by optical phase conjugation and, in particular, self-pumped phase conjugation in barium titanate (BaTiO/sub 3/) are discussed. These include placing a plasma within a dye laser cavity equipped with a phase conjugate mirror for intracavity absorption measurements, time differential refractometry with high spatial resolution, and simplified real-time holographic interferometry. The principles of phase conjugation with particular reference to photorefractive media and the special advantages of self-pumped phase conjugation are reviewed prior to the discussion of the applications. Distinctions are made in the applications between those for which photorefractive conjugators are essential and those for which they only offer experimental simplification relative to other types of phase conjugators.

  2. Clinics in diagnostic imaging (58). Chronic cerebral paragonimiasis.

    Science.gov (United States)

    Kaw, G J; Sitoh, Y Y

    2001-02-01

    A 36-year-old Korean man presented with a history of epilepsy. MR imaging of the brain revealed multiple conglomerated round nodules that were hypointense on both T1-and-T2 weighted images. These were located at the left temporal and occipital lobes and had surrounding encephalomalacia. CT scan confirmed the presence of large calcified nodules in the corresponding regions. These imaging findings were typical of chronic cerebral paragonimiasis. The clinical, CT and MR features of cerebral paragonimiasis are reviewed.

  3. Clinics in diagnostic imaging (90). Childhood nasopharyngeal carcinoma.

    Science.gov (United States)

    Ng, B K; Chong, C L; Tan, A M; Hwang, W S

    2003-10-01

    An 11-year-old boy presented with a nasopharyngeal mass that was thought to represent a juvenile angiofibroma based on the initial clinical and radiological evaluation. Partial tumour resection was performed. Resected specimen revealed histological diagnosis of undifferentiated carcinoma. Further evaluation of the tumour including MR imaging, radioisotope bone scan, CT thorax and abdomen were performed. Differential diagnoses of childhood nasopharyngeal masses were discussed. The differences between childhood NPC and adult NPC, rhabdomyosarcoma, malignant lymphoma and juvenile nasopharyngeal angiofibroma were also discussed.

  4. Clinical and radiological diagnostic of foreign bodies in companion birds

    International Nuclear Information System (INIS)

    Sometimes curious foreign bodies placed in the proventriculus/ventriculus of companion birds are causes of single case diseases. Clinical signs include untypical symptoms such as distress, lameness, vomiting and diarrhoe. In cases of heavy metal intoxication, e.g. lead poisoning, CNS-disorders are found. Radiographs taken in a ventro-dorsal and a latero-lateral view show the presence of foreign bodies in suspicion. In most cases of foreign bodies in birds a surgical intervention (Gastrotomy) is indicated

  5. The Use of a Diagnostic Database in Clinical Oncogenetics

    Directory of Open Access Journals (Sweden)

    Sijmons Rolf H

    2003-12-01

    Full Text Available Abstract In addition to a relatively small number of well known hereditary cancer syndromes, hundreds of presumed or proven hereditary disorders have been observed to manifest cancer as a characteristic feature or as a possible complication. The recognition of these disorders may be of great importance for the medical management of the families involved. Specialized databases, like the Familial Cancer Database (FaCD, http://www.facd.info, may be helpful in the making of differential diagnoses and offer advantages compared with traditional textbooks and on-line literature searches. Based on our own experience and interviews with the other Dutch family cancer clinics, we expect that in similar clinics, computer-assisted differential diagnosis will be primarily used in helping to decide whether or not cancer patients and families should be referred to family cancer clinics for further study and counseling. FaCD has been developed as a tool for experts. As general practitioners and other health professionals with non-expert knowledge of cancer genetics are under increasing pressure to advise on genetic risks, it should be encouraged that other software is developed to support them in interpreting family histories of cancer.

  6. Epidemiological, clinical and diagnostic aspects of sheep conidiobolomycosis in Brazil

    Directory of Open Access Journals (Sweden)

    Carla Weiblen

    2016-05-01

    Full Text Available ABSTRACT: Conidiobolomycosis is an emerging disease caused by fungi of the cosmopolitan genus Conidiobolus . Particular strains of Conidiobolus coronatus, Conidiobolus incongruus and Conidiobolus lamprauges , mainly from tropical or sub-tropical origin, cause the mycosis in humans and animals, domestic or wild. Lesions are usually granulomatous and necrotic in character, presenting two clinical forms: rhinofacial and nasopharyngeal. This review includes the main features of the disease in sheep, with an emphasis on the epidemiology, clinical aspects, and diagnosis of infections caused by Conidiobolus spp. in Brazil. In this country, the disease is endemic in the Northeast and Midwest, affecting predominantly woolless sheep breeds and occasioning death in the majority of the studied cases. The species responsible for infections of sheep are C. coronatus and C. lamprauges and the predominant clinical presentation is nasopharyngeal. These fungal infections are very important, since they compromise the health status of the sheep flock and cause serious economic losses to the sheep industry. Thus, research is needed to investigate faster tools for diagnosis and effective methods for the control and treatment of conidiobolomycosis.

  7. Autoimmune thyroiditis goitrogenic. Aspects of clinical and laboratorial diagnostic

    International Nuclear Information System (INIS)

    To asses the accuracy achieved by the A.C.A.T. and other clinical and laboratorial criterion in the diagnoses of T.A.I.B. we investigated twenty patients with goiter and antimicrossomal antibodies titres of 1/1.600 or more. Analysing the parameters useful in the diagnosis, we found a significant correlation between the antimicrossomal antibodies titres and the basal TSH concentration, an elevated basal TSH and an exaggerated response to TRH independent of the patient clinical status reflecting in the majority of the cases a state of subclinical hypotyroidism; an irregular appearance of the radioisotope thyroid scan and a positive response to a perchlorate discharge test. We conclude that from the parameters useful in the T.A.I.B. diagnosis, the A.C.A.T. detection mainly the antimicrossomal antibodies, is an excellent tool to detect patients with a clinical suspect of thyroid auto-immune disease and when we found high tires in a patient with goiter and an elevated basal TSH concentration we can suggest T.A.I.B. diagnosis. (author)

  8. Clinical applications of iterative reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Eberl, S. [Royal Prince Alfred Hospital, Camperdown, NSW (Australia). Department of PET and Nuclear Medicine

    1998-03-01

    Expectation maximisation (EM) reconstruction largely eliminates the hot and cold streaking artifacts characteristic of filtered-back projection (FBP) reconstruction around localised hot areas, such as the bladder. It also substantially reduces the problem of decreased inferior wall counts in MIBI myocardial perfusion studies due to ``streaking`` from high liver uptake. Non-uniform attenuation and scatter correction, resolution recovery, anatomical information, e.g. from MRI or CT tracer kinetic modelling, can all be built into the EM reconstruction imaging model. The properties of ordered subset EM (OSEM) have also been used to correct for known patient motion as part of the reconstruction process. These uses of EM are elaborated more fully in some of the other abstracts of this meeting. Currently we use OSEM routinely for: (i) studies where streaking is a problem, including all MIBI myocardial perfusion studies, to avoid hot liver inferior wall artifact, (ii) all whole body FDG PET, all lung V/Q SPECT (which have a short acquisition time) and all gated {sup 201}TI myocardial perfusion studies due to improved noise characteristics of OSEM in these studies; (iii) studies with measured, non-uniform attenuation correction. With the accelerated OSEM algorithm, iterative reconstruction is practical for routine clinical applications and we have found OSEM to provide clearly superior reconstructions for the areas listed above and are investigating its application to other studies. In clinical use, we have not found OSEM to introduce artifacts which would not also occur with FBP, e.g. uncorrected patient motion will cause artifacts with both OSEM and FBP.

  9. Proteomics in veterinary medicine: applications and trends in disease pathogenesis and diagnostics.

    Science.gov (United States)

    Ceciliani, F; Eckersall, D; Burchmore, R; Lecchi, C

    2014-03-01

    Advancement in electrophoresis and mass spectrometry techniques along with the recent progresses in genomics, culminating in bovine and pig genome sequencing, widened the potential application of proteomics in the field of veterinary medicine. The aim of the present review is to provide an in-depth perspective about the application of proteomics to animal disease pathogenesis, as well as its utilization in veterinary diagnostics. After an overview on the various proteomic techniques that are currently applied to veterinary sciences, the article focuses on proteomic approaches to animal disease pathogenesis. Included as well are recent achievements in immunoproteomics (ie, the identifications through proteomic techniques of antigen involved in immune response) and histoproteomics (ie, the application of proteomics in tissue processed for immunohistochemistry). Finally, the article focuses on clinical proteomics (ie, the application of proteomics to the identification of new biomarkers of animal diseases).

  10. [Modern clinical and radiological approach to diagnostics of odontogenic sinusitis].

    Science.gov (United States)

    Khomutova, E Yu; Ignat'ev, Yu T; Demyanchuk, A N; Demyanchuk, A B

    2015-01-01

    Inflammatory diseases of the maxillary sinuses affect up to 70% of the adult population. Odontogenic maxillary sinusitis represents 13-86% of the inflammatory processes of maxillofacial area, with the incidence range being explained rather by varying diagnosis criteria than the true incidence difference of odontogenic lesions. The aim of the study was to summarize the clinical and radiological characteristics of odontogenic sinusitis according to patients records in the Department of Maxillofacial Surgery of Omsk Clinical Hospital No11 and the oral surgery department of BUZ GKSP No1 in 2009-2014. A total of 948 records of patient (aged 17 to 68 years) with maxillary sinusitis were identified. X-ray examinations were performed by CT PISASSO TRIO ("KoYo", South Korea) and MSCT Brillians 6 and Brillians 64 ((Philips HealthCare), Netherlands). Images were obtained in axial projection with slice thickness of 0.2-0.6 mm with multiplanar reconstructions (MPR) in a variety of direct and oblique projections. Altogether 664 patients were diagnosed with foreign bodies in the maxillary sinuses (filling material in 569 cases, roots or root fragments? implants, rubber drains, fragments of endodontic instruments in 95 cases). In 284 persons odontogenic cysts were found. Almost every fifth case was complicated by mycotic infection. Analysis of the results showed that only a multidisciplinary approach including dentists, maxillofacial surgeons, otolaryngologists and radiologists, as well as dental volumetric tomography or multislice CT can ensure the correct clinical and radiological approaches to determine the tactics of treatment in patients with sinusitis, reduce the incidence of relapses and chronic inflammatory processes in the maxillary sinuses.

  11. Considerations for Implementation of Cancer Molecular Diagnostics Into Clinical Care.

    Science.gov (United States)

    Hayes, Daniel F

    2016-01-01

    Physicians have provided personalized care with as much precision as possible for several centuries. However, increasingly sophisticated understanding of the human genome and of cancer biology has permitted identification of genetic and phenotypic distinctions that might permit development of new tumor biomarker tests for risk categorization, screening, differential diagnosis, prognosis, prediction, and monitoring. Both commercial and academic laboratories are offering tests for single analytes, panels of tests of single analytes, multiparameter assays coalesced into a signature, and total genomic, transcriptomic, or proteomic analyses. However, the absence of a consistent regulatory environment has led to marketing of assays without proven analytic validity or clinical utility. U.S. Food and Drug Administration (FDA) approval or clearance does not necessarily imply that use of the test will improve patient outcomes, and FDA discretion to permit laboratory-developed tests results in unknown benefit, or harm, of others. In this regard, a "bad tumor marker is as bad as a bad drug." Caveat emptor is not a satisfactory approach to delivering high-quality care. Rather, adoption of tumor biomarker tests should be based on high levels of evidence generated in scientifically rigorous studies that demonstrate both analytical validity and clinical utility. Doing so will ensure that clinicians and patients are confident that a tumor biomarker test is likely to improve their outcomes. PMID:27249708

  12. Clinical and diagnostic characteristics of patients with suspected polyneuropathy

    Directory of Open Access Journals (Sweden)

    Mikhailova Е.V.

    2013-09-01

    Full Text Available Objective: to study the causes and clinical manifestations of disease in children referred for hospitalization in children infectious diseases hospital in Saratov with a diagnosis of «acute flaccid paralysis». Material and methods: 157 children with the diagnosis on admission of the guide «acute flaccid paralysis». Conducted clinical examination and laboratory tests included a general analysis of cerebrospinal fluid, urine, virological examination of nasal swabs and faeces, with the definition of a serological ELISA method and RPHA immunoglobulins to influenza, rubella, and enterovirus, immunological study of blood, cerebrospinal fluid PCR, electromyography of the affected limbs. Results. 77 patients (49% with the disease associated with the violation of the musculoskeletal system were registered. In the other cases revealed polyneuropathy was not of poliovirus etiology. Etiological nature of the disease could be explained by 54% of patients. In 37 (46% patients the diagnosis was formulated in accordance with the severity of paralysis. One child was diagnosed with a vaccine-associated poliomyelitis. Conclusion. The diagnosis of «acute flaccid paralysis» used as administered requires a detailed interpretation in a hospital.

  13. International Adaptations of the Millon Clinical Multiaxial Inventory: Construct Validity and Clinical Applications.

    Science.gov (United States)

    Rossi, Gina; Derksen, Jan

    2015-01-01

    This article examines the influence of the Millon Clinical Multiaxial Inventory (MCMI) as a clinical and research instrument beyond the borders of the United States. The MCMI's theoretical and empirical grounding, its alignment with the Diagnostic and Statistical Manual of Mental Disorders (DSM), and scales that can be interpreted both categorically and dimensionally, are the primary features that make the test attractive. We begin with studies that evaluated the construct equivalence of the different language adaptations. Data from the most widely researched non English-language forms (Danish, Dutch, and Spanish) show excellent comparability with Millon's original. Nevertheless, significant problems were noted in efforts to create clinical groups that would allow for equivalence of diagnostic accuracy when using the cutoff scores. Although dimensional aspects of the scale scores were not affected by this, the adapted measures might show attenuated diagnostic accuracy compared with Millon's original. Next, we present MCMI studies conducted in clinical settings to document where the adapted tests have made their greatest impact in the international literature. A wide variety of clinical applications demonstrated broad utility, and given the high number of issues addressed, we think Millon's influence will certainly stand the test of time in different domains and settings.

  14. Clinics in diagnostic imaging (166). Nonketotic hyperglycaemic chorea-hemiballismus.

    Science.gov (United States)

    Goh, Lin Wah; Chinchure, Dinesh; Lim, Tze Chwan

    2016-03-01

    A 68-year-old woman with poorly controlled diabetes mellitus presented to the emergency department with choreoathetoid movements affecting the upper and lower left limbs. Computed tomography of the brain did not show any intracranial abnormalities. However, subsequent magnetic resonance (MR) imaging of the brain revealed an increased T1 signal in the right basal ganglia, raising the suspicion of nonketotic hyperglycaemic chorea-hemiballismus. Management consisted of adjusting her insulin dose to achieve good glycaemic control. The patient subsequently recovered and was discharged after eight days. There are many causes of basal ganglia T1 hyperintensity, including hyperglycaemia in patients with poorly controlled diabetes mellitus. This case emphasises the importance of MR imaging in the early diagnosis of hyperglycaemia as a cause of chorea-hemiballismus, to enable early treatment and a better clinical outcome. PMID:26996977

  15. Diagnostic tests for influenza and other respiratory viruses: determining performance specifications based on clinical setting.

    Science.gov (United States)

    Takahashi, Hiroshi; Otsuka, Yoshihito; Patterson, Bruce K

    2010-06-01

    The lack of sensitivity of rapid immunoassays in detecting the novel 2009 H1N1 influenza virus infection has led to recommendations on influenza diagnostic testing for clinicians treating patients as well as advising clinicians on testing decisions. Studies have also shown that rapid immunoassays for seasonal influenza virus show considerable variability in performance characteristics, based on age of patient, prevalence of disease, course of infection, and the quality of the kit used. While public health authorities are currently focused on influenza virus diagnostics, a lack of sensitivity of rapid immunoassays for other viral respiratory pathogens has been widely reported, such as the very limited value of rapid immunoassays for the detection of respiratory syncytial virus in adults. In light of the lack of sensitivity of diagnostic tests for suspected 2009 H1N1 influenza virus infection, as well as their variable performance characteristics for seasonal influenza virus, a number of recommendations have been made by public health authorities advising clinicians on the need for clinical judgment as an important part of testing and treatment decisions as well as reliance on local epidemiologic and surveillance data. With the availability of new molecular methodologies that are user-friendly and allow the front-line physician as well as hospital infection control programs to significantly improve respiratory viral diagnostics, there is a need to carefully determine the most optimal diagnostic testing methodology based on the clinical setting. This review will describe the historical, current, and changing dynamics of respiratory virus infection diagnostics.

  16. Diagnostics through images in ER. From guidelines to clinical practice

    Directory of Open Access Journals (Sweden)

    Gian A. Cibinel

    2006-06-01

    Full Text Available Appropriate use of emergency and urgent radiodiagnostic techniques is fundamental for optimum patient management and in order to favour the sustainability of the health system. Guidelines compiled by healthcare organisations and research companies on suitable use of radiodiagnostics are available and can be consulted free of charge on the Internet. This work aims to review and compare the Italian guidelines issued by the Regional Health Services Agency and those of the American College of Radiology (USA, with regard to emergency and urgent conditions, and to propose a method for the application of the guidelines in different situations, based on an experience conducted within Piedmont local health authority 10.

  17. Application of diagnostic reference levels in medical practice

    Energy Technology Data Exchange (ETDEWEB)

    Bourguignon, Michel [Faculty of Medicine of Paris, Deputy Director General, Nuclear Safety Authority (ASN), Paris (France)

    2006-07-01

    Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

  18. The clinical benefits, ethics, and economics of stratified medicine and companion diagnostics.

    Science.gov (United States)

    Trusheim, Mark R; Berndt, Ernst R

    2015-12-01

    The stratified medicine companion diagnostic (CDx) cut-off decision integrates scientific, clinical, ethical, and commercial considerations, and determines its value to developers, providers, payers, and patients. Competition already sharpens these issues in oncology, and might soon do the same for emerging stratified medicines in autoimmune, cardiovascular, neurodegenerative, respiratory, and other conditions. Of 53 oncology targets with a launched therapeutic, 44 have competing therapeutics. Only 12 of 141 Phase III candidates addressing new targets face no competition. CDx choices might alter competitive positions and reimbursement. Under current diagnostic incentives, payers see novel stratified medicines that improve public health and increase costs, but do not observe companion diagnostics for legacy treatments that would reduce costs. It would be in the interests of payers to rediscover their heritage of direct investment in diagnostic development. PMID:26542060

  19. A Diagnostic Approach to Autoimmune Disorders: Clinical Manifestations: Part 1.

    Science.gov (United States)

    Sahai, Shashi; Adams, Matthew; Kamat, Deepak

    2016-06-01

    Autoimmune disorders are not commonly encountered in a general pediatric practice, but they may mimic many other disorders. Although they occur infrequently, it is always important to pause and consider an autoimmune disorder in the differential diagnosis. A detailed history and careful physical examination play an important role in guiding laboratory evaluation for these disorders. Many autoimmune disorders present with symptoms that involve multiple organ systems. The common symptoms that may make one consider a rheumatic disorder in the differential diagnosis are fever, fatigue, joint pain, rash, ulcers, and muscle weakness. The most common reason for referral to a pediatric rheumatologist is joint pain. A good joint examination may be performed by the use of the pediatric Gait, Arms, Legs, Spine screen, which is a validated screening tool. A small portion of children with fever of unknown origin may have an autoimmune disorder, with a majority of them having an infectious disease. Some patients with undiagnosed rheumatic disorders may present to the emergency. department. The characteristics of historic and clinical examination features of various autoimmune disorders are discussed in this article. [Pediatr Ann. 2016;45(6):e223-e229.]. PMID:27294498

  20. Multicystic nephroma masquerading as Wilms′ tumor: A clinical diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Bhupendra R Mehra

    2011-01-01

    Full Text Available Multicystic nephroma (MCN is an uncommon, non-heritable, unilateral, benign tumor that represents 2-3% of all primary renal tumors in the pediatric age group. It is characterized by bimodal age incidence with 50% of cases seen in children less than four years of age. Presented here is an 8-month-old boy with asymptomatic, gradually progressive renal lump of two months duration, with no other complaints. Ultrasound of the abdomen showed a well-defined multi-septated cystic mass involving whole of the kidney. Computerized Tomography (CT scan revealed a unilateral cystic lesion involving almost the entire left kidney. Keeping in mind the age, clinical presentation and radiological appearance, the possibility of cystic variant of Wilms′ tumor could not be ruled out pre-operatively. An elective left nephrectomy was done. The histopathological report revealed MCN of the left kidney. Only a few cases have been reported from India. We report here one such pediatric case.

  1. [Cystinic nephrolythiasis: clinical experience and new diagnostic and therapeutic perspectives].

    Science.gov (United States)

    Gentili, Anna; Ria, Paolo; Lupo, Antonio; Fabris, Antonia

    2016-01-01

    Cystinuria is an inherited autosomal recessive disease with a prevalence 1:7000 and typical age of onset in the second decade of life. This nephrolithiasis is not always well known and well studied and for this reason it is often underdiagnosed. Cystinuria is characterized by increased urinary excretion of cystine and dibasic amino acids (lysine, ornithine, arginine) caused by defective transport of these amino acids across the luminal membrane of proximal tubule and small intestine cells. Two mutated genes responsible of this tubular defect are SLC3A1 on chromosome 2 and SLC7A9 on chromosome 19. Clinical manifestations of cystinuria are essentially those related to stones formation and their movement across the urinary tract, like flank pain/abdomen pain and hematuria, as occurred in other nephrolithiasis types. Diagnosis is based on biochemical urine analysis, stone analysis and imaging. Genetic study of this disease may be a new and stimulating approach to better understand the defects and identify new therapeutic targets. A wider knowledge and a more detailed approach to cystinuria may help to ameliorate patients quality of life, to prevent recurrences and complications and to develop more specific and adequate treatments. PMID:27374390

  2. [Vasculitic Peripheral Neuropathies: Clinical Features and Diagnostic Laboratory Tests].

    Science.gov (United States)

    Ogata, Katsuhisa

    2016-03-01

    Vasculitic peripheral neuropathy (VPN) occurs due to ischemic changes of peripheral nerves, resulting from a deficit of vascular blood supply due to damaged vasa nervorum leading to vasculitis. VPN usually manifests as sensorimotor or sensory disturbances accompanied by pain, presenting as a type of multiple mononeuropathy, with a scattered distribution in distal limbs. VPN may also present as a mononeuropathy, distal symmetric polyneuropathy, plexopathy, or radiculopathy. The rapidity of VPN is variable, ranging from days to months, with symptoms occasionally changing with the appearance of new lesions. Careful history taking and neurological examination provides an exact diagnosis. The most common cause of VPN is primary vasculitis predominantly affecting small vessels, including vasa nervorum, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, and polyarteritis nodosa. Similar vasculitic processes can also result from a systemic collagen disorder or secondary vasculitis. Electrophysiological studies and pathological investigation of biopsied peripheral nerves and muscles are important for diagnosis of vasculitis. Serological tests, including ANCA, are useful for diagnosis of vasculitis. Accurate neurological examinations are essential for diagnosis and evaluation of clinical course.

  3. Lead intoxication: clinic and diagnostic evaluation in children

    Directory of Open Access Journals (Sweden)

    Martínez-Riera Nora

    2012-03-01

    Full Text Available Poverty, poor nutrition, environmental and social injustice prevailing in Latin America are factorsthat determine the action of pollutants on children. Lead poisoning and pollution constitute apublic health problem throughout the world. Lead affects multiple organs: nervous system particularly,hematopoietic, renal, endocrine, bone and others. Objective: to assess clinical, biochemicaland vascular effects in children exposed to known source of lead. Materials and methods: Sevenchildren with defined source lead exposure were studied, general and specific lead laboratorywere made. Endothelial function and electrocardiographic parameters were assessed. Statistic:descriptive. Results: Age average was 6,2 years (DE± 1, 6, average haematocrit 31% (DE±0,02;hemoglobin average 10,2 g/dl (DE± 0,78. 100% presented hypochromia, microcitosis, anemiaand marked anisocytosis. Lead average: 37,9 ug/dl (DE±6,22, ALA-D average: 8,9 U/L (DE±4,5.No changes were found in lipid profile and kidney function. All presented microalbuminuriaand endothelial dysfunction. Conclusion: These results show the effects of environmental leadexposure that can result in children not occupationally exposed.

  4. Clinical reasoning in the real world is mediated by bounded rationality: implications for diagnostic clinical practice guidelines.

    Directory of Open Access Journals (Sweden)

    Ana Paula Ribeiro Bonilauri Ferreira

    Full Text Available BACKGROUND: Little is known about the reasoning mechanisms used by physicians in decision-making and how this compares to diagnostic clinical practice guidelines. We explored the clinical reasoning process in a real life environment. METHOD: This is a qualitative study evaluating transcriptions of sixteen physicians' reasoning during appointments with patients, clinical discussions between specialists, and personal interviews with physicians affiliated to a hospital in Brazil. RESULTS: FOUR MAIN THEMES WERE IDENTIFIED: simple and robust heuristics, extensive use of social environment rationality, attempts to prove diagnostic and therapeutic hypothesis while refuting potential contradictions using positive test strategy, and reaching the saturation point. Physicians constantly attempted to prove their initial hypothesis while trying to refute any contradictions. While social environment rationality was the main factor in the determination of all steps of the clinical reasoning process, factors such as referral letters and number of contradictions associated with the initial hypothesis had influence on physicians' confidence and determination of the threshold to reach a final decision. DISCUSSION: Physicians rely on simple heuristics associated with environmental factors. This model allows for robustness, simplicity, and cognitive energy saving. Since this model does not fit into current diagnostic clinical practice guidelines, we make some propositions to help its integration.

  5. Superparamagnetic nanoparticles as targeted probes for diagnostic and therapeutic applications.

    Science.gov (United States)

    Xu, Chenjie; Sun, Shouheng

    2009-08-01

    Superparamagnetic nanoparticles (NPs) have been attractive for medical diagnostics and therapeutics due to their unique magnetic properties and their ability to interact with various biomolecules of interest. The solution phase based chemical synthesis provides a near precise control on NP size, and monodisperse magnetic NPs with standard deviation in diameter of less than 10% are now routinely available. Upon controlled surface functionalization and coupling with fragments of DNA strands, proteins, peptides or antibodies, these NPs can be well-dispersed in biological solutions and used for drug delivery, magnetic separation, magnetic resonance imaging contrast enhancement and magnetic fluid hyperthermia. This Perspective reviews the common syntheses and controlled surface functionalization of monodisperse Fe(3)O(4)-based superparamagnetic NPs. It further outlines the exciting application potentials of these NPs in magnetic resonance imaging and drug delivery. PMID:20449070

  6. A Dynamic Imaging Database for 3-D Morphologic Analysis and Clinical Assessment in Diagnostic Radiology

    OpenAIRE

    Niculescu, Gabriela; Toni, Louay; Foran, David J.; Nosher, John L.; DeMarco, J. Kevin

    2002-01-01

    Modern imaging techniques such as MRI and CT have become invaluable clinical and research tools for visualizing internal organs and anatomic structures, non-invasively. We present a dynamic imaging database for performing comparative morphologic studies in diagnostic radiology to facilitate clinical assessment. The prototype system utilizes a double elliptic Fourier transform to characterize shape in three dimensions. A prototype system was used to evaluate neuroanatomy from MR brain scans of...

  7. Prostaglandins: pharmacology and clinical application.

    Science.gov (United States)

    Karim, S M; Hillier, K

    1974-01-01

    Prostaglandin research has been 1 of the most stimulating features of biomedical investigation in the past decade. Interest developed at a time of expanding knowledge of hormonal and neurohormonal behavior and research work received a tremendous impetus in the early 1960s with the elucidation in Sweden of the chemical structures of prostaglandins, followed by the discovery of their biosynthetic pathways. The original findings of large amounts of prostaglandin in the male accessory genital glands and their secretions, and subsequent discovery in the menstrual and amniotic fluids linked these substances with human production. As a result of further investigation, clinical applications of prostaglandins for the induction of labor and termination of early unwanted pregnancies have been developed. Apart from the functions of the prostaglandins in the reproductive area, they have been shown to have a widespread distribution in the body and produce many different pharmacological effects. Prostaglandins are thought to be involved in the regulation of blood pressure and through their vascular effects have therapeutic potential in the treatment of hypertension and peripheral vascular disease. Through their bronchodilator effect, some prostaglandins may become useful in the treatment of asthma. PMID:4611742

  8. Primary intraventricular hemorrhage: Clinical features, risk factors, etiology, and yield of diagnostic cerebral angiography

    OpenAIRE

    Trilochan Srivastava; Raghavendra Bakki Sannegowda; Vipin Satija; R. S Jain; Shankar Tejwani; Tarun Mathur

    2014-01-01

    Background: Primary intraventricular hemorrhage (PIVH) is a rare neurological disorder, with bleeding confined to the ventricles only, without recognizable parenchymal or subarachnoid component. Aim: The purpose of this retrospective study was to identify clinical features, predisposing risk factors, etiology, radiological features and yield of diagnostic cerebral angiography in identifying the etiological causes. Settings and Design: Records of patients admitted in neurology division were an...

  9. Medicare Program; Medicare Clinical Diagnostic Laboratory Tests Payment System. Final rule.

    Science.gov (United States)

    2016-06-23

    This final rule implements requirements of section 216 of the Protecting Access to Medicare Act of 2014 (PAMA), which significantly revises the Medicare payment system for clinical diagnostic laboratory tests. This final rule also announces an implementation date of January 1, 2018 for the private payor rate-based fee schedule required by PAMA.

  10. Diagnostic performance of amyloid A protein quantification in fat tissue of patients with clinical AA amyloidosis

    NARCIS (Netherlands)

    Hazenberg, Bouke P. C.; Bijzet, Johannes; Limburg, Pieter C.; Skinner, Martha; Hawkins, Philip N.; Butrimiene, Irena; Livneh, Avi; Lesnyak, Olga; Nasonov, Evgeney L.; Filipowicz-Sosnowska, Anna; Guel, Ahmet; Merlini, Giampaolo; Wiland, Piotr; Oezdogan, Huri; Gorevic, Peter D.; Ben Maiz, Hedi; Benson, Merrill D.; Direskeneli, Haner; Kaarela, Kalevi; Garceau, Denis; Hauck, Wendy; van Rijswijk, Martin

    2007-01-01

    Objective. Amyloid A protein quantification in fat tissue is a new immunochemical method for detecting AA amyloidosis, a rare but serious disease. The objective was to assess diagnostic performance in clinical AA amyloidosis. Methods. Abdominal subcutaneous fat tissue of patients with AA amyloidosis

  11. Targeted next-generation sequencing can replace Sanger sequencing in clinical diagnostics

    NARCIS (Netherlands)

    Sikkema-Raddatz, B.; Johansson, L.F.; de Boer, E.N.; Almomani, R.; Boven, L.G.; van den Berg, M.P.; van Spaendonck-Zwarts, K.Y.; van Tintelen, J.P.; Sijmons, R.H.; Jongbloed, J.D.H.; Sinke, R.J.

    2013-01-01

    Mutation detection through exome sequencing allows simultaneous analysis of all coding sequences of genes. However, it cannot yet replace Sanger sequencing (SS) in diagnostics because of incomplete representation and coverage of exons leading to missing clinically relevant mutations. Targeted next-g

  12. Complement analysis 2016: Clinical indications, laboratory diagnostics and quality control.

    Science.gov (United States)

    Prohászka, Zoltán; Nilsson, Bo; Frazer-Abel, Ashley; Kirschfink, Michael

    2016-11-01

    In recent years, complement analysis of body fluids and biopsies, going far beyond C3 and C4, has significantly enhanced our understanding of the disease process. Such expanded complement analysis allows for a more precise differential diagnosis and for critical monitoring of complement-targeted therapy. These changes are a result of the growing understanding of the involvement of complement in a diverse set of disorders. To appreciate the importance of proper complement analysis, it is important to understand the role it plays in disease. Historically, it was the absence of complement as manifested in severe infection that was noted. Since then complement has been connected to a variety of inflammatory disorders, such as autoimmune diseases and hereditary angioedema. While the role of complement in the rejection of renal grafts has been known longer, the significant impact of complement. In certain nephropathies has now led to the reclassification of some rare kidney diseases and an increased role for complement analysis in diagnosis. Even more unexpected is that complement has also been implicated in neural, ophtalmological and dermatological disorders. With this level of involvement in some varied and impactful health issues proper complement testing is clearly important; however, analysis of the complement system varies widely among laboratories. Except for a few proteins, such as C3 and C4, there are neither well-characterized standard preparations nor calibrated assays available. This is especially true for the inter-laboratory variation of tests which assess classical, alternative, or lectin pathway function. In addition, there is a need for the standardization of the measurement of complement activation products that are so critical in determining whether clinically relevant complement activation has occurred in vivo. Finally, autoantibodies to complement proteins (e.g. anti-C1q), C3 and C4 convertases (C3 and C4 nephritic factor) or to regulatory proteins

  13. Complement analysis 2016: Clinical indications, laboratory diagnostics and quality control.

    Science.gov (United States)

    Prohászka, Zoltán; Nilsson, Bo; Frazer-Abel, Ashley; Kirschfink, Michael

    2016-11-01

    In recent years, complement analysis of body fluids and biopsies, going far beyond C3 and C4, has significantly enhanced our understanding of the disease process. Such expanded complement analysis allows for a more precise differential diagnosis and for critical monitoring of complement-targeted therapy. These changes are a result of the growing understanding of the involvement of complement in a diverse set of disorders. To appreciate the importance of proper complement analysis, it is important to understand the role it plays in disease. Historically, it was the absence of complement as manifested in severe infection that was noted. Since then complement has been connected to a variety of inflammatory disorders, such as autoimmune diseases and hereditary angioedema. While the role of complement in the rejection of renal grafts has been known longer, the significant impact of complement. In certain nephropathies has now led to the reclassification of some rare kidney diseases and an increased role for complement analysis in diagnosis. Even more unexpected is that complement has also been implicated in neural, ophtalmological and dermatological disorders. With this level of involvement in some varied and impactful health issues proper complement testing is clearly important; however, analysis of the complement system varies widely among laboratories. Except for a few proteins, such as C3 and C4, there are neither well-characterized standard preparations nor calibrated assays available. This is especially true for the inter-laboratory variation of tests which assess classical, alternative, or lectin pathway function. In addition, there is a need for the standardization of the measurement of complement activation products that are so critical in determining whether clinically relevant complement activation has occurred in vivo. Finally, autoantibodies to complement proteins (e.g. anti-C1q), C3 and C4 convertases (C3 and C4 nephritic factor) or to regulatory proteins

  14. Marketing applications for dental clinic

    OpenAIRE

    Čevela, Josef

    2010-01-01

    The essay deals with the marketing strategy of the dental clinic, more specifically the dental clinic Sorriso DENTAL s.r.o. It also analyses and describes the marketing mix. Based on these things, it offers certain recommendations for the clinic and its marketing conception.

  15. [Bacterial genomics and metagenomics: clinical applications and medical relevance].

    Science.gov (United States)

    Diene, S M; Bertelli, C; Pillonel, T; Schrenzel, J; Greub, G

    2014-11-12

    New sequencing technologies provide in a short time and at low cost high amount of genomic sequences useful for applications such as: a) development of diagnostic PCRs and/or serological tests; b) detection of virulence factors (virulome) or genes/SNPs associated with resistance to antibiotics (resistome) and c) investigation of transmission and dissemination of bacterial pathogens. Thus, bacterial genomics of medical importance is useful to clinical microbiologists, to infectious diseases specialists as well as to epidemiologists. Determining the microbial composition of a sample by metagenomics is another application of new sequencing technologies, useful to understand the impact of bacteria on various non-infectious diseases such as obesity, asthma, or diabetes. Genomics and metagenomics will likely become a specialized diagnostic analysis.

  16. Clinical application of functional MRI

    International Nuclear Information System (INIS)

    Described is the present state of clinical application of fMRI in the preoperative assessment of brain tumors, and plasticity in and pathophysiology of central diseases. For the tumor resection, fMRI is useful for risk assessment of postoperative nerve dysfunction, for selection of the patient rather suitable for brain mapping at the invasive surgery than at the pre-operation and for guidance of the operation itself. Preoperative fMRI alone can neither distinguish the regions of the primary and secondary functions nor exhibit the relation between the tumor and white matter fibers but there are compensatory means for these drawbacks. Benefit of preoperative fMRI has not yet been based on the evidence on double blind trials. Combination of fMRI imaging and electroencephalography (EEG) finding has shown that, in generalized epilepsy, extensive and stimulated activation occurs in both frontal/occipital regions and in thalamus area, respectively, and that the concomitant lowered activities are conceivably the reflection of burst discharge in normal brain functions. Plasticity in the human brain has been demonstrated by fMRI in cerebral vascular diseases, multiple sclerosis and amyotrophic lateral sclerosis. Pathogenesis of Parkinson disease and depression has been better understood by fMRI investigations revealing regions with elevated and reduced activities. Studies of attention deficit hyperactivity disorder have shown similar change of activities with functional reductions of the right dorsolateral frontal anterior area and of dorsal frontal cingulate gyrus, together with stimulated wider regions to given tasks. As above, fMRI has greatly contributed to our understanding of diseases of central nervous system and is to be expected to expand wider in this field. (T.T.)

  17. RRIA applications in clinical research

    International Nuclear Information System (INIS)

    When laboratory tests are limited to the measurement of substances in gram quantities, and occasionally milligrams micrograms, the development of radioisotope techniques made possible by first determining substances in very low concentrations in biological fluids. The combination of radioisotopes with high specificity binding proteins made possible the sensitivity and specificity to accurately measure physiological concentrations of substances at the level of micrograms, nanograms picograms (10-6, 10-9, 10-12 respectively). Radioimmunoassay development and later the immunoradiometric assays was a breakthrough in Laboratory Medicine. The main advantages are their specificity, sensitivity and reproducibility, which together with the constancy of the isotopic signal, and durability make this method one of the fattest of modern technology. The disadvantages are the need for special equipment, and also the use of radioactive isotopes, which involves subject to multiple rules for the use, storage and disposal of these products, according to the laws of each country and international standards. Other applications of isotope techniques are the receptor assays (RRA), very diverse in terms of objectives and methods, and depend mainly on the characteristics of the receiver. Are used mainly in tissue fragments extracted by biopsy or surgery, and currently especially in detecting hormone receptors in malignant tissues, which can guide as to the subsequent course of action regarding the patient. These tests are generally used with very specific interests, usually develop in living cells, or fragments of freshly obtained tissues, as also the internalization process of hormone-receptor complex is considered essential. isotopes may also be used in clinical research to measure products of enzymatic assays, or malignant abnormal tissue, or even to assess the purity of particular biological product capable of being isotopically labeled. (author)

  18. Diagnostic Approaches to Sjögren’s Syndrome: a Literature Review and Own Clinical Experience

    Directory of Open Access Journals (Sweden)

    Pedro de Sousa Gomes

    2012-03-01

    Full Text Available Objectives: The purpose of present paper is to critically address the recent advances on diagnostic procedures of Sjögren’s syndrome, taking into account the attained local and systemic features of the disease. Material and Methods: A comprehensive review of the available literature regarding to the diagnostic approaches to Sjögren’s syndrome was conducted. Eligible studies were identified by searching the electronic literature PubMed, Medline, Embase, and ScienceDirect databases for relevant reports (last search update January 2012 combining the MESH heading term “Sjögren’s syndrome”, with the words "diagnosis, diagnostic procedures, salivary gland function, ocular tests, histopathology, salivary gland imaging, serology". The authors checked the references of the selected articles to identify additional eligible publications and contacted the authors, if necessary. Results: Presented article addresses the established diagnostic criteria for Sjögren’s syndrome and critically evaluates the most commonly used diagnostic procedures, presenting data from author’s own clinical experience. Diagnostic criteria for Sjögren’s syndrome are required both by healthcare professionals and patients, namely in order to provide a rational basis for the assessment of the symptoms, establish an individual disease prognosis, and orientate the therapeutic intervention. Conclusions: Sjögren’s syndrome is quite a common autoimmune disease of which the diagnosis and treatment are not easily established. Due to its systemic involvement, it can exhibit a wide range of clinical manifestations that contribute to confusion and delay in diagnosis. The use of proper diagnostic modalities will help to reduce the time to diagnosis and preserve the health and quality of life of patients with Sjögren’s syndrome.

  19. Clinical biophysics

    Energy Technology Data Exchange (ETDEWEB)

    Anbar, M.; Spangler, R.A.; Scott, P.

    1985-01-01

    Chapters are included on clinical decision making, principles of biomedical engineering, computers and their medical uses, clinical radiobiology, diagnostic x-ray radiology, clinical applications of ultrasonics, nuclear medicine, NMR imaging, diagnostic imaging, bioelectric techniques in diagnosis and therapy, biophysical aspects of the clinical laboratory, and biophysical aspects of modern surgery.

  20. Clinical and diagnostic challenges in a rare case of motor weakness with endocrinopathy: A case report

    Directory of Open Access Journals (Sweden)

    Ravinder Garg

    2016-01-01

    Full Text Available Electrolyte imbalance always poses challenging situations to the attending intensivists, particularly if it is associated with endocrinopathies and other comorbidities. One such rare clinical scenario is hypokalemic periodic paralysis (HPP due to hyperthyroidism. The epidemiology of such a condition is slightly higher among males of Asian origin as compared to its universal occurrence. The diagnostic challenges in this clinical situation can lead to higher morbidity if timeliness is compromised from the presentation to active management. Moreover, atypical presentation of this pathologic condition further compounds the problem if it is associated with overt hyperthyroidism. Here, we report a unique case that presented to the emergency medicine department of our institute with weakness of all the four limbs and in which we faced all the diagnostic and management challenges as the clinical condition of hypokalemia was somehow dominated by overt hyperthyroidism.

  1. New technology for ultrasensitive detection and isolation of rare cells for clinical diagnostics and therapeutics

    Science.gov (United States)

    Leary, James F.; McLaughlin, Scott R.

    1995-04-01

    A high-speed, 11-parameter, 6-color fluorescence, laser flow cytometer/cell sorter with a number of special and unique features has been built for ultrasensitive detection and isolation of rare cells for clinical diagnostics and therapeutics. The software for real-time data acquisition and sort control, written as C++ programming language modules with a WindowsTM graphical user interface, runs on a 66-MHz 80486 computer joined by an extended bus to 23 sophisticated multi-layered boards of special data acquisition and sorting electronics. Special features include: high-speed (> 100,000 cells/sec) real-time data classification module (U.S. Patent 5,204,884 (1993)); real-time principal component cell sorting; multi-queue signal-processing system with multiple hardware and software event buffers to reduce instrument dead time, LUT charge-pulse definition, high-resolution `flexible' sorting for optimal yield/purity sort strategies (U.S. Patent 5,199,576); pre-focusing optical wavelength correction for a second laser beam; and two trains of three fluorescence detectors-- each adjustable for spatial separation to interrogate only one of two laser beams, syringe- driven or pressure-driven fluidics, and time-windowed parameters. The system has been built to be both expandable and versatile through the use of LUT's and a modular hardware and software design. The instrument is especially useful at detection and isolation of rare cell subpopulations for which our laboratory is well-known. Cell subpopulations at frequencies as small as 10-7 have been successfully studied with this system. Current applications in clinical diagnostics and therapeutics include detection and isolation of (1) fetal cells from material blood for prenatal diagnosis of birth defects, (2) hematopoietic stem and precursor cells for autologous bone marrow transplantation, (3) metastatic breast cancer cells for molecular characterization, and (4) HIV-infected maternal cells in newborn blood to study mother

  2. Feasibility of streamlining an interactive Bayesian-based diagnostic support tool designed for clinical practice

    Science.gov (United States)

    Chen, Po-Hao; Botzolakis, Emmanuel; Mohan, Suyash; Bryan, R. N.; Cook, Tessa

    2016-03-01

    In radiology, diagnostic errors occur either through the failure of detection or incorrect interpretation. Errors are estimated to occur in 30-35% of all exams and contribute to 40-54% of medical malpractice litigations. In this work, we focus on reducing incorrect interpretation of known imaging features. Existing literature categorizes cognitive bias leading a radiologist to an incorrect diagnosis despite having correctly recognized the abnormal imaging features: anchoring bias, framing effect, availability bias, and premature closure. Computational methods make a unique contribution, as they do not exhibit the same cognitive biases as a human. Bayesian networks formalize the diagnostic process. They modify pre-test diagnostic probabilities using clinical and imaging features, arriving at a post-test probability for each possible diagnosis. To translate Bayesian networks to clinical practice, we implemented an entirely web-based open-source software tool. In this tool, the radiologist first selects a network of choice (e.g. basal ganglia). Then, large, clearly labeled buttons displaying salient imaging features are displayed on the screen serving both as a checklist and for input. As the radiologist inputs the value of an extracted imaging feature, the conditional probabilities of each possible diagnosis are updated. The software presents its level of diagnostic discrimination using a Pareto distribution chart, updated with each additional imaging feature. Active collaboration with the clinical radiologist is a feasible approach to software design and leads to design decisions closely coupling the complex mathematics of conditional probability in Bayesian networks with practice.

  3. Clinical and diagnostic utility of saliva as a non-invasive diagnostic fluid: 
a systematic review.

    Science.gov (United States)

    Nunes, Lazaro Alessandro Soares; Mussavira, Sayeeda; Bindhu, Omana Sukumaran

    2015-01-01

    This systematic review presents the latest trends in salivary research and its applications in health and disease. Among the large number of analytes present in saliva, many are affected by diverse physiological and pathological conditions. Further, the non-invasive, easy and cost-effective collection methods prompt an interest in evaluating its diagnostic or prognostic utility. Accumulating data over the past two decades indicates towards the possible utility of saliva to monitor overall health, diagnose and treat various oral or systemic disorders and drug monitoring. Advances in saliva based systems biology has also contributed towards identification of several biomarkers, development of diverse salivary diagnostic kits and other sensitive analytical techniques. However, its utilization should be carefully evaluated in relation to standardization of pre-analytical and analytical variables, such as collection and storage methods, analyte circadian variation, sample recovery, prevention of sample contamination and analytical procedures. In spite of all these challenges, there is an escalating evolution of knowledge with the use of this biological matrix.

  4. Infant Hip Joint Diagnostic Support System Based on Clinical Manifestations in X-ray Images

    OpenAIRE

    Honda, Mitsugi; Arita, Seizaburo; Mitani, Shigeru; TAKEDA, Yoshihiro; Ozaki,Toshifumi; Inamura, Keiji; Kanazawa, Susumu

    2010-01-01

    Plain X-ray radiography is frequently used for the diagnosis of developmental dislocation of the hip (DDH). The aim of this study was to construct a diagnostic support system for DDH based on clinical findings obtained from the X-ray images of 154 female infants with confirmed diagnoses made by orthopedists. The data for these subjects were divided into 2 groups. The Min-Max method of nonlinear analysis was applied to the data from Group 1 to construct the diagnostic support system based on t...

  5. Clinical Application and Characteristics of KONG's Scalp Acupuncture and Daoyin Technique

    Institute of Scientific and Technical Information of China (English)

    JIANG Ling-zhen; XIAO Yuan-chun

    2004-01-01

    @@ Scalp Acupuncture and Daoyin Technique, which are summarized by Dr. KONG in the light of his long-term acupuncture practice, has been considered as one of the clinical diagnostic and treatment programs in Chinese medicine by the State Administration of Traditional Chinese Medicine. In this paper, the characteristics and clinical application of Scalp Acupuncture and Daoyin Technique are presented as follows.

  6. A clinical audit programme for diagnostic radiology: the approach adopted by the International Atomic Energy Agency.

    Science.gov (United States)

    Faulkner, K; Järvinen, H; Butler, P; McLean, I D; Pentecost, M; Rickard, M; Abdullah, B

    2010-01-01

    The International Atomic Energy Agency (IAEA) has a mandate to assist member states in areas of human health and particularly in the use of radiation for diagnosis and treatment. Clinical audit is seen as an essential tool to assist in assuring the quality of radiation medicine, particularly in the instance of multidisciplinary audit of diagnostic radiology. Consequently, an external clinical audit programme has been developed by the IAEA to examine the structure and processes existent at a clinical site, with the basic objectives of: (1) improvement in the quality of patient care; (2) promotion of the effective use of resources; (3) enhancement of the provision and organisation of clinical services; (4) further professional education and training. These objectives apply in four general areas of service delivery, namely quality management and infrastructure, patient procedures, technical procedures and education, training and research. In the IAEA approach, the audit process is initiated by a request from the centre seeking the audit. A three-member team, comprising a radiologist, medical physicist and radiographer, subsequently undertakes a 5-d audit visit to the clinical site to perform the audit and write the formal audit report. Preparation for the audit visit is crucial and involves the local clinical centre completing a form, which provides the audit team with information on the clinical centre. While all main aspects of clinical structure and process are examined, particular attention is paid to radiation-related activities as described in the relevant documents such as the IAEA Basic Safety Standards, the Code of Practice for Dosimetry in Diagnostic Radiology and related equipment and quality assurance documentation. It should be stressed, however, that the clinical audit does not have any regulatory function. The main purpose of the IAEA approach to clinical audit is one of promoting quality improvement and learning. This paper describes the background to

  7. A clinical audit programme for diagnostic radiology: The Approach adopted by the international atomic energy agency

    International Nuclear Information System (INIS)

    The International Atomic Energy Agency (IAEA) has a mandate to assist member states in areas of human health and particularly in the use of radiation for diagnosis and treatment. Clinical audit is seen as an essential tool to assist in assuring the quality of radiation medicine, particularly in the instance of multidisciplinary audit of diagnostic radiology. Consequently, an external clinical audit programme has been developed by the IAEA to examine the structure and processes existent at a clinical site, with the basic objectives of: (1) improvement in the quality of patient care; (2) promotion of the effective use of resources; (3) enhancement of the provision and organisation of clinical services; (4) further professional education and training. These objectives apply in four general areas of service delivery, namely quality management and infrastructure, patient procedures, technical procedures and education, training and research. In the IAEA approach, the audit process is initiated by a request from the centre seeking the audit. A three-member team, comprising a radiologist, medical physicist and radiographer, subsequently undertakes a 5-d audit visit to the clinical site to perform the audit and write the formal audit report. Preparation for the audit visit is crucial and involves the local clinical centre completing a form, which provides the audit team with information on the clinical centre. While all main aspects of clinical structure and process are examined, particular attention is paid to radiation-related activities as described in the relevant documents such as the IAEA Basic Safety Standards, the Code of Practice for Dosimetry in Diagnostic Radiology and related equipment and quality assurance documentation. It should be stressed, however, that the clinical audit does not have any regulatory function. The main purpose of the IAEA approach to clinical audit is one of promoting quality improvement and learning. This paper describes the background to

  8. The Application of Molecular Diagnostics to Stained Cytology Smears.

    Science.gov (United States)

    Oktay, Maja H; Adler, Esther; Hakima, Laleh; Grunblatt, Eli; Pieri, Evan; Seymour, Andrew; Khader, Samer; Cajigas, Antonio; Suhrland, Mark; Goswami, Sumanta

    2016-05-01

    Detection of mutational alterations is important for guiding treatment decisions of lung non-small-cell carcinomas and thyroid nodules with atypical cytologic findings. Inoperable lung tumors requiring further testing for staging and thyroid lesions often are diagnosed using only cytology material. Molecular diagnostic tests of these samples typically are performed on cell blocks; however, insufficient cellularity of cell blocks is a limitation for test performance. In addition, some of the fixatives used while preparing cell blocks often introduces artifacts for mutation detection. Here, we applied qClamp xenonucleic technology and quantitative RT-PCR to cells microdissected directly from stained cytology smears to detect common alterations including mutations and translocations in non-small-cell carcinomas and thyroid lesions. By using this approach, we achieved a 1% molecular alteration detection rate from as few as 50 cells. Ultrasensitive methods of molecular alteration detection similar to the one described here will be increasingly important for the evaluation of molecular alterations in clinical scenarios when only tissue samples that are small are available. PMID:26921541

  9. Clinical application of computed radiography

    International Nuclear Information System (INIS)

    Observer performance tests were performed to compare the diagnostic accuracy of digitized storage phosphors and conventional radiography in the detection of microcalcification in the breast and pulmonary nodules. Clustered microcalcifications (0.125-0.177 mm, 0.210-0.250 mm) were randomly superimposed on a human breast specimen. Two types of screen-film systems (Toshiba MM6/Fuji MINC, Kodak MinR/Kodak MinR) and CR images either with unsharp mask or with no image processing (unprocess) were used as imaging systems. Nine readers assessed the capability of screen-films, and unsharp-masked and unprocessed mammograms to detect microcalcifications. Observer performance data were evaluated by receiver operating characteristics (ROC) analysis. Both the area under ROC curve and the true positive localization fraction were used as performance indexes. Two screen-film images provided a higher detectability of microcalcifications than CR images. In the detectability of microcalcifications, unsharp-masked images were superior to unprocessed images, with no statistically significant difference. CR images showed higher false positive fraction than screen-film systems. To assess the detectability of pulmonary nodules, 15 radiologists compared the diagnostic accuracy of screen-film system and CR images, including unprocessed, unsharp-masked, reversed and paired images, in 18 normal volunteers and 18 patients with pulmonary nodules. Overall diagnostic accuracy of CR images, except for reversed images, were comparable to the screen-film system. In case of definite, large nodules, unprocessed, unsharp-masked, and paired images were superior to the screen-film and reversed images. Screen-film and unprocessed images were helpful in cases of tiny nodules without definite contrast. The detectability of pulmonary nodules may be affected by image processing conditions, radiologist' experiences, and characteristics of nodules themselves. (N.K.) 59 refs

  10. Magnetic Nanoparticles From Fabrication to Clinical Applications

    CERN Document Server

    Thanh, Nguyen TK

    2012-01-01

    Offering the latest information in magnetic nanoparticle (MNP) research, Magnetic Nanoparticles: From Fabrication to Clinical Applications provides a comprehensive review, from synthesis, characterization, and biofunctionalization to clinical applications of MNPs, including the diagnosis and treatment of cancers. This book, written by some of the most qualified experts in the field, not only fills a hole in the literature, but also bridges the gaps between all the different areas in this field. Translational research on tailored magnetic nanoparticles for biomedical applications spans a variet

  11. Comprehensive Clinical Audits of Diagnostic Radiology Practices: A Tool for Quality Improvement. Quality Assurance Audit for Diagnostic Radiology Improvement and Learning (QUAADRIL)

    International Nuclear Information System (INIS)

    Interest in quality assurance processes and quality improvement in diagnostic radiology is being driven by a number of factors. These include the high cost and complexity of radiological equipment, acknowledgement of the possibility of increasing doses to patients, and the importance of radiological diagnosis to patient management within the health care environment. To acknowledge these interests, clinical audits have been introduced and, in Europe, mandated under a European Directive (Council Directive 97/47/EURATOM). Comprehensive clinical audits focus on clinical management and infrastructure, patient related and technical procedures, and education and research. This publication includes a structured set of standards appropriate for diagnostic radiology, an audit guide to their clinical review, and data collection sheets for the rapid production of reports in audit situations. It will be a useful guide for diagnostic radiology facilities wishing to improve their service to patients through timely diagnosis with minimal radiation dose.

  12. Prevalence of neuropathic features of back pain in clinical populations: implications for the diagnostic triage paradigm.

    Science.gov (United States)

    Hush, Julia M; Marcuzzi, Anna

    2012-07-01

    SUMMARY Contemporary clinical assessment of back pain is based on the diagnostic triage paradigm. The most common diagnostic classification is nonspecific back pain, considered to be of nociceptive etiology. A small proportion are diagnosed with radicular pain, of neuropathic origin. In this study we review the body of literature on the prevalence of neuropathic features of back pain, revealing that the point prevalence is 17% in primary care, 34% in mixed clinical settings and 53% in tertiary care. There is evidence that neuropathic features of back pain are not restricted to typical clinical radicular pain phenotypes and may be under-recognized, particularly in primary care. The consequence of this is that in the clinic, diagnostic triage may erroneously classify patients with nonspecific back pain or radicular pain. A promising alternative is the development of mechanism-based pain phenotyping in patients with back pain. Timely identification of contributory pain mechanisms may enable greater opportunity to select appropriate therapeutic targets and improve patient outcomes.

  13. Diagnostic outcome following routine genetics clinic referral for the assessment of global developmental delay.

    LENUS (Irish Health Repository)

    Shahdadpuri, R

    2012-02-01

    The aim of this study was to ascertain the diagnostic yield following a routine genetics clinic referral for the assessment of global developmental delay. Detailed retrospective review of 119 complete consecutive case notes of patients referred to one single clinical geneticist over a 14 month time period was undertaken (n = 119; 54 males, 65 females). The age at initial review ranged from 2 months to 37 years 3 months (mean 8 y 3 mo [SD 7 y 10 mo]). We made a diagnosis in 36\\/119 (30%); 21\\/36 were new diagnoses and 15\\/36 were confirmations of diagnoses. We removed a wrong diagnostic label in 8\\/119 (7%). In 3\\/8 we were able to achieve a diagnosis but in 5\\/8 no alternative diagnosis was reached. We had a better diagnostic rate where the patients were dysmorphic (odds ratio [OR] 1.825; 95% confidence interval [CI] 1.065 to 3.128, p = 0.044). In the majority, the diagnosis was made by clinical examination only. Molecular diagnosis was reached in seven cases. Five cases were confirmed by cytogenetic analysis. Brain magnetic resonance imaging (MRI) revealed a diagnosis in three cases. This study confirms the importance of a clinical genetics assessment in the investigation of global developmental delay.

  14. The objectivity of the Autism Diagnostic Observation Schedule (ADOS) in naturalistic clinical settings.

    Science.gov (United States)

    Zander, Eric; Willfors, Charlotte; Berggren, Steve; Choque-Olsson, Nora; Coco, Christina; Elmund, Anna; Moretti, Åsa Hedfors; Holm, Anette; Jifält, Ida; Kosieradzki, Renata; Linder, Jenny; Nordin, Viviann; Olafsdottir, Karin; Poltrago, Lina; Bölte, Sven

    2016-07-01

    The Autism Diagnostic Observation Schedule (ADOS) is a first-choice diagnostic tool in autism spectrum disorder (ASD). Excellent interpersonal objectivity (interrater reliability) has been demonstrated for the ADOS under optimal conditions, i.e., within groups of highly trained "research reliable" examiners in research setting. We investigated the spontaneous interrater reliability among clinically trained ADOS users across multiple sites in clinical routine. Forty videotaped administrations of the ADOS modules 1-4 were rated by five different raters each from a pool of in total 15 raters affiliated to 13 different clinical sites. G(q,k) coefficients (analogous to intraclass correlations), kappas (ĸ) and percent agreement (PA) were calculated. The median interrater reliability for items across the four modules was G(q,k) = .74-.83, with the single ADOS items ranging from .23 to .94. G(q,k) for total scores was .85-.92. For diagnostic classification (ASD/non-spectrum), PA was 64-82 % and Fleiss' ĸ .19-.55. Objectivity was lower for pervasive developmental disorder not otherwise specified and non-spectrum diagnoses as compared to autism. Interrater reliabilities of the ADOS items and domain totals among clinical users across multiple sites were in the same range as previously reported for research reliable users, while the one for diagnostic classification was lower. Differences in sample characteristics, rater skills and statistics compared with previous studies are discussed. Findings endorse the objectivity of the ADOS in naturalistic clinical settings, but also pinpoint its limitations and the need and value of adequate and continuous rater training. PMID:26584575

  15. The Diagnostic Validity and Reliability of an Internet-Based Clinical Assessment Program for Mental Disorders

    Science.gov (United States)

    Klein, Britt; Meyer, Denny; Austin, David William; Abbott, Jo-Anne M

    2015-01-01

    Background Internet-based assessment has the potential to assist with the diagnosis of mental health disorders and overcome the barriers associated with traditional services (eg, cost, stigma, distance). Further to existing online screening programs available, there is an opportunity to deliver more comprehensive and accurate diagnostic tools to supplement the assessment and treatment of mental health disorders. Objective The aim was to evaluate the diagnostic criterion validity and test-retest reliability of the electronic Psychological Assessment System (e-PASS), an online, self-report, multidisorder, clinical assessment and referral system. Methods Participants were 616 adults residing in Australia, recruited online, and representing prospective e-PASS users. Following e-PASS completion, 158 participants underwent a telephone-administered structured clinical interview and 39 participants repeated the e-PASS within 25 days of initial completion. Results With structured clinical interview results serving as the gold standard, diagnostic agreement with the e-PASS varied considerably from fair (eg, generalized anxiety disorder: κ=.37) to strong (eg, panic disorder: κ=.62). Although the e-PASS’ sensitivity also varied (0.43-0.86) the specificity was generally high (0.68-1.00). The e-PASS sensitivity generally improved when reducing the e-PASS threshold to a subclinical result. Test-retest reliability ranged from moderate (eg, specific phobia: κ=.54) to substantial (eg, bulimia nervosa: κ=.87). Conclusions The e-PASS produces reliable diagnostic results and performs generally well in excluding mental disorders, although at the expense of sensitivity. For screening purposes, the e-PASS subclinical result generally appears better than a clinical result as a diagnostic indicator. Further development and evaluation is needed to support the use of online diagnostic assessment programs for mental disorders. Trial Registration Australian and New Zealand Clinical Trials

  16. Effect of clinical specialist physiotherapists in orthopaedic diagnostic setting - A systematic review

    DEFF Research Database (Denmark)

    Trøstrup, Jeanette; Juhl, Carsten; Mikkelsen, Lone Ramer

    2016-01-01

    on diagnostic agreement, economic costs and patient satisfaction. Methods: A systematic review was performed searching MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, CINAHL, PEDro and reference lists of included studies as well as previously published systematic reviews. Inclusion...... quality compared to studies with high quality. Cost analysis (n=4) showed 27-49 % cost savings for assessments performed by CSP compared to OS (n=3), and that CSP-led clinics were more expensive but also more beneficial compared to OS-led clinics (n=1). Cost savings was found in studies of mixed...... percentage wasn’t mentioned instead it was reported that patients were generally satisfied (n=1) or that satisfaction was in favour of CSP assessment (n=2). Discussion and conclusion: CSP care may be as beneficial or even better than assessment performed by OS in terms of diagnostic accuracy, economic costs...

  17. Clinical applications of bacterial glycoproteins.

    Science.gov (United States)

    Fulton, Kelly M; Smith, Jeffrey C; Twine, Susan M

    2016-01-01

    There is an ongoing race between bacterial evolution and medical advances. Pathogens have the advantages of short generation times and horizontal gene transfer that enable rapid adaptation to new host environments and therapeutics that currently outpaces clinical research. Antibiotic resistance, the growing impact of nosocomial infections, cancer-causing bacteria, the risk of zoonosis, and the possibility of biowarfare all emphasize the increasingly urgent need for medical research focussed on bacterial pathogens. Bacterial glycoproteins are promising targets for alternative therapeutic intervention since they are often surface exposed, involved in host-pathogen interactions, required for virulence, and contain distinctive glycan structures. The potential exists to exploit these unique structures to improve clinical prevention, diagnosis, and treatment strategies. Translation of the potential in this field to actual clinical impact is an exciting prospect for fighting infectious diseases. PMID:26971465

  18. Clinical application of PET/MRI in oncology.

    Science.gov (United States)

    Sotoudeh, Houman; Sharma, Akash; Fowler, Kathryn J; McConathy, Jonathan; Dehdashti, Farrokh

    2016-08-01

    Hybrid imaging with integrated positron emission tomography (PET) and magnetic resonance imaging (MRI) combines the advantages of the high-resolution anatomic data from MRI and functional imaging data from PET, and has the potential to improve the diagnostic evaluation of various types of cancers. The clinical oncologic applications of this newest hybrid imaging technology are evolving and substantial efforts are underway to define the role of PET/MRI in routine clinical use. The current published literature suggests that PET/MRI may play an important role in the evaluation of patients with certain types of malignancies, involving anatomic locations such as the pelvis and the liver. The purpose of this article is to review the current published PET/MRI literature in specific body oncologic applications. In addition, PET/MRI protocols and some of the technical issues of this hybrid imaging will be briefly discussed. J. Magn. Reson. Imaging 2016;44:265-276. PMID:27007987

  19. BRIEF REVIEW ON DIAGNOSTIC TECHNIQUE AND NOVEL MOLECULES IN CLINICAL TRIALS FOR TREATMENT OF BREAST CANCER

    Directory of Open Access Journals (Sweden)

    VISHAL KUMAR S. MODI

    2015-01-01

    Full Text Available Breast cancer is the most common cancer in women in both developed and undeveloped countries, and the second most frequent cause of cancer deaths after lung cancer. Although there have been many chemotherapeutic agents like 5-fluorouracil, taxol, tamoxifen, doxorubicin, cisplatin, and camptothecin and hormones are used to treat breast cancer. This review focuses on the causes of breast cancer, latest diagnostic techniques and various molecules under clinical trials for the treatment of breast cancer.

  20. Clinical evaluation of a wireless ECG sensor system for arrhythmia diagnostic purposes

    OpenAIRE

    Fensli, Rune; Gundersen, Torstein; Snaprud, Tormod; Heljesen, Ole

    2013-01-01

    In a clinical study, a novel wireless electrocardiogram (ECG) recorder has been evaluated with regard to its ability to perform arrhythmia diagnostics. As the ECG recorder will detect a "non-standard" ECG signal, it has been necessary to compare those signals to "standard" ECG recording signals in order to evaluate the arrhythmia detection ability of the new system. Simultaneous recording of ECG signals from both the new wireless ECG recorder and a conventional Holter recorder was compared by...

  1. Imaging retinal ganglion cells: enabling experimental technology for clinical application.

    Science.gov (United States)

    Smith, Corey A; Chauhan, Balwantray C

    2015-01-01

    Recent advances in clinical ophthalmic imaging have enhanced patient care. However, the ability to differentiate retinal neurons, such as retinal ganglion cells (RGCs), would advance many areas within ophthalmology, including the screening and monitoring of glaucoma and other optic neuropathies. Imaging at the single cell level would take diagnostics to the next level. Experimental methods have provided techniques and insight into imaging RGCs, however no method has yet to be translated to clinical application. This review provides an overview of the importance of non-invasive imaging of RGCs and the clinically relevant capabilities. In addition, we report on experimental data from wild-type mice that received an in vivo intravitreal injection of a neuronal tracer that labelled RGCs, which in turn were monitored for up to 100 days post-injection with confocal scanning laser ophthalmoscopy. We were able to demonstrate efficient and consistent RGC labelling with this delivery method and discuss the issue of cell specificity. This type of experimental work is important in progressing towards clinically applicable methods for monitoring loss of RGCs in glaucoma and other optic neuropathies. We discuss the challenges to translating these findings to clinical application and how this method of tracking RGCs in vivo could provide valuable structural and functional information to clinicians. PMID:25448921

  2. Clinical Application of Point Diji

    Institute of Scientific and Technical Information of China (English)

    栾继萍

    2004-01-01

    @@ Diji (SP 8) is a cleft point of the Spleen Channel of Foot-Taiyang. Its indications include abdominal pain, diarrhea, edema, dysmenorrhea and certain other symptoms caused by incoordination between the liver and the spleen. Either taking the point alone or together with some other adjunct points in clinical practice, the author has obtained satisfactory curative effects.

  3. Diagnosing alcohol abuse in alcohol dependent individuals: diagnostic and clinical implications

    OpenAIRE

    Ray, Lara A.; Hutchison, Kent E.; Leventhal, Adam M.; Miranda, Robert; Francione, Caren; Chelminski, Iwona; Young, Diane; ZIMMERMAN, MARK

    2009-01-01

    In DMS-IV, the diagnosis of alcohol abuse is precluded by the diagnosis of alcohol dependence. The goal of this study was to examine the diagnostic and clinical implications of diagnosing alcohol abuse among alcohol dependent individuals. Treatment-seeking psychiatric outpatients with a lifetime history of alcohol dependence (n = 544), some of whom (n = 45) did not meet lifetime criteria for alcohol abuse completed in-depth, face-to-face, semi-structured clinical assessments of DSM-IV axis I ...

  4. Clinical impact of diagnostic SPET investigations with a dopamine re-uptake ligand

    Energy Technology Data Exchange (ETDEWEB)

    Loekkegaard, Annemette [Department of Neurology, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV (Denmark); Department of Clinical Physiology and Nuclear Medicine, Bispebjerg Hospital, Copenhagen (Denmark); Werdelin, Lene M. [Department of Neurology, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV (Denmark); Friberg, Lars [Department of Clinical Physiology and Nuclear Medicine, Bispebjerg Hospital, Copenhagen (Denmark)

    2002-12-01

    The diagnosis of Parkinson's disease is based on clinical features with pathological verification. However, autopsy has been found to confirm a specialist diagnosis in only about 75% of cases. Especially early in the course of the disease, the clinical diagnosis can be difficult. Imaging of presynaptic dopamine transporters (DAT receptors) has provided a possible diagnostic probe in the evaluation of Parkinson's disease. The cocaine analogue [{sup 123}I]-2-{beta}-carboxymethoxy-3-{beta}(4-iodophenyl)tropane ([{sup 123}I]-{beta}-CIT) is one of several radioligands that have been developed for single-photon emission tomography (SPET). The purpose of this study was to evaluate the impact of [{sup 123}I]-{beta}-CIT SPET on the diagnosis and clinical management of patients with a primary, tentative diagnosis of parkinsonism. We undertook a retrospective evaluation of the clinical records of 90 consecutive patients referred to [{sup 123}I]-{beta}-CIT SPET from the neurological department, Bispebjerg Hospital. In 58 subjects the scans revealed altered tracer uptake consistent with Parkinson's disease, progressive supranuclear palsy and multiple system atrophy. A significant change in the management or treatment because of the scan was found in 25 patients (28%). The sensitivity of the examination was 97% and the specificity 83%. In conclusion, a significant clinical impact of DAT receptor SPET imaging was found. DAT receptor imaging is a useful diagnostic probe in patients with a possible diagnosis of parkinsonism. (orig.)

  5. Digital mammography: Experiences in clinical application

    International Nuclear Information System (INIS)

    Target: In 1989 in the Kantonal Hospital of Lucerne conventional film-screen mammography was replaced by digital mammography. With the support of a retrospective study, it was checked whether or not digital mammography represents an equally valid diagnostic procedure in daily routine. Methods: 1204 patients were examined using digital mammography. A reevaluation of these patients was carried out using clinical and r[iological routine controls. [ditionally a r[iological and histological examination was performed in 127 cases in which excisional biopsies h[ been done, paying particular attention to detail perception. Results: The sensitivity of digital mammography achieved a total of 85%, whereas the accuracy was 81%. With [ditional use of ultrasound and galactography the sensitivity attained 91%. By reevaluation the sensitivity amounted to 87%, the accuracy remaining at 81%. The positive predictive value was especially high with 76% and 77%. Conclusion: Digital mammography offers satisfactory diagnostic performance. (orig.)

  6. Clinical application of fast neutrons

    International Nuclear Information System (INIS)

    The results of treatments and clinical experiments with neutrons (from a medical d+T neutron generator with an output of 1012 neutrons per second) are reported and discussed. Data on RBE values are presented after single doses and multiple fractions of neutrons and 60Co-gamma rays on pulmonary metastases. The results of pilot studies on head and neck tumours, brain tumours and pelvic tumours are discussed. The accuracy of the calculated dose is tested with some in-vivo experiments during neutron irradiation of the pelvis. Estimations of RBE values for tumour control, skin damage and intestinal damage after fractionated neutron therapy are dealt with and the results obtained in treatment of sarcomas are discussed. The preliminary results are given of some clinical trials in Amsterdam. Also some data from other centres are reviewed. From these data some remarks about the future of neutron therapy are made. (Auth.)

  7. Applications of stable isotopes in clinical pharmacology

    NARCIS (Netherlands)

    Schellekens, Reinout C A; Stellaard, Frans; Woerdenbag, Herman J; Frijlink, Henderik W; Kosterink, Jos G W

    2011-01-01

    This review aims to present an overview of the application of stable isotope technology in clinical pharmacology. Three main categories of stable isotope technology can be distinguished in clinical pharmacology. Firstly, it is applied in the assessment of drug pharmacology to determine the pharmacok

  8. Clinical Application of Insect Drugs

    Institute of Scientific and Technical Information of China (English)

    钟洪; 赵洁

    2003-01-01

    @@ Chinese insect drugs are drastic in nature, capable ofclearing channels and collaterals to promote a freeflow of qi and blood, and effective in someintractable and obstinate diseases due to long-termstagnation of phlegm and blood, which are hard to betreated by ordinary Chinese drugs. In clinic, properuse of insect drugs can often help raise thetherapeutic effects. Some commonly used pairs ofinsect drugs are introduced in the following.

  9. Clinical approved fluorescent dyes coupled to endomicroscopy for in vivo diagnostic of peritoneal carcinomatosis

    Science.gov (United States)

    Abbaci, Muriel; Dartigues, Peggy; Soufan, Ranya; De Leeuw, Frederic; Fabre, Monique; Laplace-Builhé, Corinne

    2015-03-01

    Peritoneal carcinomatosis is metastatic stage aggravating digestive, gynecological or bladder cancer dissemination and the preoperative evaluation of lesions remains difficult. There is therefore a need for minimal invasive innovative techniques to establish a precise preoperative assessment of cancer peritoneal cavity. Probe-based confocal laser endomicroscopy (pCLE) provides dynamic images of the microarchitecture of tissues during an endoscopy. The PERSEE project proposes new developments in robotics and pCLE for the exploration of the peritoneal cavity during laparoscopy. Two fluorescent dyes, Patent blue V and Indocyanine green have been evaluated on human ex vivo samples to improve the contrast of pCLE images. For a future implementation in clinical study, two topically staining protocols operable in vivo have been validated on 70 specimens from 25 patients with a peritoneal carcinomatosis. The specimens were then imaged by pCLE with an optical probe designed for the application. A histo-morphological correlative study was performed on 350 pCLE images and 70 standard histological preparations. All images were interpreted in a random way by two pathologists. Differential histological diagnostics such as normal peritoneum or pseudomyxoma could be recognized on fluorescence images. The statistical analysis of the correlative study is underway. These dyes already approved for human use are interesting for pCLE imaging because some micromorphological criteria look like to conventional histology and are readable by pathologist. Thus pCLE images using both dyes do not require a specific semiology unlike to what is described in the literature, for pCLE associated with fluorescein for the in vivo imaging of pancreatic cysts.

  10. Application of statistical process control to qualitative molecular diagnostic assays

    LENUS (Irish Health Repository)

    O'Brien, Cathal P.

    2014-11-01

    Modern pathology laboratories and in particular high throughput laboratories such as clinical chemistry have developed a reliable system for statistical process control (SPC). Such a system is absent from the majority of molecular laboratories and where present is confined to quantitative assays. As the inability to apply SPC to an assay is an obvious disadvantage this study aimed to solve this problem by using a frequency estimate coupled with a confidence interval calculation to detect deviations from an expected mutation frequency. The results of this study demonstrate the strengths and weaknesses of this approach and highlight minimum sample number requirements. Notably, assays with low mutation frequencies and detection of small deviations from an expected value require greater sample numbers to mitigate a protracted time to detection. Modeled laboratory data was also used to highlight how this approach might be applied in a routine molecular laboratory. This article is the first to describe the application of SPC to qualitative laboratory data.

  11. Clinical utility of machine learning approaches in schizophrenia: Improving diagnostic confidence for translational neuroimaging

    Directory of Open Access Journals (Sweden)

    Sarina eIwabuchi

    2013-08-01

    Full Text Available Machine-learning approaches are becoming commonplace in the neuroimaging literature as potential diagnostic and prognostic tools for the study of clinical populations. However, very few studies provide clinically informative measures to aid in decision-making and resource allocation. Head-to-head comparison of neuroimaging-based multivariate classifiers is an essential first step to promote translation of these tools to clinical practice. We systematically evaluated the classifier performance using back-to-back structural MRI in two field strengths (3-Tesla and 7-Tesla to discriminate patients with schizophrenia (n=19 from healthy controls (n=20. Grey (GM and white matter (WM images were used as inputs into a support vector machine (SVM to classify patients and control subjects. 7T classifiers outperformed the 3T classifiers with accuracy reaching as high as 77% for the 7T GM classifier compared to 66.6% for the 3T GM classifier. Furthermore, diagnostic odds ratio (a measure that is not affected by variations in sample characteristics and number needed to predict (a measure based on Bayesian certainty of a test result indicated superior performance of the 7T classifiers, whereby for each correct diagnosis made, the number of patients that need to be examined using the 7T GM classifier was one less than the number that need to be examined if a different classifier was used. Using a hypothetical example, we highlight how these findings could have significant implications for clinical decision-making. We encourage the reporting of measures proposed here in future studies utilizing machine-learning approaches. This will not only promote the search for an optimum diagnostic tool but also aid in the translation of neuroimaging to clinical use.

  12. Clinical utility of machine-learning approaches in schizophrenia: improving diagnostic confidence for translational neuroimaging.

    Science.gov (United States)

    Iwabuchi, Sarina J; Liddle, Peter F; Palaniyappan, Lena

    2013-01-01

    Machine-learning approaches are becoming commonplace in the neuroimaging literature as potential diagnostic and prognostic tools for the study of clinical populations. However, very few studies provide clinically informative measures to aid in decision-making and resource allocation. Head-to-head comparison of neuroimaging-based multivariate classifiers is an essential first step to promote translation of these tools to clinical practice. We systematically evaluated the classifier performance using back-to-back structural MRI in two field strengths (3- and 7-T) to discriminate patients with schizophrenia (n = 19) from healthy controls (n = 20). Gray matter (GM) and white matter images were used as inputs into a support vector machine to classify patients and control subjects. Seven Tesla classifiers outperformed the 3-T classifiers with accuracy reaching as high as 77% for the 7-T GM classifier compared to 66.6% for the 3-T GM classifier. Furthermore, diagnostic odds ratio (a measure that is not affected by variations in sample characteristics) and number needed to predict (a measure based on Bayesian certainty of a test result) indicated superior performance of the 7-T classifiers, whereby for each correct diagnosis made, the number of patients that need to be examined using the 7-T GM classifier was one less than the number that need to be examined if a different classifier was used. Using a hypothetical example, we highlight how these findings could have significant implications for clinical decision-making. We encourage the reporting of measures proposed here in future studies utilizing machine-learning approaches. This will not only promote the search for an optimum diagnostic tool but also aid in the translation of neuroimaging to clinical use. PMID:24009589

  13. Standardizing in vitro diagnostics tasks in clinical trials: a call for action.

    Science.gov (United States)

    Lippi, Giuseppe; Simundic, Ana-Maria; Rodriguez-Manas, Leocadio; Bossuyt, Patrick; Banfi, Giuseppe

    2016-05-01

    Translational research is defined as the process of applying ideas, insights and discoveries generated through basic scientific inquiry to treatment or prevention of human diseases. Although precise information is lacking, several lines of evidence attest that up to 95% early-phase studies may not translate into tangible outcomes for improving clinical management. Major theoretical hurdles exist in the translational process, but is it also undeniable that many studies may have failed for practical reasons, such as the use of inappropriate diagnostic testing for evaluating efficacy, effectiveness or safety of a given medical intervention, or poor quality in laboratory testing. This can generate biased test results and result in misconceptions during data interpretation, eventually leading to no clinical benefit, possible harm, and a waste of valuable resources. From a genuine economic perspective, it can be estimated that over 10 million euros of funding may be lost each year in clinical trials in the European Union due to preanalytical and analytical problems. These are mostly attributions to the heterogeneity of current guidelines and recommendations for the testing process, to the poor evidence base for basic pre-analytical, analytical and post-analytical requirements in clinical trials, and to the failure to thoughtfully integrate the perspectives of clinicians, patients, nurses and diagnostic companies in laboratory best practices. The most rational means for filling the gap between what we know and what we practice in clinical trials cannot discount the development of multidisciplinary teams including research scientists, clinicians, nurses, patients associations and representative of in vitro diagnostic (IVD) companies, who should actively interplay and collaborate with laboratory professionals to adapt and disseminate evidence-based recommendations about biospecimen collection and management into the research settings, from preclinical to phase III studies

  14. Fiber optics in x-ray diagnostics applications

    International Nuclear Information System (INIS)

    In this section, the author describes how fiber optics can be used as active transmitters of diagnostic data and some ways in which they can be used as passive radiation-to-light converters. The author also discusses the problems of radiation damage and temporal dispersion which are encountered in using fiber optics to transmit diagnostic data and some of the techniques used to mitigate these problems

  15. Applications of ROC analysis in diagnostic image evaluation

    International Nuclear Information System (INIS)

    The need for Receiver Operating Characteristic (ROC) analysis is indicated by a discussion of the limitations of accuracy and of sensitivity and specificity as indices of diagnostic detection or discrmination performance. The concept of a variable decision threshold is shown to lead in a natural way to the ROC curve as a means for specifying diagnostic performance. Practical techniques for measuring ROC curves are described, and directions for possible generalizations of conventional ROC analysis are indicated

  16. Impact of clinical awareness and diagnostic tests on the underdiagnosis of Clostridium difficile infection.

    Science.gov (United States)

    Alcalá, L; Reigadas, E; Marín, M; Martín, A; Catalán, P; Bouza, E

    2015-08-01

    A multicenter study of Clostridium difficile infection (CDI) performed during 2008 in Spain revealed that two of every three episodes went undiagnosed or were misdiagnosed owing to nonsensitive diagnostic tests or lack of clinical suspicion and request. Since then, efforts have been made to improve the diagnostic tests used by laboratories and to increase the awareness of this disease among both clinicians and microbiologists. Our objective was to evaluate the impact of these efforts by assessing the current magnitude of underdiagnosis of CDI in Spain using two point-prevalence studies performed on one day each in January and July of 2013. A total of 111 Spanish laboratories selected all unformed stool specimens received for microbiological diagnosis on these days, and toxigenic culture was performed at a central reference laboratory. Toxigenic isolates were characterized both pheno- and genotypically. The reference laboratory detected 103 episodes of CDI in patients aged 2 years or more. Half (50.5 %) of the episodes were not diagnosed in the participating laboratories, owing to insensitive diagnostic tests (15.5 %) or the lack of clinical suspicion and request (35.0 %). The main ribotypes were 014, 078/126, 001/072, and 106. Ribotype 027 caused 2.9 % of all cases. Despite all the interventions undertaken, CDI remains a highly neglected disease because of the lack of sensitive diagnostic tests in some institutions and, especially, the absence of clinical suspicion, mainly in patients with community-associated CDI. Toxigenic C. difficile should be routinely sought in unformed stools sent for microbiological diagnosis, regardless of their origin.

  17. Clinical impact of recurrently mutated genes on lymphoma diagnostics: state-of-the-art and beyond.

    Science.gov (United States)

    Rosenquist, Richard; Rosenwald, Andreas; Du, Ming-Qing; Gaidano, Gianluca; Groenen, Patricia; Wotherspoon, Andrew; Ghia, Paolo; Gaulard, Philippe; Campo, Elias; Stamatopoulos, Kostas

    2016-09-01

    Similar to the inherent clinical heterogeneity of most, if not all, lymphoma entities, the genetic landscape of these tumors is markedly complex in the majority of cases, with a rapidly growing list of recurrently mutated genes discovered in recent years by next-generation sequencing technology. Whilst a few genes have been implied to have diagnostic, prognostic and even predictive impact, most gene mutations still require rigorous validation in larger, preferably prospective patient series, to scrutinize their potential role in lymphoma diagnostics and patient management. In selected entities, a predominantly mutated gene is identified in almost all cases (e.g. Waldenström's macroglobulinemia/lymphoplasmacytic lymphoma and hairy-cell leukemia), while for the vast majority of lymphomas a quite diverse mutation pattern is observed, with a limited number of frequently mutated genes followed by a seemingly endless tail of genes with mutations at a low frequency. Herein, the European Expert Group on NGS-based Diagnostics in Lymphomas (EGNL) summarizes the current status of this ever-evolving field, and, based on the present evidence level, segregates mutations into the following categories: i) immediate impact on treatment decisions, ii) diagnostic impact, iii) prognostic impact, iv) potential clinical impact in the near future, or v) should only be considered for research purposes. In the coming years, coordinated efforts aiming to apply targeted next-generation sequencing in large patient series will be needed in order to elucidate if a particular gene mutation will have an immediate impact on the lymphoma classification, and ultimately aid clinical decision making. PMID:27582569

  18. Diagnostic Accuracy of Clinical Tests for Morton's Neuroma Compared With Ultrasonography.

    Science.gov (United States)

    Mahadevan, Devendra; Venkatesan, Muralidharan; Bhatt, Raj; Bhatia, Maneesh

    2015-01-01

    The aim of the present study was to assess the diagnostic accuracy of 7 clinical tests for Morton's neuroma (MN) compared with ultrasonography (US). Forty patients (54 feet) were diagnosed with MN using predetermined clinical criteria. These patients were subsequently referred for US, which was performed by a single, experienced musculoskeletal radiologist. The clinical test results were compared against the US findings. MN was confirmed on US at the site of clinical diagnosis in 53 feet (98%). The operational characteristics of the clinical tests performed were as follows: thumb index finger squeeze (96% sensitivity, 96% accuracy), Mulder's click (61% sensitivity, 62% accuracy), foot squeeze (41% sensitivity, 41% accuracy), plantar percussion (37% sensitivity, 36% accuracy), dorsal percussion (33% sensitivity, 26% accuracy), and light touch and pin prick (26% sensitivity, 25% accuracy). No correlation was found between the size of MN on US and the positive clinical tests, except for Mulder's click. The size of MN was significantly larger in patients with a positive Mulder's click (10.9 versus 8.5 mm, p = .016). The clinical assessment was comparable to US in diagnosing MN. The thumb index finger squeeze test was the most sensitive screening test for the clinical diagnosis of MN. PMID:25432459

  19. Clinical Efficacy of Various Diagnostic Tests for Small Bowel Tumors and Clinical Features of Tumors Missed by Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Jung Wan Han

    2015-01-01

    Full Text Available Background. We aimed to evaluate the efficacy of various diagnostic tools such as computerized tomography (CT, small bowel follow-through (SBFT, and capsule endoscopy (CE in diagnosing small bowel tumors (SBTs. Additionally, we aimed to evaluate the clinical features of SBTs missed by CE. Methods. We retrospectively studied 79 patients with histologically proven SBT. Clinical data were analyzed with particular attention to the efficacy of CT, SBFT, and CE in detecting SBT preoperatively. We also analyzed the clinical features of SBTs missed by CE. Results. The most common symptoms of SBT were bleeding (43% and abdominal pain (13.9%. Diagnostic yields were as follows: CT detected 55.8% of proven SBTs; SBFT, 46.1%; and CE, 83.3%. The sensitivity for detecting SBTs was 40.4% for CT, 43.9% for SBFT, and 79.6% for CE. Two patients with nondiagnostic but suspicious findings on CE and seven patients with negative findings on CE were eventually found to have SBT. These nine patients were eventually diagnosed with gastrointestinal stromal tumor (4, small polyps (3, inflammatory fibroid polyp (1, and adenocarcinoma (1. These tumors were located in the proximal jejunum (5, middle jejunum (1, distal jejunum (1, and proximal ileum (1. Conclusion. CE is more efficacious than CT or SBFT for detecting SBTs. However, significant tumors may go undetected with CE, particularly when located in the proximal jejunum.

  20. Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region

    OpenAIRE

    Nurgul Ceran; Recai Turkoglu; Ilknur Erdem; Asuman Inan; Derya Engin; Hulya Tireli; Pasa Goktas

    2011-01-01

    Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, s...

  1. The use of rapid dengue diagnostic tests in a routine clinical setting in a dengue-endemic area of Colombia

    OpenAIRE

    Lyda Osorio; Marcela Uribe; Gloria Ines Ardila; Yaneth Orejuela; Margarita Velasco; Anilza Bonelo; Beatriz Parra

    2015-01-01

    There is insufficient evidence of the usefulness of dengue diagnostic tests under routine conditions. We sought to analyse how physicians are using dengue diagnostics to inform research and development. Subjects attending 14 health institutions in an endemic area of Colombia with either a clinical diagnosis of dengue or for whom a dengue test was ordered were included in the study. Patterns of test-use are described herein. Factors associated with the ordering of dengue diagnostic tests were ...

  2. Late gadolinium enhancement in the diagnostics of ischemic heart disease. Technical principles, contrast optimization and clinical application; Late-Gadolinium-Enhancement in der Diagnostik der koronaren Herzerkrankung. Technische Grundlagen, Kontrastoptimierung und klinische Anwendung

    Energy Technology Data Exchange (ETDEWEB)

    Bauner, K.U.; Picciolo, M.; Theisen, D.; Sandner, T.A.; Notohamiprodjo, M.; Reiser, M.F.; Wintersperger, B.J. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Biffar, A. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Joseph Lissner Laboratory of Biomedical Imaging, Muenchen (Germany); Greif, M.; Becker, A. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Medizinische Klinik und Poliklinik I, Muenchen (Germany)

    2010-06-15

    The purpose of the study was to explore a ''dark blood'' technique and to compare it with a standard inversion recovery gradient echo (IR GRE) sequence in the visualization of myocardial infarction. A total of 9 patients were examined with standard IR GRE and a ''dark blood'' sequence 15 mins after contrast medium application (0.2 mmol/kg body weight gadobenate dimeglumine). Contrast-to-noise ratios (CNR) were calculated for each sequence. The CNR{sub inf-lvc} was significantly higher in the ''dark blood'' technique compared to the IR GRE sequence, while the CNR{sub inf-myo} was significantly lower. Small subendocardial infarctions may be easier to detect with the ''dark blood'' technique. However, the standard IR GRE sequence is superior in the demarcation of infarctions in relation to the myocardium and cannot be replaced by the ''dark blood'' technique. (orig.) [German] In der kardialen MRT ist die Methodik des Late-Gadolinium-Enhancements (LGE) zur Darstellung von Myokardinfarkten waehrend des letzten Jahrzehnts zu einem klinischen Routineverfahren geworden. In manchen Faellen kann die Abgrenzung des LGE vom Ventrikellumen in der Standardsequenz (Inversion-recovery-Gradientenecho- [IR-GRE-]Sequenz) jedoch schwierig sein. Ziel unserer Untersuchungen war es daher, eine ''Dark-blood''-Sequenz in der LGE-Bildgebung einzusetzen und mit der Referenztechnik zu vergleichen. Bei 9 Patienten wurden 15 min nach Kontrastmittelapplikation (0,2 mmol/kgKG Gadobenate Dimeglumine) eine IR-GRE-Sequenz (Referenztechnik) und eine ''Dark-blood''-Sequenz durchgefuehrt. Das Kontrast-zu-Rauschen (CNR) beider Sequenzen wurde verglichen. Waehrend das CNR zwischen Infarkt und Myokard in der IR-GRE-Technik signifikant besser als in der ''Dark-blood''-Darstellung ausfiel (p=0,039), war das CNR von Infarkt zum Ventrikellumen in der

  3. [The reactions of hypersensitivity: the mechanisms of development, clinical manifestations, principles of diagnostic (a lecture)].

    Science.gov (United States)

    Tukavkina, S Yu; Kharseyeva, G G

    2014-05-01

    The article considers the principles of modern classification of hypersensitivity, pathogenic mechanisms of formation of its various types resulting in development of typical clinical symptoms and syndromes. The knowledge and comprehension of these issues is important for physicians of different specializations since it permits to properly make out and formulate diagnosis and timely send patient for examination and treatment to such specialist as allergist-immunologist. The particular attention was paid to description of pathogenesis of diseases and syndromes underlaid by IgE-mediated type of hypersensitivity since their share is highest and clinical manifestations frequently require emergency medical care. The diagnostic of allergic diseases is to be implemented sequentially (step-by-step) and include common clinical and special (specific) methods. In case of choosing of extent of specialized allergological examination the diagnostic significance of techniques and their safety is to be taken into account concerning condition of patient. The diagnosis is objectively formulated only by complex of examination results. It is worth to remember about possibility of development of syndromes similar to IgE-mediated allergy by their clinical manifestations but belonging to non-allergic type of hypersensitivity. It is important to know main causes, mechanisms and ways of formation of such reactions previously named as anaphylactoid ones. PMID:25338461

  4. [The issues and basic principles of training of physicians of clinical laboratory diagnostics].

    Science.gov (United States)

    Morozova, V T; Naumova, E V

    2012-07-01

    The article considers the main positions concerning the clinical laboratory diagnostics as an independent clinical specialty and the principles of professional training and improvement of specialists. The basic issues complicating the training and improvement of personnel to be kept in line with actual needs of laboratory service of public health system are discussed. Among them are the availability of laboratory academic sub disciplines demanding a profound special theoretical education and technical skills; the need to account in the process of professional training the variety of forms, sizes and types of laboratory structures in different medical institutions; the need of special training programs for numerous specialists with non-medical basic education. The combination of the present system of postgraduate training of specialists on chairs of state educational organizations with initiative involvement of specialists in various public forms of permanent professional improvement (professional scientific societies meetings, research conferences, internet seminars, etc.) is supported Along with a positive appraisal of the existing system of training in the state educational institutions and corresponding regulation documents, a critique is expressed regarding certain actual documents which improperly limit the administrative functions of physicians of clinical laboratory diagnostics and complicate training of bacteriologists for clinical laboratories.

  5. Small-Fiber Neuropathy: A Diabetic Microvascular Complication of Special Clinical, Diagnostic, and Prognostic Importance.

    Science.gov (United States)

    Körei, A E; Istenes, I; Papanas, N; Kempler, P

    2016-01-01

    Damage of small nerve fibers may lead to a large variety of clinical symptoms. Small-fiber neuropathy underlies the symptoms of painful diabetic neuropathy, which may decrease quality of life. It also contributes to the poor prognosis of diabetic neuropathy because it plays a key role in the pathogenesis of foot ulceration and autonomic neuropathy. Impairment of small nerve fibers is considered the earliest alteration in the course of diabetic neuropathy. Therefore, assessment of functional and morphological abnormalities of small nerve fibers may enable timely diagnosis. The definition, symptoms, and clinical significance of small-fiber neuropathy are considered in the present review. An apparently more complex interaction between small-fiber impairment and microcirculation is extensively discussed. Diagnostic modalities include morphometric and functional methods. Corneal confocal microscopy and punch skin biopsy are considered gold standards, but noninvasive functional tests are also diagnostically useful. However, in routine clinical practice, small-fiber neuropathy is diagnosed by its typical clinical presentation. Finally, prompt treatment should be initiated following diagnosis.

  6. Proton radiography for clinical applications

    International Nuclear Information System (INIS)

    Proton imaging is not yet applied as a clinical routine, although its advantages have been demonstrated. In the context of quality assurance in proton therapy, proton images can be used to verify the correct positioning of the patient and to control the range of protons. Proton computed tomography (pCT) is a 3D imaging method appropriate for planning and verification of proton radiation treatments, because it allows evaluating the distributions of proton stopping power within the tissues and can be directly utilized when the patient is in the actual treatment position. The aim of the PRoton IMAging experiment, supported by INFN, and the PRIN 2006 project, supported by MIUR, is to realize a proton computed radiography (pCR) prototype for reconstruction of proton images from a single projection in order to validate the technique with pre-clinical studies and, eventually, to conceive the configuration of a complete pCT system. A preliminary experiment performed at the 250 MeV proton synchrotron of Loma Linda University Medical Center (LLUMC) allowed acquisition of experimental data before the completion of PRIMA project's prototype. In this paper, the results of the LLUMC experiment are reported and the reconstruction of proton images of two phantoms is discussed.

  7. Proton radiography for clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Talamonti, C., E-mail: cinzia.talamonti@unifi.i [Dipartimento di Fisiopatologia Clinica, Universita degli Studi di Firenze, v.le Morgagni 85, I-50134 Firenze (Italy); INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Italy); Azienda Ospedaliero-Universitaria Careggi, v.le Morgagni 85, I-50134 Firenze (Italy); Reggioli, V. [Dipartimento di Fisiopatologia Clinica, Universita degli Studi di Firenze, v.le Morgagni 85, I-50134 Firenze (Italy); Bruzzi, M. [INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Italy); Dipartimento di Energetica, Universita degli Studi di Firenze, via S. Marta 3, I-50139 Firenze (Italy); Bucciolini, M. [Dipartimento di Fisiopatologia Clinica, Universita degli Studi di Firenze, v.le Morgagni 85, I-50134 Firenze (Italy); INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Italy); Azienda Ospedaliero-Universitaria Careggi, v.le Morgagni 85, I-50134 Firenze (Italy); Civinini, C. [INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Italy); Marrazzo, L. [Azienda Ospedaliero-Universitaria Careggi, v.le Morgagni 85, I-50134 Firenze (Italy); Menichelli, D. [INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Finland) (Italy); Dipartimento di Energetica, Universita degli Studi di Firenze, via S. Marta 3, I-50139 Firenze (Italy); Pallotta, S. [Dipartimento di Fisiopatologia Clinica, Universita degli Studi di Firenze, v.le Morgagni 85, I-50134 Firenze (Italy); INFN, sezione di Firenze, via G. Sansone 1, I-50019 Sesto Fiorentino (Italy); Azienda Ospedaliero-Universitaria Careggi, v.le Morgagni 85, I-50134 Firenze (Italy); Randazzo, N. [INFN, sezione di Catania, via S. Sofia 64, I-95123 Catania (Italy); Sipala, V. [INFN, sezione di Catania, via S. Sofia 64, I-95123 Catania (Italy); Dipartimento di Fisica, Universita degli Studi di Catania, via S. Sofia 64, I-95123 Catania (Italy)

    2010-01-11

    Proton imaging is not yet applied as a clinical routine, although its advantages have been demonstrated. In the context of quality assurance in proton therapy, proton images can be used to verify the correct positioning of the patient and to control the range of protons. Proton computed tomography (pCT) is a 3D imaging method appropriate for planning and verification of proton radiation treatments, because it allows evaluating the distributions of proton stopping power within the tissues and can be directly utilized when the patient is in the actual treatment position. The aim of the PRoton IMAging experiment, supported by INFN, and the PRIN 2006 project, supported by MIUR, is to realize a proton computed radiography (pCR) prototype for reconstruction of proton images from a single projection in order to validate the technique with pre-clinical studies and, eventually, to conceive the configuration of a complete pCT system. A preliminary experiment performed at the 250 MeV proton synchrotron of Loma Linda University Medical Center (LLUMC) allowed acquisition of experimental data before the completion of PRIMA project's prototype. In this paper, the results of the LLUMC experiment are reported and the reconstruction of proton images of two phantoms is discussed.

  8. Cranial MRI: Current clinical applications

    International Nuclear Information System (INIS)

    Human MR images were first published by the Nottingham group in 1980. Since that time, there have been steady improvements in image quality and significant reductions in imaging time. After initial studies by the Hammersmith group in London, investigators at UCSF published studies comparing CT with MR, clearly demonstrating the higher sensitivity of MR to pathologic intracranial processes. Since that time, several investigators have demonstrated the efficacy of MR in the evaluation of a wide range of intracranial pathologic processes, including neoplasms, demyelinating disease, trauma, and congenital abnormalities. In the authors' studies comparing MR with CT in 400 consecutive cases of suspected CNS pathology, MR detected abnormalities which were not seen on CT in 30 percent of these cases. MR has become established as the imaging modality of choice in the evaluation of a broad range of CNS abnormalities and is rapidly being implemented not only at university medical centers but also in community hospitals and free-standing clinics. This chapter deals with fundamental principles of MR image interpretation and provides insight into current clinical indications for MR in intracranial disorders

  9. Clinical neuroanatomy and diagnostic imaging of the skull. 2. rev. and enlarged ed.

    International Nuclear Information System (INIS)

    In the last few years, the techniques of CT, MRI, PET and utrasonography have been improved in their diagnostic efficiency, but in spite of the much enhanced resolution achievable with the new techniques, a large part of the neurofunctional systems that are of great significance to clinical diagnostic evaluation remains in the dark. The local structure of the neurofunctional systems is derived from the data describing the position of the conductive structures such as cerebral ventricles or typical cerebral sulci or gyri. A good knowledge of the three-dimensional topography of the neuroanatomy in the skull is required for this purpose, and this is what the book at hand is intended to confer. The arteries and their vascular environment are shown in the frontal, sagittal and axial plane and are compared with drawings produced from angiographies. The information given covers the cranium viscerale, the craniocervical neighbouring areas, and the motor innervation areas of the skull. The term 'diagnostic imaging of the skull' comprises the whole head and the transitional zones. The illustration of the neurofunctional system anatomy in the tomogram presented in this book is a source of information that may serve as a guide for pathfinding in CT, MRI, PET and ultrasonography. In addition, the knowledge found in the book will help to assign clinical data to pathologic findings revealed by CT or MRI. (orig.) With 596 mostly coloured figs

  10. Application of in situ DNA hybridization technology to diagnostic surgical pathology

    International Nuclear Information System (INIS)

    Using cloned genes obtained through the latest recombinant DNA technology as probes, and relying on the property that these DNAs bind only to their own complementary sequences through hydrogen bonds, it is now possible to detect many genes of pathologic interest in clinical specimens. In molecular biology laboratories, such hybridization reactions are usually performed on target DNA which has been bound and immobilized on filter membranes, using highly radioactive DNA probes and subsequent auto-radiography for detection. In this review the authors focus on the advent of two recent discoveries which have now allowed this technology to leave the rarified domain of the research laboratory and become applicable to routine use in diagnostic pathology: the ability to label DNA probes by nonradioactive methods and the finding that endogeneous nucleic acid sequences in tissue sections and cytologic smears can be used as targets for these probes directly on the microscope slide by in situ hybridization

  11. Biomolecular urease thin films grown by laser techniques for blood diagnostic applications

    International Nuclear Information System (INIS)

    Matrix assisted pulsed laser evaporation (MAPLE) was used for growing urease thin films designed for bio-sensor applications in clinical diagnostics. The targets exposed to laser radiation were made from a frozen composite manufactured by dissolving biomaterials in distilled water. We used a UV KrF* (λ = 248 nm, τFWHM ≅ 30 ns, ν = 10 Hz) excimer source for multipulse laser irradiation of the frozen targets cooled with Peltier elements. The laser source was operated at an incident fluence of 0.4 J/cm2. Urease activity and kinetics were assayed by the Worthington method that monitors urea hydrolysis by coupling ammonia production to a glutamate dehydrogenase reaction. A decrease in absorbance was measured at 340 nm and correlated with the enzymatic activity of urease. We show that the urease films obtained by MAPLE techniques remain active up to three months after deposition.

  12. A Robust Automated Cataract Detection Algorithm Using Diagnostic Opinion Based Parameter Thresholding for Telemedicine Application

    Directory of Open Access Journals (Sweden)

    Shashwat Pathak

    2016-09-01

    Full Text Available This paper proposes and evaluates an algorithm to automatically detect the cataracts from color images in adult human subjects. Currently, methods available for cataract detection are based on the use of either fundus camera or Digital Single-Lens Reflex (DSLR camera; both are very expensive. The main motive behind this work is to develop an inexpensive, robust and convenient algorithm which in conjugation with suitable devices will be able to diagnose the presence of cataract from the true color images of an eye. An algorithm is proposed for cataract screening based on texture features: uniformity, intensity and standard deviation. These features are first computed and mapped with diagnostic opinion by the eye expert to define the basic threshold of screening system and later tested on real subjects in an eye clinic. Finally, a tele-ophthamology model using our proposed system has been suggested, which confirms the telemedicine application of the proposed system.

  13. Next-Generation Sequencing in Clinical Molecular Diagnostics of Cancer: Advantages and Challenges

    OpenAIRE

    Rajyalakshmi Luthra; Hui Chen; Sinchita Roy-Chowdhuri; R. Rajesh Singh

    2015-01-01

    The application of next-generation sequencing (NGS) to characterize cancer genomes has resulted in the discovery of numerous genetic markers. Consequently, the number of markers that warrant routine screening in molecular diagnostic laboratories, often from limited tumor material, has increased. This increased demand has been difficult to manage by traditional low- and/or medium-throughput sequencing platforms. Massively parallel sequencing capabilities of NGS provide a much-needed alternativ...

  14. [Genetic bases of diversity of the repertoire of immunoglobulins in application to diagnostics of clonality of B-cell lymphoid populations].

    Science.gov (United States)

    Zakharova, E S; Kazilo, N A; Stefanov, D N; Sinitsina, M N; Kovrigina, A M

    2011-06-01

    Molecular mechanisms underlying the formation of B-cell lymphomas in connection with processes associated with the maturation of B lymphocytes are reviewed. The currently used diagnostic methods do not always distinguish lymphomas from reactive changes of the lymphoid tissue. The principle of the molecular genetic method ofclonality detection in lymphocyte populations, technical problems, and the strategy of its application in clinical diagnostics of lymphomas are described in detail.

  15. Stenting:84 Cases of Clinical Application

    Institute of Scientific and Technical Information of China (English)

    GUANG Yongsong

    2002-01-01

    Objective To evaluate clinical application of therapeutic stenting. Methods 84 cases were managed with stents clinically, 136 procedures of intervention in all. The cases were suffering from portal hypertension of cirrhosis, stricture of inferior vana cava, superior vana cava syndrome, post- operative esophageal stricture, narrowig of femoral, common carotid, renal, superior mesentery arteries and biliary tract, etc. Results Therapeutic stenting achieves clinical effects completely different from conventional intemal medicine and surgery. Conclusion Therapeutic stenting is clinically unique, dramatically effective, with minor risks and worthy promoting.

  16. Next-generation sequencing-based genome diagnostics across clinical genetics centers : implementation choices and their effects

    NARCIS (Netherlands)

    Vrijenhoek, Terry; Kraaijeveld, Ken; Elferink, Martin; de Ligt, Joep; Kranendonk, Elcke; Santen, Gijs; Nijman, Isaac J.; Butler, Derek; Claes, Godelieve; Costessi, Adalberto; Dorlijn, Wim; van Eyndhoven, Winfried; Halley, Dicky J. J.; van den Hout, Mirjam C. G. N.; van Hove, Steven; Johansson, Lennart F.; Jongbloed, Jan D. H.; Kamps, Rick; Kockx, Christel E. M.; de Koning, Bart; Kriek, Marjolein; Deprez, Ronald Lekanne Dit; Lunstroo, Hans; Mannens, Marcel; Mook, Olaf R.; Nelen, Marcel; Ploem, Corrette; Rijnen, Marco; Saris, Jasper J.; Sinke, Richard; Sistermans, Erik; van Slegtenhorst, Marjon; Sleutels, Frank; van der Stoep, Nienke; van Tienhoven, Marianne; Vermaat, Martijn; Vogel, Maartje; Waisfisz, Quinten; Weiss, Janneke Marjan; van den Wijngaard, Arthur; van Workum, Wilbert; Ijntema, Helger; van der Zwaag, Bert; van IJcken, Wilfred F. J.; den Dunnen, Johan T.; Veltman, Joris A.; Hennekam, Raoul; Cuppen, Edwin

    2015-01-01

    Implementation of next-generation DNA sequencing (NGS) technology into routine diagnostic genome care requires strategic choices. Instead of theoretical discussions on the consequences of such choices, we compared NGS-based diagnostic practices in eight clinical genetic centers in the Netherlands, b

  17. Emerging clinical applications of computed tomography

    Science.gov (United States)

    Liguori, Carlo; Frauenfelder, Giulia; Massaroni, Carlo; Saccomandi, Paola; Giurazza, Francesco; Pitocco, Francesca; Marano, Riccardo; Schena, Emiliano

    2015-01-01

    X-ray computed tomography (CT) has recently been experiencing remarkable growth as a result of technological advances and new clinical applications. This paper reviews the essential physics of X-ray CT and its major components. Also reviewed are recent promising applications of CT, ie, CT-guided procedures, CT-based thermometry, photon-counting technology, hybrid PET-CT, use of ultrafast-high pitch scanners, and potential use of dual-energy CT for material differentiations. These promising solutions and a better knowledge of their potentialities should allow CT to be used in a safe and effective manner in several clinical applications. PMID:26089707

  18. Clinical applications of hepatocyte transplantation

    Institute of Scientific and Technical Information of China (English)

    Giada Pietrosi; Giovanni Battista Vizzini; Salvatore Gruttadauria; Bruno Gridelli

    2009-01-01

    The shortage of organ donors is a problem worldwide, with approximately 15% of adult patients with lifethreatening liver diseases dying while on the waiting list. The use of cell transplantation for liver disease is an attempt to correct metabolic defects, or to support liver function as a bridge to liver transplantation and, as such, has raised a number of expectations. Most of the available studies briefly reported here focus on adult hepatocyte transplantation (HT), and the results are neither reproducible nor comparable, because the means of infusion, amount of injected cells and clinical variability differ among the studies. To better understand the specific role of HT in the management of end-stage liver disease, it is important that controlled studies, designed on the principles of evidence-based medicine, be done in order to guarantee the reproducibility of results.

  19. Modular microfluidic cartridge-based universal diagnostic system for global health applications

    Science.gov (United States)

    Becker, Holger; Klemm, Richard; Dietze, William; White, Wallace; Hlawatsch, Nadine; Freyberg, Susanne; Moche, Christian; Dailey, Peter; Gärtner, Claudia

    2016-03-01

    Current microfluidics-enabled point-of-care diagnostic systems are typically designed specifically for one assay type, e.g. a molecular diagnostic assay for a single disease of a class of diseases. This approach often leads to high development cost and a significant training requirement for users of different instruments. We have developed an open platform diagnostic system which allows to run molecular, immunological and clinical assays on a single instrument platform with a standardized microfluidic cartridge architecture in an automated sample-in answer-out fashion. As examples, a molecular diagnostic assay for tuberculosis, an immunoassay for HIV p24 and a clinical chemistry assay for ALT liver function have been developed and results of their pre-clinical validation are presented.

  20. Advances and applications of molecular cloning in clinical microbiology.

    Science.gov (United States)

    Sharma, Kamal; Mishra, Ajay Kumar; Mehraj, Vikram; Duraisamy, Ganesh Selvaraj

    2014-10-01

    Molecular cloning is based on isolation of a DNA sequence of interest to obtain multiple copies of it in vitro. Application of this technique has become an increasingly important tool in clinical microbiology due to its simplicity, cost effectiveness, rapidity, and reliability. This review entails the recent advances in molecular cloning and its application in the clinical microbiology in the context of polymicrobial infections, recombinant antigens, recombinant vaccines, diagnostic probes, antimicrobial peptides, and recombinant cytokines. Culture-based methods in polymicrobial infection have many limitation, which has been overcome by cloning techniques and provide gold standard technique. Recombinant antigens produced by cloning technique are now being used for screening of HIV, HCV, HBV, CMV, Treponema pallidum, and other clinical infectious agents. Recombinant vaccines for hepatitis B, cholera, influenza A, and other diseases also use recombinant antigens which have replaced the use of live vaccines and thus reduce the risk for adverse effects. Gene probes developed by gene cloning have many applications including in early diagnosis of hereditary diseases, forensic investigations, and routine diagnosis. Industrial application of this technology produces new antibiotics in the form of antimicrobial peptides and recombinant cytokines that can be used as therapeutic agents. PMID:25023463

  1. Development of an instrument to measure the clinical learning environment in diagnostic radiology

    International Nuclear Information System (INIS)

    A clinical learning environment survey instrument was developed that provided insights into diagnostic radiology trainees' perceptions of the culture and context of the hospital-based training programme. The survey was completed by trainees allocated to 37 important training hospitals in Australia, New Zealand and Singapore in 2006. The main findings were that most obvious strengths of the diagnostic radiology programme are the wide variety of work-based learning opportunities and the social atmosphere. These were well regarded in all training sites. Work overload was seen as a significant problem in most hospitals and will probably remain a challenge. The areas that are most likely to repay efforts to bring about change are supervision and feedback. The study provides baseline data against which the influence of changes to the training programme may be evaluated.

  2. Infant Hip Joint Diagnostic Support System Based on Clinical Manifestations in X-ray Images

    Directory of Open Access Journals (Sweden)

    Honda,Mitsugi

    2010-06-01

    Full Text Available Plain X-ray radiography is frequently used for the diagnosis of developmental dislocation of the hip (DDH. The aim of this study was to construct a diagnostic support system for DDH based on clinical findings obtained from the X-ray images of 154 female infants with confirmed diagnoses made by orthopedists. The data for these subjects were divided into 2 groups. The Min-Max method of nonlinear analysis was applied to the data from Group 1 to construct the diagnostic support system based on the measurement of 4 items in X-ray images:the outward displacement rate, upward displacement rate, OE angle, and alpha angle. This system was then applied to the data from Group 2, and the results were compared between the 2 groups to verify the reliability of the system. We obtained good results that matched the confirmed diagnoses of orthopedists with an accuracy of 85.9%.

  3. Avian Paramyxovirus Serotype-1: A Review of Disease Distribution, Clinical Symptoms, and Laboratory Diagnostics

    Directory of Open Access Journals (Sweden)

    Nichole L. Hines

    2012-01-01

    Full Text Available Avian paramyxovirus serotype-1 (APMV-1 is capable of infecting a wide range of avian species leading to a broad range of clinical symptoms. Ease of transmission has allowed the virus to spread worldwide with varying degrees of virulence depending on the virus strain and host species. Classification systems have been designed to group isolates based on their genetic composition. The genetic composition of the fusion gene cleavage site plays an important role in virulence. Presence of multiple basic amino acids at the cleavage site allows enzymatic cleavage of the fusion protein enabling virulent viruses to spread systemically. Diagnostic tests, including virus isolation, real-time reverse-transcription PCR, and sequencing, are used to characterize the virus and identify virulent strains. Genetic diversity within APMV-1 demonstrates the need for continual monitoring for changes that may arise requiring modifications to the molecular assays to maintain their usefulness for diagnostic testing.

  4. Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: Diagnostic study

    NARCIS (Netherlands)

    R.G. Nijman (Ruud); Y. Vergouwe (Yvonne); M.J. Thompson (Matthew); M.V. Veen (Mirjam Van); A.H.J. van Meurs (Alfred); J. van der Lei (Johan); E.W. Steyerberg (Ewout); H.A. Moll (Henriëtte); R. Oostenbrink (Rianne)

    2013-01-01

    textabstractObjective: To derive, cross validate, and externally validate a clinical prediction model that assesses the risks of different serious bacterial infections in children with fever at the emergency department. Design: Prospective observational diagnostic study. Setting: Three paediatric em

  5. Optical and laser spectroscopic diagnostics for energy applications

    Science.gov (United States)

    Tripathi, Markandey Mani

    The continuing need for greater energy security and energy independence has motivated researchers to develop new energy technologies for better energy resource management and efficient energy usage. The focus of this dissertation is the development of optical (spectroscopic) sensing methodologies for various fuels, and energy applications. A fiber-optic NIR sensing methodology was developed for predicting water content in bio-oil. The feasibility of using the designed near infrared (NIR) system for estimating water content in bio-oil was tested by applying multivariate analysis to NIR spectral data. The calibration results demonstrated that the spectral information can successfully predict the bio-oil water content (from 16% to 36%). The effect of ultraviolet (UV) light on the chemical stability of bio-oil was studied by employing laser-induced fluorescence (LIF) spectroscopy. To simulate the UV light exposure, a laser in the UV region (325 nm) was employed for bio-oil excitation. The LIF, as a signature of chemical change, was recorded from bio-oil. From this study, it was concluded that phenols present in the bio-oil show chemical instability, when exposed to UV light. A laser-induced breakdown spectroscopy (LIBS)-based optical sensor was designed, developed, and tested for detection of four important trace impurities in rocket fuel (hydrogen). The sensor can simultaneously measure the concentrations of nitrogen, argon, oxygen, and helium in hydrogen from storage tanks and supply lines. The sensor had estimated lower detection limits of 80 ppm for nitrogen, 97 ppm for argon, 10 ppm for oxygen, and 25 ppm for helium. A chemiluminescence-based spectroscopic diagnostics were performed to measure equivalence ratios in methane-air premixed flames. A partial least-squares regression (PLS-R)-based multivariate sensing methodology was investigated. It was found that the equivalence ratios predicted with the PLS-R-based multivariate calibration model matched with the

  6. The frequency of peritoneal tuberculosis using diagnostic laparoscopy in clinically suspected cases

    International Nuclear Information System (INIS)

    Introduction: Diagnostic laparoscopy allows the visual examination and documentation of intra-abdominal organs in order to detect any pathology. It is an important tool for final minimally invasive exploration of patients with abdominal tuberculosis, the diagnosis of which remains uncertain despite employing the requisite laboratory and non-invasive imaging investigations. Objective: To determine the frequency of peritoneal tuberculosis using diagnostic laparoscopy in clinically suspected cases of peritoneal tuberculosis. Study Design: Cross sectional survey. Setting: The study was conducted in all the four Surgical Wards on surgical floor of Mayo Hospital Lahore. Duration of Study with Dates: Six months (1st July 2009 to 31st December 2009). Material and Methods: 35 Patients aged between 13-60 years with clinical suspicion of peritoneal tuberculosis were selected. The patients underwent the procedure accordingly. Per operative diagnosis of peritoneal tuberculosis made on the basis of presence of any or all of the operative (laparoscopic) findings such as multiple peritoneal adhesions, fibrous bands, whitish peritoneal tubercles, omental thickening and ascites. Diagnosis was confirmed with histopathology of peritoneal tissue biopsy. Also the biochemical analysis and culture sensitivity of ascetic fluid was routinely performed if any ascites is present. Results: Out of 35 patients, 40% were males and 60% females with mean age of 24.91+-6.69 years. The Laparoscopic findings of peritoneal tuberculosis were whitish peritoneal tubercles (57.2%) peritoneal adhesions (28.6%), ascites (17.2%), omental thickening (14.3%), fibrous bands (11.4%) and swollen edematous appendix (5.7%). Eighty percent were labeled with diagnosis of peritoneal tuberculosis on basis of diagnostic laparoscopy. These patients were confirmed to have peritoneal tuberculosis on histopathology of tissue biopsy. Conclusion: Diagnostic laparoscopy is useful in patients with suspected peritoneal

  7. Semiconductor Quantum Dots Surface Modification for Potential Cancer Diagnostic and Therapeutic Applications

    Directory of Open Access Journals (Sweden)

    Jidong Wang

    2012-01-01

    Full Text Available Semiconductor Quantum dots (QDs have generated extensive interest for biological and clinical applications. These applications arise from their unique properties, such as high brightness, long-term stability, simultaneous detection of multiple signals, tunable emission spectra. However, high-quality QDs, whether single or core-shell QDs, are most commonly synthesized in organic solution and surface-stabilized with hydrophobic organic ligands and thus lack intrinsic aqueous solubility. For biological applications, very often it is necessary to make the QDs dispersible in water and therefore to modify the QD surfaces with various bifunctional surface ligands or caps to promote solubility in aqueous media. Well-defined methods have been developed for QD surface modification to impart biocompatibility to these systems. In this review, we summarize the recent progress and strategies of QDs surface modification for potential cancer diagnostic and therapeutic applications. In addition, the question that arose from QD surface modification, such as impact of size increase of QD bioconjugates after surface-functionalization or surface modification on photophysical properties of QDs, are also discussed.

  8. Laser scatter in clinical applications

    Science.gov (United States)

    Luther, Ed; Geddie, William

    2008-02-01

    Brightfield Laser Scanning Imaging (BLSI) is available on Laser Scanning Cytometers (LSCs) from CompuCyte Corporation. Briefly, digitation of photodetector outputs is coordinated with the combined motions of a small diameter (typically 2 to 10 microns) laser beam scanning a specimen in the Y direction (directed by a galvanometer-driven scanning mirror) and the microscope stage motion in the X direction. The output measurements are assembled into a two-dimensional array to provide a "non-real" digital image, where each pixel value reports the amount of laser-scattered light that is obtained when the laser beam is centered on that location. Depending on the detector positions, these images are analogous to Differential Interference Contrast or Phase Contrast microscopy. We report the incorporation of the new laser scattering capabilities into the workflow of a high-volume clinical cytology laboratory at University Health Network, Toronto, Canada. The laboratory has been employing LSC technology since 2003 for immunophenotypic fluorescence analysis of approximately 1200 cytological specimens per year, using the Clatch methodology. The new BLSI component allows visualization of cellular morphology at higher resolution levels than is possible with standard brightfield microscopic evaluation of unstained cells. BLSI is incorporated into the triage phase, where evaluation of unstained samples is combined with fluorescence evaluation to obtain specimen background levels. Technical details of the imaging methodology will be presented, as well as illustrative examples from current studies and comparisons to detailed, but obscure, historical studies of cytology specimens based on phase contrast microscopy.

  9. Clinical applications of functional MRI in epilepsy

    International Nuclear Information System (INIS)

    The role of functional MRI (fMRI) in the presurgical evaluation of patients with intractable epilepsy is being increasingly recognized. Real-time fMRI is an easily performable diagnostic technique in the clinical setting. It has become a noninvasive alternative to intraoperative cortical stimulation and the Wada test for eloquent cortex mapping and language lateralization, respectively. Its role in predicting postsurgical memory outcome and in localizing the ictal activity is being recognized. This review article describes the biophysical basis of blood-oxygen-level-dependent (BOLD) fMRI and the methodology adopted, including the design, paradigms, the fMRI setup, and data analysis. Illustrative cases have been discussed, wherein the fMRI results influenced the seizure team's decisions with regard to diagnosis and therapy. Finally, the special issues involved in fMRI of epilepsy patients and the various challenges of clinical fMRI are detailed

  10. Diagnostic Work-up and Follow-up in Children with Tall Stature: A Simplified Algorithm for Clinical Practice

    OpenAIRE

    Stalman, Susanne E.; Pons, Anke; Wit, Jan M; Kamp, Gerdine A.; Plötz, Frans B.

    2015-01-01

    Objective: No evidence-based guideline has been published about optimal referral criteria and diagnostic work-up for tall stature in children. The aim of our study was to describe auxological and clinical characteristics of a cohort of children referred for tall stature, to identify potential candidates for adult height reduction, and to use these observations for developing a simple algorithm for diagnostic work-up and follow-up in clinical practice. Methods: Data regarding family and medica...

  11. Children with Generalised Joint Hypermobility and Musculoskeletal Complaints: State of the Art on Diagnostics, Clinical Characteristics, and Treatment

    OpenAIRE

    Scheper, M. C.; Engelbert, R. H. H.; E. A. A. Rameckers; J. Verbunt; Remvig, L.; Juul-Kristensen, B

    2013-01-01

    Introduction. To provide a state of the art on diagnostics, clinical characteristics, and treatment of paediatric generalised joint hypermobility (GJH) and joint hypermobility syndrome (JHS). Method. A narrative review was performed regarding diagnostics and clinical characteristics. Effectiveness of treatment was evaluated by systematic review. Searches of Medline and Central were performed and included nonsymptomatic and symptomatic forms of GJH (JHS, collagen diseases). Results. In the las...

  12. Motion tracking in infrared imaging for quantitative medical diagnostic applications

    Science.gov (United States)

    Cheng, Tze-Yuan; Herman, Cila

    2014-01-01

    In medical applications, infrared (IR) thermography is used to detect and examine the thermal signature of skin abnormalities by quantitatively analyzing skin temperature in steady state conditions or its evolution over time, captured in an image sequence. However, during the image acquisition period, the involuntary movements of the patient are unavoidable, and such movements will undermine the accuracy of temperature measurement for any particular location on the skin. In this study, a tracking approach using a template-based algorithm is proposed, to follow the involuntary motion of the subject in the IR image sequence. The motion tacking will allow to associate a temperature evolution to each spatial location on the body while the body moves relative to the image frame. The affine transformation model is adopted to estimate the motion parameters of the template image. The Lucas-Kanade algorithm is applied to search for the optimized parameters of the affine transformation. A weighting mask is incorporated into the algorithm to ensure its tracking robustness. To evaluate the feasibility of the tracking approach, two sets of IR image sequences with random in-plane motion were tested in our experiments. A steady-state (no heating or cooling) IR image sequence in which the skin temperature is in equilibrium with the environment was considered first. The thermal recovery IR image sequence, acquired when the skin is recovering from 60-s cooling, was the second case analyzed. By proper selection of the template image along with template update, satisfactory tracking results were obtained for both IR image sequences. The achieved tracking accuracies are promising in terms of satisfying the demands imposed by clinical applications of IR thermography.

  13. Volumetric capnography: lessons from the past and current clinical applications.

    Science.gov (United States)

    Verscheure, Sara; Massion, Paul B; Verschuren, Franck; Damas, Pierre; Magder, Sheldon

    2016-01-01

    Dead space is an important component of ventilation-perfusion abnormalities. Measurement of dead space has diagnostic, prognostic and therapeutic applications. In the intensive care unit (ICU) dead space measurement can be used to guide therapy for patients with acute respiratory distress syndrome (ARDS); in the emergency department it can guide thrombolytic therapy for pulmonary embolism; in peri-operative patients it can indicate the success of recruitment maneuvers. A newly available technique called volumetric capnography (Vcap) allows measurement of physiological and alveolar dead space on a regular basis at the bedside. We discuss the components of dead space, explain important differences between the Bohr and Enghoff approaches, discuss the clinical significance of arterial to end-tidal CO2 gradient and finally summarize potential clinical indications for Vcap measurements in the emergency room, operating room and ICU. PMID:27334879

  14. Alternative Lead Systems for Diagnostic Electrocardiography: Validation and Clinical Applicability

    OpenAIRE

    Welinder, Annika

    2009-01-01

    The standard 12-lead electrocardiogram (ECG) remains one of the most important and most frequently used tools for diagnosing cardiac diseases, although several different examination modalities in cardio¬logy have been developed over the years. The standard ECG uses 10 electrodes placed on well-defined positions on the body, 6 on the torso and 4 distally on the limbs. Both industry and academia have invested many years in development of the criteria used to interpret the “diagnostic” standard ...

  15. Application of statistical process control to qualitative molecular diagnostic assays.

    Directory of Open Access Journals (Sweden)

    Cathal P O'brien

    2014-11-01

    Full Text Available Modern pathology laboratories and in particular high throughput laboratories such as clinical chemistry have developed a reliable system for statistical process control. Such a system is absent from the majority of molecular laboratories and where present is confined to quantitative assays. As the inability to apply statistical process control to assay is an obvious disadvantage this study aimed to solve this problem by using a frequency estimate coupled with a confidence interval calculation to detect deviations from an expected mutation frequency. The results of this study demonstrate the strengths and weaknesses of this approach and highlight minimum sample number requirements. Notably, assays with low mutation frequencies and detection of small deviations from an expected value require greater samples with a resultant protracted time to detection. Modelled laboratory data was also used to highlight how this approach might be applied in a routine molecular laboratory. This article is the first to describe the application of statistical process control to qualitative laboratory data.

  16. Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region

    Directory of Open Access Journals (Sweden)

    Nurgul Ceran

    2011-02-01

    Full Text Available Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, sagittal sinus thrombosis in one case, spinal arachnoiditis in one case, intracranial vasculitis in one case, in addition to meningitis in all cases. Eleven patients were male and seven were female. The most prevalent symptoms were headache (83% and fever (44%. All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Duration of treatment (varied 3-12 months was determined on basis of the CSF response. In four patients presented with left mild sequelae including aphasia, hearing loss, hemiparesis. In conclusion, although mortality is rare in neurobrucellosis, its sequelae are significant. In neurobrucellosis various clinical and neuroradiologic signs and symptoms can be confused with other neurologic diseases. In inhabitants or visitors of endemic areas, neurobrucellosis should be kept in mind in cases that have unusual neurological manifestations.

  17. Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region.

    Science.gov (United States)

    Ceran, Nurgul; Turkoglu, Recai; Erdem, Ilknur; Inan, Asuman; Engin, Derya; Tireli, Hulya; Goktas, Pasa

    2011-01-01

    Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, sagittal sinus thrombosis in one case, spinal arachnoiditis in one case, intracranial vasculitis in one case, in addition to meningitis in all cases. Eleven patients were male and seven were female. The most prevalent symptoms were headache (83%) and fever (44%). All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Duration of treatment (varied 3-12 months) was determined on basis of the CSF response. In four patients presented with left mild sequelae including aphasia, hearing loss, hemiparesis. In conclusion, although mortality is rare in neurobrucellosis, its sequelae are significant. In neurobrucellosis various clinical and neuroradiologic signs and symptoms can be confused with other neurologic diseases. In inhabitants or visitors of endemic areas, neurobrucellosis should be kept in mind in cases that have unusual neurological manifestations.

  18. Detection of Artifacts and Its Effects in the Clinical Evaluation of Diagnostic and Therapy CT Images

    Directory of Open Access Journals (Sweden)

    Sadiq R Malik

    2014-01-01

    Full Text Available Importance of imaging in all clinical or medical research, and especially, of Computerized Axial Tomography (CAT scan, has demonstrated a unique place in diagnostic or radiation therapy. Two-dimensional images of internal structures of the body are examined and reported. This process of imaging, any anatomical location, viz. head and neck, thorax, pelvis, etc. takes about 30 seconds to perform with a minimal dose of less than 1.6- 2.0 mGy. The images are constructed by the hardware with software algorithm, using the attenuation and absorption of X rays of tissues, of varying electron densities of the anatomical structures. Sometimes a contrast dye is injected to a patient intravenously, rectally or orally, to make hollow or fluid-filled structures such as blood vessels more visible. Radiologists and radiation oncologists are confronted with a task to delineate the information of the CT images to a meaningful diagnosis. The images are, therefore, valuable for diagnostic reports, some of these may relate to cancerous tumors and tissues. Cancer treatment, radiation therapy or else, from such observations may start. But an artifact and distortion on such images will contribute to erroneous and/or unusable interpretations in offering a clinical report to provide wrong clinical decisions. The implications of the presence of distortion in CT images is, for a patient, described here so as to instruct the experts, in medical and clinical fields, to rectify the situation in acquiring a sharp and flawless image or in reaching the correct clinical goal.

  19. MEDICINAL VESICULATION THERAPY AND ITS CLINICAL APPLICATION

    Institute of Scientific and Technical Information of China (English)

    WANG Wei; LIU Haijing; SUN Zhanling

    2002-01-01

    In this paper, the authors introduce medicinal vesiculation therapy from its origin, points for attention in clinical application, and their individual experiences. In clinical application, the authors advocate: ① avoid using drugs that are over-irritating in the property, and strictly controlling the dose of drugs end the duration of application,②) in selection of drugs, some factors as patients' conditions, the season, the geographic location, etc. should be taken into account. In the present paper, 3 typical cases of bronchial asthma, tonsil swelling and facial paralysis treated with medicinal vesiculation therapy are introduced. Clinical practice demonsetrates that this therapy is economical,simple and convenient and fairly effective in treatment of some chronic diseases.

  20. Clinical applications of Genome Polymorphism Scans

    OpenAIRE

    Weber James L

    2006-01-01

    Abstract Applications of Genome Polymorphism Scans range from the relatively simple such as gender determination and confirmation of biological relationships, to the relatively complex such as determination of autozygosity and propagation of genetic information throughout pedigrees. Unlike nearly all other clinical DNA tests, the Scan is a universal test – it covers all people and all genes. In balance, I argue that the Genome Polymorphism Scan is the most powerful, affordable clinical DNA te...

  1. A Bacterial Analysis Platform: An Integrated System for Analysing Bacterial Whole Genome Sequencing Data for Clinical Diagnostics and Surveillance

    DEFF Research Database (Denmark)

    Thomsen, Martin Christen Frølund; Ahrenfeldt, Johanne; Bellod Cisneros, Jose Luis;

    2016-01-01

    and antimicrobial resistance genes. A short printable report for each sample will be provided and an Excel spreadsheet containing all the metadata and a summary of the results for all submitted samples can be downloaded. The pipeline was benchmarked using datasets previously used to test the...... web-based tools we developed a single pipeline for batch uploading of whole genome sequencing data from multiple bacterial isolates. The pipeline will automatically identify the bacterial species and, if applicable, assemble the genome, identify the multilocus sequence type, plasmids, virulence genes...... platform was developed and made publicly available, providing easy-to-use automated analysis of bacterial whole genome sequencing data. The platform may be of immediate relevance as a guide for investigators using whole genome sequencing for clinical diagnostics and surveillance. The platform is freely...

  2. Principles of dispensary observation of patients with Parkinson's disease in a specialized clinical diagnostic room

    Directory of Open Access Journals (Sweden)

    Krivonos О.V.

    2013-12-01

    Full Text Available Aim: to develop and implement of the order of the dispensary observation of Parkinson's disease patients. Material and methods, the dispensary observation of Parkinson's disease patients had been performed by neurologist and diagnostic room (CDR based on the outpatient department of health care institutions obeyed by FMBA of Russia in six Closed Administrative-Territorial Units: Seversk, Zarechniy, Ozersk, Lesnoy, Sarov and Zheleznogorsk. Neurologist examined of patients and put data to the Register's database. Register's database had 588 Parkinson's disease examined patients, 112 of them (19,1% had stage II of the disease by Hoehn and Yahr, 231 (39,3% patients — stage III by Hoehn and Yahr, 187 (31,8% patients — stage IV byHoehn and Yahr, 58 (9,9% patients — stage V by Hoehn and Yahr. The duration of the dispensary observation of Parkinson's disease patients was 4 years (2009-2012. Results. There are and implement the order of the observed and accounting of adult's group of Parkinson's disease patients were developed, who are registered in the clinical and diagnostic rooms, including the frequency of physician's visits, the list of diagnostic and treatment activities and efficiency endpoint of the dispensary observation. Conclusion. Implementation of the order of the dispensary observation according to the Register allowed to identify the main disabling PD's symptoms (depression, dementia, motor fluctuations and dyskinesia and timely correction of therapy.

  3. Computational modeling of time-resolved fluorescence transport in turbid media for non-invasive clinical diagnostics

    Science.gov (United States)

    Vishwanath, Karthik

    Fluorescence spectroscopy and imaging methods, including fluorescence lifetime sensing, are being developed for a variety of non-invasive clinical diagnostic procedures, including applications to early cancer diagnosis. Here, both the theoretical developments and experimental validations of a versatile, numerical Monte Carlo code that models photon migration in turbid media to include simulations of time-resolved fluorescence transport are presented. The developed numerical model was used to study, for the first time, the dependence of time-resolved fluorescence signals emanating from turbid media on the optical transport coefficients, fluorophore properties and source-detector configurations in single-layered turbid media as well as more complex multi-layered turbid media. The numerical codes presented here can be adapted to model a wide range of experimental techniques measuring the optical responses of biological tissues to laser irradiation and are demonstrated here for two specific applications (a) to model time-resolved fluorescence dynamics in human colon tissues and (b) to extract the frequency-dependent optical responses of a model adult human head to an incident laser-source whose intensity was harmonically modulated i.e. simulating frequency-domain measurements. Specifically, measurements of time-resolved fluorescence decays from a previous clinical study aimed toward detecting differences in tissue pathologies in patients undergoing gastro-intestinal endoscopy were simulated using the Monte Carlo model and results demonstrated that variations in tissue optical transport coefficients (absorption and scattering) alone could not account for the fluorescence decay differences detected between tissue pathologies in vivo. However, variations in fluorescence decay time as large as those detected clinically between normal and pre-malignant tissues (of 2 ns) could be accounted for by simulated variations in tissue morphology or biochemistry while intrinsic

  4. Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia

    Directory of Open Access Journals (Sweden)

    Nusbaumer Charly

    2007-03-01

    Full Text Available Abstract Background Community-acquired pneumonia (CAP is the most frequent infection-related cause of death. The reference standard to diagnose CAP is a new infiltrate on chest radiograph in the presence of recently acquired respiratory signs and symptoms. This study aims to evaluate the diagnostic and prognostic accuracy of clinical signs and symptoms and laboratory biomarkers for CAP. Methods 545 patients with suspected lower respiratory tract infection, admitted to the emergency department of a university hospital were included in a pre-planned post-hoc analysis of two controlled intervention trials. Baseline assessment included history, clinical examination, radiography and measurements of procalcitonin (PCT, highly sensitive C-reactive protein (hsCRP and leukocyte count. Results Of the 545 patients, 373 had CAP, 132 other respiratory tract infections, and 40 other final diagnoses. The AUC of a clinical model including standard clinical signs and symptoms (i.e. fever, cough, sputum production, abnormal chest auscultation and dyspnea to diagnose CAP was 0.79 [95% CI, 0.75–0.83]. This AUC was significantly improved by including PCT and hsCRP (0.92 [0.89–0.94]; p Conclusion PCT, and to a lesser degree hsCRP, improve the accuracy of currently recommended approaches for the diagnosis of CAP, thereby complementing clinical signs and symptoms. PCT is useful in the severity assessment of CAP.

  5. Uptake and Diagnostic Yield of Chromosomal Microarray in an Australian Child Development Clinic

    Directory of Open Access Journals (Sweden)

    Dylan Mordaunt

    2014-05-01

    Full Text Available Autism is an etiologically heterogeneous developmental disorder for which the range of genetic investigations has expanded considerably over the past decade. Introduction of chromosomal microarray (CMA to clinical practice has expanded the range of conditions which pediatricians are able to detect. This study reviewed the utilization, yield and cost of genetic investigations in a sample of children with pervasive developmental disorders (PDD in an Australian metropolitan child development service. Six hundred and ninety eight patients with PDD were identified from the clinic population. One hundred and ten (15.7% of the clinic population had undergone investigation with chromosomal microarray, 140 (20.0% with karyotype (KT, and 167 (23.9% with Fragile X testing (FRGX. Twelve (10.9% CMA findings were reported, of which seven (6.3% were felt to be the likely cause of the child’s clinical features. Five (3.5% KT findings were reported, of which four (2.9% were felt to be the likely cause of the child’s clinical features. Two patients (1.2% were identified with Fragile X expansions. One fifth of the clinic’s recent PDD population had undergone testing with CMA. CMA appears to have increased the diagnostic yield of the genetic investigation of autism, in line with internationally reported levels. Number needed to test (NNT and cost per incremental diagnosis, were also in line with internationally reported levels.

  6. Development and Application of Single-Ended Picosecond Laser Diagnostics

    OpenAIRE

    Kaldvee, Billy

    2012-01-01

    Light detection and ranging (lidar), a method for nonintrusive, single-ended, and range resolved measurements, has been developed and applied for combustion related diagnostics. Employing picosecond laser pulse durations and detectors providing temporal resolution on the order of picoseconds, lidar has been applied successfully for both quantitative temperature- and species concentration measurements, obtaining an ultimate range resolution of 0.46 cm. The use of a streak camera as detector...

  7. [Gastrointestinal causes of weight loss: clinical presentation, diagnostic workup and therapy].

    Science.gov (United States)

    Fromhold-Treu, Sophie; Lamprecht, Georg

    2016-02-01

    This review describes the gasterointestinal entities, their pathophysiology, clinical presentation, diagnostic workup and therapy that typically involve weight loss as the major presenting symptom. The differentiation of malassimilation into maldigestion and malabsorption is clinically mostly not helpful. Instead primary malasssimilation can be distinguished from secondary due to another disease. Celiac disease, lambliasis, small bowel CD, CVIDS and Whipple's disease result in loss of absorptive surface. Chronic intestinal pseudobstruction leads to weight loss through dysmotility and postprandial pain. Microscopic colitis involves some weight loss and needs to be considered because of its high prevalence. Exocrine pancreatic insufficiency and the various protein loosing enteropathies may be primary or secondary syndromes. Dumping, bile acid malabsorption and short bowel syndrome occur after typical operative procedures. Chronic radiation enteritis, chronic intestinal ischemia and intestinal diabetic polyneuropathy are due to chronic intestinal injury. PMID:26886038

  8. Effect of clinical specialist physiotherapists in orthopaedic diagnostic setting - A systematic review

    DEFF Research Database (Denmark)

    Trøstrup, Jeanette; Mikkelsen, Lone Ramer; Juhl, Carsten

    2016-01-01

    Trøstrup J1, Mikkelsen LR1, Juhl CB2 1 Center for Planlagt Kirurgi, Regionshospitalet Silkeborg 2 Forskningsenheden for Muskuloskeletal Funktion og Fysioterapi (FoF), Institut for idræt og biomekanik, Syddansk Universitet Aim: To evaluate the effectiveness of clinical assessment of patients...... with musculoskeletal complaint performed by Clinical Specialist Physiotherapists (CSP) compared to Orthopaedic Surgeons (OS) on diagnostic agreement, economic cost and patient satisfaction. Methods: A systematic review was performed by searching in MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL......), EMBASE, CINAHL, PEDro and reference lists of included studies and previously published systematic reviews. Studies evaluating 1) adults (18+) with a musculoskeletal complaint referred to orthopaedic outpatient assessment and 2) patient assessment performed by CSP were included. Studies conducted...

  9. Adult Attention Deficit Hyperactivity Disorder: Neurobiology, Diagnostic Problems and Clinical Features

    Directory of Open Access Journals (Sweden)

    Cengiz Tuglu

    2010-04-01

    Full Text Available Attention-deficit/hyperactivity disorder (ADHD is a chronic, lifelong neurobeha-vioral disorder with childhood-onset, which seriously impairs the affected adults in a variety of daily living functions like academic, social and occupational functioning. Prevalence of ADHD declines with age in the general population. The approximate prevalence rates of ADHD is 8% in childhood, 6% in adolescence and 4% in adulthood. The unclear validity of DSM-IV diagnostic criteria for this condition can lead to reduced prevalence rates by underestimation of the prevalence of adult ADHD. The disorder is characterized by behavioral symptoms of inattention, hyperactivity, and impulsivity across the life cycle and is associated with considerable morbidity and disability. Although its etiology remains unclear, considerable evidence documents its strong neurobiological and genetic underpinnings. ADHD is associated with a high percentage of comorbid psychiatric disorders in every lifespan. In adulthood between 65-89% of all patients with ADHD suffer from one or more additional psychiatric disorders, above all mood and anxiety disorders, substance use disorders and personality disorders, which complicate the clinical picture in terms of diagnostics, treatment and outcome issues. The high comorbidity with other psychiatric disorders, the resulting deficits in social competences and risky health behavior that often go along with a diminished life quality must be stressed in these patients. Preventive and therapeutic interventions should be taken at an early stage to counteract the possible negative influences of ADHD on functioning and relationships. In this paper, we reviewed the historical aspects, epidemiology, neurobiology, comorbidity, diagnostic difficulties and clinical features of adult ADHD.

  10. Update on oral Chagas disease outbreaks in Venezuela: epidemiological, clinical and diagnostic approaches

    Science.gov (United States)

    de Noya, Belkisyolé Alarcón; Díaz-Bello, Zoraida; Colmenares, Cecilia; Ruiz-Guevara, Raiza; Mauriello, Luciano; Muñoz-Calderón, Arturo; Noya, Oscar

    2015-01-01

    Orally transmitted Chagas disease has become a matter of concern due to outbreaks reported in four Latin American countries. Although several mechanisms for orally transmitted Chagas disease transmission have been proposed, food and beverages contaminated with whole infected triatomines or their faeces, which contain metacyclic trypomastigotes of Trypanosoma cruzi, seems to be the primary vehicle. In 2007, the first recognised outbreak of orally transmitted Chagas disease occurred in Venezuela and largest recorded outbreak at that time. Since then, 10 outbreaks (four in Caracas) with 249 cases (73.5% children) and 4% mortality have occurred. The absence of contact with the vector and of traditional cutaneous and Romana’s signs, together with a florid spectrum of clinical manifestations during the acute phase, confuse the diagnosis of orally transmitted Chagas disease with other infectious diseases. The simultaneous detection of IgG and IgM by ELISA and the search for parasites in all individuals at risk have been valuable diagnostic tools for detecting acute cases. Follow-up studies regarding the microepidemics primarily affecting children has resulted in 70% infection persistence six years after anti-parasitic treatment. Panstrongylus geniculatus has been the incriminating vector in most cases. As a food-borne disease, this entity requires epidemiological, clinical, diagnostic and therapeutic approaches that differ from those approaches used for traditional direct or cutaneous vector transmission. PMID:25946155

  11. Risks to the fetus from diagnostic imaging during pregnancy: review and proposal of a clinical protocol

    Energy Technology Data Exchange (ETDEWEB)

    Gomes, Mafalda; Matias, Alexandra [University of Porto, Faculty of Medicine, Porto (Portugal); Macedo, Filipe [SMIC, Porto (Portugal)

    2015-12-15

    Every day, medical practitioners face the dilemma of exposing pregnant or possibly pregnant patients to radiation from diagnostic examinations. Both doctors and patients often have questions about the risks of radiation. The most vulnerable period is between the 8th and 15th weeks of gestation. Deterministic effects like pregnancy loss, congenital malformations, growth retardation and neurobehavioral abnormalities have threshold doses above 100-200 mGy. The risk is considered negligible at 50 mGy and in reality no diagnostic examination exceeds this limit. The risk of carcinogenesis is slightly higher than in the general population. Intravenous iodinated contrast is discouraged, except in highly selected patients. Considering all the possible noxious effects of radiation exposure, measures to diminish radiation are essential and affect the fetal outcome. Nonionizing procedures should be considered whenever possible and every radiology center should have its own data analysis on fetal radiation exposure. In this review, we analyze existing literature on fetal risks due to radiation exposure, producing a clinical protocol to guide safe radiation use in a clinical setting. (orig.)

  12. Clinical application of hepatic CT perfusion

    Institute of Scientific and Technical Information of China (English)

    Liang Zhong; Wen-Jing Wang; Jian-Rong Xu

    2009-01-01

    Complicated changes occur in hemodynamics of hepatic artery and vein, and portal vein under various kinds of pathologic status because of distinct double hepatic blood supply. This article reviews the clinical application of hepatic computed tomography perfusion in some liver diseases.

  13. Clinical Factors and Disease Course Related to Diagnostic Delay in Korean Crohn's Disease Patients: Results from the CONNECT Study.

    Directory of Open Access Journals (Sweden)

    Chang Mo Moon

    Full Text Available Diagnostic delay frequently occurs in Crohn's disease (CD patients because of diagnostic limitations. However, diagnostic delay and its related factors remain poorly defined. Therefore, we aimed to identify the predictors associated with diagnostic delay and to evaluate the impact of diagnostic delay on clinical course in a Korean CD patient cohort. We performed a multicenter retrospective analysis of 1,047 CD patients registered in the Crohn's Disease Clinical Network and Cohort study in Korea. The mean interval of diagnostic delay was 16.0 ± 33.1 months. Multivariate analysis showed that older age at diagnosis (≥40 years (p = 0.014, concomitant upper gastrointestinal (UGI disease (p = 0.012 and penetrating disease behavior at diagnosis (p = 0.001 were positively associated with long diagnostic delay (≥18 months. During the longitudinal follow-up, long diagnostic delay was independently predictive of further development of intestinal stenosis (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.07-1.93; p = 0.017, internal fistulas (HR, 1.62; 95% CI, 1.12-2.33; p = 0.011, and perianal fistulas (HR, 1.38; 95% CI, 1.06-1.80; p = 0.016. However, as for the risk of abscess formation, bowel perforation, and CD-related abdominal surgery, no significant association with diagnostic delay was observed. Older age at diagnosis, UGI involvement, and penetrating behavior are associated with long diagnostic delay in Korean CD patients. Moreover, diagnostic delay is associated with an increased risk of CD-related complications such as intestinal stenosis, internal fistulas, and perianal fistulas.

  14. Assessment Procedures for Narcissistic Personality Disorder: A Comparison of the Personality Diagnostic Questionnaire-4 and Best-Estimate Clinical Judgments

    Science.gov (United States)

    Miller, Joshua D.; Campbell, W. Keith; Pilkonis, Paul A.; Morse, Jennifer Q.

    2008-01-01

    This study examined the degree of correspondence between two assessments for narcissistic personality disorder (NPD) in a mixed clinical and community sample--one using a self-report measure (Personality Diagnostic Questionnaire-4) and the other using clinical judgments derived from an assessment based on the longitudinal, expert, all data (LEAD)…

  15. Magnetic resonance urography. Part 2 - clinical applications

    International Nuclear Information System (INIS)

    MR urography is a new, modern modality for evaluation of various urological abnormalities. MR urography provides both morphological and functional information. The method is clinically useful in the evaluation of the collecting system, variants and congenital abnormalities of the kidney, tumors and inflammatory diseases, hematuria. Correlation is made with MDCT urography. MR urography is particularly beneficial in pediatrics and pregnant patients. It can be useful in patients with renal insufficiency, and if contra indications to conventional radiological examination are considered. The role of MRU in patients for the preoperative assessment and the follow-up after renal transplantation is emerging. Nephrogenic system fibrosis have been discussed as potential risk to gadolinium contrast enhanced MR urography. MR urography is promising diagnostic method in a wide spectrum of pathological conditions affecting the urinary tract. It is highly informative and overcomes a lot of limitations of the other imaging modalities

  16. Application of modern diagnostic methods to environmental improvement. Annual progress report, October 1994--September 1995

    Energy Technology Data Exchange (ETDEWEB)

    Shepard, W.S.

    1995-12-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL), an interdisciplinary research department in the College of Engineering at Mississippi State University (MSU), is under contract with the US Department of Energy (DOE) to develop and apply advanced diagnostic instrumentation and analysis techniques to aid in solving DOE`s nuclear waste problem. The program is a comprehensive effort which includes five focus areas: advanced diagnostic systems; development/application; torch operation and test facilities; process development; on-site field measurement and analysis; technology transfer/commercialization. As part of this program, diagnostic methods will be developed and evaluated for characterization, monitoring and process control. Also, the measured parameters, will be employed to improve, optimize and control the operation of the plasma torch and the overall plasma treatment process. Moreover, on-site field measurements at various DOE facilities are carried out to aid in the rapid demonstration and implementation of modern fieldable diagnostic methods. Such efforts also provide a basis for technology transfer.

  17. Application of modern diagnostic methods to environmental improvement. Annual progress report, October 1994--September 1995

    International Nuclear Information System (INIS)

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL), an interdisciplinary research department in the College of Engineering at Mississippi State University (MSU), is under contract with the US Department of Energy (DOE) to develop and apply advanced diagnostic instrumentation and analysis techniques to aid in solving DOE's nuclear waste problem. The program is a comprehensive effort which includes five focus areas: advanced diagnostic systems; development/application; torch operation and test facilities; process development; on-site field measurement and analysis; technology transfer/commercialization. As part of this program, diagnostic methods will be developed and evaluated for characterization, monitoring and process control. Also, the measured parameters, will be employed to improve, optimize and control the operation of the plasma torch and the overall plasma treatment process. Moreover, on-site field measurements at various DOE facilities are carried out to aid in the rapid demonstration and implementation of modern fieldable diagnostic methods. Such efforts also provide a basis for technology transfer

  18. Quality management in clinical application of mass spectrometry measurement systems.

    Science.gov (United States)

    Vogeser, Michael; Seger, Christoph

    2016-09-01

    Thanks to highly specific analyte detection and potentially complete compensation for matrix variables based on the principle of stable isotope derivative internal standardisation, mass spectrometry methods allow the development of diagnostic tests of outstanding analytical quality. However, these features per se do not guarantee reliability of tests. A wide range of factors can introduce analytical errors and inaccuracy due to the extreme complexity of the methods involved. Furthermore, it can be expected that the application patterns of MS methods in diagnostic laboratories will change substantially during the coming years - with presumably less specialised laboratories implementing mass spectrometry. Introduction of highly automated test solutions by manufacturers will require some trade-off between operation convenience, sample throughput and analytical performance. Structured and careful quality and risk management is therefore crucial to translate the analytical power of mass spectrometry into actionable and reliable results for individual patients' care and to maintain the degree of reliability that is expected from MS methods in clinical pathology. This reflection review discusses whether particular quality assurance tools have to be applied for MS-based diagnostic tests and whether these tools are different from those applied for optical- and affinity-based standard tests. Both pre-implementation strategies and surveillance of assays with assessment of metadata in routine testing are addressed. The release of the CLSI guideline C62-A in 2014 was a substantial achievement in this context because it addresses a wide spectrum of relevant issues in quality assurance of mass spectrometry-based clinical tests. However, the translation of this best practice document into individual laboratory settings is likely to be heterogeneous.

  19. Clinical applications of 7 T MRI in the brain

    Energy Technology Data Exchange (ETDEWEB)

    Kolk, Anja G. van der, E-mail: A.G.vanderKolk@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Hendrikse, Jeroen, E-mail: J.Hendrikse@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Zwanenburg, Jaco J.M., E-mail: J.J.M.Zwanenburg@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Image Sciences Institute, University Medical Center Utrecht (Netherlands); Visser, Fredy, E-mail: F.Visser-2@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Philips Healthcare, Best (Netherlands); Luijten, Peter R., E-mail: P.Luijten@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands)

    2013-05-15

    This review illustrates current applications and possible future directions of 7 Tesla (7 T) Magnetic Resonance Imaging (MRI) in the field of brain MRI, in clinical studies as well as clinical practice. With its higher signal-to-noise (SNR) and contrast-to-noise ratio (CNR) compared to lower field strengths, high resolution, contrast-rich images can be obtained of diverse pathologies, like multiple sclerosis (MS), brain tumours, aging-related changes and cerebrovascular diseases. In some of these diseases, additional pathophysiological information can be gained compared to lower field strengths. Because of clear depiction of small anatomical details, and higher lesion conspicuousness, earlier diagnosis and start of treatment of brain diseases may become possible. Furthermore, additional insight into the pathogenesis of brain diseases obtained with 7 T MRI could be the basis for new treatment developments. However, imaging at high field comes with several limitations, like inhomogeneous transmit fields, a higher specific absorption rate (SAR) and, currently, extensive contraindications for patient scanning. Future studies will be aimed at assessing the advantages and disadvantages of 7 T MRI over lower field strengths in light of clinical applications, specifically the additional diagnostic and prognostic value of 7 T MRI.

  20. Clinical diagnostic approach to severe acute respiratory syndrome: an institution's experience

    Institute of Scientific and Technical Information of China (English)

    孙永昌; 姚婉贞; 王筱宏; 贺蓓; 赵鸣武; 孙伯章; 山耘; 郑亚安; 张福春; 孙威

    2003-01-01

    Objective To analyze diagnostic approach to severe acute respiratory syndrome (SARS) according to the diagnostic criteria issued by the Ministry of Health of China (MHC). Methods The clinical data and the diagnostic results of 108 cases of SARS were retrospectively reviewed according to the MHC criteria. Results There were 55 men and 53 women, with a median age of 34.5 years (range, 12-78 years). The interval between their first visit and clinical diagnosis was 3 days (range, 0-14 days). The diagnosis was made at the first visit in 7 (6.5%, 7/108) cases with a history of exposure to SARS patients and infiltrates on chest radiograph. Eighty-nine (82.4%) and 12 (11.1%) patients were categorized as probable cases and suspected cases respectively at their first visit and a clinical diagnosis of SARS was made subsequently. The interval between first visit and reaching the final diagnosis was 1-3 days in 72 (66.7%) cases and 4 days in 29 (26.9%) cases. The final diagnosis was made in 0-14 days (median, 2 days) for those (n=59, 54.6%) with a history of close contact with SARS patients and 2-8 days (median, 3 days) for those (n=49, 45.4%) living in Beijing but without such a history (P=0.03). The chest radiograph was interpreted as unremarkable in 26 (24.1%) cases at their first visit, and the diagnosis was made in 4 days (range 2-8 days), which was significantly longer compared with other cases (P<0.001). In patients without a history of close contact with SARS patients, all the five criteria were met after combination antibiotic therapy had failed. Conclusions A chest radiograph without infiltrates at the early stage of SARS is an important factor responsible for delayed diagnosis. In patients without a history of close contact with SARS cases, antibiotic effect was a major factor influencing doctors' diagnosis.

  1. Clinical applications of Genome Polymorphism Scans

    Directory of Open Access Journals (Sweden)

    Weber James L

    2006-06-01

    Full Text Available Abstract Applications of Genome Polymorphism Scans range from the relatively simple such as gender determination and confirmation of biological relationships, to the relatively complex such as determination of autozygosity and propagation of genetic information throughout pedigrees. Unlike nearly all other clinical DNA tests, the Scan is a universal test – it covers all people and all genes. In balance, I argue that the Genome Polymorphism Scan is the most powerful, affordable clinical DNA test available today. Reviewers: This article was reviewed by Scott Weiss (nominated by Neil Smalheiser, Roberta Pagon (nominated by Jerzy Jurka and Val Sheffield (nominated by Neil Smalheiser.

  2. 77 FR 72409 - Manufacturer of Controlled Substances; Notice of Application: Siemens Healthcare Diagnostics, Inc.

    Science.gov (United States)

    2012-12-05

    ... Enforcement Administration Manufacturer of Controlled Substances; Notice of Application: Siemens Healthcare... notice that on November 7, 2012, Siemens Healthcare Diagnostics, Inc., Attn: RA, 100 GBC Drive, Mail Stop 514, Newark, Delaware 19702, made application by renewal to the Drug Enforcement Administration...

  3. Redefined clinical features and diagnostic criteria in autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy

    Science.gov (United States)

    Ferre, Elise M.N.; Rose, Stacey R.; Rosenzweig, Sergio D.; Burbelo, Peter D.; Romito, Kimberly R.; Niemela, Julie E.; Rosen, Lindsey B.; Break, Timothy J.; Gu, Wenjuan; Hunsberger, Sally; Browne, Sarah K.; Hsu, Amy P.; Rampertaap, Shakuntala; Swamydas, Muthulekha; Collar, Amanda L.; Kong, Heidi H.; Chascsa, David; Simcox, Thomas; Pham, Angela; Bondici, Anamaria; Natarajan, Mukil; Monsale, Joseph; Kleiner, David E.; Quezado, Martha; Alevizos, Ilias; Moutsopoulos, Niki M.; Yockey, Lynne; Frein, Cathleen; Soldatos, Ariane; Calvo, Katherine R.; Adjemian, Jennifer; Similuk, Morgan N.; Lang, David M.; Stone, Kelly D.; Uzel, Gulbu; Bishop, Rachel J.; Holland, Steven M.; Olivier, Kenneth N.; Fleisher, Thomas A.; Heller, Theo; Winer, Karen K.

    2016-01-01

    Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare primary immunodeficiency disorder typically caused by homozygous AIRE mutations. It classically presents with chronic mucocutaneous candidiasis and autoimmunity that primarily targets endocrine tissues; hypoparathyroidism and adrenal insufficiency are most common. Developing any two of these classic triad manifestations establishes the diagnosis. Although widely recognized in Europe, where nonendocrine autoimmune manifestations are uncommon, APECED is less defined in patients from the Western Hemisphere. We enrolled 35 consecutive American APECED patients (33 from the US) in a prospective observational natural history study and systematically examined their genetic, clinical, autoantibody, and immunological characteristics. Most patients were compound heterozygous; the most common AIRE mutation was c.967_979del13. All but one patient had anti–IFN-ω autoantibodies, including 4 of 5 patients without biallelic AIRE mutations. Urticarial eruption, hepatitis, gastritis, intestinal dysfunction, pneumonitis, and Sjögren’s-like syndrome, uncommon entities in European APECED cohorts, affected 40%–80% of American cases. Development of a classic diagnostic dyad was delayed at mean 7.38 years. Eighty percent of patients developed a median of 3 non-triad manifestations before a diagnostic dyad. Only 20% of patients had their first two manifestations among the classic triad. Urticarial eruption, intestinal dysfunction, and enamel hypoplasia were prominent among early manifestations. Patients exhibited expanded peripheral CD4+ T cells and CD21loCD38lo B lymphocytes. In summary, American APECED patients develop a diverse syndrome, with dramatic enrichment in organ-specific nonendocrine manifestations starting early in life, compared with European patients. Incorporation of these new manifestations into American diagnostic criteria would accelerate diagnosis by approximately 4 years and

  4. Optical diagnostics based on elastic scattering: Recent clinical demonstrations with the Los Alamos Optical Biopsy System

    Energy Technology Data Exchange (ETDEWEB)

    Bigio, I.J.; Loree, T.R.; Mourant, J.; Shimada, T. [Los Alamos National Lab., NM (United States); Story-Held, K.; Glickman, R.D. [Texas Univ. Health Science Center, San Antonio, TX (United States). Dept. of Ophthalmology; Conn, R. [Lovelace Medical Center, Albuquerque, NM (United States). Dept. of Urology

    1993-08-01

    A non-invasive diagnostic tool that could identify malignancy in situ and in real time would have a major impact on the detection and treatment of cancer. We have developed and are testing early prototypes of an optical biopsy system (OBS) for detection of cancer and other tissue pathologies. The OBS invokes a unique approach to optical diagnosis of tissue pathologies based on the elastic scattering properties, over a wide range of wavelengths, of the microscopic structure of the tissue. The use of elastic scattering as the key to optical tissue diagnostics in the OBS is based on the fact that many tissue pathologies, including a majority of cancer forms, manifest significant architectural changes at the cellular and sub-cellular level. Since the cellular components that cause elastic scattering have dimensions typically on the order of visible to near-IR wavelengths, the elastic (Mie) scattering properties will be strongly wavelength dependent. Thus, morphology and size changes can be expected to cause significant changes in an optical signature that is derived from the wavelength dependence of elastic scattering. The data acquisition and storage/display time with the OBS instrument is {approximately}1 second. Thus, in addition to the reduced invasiveness of this technique compared with current state-of-the-art methods (surgical biopsy and pathology analysis), the OBS offers the possibility of impressively faster diagnostic assessment. The OBS employs a small fiber-optic probe that is amenable to use with any endoscope, catheter or hypodermic, or to direct surface examination (e.g. as in skin cancer or cervical cancer). It has been tested in vitro on animal and human tissue samples, and clinical testing in vivo is currently in progress.

  5. The application of microRNAs in cancer diagnostics

    DEFF Research Database (Denmark)

    Sørensen, Karina Dalsgaard; Ostenfeld, Marie Stampe; Kristensen, Helle;

    2012-01-01

    identified exosome-associated tumor-derived miRNAs in, e.g., blood samples from cancer patients, suggesting that miRNAs may be useful as circulation biomarkers for noninvasive diagnostic testing. In this chapter, we review the current state of development of miRNAs as cancer biomarkers with examples from......MicroRNAs (miRNAs) play important biological roles in cancer development and progression. During the past decade, widespread use of novel high-throughput technologies for miRNA profiling (e.g., microarrays and next-generation sequencing) has revealed deregulation of miRNA expression as a common...... hallmark of human cancer. Furthermore, miRNAs have been found to be a new class of promising cancer biomarkers with potential to improve the accuracy of diagnosis and prognosis in several hematologic and solid malignancies, as well as to predict response to specific treatments. Recent studies have...

  6. Clinical impact and cost-effectiveness of whole exome sequencing as a diagnostic tool: a pediatric center’s experience

    Directory of Open Access Journals (Sweden)

    C. Alexander Valencia

    2015-08-01

    Full Text Available Background: There are limited reports of the use of whole exome sequencing as a clinical diagnostic tool. Moreover, there are no reports addressing the cost burden associated with genetic tests performed prior to WES.Objective: We demonstrate the performance characteristics of WES in a pediatric setting by describing our patient cohort, calculating the diagnostic yield, and detailing the patients for whom clinical management was altered. Moreover, we examined the potential cost-effectiveness of WES by examining the cost burden of diagnostic workups.Methods: To determine the clinical utility of our hospital’s clinical WES, we performed a retrospective review of the first 40 cases. We utilized dual bioinformatics analyses pipelines based on commercially available software and in-house tools. Results: Of the first 40 clinical cases, we identified genetic defects in twelve (30% patients, of which, 47% of the mutations were previously unreported in the literature. Among the 12 patients with positive findings, 7 have autosomal dominant disease and 5 have autosomal recessive disease. Ninety percent of the cohort opted to receive secondary findings, and of those, secondary medical actionable results were returned in three cases. Among these positive cases there are a number of novel mutations that are being reported here. The diagnostic workup included a significant number of genetic tests with microarray and single gene sequencing being the most popular tests. Significantly, genetic diagnosis from WES led to altered patient medical management in positive cases. Conclusions: We demonstrate the clinical utility of WES by establishing the clinical diagnostic rate and its impact on medical management in a large pediatric center. The cost-effectiveness of WES was demonstrated by ending the diagnostic odyssey in positive cases. Also, in some cases it may be most cost-effective to directly perform WES. WES provides a unique glimpse into the complexity of

  7. Clinical evaluation of a wireless ECG sensor system for arrhythmia diagnostic purposes.

    Science.gov (United States)

    Fensli, Rune; Gundersen, Torstein; Snaprud, Tormod; Hejlesen, Ole

    2013-06-01

    In a clinical study, a novel wireless electrocardiogram (ECG) recorder has been evaluated with regard to its ability to perform arrhythmia diagnostics. As the ECG recorder will detect a "non-standard" ECG signal, it has been necessary to compare those signals to "standard" ECG recording signals in order to evaluate the arrhythmia detection ability of the new system. Simultaneous recording of ECG signals from both the new wireless ECG recorder and a conventional Holter recorder was compared by two independent cardiology specialists with regard to signal quality for performing arrhythmia diagnosis. In addition, calculated R-R intervals from the two systems were correlated. A total number of 16 patients participated in the study. It can be considered that recorded ECG signals obtained from the wireless ECG system had an acceptable quality for arrhythmia diagnosis. Some of the patients used the wireless sensor while doing physical sport activities, and the quality of the recorded ECG signals made it possible to perform arrhythmia diagnostics even under such conditions. Consequently, this makes possible improvements in correlating arrhythmias to physical activities.

  8. Diagnostic Value of the First and Second Generation of Thyrotropin Receptor Antibodies in Clinical Practice

    Directory of Open Access Journals (Sweden)

    V Fadeyev

    2006-06-01

    Full Text Available Introduction: The pathogenesis of Graves’ disease consists in production of stimulating antibodies against thyrotropin receptors (rTHS-AB. In the last decades two different assays for detection of rTHS-AB were introduced in clinical practice: I-st (with animal antigen and Il-nd generation (with human antigen assays. Design: 44 patient with hyperthyroidism (age 52.0 [34.0; 64.0] years; 42 women were enrolled in the study. 29 of them have hyperthyroidism due to Graves’ disease (GD, 15 due to multinodular toxic goiter (functional autonomy of the thyroid; FA. rTHS-AB in all the patients were detected by two methods: I-st (Medipan Diagnostica and II-nd generation (BRAHMS. Results: The sensitivity, specificity and likelihood ratio in the diagnostics of GD of the II-nd generation assay were higher than for the I-st generation assay for detection of rTHS-AB (93.1%, 94% and 15.5 vs. 75.9%, 80% and 3.8. Conclusion: II-nd generation assay (with human antigen has superior value for the diagnostics of Graves’ disease.

  9. Neonatal hemochromatosis and patent ductus venosus: clinical course and diagnostic pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, Andy; Paltiel, Harriet J.; Sena, Laureen M. [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States); Kim, Heung Bae; Fishman, Steven J. [Children' s Hospital Boston and Harvard Medical School, Department of Surgery, Boston, MA (United States); Alomari, Ahmad I. [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States); Children' s Hospital Boston, Division of Vascular and Interventional Radiology, Boston, MA (United States)

    2009-08-15

    Neonatal hemochromatosis is a rare metabolic disorder characterized by excessive iron deposition within the liver leading to hepatic failure and portal hypertension. We describe the clinical course and imaging findings in three infants with neonatal hemochromatosis associated with patent ductus venosus. We paid special attention to the diagnostic challenges encountered in these patients in order to emphasize some of the potential diagnostic pitfalls. We conducted a comprehensive search of our radiology database of the last 10 years (1999-2008) for the keywords ''neonatal hemochromatosis.'' Medical records and imaging studies of various modalities were reviewed. Three neonates were found to have neonatal hemochromatosis; all of them were associated with patent ductus venosus. Two of these patients were referred to our tertiary center for embolization of an inaccurately diagnosed hepatic vascular malformation. Two patients underwent successful liver transplantation and one died shortly after referral. The awareness and inclusion of neonatal hemochromatosis in the differential diagnosis of newborns with liver failure and patent ductus venosus has critical treatment implications. (orig.)

  10. Evaluating autism in a Chinese population:the Clinical Autism Diagnostic Scale

    Institute of Scientific and Technical Information of China (English)

    Grace Hao; Thomas L Layton; Xiao-Bing Zou; Dong-Yun Li

    2014-01-01

    Background: The purpose of this study was to report on the psychometric measures and discriminatory function of a new diagnostic test for autism spectrum disorders, the Clinical Autism Diagnostic Scale (CADS). Methods: The CADS was used to test 216 children in the study, including 86 with low-functioning autism specturm disorders (ASD), 16 children with highfunctioning ASD, 16 with pervasive developmental disorder, not otherwise specified, 7 with Asperger syndrome, 65 with typical development, 11 children with language impairments and 15 with intellectual disabilities. Ages ranged from 38-73 months. Behaviors for the groups were compared across seven domains. Results: The results indicated the instrument was reliable, valid, and successfully differentiated the different groups of children with and without autism. All ASD groups were found to display difficulties in the domains of sensory behaviors and stereotyped behaviors. The play and social domains were found to measure similar underlying concepts of behaviors, while the receptive language and expressive language domains were also found to measure similar underlying-language concepts. The group of children diagnosed as having low-functioning autism performed less well on all tested domains in the instrument than did the other three groups of children with ASD, and these other three groups each also presented unique patterns of behaviors and differed on individual domains. Conclusions: CADS is a reliable and valid test. It successfully differentiates the abilities of children with ASD at different levels of functioning.

  11. Clinicians' emotional responses and Psychodynamic Diagnostic Manual adult personality disorders: A clinically relevant empirical investigation.

    Science.gov (United States)

    Gazzillo, Francesco; Lingiardi, Vittorio; Del Corno, Franco; Genova, Federica; Bornstein, Robert F; Gordon, Robert M; McWilliams, Nancy

    2015-06-01

    The aim of this study is to explore the relationship between level of personality organization and type of personality disorder as assessed with the categories in the Psychodynamic Diagnostic Manual (PDM; PDM Task Force, 2006) and the emotional responses of treating clinicians. We asked 148 Italian clinicians to assess 1 of their adult patients in treatment for personality disorders with the Psychodiagnostic Chart (PDC; Gordon & Bornstein, 2012) and the Personality Diagnostic Prototype (PDP; Gazzillo, Lingiardi, & Del Corno, 2012) and to complete the Therapist Response Questionnaire (TRQ; Betan, Heim, Zittel-Conklin, & Westen, 2005). The patients' level of overall personality pathology was positively associated with helpless and overwhelmed responses in clinicians and negatively associated with positive emotional responses. A parental and disengaged response was associated with the depressive, anxious, and dependent personality disorders; an exclusively parental response with the phobic personality disorder; and a parental and criticized response with narcissistic disorder. Dissociative disorder evoked a helpless and parental response in the treating clinicians whereas somatizing disorder elicited a disengaged reaction. An overwhelmed and disengaged response was associated with sadistic and masochistic personality disorders, with the latter also associated with a parental and hostile/criticized reaction; an exclusively overwhelmed response with psychopathic patients; and a helpless response with paranoid patients. Finally, patients with histrionic personality disorder evoked an overwhelmed and sexualized response in their clinicians whereas there was no specific emotional reaction associated with the schizoid and the obsessive-compulsive disorders. Clinical implications of these findings were discussed.

  12. Radiolabelled blood elements techniques and clinical applications

    International Nuclear Information System (INIS)

    Over the past few years, in nuclear medicine, the diagnostic applications of radiolabelled blood elements in general, and of radiolabelled white blood cells in particular, have become increasingly popular. This is primarily due to the introduction of lipid soluble 111In-oxine as an agent, which not only is an excellent and a reliable tracer for blood cells but also enables the investigators to study the in vivo cell kinetics and map the localization of labelled cells by external gamma scintigraphy. The tracer has the modest half life of 67 hours and decays with the emission of two gamma photons (173 and 247 keV) in high abundance. This technique has provided a powerful tool to study the in vivo cell kinetics in health and localize abnormal lesions in diseases which invoke intense focal cellular concentration

  13. Diagnostic accuracy of the vegetative and minimally conscious state: Clinical consensus versus standardized neurobehavioral assessment

    Directory of Open Access Journals (Sweden)

    Majerus Steve

    2009-07-01

    Full Text Available Abstract Background Previously published studies have reported that up to 43% of patients with disorders of consciousness are erroneously assigned a diagnosis of vegetative state (VS. However, no recent studies have investigated the accuracy of this grave clinical diagnosis. In this study, we compared consensus-based diagnoses of VS and MCS to those based on a well-established standardized neurobehavioral rating scale, the JFK Coma Recovery Scale-Revised (CRS-R. Methods We prospectively followed 103 patients (55 ± 19 years with mixed etiologies and compared the clinical consensus diagnosis provided by the physician on the basis of the medical staff's daily observations to diagnoses derived from CRS-R assessments performed by research staff. All patients were assigned a diagnosis of 'VS', 'MCS' or 'uncertain diagnosis.' Results Of the 44 patients diagnosed with VS based on the clinical consensus of the medical team, 18 (41% were found to be in MCS following standardized assessment with the CRS-R. In the 41 patients with a consensus diagnosis of MCS, 4 (10% had emerged from MCS, according to the CRS-R. We also found that the majority of patients assigned an uncertain diagnosis by clinical consensus (89% were in MCS based on CRS-R findings. Conclusion Despite the importance of diagnostic accuracy, the rate of misdiagnosis of VS has not substantially changed in the past 15 years. Standardized neurobehavioral assessment is a more sensitive means of establishing differential diagnosis in patients with disorders of consciousness when compared to diagnoses determined by clinical consensus.

  14. [Cowpox virus infection in an alpaca (Vicugna pacos) - clinical symptoms, laboratory diagnostic findings and pathological changes].

    Science.gov (United States)

    Goerigk, D; Theuß, T; Pfeffer, M; Konrath, A; Kalthoff, D; Woll, D; Vahlenkamp, T W; Beer, M; Starke, A

    2014-01-01

    Orthopoxvirus infections appear to be rare in South American Camelids, because only a few cases have been reported in the literature. Based on a generalized infection with cowpox virus in an alpaca, the clinical symptoms, laboratory diagnostic findings and the pathological changes are described. The case history showed a long treatment because of chronic skin lesions. The main clinical symptom was miliary papules over the entire skin. Furthermore, a bilateral mucopurulent conjunctivitis occurred as well as excessive salivation due to a severe erosive-ulcerative stomatitis. Although the animal received intensive treatment, it died 8 days after admission to the clinic. During necropsy, an erosive-ulcerative laryngitis as well as a necrotising pneumonia and lymphadenitis were observed. Histopathological examination of representative organ samples led to the diagnosis of a suspected orthopoxvirus infection. Electron microscopy and quantitative polymerase chain reaction (qPCR) of tissue samples confirmed this diagnosis. The virus could be isolated in tissue culture and a PCR with subsequent nucleotide sequencing identified cowpox virus as the causative agent for this generalised infection. PMID:24920091

  15. Application of scientific developments into clinical practice

    International Nuclear Information System (INIS)

    In 2002, in the Republic of Belarus, the incidence rate of thyroid cancer in comparison with 1986 increased by a factor of 5.7, and amounted to 8,6 cases per 100 000. The increase of prevalence of thyroid cancer continues, especially for adolescents and young adults. For the period of 17 years in the republic have been operated 9526 patients, including 728 children, 414 adolescents and 856 young adults under 35 years. In this group consisting of 1998 patients, in 184 (9.2 %) lung metastases have been diagnosed. In the long-term period after the treatment 19 (0.9 %) died of tumor progression. The remaining 1979 (99.5 %) survived. The minimum lethality of young patients with thyroid cancer is achieved due to the excellent qualification of doctors and technical equipment of the Center, improvement of cancer detection in regions at the pre-hospital stage and timely rehabilitation in case of arisen complications. Scientific developments of the Republican Center contributed to the improvement of treatment of patients with thyroid cancer. Standardization of treatment modes of patients have been developed based on latest developments of the world science in the thyroid research area. The method of optimal treatment of children and adolescents has been developed and introduced into practice. Radioiodine treatment with the use of new technologies has been introduced into clinical practice. The surgical technique has been improved for recurrent, locally-spread and cervical- mediastinal cancer. Clinical-biological features of radiation-induced cancer, including the study on the molecular-genetic level have been studied, and its highly aggressive nature have been determined being revealed by early and multiple metastatic disease. Necessity has been justified to carry out preventive cervical neck lympho-dissection for patients with radiogenic cancer, if metastases have been not clinically revealed. All these developments are represented in the instruction and the treatment

  16. Clinical application of the five-factor model.

    Science.gov (United States)

    Widiger, Thomas A; Presnall, Jennifer Ruth

    2013-12-01

    The Five-Factor Model (FFM) has become the predominant dimensional model of general personality structure. The purpose of this paper is to suggest a clinical application. A substantial body of research indicates that the personality disorders included within the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) can be understood as extreme and/or maladaptive variants of the FFM (the acronym "DSM" refers to any particular edition of the APA DSM). In addition, the current proposal for the forthcoming fifth edition of the DSM (i.e., DSM-5) is shifting closely toward an FFM dimensional trait model of personality disorder. Advantages of this shifting conceptualization are discussed, including treatment planning. PMID:22924994

  17. Medical beam monitor—Pre-clinical evaluation and future applications

    CERN Document Server

    Frais-Kölbl, H; Schreiner, T; Georg, D; Pernegger, H

    2007-01-01

    Future medical ion beam applications for cancer therapy which are based on scanning technology will require advanced beam diagnostics equipment. For a precise analysis of beam parameters we want to resolve time structures in the range of microseconds to nanoseconds. A prototype of an advanced beam monitor was developed by the University of Applied Sciences Wiener Neustadt and its research subsidiary Fotec in co-operation with CERN RD42, Ohio State University and the Jožef Stefan Institute in Ljubljana. The detector is based on polycrystalline Chemical Vapor Deposition (pCVD) diamond substrates and is equipped with readout electronics up to 2 GHz analog bandwidth. In this paper we present the design of the pCVD-detector system and results of tests performed in various particle accelerator based facilities. Measurements performed in clinical high energy photon beams agreed within 1.2% with results obtained by standard ionization chambers.

  18. Clinical use of the autism diagnostic observation schedule-second edition with children who are deaf.

    Science.gov (United States)

    Mood, Deborah; Shield, Aaron

    2014-11-01

    The Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) was administered to eight children who are deaf and who are native American Sign Language (ASL) users with previous autism spectrum disorder (ASD) diagnosis. Classification on two different module selection criteria was compared based on: (1) standardized administration rules (signs not counted as equivalent to words) and (2) commonly utilized clinical administration (sign language complexity treated equivalently to spoken language complexity). Differential module selection resulted in discrepant classification in five of the eight cases (63%) and suggests that ADOS-2 via standardized test administration may result in a failure to identify autism among children who are deaf with primary communication in ASL. Two of the eight children (25%) did not exceed the cutoff for an ASD classification on either module administered despite previous ASD diagnosis. Overall results suggest that caution should be used when utilizing the ADOS-2 with children who are deaf who primarily communicate using ASL. PMID:25321853

  19. Biopsies of colorectal clinical polyps--emergence of diagnostic information on deeper levels

    DEFF Research Database (Denmark)

    Engel, Ulla Højholt; Warnecke, Mads; Engel, Ulla;

    2009-01-01

    Although the occasional appearance of a normal histology of biopsies from endoscopic colorectal (CR) polyps is generally held knowledge, its prevalence has rarely been focused on, and the yield of additional sections in such cases has been previously addressed in merely four communications...... endoscopy. Additionally, an appropriate, cost-effective approach for handling NDB was sought. Biopsies from 480 clinical polyps were prospectively evaluated by one of three gastrointestinal pathologists and classified as (a) diagnostic biopsies (DB), comprising neoplastic polyps, hyperplastic polyps (HP......), sessile-serrated polyp, other diverse causes of polyp formation and (b) NDB comprising normal histology (group 1), suspicious of either adenoma (group 2) or HP (group 3). Material grouped 1-3 was subsequently step-sectioned (three sections prepared from each of nine additional levels). The biopsy...

  20. 良、恶性梗阻性黄疸应用多层螺旋CT(MSCT)的临床诊断价值研究%Clinical diagnostic and value study of multi slice spiral CT (MSCT) application for benign and malignant obstructive jaundice

    Institute of Scientific and Technical Information of China (English)

    孙赞江

    2015-01-01

    目的:探讨多层螺旋 CT(MSCT)对于良、恶性梗阻性黄疸的临床诊断价值。方法回顾分析72例梗阻性黄疸患者的临床资料与影像学资料,分析 MSCT 对于梗阻性黄疸的良恶性诊断价值。结果 MSCT 对于梗阻性黄疸的定位诊断准确率为100%,对恶性梗阻性黄疸的诊断准确率为96.43%,对良性梗阻性黄疸的诊断准确率为95.45%。结论MSCT 对于梗阻性黄疸的定位及定性诊断具有较高的准确性,值得在临床中推广应用。%Objective investigate clinical diagnostic value of multi-slice spiral CT (MSCT) for diagnosis of benign and malignant obstructive jaundice. Method analyze and review clinical and imaging data of 72 patients with obstructive jaundice, and analyze diagnostic value of MSCT for benign and malignant obstructive jaundice. Result diagnostic accuracy of MSCT for obstructive jaundice diagnosis is 100%, and for malignant obstructive jaundice is 96.43%, for benign obstructive jaundice is 95.45%. Conclusion MSCT has high accuracy for localization and qualitative diagnosis on obstructive jaundice, which is worthy of being spreaded and applied clinically.

  1. Everting (toposcopic) catheter for broad clinical application.

    Science.gov (United States)

    Shook, D R; Doppman, J L; Cattau, E L; Goldstein, S R

    1986-05-01

    The advanced development of the clinical everting (toposcopic) catheter is described. A detailed discussion of the design and outline of the fabrication techniques are followed by a thorough performance evaluation and summary of the first two clinical applications. The everting element is a low-durometer thermoplastic polyurethane elastomer. Surface treatments include the bonding of a hydrophilic polymeric coating, optimized for lubricity, to the sliding internal surfaces of the catheter. Eversion pressures and infusion/aspiration flow rates have been measured under various conditions and the infusate-in-blood mixing potential investigated. A preliminary assessment is given of the clinical performance of the catheter in the vascular delivery of chemotherapy and standard endoscopic retrograde cholangiopancreatography. PMID:3724105

  2. Clinical Application of the Forced Oscillation Technique.

    Science.gov (United States)

    Shirai, Toshihiro; Kurosawa, Hajime

    2016-01-01

    The forced oscillation technique (FOT) is a noninvasive method with which to measure respiratory system resistance and reactance during tidal breathing. Recently, its clinical application has spread worldwide with the expansion of commercially available broadband frequency FOT devices, including MostGraph and Impulse Oscillometry. An increasing number of reports have supported the usefulness of the FOT in the management of asthma and chronic obstructive pulmonary disease (COPD). However, the FOT is not a surrogate test for spirometry, but should be used complementarily. Furthermore, reference values are not necessarily available and the interpretation of some measured data is controversial. There is a need to update the international statement for not only technical aspects but also the clinical use of the FOT. In this review, we summarize the previously published studies and discuss how to use the FOT in a clinical setting. PMID:26984069

  3. Development of clinical application of radiation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Sook; Yoo, Seoung Yul; Yoo, Hyung Jun [and others

    2000-04-01

    The aim is to develop the clinical radiation therapy techniques, which increase local control and cure rate of cancer. The contents were 1. technique of stereotactic radiotherapy 2. technique of intraoperative radiation therapy(IORT) 3. technique of fractionated radiotherapy 4. technique of 3D conformal therapy 5. chemoradiotherapy in lung cancer, rectal cancer and biliopancreatic cancer 6. network based information communication system of radiation oncology 7. animal studies for the best application of chemoradiotherapy and for elucidating mechanism of slide effect in radiotherapy. The results were 1. completion of quality assurance protocol, frame and mounting system 2. completion of applicator of IORT 3. clinical protocol of fractionated radiotherapy 4. clinical protocol of 3D conformal therapy for brain, head and neck, breast and lung cancer 5. completion of multimodality treatment protocol for lung, rectal and biliopancreatic cancer 6. completion of database system for patient information and simulation image 7. standardization of estimation for radiation induced pneumonitis in animal model. Future plans are (1) developed fractionated stereotactic radiotherapy system will be commercialized (2) developed applicator of brachytherapy for IORT will be commercialized (3) 3D conformal therapy will increase local control rate for brain tumor and decrease complications such as zerostomia after treatment for nasopharygeal cancer (4) training manpower and skills for randomized clinical trial (5) suggest possibility of clinical usefulness of oral 5-fluorouracil (6) to provide basic technique for electric chart (7) promote developing database system for image information (8) also in view of double edge sword effect of NO, it is possible to modify the NO production from irradiation to increase the tolerance to radiation.

  4. Development of clinical application of radiation

    International Nuclear Information System (INIS)

    The aim is to develop the clinical radiation therapy techniques, which increase local control and cure rate of cancer. The contents were 1. technique of stereotactic radiotherapy 2. technique of intraoperative radiation therapy(IORT) 3. technique of fractionated radiotherapy 4. technique of 3D conformal therapy 5. chemoradiotherapy in lung cancer, rectal cancer and biliopancreatic cancer 6. network based information communication system of radiation oncology 7. animal studies for the best application of chemoradiotherapy and for elucidating mechanism of slide effect in radiotherapy. The results were 1. completion of quality assurance protocol, frame and mounting system 2. completion of applicator of IORT 3. clinical protocol of fractionated radiotherapy 4. clinical protocol of 3D conformal therapy for brain, head and neck, breast and lung cancer 5. completion of multimodality treatment protocol for lung, rectal and biliopancreatic cancer 6. completion of database system for patient information and simulation image 7. standardization of estimation for radiation induced pneumonitis in animal model. Future plans are 1) developed fractionated stereotactic radiotherapy system will be commercialized 2) developed applicator of brachytherapy for IORT will be commercialized 3) 3D conformal therapy will increase local control rate for brain tumor and decrease complications such as zerostomia after treatment for nasopharygeal cancer 4) training manpower and skills for randomized clinical trial 5) suggest possibility of clinical usefulness of oral 5-fluorouracil 6) to provide basic technique for electric chart 7) promote developing database system for image information 8) also in view of double edge sword effect of NO, it is possible to modify the NO production from irradiation to increase the tolerance to radiation

  5. Combined central and peripheral demyelination: Clinical features, diagnostic findings, and treatment.

    Science.gov (United States)

    Cortese, A; Franciotta, D; Alfonsi, E; Visigalli, N; Zardini, E; Diamanti, L; Prunetti, P; Osera, C; Gastaldi, M; Berzero, G; Pichiecchio, A; Piccolo, G; Lozza, A; Piscosquito, G; Salsano, E; Ceroni, M; Moglia, A; Bono, G; Pareyson, D; Marchioni, E

    2016-04-15

    Combined central and peripheral demyelination (CCPD) is rare, and current knowledge is based on case reports and small case series. The aim of our study was to describe the clinical features, diagnostic results, treatment and outcomes in a large cohort of patients with CCPD. Thirty-one patients entered this retrospective, observational, two-center study. In 20 patients (65%) CCPD presented, after an infection, as myeloradiculoneuropathy, encephalopathy, cranial neuropathy, length-dependent peripheral neuropathy, or pseudo-Guillain-Barré syndrome. Demyelinating features of peripheral nerve damage fulfilling European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria for CIDP were found in 23 patients (74%), and spatial dissemination of demyelinating lesions on brain MRI fulfilling the 2010 McDonald criteria for multiple sclerosis (MS) in 11 (46%). Two thirds of the patients had a relapsing or progressive disease course, usually related to the appearance of new spinal cord lesions or worsening of the peripheral neuropathy, and showed unsatisfactory responses to high-dose corticosteroids and intravenous immunoglobulins. The clinical presentation of CCPD was severe in 22 patients (71%), who were left significantly disabled. Our data suggest that CCPD has heterogeneous features and shows frequent post-infectious onset, primary peripheral nervous system or central nervous system involvement, a monophasic or chronic disease course, inadequate response to treatments, and a generally poor outcome. We therefore conclude that the current diagnostic criteria for MS and CIDP may not fully encompass the spectrum of possible manifestations of CCPD, whose pathogenesis remains largely unknown. PMID:27000248

  6. The Diagnostic Utility of the NINDS-CSN Neuropsychological Battery in Memory Clinics

    Science.gov (United States)

    Xu, Xin; Chan, Qun Lin; Hilal, Saima; Ikram, Mohammad Kamran; Venketasubramanian, Narayanaswamy; Tan, Boon Yeow; Dong, Yanhong; Chen, Christopher Li-Hsian; Collinson, Simon L.

    2016-01-01

    Aims To examine the diagnostic utility of the National Institute of Neurological Disorders and Stroke and the Canadian Stroke Network (NINDS-CSN) neuropsychological battery in memory clinics comparing controls with patients with no cognitive impairment (NCI), patients with cognitive impairment-no dementia (CIND) at varying severity levels (mild/moderate), and patients with dementia. Methods A total of 405 participants with NCI, CIND or dementia were assessed with the NINDS-CSN battery. The discriminatory properties of all three protocols (5, 30 and 60 min) before and after education stratification (none/primary vs. secondary/above) were examined by receiver operating characteristic curves. Results Overall, the shorter protocols are equivalent to the longer protocol in diagnosing dementia, regardless of education. To discriminate between nondementia groups, before education stratification, the 5-min protocol showed varied discriminatory properties between different diagnostic/severity groups. After stratification, the 5-min protocol was broadly equivalent to the longer protocols in lower-education groups [area under the curve (AUC) range: 0.77-0.87] but was less accurate in the higher-education groups (AUC range: 0.68-0.78). The 30- and 60-min protocol constantly showed moderate-to-excellent differentiating capacities regardless of education (AUC range: 0.80-0.90). Conclusion The NINDS-CSN neuropsychological battery can be applied in memory clinics and effectively discriminate between cognitively intact individuals and those with cognitive impairments of varying severity. Furthermore, level of education should be taken into consideration when choosing protocols with different lengths for cognitive assessment. PMID:27504116

  7. Combined central and peripheral demyelination: Clinical features, diagnostic findings, and treatment.

    Science.gov (United States)

    Cortese, A; Franciotta, D; Alfonsi, E; Visigalli, N; Zardini, E; Diamanti, L; Prunetti, P; Osera, C; Gastaldi, M; Berzero, G; Pichiecchio, A; Piccolo, G; Lozza, A; Piscosquito, G; Salsano, E; Ceroni, M; Moglia, A; Bono, G; Pareyson, D; Marchioni, E

    2016-04-15

    Combined central and peripheral demyelination (CCPD) is rare, and current knowledge is based on case reports and small case series. The aim of our study was to describe the clinical features, diagnostic results, treatment and outcomes in a large cohort of patients with CCPD. Thirty-one patients entered this retrospective, observational, two-center study. In 20 patients (65%) CCPD presented, after an infection, as myeloradiculoneuropathy, encephalopathy, cranial neuropathy, length-dependent peripheral neuropathy, or pseudo-Guillain-Barré syndrome. Demyelinating features of peripheral nerve damage fulfilling European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria for CIDP were found in 23 patients (74%), and spatial dissemination of demyelinating lesions on brain MRI fulfilling the 2010 McDonald criteria for multiple sclerosis (MS) in 11 (46%). Two thirds of the patients had a relapsing or progressive disease course, usually related to the appearance of new spinal cord lesions or worsening of the peripheral neuropathy, and showed unsatisfactory responses to high-dose corticosteroids and intravenous immunoglobulins. The clinical presentation of CCPD was severe in 22 patients (71%), who were left significantly disabled. Our data suggest that CCPD has heterogeneous features and shows frequent post-infectious onset, primary peripheral nervous system or central nervous system involvement, a monophasic or chronic disease course, inadequate response to treatments, and a generally poor outcome. We therefore conclude that the current diagnostic criteria for MS and CIDP may not fully encompass the spectrum of possible manifestations of CCPD, whose pathogenesis remains largely unknown.

  8. Equivalence of MammaPrint array types in clinical trials and diagnostics.

    Science.gov (United States)

    Beumer, Inès; Witteveen, Anke; Delahaye, Leonie; Wehkamp, Diederik; Snel, Mireille; Dreezen, Christa; Zheng, John; Floore, Arno; Brink, Guido; Chan, Bob; Linn, Sabine; Bernards, Rene; van 't Veer, Laura; Glas, Annuska

    2016-04-01

    MammaPrint is an FDA-cleared microarray-based test that uses expression levels of the 70 MammaPrint genes to assess distant recurrence risk in early-stage breast cancer. The prospective RASTER study proved that MammaPrint Low Risk patients can safely forgo chemotherapy, which is further subject of the prospective randomized MINDACT trial. While MammaPrint diagnostic results are obtained from mini-arrays, clinical trials may be performed on whole-genome arrays. Here we demonstrate the equivalence and reproducibility of the MammaPrint test. MammaPrint indices were collected for breast cancer samples: (i) on both customized certified array types (n = 1,897 sample pairs), (ii) with matched fresh and FFPE tissues (n = 552 sample pairs), iii) for control samples replicated over a period of 10 years (n = 11,333), and iv) repeated measurements (n = 280). The array type indicated a near perfect Pearson correlation of 0.99 (95 % CI: 0.989-0.991). Paired fresh and FFPE samples showed an excellent Pearson correlation of 0.93 (95 % CI 0.92-0.94), in spite of the variability introduced by intratumoral tissue heterogeneity. Control samples showed high consistency over 10 year's time (overall reproducibility of 97.4 %). Precision and repeatability are overall 98.2 and 98.3 %, respectively. Results confirm that the combination of the near perfect correlation between array types, excellent equivalence between tissue types, and a very high stability, precision, and repeatability demonstrate that results from clinical trials (such as MINDACT and I-SPY 2) are equivalent to current MammaPrint FFPE and fresh diagnostics, and can be used interchangeably. PMID:27002507

  9. Evaluation of diagnostic tools for epidemiological purposes - Application to FMD

    International Nuclear Information System (INIS)

    Since the implementation in 1988 of the foot-and-mouth disease (FMD) eradication programme in South America (PHEFA), significant advances have been made in the control of the disease. Particularly relevant has been the progress attained in one of the three subregions, the Southern Cone, where during the late 1990s most areas were recognized as FMD-free by OIE, with or without vaccination. To achieve PHEFA goals, development and implementation of diagnostic tools to trace for potential sources of infection was of utmost importance. Accordingly, priority was given to the identification of genetic links among circulating strains and, in relevant areas, to the systematic sero-epidemiological monitoring of persistent viral activity, regardless of vaccination condition. A genetic database of representative strains from South America, constructed at the Pan American Foot-and-Mouth Disease Center, constituted the basis for the phylogenetic analysis of viruses types 0 and A recorded recently in endemic regions, and during the emergencies in FMD-free areas of the Southern Cone. The genetic data placed all variants from the Southern Cone in a single lineage, which clearly differed from the evolutionary nodes that included the isolates in the Andean subregion, reflecting two independent production systems and livestock trade circuits. To complement the search for potential sources of infection, serosurveillance became an important adjunct. To this end, new tools to infer viral circulation within and between herds, irrespective of vaccination, were developed and validated. The diagnostic approach, based on an immuno-enzymatic system that detects antibodies against non-capsid proteins, was particularly useful in support of epidemiological investigations after episodes and to confirm absence of viral activity in regions to be recognized as FMD-free, being especially important prior to the suspension of vaccination. Results of samplings in the Southern Cone during the 1990s

  10. Nuclear physics applications in diagnostics and cancer therapy

    CERN Document Server

    Amaldi, Ugo

    2005-01-01

    Only 1% of the 18,000 world accelerators are devoted to the production of radioisotopes for medical diagnostics. In fact at present about 85% of all the medical examinations use /sup 99m/Tc produced in nuclear reactors. But the development of Positron Emission Tomography and of its combination with Computer Tomography will boost the hospital use of cyclotrons. Much more general is the use of electron linacs in cancer therapy about 40% of the world accelerators are used for this so called "conventional" radiotherapy. In the developed countries every 10 million inhabitants about 20,000 oncological patients are irradiated every year with high-energy photons (called X-rays by radiotherapists) produced by electron linacs. Much less used is "hadrontherapy", the radiotherapy technique that employs protons, neutrons or carbon ions. Protons and ions are 'heavy' charged particles: they assure a more 'conformal' treatment than X-rays and thus spare better the surrounding healthy tissues allowing a larger dose and thus a...

  11. Fluorescence spectroscopy of gastrointestinal tumors: in vitro studies and in vivo clinical applications

    Science.gov (United States)

    Angelova, L.; Borisova, E.; Zhelyazkova, Al.; Keremedchiev, M.; Vladimirov, B.; Avramov, L.

    2013-11-01

    The limitations of standard endoscopy for detection and evaluation of cancerous changes in the gastrointestinal tract (GIT) are significant challenges and initiate development of new diagnostic modalities. Therefore many spectral and optical techniques are applied recently into the clinical practice for obtaining qualitatively and quantitatively new data from gastrointestinal neoplasia with different levels of clinical applicability and diagnostic success. Fluorescence imaging has been one of the most promising technologies in this area. The technique is very topical with its practical application in intra-operative, image-guided resection of tumors, because it permits minimal surgery intervention and friendly therapeutic conditions. The investigations presented here are based on in vitro measurements of excitation-emission matrices (EEM) for GIT neoplasia and in vivo measurements in the frames of initial clinical trial for tumor fluorescence spectra detection, applied for introduction of spectroscopic diagnostic system for optical biopsy of GIT tumors in the daily clinical practice of the University Hospital "Queen Jiovanna - ISUL"- Sofia. Autofluorescence and exogenous fluorescence signals are detected from normal mucosa, inflammation, dysphasia and carcinoma and main spectral features are evaluated. The systems and methods developed for diagnosis and monitoring could open new dimensions in diagnostic and real-time tumor resection. This will make the entire procedure more personal, patient friendly and effective and will help for further understanding of the tumor nature.

  12. Clinical and diagnostic methods for evaluation of sharp foreign body syndrome in buffaloes

    Directory of Open Access Journals (Sweden)

    Nasr-Eldin M. Aref

    2013-06-01

    Full Text Available Aim: The present study was designed to evaluate clinically and under laboratory condition the sharp foreign body syndrome (SFBS in buffaloes with special emphasis on the diagnostic value of radiography, ultrasonography and blood gases and acidbase balance. Materials and Methods: 196 buffaloes with a history of anorexia, reduction of milk production and no response to previous medical treatment were included in the present study. These animals were subjected to clinical and radiographical examinations. Positive cases for SFBS were further evaluated by sonography, hemato-biochemical and blood gas and acid base balance analysis.Results: Out of 196 admitted cases, 49 (25% cases were confirmed as SFBS by clinical and radiographical examination. Positive cases were subsequently divided into two main categories (complicated and non complicated according to radiographical and sonographical findings. SFBS with no complication was diagnosed in 16 cases while 33 cases showed various degrees of complication including reticular adhesion (abdominal and diaphragmatic, n= 23, diaphragmatic hernia (n = 6 and traumatic pericarditis (n = 4. Leukocytosis, hyperprotenemia and increased activity of AST and ALT were of additional values in the diagnosis of SFBS. A consistent finding of primary metabolic alkalosis was recorded in all cases except one with advanced traumatic pericarditis that showed metabolic acidosis. Conclusion: While there is no substitution for clinical examination, using of ultrasonography and radiography simultaneously are essential for proper evaluation and differentiation between various sequelae of SFBS in buffaloes. Radiography is an efficient tool for visualization of metallic foreign body while ultrasonography is an excellent device in assessing fibrinous deposits. Hemato-biochemical and blood gases and acid base balance are of additional values in discriminating between various outcomes of SFBS.

  13. Chlamydia trachomatis: milestones in clinical and microbiological diagnostics in the last hundred years: a review.

    Science.gov (United States)

    Budai, Irén

    2007-03-01

    Chlamydia trachomatis an obligate intracellular, Gram-negative bacterium is the causative agent of several acute or chronic, local and systemic human diseases such as trachoma, oculogenital and neonatal infections. It was discovered in 1907 by Halberstaedter and von Prowazek who observed it in conjunctival scrapings from an experimentally infected orangutan. In the last hundred years the detection and study of the intracellular pathogens, including chlamydiae, passed through an enormous evolution. This memorial review is dedicated to these important research and diagnostic discoveries and to the scientists who significantly contributed to this evolution starting from the application of simple light microscopy through the cell culture technique, antibiotic susceptibility, antigen and antibody detection, serotyping, to the real-time nucleic acid amplification and restriction fragment lengths polymorphism analysis. Although the majority of these old and new excellent diagnostic methods have been introduced into the rutine practice, the trachoma has remained one of the leading causes of blindness, and oculogenital chlamydial infections still are the most frequent sexually transmitted bacterial diseases, furthermore lymphogranuloma venereum is a disease emerging in the developed countries at the beginning of the 21 st century.

  14. NMR-based metabolomics of prostate cancer: a protagonist in clinical diagnostics.

    Science.gov (United States)

    Kumar, Deepak; Gupta, Ashish; Nath, Kavindra

    2016-06-01

    Advances in the application of NMR spectroscopy-based metabolomic profiling of prostate cancer comprises a potential tactic for understanding the impaired biochemical pathways arising due to a disease evolvement and progression. This technique involves qualitative and quantitative estimation of plethora of small molecular weight metabolites of body fluids or tissues using state-of-the-art chemometric methods delivering an important platform for translational research from basic to clinical, to reveal the pathophysiological snapshot in a single step. This review summarizes the present arrays and recent advancements in NMR-based metabolomics and a glimpse of currently used medical imaging tactics, with their role in clinical diagnosis of prostate cancer. PMID:26959614

  15. RNA quantification using gold nanoprobes - application to cancer diagnostics

    Directory of Open Access Journals (Sweden)

    Baptista Pedro V

    2010-02-01

    Full Text Available Abstract Molecular nanodiagnostics applied to cancer may provide rapid and sensitive detection of cancer related molecular alterations, which would enable early detection even when those alterations occur only in a small percentage of cells. The use of gold nanoparticles derivatized with thiol modified oligonucleotides (Au-nanoprobes for the detection of specific nucleic acid targets has been gaining momentum as an alternative to more traditional methodologies. Here, we present an Au-nanoparticles based approach for the molecular recognition and quantification of the BCR-ABL fusion transcript (mRNA, which is responsible for chronic myeloid leukemia (CML, and to the best of our knowledge it is the first time quantification of a specific mRNA directly in cancer cells is reported. This inexpensive and very easy to perform Au-nanoprobe based method allows quantification of unamplified total human RNA and specific detection of the oncogene transcript. The sensitivity settled by the Au-nanoprobes allows differential gene expression from 10 ng/μl of total RNA and takes less than 30 min to complete after total RNA extraction, minimizing RNA degradation. Also, at later stages, accumulation of malignant mutations may lead to resistance to chemotherapy and consequently poor outcome. Such a method, allowing for fast and direct detection and quantification of the chimeric BCR-ABL mRNA, could speed up diagnostics and, if appropriate, revision of therapy. This assay may constitute a promising tool in early diagnosis of CML and could easily be extended to further target genes with proven involvement in cancer development.

  16. Respiratory gated multidetector computed tomography: Applicable for diagnostic abdominal imaging?

    International Nuclear Information System (INIS)

    Purpose: To evaluate the ability and accuracy of a respiratory gated technique used with contrast enhanced MDCT of the upper abdomen with focus on diagnostic image quality and depiction of organs and major vessels. Materials and methods: Forty-five adult patients who were referred to our institution for follow-up dynamic contrast enhanced abdominal CT imaging were included in this study. Respiratory gated CT scans were performed with the use of a dedicated hardware. A multiphasic CT scan was performed for each patient. Respiratory gated images were obtained between early arterial and portal venous phases during free breathing. Images of respiratory gated (RG) and breathhold (BH) phases were compared qualitatively and quantitatively by two radiologists. Definitive statistical methods were used for evaluating the scoring data, while Mann Whitney U test was used for comparison. Statistical significance was accepted for p values <0.05. Results: Statistical significant difference was found for comparison of scores regarding luminal opacification and contoural integrity of intrahepatic vascular structures with scores of RG scans rated poor to moderate (e.g. 2.86 ± 1.07 for luminal opacification of intrahepatic portal veins as well as border detectability) in comparison to scores of BH scans rated good to excellent (e.g. 1.37 ± 1.31 for luminal opacification, 1.35 ± 1.28 for border detectability of intrahepatic portal veins, p < 0.001). Furthermore, statistical significant differences were found for general image noise levels (p < 0.001). Conclusions: Further technical advances of RG technique could enable routine use of this technique for selected patient groups.

  17. Diagnostic and clinical observation on the infectious bronchitis virus strain Q1 in Italy

    Directory of Open Access Journals (Sweden)

    Anna Toffan

    2013-12-01

    Full Text Available This paper describes the diagnostic and clinical observations of an infectious bronchitis virus (IBV variant, referred to as Q1, in clinically ill chickens in Italy. This IBV variant was described for the first time in 1998 in China. In the autumn of 2011 it caused a small-scale epidemic in non-vaccinated meat chickens in farms located in Northern Italy. The disease was characterized by increased mortality, kidney lesions and proventriculitis. Histopatological observations confirmed the nephritis and described an unusual erosive/necrotic proventriculitis with infiltration of lymphocytes, plasma cells and heterophils, as well as fibroplasia in the lamina propria. Despite these findings and the isolation of the Q1 IB virus directly from proventricular tissue, further studies are necessary to confirm the role of this IBV strain in the development of proventricular lesions. Phylogenetic analysis revealed that all the IBV isolates were very similar and probably had a common origin. The IBV Q1 variant appears to be now endemic in the North of Italy and at times it is detected in vaccinated backyard and commercial broiler farms. The importance of continuous monitoring in controlling the spread of known or emerging IBV variants is underlined.

  18. Whole-Body Clinical Applications of Digital Tomosynthesis.

    Science.gov (United States)

    Machida, Haruhiko; Yuhara, Toshiyuki; Tamura, Mieko; Ishikawa, Takuya; Tate, Etsuko; Ueno, Eiko; Nye, Katelyn; Sabol, John M

    2016-01-01

    With flat-panel detector mammography, radiography, and fluoroscopy systems, digital tomosynthesis (DT) has been recently introduced as an advanced clinical application that removes overlying structures, enhances local tissue separation, and provides depth information about structures of interest by providing high-quality tomographic images. DT images are generated from projection image data, typically using filtered back-projection or iterative reconstruction. These low-dose x-ray projection images are easily and swiftly acquired over a range of angles during a single linear or arc sweep of the x-ray tube assembly. DT is advantageous in a variety of clinical contexts, including breast, chest, head and neck, orthopedic, emergency, and abdominal imaging. Specifically, compared with conventional mammography, radiography, and fluoroscopy, as a result of reduced tissue overlap DT can improve detection of breast cancer, pulmonary nodules, sinonasal mucosal thickening, and bone fractures and delineation of complex anatomic structures such as the ostiomeatal unit, atlantoaxial joint, carpal and tarsal bones, and pancreatobiliary and gastrointestinal tracts. Compared with computed tomography, DT offers reduced radiation exposure, better in-plane resolution to improve assessment of fine bony changes, and less metallic artifact, improving postoperative evaluation of patients with metallic prostheses and osteosynthesis materials. With more flexible patient positioning, DT is also useful for functional, weight-bearing, and stress tests. To optimize patient management, a comprehensive understanding of the clinical applications and limitations of whole-body DT applications is important for improvement of diagnostic quality, workflow, and cost-effectiveness. Online supplemental material is available for this article. (©)RSNA, 2016. PMID:27163590

  19. Measurement of ferritin in serum: Application in Diagnostic use

    OpenAIRE

    van Oost, B A; Beld, B. van den; Cloin, L.G.L.M.; Marx, J.J.M.

    1984-01-01

    A sandwich-type radioimmunoassay for serum ferritin was developed using iron-rich human liver ferritin and evaluated for its clinical usefulness. In young healthy males and females, the mean serum ferritin concentrations were 44 μg/L (range 7–158) and 16 μg/L (range 4–56), respectively. In anemic patients lower serum ferritin concentrations were found, while in most patients with iron overload serum ferritin concentrations well above 1000 μg/L were measured. Comparison of our method with a co...

  20. Update in salivary gland cytopathology: Recent molecular advances and diagnostic applications.

    Science.gov (United States)

    Pusztaszeri, Marc P; Faquin, William C

    2015-07-01

    Salivary gland tumors (SGT) are notorious for their extraordinary diversity and for the morphological overlap that exists between many of these entities. Fine-needle aspiration biopsy (FNAB) has a well-established role in the evaluation of patients with a salivary gland lesion, helping to guide clinical management. However, salivary gland FNAB has several limitations and does not allow for a specific diagnosis in some cases. For these reasons, salivary gland FNAB is considered one of the most challenging areas in cytopathology. Over the last decade, new salivary gland entities have been recognized, enlarging SGT diversity and complexity even more. In addition, a subset of SGT, including common entities such as pleomorphic adenoma and uncommon new entities such as mammary analog secretory carcinoma, have been characterized cytogenetically by the presence of specific translocations. The molecular consequences of these translocations and their potential prognostic and therapeutic values are not yet well characterized. However, these translocations and their resulting fusion oncogenes and oncoproteins can be used as diagnostic clues in salivary gland FNAB material in order to overcome the limitations of cytomorphological evaluation alone. In this review, we focus on SGTs currently known to harbor translocations and fusion genes, including uncommon and recently recognized entities, and discuss their potential application to salivary gland FNAB. PMID:25613003

  1. Clinical Applications of Reverse Panoramic Radiography

    Directory of Open Access Journals (Sweden)

    Sujatha S Reddy

    2011-09-01

    Full Text Available The essence of oral and maxil-lofacial radiology is not only to be an important tool in the diagnostic assessment of dental patients but also to equip the clinician with the ability to interpret images of certain maxillocraniofacial structures of importance to dental, medical and surgical practices. Although combinations of several conven-tional x-ray projections can be adequate in a number of clinical situations, radiographic assessment of certain craniofacial structures some-times needs to be facilitated by other imaging modalities. A not-so-recent development called reverse panoramic radiography may be a useful adjuvant to such a situation, at least in the near future. It is essentially a technique where the patient is placed backwards in the panoramic machine in a reverse position in such a way that x-ray beam is directed through the patient’s face and the exit beam then passes through the patient’s head on the opposite side where it is captured on the receptor. The following manuscript is an attempt to throw light on this technique and the impact it may have on dental, medical and surgical practices. The advantages and disadvantages of reverse panoramic radiography and it’s comparison to conventional panoramic radiographs and other skull views are also dis-cussed.

  2. Clinical Application of Stents in Digestive Diseases

    Institute of Scientific and Technical Information of China (English)

    GUAN Yongsong

    2002-01-01

    Objective To evaluate clinical application of therapeutic stenting of digestive diseases as a new approach from conventional management. Methods 115 cases of disorders in digestive system were managed with stents clinically, 148 procedures of intervention in all. The cases were suffering from portal hypertension of cirrhosis, post - operative esophageal stricture, Stricture resulted from esophageal carcinoma, Buddi - Chari syndrome, narrowing of superior mesentery arteries and biliary tract, etc. All had had the strictured or obliterated original natural tube lumen been dilated or recanalized under the guidance of monitoring of the fluoroscope before the stent placement except those receiving TIPS needing the creation of an artificial passage within the liver to place the stent. Results Therapeutic stenting achieves clinical effects completely different from conventional internal medicine and surgery such as portal hypertension by cirrhosis with esophageal varices, megalospleen, ascites improved; jaundis relived then resided and liver function improved and appetite better in postoperative stricture of bile duct; ascites and edema of lower limbs resided in Buddi - Chari syndrom; intestininal distention disappeared, appetite and digestive function improved in stricture in superior mesentery artery; and no dysphagia and easy food intake, appetite improved in patients of stricture of postoperative esophagus and stricture resulted from esophageal carcinoma. Conclusion Therapeutic stenting is clinically unique, dramatically effective, with minor risks and worthy promoting in the management of certain digestive disorders.

  3. The validation and clinical implementation of BRCAplus: a comprehensive high-risk breast cancer diagnostic assay.

    Directory of Open Access Journals (Sweden)

    Hansook Kim Chong

    Full Text Available Breast cancer is the most commonly diagnosed cancer in women, with 10% of disease attributed to hereditary factors. Although BRCA1 and BRCA2 account for a high percentage of hereditary cases, there are more than 25 susceptibility genes that differentially impact the risk for breast cancer. Traditionally, germline testing for breast cancer was performed by Sanger dideoxy terminator sequencing in a reflexive manner, beginning with BRCA1 and BRCA2. The introduction of next-generation sequencing (NGS has enabled the simultaneous testing of all genes implicated in breast cancer resulting in diagnostic labs offering large, comprehensive gene panels. However, some physicians prefer to only test for those genes in which established surveillance and treatment protocol exists. The NGS based BRCAplus test utilizes a custom tiled PCR based target enrichment design and bioinformatics pipeline coupled with array comparative genomic hybridization (aCGH to identify mutations in the six high-risk genes: BRCA1, BRCA2, PTEN, TP53, CDH1, and STK11. Validation of the assay with 250 previously characterized samples resulted in 100% detection of 3,025 known variants and analytical specificity of 99.99%. Analysis of the clinical performance of the first 3,000 BRCAplus samples referred for testing revealed an average coverage greater than 9,000X per target base pair resulting in excellent specificity and the sensitivity to detect low level mosaicism and allele-drop out. The unique design of the assay enabled the detection of pathogenic mutations missed by previous testing. With the abundance of NGS diagnostic tests being released, it is essential that clinicians understand the advantages and limitations of different test designs.

  4. Idiopathic normal pressure hydrocephalus: diagnostic and predictive value of clinical testing, lumbar drainage, and CSF dynamics.

    Science.gov (United States)

    Mahr, Cynthia V; Dengl, Markus; Nestler, Ulf; Reiss-Zimmermann, Martin; Eichner, Gerrit; Preuß, Matthias; Meixensberger, Jürgen

    2016-09-01

    OBJECTIVE The aim of the study was to analyze the diagnostic and predictive values of clinical tests, CSF dynamics, and intracranial pulsatility tests, compared with external lumbar drainage (ELD), for shunt response in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS Sixty-eight consecutive patients with suspected iNPH were prospectively evaluated. Preoperative assessment included clinical tests, overnight intracranial pressure (ICP) monitoring, lumbar infusion test (LIFT), and ELD for 24-72 hours. Simple and multiple linear regression analyses were conducted to identify predictive parameters concerning the outcome after shunt therapy. RESULTS Positive response to ELD correctly predicted improvement after CSF diversion in 87.9% of the patients. A Mini-Mental State Examination (MMSE) value below 21 was associated with nonresponse after shunt insertion (specificity 93%, sensitivity 67%). Resistance to outflow of CSF (ROut) > 12 mm Hg/ml/min was false negative in 21% of patients. Intracranial pulsatility parameters yielded different results in various parameters (correlation coefficient between pulse amplitude and ICP, slow wave amplitude, and mean ICP) but did not correlate to outcome. In multiple linear regression analysis, a calculation of presurgical MMSE versus the value after ELD, ROut, and ICP amplitude quotient during LIFT was significantly associated with outcome (p = 0.04). CONCLUSIONS Despite a multitude of invasive tests, presurgical clinical testing and response to ELD yielded the best prediction for improvement of symptoms following surgery. The complication rate of invasive testing was 5.4%. Multiple and simple linear regression analyses indicated that outcome can only be predicted by a combination of parameters, in accordance with a multifactorial pathogenesis of iNPH. PMID:26824377

  5. Chromosomal microarray analysis as a first-tier clinical diagnostic test: Estonian experience.

    Science.gov (United States)

    Zilina, Olga; Teek, Rita; Tammur, Pille; Kuuse, Kati; Yakoreva, Maria; Vaidla, Eve; Mölter-Väär, Triin; Reimand, Tiia; Kurg, Ants; Ounap, Katrin

    2014-03-01

    Chromosomal microarray analysis (CMA) is now established as the first-tier cytogenetic diagnostic test for fast and accurate detection of chromosomal abnormalities in patients with developmental delay/intellectual disability (DD/ID), multiple congenital anomalies (MCA), and autism spectrum disorders (ASD). We present our experience with using CMA for postnatal and prenatal diagnosis in Estonian patients during 2009-2012. Since 2011, CMA is on the official service list of the Estonian Health Insurance Fund and is performed as the first-tier cytogenetic test for patients with DD/ID, MCA or ASD. A total of 1191 patients were analyzed, including postnatal (1072 [90%] patients and 59 [5%] family members) and prenatal referrals (60 [5%] fetuses). Abnormal results were reported in 298 (25%) patients, with a total of 351 findings (1-3 per individual): 147 (42%) deletions, 106 (30%) duplications, 89 (25%) long contiguous stretches of homozygosity (LCSH) events (>5 Mb), and nine (3%) aneuploidies. Of all findings, 143 (41%) were defined as pathogenic or likely pathogenic; for another 143 findings (41%), most of which were LCSH, the clinical significance remained unknown, while 61 (18%) reported findings can now be reclassified as benign or likely benign. Clinically relevant findings were detected in 126 (11%) patients. However, the proportion of variants of unknown clinical significance was quite high (41% of all findings). It seems that our ability to detect chromosomal abnormalities has far outpaced our ability to understand their role in disease. Thus, the interpretation of CMA findings remains a rather difficult task requiring a close collaboration between clinicians and cytogeneticists.

  6. Diagnostic clinical and laboratory findings in response to predetermining bacterial pathogen: data from the Meningitis Registry.

    Directory of Open Access Journals (Sweden)

    Maria Karanika

    Full Text Available BACKGROUND: Childhood meningitis continues to be an important cause of mortality in many countries. The search for rapid diagnosis of acute bacterial meningitis has lead to the further exploration of prognostic factors. This study was scheduled in an attempt to analyze various clinical symptoms as well as rapid laboratory results and provide an algorithm for the prediction of specific bacterial aetiology of childhood bacterial meningitis. METHODOLOGY AND PRINCIPAL FINDINGS: During the 32 year period, 2477 cases of probable bacterial meningitis (BM were collected from the Meningitis Registry (MR. Analysis was performed on a total of 1331 confirmed bacterial meningitis cases of patients aged 1 month to 14 years. Data was analysed using EPI INFO (version 3.4.3-CDC-Atlanta and SPSS (version 15.0-Chicago software. Statistically significant (p or = 15000/microL (OR 2.19 with a PPV of 77.8% (95%CI 40.0-97.2. For the diagnosis of Haemophilus influenzae, the most significant group of diagnostic criteria included, absence of haemorrhagic rash (OR 13.61, age > or = 1 year (OR 2.04, absence of headache (OR 3.01, CSF Glu < 40 mg/dL (OR 3.62 and peripheral WBC < 15,000/microL (OR 1.74 with a PPV of 58.5% (95%CI 42.1-73.7. CONCLUSIONS: The use of clinical and laboratory predictors for the assessment of the causative bacterial pathogen rather than just for predicting outcome of mortality seems to be a useful tool in the clinical management and specific treatment of BM. These findings should be further explored and studied.

  7. Emerging clinical applications of computed tomography

    Directory of Open Access Journals (Sweden)

    Liguori C

    2015-06-01

    Full Text Available Carlo Liguori,1 Giulia Frauenfelder,2 Carlo Massaroni,3 Paola Saccomandi,3 Francesco Giurazza,4 Francesca Pitocco,4 Riccardo Marano,5 Emiliano Schena,3 1Radiology Unit, AORN A Cardarelli, 2Radiology Unit, AOU Federico II, Naples, 3Measurement and Biomedical Instrumentation Unit, 4Radiology Unit, Università Campus Bio-Medico di Roma, 5Department of Radiological Sciences, Institute of Radiology, Catholic University of Rome, A Gemelli University Hospital, Rome, Italy Abstract: X-ray computed tomography (CT has recently been experiencing remarkable growth as a result of technological advances and new clinical applications. This paper reviews the essential physics of X-ray CT and its major components. Also reviewed are recent promising applications of CT, ie, CT-guided procedures, CT-based thermometry, photon-counting technology, hybrid PET-CT, use of ultrafast-high pitch scanners, and potential use of dual-energy CT for material differentiations. These promising solutions and a better knowledge of their potentialities should allow CT to be used in a safe and effective manner in several clinical applications. Keywords: computed tomography, X-ray, thermometry, dual-energy, ultrafast scanner, guidance, photon-counting technology

  8. THz Plasma Diagnostics: an evolution from FIR and Millimeter waves historical applications

    Science.gov (United States)

    Bombarda, F.; Doria, A.; Galatola Teka, G.; Giovenale, E.; Zerbini, M.

    2016-08-01

    Extremely broadband (100 GHz–30 THz) single cycle THz pulses are routinely generated with femtosecond laser for Time Domain Spectroscopy applications (TDS). The wide frequency range has an unquestionable diagnostic potential for Tokamak plasmas and not surprisingly THz TDS finds a natural field of application in this area, which is an evolution of the FIR and millimeter waves diagnostics, where ENEA Frascati holds historical expertise. By illuminating the plasma with a THz beam, phase, intensity and polarization of both reflected and transmitted beams can be detected, devising a single diagnostic instrument capable of measuring multiple plasma parameters. We will describe and discuss the laboratory work now in progress to realise a tailored THz-TDS spectrometer with design parameters optimised for the requirements of Tokamak plasmas and the tests of optical fibers and quasioptical couplers to optimise access to plasma. ENEA Frascati and the Photonics group of Physics Dept. of Oxford University are collaborating on this subject [1].

  9. Handbook of technical diagnostics fundamentals and application to structures and systems

    CERN Document Server

    2013-01-01

    This book presents concepts, methods and techniques to examine symptoms of faults and failures of structures, systems and components and to monitor functional performance and structural integrity. The book is organized in five parts. Part A introduces the scope and application of technical diagnostics and gives a comprehensive overview of the physics of failure. Part B presents all relevant methods and techniques for diagnostics and monitoring: from stress, strain, vibration analysis, nondestructive evaluation, thermography and industrial radiology to computed tomography and subsurface microstructural analysis. Part C cores the principles and concepts of technical failure analysis, illustrates case studies, and outlines machinery diagnostics with an emphasis on tribological systems. Part D describes the application of structural health monitoring and performance control to plants and the technical infrastructure, including buildings, bridges, pipelines, electric power stations, offshore wind structures, and r...

  10. International adaptations of the Millon Clinical Multiaxial Inventory: Construct validity and clinical applications

    NARCIS (Netherlands)

    Rossi, G.M.P.; Derksen, J.J.L.

    2015-01-01

    This article examines the influence of the Millon Clinical Multiaxial Inventory (MCMI) as a clinical and research instrument beyond the borders of the United States. The MCMI's theoretical and empirical grounding, its alignment with the Diagnostic and Statistical Manual of Mental Disorders (DSM), an

  11. Clinical applications of bovine colostrum therapy

    DEFF Research Database (Denmark)

    Rathe, Mathias; Müller, Klaus; Sangild, Per Torp;

    2014-01-01

    Bovine colostrum, the first milk that cows produce after parturition, contains high levels of growth factors and immunomodulatory components. Some healthy and diseased individuals may gain health benefits by consuming bovine colostrum as a food supplement. This review provides a systematic...... to populations, outcomes, and methodological quality, as judged by the Jadad assessment tool. Many studies used surrogate markers to study the effects of bovine colostrum. Studies suggesting clinical benefits of colostrum supplementation were generally of poor methodological quality, and results could...... not be confirmed by other investigators. Bovine colostrum may provide gastrointestinal and immunological benefits, but further studies are required before recommendations can be made for clinical application. Animal models may help researchers to better understand the mechanisms of bovine colostrum supplementation...

  12. Development of polymer-coated nanoparticle imaging agents for diagnostic applications

    Science.gov (United States)

    Kairdolf, Brad A.

    produce water soluble nanoparticle imaging agents in a one-pot method. Nanoparticle surface chemistry was also explored as a means to improve the functionality of these imaging agents in biological environments, leading to a novel, non-stick hydroxyl surface chemistry for nanoparticles with utility in clinical applications, particularly blood, cell and tissue assays. These advancements further elucidate the properties of polymer coatings and nanoparticle surfaces and enhance our understanding of nanoparticle interactions in clinically relevant environments. The technologies developed in this work will have a significant impact on nanoparticle use in ultrasensitive biomarker detection in complex biological samples and provide further advancements in early stage disease diagnostics.

  13. Application of Rough Set Theory in Fault Diagnostic Rules Acquisition

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Rough set theory is a new mathematical tool to deal with vagueness and uncertainty. But original rough sets theory only generates deterministic rules and deals with data sets in which there is no noise. The variable precision rough set model (VPRSM) is presented to handle uncertain and noisy information. A method based on VPRSM is proposed to apply to fault diagnosis feature extraction and rules acquisition for industrial applications. An example for fault diagnosis of rotary machinery is given to show that the method is very effective.

  14. A Review of the Giant Protein Titin in Clinical Molecular Diagnostics of Cardiomyopathies.

    Science.gov (United States)

    Gigli, Marta; Begay, Rene L; Morea, Gaetano; Graw, Sharon L; Sinagra, Gianfranco; Taylor, Matthew R G; Granzier, Henk; Mestroni, Luisa

    2016-01-01

    Titin (TTN) is known as the largest sarcomeric protein that resides within the heart muscle. Due to alternative splicing of TTN, the heart expresses two major isoforms (N2B and N2BA) that incorporate four distinct regions termed the Z-line, I-band, A-band, and M-line. Next-generation sequencing allows a large number of genes to be sequenced simultaneously and provides the opportunity to easily analyze giant genes such as TTN. Mutations in the TTN gene can cause cardiomyopathies, in particular dilated cardiomyopathy (DCM). DCM is the most common form of cardiomyopathy, and it is characterized by systolic dysfunction and dilation of the left ventricle. TTN truncating variants have been described as the most common cause of DCM, while the real impact of TTN missense variants in the pathogenesis of DCM is still unclear. In a recent population screening study, rare missense variants potentially pathogenic based on bioinformatic filtering represented only 12.6% of the several hundred rare TTN missense variants found, suggesting that missense variants are very common in TTN and are frequently benign. The aim of this review is to understand the clinical role of TTN mutations in DCM and in other cardiomyopathies. Whereas TTN truncations are common in DCM, there is evidence that TTN truncations are rare in the hypertrophic cardiomyopathy (HCM) phenotype. Furthermore, TTN mutations can also cause arrhythmogenic right ventricular cardiomyopathy (ARVC) with distinct clinical features and outcomes. Finally, the identification of a rare TTN missense variant cosegregating with the restrictive cardiomyopathy (RCM) phenotype suggests that TTN is a novel disease-causing gene in this disease. Clinical diagnostic testing is currently able to analyze over 100 cardiomyopathy genes, including TTN; however, the size and presence of extensive genetic variation in TTN presents clinical challenges in determining significant disease-causing mutations. This review discusses the current

  15. The Asperger Syndrome (and High-Functioning Autism) Diagnostic Interview (ASDI): A Preliminary Study of a New Structured Clinical Interview.

    Science.gov (United States)

    Gillberg, Christopher; Gillberg, Carina; Rastam, Maria; Wentz, Elisabeth

    2001-01-01

    The development of the Asperger Syndrome (and high-functioning autism) Diagnostic Interview (ASDI) is described. Preliminary data from a clinical study of 20 individuals (ages 6-55) suggest that interrater reliability and test-retest stability may be excellent, with kappas exceeding 0.90 in both instances. The validity appears to be relatively…

  16. Development, diagnostic and applications of radio-frequency plasma reactor

    Science.gov (United States)

    Puac, N.

    2008-07-01

    In many areas of the industry, plasma processing of materials is a vital technology. Nonequilibrium plasmas proved to be able to produce chemically reactive species at a low gas temperature while maintaining highly uniform reaction rates over relatively large areas (Makabe and Petrovic 2006). At the same time nonequilibrium plasmas provide means for good and precise control of the properties of active particles that determine the surface modification. Plasma needle is one of the atmospheric pressure sources that can be used for treatment of the living matter which is highly sensitive when it comes to low pressure or high temperatures (above 40 C). Dependent on plasma conditions, several refined cell responses are induced in mammalian cells (Sladek et al. 2005). It appears that plasma treatment may find many biomedical applications. However, there are few data in the literature about plasma effects on plant cells and tissues. So far, only the effect of low pressure plasmas on seeds was investigated. It was shown that short duration pretreatments by non equilibrium low temperature air plasma were stimulative in light induced germination of Paulownia tomentosa seeds (Puac et al. 2005). As membranes of plants have different properties to those of animals and as they show a wide range of properties we have tried to survey some of the effects of typical plasma which is envisaged to be used in biotechnological applications on plant cells. In this paper we will make a comparison between two configurations of plasma needle that we have used in treatment of biological samples (Puac et al. 2006). Difference between these two configurations is in the additional copper ring that we have placed around glass tube at the tip of the needle. We will show some of the electrical characteristics of the plasma needle (with and without additional copper ring) and, also, plasma emission intensity obtained by using fast ICCD camera.

  17. The Eating Disorder Diagnostic Scale: psychometric features within a clinical population and a cut-off point to differentiate clinical patients from healthy controls

    NARCIS (Netherlands)

    Krabbenborg, M.A.M.; Danner, U.N.; Larsen, J.K.; Veer, N. van der; Elburg, A.A. van; Ridder, D.T. de; Evers, C.; Stice, E.; Engels, R.C.E.M.

    2012-01-01

    The Eating Disorder Diagnostic Scale (EDDS) is a brief self-report measure for diagnosing anorexia nervosa, bulimia nervosa and binge eating disorder. Research has provided evidence of the reliability and validity of this scale in non-clinical populations. Our study is the first to examine the psych

  18. SEMIOTICS, DIAGNOSTICS AND THERAPY TACTICS OF DEPRESSIVE DISORDERS IN CLINICAL MEDICINE

    Directory of Open Access Journals (Sweden)

    N. A. Kornetov

    2014-01-01

    Full Text Available Study objectives are dedicated to brief synthesized establishment of diagnostics general standard, management and therapy of major depressive disorders (MDD in clinical medicine to provide education in medical practice.Study methods are based on short-term, medium-term and long-term educational programs in 24 Russian and Ukraine cities, which were based on original educational programs under the direction of World Psychiatric Association (WPA and International Committee For Prevention and Treatment of Depression (PTD. There, about 1450 doctors of different occupations were acquainted with the detection, management and treatment of MDD. The Russian version of WPA/PTD programs was created. The program of education included 4 modules. The Core module included an overview of the epidemiology, impact, concepts and classification, and etiology of depressive disorders as well as their recognition, diagnosis, and management in the primary care setting. The second module focused on depressive disorders in physical illness and covered those major illnesses for which is reasonable evidence for an association with depressive disorders. The third module included the development of the depressive disorders in older persons. The forth module included training physicians in mental health skills. 39 theme improvements for 858 primary care setting physicians within the framework of faculty training program of physicians’ development were the part of other programs of physicians’ occupations.Results. A number of highlights were included in the general algorithm of the educational programs. The creation of optimum «physician-depressive patient» contact demands a number of new skills to establish effective communication. These skills involve training of meeting of depressive patient and physician, the ability to follow a certain communication style; identify emotional, cognitive, psychomotor and nonverbal patterns of behavior. Besides that, the education

  19. The Diagnostic Value of MRI in Brucella Spondylitis With Comparison to Clinical and Laboratory Findings

    Science.gov (United States)

    Bagheri, Ali Baradaran; Ahmadi, Koorosh; Chokan, Niaz Mohamad Jafari; Abbasi, Bita; Akhavan, Reza; Bolvardi, Ehsan; Soroureddin, Somayeh

    2016-01-01

    Background: Brucellosis is an endemic zoonotic disease, especially in the Middle East and Mediterranean regions and can involve many organs and tissue. Osteoarticular involvement is the most common complication. Spondylitis is its most prevalent clinical form in adults, and there may be difficult in diagnosis and treatment. In present study, we aimed to assess these diagnostic value of MRI, in patients with spondylitis due to brucella, comparing with clinical and laboratory findings. Method: Patients with low back pain who were admitted to Sheikhol-raees MRI center were included in this study. None of these patients had any documented infectious disease. Diagnosis of brucellosis was made, based on MRI findings, which would be approved by serology. After confirmation with serology, the group with positive serology were compared with the negative group, in sex, age, MRI findings level of vertebral involvements, signal intensity in T1 weighted and T2 weighted. Results: Among 53 patients with diagnosis of brucella spondylitis, 33 underwent serology study, 20 were positive and 13 were negative and the others consider out of study. From these 20, 3 had tuberculosis spondylitis, whose mean age was 56 and the 67% of them were male. Mean age in the positive brucella spondylitis were 46 and 67% of them were male. In negative group mean age was 55, and of whom 57% were male. There was no statistically significant difference in MRI findings such as changes in signal intensity, disk space narrowing, Intracanalicular mass, Abscess formation. Level of invlovment in vertebrae. Conclusion: The results of this study shows that although MRI is Modality of choice in diagnosis of spondylitis, it is not enough specific to diagnosis the reasons of spondylitis. PMID:27147801

  20. Electro-diagnostic and Clinical Changes of Peripheral Neuropathies in Bam Earthquake Victims

    Directory of Open Access Journals (Sweden)

    Naser Zangiabadi

    2005-01-01

    Full Text Available To examine and diagnose patients who injured in Bam earthquake at 5:26:52 Am (local time on Friday, December 26, 2003 with traumatic peripheral neuropathies then treat and follow up. A longitudinal study was deigned. 159 patients with traumatic neuropathies were selected at the first stage of study. After six months follow up only 39 patients satisfied to enter the study. Clinical examination, Nerve conduction velocity, F wave and H wave were done and registered. The male and female frequency was equal (19M/20F and average of age was 31.1+/-11.6. During 6 months period following earthquake 19 cases (48.7% were improved in healing of neuropathies and were better in both neurological examination and electro-diagnostic tests. The repeated measurement analysis of variances did not reveal any difference in healing of nerves in sex and age groups. So patients'gender and age did not influence on recovery of neuropathies. The neuropathy injuries in Bam earthquake was the same as other earthquakes in Japan, China and Turkey, approximately. The notification to neuropathy in crush injuries and extremity damage for early diagnosis and treatment of neuropathies is considerable. At the earthquake disaster management, It is important that trained person rescue the victims to prevent extra injuries.

  1. Changing clinical picture of endemic Burkitt’s lymphoma with improved diagnostic technology: A systematic review

    Directory of Open Access Journals (Sweden)

    Kamulegeya A

    2015-07-01

    Full Text Available We evaluated the changes in anatomical locations of endemic Burkitt’s lymphoma (eBL by systematic review. We compared the reports before ultrasound became a routine investigation in Burkitt’s lymphoma (BL diagnosis with those that used ultrasound as part of pre therapeutic diagnosis. Methods: All alternative match terms able to capture the anatomical distribution of eBL were used as search terms for two electronic databases, namely Medline and “Web of Science”. Only reports that had reasonable case load were considered for analysis. However the case reports and case series with five or less patients were not included. Results: Medline produced more systematic review identified reports. The search terms “endemic Burkitt lymphoma Africa” yielded the highest number of articles in both databases but had a low precision, at 3.5. Pattern of organ involvement Burkitt lymphoma Africa had a precision at 100%. Medline recalled 27 reports that were not recalled by the Web of Science. Generally it appears that studies that have relied on laparotomies, autopsies and ultrasound have reported a higher abdominal involvement in eBL than those using clinical examination and plain radiographs. This points to the possibility of missed abdominal involvement due to diagnostic techniques. Conclusion: the review confirms that as more Sub Saharan African (SSA countries incorporate US as a routine investigation in management of eBL, we are likely to see more abdominal disease with or without facial manifestation

  2. Usefulness of clinical data and rapid diagnostic tests to identify bacterial etiology in adult respiratory infections

    Directory of Open Access Journals (Sweden)

    Pilar Toledano-Sierra

    2015-01-01

    Full Text Available Respiratory tract infections are a common complaint and most of them, such as common cold and laryngitis, are viral in origin, so antibiotic use should be exceptional. However, there are other respiratory tract infections (sinusitis, pharyngitis, lower respiratory tract infections, and exacerbations of chronic obstructive pulmonary disease where a bacterial etiology is responsible for a non-negligible percentage, and antibiotics are often empirically indicated. The aim of the study is to identify the strength of the data obtained from the symptoms, physical examination and rapid diagnostic methods in respiratory infections in which antibiotic use is frequently proposed in order to improve diagnosis and influence the decision to prescribe these drugs. The review concludes that history, physical examination and rapid tests are useful to guide the need for antibiotic treatment in diseases such as acute sinusitis, acute pharyngitis, exacerbation of lower respiratory tract infection and chronic obstructive pulmonary disease. However, no isolated data is accurate enough by itself to confirm or rule out the need for antibiotics. Therefore, clinical prediction rules bring together history and physical examination, thereby improving the accuracy of the decision to indicate or not antibiotics.

  3. Immune reactions in tuberculous and chronic constrictive pericarditis. Clinical data and diagnostic significance of antimyocardial antibodies.

    Science.gov (United States)

    Maisch, B; Maisch, S; Kochsiek, K

    1982-11-01

    Humoral immune reactions were analyzed in 12 patients with exudative tuberculous pericarditis, 10 patients with constrictive pericarditis due to former tuberculosis, 10 patients with viral pericarditis, 20 patients with pulmonary tuberculosis, and 98 healthy donors. Pericarditis occurred in 12.5% of the patients with tuberculosis, whereas the incidence of tuberculosis in the 149 patients with pericarditis was 8%. Repeated pericardial puncture and pericardial effusions of greater than 500 ml with impending cardiac tamponade had to be performed in 4 patients. Clinical data indicated probable myocardial involvement in 4 of 12 patients. Antimyolemmal antibodies, which are a muscle-specific subtype of antisarcolemmal antibodies, were found in all patients with exudative tuberculous pericarditis and viral perimyocarditis, in only 1 of 12 patients with constrictive pericarditis, and in no patients with pulmonary tuberculosis. Antifibrillary antibodies--primarily of the antimyosin type--were missed in patients with viral heart disease but were demonstrated in 75% of patients with tuberculous pericarditis. Only sera with complement-fixing antimyolemmal antibodies of the IgG type in titers greater than 1:40 induced cytolysis of vital adult heterologous cardiocytes isolated and enriched by silica sol gradient centrifugation. These findings suggest not only that antimyolemmal antibodies are diagnostic indicators of perimyocardial involvement in tuberculous pericarditis, but also that they may play a significant role in its pathogenesis. PMID:6753555

  4. Diagnostic thresholds for ambulatory blood pressure moving lower: a review based on a meta-analysis-clinical implications

    DEFF Research Database (Denmark)

    Hansen, T.W.; Kikuya, M.; Thijs, L.;

    2008-01-01

    Upper limits of normal ambulatory blood pressure (ABP) have been a matter of debate in recent years. Current diagnostic thresholds for ABP rely mainly on statistical parameters derived from reference populations. Recent findings from the International Database of Ambulatory Blood Pressure....../75 mm Hg, 130/85 mm Hg, and 110/70 mm Hg, respectively, and those for ambulatory hypertension were 130/80 mm Hg, 140/85 mm Hg, and 120/70 mm Hg. However, in clinical practice, any diagnostic threshold for blood pressure needs to be assessed in the context of the patient's overall risk profile. The IDACO...

  5. Impact of social and clinical factors on diagnostic delay of breast cancer

    Science.gov (United States)

    Dianatinasab, Mostafa; Fararouei, Mohammad; Mohammadianpanah, Mohammad; Zare-Bandamiri, Mohammad

    2016-01-01

    Abstract One of the reasons for high mortality of breast cancer is long delay in seeking medical care. This study was designed to measure the association of a wide range of socio-demographic and clinical factors with the diagnostic delay in breast cancer among Iranian patients. This study was conducted on 505 newly diagnosed patients with breast cancer from southern part of Iran. Medical files of the patients who were admitted to the hospital from November 2013 to May 2015 were examined and clinical and demographic information were extracted. According to the results, illiterate patients were diagnosed on average 87.42 days later compared with those with a college degree (95%CI: 29.68–145.16, P = 0.003) and those from rural area were diagnosed on average 72.48 days later (95%CI: 35.94–109.03, P = 0.001) compared with urban residences. Single women were diagnosed 65.99 days later (95%CI: 7.37–124.61, P = 0.02) compared with those married. Lobular or medullary types of cancer were diagnosed 65.19 days later (95%CI: 2.67–127.70, P = 0.04) compared with ductal type. On the other hand, those who were able to perform breast self-exam were diagnosed 49.07 days earlier compared with others (95%CI: 18.69–79.45, P = 0.002). Those felt lump as the initiating symptom were diagnosed 62.01 days earlier, (95%CI: 8.17–115.85, P = 0.02) compared with those with other initial symptoms. The only factor associated with doctors diagnosis delay was the place of residence as rural residences were diagnosed on average 87.42 days later compared with urban residences, (95%CI: 53.82–121.92, P = 0.001). Higher education, living in cities, ductal type of tumor, and noticing lump in breast were the most important demographic and clinical factors associated with shorter breast cancer diagnosis delay. Informing women and doctors, especially general physicians who are practicing in rural areas, of the common symptoms of breast cancer as well as training women to perform breast self

  6. Application of Diagnostic Analysis Tools to the Ares I Thrust Vector Control System

    Science.gov (United States)

    Maul, William A.; Melcher, Kevin J.; Chicatelli, Amy K.; Johnson, Stephen B.

    2010-01-01

    The NASA Ares I Crew Launch Vehicle is being designed to support missions to the International Space Station (ISS), to the Moon, and beyond. The Ares I is undergoing design and development utilizing commercial-off-the-shelf tools and hardware when applicable, along with cutting edge launch technologies and state-of-the-art design and development. In support of the vehicle s design and development, the Ares Functional Fault Analysis group was tasked to develop an Ares Vehicle Diagnostic Model (AVDM) and to demonstrate the capability of that model to support failure-related analyses and design integration. One important component of the AVDM is the Upper Stage (US) Thrust Vector Control (TVC) diagnostic model-a representation of the failure space of the US TVC subsystem. This paper first presents an overview of the AVDM, its development approach, and the software used to implement the model and conduct diagnostic analysis. It then uses the US TVC diagnostic model to illustrate details of the development, implementation, analysis, and verification processes. Finally, the paper describes how the AVDM model can impact both design and ground operations, and how some of these impacts are being realized during discussions of US TVC diagnostic analyses with US TVC designers.

  7. RETINOIDS AND THEIR APPLICATIONS IN CLINIC

    Institute of Scientific and Technical Information of China (English)

    吴文; 王振义

    2004-01-01

    This review provides an overview of relevant aspects of retinoid physiology and molecular biology, and summarizes the current status of clinical investigations on the use of retinoid for the treatment of malignancies. The mechanism underlying the anticarcinogenic activity of retinoids appears to be associated with the ability of retinoids to modulate the growth and induce differentiation, and apoptosis of normal, premalignant, and malignant cells in vitro and in vivo. Retinoid effects seem to be resulted from changes in gene expression mediated via specific nuclear receptors (termed retinoic acid receptors, RAR-α, -β and -γ).Chromosome translocations play an important role in APL pathogenesis. In the classical translocation, RAR α gene is fused with PML gene to form PML-RAR α chimeric gene,which is expressed in over 95% of the APL patients with t (15; 17) (q22; q21). Therefore, PML-RAR α fusion gene is the molecular marker of APL. ATRA can induce relocalization of the PML and restore the normal structure of POD. Furthermore, it could cause a degradation of PML-RAR α. In addition to the very high clinical response rate for APL patients treated with ATRA, clinical responses have been observed for patients with myelodysplastic syndrome,cutaneous T-cell lymphoma and skin cancers. Applications of retinoids are reviewed in different malignancies:including skin cancer, head and neck carcinoma,neuroblastoma, lung cancer, breast cancer, prostate cancer,bladder cancer and ovarian cancer in vivo and in vitro studies. The results indicate that retinoids are potentially useful agents for cancer prevention. RA combined with IFNs or RA combined with G-CSF has synergistic effect in inducing differentiation of cell growth. From current clinical results at least four leads are expected to impact on clinical development of retinoids in future: (1) development of retinoid receptor-selective agents;(2) investigation on cross-talk among members of the steroid superfamily; (3

  8. Chlorhexidine--pharmacology and clinical applications.

    Science.gov (United States)

    Lim, K-S; Kam, P C A

    2008-07-01

    Chlorhexidine is a widely used skin antisepsis preparation and is an ingredient in toothpaste and mouthwash. It is an especially effective antiseptic when combined with alcohol. Its antimicrobial effects persist because it is binds strongly to proteins in the skin and mucosa, making it an effective antiseptic ingredient for handwashing, skin preparation for surgery and the placement of intravascular access. Catheters impregnated with chlorhexidine and antimicrobial agents can reduce the incidence of catheter-related bloodstream infections. Contact dermatitis related to chlorhexidine is not common in health care workers. The incidence of contact dermatitis to chlorhexidine in atopic patients is approximately 2.5 to 5.4%. Acute hypersensitivity reactions to chlorhexidine are often not recognised and therefore may be underreported. This review discusses the pharmacology, microbiology, clinical applications and adverse effects of chlorhexidine.

  9. Coleopteran Antimicrobial Peptides: Prospects for Clinical Applications

    Directory of Open Access Journals (Sweden)

    Monde Ntwasa

    2012-01-01

    Full Text Available Antimicrobial peptides (AMPs are activated in response to septic injury and have important roles in vertebrate and invertebrate immune systems. AMPs act directly against pathogens and have both wound healing and antitumor activities. Although coleopterans comprise the largest and most diverse order of eukaryotes and occupy an earlier branch than Drosophila in the holometabolous lineage of insects, their immune system has not been studied extensively. Initial research reports, however, indicate that coleopterans possess unique immune response mechanisms, and studies of these novel mechanisms may help to further elucidate innate immunity. Recently, the complete genome sequence of Tribolium was published, boosting research on coleopteran immunity and leading to the identification of Tribolium AMPs that are shared by Drosophila and mammals, as well as other AMPs that are unique. AMPs have potential applicability in the development of vaccines. Here, we review coleopteran AMPs, their potential impact on clinical medicine, and the molecular basis of immune defense.

  10. Clinical features and applications of thallium-201

    International Nuclear Information System (INIS)

    Thallium-201 is not only used widely in myocardial imaging but also has a great potential in other various nuclear medicine imaging studies. This paper presents clinical features and applications of thallium-201, focusing on clinical trials with thallium-201 at the Shinshu University School of Medicine. Thallium-201 myocardial scintigraphy offers information on 1) ventricular position and morphology, 2) hypertrophy or dilatation of the left ventricle, 3) hypertrophy or dilatation of the right ventricle, 4) site and extent of myocardial ischemia and infarct, 5) myocardial blood flow, 6) pulmonary congestion or interstitial pulmonary edema, and 7) pericardial effusion. It can be used in the following evaluation or diagnosis: 1) acute or old myocardial infarction, 2) angina pectoris, 3) treatment strategy or prognosis of ischemic heart disease, 4) treatment strategy or observation of bypass graft or drug therapy, 5) hypertrophic or dilated idiopathic cardiomyopathy, 6) myocardial lesions induced by sarcoidosis, collagen disease, and neuro-muscular disease, 7) ventricular hypertrophy and pulmonary edema, and 9) pericarditis, pericardial effusion, and systolic pericarditis associated with underlying disease. The significance of tumor, liver, bone marrow scintigraphies is also referred to. (Namekawa, K) 69 refs

  11. Quantifying heterogeneity attributable to polythetic diagnostic criteria: theoretical framework and empirical application.

    Science.gov (United States)

    Olbert, Charles M; Gala, Gary J; Tupler, Larry A

    2014-05-01

    Heterogeneity within psychiatric disorders is both theoretically and practically problematic: For many disorders, it is possible for 2 individuals to share very few or even no symptoms in common yet share the same diagnosis. Polythetic diagnostic criteria have long been recognized to contribute to this heterogeneity, yet no unified theoretical understanding of the coherence of symptom criteria sets currently exists. A general framework for analyzing the logical and mathematical structure, coherence, and diversity of Diagnostic and Statistical Manual diagnostic categories (DSM-5 and DSM-IV-TR) is proposed, drawing from combinatorial mathematics, set theory, and information theory. Theoretical application of this framework to 18 diagnostic categories indicates that in most categories, 2 individuals with the same diagnosis may share no symptoms in common, and that any 2 theoretically possible symptom combinations will share on average less than half their symptoms. Application of this framework to 2 large empirical datasets indicates that patients who meet symptom criteria for major depressive disorder and posttraumatic stress disorder tend to share approximately three-fifths of symptoms in common. For both disorders in each of the datasets, pairs of individuals who shared no common symptoms were observed. Any 2 individuals with either diagnosis were unlikely to exhibit identical symptomatology. The theoretical and empirical results stemming from this approach have substantive implications for etiological research into, and measurement of, psychiatric disorders.

  12. Clinical application of fluorescence in situ hybridization for prenatal diagnosis

    Directory of Open Access Journals (Sweden)

    Shu-fang JIANG

    2012-07-01

    Full Text Available Objective To establish and optimize the procedures of fluorescence in situ hybridization(FISH), and evaluate its clinical value in rapid prenatal diagnosis of fetal numerical abnormality of chromosomes 21, 18, 13, X, Y. Methods Amniotic fluid or fetal blood was sampled by routine invasive procedures. After the amniotic fluid cells or fetal blood cells were separated and sequentially processed with hypotonic solution, fixation solution, smear and high temperature, they were hybridized in situ with two panels of specific fluorescence probes to detect numerical abnormality of chromosomes 21, 18, 13, X, Y. All the samples were also cultured and analyzed for their karyotype by conventional methods. Results When it was used as a diagnostic criterion of chromosomal number that the fluorescence signals were observed in ≥90% cells, GLP 13/GLP 21 probe panel showed 2 green/2 red fluorescence signals and CSP18/CSP X/CSP Y probe panel showed 2 blue/2 yellow (female or 2 blue/1 yellow/1 red fluorescence signals (male under normal condition. The test reports of all 196 cases were sent out in 72-96 hours, and 7 cases of Down syndrome, 2 cases of trisomy 18 and 1 case of sex chromosomal numerical abnormality were detected, which were accordant with karyotype analysis results reported one month later. Conclusions FISH has potential for clinical application, and is applicable to rapid prenatal diagnosis of fetal numerical abnormality of chromosomes 21, 18, 13, X, Y. The rapid FISH, together with conventional karyotyping, offer a valuable means for prenatal diagnosis of fetal aneuploidies.

  13. CT colonography after colostomy - clinical application and technical feasibility

    International Nuclear Information System (INIS)

    Full text:Introduction: The aim of this study was to evaluate the clinical application and technical implementation of computed tomographic (CT ) colonoscopy in patients undergoing sigmoid or rectal resection and following sigmoid colostomy in the course of standard diagnostic postoperative follow-up and prior to the reconstructive colon surgery. Materials and Methods: The study included 48 patients who underwent anterior abdomen-perineal or rectal resection and subsequent sigmoid colostomy in case of sigma or rectum carcinoma. The pre-procedure bowel preparation included a full colon cleansing and barium-based fecal tagging. The balloon catheter (18 F) is placed in the colonic stoma. The balloon is insufflated with 15-30 ml saline or air. The balloon was gently pulled until opening of the stoma has been closed completely. In 15 patients, a second catheter was placed in the remaining rectum. Contrast scanning in supination was done for all patients. An additional scanning in left and right lateral position was necessary for 9 patients. Results: All studies were carried out without any major complications. All patients tolerated the intubation and insufflation of air into the intestinal lumen. Two patients (4%) have evaluated the examination as uncomfortable. In 6 patients (12.5 %) it was impossible to evaluate the intestinal segments because due to a collapse of the wall. Five of them were localized in the descending colon. In 5 patients there was a significant amount of residual intestinal contents. The fecal tagging and intravenous contrast enhancing allowed the assessment of these intestinal segments. The rectal residue was correctly assessed in all patients in terms of length, position and wall changes. Conclusion: CT colonoscopy is applicable after sigmostoma in patients with abdomen-perineal and anterior rectal resection. Further in-depth studies are needed to determine the clinical indications and reliability of the method

  14. Primary intraventricular hemorrhage: Clinical features, risk factors, etiology, and yield of diagnostic cerebral angiography

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    Trilochan Srivastava

    2014-01-01

    Full Text Available Background: Primary intraventricular hemorrhage (PIVH is a rare neurological disorder, with bleeding confined to the ventricles only, without recognizable parenchymal or subarachnoid component. Aim: The purpose of this retrospective study was to identify clinical features, predisposing risk factors, etiology, radiological features and yield of diagnostic cerebral angiography in identifying the etiological causes. Settings and Design: Records of patients admitted in neurology division were analyzed in a tertiary care teaching hospital. Materials and Methods: We analyzed the records of 27 patients with PIVH evaluated and treated at our institute from August 2010 to April 2013. PIVH was diagnosed as hemorrhage in the ventricles only, detected by computed tomography scan without evidence of intraparenchymal, subarachnoid hemorrhage or intraventricular hemorrhage associated with trauma. CT angiography (CTA alone was done in 10 patients (37.03%, digital subtraction angiography (DSA in 2 patients (7.4% and both CTA as well as DSA was done in 15 patients (55.5%. Statistical Analysis Used: Categorical and continuous data were analyzed using SPSS version 17. Results: 17 (62.96% patients were females and 10 (37.03% were males with ratio of F:M= 1.7:1. Headache was the commonest mode of presentation (85.18%. Hypertension was most common predisposing factor (29.62% followed by arterio-venous malformations (AVMs (25.92%, moyamoya disease (MMD (11.11%, lenticuostriate artery aneurysm (LSA (11.11%, arterial dissections (7.4% and dural arteriovenous fistula (dAVF (3.7%. Conclusions: PIVH is rare and hypertension is important predisposing factor. Yield of cerebral angiography is high in diagnosing the etiology. AVMs and other rare etiological causes like MMD, LSA aneurysm, arterial dissection, and dAVF should be kept in mind with a high index of suspicion and warrants cerebral angiography in them, as some of the causes are potentially treatable.

  15. Investigation of the clinical performance of a novel solid-state diagnostic dosimeter.

    Science.gov (United States)

    Tse, Jason; McLean, Donald

    2015-01-01

    This study investigated the clinical performance of a novel solid-state diagnostic dosimeter, the RaySafe Xi transparent detector, by comparing its performance to a reference-class ionization chamber. Firstly a comparison of dosimeter response "free-in-air" with standard beam qualities was made, followed by an investigation into its relative transparency in an X-ray field and angular sensitivity dependence. The second part of the study looked at the overall performance of the transparent detector under scatter conditions with a number of beam qualities, including standard beam and those hardened by copper (Cu) filtration of thickness up to 0.9 mm, as would be encountered in the equipment testing of fluoroscopy systems. Overall, the transparent detector has demonstrated equivalent measurement properties to the ionization chamber under standard conditions and provided similar X-ray attenuation as reflected by the nearly identical radiographic parameters selected for both dosimeters by the automatic dose rate control (ADRC) system. Yet, it also possessed an asymmetric angular response which respectively under- and overestimated the dose contribution from the rear and lateral directions by the same amount of 50%. The transparent detector provided comparable dose reading of ± 3% to the ionization chamber with standard beam qualities and backscatter radiation present. These results were in good agreement with those of free-in-air measurement, indicating that the angular under- and overresponse might potentially compensate one another for accurate measurement. However, for identical Cu filtered beam qualities and setups, the transparent detector on average overresponded by 5.4% across the useful tube voltage range. In conclusion, the transparent detector, with its novel design, is essentially equivalent, within a 5% tolerance, to an ionization chamber, except in situations where beams hardened with Cu filtration are used with backscatter radiation present requiring

  16. Development and potential applications of microarrays based on fluorescent nanocrystal-encoded beads for multiplexed cancer diagnostics

    Science.gov (United States)

    Brazhnik, Kristina; Grinevich, Regina; Efimov, Anton E.; Nabiev, Igor; Sukhanova, Alyona

    2014-05-01

    Advanced multiplexed assays have recently become an indispensable tool for clinical diagnostics. These techniques provide simultaneous quantitative determination of multiple biomolecules in a single sample quickly and accurately. The development of multiplex suspension arrays is currently of particular interest for clinical applications. Optical encoding of microparticles is the most available and easy-to-use technique. This technology uses fluorophores incorporated into microbeads to obtain individual optical codes. Fluorophore-encoded beads can be rapidly analyzed using classical flow cytometry or microfluidic techniques. We have developed a new generation of highly sensitive and specific diagnostic systems for detection of cancer antigens in human serum samples based on microbeads encoded with fluorescent quantum dots (QDs). The designed suspension microarray system was validated for quantitative detection of (1) free and total prostate specific antigen (PSA) in the serum of patients with prostate cancer and (2) carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA 15-3) in the serum of patients with breast cancer. The serum samples from healthy donors were used as a control. The antigen detection is based on the formation of an immune complex of a specific capture antibody (Ab), a target antigen (Ag), and a detector Ab on the surface of the encoded particles. The capture Ab is bound to the polymer shell of microbeads via an adapter molecule, for example, protein A. Protein A binds a monoclonal Ab in a highly oriented manner due to specific interaction with the Fc-region of the Ab molecule. Each antigen can be recognized and detected due to a specific microbead population carrying the unique fluorescent code. 100 and 231 serum samples from patients with different stages of prostate cancer and breast cancer, respectively, and those from healthy donors were examined using the designed suspension system. The data were validated by comparing with the results of

  17. Decisions to withhold diagnostic investigations in nursing home patients with a clinical suspicion of venous thromboembolism.

    Directory of Open Access Journals (Sweden)

    Henrike J Schouten

    Full Text Available This study aimed to gather insights in physicians' considerations for decisions to either refer for- or to withhold additional diagnostic investigations in nursing home patients with a suspicion of venous thromboembolism.Our study was nested in an observational study on diagnostic strategies for suspected venous thromboembolism in nursing home patients. Patient characteristics, bleeding-complications and mortality were related to the decision to withhold investigations. For a better understanding of the physicians' decisions, 21 individual face-to-face in-depth interviews were performed and analysed using the grounded theory approach.Referal for additional diagnostic investigations was forgone in 126/322 (39.1% patients with an indication for diagnostic work-up. 'Blind' anticoagulant treatment was initiated in 95 (75.4% of these patients. The 3 month mortality rates were higher for patients in whom investigations were withheld than in the referred patients, irrespective of anticoagulant treatment (odds ratio 2.45; 95% confidence interval 1.40 to 4.29 but when adjusted for the probability of being referred (i.e. the propensity score, there was no relation of non-diagnosis decisions to mortality (odds ratio 1.75; 0.98 to 3.11. In their decisions to forgo diagnostic investigations, physicians incorporated the estimated relative impact of the potential disease; the potential net-benefits of diagnostic investigations and whether performing investigations agreed with established management goals in advance care planning.Referral for additional diagnostic investigations is withheld in almost 40% of Dutch nursing home patients with suspected venous thromboembolism and an indication for diagnostic work-up. We propose that, given the complexity of these decisions and the uncertainty regarding their indirect effects on patient outcome, more attention should be focused on the decision to either use or withhold additional diagnostic tests.

  18. Aptamers: An in vitro Evolution of Therapeutic and Diagnostic Applications in Medicine

    OpenAIRE

    Kayhan, Basak; Uner KAYABAs

    2013-01-01

    Aptamers are nucleic acid oligomers with distinct conformational shapes that allow binding targets with high affinity and specificity. Selective Evolution of Ligands by Exponential Enrichment (SELEX); an in vitro selection process to develop aptamers, has been invented in 1990. Despite more than 20 years have passed after its discovery, products of SELEX technology are in use in medicine. In this review we discuss why we need aptamers not only in therapeutic but also in diagnostic application...

  19. Clinical and laboratory features that discriminate dengue from other febrile illnesses: a diagnostic accuracy study in Rio de Janeiro, Brazil

    OpenAIRE

    Daumas Regina P; Passos Sonia RL; Oliveira Raquel VC; Nogueira Rita MR; Georg Ingebourg; Marzochi Keyla BF; Brasil Patrícia

    2013-01-01

    Abstract Background Dengue is an acute febrile illness caused by an arbovirus that is endemic in more than 100 countries. Early diagnosis and adequate management are critical to reduce mortality. This study aims to identify clinical and hematological features that could be useful to discriminate dengue from other febrile illnesses (OFI) up to the third day of disease. Methods We conducted a sectional diagnostic study with patients aged 12 years or older who reported fever lasting up to three ...

  20. Laboratory demonstration of a prozone-like effect in HRP2-detecting malaria rapid diagnostic tests: implications for clinical management

    OpenAIRE

    McCarthy James S; Cheng Qin; Belizario Vicente; Alcantara Sheila; Baker Joanne; Luchavez Jennifer; Bell David

    2011-01-01

    Abstract Background Malaria rapid diagnostic tests (RDTs) are now widely used for prompt on-site diagnosis in remote endemic areas where reliable microscopy is absent. Aberrant results, whereby negative test results occur at high parasite densities, have been variously reported for over a decade and have led to questions regarding the reliability of the tests in clinical use. Methods In the first trial, serial dilutions of recombinant HRP2 antigen were tested on an HRP2-detectiing RDT. In a s...

  1. Comparison of ICD-10R, DSM-IV-TR and DSM-5 in an Adult Autism Spectrum Disorder Diagnostic Clinic

    Science.gov (United States)

    Wilson, C. Ellie; Gillan, Nicola; Spain, Deborah; Robertson, Dene; Roberts, Gedeon; Murphy, Clodagh M.; Maltezos, Stefanos; Zinkstok, Janneke; Johnston, Katie; Dardani, Christina; Ohlsen, Chris; Deeley, P. Quinton; Craig, Michael; Mendez, Maria A.; Happé, Francesca; Murphy, Declan G. M.

    2013-01-01

    An Autism Spectrum Disorder (ASD) diagnosis is often used to access services. We investigated whether ASD diagnostic outcome varied when DSM-5 was used compared to ICD-10R and DSM-IV-TR in a clinical sample of 150 intellectually able adults. Of those diagnosed with an ASD using ICD-10R, 56% met DSM-5 ASD criteria. A further 19% met DSM-5 (draft)…

  2. COMPARATIVE EFFICIENCY OF SOME INDIRECT DIAGNOSTIC TESTS FOR THE DETECTION OF SUB-CLINICAL MASTITIS IN COWS AND BUFFALOES

    OpenAIRE

    M. IQBAL, M. AMJED1, M. A. KHAN, M. S. QURESHI1 AND U. SADIQUE1

    2006-01-01

    The present study was undertaken to compare five laboratory diagnostic tests for sub-clinical mastitis in cattle and buffaloes and to compute cost, time taken by each test and its ranking for availability, adoptability, interpretability and sensitivity. There were 352 cases with each test type viz. California Mastitis Test (CMT), White Side Test (WST), White Side + Dye (WSTD), Surf Test and Surf + Dye, and 880 cases with each species type (cattle and buffaloes). Result scores (1760 ) for sub...

  3. Quality control in diagnostic radiology: software (Visual Basic 6) and database applications

    International Nuclear Information System (INIS)

    Quality Assurance programme in diagnostic Radiology is being implemented by the Ministry of Health (MoH) in Malaysia. Under this program the performance of an x-ray machine used for diagnostic purpose is tested by using the approved procedure which is commonly known as Quality Control in diagnostic radiology. The quality control or performance tests are carried out b a class H licence holder issued the Atomic Energy Licensing Act 1984. There are a few computer applications (software) that are available in the market which can be used for this purpose. A computer application (software) using Visual Basics 6 and Microsoft Access, is being developed to expedite data handling, analysis and storage as well as report writing of the quality control tests. In this paper important features of the software for quality control tests are explained in brief. A simple database is being established for this purpose which is linked to the software. Problems encountered in the preparation of database are discussed in this paper. A few examples of practical usage of the software and database applications are presented in brief. (Author)

  4. PLZT-Modified Relaxor Piezoelectric Ceramic System for Medical Diagnostic Applications

    Directory of Open Access Journals (Sweden)

    Koduri Ramam

    2008-01-01

    Full Text Available The piezoelectric ceramic system [Pb0.978–yLa0.012Ba0.01Sry][(Zr0.534Ti0.4660.987Nb0.008]O3 (PLBSZNT has been fabricated for use in medical diagnostics applications. The fundamental pre-requisites are high-density, high dielectric constant and high piezoelectric properties that serve as compatible ceramic materials for medical diagnostic applications. It is essential for sensitive transducers that the piezoelectric ceramics must efficiently convert between electrical and mechanical energy, and so the electromechanical coupling coefficients should be high, as the fabrication process of tiny elements for medical arrays must be carried out without damaging the material and its properties. In our study, Sr-modified PLBZNT had shown single ferroelectric tetragonal phase. An analysis of different Sr doping concentration is reported, and the high dielectric permittivity, low dielectric loss along with high electromechanical properties indicate that PLBSZNT is suitable for medical diagnostic applications as well as sensors and actuators.

  5. Diagnostic stability among chronic patients with functional psychoses: an epidemiological and clinical study

    Directory of Open Access Journals (Sweden)

    Jakobsen Klaus D

    2007-08-01

    Full Text Available Abstract Background Diagnostic stability and illness course of chronic non-organic psychoses are complex phenomena and only few risk factors or predictors are known that can be used reliably. This study investigates the diagnostic stability during the entire course of illness in patients with non-organic psychoses and attempts to identify non-psychopathological risk factors or predictors. Method 100 patients with functional psychosis were initially characterised using the Operational Criteria Checklist for Psychotic Illness and Affective Illness (OPCRIT, medical records and health registers. To study the stability of diagnoses (i.e. shifts per time, we used registry data to define four measures of diagnostic variation that were subsequently examined in relation to four possible measures of time (i.e. observation periods or hospitalisation events. Afterwards, we identified putative co-variables and predictors of the best measures of diagnostic stability. Results All four measures of diagnostic variation are very strongly associated with numbers-of-hospitalisations and less so with duration-of-illness, duration-of-hospitalisation and with year-of-first-admission. The four measures of diagnostic variation corrected for numbers-of-hospitalisations were therefore used to study the diagnostic stability. Conventional predictors of illness course – e.g. age-of-onset and premorbid-functioning – are not significantly associated with stability. Only somatic-comorbidity is significantly associated with two measures of stability, while family-history-of-psychiatric-illness and global-assessment-of-functioning (GAF scale score show a trend. However, the traditional variables age-of-first-admission, civil-status, first-diagnosis-being-schizophrenia and somatic-comorbidity are able to explain two-fifth of the variation in numbers-of-hospitalisations. Conclusion Diagnostic stability is closely linked with the contact between patient and the healthcare system

  6. Acute Respiratory Distress Syndrome diagnosis after coronary artery bypass: comparison between diagnostic criteria and clinical picture.

    Directory of Open Access Journals (Sweden)

    Manzar Vakili

    2015-01-01

    Full Text Available Acute Respiratory Distress Syndrome (ARDS is a potential complication of cardiac surgery, given that patients undergoing CABG frequently have hypoxemia and pulmonary dysfunction during initial hours after surgery. Thus, ARDS criteria in these patients are more likely to be positive while these criteria may not match the patient`s clinical picture. We aimed to investigate frequency of rapid onset hypoxemia in Pressure of Arterial Oxygen to Fractional Inspired Oxygen Concentration (PaO2/FiO2 less than 200 and diffuse pulmonary infiltrates as two diagnostic criteria forwards and compared these criteria with the clinical picture of the patients after Coronary Artery Bypass Graft (CABG in this study. The study was prospective case series which carried out in about six months. All patients admitted to intensive care unit of Tehran Heart Center, who had undergone CABG on cardiopulmonary pump (CPB recruited in the study. After considering inclusion criteria, age, sex, duration of intubation, arterial blood gas and chest radiography, on 24 hours and 48 hours after admission to the ICU were recorded. Then, patients with rapid onset of hypoxemia (PaO2/FiO2≤200mmHg and diffuse pulmonary infiltrates and without sign or symptoms of obvious heart failure (probable positive ARDS cases criteria were recorded and comparison between these probable positive cases with clinician`s clinical diagnosis (blinded to the study was performed. In this study, a total of 300 patients after on-pump coronary artery bypass surgery were included. Postoperatively, 2 (0.66 % in the 24 hours and 4 (1.33% patients in 48 hours after surgery were positive for the two ARDS criteria according to the checklists, but; nobody had saved persistently ARDS criteria persistently during 48 hours after surgery. At the same time, clinician did not report any case of ARDS among 300 patients. In this study patients with ARDS criteria had no significant differences in age (P.value=0.937 and sex (P

  7. Principles for new optical techniques in medical diagnostics for mHealth applications

    Science.gov (United States)

    Balsam, Joshua Michael

    Medical diagnostics is a critical element of effective medical treatment. However, many modern and emerging diagnostic technologies are not affordable or compatible with the needs and conditions found in low-income and middle-income countries and regions. Resource-poor areas require low-cost, robust, easy-to-use, and portable diagnostics devices compatible with telemedicine (i.e. mHealth) that can be adapted to meet diverse medical needs. Many suitable devices will need to be based on optical technologies, which are used for many types of biological analyses. This dissertation describes the fabrication and detection principles for several low-cost optical technologies for mHealth applications including: (1) a webcam based multi-wavelength fluorescence plate reader, (2) a lens-free optical detector used for the detection of Botulinum A neurotoxin activity, (3) a low cost micro-array reader that allows the performance of typical fluorescence based assays demonstrated for the detection of the toxin staphylococcal enterotoxin (SEB), and (4) a wide-field flow cytometer for high throughput detection of fluorescently labeled rare cells. This dissertation discusses how these technologies can be harnessed using readily available consumer electronics components such as webcams, cell phones, CCD cameras, LEDs, and laser diodes. There are challenges in developing devices with sufficient sensitivity and specificity, and approaches are presented to overcoming these challenges to create optical detectors that can serve as low cost medical diagnostics in resource-poor settings for mHealth.

  8. Proteomics of ovarian cancer: functional insights and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Elzek, Mohamed A.; Rodland, Karin D.

    2015-03-01

    In the past decade, there has been an increasing interest in applying proteomics to assist in understanding the pathogenesis of ovarian cancer, elucidating the mechanism of drug resistance, and in the development of biomarkers for early detection of ovarian cancer. Although ovarian cancer is a spectrum of different diseases, the strategies for diagnosis and treatment with surgery and adjuvant therapy are similar across ovarian cancer types, increasing the general applicabil- ity of discoveries made through proteomics research. While proteomic experiments face many difficulties which slow the pace of clinical applications, recent advances in proteomic technology contribute significantly to the identification of aberrant proteins and networks which can serve as targets for biomarker development and individualized therapies. This review provides a summary of the literature on proteomics’ contributions to ovarian cancer research and highlights the current issues, future directions, and challenges. We propose that protein-level characterization of primary lesion in ovarian cancer can decipher the mystery of this disease, improve diagnostic tools, and lead to more effective screening programs.

  9. Development and clinical application of transient elastography(FibroScan

    Directory of Open Access Journals (Sweden)

    Guo-feng CHEN

    2011-11-01

    Full Text Available Chronic liver fibrosis,an important step in the development of liver diseases,is an anaplerotic reaction of an organism to chronic liver damage caused by various kinds of pathogens.It is a common pathologic change in chronic liver diseases and the intermediate link in the development of liver cirrhosis.Liver fibrosis can be reversed in the early stage,as well as in the later stage.Cases of liver cirrhosis that are confirmed during the earlier stage can be treated and prognosticated more efficiently.Currently,liver biopsy is still the gold standard for diagnosing liver fibrosis.However,its invasiveness causes patients to refuse the examination.Noninvasive diagnostic technology for liver fibrosis has made considerable development in recent years.One of these technologies is transient elastography(FibroScan of liver stiffness using elastic shear wave,which has good accuracy and specificity for the determination of liver fibrosis.It is noninvasive,fast,repeatable,and it can evaluate liver fibrosis objectively and quantitatively.It will have a broad range of clinical applications in the future.

  10. Clinical application of therapeutic erythrocytapheresis (TEA).

    Science.gov (United States)

    Valbonesi, M; Bruni, R

    2000-06-01

    Therapeutic erythrocytapheresis (TEA) has been used in different diseases such as polycythemia vera (PV), secondary erythrocytosis or hemochromatosis as a process of the less cumbersome but more expensive phlebotomy. TEA is preferred in emergency conditions such as thrombocytosis or in conditions such as porphyria cutanea tarda (PCT) or erythropoietic porphyria when plasma exchange (PEX) is often combined with TEA to reduce extracellular levels of uroporphyrin which contribute to plasma hyperviscosity. TEA is often combined with drug therapy that varies from etoposide in PV to EPO and desferoxamine which are used to mobilize and reduce iron stores in hemochromatosis. Benefits from this combination may be more long lasting than expected. Nonetheless for TEA, there is no standard protocol and, clinical experience with this therapy remains highly anecdotal. Therapeutic red cell-exchange (TREX) has been used with much interest over the years, starting with the management of hemolytic disease of the newborn and later used to correct severe anemia in thalassemia patients thereby preventing iron overload. It has also been used for the management of complications of sickle cell disease such as priapism, chest syndrome, stroke, retinal, bone, splenic and hepatic infarction or in preparation for surgery by reducing HbS to less than 30%. Automated apheresis has also favored the use of TREX in conditions such as paroxysmal nocturnal hemoglobinuria and aniline poisoning, arsenic poisoning, Na chlorate intoxications and CO intoxications, hemoglobinopathies, autoimmune hemolytic anemia, reactions due to ABO incompatibility, in preparation for ABO incompatible bone marrow transplantation or for preventing anti-D immunization after the transfusion of D(+) cells to D(-) recipients. Another field of application has been in the emergency management of intraerythrocytic parasite infections such as malaria and babesiosis. Application of TREX may be wide but its real use remains limited

  11. PREFACE: IX International Conference on Modern Techniques of Plasma Diagnostics and their Application

    Science.gov (United States)

    Savjolov, A. S.; Dodulad, E. I.

    2016-01-01

    The IX Conference on ''Modern Techniques of Plasma Diagnosis and their Application'' was held on 5 - 7 November, 2014 at National Research Nuclear University MEPhI (NRNU MEPhI). The goal of the conference was an exchange of information on both high-temperature and low-temperature plasma diagnostics as well as deliberation and analysis of various diagnostic techniques and their applicability in science, industry, ecology, medicine and other fields. The Conference also provided young scientists from scientific centres and universities engaged in plasma diagnostics with an opportunity to attend the lectures given by the leading specialists in this field as well as present their own results and findings. The first workshop titled ''Modern problems of plasma diagnostics and their application for control of chemicals and the environment'' took place at Moscow Engineering and Physics Institute (MEPhI) in June 1998 with the support of the Section on Diagnostics of the Council of Russian Academic of Science on Plasma Physics and since then these forums have been held at MEPhI every two years. In 2008 the workshop was assigned a conference status. More than 150 specialists on plasma diagnostics and students took part in the last conference. They represented leading Russian scientific centres (such as Troitsk Institute of Innovative and Thermonuclear Research, National Research Centre ''Kurchatov Institute'', Russian Federal Nuclear Centre - All-Russian Scientific Research Institute of Experimental Physics and others) and universities from Belarus, Ukraine, Germany, USA, Belgium and Sweden. About 30 reports were made by young researchers, students and post-graduate students. All presentations during the conference were broadcasted online over the internet with viewers in Moscow, Prague, St. Petersburgh and other cities. The Conference was held within the framework of the Centre of Plasma, Laser Research and Technology supported by MEPhI Academic Excellence Project (Russian

  12. Application of contrast sensitivity in clinical neurology

    NARCIS (Netherlands)

    C. Bulens (Carel)

    1988-01-01

    textabstractThis thesis is devoted to one new diagnostic technique called spatial contrast sensitivity (CS) measurement, to study visual function. This technique provides a much more comprehensive measure of visual efficiency than a standard acuity score. The visibility of objects depends not only o

  13. Noncontact blood perfusion mapping in clinical applications

    Science.gov (United States)

    Iakovlev, Dmitry; Dwyer, Vincent; Hu, Sijung; Silberschmidt, Vadim

    2016-04-01

    Non-contact imaging photoplethysmography (iPPG) to detect pulsatile blood microcirculation in tissue has been selected as a successor to low spatial resolution and slow scanning blood perfusion techniques currently employed by clinicians. The proposed iPPG system employs a novel illumination source constructed of multiple high power LEDs with narrow spectral emission, which are temporally modulated and synchronised with a high performance sCMOS sensor. To ensure spectrum stability and prevent thermal wavelength drift due to junction temperature variations, each LED features a custom-designed thermal management system to effectively dissipate generated heat and auto-adjust current flow. The use of a multi-wavelength approach has resulted in simultaneous microvascular perfusion monitoring at various tissue depths, which is an added benefit for specific clinical applications. A synchronous detection algorithm to extract weak photoplethysmographic pulse-waveforms demonstrated robustness and high efficiency when applied to even small regions of 5 mm2. The experimental results showed evidences that the proposed system could achieve noticeable accuracy in blood perfusion monitoring by creating complex amplitude and phase maps for the tissue under examination.

  14. Clinical Application of Partial Splenic Embolization

    Directory of Open Access Journals (Sweden)

    Yong-Song Guan

    2014-01-01

    Full Text Available Partial splenic embolization (PSE is one of the intra-arterial therapeutic approaches of diseases. With the development of interventional radiology, the applications of PSE in clinical practice are greatly extended, while various materials are developed for embolization use. Common indications of PSE include hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia, autoimmune hemolytic anemia, splenic trauma, idiopathic thrombocytopenic purpura, splenic hemangioma, and liver cancer. It is also performed to exclude splenic artery aneurysms from the parent vessel lumen and prevent aneurysm rupture, to treat splenic artery steal syndrome and improve liver perfusion in liver transplant recipients, and to administer targeted treatment to areas of neoplastic disease in the splenic parenchyma. Indicators of the therapeutic effect evaluation of PSE comprise blood routine test, changes in hemodynamics and in splenic volume. Major complications of PSE include the pulmonary complications, severe infection, damages of renal and liver function, and portal vein thrombosis. The limitations of PSE exist mainly in the difficulties in selecting the arteries to embolize and in evaluating the embolized volume.

  15. Clinical application of partial splenic embolization.

    Science.gov (United States)

    Guan, Yong-Song; Hu, Ying

    2014-01-01

    Partial splenic embolization (PSE) is one of the intra-arterial therapeutic approaches of diseases. With the development of interventional radiology, the applications of PSE in clinical practice are greatly extended, while various materials are developed for embolization use. Common indications of PSE include hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia, autoimmune hemolytic anemia, splenic trauma, idiopathic thrombocytopenic purpura, splenic hemangioma, and liver cancer. It is also performed to exclude splenic artery aneurysms from the parent vessel lumen and prevent aneurysm rupture, to treat splenic artery steal syndrome and improve liver perfusion in liver transplant recipients, and to administer targeted treatment to areas of neoplastic disease in the splenic parenchyma. Indicators of the therapeutic effect evaluation of PSE comprise blood routine test, changes in hemodynamics and in splenic volume. Major complications of PSE include the pulmonary complications, severe infection, damages of renal and liver function, and portal vein thrombosis. The limitations of PSE exist mainly in the difficulties in selecting the arteries to embolize and in evaluating the embolized volume.

  16. Clinical applications of radiolabeled blood elements in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Martin-Comin, J. (Hospital Princeps d' Espanya, Barcelona (Spain). S. Medicina Nuclear); Prats, E. (Hospital Cinico, Zaragoza (Spain). S.Medicina Nuclear)

    1999-03-01

    The work discusses the main clinical features of inflammatory bowel disease (IBD) and the methods to obtain an accurate diagnostic. Nuclear medicine procedures are deeply analysed, with special emphasis in those where clinical experience is larger and that are available for clinical practice in most countries. In the opinion of the authors [sup 99m]Tc-HMPAO is the first choice agent, while [sup 111]In-oxine could be considered as a gold standard for evaluation of new agents. In the context of IBD, the WBC scintigraphy is useful for its diagnosis and the evaluation of disease extension. The evaluation of disease severity deserves further experiences.

  17. A clinical diagnostic model for predicting influenza among young adult military personnel with febrile respiratory illness in Singapore.

    Directory of Open Access Journals (Sweden)

    Vernon J Lee

    Full Text Available INTRODUCTION: Influenza infections present with wide-ranging clinical features. We aim to compare the differences in presentation between influenza and non-influenza cases among those with febrile respiratory illness (FRI to determine predictors of influenza infection. METHODS: Personnel with FRI (defined as fever ≥ 37.5 °C, with cough or sore throat were recruited from the sentinel surveillance system in the Singapore military. Nasal washes were collected, and tested using the Resplex II and additional PCR assays for etiological determination. Interviewer-administered questionnaires collected information on patient demographics and clinical features. Univariate comparison of the various parameters was conducted, with statistically significant parameters entered into a multivariate logistic regression model. The final multivariate model for influenza versus non-influenza cases was used to build a predictive probability clinical diagnostic model. RESULTS: 821 out of 2858 subjects recruited from 11 May 2009 to 25 Jun 2010 had influenza, of which 434 (52.9% had 2009 influenza A (H1N1, 58 (7.1% seasonal influenza A (H3N2 and 269 (32.8% influenza B. Influenza-positive cases were significantly more likely to present with running nose, chills and rigors, ocular symptoms and higher temperature, and less likely with sore throat, photophobia, injected pharynx, and nausea/vomiting. Our clinical diagnostic model had a sensitivity of 65% (95% CI: 58%, 72%, specificity of 69% (95% CI: 62%, 75%, and overall accuracy of 68% (95% CI: 64%, 71%, performing significantly better than conventional influenza-like illness (ILI criteria. CONCLUSIONS: Use of a clinical diagnostic model may help predict influenza better than the conventional ILI definition among young adults with FRI.

  18. Recurrence Incidence in Differentiated Thyroid Cancers and the Importance of Diagnostic Iodine-131 Scintigraphy in Clinical Follow-up

    Directory of Open Access Journals (Sweden)

    Filiz Hatipoğlu

    2016-06-01

    Full Text Available Objective: Differentiated thyroid cancers (DTC are tumors with good prognosis. However, local recurrence or distant metastasis can be observed. In our study, we aimed to investigate the incidence of recurrence and the importance of diagnostic iodine-131 whole body scan (WBS in clinical follow-up in patients with DTC. Methods: The clinical data of 217 patients with DTC who were followed-up more than 3 years were reviewed retrospectively. The incidence of recurrence was investigated in a group of patients who had radioactive iodine (RAI treatment and showed no sign of residual thyroid tissue or metastasis with diagnostic WBS that was performed at 6-12 months after therapy and had a thyroglobulin (Tg level lower than 2 ng/dl. Results: At the time of diagnosis, ten cases had thyroid capsule invasion, 25 cases had extra-thyroid soft tissue invasion, 11 patients showed lymph node metastasis and four patients had distant organ metastasis. One hundred forty-five patients had RAI treatment at ablation dose (75-100 mCi, whereas 35 patients had RAI treatment at metastasis dose (150-200 mCi. Thirty-seven patients with papillary microcarcinoma did not receive RAI treatment. In 12 (%7.5 of the 160 patients who were considered as “successful ablation”, a recurrence was identified. Recurrence was detected by diagnostic WBS in all cases and stimulated Tg level was <2 ng/dL with the exception of the two cases who had distant metastasis. Conclusion: Identification of pathological findings with WBS in patients who developed local recurrence in the absence of elevated Tg highlights the importance of diagnostic WBS in clinical follow-up.

  19. PET and diagnostic technology evaluation in a global clinical process. DGN's point of view

    International Nuclear Information System (INIS)

    The German Society of Nuclear Medicine (DGN) criticizes the methodological approach of the IQWiG for evaluation of PET and the conclusions, which represent the opposite point of view compared to the most other European countries and health companies in the USA: (1) Real integration of experienced physicians into the interpretation of data and the evaluation of effectiveness should be used for best possible reporting instead of only formal hearing. (2) Data of the National Oncologic PET Registry (NOPR) from the USA have shown, that PET has changed the therapeutic management in 38% of patients. (3) The decision of the IQWiG to accept outcome data only for their benefit analyses, is controversial. Medical knowledge is generated by different methods, and an actual analysis of the scientific guidelines has shown that only 15% out of all guidelines are based on the level of evidence demanded by the IQWiG. Health economics has created different assessment methods for the evaluation of a diagnostic procedure. The strategy chosen by the IQWiG overestimated the perspective of the population and undervalue the benefit for an individual patient. (4) PET evaluates the effectiveness of a therapeutic procedure, but does not create an effective therapy. When the predictive value of PET is already implemented in a specific study design and the result of PET define a specific management, the trial evaluate the whole algorithm and PET is part of this algorithm only. When PET is implemented as test during chemotherapy or by the end of chemotherapy, the predictive value of PET will depend decisively on the effectiveness of the therapy: The better the therapy, the smaller the differences in survival detected by PET. (5) The significance of an optimal staging by the integration of PET will increase. Rationale is the actual development of ''titration'' of chemotherapy intensity and radiation dose towards the lowest possible, just about effective dosage. (6) The medical therapy of

  20. Implementation and Operational Research: What Happens After a Negative Test for Tuberculosis? Evaluating Adherence to TB Diagnostic Algorithms in South African Primary Health Clinics

    OpenAIRE

    McCarthy, K. M.; Grant, A. D.; Chihota, V.; Ginindza, S; Mvusi, L.; Churchyard, G.J.; Fielding, K.L.

    2016-01-01

    Introduction and Background: Diagnostic tests for tuberculosis (TB) using sputum have suboptimal sensitivity among HIV-positive persons. We assessed health care worker adherence to TB diagnostic algorithms after negative sputum test results. Methods: The XTEND (Xpert for TB—Evaluating a New Diagnostic) trial compared outcomes among people tested for TB in primary care clinics using Xpert MTB/RIF vs. smear microscopy as the initial test. We analyzed data from XTEND participants who were HIV po...

  1. The use of rapid dengue diagnostic tests in a routine clinical setting in a dengue-endemic area of Colombia.

    Science.gov (United States)

    Osorio, Lyda; Uribe, Marcela; Ardila, Gloria Ines; Orejuela, Yaneth; Velasco, Margarita; Bonelo, Anilza; Parra, Beatriz

    2015-06-01

    There is insufficient evidence of the usefulness of dengue diagnostic tests under routine conditions. We sought to analyse how physicians are using dengue diagnostics to inform research and development. Subjects attending 14 health institutions in an endemic area of Colombia with either a clinical diagnosis of dengue or for whom a dengue test was ordered were included in the study. Patterns of test-use are described herein. Factors associated with the ordering of dengue diagnostic tests were identified using contingency tables, nonparametric tests and logistic regression. A total of 778 subjects were diagnosed with dengue by the treating physician, of whom 386 (49.5%) were tested for dengue. Another 491 dengue tests were ordered in subjects whose primary diagnosis was not dengue. Severe dengue classification [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.1-4.5], emergency consultation (OR 1.9; 95% CI 1.4-2.5) and month of the year (OR 3.1; 95% CI 1.7-5.5) were independently associated with ordering of dengue tests. Dengue tests were used both to rule in and rule out diagnosis. The latter use is not justified by the sensitivity of current rapid dengue diagnostic tests. Ordering of dengue tests appear to depend on a combination of factors, including physician and institutional preferences, as well as other patient and epidemiological factors.

  2. Application of Dynamic Logic Algorithm to Inverse Scattering Problems Related to Plasma Diagnostics

    Science.gov (United States)

    Perlovsky, L.; Deming, R. W.; Sotnikov, V.

    2010-11-01

    In plasma diagnostics scattering of electromagnetic waves is widely used for identification of density and wave field perturbations. In the present work we use a powerful mathematical approach, dynamic logic (DL), to identify the spectra of scattered electromagnetic (EM) waves produced by the interaction of the incident EM wave with a Langmuir soliton in the presence of noise. The problem is especially difficult since the spectral amplitudes of the noise pattern are comparable with the amplitudes of the scattered waves. In the past DL has been applied to a number of complex problems in artificial intelligence, pattern recognition, and signal processing, resulting in revolutionary improvements. Here we demonstrate its application to plasma diagnostic problems. [4pt] Perlovsky, L.I., 2001. Neural Networks and Intellect: using model-based concepts. Oxford University Press, New York, NY.

  3. A flexible mobile-device biosensing instrumentation platform for point-of-care medical diagnostics applications

    DEFF Research Database (Denmark)

    Patou, François; Pfreundt, Andrea; Zulfiqar, Azeem;

    2014-01-01

    C medical diagnostics context necessitates considering broader requirements, notably in terms of usability, flexibility, and integration capabilities. These characteristics call for multi-disciplinary design methodologies inspired from the field of systems engineering and constitute the motivations...... helping to address this challenge. Specifically, Lab-on-Chip (LoC) devices have a key role to play in the advent of Point-of-Care (PoC) medical applications, driving a shift of the medical diagnostics paradigm and the transition from a centralized, technical, high-throughput biological sample analysis...... programmable electrical readout from LoCs potentially comprehending varied transducers addressing different targeted biological markers. A smart-phone/tablet docking-station embeds the hardware interface necessary for the implementation of a smart-phone digital lock-in amplifier. The platform is tested...

  4. [The importance of clinical information in diagnostic imaging in the febrile patient].

    Science.gov (United States)

    Szücs-Farkas, Z; Vock, P

    2006-10-01

    From conventional radiography to cross-sectional imaging methods, modern radiology offers a wide range of diagnostic tools for investigating patients with fever. To achieve the best results and to yield a correct diagnosis, the radiologist must tailor the diagnostic protocol individually for every patient. The decision on the most suitable imaging method, and the type and timing of contrast media strongly depends on the suspected diagnosis. Based on patient history and laboratory data, some modalities may be contraindicated or the patient may need a premedication. The authors give a short overview of diagnostic strategies in evaluating the most important causes of fever and point to the need of discussion and co-operation between clinicians and radiologists. PMID:17048182

  5. MALDI TOF imaging mass spectrometry in clinical pathology: a valuable tool for cancer diagnostics (review).

    Science.gov (United States)

    Kriegsmann, Jörg; Kriegsmann, Mark; Casadonte, Rita

    2015-03-01

    Matrix-assisted laser desorption/ionization (MALDI) time-of-flight (TOF) imaging mass spectrometry (IMS) is an evolving technique in cancer diagnostics and combines the advantages of mass spectrometry (proteomics), detection of numerous molecules, and spatial resolution in histological tissue sections and cytological preparations. This method allows the detection of proteins, peptides, lipids, carbohydrates or glycoconjugates and small molecules.Formalin-fixed paraffin-embedded tissue can also be investigated by IMS, thus, this method seems to be an ideal tool for cancer diagnostics and biomarker discovery. It may add information to the identification of tumor margins and tumor heterogeneity. The technique allows tumor typing, especially identification of the tumor of origin in metastatic tissue, as well as grading and may provide prognostic information. IMS is a valuable method for the identification of biomarkers and can complement histology, immunohistology and molecular pathology in various fields of histopathological diagnostics, especially with regard to identification and grading of tumors.

  6. Hemicrania continua in a headache clinic: referral source and diagnostic delay in a series of 22 patients.

    Science.gov (United States)

    Cortijo, Elisa; Guerrero, Angel L; Herrero, Sonia; Mulero, Patricia; Muñoz, Irene; Pedraza, María I; Peñas, María L; Rojo, Esther; Campos, Dulce; Fernández, Rosa

    2012-10-01

    Hemicrania continua (HC) is a unilateral and continuous primary headache with superimposed exacerbations frequently associated with autonomic features. Diagnostic criteria of HC, according to II Edition of International Classification of Headache Disorders require complete response to indomethacin. HC is probably misdiagnosed more often than other primary headaches. We aim to analyze characteristics of a series of 22 consecutive cases of HC. We recruited patients from a headache outpatient clinic in a tertiary hospital over a 3-year period (January 2008 to January 2011). We prospectively gathered demographic and nosological characteristics and considered referral source and delay between onset of headache and diagnosis of HC. Twenty-two patients (14 females, 8 males) out of 1,150, who attended the mentioned clinic during the inclusion period (1.9 %) were diagnosed with HC. All cases responded to indomethacin. No patient received a diagnosis of HC before attending our headache office. Mean latency of diagnosis was 86.1 ± 106.5 months (range 3-360). 11 patients (50 %) were referred from primary care, with 9 (40.9 %) from other neurology clinics and 2 (9.1 %) from other specialities offices. According to our series, HC is not an infrequent diagnosis in a headache outpatient clinic. Diagnostic delay is comparable to data collected in previous studies. As HC is frequently misdiagnosed, we thing there is a need for increasing the understanding of this entity, potentially responsive to indomethacin.

  7. The road map towards providing a robust Raman spectroscopy-based cancer diagnostic platform and integration into clinic

    Science.gov (United States)

    Lau, Katherine; Isabelle, Martin; Lloyd, Gavin R.; Old, Oliver; Shepherd, Neil; Bell, Ian M.; Dorney, Jennifer; Lewis, Aaran; Gaifulina, Riana; Rodriguez-Justo, Manuel; Kendall, Catherine; Stone, Nicolas; Thomas, Geraint; Reece, David

    2016-03-01

    Despite the demonstrated potential as an accurate cancer diagnostic tool, Raman spectroscopy (RS) is yet to be adopted by the clinic for histopathology reviews. The Stratified Medicine through Advanced Raman Technologies (SMART) consortium has begun to address some of the hurdles in its adoption for cancer diagnosis. These hurdles include awareness and acceptance of the technology, practicality of integration into the histopathology workflow, data reproducibility and availability of transferrable models. We have formed a consortium, in joint efforts, to develop optimised protocols for tissue sample preparation, data collection and analysis. These protocols will be supported by provision of suitable hardware and software tools to allow statistically sound classification models to be built and transferred for use on different systems. In addition, we are building a validated gastrointestinal (GI) cancers model, which can be trialled as part of the histopathology workflow at hospitals, and a classification tool. At the end of the project, we aim to deliver a robust Raman based diagnostic platform to enable clinical researchers to stage cancer, define tumour margin, build cancer diagnostic models and discover novel disease bio markers.

  8. The American College of Radiology Imaging Network (ACRIN) – Clinical Trials of Diagnostic Imaging and Image-Guided Treatment

    OpenAIRE

    Hillman, Bruce J.; Gatsonis, Constantine

    2008-01-01

    The American College of Radiology Imaging Network (ACRIN) is the youngest of the NCI cooperative groups. ACRIN trials are directed towards evaluating the applications of diagnostic imaging and image-guided treatment to cancer. As ACRIN begins its third funding cycle, the organization is increasingly emphasizing several themes: linking imaging surveillance to pre-imaging testing for disease to improve the efficiency of cancer screening; the evaluation of imaging tests as biomarkers for molecul...

  9. [Clinical application of skin sympathetic nerve activity].

    Science.gov (United States)

    Iwase, Satoshi

    2009-03-01

    Skin sympathetic nerve activity (SSNA) is microneurographically recorded from the skin nerve fascicle in the peripheral nerves. It is characterized by the following features: 1) irregular, pulse asynchronous, burst activity with respiratory variation, 2) burst activity followed by vasoconstriction and/or sweating, 3) elicited by mental stress and arousal stimuli, e.g., sound, pain, electric stimulation, 4) burst with longer duration as compared with sympathetic outflow to muscles, and 5) burst activity following sudden inspiratory action. It comprises vasoconstrictor (VC) and sudomotor(SM) activity, as well as vasodilator (VD) activity. VC and SM discharge independently, whereas VD is the same activity with different neurotransmission. The VC and SM are differentiated by effector response, e.g., laser Doppler flowmetry and skin potential changes. SSNA function in thermoregulation in the human body; however it is also elicited by mental stress. SSNA is the lowest at thermoneutral ambient temperature (approximately 27 degrees C), and is enhanced in the pressence of ambient warm and cool air. The burst amplitude is well-correlated to both skin blood flow reduction rate or sweat rate change. The clinical application of SSNA comprises the following: 1) clarification of sweating phenomenon, 2) clarification and diagnosis of anhidrosis, 3) clarification and diagnosis of hyperhidrosis, 4) clarification of thermoregulatory function and diagnosis of thermoregulatory disorder, 5) clarification of pathophysiology and diagnosis of vascular diseases, e.g., Raynaud and Buerger diseases. 6) clarification of the relation between cognitive function and SSNA and 7) determination of pharmacological effect attributable to change in neuroeffector responses. PMID:19301594

  10. Clinical utility of Raman spectroscopy: current applications and ongoing developments

    OpenAIRE

    Wang, Wenbo

    2016-01-01

    Hanna C McGregor,1 Wenbo Wang,1,2 Michael A Short,1 Haishan Zeng,1,3 1Integrative Oncology Department, BC Cancer Agency Research Centre, 2Department of Biomedical Engineering, 3Department of Dermatology, The University of British Columbia, Vancouver, BC, Canada Abstract: Availability of fast, noninvasive/minimally invasive, and accurate diagnostic tests can maximize the benefit of patient care. The application of Raman spectroscopy (RS) in biological and biomedical applications has ...

  11. Diagnostic accuracy of the STRATIFY clinical prediction rule for falls: A systematic review and meta-analysis

    LENUS (Irish Health Repository)

    Billington, Jennifer

    2012-08-07

    AbstractBackgroundThe STRATIFY score is a clinical prediction rule (CPR) derived to assist clinicians to identify patients at risk of falling. The purpose of this systematic review and meta-analysis is to determine the overall diagnostic accuracy of the STRATIFY rule across a variety of clinical settings.MethodsA literature search was performed to identify all studies that validated the STRATIFY rule. The methodological quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A STRATIFY score of ≥2 points was used to identify individuals at higher risk of falling. All included studies were combined using a bivariate random effects model to generate pooled sensitivity and specificity of STRATIFY at ≥2 points. Heterogeneity was assessed using the variance of logit transformed sensitivity and specificity.ResultsSeventeen studies were included in our meta-analysis, incorporating 11,378 patients. At a score ≥2 points, the STRATIFY rule is more useful at ruling out falls in those classified as low risk, with a greater pooled sensitivity estimate (0.67, 95% CI 0.52–0.80) than specificity (0.57, 95% CI 0.45 – 0.69). The sensitivity analysis which examined the performance of the rule in different settings and subgroups also showed broadly comparable results, indicating that the STRATIFY rule performs in a similar manner across a variety of different ‘at risk’ patient groups in different clinical settings.ConclusionThis systematic review shows that the diagnostic accuracy of the STRATIFY rule is limited and should not be used in isolation for identifying individuals at high risk of falls in clinical practice.

  12. Functional MRI in children: clinical and research applications

    International Nuclear Information System (INIS)

    Functional MRI has become a critical research tool for evaluating brain function and developmental trajectories in children. Its clinical use in children is becoming more common. This presentation will review the basic underlying physiologic and technical aspects of fMRI, review research applications that have direct clinical relevance, and outline the current clinical uses of this technology. (orig.)

  13. Genome and exome sequencing in the clinic: unbiased genomic approaches with a high diagnostic yield

    NARCIS (Netherlands)

    Nelen, M.; Veltman, J.A.

    2012-01-01

    For the reasons discussed here, we think whole-genome- or exome-based approaches are currently most suited for diagnostic implementation in genetically heterogeneous diseases, initially to complement and later to replace Sanger sequencing, qPCR and genomic microarrays. Patients do need to be counsel

  14. Amniocentesis is a safe and effective prenatal diagnostic tool: a clinical study in Eastern India

    Directory of Open Access Journals (Sweden)

    Kanchan Mukherjee

    2015-10-01

    Conclusions: Two factors, indications for amniocentesis as well as the procedure itself, contribute to the risk of miscarriage. The procedure-related risk is very low and the total risk of miscarriage is around one percent. Amniocentesis is a safe and effective prenatal diagnostic procedure. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1330-1334

  15. The challenge of Clostridium difficile infection: Overview of clinical manifestations, diagnostic tools and therapeutic options

    NARCIS (Netherlands)

    Postma, N.; Kiers, D.; Pickkers, P.

    2015-01-01

    The most important infectious cause of antibiotic-associated diarrhoea and colitis is Clostridium difficile, which is a Gram-positive, anaerobic, spore-forming, toxin-producing bacillus. In this overview we will discuss the diagnostic and therapeutic management of patients presenting with suspected

  16. DRAFT: Russian Association of Endocrinologists Clinic Guidelines for Thyroid Nodules Diagnostic and Treatment

    Directory of Open Access Journals (Sweden)

    Vladimir Eduardovich Vanushko

    2015-05-01

    Full Text Available Russian guidelines for diagnostic of thyroid nodules gained some actual questions: necessity of ultrasound (US-screening of the thyroid cancer, indications for fine needle aspiration and exam of calcitonin, necessity of unification of US and cytopathology classification for signs of thyroid nodules. 

  17. Clinical impact of diagnostic SPET investigations with a dopamine re-uptake ligand

    DEFF Research Database (Denmark)

    Løkkegaard, Annemette; Werdelin, Lene M; Friberg, Lars

    2002-01-01

    of presynaptic dopamine transporters (DAT receptors) has provided a possible diagnostic probe in the evaluation of Parkinson's disease. The cocaine analogue [(123)I]-2-beta-carboxymethoxy-3-beta(4-iodophenyl)tropane ([(123)I]-beta-CIT) is one of several radioligands that have been developed for single...

  18. A Clinical Analysis of 293 FUO Patients, A Diagnostic Model Discriminating infectious Diseases from Non-infectious Diseases

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    Objective A diagnostic model was established to discriminate infectious diseases from non-infectious diseases. Methods The clinical data of patients with fever of unknown origin (FUO) hospitalized in Xiangya Hospital Central South University, from January, 2006 to April, 2011 were retrospectively analyzed. Patients enrolled were divided into two groups. The ifrst group was used to develop a diagnostic model: independent variables were recorded and considered in a logistic regression analysis to identify infectious and non-infectious diseases (αin= 0.05, αout= 0.10). The second group was used to evaluate the diagnostic model and make ROC analysis. Results The diagnostic rate of 143 patients in the ifrst group was 87.4%, the diagnosis included infectious disease (52.4%), connective tissue diseases (16.8%), neoplastic disease (16.1%) and miscellaneous (2.1%). The diagnostic rate of 168 patients in the second group was 88.4%, and the diagnosis was similar to the ifrst group. Logistic regression analysis showed that decreased white blood cell count (WBC 320 U/L) and lymphadenectasis were independent risk factors associated with non-infectious diseases. The odds ratios were 14.74, 5.84 and 5.11 (P≤ 0.01) , respectively. In ROC analysis, the sensitivity and speciifcity of the positive predictive values was 62.1% and 89.1%, respectively, while that of negative predicting values were 75% and 81.7%, respectively (AUC = 0.76,P = 0.00). Conclusions The combination of WBC 320 U/L and lymphadenectasis may be useful in discriminating infectious diseases from non-infectious diseases in patients hospitalized as FUO.

  19. Interleukin (IL)-1A and IL-6: Applications to the predictive diagnostic testing of radiation pneumonitis

    International Nuclear Information System (INIS)

    Purpose: To explore the application of interleukin (IL)-1α and IL-6 measurements in the predictive diagnostic testing for symptomatic radiation pneumonitis (RP). Methods and materials: In a prospective protocol investigating RP and cytokines, IL-1α and IL-6 values were analyzed by enzyme-linked immunosorbent assay from serial weekly blood samples of patients receiving chest radiation. We analyzed sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) over selected threshold values for both cytokines in the application to diagnostic testing. Results: The average coefficient of variation was 51% of the weekly mean IL-1α level and 39% of the weekly mean IL-6 value. Interleukin 1α and IL-6 became positively correlated with time. Specificity for both cytokines was better than sensitivity. IL-6 globally outperformed IL-1α in predicting RP, with higher PPV and NPV. Conclusions: Our data demonstrate the feasibility of applying IL-1α and IL-6 measurements of blood specimens to predict RP. Interleukin-6 measurements offer stronger positive predictive value than IL-1α. This application might be further explored in a larger sample of patients

  20. [The clinical management guidelines of the Sociedad Española de Cardiología. Nuclear cardiology: the technical bases and clinical applications].

    Science.gov (United States)

    Candell Riera, J; Castell Conesa, J; Jurado López, J A; López de Sá, E; Nuño de la Rosa, J A; Ortigosa Aso, F J; Valle Tudela, V

    1999-11-01

    Although the role of nuclear cardiology is currently well consolidated, the addition of new radiotracers and modern techniques prompt us to permanently update the requirements, equipment and clinical applications of these isotopic tests. Radioisotopic drugs, instrumentation and characteristics of radionuclide tests that are presently used are explained in the first part of this text. In the second part, diagnostic and prognostic indications of these tests are presented in detail.

  1. Atypical phenotypes associated with pathogenic CHD7 variants and a proposal for broadening CHARGE syndrome clinical diagnostic criteria.

    Science.gov (United States)

    Hale, Caitlin L; Niederriter, Adrienne N; Green, Glenn E; Martin, Donna M

    2016-02-01

    CHARGE syndrome (Coloboma of the eye, Heart defects, Atresia of the choanae, Retardation of growth and/or development, Genital and/or urinary anomalies, and Ear malformations, including deafness and vestibular disorders) is a genetic condition characterized by a specific and recognizable pattern of features. Heterozygous pathogenic variants in the chromodomain helicase DNA-binding protein 7 (CHD7) are the major cause of CHARGE syndrome, and have been identified in 70-90% of individuals fulfilling clinical diagnostic criteria. Since 2004, when CHD7 was discovered as the causative gene for CHARGE syndrome, the phenotypic spectrum associated with pathogenic CHD7 variants has expanded. Predicted pathogenic CHD7 variants have been identified in individuals with isolated features of CHARGE including autism and hypogonadotropic hypogonadism. Here, we present genotype and phenotype data from a cohort of 28 patients who were considered for a diagnosis of CHARGE syndrome, including one patient with atypical presentations and a pathogenic CHD7 variant. We also summarize published literature on pathogenic CHD7 variant positive individuals who have atypical clinical presentations. Lastly, we propose a revision to current clinical diagnostic criteria, including broadening of the major features associated with CHARGE syndrome and addition of pathogenic CHD7 variant status as a major criterion. PMID:26590800

  2. Children with Generalised Joint Hypermobility and Musculoskeletal Complaints: State of the Art on Diagnostics, Clinical Characteristics, and Treatment

    Directory of Open Access Journals (Sweden)

    M. C. Scheper

    2013-01-01

    Full Text Available Introduction. To provide a state of the art on diagnostics, clinical characteristics, and treatment of paediatric generalised joint hypermobility (GJH and joint hypermobility syndrome (JHS. Method. A narrative review was performed regarding diagnostics and clinical characteristics. Effectiveness of treatment was evaluated by systematic review. Searches of Medline and Central were performed and included nonsymptomatic and symptomatic forms of GJH (JHS, collagen diseases. Results. In the last decade, scientific research has accumulated on all domains of the ICF. GJH/JHS can be considered as a clinical entity, which can have serious effects during all stages of life. However research regarding the pathological mechanism has resulted in new potential opportunities for treatment. When regarding the effectiveness of current treatments, the search identified 1318 studies, from which three were included (JHS: n=2, Osteogenesis Imperfecta: n=1. According to the best evidence synthesis, there was strong evidence that enhancing physical fitness is an effective treatment for children with JHS. However this was based on only two studies. Conclusion. Based on the sparsely available knowledge on intervention studies, future longitudinal studies should focus on the effect of physical activity, fitness, and joint stabilisation. In JHS and chronic pain, the effectiveness of a multidisciplinary approach should be investigated.

  3. Monitoring and Diagnostics for C/C++ Real-Time Applications

    CERN Document Server

    Fischer, Yves

    Knowledge about the internal state of computational processes is essential for problem diagnostics as well as for constant monitoring and pre-failure recognition. The CMX li- brary provides monitoring capabilities similiar to the Java Management Extensions (JMX) for C and C++ applications. This thesis provides a detailed analysis of the requirements for monitoring and diagnos- tics of the C/C++ processes at CERN. The developed CMX library enables real-time C/C++ processes to expose values with- out harming their normal execution. CMX is portable and can be integrated in different monitoring architectures.

  4. Novel insights into esophageal diagnostic procedures

    DEFF Research Database (Denmark)

    Savarino, Edoardo; Ottonello, Andrea; Tolone, Salvatore;

    2016-01-01

    The 21st century offers new advances in diagnostic procedures and protocols in the management of esophageal diseases. This review highlights the most recent advances in esophageal diagnostic technologies, including clinical applications of novel endoscopic devices, such as ultrathin endoscopy and...

  5. Magnetoencephalography: From first steps to clinical applications

    Science.gov (United States)

    Ilmoniemi, Risto

    2014-03-01

    -density imaging (Nieminen et al. Magn Reson Imaging, 2013). MEG has established itself as a standard tool in human neuroscience (Hamalainen et al., Rev Mod Phys 65:413-97, 1993). It is used increasingly in clinical applications such as in locating motor or language areas prior to brain surgery or in determining characteristics of epileptic activity of patients. Support from the Academy of Finland is acknowledged.

  6. Smartphone Applications for the Clinical Oncologist in UK Practice.

    Science.gov (United States)

    Rozati, Hamoun; Shah, Sonya Pratik; Shah, Neha

    2015-06-01

    A number of medical smartphone applications have been developed to assist clinical oncology specialists. Concerns have arisen that the information provided may not be under sufficient scrutiny. This study aims to analyse the current applications available for clinical oncologists in the UK. Applications aimed specifically at physician clinical oncologists were searched for on the major smartphone operating systems: Apple iOS; Google Android; Microsoft Windows OS; and Blackberry OS. All applications were installed and analysed. The applications were scrutinised to assess the following information: cost; whether the information included was referenced; when the information was last updated; and whether they made any reference to UK guidelines. A novel rating score based on these criteria was applied to each application. Fifty applications were identified: 24 for Apple's iOS; 23 for Google's Android; 2 for Blackberry OS; and 1 for Windows OS. The categories of applications available were: drug reference; journal reference; learning; clinical calculators; decision support; guidelines; and dictionaries. Journal reference and guideline applications scored highly on our rating system. Drug reference application costs were prohibitive. Learning tools were poorly referenced and not up-to-date. Smartphones provide easy access to information. There are numerous applications devoted to oncology physicians, many of which are free and contain referenced, up-to-date data. The cost and quality of drug reference and learning applications have significant scope for improvement. A regulatory body is needed to ensure the presence of peer-reviewed, validated applications to ensure their reliability. PMID:24903139

  7. Clinical diagnostic value of assessment of helicobacter pylori infection with 14C-UBT in gastrointestinal and other diseases

    International Nuclear Information System (INIS)

    Objective: To investigate clinical diagnostic value of assessment of HP infection with 14C-Urea breath test (14C- UBT) in gastrointestinal and other diseases. Methods: The rate of HP infection was detected with 14C-UBT in 2050 patients with gastrointestinal disease, 510 patients with other diseases and 70 healthy controls. Results: (1) The positive rate and rate of moderate and advanced degree of HP infection in patients with gastrointestinal disease were significantly higher than those in controls (86% vs 51%, P14C-UBT is of high sensitivity and specificity. This test is cheap and can be readily performed, and is one of the best methods available. (authors)

  8. Selection and evaluation of clinical diagnostic cut point of glycated albumin

    Institute of Scientific and Technical Information of China (English)

    杨静

    2014-01-01

    Objective To investigate the relationship between GA and HbA1c,to identify the optimal GA cut-off values used to diagnose preDM and DM,and to verify the diagnostic significance of blood glucose biomarkers.Methods A total of 20 491 samples from Chinese people were involved in the correlation analysis.The participants were expected to complete the test of FPG,HbA1cand GA.

  9. Clinical diagnostic criteria of multiple sclerosis: the role of magnetic resonance imaging

    International Nuclear Information System (INIS)

    The objective of this article is to summarize the diagnostic criteria recommended by the International Panel on the Diagnosis of Multiple Sclerosis in 2001. The recommendations of another working group, the Consortium of Multiple Sclerosis Centers Consensus Meeting, which met in Vancouver in 2001, concerning the diagnosis and follow-up of patients with multiple sclerosis are also presented in an effort to standardize the protocols for magnetic resonance imaging of these patients. (author)

  10. Clinical and diagnostic role of autoantibodies to gangliosides of peripheral nerves: literature review and own expirience

    Directory of Open Access Journals (Sweden)

    N. A. Suponeva

    2013-01-01

    Full Text Available The study of anti-glycolipid antibodies has become available to general practice in Russia. Indications for determining antibodies to gangliosidesare Guillain–Barré syndrome, Miller Fisher syndrome, Bickerstaff’s encephalitis, chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy. The indication for measuring anti-MAG antibodies is IgM paraprotein-associated polyneuropathy. These immunological tests must be included in diagnostic protocols if the listed dysimmune diseases are suspected.

  11. Clinical Performance of an Automated Reader in Interpreting Malaria Rapid Diagnostic Tests in Tanzania.

    OpenAIRE

    Shekalaghe, Seif; Cancino, Marcela; Mavere, Caroline; Juma, Omar; Mohammed, Ali; Abdulla, Salim; Ferro, Santiago

    2013-01-01

    Background Parasitological confirmation of malaria is now recommended in all febrile patients by the World Health Organization (WHO) to reduce inappropriate use of anti-malarial drugs. Widespread implementation of rapid diagnostic tests (RDTs) is regarded as an effective strategy to achieve this goal. However, the quality of diagnosis provided by RDTs in remote rural dispensaries and health centres is not ideal. Feasible RDT quality control programmes in these settings are challenging. Collec...

  12. Laser diagnostic and therapy of dental caries: the clinic point of view

    International Nuclear Information System (INIS)

    Dental caries's diagnosis is a major dentistry problem from the clinic point of view. The laser beam on the region of 655 nm induces the fluorescence of the compounds present in the hard tissue, quantifying differences between sound and carious enamel and dentine. Diagnodent (Kavo, Germany), showed to be effective regarding dental caries's diagnosis in the present research sampling. The Er:YAG laser (Kavo Key Laser 2, Germany) performed efficient cavity preparations in caries lesions of I and V class type, using up energies that ranged from 300 mJ to 350 mJ with 4 Hz repetition rate for the enamel; and from 250 mJ to 300 mJ with 4 Hz repetition rate for the dentine, and with 80 mJ with 6 Hz of repetition rate for laser conditioning. In the Er:YAG laser preparations no patient was anesthetized even when there were deeper cavities, and the maximum degree of pain ( which ranged from 0 to 10) was 4. In the control group with conventional high-speed drill two patients were anesthetized and the maximum degree of pain was 7. Restorations performed by conventional method of composite were equally satisfying both in caries groups of I and V class type and in the control group. The laser application in the operative dentistry office as a new method of diagnosis and dental preparations should be a good alternative to the use of the conventional dental drill. Nevertheless, dentistry practice has a lot to improve from technology progress, as well as new researches on laser dentistry are necessary in a long term. New types of lasers will come about and will increasingly improve the dental practice assistance and procedures quality. (author)

  13. Clinical Application of Heat-Acupuncture Therapy

    Institute of Scientific and Technical Information of China (English)

    Guan Zunhui; Wang Xinzhong

    2006-01-01

    @@ Heat-acupuncture therapy refers to a therapeutic method with which a GZH heat-acupuncture apparatus is used to warm the needle inserted in the human body, and to keep the needle in a constant temperature. It has been proved by clinical researches over 20 years that the heat-acupuncture therapy can yield a joint therapeutic effect of acupuncture,moxibustion, moxibustion with warming needle and fire needle, thus raising the clinical therapeutic effects in treating certain diseases.

  14. Evolvable Smartphone-Based Platforms for Point-Of-Care In-Vitro Diagnostics Applications

    DEFF Research Database (Denmark)

    Patou, François; Al Atraktchi, Fatima Al-Zahraa; Kjærgaard, Claus;

    2016-01-01

    The association of smart mobile devices and lab-on-chip technologies offers unprecedented opportunities for the emergence of direct-to-consumer in vitro medical diagnostics applications. Despite their clear transformative potential, obstacles remain to the large-scale disruption and long-lasting ......The association of smart mobile devices and lab-on-chip technologies offers unprecedented opportunities for the emergence of direct-to-consumer in vitro medical diagnostics applications. Despite their clear transformative potential, obstacles remain to the large-scale disruption and long......-lasting success of these systems in the consumer market. For instance, the increasing level of complexity of instrumented lab-on-chip devices, coupled to the sporadic nature of point-of-care testing, threatens the viability of a business model mainly relying on disposable/consumable lab-on-chips. We argued...... recently that system evolvability, defined as the design characteristic that facilitates more manageable transitions between system generations via the modification of an inherited design, can help remedy these limitations. In this paper, we discuss how platform-based design can constitute a formal entry...

  15. FAR-TECH's Nanoparticle Plasma Jet System and its Application to Disruptions, Deep Fueling, and Diagnostics

    Science.gov (United States)

    Thompson, J. R.; Bogatu, I. N.; Galkin, S. A.; Kim, J. S.

    2012-10-01

    Hyper-velocity plasma jets have potential applications in tokamaks for disruption mitigation, deep fueling and diagnostics. Pulsed power based solid-state sources and plasma accelerators offer advantages of rapid response and mass delivery at high velocities. Fast response is critical for some disruption mitigation scenario needs, while high velocity is especially important for penetration into tokamak plasma and its confining magnetic field, as in the case of deep fueling. FAR-TECH is developing the capability of producing large-mass hyper-velocity plasma jets. The prototype solid-state source has produced: 1) >8.4 mg of H2 gas only, and 2) >25 mg of H2 and >180 mg of C60 in a H2/C60 gas mixture. Using a coaxial plasma gun coupled to the source, we have successfully demonstrated the acceleration of composite H/C60 plasma jets, with momentum as high as 0.6 g.km/s, and containing an estimated C60 mass of ˜75 mg. We present the status of FAR-TECH's nanoparticle plasma jet system and discuss its application to disruptions, deep fueling, and diagnostics. A new TiH2/C60 solid-state source capable of generating significantly higher quantities of H2 and C60 in <0.5 ms will be discussed.

  16. Continuous-wave infrared optical nerve stimulation for potential diagnostic applications

    Science.gov (United States)

    Tozburun, Serhat; Cilip, Christopher M.; Lagoda, Gwen A.; Burnett, Arthur L.; Fried, Nathaniel M.

    2010-09-01

    Optical nerve stimulation using infrared laser radiation has recently been developed as a potential alternative to electrical nerve stimulation. However, recent studies have focused primarily on pulsed delivery of the laser radiation and at relatively low pulse rates. The objective of this study is to demonstrate faster optical stimulation of the prostate cavernous nerves using continuous-wave (cw) infrared laser radiation for potential diagnostic applications. A thulium fiber laser (λ=1870 nm) is used for noncontact optical stimulation of the rat prostate cavernous nerves in vivo. Optical nerve stimulation, as measured by an intracavernous pressure (ICP) response in the penis, is achieved with the laser operating in either cw mode, or with a 5-ms pulse duration at 10, 20, 30, 40, 50, and 100 Hz. Successful optical stimulation is observed to be primarily dependent on a threshold nerve temperature (42 to 45 °C), rather than an incident fluence, as previously reported. cw optical nerve stimulation provides a significantly faster ICP response time using a lower power (and also less expensive) laser than pulsed stimulation. cw optical nerve stimulation may therefore represent an alternative mode of stimulation for intraoperative diagnostic applications where a rapid response is critical, such as identification of the cavernous nerves during prostate cancer surgery.

  17. Status and headway of the clinical application of artificial ligaments

    Directory of Open Access Journals (Sweden)

    Tianwu Chen

    2015-01-01

    Full Text Available The authors first reviewed the history of clinical application of artificial ligaments. Then, the status of clinical application of artificial ligaments was detailed. Some artificial ligaments possessed comparable efficacy to, and fewer postoperative complications than, allografts and autografts in ligament reconstruction, especially for the anterior cruciate ligament. At the end, the authors focused on the development of two types of artificial ligaments: polyethylene glycol terephthalate artificial ligaments and tissue-engineered ligaments. In conclusion, owing to the advancements in surgical techniques, materials processing, and weaving methods, clinical application of some artificial ligaments so far has demonstrated good outcomes and will become a trend in the future.

  18. Diagnostic and prognostic value of asphyxia, Sarnat's clinical classification, and CT-scan in perinatal brain damage

    International Nuclear Information System (INIS)

    A retrospective review was made of 145 babies, excluding those with congenital heart disease or chromosome aberration, admitted for CT scanning. The study was done to determine the diagnostic and prognostic value of CT findings, as well as the presence of asphyxia and the clinical stage based on the Sarnat's classification, in perinatal brain damage. The patients had a minimum follow up of 2 years for the evaluation of neurologic manifestations, such as cerebral palsy, epilepsy and mental retardation. Among babies weighing 2,000 g or more at birth, neonatal asphyxia was significantly correlated with neurologic prognosis. In addition, both clinical stages and CT findings were significantly correlated with neurologic prognosis, irrespective of birth weight. The correlation between clinical stages and CT findings was significant, irrespective of body weight, however, a significant correlation between clinical stages and neonatal asphyxia was restricted to those weighing 2,000 g or more. These findings suggest that the presence of asphyxia, clinical stages and CT findings are complementary in the diagnosis and prognosis evaluation of perinatal brain damage. (N.K.)

  19. Application of special computer programs for diagnostics and treatment of amblyopia.

    Science.gov (United States)

    Tsitsiashvili, E

    2007-09-01

    Under amblyopia one ought to understand a variety by origin forms of reduction of vision the reason for which are functional disorders of the visual analyzer with no changes in the fundus of the eye and without any organic affections of the visual pathways and centers. At the present time, the pathophysiological mechanisms of amblyopia remain a puzzle. Diagnostics and adequate treatment of amblyopia remains so far a topical problem in clinical ophthalmology. The objective of our investigation was to estimate functional state of the visual system and efficiency of treatment of amblyopia of varying degree by means of special computer programs. Clinical researches were based on the analysis of results of 317 patients (410 eyes) with anisometropic (120 patients-120 eyes), disbinocular (127 patients-150 eyes) and refractive (70 patients-140 eyes) amblyopias of different degrees at the age from 5 to 17 with visual acuity from 0.05 up to 0.5 on the amblyopic eye, with the symptoms of functional disturbance: decrease in achromatic and color spatial contrast sensitivity in the domain of high and middle frequencies; decrease in contrast sensitivity of on-off channels of the retinal cone system; normal sensitivity to saturated colors; decrease in color sensitivity to unsaturated, red and green colors; dramatic changes in color (red and green) sensitivity in the paracentral zone (5 degrees -10 degrees ) of the retina and 20 healthy children-40 eyes. In addition to routine ophthalmologic methods we also used the special computer programs for diagnostics and adequate treatment of amblyopia: "ZEBRA"; "OFF-ON"; "eYe" ("Shooting-gallery", "Chase", "Crosses","Spiders"); "Contour"; "MEKO" ("KONSTR", "UFO", "SHOW"). Statistical analysis of results was performed with statistical method "ANOVA". Diagnostical computer methods enable quantitative estimation of the functional state of different channels of the visual system (based on the data of spatial contrast, light, color and contrast

  20. Application of special computer programs for diagnostics and treatment of amblyopia.

    Science.gov (United States)

    Tsitsiashvili, E

    2007-09-01

    Under amblyopia one ought to understand a variety by origin forms of reduction of vision the reason for which are functional disorders of the visual analyzer with no changes in the fundus of the eye and without any organic affections of the visual pathways and centers. At the present time, the pathophysiological mechanisms of amblyopia remain a puzzle. Diagnostics and adequate treatment of amblyopia remains so far a topical problem in clinical ophthalmology. The objective of our investigation was to estimate functional state of the visual system and efficiency of treatment of amblyopia of varying degree by means of special computer programs. Clinical researches were based on the analysis of results of 317 patients (410 eyes) with anisometropic (120 patients-120 eyes), disbinocular (127 patients-150 eyes) and refractive (70 patients-140 eyes) amblyopias of different degrees at the age from 5 to 17 with visual acuity from 0.05 up to 0.5 on the amblyopic eye, with the symptoms of functional disturbance: decrease in achromatic and color spatial contrast sensitivity in the domain of high and middle frequencies; decrease in contrast sensitivity of on-off channels of the retinal cone system; normal sensitivity to saturated colors; decrease in color sensitivity to unsaturated, red and green colors; dramatic changes in color (red and green) sensitivity in the paracentral zone (5 degrees -10 degrees ) of the retina and 20 healthy children-40 eyes. In addition to routine ophthalmologic methods we also used the special computer programs for diagnostics and adequate treatment of amblyopia: "ZEBRA"; "OFF-ON"; "eYe" ("Shooting-gallery", "Chase", "Crosses","Spiders"); "Contour"; "MEKO" ("KONSTR", "UFO", "SHOW"). Statistical analysis of results was performed with statistical method "ANOVA". Diagnostical computer methods enable quantitative estimation of the functional state of different channels of the visual system (based on the data of spatial contrast, light, color and contrast

  1. MR angiography: clinical applications in thoracic surgery

    International Nuclear Information System (INIS)

    MR angiography (MRA) is a promising completion of MR imaging in the preoperative assessment of pulmonary and mediastinal tumours. Scan acquisition was done by sequential FLASH 2D angiograms (TR = 30 ms, TE = 10 ms, FA = 30 ), one section per breathhold, section thickness 5 mm with 1 mm overlap between sequential sections. An automated control procedure allowed individual continuation of the examination. Postprocessing by a maximum-intensity-projection algorithm using angiograms of interest (AOI) resulted in 3D reconstructions illustrating vascular anatomy and avoiding superimposition. This technique was evaluated in a prospective study of 15 patients with malignant intrathoracic tumours. The results were validated by conventional angiographic procedures such as pulmonary angiography, digital subtraction angiography or cavography. Complementing spin-echo (SE) imaging, MRA provided diagnostic information about vessel displacement, stenosis and perfusion defects due to space-occupying lesions. Thus, MRA was helpful in planning thoracic surgery. (orig.)

  2. Probing intracellular mass density fluctuation through confocal microscopy: application in cancer diagnostics as a case study

    CERN Document Server

    Sahay, Peeyush; Ghimire, Hemendra M; Almabadi, Huda; Yallappu, Murali M; Skalli, Omar; Jaggi, Meena; Chauhan, Subhash C; Pradhan, Prabhakar

    2015-01-01

    Intracellular structural alterations are hallmark of several disease conditions and treatment modalities. However, robust methods to quantify these changes are scarce. In view of this, we introduce a new method to quantify structural alterations in biological cells through the widely used confocal microscopy. This novel method employs optical eigenfunctions localization properties of cells and quantifies the degree of structural alterations, in terms of nano- to micron scale intracellular mass density fluctuations, in one single parameter. Such approach allows a powerful way to compare changing structures in heterogeneous cellular media irrespective of the origin of the cause. As a case study, we demonstrate its applicability in cancer detection with breast and prostate cancer cases of different tumorigenicity levels. Adding new dimensions to the confocal based studies, this technique has potentially significant applications in areas ranging from disease diagnostics to therapeutic studies, such as patient pro...

  3. Short-Term Memory and Auditory Processing Disorders: Concurrent Validity and Clinical Diagnostic Markers

    Science.gov (United States)

    Maerlender, Arthur

    2010-01-01

    Auditory processing disorders (APDs) are of interest to educators and clinicians, as they impact school functioning. Little work has been completed to demonstrate how children with APDs perform on clinical tests. In a series of studies, standard clinical (psychometric) tests from the Wechsler Intelligence Scale for Children, Fourth Edition…

  4. ANALYSIS OF MAIN REASONS FOR MISTAKES IN DIAGNOSTICS OF EPILEPTIC SEIZURES AND EPILEPTIC SYNDROMES (CLINICAL PECULIARITIES OF EPILEPTIC SEIZURES

    Directory of Open Access Journals (Sweden)

    M. B. Mironov

    2014-01-01

    Full Text Available Epilepsy is a chronic brain disease that requires long therapy and continuous careful supervision of the status of the patient. In connection with this, both overdiagnosis and underdiagnosis of this disease is extremely dangerous. Overdiagnosis causes ungrounded social "label", limitation in rights, significant decreasing quality of life of the patient, family problems, prescription of long-term anti-epileptic therapy that may cause potential side effects. Underdiagnosis of epilepsy frequently causes further resistance of seizures to therapy, they become more frequent, there appears the possibility of development of epileptic status, life threatening situations, possibility of development of cognitive disorders associated with the disease. A significant progress in epileptology and medical technologies (video electroencephalographic (EEG monitoring, neuroimaging methods, genetic studies that has been marked in recent decades has allowed minimizing errors of physicians. Despite this, certain difficulties still remain in diagnostics of epilepsy. In the author's opinion, there is a range of epileptic seizures visual assessment of which is extremely difficult and is literally impossible without video EEG monitoring. Short, phantom, atypical absences, absences on the outside, epileptic myoclonus of the eyelids with or without absences, myoclonic, tonic, gelastic, focal hyperkinetic seizures, epileptic aura, reversing focal seizures, epileptic spasms, ictal syncopes, negative myoclonus, focal epileptic myoclonus, epileptic seizures arising when closing the eyes, and self-induced seizures can be attributed to such seizures with difficulties in diagnosis. The author reviews each of these types epileptic seizures in details focusing the attention on their diagnostic criteria and characteristics of the clinical and the EEF features that are of utmost importance in the course of performance of differential diagnostics. Own experience of the

  5. 小儿晕厥的临床诊断程序%Clinical diagnostic protocal for syncope in children

    Institute of Scientific and Technical Information of China (English)

    张清友; 杜军保

    2010-01-01

    晕厥是儿童时期的常见病症,但其诊断往往十分困难.制定合理的小儿晕厥的诊断程序,既可提高对小儿晕厥的诊断效率,又能减少过度检查,减少患儿的诊断费用.根据我国目前关于小儿晕厥的研究成果,中华医学会儿科学分会心血管组制定了我国儿童的晕厥指南,提出了符合我国小儿晕厥特点的晕厥诊断程序,根据多中心的联合研究,该诊断程序具有简单、实用的特点.%Syncope is a common clinical problem in children and adolescents. It is a major challenge for practicing physicians, and medical resource utilization and expenses associated with syncope management are enormous. A diagnostic protocol to syncope must be developed for children and adolescents for convenient and effective final diagnosis, and an analysis of cost-effectiveness is meaningful. Thus, according to the studies of syncope in children in China,the Chinese Pediatric Cardiology Society proposed the guidelines for diagnosis of syncope in children in China, and developed a simplified diagnostic protocol for children and adolescents with syncope. According to a multi-center prospective study,the diagnostic protocol in children and adolescents with syncope results in an improvement of diagnostic yield.

  6. Current views on the etiopathogenesis, clinical manifestation, diagnostics, treatment and correlation with other nosological entities of SIBO.

    Science.gov (United States)

    Miazga, Angelika; Osiński, Maciej; Cichy, Wojciech; Żaba, Ryszard

    2015-03-01

    Small intestinal bacterial overgrowth (SIBO) is a disease of great clinical and socioeconomic importance caused by an excessive amount of bacteria in the upper alimentary tract. Physiological microbiota are replaced by pathogenic bacteria mainly from large intestine, which is called dysbacteriosis. SIBO disturbs digestion and absorption in the alimentary tract, which seems to cause inflammation. SIBO affects the morphology and function of the digestive system and causes systemic complications (e.g. osteoporosis, macrocytic anemia). Inflammation interferes with gene expression responsible for producing and secreting mucus, therefore, a correlation between SIBO and cystic fibrosis, irritable bowel syndrome and chronic abdominal pain are postulated. All conditions leading to bacterial growth such as congenital and anatomical abnormalities in the digestive tract, motility disorder or immunological deficits are risk factors of SIBO. A typical clinical manifestation of SIBO comprises meteorism, enterectasia, abdominal discomfort and diarrhea. Diagnostic procedures such as glucose, lactulose, methane, 13C mixed triglyceride breath tests are being used in diagnosing SIBO. PMID:25657082

  7. Subjective cognitive complaints included in diagnostic evaluation of dementia helps accurate diagnosis in a mixed memory clinic cohort

    DEFF Research Database (Denmark)

    Salem, L C; Vogel, Asmus Mejling; Ebstrup, J;

    2015-01-01

    OBJECTIVE: Our objective was to examine the quantity and profile of subjective cognitive complaints in young patients as compared with elderly patients referred to a memory clinic. METHODS: Patients were consecutively recruited from the Copenhagen University Hospital Memory Clinic at Rigshospitalet...... functions were assessed with the Mini-mental state examination (MMSE) and Addenbrooke's cognitive examination (ACE), and symptoms of depression were rated with Major Depression Inventory (MDI). All interviews and the diagnostic conclusion were blinded to the SMC score. RESULTS: We found that young patients...... with dementia have a significantly higher level and a different profile of subjective cognitive complaints as compared with elderly patients with dementia. Furthermore, young patients, diagnosed with an affective disorder, had the highest level of subjective cognitive complaints of all patients in a memory...

  8. Efficacy of clinical diagnostic procedures utilized in nuclear medicine. Technical progress report, 1 December 1981-30 November 1982

    International Nuclear Information System (INIS)

    The efficacy of nuclear medicine diagnostic procedures was measured. Three levels of efficacy were defined. However, two different methods of evaluating efficacy itself were first compared. Using two methods, logistic regression and entropy-minimax pattern detection, substantial agreement was found between them in several clinical observations. (1) There are no attributes that indicate that any grouping of symptoms, signs, and laboratory findings is capable of suggesting that a patient does or does not have a pulmonary embolus. (2) The lung scan test is the only reliable method which indicates that a patient may have a pulmonary embolus or does not have a pulmonary embolus. (3) The validity of these conclusions and the ability to apply them widely to ongoing clinical practice is based on the prospective design of the Study which included an appropriate distribution of institutions by type, size, and geographic location. Also, the only judgement samples was that of the referring physician

  9. Application of PCR-based methods for diagnosis of intestinal parasitic infections in the clinical laboratory.

    Science.gov (United States)

    Verweij, Jaco J

    2014-12-01

    For many years PCR- and other DNA-based methods of pathogen detection have been available in most clinical microbiology laboratories; however, until recently these tools were not routinely exploited for the diagnosis of parasitic infections. Laboratories were initially reluctant to implement PCR as incorporation of such assays within the algorithm of tools available for the most accurate diagnosis of a large variety of parasites was unclear. With regard to diagnosis of intestinal parasitic infections, the diversity of parasites that one can expect in most settings is far less than the parasitological textbooks would have you believe, hence developing a simplified diagnostic triage is feasible. Therefore the classical algorithm based on population, patient groups, use of immuno-suppressive drugs, travel history etc. is also applicable to decide when to perform and which additional techniques are to be used, if a multiplex PCR panel is used as a first-line screening diagnostic.

  10. Clinical Application of the Acupoint Yanglingquan

    Institute of Scientific and Technical Information of China (English)

    王金全

    2004-01-01

    @@ The acupoint Yanglingquan (GB 34) has the effects of normalizing the functions of the liver and gallbladder, clearing away damp-heat, and strengthening the muscles and tendons. In clinic, it is commonly used for treating hemiplegia, paralysis,pain and numbness in the lower limbs, swelling and pain in the knee, and hypochondriac pain. Through clinical practice, the author has found that this point has satisfactory therapeutic effects for treating shoulder arthritis, involuntary shaking of the head due to attack of the pathogenic wind in the craniofacial region, acute lumbar pain, and hysteric paralysis and others. These are reported in the following.

  11. A Bright Future for Precision Medicine: Advances in Fluorescent Chemical Probe Design and Their Clinical Application.

    Science.gov (United States)

    Garland, Megan; Yim, Joshua J; Bogyo, Matthew

    2016-01-21

    The Precision Medicine Initiative aims to use advances in basic and clinical research to develop therapeutics that selectively target and kill cancer cells. Under the same doctrine of precision medicine, there is an equally important need to visualize these diseased cells to enable diagnosis, facilitate surgical resection, and monitor therapeutic response. Therefore, there is a great opportunity for chemists to develop chemically tractable probes that can image cancer in vivo. This review focuses on recent advances in the development of optical probes, as well as their current and future applications in the clinical management of cancer. The progress in probe development described here suggests that optical imaging is an important and rapidly developing field of study that encourages continued collaboration among chemists, biologists, and clinicians to further refine these tools for interventional surgical imaging, as well as for diagnostic and therapeutic applications. PMID:26933740

  12. Evaluation of the efficiency of biofield diagnostic system in breast cancer detection using clinical study results and classifiers.

    Science.gov (United States)

    Subbhuraam, Vinitha Sree; Ng, E Y K; Kaw, G; Acharya U, Rajendra; Chong, B K

    2012-02-01

    The division of breast cancer cells results in regions of electrical depolarisation within the breast. These regions extend to the skin surface from where diagnostic information can be obtained through measurements of the skin surface electropotentials using sensors. This technique is used by the Biofield Diagnostic System (BDS) to detect the presence of malignancy. This paper evaluates the efficiency of BDS in breast cancer detection and also evaluates the use of classifiers for improving the accuracy of BDS. 182 women scheduled for either mammography or ultrasound or both tests participated in the BDS clinical study conducted at Tan Tock Seng hospital, Singapore. Using the BDS index obtained from the BDS examination and the level of suspicion score obtained from mammography/ultrasound results, the final BDS result was deciphered. BDS demonstrated high values for sensitivity (96.23%), specificity (93.80%), and accuracy (94.51%). Also, we have studied the performance of five supervised learning based classifiers (back propagation network, probabilistic neural network, linear discriminant analysis, support vector machines, and a fuzzy classifier), by feeding selected features from the collected dataset. The clinical study results show that BDS can help physicians to differentiate benign and malignant breast lesions, and thereby, aid in making better biopsy recommendations.

  13. The relative diagnostic yields of clinical, FOTI and radiographic examinations for the detection of approximal caries in youngsters

    Directory of Open Access Journals (Sweden)

    Mialhe Fabio

    2009-01-01

    Full Text Available Background: The detection of carious lesions in the initial stages of development is very important in order to prevent the occurrence of cavitation. Aims and Objectives: The aim of the present study was to compare three methods-visual examination, FOTI, and bitewing radiographic examination-for the detection of noncavitated and cavitated approximal carious lesions. Materials and Methods: Seventy students (mean age 14 years with low caries prevalence were examined by three examiners. The tooth surfaces judged as having caries by at least one examiner or one diagnostic method were scheduled for tooth separation. Results: The results showed that the incorporation of FOTI and radiographic examination represented an additional diagnostic yield of 50% and about 110%, respectively, compared to clinical examination alone. Conclusion: We conclude that FOTI or radiographic examination, or both, used as adjuncts to clinical examination, could improve the detection of noncavitated and cavitated approximal carious lesions. Although FOTI should not replace bitewing radiographic examination, it does seem to have additional value for the detection of carious lesions on approximal surfaces of the posterior teeth in school children with low caries prevalence.

  14. Evaluation of the efficiency of biofield diagnostic system in breast cancer detection using clinical study results and classifiers.

    Science.gov (United States)

    Subbhuraam, Vinitha Sree; Ng, E Y K; Kaw, G; Acharya U, Rajendra; Chong, B K

    2012-02-01

    The division of breast cancer cells results in regions of electrical depolarisation within the breast. These regions extend to the skin surface from where diagnostic information can be obtained through measurements of the skin surface electropotentials using sensors. This technique is used by the Biofield Diagnostic System (BDS) to detect the presence of malignancy. This paper evaluates the efficiency of BDS in breast cancer detection and also evaluates the use of classifiers for improving the accuracy of BDS. 182 women scheduled for either mammography or ultrasound or both tests participated in the BDS clinical study conducted at Tan Tock Seng hospital, Singapore. Using the BDS index obtained from the BDS examination and the level of suspicion score obtained from mammography/ultrasound results, the final BDS result was deciphered. BDS demonstrated high values for sensitivity (96.23%), specificity (93.80%), and accuracy (94.51%). Also, we have studied the performance of five supervised learning based classifiers (back propagation network, probabilistic neural network, linear discriminant analysis, support vector machines, and a fuzzy classifier), by feeding selected features from the collected dataset. The clinical study results show that BDS can help physicians to differentiate benign and malignant breast lesions, and thereby, aid in making better biopsy recommendations. PMID:20703753

  15. ORF virus infection in children: clinical characteristics, transmission, diagnostic methods, and future therapeutics.

    Science.gov (United States)

    Lederman, Edith R; Austin, Connie; Trevino, Ingrid; Reynolds, Mary G; Swanson, Holly; Cherry, Bryan; Ragsdale, Jennifer; Dunn, John; Meidl, Susan; Zhao, Hui; Li, Yu; Pue, Howard; Damon, Inger K

    2007-08-01

    Orf virus leads to self-limited, subacute cutaneous infections in children who have occupational or recreational contact with infected small ruminants. Breaches in the integument and contact with animals recently vaccinated for orf may be important risk factors in transmission. Common childhood behaviors are likely important factors in the provocation of significant contact (ie, bites) or in unusual lesion location (eg, facial lesions). Clinician recognition is important in distinguishing orf infection from life-threatening cutaneous zoonoses. Recently developed molecular techniques provide diagnostic precision and newer topical therapeutics may hasten healing.

  16. Validation and clinical use of a novel diagnostic device for screening of atrial fibrillation

    OpenAIRE

    Tieleman, R. G.; Plantinga, Y.; Rinkes, D.; Bartels, G.L.; Posma, J.L.; Cator, R.; Hofman, C.; Houben, R.P.

    2014-01-01

    Aims Patients with asymptomatic and undiagnosed atrial fibrillation (AF) are at increased risk of heart failure and ischaemic stroke. In this study, we validated a new diagnostic device, the MyDiagnostick, for detection of AF by general practitioners and patients. It records and stores a Lead I electrocardiogram (ECG) which is automatically analysed for the presence of AF. Methods and results In total, 192 patients (age 69.4 ± 12.6 years) were asked to hold the MyDiagnostick for 1 min, immedi...

  17. From Diagnosis to Treatment: Clinical Applications of Nanotechnology in Thoracic Surgery.

    Science.gov (United States)

    Digesu, Christopher S; Hofferberth, Sophie C; Grinstaff, Mark W; Colson, Yolonda L

    2016-05-01

    Nanotechnology is an emerging field with potential as an adjunct to cancer therapy, particularly thoracic surgery. Therapy can be delivered to tumors in a more targeted fashion, with less systemic toxicity. Nanoparticles may aid in diagnosis, preoperative characterization, and intraoperative localization of thoracic tumors and their lymphatics. Focused research into nanotechnology's ability to deliver both diagnostics and therapeutics has led to the development of nanotheranostics, which promises to improve the treatment of thoracic malignancies through enhanced tumor targeting, controlled drug delivery, and therapeutic monitoring. This article reviews nanoplatforms, their unique properties, and the potential for clinical application in thoracic surgery. PMID:27112260

  18. Nanoparticles and clinically applicable cell tracking

    NARCIS (Netherlands)

    M.R. Bernsen (Monique); J. Guenoun (Jamal); S.T. van Tiel (Sandra); G.P. Krestin (Gabriel)

    2015-01-01

    textabstractIn vivo cell tracking has emerged as a much sought after tool for design and monitoring of cell-based treatment strategies. Various techniques are available for pre-clinical animal studies, from which much has been learned and still can be learned. However, there is also a need for clini

  19. Volumetric capnography: lessons from the past and current clinical applications

    OpenAIRE

    Verscheure, Sara; Massion, Paul B; Verschuren, Franck; Damas, Pierre; Magder, Sheldon

    2016-01-01

    Dead space is an important component of ventilation–perfusion abnormalities. Measurement of dead space has diagnostic, prognostic and therapeutic applications. In the intensive care unit (ICU) dead space measurement can be used to guide therapy for patients with acute respiratory distress syndrome (ARDS); in the emergency department it can guide thrombolytic therapy for pulmonary embolism; in peri-operative patients it can indicate the success of recruitment maneuvers. A newly available techn...

  20. Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis

    Directory of Open Access Journals (Sweden)

    Stefania Battista

    2016-01-01

    Full Text Available The diagnostic and prognostic usefulness of copeptin were evaluated in septic patients, as compared to procalcitonin assessment. In this single centre and observational study 105 patients were enrolled: 24 with sepsis, 25 with severe sepsis, 15 with septic shock, and 41 controls, divided in two subgroups (15 patients with gastrointestinal bleeding and 26 with suspected SIRS secondary to trauma, acute coronary syndrome, and pulmonary embolism. Biomarkers were determined at the first medical evaluation and thereafter 24, 48, and 72 hours after admission. Definitive diagnosis and in-hospital survival rates at 30 days were obtained through analysis of medical records. At entry, copeptin proved to be able to distinguish cases from controls and also sepsis group from septic shock group, while procalcitonin could distinguish also severe sepsis from septic shock group. Areas under the ROC curve for copeptin and procalcitonin were 0.845 and 0.861, respectively. Noteworthy, patients with copeptin concentrations higher than the threshold value (23.2 pmol/L, calculated from the ROC curve, at admission presented higher 30-day mortality. No significant differences were found in copeptin temporal profile among different subgroups. Copeptin showed promising diagnostic and prognostic role in the management of sepsis, together with its possible role in monitoring the response to treatment.

  1. Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis.

    Science.gov (United States)

    Battista, Stefania; Audisio, Umberto; Galluzzo, Claudia; Maggiorotto, Matteo; Masoero, Monica; Forno, Daniela; Pizzolato, Elisa; Ulla, Marco; Lucchiari, Manuela; Vitale, Annarita; Moiraghi, Corrado; Lupia, Enrico; Settanni, Fabio; Mengozzi, Giulio

    2016-01-01

    The diagnostic and prognostic usefulness of copeptin were evaluated in septic patients, as compared to procalcitonin assessment. In this single centre and observational study 105 patients were enrolled: 24 with sepsis, 25 with severe sepsis, 15 with septic shock, and 41 controls, divided in two subgroups (15 patients with gastrointestinal bleeding and 26 with suspected SIRS secondary to trauma, acute coronary syndrome, and pulmonary embolism). Biomarkers were determined at the first medical evaluation and thereafter 24, 48, and 72 hours after admission. Definitive diagnosis and in-hospital survival rates at 30 days were obtained through analysis of medical records. At entry, copeptin proved to be able to distinguish cases from controls and also sepsis group from septic shock group, while procalcitonin could distinguish also severe sepsis from septic shock group. Areas under the ROC curve for copeptin and procalcitonin were 0.845 and 0.861, respectively. Noteworthy, patients with copeptin concentrations higher than the threshold value (23.2 pmol/L), calculated from the ROC curve, at admission presented higher 30-day mortality. No significant differences were found in copeptin temporal profile among different subgroups. Copeptin showed promising diagnostic and prognostic role in the management of sepsis, together with its possible role in monitoring the response to treatment. PMID:27366743

  2. Does PACS improve diagnostic accuracy in chest radiograph interpretations in clinical practice?

    International Nuclear Information System (INIS)

    Objectives: To assess the impact of a Picture Archiving and Communication System (PACS) on the diagnostic accuracy of the interpretation of chest radiology examinations in a “real life” radiology setting. Materials and methods: During a period before PACS was introduced to radiologists, when images were still interpreted on film and reported on paper, images and reports were also digitally stored in an image database. The same database was used after the PACS introduction. This provided a unique opportunity to conduct a blinded retrospective study, comparing sensitivity (the main outcome parameter) in the pre and post-PACS periods. We selected 56 digitally stored chest radiograph examinations that were originally read and reported on film, and 66 examinations that were read and reported on screen 2 years after the PACS introduction. Each examination was assigned a random number, and both reports and images were scored independently for pathological findings. The blinded retrospective score for the original reports were then compared with the score for the images (the gold standard). Results: Sensitivity was improved after the PACS introduction. When both certain and uncertain findings were included, this improvement was statistically significant. There were no other statistically significant changes. Conclusion: The result is consistent with prospective studies concluding that diagnostic accuracy is at least not reduced after PACS introduction. The sensitivity may even be improved.

  3. Diagnostic Support for Selected Paediatric Pulmonary Diseases Using Answer-Pattern Recognition in Questionnaires Based on Combined Data Mining Applications--A Monocentric Observational Pilot Study.

    Directory of Open Access Journals (Sweden)

    Ann-Katrin Rother

    Full Text Available Clinical symptoms in children with pulmonary diseases are frequently non-specific. Rare diseases such as primary ciliary dyskinesia (PCD, cystic fibrosis (CF or protracted bacterial bronchitis (PBB can be easily missed at the general practitioner (GP.To develop and test a questionnaire-based and data mining-supported tool providing diagnostic support for selected pulmonary diseases.First, interviews with parents of affected children were conducted and analysed. These parental observations during the pre-diagnostic time formed the basis for a new questionnaire addressing the parents' view on the disease. Secondly, parents with a sick child (e.g. PCD, PBB answered the questionnaire and a data base was set up. Finally, a computer program consisting of eight different classifiers (support vector machine (SVM, artificial neural network (ANN, fuzzy rule-based, random forest, logistic regression, linear discriminant analysis, naive Bayes and nearest neighbour and an ensemble classifier was developed and trained to categorise any given new questionnaire and suggest a diagnosis. For estimating the diagnostic accuracy, we applied ten-fold stratified cross validation.All questionnaires of patients suffering from CF, asthma (AS, PCD, acute bronchitis (AB and the healthy control group were correctly diagnosed by the fusion algorithm. For the pneumonia (PM group 19/21 (90.5% and for the PBB group 17/18 (94.4% correct diagnoses could be reached. The program detected the correct diagnoses with an overall sensitivity of 98.8%. Receiver operating characteristics (ROC analyses confirmed the accuracy of this diagnostic tool. Case studies highlighted the applicability of the tool in the daily work of a GP.For children with symptoms of pulmonary diseases a questionnaire-based diagnostic support tool using data mining techniques exhibited good results in arriving at diagnostic suggestions. In the hands of a doctor, this tool could be of value in arousing awareness for

  4. Feasibility of Using a Large Clinical Data Warehouse to Automate the Selection of Diagnostic Cohorts

    OpenAIRE

    Stephen, Reejis; Boxwala, Aziz; Gertman, Paul

    2003-01-01

    Data from Clinical Data Warehouses (CDWs) can be used for retrospective studies and for benchmarking. However, automated identification of cases from large datasets containing data items in free text fields is challenging. We developed an algorithm for categorizing pediatric patients presenting with respiratory distress into Bronchiolitis, Bacterial pneumonia and Asthma using clinical variables from a CDW. A feasibility study of this approach indicates that case selection may be automated.

  5. Methods and clinical applications in nuclear cardiology: a position statement

    International Nuclear Information System (INIS)

    Nuclear cardiological procedures have paved the way for non-invasive diagnostics of various partial functions of the heart. Many of these functions cannot be visualised for diagnosis by any other method (e.g. innervation). These techniques supplement morphological diagnosis with regard to treatment planning and monitoring. Furthermore, they possess considerable prognostic relevance, an increasingly important issue in clinical medicine today, not least in view of the cost-benefit ratio. Our current understanding shows that effective, targeted nuclear cardiology diagnosis - in particular for high-risk patients - can contribute toward cost savings while improving the quality of diagnostic and therapeutic measures. In the future, nuclear cardiology will have to withstand mounting competition from other imaging techniques (magnetic resonance imaging, electron beam tomography, multislice computed tomography). The continuing development of these methods increasingly enables measurement of functional aspects of the heart. Nuclear radiology methods will probably develop in the direction of molecular imaging. (orig.)

  6. Application and Exploration of Big Data Mining in Clinical Medicine

    OpenAIRE

    Yue Zhang; Shu-Li Guo; Li-Na Han; Tie-Ling Li

    2016-01-01

    Objective: To review theories and technologies of big data mining and their application in clinical medicine. Data Sources: Literatures published in English or Chinese regarding theories and technologies of big data mining and the concrete applications of data mining technology in clinical medicine were obtained from PubMed and Chinese Hospital Knowledge Database from 1975 to 2015. Study Selection: Original articles regarding big data mining theory/technology and big data mining′s app...

  7. Liver imaging. Clinical applications and future perspectives

    International Nuclear Information System (INIS)

    Primary hepatocellular carcinoma and liver metastases affect several millon people each year. The main imaging modalities to detect and assist diagnosis of primary and secondary liver tumours include MR imaging, CT, and US. The value of these techniques is further increased by the use of contrast agents which increase the sensitivity, and sometimes also the specificity, of the investigations. The relative advantages and drawbacks of the different contrast agents and imaging modalities in the detection and characterisation of liver tumours are discussed. Currently there is no consensus amongst investigators as to which is superior, due to the technical complexities and number of combinations possible within each of the different modalities. There continues to be advances in the hardware and software of imaging equipment, as well as a trend to develop new contrast agents with more organ-specificity. These include those targeting the hepatocytes, such as mangafodipir trisodium (MnDPDP, Teslascan), and those with reticuloendothelial cell specificity, such as the superparamagnetic iron oxides. These developments have the potential for making significant contributions to the diagnostic value of imaging procedures and, by reducing the number of investigations necessary to reach a final diagnosis, having a significant and beneficial impact on the pharmaco-economics of patient health care. (orig.)

  8. Thymomodulin: biological properties and clinical applications.

    Science.gov (United States)

    Kouttab, N M; Prada, M; Cazzola, P

    1989-01-01

    Thymomodulin (Ellem Industria Farmaceutica s.p.a., Milan, Italy) is a calf thymus acid lysate derivative, composed of several peptides with a molecular weight range of 1-10 kD. Thymomodulin did not exhibit any mutagenic effect. Furthermore, thymomodulin used in animal studies showed no toxicity even when used at high concentrations. Of major significance are the observations in murine and human systems that thymomodulin remains active when administered orally. In vitro and in vivo administered thymomodulin was able to induce the maturation of T-lymphocytes. Additionally, studies in vitro showed that this thymic derivative can enhance the functions of mature T-lymphocytes with cascading effects on B-cell and macrophage functions. Extensive human clinical trials with thymomodulin showed that this agent can improve the clinical symptoms observed with various disease processes, including infections, allergies and malignancies, and can improve immunological functions during ageing. PMID:2657249

  9. Ion beam therapy fundamentals, technology, clinical applications

    CERN Document Server

    2012-01-01

    The book provides a detailed, up-to-date account of the basics, the technology, and the clinical use of ion beams for radiation therapy. Theoretical background, technical components, and patient treatment schemes are delineated by the leading experts that helped to develop this field from a research niche to its current highly sophisticated and powerful clinical treatment level used to the benefit of cancer patients worldwide. Rather than being a side-by-side collection of articles, this book consists of related chapters. It is a common achievement by 76 experts from around the world. Their expertise reflects the diversity of the field with radiation therapy, medical and accelerator physics, radiobiology, computer science, engineering, and health economics. The book addresses a similarly broad audience ranging from professionals that need to know more about this novel treatment modality or consider to enter the field of ion beam therapy as a researcher. However, it is also written for the interested public an...

  10. Clinical application of dendritic cells in cancer vaccination therapy

    DEFF Research Database (Denmark)

    Svane, Inge Marie; Soot, Mette Line; Buus, Søren;

    2003-01-01

    for large-scale generation of dendritic cells for clinical applications has made possible phase I/II studies designed to analyze the toxicity, feasibility and efficacy of this approach. In clinical trials, DC-based vaccination of patients with advanced cancer has in many cases led to immunity...

  11. Application of diagnostic tests for mycoplasmal infections of desert and gopher tortoises with management recommendations

    Science.gov (United States)

    Brown, D.R.; Schumacher, Isabella M.; Mclaughlin, Grace S.; Wendland, L.D.; Brown, Mary E.; Klein, P.A.; Jacobson, E.R.

    2002-01-01

    Mycoplasmosis is a transmissible upper respiratory tract disease that has affected plans for management and conservation of wild desert and gopher tortoises in the United States. Although impact of mycoplasmosis on populations of desert and gopher tortoises is unknown, increased prevalence of seropositive animals as well as field observations of clinically ill tortoises have occurred in association with declining populations. In order to help in the identification of potentially infected animals, three tests have been developed to diagnose mycoplasmal infections of tortoises: 1) direct mycoplasmal culture; 2) detection of mycolplasmal chromosomal DNA by polymerase chain reaction (PCR); and 3) detection of anti-Mycoplasma antibodies in tortoise plasma by enzyme-linked immunosorbent assay (ELISA). Each test provides different, complementary information that collectively can be used to define tortoise mycoplasmal infection status. The types of samples required, the predictive value, interpretation, and cost vary among tests. These assays have been used for epidemiological surveys and in decision making for relocation, repatriation, or captive management of tortoises to minimize the risk of outbreaks of mycoplasmal respiratory disease and spread of the causative agent of this disease. Certain features of mycoplasmal infections of tortoises and other animals create a diagnostic dilemma. Multiple Mycoplasma species can cause respiratory disease with identical clinical presentations. Further, individual strains of a given species may vary with respect to their virulence potential, and some species may be commensals rather than pathogens. Current diagnostic tests may not differentiate among mycoplasmal species or strains or permit determination of pathogenicity of individual isolates. Thus, the information provided by testing is not a simple 'positive' vs. 'negative' issue. While these tests provide much needed information on the exposure of tortoise populations to

  12. Clinical application of several tumor imaging agents

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    Neoplasms is one of the main diseases for harming health.It is difficult to prevent the neoplasms because the factors of bringing out them are complex.To raise survival rate the early diagnosis of tumors is very important.Radionuclide imaging is useful to detect recurrent or residual diseaseand to identificate benign or malignant tumor.Several tumorimaging agents as following have clinical significance indiagnosing tumors.

  13. [Clinical applications of thermoplasticized gutta percha].

    Science.gov (United States)

    Vincente Gómez, A

    1990-01-01

    Step-Back technique or similar is the method of choice for the thermoplasticized gutta-percha. There are no significant differences in the apical seal produced by different filling techniques. There is a little volumetric reduction, similar than in the regular gutta-percha points, when cooling gutta-percha. The results of a clinical study about thermoplasticized gutta-percha with and without sealer are similar than in a control group filled by lateral condensation. PMID:1964066

  14. [Clinical applications of thermoplasticized gutta percha].

    Science.gov (United States)

    Vincente Gómez, A

    1990-01-01

    Step-Back technique or similar is the method of choice for the thermoplasticized gutta-percha. There are no significant differences in the apical seal produced by different filling techniques. There is a little volumetric reduction, similar than in the regular gutta-percha points, when cooling gutta-percha. The results of a clinical study about thermoplasticized gutta-percha with and without sealer are similar than in a control group filled by lateral condensation.

  15. Clinical decision support systems for improving diagnostic accuracy and achieving precision medicine.

    Science.gov (United States)

    Castaneda, Christian; Nalley, Kip; Mannion, Ciaran; Bhattacharyya, Pritish; Blake, Patrick; Pecora, Andrew; Goy, Andre; Suh, K Stephen

    2015-01-01

    As research laboratories and clinics collaborate to achieve precision medicine, both communities are required to understand mandated electronic health/medical record (EHR/EMR) initiatives that will be fully implemented in all clinics in the United States by 2015. Stakeholders will need to evaluate current record keeping practices and optimize and standardize methodologies to capture nearly all information in digital format. Collaborative efforts from academic and industry sectors are crucial to achieving higher efficacy in patient care while minimizing costs. Currently existing digitized data and information are present in multiple formats and are largely unstructured. In the absence of a universally accepted management system, departments and institutions continue to generate silos of information. As a result, invaluable and newly discovered knowledge is difficult to access. To accelerate biomedical research and reduce healthcare costs, clinical and bioinformatics systems must employ common data elements to create structured annotation forms enabling laboratories and clinics to capture sharable data in real time. Conversion of these datasets to knowable information should be a routine institutionalized process. New scientific knowledge and clinical discoveries can be shared via integrated knowledge environments defined by flexible data models and extensive use of standards, ontologies, vocabularies, and thesauri. In the clinical setting, aggregated knowledge must be displayed in user-friendly formats so that physicians, non-technical laboratory personnel, nurses, data/research coordinators, and end-users can enter data, access information, and understand the output. The effort to connect astronomical numbers of data points, including '-omics'-based molecular data, individual genome sequences, experimental data, patient clinical phenotypes, and follow-up data is a monumental task. Roadblocks to this vision of integration and interoperability include ethical, legal

  16. Hand kinematics: Application in clinical practice

    Directory of Open Access Journals (Sweden)

    Santosh Rath

    2011-01-01

    Full Text Available Pathological conditions of the hand consequent to injuries, paralysis, disease, arthritis and congenital difference results in loss or limitation of function, deformities, stiffness, inadequate power and poor position for pinch. The pathogenesis of deformities is influenced by bio-mechanical principles of joints and muscle function. The crippling impact of secondary changes due to edema, soft tissue contractures, muscle shortening and functional adaptations also have a mechanical basis. For clinicians and hand therapists, it is necessary to understand these fundamental principles of biomechanics to plan treatment modalities. Interpretation of mechanics of hand deformities in rheumatoid arthritis and paralysis will enable the treating team to identify the appropriate interventions of splinting, therapy and surgical procedures. Basic knowledge of the principles of hand clinical bio-mechanics will help the beginner to sail through the multitude of tendon transfers described in the text books of hand surgery and find the best solution for a particular clinical presentation. Similarly, knowledge of bio-mechanics will provide solutions to an experienced surgeon to plan treatment protocols for complex situations. The article presents a concise summary of the basic principles of hand bio-mechanics for common hand conditions seen in clinical practice. Understanding and applying these principles will help clinicians in planning and devising treatment options for common and complex hand conditions.

  17. Clinical and neuroimaging features as diagnostic guides in neonatal neurology diseases with cerebellar involvement.

    Science.gov (United States)

    Klein, Jessica L; Lemmon, Monica E; Northington, Frances J; Boltshauser, Eugen; Huisman, Thierry A G M; Poretti, Andrea

    2016-01-01

    Cerebellar abnormalities are encountered in a high number of neurological diseases that present in the neonatal period. These disorders can be categorized broadly as inherited (e.g. malformations, inborn errors of metabolism) or acquired (e.g. hemorrhages, infections, stroke). In some disorders such as Dandy-Walker malformation or Joubert syndrome, the main abnormalities are located within the cerebellum and brainstem. In other disorders such as Krabbe disease or sulfite oxidase deficiency, the main abnormalities are found within the supratentorial brain, but the cerebellar involvement may be helpful for diagnostic purposes. In In this article, we review neurological disorders with onset in the neonatal period and cerebellar involvement with a focus on how characterization of cerebellar involvement can facilitate accurate diagnosis and improved accuracy of neuro-functional prognosis. PMID:26770813

  18. Impact of gender, work, and clinical presentation on diagnostic delay in Italian patients with primary ankylosing spondylitis.

    Science.gov (United States)

    Bandinelli, F; Salvadorini, G; Sedie, A Delle; Riente, L; Bombardieri, S; Matucci-Cerinic, M

    2016-02-01

    The variability of demographic, social, genetic, and clinical factors might influence the time between the onset of symptoms and the diagnosis [diagnostic delay (DD)] of ankylosing spondylitis (AS) in different geographic areas. Different clinical manifestations in men and women affected by AS might indicate a possible role of gender in DD. The aim of the present study was to investigate the influence of demographic, social, genetic, and clinical factors on DD and the differences of DD between men and women related to the presence of different demographic, social, clinical, and genetic parameters in an Italian cohort of primary AS patients. A total of 135 Italian primary AS patients (45 female and 90 male, 27.9 ± 0.89 years old at onset) were studied. The DD, gender, education and work (manual or non-manual) levels, and type of first clinical presentation (inflammatory back pain, arthritis, enthesitis) at onset, family history of AS, and HLA B27 presence were analyzed. The DD (8.744 mean ±0.6869) was significantly higher in men (p = 0.0023), in axial presentation (p = 0.0021), and in manual work (even if with low significance, p = 0.047). The lower DD in women in comparison to that in men was likely related to higher education (p = 0.0045) and work (p = 0.0186) levels, peripheral involvement (p = 0.0009), and HLA B27 positivity (p = 0.0231). DD was higher in AS patients: male, employed in manual jobs, and with axial symptoms at onset. In men, DD seemed to be negatively influenced by lower level of education and work, axial clinical presentation, and HLA B27. PMID:26238665

  19. Multicenter Evaluation of Clinical Diagnostic Methods for Detection and Isolation of Campylobacter spp. from Stool.

    Science.gov (United States)

    Fitzgerald, Collette; Patrick, Mary; Gonzalez, Anthony; Akin, Joshua; Polage, Christopher R; Wymore, Kate; Gillim-Ross, Laura; Xavier, Karen; Sadlowski, Jennifer; Monahan, Jan; Hurd, Sharon; Dahlberg, Suzanne; Jerris, Robert; Watson, Renee; Santovenia, Monica; Mitchell, David; Harrison, Cassandra; Tobin-D'Angelo, Melissa; DeMartino, Mary; Pentella, Michael; Razeq, Jafar; Leonard, Celere; Jung, Carrianne; Achong-Bowe, Ria; Evans, Yaaqobah; Jain, Damini; Juni, Billie; Leano, Fe; Robinson, Trisha; Smith, Kirk; Gittelman, Rachel M; Garrigan, Charles; Nachamkin, Irving

    2016-05-01

    The use of culture-independent diagnostic tests (CIDTs), such as stool antigen tests, as standalone tests for the detection of Campylobacter in stool is increasing. We conducted a prospective, multicenter study to evaluate the performance of stool antigen CIDTs compared to culture and PCR for Campylobacter detection. Between July and October 2010, we tested 2,767 stool specimens from patients with gastrointestinal illness with the following methods: four types of Campylobacter selective media, four commercial stool antigen assays, and a commercial PCR assay. Illnesses from which specimens were positive by one or more culture media or at least one CIDT and PCR were designated "cases." A total of 95 specimens (3.4%) met the case definition. The stool antigen CIDTs ranged from 79.6% to 87.6% in sensitivity, 95.9 to 99.5% in specificity, and 41.3 to 84.3% in positive predictive value. Culture alone detected 80/89 (89.9% sensitivity) Campylobacter jejuni/Campylobacter coli-positive cases. Of the 209 noncases that were positive by at least one CIDT, only one (0.48%) was positive by all four stool antigen tests, and 73% were positive by just one stool antigen test. The questionable relevance of unconfirmed positive stool antigen CIDT results was supported by the finding that noncases were less likely than cases to have gastrointestinal symptoms. Thus, while the tests were convenient to use, the sensitivity, specificity, and positive predictive value of Campylobacter stool antigen tests were highly variable. Given the relatively low incidence of Campylobacter disease and the generally poor diagnostic test characteristics, this study calls into question the use of commercially available stool antigen CIDTs as standalone tests for direct detection of Campylobacter in stool. PMID:26962088

  20. CLINICAL APPLICATION OF OMNIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHY

    Institute of Scientific and Technical Information of China (English)

    王国干; 刘汉英; 孟宪强; 程克正

    1996-01-01

    One hundred and twenty-four patients with heart disease (75 cases of rheumatic heart disease, 26 cases of congenital heart disease, 13 cases of aortic disease and 10 cases of other disease) were examined byOmniplane transesophageal eehoeardiography (TEE). The result showed that Omniplane TEE transducercan be rotated from 0° to 180° in probe and had the advantages o1[ broader scope, obtaining more niforma-tion, le~ stimulation to esophagus and easy to manipulate. It suggests that Omniplane TEE is a efficient technique in clinical diagnosis and can be extensively used in the future.

  1. [Clinical application and therapeutic effects of elementalin].

    Science.gov (United States)

    Xu, Q S

    1990-12-01

    Elementalin, similar to Vivonex NH in composition. consisted of an amino acid mixture and many other essential nutrients. The amino acid mixture was extracted from swine blood and supplemented with some crystal L-amino acids. Animal experiment suggested that it have a better therapeutic effects than a domestic elemental diet. 86 malnourished patients with digestive tract diseases were selected to carry out its clinic evaluation. The results showed that it could maintain or increase body weight, improve nitrogen balance and elevate the level of plasma proteins postoperatively. The total effective rate was 94.2%. No obvious side effect was found. PMID:2128267

  2. Biosensors and invasive monitoring in clinical applications

    CERN Document Server

    Córcoles, Emma P

    2013-01-01

    This volume examines the advances of invasive monitoring by means of biosensors and microdialysis. Physical and physiological parameters are commonly monitored in clinical settings using invasive techniques due to their positive outcome in patients’ diagnosis and treatment. Biochemical parameters, however, still rely on off-line measurements and require large pieces of equipment. Biosensing and sampling devices present excellent capabilities for their use in continuous monitoring of patients’ biochemical parameters. However, certain issues remain to be solved in order to ensure a more widespread use of these techniques in today’s medical practices.

  3. Substrates for clinical applicability of stem cells

    Institute of Scientific and Technical Information of China (English)

    Sanjar Enam; Sha Jin

    2015-01-01

    The capability of human pluripotent stem cells (hPSCs)to differentiate into a variety of cells in the human bodyholds great promise for regenerative medicine. Manysubstrates exist on which hPSCs can be self-renewed,maintained and expanded to further the goal of clinicalapplication of stem cells. In this review, we highlightnumerous extracellular matrix proteins, peptide andpolymer based substrates, scaffolds and hydrogelsthat have been pioneered. We discuss their benefitsand shortcomings and offer future directions as well asemphasize commercially available synthetic peptidesas a type of substrate that can bring the benefits ofregenerative medicine to clinical settings.

  4. Pulmonary hypertension. Radiological diagnostics in the clinical context; Pulmonale Hypertonie. Radiologische Diagnostik im klinischen Kontext

    Energy Technology Data Exchange (ETDEWEB)

    Ley, Sebastian [Toronto General Hospital, Toronto, ON (Canada). Dept. of Medical Imaging

    2012-06-15

    Pulmonary hypertension (PH) has a broad differential and the radiological task is to define and characterize the pathophysiological background. The first part of the review is focused on the clinical categorization and specific features of the various groups of PH. Overall, PH is a rare disease and the clinical symptoms are non specific. Therefore, the disease is usually detected delayed. Each radiological technique, especially chest X-ray and CT, do show specific findings suggestive of PH, which will be discussed. Verification of the severity of PH is still a domain of invasive right heart catheterization. However, there are promising approaches using MRI to determine the pulmonary arterial pressure non-invasively. (orig.)

  5. Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel.

    Science.gov (United States)

    Graham, Stephen M; Ahmed, Tahmeed; Amanullah, Farhana; Browning, Renee; Cardenas, Vicky; Casenghi, Martina; Cuevas, Luis E; Gale, Marianne; Gie, Robert P; Grzemska, Malgosia; Handelsman, Ed; Hatherill, Mark; Hesseling, Anneke C; Jean-Philippe, Patrick; Kampmann, Beate; Kabra, Sushil Kumar; Lienhardt, Christian; Lighter-Fisher, Jennifer; Madhi, Shabir; Makhene, Mamodikoe; Marais, Ben J; McNeeley, David F; Menzies, Heather; Mitchell, Charles; Modi, Surbhi; Mofenson, Lynne; Musoke, Philippa; Nachman, Sharon; Powell, Clydette; Rigaud, Mona; Rouzier, Vanessa; Starke, Jeffrey R; Swaminathan, Soumya; Wingfield, Claire

    2012-05-15

    There is a critical need for improved diagnosis of tuberculosis in children, particularly in young children with intrathoracic disease as this represents the most common type of tuberculosis in children and the greatest diagnostic challenge. There is also a need for standardized clinical case definitions for the evaluation of diagnostics in prospective clinical research studies that include children in whom tuberculosis is suspected but not confirmed by culture of Mycobacterium tuberculosis. A panel representing a wide range of expertise and child tuberculosis research experience aimed to develop standardized clinical research case definitions for intrathoracic tuberculosis in children to enable harmonized evaluation of new tuberculosis diagnostic technologies in pediatric populations. Draft definitions and statements were proposed and circulated widely for feedback. An expert panel then considered each of the proposed definitions and statements relating to clinical definitions. Formal group consensus rules were established and consensus was reached for each statement. The definitions presented in this article are intended for use in clinical research to evaluate diagnostic assays and not for individual patient diagnosis or treatment decisions. A complementary article addresses methodological issues to consider for research of diagnostics in children with suspected tuberculosis.

  6. Clinical Applications of Diffusion Tensor Imaging

    Directory of Open Access Journals (Sweden)

    Sona Saksena

    2008-01-01

    Full Text Available During the last decade, advances in the field of magnetic resonance imaging (MRI have led to the design of numerous innovative imaging techniques. These techniques have not only facilitated structural visualization of anatomy, but also have provided a wealth of functional information regarding biological processes. Diffusion tensor imaging (DTI is one such MRI technique that has generated tremendous amount of interest both in the clinical and laboratory fields. DTI attempts to analyze the magnitude and orientation of random microscopic motion of water molecules in brain tissue. It is based upon the phenomenon of water diffusion known as Brownian motion. This technique pro- vides details on tissue microstructure and organization well beyond the usual image resolution. With diffusion tensor MR imaging, diffusion anisotropy can be quantified and subtle white matter changes not normally seen on conventional MRI can be detected. These features have encouraged scientists to evaluate the integrity and direction of the fiber tracts in various pathological conditions using DTI. Tissue maladies studied by DTI in this review include cerebral ischemia and wallerian degeneration, epilepsy, multiple sclerosis, Alzheimer’s disease, schizophrenia, metabolic disorders, infections and brain tumors. We have only included the common clinical conditions to keep this review precise.

  7. Clinical applications of corneal confocal microscopy

    Directory of Open Access Journals (Sweden)

    Mitra Tavakoli

    2008-06-01

    Full Text Available Mitra Tavakoli1, Parwez Hossain2, Rayaz A Malik11Division of Cardiovascular Medicine, University of Manchester and Manchester Royal Infirmary, Manchester, UK; 2University of Southampton, Southampton Eye Unit, Southampton General Hospital, Southampton, UKAbstract: Corneal confocal microscopy is a novel clinical technique for the study of corneal cellular structure. It provides images which are comparable to in-vitro histochemical techniques delineating corneal epithelium, Bowman’s layer, stroma, Descemet’s membrane and the corneal endothelium. Because, corneal confocal microscopy is a non invasive technique for in vivo imaging of the living cornea it has huge clinical potential to investigate numerous corneal diseases. Thus far it has been used in the detection and management of pathologic and infectious conditions, corneal dystrophies and ecstasies, monitoring contact lens induced corneal changes and for pre and post surgical evaluation (PRK, LASIK and LASEK, flap evaluations and Radial Keratotomy, and penetrating keratoplasty. Most recently it has been used as a surrogate for peripheral nerve damage in a variety of peripheral neuropathies and may have potential in acting as a surrogate marker for endothelial abnormalities.Keywords: corneal confocal microscopy, cornea, infective keratitis, corneal dystrophy, neuropathy

  8. Mesenchymal stem cells for clinical application.

    Science.gov (United States)

    Sensebé, L; Krampera, M; Schrezenmeier, H; Bourin, P; Giordano, R

    2010-02-01

    Mesenchymal Stem Cells/Multipotent Marrow Stromal Cells (MSC) are multipotent adult stem cells present in all tissues, as part of the perivascular population. As multipotent cells, MSCs can differentiate into different tissues originating from mesoderm ranging from bone and cartilage, to cardiac muscle. Conflicting data show that MSCs could be pluripotent and able to differentiate into tissues and cells of non-mesodermic origin as neurons or epithelial cells. Moreover, MSCs exhibit non-HLA restricted immunosuppressive properties. This wide range of properties leads to increasing uses of MSC for immunomodulation or tissue repair. Based on their immunosuppressive properties MSC are used particularly in the treatment of graft versus host disease, For tissue repair, MSCs can work by different ways from cell replacement to paracrine effects through the release of cytokines and to regulation of immune/inflammatory responses. In regenerative medicine, trials are in progress or planed for healing/repair of different tissue or organs as bone, cartilage, vessels, myocardium, or epithelia. Although it has been demonstrated that ex-vivo expansion processes using fetal bovine serum, recombinant growth factors (e.g. FGF2) or platelet lysate are feasible, definitive standards to produce clinical-grade MSC are still lacking. MSCs have to be produced according GMP and regulation constraints. For answering to the numerous challenges in this fast developing field of biology and medicine, integrative networks linking together research teams, cell therapy laboratories and clinical teams are needed.

  9. The progress and clinical application of radionuclide neuroimaging

    International Nuclear Information System (INIS)

    Development of site-specific brain radiopharmaceuticals extends the the functional neuroimaging applications in the diagnosis and monitoring treatments of various neurologic and psychiatric disorders. This article highlights recent advances and clinical applications of the functional neuroimaging in Parkinson disease, epilepsy, dementia, substance abuse, psychiatric disorders and brain functional research. (authors)

  10. Multiparametric magnetic resonance imaging of the prostate. Technique and clinical applications; Multiparametrische Magnetresonanztomografie der Prostata. Technik und klinische Anwendungen

    Energy Technology Data Exchange (ETDEWEB)

    Franiel, Tobias [Charite, Berlin (Germany). Radiologie CCM

    2011-07-15

    Multiparametric magnetic resonance imaging (MRI) includes 1 H magnetic resonance spectroscopy, diffusion-weighted imaging, and dynamic contrast-enhanced MRI. These new MRI techniques are increasingly being used to supplement conventional T 2 and T 1-weighted MR sequences in prostate imaging. The first part of this review outlines each of these techniques, the most important diagnostic parameters, and the pathophysiological background. The characteristic features of prostate cancer and noncancerous prostate tissue as depicted with each of the three techniques are presented. The second, clinical part outlines the diagnostic applications of the three MRI techniques for the early detection and localization of prostate cancer, staging, and the identification of recurrent cancer and discusses the most recent publications in this field. The review concludes with a look at emerging clinical applications such as the evaluation of biological aggressiveness and tumor volume. (orig.)

  11. RNA interference - From Biology to clinical applications

    Directory of Open Access Journals (Sweden)

    CarloAlberto Redi

    2010-12-01

    Full Text Available I strongly advice the readers to go to the Nobel foundation web site and read the Nobel lectures by Andrew Z. Fire and Craig C. Mello, the two 2006 Nobel laureates "for their discovery of RNA interference - gene silencing by double-stranded RNA" (http://nobelprize.org/nobel_prizes/medicine/laureates/2006/. Well, it is impressive how both the Nobel laureates clearly anticipate the immense possibility the phenomenon they discovered is giving to Biology and its applications. That is to say, they clearly visioned the great chance to both advance our theoretical understanding of gene expression regulation (i.e., how the gene networks and circuiteries are finely tuned by RNA interference, and its critical role in ontogeny and make use in biotechnological applications of this formidable tool, notably in translational medicine. Here we go to the............

  12. Estetrol review: profile and potential clinical applications.

    Science.gov (United States)

    Coelingh Bennink, H J T; Holinka, C F; Diczfalusy, E

    2008-01-01

    In this review paper, the existing information on the human fetal steroid estetrol (E4) has been summarized. In the past, E4 was considered as a weak estrogen and interest disappeared. However, recent new research has demonstrated that E4 is a potent, orally bioavailable, natural human fetal selective estrogen receptor modulator, since it acts in the rat as an estrogen on all tissues investigated except breast tumor tissue, where it has estrogen antagonistic properties in the presence of estradiol. Based on its safety data, its pharmacokinetic properties, its pharmacological profile and the results of first human studies, E4 may be suitable as a potential drug for human use in applications such as hormone replacement therapy (vaginal atrophy, hot flushes), contraception and osteoporosis. Additional areas worth exploring are the treatment of breast and prostate cancer, hypoactive sexual desire disorder and topical use (wrinkles) in women, auto-immune diseases, migraine, cardiovascular applications and the treatment of selected obstetric disorders. PMID:18464023

  13. Age-Related Decline and Diagnostic Performance of More and Less Prevalent Clinical Cases

    Science.gov (United States)

    St-Onge, Christina; Landry, Marjolaine; Xhignesse, Marianne; Voyer, Gilles; Tremblay-Lavoie, Stéphanie; Mamede, Sílvia; Schmidt, Henk; Rikers, Remy

    2016-01-01

    Since cognitive abilities have been shown to decrease with age, it is expected that older physicians would not perform as well as their younger counterparts on clinical cases unless their expertise can counteract the cognitive effects of aging. However, studies on the topic have shown contradictory results. This study aimed to further investigate…

  14. Uveitis in Thailand : emphasis on clinical patterns and novel developments in diagnostics using intraocular fluid analysis

    NARCIS (Netherlands)

    Pathanapitoon, K.

    2010-01-01

    In this thesis, we report on the so far unknown causes of uveitis in Thailand and describe their clinical manifestations. We found out that intraocular infections were the second most common cause of blindness and low vision in a tertiary center in northern Thailand. These infections predominantly c

  15. Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours

    Directory of Open Access Journals (Sweden)

    Søreide Jon

    2011-10-01

    Full Text Available Abstract Esophageal perforation is a rare and potentially life-threatening condition. Early clinical suspicion and imaging is important for case management to achieve a good outcome. However, recent studies continue to report high morbidity and mortality greater than 20% from esophageal perforation. At least half of the perforations are iatrogenic, mostly related to endoscopic instrumentation used in the upper gastrointestinal tract, while about a third are spontaneous perforations. Surgical treatment remains an important option for many patients, but a non-operative approach, with or without use of an endoscopic stent or placement of internal or external drains, should be considered when the clinical situation allows for a less invasive approach. The rarity of this emergency makes it difficult for a physician to obtain extensive individual clinical experience; it is also challenging to obtain firm scientific evidence that informs patient management and clinical decision-making. Improved attention to non-specific symptoms and signs and early diagnosis based on imaging may translate into better outcomes for this group of patients, many of whom are elderly with significant comorbidity.

  16. Clinical and diagnostic importance of changes of colon at chronic prostatitis

    Directory of Open Access Journals (Sweden)

    V.M. Popkov

    2010-06-01

    Full Text Available The aim of researches was studying clinical, microbiological and morphological characteristic of colon at patients at chronic prostatitis, definition of method of pathogenetic therapy on the basis of the received results. Material and methods of investigation. 50 patients at chronic bacterial prostatitis, 50 patients at asymptomatic inflammatory prostatitis and 30 practically healthy males were inspected. Microflora of prostata's secret and colon, morphology and structure of components of diffuse neuroendocrine system of colon were studied. Clinical, microbiological, иммуногистохимические methods and morphometrical analysis were applied. Results. It is defined, that at 74% patients with asymptomatic inflammatory prostatitis irritable bowel syndrome and at 26% - chronic nonulcerative colitis were diagnosed. At all patients at chronic bacterial prostatitis chronic nonulcerative colitis were detected. These variants were correlleted with different types of intestinal dysbiosis and degree of microbe producing of prostate. Use probiotic Bactistatin® at patients with a chronic prostatitis raises clinical efficiency of antibacterial therapy, promotes reduction of inflammatory changes, restoration of its microbic landscape and neuroendocrine homeostasis of colon. inclusion. At chronic prostatitis structural and functional pathology of colon are often registered, they are connected with clinical variant of prostatitis and can mask of prostata's pathology. Using Bactistatin® at patients with a chronic prostatitis is proved and effective

  17. Clinical value of component-resolved diagnostics in peanut-allergic patients

    DEFF Research Database (Denmark)

    Eller, E; Bindslev-Jensen, C

    2013-01-01

    As replacement for the oral food challenge, decision-points for sensitization test have been established, but suboptimal sensitivity and/or specificity, as well as regional differences, have reduced the clinical usability. IgE toward specific peanut protein components has been reported to be of v...

  18. Personality Diagnostic Questionnaire 4+ is not useful as a screener in clinical practice

    NARCIS (Netherlands)

    R.J.M. de Reus; J.F. van den Berg; P.M.G. Emmelkamp

    2011-01-01

    In clinical practice, the combination of brief, cost effective, valid and reliable assessment of personality disorders (PDs) is highly important. Substantial budget cuts require optimal use of the clinician's time. PDs are related with high axis I comorbidity, poorer therapy outcome and increased he

  19. The ANA-reflex test as a model for improving clinical appropriateness in autoimmune diagnostics.

    Science.gov (United States)

    Tonutti, Elio; Bizzaro, Nicola; Morozzi, Gabriella; Radice, Antonella; Cinquanta, Luigi; Villalta, Danilo; Tozzoli, Renato; Tampoia, Marilina; Porcelli, Brunetta; Fabris, Martina; Brusca, Ignazio; Alessio, Maria Grazia; Barberio, Giuseppina; Sorrentino, Maria Concetta; Antico, Antonio; Bassetti, Danila; Fontana, Desré Ethel; Imbastaro, Tiziana; Visentini, Daniela; Pesce, Giampaola; Bagnasco, Marcello

    2016-12-01

    Reflex tests are widely used in clinical laboratories, for example, to diagnose thyroid disorders or in the follow-up of prostate cancer. Reflex tests for antinuclear antibodies (ANA) have recently gained attention as a way to improve appropriateness in the immunological diagnosis of autoimmune rheumatic diseases and avoid waste of resources. However, the ANA-reflex test is not as simple as other consolidated reflex tests (the TSH-reflex tests or the PSA-reflex tests) because of the intrinsic complexity of the ANA test performed by the indirect immunofluorescence method on cellular substrates. The wide heterogeneity of the ANA patterns, which need correct interpretation, and the subsequent choice of the most appropriate confirmatory test (ANA subserology), which depend on the pattern feature and on clinical information, hinder any informatics automation, and require the pathologist's intervention. In this review, the Study Group on Autoimmune Diseases of the Italian Society of Clinical Pathology and Laboratory Medicine provides some indications on the configuration of the ANA-reflex test, using two different approaches depending on whether clinical information is available or not. We further give some suggestions on how to report results of the ANA-reflex test. PMID:27423928

  20. Clinical diagnosis of influenza virus infection : evaluation of diagnostic tools in general practice

    NARCIS (Netherlands)

    van Elden, LJR; van Essen, GA; Boucher, CAB; van Loon, AM; Nijhuis, M; Schipper, P; Verheij, TJM; Hoepelman, IM

    2001-01-01

    Background: With the development of new antiviral agents for influenza, the urge for rapid and reliable diagnosis of influenza becomes increasingly important. Respiratory virus infections are difficult to distinguish on clinical grounds General practitioners (GPs) however still depend on their clini