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Sample records for clinical icd-10 diagnoses

  1. Reliability of clinical ICD-10 schizophrenia diagnoses

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  2. Reliability of clinical ICD-10 diagnoses among electroconvulsive therapy patients with chronic affective disorders

    DEFF Research Database (Denmark)

    Jakobsen, Klaus Damgaard; Hansen, Thomas Folkmann; Dam, Henrik;

    2008-01-01

    investigated. A standardized schema for basic anamnesis and the Operational Criteria Checklist for Psychotic and Affective Illness (OPCRIT) were used. The sensitivity, specificity, positive and negative predictive values of clinical affective disorder ICD-10 diagnoses and the formal agreement between clinical...

  3. Asperger's Syndrome: A Comparison of Clinical Diagnoses and Those Made According to the ICD-10 and DSM-IV

    Science.gov (United States)

    Woodbury-Smith, Marc; Klin, Ami; Volkmar, Fred

    2005-01-01

    The diagnostic criteria for Asperger Syndrome (AS) according to ICD-10 and DSM-IV have been criticized as being too narrow in view of the rules of onset and precedence, whereby autism takes precedence over AS in a diagnostic hierarchy. In order to investigate this further, cases from the DSM-IV multicenter study who had been diagnosed clinically…

  4. ICD-10 and the clinical features of depressions: data of the CIRCADIAN-I program

    OpenAIRE

    O V Serdyuk; Ovchinnikov, A.; Kutuzova, N. A.; M Y Drobizhev; K Y Retyunsky

    2011-01-01

    The data of the CIRCADIAN-I trial suggest that depressions are unsatisfactorily diagnosed in psychiatric practice. Thus, some of the ICD-10 diagnoses used to denote depressive states (dysthymia, cyclothymia) are made extremely rarely. Only comparatively short-term and reversible vital depressions are considered to be preferred for the categories of affective disorders (F.30-F.33). Any clinical deviations from this clinical presentation (sensitive, anxiety symptoms, a prolonged course, and no ...

  5. 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)…

  6. The data quality of splenomegaly ICD-10 diagnoses in a population-based hospital discharge registry

    DEFF Research Database (Denmark)

    Rotbain, E. C.; Lund Hansen, Dennis; Frederiksen, H.

    2015-01-01

    months; distribution can be seen in figure 1. The most common method for determining enlarged spleen, as seen in table 1, was ultrasonic imaging. Table 2 shows that hematological diseases was the most common underlying causal disease group (50%), followed by hepatic diseases (25%), other diseases (12......Background Splenomegaly is a common finding in general medical patients. The cause of splenomegaly is often found outside the spleen and therefore an extensive diagnostic medical work-up is frequently required. There is very little data on the distribution of causal diagnoses and, to the best of...... nationwide registry study of the above stated risks can be undertaken, and to investigate which causal diagnoses are most common. Method The study was conducted as a cohort with data from the Danish health care system. Patients with an ICD-10 diagnosis of splenomegaly at Odense University Hospital (OUH) from...

  7. Coding training for medical students: How good is diagnoses coding with ICD-10 by novices?

    OpenAIRE

    Stausberg, Jürgen; Lehmann, Nils

    2005-01-01

    Teaching of knowledge and competence in documentation and coding is an essential part of medical education. Therefore, coding training had been placed within the course of epidemiology, medical biometry, and medical informatics. From this, we can draw conclusions about the quality of coding by novices. One hundred and eighteen students coded diagnoses from 15 nephrological cases in homework. In addition to interrater reliability, validity was calculated by comparison with a reference coding. ...

  8. Reliability of ADDIS for diagnoses of substance use disorders according to ICD-10, DSM-IV and DSM-5: test-retest and inter-item consistency

    OpenAIRE

    Gerdner, Arne; Wickström, Lynn

    2015-01-01

    Background This study investigates test-retest and inter-item consistency of Alcohol Drog Diagnos InStrument (ADDIS), a structured interview to diagnose substance use disorders according to ICD-10, DSM-IV and DSM-5. ADDIS, the Swedish version of SUDDS, is the only instrument in Swedish that produces diagnostic proposals specific to all drug categories, and for all three diagnostic systems. Screening of stressful life events, anxiety, and depression is also included. Methods Thirty patients at...

  9. An administrative data merging solution for dealing with missing data in a clinical registry: adaptation from ICD-9 to ICD-10

    Directory of Open Access Journals (Sweden)

    Galbraith P Diane

    2008-01-01

    Full Text Available Abstract Background We have previously described a method for dealing with missing data in a prospective cardiac registry initiative. The method involves merging registry data to corresponding ICD-9-CM administrative data to fill in missing data 'holes'. Here, we describe the process of translating our data merging solution to ICD-10, and then validating its performance. Methods A multi-step translation process was undertaken to produce an ICD-10 algorithm, and merging was then implemented to produce complete datasets for 1995–2001 based on the ICD-9-CM coding algorithm, and for 2002–2005 based on the ICD-10 algorithm. We used cardiac registry data for patients undergoing cardiac catheterization in fiscal years 1995–2005. The corresponding administrative data records were coded in ICD-9-CM for 1995–2001 and in ICD-10 for 2002–2005. The resulting datasets were then evaluated for their ability to predict death at one year. Results The prevalence of the individual clinical risk factors increased gradually across years. There was, however, no evidence of either an abrupt drop or rise in prevalence of any of the risk factors. The performance of the new data merging model was comparable to that of our previously reported methodology: c-statistic = 0.788 (95% CI 0.775, 0.802 for the ICD-10 model versus c-statistic = 0.784 (95% CI 0.780, 0.790 for the ICD-9-CM model. The two models also exhibited similar goodness-of-fit. Conclusion The ICD-10 implementation of our data merging method performs as well as the previously-validated ICD-9-CM method. Such methodological research is an essential prerequisite for research with administrative data now that most health systems are transitioning to ICD-10.

  10. A Clinical Comparison Study of Attention Deficit/Hyperactivity Disorder (DSM-IV) and Hyperkinetic Disorder (ICD-10) in Indian children and Adolescents

    Science.gov (United States)

    Sitholey, Prabhat; Agarwal, Vivek; Bharti, Vikram

    2012-01-01

    Aims: To compare the usefulness of DSM IV and ICD-10 DCR criteria in clinic children presenting with the symptoms of inattention and hyperactivity-impulsivity. Methods: 62 children (54 boys and 8 girls) participated in the study. Children were assessed on Kiddie schedule for affective disorders and schizophrenia--present and lifetime version and…

  11. A Method for Modeling Co-Occurrence Propensity of Clinical Codes with Application to ICD-10-PCS Auto-Coding

    OpenAIRE

    Subotin, Michael; Davis, Anthony R.

    2015-01-01

    Objective. Natural language processing methods for medical auto-coding, or automatic generation of medical billing codes from electronic health records, generally assign each code independently of the others. They may thus assign codes for closely related procedures or diagnoses to the same document, even when they do not tend to occur together in practice, simply because the right choice can be difficult to infer from the clinical narrative. Materials and Methods. We propose a method that in...

  12. Monitoring of clinical activities and performances by using international classifications ICD-10 and ICPC-2: Three years experience of the Kigali University Teaching Hospital, Rwanda

    OpenAIRE

    Hategekimana, Theobald; Tran Ngoc, Candide; Porignon, Denis; De Jonghe, Michel; Verbeke, Frank; Van Bastelaere, Stefan

    2010-01-01

    Measuring performances of health professionals and health facilities is a difficult task. However, with the appropriate information management tools, a lot of useful information can be collected from routine data registration activities. Situated in the capital of Rwanda, the Central Kigali University Teaching Hospital developed in January 2006 its electronic patient record using both ICD10 and ICPC2 codes for the structured registration of diseases and procedures. In order to ...

  13. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

    Directory of Open Access Journals (Sweden)

    Adornetto Carmen

    2012-12-01

    Full Text Available Abstract Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD, specific phobia, social phobia, and generalized anxiety disorder (GAD. Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9 than with the adult section (F4 of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population is not identical with the population examined using the ICD (clinical population.

  14. The Choice of ICD-10 Code to Granuloma%肉芽肿的ICD-10编码选择

    Institute of Scientific and Technical Information of China (English)

    孙凯; 李春秀

    2011-01-01

    0bjectives to make sure correct ICD-10 code for different granuloma.Methods learning relevant know ledge of different granulom a giving the correct ICD-10 code for them according to classification rules.Results choosing correct code according to causes of disease and location.Conclusions Coder notonly should master ICD-10 coding know ledge, not also need to learn related medical know ledge.They also need to read medical records carefully therefore can im prove the correction of coding and disease classification coding quality in order to provide reliable inform ation materials for clinical scientific research and teaching.%目的确定各类肉芽肿的正确的ICD-10编码.方法学习各类肉芽肿的相关知识,按照分类原则给予正确的ICD-10编码.结果根据病因、部位选择肉芽肿的正确编码.结论编码员不仅要掌握ICD-10编码知识,也要学习相关的医学知识,并仔细阅读病案,才能提高编码的准确性,提高疾病分类编码质量,为临床科研、教学等提供可靠的信息资料.

  15. Strategies for successful ICD-10 implementation.

    Science.gov (United States)

    Goldstein, Jeffrey

    2015-09-01

    The transition to ICD-10 is the largest mandate in U.S. healthcare history. Full ICD-10 implementation will require diligent, comprehensive actions. The three pillars to ICD-10 success are the same with any enormous organizational change: governance, education, and documentation. Many organizations have called for additional delays before full implementation, while other organizations across the United States have already made significant strides to prepare for the change. But is another delay of ICD-10 the solution? Many believe not, because any further delays can hinder forward momentum. Organizations that fell behind before the delay haven't taken the extra time to get up to speed, and therefore additional time to prepare isn't likely to motivate them any more than the first delay did. ICD-10 readiness is a journey, but unless the fundamentals are in place, moving toward an Oct. 1 launch is an uphill journey on a very steep slope. But with a solid strategy in place, healthcare organizations can complete the transition, even if they're a little late at the start. PMID:26540953

  16. OPS und ICD-10-GM 2009

    OpenAIRE

    DIMDI-Pressestelle

    2007-01-01

    Das DIMDI nimmt ab sofort Änderungsvorschläge zu den Klassifikationen ICD-10-GM (Internationale Klassifikation der Krankheiten) und OPS (Operationen- und Prozedurenschlüssel) für die Versionen 2009 entgegen. Der Redaktionsschluss ist am 29. Februar 2008.

  17. OPS und ICD-10-GM 2008

    OpenAIRE

    DIMDI-Pressestelle

    2006-01-01

    Das DIMDI nimmt ab sofort Änderungsvorschläge zu den Klassifikationen ICD-10-GM (Internationale Klassifikation der Krankheiten) und OPS (Operationen- und Prozedurenschlüssel) für die Versionen 2008 entgegen. Der Redaktionsschluss ist am 28. Februar 2007.

  18. ICD-10 Medical Coding: The Role of Perioperative Services in Addressing Implementation Challenges.

    Science.gov (United States)

    Wing, Toni L

    2016-02-01

    The International Classification of Diseases, 10th Revision (ICD-10) was adopted in the United States on October 1, 2015. Replacing the outdated ICD, Ninth Revision, Clinical Modification (ICD-9-CM) coding system was long overdue, and the updated classifications were needed to accurately collect data and improve patient care. However, the complexity of ICD-10 may present substantial challenges for health information management coders and affect hospital revenue collection. Because the OR generates a large share of a hospital's overall revenue, perioperative services personnel must take a critical look at ICD-10 changes and address adoption challenges to minimize the negative effects ICD-10 may have on surgical revenue and help personnel identify perioperative services' important role in ICD-10 implementation. PMID:26849983

  19. Verbesserte ICD-10-Suche mittels XML

    Directory of Open Access Journals (Sweden)

    Schweiger R

    2002-01-01

    Full Text Available Mit der Anforderung an Ärzte, ihre Diagnosen zu verschlüsseln, gewinnen effiziente Nachschlagewerke von Verschlüsselungssystemen zunehmend an Bedeutung. Die Universität Gießen hat unter Einsatz neuester und standardisierter Technologien wie XML eine Suchmaschine entwickelt, mit der elektronische Nachschlagewerke und Wörterbücher sehr einfach aufgebaut und gepflegt werden können. XML liefert in diesem Zusammenhang Beziehungen zwischen den Suchbegriffen, die eine hohe Suchqualität (Relevanz und Vollständigkeit garantieren. Die Suchmaschine wurde am Beispiel der ICD-10 bereits erfolgreich getestet und ist unter der Webadresse http://www.lumrix.net frei zugänglich. Da die Suchmaschine komplett im Web-Browser läuft, können Wissen und Information sehr leicht an jeden klinischen Arbeitsplatz mit Internet-Zugang transportiert werden.

  20. 肠炎的ICD-10编码%The ICD-10 coding of enteritis

    Institute of Scientific and Technical Information of China (English)

    褚云生

    2012-01-01

    Although enteritis is a kind of common and frequent occurred disease in digestive system , there are many difficulties existing in its cod ing . In our country , enteritis supposed to be no infectious are coding in K 52 .9 according to the rules of the first edition of ICD-10 . As the canceling of assumed classification rules in the second edition of ICD-10 , there are as many as dozens of coding of enteritis and different pathogenesis can lead to different coding . So the coders should pay great attention when coding enteritis and avoid haste work as the bigger difficulty comes .%肠炎是消化系统中的常见病、多发病,但对肠炎的编码却存在诸多难点.ICD-10第1版执行假定分类原则,在我国肠炎假定为非传染性的均编码于K52.9.ICD-10第2版取消假定分类原则,意味着分类规则的改变,分类时应依照肠炎的发病病因,病因不同时,肠炎所对应的编码也不同,多达几十个不同编码.相当于增加了编码难度,编码员在对肠炎进行编码时应引起重视,切忌草率编码.

  1. Comparing ICD-9-CM and ICD-10 classification systems in a primary health care setting: some initial observations.

    Science.gov (United States)

    Walker, S; Wood, M; Wilks, J; Nicol, J

    1995-01-01

    The ICD-10 is due to be introduced into Australia during the late 1990s, superseding the current and widely used ICD-9-CM. Improvements in areas such as number of codes, an expanded external cause framework, and more context to injuries are expected to make the ICD-10 a more streamlined system for practitioners. The present study examined both classification formats using data from 1183 presentations to primary health clinics at island tourist resorts. Some initial observations are made about differences in the two systems, highlighting the greater coding detail provided by the ICD-10, particularly in the area of injuries. It is recommended that further empirical testing be undertaken using the ICD-10 in a variety of settings so as to identify benefits in the coding of both medical conditions and injuries. PMID:10163113

  2. An Ensemble Learning Based Framework for Traditional Chinese Medicine Data Analysis with ICD-10 Labels

    OpenAIRE

    Gang Zhang; Yonghui Huang; Ling Zhong; Shanxing Ou; Yi Zhang; Ziping Li

    2015-01-01

    Objective. This study aims to establish a model to analyze clinical experience of TCM veteran doctors. We propose an ensemble learning based framework to analyze clinical records with ICD-10 labels information for effective diagnosis and acupoints recommendation. Methods. We propose an ensemble learning framework for the analysis task. A set of base learners composed of decision tree (DT) and support vector machine (SVM) are trained by bootstrapping the training dataset. The base learners are...

  3. Impact of the Transition to ICD-10 on Medicare Payment

    Data.gov (United States)

    U.S. Department of Health & Human Services — Although the transition from the ICD-9-CM to the ICD-10 version of MS-DRGs resulted in 1.68 percent of the patients being assigned to a different MS-DRG, payment...

  4. Migration to the ICD-10 coding system: A primer for spine surgeons (Part 1

    Directory of Open Access Journals (Sweden)

    Gazanfar Rahmathulla

    2014-01-01

    Full Text Available Background: On 1 October 2015, a new federally mandated system goes into effect requiring the replacement of the International Classification of Disease-version 9-Clinical Modification (ICD-9-CM with ICD-10-CM. These codes are required to be used for reimbursement and to substantiate medical necessity. ICD-10 is composite with as many as 141,000 codes, an increase of 712% when compared to ICD-9. Methods: Execution of the ICD-10 system will require significant changes in the clinical administrative and hospital-based practices. Through the transition, diminished productivity and practice revenue can be anticipated, the impacts of which the spine surgeon can minimizeby appropriate education and planning. Results: The advantages of the new system include increased clarity and more accurate definitions reflecting patient condition, information relevant to ambulatory and managed care encounters, expanded injury codes, laterality, specificity, precise data for safety and compliance reporting, data mining for research, and finally, enabling pay-for-performance programs. The disadvantages include the cost per physician, training administrative staff, revenue loss during the learning curve, confusion, the need to upgrade hardware along with software, and overall expense to the healthcare system. Conclusions: With the deadline rapidly approaching, gaps in implementation result in delayed billing, delayed or diminished reimbursements, and absence of quality and outcomes data. It is thereby essential for spine surgeons to understand their role in transitioning to this new environment. Part I of this article discusses the background, coding changes, and costs as well as reviews the salient features of ICD-10 in spine surgery

  5. A retrospective analysis of the clinical case records of 'autistic psychopaths' diagnosed by Hans Asperger and his team at the University Children's Hospital, Vienna.

    OpenAIRE

    Hippler, Kathrin; Klicpera, Christian

    2003-01-01

    To date, it is questionable whether the diagnostic criteria for Asperger syndrome (AS) as stated by ICD-10 or DSM-IV still reflect Asperger's original account of 'autistic psychopathy' (AP) from the 1940s. The present study examined 74 clinical case records of children with AP diagnosed by Hans Asperger and his team at the Viennese Children's Clinic and Asperger's private practice between 1950 and 1986. The characteristic features of the children are outlined, including reasons for referral, ...

  6. ICD 10 Based Medical Expert System Using Fuzzy Temporal Logic

    OpenAIRE

    Chinniah, P.; Dr. S.Muttan

    2010-01-01

    Medical diagnosis process involves many levels and considerable amount of time and money are invariably spent for the first level of diagnosis usually made by the physician for all the patients every time. Hence there is a need for a computer based system which not only asks relevant questions to the patients but also aids the physician by giving a set of possible diseases from the symptoms obtained using logic at inference. In this work, an ICD10 based Medical Expert System that provides adv...

  7. Metrics and tools for consistent cohort discovery and financial analyses post-transition to ICD-10-CM.

    Science.gov (United States)

    Boyd, Andrew D; Li, Jianrong John; Kenost, Colleen; Joese, Binoy; Yang, Young Min; Kalagidis, Olympia A; Zenku, Ilir; Saner, Donald; Bahroos, Neil; Lussier, Yves A

    2015-05-01

    In the United States, International Classification of Disease Clinical Modification (ICD-9-CM, the ninth revision) diagnosis codes are commonly used to identify patient cohorts and to conduct financial analyses related to disease. In October 2015, the healthcare system of the United States will transition to ICD-10-CM (the tenth revision) diagnosis codes. One challenge posed to clinical researchers and other analysts is conducting diagnosis-related queries across datasets containing both coding schemes. Further, healthcare administrators will manage growth, trends, and strategic planning with these dually-coded datasets. The majority of the ICD-9-CM to ICD-10-CM translations are complex and nonreciprocal, creating convoluted representations and meanings. Similarly, mapping back from ICD-10-CM to ICD-9-CM is equally complex, yet different from mapping forward, as relationships are likewise nonreciprocal. Indeed, 10 of the 21 top clinical categories are complex as 78% of their diagnosis codes are labeled as "convoluted" by our analyses. Analysis and research related to external causes of morbidity, injury, and poisoning will face the greatest challenges due to 41 745 (90%) convolutions and a decrease in the number of codes. We created a web portal tool and translation tables to list all ICD-9-CM diagnosis codes related to the specific input of ICD-10-CM diagnosis codes and their level of complexity: "identity" (reciprocal), "class-to-subclass," "subclass-to-class," "convoluted," or "no mapping." These tools provide guidance on ambiguous and complex translations to reveal where reports or analyses may be challenging to impossible.Web portal: http://www.lussierlab.org/transition-to-ICD9CM/Tables annotated with levels of translation complexity: http://www.lussierlab.org/publications/ICD10to9. PMID:25681260

  8. Bipolar and related disorders in DSM-5 and ICD-10.

    Science.gov (United States)

    Kaltenboeck, Alexander; Winkler, Dietmar; Kasper, Siegfried

    2016-08-01

    Bipolar disorders are a group of psychiatric disorders with profound negative impact on affected patients. Even if their symptomatology has long been recognized, diagnostic criteria have changed over time and diagnosis often remains difficult. The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), issued in May 2013, comprises several changes regarding the diagnosis of bipolar disorders compared to the previous edition. Diagnostic categories and criteria for bipolar disorders show some concordance with the internationally also widely used Tenth Edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). However, there are also major differences that are worth highlighting. The aim of the following text is to depict and discuss those. PMID:27378177

  9. ICD 10 Based Medical Expert System Using Fuzzy Temporal Logic

    CERN Document Server

    Chinniah, P

    2010-01-01

    Medical diagnosis process involves many levels and considerable amount of time and money are invariably spent for the first level of diagnosis usually made by the physician for all the patients every time. Hence there is a need for a computer based system which not only asks relevant questions to the patients but also aids the physician by giving a set of possible diseases from the symptoms obtained using logic at inference. In this work, an ICD10 based Medical Expert System that provides advice, information and recommendation to the physician using fuzzy temporal logic. The knowledge base used in this system consists of facts of symptoms and rules on diseases. It also provides fuzzy severity scale and weight factor for symptom and disease and can vary with respect to time. The system generates the possible disease conditions based on modified Euclidean metric using Elders algorithm for effective clustering. The minimum similarity value is used as the decision parameter to identify a disease.

  10. Reliability of the ICD 10 version of the Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD).

    Science.gov (United States)

    Costello, H; Moss, S; Prosser, H; Hatton, C

    1997-08-01

    The Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD) is a semi-structured clinical interview designed for use with respondents who have learning disability. The first version was based on the Present State Examination. The revised version was derived from the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), and makes ICD 10 diagnoses using the SCAN diagnostic program. This current version has a 4-point scale of severity, compared with the 3-point scale of the first version. It also has a new module relating to psychotic disorders. The sample consisted of 40 individuals representing a spectrum of neurotic, depressive and psychotic disorders. Videotapes of 40 PAS-ADD interviews were re-rated by trained interviewers who had not been involved in the original study in which the videotapes were produced. The mean Kappa across all individual item codes was 0.65, ranging from 0.94 to 0.35. The mean Kappa agreement on item groups was 0.66. Correlation between total symptom scores was 0.74. Agreement on index of definition was Kappa 0.70. We concluded that, agreement was generally lower than for the ICD 9 version. This was probably due mainly to the increase in the severity categories from three to four. However, the new items (most of which related to psychosis) were of comparable reliability to other items. PMID:9299928

  11. The relationship of reactive psychosis and ICD-10 acute and transient psychotic disorders: evidence from a case register-based comparison

    DEFF Research Database (Denmark)

    Castagnini, Augusto; Bertelsen, Aksel; Munk-Jørgensen, Povl;

    2006-01-01

    relationship between the concept of reactive psychosis (RP), equivalent to the ICD-8 298 category of 'other psychoses', and ATPD. SAMPLING AND METHOD: Since January 1, 1994, ICD-10 has replaced ICD-8 as official classification in Denmark. Patients given an ICD-8 298 diagnosis on their last admission in 1992...... accounted for 8.7% of those with non-organic psychotic and affective disorders in 1994-1995. Thirty-eight per cent of patients with an ICD-8 298 diagnosis were readmitted during the years 1994-1995. Schizophrenia and related disorders (F2) and affective disorders (F3) accounted for three quarters of ICD-10......-1993 were identified from the Danish Psychiatric Central Register, and the ICD-8 diagnoses assigned were compared with their ICD-10 diagnoses when readmitted in 1994-1995. RESULTS: Diagnosis of RP was recorded in 19.2% of patients with functional psychoses in 1992-1993, whereas ATPD overall prevalence...

  12. ICD 10 Based Medical Expert System Using Fuzzy Temporal Logic

    Directory of Open Access Journals (Sweden)

    P.Chinniah

    2009-12-01

    Full Text Available Medical diagnosis process involves many levels and considerable amount of time and money are invariably spent for the first level of diagnosis usually made by the physician for all the patients every time. Hence there is a need for a computer based system which not only asks relevant questions to the patients but also aids the physician by giving a set of possible diseases from the symptoms obtained using logic at inference. In this work, an ICD10 based Medical Expert System that provides advice, information and recommendation to the physician using fuzzy temporal logic. The knowledge base used in this system consists of facts of symptoms and rules on diseases. It also provides fuzzy severity scale and weight factor for symptom and disease and can vary with respect to time. The system generates the possible disease conditions based on modified Euclidean metric using Elder’s algorithm for effective clustering. The minimum similarity value is used as the decision parameter to identify a disease. Keywords -Fuzzy clustering, symptoms, fuzzy severity scale, weight factor, Minkowski distance, ICD, WHO, Rules Base, TSQL

  13. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

    OpenAIRE

    Adornetto Carmen; Suppiger Andrea; In-Albon Tina; Neuschwander Murielle; Schneider Silvia

    2012-01-01

    Abstract Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD). Methods A structured clinical interview, the Kinder-DIPS, was administered to...

  14. A Discussion on the Code of Brugada's Syndrome in ICD-10%Brugada综合征的ICD-10编码探讨

    Institute of Scientific and Technical Information of China (English)

    刘红云

    2008-01-01

    目的 探讨Brugada综合征的正确ICD-10编码.方法 通过分析了解Brugada综合征病因以及临床特征,找寻Brugada综合征对应的ICD-10疾病编码.结论 对于新生病种要通过多方面查找资料,以确保编码的准确性和唯一性.

  15. ICD-10-GM 2008: DIMDI veröffentlicht die endgültige Fassung

    OpenAIRE

    DIMDI-Pressestelle

    2007-01-01

    Das DIMDI hat die endgültige Fassung der ICD-10-GM Version 2008 (Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, German Modification) auf seinen Internetseiten veröffentlicht.

  16. Do coder characteristics influence validity of ICD-10 hospital discharge data?

    Directory of Open Access Journals (Sweden)

    Beck Cynthia A

    2010-04-01

    Full Text Available Abstract Background Administrative data are widely used to study health systems and make important health policy decisions. Yet little is known about the influence of coder characteristics on administrative data validity in these studies. Our goal was to describe the relationship between several measures of validity in coded hospital discharge data and 1 coders' volume of coding (≥13,000 vs. Methods This descriptive study examined 6 indicators of face validity in ICD-10 coded discharge records from 4 hospitals in Calgary, Canada between April 2002 and March 2007. Specifically, mean number of coded diagnoses, procedures, complications, Z-codes, and codes ending in 8 or 9 were compared by coding volume and employment status, as well as hospital type. The mean number of diagnoses was also compared across coder characteristics for 6 major conditions of varying complexity. Next, kappa statistics were computed to assess agreement between discharge data and linked chart data reabstracted by nursing chart reviewers. Kappas were compared across coder characteristics. Results 422,618 discharge records were coded by 59 coders during the study period. The mean number of diagnoses per record decreased from 5.2 in 2002/2003 to 3.9 in 2006/2007, while the number of records coded annually increased from 69,613 to 102,842. Coders at the tertiary hospital coded the most diagnoses (5.0 compared with 3.9 and 3.8 at other sites. There was no variation by coder or site characteristics for any other face validity indicator. The mean number of diagnoses increased from 1.5 to 7.9 with increasing complexity of the major diagnosis, but did not vary with coder characteristics. Agreement (kappa between coded data and chart review did not show any consistent pattern with respect to coder characteristics. Conclusions This large study suggests that coder characteristics do not influence the validity of hospital discharge data. Other jurisdictions might benefit from

  17. ICD-10-GM 2009: Vorabversion beim DIMDI veröffentlicht

    OpenAIRE

    DIMDI-Pressestelle

    2008-01-01

    Die vorläufige Fassung der ICD-10-GM 2009 steht als Vorabversion ab sofort auf den Internetseiten des DIMDI bereit. Bitte beachten Sie, dass es in der endgültigen amtlichen Fassung noch Änderungen gegenüber dieser Vorabversion geben kann.

  18. ICD-10-GM und OPS: Neue Versionen für das Jahr 2005

    OpenAIRE

    Müller, W.

    2004-01-01

    Das Deutsche Institut für Medizinische Dokumentation und Information (DIMDI) teilt mit: Für das DRG-Vergütungssystem beginnt am 1. Januar 2005 die Konvergenzphase. Zur Vorbereitung darauf hat das DIMDI die neuen Versionen 2005 der Internationalen Klassifikation der Krankheiten (ICD-10-GM) und des Operationen- und Prozedurenschlüssels (OPS) auf seinen Internetseiten veröffentlicht.

  19. ICD-10-GM 2008: Vorabversion beim DIMDI veröffentlicht

    OpenAIRE

    DIMDI-Pressestelle

    2007-01-01

    Die vorläufige Fassung der ICD-10-GM 2008 steht als Vorabversion ab sofort auf den Internetseiten des DIMDI bereit. Bitte beachten Sie, dass gegenüber der endgültigen Fassung noch Änderungen möglich sind.

  20. DIMDI veröffentlicht Vorabversionen von OPS Version 2010 und ICD-10-GM 2010

    OpenAIRE

    DIMDI-Pressestelle

    2009-01-01

    Die vorläufigen Fassungen des OPS 2010 und des ICD-10-GM werden ab sofort auf den Internetseiten des DIMDI publiziert. Bitte beachten Sie, dass es in der endgültigen amtlichen Fassung noch Änderungen gegenüber diesen Vorabversionen geben kann.

  1. ICD-10-GM 2006: Endgültige Fassungen beim DIMDI veröffentlicht

    OpenAIRE

    DIMDI, P

    2005-01-01

    Das DIMDI hat die endgültige Fassung der Internationalen Klassifikation der Krankheiten (deutsche Modifikation: ICD-10-GM) Version 2006 auf seinen Internetseiten veröffentlicht. Wichtige Erkrankungen werden in der neuen ICD-Version differenzierter als bisher verschlüsselt.

  2. DIMDI veröffentlicht Vorabversion der ICD-10-GM 2012

    OpenAIRE

    DIMDI-Pressestelle

    2011-01-01

    Die vorläufige Fassung der ICD-10-GM 2012 finden Sie ab sofort auf den Internetseiten des DIMDI. Bitte beachten Sie, dass es in der endgültigen amtlichen Fassung noch Änderungen gegenüber dieser Vorabversion geben kann.

  3. OPS und ICD-10-GM Versionen 2006: Redaktionsschluss für Änderungsvorschläge

    OpenAIRE

    Müller, W.

    2004-01-01

    Zur Weiterentwicklung des G-DRG-Systems werden die Klassifikationen OPS und ICD-10-GM kontinuierlich bearbeitet und angepasst. Änderungsvorschläge zu den Klassifikationen nimmt das DIMDI entgegen. Der Redaktionsschluss für Änderungsvorschläge zu den OPS- und ICD-10-Versionen des Jahres 2006 ist am 31. März 2005.

  4. ICD-10-GM 2011: DIMDI veröffentlicht endgültige Fassung

    OpenAIRE

    Müller, W.; DIMDI-Pressestelle

    2010-01-01

    Das DIMDI hat die endgültige Fassung der ICD-10-GM Version 2011 (Internationale Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, German Modification) auf seinen Internetseiten veröffentlicht. In die neue Version flossen knapp 60 Vorschläge aus Fachgesellschaften und von Fachleuten aus Ärzteschaft, Krankenkassen und Kliniken ein sowie zahlreiche Änderungen der Weltgesundheitsorganisation (WHO). Die Klassifikation bildet die Basis für das pauschalierende Vergütungssystem G-DRG...

  5. ICD-10-GM 2012: DIMDI veröffentlicht endgültige Fassung

    OpenAIRE

    Müller, W.; DIMDI-Pressestelle

    2011-01-01

    Das DIMDI hat die endgültige Fassung der ICD-10-GM Version 2012 (Internationale Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, German Modification) auf seinen Internetseiten veröffentlicht. In die neue Version flossen knapp 80 Vorschläge aus Fachgesellschaften und von Fachleuten aus Ärzteschaft, Krankenkassen und Kliniken sowie Änderungen der Weltgesundheitsorganisation (WHO) ein. Die Klassifikation bildet die Basis für das pauschalierende Vergütungssystem G-DRG (German Di...

  6. Neurodevelopmental Disorders (ASD and ADHD): DSM-5, ICD-10, and ICD-11.

    Science.gov (United States)

    Doernberg, Ellen; Hollander, Eric

    2016-08-01

    Neurodevelopmental disorders, specifically autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have undergone considerable diagnostic evolution in the past decade. In the United States, the current system in place is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), whereas worldwide, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) serves as a general medical system. This review will examine the differences in neurodevelopmental disorders between these two systems. First, we will review the important revisions made from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) to the DSM-5, with respect to ASD and ADHD. Next, we will cover the similarities and differences between ASD and ADHD classification in the DSM-5 and the ICD-10, and how these differences may have an effect on neurodevelopmental disorder diagnostics and classification. By examining the changes made for the DSM-5 in 2013, and critiquing the current ICD-10 system, we can help to anticipate and advise on the upcoming ICD-11, due to come online in 2017. Overall, this review serves to highlight the importance of progress towards complementary diagnostic classification systems, keeping in mind the difference in tradition and purpose of the DSM and the ICD, and that these systems are dynamic and changing as more is learned about neurodevelopmental disorders and their underlying etiology. Finally this review will discuss alternative diagnostic approaches, such as the Research Domain Criteria (RDoC) initiative, which links symptom domains to underlying biological and neurological mechanisms. The incorporation of new diagnostic directions could have a great effect on treatment development and insurance coverage for neurodevelopmental disorders worldwide. PMID:27364515

  7. DIMDI veröffentlicht endgültige Fassungen von ICD-10-GM 2010 und OPS Version 2010

    OpenAIRE

    Müller, W.

    2009-01-01

    Das DIMDI hat die endgültigen Fassungen der ICD-10-GM Version 2010 (Internationale Klassifikation der Krankheiten, German Modification) und des Operationen- und Prozedurenschlüssels (OPS) Version 2010 online veröffentlicht.

  8. RELIABILITY OF THE ICD-10 INTERNATIONAL PERSONALITY DISORDER EXAMINATION (IPDE) (HINDI VERSION): A PRELIMINARY STUDY

    OpenAIRE

    Sharan, Pratap; Kulhara, P.; Verma, S. K.; Mohanty, Manju

    2002-01-01

    The study was aimed at estimating the joint-rater reliability and applicability of Hindi version of ICD-10 IPDE that was obtained following a standard translation protocol. The instrument was administered to 22 non-psychotic patients by two raters. The average intraclass correlation for each item (0.89), number of criteria met per disorder (0.92) and dimensional scores (0.98) was high. Kappa for definite (0.65-0.78) and probaole personality disorder (PD) (0.78-1.00) and for presence/absence o...

  9. The road to ICD-10-CM/PCS implementation: forecasting the transition for providers, payers, and other healthcare organizations.

    Science.gov (United States)

    Sanders, Tekla B; Bowens, Felicia M; Pierce, William; Stasher-Booker, Bridgette; Thompson, Erica Q; Jones, Warren A

    2012-01-01

    This article will examine the benefits and challenges of the US healthcare system's upcoming conversion to use of the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) and will review the cost implications of the transition. Benefits including improved quality of care, potential cost savings from increased accuracy of payments and reduction of unpaid claims, and improved tracking of healthcare data related to public health and bioterrorism events are discussed. Challenges are noted in the areas of planning and implementation, the financial cost of the transition, a shortage of qualified coders, the need for further training and education of the healthcare workforce, and the loss of productivity during the transition. Although the transition will require substantial implementation and conversion costs, potential benefits can be achieved in the areas of data integrity, fraud detection, enhanced cost analysis capabilities, and improved monitoring of patients' health outcomes that will yield greater cost savings over time. The discussion concludes with recommendations to healthcare organizations of ways in which technological advances and workforce training and development opportunities can ease the transition to the new coding system. PMID:22548024

  10. Differences in the ICD-10 diagnostic subtype of depression in bipolar disorder compared to recurrent depressive disorder

    DEFF Research Database (Denmark)

    Jensen, H.M.; Christensen, E.M.; Kessing, Lars Vedel

    2008-01-01

    Background: The aim of the study was to investigate whether patients with bipolar depression and patients with recurrent depressive disorder present with different subtypes of depressive episode as according to ICD-10. Sampling and Methods: All patients who got a diagnosis of bipolar affective di...

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

    Institute of Scientific and Technical Information of China (English)

    周佳丽

    2014-01-01

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

  12. ICD-10-GM: DIMDI veröffentlicht die endgültige Fassung für 2007

    OpenAIRE

    Müller, W.; DIMDI Pressestelle

    2006-01-01

    Das DIMDI hat die endgültige Fassung der ICD-10-GM Version 2007 (Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, German Modification) auf seinen Internetseiten veröffentlicht. In die neue Version flossen über 50 Vorschläge aus Fachgesellschaften und von Fachleuten aus Ärzteschaft, Krankenkassen und Kliniken ein. Die Krankheiten-Klassifikation bildet zusammen mit dem Operationen- und Prozedurenschlüssel (OPS) die Basis für das pauschalierende Verg...

  13. Frequency of nursing diagnoses in a surgical clinic

    OpenAIRE

    Andreza Cavalcanti Vasconcelos; Claudia Germania Alencar de Castro; Durcival Francisco da Silva; Vanessa Juvino de Sousa

    2016-01-01

    Objective: to identify the frequency of Nursing Diagnoses of patients in a surgical clinic. Methods: cross-sectional study, performed with 99 patients in the postoperative of general surgery. Data were collected through a questionnaire validated according to domains of NANDA International, including physical and laboratory examination. Results: 17 nursing diagnoses were found; eight had a frequency higher than 50.0% (infection risk, impaired tissue integrity, constipation risk, anxiety, bleed...

  14. Trends in Gastroenteritis-associated Mortality in the United States 1985-2005: Variations by ICD-9 and ICD-10 Codes

    Science.gov (United States)

    BackgroundTrends in gastroenteritis-associated mortality are changing over time with development of antibiotic resistant strains of certain pathogens, improved diagnostic methods, and changing healthcare. In 1999, ICD-10 coding was introduced for mortality records which can also ...

  15. Internationally comparable diagnosis-specific survival probabilities for calculation of the ICD-10-based Injury Severity Score

    DEFF Research Database (Denmark)

    Gedeborg, R.; Warner, M.; Chen, L. H.;

    2014-01-01

    BACKGROUND: The International Statistical Classification of Diseases, 10th Revision (ICD-10) -based Injury Severity Score (ICISS) performs well but requires diagnosis-specific survival probabilities (DSPs), which are empirically derived, for its calculation. The objective was to examine if DSPs...... country's own DSPs for ICISS calculation, the pooled DSPs resulted in somewhat reduced discrimination in predicting mortality (difference in c statistic varied from 0.006 to 0.04). Calibration was generally good when the predicted mortality risk was less than 20%. When Danish and Swedish data were used...

  16. 77 FR 32975 - AHRQ Workgroups on ICD-10-CM/PCS Conversion of Quality Indicators (QIs)

    Science.gov (United States)

    2012-06-04

    ..., neurologic disease, orthopedic and musculoskeletal disease, obstetrics and gynecologic disease, surgery... individuals with relevant clinical expertise (e.g., cardiovascular disease, neurologic disease, orthopedic and musculoskeletal disease, obstetrics and gynecologic disease, surgery, critical care and pulmonary...

  17. Gender and depression: a study of severity and symptomatology of depressive disorders (ICD-10) in general practice

    DEFF Research Database (Denmark)

    Hildebrandt, M G; Stage, K B; Kragh-Soerensen, P

    OBJECTIVE: Gender differences in severity and symptomatology of depression in a large and representative sample of depressive patients from general practice were examined. METHOD: During a 2-year study period, 31 Danish general practitioners consecutively assessed patients, aged >18, for depression....... A total of 1033 patients (692 female, 341 male) fulfilled ICD-10 criteria for depressive disorders. Gender differences were examined with regard to severity and symptomatology of depression. RESULTS: The severity of depression was similar for men and women with the following distribution: 22% mild......, 56% moderate and 23% severe depressive episodes. The mean number of symptoms presented was 6.6 of 10 for both genders. There were no gender differences in prevalence of single depressive symptoms. CONCLUSION: No gender differences in the severity or symptomatology of depression were found in a highly...

  18. Are the ICD-10 or DSM-5 diagnostic systems able to define those who will benefit from treatment for depression?

    Science.gov (United States)

    Montgomery, Stuart

    2016-08-01

    Two widely used diagnostic systems, the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), are reviewed for their ability to define those who will benefit from active treatment rather than placebo. Both systems suffer from a weakness in defining symptoms sufficiently clearly to separate depression from normal mood variations in the general population. Consequently, normal individuals may be medicalized and defined as suffering from and treated for depression. Also, in mild depression, unlike moderate depression, a lack of significant separation of active treatment from placebo has been shown in individual double-blind, placebo-controlled studies and in meta-analyses of these treatment studies. Both systems would be more useful for treatment purposes if they provided a clearer symptomatic definition of moderate depression, as is widely used in pivotal regulatory standard efficacy studies. PMID:27418397

  19. Frequency of nursing diagnoses in a surgical clinic

    Directory of Open Access Journals (Sweden)

    Andreza Cavalcanti Vasconcelos

    2015-12-01

    Full Text Available Objective: to identify the frequency of Nursing Diagnoses of patients in a surgical clinic. Methods: cross-sectional study, performed with 99 patients in the postoperative of general surgery. Data were collected through a questionnaire validated according to domains of NANDA International, including physical and laboratory examination. Results: 17 nursing diagnoses were found; eight had a frequency higher than 50.0% (infection risk, impaired tissue integrity, constipation risk, anxiety, bleeding risk, acute pain, delayed surgical recovery, dysfunctional gastrointestinal motility. It was observed in all patients the Nursing Diagnostics: risk of infection, impaired tissue integrity and risk of constipation. Conclusion: the frequency of the most prevalent diagnosis is inserted in the domains safety/protection and nutrition, which determines the need to redirect nursing care, prioritizing the patient's clinic.

  20. Emergency department coding of bicycle and pedestrian injuries during the transition from ICD-9 to ICD-10

    Science.gov (United States)

    Karkhaneh, M; Hagel, B E; Couperthwaite, A; Saunders, L D; Voaklander, D C

    2011-01-01

    Background The international classification of diseases version 10 (ICD-10) uses alphanumeric expanded codes and external cause of injury codes (E-codes). Objective To examine the reliability and validity of emergency department (ED) coders in applying E-codes in ICD-9 and -10. Methods Bicycle and pedestrian injuries were identified from the ED information system from one period before and two periods after transition from ICD-9 to -10 coding. Overall, 180 randomly selected bicycle and pedestrian injury charts were reviewed as the reference standard (RS). Original E-codes assigned by ED coders (ICD-9 in 2001 and ICD-10 in 2004 and 2007) were compared with charts (validity) and also to ICD-9 and -10 codes assigned from RS chart review, to each case by an independent (IND) coder (reliability). Sensitivity, specificity, simple, and chance-corrected agreements (κ statistics) were calculated. Results Sensitivity of E-coding bicycle injuries by the IND coder in comparison with the RS ranged from 95.1% (95% CI 86.3 to 99.0) to 100% (95% CI 94.0 to 100.0) for both ICD-9 and -10. Sensitivity of ED coders in E-coding bicycle injuries ranged from 90.2% (95% CI 79.8 to 96.3) to 96.7% (95% CI 88.5 to 99.6). The sensitivity estimates for the IND coder ranged from 25.0% (95% CI 14.7 to 37.9) to 45.0% (95% CI 32.1 to 58.4) for pedestrian injuries for both ICD-9 and -10. Conclusion Bicycle injuries are coded in a reliable and valid manner; however, pedestrian injuries are often miscoded as falls. These results have important implications for injury surveillance research. PMID:21705466

  1. A Hybrid Approach to Determining Modification of Clinical Diagnoses

    OpenAIRE

    Pakhomov, Serguei; Christopher G Chute

    2006-01-01

    Health care providers that use electronic medical records maintain an administrative database of diagnoses generated by physicians in the course of medical care delivery. This database is subsequently used for billing and reimbursement but can also be used to identify patients for clinical research. In this paper we present a hybrid rule-based and machine learning technique for automatic determination of whether a diagnosis is confirmed, probable or represents a history of a disorder. The rul...

  2. Clinical characteristics of sarcoidosis patients diagnosed in a university hospital

    OpenAIRE

    Özlem Abakay; Abdurrahman Abakay; Abdullah Çetin Tanrıkulu; Fatih Meteroğlu; Cengizhan Sezgi; Hadice Selimoğlu Şen; Ayşe Dallı; Mehmet Kabak

    2012-01-01

    Objectives: The clinical characteristics and treatment resultsof patients diagnosed with sarcoidosis was investigatedin Dicle University Medical Faculty Hospital.Materials and methods: A total of 39 patients were includeddiagnosed with sarcoidosis between 01 January2008 and31 December 2011.Demographic data, laboratoryfindings, spirometric test data, diagnostic methodsand treatment regimens for the study were recorded form.According to pulmonary function test results of patients,61.5% were nor...

  3. Dementia DSM-IV/ICD-10 or neurocognitive disorder DSM-5?

    Directory of Open Access Journals (Sweden)

    Joaquim Pujol Domenech

    2015-03-01

    Full Text Available Background and Objectives: According to existing data the term dementia was invented in the first century BC. It was introduced in the European literature in the 17th and 18th centuries AC. At the end of the 17th century, the French Encyclopedia points at ethiological implications which would later shape legal concepts. In the 19th century the Centroeuropean research develops specific nosologies until, in the 20th century, senile dementia is gradually discredited. Methods: Slightly over ten years ago, the Mild Cognitive Disorder (MCD conceptualization was introduced as an early stage of Alzheimer's disease (AD, but the lack of coherence in relation to lesions sparked a still ongoing controversy, as the author of the MCD concept belongs to the Writing Board of DSM 5. Results: The DSM IV focuses on a categorical approach in spite of the difficulty in differentiating “normal” from “pathological” impairment at certain ages. On the other hand, the DSM 5 adopts the Dimensional System with a Mild or Severe Neurocognitive Disorder definition, which is necessarily arbitrary and imposes a statistical criterion. The widespread use of this classification would imply diagnosing a large proportion of the population with huge social and medical implications. This triggered a variety of reactions, such as the APA note which claims that DSM 5 and CIE-10 “virtually contain the same codes”. However a WHO study revealed that 70% of surveyed psychiatrists used CIE 10 criteria. Conclusions: The DSM 5 gives weight to cognitive aspects using as a severity criterion the number of standard deviations in relation to psychometric normality. It might be misleading if applied to some forms of dementia, for instance frontal dementias. The CIE-10 and DSM IV criteria are more operational.

  4. Occurrence of Clinically Diagnosed Hypertrophic Cardiomyopathy in the United States.

    Science.gov (United States)

    Maron, Martin S; Hellawell, Jennifer L; Lucove, Jaime C; Farzaneh-Far, Ramin; Olivotto, Iacopo

    2016-05-15

    Hypertrophic cardiomyopathy (HC) is the most common genetic heart disease and an important cause of sudden death and heart failure symptoms. The current prevalence for HC (1:500) is based on echocardiographic population studies in which a substantial proportion of affected subjects have not come to clinical recognition. Therefore, we sought to define the subset of patients with HC who are diagnosed in the US. A proprietary integrated claims database including medical condition International Classification of Diseases, Ninth Revision diagnostic codes for over 160 million individual patients in the US was interrogated for 2013 to identify the prevalence of clinically recognized HC. Patients with ≥1 claim for any of the HC International Classification of Diseases, Ninth Revision diagnosis codes from January to December 2013 were identified. The combined occurrence rate of HC was stratified by age and gender and multiplied by the 2013 United States population in the same age/gender categories to produce the final projected prevalence. The analysis was performed on 169,089,614 patients, of whom 59,009 unique patients were identified with ≥1 claim for HC. The projected estimated occurrence of diagnosed HC in the US in 2013 was 1:3,195 for a total of 98,958 subjects. Average age at HC diagnosis was in the fifth decade of life, with 43% of the cohort composed of women. In conclusion, leveraging a claims-based data analytic technique, about 100,000 patients are diagnosed clinically with HC in the US, an occurrence which is less than the prevalence reported in systematic population studies based on echocardiographic diagnosis. This observation supports the view that many patients with HC are undiagnosed throughout life and enhances our understanding of the burden of this genetic heart disease on the health care system. PMID:27006153

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

    DEFF Research Database (Denmark)

    Luk, Adriana; Metawee, Mohammed; Ahn, Eric;

    2009-01-01

    BACKGROUND: Heart transplantation remains the last treatment option for patients with end-stage cardiac disease. Such diseases include ischemic cardiomyopathy, nonischemic cardiomyopathy and other conditions such as arrhythmogenic right ventricular dysplasia, cardiac sarcoidosis and cardiac...... amyloidosis. OBJECTIVE: To review the changes that have occurred over time in the etiology of heart disease in patients requiring heart transplantation, and to compare the clinical and histological diagnoses of explanted hearts from patients with progressive cardiac disease. METHODS: The pathological findings...... of 296 surgically excised hearts over a 20-year period (January 1987 to July 2006) at one institution were examined. Patients were separated into groups based on year of heart transplantation. The tissue was examined to determine the underlying cardiac pathology leading to congestive heart failure...

  6. Spinocerebellar degeneration: Discrepancies between clinical and pathological diagnoses.

    Science.gov (United States)

    Yamada, Mitsunori; Toyoshima, Yasuko; Makifuchi, Takao; Kakita, Akiyoshi; Takahashi, Hitoshi

    2016-08-01

    To improve the diagnostic accuracy of sporadic spinocerebellar degeneration (SCD), we assessed the clinical and pathological data of 1494 consecutive autopsy cases. The number of patients who received a diagnosis of sporadic SCD (including multiple system atrophy) either clinically or pathologically was 19 (1.3%). We identified six cases with clinical misdiagnoses of SCD that were confirmed pathologically as progressive supranuclear palsy (PSP, four cases), basilar artery thrombosis (one case) and unclassified tauopathy (one case). The total number of patients who received a clinical diagnosis of sporadic SCD was 93 and the positive predictive value was 93.5%. We also identified 13 autopsy cases that were pathologically confirmed as SCD, but had been clinically misdiagnosed as having other disorders. Their clinical diagnoses comprised progressive supranuclear palsy (five cases) and Parkinson's disease (PD, four cases), as well as parkinsonism with dementia, amyotrophic lateral sclerosis, paraneoplastic syndrome and multiple cerebral infarction (one case each). The results indicate that it is often difficult to distinguish PSP and PD from SCD, because of the atypical combination of symptoms or atypical timing of the appearance of symptoms, such as severe autonomic failure, cognitive impairment, poor L-dopa responsiveness, early cerebellar signs and obvious vertical gaze palsy. PMID:26556659

  7. Choice of ICD-10 codes for the identification of acute coronary syndrome in the French hospitalization database.

    Science.gov (United States)

    Bezin, Julien; Girodet, Pierre-Olivier; Rambelomanana, Sahondra; Touya, Maëlys; Ferreira, Paul; Gilleron, Véronique; Robinson, Philip; Moore, Nicholas; Pariente, Antoine

    2015-12-01

    The objective of this study was to evaluate the performance of the ICD-10 (International Classification of Diseases and Related Health Problems, 10(th) Edition) coding in the French hospitalization database (PMSI) to identify acute coronary syndrome (ACS) occurrence. Eligible hospitalizations were those that occurred at the Bordeaux teaching hospitals between 1 January 2011 and 31 December 2011 and had one of the ICD-10 codes related to ischaemic heart diseases (I20 to I25, excluding I23 and I25.2). Among these, 100 hospitalizations were randomly selected; for each case, the ACS diagnosis was confirmed/excluded after medical file examination by an independent events validation committee and the performance of codes, and combinations of codes, to identify ACS was evaluated by calculating the positive predictive value (PPV). Of the individual codes, I20.0, I21 and I24 had the highest PPV; 100.0% for I24 (95%CI [15.8-100.0]); 90.0% for I21 (95%CI [76.3-97.2]); and 66.7% for I20.0 (95%CI [38.4-88.2]). The combination of I20.0 or I24 codes was able to identify 12 of the 56 validated ACS cases with a PPV of 70.6% (95%CI [44.0-89.7]), the combination of I21 or I24 identified 38 cases with a PPV of 90.5% (95%CI [77.4-97.3]), the combination of I20.0 or I21 identified 46 cases with a PPV of 83.6% (95%CI [71.2-92.2]), and the combination of I20.0, I21 or I24 identified 48 cases with a PPV of 84.2% (95%CI [72.1-92.5]). The combination of I20.0, I21 or I24 codes had the best performance to identify occurrence of ACS in the French hospitalization database. PMID:26301735

  8. Clinical characteristics and outcome of cancer diagnosed during pregnancy

    Science.gov (United States)

    Shim, Min Hee; Mok, Chi-Won; Chang, Kylie Hae-Jin; Sung, Ji-Hee; Oh, Soo-young; Roh, Cheong-Rae; Kim, Jong-Hwa

    2016-01-01

    Objective The aim of this study is to describe the clinical characteristics and outcome of cancer diagnosed during pregnancy. Methods This is a retrospective cohort study of women who were diagnosed with cancer during pregnancy at a tertiary academic hospital between 1995 and 2013. Maternal characteristics, gestational age at diagnosis, and type, stage, symptoms and signs of cancer for each patient were retrieved from the medical records. The cancer treatment, pregnancy management and the subsequent perinatal and maternal outcomes for each cancer were assessed. Results A total of 87 women were diagnosed with cancer during pregnancy (172.6 cases per 100,000 deliveries). The most common cancer was breast cancer (n=20), followed by gastrointestinal (n=17), hematologic (n=13), thyroid (n=11), central nervous system (n=7), cervical (n=7), ovarian (n=5), lung (n=3), and other cancers (n=4). Eighteen (20.7%) patients terminated their pregnancies. In the 69 (79.3%) patients who maintained their pregnancies, one patient miscarried and 34 patients delivered preterm. Of the preterm babies, 24 (70.6%) were admitted to the neonatal intensive care unit and 3 (8.8%) of those expired. The maternal mortality rate was 31.0%, with highest rate seen with lung cancers (66.7%), followed by gastrointestinal (50.0%), central nervous system (50.0%), hematologic (30.8%), breast (25.0%), ovarian (20.0%) cervical (14.3%), and thyroid cancers (0%). Conclusion The clinical characteristics and outcome of cancer during pregnancy were highly variable depending on the type of cancer. However, timely diagnosis and appropriate management of cancer during pregnancy may improve both maternal and neonatal outcome. PMID:26866029

  9. OPS und ICD-10-GM 2007: Eröffnung des Vorschlagsverfahrens und Redaktionsschluss für Änderungsvorschläge

    OpenAIRE

    Müller, W.; DIMDI, P

    2005-01-01

    Das DIMDI nimmt ab sofort Änderungsvorschläge zu den Klassifikationen ICD-10-GM (Internationale Klassifikation der Krankheiten) und OPS (Operationen- und Prozedurenschlüssel) entgegen. Der Redaktionsschluss für Änderungsvorschläge für die Versionen des Jahres 2007 ist am 28. Februar 2006.

  10. Clinical characteristics of sarcoidosis patients diagnosed in a university hospital

    Directory of Open Access Journals (Sweden)

    Özlem Abakay

    2012-09-01

    Full Text Available Objectives: The clinical characteristics and treatment resultsof patients diagnosed with sarcoidosis was investigatedin Dicle University Medical Faculty Hospital.Materials and methods: A total of 39 patients were includeddiagnosed with sarcoidosis between 01 January2008 and31 December 2011.Demographic data, laboratoryfindings, spirometric test data, diagnostic methodsand treatment regimens for the study were recorded form.According to pulmonary function test results of patients,61.5% were normal pattern, 30.8% were restrictive patternand 7.7% were obstructive pattern.Results: Of the 39 patients 15.4% male, 84.6% werefemale. The mean age was 39.5±13.1 years for males,females 44.8±14.0 years. All patients of was 17.9%stage 1, 66.7% stage 2, 10.3% stage 3 and 5.1% stage4. 61.5% were symptomatic, 38.5% were asymptomatic.Methods of diagnosis of the patients examined, 25.6% ofpatients bronchoscopic biopsy procedures, 74.4% of patientssurgical biopsy procedures. Of the 56.4% patientshad received corticosteroid treatment, 5.1% patients hadreceived corticosteroid + methotrexate treatment, 38.5%were followed up without the pharmacological treatment.Pharmacological treatment in the group complete at thetime of the study 20.5% concluded the treatment of theperson. Patients who treatment ending 8.4 months hadused pharmacological treatment.Conclusions: Interstitial lung diseases which are prevalentamong patients with sarcoidosis diagnosed by examiningthe clinical features, differential diagnosis and treatmentmay be possible detection of potential problems. JClin Exp Invest 2012; 3 (3: 363-367Key words: Sarcoidosis diagnosis, treatment

  11. [Autism Spectrum Disorder in DSM-5 - concept, validity, and reliability, impact on clinical care and future research].

    Science.gov (United States)

    Freitag, Christine M

    2014-05-01

    Autism Spectrum Disorder (ASD) in DSM-5 comprises the former DSM-IV-TR diagnoses of Autistic Disorder, Asperger's Disorder and PDD-nos. The criteria for ASD in DSM-5 were considerably revised from those of ICD-10 and DSM-IV-TR. The present article compares the diagnostic criteria, presents studies on the validity and reliability of ASD, and discusses open questions. It ends with a clinical and research perspective. PMID:24846867

  12. Importance of ICD-10 coding directive change for acute gastroenteritis (unspecified) for rotavirus vaccine impact studies: illustration from a population-based cohort study from Ontario, Canada

    OpenAIRE

    Wilson, Sarah E.; Shelley L Deeks; Rosella, Laura C

    2015-01-01

    Background In Ontario, Canada, we conducted an evaluation of rotavirus (RV) vaccine on hospitalizations and Emergency Department (ED) visitations for acute gastroenteritis (AGE). In our original analysis, any one of the International Classification of Disease, Version 10 (ICD-10) codes was used for outcome ascertainment: RV-specific- (A08.0), viral- (A08.3, A08. 4, A08.5), and unspecified infectious- gastroenteritis (A09). Annual age-specific rates per 10,000 population were calculated. Findi...

  13. Clinically Diagnosed Insomnia and Risk of All-Cause and Diagnosis-Specific Disability Pension: A Nationwide Cohort Study

    Directory of Open Access Journals (Sweden)

    Catarina Jansson

    2013-01-01

    Full Text Available Background. Insomnia and disability pension are major health problems, but few population-based studies have examined the association between insomnia and risk of disability pension. Methods. We conducted a prospective nationwide cohort study based on Swedish population-based registers including all 5,028,922 individuals living in Sweden on December 31, 2004/2005, aged 17–64 years, and not on disability or old age pension. Those having at least one admission/specialist visit with a diagnosis of disorders of initiating and maintaining sleep (insomnias (ICD-10: G47.0 during 2000/2001–2005 were compared to those with no such inpatient/outpatient care. All-cause and diagnosis-specific incident disability pension were followed from 2006 to 2010. Incidence rate ratios (IRRs and 95% confidence intervals (CIs were estimated by Cox regression. Results. In models adjusted for prior sickness absence, sociodemographic factors, and inpatient/specialized outpatient care, associations between insomnia and increased risks of all-cause disability pension (IRR 1.35, 95% CI 1.09–1.67 and disability pension due to mental diagnoses (IRR 1.86, 95% CI 1.38–2.50 were observed. After further adjustment for insomnia medications these associations disappeared. No associations between insomnia and risk of disability pension due to cancer, circulatory, or musculoskeletal diagnoses were observed. Conclusion. Insomnia seems to be positively associated with all-cause disability pension and disability pension due to mental diagnoses.

  14. New proposals for the international classification of diseases-11 revision of pain diagnoses

    DEFF Research Database (Denmark)

    Rief, Winfried; Kaasa, Stein; Jensen, Rigmor;

    2012-01-01

    The representation of pain diagnoses in current classification systems like International Classification of Diseases (ICD)-10 and Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV does not adequately reflect the state of the art of pain research, and does not sufficiently support the...... clinical management and research programs for pain conditions. Moreover, there is an urgent need to harmonize classification of pain syndromes of special expert groups (eg, International Classification of Headache Disorders) and general classification systems (eg, ICD-11, DSM-V). Therefore, this paper...... current pain-specific classification proposals to the revision of ICD-11. PERSPECTIVE: Pain research and expertise must be more visible in the ICD-11 revision process. A general category for pain diagnoses as well as specific pain diagnoses under existing categories of organ-specific sections are needed....

  15. Designing a software for systematic registration of oral and maxillofacial diseases based on the latest update of the World Health Organization ICD-10 classification system in 2010

    Directory of Open Access Journals (Sweden)

    Arash Mansorian

    2014-04-01

    Full Text Available   Background and Aims: Classification is a fundamental issue in quantitative studies of any phenomenon and has been known as a necessity for the advancement of science. Using a standard record system for diseases is critical for research purposes and also could improve the quality of medical health services. In this study, after evaluating current codding systems in oral medicine, we designed a software for systematic coding and registration of Oral and Maxillofacial diseases based on the latest update of the World Health Organization ICD-10 classification system in 2010.   Materials and Methods: Based on the latest WHO ICD-10 update in 2010 and by using software s as: vb.net, net framework, SQL Server and Microsoft Visual Studio, standard coding software for recording patient's data at the department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences was designed. Data from all patients were codded by standard ICD-10 codes and registered by the software. Also an online portal for recording patient's data which could be used nationwide was designed. By d esigning this software the process of forming and registering patient's records, and their treatment process is facilitated . An archive of patient data was also stablished .   Conclusion: As a result , this software in addition to maintaining patient data , facilitate studies and research projects greatly. It’s recommended that the Iranian Ministry of Health and Medical Education as the concessioner of this software, improves codding and registration systems of oral diseases at the dental schools by developing this software.

  16. CLINICAL AND FAMILY PROFILE OF PATIENTS DIAGNOSED WITH KERATOCONUS

    OpenAIRE

    Kalpana; Rekha B.; Vidyadevi; De, Anuradha

    2015-01-01

    PURPOSE: To screen the first degree relatives of patient diagnosed with keratoconus . MATERIALS AND METHODS : All the patients included in the study, patient details were taken which included - name, age, gender, hospital number, address and family history [pedigree tree] . All the patients underwent refraction, best corrected visual acuity, colour vision , keratometry, intraocular pressure measurement and cornea...

  17. Clinical spectrum of pulmonary hamartoma diagnosed by surgical resection

    International Nuclear Information System (INIS)

    We retrospectively reviewed our institutional experience of pulmonary hamartomas. We analyzed the records of 23 patients with pulmonary hamartomas which were diagnosed by surgical resection. There were 12 males and 11 females. Their mean age was 53.5 years old (range: 28 to 71 years). Twenty patients were asymptomatic, 2 had chest pain and 1 had a cough. Twenty-two patients had solitary and only 1 patient had multiple lesions. The tumor sizes ranged from 0.5 to 3.0 cm (mean: 1.5 cm). Graphically, 6 patients had calcification which was not popcorn-like. We could not diagnose nodules by bronchoscopic biopsy, which was preoperatively performed in 17 patients. Surgery was performed because we could not rule out malignancy in all patients. Surgical procedures consisted of 6 enucleation, 16 wedge resection and 1 lobectomy. Video-assisted thoracic surgery was performed in 17 patients. To diagnose pulmonary nodule, whose malignancy is difficult to determine, surgical resection should be considered. (author)

  18. Economic evaluation of a clinical protocol for diagnosing emergency patients with suspected pulmonary embolism

    OpenAIRE

    Gospodarevskaya, Elena V; Goergen, Stacy K; Harris, Anthony H; Chan, Thomas; de Campo, John F; Wolfe, Rory; Gan, Eng T; Wheeler, Michael B.; McKay, John

    2006-01-01

    Background The objective of this paper is to estimate the amount of cost-savings to the Australian health care system from implementing an evidence-based clinical protocol for diagnosing emergency patients with suspected pulmonary embolism (PE) at the Emergency department of a Victorian public hospital with 50,000 presentations in 2001–2002. Methods A cost-minimisation study used the data collected in a controlled clinical trial of a clinical protocol for diagnosing patients with suspected PE...

  19. Using clinical signs to diagnose anaemia in African children.

    OpenAIRE

    Luby, S. P.; Kazembe, P.N.; Redd, S. C.; Ziba, C.; Nwanyanwu, O. C.; Hightower, A. W.; C. Franco; Chitsulo, L.; Wirima, J J; Olivar, M. A.

    1995-01-01

    Anaemia is a serious and common problem among young children in sub-Saharan Africa. As a first step towards developing guidelines for its recognition and treatment, we conducted a study to evaluate the ability of health workers to use clinical findings to identify children with anaemia. Health care workers examined a total of 1104 children under 5 years of age at two hospital-based outpatient clinics in rural Malawi. Blood samples were taken to determine haemoglobin concentrations. Pallor of ...

  20. Can we clinically diagnose dementia with Lewy bodies yet?

    OpenAIRE

    Huang Yue; Halliday Glenda

    2013-01-01

    Abstract Dementia with Lewy Bodies (DLB) was initially identified and confirmed primarily by pathology, but is soon to be incorporated into the Diagnostic and Statistical Manual criteria as a clinical disease entity. Despite these advances over more than 20 years, current data suggest that the sensitivity of accurate clinical diagnosis of DLB is still very low, although there is mounting evidence that supportive features may increase diagnostic accuracy. Although DLB remains easy to identify ...

  1. Psychiatric Diagnoses and Clinical Characteristics of Asian American Youth in Children's Services

    Science.gov (United States)

    Nguyen, Ly; Arganza, Girlyn F.; Huang, Larke N.; Liao, Qinghong; Nguyen, Hoang T.; Santiago, Rolando

    2004-01-01

    This study examined the psychiatric diagnoses and clinical characteristics of the 981 Asian American children enrolled in the first phase of the Comprehensive Community Mental Health Services for Children and Their Families Program. Asian Americans were less likely than non-Asian Americans to receive diagnoses of depression and ADHD and more…

  2. Consistency between Research and Clinical Diagnoses of Autism among Boys and Girls with Fragile X Syndrome

    Science.gov (United States)

    Klusek, J.; Martin, G. E.; Losh, M.

    2014-01-01

    Background: Prior research suggests that 60-74% of males and 16-45% of females with fragile X syndrome (FXS) meet criteria for autism spectrum disorder (ASD) in research settings. However, relatively little is known about the rates of clinical diagnoses in FXS and whether such diagnoses are consistent with those performed in a research setting…

  3. Clinical inquiries: How useful are autoantibodies in diagnosing thyroid disorders?

    Science.gov (United States)

    Downs, Heather; Meyer, Albert A; Flake, Donna; Solbrig, Ron

    2008-09-01

    They're useful in diagnosing Graves' disease and, to a lesser extent, autoimmune thyroid disease; they can also help predict hypothyroidism. Thyrotropin receptor antibodies (TRAb) may be mildly elevated in a variety of thyroid disorders, but a TRAb level >10 U/L increases the probability of Graves' disease by a moderate to large degree (strength of recommendation [SOR]: cross-sectional study). A positive or negative thyroid peroxidase antibody (TPOAb) test increases or decreases the probability of autoimmune thyroid disease by only a small to moderate degree (SOR: 3 cross-sectional studies). Thyroid-stimulating hormone (TSH) levels >2 mU/L, although still in the normal range, can be followed up with TPOAb testing to determine whether the patient has an increased probability of developing hypothyroidism (SOR: cohort study with a vague hypothyroidism reference standard). PMID:18786338

  4. CLINICAL AND FAMILY PROFILE OF PATIENTS DIAGNOSED WITH KERATOCONUS

    Directory of Open Access Journals (Sweden)

    Kalpana

    2015-03-01

    Full Text Available PURPOSE: To screen the first degree relatives of patient diagnosed with keratoconus . MATERIALS AND METHODS : All the patients included in the study, patient details were taken which included - name, age, gender, hospital number, address and family history [pedigree tree] . All the patients underwent refraction, best corrected visual acuity, colour vision , keratometry, intraocular pressure measurement and corneal topography [orbscan]. Family screening was done, which included - refraction, best corrected visual acuity, colour vision, keratometry, intraocular pressure and corneal topography [orbscan]. RESULTS: In this study of 40 eyes, 24 eyes [Right eyes - 12 & Left eyes - 12] i.e. 60% have keratoconus, 3 eyes [2 - Right eyes & 1 - Left eye] i.e.15% have advanced keratoconus, 12 eyes [Right eye - 6 & Left eye - 6] i.e. 30% have VKC & Keratoconus, 1 eye have acute hydrops. Total family members screened 55, out of that 17 members are fathers, 20 members are mothers, 12 members are brothers and 6 are sisters

  5. Can we clinically diagnose dementia with Lewy bodies yet?

    Directory of Open Access Journals (Sweden)

    Huang Yue

    2013-02-01

    Full Text Available Abstract Dementia with Lewy Bodies (DLB was initially identified and confirmed primarily by pathology, but is soon to be incorporated into the Diagnostic and Statistical Manual criteria as a clinical disease entity. Despite these advances over more than 20 years, current data suggest that the sensitivity of accurate clinical diagnosis of DLB is still very low, although there is mounting evidence that supportive features may increase diagnostic accuracy. Although DLB remains easy to identify pathologically with different cellular pathologies differentiating it from other dementia syndromes, pathological identification using only Lewy body pathology has been shown to be inaccurate due to overlap with patients without dementia symptoms. A number of studies now suggest that a combination of cellular pathologies, which include α-synuclein and β-amyloid deposition as well as dopamine denervation, assist with differentiating this dementia syndrome from others. The clinical and pathological overlap with the tauopathy of Alzheimer’s disease still remains to be clarified. To determine more robust and independent clinicopathological correlates from Alzheimer’s disease, longitudinal prospective studies, using specific clinical batteries on dementia patients reaching the proposed criteria for DLB, with post-mortem assessment of the multiple pathologies associated with dementia, are required. Identifying genetic causes for DLB is another approach to investigate the pathogenesis of DLB. However this approach has been hindered to date by difficulties with identifying DLB clinically. The use of novel techniques is likely to advance knowledge on the pathogenesis of DLB and assist with redefining clinical and pathologic diagnostic criteria. To achieve the goal of more accurate clinical diagnosis of DLB, breakthroughs are necessary on the pathogenesis of DLB.

  6. Views of diagnosis distribution in primary care in 2.5 million encounters in Stockholm: a comparison between ICD-10 and SNOMED CT

    Directory of Open Access Journals (Sweden)

    Anna Vikström

    2010-03-01

    Conclusions SNOMED CT provides a different view of diagnoses and health problems on a chapter level, and adds significant new views of the clinical data with aggregations generated fromSNOMED CT Is a and attribute relationships. A broader use of SNOMED CT is therefore of importance when describing and developing primary care.

  7. The importance of biopsy in clinically diagnosed metastatic lesions in patients with breast cancer

    OpenAIRE

    Qu, Qing; Zong, Yu; Fei, Xiao-Chun; Chen, Xiao-Song; Xu, Cheng; Lou, Gu-yin; Shen, Kun-wei

    2014-01-01

    Background Receptor status discordance, such as estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status between primary breast cancer and metastatic lesions has been reported. The aim of this study was to evaluate the biopsy of clinically diagnosed metastatic lesions and to determine the changes in hormonal receptor and HER2 status of the metastatic lesions. Methods Sixty-three patients with clinically diagnosed metastatic breast cancer un...

  8. Study of cognitive functions in newly diagnosed cases of subclinical and clinical hypothyroidism

    OpenAIRE

    Sharma, Kirti; Behera, Joshil Kumar; Sood, Sushma; Rajput, Rajesh; Satpal; Praveen, Prashant

    2014-01-01

    Introduction: Hypothyroidism is associated with significant neurocognitive deficits because hypothyroidism prevents the brain from adequately sustaining the energy consuming processes needed for neurotransmission, memory, and other higher brain functions. Hence, the study was done to assess the cognitive functions of newly diagnosed subclinical and clinical hypothyroid patients by evoked response potential P300. Materials and Methods: 75 patients each of newly diagnosed subclinical and clinic...

  9. Characteristic clinical and pathologic features for preoperative diagnosed groove pancreatitis

    OpenAIRE

    Kim, Joo Dong; Han, Young Seok; Choi, Dong Lak

    2011-01-01

    Purpose Groove pancreatitis is a rare specific form of chronic pancreatitis that extends into the anatomical area between the pancreatic head, the duodenum, and the common bile duct, which are referred to as the groove areas. We present the diagnostic modalities, pathological features and clinical outcomes of a series of symptomatic patients with groove pancreatitis who underwent pancreaticoduodenectomy. Methods Six patients undergoing pancreaticoduodenectomy between May 2006 and May 2009 due...

  10. Clinical usefulness of 201Tl SPECT in diagnosing nasopharyngeal tumor

    International Nuclear Information System (INIS)

    201Tl SPECT was performed on 54 patients suspected of nasopharyngeal tumor using a three-head rotating gamma camera and its clinical usefulness was evaluated. 201Tl accumulations were shown in 53 of the 54 patients (50 nasopharyngeal carcinoma, 1 malignant melanoma and 2 lymphoid hyperplasia) before treatment. In 48 of 50 patients with nasopharyngeal carcinoma, the effectiveness for treatment response could be assessed after treatment. 201Tl SPECT was concordant with MRI and CT in 26 patients (15 complete response (CR), 11 partial response (PR)), whereas it was discordant in 22 patients who showed CR in 201Tl SPECT but PR in MRI and CT. Follow-up MRI and 201Tl SPECT studies of 16 of these 22 patients from 6 to 33 months (mean 13 months) after treatment revealed that the tumor gradually decreased and finally vanished. Recurrent and metastatic lesions occurred in 8 patients from 9 to 69 months (mean 24 months) after treatment, and 201Tl SPECT could detect all 10 lesions in 8 patients. From the results obtained, it was concluded that 201Tl SPECT is very useful in the initial evaluation, in the assessment of treatment response and in detecting recurrent and metastatic lesions of nasopharyngeal tumor. (author)

  11. Determinants of sexual dysfunction among clinically diagnosed diabetic patients

    Directory of Open Access Journals (Sweden)

    Sarpong Charity

    2011-05-01

    Full Text Available Abstract Background Diabetes mellitus is a chronic disease that can result in various medical, psychological and sexual dysfunctions (SD if not properly managed. SD in men is a common under-appreciated complication of diabetes. This study assessed the prevalence and determinants of SD among diabetic patients in Tema, Greater Accra Region of Ghana. Method Sexual functioning was determined in 300 consecutive diabetic men (age range: 18-82 years visiting the diabetic clinic of Tema General Hospital with the Golombok Rust Inventory of Sexual Satisfaction (GRISS questionnaire, between November, 2010 and March, 2011. In addition to the socio-demographic characteristics of the participants, the level of glycosylated haemoglobin, fasting blood sugar (FBS and serum testosterone were assessed. All the men had a steady heterosexual relationship for at least 2 years before enrolment in the study. Results Out the 300 participants contacted, the response rate was 91.3% after 20 declined participation and 6 incomplete data were excluded All the respondents had at least basic education, 97.4% were married, 65.3% were known hypertensive, 3.3% smoked cigarettes, 27% took alcoholic beverages and 32.8% did some form of exercise. The 69.3% SD rate observed in this study appears to be related to infrequency (79.2%, non-sensuality (74.5%, dissatisfaction with sexual acts (71.9%, non-communication (70.8% and impotence (67.9%. Other areas of sexual function, including premature ejaculation (56.6% and avoidance (42.7% were also substantially affected. However, severe SD was seen in only 4.7% of the studied population. The perceived "adequate", "desirable", "too short" and "too long intra-vaginal ejaculatory latency time (IELT are 5-10, 5-10, 1-2 and 15-30 minutes respectively. Testosterone correlates negatively with glycated haemoglobin (HBA1c, FBS, perceived desirable, too short IELT, and weight as well as waist circumference. Conclusion SD rate from this study is high

  12. New clinical score to diagnose nonalcoholic steatohepatitis in obese patients

    Directory of Open Access Journals (Sweden)

    Pulzi Fernanda BU

    2011-02-01

    Full Text Available Abstract Background Nonalcoholic fatty liver disease (NAFLD is the most frequent disease associated with abnormal liver tests that is characterized by a wide spectrum of liver damage, ranging from simple macro vesicular steatosis to steatohepatitis (NASH, cirrhosis or liver carcinoma. Liver biopsy is the most precise test to differentiate NASH from other stages of NAFLD, but it is an invasive and expensive method. This study aimed to create a clinical laboratory score capable of identify individual with NASH in severely obese patients submitted to bariatric surgery. Methods The medical records from 66 patients submitted to gastroplasty were reviewed. Their chemistry profile, abdominal ultrasound (US and liver biopsy done during the surgical procedure were analyzed. Patients were classified into 2 groups according to liver biopsy: Non-NASH group - those patients without NAFLD or with grade I, II or III steatosis; and NASH group - those with steatohepatitis or fibrosis. The t-test was used to compare each variable with normal distribution between NASH and Non-NASH groups. When comparing proportions of categorical variables, we used chi-square or z-test, where appropriate. A p-value Results 83% of patients with obesity grades II or III showed NAFLD, and the majority was asymptomatic. Total Cholesterol (TC≥200 mg/dL, alanine aminotransferase (ALT ≥30, AST/ALT ratio (AAR≤ 1, gammaglutaril-transferase (γGT≥30 U/L and abdominal US, compatible with steatosis, showed association with NASH group. We proposed 2 scores: Complete score (TC, ALT, AAR, γGT and US and the simplified score, where US was not included. The combination of biochemical and imaging results improved accuracy to 84.4% the recognition of NASH (sensitivity 70%, specificity 88.6%, NPV 91.2%, PPV 63. 6%. Conclusion Alterations in TC, ALT, AAR, γGT and US are related to the most risk for NASH. The combination of biochemical and imaging results improved accuracy to 84.4% the

  13. Clinical Impact of the KL-6 Concentration of Pancreatic Juice for Diagnosing Pancreatic Masses

    OpenAIRE

    Kazuya Matsumoto; Yohei Takeda; Kenichi Harada; Takumi Onoyama; Soichiro Kawata; Yasushi Horie; Teruhisa Sakamoto; Masaru Ueki; Norimasa Miura; Yoshikazu Murawaki

    2015-01-01

    Background and Aim. Pancreatic juice cytology (PJC) is considered optimal for differentially diagnosing pancreatic masses, but the accuracy of PJC ranges from 46.7% to 93.0%. The aim of this study was to evaluate the clinical impact of measuring the KL-6 concentration of pancreatic juice for diagnosing pancreatic masses. Methods. PJC and the KL-6 concentration measurements of pancreatic juice were performed for 70 consecutive patients with pancreatic masses (39 malignancies and 31 benign). Re...

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

    OpenAIRE

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

    2012-01-01

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

  15. Clinical characteristics and outcome of patients diagnosed with psychogenic nonepileptic seizures: a 5-year review.

    LENUS (Irish Health Repository)

    O'Sullivan, S S

    2012-02-03

    OBJECTIVE: The goal of this article was to describe the clinical characteristics and outcomes of patients diagnosed with psychogenic nonepileptic seizures (PNES). METHODS: We conducted a retrospective review of patients diagnosed with PNES in a 5-year period. RESULTS: Fifty patients with PNES were identified, giving an estimated incidence of 0.91\\/100,000 per annum. Thirty-eight were included for review, 15 of whom were male (39%). Eighteen patients had been diagnosed with epilepsy as well as PNES (47%). We demonstrated a gender difference in our patients, with males having higher seizure frequencies, more antiepileptic drug use, and a longer interval before diagnosis of PNES. Females were diagnosed with other conversion disorders more often than males. Impaired social function was observed in PNES, as was resistance to psychological interventions with a subsequent poor response to treatments. CONCLUSIONS: PNES remains a difficult condition to treat, and may affect males in proportions higher than those described in previous studies.

  16. [Are the current concepts of obsessive disorders a novelty? From Westphal (1877) and Thomsen (1895) to ICD-10 and DSM-5].

    Science.gov (United States)

    Oberbeck, A; Steinberg, H

    2015-09-01

    In German-speaking countries it was Carl Westphal who in 1877 offered the first precise definition of obsessive ideas and distinguished obsessive compulsive disorder (OCD) as an independent disorder in its own right. The criteria mentioned by him for establishing OCD gave rise to a debate on the character and classification of OCD but were not fully acknowledged by his colleagues at the time. In 1895 Westphal's student Robert Thomsen tried to substantiate all points in his teacher's theory that had raised criticism. Thus the works by Westphal and Thomsen are most relevant for the current conceptualization and definition of OCD, for they laid the basis for the present phenomenology, definition and classification of OCD according to ICD-10 and DSM-5. Apart from phenomenologically differentiating between obsessions (i.e. obsessive thoughts and impulses) and compulsions (i.e. compulsive actions and inhibitions), Westphal and Thomsen also laid the basis for most of the current diagnostic criteria. Thomsen led the way to current classifications by subdifferentiating OCD as an illness on its own on the one hand and obsessions and compulsions as symptoms accompanying other conditions on the other. PMID:25899135

  17. Differences between men with screening-detected versus clinically diagnosed prostate cancers in the USA

    Directory of Open Access Journals (Sweden)

    Stone S Noell

    2005-03-01

    Full Text Available Abstract Background The advent of prostate specific antigen (PSA testing in the United States of America (USA has led to a dramatic increase in the incidence of prostate cancer in the United States as well as the number of men undergoing aggressive treatment with radical prostatectomy and radiation therapy. We compared patient characteristics and treatment selection between American men with screening-detected versus clinically diagnosed prostate cancers. Methods We evaluated 3,173 men with prostate cancer in the USA. Surveys and medical records provided information on demographics, socioeconomic status, comorbidities, symptoms, tumor characteristics, and treatment. We classified men presenting with symptoms of advanced cancer – bone pain, weight loss, or hematuria – as "clinically diagnosed"; asymptomatic men and those with only lower urinary tract symptoms were considered "screening-detected." We used multivariate analyses to determine whether screening predicted receiving aggressive treatment for a clinically localized cancer. Results We classified 11% of cancers as being clinically diagnosed. Men with screening-detected cancers were more often non-Hispanic white (77% vs. 65%, P Conclusion Most cancers were detected by screening in this American cohort. Appropriately, younger, healthier men were more likely to be diagnosed by screening. Minority status and lower socio-economic status appeared to be screening barriers. Screening detected earlier-stage cancers and was associated with receiving aggressive treatment.

  18. Randomized controlled trial of oral vs intravenous therapy for the clinically diagnosed acute uncomplicated diverticulitis.

    LENUS (Irish Health Repository)

    Ridgway, P F

    2009-11-01

    Despite the high prevalence of hospitalization for left iliac fossa tenderness, there is a striking lack of randomized data available to guide therapy. The authors hypothesize that an oral antibiotic and fluids are not inferior to intravenous (IV) antibiotics and \\'bowel rest\\' in clinically diagnosed acute uncomplicated diverticulitis.

  19. 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…

  20. Serological and Virological Characterization of Clinically Diagnosed Cases of Measles in Suburban Khartoum

    OpenAIRE

    Mubarak, H.S.; Niesters, Bert; S. A. Ibrahim; Swart, Rik; Zijlstra, Edward; Wild, T. F.; Mustafa, O.A.; Vos, Helma; Mukhtar, M. M.; Groen, Jan; El-Hassan, Ahmed Mohamed; Osterhaus, Ab; van de Bildt, Marco

    2000-01-01

    textabstractMeasles continues to be a major childhood disease in terms of global morbidity and mortality. In the main areas of its endemicity the only available means of diagnosis are based on clinical criteria: the presence of a maculopapular rash and fever accompanied by cough, coryza, and/or conjunctivitis. We have studied 38 clinically diagnosed cases of measles in Khartoum, Sudan, by means of serology, reverse transcriptase PCR (RT-PCR) on throat swabs and virus isolation from lymphocyte...

  1. Economic evaluation of a clinical protocol for diagnosing emergency patients with suspected pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Wolfe Rory

    2006-06-01

    Full Text Available Abstract Background The objective of this paper is to estimate the amount of cost-savings to the Australian health care system from implementing an evidence-based clinical protocol for diagnosing emergency patients with suspected pulmonary embolism (PE at the Emergency department of a Victorian public hospital with 50,000 presentations in 2001–2002. Methods A cost-minimisation study used the data collected in a controlled clinical trial of a clinical protocol for diagnosing patients with suspected PE. Thenumber and type of diagnostic tests in a historic cohort of 185 randomly selected patients, who presented to the emergency department with suspectedPE during an eight month period prior to the clinical trial (January 2002 -August 2002 were compared with the number and type of diagnostic tests in745 patients, who presented to the emergency department with suspected PE from November 2002 to August 2003. Current Medicare fees per test were usedas unit costs to calculate the mean aggregated cost of diagnostic investigation per patient in both study groups. A t-test was used to estimate the statistical significance of the difference in the cost of resources used for diagnosing PE in the control and in the intervention group. Results The trial demonstrated that diagnosing PE using an evidence-based clinical protocol was as effective as the existing clinical practice. The clinical protocol offers the advantage of reducing the use of diagnostic imaging, resulting in an average cost savings of at least $59.30 per patient. Conclusion Extrapolating the observed cost-savings of $59.30 per patient to the wholeof Australia could potentially result in annual savings between $3.1 million to $3.7 million.

  2. Re-Evaluation of Clinical Dementia Diagnoses with Pittsburgh Compound B Positron Emission Tomography

    Directory of Open Access Journals (Sweden)

    M. Degerman Gunnarsson

    2013-12-01

    Full Text Available Objectives: There is an overlap regarding Pittsburgh compound B (PIB retention in patients clinically diagnosed as Alzheimer's disease (AD and non-AD dementia. The aim of the present study was to investigate whether there are any differences between PIB-positive and PIB-negative patients in a mixed cohort of patients with neurodegenerative dementia of mild severity regarding neuropsychological test performance and regional cerebral glucose metabolism measured with [18F]fluoro-2-deoxy-D-glucose (FDG positron emission tomography (PET. Methods: Eighteen patients clinically diagnosed as probable AD or frontotemporal dementia were examined with PIB PET, FDG PET and neuropsychological tests and followed for 5-9 years in a clinical setting. Results: The PIB-positive patients (7 out of 18 had slower psychomotor speed and more impaired visual episodic memory than the PIB-negative patients; otherwise performance did not differ between the groups. The initial clinical diagnoses were changed in one third of the patients (6 out of 18 during follow-up. Conclusions: The subtle differences in neuropsychological performance, the overlap of hypometabolic patterns and clinical features between AD and non-AD dementia highlight the need for amyloid biomarkers and a readiness to re-evaluate the initial diagnosis.

  3. Disability and Comorbidity: Diagnoses and Symptoms Associated with Disability in a Clinical Population with Panic Disorder

    OpenAIRE

    Bonham, Caroline A.; Eberhard Uhlenhuth

    2014-01-01

    Background. Anxiety disorders are associated with considerable disability in the domains of (1) work, (2) social, and (3) family and home interactions. Psychiatric comorbidity is also known to be associated with disability. Methods. Data from the Cross-National Collaborative Panic Study was used to identify rates of comorbid diagnoses, anxiety and depression symptom ratings, and Sheehan disability scale ratings from a clinical sample of 1165 adults with panic disorder. Results. Comorbid diagn...

  4. Prevalence of parenterally transmitted hepatitis viruses in clinically diagnosed cases of hepatitis

    OpenAIRE

    Arora D; Sehgal R; Gupta N; Yadav A; Mishra N; Siwach S

    2005-01-01

    Hepatitis B virus (HBV) is the most important causative agent of blood borne hepatitis in humans. Hepatitis D Virus (HDV) infection occurs either as a coinfection or superinfection in HBV carriers. Hepatitis C virus (HCV) is the major cause of transfusion non-A, non-B hepatitis and continues to be a major cause of human liver disease throughout the world. The present study was conducted on 70 clinically diagnosed cases of viral hepatitis to study the prevalence of parenterally transmitted vir...

  5. Warfarin-induced skin necrosis diagnosed on clinical grounds and treated with maggot debridement therapy

    OpenAIRE

    Biscoe, Anna Louise; Bedlow, Alison

    2013-01-01

    A patient with a history of deep vein thrombosis presented with painful bruising and blistering on his left leg 7–10 days after warfarin treatment. A complicated 2-month treatment followed, where vasculitis was originally diagnosed from histological findings before the final diagnosis of warfarin-induced skin necrosis (WISN) was made on clinical grounds. Warfarin was stopped, reversed and low molecular weight heparin started but, the lesions had progressed to full thickness necrosis. This was...

  6. A nomogram to predict Gleason sum upgrading of clinically diagnosed localized prostate cancer among Chinese patients

    OpenAIRE

    Jin-You Wang; Yao Zhu; Chao-Fu Wang; Shi-Lin Zhang; Bo Dai; Ding-Wei Ye

    2014-01-01

    Although several models have been developed to predict the probability of Gleason sum upgrading between biopsy and radical prostatectomy specimens, most of these models are restricted to prostate-specific antigen screening-detected prostate cancer. This study aimed to build a nomogram for the prediction of Gleason sum upgrading in clinically diagnosed prostate cancer. The study cohort comprised 269 Chinese prostate cancer patients who underwent prostate biopsy with a minimum of 10 cores and w...

  7. New proposals for the international classification of diseases-11 revision of pain diagnoses.

    NARCIS (Netherlands)

    Rief, W.; Kaasa, S.; Jensen, R.; Perrot, S.; Vlaeyen, J.W.S.; Treede, R.D.; Vissers, K.C.P.

    2012-01-01

    The representation of pain diagnoses in current classification systems like International Classification of Diseases (ICD)-10 and Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV does not adequately reflect the state of the art of pain research, and does not sufficiently support the cl

  8. 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 ...

  9. Using plant clinic registers to assess the quality of diagnoses and advice given to farmers

    DEFF Research Database (Denmark)

    Danielsen, Solveig; Boa, Eric; Mafabi, Moses;

    2012-01-01

    clinic registers have been used to systematically assess quality of plant clinic services. Apart from being a valuable tool for quality assessment of extension, the plant clinic registers constitute a novel source of regular information about pests, diseases and farmer demand that can help improve...... validated diagnoses. The majority of recommendations (82%) were assessed ‘partially effective’. ‘Best practice’ was recommended for 10% and ineffective advice was given in 8% of the cases with considerable variation between diseases. Practical implications: Plant doctors need more training in symptom...... recognition, pest management and record keeping as well as better technical backstopping to solve unknown problems. Common standards and procedures for clinic data collection and analysis should be established, and roles and responsibilities clearly defined. Originality/value: This is the first time plant...

  10. Disability and Comorbidity: Diagnoses and Symptoms Associated with Disability in a Clinical Population with Panic Disorder

    Directory of Open Access Journals (Sweden)

    Caroline A. Bonham

    2014-01-01

    Full Text Available Background. Anxiety disorders are associated with considerable disability in the domains of (1 work, (2 social, and (3 family and home interactions. Psychiatric comorbidity is also known to be associated with disability. Methods. Data from the Cross-National Collaborative Panic Study was used to identify rates of comorbid diagnoses, anxiety and depression symptom ratings, and Sheehan disability scale ratings from a clinical sample of 1165 adults with panic disorder. Results. Comorbid diagnoses of agoraphobia, major depression, and social phobia were associated with disability across the three domains of work, social, and family and home interactions. The symptom of agoraphobic avoidance makes the largest contribution to disability but there is no single symptom cluster that entirely predicts impairment and disability. Limitations. The findings about the relative contributions that comorbid diagnoses make to disability only apply to a population with panic disorder. Conclusions. Although panic disorder is not generally considered to be among the serious and persistent mental illnesses, when it is comorbid with other diagnoses, it is associated with considerable impairment. In particular, the presence of agoraphobic avoidance should alert the clinician to the likelihood of important functional impairment. When measuring the functional impact of comorbid anxiety disorders, both the categorical and the dimensional approaches to diagnosis make valuable contributions.

  11. A nomogram to predict Gleason sum upgrading of clinically diagnosed localized prostate cancer among Chinese patients

    Institute of Scientific and Technical Information of China (English)

    Jin-You Wang; Yao Zhu; Chao-Fu Wang; Shi-Lin Zhang; Bo Dai; Ding-Wei Ye

    2014-01-01

    Although several models have been developed to predict the probability of Gleason sum upgrading between biopsy and radical prostatectomy specimens, most of these models are restricted to prostate-specific antigen screening-detected prostate cancer. This study aimed to build a nomogram for the prediction of Gleason sum upgrading in clinical y diagnosed prostate cancer. The study cohort comprised 269 Chinese prostate cancer patients who underwent prostate biopsy with a minimum of 10 cores and were subsequently treated with radical prostatectomy. Of al included patients, 220 (81.8%) were referred with clinical symptoms. The prostate-specific antigen level, primary and secondary biopsy Gleason scores, and clinical T category were used in a multivariate logistic regression model to predict the probability of Gleason sum upgrading. The developed nomogram was validated internally. Gleason sum upgrading was observed in 90 (33.5%) patients. Our nomogram showed a bootstrap-corrected concordance index of 0.789 and good calibration using 4 readily available variables. The nomogram also demonstrated satisfactory statistical performance for predicting significant upgrading. External validation of the nomogram published by Chun et al. in our cohort showed a marked discordance between the observed and predicted probabilities of Gleason sum upgrading. In summary, a new nomogram to predict Gleason sum upgrading in clinically diagnosed prostate cancer was developed, and it demonstrated good statistical performance upon internal validation.

  12. A nomogram to predict Gleason sum upgrading of clinically diagnosed localized prostate cancer among Chinese patients

    Directory of Open Access Journals (Sweden)

    Jin-You Wang

    2014-05-01

    Full Text Available Although several models have been developed to predict the probability of Gleason sum upgrading between biopsy and radical prostatectomy specimens, most of these models are restricted to prostate-specific antigen screening-detected prostate cancer. This study aimed to build a nomogram for the prediction of Gleason sum upgrading in clinically diagnosed prostate cancer. The study cohort comprised 269 Chinese prostate cancer patients who underwent prostate biopsy with a minimum of 10 cores and were subsequently treated with radical prostatectomy. Of all included patients, 220 (81.8% were referred with clinical symptoms. The prostate-specific antigen level, primary and secondary biopsy Gleason scores, and clinical T category were used in a multivariate logistic regression model to predict the probability of Gleason sum upgrading. The developed nomogram was validated internally. Gleason sum upgrading was observed in 90 (33.5% patients. Our nomogram showed a bootstrap-corrected concordance index of 0.789 and good calibration using 4 readily available variables. The nomogram also demonstrated satisfactory statistical performance for predicting significant upgrading. External validation of the nomogram published by Chun et al. in our cohort showed a marked discordance between the observed and predicted probabilities of Gleason sum upgrading. In summary, a new nomogram to predict Gleason sum upgrading in clinically diagnosed prostate cancer was developed, and it demonstrated good statistical performance upon internal validation.

  13. How does a real-world child psychiatric clinic diagnose and treat attention deficit hyperactivity disorder?

    Science.gov (United States)

    Yuki, Kumi; Bhagia, Jyoti; Mrazek, David; Jensen, Peter S

    2016-01-01

    AIM: To investigate child and adolescent psychiatrists’ (CAPs) attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) diagnoses and treatments in real-world clinical practice. METHODS: The medical records of 69 ADHD children (mean age = 9.5 years), newly referred to the ADHD clinic, were reviewed for their scores of parent- and teacher-reported Vanderbilt ADHD Diagnostic Rating Scales (VADRSs), CAPs’ diagnoses of ADHD and ODD, and CAPs’ treatment recommendations. Among 63 ADHD subjects who completed both parent and teacher VADRSs, we examined the agreement of the parent and teacher VADRSs. We also examined the concurrent validity of CAPs’ ODD diagnoses against the results from the VADRSs. In addition, we compared CAPs’ treatment recommendations against established ADHD and ODD guidelines. RESULTS: Among 63 ADHD subjects, the majority of the subjects (92%) met full ADHD diagnostic criteria at least in one setting (parent or teacher) on the VADRSs. Nearly half of the patients met full ADHD diagnostic criteria in two settings (parent and teacher). Relatively low agreement between the parent and teacher VADRSs were found (95%CI: -0.33 to 0.14). For 29 children who scored positive for ODD on the rating scales, CAPs confirmed the ODD diagnosis in only 12 of these case-positives, which is considered as a fair agreement between CAPs and VADRSs (95%CI: 0.10-0.53). For 27 children with no ODD diagnosis made by either CAP or VADRS, more than half of them were recommended for medication only. In contrast, where CAPs made the diagnosis of ODD, or where the parent or teacher VADRS was positive for ODD, almost all of the patients received recommendations for medication and behavior therapy. CONCLUSION: CAPs’ ADHD diagnoses have strong concurrent validity against valid rating scales, but ADHD’s most common comorbid condition - ODD - may be under-recognized. PMID:27014602

  14. Utility of serum thymidine kinase activity measurements for cases of bovine leukosis with difficult clinical diagnoses.

    Science.gov (United States)

    Tawfeeq, Mohammad Monir; Miura, Saori; Horiuchi, Noriyuki; Kobayashi, Yoshiyasu; Furuoka, Hidefumi; Inokuma, Hisashi

    2013-01-01

    This study evaluated the clinical usefulness of serum thymidine kinase (TK) activity for diagnosing bovine leukosis cases for which clinical diagnosis was difficult ('BL with difficult diagnosis'). Median TK activity values in 24 'BL with difficult diagnosis' and 36 cattle for which BL was clinically confirmed by cytology findings of enlarged superficial lymph nodes ('clinically confirmed BL') were 36.8 and 39.4 U/l, respectively (no significant difference). The percentage with positive TK activity (> 5.4 U/l) was also similar in both groups (83.3% for 'BL with difficult diagnosis' and 97.2% for 'clinically confirmed BL'). TK activity was significantly higher in cows with 'BL with difficult diagnosis' compared to those with other tumors (N = 13) and those with inflammatory diseases (N = 14). Maximum TK activity in cows with other tumors and inflammatory diseases was not high (cows with other tumors and those with inflammatory diseases were 1.8 and 1.4 IU/l, respectively. Positive TK activity was found in a significantly higher percentage of cows with 'BL with difficult diagnosis' (83.3%) relative to the percentages of cows with other tumors (15.3%) and inflammatory diseases (21.4%). Thus, TK activity is an appropriate marker for detecting BL onset in cows with 'BL with difficult diagnosis' as well as 'clinically confirmed BL' group. While the specificity of TK activity required for BL diagnosis is not clear, simultaneous evaluation of serum lactate dehydrogenase activity may assist in the differential diagnoses of other tumors and inflammatory diseases from BL. PMID:23628971

  15. Analysis on Clinical Features of 2168 Patients with Lung Cancer Diagnosed by Bronchoscope

    Directory of Open Access Journals (Sweden)

    Yu Zhang

    2013-06-01

    Full Text Available Objective: To analyze the clinical features of lung cancer diagnosed by bronchoscopy. Methods: The clinical features of 2168 patients with lung cancer diagnosed by bronchoscopy were retrospectively analyzed, including gender, age, pathological type, diseased region, manifestations under bronchoscopy and methods of drawing materials. Results: The ratio of male/female was 4.8:1 and the peak onset age was 60 - 69 years old. The major pathological type was squamous cell carcinoma (44.5%, then adenocarcinoma (25.9% and small cell lung cancer (18.3%. The incidence of squamous cell carcinoma was the highest in males (50.6%, while that of adenocarcinoma in females (56.2%. The positive diagnostic rates of forceps biopsy, brush biopsy, bronchial alveolar lavage and transbronchial needle aspiration were 81.6%, 49.4%, 18.2% and 62.6%, respectively, whereas that of biopsy combined with brush biopsy came up to 89.0%. Conclusion: Bronchoscopy is an important method in diagnosis of lung cancer. Different ages and genders of patients with lung cancer have different onset, and the distribution of pathological types is diverse. Attaching more importance to bronchoscopy and improving biopsy technique can significantly improve the diagnostic rate and provide reliable evidences for clinical treatment.

  16. Analysis on Clinical Features of 2168 Patients with Lung Cancer Diagnosed by Bronchoscope

    Institute of Scientific and Technical Information of China (English)

    Zhang Yu; Yu Like; Xie Haiyan; Hu Weihua; Hao Keke; Xia Ning

    2013-01-01

    Objective: To analyze the clinical features of lung cancer diagnosed by bronchoscopy. Methods:The clinical features of2168 patients with lung cancer diagnosed by bronchoscopy were retrospectively analyzed, including gender, age, pathological type, diseased region, manifestations under bronchoscopy and methods of drawing materials. Results:The ratio of male/female was 4.8:1 and the peak onset age was 60~69 years old. The major pathological type was squamous cell carcinoma (44.5%), then adenocarcinoma (25.9%) and small cell lung cancer (18.3%). The incidence of squamous cell carcinoma was the highest in males (50.6%), while that of adenocarcinoma in females (56.2%). The positive diagnostic rates of forceps biopsy, brush biopsy, bronchial alveolar lavage and transbronchial needle aspiration were 81.6%, 49.4%, 18.2% and 62.6%, respectively, whereas that of biopsy combined with brush biopsy came up to 89.0%. Conclusion: Bronchoscopy is an important method in diagnosis of lung cancer. Different ages and genders of patients with lung cancer have different onset, and the distribution of pathological types is diverse. Attaching more importance to bronchoscopy and improving biopsy technique can signiifcantly improve the diagnostic rate and provide reliable evidences for clinical treatment.

  17. Warfarin-induced skin necrosis diagnosed on clinical grounds and treated with maggot debridement therapy.

    Science.gov (United States)

    Biscoe, Anna Louise; Bedlow, Alison

    2013-01-01

    A patient with a history of deep vein thrombosis presented with painful bruising and blistering on his left leg 7-10 days after warfarin treatment. A complicated 2-month treatment followed, where vasculitis was originally diagnosed from histological findings before the final diagnosis of warfarin-induced skin necrosis (WISN) was made on clinical grounds. Warfarin was stopped, reversed and low molecular weight heparin started but, the lesions had progressed to full thickness necrosis. This was originally treated with conventional surgical debridement before introducing maggot debridement therapy (MDT) in an effort to try to salvage the limb. PMID:23362073

  18. Clinical study of hepatic dysfunction and its correlative factors in newly diagnosed patients with Graves hyperthyroidism

    International Nuclear Information System (INIS)

    Objective: To investigate the incidence,clinical features and the possible risk factors of hepatic dysfunction in the newly diagnosed patients with Graves hyperthyroidism. Methods: A retrospective analysis about total 204 newly diagnosed patients with Graves hyperthyroidism was studied. All the patients were divided into two groups by liver function:the hepatic dysfunction group (146 cases)and the normal group (58 cases). The gender composition, age, thyroid weight, 24 h-131I intake rate,free triiodothyronine (FT3), free thyronine (FT4), thyroid-stimulating hormone receptor antibody (TRAb), thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibody (TGAb)were compared between the two groups. A correlation analysis was progressed between the indicators of liver function and thyroid hormone. Results: (1) The incidence of hepatic dysfunction (at least one abnormal parameter) in the newly diagnosed patients with Graves hyperthyroidism was 71.6% and the most familiar abnormal parameter was alanine transaminase (ALT) (37.7 %). Altogether 61 patients (41.8 %) had only one abnormal parameter in the hepatic dysfunction group and the most common abnormal parameter was alkaline phosphatase (ALP) (50.8%). (2) Compared with the normal group, hepatic dysfunction group had longer disease duration, higher serum FT3, FT4 and TRAb levels,but there were no significant differences in gender composition, age, thyroid weight, 24 h-131I intake rate, TPOAb, TGAb between the two groups. (3) A significantly positive correlation was found between the aspartate aminotransferase and FT3, the ALP and FT3, FT4, the total bilirubin and FT4, the direct bilirubin and FT3, FT4, respectively. Conclusions: Hepatic dysfunction in newly diagnosed patients with Graves hyperthyroidism is very common and the most common abnormal parameters include ALT and ALP. The hepatic dysfunction is closely correlated with patients' disease duration, thyroid hormone and TRAb levels. (authors)

  19. MGMT inactivation and clinical response in newly diagnosed GBM patients treated with Gliadel.

    Science.gov (United States)

    Grossman, Rachel; Burger, Peter; Soudry, Ethan; Tyler, Betty; Chaichana, Kaisorn L; Weingart, Jon; Olivi, Alessandro; Gallia, Gary L; Sidransky, David; Quiñones-Hinojosa, Alfredo; Ye, Xiaobu; Brem, Henry

    2015-12-01

    We examined the relationship between the O(6)-methylguanine-methyltransferase (MGMT) methylation status and clinical outcomes in newly diagnosed glioblastoma multiforme (GBM) patients who were treated with Gliadel wafers (Eisai, Tokyo, Japan). MGMT promoter methylation has been associated with increased survival among patients with GBM who are treated with various alkylating agents. MGMT promoter methylation, in DNA from 122 of 160 newly diagnosed GBM patients treated with Gliadel, was determined by a quantitative methylation-specific polymerase chain reaction, and was correlated with overall survival (OS) and recurrence-free survival (RFS). The MGMT promoter was methylated in 40 (32.7%) of 122 patients. The median OS was 13.5 months (95% confidence interval [CI] 11.0-14.5) and RFS was 9.4 months (95% CI 7.8-10.2). After adjusting for age, Karnofsky performance score, extent of resection, temozolomide (TMZ) and radiation therapy (RT), the newly diagnosed GBM patients with MGMT methylation had a 15% reduced mortality risk, compared to patients with unmethylated MGMT (hazard ratio 0.85; 95% CI 0.56-1.31; p=0.46). The patients aged over 70 years with MGMT methylation had a significantly longer median OS of 13.5 months, compared to 7.6 months in patients with unmethylated MGMT (p=0.027). A significant difference was also found in older patients, with a median RFS of 13.1 versus 7.6 months for methylated and unmethylated MGMT groups, respectively (p=0.01). Methylation of the MGMT promoter in newly diagnosed GBM patients treated with Gliadel, RT and TMZ, was associated with significantly improved OS compared to the unmethylated population. In elderly patients, methylation of the MGMT promoter was associated with significantly better OS and RFS. PMID:26249244

  20. Skin Disease in the Uninsured: Diagnoses, Management Decisions, and Referral Outcomes of an Urban Free Clinic.

    Science.gov (United States)

    Rosenbaum, Brooke E; Freitas, Derek; Nosal, Sarah C; Meydani, Ahou

    2016-01-01

    An understanding of the burden of skin disease in the uninsured population is needed to address the unique barriers they face to access dermatologic care. We conducted a retrospective chart review of patients seen for skin conditions over three years at the New York City (NYC) Free Clinic, a weekly primary care clinic operated by the NYU School of Medicine and the Institute for Family Health. Main outcomes of this study were descriptive analyses of demographic characteristics, diagnoses, management strategies, and referral outcomes, as well as key factors influencing referral to a dermatologist and referral attendance. Diagnosis was a significant predictor of referral (ptravel distance had no significant association with non-attendance. While demand for dermatologic care by uninsured patients in NYC is high, referral non-attendance remains a substantial barrier to care. PMID:27180711

  1. Comparison of clinically diagnosed asthma with parental assessment of children's asthma in a questionnaire

    DEFF Research Database (Denmark)

    Hederos, C.A.; Hasselgren, M.; Hedlin, G.;

    2007-01-01

    corresponding medical records in the same region. An International Study of Asthma and Allergies in Childhood (ISAAC)-based WQ was answered by 75% of the parents of 6295 children aged 1-6 yr. Clinically diagnosed asthma, recorded in connection with admissions to the hospital or a visit to any of the outpatient...... medical record of asthma. Forty percent of the children claimed by their parents to be asthmatic had no medical record of asthma. An ISAAC-based parentally completed WQ provided an acceptable estimation of the prevalence of asthma in children 2-6 yr of age, although only half of the individual patients......Epidemiological evaluations of the prevalence of asthma are usually based on written questionnaires (WQs) in combination with validation by clinical investigation. In the present investigation, we compared parental assessment of asthma among their preschool children in response to a WQ with the...

  2. Isolation and Antibiogram of Clostridium tetani from Clinically Diagnosed Tetanus Patients.

    Science.gov (United States)

    Hanif, Hajra; Anjum, Awais; Ali, Naeem; Jamal, Asif; Imran, Muhammad; Ahmad, Bashir; Ali, Muhammad Ishtiaq

    2015-10-01

    Clostridium tetani, the etiologic agent of tetanus, produces a toxin that causes spastic paralysis in humans and other vertebrates. This study was aimed for isolation, identification, and determination of antimicrobial susceptibility of C. tetani from clinically diagnosed tetanus patients. Isolation was done from deep-punctured tissues of the foot and arm injuries of 80 clinically diagnosed tetanus patients from the Pakistan Institute of Medical Sciences hospital. We successfully screened out five C. tetani isolates out of 80 samples based on the strain-specific characteristics confirmed through biochemical testing and toxin production. A disc diffusion method was used for antimicrobial susceptibilities and C. tetani isolates showed susceptibility to cefoperazone, chloramphenicol, metronidazole, penicillin G, and tetracycline, but were found to be resistant to erythromycin and ofloxacin. During animal testing, all the infected mice developed symptoms of tetanus. The results showed that identification of C. tetani is possible using biochemical and molecular tools and that the strains of C. tetani isolated had not developed resistance against the antibiotics most often used for the treatment of tetanus. PMID:26175031

  3. Guidelines and mindlines: why do clinical staff over-diagnose malaria in Tanzania? A qualitative study

    Directory of Open Access Journals (Sweden)

    Juma Kaseem

    2008-04-01

    Full Text Available Abstract Background Malaria over-diagnosis in Africa is widespread and costly both financially and in terms of morbidity and mortality from missed diagnoses. An understanding of the reasons behind malaria over-diagnosis is urgently needed to inform strategies for better targeting of antimalarials. Methods In an ethnographic study of clinical practice in two hospitals in Tanzania, 2,082 patient consultations with 34 clinicians were observed over a period of three months at each hospital. All clinicians were also interviewed individually as well as being observed during routine working activities with colleagues. Interviews with five tutors and 10 clinical officer students at a nearby clinical officer training college were subsequently conducted. Results Four, primarily social, spheres of influence on malaria over-diagnosis were identified. Firstly, the influence of initial training within a context where the importance of malaria is strongly promoted. Secondly, the influence of peers, conforming to perceived expectations from colleagues. Thirdly, pressure to conform with perceived patient preferences. Lastly, quality of diagnostic support, involving resource management, motivation and supervision. Rather than following national guidelines for the diagnosis of febrile illness, clinician behaviour appeared to follow 'mindlines': shared rationales constructed from these different spheres of influence. Three mindlines were identified in this setting: malaria is easier to diagnose than alternative diseases; malaria is a more acceptable diagnosis; and missing malaria is indefensible. These mindlines were apparent during the training stages as well as throughout clinical careers. Conclusion Clinicians were found to follow mindlines as well as or rather than guidelines, which incorporated multiple social influences operating in the immediate and the wider context of decision making. Interventions to move mindlines closer to guidelines need to take the

  4. Spreading the clinical window for diagnosing fetal-onset hypogonadism in boys

    Directory of Open Access Journals (Sweden)

    Rodolfo eRey

    2014-05-01

    Full Text Available In early fetal development, the testis secretes –independently of pituitary gonadotropins– androgens and anti-Müllerian hormone (AMH which are essential for male sex differentiation. In the second half of fetal life, the hypothalamic-pituitary axis gains control of testicular hormone secretion. FSH controls Sertoli cell proliferation, responsible for testis volume increase and AMH and inhibin B secretion, whereas LH regulates Leydig cell androgen and INSL3 secretion, involved in the growth and trophism of male external genitalia and in testis descent. This differential regulation of testicular function between early and late fetal periods underlies the distinct clinical presentations of fetal-onset hypogonadism in the newborn male: primary hypogonadism results in ambiguous or female genitalia when early fetal-onset whereas it becomes clinically undistinguishable from central hypogonadism when established later in fetal life. The assessment of the hypothalamic-pituitary-gonadal axis in the male has classically relied on the measurement of gonadotropin and testosterone levels in serum. These hormone levels normally decline 3-6 months after birth, thus constraining the clinical evaluation window for diagnosing male hypogonadism. The advent of new markers of gonadal function has spread this clinical window beyond the first 6 months of life. In this review, we discuss the advantages and limitations of old and new markers used for the functional assessment of the hypothalamic-pituitary-testicular axis in boys suspected of fetal-onset hypogonadism.

  5. Comparisons of Prognosis between Surgically and Clinically Diagnosed Idiopathic Pulmonary Fibrosis Using Gap Model

    Science.gov (United States)

    Lee, Sang Hoon; Kim, Song Yee; Kim, Dong Soon; Kim, Young Whan; Chung, Man Pyo; Uh, Soo Taek; Park, Choon Sik; Jeong, Sung Hwan; Park, Yong Bum; Lee, Hong Lyeol; Shin, Jong Wook; Lee, Eun Joo; Lee, Jin Hwa; Jegal, Yangin; Lee, Hyun Kyung; Kim, Yong Hyun; Song, Jin Woo; Park, Moo Suk

    2016-01-01

    Abstract Although a multidisciplinary approach has become an important criterion for an idiopathic pulmonary fibrosis (IPF) diagnosis, lung biopsies remain crucial. However, the prognosis of patients with surgically diagnosed IPF (sIPF) is uncertain. We aimed to investigate the prognosis of patients with clinically diagnosed IPF (cIPF) and sIPF. In this retrospective observational study, the Korean Interstitial Lung Disease Study Group conducted a national survey to evaluate the clinical, physiological, radiological, and survival characteristics of patients with IPF from January 1, 2003 to December 31, 2007. Patients were recruited from 54 universities and teaching hospitals across the Republic of Korea. IPF diagnoses were established according to the 2002 American Thoracic Society (ATS)/European Respiratory Society criteria (ERS) guideline. A total of 1685 patients with IPF (1027 cIPF and 658 sIPF) were enrolled. Patients with sIPF were significantly younger, predominantly female, and nonsmokers (all P < 0.001). sIPF group had significantly better initial pulmonary function. The proportion of computed tomography-based honeycomb findings of patients with cIPF was higher than in those with sIPF (P < 0.001). A Kaplan-Meier analysis showed that the sIPF group had a better prognosis (P = 0.001). A survival analysis showed that age, pulmonary function parameters, pulmonary oxygen tension, honeycombing change, and combined lung cancer had a significant influence on patient prognosis. However, there was no significant difference in prognosis between the cIPF and sIPF groups after adjusting for GAP (gender, age, physiology) stage. The patients with sIPF had better clinical features than those with cIPF. However, after adjusting for GAP stage, the sIPF group showed similar prognoses as the cIPF group. This study showed that after adjusting for GAP stage, the prognosis of patients with IPF is the same regardless of the diagnostic method used. PMID:26986154

  6. Comparing ICD9-Encoded Diagnoses and NLP-Processed Discharge Summaries for Clinical Trials Pre-Screening: A Case Study

    OpenAIRE

    Li, Li; Chase, Herbert S.; Patel, Chintan O.; Friedman, Carol; Weng, Chunhua

    2008-01-01

    The prevalence of electronic medical record (EMR) systems has made mass-screening for clinical trials viable through secondary uses of clinical data, which often exist in both structured and free text formats. The tradeoffs of using information in either data format for clinical trials screening are understudied. This paper compares the results of clinical trial eligibility queries over ICD9-encoded diagnoses and NLP-processed textual discharge summaries. The strengths and weaknesses of both ...

  7. Aromatic L-amino acid decarboxylase deficiency diagnosed by clinical metabolomic profiling of plasma.

    Science.gov (United States)

    Atwal, Paldeep S; Donti, Taraka R; Cardon, Aaron L; Bacino, C A; Sun, Qin; Emrick, L; Reid Sutton, V; Elsea, Sarah H

    2015-01-01

    Aromatic L-amino acid decarboxylase (AADC) deficiency is an inborn error of metabolism affecting the biosynthesis of serotonin, dopamine, and catecholamines. We report a case of AADC deficiency that was detected using the Global MAPS platform. This is a novel platform that allows for parallel clinical testing of hundreds of metabolites in a single plasma specimen. It uses a state-of-the-art mass spectrometry platform, and the resulting spectra are compared against a library of ~2500 metabolites. Our patient is now a 4 year old boy initially seen at 11 months of age for developmental delay and hypotonia. Multiple tests had not yielded a diagnosis until exome sequencing revealed compound heterozygous variants of uncertain significance (VUS), c.286G>A (p.G96R) and c.260C>T (p.P87L) in the DDC gene, causal for AADC deficiency. CSF neurotransmitter analysis confirmed the diagnosis with elevated 3-methoxytyrosine (3-O-methyldopa). Metabolomic profiling was performed on plasma and revealed marked elevation in 3-methoxytyrosine (Z-score +6.1) consistent with the diagnosis of AADC deficiency. These results demonstrate that the Global MAPS platform is able to diagnose AADC deficiency from plasma. In summary, we report a novel and less invasive approach to diagnose AADC deficiency using plasma metabolomic profiling. PMID:25956449

  8. INTEGRATING CLINICAL LABORATORY MEASURES AND ICD-9 CODE DIAGNOSES IN PHENOME-WIDE ASSOCIATION STUDIES

    Science.gov (United States)

    Verma, Anurag; Leader, Joseph B.; Verma, Shefali S.; Frase, Alex; Wallace, John; Dudek, Scott; Lavage, Daniel R.; Van Hout, Cristopher V.; Dewey, Frederick E.; Penn, John; Lopez, Alex; Overton, John D.; Carey, David J.; Ledbetter, David H.; Kirchner, H. Lester; Ritchie, Marylyn D.; Pendergrass, Sarah A.

    2016-01-01

    defined p-value cutoff and 165 ICD-9 codes. Through the GWAS we found a series of results replicating known associations, and also some potentially novel associations with less studied clinical lab measures. We found the majority of the PheWAS ICD-9 diagnoses highly related to the clinical lab measures associated with same SNPs. Moving forward, we will be evaluating further phenotypes and expanding the methodology for successful extraction of clinical lab measurements for research and PheWAS use. These developments are important for expanding the PheWAS approach for improved EHR based discovery. PMID:26776183

  9. Clinically diagnosed glomus vagale tumour treated with external beam radiotherapy: a review of the published reports

    International Nuclear Information System (INIS)

    Full text: The aim of the study was to present a case of clinically diagnosed glomus vagale in a 42-year-old Aboriginal woman treated with external beam radiotherapy and to carry out a review of the published work. The details of presentation, diagnosis, treatment and follow up of the patient are discussed. A review of the published work was carry out using MEDLINE database with respect to aetiology, clinical presentation, diagnosis, treatment and expected outcomes. Glomus vagale tumours are a subtype of paragangliomas of the head and neck derived from extra-adrenal paraganglia of the autonomic nervous system. They are typically slow-growing, benign masses that are often asymptomatic and rarely show signs of hypersecretion. Treatment options include embolization, surgical excision, radiotherapy or surveillance. Radiotherapy is often used for extensive lesions where surgery is considered prohibitively morbid. Following treatment relapse rates are low with the most patients achieving long-term control. Our patient presented with an extensive lesion compressing the wall of the carotid artery and invading the jugular fossa to involve the clivus. Surgery was offered; however, the patient opted for external beam radiotherapy. A dose of 45 Gy in 25 fractions was delivered with 6-MV photons employing a CT-planned, wedge pair technique. Glomus vagale tumours are rare and should be managed in a multidisciplinary head and neck clinic with both surgical and radiation oncology opinions offered. The toxicities and outcomes of both methods should be discussed

  10. Clinical or radiological diagnosis of impingement; Klinische oder radiologische Diagnose des Impingements

    Energy Technology Data Exchange (ETDEWEB)

    Kloth, J.K.; Weber, M.A. [Universitaetsklinikum Heidelberg, Klinik fuer diagnostische und interventionelle Radiologie, Heidelberg (Germany); Zeifang, F. [Universitaetsklinikum Heidelberg, Zentrum fuer Orthopaedie, Unfallchirurgie und Paraplegiologie, Heidelberg (Germany)

    2015-03-01

    Shoulder impingement syndrome is a clinically common entity involving trapping of tendons or bursa with typical clinical findings. Important radiological procedures are ultrasound, magnetic resonance imaging (MRI) and MR arthrography. Projection radiography and computed tomography (CT) are ideal to identify bony changes and CT arthrography also serves as an alternative method in cases of contraindications for MRI. These modalities support the clinically suspected diagnosis of impingement syndrome and may identify its cause in primary diagnosis. In addition, effects of impingement are determined by imaging. Therapy decisions are based on a synopsis of radiological and clinical findings. The sensitivity and specificity of these imaging modalities with regard to the diagnostics of a clinically evident impingement syndrome are given in this review article. Orthopedic and trauma surgeons express the suspicion of an impingement syndrome based on patient history and physical examination and radiologists confirm structural changes and damage of intra-articular structures using dedicated imaging techniques. (orig.) [German] Das Impingementsyndrom der Schulter ist ein haeufiges Einklemmungsphaenomen von Sehnen oder Bursen mit typischem klinischem Befund. Wichtige radiologische Verfahren sind Sonographie, MRT und MR-Arthrographie. Projektionsradiographie und CT sind ideal, um knoecherne Veraenderungen aufzuzeigen. Die CT-Arthrographie dient zudem als Ersatzverfahren bei Kontraindikationen fuer die MRT. Diese genannten Modalitaeten koennen in der Primaerdiagnostik die Diagnose eines Impingementsyndroms stuetzen und dessen Ursache aufzeigen. Zudem werden bildgebend Folgen der Einklemmung festgestellt und in Zusammenschau von klinischer Symptomatik und radiologischem Befund Therapieentscheidungen getroffen. Die Sensitivitaet und Spezifitaet der zuvor genannten bildgebenden Verfahren in Bezug auf die diagnostische Aufarbeitung einer klinisch evidenten Impingementsymptomatik

  11. Screening and diagnosing depression in women visiting GPs' drop in clinic in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Johansson Sven-Erik

    2008-06-01

    Full Text Available Abstract Background Only half of all depressions are diagnosed in Primary Health Care (PHC. Depression can remain undetected for a long time and entail high costs for care and low quality of life for the individuals. Drop in clinic is a common form of organizing health care; however the visits are short and focus on solving the most urgent problems. The aim of this study was to investigate the prevalence and severity of depression among women visiting the GPs' drop in clinic and to identify possible clues for depression among women. Methods The two-stage screening method with "high risk feedback" was used. Beck's Depression Inventory (BDI was used to screen 155 women visiting two GPs' drop in clinic. Women who screened positive (BDI score ≥10 were invited by the GP to a repeat visit. Major depression (MDD was diagnosed according to DSM-IV criteria and the severity was assessed with Montgomery-Asberg Depression Rating Scale (MADRS. Women with BDI score Results The two-stage method worked well with a low rate of withdrawals in the second step, when the GP invited the women to a repeat visit. The prevalence of depression was 22.4% (95% CI 15.6–29.2. The severity was mild in 43%, moderate in 53% and severe in 3%. The depressed women mentioned mental symptoms significantly more often (69% than the controls (15% and were to a higher extent sick-listed for a longer period than 14 days. Nearly one third of the depressed women did not mention mental symptoms. The majority of the women who screened as false positive for depression had crisis reactions and needed further care from health professionals in PHC. Referrals to a psychiatrist were few and revealed often psychiatric co-morbidity. Conclusion The prevalence of previously undiagnosed depression among women visiting GPs' drop in clinic was high. Clues for depression were identified in the depressed women's symptom presentation; they often mention mental symptoms when they visit the GP for somatic

  12. The Value of Admission Clinical Data for Diagnosing Heart Failure in Long-term Care

    Science.gov (United States)

    Heckman, George A.; Foebel, Andrea D.; Dubin, Joel A.; Ng, Jennifer; Turpie, Irene D.; Hussack, Patricia; McKelvie, Robert S.

    2013-01-01

    Background Heart failure (HF) is common in long-term care (LTC). Diagnostic uncertainty is important barrier to optimal HF management, stemming from inadequate health information transfer upon LTC admission. We determine the utility of admission clinical information to confirm a HF diagnosis in new LTC residents. Methods This was a prospective cohort study. From February 2004 to November 2006, information about new residents from 41 LTC homes in Ontario, Canada, was collected from residents and caregivers, and all available health records. A prior HF diagnosis was confirmed by consensus review of available data by two independent experts. Multivariate modelling was utilized to determine the utility of the admission clinical assessment in confirming a prior HF diagnosis. Results A total of 449 residents were included for analysis, aged 84.3±6.5 years, and 21.6% had a prior HF diagnosis. The most useful clinical item for diagnosing HF was a “history of HF”. The final model included “history of HF’ (OR [odds ratio] 13.66, 95% CI 6.61–28.24), “fluid on the lungs” (OR 2.01, 95% CI 1.04–3.89), “orthopnea” (OR 1.76, 95% CI 0.93–3.33), “taking β-blocker” (OR 2.09, 95% CI 1.10–3.94), “taking loop diuretics” (OR 2.11, 95% CI 1.12–3.98), and “history of coronary artery disease” (OR 2.83, 95% CI 1.42–5.64). Conclusion Elements of the clinical assessment for new LTC residents can help confirm a prior HF diagnosis. An admission history of HF is highly predictive. PMID:24278092

  13. Clinical, endoscopic and histopathological profiles of parasitic duodenitis cases diagnosed by upper digestive endoscopy

    Directory of Open Access Journals (Sweden)

    Reinaldo Benevides dos Santos

    2011-12-01

    Full Text Available CONTEXT: Intestinal parasites induce detectable histopathological changes, which have been studied in groups with known diagnosis of parasitic disease. There is no available study with a larger base without previous diagnosis. OBJECTIVE: To describe clinical and histopathological findings of parasitosis diagnosed by endoscopic biopsy in patients submitted to upper digestive endoscopy. METHODS: Recorded biopsies archive at "Complexo Hospitalar Professor Edgar Santos" , a general teaching Hospital in the state of Bahia, Northeast Brazil, from January 1995 to January 2009, were reviewed. One thousand ten duodenal biopsy reports were found. Reports positive for parasites had their specimens reviewed and photographed. All blocks of biopsy selected as case were retrieved and reviewed by an experienced pathologist. Clinical, laboratorial and endoscopic data were collected. RESULTS: Eleven biopsies showed parasites, including cases of Cryptosporidium sp. and Strongyloides stercoralis. Vomiting (91%, abdominal pain (78%, diarrhea (78% and weight loss (78% were usual symptoms. Seventy-five percent had duodenal mucosa changes on endoscopy, while 25% have no changes. Anemia and low serum albumin were important laboratorial data. HIV infection association was observed. Villus atrophy and reactive epithelium were usual in Strongyloides cases. CONCLUSIONS: No endoscopic or histopathologic finding was pathognomonic. One percent of duodenal endoscopic biopsies showed parasites.

  14. A study on clinical findings about vertebral disease diagnosed with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ham-Gyum [Ansan College, Seoul (Korea, Republic of)

    2006-09-15

    In order to analyze clinical characteristics like sex-and age-based onset frequency and onset region from vertebral disease cases, this study investigated total 1,291 cases of vertebral disease that were diagnosed via magnetic resonance imaging (MRI) from January to December 2004 at B University Hospital in metropolitan area. For higher diagnostic accuracy in cases of spinal disorder diagnosed, this study analyzed findings from data reading conducted by veteran specialists in diagnostic radiology. But this study excluded uncertain lesion cases, the cases requiring differential diagnosis from other disorders and so on from subjects under analysis. This study employed superconductive 1.5 Tesla SIGNA MR/i for MRI test and basically received resulting images via FSE (fast spin echo). In particular, this study obtained T1 and T2 myelogram with regard to regional characteristics (such as cervical vertebrae, thoracic vertebrae and lumbar vertebra) and imaging characteristics for sagittal and transverse section. As a result, this study came to the following conclusions: 1. In terms of general characteristics of subjects under analysis, male group comprised 53.5% and female 46.5% out of total 1,291 subjects. 2. The regional onset frequency of spinal disorders was converged primarily on lumbar vertebra (65.5%), which was followed by cervical vertebrae (27.3%) and thoracic vertebrae (7.0%) respectively. 3. Top 10 cases with high onset frequency of spinal disorders can be listed as follows: 1) posterior bulging disc 65.8% 2) narrowing of neural foramen 23.8% 3) herniated intervertebral disc (HIVD) 22.4% 4) spinal stenosis 16.7% 5) osteochondrosis 6.4% 6) compression fracture 6.4% 7) facet joint arthropathy 6.2% 8) spondylolisthesis 6.0% 9) spinal cord tumor 3.5% 10) inter body fusion 2.6%.

  15. A study on clinical findings about vertebral disease diagnosed with MRI

    International Nuclear Information System (INIS)

    In order to analyze clinical characteristics like sex-and age-based onset frequency and onset region from vertebral disease cases, this study investigated total 1,291 cases of vertebral disease that were diagnosed via magnetic resonance imaging (MRI) from January to December 2004 at B University Hospital in metropolitan area. For higher diagnostic accuracy in cases of spinal disorder diagnosed, this study analyzed findings from data reading conducted by veteran specialists in diagnostic radiology. But this study excluded uncertain lesion cases, the cases requiring differential diagnosis from other disorders and so on from subjects under analysis. This study employed superconductive 1.5 Tesla SIGNA MR/i for MRI test and basically received resulting images via FSE (fast spin echo). In particular, this study obtained T1 and T2 myelogram with regard to regional characteristics (such as cervical vertebrae, thoracic vertebrae and lumbar vertebra) and imaging characteristics for sagittal and transverse section. As a result, this study came to the following conclusions: 1. In terms of general characteristics of subjects under analysis, male group comprised 53.5% and female 46.5% out of total 1,291 subjects. 2. The regional onset frequency of spinal disorders was converged primarily on lumbar vertebra (65.5%), which was followed by cervical vertebrae (27.3%) and thoracic vertebrae (7.0%) respectively. 3. Top 10 cases with high onset frequency of spinal disorders can be listed as follows: 1) posterior bulging disc 65.8% 2) narrowing of neural foramen 23.8% 3) herniated intervertebral disc (HIVD) 22.4% 4) spinal stenosis 16.7% 5) osteochondrosis 6.4% 6) compression fracture 6.4% 7) facet joint arthropathy 6.2% 8) spondylolisthesis 6.0% 9) spinal cord tumor 3.5% 10) inter body fusion 2.6%

  16. A disappearing heritage: the clinical core of schizophrenia

    DEFF Research Database (Denmark)

    Parnas, Josef

    2011-01-01

    specificity and typicality of schizophrenia was anchored to its "fundamental" clinical core (with trait status) and not to positive psychotic features, which were considered as "state", "accessory" phenomena. The clinical core of schizophrenia was, in a diluted form, constitutive of the spectrum conditions...... (eg, discordance, autism, "Spaltung"), and not on the level of single features. In other words, the phenomenological specificity was seen as being expressive of a fundamental structural or formal change of the patient's mentality (consciousness, subjectivity). This overall change transpires through...... the single symptoms and signs, lending them a characteristic phenomenological pattern. This concept of schizophrenia bears little resemblance to the current operational definitions. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and ICD-10 seem to diagnose a subset of...

  17. What Proportion of Incident Radiographic Vertebral Fractures in Older Men Is Clinically Diagnosed and Vice Versa: A Prospective Study.

    Science.gov (United States)

    Ensrud, Kristine E; Blackwell, Terri L; Fink, Howard A; Zhang, Jie; Cauley, Jane A; Cawthon, Peggy M; Black, Dennis M; Bauer, Douglas C; Curtis, Jeffrey R; Orwoll, Eric S; Barrett-Connor, Elizabeth; Kado, Deborah M; Marshall, Lynn M; Shikany, James M; Schousboe, John T

    2016-08-01

    To determine the proportion of incident radiographic vertebral fractures (vfx) also diagnosed as incident clinical vfx in older men and vice-versa, we used data from 4398 community-dwelling men age ≥65 years enrolled in the Osteoporotic Fractures in Men (MrOS) study. Incident radiographic vfx were identified by comparing baseline and follow-up lateral thoracic and lumbar spine study films (average 4.6 years between films) using a semiquantitative (SQ) method and defined as a change in SQ reading of ≥1 at a given vertebral level from baseline to follow-up study radiograph. Participants were contacted triannually to ascertain incident clinical vfx; community spinal imaging studies were obtained and clinical vfx were confirmed when the study radiologist determined that the community imaging study showed a new deformity of higher grade than was present in the same vertebra on the baseline study radiograph. A total of 237 incident radiographic vfx were identified in 197 men, whereas 31 men experienced 37 confirmed incident clinical vfx. Of incident radiographic vfx, 13.5% were also clinically diagnosed as incident fractures, with clinical diagnoses made for 16.3% of the radiographic vfx with SQ grade change ≥2. Of incident clinical vfx, 86.5% were identified as incident radiographic vfx, most of them with SQ grade change ≥2. In summary, less than 15% of incident radiographic vfx were also clinically diagnosed, whereas the majority of incident clinical vfx were identified as severe radiographic vfx. These results in men supplement those previously published for women and suggest a complex relationship between clinical and radiographic vfx in older adults. Published 2016.(†) American Society for Bone and Mineral Research. PMID:26969847

  18. Patients Newly Diagnosed with Clinical Type 2 Diabetes during Oral Glucocorticoid Treatment and Observed for 14 Years: All-Cause Mortality and Clinical Developments

    DEFF Research Database (Denmark)

    Olivarius, Niels de Fine; Siersma, Volkert; Dyring-Andersen, Beatrice; Drivsholm, Thomas Bo; Hansen, Lars J; Henriksen, Jan Erik

    2010-01-01

    sex and to 1.39 (0.92-2.11, p = 0.12, n = 1086) when risk factors, complications and cancer were added to the model. Apart from differences in age and overweight, patients in this relatively small sample of those diagnosed with clinical type 2 diabetes during GC treatment were comparable at diagnosis......  Chronic exposure to glucocorticoids (GCs) has many side effects including glucose intolerance and diabetes and may accelerate the occurrence of cardiovascular disease and increase mortality. We studied the 14-year clinical development of diabetes in patients diagnosed with diabetes during GC...... treatment. A population-based sample of 1369 people newly diagnosed with clinical type 2 diabetes underwent a clinical examination at diagnosis, and surviving patients were followed up 6 and 14 years later. Patients receiving oral GC treatment at diagnosis were compared with the other patients. Of 1369...

  19. Patients newly diagnosed with clinical type 2 diabetes during oral glucocorticoid treatment and observed for 14 years: all-cause mortality and clinical developments

    DEFF Research Database (Denmark)

    Olivarius, Niels de Fine; Siersma, Volkert Dirk; Dyring-Andersen, B.; Drivsholm, Thomas Bo; Hansen, L.J.; Henriksen, J.E.

    2011-01-01

    sex and to 1.39 (0.92-2.11, p = 0.12, n = 1086) when risk factors, complications and cancer were added to the model. Apart from differences in age and overweight, patients in this relatively small sample of those diagnosed with clinical type 2 diabetes during GC treatment were comparable at diagnosis......Chronic exposure to glucocorticoids (GCs) has many side effects including glucose intolerance and diabetes and may accelerate the occurrence of cardiovascular disease and increase mortality. We studied the 14-year clinical development of diabetes in patients diagnosed with diabetes during GC...... treatment. A population-based sample of 1369 people newly diagnosed with clinical type 2 diabetes underwent a clinical examination at diagnosis, and surviving patients were followed up 6 and 14 years later. Patients receiving oral GC treatment at diagnosis were compared with the other patients. Of 1369...

  20. Time trend in Alzheimer diagnoses and the association between distance to an Alzheimer clinic and Alzheimer diagnosis

    DEFF Research Database (Denmark)

    Jørgensen, Terese Sara Høj; Torp-Pedersen, Christian; Gislason, Gunnar H.;

    2015-01-01

    BACKGROUND: Centralization of specialized health care in Denmark has caused increased geographical distance to health-care providers, which may be a barrier for Alzheimer patients to seek health care. We examined the incidence of Alzheimer diagnosis in Denmark between 2000 and 2009 and investigated...... the association between patients' distance to Alzheimer clinics and Alzheimer diagnoses. METHODS: Data of all individuals aged 65+ years were collected from Danish national registers. Incidences of Alzheimer diagnoses were analysed with joinpoint regression and hazard ratios (HRs) for Alzheimer...... diagnoses were analysed with Cox regressions. RESULTS: The annual incidence of Alzheimer diagnoses increased with 32.5% [95% confidence interval (CI): 7.1-63.8] among individuals aged 65-74 years from 2000 to 2002 and with 29.1% (95% CI: 11.0-50.2) among individuals aged 75+ years from 2000 to 2003. For...

  1. Clinical value of MRI and acute madopar responsiveness test in diagnosing progressive supranuclear palsy

    Directory of Open Access Journals (Sweden)

    LI Xiao-hong

    2013-07-01

    Full Text Available Objective To investigate the MRI abnormalities and acute madopar responsiveness test in diagnosing progressive supranuclear palsy (PSP and Parkinson's disease (PD. Methods Seventeen patients with PSP and 17 gender and age matched patients with PD were studied with cranial MRI examinations and results of acute madopar responsiveness test, and the clinical manifestations of PSP were summarized. Results The atrophy of the midbrain tegmentum and hummingbird sign was demonstrated in all of the PSP patients in our study, but was not observed in the PD patients. The areas of the midbrain on mid-sagittal MRI in PSP patients [(77.35 ± 15.30 mm2] were significantly smaller than that in those with PD [(142.35 ± 31.49 mm2]. The average ratio of the area of the midbrain to the area of pons in the patients with PSP [(14.31 ± 2.47%] was significantly smaller than that in those with PD [(24.08 ± 4.73%; P = 0.000, for all]. According to the result of acute madopar responsiveness test, the maximum Unified Parkinson's Disease Rating Scale (UPDRS Ⅲ improvement rate of 2 patients with PSP and 16 patients with PD was more than 30% (χ2 = 23.142, P = 0.000. Conclusion The assessment of the mid-sagittal MRI and acute madopar responsiveness test may be a useful method to differentiate PSP from PD.

  2. Stent-graft implantation for clinically diagnosed syphilitic aortic aneurysm in an HIV-infected patient.

    Science.gov (United States)

    Yasuda, Shota; Imoto, Kiyotaka; Uchida, Keiji; Kawaguchi, Satoshi; Yokoi, Yoshihiko; Shigematsu, Hiroshi; Masuda, Munetaka

    2014-01-01

    We describe our experience with stent-graft placement in a patient with a clinically diagnosed syphilitic aortic aneurysm.The patient was a 43-year-old man with syphilitic and human immunodeficiency virus (HIV) co-infection. Computed tomography (CT) revealed an aortic aneurysm with 89 mm in maximum size which was located at distal aortic arch and was considered syphilis derived saccular aneurysm. The aneurysm was judged at high risk of rupture from its shape. We decided to perform stent-graft implantation. Before surgery, the patient was given antibacterial and anti-HIV agents. Hand-made fenestrated stent graft by Tokyo Medical University was implanted. The graft was placed from the ascending aorta to Th 9 level in the descending aorta. The aneurysm completely disappeared during follow-up, with no flare-up of syphilitic infection up to 2 years after surgery.The number of patients with syphilis and human immunodeficiency virus co-infection is now increasing. Stent-graft implantation may be an effective treatment in such immunocompromised patients. PMID:23774613

  3. Clinical characteristics of constrictive pericarditis diagnosed by echo-Doppler technique in Korea.

    Science.gov (United States)

    Yang, H. S.; Song, J. K.; Song, J. M.; Kang, D. H.; Lee, C. W.; Nam, G. B.; Choi, K. J.; Kim, Y. H.; Hong, M. K.; Kim, J. J.; Park, S. W.; Park, S. J.; Song, H.; Lee, J. W.; Song, M. G.

    2001-01-01

    A retrospective analysis of clinical data of 71 patients with constrictive pericarditis (CP) diagnosed by echo-Doppler technique (mean age, 49+/-17) was done. In 27 patients (38%), the etiology was unknown, and the three most frequent identifiable causes were tuberculosis (23/71, 32%), cardiac surgery (8/71, 11%), and mediastinal irradiation (6/71, 9%). Pericardiectomy was performed in 35 patients (49%) with a surgical mortality of 6% (2/35), and 11 patients (15%, 11/ 71) showed complete resolution of constrictive physiology with medical treatment. Patients with transient CP were characterized by absence of pericardial calcification, shorter symptom duration, and higher incidence of fever, weight loss, and tuberculosis. The 5-yr survival rates of patients with transient CP and those undergoing pericardiectomy were 100% and 85+/-6%, respectively, which were significantly higher than that of patients without undergoing pericardiectomy (33+/-17%, p=0.0083). Mediastinal irradiation, higher functional class, low voltage in ECG, low serum albumin, and old age were the independent variables associated with a higher mortality. Tuberculosis is still the most important etiology of CP in Korea, and not infrequently, it may cause transient CP. Early diagnosis and decision-making using follow-up echocardiography are crucial to improve the prognosis of patients with CP. PMID:11641523

  4. Bayesian comparison of cost-effectiveness of different clinical approaches to diagnose coronary artery disease.

    Science.gov (United States)

    Patterson, R E; Eng, C; Horowitz, S F; Gorlin, R; Goldstein, S R

    1984-08-01

    The objective of this study was to compare the cost-effectiveness of four clinical policies (policies I to IV) in the diagnosis of the presence or absence of coronary artery disease. A model based on Bayes' theorem and published clinical data was constructed to make these comparisons. Effectiveness was defined as either the number of patients with coronary disease diagnosed or as the number of quality-adjusted life years extended by therapy after the diagnosis of coronary disease. The following conclusions arise strictly from analysis of the model and may not necessarily be applicable to all situations. As prevalence of coronary disease in the population increased, it caused a linear increase in cost per patient tested, but a hyperbolic decrease in cost per effect, that is, increased cost-effectiveness. Thus, cost-effectiveness of all policies (I to IV) was poor in populations with a prevalence of disease below 10%, for example, asymptomatic people with no risk factors. Analysis of the model also indicates that at prevalences less than 80%, exercise thallium scintigraphy alone as a first test (policy II) is a more cost-effective initial test than is exercise electrocardiography alone as a first test (policy I) or exercise electrocardiography first combined with thallium imaging as a second test (policy IV). Exercise electrocardiography before thallium imaging (policy IV) is more cost-effective than exercise electrocardiography alone (policy I) at prevalences less than 80%. 4) Noninvasive exercise testing before angiography (policies I, II and IV) is more cost-effective than using coronary angiography as the first and only test (policy III) at prevalences less than 80%. 5) Above a threshold value of prevalence of 80% (for example patients with typical angina), proceeding to angiography as the first test (policy III) was more cost-effective than initial noninvasive exercise tests (policies I, II and IV). One advantage of this quantitative model is that it estimates a

  5. What factors influence the prevalence and accuracy of nursing diagnoses documentation in clinical practice? A systematic literature review

    NARCIS (Netherlands)

    Paans, W.; Nieweg, R.M.B.; van der Schans, C.P.; Sermeus, W.

    2011-01-01

    Aim. To identify what determinants influence the prevalence and accuracy of nursing diagnosis documentation in clinical practice. Background. Nursing diagnoses guide and direct nursing care. They are the foundation for goal setting and provide the basis for interventions. The literature mentions sev

  6. Diagnosing Borderline Personality Disorder: Examination of How Clinical Indicators Are Used by Professionals in the Health Setting

    Science.gov (United States)

    Treloar, Amanda Jane Commons; Lewis, Andrew J.

    2009-01-01

    This paper reviews the history of the recognition of borderline personality disorder as a clinical disorder, followed by a review of the contemporary practice of diagnosing borderline personality disorder in psychiatric settings. Many researchers have cautioned against the conflation of difficult patients with the diagnostic category of borderline…

  7. Implementing the semi-structured interview Kiddie-SADS-PL into an in-patient adolescent clinical setting: impact on frequency of diagnoses

    OpenAIRE

    Ferrari Pierre; Júlíusdóttir Guðlaug; Levy Sigurður; Lauth Bertrand; Pétursson Hannes

    2008-01-01

    Abstract Background Research is needed to establish the utility of diagnostic interviews in clinical settings. Studies comparing clinical diagnoses with diagnoses generated with structured instruments show generally low or moderate agreement and clinical diagnostic assignment (e.g. admission or chart diagnoses) are often considered to underdiagnose disorders. The objective of this study was to evaluate the impact of implementing the Schedule for Affective Disorders and Schizophrenia for Schoo...

  8. Clinical Significance of the Degree of Fatty Liver Diagnosed by Ultrasonography

    International Nuclear Information System (INIS)

    Fatty liver is one of the most commonly found disease by abdominal ultrasonography. The status of fatty liver is classified into mild, moderate and severe degrees. The study was conducted to investigate the clinical significance of fatty liver using ultrasonography. Test set consisted of 2,185 patients who visited D healthcare center in Daejeon to receive an abdominal ultrasonic test from January to December 2007. Out of the 2185 patients, 524 patients was diagnosed as fatty liver (290 male and 234 female patients). They were divided into three groups, group I for mild degree. II for moderate degree, and III for severe degree, depending on the echo of liver parenchyma, the sound attenuation, and the visibility of intrahepatic blood vessels and diaphragm. Then the correlation of obesity indices, liver function tests and metabolic syndrome was analyzed for males and females separately. As for the degree of fatty liver, 350 cases (66.8%) were classified as group I, 153 cases (29.2%) as group II, and 21 cases (4.1%) as group III. In addition, severe degree of fatty liver was more frequently found in males than in females. The mean ages of three groups for males were 46.1, 44.5, and 39.1, and those for females were 48.8, 50.2, 52.4, respectively. Males with lower mean ages have severely of fatty liver for both males and females. The results in this study show that the classification into three degrees of fatty liver in ultrasonography practice is helpful to treat and observe the progress of fatty liver. In addition, careful examination is required to measure the severity of fatty liver as well as detection of it. A standardized method to classify the degree of fatty liver is also needed for more objective measurement.

  9. Typical Versus Atypical Anorexia Nervosa Among Adolescents: Clinical Characteristics and Implications for ICD-11.

    Science.gov (United States)

    Silén, Yasmina; Raevuori, Anu; Jüriloo, Elisabeth; Tainio, Veli-Matti; Marttunen, Mauri; Keski-Rahkonen, Anna

    2015-09-01

    There is scant research on the clinical utility of differentiating International Classification of Diseases (ICD) 10 diagnoses F50.0 anorexia nervosa (typical AN) and F50.1 atypical anorexia. We reviewed systematically records of 47 adolescents who fulfilled criteria for ICD-10 F50.0 (n = 34) or F50.1 (n = 13), assessing the impact of diagnostic subtype, comorbidity, background factors and treatment choices on recovery. Atypical AN patients were significantly older (p = 0.03), heavier (minimum body mass index 16.7 vs 15.1 kg/m(2) , p = 0.003) and less prone to comorbidities (38% vs 71%, p = 0.04) and had shorter, less intensive and less costly treatments than typical AN patients. The diagnosis of typical versus atypical AN was the sole significant predictor of treatment success: recovery from atypical AN was 4.3 times (95% confidence interval [1.1, 17.5]) as likely as recovery from typical AN. Overall, our findings indicate that a broader definition of AN may dilute the prognostic value of the diagnosis, and therefore, ICD-11 should retain its distinction between typical and atypical AN. PMID:26010207

  10. Evaluation of an ICD-10 algorithm to detect osteonecrosis of the jaw among cancer patients in the Danish National Registry of Patients

    DEFF Research Database (Denmark)

    Ehrenstein, Vera; Gammelager, Henrik; Schiødt, Morten;

    2015-01-01

    PURPOSE: This study aimed to validate a predefined algorithm for osteonecrosis of the jaw (ONJ) among cancer patients in the Danish National Registry of Patients and to assess the nature of clinical information recorded in medical charts of ONJ patients. METHODS: We identified potential ONJ cases......%-81%]). CONCLUSIONS: The predefined algorithm is not adequate for monitoring ONJ in pharmacovigilance studies. Additional case-finding approaches, coupled with adjudication, are necessary to estimate ONJ incidence accurately....

  11. Exploring the Clinical Utility of the Development and Well-Being Assessment (DAWBA) in the Detection of Hyperkinetic Disorders and Associated Diagnoses in Clinical Practice

    Science.gov (United States)

    Foreman, David; Morton, Stephanie; Ford, Tamsin

    2009-01-01

    Background: The clinical diagnosis of ADHD is time-consuming and error-prone. Secondary care referral results in long waiting times, but primary care staff may not provide reliable diagnoses. The Development And Well-Being Assessment (DAWBA) is a standardised assessment for common child mental health problems, including attention…

  12. Clinical value of diagnosing intracranial aneurysms with fly-around of multislice helical

    International Nuclear Information System (INIS)

    Objective: To exploring the clinical value of multislice helical CT fly-around as a new method for diagnosing micro intracranial aneurysms (≤2 mm in diameter). Methods: In this retrospective study, the authors compared the usefulness of multislice helical computed tomographic three dimensional angiography (MS 3D-CTA), digital subtraction angiography (DSA) and surgery for the detection and assessment of clinical suspected intracranial aneurysms in 104 patients, 86 patients who presented with acute, non-traumatic SAH. Row data was acquired by Multislice helical CT-Aquilion (Toshiba). The parameters of scanning and images reconstructing were: slice thickness 1.0 mm, helical pitch 3.5, scan speed was 0.5 s per rotation, delay time was 15 - 23 s; Nonionic contrast medium was injected intravenously (2.0 ml/kg) at speed of 3.0 - 5.0 ml/s. Source images were processed using a workstation SGI-O2, images post-processing software was Alatoview, ver: 1.42. The reconstructed images were then processed into fly-around and shaded volume rendering (SVR) and maximal intensity projection (MIP), and Entire brain DSA was performed. Images of MS 3D-CTA and DSA were analyzed by 3 radiologists at double blinded. Results: 70 aneurysms were proved at DSA and surgery, largest aneurysms was 24.0 mm in diameter and smallest aneurysms was 1.0 mm in diameter. Five of 70 aneurysms was large aneurysms, 40 was small aneurysms and 25 was micro aneurysms: fly-around found out 25 micro aneurysms, SVR and MIP found out 23 of them, DSA found out only 21 of them. For detected micro aneurysm, accuracy of fly-around was 95.71%, sensitivity was 100.0% and specificity was 93.33%, positive predictive value was 89.29, negative predictive value was 100.0%, accuracy of SVR and MIP was 95.71%, sensitivity was 92.0% and specificity was 97.78%, positive predictive value was 95.83%, negative predictive value was 95.65%, accuracy of DSA was 94.29%, sensitivity was 84.0% and specificity was 100.0%, positive

  13. Registration of symptoms and diagnoses in patients of a Belarussian-Dutch outpatient clinic in Gomel, October 1991 - September 1993

    International Nuclear Information System (INIS)

    The results of a survey of the medical consumption of 4,500 patients at the Belarussian-Dutch Outpatient Clinic in Gomel during 1991-1993 are presented and discussed. Analysis of the patient registration data was focused on complaints related to possible enhanced radiation exposure of the patients since the reactor incident at Chernobyl in 1986. The pattern of complaints and diagnoses was comparable to the situation in a Dutch outpatient clinic, except for a higher number of goitre, gastritis, gastric and duodenal ulcers. Diagnoses that could be attributed to increased radiation exposure were not enhanced compared to the pattern in a Dutch population of similar size, except for a higher number of thyroid disease. 19 refs

  14. Concordance between Patient Self-Reports and Claims Data on Clinical Diagnoses, Medication Use, and Health System Utilization in Taiwan

    OpenAIRE

    Wu, Chi-Shin; Lai, Mei-Shu; Gau, Susan Shur-Fen; Wang, Sheng-Chang; Tsai, Hui-Ju

    2014-01-01

    Purpose The aim of this study was to evaluate the concordance between claims records in the National Health Insurance Research Database and patient self-reports on clinical diagnoses, medication use, and health system utilization. Methods In this study, we used the data of 15,574 participants collected from the 2005 Taiwan National Health Interview Survey. We assessed positive agreement, negative agreement, and Cohen's kappa statistics to examine the concordance between claims records and pat...

  15. Birth Order and Sibling Gender Ratio of a Clinical Sample of Children and Adolescents Diagnosed with Attention Deficit Hyperactivity Disorder

    OpenAIRE

    Ahmad Ghanizadeh; Marzie Abotorabi-Zarchi; Mohammad Reza Mohammadi; Ali Firoozabadi

    2012-01-01

    Objective: It is not clear whether sibling’s gender ratio is associated with attention deficit hyperactivity disorder (ADHD). This study examines whether inattentiveness severity and hyperactivity/impulsivity severity are associated with birth order of children with ADHD.Method: Participants are a clinical sample of 173 children and adolescents with ADHD and 43 ones without ADHD. Diagnoses were made using Diagnostic and Statistical Manual of Mental Disorders forth edition-Text Revision (DSM-I...

  16. Comparisons of Prognosis between Surgically and Clinically Diagnosed Idiopathic Pulmonary Fibrosis Using Gap Model: A Korean National Cohort Study.

    Science.gov (United States)

    Lee, Sang Hoon; Kim, Song Yee; Kim, Dong Soon; Kim, Young Whan; Chung, Man Pyo; Uh, Soo Taek; Park, Choon Sik; Jeong, Sung Hwan; Park, Yong Bum; Lee, Hong Lyeol; Shin, Jong Wook; Lee, Eun Joo; Lee, Jin Hwa; Jegal, Yangin; Lee, Hyun Kyung; Kim, Yong Hyun; Song, Jin Woo; Park, Moo Suk

    2016-03-01

    Although a multidisciplinary approach has become an important criterion for an idiopathic pulmonary fibrosis (IPF) diagnosis, lung biopsies remain crucial. However, the prognosis of patients with surgically diagnosed IPF (sIPF) is uncertain. We aimed to investigate the prognosis of patients with clinically diagnosed IPF (cIPF) and sIPF.In this retrospective observational study, the Korean Interstitial Lung Disease Study Group conducted a national survey to evaluate the clinical, physiological, radiological, and survival characteristics of patients with IPF from January 1, 2003 to December 31, 2007. Patients were recruited from 54 universities and teaching hospitals across the Republic of Korea. IPF diagnoses were established according to the 2002 American Thoracic Society (ATS)/European Respiratory Society criteria (ERS) guideline. A total of 1685 patients with IPF (1027 cIPF and 658 sIPF) were enrolled.Patients with sIPF were significantly younger, predominantly female, and nonsmokers (all P influence on patient prognosis. However, there was no significant difference in prognosis between the cIPF and sIPF groups after adjusting for GAP (gender, age, physiology) stage.The patients with sIPF had better clinical features than those with cIPF. However, after adjusting for GAP stage, the sIPF group showed similar prognoses as the cIPF group. This study showed that after adjusting for GAP stage, the prognosis of patients with IPF is the same regardless of the diagnostic method used. PMID:26986154

  17. A disappearing heritage: the clinical core of schizophrenia

    DEFF Research Database (Denmark)

    Parnas, Josef

    2011-01-01

    the single symptoms and signs, lending them a characteristic phenomenological pattern. This concept of schizophrenia bears little resemblance to the current operational definitions. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and ICD-10 seem to diagnose a subset of...

  18. Influence of the introduction of the ICD-10 on tendencies of mortality by causes (1980-2004 Influencia de la introducción de la CIE-10 en las tendencias de mortalidad por causas (1980-2004

    Directory of Open Access Journals (Sweden)

    Diego Salmerón

    2009-04-01

    Full Text Available Objective: To evaluate the influence of the tenth revision of the International Statistical Classification of Diseases (ICD-10 on tendencies of annual mortality rates, corrected and uncorrected to the ICD-9. Methods: Starting with the causes with a significant comparability ratio, we calculated the annual ageadjusted rates from 1980 to 2004. The comparability ratio was applied to the rates for 1999-2004, obtaining the corrected series for the whole period. This series was then compared with the uncorrected series using joinpoint regression. Results: Mortality decreased between 1999 and 2004. Differences were found in blood diseases, hypertensive diseases, cancer of illdefined sites, respiratory insufficiency, and myelodysplastic syndrome. Conclusions: The tendency of the main causes of mortality has been largely unaffected by the revisions in the ICD-10, except in infrequent or less specific diseases.Objetivo: Evaluar la influencia de la décima revisión de la Clasificación Estadística Internacional de Enfermedades (CIE-10 sobre las tendencias de las tasas anuales de mortalidad, con y sin corrección a la CIE-9. Métodos: Partiendo de las causas con razón de comparabilidad significativas, se calcularon las tasas anuales ajustadas por edad de 1980 a 2004. Se aplicaron a las tasas de 1999-2004 su razón de comparabilidad, y se obtuvo la serie corregida en todo el período, que se comparó con la serie sin corrección utilizando una regresión joinpoint. Resultados: La mortalidad disminuye en el período 1999-2004. Se encontraron diferencias en el grupo de enfermedades de la sangre, enfermedades hipertensivas, cáncer de sitios mal definidos, insuficiencia respiratoria y síndrome mielodisplásico. Conclusiones: La tendencia de las principales causas de mortalidad no se afecta por el cambio de revisión, excepto en enfermedades infrecuentes o poco específicas.

  19. Clinical value of CT scan in diagnosing nasal malignant lymphoma (a report of 11 cases)

    International Nuclear Information System (INIS)

    Objective: To investigate the value of CT in diagnosing nasal malignant lymphoma. Methods: CT findings of 11 patients with nasal malignant lymphoma proved pathologically were reviewed retrospectively. Results: The lesions pathologically diagnosed were all NHL and 9 cases were peripheral T-cell lymphoma. CT scan showed: (1) Lesions arose mainly from nasal vestibule or anterior part of nasal cavity, consisting of hyperplasia type 2 cases, infiltration type 3 cases, and hyperplasia-infiltration (mixed) type 6 cases. (2) Density of mass of hyperplasia type was relatively homogeneous, presenting as isodensity or slight hyper-density, while infiltration and mixed type appeared inhomogeneous. (3) Slight bony erosion was found in 8 cases, characterized by 'mouse nibbled' or cribriform bony absorption. (4) Adjacent structures were usually involved, and lesions might be polycentric. (5) Lesions often shrank or disappeared after radiotherapy. Conclusion: CT findings of nasal malignant lymphoma are relatively characteristic. It can clearly demonstrate the extent of lesion

  20. Optimizing the clinical utility of PCA3 to diagnose prostate cancer in initial prostate biopsy

    OpenAIRE

    Rubio-Briones, Jose; Borque, Angel; Esteban, Luis M.; Casanova, Juan; Fernandez-Serra, Antonio; Rubio, Luis; Casanova-Salas, Irene; Sanz, Gerardo; Domínguez-Escrig, Jose; Collado, Argimiro; Gómez-Ferrer, Alvaro; Iborra, Inmaculada; Ramírez-Backhaus, Miguel; Martínez, Francisco; Calatrava, Ana

    2015-01-01

    Background PCA3 has been included in a nomogram outperforming previous clinical models for the prediction of any prostate cancer (PCa) and high grade PCa (HGPCa) at the initial prostate biopsy (IBx). Our objective is to validate such IBx-specific PCA3-based nomogram. We also aim to optimize the use of this nomogram in clinical practice through the definition of risk groups. Methods Independent external validation. Clinical and biopsy data from a contemporary cohort of 401 men with the same in...

  1. Verbesserte ICD-10-Suche mittels XML

    OpenAIRE

    Schweiger R.; Dudeck J; Hölzer S; Rudolf D

    2002-01-01

    Mit der Anforderung an Ärzte, ihre Diagnosen zu verschlüsseln, gewinnen effiziente Nachschlagewerke von Verschlüsselungssystemen zunehmend an Bedeutung. Die Universität Gießen hat unter Einsatz neuester und standardisierter Technologien wie XML eine Suchmaschine entwickelt, mit der elektronische Nachschlagewerke und Wörterbücher sehr einfach aufgebaut und gepflegt werden können. XML liefert in diesem Zusammenhang Beziehungen zwischen den Suchbegriffen, die eine hohe Suchqualität (Relevanz und...

  2. Impact of vitamin D deficiency on the clinical presentation and prognosis of patients with newly diagnosed multiple myeloma

    OpenAIRE

    Ng, Alvin C.; Kumar, Shaji K.; Rajkumar, S. Vincent; Drake, Matthew T.

    2009-01-01

    Vitamin D is a fundamental mediator of skeletal metabolism. It also has important non-skeletal actions. We hypothesized that vitamin D deficiency may play an important role in skeletal morbidity and clinical outcomes in MM. We studied 148 newly diagnosed MM patients from January 1, 2004 through December 31, 2008 who had a serum 25-hydroxyvitamin D [25(OH)D] obtained within 14 days of diagnosis. Subjects with vitamin D deficiency [25(OH)D level less than 50 nmol/L (20 ng/mL)] had higher mean v...

  3. Generating Evidence for Clinical Benefit of PET/CT in Diagnosing Cancer Patients

    DEFF Research Database (Denmark)

    Vach, Werner; Høilund-Carlsen, Poul Flemming; Gerke, Oke;

    2011-01-01

    For diagnostic methods such as PET/CT, not only diagnostic accuracy but also clinical benefit must be demonstrated. However, there is a lack of consensus about how to approach this task. Here we consider 6 clinical scenarios to review some basic approaches to demonstrating the clinical benefit of....... We also develop some guidelines for the evaluation of clinical benefit. First, it should be clarified whether there is a direct benefit of the use of PET/CT or an indirect benefit because of improved diagnostic accuracy. If there is an indirect benefit, then decision modeling should be used initially...... to assess the benefit expected from the use of PET/CT. Only if decision modeling does not allow definitive conclusions should randomized controlled trials be planned....

  4. [A case of pulmonary dirofilariasis diagnosed by biopsy, immunological tests and the clinical course without operation].

    Science.gov (United States)

    Magono, Naoki; Yosimatu, Harukazu; Suzuki, Yujiro; Yamada, Eiichi; Kasai, Yositaka; Masuya, Daiki; Kondo, Takesi

    2009-06-01

    A 52-year-old woman who was a pet trimmer by occupation and had four cats, presented with cold-like symptoms. Her chest radiograph and CT scan on admission showed a tumor about 4cm in size with spicula and ground-glass opacity in the right middle lobe. We performed fiberoptic bronchoscopy and CT-guided percutaneous needle lung biopsy on the suspicion of lung cancer, but the tissue consisted largely of granulation tissue with eosinophilic infiltration and no findings of malignancy. The cold-like symptoms subsided and C-reactive protein became within the normal range. Because of the histological findings, her occupation and her pets, we suspected pulmonary dirofilariasis. We asked the National Institute for Infectious Diseases for specific IgG antibody assays to various parasite antigens, which showed positive finding for pulmonary dirofilariasis. We therefore diagnosed pulmonary dirofilariasis and did not perform an operation. PMID:19601520

  5. Diagnosing Pulmonary Embolism in Pregnancy: Are Biomarkers and Clinical Predictive Models Useful?

    Science.gov (United States)

    Parilla, Barbara V.; Fournogerakis, Rachel; Archer, Amy; Sulo, Suela; Laurent, Lisa; Lee, Patricia; Chhotani, Benazir; Hesse, Kathleen; Kulstad, Erik

    2016-01-01

    Objective The objective of this study was to evaluate whether trimester-specific D-dimer levels or the modified Wells score (MWS) is a useful risk stratification tool to exclude pregnant women at low risk of pulmonary embolism (PE) from diagnostic imaging. Study Design This is a prospective and retrospective cohort study. Pregnant women who underwent diagnostic imaging for suspected PE were prospectively enrolled. D-dimer serum levels were drawn, and a MWS was assigned. Pregnant women diagnosed with a PE before study launch who underwent diagnostic imaging and had a D-dimer level drawn were also evaluated. Results In this study, 17 patients were diagnosed with a PE and 42 patients had no PE on diagnostic imaging. Sixteen out of 17 patients with a PE versus 11 out of 42 without PE had an abnormal D-dimer level (p = 0.001). Four patients with a PE versus zero without a PE had an abnormal MWS (p = 0.005). The combination of a trimester-specific D-dimer level along with the MWS was abnormal in all 17 patients with a documented PE versus 11/42 (26.2%) patients without a documented PE (p = 0.001). Conclusion A combination of trimester-specific D-dimer levels along with a MWS can be used in pregnancy to triage women into a low-risk category for PE and thereby avoid radiation exposure in a majority of pregnant patients. PMID:27119048

  6. Chronic lymphocytic leukemia and myeloproliferative neoplasms concurrently diagnosed: clinical and biological characteristics.

    Science.gov (United States)

    Todisco, Gabriele; Manshouri, Taghi; Verstovsek, Srdan; Masarova, Lucia; Pierce, Sherry A; Keating, Michael J; Estrov, Zeev

    2016-05-01

    Chronic lymphocytic leukemia (CLL) and myeloproliferative neoplasms (MPN) may occur concomitantly. However, little is known about the pathobiological characteristics and interaction between the neoplastic clones in these rare cases of coinciding malignancies. We retrospectively examined the clinical and biological characteristics of 13 patients with concomitant CLL and MPN--eight primary myelofibrosis (PMF), three essential thrombocytosis (ET), and two polycythemia vera (PV)--who presented to our institution between 1998 and 2014, and tested all patients for MPN-specific aberrations, such as JAK2, MPL and CALR mutations. Along with epidemiological and molecular characterization of this rare condition, we found that JAK2 mutation can be detected 9 years prior to PMF diagnosis, suggesting that PMF clinical phenotype may require several years to develop and CLL/MPN clinical co-occurrence might be sustained by common molecular events. Some features of these patients suggest that pathobiologies of these diseases might be intertwined. PMID:26402369

  7. Clinical Approach to Nonresponsive Pneumonia in Adults Diagnosed by a Primary Care Clinician: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Kiley B. Vander Wyst

    2016-04-01

    Full Text Available Purpose: Community-acquired pneumonia (CAP is commonly diagnosed in the primary care setting. Management of nonresponsive pneumonia (NRP, i.e. failure to respond to CAP treatment, is not clearly understood. The purpose of this study was to describe the initial work-up and treatment of CAP in the ambulatory primary care setting and to determine relative proportion of, diagnostic approach to and treatment of NRP. Methods: We retrospectively studied adult patients diagnosed with CAP within our large, integrated health care system from October 2006 through July 2013. Cases were defined as patients with CAP who worsened after 4 days, or did not improve within 10 days, of antibiotic treatment. Controls were CAP patients who did not meet case definition. Mann-Whitney and t-tests were used to analyze continuous variables. Chi-square or Fisher’s exact test was used to analyze categorical variables. Significant variables were used to construct a multivariable logistic regression model. Results: Of 250 total patients studied, there were 85 cases and 165 controls. The case population was significantly older (59 ± 16 vs. 53 ± 19 years, P = 0.02. Multivariable logistic regression revealed former smoker (P < 0.01, initial presentation to urgent care (P = 0.02 and myalgia (P = 0.003 as predictors of NRP. Chest X-rays were more commonly ordered for cases at initial visit (80% vs. 68%, P = 0.06. Overall, 24% of patients had additional testing at the initial visit (39% of cases vs. 16% of controls, P < 0.001. Additionally, a higher proportion of cases underwent antibiotic change at their first (62% vs. 15%, P < 0.001 or second (47% vs. 5%, P < 0.001 follow-up visit. Conclusions: Patients with NRP tended to be former smokers, report myalgia and/or present to urgent care. The majority of providers conducted chest X-rays, but no further pneumonia testing, at the initial visit. Further study is needed to determine if this strategy leads to delayed etiologic

  8. The feasibility of white matter volume reduction analysis using SPM8 plus DARTEL for the diagnosis of patients with clinically diagnosed corticobasal syndrome and Richardson’s syndrome

    OpenAIRE

    Keita Sakurai; Etsuko Imabayashi; Aya M. Tokumaru; Shin Hasebe; Shigeo Murayama; Satoru Morimoto; Kazutomi Kanemaru; Masaki Takao; Yuta Shibamoto; Noriyuki Matsukawa

    2015-01-01

    Purpose: Diagnosing corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP) is often difficult due to the wide variety of symptoms and overlaps in the similar clinical courses and neurological findings. The purpose of this study was to evaluate the utility of white matter (WM) atrophy for the diagnosis of patients with clinically diagnosed CBD (corticobasal syndrome, CBS) and PSP (Richardson’s syndrome, RS). Methods: We randomly divided the 3D T1-weighted MR images of 18 C...

  9. Clinical and radiological parameters of patients with lung thromboembolism, diagnosed by high probability ventilation / perfusion scintigraphies

    International Nuclear Information System (INIS)

    Background: pulmonary embolism (PE) remains an elusive diagnosis, and still causes too many unexpected deaths. Because of this, noninvasive investigations are done when pulmonary embolism is suspected. Objective: to determine the clinical and x-rays findings in patients with diagnosis of pulmonary embolism by high probability ventilation/perfusion (V/Q) lung scan. Materials and methods: inpatient medical records of 91 patients with clinical suspected PE and high and low probability V/Q lung scan were analyzed (PIOPED criterion). Results: there were statistics correlation with four clinical findings: hemoptysis (p value=0,02, odds ratio=8,925), taquicardia (p value=0,02 odds ratio=3,5), chest pain (p value=0,01, odds ratio=1,87), and recent surgery (p value=0,02, odds ratio=2,762). The 70,7% chest x-rays were normal (p value < 0,001). Conclusion: the clinical and x-rays findings in patients with diagnosis of PE by high probability V/Q lung scan were: hemoptysis, taquicardia, chest pain, recent surgery and normal chest x-ray. This is important because would help to choose the patients in whom the V/Q lung scan will have the maximal performance (Au)

  10. Correlation between self-reported and clinically based diagnoses of bruxism in temporomandibular disorders patients

    NARCIS (Netherlands)

    D.A. Paesani; F. Lobbezoo; C. Gelos; L. Guarda-Nardini; J. Ahlberg; D. Manfredini

    2013-01-01

    The present investigation was performed in a population of patients with temporomandibular disorders (TMD), and it was designed to assess the correlation between self-reported questionnaire-based bruxism diagnosis and a diagnosis based on history taking plus clinical examination. One-hundred-fifty-n

  11. Patients newly diagnosed with clinical type 2 diabetes mellitus but presenting with HbA1c within normal range: 19-year mortality and clinical outcomes

    DEFF Research Database (Denmark)

    Veloso, A.G.; Siersma, V.; Heldgaard, P.E.; Olivarius, N.de F.

    2013-01-01

    AIMS: To investigate whether long-term mortality or clinical outcomes differed between patients diagnosed with type 2 diabetes mellitus and presenting with HbA1c within or above normal range at time of diagnosis. METHODS: Data were from a population-based sample of 1136 individuals with newly...... diagnosed type 2 diabetes mellitus. The diagnosis was confirmed with a single fasting whole blood/plasma glucose ≥7.0/8.0mmol/l. The median time from day of diagnosis until end of follow up was 18.8years. Patients were grouped according to normal HbA1c and elevated HbA1c at diagnosis. The effect of elevated...

  12. Clinical study of CT virtual endoscopy in diagnosing polyps of the gallbladder

    International Nuclear Information System (INIS)

    Objective: To evaluate the ability and clinical application of CT virtual endoscopy on polyps of the gallbladder. Methods: CT virtual endoscopy findings of 32 patients with polyps of the gallbladder proved pathologically were presented by using oral iodine contrast, and compared with color Doppler ultrasound. Results: The accuracy rate of color Doppler ultrasound and CTVEGB were 96.9% (93/96) and 93.8% (90/96) respectively (x2 = 0.466, P > 0.05). CTVEGB could more correctly demonstrate the surface details of polyps which were viewed in a 3D fashion in any projection than ultrasound. CTVEGB corresponded well with color Doppler ultrasound and operation and pathology in demonstrating the size, configuration and location of the lesions. Conclusion: CTVEGB is a noninvasive and accurate procedure, which has a important value in clinic applications

  13. Diagnosing Autism in Individuals with Known Genetic Syndromes: Clinical Considerations and Implications for Intervention

    OpenAIRE

    Hepburn, Susan L.; Moody, Eric J.

    2011-01-01

    Assessing symptoms of autism in persons with known genetic syndromes associated with intellectual and/or developmental disability is a complex clinical endeavor. We suggest that a developmental approach to evaluation is essential to reliably teasing apart global impairments from autism-specific symptomology. In this chapter, we discuss our assumptions about autism spectrum disorders, the process of conducting a family-focused, comprehensive evaluation with behaviorally complex children and so...

  14. Treatment of Clinically Diagnosed Equine Sarcoid with a Mistletoe Extract (Viscum album austriacus)

    OpenAIRE

    Christen-Clottu, Ophélie; Klocke, Peter; Burger, Dominik; Straub, Reto; Gerber, Vinzenz

    2010-01-01

    Background: Equine sarcoids (ES) are common, difficult to treat, and have high recurrence rates. Viscum album extracts (VAE) are used in human cancer treatment. Hypothesis: That therapy with VAE (Iscador P) is effective in the treatment of ES. Animals: Fifty-three horses (444 ES); 42 were treated with VAE or placebo as monotherapy; 11 were treated with VAE or placebo after selective excision of ES. Methods: Prospective, randomised, blinded, clinical trial. Horses were randomly assigned to tre...

  15. Catatonia: Etiopathological diagnoses and treatment response in a tertiary care setting: A clinical study

    Directory of Open Access Journals (Sweden)

    Santosh Ramdurg

    2013-01-01

    Full Text Available Aim: Catatonia is caused by a variety of psychiatric and organic conditions. The onset, clinical profile, and response to treatment may vary depending on the underlying cause. The study is an attempt to explore clinical profile, possible etiological correlates with neurotic/psychotic spectrum illnesses, and response to treatment and outcome in patients of catatonia. Materials and Methods: Retrospective chart analysis by using semistructured data sheet for the analysis of sociodemographic data, clinical profile, precipitating event, and response to treatment in patients with catatonic symptoms admitted to IHBAS (Institute of Human Behaviour and Allied Sciences, New Delhi, India from January 2009 to December 2010 was undertaken. Results: Catatonia was commonly observed in patients with the following profile - late twenties, female, Hindu religion, urban background, and housewives. Psychotic spectrum disorder (57%, N=35 was the most commonly entertained diagnosis and affective disorder (18%, N=11 being the second common. Thirty four percent of the subjects responded to lorazepam treatment and rest required modified electroconvulsive therapy (MECT. Conclusion: Catatonia is more likely to be associated with Schizophrenia and Other Psychotic Disorders in Indian settings. Majority of patients responded to therapy either by lorazepam alone or to its augmentation with modified ECT. The study being a retrospective one, the sample being representative of the treatment seeking group only, and unavailability of the follow up data were the limitations of the study

  16. The prevalence of neovascularity in patients clinically diagnosed with rotator cuff tendinopathy

    Directory of Open Access Journals (Sweden)

    Raza Syed A

    2009-12-01

    Full Text Available Abstract Background Shoulder dysfunction is common and pathology of the rotator cuff tendons and subacromial bursa are considered to be a major cause of pain and morbidity. Although many hypotheses exist there is no definitive understanding as to the origin of the pain arising from these structures. Research investigations from other tendons have placed intra-tendinous neovascularity as a potential mechanism of pain production. The prevalence of neovascularity in patients with a clinical diagnosis of rotator cuff tendinopathy is unknown. As such the primary aim of this pilot study was to investigate if neovascularity could be identified and to determine the prevalence of neovascularity in the rotator cuff tendons and subacromial bursa in subjects with unilateral shoulder pain clinically assessed to be rotator cuff tendinopathy. The secondary aims were to investigate the association between the presence of neovascularity and pain, duration of symptoms, and, neovascularity and shoulder function. Methods Patients with a clinical diagnosis of unilateral rotator cuff tendinopathy referred for a routine diagnostic ultrasound (US scan in a major London teaching hospital formed the study population. At referral patients were provided with an information document. On the day of the scan (on average, at least one week later the patients agreeing to participate were taken through the consent process and underwent an additional clinical examination prior to undergoing a bilateral grey scale and colour Doppler US examination (symptomatic and asymptomatic shoulder using a Philips HDI 5000 Sono CT US machine. The ultrasound scans were performed by one of two radiologists who recorded their findings and the final assessment was made by a third radiologist blinded both to the clinical examination and the ultrasound examination. The findings of the radiologists who performed the scans and the blinded radiologist were compared and any disagreements were resolved

  17. Clinical and demographic profile of HIV/AIDS patients diagnosed at a tertiary care centre in Kashmir

    International Nuclear Information System (INIS)

    Objectives: To study the clinical and demographic profile of HIV/AIDS patients diagnosed at a tertiary care centre. Methods: The study was conducted on a group of 1141 patients suspected of having HIV/AIDS on clinical grounds. Screening was done using different Elisa's as advised by NACO and those confirmed as HIV positive were studied for their clinical spectrum and different demographic parameters. Results: Out of 1141 patients tested, 26 proved to have HIV 1 infection with no case of HIV 2 detected. Mean age of presentation was 40.04 +- 7 years, main age group affected 31-40 years and a male: female ratio of 4.2:1 was observed. More than 42% were non Kashmiris with armed forces outnumbering all other occupational classes. Heterosexual transmission was the commonest with married out numbering unmarried. Fever, asthenia and weight loss were the predominant symptoms and pulmonary tuberculosis and oropharyngeal candidiasis commonest opportunistic infections. Conclusion: The clinical and demographic profile of HIV/AIDS patients in Kashmir is largely similar to the rest of India. Kashmir no longer stands immune to the menace of HIV/AIDS. With increasing globalization, frequent travel and change in social values the state is likely to witness an alarming rise in new cases unless a multi pronged approach is undertaken to control the spread. (author)

  18. A systematic review of clinical outcomes for patients diagnosed with skin cancer spinal metastases.

    Science.gov (United States)

    Goodwin, C Rory; Sankey, Eric W; Liu, Ann; Elder, Benjamin D; Kosztowski, Thomas; Lo, Sheng-Fu L; Fisher, Charles G; Clarke, Michelle J; Gokaslan, Ziya L; Sciubba, Daniel M

    2016-05-01

    OBJECT Surgical procedures and/or adjuvant therapies are effective modalities for the treatment of symptomatic spinal metastases. However, clinical results specific to the skin cancer spinal metastasis cohort are generally lacking. The purpose of this study was to systematically review the literature for treatments, clinical outcomes, and survival following the diagnosis of a skin cancer spinal metastasis and evaluate prognostic factors in the context of spinal skin cancer metastases stratified by tumor subtype. METHODS The authors performed a literature review using PubMed, Embase, CINAHL, and Web of Science to identify articles since 1950 that reported survival, clinical outcomes, and/or prognostic factors for the skin cancer patient population with spinal metastases. The methodological quality of reviews was assessed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) tool. RESULTS Sixty-five studies met the preset criteria and were included in the analysis. Of these studies, a total of 25, 40, 25, and 12 studies included patients who underwent some form of surgery, radiotherapy, chemotherapy, or observation alone, respectively. Sixty-three of the 65 included studies were retrospective in nature (Class of Evidence [CoE] IV), and the 2 prospective studies were CoE II. Based on the studies analyzed, the median overall survival for a patient with a spinal metastasis from a primary skin malignancy is 4.0 months; survival by tumor subtype is 12.5 months for patients with basal cell carcinoma (BCC), 4.0 months for those with melanoma, 4.0 months for those with squamous cell carcinoma, 3.0 months for those with pilomatrix carcinoma, and 1.5 months for those with Merkel cell carcinoma (p radiation) alone, or the combination of therapies was similar across interventions. Age, spinal region, and neurological status may be associated with poor survival following surgery. PMID:26544595

  19. The validity and clinical utility of structured diagnoses of antisocial personality disorder with forensic patients.

    Science.gov (United States)

    Marin-Avellan, Luisa E; McGauley, Gillian A; Campbell, Colin D; Fonagy, Peter

    2014-08-01

    Current DSM-based instruments for personality disorders (PDs) limit the investigation of the course and outcome of treatment of these disorders. This study examined the validity of the Shedler-Westen Assessment Procedure-200 (SWAP-200) and the Structured Clinical Interview for DSM-IV Axis II PD (SCID-II) in a sample of forensic PD patients. Results based on 66 participants indicated that the SWAP-200 Q-factors reduced the frequency of diagnostic comorbidity of PD categories by half compared with the SCID-II. Only the SWAP-200's Antisocial PD category showed good convergent and discriminant validity with respect to other instruments describing aspects of PD. The validity of the cutoff score for severe antisocial PD was confirmed, and this category predicted severe incidents in the hospital at 1 year of follow-up. A violence risk scale was constructed, which differentiated violent and nonviolent offenders. The results support the validity of the SWAP-200 and its potential clinical utility with forensic PD patients. PMID:24511901

  20. Predicting reoffense in pedophilic child molesters by clinical diagnoses and risk assessment.

    Science.gov (United States)

    Eher, Reinhard; Olver, Mark E; Heurix, Isabelle; Schilling, Frank; Rettenberger, Martin

    2015-12-01

    A Diagnostic and Statistical Manual of Mental Disorders (DSM)-based diagnosis of pedophilia has so far failed to predict sexual reoffense in convicted child molesters, probably because of its broad and unspecific conceptualization. In this study, therefore, we investigated the prognostic value of the subtype exclusive pedophilia and a series of customary risk assessment instruments (SSPI, Static-99, Stable-2007, VRS:SO) and the PCL-R in a sample of prison released pedophilic sexual offenders. First, we examined the convergent validity of risk assessment instruments (N = 261). Then, we calculated the predictive accuracy of the measures and diagnosis for sexual recidivism by ROC analyses and subsequent Cox regression (N = 189). Also, predictive values with more clinical immediacy were calculated (sensitivity, specificity, PPV and NPV). The VRS:SO, the SSPI, and the Static-99 significantly predicted sexual recidivism, as did a diagnosis of exclusive pedophilia. Also, the VRS:SO predicted sexual reoffense significantly better than the Stable-2007, the Static-99/Stable-2007 combined score, and the PCL-R. When used combined, only the VRS:SO and a diagnosis of exclusive pedophilia added incremental validity to each other. Our findings support that the clinical diagnosis of an exclusive pedophilia based on DSM criteria and VRS:SO defined risk factors can reliably discriminate higher from lower risk offenders, even within the select subgroup of pedophilic child molesters. PMID:26146817

  1. The validity of clinical findings for diagnosing temporomandibular disorders in patients from different age and gender groups

    International Nuclear Information System (INIS)

    This study was to clarify the diagnostic accuracy of clinical findings for internal derangement of the temporomandibular joint (TMJ) compared with that of magnetic resonance imaging. A series of 4559 patients (879 male and 3680 female, mean age 32.7 years; range 8-85 years;) with temporomandibular disorders were clinically examined by un unspecified number of dentists. All patients underwent magnetic resonance imaging (MRI). The clinical findings that characterize disc displacement, anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) are pain, clicking sound and limitation of maximum mouth opening. These clinical findings were compared to the MRI interpretation, which was used as the gold standard for diagnosis of temporomandibular disorders to define the diagnostic accuracy, specificity, sensitivity, positive predictive value and negative predictive value of clinical findings. The prevalence of clinical finding was 3990 joints (43%) with pain, 2775 joints (30%) with clicking sound and 1731 patients (38%) with limitation of opening. Three thousands forty seven joints were diagnosed as having a normal disc position, 510 joints with sideways disc displacement, 2312 joints with ADDwR, 3239 joints with ADDwoR on MR image. The sensitivity of clinical findings was considerably low: sensitivity was 0.48 for pain versus internal derangement, 0.51 for clicking sound versus ADDwR, 0.62 for limitation of opening versus ADDwoR. The sensitivity was higher in the younger group for clicking sound versus ADDwR, but sensitivity was higher in the older group for limitation of opening versus ADDwoR. The diagnostic accuracy based on clinical findings of internal derangement of TMJ was found to be correlated with age. This study has been that the overall diagnostic accuracy of the clinical findings to determine the status of the joint is about 50-60%. The status of the joint could not be accurately determined by clinical findings

  2. Multiple sclerosis: disability and mortality in a cohort of clinically diagnosed patients.

    Science.gov (United States)

    Citterio, A; Azan, G; Bergamaschi, R; Erbetta, A; Cosi, V

    1989-01-01

    A sample of hospitalized MS patients was selected according to clinical and demographic criteria with the aim of establishing prognostic factors. The sample included 52 patients with first hospitalization from 1 January, 1975, to 31 December, 1976. At follow-up after 12 years a malignant course was observed in 33 patients (death in 13, severe disability in 20 patients). The malignant course was related to age at onset (greater than or equal to 35 years) and higher disability, progressive course and cerebellar symptoms at onset. One half of patients with a relapsing-remitting course entered into a progressive phase of the disease after a mean duration of 7.3 years. PMID:2530458

  3. Evaluation of efficacy and clinical impact of FDG-PET 27 patients with surgery of newly diagnosed colorectal cancer

    International Nuclear Information System (INIS)

    The aim of this study was to assess the potential clinical benefit of positron emission tomography (PET) with Fluorine-18-fluorodeoxyglucose (FDG) in patients with colorectal cancer. A total of 27 patients with surgery of newly diagnosed colorectal cancer who were examined preoperatively by FDG-PET between July 2002 and December 2004 were retrospectively analyzed in this study. FDG-PET detected 89% of primary tumors. FDG-PET depicted lymph node metastases in 4 of 9 patients (sensitivity, 44%) and true-negative in 17 of 18 patients (specificity, 94%). FDG-PET depicted liver metastases in 3 of 3 patients (sensitivity, 100%) and true-negative in 22 of 24 patients (specificity, 91%). A comparison of the FDG uptake and the clinicopathologic findings showed that there was no significant association between FDG uptake and the macro finding type, the depth of invasion and histological type. Five of 8 cases with a preoperative diagnosis as lymph-node negative were diagnosed histologically as lymph-node positive, in which the tumor was less than 10 mm in maximum horizontal size, so its size can be a significant factor. FDG-PET can serve as a valuable tool for detecting primary lesions with preoperative colorectal cancer. (author)

  4. The role of the Oregon State University Endophyte Service Laboratory in diagnosing clinical cases of endophyte toxicoses.

    Science.gov (United States)

    Craig, A Morrie; Blythe, Linda L; Duringer, Jennifer M

    2014-07-30

    The Oregon State University Colleges of Veterinary Medicine and Agricultural Sciences instituted the Endophyte Service Laboratory to aid in diagnosing toxicity problems associated with cool-season grasses in livestock. The endophyte (Neotyphodium coenophalum) present in tall fescue (Festuca arundinacea) produces ergopeptine alkaloids, of which ergovaline is the molecule used to determine exposure and toxicity thresholds for the vasoconstrictive conditions "fescue foot" and "summer slump". Another vasoconstrictive syndrome, "ergotism," is caused by a parasitic fungus, Claviceps purpurea, and its primary toxin, ergotamine. "Ryegrass staggers" is a neurological condition that affects livestock consuming endophyte (Neotyphodium lolii)-infected perennial ryegrass (Lolium perenne) with high levels of lolitrem B. HPLC-fluorescent analytical methods for these mycotoxins are described and were used to determine threshold levels of toxicity for ergovaline and lolitrem B in cattle, sheep, horses, and camels. In addition, six clinical cases in cattle are presented to illustrate diagnosis of these three diseases. PMID:25017309

  5. Prevalence, incidence, and comorbidity of clinically diagnosed obsessive-compulsive disorder in Taiwan: a national population-based study.

    Science.gov (United States)

    Huang, Li-Chung; Tsai, Kuen-Jer; Wang, Hao-Kuang; Sung, Pi-Shan; Wu, Ming-Hsiu; Hung, Kuo-Wei; Lin, Sheng-Hsiang

    2014-12-15

    Obsessive-compulsive disorder (OCD) is a chronic debilitating anxiety disorder significant in intrusive thoughts and compensation repetitive behaviors. Few studies have reported on this condition Asia. This study estimated the prevalence, incidence and psychiatric comorbidities of OCD in Taiwan. We identified study subjects for 2000-2008 with a principal diagnosis of OCD according to the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic criteria by using National Health Research Institute database. These patients received either outpatient or inpatient care for their condition. Rates were directly age- and sex-adjusted to the 2004 Taiwan population distribution. The estimated mean annual incidence was 27.57 per 10(5) inhabitants and the one year prevalence was 65.05 per 10(5) inhabitants. Incidence and prevalence increased with age, peaking at age 18-24 years in males and at 35-44 years in females. About 53% of adults (≥18 years) and 48% of child and adolescent patients (6-17 years) had one or more comorbid psychiatric conditions. The most common comorbid diagnosis was depressive disorders for both adult and child-adolescent patients. We found a lower prevalence and incidence of clinically diagnosed OCD than that of community studies. Many Asian patients with OCD also had various psychiatric comorbidities, a clinically relevant finding. PMID:25169892

  6. MR elastography of the liver at 3.0 T in diagnosing liver fibrosis grades; preliminary clinical experience

    International Nuclear Information System (INIS)

    To clarify the usefulness of 3.0-T MR elastography (MRE) in diagnosing the histological grades of liver fibrosis using preliminary clinical data. Between November 2012 and March 2014, MRE was applied to all patients who underwent liver MR study at a 3.0-T clinical unit. Among them, those who had pathological evaluation of liver tissue within 3 months from MR examinations were retrospectively recruited, and the liver stiffness measured by MRE was correlated with histological results. Institutional review board approved this study, waiving informed consent. There were 70 patients who met the inclusion criteria. Liver stiffness showed significant correlation with the pathological grades of liver fibrosis (rho = 0.89, p < 0.0001, Spearman's rank correlation). Areas under the receiver operating characteristic curve were 0.93, 0.95, 0.99 and 0.95 for fibrosis score greater than or equal to F1, F2, F3 and F4, with cut-off values of 3.13, 3.85, 4.28 and 5.38 kPa, respectively. Multivariate analysis suggested that grades of necroinflammation also affected liver stiffness, but to a significantly lesser degree as compared to fibrosis. 3.0-T clinical MRE was suggested to be sufficiently useful in assessing the grades of liver fibrosis. (orig.)

  7. MR elastography of the liver at 3.0 T in diagnosing liver fibrosis grades; preliminary clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimitsu, Kengo; Mitsufuji, Toshimichi; Shinagawa, Yoshinobu; Fujimitsu, Ritsuko; Morita, Ayako; Urakawa, Hiroshi; Takano, Koichi [Fukuoka University, Department of Radiology, Fukuoka (Japan); Hayashi, Hiroyuki [Fukuoka University, Department of Pathology, Faculty of Medicine, Fukuoka (Japan)

    2016-03-15

    To clarify the usefulness of 3.0-T MR elastography (MRE) in diagnosing the histological grades of liver fibrosis using preliminary clinical data. Between November 2012 and March 2014, MRE was applied to all patients who underwent liver MR study at a 3.0-T clinical unit. Among them, those who had pathological evaluation of liver tissue within 3 months from MR examinations were retrospectively recruited, and the liver stiffness measured by MRE was correlated with histological results. Institutional review board approved this study, waiving informed consent. There were 70 patients who met the inclusion criteria. Liver stiffness showed significant correlation with the pathological grades of liver fibrosis (rho = 0.89, p < 0.0001, Spearman's rank correlation). Areas under the receiver operating characteristic curve were 0.93, 0.95, 0.99 and 0.95 for fibrosis score greater than or equal to F1, F2, F3 and F4, with cut-off values of 3.13, 3.85, 4.28 and 5.38 kPa, respectively. Multivariate analysis suggested that grades of necroinflammation also affected liver stiffness, but to a significantly lesser degree as compared to fibrosis. 3.0-T clinical MRE was suggested to be sufficiently useful in assessing the grades of liver fibrosis. (orig.)

  8. Clinical usefulness of {sup 201}Tl SPECT in diagnosing nasopharyngeal tumor

    Energy Technology Data Exchange (ETDEWEB)

    Togawa, Takashi; Yui, Nobuharu; Hatano, Kazuo; Takeuchi, Yousuke; Hayasaki, Katsutake [Chiba Cancer Center (Japan); Omura, Ken [Tokyo Medical and Dental Univ. (Japan). Graduate School

    2003-03-01

    {sup 201}Tl SPECT was performed on 54 patients suspected of nasopharyngeal tumor using a three-head rotating gamma camera and its clinical usefulness was evaluated. {sup 201}Tl accumulations were shown in 53 of the 54 patients (50 nasopharyngeal carcinoma, 1 malignant melanoma and 2 lymphoid hyperplasia) before treatment. In 48 of 50 patients with nasopharyngeal carcinoma, the effectiveness for treatment response could be assessed after treatment. {sup 201}Tl SPECT was concordant with MRI and CT in 26 patients (15 complete response (CR), 11 partial response (PR)), whereas it was discordant in 22 patients who showed CR in {sup 201}Tl SPECT but PR in MRI and CT. Follow-up MRI and {sup 201}Tl SPECT studies of 16 of these 22 patients from 6 to 33 months (mean 13 months) after treatment revealed that the tumor gradually decreased and finally vanished. Recurrent and metastatic lesions occurred in 8 patients from 9 to 69 months (mean 24 months) after treatment, and {sup 201}Tl SPECT could detect all 10 lesions in 8 patients. From the results obtained, it was concluded that {sup 201}Tl SPECT is very useful in the initial evaluation, in the assessment of treatment response and in detecting recurrent and metastatic lesions of nasopharyngeal tumor. (author)

  9. Clinical Applications of Successive Spot Radiographs in Esophagography for Diagnosing the Early Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    TANGLi-jun; KONGFan-fu; WANGDe-hang

    2004-01-01

    To introduce primary experience of clinical applications of successive spot radiographs in esophagography for the din mlosis of early esoplmgeal cancer (EEC). Methods: Six patients with EEC were examined and doagnosed dlaarmsed by a digital X-ray machine. According to the routine double contrast study of esophagus, the patient gulped a barimn suspension in the upright position when the successive films were taken by 2 frmnes per second lasting for about 10 seconds. Various phases were obtained including barimn-filled views,mucosal relief views and double contrast views. Results: Functional changes and abnormal mucosal folds of esophagus were present on successive spot radiographs of esophagography in patients with EEC and those patients with EEC were confirmed by endoscopic and pathologic findings. Four patients had mild loss of distensibility, 2 patients had spasmodic contraction and 1 patient had barium retention. Thickened or interrupted folds were found in all cases.Little niches were detected in 5 of 6 patients. Conctusion: Evidence presented in barimn studies of esophagus is more comprehensive and intact for the diagnosis of EEC when successive spot radiographs are employed. Functional changes of esophagus are more evident with this approach.

  10. Das Strukturierte Interview für Anorektische und Bulimische Ess-Störungen nach DSM-IV und ICD-10 zur Expertenbeurteilung (SIAB-EX) und dazugehöriger Fragebogen zur Selbsteinschätzung (SIAB-S)

    OpenAIRE

    Fichter, Manfred M.; Quadflieg, Norbert

    2001-01-01

    Background: The Structured Inventory for Anorexic and Bulimic Syndromes according to DSM-IV and ICD-10 consists of the Structured Expert Interview for Anorexic and Bulimic Syndromes (SIAB-EX) and the corresponding self report questionnaire (SIAB-S). These instruments assess symptoms of eating disorders and other symptoms often found in eating-disordered individuals (e.g. anxieties, symptoms of OCD, depression, substance abuse and impairment of sexuality and social integration). Thus, parallel...

  11. Clinical, Radiographic, and Pathologic Findings in Patients Undergoing Reoperation Following Radiation Therapy and Temozolomide for Newly Diagnosed Glioblastoma

    Science.gov (United States)

    Ellsworth, Susannah; Ye, Xiaobu; Grossman, Stuart A.

    2016-01-01

    Purpose Patients with glioblastoma (GBM) frequently deteriorate clinically and radiographically after chemoradiation and may require repeat surgical intervention. We attempted to correlate pathologic findings with preoperative clinical characteristics and survival in patients undergoing reoperation for GBM. Materials and Methods Patients eligible for this retrospective analysis had pathologically confirmed GBM diagnosed between 2005 and 2010, received standard radiation and temozolomide, and underwent repeat resection within 18 months of diagnosis. Results Thirty-eight patients were identified. Median age was 56 years (range, 30 to 80 y), 55% were male, and 66% had baseline performance status ≥90%. Median survival was 16.3 months (95% confidence interval [CI], 13.3–19.8) from initial surgery. At reoperation, 21% of patients had no pathologically evident tumor. Median time from initial diagnosis to second surgery was similar in patients with and without evident tumor (8.5 vs. 8.8 mo, respectively). Patients without evident tumor tended to have a worse performance status. Median overall survival from second surgery was 7 months (95% CI, 4.2–10.1) and 9.1 months (95% CI, 2.1–25.3) for patients with and without evident tumor, respectively. Multivariate proportional hazards analysis showed a hazard ratio for death of 0.61 (95% CI, 0.25–1.49) for patients without evident tumor after adjusting for Karnofsky performance status and second surgical procedure. Conclusions GBM patients with and without disease recurrence have similar clinical characteristics at the time of second surgical resection. Pathologic outcomes were not correlated with specific clinical or radiologic characteristics, including the time from diagnosis to reoperation. There was a trend toward improved overall survival among patients without evident tumor at reoperation. PMID:26491903

  12. Convergent and divergent validity of K-SADS-PL anxiety and attention deficit hyperactivity disorder diagnoses in a clinical sample of school-aged children.

    Science.gov (United States)

    Villabø, Marianne A; Oerbeck, Beate; Skirbekk, Benedicte; Hansen, Berit Hjelde; Kristensen, Hanne

    2016-07-01

    Background The Schedule for Affective Disorders and Schizophrenia for School Age Children, Present and Lifetime Version (K-SADS-PL) is a commonly used diagnostic interview both in research and clinical settings, yet published data on the psychometric properties of the interview generated diagnoses are scarce. Aims To examine the convergent and divergent validity of the Norwegian version of the K-SADS-PL current diagnoses of anxiety disorders and attention deficit hyperactivity disorder (ADHD). Method Participants were 105 children aged 7-13 years referred for treatment at child mental health clinics and 36 controls. Diagnostic status was determined based on K-SADS-PL interviews with the mothers. Child and mother reported child symptoms of anxiety on the Multidimensional Anxiety Scale for Children and teachers reported anxiety symptoms on the Teacher Report Form. Mother and teacher reported on symptoms of ADHD on the Disruptive Behavior Rating Scale. Results Rating scale data from multiple informants in a clinical sample and healthy controls supported the convergent and divergent validity of K-SADS-PL anxiety diagnoses combined, and, specifically, the diagnoses of separation anxiety disorder, social phobia, and specific phobia. Support was also observed for convergent and divergent validity of ADHD diagnoses, including the predominately inattentive subtype. Conclusion The K-SADS-PL generates valid diagnoses of anxiety disorders and ADHD. PMID:26836986

  13. Clinically unsuspected Hodgkin′s lymphoma diagnosed primarily from bone marrow trephine biopsy: Report of six cases

    Directory of Open Access Journals (Sweden)

    Kar Rakhee

    2008-04-01

    Full Text Available Bone marrow may be the initial or rarely the only site of involvement in Hodgkin′s lymphoma. A high index of suspicion is required to pick up the histopathological changes of Hodgkin′s lesions in the bone marrow like necrosis, presence of Reed-Sternberg cell or its variant in a polymorphic background infiltrate, focal fibrosis and myxoid change especially in the absence of classical clinical picture. Bone marrow with immunohistochemistry has a valuable role in the staging and in the diagnosis of primary medullary Hodgkin′s lymphoma. B-symptoms may easily masquerade as an infectious process as in all our cases the patients had fever as a presenting feature, in four of them tuberculosis was suspected clinically and two had received antitubercular therapy elsewhere. We report six human immunodeficiency virus-negative patients diagnosed over a period of 5 years in which the initial diagnosis of Hodgkin′s lymphoma was suggested from bone marrow histology.

  14. Variants Within TSC2 Exons 25 and 31 Are Very Unlikely to Cause Clinically Diagnosable Tuberous Sclerosis.

    Science.gov (United States)

    Ekong, Rosemary; Nellist, Mark; Hoogeveen-Westerveld, Marianne; Wentink, Marjolein; Panzer, Jessica; Sparagana, Steven; Emmett, Warren; Dawson, Natalie L; Malinge, Marie Claire; Nabbout, Rima; Carbonara, Caterina; Barberis, Marco; Padovan, Sergio; Futema, Marta; Plagnol, Vincent; Humphries, Steve E; Migone, Nicola; Povey, Sue

    2016-04-01

    Inactivating mutations in TSC1 and TSC2 cause tuberous sclerosis complex (TSC). The 2012 international consensus meeting on TSC diagnosis and management agreed that the identification of a pathogenic TSC1 or TSC2 variant establishes a diagnosis of TSC, even in the absence of clinical signs. However, exons 25 and 31 of TSC2 are subject to alternative splicing. No variants causing clinically diagnosed TSC have been reported in these exons, raising the possibility that such variants would not cause TSC. We present truncating and in-frame variants in exons 25 and 31 in three individuals unlikely to fulfil TSC diagnostic criteria and examine the importance of these exons in TSC using different approaches. Amino acid conservation analysis suggests significantly less conservation in these exons compared with the majority of TSC2 exons, and TSC2 expression data demonstrates that the majority of TSC2 transcripts lack exons 25 and/or 31 in many human adult tissues. In vitro assay of both exons shows that neither exon is essential for TSC complex function. Our evidence suggests that variants in TSC2 exons 25 or 31 are very unlikely to cause classical TSC, although a role for these exons in tissue/stage specific development cannot be excluded. PMID:26703369

  15. The clinical application of C arm CT imaging in diagnosing and treating hypo-vascular primary hepatic carcinomas

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical application of C arm CT imaging technique in diagnosing and treating of hypo-vascular primary hepatic carcinomas. Methods: Forty-three patients with hypo-vascular primary hepatic carcinomas were enrolled in this study. All the patients underwent DSA and C arm CT imaging (Philips dual x-ray flat-panel digital imaging system) before transcatheter arterial chemoembolization (TACE). The imaging findings were retrospectively analyzed. The detection rate of hepatic tumors estimated before TACE were compared among CT/MRI, DSA and C arm CT imaging. Results: After TACE a total of 97 hypo-vascular tumors were found on CT scanning. The detection rates of hepatic tumors on CT/MRI, DSA and C arm CT imaging were 71.1% (69/97), 78.4% (76/97) and 89.7% (87/97), respectively, with P0.05. Conclusion: C arm CT imaging technique is superior to CT/MRI and DSA in detecting the hypo-vascular hepatic tumors. This technique can more precisely and more sensitively demonstrate the hepatic lesions, especially for the tumors with a diameter smaller than 10 mm. Therefore, this technique has great clinical value in treating hepatocellular carcinomas. (authors)

  16. An audit of first prescription of new patients attending a psychiatry walk-in-clinic in north India

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2012-01-01

    Full Text Available Background: Although almost all psychotropic medications available worldwide are readily available in India, there is meager data in this country on the prescription patterns of psychiatrists. Aim: To study the first prescription handed over to patients attending the psychiatry outpatient clinic of a tertiary care hospital. Materials and Methods: Data of all patients (for the period of January 1, 2009 to November 30, 2010; diagnosed with an ICD-10 diagnosis of F2-F4 were extracted from the computer-based registry and analyzed. Results: Ten thousand two hundred and fourteen (10 214 patients were diagnosed to have a diagnosis of F2-F4 ICD-10 category. In all diagnostic groups, olanzapine was the most commonly prescribed antipsychotic followed by risperidone. Very few patients (8% received typical antipsychotic medication. In all diagnostic groups, escitalopram was the most commonly prescribed antidepressant; other frequently prescribed antidepressants were sertraline, paroxetine, and venlafaxine. Among the mood stabilizers, valproate was preferred over lithium. In all the groups, more than half of the patients were prescribed benzodiazepines, clonazepam being the most commonly prescribed agent, followed by lorazepam. The mean number of psychotropic medications was highest in the bipolar disorder group. Very few patients received the combination of same group of drugs. Conclusions: Olanzapine, escitalopram, and clonazepam are the most commonly prescribed antipsychotic, antidepressants, and benzodiazepines, respectively. Valproate was preferred over lithium as a mood stabilizer. In general, the prescription trends were in accordance to the recommendations of various treatment guidelines, except for the use of benzodiazepines, which was higher.

  17. Sociodemographic Characteristics and Diagnoses of Individuals Referred to a Child and Adolescent Psychiatry Outpatient Clinic of a University Hospital

    Directory of Open Access Journals (Sweden)

    Sevcan Karakoç Demirkaya

    2015-04-01

    Full Text Available OBJECTIVE: The aim of this study is to evaluate the sociodemographic characteristics, complaints, and diagnoses of individuals who were admitted to a child and adolescent psychiatry outpatient clinic. MATERIALS AND METHODS: Medical charts of the patients who were admitted to the child and adolescent psychiatry unit of Adnan Menderes University between February 1st and July 31st, 2014 were retrospectively studied. RESULTS: The rate of girls and boys from a total of 832 cases who were referred to the child and adolescent psychiatry outpatient clinic in the six month period was 41.8% and 58.2%, respectively. The mean age of the girls and boys was 10.8±4.9 and 8.5±4.7 years, respectively. The most common age range was between 12 and 18 years. The proportion of patients who lived with both parents was 81.1%; however, the proportion of individuals brought in by institutional caregivers was 0.8%. The proportion of consanguineous marriages was 13.7%. The education level of mothers and fathers was mostly a primary school degree (47% and 45.6%, respectively. A positive psychiatric history was present in 13.7% of the mothers and 7.6% of the fathers. Reasons for child psychiatric assessments were as follows: 21.9% for disability report, 13.8% for forensic evaluation, 11.2% for consultation, and 52.9% for general psychiatric evaluation. Referral complaints were irritability/anger (15.7%, attention deficit/hyperactivity (14.8%, delay in speech (10.5%, fear/anxiety (5.9%, and poor school performance (5.7%. The diagnoses were as follows: attention deficit hyperactivity disorder (ADHD (20.6%, other disruptive behaviors (12.4%, and anxiety disorder (10.2%. CONCLUSION: We revealed that the most common referring complaint was irritability/anger and that the most common diagnosis was ADHD in our patient group, which was similar to previous studies. Our results showed that a low parental educational level and a positive history for parental psychopathology were

  18. Clinical-epidemiological features of HIV-infected patients diagnosed at age of 50 years or older

    Directory of Open Access Journals (Sweden)

    V Fink

    2012-11-01

    Full Text Available HIV/AIDS prevention and care efforts are directed to individuals of reproductive age (15–49 yrs. With the extension of sexual life of older people, they became a growing population at risk of HIV infection, usually not included in prevention strategies. In order to evaluate clinical profile of HIV/AIDS pts diagnosed at 50 yrs or older assisted in an HIV outpatient center in Buenos Aires, we retrospectively assessed clinical records of pts initiating care between Jan 1986 and Dec 2011. Age, CD4 cells and viral load (pVL at HIV diagnosis and most recent value, opportunistic infections (OIs, co-morbidities and antiretroviral therapy (ARV were recorded. Of 10,998 pts assisted in the 26-yr period, 495 (4.5% were≥50 yrs old at HIV diagnosis; median annual diagnoses: 18.5 (IQR 3.3–30.3 without significant changes in the last 20 yrs. Demographics: median age 54.7 yrs (IQR 51.8–59.2, rank 50–80, 76.6% male. Risk behavior: HTX 61.4%, MSM 34.1%, others 4.4%. 55.4% of HIV diagnoses occurred during hospitalization or simultaneously with acute OIs. One third (n=176 had AIDS at diagnosis, 24% had history of STDs. HCV co-infection 5.7%, past HBV infection 28.1% and chronic HBV infection 5.1%. Median CD4 cells at HIV diagnosis: 223.5 (13.7% (IQR 98.8–420.3, initial pVL 60,000 cp/mL (IQR 9,995.5–208,391. 69.3% of pts started ARV therapy during follow-up (FU, and the median time between diagnosis and treatment initiation was 3.4 mo (IQR 0.7–14; 56.9% of them started a non-nucleoside-based regimen (ZDV/3TC/EFV, 28.3% a PI-based regimen (ZDV/3TC/IDV and 14.6% a nucleoside-based regimen (ZDV/ddI pre-HAART era. After a year (±6 mo, 63.8% pts achieved undetectable pVL and gained 136 CD4 cells from BSL (IQR 83–204. After 40.6 mo of FU (IQR 6.7-89.8, 66.3% are alive, 7.1% died (68.6% of HIV-related diseases and 26.7% are lost to FU. Co-morbidities were present in 125 (25.3%, mainly hypertension, increased lipids, CVD and DBT. Among treated pts, 70

  19. Modifiable clinical and lifestyle factors are associated with elevated alanine aminotransferase levels in newly diagnosed type 2 diabetes patients

    DEFF Research Database (Denmark)

    Mor, Anil; Svensson, Elisabeth; Rungby, Jørgen; Ulrichsen, Sinna Pilgaard; Berencsi, Klara; Nielsen, Jens Steen; Stidsen, Jacob Volmer; Friborg, Søren; Brandslund, Ivan; Christiansen, Jens Sandahl; Beck-Nielsen, Henning; Sørensen, Henrik Toft; Thomsen, Reimar Wernich

    2014-01-01

    BACKGROUND: Current literature lacks data on markers of non-alcoholic fatty liver disease (NAFLD) in newly diagnosed type 2 diabetes mellitus (T2DM) patients. We therefore, conducted a cross-sectional study to examine modifiable clinical and lifestyle factors associated with elevated alanine...... aminotransferase (ALT) levels as a marker of NAFLD in new T2DM patients. METHODS: Alanine aminotransferase levels were measured in 1026 incident T2DM patients enrolled in the nationwide Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. We examined prevalence of elevated ALT (>38 IU/L for women....../>21 drinks per week for women/men) (aPR: 1.60, 95% CI: 1.03-2.50), and in those with no regular physical activity (aPR: 1.42, 95% CI: 1.04-1.93). Obesity and metabolic syndrome per se showed no association with elevated ALT when adjusted for other markers, whereas we found positive associations of ALT with...

  20. Birth Order and Sibling Gender Ratio of a Clinical Sample of Children and Adolescents Diagnosed with Attention Deficit Hyperactivity Disorder

    Directory of Open Access Journals (Sweden)

    Ahmad Ghanizadeh

    2012-09-01

    Full Text Available Objective: It is not clear whether sibling’s gender ratio is associated with attention deficit hyperactivity disorder (ADHD. This study examines whether inattentiveness severity and hyperactivity/impulsivity severity are associated with birth order of children with ADHD.Method: Participants are a clinical sample of 173 children and adolescents with ADHD and 43 ones without ADHD. Diagnoses were made using Diagnostic and Statistical Manual of Mental Disorders forth edition-Text Revision (DSM-IV-TR, diagnostic criteria according to face-to-face interview with the children and their parents. ADHD DSM-IV checklist was used to measure inattentiveness and hyperactivity/impulsivity scores.Results: The association of birth order and diagnosis of ADHD was not statistically significant after adjusting for covariate factors. The gender ratio of siblings is not associated with ADHD.Conclusion: Birth order and siblings gender ratio are independent of ADHD diagnosis. The results of this study support the fact that genetic factors rather than environmental factor of birth order is associated with ADHD. Moreover, contrary to autism, the current results do not suggest the androgen theory for ADHD.

  1. Evidence of zoonotic Poxviridae coinfections in clinically diagnosed papillomas using a newly developed mini-array test.

    Science.gov (United States)

    Scagliarini, Alessandra; Casà, Giovanni; Trentin, Bernadette; Gallina, Laura; Savini, Federica; Morent, Marine; Lavazza, Antonio; Puleio, Roberto; Buttaci, Calogera; Cannella, Vincenza; Purpari, Giuseppa; Di Marco, Patrizia; Piquemal, David; Guercio, Annalisa

    2016-01-01

    Our study describes a newly developed mini-array test for the rapid detection of poxviruses in animals and humans. The method is based on detection that combines target nucleic acid amplification by polymerase chain reaction and specific hybridization, using enzyme-linked antibodies, allowing identification of zoonotic orthopoxviruses and parapoxviruses in animal and human biological samples. With 100% specificity, the test rules out the possibility of cross-reactions with viral agents causing look-alike diseases. The assay was employed in the field to investigate the causes of several outbreaks of a malignant proliferative skin disease that affected domestic ruminants in Sicily during 2011-2014. Due to specific aspects of the lesions, the animals were clinically diagnosed with papillomatosis. The mini-array test allowed the identification of coinfections caused by more than 1 viral species belonging to the Parapoxvirus and Orthopoxvirus genera, either in goats or in cattle. Our study suggests that the so-called "papillomatosis" can be the result of multiple infections with epitheliotropic viruses, including zoonotic poxviruses that cannot be properly identified with classical diagnostic techniques. PMID:26699526

  2. Detection of serum amyloid-A concentration in the calf clinically diagnosed with pneumonia, enteritis and pneumoenteritis

    Directory of Open Access Journals (Sweden)

    Mustafa Kabu

    2016-02-01

    Full Text Available ABSTRACT: The aim of this study is to determine serum amyloid-A (SAA concentration in the cases of pneumonia, pneumoenteritis, and enteritis which are frequently encountered in calves in veterinary medicine. Although a great deal of experimental studies has been conducted in this field, studies on naturally infected calves are quite few. Eighty calves at the age of 0-6 months were used in the study and the calves were divided into four groups. Due to the clinical examination, the calves diagnosed with pneumonia (Group P; n=20, with pneumoenteritis (Group PE; n=20 and with enteritis (Group E; n=20 formed the disease group as the healthy ones formed the control (Group C; n=20 group. After the body temperatures of all calves were taken, blood samples were obtained from Jugular vein for haematological and biochemical measurements. As haematological, white blood cell (WBC, red blood cell (RBC, hemoglobin (Hb and hematocrit (Hct measurements were performed in Veterinary Hematology Analyzer. Serum amyloid-A (SAA, interleukin 1 (IL-1β, interleukin 6 (IL-6, tumor necrosis factor-α (TNF-α concentration measurements were carried out with ELISA reader by using commercial kits. Aspartate aminotransferase (AST, alanine aminotransferase (ALT, albumin (ALB, total bilirubin (T. Bil, total protein (TP, gamma glutamyltransferase (GGT, blood urea nitrogen (BUN concentration measurements were conducted in autoanalyzer by using commercial kits. In all disease groups (P, PE, and E body temperature, haematologic parameters (WBC, RBC, Hb and Hct, serum biochemical parameters (AST, ALT, ALB, T. Bil, TP, GGT and BUN, SAA concentration and serum concentrations of cytokines (IL-1β, IL-6 and TNF-α were determined to be higher in comparison to the control group (P<0.005. According to these findings, routine measurement of serum SAA concentration in veterinary medicine is considered to be beneficial in determining the severity of the disease, in selecting the proper

  3. Effects of metformin on markers of oxidative stress and antioxidant reserve in patients with newly diagnosed type 2 diabetes: A randomized clinical trial

    OpenAIRE

    Yu V Pankratova

    2012-01-01

    Реферат по статье: Effects of metformin on markers of oxidative stress and antioxidant reserve in patients with newly diagnosed type 2 diabetes: A randomized clinical trial Alireza Esteghamati, Delaram Eskandari, Hossein Mirmiranpour, Sina Noshad, Mostafa Mousavizadeh, Mehdi Hedayati, Manouchehr Nakhjavan//Clinical Nutrition xxx (2012) 1-7 Tehran, Iran

  4. 医学生辅助诊断能力的培养%Medical ethics education in clinic practice: Training medicos to envisage the effects of high- tech instruments in diagnoses of diseases

    Institute of Scientific and Technical Information of China (English)

    韦怀新; 蔡绍曦

    2005-01-01

    It belongs to the ethics that depending to much on high - tech instruments in diagnoses of diseases and overlooking medical examination and clinical history. In clinic educations, we should train medicos to envisage the effects of high - tech instruments in diagnoses of diseases, and strengthen their feeling of responsibihty and training of clinic basic shills.

  5. Discrepancies between clinical and autoptic diagnoses in Italy: evaluation of 879 consecutive cases at the "Policlinico of Bari" teaching hospital in the period 1990-2009

    Directory of Open Access Journals (Sweden)

    Sara Sblano

    2014-03-01

    Full Text Available INTRODUCTION: In spite of the benefits of autopsies, there has been in recent years a drastic decline in the number of autopsies performed, mainly due to an apparent unattractive cost-benefit ratio and fears of the medico-legal consequences. MATERIAL AND METHODS: A retrospective study was conducted on the reports of all the 879 consecutive autopsies performed at "Policlinico of Bari" from 1990 to 2009. RESULTS: All clinical diagnoses were compared with autopsy findings showing 558 concordant diagnoses (most of all neoplasms; 123 certain discordant diagnoses (69 of them with potential impact on survival, such as acute myocardial infarctions, pulmonary thromboembolisms, internal haemorrhages, surgery complications, aortic aneurism ruptures, and so on; 116 uncertain discrepant diagnoses; 82 unclear diagnoses. CONCLUSIONS: The rate of discrepancy allows the authors to hypothesize that a better diagnostic assessment could lead to a different outcome. In terms of risk-management this negative performance needs to be carefully analysed and requires a comprehensive audit of all services provided. In this sense, the authors underline the crucial importance of autopsy as an essential tool to address unresolved clinical questions and highlight previously undiagnosed medical conditions.

  6. The Clinical Course of Late Diagnosed Fatal Cases of A (H1N1 Influenza in Poland 

    Directory of Open Access Journals (Sweden)

    Marta Rorat

    2013-06-01

    Full Text Available Introduction: The most frequent complication of A (H1N1 influenza and the leading cause of death was pneumonia with a primary viral or mixed viral and bacterial etiology. 182 patients had died because of a pandemic influenza in Poland by 31st July 2010.Material and Methods: A retrospective study of 6 fatal cases of pandemic influenza, aged 23-41, including 3 women, hospitalised between November 2009 and February 2011 in different Polish medical centres.Results: We present the clinical course of 6 late diagnosed cases of A (H1N1 influenza. All patients presented typical flu-like symptoms in the beginning. 4/6 patients had severe disease risk factors: pregnancy, arthritis, Wegener granulomatosis and obesity. All patients were seen by doctors, no one had received antiviral therapy, 4/5 were treated with antibiotics before they were hospitalized. One patient had nosocomial infection. Patients were admitted to the hospital on the 3rd to 8th day of the disease. They received oseltamivir treatment on the 4th to 9th day. All patients developed pneumonia complicated by acute respiratory distress syndrome. Death appeared between the 4th and 27th day after the onset of symptoms. Autopsies were performed in 5 cases and revealed haemorrhagic pneumonia in 2 patients.Conclusion: Delayed diagnosis and antiviral treatment initiation has a significant impact on mortality in A (H1N1 influenza. During the influenza epidemic, patients presenting typical symptoms should always be suspected of having influenza. Antiviral treatment has to be initiated immediately, especially ifthere are risk factors of severe disease.

  7. Getting Diagnosed

    Science.gov (United States)

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

  8. Comparison of Rates of Death Having any Death-Certificate Mention of Heart, Kidney, or Liver Disease Among Persons Diagnosed with HIV Infection with those in the General US Population, 2009-2011

    OpenAIRE

    Whiteside, Y. Omar; Selik, Richard; An, Qian; Huang, Taoying; Karch, Debra; Hernandez, Angela L; Hall, H. Irene

    2015-01-01

    Objective : Compare age-adjusted rates of death due to liver, kidney, and heart diseases during 2009-2011 among US residents diagnosed with HIV infection with those in the general population. Methods : Numerators were numbers of records of multiple-cause mortality data from the national vital statistics system with an ICD-10 code for the disease of interest (any mention, not necessarily the underlying cause), divided into those 1) with and 2) without an additional code for HIV infection. Deno...

  9. Validity of a Farsi translation of the composite International Diagnostic Interview (CIDI to diagnose schizophrenia and bipolar disorder

    Directory of Open Access Journals (Sweden)

    H. Amini

    2006-08-01

    Full Text Available Background: The Composite International Diagnostic Interview (CIDI is a comprehensive, standardized diagnostic interview for the assessment of psychiatric disorders. There have been few studies on the validity of the CIDI. The objective of present study was to assess the validity of a Farsi translation of the complete CIDI and its psychosis/mania module in five referral clinical psychiatric settings. Methods: Two hundred and three as well as 104 consecutive admissions were interviewed using the complete and the psychosis/mania module, respectively. Within two days of the CIDI interview, two last year residents of psychiatry or psychiatrist who were blind to the CIDI diagnosis completed the Clinical diagnostic checklists (based on DSM-IV and ICD-10 criteria simultaneously and reached the consensus diagnosis. Data analysis was performed using SPSS 11 to determine the validity of CIDI. Results: The sensitivity and specificity for the diagnosis of schizophrenia was 0.12 and 0.96 using DSM-IV criteria. According to ICD-10 criteria, the results were the same with 0.19% sensitivity and 0.96% specificity. The sensitivity for the diagnosis of bipolar I disorder was low (0.21 using DSM-IV criteria and 0.17% using ICD-10 and specificity, high (0.90 compared to DSM-IV and 0.89 compared to ICD-10 criteria. The results were rather similar for the psychosis/mania module of CIDI. Conclusion: This study suggests that the Farsi translation of both the complete CIDI and the psychosis/mania module of CIDI have good specificity, but poor sensitivity for the diagnosis of schizophrenia and of bipolar I disorder.

  10. Validity of dementia diagnoses in the danish hospital registers

    DEFF Research Database (Denmark)

    Andersen, B.B.; Phung, T.K.T.; Høgh, P.;

    2007-01-01

    Background:The validity of dementia diagnoses in the Danish nationwide hospital registers was evaluated to determine the value of these registers in epidemiological research about dementia. Methods: Two hundred patients were randomly selected from 4,682 patients registered for the first time with a...... dementia diagnosis in the last 6 months of 2003. The patients' medical journals were reviewed to evaluate if they fulfilled ICD-10 and/or DSM-IV criteria for dementia and specific dementia subtypes. The patients who were still alive in 2006 were invited to an interview. Results: One hundred and ninety......-seven journals were available for review and 51 patients were interviewed. A registered diagnosis of dementia was found to be correct in 169 (85.8%) cases. Regarding dementia subtypes, the degree of agreement between the registers and the results of the validating process was low with a kappa of 0.36 (95% CI 0...

  11. How Is Muscular Dystrophy Diagnosed?

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2016-06-01

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

  13. Bulimia nervosa patient diagnosed with previously unsuspected ADHD in adulthood: clinical case report, literature review, and diagnostic challenges.

    Science.gov (United States)

    Ioannidis, Konstantinos; Serfontein, Jaco; Müller, Ulrich

    2014-05-01

    There is increasing literature suggesting a link between attention-deficit hyperactivity disorder (ADHD) and eating disorders (EDs), especially bulimia nervosa. ADHD is under-diagnosed in girls and children of high intelligence are typically missed. We identified a case of a 23-year-old woman suffering from severe bulimia nervosa and previously unsuspected ADHD in adulthood; we diagnosed and treated her with extended-release methylphenidate. We performed a literature review on the ADHD and bulimia nervosa comorbidity. We discuss the reasons why her ADHD remained undiagnosed and the difficulties in diagnosing ADHD in patients with EDs. We suggest that identifying comorbid ADHD is crucial for these patients and argue for the use of a structured interview, collateral history and investigation of onset of symptoms to establish a diagnosis of ADHD in adults with bulimia nervosa. Comorbidities and overlap of symptomatology need to be taken into account. PMID:24311027

  14. Most lobular carcinoma in situ and atypical lobular hyperplasia diagnosed on core needle biopsy can be managed clinically with radiologic follow-up in a multidisciplinary setting

    OpenAIRE

    Middleton, Lavinia P.; Sneige, Nour; Coyne, Robin; Shen, Yu; Dong, Wenli; Dempsey, Peter; Bevers, Therese B.

    2014-01-01

    We evaluated the efficacy of using standard radiologic and histologic criteria to guide the follow-up of patients with lobular carcinoma in situ (LCIS), lobular neoplasia (LN), or atypical lobular hyperplasia (ALH). Patients with high-risk benign lesions diagnosed on biopsy were presented and reviewed in a multidisciplinary clinical management conference from 1 November 2003 through September 2011. Associations between patient characteristics and rates of upgrade were determined by univariate...

  15. Lifestyle and clinical factors associated with elevated C-reactive protein among newly diagnosed Type 2 diabetes mellitus patients

    DEFF Research Database (Denmark)

    Svensson, Elisabeth; Mor, Anil; Rungby, Jørgen;

    2014-01-01

    BACKGROUND: We aimed to examine the prevalence of and modifiable factors associated with elevated C-reactive Protein (CRP), a marker of inflammation, in men and women with newly diagnosed Type 2 Diabetes mellitus (DM) in a population-based setting. METHODS: CRP was measured in 1,037 patients (57%...

  16. National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses with Clinical Reassessments

    Science.gov (United States)

    Kessler, Ronald C.; Avenevoli, Shelli; Green, Jennifer; Gruber, Michael J.; Guyer, Margaret; He, Yulei; Jin, Robert; Kaufman, Joan; Sampson, Nancy A.; Zaslavsky, Alan M.; Merikangas, Kathleen R.

    2009-01-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnoses that was based on the World Health Organization's Composite International Diagnostic Interview (CIDI) and implemented in the National comorbidity survey replication adolescent supplement is found to have good individual-level concordance with diagnosis based on blinded…

  17. Influenza-like-illness and clinically diagnosed flu: disease burden, costs and quality of life for patients seeking ambulatory care or no professional care at all.

    Directory of Open Access Journals (Sweden)

    Joke Bilcke

    Full Text Available This is one of the first studies to (1 describe the out-of-hospital burden of influenza-like-illness (ILI and clinically diagnosed flu, also for patients not seeking professional medical care, (2 assess influential background characteristics, and (3 formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011-2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever, a longer duration of illness, more use of medication (especially antibiotics and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5-6 symptoms over a 6-day period; required 1.6 physician visits and 86-91% took medication. An average episode amounted to €51-€53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries.

  18. Influenza-like-illness and clinically diagnosed flu: disease burden, costs and quality of life for patients seeking ambulatory care or no professional care at all.

    Science.gov (United States)

    Bilcke, Joke; Coenen, Samuel; Beutels, Philippe

    2014-01-01

    This is one of the first studies to (1) describe the out-of-hospital burden of influenza-like-illness (ILI) and clinically diagnosed flu, also for patients not seeking professional medical care, (2) assess influential background characteristics, and (3) formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011-2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever), a longer duration of illness, more use of medication (especially antibiotics) and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5-6 symptoms over a 6-day period; required 1.6 physician visits and 86-91% took medication. An average episode amounted to €51-€53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries. PMID:25032688

  19. Influenza-Like-Illness and Clinically Diagnosed Flu: Disease Burden, Costs and Quality of Life for Patients Seeking Ambulatory Care or No Professional Care at All

    Science.gov (United States)

    Bilcke, Joke; Coenen, Samuel; Beutels, Philippe

    2014-01-01

    This is one of the first studies to (1) describe the out-of-hospital burden of influenza-like-illness (ILI) and clinically diagnosed flu, also for patients not seeking professional medical care, (2) assess influential background characteristics, and (3) formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011–2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever), a longer duration of illness, more use of medication (especially antibiotics) and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5–6 symptoms over a 6-day period; required 1.6 physician visits and 86–91% took medication. An average episode amounted to €51–€53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries. PMID:25032688

  20. Diagnoses behind patients with hard-to-classify tremor and normal DaT-SPECT: A clinical follow up study

    Directory of Open Access Journals (Sweden)

    Manuel Menéndez-González

    2014-04-01

    Full Text Available The [123I]ioflupane - a dopamine transporter radioligand - SPECT (DaT-SPECT has proven to be useful in the differential diagnosis of tremor. Here, we investigate the diagnoses behind patients with hard-to-classify tremor and normal DaT-SPECT. Therefore, 30 patients with tremor and normal DaT-SPECT were followed up for 2 years. In 18 cases we were able to make a diagnosis. The residual 12 patients underwent a second DaT-SPECT, were then followed for additional 12 months and thereafter the diagnosis was reconsidered again. The final diagnoses included cases of essential tremor, dystonic tremor, multisystem atrophy, vascular parkinsonism, progressive supranuclear palsy, corticobasal degeneration, fragile X–associated tremor ataxia syndrome, psychogenic parkinsonism, iatrogenic parkinsonism and Parkinson’s disease. However, for 6 patients the diagnosis remained uncertain. Larger series are needed to better establish the relative frequency of the different conditions behind these cases.

  1. Comparando a Classificação Internacional de Doenças em Odontologia e Estomatologia (CID-OE com a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-10 Comparing the International Classification of Disease to Dentistry and Stomatology (ICD-DA and the International Statistical Classification of Diseases and Related Health Problems (ICD-10

    Directory of Open Access Journals (Sweden)

    Olga M. P. Silva

    2001-08-01

    Full Text Available INTRODUÇÃO: Nos estudos epidemiológicos de morbidade é necessário se adotar um sistema de classificação de doenças. Na odontologia e nos traumatismos buco-maxilo-faciais pode-se usar a Classificação Internacional de Doenças em Estomatologia e Odontologia (CID-OE mas, em alguns casos, esta classificação não é adequada. O objetivo deste estudo é comparar a aplicação da CID-OE com a aplicação da CID-10 na classificação de diagnósticos da área. MATERIAL E MÉTODOS: Foram analisados 2.372 casos atendidos em serviços de traumatismos buco-maxilo-faciais e emergências dentais no Município de São Paulo, Brasil, onde os diagnósticos encontrados foram codificados por ambas as classificações. RESULTADOS: A CID-OE especificou melhor 1.117 casos mas, em 267, não ofereceu possibilidade de codificação. Em 978 casos, o detalhamento dado pela codificação foi o mesmo em ambas as classificações.INTRODUCTION: Adopting a classification system of diseases is necessary to perform epidemiological studies of morbidity. In oral and maxillo-facial injuries and in dentistry we may use the International Classification of Diseases for Dentistry and Stomatology (ICD-DA, but the classification is not always appropriate. The objective of the study is to compare the accuracy of the ICD-DA to the International Classification of Diseases-10th Revision (ICD-10 in the classification of diagnoses. MATERIAL AND METHODS: 2,372 encounters were analyzed in oral and maxillo-facial care and in dental emergency services, in the city of São Paulo, Brazil. The encounters were codified by both classifications. RESULTS: 1,117 cases were better classified by the dental classification, but in 267 cases the ICD-DA does not offer a code. In 978 cases the details were the same in both classifications.

  2. Typology of adults diagnosed with mental disorders based on socio-demographics and clinical and service use characteristics

    OpenAIRE

    Perreault Michel; Bamvita Jean-Marie; Grenier Guy; Fleury Marie-Josée; Jean-Caron,

    2011-01-01

    Abstract Background Mental disorder is a leading cause of morbidity worldwide. Its cost and negative impact on productivity are substantial. Consequently, improving mental health-care system efficiency - especially service utilisation - is a priority. Few studies have explored the use of services by specific subgroups of persons with mental disorder; a better understanding of these individuals is key to improving service planning. This study develops a typology of individuals, diagnosed with ...

  3. Retrospective Analysis of Discrepancies between Clinical and Histopathological Diagnoses in Head and Neck Lesions: An Institutional Study with 10 Years Database

    Directory of Open Access Journals (Sweden)

    Ketki P Kalele

    2016-01-01

    Full Text Available Introduction: Oral and maxillofacial lesions present a wide spectrum of clinical manifestations ranging from an asympto - matic small lesion to a large destructive one. Several lesions mimic each other in their clinical presentation posing a diag - nostic dilemma. Due to interoperator subjectivity and lack of defined objective diagnostic criteria, histopathological investi - gation, most of the times, plays a vital role in final diagnosis. Many studies have reported the concordance rates among the clinical and histopathological diagnoses of oral lesions, however, there are very few studies which have highlighted the discrepancies in them that have led to drastic changes in the lines of diagnoses and treatment. This institutional retro - spective descriptive study intended to highlight this lacuna by going through histopathological registry to study such cases with discrepancies in clinical and histopathological diagnoses in last 10 years. The aim of this study was to systematically analyze the discrepancies in clinical and histopathological diagnoses of various oral lesions with an emphasis on malig - nant and nonmalignant groups so as to stress the importance of histopathological examination to ultimately minimize the risk of inadvertent inappropriate treatment. Materials and methods: A total of 1570 cases that were reported to our institute over a period of 10 years were evaluated from the histopathology registry. Out of these, 1300 cases met our inclusion criteria. Discrepancies were charted as major and minor discrepancies and discrepancy indices were calculated. Lesions were divided into malignan t and nonmalignant groups and were subjected to d i agnostic-screening test evaluation to assess the discrepancies. Results: Total discrepancy value (discrepancy index obtained was 12.9%, out of which 9.23% showed major discrepancies and 3.69% showed minor discrepancies. Ninety-five percent confidence interval (CI was calculated, and was found in

  4. Validity and clinical feasibility of the ADHD rating scale (ADHD-RS) A Danish Nationwide Multicenter Study

    DEFF Research Database (Denmark)

    Szomlaiski, N; Dyrborg, J; Rasmussen, H;

    2008-01-01

    clinical standards. The HKD children were rated by parents and teachers at baseline and at follow-up 3 months later. Results: Internal validity of ADHD-RS was high and the factor structure supported the diagnostic classification system ICD-10. The questionnaire discriminated HKD patients in a mixed...

  5. Evaluation of NANDA nursing diagnoses of healthcare college final year students during the clinical application of the mental health and disease nursing course

    Directory of Open Access Journals (Sweden)

    Gülay Taşdemir

    2013-01-01

    Full Text Available The aim of this descriptive study was to evaluate the NANDA nursing diagnoses of Pamukkale University Denizli Healthcare College final year students for the patients they undertook the care of and to determine the aims and interventions relevant to these diagnoses.The study universe consisted of all Pamukkale University Denizli Healthcare College final year students who were continuing their education during the 2009-2010 educational year and took the Mental Health and Disease Nursing course (84. The universe was studied before selecting a sample. The internal medicine, surgery, cardiovascular surgery, chest disease, orthopedics-urology, and physical treatment and rehabilitation clinics were chosen for the consultation liaison psychiatry (CLP while the AMATEM Center of the Denizli State Hospital and the Pamukkale University Psychiatry clinics were chosen as the student clinical application areas. The data were collected by evaluating the 136 nursing care plans prepared by the students and the data collection forms the students had used for nursing care during the 2009-2010 autumn semester. The nursing care was evaluated according to the symptom, etiology and problem (SEP format, using the diagnostic list containing the NANDA diagnoses that had previously been provided to the students, and the number and percentage distributions were determined.The patients cared for at the CLP clinics by the students included in the study had been admitted for surgical interventions at a rate of 29.8% and cancer at 28.6% while those in the psychiatry clinics had been admitted for psychosis or alcohol-substance abuse at a rate of 16.7%. The students included in the study had determined 36 nursing diagnoses in 136 cases. The 6 most common diagnoses were infection risk at 34.5%, disturbance of sleep pattern at 33.3%, anxiety at 25.0%, activity intolerance at 20.2%, inadequate personal coping at 16.7% and trauma risk at 13.1% at the CLP clinics, and disturbed sleep

  6. Profile of neurological disorders in an adult neurology clinic in Kumasi, Ghana

    Science.gov (United States)

    Sarfo, Fred Stephen; Akassi, John; Badu, Elizabeth; Okorozo, Aham; Ovbiagele, Bruce; Akpalu, Albert

    2016-01-01

    Background Although the burden of neurological disorders is highest among populations in developing countries there is a dearth of data on the clinical spectrum of these disorders. Objective To profile the frequency of neurologic disorders and basic demographic data in an adult neurology out-patient service commissioned in 2011 in Kumasi, Ghana. Methods The study was conducted at the neurology clinic of the Komfo Anokye Teaching Hospital in Kumasi, Ghana. Over a three year period, all medical records of patients enrolled at the out-patient neurology clinic was reviewed by a neurologist and neurological diagnoses classified according to ICD-10. Results 1812 adults enrolled for care in the neurology out-patient service between 2011 and 2013. This comprised of 882 males and 930 females (male: female ratio of 1.0: 1.1) with an overall median age of 54 (IQR, 39–69) years. The commonest primary neurological disorders seen were strokes, epilepsy and seizure disorders, and movement disorders at frequencies of 57.1%, 19.8%, and 8.2% respectively. Conclusions Cerebrovascular diseases, epilepsy and movement disorders were among the commonest neurological disorders and the major contributors to neurologic morbidity among Ghanaians in an urban neurology clinic. PMID:27110596

  7. Discrepancias entre diagnósticos clínicos y hallazgos de autopsia Discrepancies between clinical diagnoses and autopsy findings

    Directory of Open Access Journals (Sweden)

    María Virginia Bürgesser

    2011-04-01

    Full Text Available El objetivo principal del presente trabajo fue identificar las discrepancias clínico-patológicas en las autopsias realizadas en la institución. Se revisaron 53 autopsias de casos clínicos en adultos en el período comprendido entre enero de 2005 y junio de 2009, realizadas en el servicio de Anatomía Patológica del Hospital Privado de Córdoba, Argentina. Se excluyeron seis debido a información insuficiente. Se aplicó la clasificación de Goldman y col. para establecer las discrepancias clínico-patológicas entre los diagnósticos pre y post-mortem. Los diagnósticos clínicos más frecuentes fueron las infecciones respiratorias y el tromboembolismo pulmonar agudo. Los hallazgos de autopsia más frecuentes fueron las infecciones respiratorias y el infarto agudo de miocardio. Se detectaron 17 discrepancias mayores y 30 concordancias, no se detectaron discrepancias menores. Las infecciones respiratorias fueron la principal causa de error, seguidas por el infarto agudo de miocardio. Concluimos que en 17/47 (37% de los casos se realizó un diagnóstico clínico diferente al post-mortem, y que las infecciones respiratorias constituyen el principal tipo de error. Se sugiere adoptar estrategias informativas y educativas, revalorizar la autopsia y las prácticas clínicas tradicionales.The main objective of this study was to identify the clinical-pathological discrepancies in autopsies performed in the institution. We reviewed autopsies of clinical cases in 53 adults in the period between January 2005 and June 2009, carried out in the Pathology Service at the Hospital Privado de Córdoba, Argentina. Six autopsies were excluded due to insufficient information. The Goldman et al. classification was applied to establish clinico-pathologic discrepancies between clinical diagnoses and autopsy findings. Frequently clinical diagnoses were respiratory infections and acute pulmonary embolism. The most frequently reported postmortem diagnoses were

  8. Minding the body: situating gender identity diagnoses in the ICD-11.

    Science.gov (United States)

    Drescher, Jack; Cohen-Kettenis, Peggy; Winter, Sam

    2012-12-01

    The World Health Organization (WHO) is in the process of revising the International Statistical Classification of Diseases and Related Health Problems (ICD) and ICD-11 has an anticipated publication date of 2015. The Working Group on the Classification of Sexual Disorders and Sexual Health (WGSDSH) is charged with evaluating clinical and research data to inform the revision of diagnostic categories related to sexuality and gender identity that are currently included in the mental and behavioural disorders chapter of ICD-10, and making initial recommendations regarding whether and how these categories should be represented in the ICD-11. The diagnostic classification of disorders related to (trans)gender identity is an area long characterized by lack of knowledge, misconceptions and controversy. The placement of these categories has shifted over time within both the ICD and the American Psychiatric Association's Diagnostic and Statistical Manual (DSM), reflecting developing views about what to call these diagnoses, what they mean and where to place them. This article reviews several controversies generated by gender identity diagnoses in recent years. In both the ICD-11 and DSM-5 development processes, one challenge has been to find a balance between concerns related to the stigmatization of mental disorders and the need for diagnostic categories that facilitate access to healthcare. In this connection, this article discusses several human rights issues related to gender identity diagnoses, and explores the question of whether affected populations are best served by placement of these categories within the mental disorders section of the classification. The combined stigmatization of being transgender and of having a mental disorder diagnosis creates a doubly burdensome situation for this group, which may contribute adversely to health status and to the attainment and enjoyment of human rights. The ICD-11 Working Group on the Classification of Sexual Disorders and

  9. Preliminary study of the value of clinical applications of superparamagnetic iron oxide in diagnosing small lesions of liver

    International Nuclear Information System (INIS)

    Objective: To evaluate the value of Feridex in demonstrating small focal lesions of the liver on MRI and to discuss the optimal scan time after intravenous administration of Feridex. Methods: Small focal lesions in the liver were found on ultrasound or CT in 17 patients. Conventional MR plain scan and Gd-DTPA enhanced scan were performed. One to three days later, T2 weighted imaging was repeated at 0.5 h, 3 h and 6 h after Feridex was administered intravenously over 30-40 min at a dose of 0.05 ml/kg. The pre- and post-contrast T2WI were compared and analyzed in terms of lesion detectability and signal change. Results: Twenty-one lesions with diameter smaller than 1 cm were found on the Feridex enhanced images, and only 8 lesions were found on the conventional MR images. The small hepatic cancers, focal nodular hyperplasia (FNH), and regenerated nodules had different signal changes on the Feridex images, which made the differential diagnoses easier. The signal of the liver decreased significantly (P 0.05). Conclusion: Fridex enhanced MR images could not only improve the detection of small focal lesions, but also provide evidence for differential diagnoses

  10. Personality Trait Differences in Boys and Girls with Clinical or Sub-Clinical Diagnoses of Conduct Disorder versus Antisocial Personality Disorder

    Science.gov (United States)

    Taylor, Jeanette; Iacono, William G.

    2007-01-01

    This study tested differences in personality traits measured by the Multidimensional Personality Questionnaire (MPQ) in a community sample of adolescents with definite or probable conduct disorder (CD) diagnoses that did not progress to a diagnosis of antisocial personality disorder (ASPD) by early adulthood (n=43), those with definite or probable…

  11. Role of Physical Therapists in the Management of Individuals at Risk for or Diagnosed With Venous Thromboembolism: Evidence-Based Clinical Practice Guideline.

    Science.gov (United States)

    Hillegass, Ellen; Puthoff, Michael; Frese, Ethel M; Thigpen, Mary; Sobush, Dennis C; Auten, Beth

    2016-02-01

    The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular & Pulmonary and Acute Care sections of APTA, have developed this clinical practice guideline to assist physical therapists in their decision-making process when treating patients at risk for venous thromboembolism (VTE) or diagnosed with a lower extremity deep vein thrombosis (LE DVT). No matter the practice setting, physical therapists work with patients who are at risk for or have a history of VTE. This document will guide physical therapist practice in the prevention of, screening for, and treatment of patients at risk for or diagnosed with LE DVT. Through a systematic review of published studies and a structured appraisal process, key action statements were written to guide the physical therapist. The evidence supporting each action was rated, and the strength of statement was determined. Clinical practice algorithms, based on the key action statements, were developed that can assist with clinical decision making. Physical therapists, along with other members of the health care team, should work to implement these key action statements to decrease the incidence of VTE, improve the diagnosis and acute management of LE DVT, and reduce the long-term complications of LE DVT. PMID:26515263

  12. Patients’ and partners’ illness perceptions in screen-detected versus clinically diagnosed type 2 diabetes: partners matter!

    NARCIS (Netherlands)

    Klein Woolthuis, E.P.; Grauw, W.J.C. de; Cardol, M.; Weel, C. van; Metsemakers, J.F.M.; Biermans, M.C.J.

    2013-01-01

    Background. In type 2 diabetes, educational interventions that target differences between patients’ and partners’ illness perceptions have been advocated. Objective. To investigate how the route to diagnosis of type 2 diabetes (through screening versus clinical symptoms) affects illness perceptions

  13. A Review of the Clinical Outcomes for Patients Diagnosed with Brainstem Metastasis and Treated with Stereotactic Radiosurgery

    OpenAIRE

    Lamm, Andrew F.; Elaimy, Ameer L.; Lamoreaux, Wayne T.; Mackay, Alexander R.; Fairbanks, Robert K.; Demakas, John J.; Barton S. Cooke; Lee, Christopher M.

    2013-01-01

    Only 3%–5% of all brain metastases are located in the brainstem. We present a comprehensive review of the clinical outcomes from modern studies that treated patients with brainstem metastasis using either a Gamma Knife or a linear accelerator-based stereotactic radiosurgery. The median survival time of patients was compared to better understand what clinical or treatment factors are predictive of improved survival. This information can then be utilized to optimize patient care. The data sugge...

  14. Personality Trait Differences in Boys and Girls with Clinical or Sub-clinical Diagnoses of Conduct Disorder Versus Antisocial Personality Disorder

    OpenAIRE

    Taylor, Jeanette; Iacono, William G.

    2006-01-01

    This study tested differences in personality traits measured by the Multidimensional Personality Questionnaire (MPQ) in a community sample of adolescents with definite or probable conduct disorder (CD) diagnoses that did not progress to a diagnosis of antisocial personality disorder (ASPD) by early adulthood (n = 43), those with definite or probable ASPD that persisted into early adulthood (n = 68), or controls with neither a CD nor an ASPD diagnosis (n = 716) to examine whether antisocial be...

  15. Early weaning and hospitalization with alcohol-related diagnoses in adult life

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M;

    2006-01-01

    OBJECTIVE: This study attempted to determine whether lack of breast-feeding or a short duration of breast-feeding during infancy is associated with an elevated risk of hospitalization with alcohol-related diagnoses in adult life. METHOD: The study was a prospective longitudinal birth cohort design...... conducted in a sample of 6,562 men and women, all of whom were born in Copenhagen, Denmark, between October 1959 and December 1961. The sample was divided into two categories based on duration of breast-feeding, as assessed by a physician interview with mothers at a 1-year examination. Psychiatric...... hospitalizations with alcohol-related diagnoses according to ICD-8 or ICD-10 were identified in the Danish Psychiatric Central Register in 1999. Nine potential confounders were included as covariates: gender of the cohort member, maternal age, parental social status, maternal prenatal smoking, unwanted pregnancy...

  16. Lymphography and computed tomography of abdominal nodes in newly diagnosed patients with Hodgkin's disease in clinical stage I-III

    Energy Technology Data Exchange (ETDEWEB)

    Neumann, C.H.

    1986-10-01

    Between 1978 and 1983, 80 patients with Hodgkin's disease (HD) in clinical Stage I-III had computed tomography (CT) of the abdomen and pelvis and lymphography (LAG) prior to staging laparatomy with multiple lymph node biopsies at Stanford University Medical Center. There were 224 biopsied nodal sites. The sensitivity and specificity for CT to determine the status of biopsied paraortic and iliac nodes was .61 and .91 vs. .94 and .90 for LAG. CT appeared of even lower sensitivity (.13) in evaluating splenic hilar, celiac axis and portal nodes. Including all biopsy proven subdiaphragmatic nodal sites, CT's sensitivity to diagnose the presence of subdiaphragmatic adenopathy was .38 vs. .52 in LAG. Assessment of the final pathological stage was more successful by LAG (.61) than by CT (.49). Positive and negative predictive values of both tests indicate higher reliability of LAG results as regards individual intraabdominal nodes (LAG .71, .98 vs. CT .58, .86), the entire subdiaphragmatic nodal area (LAG .79, .77 vs. CT .61, .71) and prediction of final pathological stage. LAG appeared to be the more useful test during initial staging of newly diagnosed and untreated patients with HD. None of the test for itself or in combination can replace laparatomy when exact information is necessary for further clinical decisions.

  17. Prevalence and progression of visual impairment in patients newly diagnosed with clinical type 2 diabetes: a 6-year follow up study

    Directory of Open Access Journals (Sweden)

    Almind Gitte

    2011-02-01

    Full Text Available Abstract Background Many diabetic patients fear visual loss as the worst consequence of diabetes. In most studies the main eye pathology is assigned as the cause of visual impairment. This study analysed a broad range of possible ocular and non-ocular predictors of visual impairment prospectively in patients newly diagnosed with clinical type 2 diabetes. Methods Data were from a population-based cohort of 1,241 persons newly diagnosed with clinical, often symptomatic type 2 diabetes aged ≥ 40 years. After 6 years, 807 patients were followed up. Standard eye examinations were done by practising ophthalmologists. Results At diabetes diagnosis median age was 65.5 years. Over 6 years, the prevalence of blindness (visual acuity of best seeing eye ≤ 0.1 rose from 0.9% (11/1,241 to 2.4% (19/807 and the prevalence of moderate visual impairment (> 0.1; Conclusions In a comprehensive assessment of predictors of visual impairment, even in a health care system allowing self-referral to free eye examinations, treatable eye pathologies such as DR and cataract emerge together with age as the most notable predictors of continued visual loss after diabetes diagnosis. Our results underline the importance of eliminating barriers to efficient eye care by increasing patients' and primary care practitioners' awareness of the necessity of regular eye examinations and timely surgical treatment.

  18. Most lobular carcinoma in situ and atypical lobular hyperplasia diagnosed on core needle biopsy can be managed clinically with radiologic follow-up in a multidisciplinary setting

    International Nuclear Information System (INIS)

    We evaluated the efficacy of using standard radiologic and histologic criteria to guide the follow-up of patients with lobular carcinoma in situ (LCIS), lobular neoplasia (LN), or atypical lobular hyperplasia (ALH). Patients with high-risk benign lesions diagnosed on biopsy were presented and reviewed in a multidisciplinary clinical management conference from 1 November 2003 through September 2011. Associations between patient characteristics and rates of upgrade were determined by univariate and multivariate logistic models, and times to diagnosis carcinoma were calculated. Of 853 cases reviewed, 124 (14.5%) were lobular neoplasms. In all, 104 patients were clinically and/or radiographically monitored. In 20 patients, who were found to have LN on core biopsy and were recommended to have immediate surgical excision, a more significant lesion was identified in 8 (40%) of the excised specimens. Factors associated with a more significant lesion on excisional biopsy included whether the lobular lesion had been targeted for biopsy and whether the extent of disease involved three or more terminal duct lobular units. Of the 104 patients radiographically and clinically monitored, the median follow-up time was 3.4 years with a range of 0.44–8.6 years. Five patients under surveillance were subsequently diagnosed with breast malignancy (three of the five at a site unrelated to the initial biopsy). Patients with incidental lobular lesions identified on percutaneous core needle biopsy have a small risk of upgrade and may not require an excisional biopsy. Clinical management of low-volume lobular lesions in a multidisciplinary setting is an efficacious alternative to surgical excision when radiologic and histologic characteristics are well-defined

  19. “ STUDY OF COAGULATION PROFILE IN CLINICALLY DIAGNOSED CASES OF ACUTE DISSEMINATED INTRAVASCULAR COAGULATION USING ISTH CRITERIA

    Directory of Open Access Journals (Sweden)

    Chopade

    2013-10-01

    Full Text Available Disseminated Intravascular Coagulation (DIC is a pathological activation of coagulation (blood clotting mechanisms that happens in response to a variety of diseases. It involves the generation of intravascular fibrin (small blood c lots and the consumption of pro - coagulants and platelets. It results in the disruption of normal coagulation mechanism and abnormal bleeding occurs from the skin, the gastrointestinal tract, the respiratory tract and surgical wounds. It was the prospecti ve study of 60 patients of acute DIC, in which coagulation profile were studied from December 2010 to October 2012 . 40 controls were studied. Control group include healthy voluntary blood donors. The coagulation profile was studied and DIC scoring was p erformed using the International Society on Thrombosis and Haemostasis [ISTH] criteria. Among the coagulation profile, the sensitivity and specificity of the parameters to diagnose and to assess the severity of DIC, in the decreasing order of frequency wer e of platelet count, D - dimer, PT and APTT. Fibrinogen level was not depleted below the significant level (<1 gm/l in majority cases of DIC. According to the ISTH criteria, DIC scores among cases was ≥ 5.

  20. Recognising domestic violence in clinical practice using the diagnoses of posttraumatic stress disorder, depression and low self-esteem

    Science.gov (United States)

    Duxbury, Fiona

    2006-01-01

    This discussion paper reviews the health impacts, physical and mental, of domestic violence and explores the link between domestic violence and psychological symptoms. This paper focuses more on posttraumatic stress disorder (PTSD) than depression and low self-esteem because doctors are less familiar with PTSD. The barriers preventing health workers from detecting domestic violence are reviewed and the fear of health professionals that asking about trauma can harm patients is explored. The article then outlines practical strategies to improve detection of domestic violence using patients' presenting psychological symptoms and the diagnoses frequently associated with domestic violence namely, PTSD, depression and low self-esteem. It is argued that it is inadvisable to try to implement a policy of screening for domestic violence in general practice when the public health model is currently inappropriate. The paper discusses why the diagnostic frameworks of depression and PTSD are helpful in general practice, not only in detecting domestic violence but in working with the patient to establish trust and ways forward that can be tailored to meet the needs of the patient and their children. Patients' and professionals' dilemmas about what to do once domestic violence is detected are briefly explored. PMID:16611520

  1. Utilization of Gene Mapping and Candidate Gene Mutation Screening for Diagnosing Clinically Equivocal Conditions:A Norrie Disease Case Study

    Institute of Scientific and Technical Information of China (English)

    Vasiliki Chini; Danai Stambouli; Florina Mihaela Nedelea; George Alexandru Filipescu; Diana Mina; Marios Kambouris; Hatem El-Shanti

    2014-01-01

    Prenatal diagnosis was requested for an undiagnosed eye disease showing X-linked inheritance in a family. No medical records existed for the affected family members..Mapping of the X chromosome and candidate gene mutation screening i-dentified a c.C267A[p.F89L] mutation in NPD previously de-scribed as possibly causing Norrie disease..The detection of the c.C267A[p.F89L] variant in another unrelated family con-firms the pathogenic nature of the mutation for the Norrie dis-ease phenotype. Gene mapping, haplotype analysis, and can-didate gene screening have been previously utilized in research applications but were applied here in a diagnostic setting due to the scarcity of available clinical information..The clinical diagnosis and mutation identification were critical for provid-ing proper genetic counseling and prenatal diagnosis for this family.

  2. Self-reported and clinically diagnosed dental needs among institutionalized adults in Vijayawada: A cross-sectional study

    OpenAIRE

    Naidu, Guntipalli M.; Reddy, Vishnuvardhan B; Kandregula, Chaitanya Ram; Satti, Narayana Reddy; Allareddy, Swapna; Babu, Ravisekhar P

    2014-01-01

    Background: Frail and functionally dependent elderly people, living in institutions, have difficulties in accessing dental care. Hence, the present study aims to determine the relationship between subjective need and the equivalent clinical findings in an attempt to understand the factors that contribute to individual's perception of the need for dental care among institutionalized adults in Vijayawada. Materials and Methods: A cross-sectional study is conducted in all old age homes in Vijaya...

  3. Self – perceived and clinically diagnosed dental and periodontal health status among young adults and their implications for epidemiological surveys

    Directory of Open Access Journals (Sweden)

    Sgan-Cohen Harold D

    2003-07-01

    Full Text Available Abstract Background Clinical (normative and subjective (self-assessment evaluation of caries and periodontal diseases have been reported to demonstrate a significant disparity. The dental public health team is obligated to recognize and understand this gap. The objectives of the study were to investigate the practical values of using questionnaires (self–perceived assessment as compared to clinical examinations (normative assessment and to evaluate the implications of the results in understanding the public's perception of oral health. Methods The investigation was performed on 4920, 21 year-old Israeli adults upon release from compulsory military service between 1996 and 1998. Participants were asked to fill in a questionnaire inquiring how they would rate their personal dental and periodontal health levels. Clinical examinations, employing the DMFT and CPITN indices, were performed to determine normative oral health status. Perceived and normative assessments were compared for sensitivity, specificity, positive and negative predictive values and overall proportions using the clinical examinations as a gold standard. Results The sensitivity (disease perception for dental status was found to be 0.34, while the specificity (health perception was found to be 0.83. The positive predictive value for perceived dental status was found to be 0.68, whereas the negative predictive value was found to be 0.54. The sensitivity for perceived periodontal status was found to be 0.28, while the specificity was found to be 0.83. The positive predictive value for perceived periodontal status was found to be 0.05, whereas the negative predictive value was found to be 0.97. Regarding the overall proportions, a large discrepancy was found between self–assessment and professional assessment for both dental and periodontal health status. Conclusions Self-assessment questionnaires were of low value in evaluating oral health status both in the individual and public

  4. Typology of adults diagnosed with mental disorders based on socio-demographics and clinical and service use characteristics

    Directory of Open Access Journals (Sweden)

    Perreault Michel

    2011-04-01

    Full Text Available Abstract Background Mental disorder is a leading cause of morbidity worldwide. Its cost and negative impact on productivity are substantial. Consequently, improving mental health-care system efficiency - especially service utilisation - is a priority. Few studies have explored the use of services by specific subgroups of persons with mental disorder; a better understanding of these individuals is key to improving service planning. This study develops a typology of individuals, diagnosed with mental disorder in a 12-month period, based on their individual characteristics and use of services within a Canadian urban catchment area of 258,000 persons served by a psychiatric hospital. Methods From among the 2,443 people who took part in the survey, 406 (17% experienced at least one episode of mental disorder (as per the Composite International Diagnostic Interview (CIDI in the 12 months pre-interview. These individuals were selected for cluster analysis. Results Analysis yielded four user clusters: people who experienced mainly anxiety disorder; depressive disorder; alcohol and/or drug disorder; and multiple mental and dependence disorder. Two clusters were more closely associated with females and anxiety or depressive disorders. In the two other clusters, males were over-represented compared with the sample as a whole, namely, substance abuses with or without concomitant mental disorder. Clusters with the greatest number of mental disorders per subject used a greater number of mental health-care services. Conversely, clusters associated exclusively with dependence disorders used few services. Conclusion The study found considerable heterogeneity among socio-demographic characteristics, number of disorders, and number of health-care services used by individuals with mental or dependence disorders. Cluster analysis revealed important differences in service use with regard to gender and age. It reinforces the relevance of developing targeted programs

  5. Validity of Diagnostic Codes and Prevalence of Physician-Diagnosed Psoriasis and Psoriatic Arthritis in Southern Sweden – A Population-Based Register Study

    OpenAIRE

    Löfvendahl, Sofia; Theander, Elke; Svensson, Åke; Steen Carlsson, Katarina; Englund, Martin; Petersson, Ingemar

    2014-01-01

    Objective To validate diagnostic codes for psoriasis and psoriatic arthritis (PsA) and estimate physician-diagnosed prevalence of psoriasis and PsA in the Skåne region, Sweden. Methods In the Skåne Healthcare Register (SHR), all healthcare consultations are continuously collected for all inhabitants in the Skåne region (population 1.2 million). During 2005–2010 we identified individuals with ≥1 physician-consultations consistent with psoriasis (ICD-10). Within this group we also identified th...

  6. Patient perspectives on the experience of being newly diagnosed with HIV in the emergency department/urgent care clinic of a public hospital.

    Directory of Open Access Journals (Sweden)

    Katerina A Christopoulos

    Full Text Available We sought to understand patient perceptions of the emergency department/urgent care (ED/UC HIV diagnosis experience as well as factors that may promote or discourage linkage to HIV care. We conducted in-depth interviews with patients (n=24 whose HIV infection was diagnosed in the ED/UC of a public hospital in San Francisco at least six months prior and who linked to HIV care at the hospital HIV clinic. Key diagnosis experience themes included physical discomfort and limited functionality, presence of comorbid diagnoses, a wide spectrum of HIV risk perception, and feelings of isolation and anxiety. Patients diagnosed with HIV in the ED/UC may not have their desired emotional supports with them, either because they are alone or they are with family members or friends to whom they do not want to immediately disclose. Other patients may have no one they can rely on for immediate support. Nearly all participants described compassionate disclosure of test results by ED/UC providers, although several noted logistical issues that complicated the disclosure experience. Key linkage to care themes included the importance of continuity between the testing site and HIV care, hospital admission as an opportunity for support and HIV education, and thoughtful matching by linkage staff to a primary care provider. ED/UC clinicians and testing programs should be sensitive to the unique roles of sickness, risk perception, and isolation in the ED/UC diagnosis experience, as these things may delay acceptance of HIV diagnosis. The disclosure and linkage to care experience is crucial in forming patient attitudes towards HIV and HIV care, thus staff involved in disclosure and linkage activities should be trained to deliver compassionate, informed, and thoughtful care that bridges HIV testing and treatment sites.

  7. How Many Samples and How Many Culture Media To Diagnose a Prosthetic Joint Infection: a Clinical and Microbiological Prospective Multicenter Study.

    Science.gov (United States)

    Bémer, Pascale; Léger, Julie; Tandé, Didier; Plouzeau, Chloé; Valentin, Anne Sophie; Jolivet-Gougeon, Anne; Lemarié, Carole; Kempf, Marie; Héry-Arnaud, Geneviève; Bret, Laurent; Juvin, Marie Emmanuelle; Giraudeau, Bruno; Corvec, Stéphane; Burucoa, Christophe

    2016-02-01

    Although numerous perioperative samples and culture media are required to diagnose prosthetic joint infection (PJI), their exact number and types have not yet been definitely determined with a high level of proof. We conducted a prospective multicenter study to determine the minimal number of samples and culture media required for accurate diagnosis of PJI. Over a 2-year period, consecutive patients with clinical signs suggesting PJI were included, with five perioperative samples per patient. The bacteriological and PJI diagnosis criteria were assessed using a random selection of two, three, or four samples and compared with those obtained using the recommended five samples (references guidelines). The results obtained with two or three culture media were then compared with those obtained with five culture media for both criteria. The times-to-positivity of the different culture media were calculated. PJI was confirmed in 215/264 suspected cases, with a bacteriological criterion in 192 (89%). The PJI was monomicrobial (85%) or polymicrobial (15%). Percentages of agreement of 98.1% and 99.7%, respectively, for the bacteriological criterion and confirmed PJI diagnosis were obtained when four perioperative samples were considered. The highest percentages of agreement were obtained with the association of three culture media, a blood culture bottle, a chocolate agar plate, and Schaedler broth, incubated for 5, 7, and 14 days, respectively. This new procedure leads to significant cost saving. Our prospective multicenter study showed that four samples seeded on three culture media are sufficient for diagnosing PJI. PMID:26637380

  8. Clinical Value of MRI in Diagnosing Spinal form of Multiple Sclerosis%MRI在脊髓型多发性硬化中的临床价值

    Institute of Scientific and Technical Information of China (English)

    刘红民; 汪桦; 吴文娟; 张威江

    2011-01-01

    Objective To evaluate the value of magnetic resonance angiography (MRI) in the diagnosis of spinal type multiple sclerosis. Methods 10 patients with spinal type multiple sclerosis underwent MR scanning. Results 5 cases were multiple scleros (clinically diagnosed) and the rest misdiagnosed as other diseases were eventually diagnosed by MRI. Conclusion MRI can display various feature of spinal type multiple sclerosis and has the potential to provide an accurate diagnosis.%目的 研究核磁共振成像(MRI)在诊断脊髓型多发性硬化中的作用.方法 收集10例多发性硬化患者的MRI和临床资料进行分析.结果 10例中临床诊断多发性硬化5例,其余误诊为其他疾病而最终经MRI确诊.结论 磁共振成像(MRI)对脱髓鞘病灶易显示敏感,它的应用为诊断脊髓型多发性硬化提供了较为明确的依据.

  9. Cost differentials of dental outpatient care across clinical dentistry branches

    OpenAIRE

    Jovana Rančić; Nemanja Rančić; Nemanja Majstorović; Vladimir Biočanin; Marko Milosavljević; Mihajlo Jakovljević

    2015-01-01

    Background: Dental care presents affordability issues in Central & Eastern European transitional economies due to lack of insurance coverage in most countries of the region and almost complete out-of-pocket payments by citizens.Objective: Real world estimates on cost differentials across clinical dentistry branches, ICD-10 diagnostic groups and groups of dental services.Methods: Prospective case-series cost analysis was conducted from the patient perspective. A six months time horizon was...

  10. [Prevalence of human papillomavirus (HPV) in Belém, Pará State, Brazil, in the oral cavity of individuals without clinically diagnosable injuries].

    Science.gov (United States)

    Araújo, Marizeli Viana de Aragão; Pinheiro, Helder Henrique Costa; Pinheiro, João de Jesus Viana; Quaresma, Juarez Antônio Simões; Fuzii, Hellen Thais; Medeiros, Rita Catarina

    2014-05-01

    This cross-sectional study aimed to determine HPV prevalence in the oral cavity of individuals without clinically diagnosable lesions and to identify the respective HPV types. A total of 166 samples were analyzed from patients 18 years or older in the State of Pará, Brazil. Samples were collected by sterile brush scraping in the oral cavity. HPV detection used polymerase chain reaction (PCR). Infected samples were typed as HPV 6, 11, 16, 18, 31, 33, 35, 52, and 58. HPV was present in 40 samples (24.1%). Three samples (7.5%) were positive for HPV 6, five (12.5%) for HPV 18, and one (2.5%) for HPV 58. PMID:24936827

  11. Prevalence and clinical characteristics of carotid atherosclerosis in newly diagnosed patients with ketosis-onset diabetes: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Li Lian-Xi

    2013-01-01

    Full Text Available Abstract Background The features of carotid atherosclerosis in ketosis-onset diabetes have not been investigated. Our aim was to evaluate the prevalence and clinical characteristics of carotid atherosclerosis in newly diagnosed Chinese diabetic patients with ketosis but without islet-associated autoantibodies. Methods In total, 423 newly diagnosed Chinese patients with diabetes including 208 ketosis-onset diabetics without islet-associated autoantibodies, 215 non-ketotic type 2 diabetics and 79 control subjects without diabetes were studied. Carotid atherosclerosis was defined as the presence of atherosclerotic plaques in any of the carotid vessel segments. Carotid intima-media thickness (CIMT, carotid atherosclerotic plaque formation and stenosis were assessed and compared among the three groups based on Doppler ultrasound examination. The clinical features of carotid atherosclerotic lesions were analysed, and the risk factors associated with carotid atherosclerosis were evaluated using binary logistic regression in patients with diabetes. Results The prevalence of carotid atherosclerosis was significantly higher in the ketosis-onset diabetic group (30.80% than in the control group (15.2%, p=0.020 after adjusting for age- and sex-related differences, but no significant difference was observed in comparison to the non-ketotic diabetic group (35.8%, p=0.487. The mean CIMT of the ketosis-onset diabetics (0.70±0.20 mm was markedly higher than that of the control subjects (0.57±0.08 mm, p Conclusions The prevalence and risk of carotid atherosclerosis were significantly higher in the ketosis-onset diabetics than in the control subjects but similar to that in the non-ketotic type 2 diabetics. The characteristics of carotid atherosclerotic lesions in the ketosis-onset diabetics resembled those in the non-ketotic type 2 diabetics. Our findings support the classification of ketosis-onset diabetes as a subtype of type 2 diabetes.

  12. Giant dacryocystomucopyocele in an adult: a review of lacrimal sac enlargements with clinical and histopathologic differential diagnoses.

    Science.gov (United States)

    Perry, Lynn J P; Jakobiec, Frederick A; Zakka, Fouad R; Rubin, Peter A D

    2012-09-01

    Dacryocystocele is an umbrella term that refers to any diffuse, centrifugal enlargement of the lacrimal sac that results from combined proximal and distal obstructions in the tear drainage system. In adults, the presence of mucus in the cyst's contents leads to the modified term of dacryocystomucocele. If infection supervenes, which almost always occurs in protracted cases and adds the clinical dimension of a dacryocystitis, then a dacryocystomucopyocele is created. Dacryocystocele and its congeners are much rarer in adults than in children. We describe a 95-year-old woman with an acquired, enormous dacryocystomucopyocele, larger than any previously reported, that developed over 25 years and produced globe displacement with an associated conspicuous enlargement of the nasolacrimal duct. The aspirated sac fluid was mucopurulent and harbored low-virulence bacterial organisms of the Prevotella and Petosteptococcus species. In infants, dacryocystoceles are transitory as the result of spontaneously reversible factors. In adults, secondary proximal irreversible fibrotic strictures or bony changes around the nasolacrimal duct typically arise from chronic inflammation or low grade infection. Other possible causations of duct obstruction, in addition to florid mucosal edema, include encroachment on the duct by enlarged contiguous ethmoid air cells; a sinus mucocele or sinusitis; idiopathic, post-traumatic or dysplastic bony remodeling of the wall of the duct; and a neoplasm-all of which require some form of surgical intervention, typically dacryocystorhinostomy. The differential diagnosis of medial canthal swellings centered on the lacrimal sac spans malformations, diverticula, dermoid/epidermoid cysts, sac inflammations/infections causing swelling without generalized sac enlargement, encephaloceles and primary epithelial tumors, as well as extrinsic tumors impinging on the sac. PMID:22784678

  13. Evidence-based interventional pain medicine according to clinical diagnoses. 17. Herpes zoster and post-herpetic neuralgia.

    Science.gov (United States)

    van Wijck, Albert J M; Wallace, Mark; Mekhail, Nagy; van Kleef, Maarten

    2011-01-01

    Herpes zoster infection is caused by a reactivation of the latent varicella zoster virus that causes chicken pox. It appears predominantly in older adults whose immunity for the virus has waned. The natural course of the disease is usually favorable, and the symptoms disappear spontaneously within a few weeks. Some patients, however, have prolonged pain: post-herpetic neuralgia. The diagnosis of acute zoster infection is made on the clinical signs including the appearance of rash. Post-herpetic neuralgia is described as sharp, burning, aching, or shooting constantly present in the dermatome that corresponds with the earlier rash. The objectives of treating herpes zoster are: (1) acute pain reduction; (2) promotion of recovery of epidermal defects and prevention of secondary infections; and (3) reduction or prevention of post-herpetic neuralgia. The objective of the treatment of post-herpetic neuralgia is primarily pain alleviation and improvement of the quality of life. Early treatment of the infection and the pain is believed to reduce the risk for post-herpetic neuralgia. This persistent pain syndrome is difficult to treat. Antiepileptic drugs and tricyclic antidepressants are the first choice. Interventional treatments, such as epidural injections of corticosteroids and local anesthetic drugs, have an effect on the acute pain but are of limited use in preventing post-herpetic neuralgia. When conservative treatment fails in providing satisfactory relief of post-herpetic neuralgia, a sympathetic block may be considered (2 C+); if this treatment provides unsatisfactory results, spinal cord stimulation may be considered, in a study context (2 C+). PMID:21114617

  14. The Structured Clinical Interview for DSM-IV Childhood Diagnoses (Kid-SCID): first psychometric evaluation in a Dutch sample of clinically referred youths

    NARCIS (Netherlands)

    J. Roelofs; P. Muris; C. Braet; A. Arntz; I. Beelen

    2014-01-01

    The Structured Clinical Interview for DSM-IV Childhood Disorders (Kid-SCID) is a semi-structured interview for the classification of psychiatric disorders in children and adolescents. This study presents a first evaluation of the psychometric properties of the Kid-SCID in a Dutch sample of children

  15. Multicountry prospective clinical evaluation of two enzyme-linked immunosorbent assays and two rapid diagnostic tests for diagnosing dengue fever.

    Science.gov (United States)

    Pal, Subhamoy; Dauner, Allison L; Valks, Andrea; Forshey, Brett M; Long, Kanya C; Thaisomboonsuk, Butsaya; Sierra, Gloria; Picos, Victor; Talmage, Sara; Morrison, Amy C; Halsey, Eric S; Comach, Guillermo; Yasuda, Chadwick; Loeffelholz, Michael; Jarman, Richard G; Fernandez, Stefan; An, Ung Sam; Kochel, Tadeusz J; Jasper, Louis E; Wu, Shuenn-Jue L

    2015-04-01

    We evaluated four dengue diagnostic devices from Alere, including the SD Bioline Dengue Duo (nonstructural [NS] 1 Ag and IgG/IgM), the Panbio Dengue Duo Cassette (IgM/IgG) rapid diagnostic tests (RDTs), and the Panbio dengue IgM and IgG capture enzyme-linked immunosorbent assays (ELISAs) in a prospective, controlled, multicenter study in Peru, Venezuela, Cambodia, and the United States, using samples from 1,021 febrile individuals. Archived, well-characterized samples from an additional 135 febrile individuals from Thailand were also used. Reference testing was performed on all samples using an algorithm involving virus isolation, in-house IgM and IgG capture ELISAs, and plaque reduction neutralization tests (PRNT) to determine the infection status of the individual. The primary endpoints were the clinical sensitivities and specificities of these devices. The SD Bioline Dengue Duo had an overall sensitivity of 87.3% (95% confidence interval [CI], 84.1 to 90.2%) and specificity of 86.8% (95% CI, 83.9 to 89.3%) during the first 14 days post-symptom onset (p.s.o.). The Panbio Dengue Duo Cassette demonstrated a sensitivity of 92.1% (87.8 to 95.2%) and specificity of 62.2% (54.5 to 69.5%) during days 4 to 14 p.s.o. The Panbio IgM capture ELISA had a sensitivity of 87.6% (82.7 to 91.4%) and specificity of 88.1% (82.2 to 92.6%) during days 4 to 14 p.s.o. Finally, the Panbio IgG capture ELISA had a sensitivity of 69.6% (62.1 to 76.4%) and a specificity of 88.4% (82.6 to 92.8%) during days 4 to 14 p.s.o. for identification of secondary dengue infections. This multicountry prospective study resulted in reliable real-world performance data that will facilitate data-driven laboratory test choices for managing patient care during dengue outbreaks. PMID:25588659

  16. Genotypic and phenotypic applications for the differentiation and species-level identification of achromobacter for clinical diagnoses.

    Science.gov (United States)

    Gomila, Margarita; Prince-Manzano, Claudia; Svensson-Stadler, Liselott; Busquets, Antonio; Erhard, Marcel; Martínez, Deny L; Lalucat, Jorge; Moore, Edward R B

    2014-01-01

    The Achromobacter is a genus in the family Alcaligenaceae, comprising fifteen species isolated from different sources, including clinical samples. The ability to detect and correctly identify Achromobacter species, particularly A. xylosoxidans, and differentiate them from other phenotypically similar and genotypically related Gram-negative, aerobic, non-fermenting species is important for patients with cystic fibrosis (CF), as well as for nosocomial and other opportunistic infections. Traditional phenotypic profile-based analyses have been demonstrated to be inadequate for reliable identifications of isolates of Achromobacter species and genotypic-based assays, relying upon comparative 16S rRNA gene sequence analyses are not able to insure definitive identifications of Achromobacter species, due to the inherently conserved nature of the gene. The uses of alternative methodologies to enable high-resolution differentiation between the species in the genus are needed. A comparative multi-locus sequence analysis (MLSA) of four selected 'house-keeping' genes (atpD, gyrB, recA, and rpoB) assessed the individual gene sequences for their potential in developing a reliable, rapid and cost-effective diagnostic protocol for Achromobacter species identifications. The analysis of the type strains of the species of the genus and 46 strains of Achromobacter species showed congruence between the cluster analyses derived from the individual genes. The MLSA gene sequences exhibited different levels of resolution in delineating the validly published Achromobacter species and elucidated strains that represent new genotypes and probable new species of the genus. Our results also suggested that the recently described A. spritinus is a later heterotypic synonym of A. marplatensis. Strains were analyzed, using whole-cell Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight mass spectrometry (MALDI-TOF MS), as an alternative phenotypic profile-based method with the potential to

  17. Genotypic and phenotypic applications for the differentiation and species-level identification of achromobacter for clinical diagnoses.

    Directory of Open Access Journals (Sweden)

    Margarita Gomila

    Full Text Available The Achromobacter is a genus in the family Alcaligenaceae, comprising fifteen species isolated from different sources, including clinical samples. The ability to detect and correctly identify Achromobacter species, particularly A. xylosoxidans, and differentiate them from other phenotypically similar and genotypically related Gram-negative, aerobic, non-fermenting species is important for patients with cystic fibrosis (CF, as well as for nosocomial and other opportunistic infections. Traditional phenotypic profile-based analyses have been demonstrated to be inadequate for reliable identifications of isolates of Achromobacter species and genotypic-based assays, relying upon comparative 16S rRNA gene sequence analyses are not able to insure definitive identifications of Achromobacter species, due to the inherently conserved nature of the gene. The uses of alternative methodologies to enable high-resolution differentiation between the species in the genus are needed. A comparative multi-locus sequence analysis (MLSA of four selected 'house-keeping' genes (atpD, gyrB, recA, and rpoB assessed the individual gene sequences for their potential in developing a reliable, rapid and cost-effective diagnostic protocol for Achromobacter species identifications. The analysis of the type strains of the species of the genus and 46 strains of Achromobacter species showed congruence between the cluster analyses derived from the individual genes. The MLSA gene sequences exhibited different levels of resolution in delineating the validly published Achromobacter species and elucidated strains that represent new genotypes and probable new species of the genus. Our results also suggested that the recently described A. spritinus is a later heterotypic synonym of A. marplatensis. Strains were analyzed, using whole-cell Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight mass spectrometry (MALDI-TOF MS, as an alternative phenotypic profile-based method with the

  18. Diagnosing malnutrition.

    OpenAIRE

    Dionigi, R; Dominioni, L; Jemos, V; Cremaschi, R; Monico, R

    1986-01-01

    The measurement of selected anthropometric, biochemical and immunological variables, and clinical judgment can be used to assess nutritional state. Nutritional assessment has three main aims: to define the type and severity of malnutrition; to identify high risk patients; to monitor the efficacy of nutritional support. The problems associated with the various methods to assess the nutritional state and the applications of nutritional assessment in clinical practice are presented and discussed.

  19. Analysis of C9orf72 repeat expansions in a large series of clinically and pathologically diagnosed cases with atypical parkinsonism.

    Science.gov (United States)

    Schottlaender, Lucia V; Polke, James M; Ling, Helen; MacDoanld, Nicola D; Tucci, Arianna; Nanji, Tina; Pittman, Alan; de Silva, Rohan; Holton, Janice L; Revesz, Tamas; Sweeney, Mary G; Singleton, Andy B; Lees, Andrew J; Bhatia, Kailash P; Houlden, Henry

    2015-02-01

    A GGGGCC repeat expansion in the C9orf72 gene was recently identified as a major cause of familial and sporadic amyotrophic lateral sclerosis and frontotemporal dementia. There is suggestion that these expansions may be a rare cause of parkinsonian disorders such as progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and corticobasal degeneration (CBD). Screening the C9orf72 gene in 37 patients with features of corticobasal syndrome (CBS) detected an expansion in 3 patients, confirmed by Southern blotting. In a series of 22 patients with clinically diagnosed PSP, we found 1 patient with an intermediate repeat length. We also screened for the C9orf72 expansion in a large series of neuropathologically confirmed samples with MSA (n = 96), PSP (n = 177), and CBD (n = 18). Patients were found with no more than 22 GGGGCC repeats. Although these results still need to be confirmed in a larger cohort of CBS and/or CBD patients, these data suggest that in the presence of a family history and/or motor neuron disease features, patients with CBS or clinical PSP should be screened for the C9orf72 repeat expansion. In addition, we confirm that the C9orf72 expansions are not associated with pathologically confirmed MSA, PSP, or CBD in a large series of cases. PMID:25308964

  20. Use of ICD-10 codes to monitor uterine rupture

    DEFF Research Database (Denmark)

    Thisted, Dorthe L A; Mortensen, Laust Hvas; Hvidman, Lone;

    2014-01-01

    OBJECTIVES: Uterine rupture is a rare but severe complication in pregnancies after a previous cesarean section. In Denmark, the monitoring of uterine rupture is based on reporting of relevant diagnostic codes to the Danish Medical Birth Registry (MBR). The aim of our study was to examine the vali...

  1. How Is Lactose Intolerance Diagnosed?

    Science.gov (United States)

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

  2. How Is Atrial Fibrillation Diagnosed?

    Science.gov (United States)

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

  3. Low incidence of limb-girdle muscular dystrophy type 2C revealed by a mutation study in Japanese patients clinically diagnosed with DMD

    Directory of Open Access Journals (Sweden)

    Maruyama Koichi

    2010-03-01

    Full Text Available Abstract Background Limb-girdle muscular dystrophy type 2C (LGMD2C is an autosomal recessive muscle dystrophy that resembles Duchenne muscular dystrophy (DMD. Although DMD is known to affect one in every 3500 males regardless of race, a widespread founder mutation causing LGMD2C has been described in North Africa. However, the incidence of LGMD2C in Japanese has been unknown because the genetic background remains uncharacterized in many patients clinically diagnosed with DMD. Methods We enrolled 324 patients referred to the Kobe University Hospital with suspected DMD. Mutations in the dystrophin or the SGCG genes were analyzed using not only genomic DNA but also cDNA. Results In 322 of the 324 patients, responsible mutations in the dystrophin were successfully revealed, confirming DMD diagnosis. The remaining two patients had normal dystrophin expression but absence of γ-sarcoglycan in skeletal muscle. Mutation analysis of the SGCG gene revealed homozygous deletion of exon 6 in one patient, while the other had a novel single nucleotide insertion in exon 7 in one allele and deletion of exon 6 in the other allele. These mutations created a stop codon that led to a γ-sarcoglycan deficiency, and we therefore diagnosed these two patients as having LGMD2C. Thus, the relative incidence of LGMD2C among Japanese DMD-like patients can be calculated as 1 in 161 patients suspected to have DMD (2 of 324 patients = 0.6%. Taking into consideration the DMD incidence for the overall population (1/3,500 males, the incidence of LGMD2C can be estimated as 1 per 560,000 or 1.8 per million. Conclusions To the best of our knowledge, this is the first study to demonstrate a low incidence of LGMD2C in the Japanese population.

  4. The prevalence of clinically-relevant comorbid conditions in patients with physician-diagnosed COPD: a cross-sectional study using data from NHANES 1999–2008

    Directory of Open Access Journals (Sweden)

    Schnell Kerry

    2012-07-01

    Full Text Available Abstract Background Treatment of chronic diseases such as chronic obstructive pulmonary disease (COPD is complicated by the presence of comorbidities. The objective of this analysis was to estimate the prevalence of comorbidity in COPD using nationally-representative data. Methods This study draws from a multi-year analytic sample of 14,828 subjects aged 45+, including 995 with COPD, from the National Health and Nutrition Examination Survey (NHANES, 1999–2008. COPD was defined by self-reported physician diagnosis of chronic bronchitis or emphysema; patients who reported a diagnosis of asthma were excluded. Using population weights, we estimated the age-and-gender-stratified prevalence of 22 comorbid conditions that may influence COPD and its treatment. Results Subjects 45+ with physician-diagnosed COPD were more likely than subjects without physician-diagnosed COPD to have coexisting arthritis (54.6% vs. 36.9%, depression (20.6% vs. 12.5%, osteoporosis (16.9% vs. 8.5%, cancer (16.5% vs. 9.9%, coronary heart disease (12.7% vs. 6.1%, congestive heart failure (12.1% vs. 3.9%, and stroke (8.9% vs. 4.6%. Subjects with COPD were also more likely to report mobility difficulty (55.6% vs. 32.5%, use of >4 prescription medications (51.8% vs. 32.1, dizziness/balance problems (41.1% vs. 23.8%, urinary incontinence (34.9% vs. 27.3%, memory problems (18.5% vs. 8.8%, low glomerular filtration rate (16.2% vs. 10.5%, and visual impairment (14.0% vs. 9.6%. All reported comparisons have p  Conclusions Our study indicates that COPD management may need to take into account a complex spectrum of comorbidities. This work identifies which conditions are most common in a nationally-representative set of COPD patients (physician-diagnosed, a necessary step for setting research priorities and developing clinical practice guidelines that address COPD within the context of comorbidity.

  5. Clinical features, neuroimaging and prognosis of adult patients with clinically diagnosed acute-onset encephalitis treated at a teaching neurology center in the Toyama area of Japan

    International Nuclear Information System (INIS)

    Although acute viral encephalitis (AVE) and acute disseminated encephalomyelitis (ADEM) are etiologically and pathologically distinct, a differential diagnosis between these two disorders is often difficult, especially if the patient exhibits a disturbance in consciousness. To identify useful clinical differences enabling a differential diagnosis to be made at an early stage, we retrospectively analyzed patients who had been admitted to our hospital within the past seven years because of acute-onset encephalitis with a disturbance in consciousness. Eleven adult patients were classified as having AVE, and 8 adult patients were classified as having ADEM within this period. The clinical characteristics of the two groups were then compared. Patients with AVE exhibited a disturbance in consciousness as their first neurological sign, whereas patients with ADEM initially showed focal signs like spastic paralysis, urinary disturbance and ataxia, which were followed by a disturbance in consciousness. ADEM is usually preceded by infection or vaccination, but obtaining a medical history from patients with disturbed consciousness is often difficult. Based on the present analysis, the initial manifestation of focal neurological signs may be very useful for distinguishing ADEM from AVE. (author)

  6. Prevalence of delirium among patients at a cancer ward: Clinical risk factors and prediction by bedside cognitive tests.

    Science.gov (United States)

    Grandahl, Mia Gall; Nielsen, Svend Erik; Koerner, Ejnar Alex; Schultz, Helga Holm; Arnfred, Sidse Marie

    2016-08-01

    Background Delirium is a frequent psychiatric complication to cancer, but rarely recognized by oncologists. Aims 1. To estimate the prevalence of delirium among inpatients admitted at an oncological cancer ward 2. To investigate whether simple clinical factors predict delirium 3. To examine the value of cognitive testing in the assessment of delirium. Methods On five different days, we interviewed and assessed patients admitted to a Danish cancer ward. The World Health Organization International Classification of Diseases Version 10, WHO ICD-10 Diagnostic System and the Confusion Assessment Method (CAM) were used for diagnostic categorization. Clinical information was gathered from medical records and all patients were tested with Mini Cognitive Test, The Clock Drawing Test, and the Digit Span Test. Results 81 cancer patients were assessed and 33% were diagnosed with delirium. All delirious participants were CAM positive. Poor performance on the cognitive tests was associated with delirium. Medical records describing CNS metastases, benzodiazepine or morphine treatment were associated with delirium. Conclusions Delirium is prevalent among cancer inpatients. The Mini Cognitive Test, The Clock Drawing Test, and the Digit Span Test can be used as screening tools for delirium among inpatients with cancer, but even in synergy, they lack specificity. Combining cognitive testing and attention to nurses' records might improve detection, yet further studies are needed to create a more detailed patient profile for the detection of delirium. PMID:26882016

  7. How Are Obesity and Overweight Diagnosed?

    Science.gov (United States)

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

  8. Effects of potassium iodide (KI) protective dose on the course of thyroid diseases diagnosed at the Outpatient Endocrinologic Clinic in Lodz, 1986, before Chernobyl accident

    International Nuclear Information System (INIS)

    2521 patients of the Lodz Outpatient Endocrinologic Clinic (2290 females, 231 males; inhabitants of the central region of Poland were included in the study. The obtained results indicate that: 1) KI administration neither increased the number of exacerbations of hyperthyroidism nor affected the onset of new cases of that disease in 1986. 2) The same can be said about the cases of thyroiditis and hypothyroidism. 3) No increase of ATMA or ATG antibodies ''prevalence, as well as no elevation of those antibodies'' titres after KI prophylactic dose were observed in the patients with Grave's disease and chronic thyroiditis, when compared to persons who did not take Lugol's iodine. 4) The course of the majority of diseases diagnosed in 1986, evaluated with use of the, so called, test for analysis of trends, became unchanged. 5) There were adverse side effects noted after KI in 32 patients out of all the examined 774 patients (i.e., in 4.13%); five of the affected patients required medical care. 6) After iodine tincture; side effects occurred in three patients in the group of 35 patients included in the examination, i.e., in 8.57%; none of the affected patients required medical care. 7) Our results, comprising the four year observation period after Chernobyl accident, do not indicate any increased incidence of malignant neoplasms of the thyroid gland, what confirms the apparent theoretical data; much longer observation time is necessary to reveal phenomena of scholastic type (10-15 years). (author). 30 refs, 11 figs, 14 tabs

  9. Diagnosing Patients with Age-Related Hearing Loss and Tinnitus: Supporting GP Clinical Engagement through Innovation and Pathway Redesign in Audiology Services

    Directory of Open Access Journals (Sweden)

    Adrian Davis

    2012-01-01

    Full Text Available The public health challenge of hearing impairment is growing, as age is the major determinant of hearing loss. Almost one in four (22.6% over 75-year olds reports moderate or severe worry because of hearing problems. There is a 40% comorbidity of tinnitus and balance disorders. Good outcomes depend on early presentation and appropriate referral. This paper describes how the NHS Improvement Programme in England used service improvement methodologies to identify referral pathways and tools which were most likely to make significant improvements in diagnosing hearing loss, effective referrals and better patient outcomes. An audiometric screening device was used in GP surgeries to enable thresholds for effective referrals to be measured in the surgery. Revised referral criteria, the use of this device, new “assess and fit” technology in the audiology clinic, and direct access pathways can transform audiology service delivery so that patient outcomes are measurably better. This, in turn, changes the experience of GPs, so they are more likely to refer patients who can benefit from treatment. At the end of 2011, 51 GP practices in one of the audiology pilot areas had bought HearCheck screeners, a substantial development from the 4 practices who first engaged with the pilot.

  10. Multi-institutional phase 2 clinical and pharmacogenomic trial of tipifarnib plus etoposide for elderly adults with newly diagnosed acute myelogenous leukemia

    Science.gov (United States)

    Vener, Tatiana I.; Raponi, Mitch; Ritchie, Ellen K.; Smith, B. Douglas; Gore, Steven D.; Morris, Lawrence E.; Feldman, Eric J.; Greer, Jacqueline M.; Malek, Sami; Carraway, Hetty E.; Ironside, Valerie; Galkin, Steven; Levis, Mark J.; McDevitt, Michael A.; Roboz, Gail R.; Gocke, Christopher D.; Derecho, Carlo; Palma, John; Wang, Yixin; Kaufmann, Scott H.; Wright, John J.; Garret-Mayer, Elizabeth

    2012-01-01

    Tipifarnib (T) exhibits modest activity in elderly adults with newly diagnosed acute myelogenous leukemia (AML). Based on preclinical synergy, a phase 1 trial of T plus etoposide (E) yielded 25% complete remission (CR). We selected 2 comparable dose levels for a randomized phase 2 trial in 84 adults (age range, 70-90 years; median, 76 years) who were not candidates for conventional chemotherapy. Arm A (T 600 mg twice a day × 14 days, E 100 mg days 1-3 and 8-10) and arm B (T 400 mg twice a day × 14 days, E 200 mg days 1-3 and 8-10) yielded similar CR, but arm B had greater toxicity. Total CR was 25%, day 30 death rate 7%. A 2-gene signature of high RASGRP1 and low aprataxin (APTX) expression previously predicted for T response. Assays using blasts from a subset of 40 patients treated with T plus E on this study showed that AMLs with a RASGRP1/APTX ratio of more than 5.2 had a 78% CR rate and negative predictive value 87%. This ratio did not correlate with outcome in 41 patients treated with conventional chemotherapies. The next T-based clinical trials will test the ability of the 2-gene signature to enrich for T responders prospectively. This study is registered at www.clinicaltrials.gov as #NCT00602771. PMID:22001391

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  12. Evaluation of the Quality of Information Retrieval of Clinical Findings from a Computerized Patient Database Using a Semantic Terminological Model

    OpenAIRE

    Brown, Philip J. B.; Sönksen, Peter

    2000-01-01

    Objectives: To measure the strength of agreement between the concepts and records retrieved from a computerized patient database, in response to physician-derived questions, using a semantic terminological model for clinical findings with those concepts and records excerpted clinically by manual identification. The performance of the semantic terminological model is also compared with the more established retrieval methods of free-text search, ICD-10, and hierarchic re...

  13. Behavioral and psychosocial effects of rapid genetic counseling and testing in newly diagnosed breast cancer patients: Design of a multicenter randomized clinical trial

    International Nuclear Information System (INIS)

    It has been estimated that between 5% and 10% of women diagnosed with breast cancer have a hereditary form of the disease, primarily caused by a BRCA1 or BRCA2 gene mutation. Such women have an increased risk of developing a new primary breast and/or ovarian tumor, and may therefore opt for preventive surgery (e.g., bilateral mastectomy, oophorectomy). It is common practice to offer high-risk patients genetic counseling and DNA testing after their primary treatment, with genetic test results being available within 4-6 months. However, some non-commercial laboratories can currently generate test results within 3 to 6 weeks, and thus make it possible to provide rapid genetic counseling and testing (RGCT) prior to primary treatment. The aim of this study is to determine the effect of RGCT on treatment decisions and on psychosocial health. In this randomized controlled trial, 255 newly diagnosed breast cancer patients with at least a 10% risk of carrying a BRCA gene mutation are being recruited from 12 hospitals in the Netherlands. Participants are randomized in a 2:1 ratio to either a RGCT intervention group (the offer of RGCT directly following diagnosis with tests results available before surgical treatment) or to a usual care control group. The primary behavioral outcome is the uptake of direct bilateral mastectomy or delayed prophylactic contralateral mastectomy. Psychosocial outcomes include cancer risk perception, cancer-related worry and distress, health-related quality of life, decisional satisfaction and the perceived need for and use of additional decisional counseling and psychosocial support. Data are collected via medical chart audits and self-report questionnaires administered prior to randomization, and at 6 month and at 12 month follow-up. This trial will provide essential information on the impact of RGCT on the choice of primary surgical treatment among women with breast cancer with an increased risk of hereditary cancer. This study will also provide

  14. Behavioral and psychosocial effects of rapid genetic counseling and testing in newly diagnosed breast cancer patients: Design of a multicenter randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Valdimarsdottir Heiddis B

    2011-01-01

    Full Text Available Abstract Background It has been estimated that between 5% and 10% of women diagnosed with breast cancer have a hereditary form of the disease, primarily caused by a BRCA1 or BRCA2 gene mutation. Such women have an increased risk of developing a new primary breast and/or ovarian tumor, and may therefore opt for preventive surgery (e.g., bilateral mastectomy, oophorectomy. It is common practice to offer high-risk patients genetic counseling and DNA testing after their primary treatment, with genetic test results being available within 4-6 months. However, some non-commercial laboratories can currently generate test results within 3 to 6 weeks, and thus make it possible to provide rapid genetic counseling and testing (RGCT prior to primary treatment. The aim of this study is to determine the effect of RGCT on treatment decisions and on psychosocial health. Methods/Design In this randomized controlled trial, 255 newly diagnosed breast cancer patients with at least a 10% risk of carrying a BRCA gene mutation are being recruited from 12 hospitals in the Netherlands. Participants are randomized in a 2:1 ratio to either a RGCT intervention group (the offer of RGCT directly following diagnosis with tests results available before surgical treatment or to a usual care control group. The primary behavioral outcome is the uptake of direct bilateral mastectomy or delayed prophylactic contralateral mastectomy. Psychosocial outcomes include cancer risk perception, cancer-related worry and distress, health-related quality of life, decisional satisfaction and the perceived need for and use of additional decisional counseling and psychosocial support. Data are collected via medical chart audits and self-report questionnaires administered prior to randomization, and at 6 month and at 12 month follow-up. Discussion This trial will provide essential information on the impact of RGCT on the choice of primary surgical treatment among women with breast cancer with an

  15. Bayesian evaluation of clinical diagnostic test characteristics of visual observations and remote monitoring to diagnose bovine respiratory disease in beef calves.

    Science.gov (United States)

    White, Brad J; Goehl, Dan R; Amrine, David E; Booker, Calvin; Wildman, Brian; Perrett, Tye

    2016-04-01

    Accurate diagnosis of bovine respiratory disease (BRD) in beef cattle is a critical facet of therapeutic programs through promotion of prompt treatment of diseased calves in concert with judicious use of antimicrobials. Despite the known inaccuracies, visual observation (VO) of clinical signs is the conventional diagnostic modality for BRD diagnosis. Objective methods of remotely monitoring cattle wellness could improve diagnostic accuracy; however, little information exists describing the accuracy of this method compared to traditional techniques. The objective of this research is to employ Bayesian methodology to elicit diagnostic characteristics of conventional VO compared to remote early disease identification (REDI) to diagnose BRD. Data from previous literature on the accuracy of VO were combined with trial data consisting of direct comparison between VO and REDI for BRD in two populations. No true gold standard diagnostic test exists for BRD; therefore, estimates of diagnostic characteristics of each test were generated using Bayesian latent class analysis. Results indicate a 90.0% probability that the sensitivity of REDI (median 81.3%; 95% probability interval [PI]: 55.5, 95.8) was higher than VO sensitivity (64.5%; PI: 57.9, 70.8). The specificity of REDI (median 92.9%; PI: 88.2, 96.9) was also higher compared to VO (median 69.1%; PI: 66.3, 71.8). The differences in sensitivity and specificity resulted in REDI exhibiting higher positive and negative predictive values in both high (41.3%) and low (2.6%) prevalence situations. This research illustrates the potential of remote cattle monitoring to augment conventional methods of BRD diagnosis resulting in more accurate identification of diseased cattle. PMID:26879058

  16. Evaluation of NANDA nursing diagnoses of healthcare college final year students during the clinical application of the mental health and disease nursing course

    OpenAIRE

    Gülay Taşdemir; Mehtap Kızılkaya

    2013-01-01

    The aim of this descriptive study was to evaluate the NANDA nursing diagnoses of Pamukkale University Denizli Healthcare College final year students for the patients they undertook the care of and to determine the aims and interventions relevant to these diagnoses.The study universe consisted of all Pamukkale University Denizli Healthcare College final year students who were continuing their education during the 2009-2010 educational year and took the Mental Health and Disease Nursing course ...

  17. Epidemiological and clinical use of GMHAT-PC (Global Mental Health assessment tool – primary care in cardiac patients

    Directory of Open Access Journals (Sweden)

    Krishna Murali

    2009-04-01

    Full Text Available Abstract Background A computer assisted interview, the GMHAT/PC has been developed to assist General Practitioners and other Health Professionals to make a quick, convenient and comprehensive standardised mental health assessment. It has proved to be a reliable and valid tool in our previous studies involving General Practitioners and Nurses. Little is known about its use in cardiac rehabilitation settings. Aim The study aims to assess the feasibility of using a computer assisted diagnostic interview by nurses for patients attending Cardiac Rehabilitation Clinics and to examine the level of agreement between the GMHAT/PC diagnosis and a Psychiatrist clinical diagnosis. Prevalence of mental illness was also measured. Design Cross sectional validation and feasibility study. Methods Nurses using GMHAT/PC examined consecutive patients presenting to a cardiac rehabilitation centre. A total of 118 patients were assessed by nurses and consultant psychiatrist in cardiac rehabilitation centres. The kappa coefficient (κ, sensitivity, and specificity of the GMHAT/PC diagnosis were analysed as measures of validity. The time taken for the interview as well as feedback from patients and interviewers were indicators of feasibility. Data on prevalence of mental disorders in an outpatient cardiac rehabilitation setting was collected. Results The mean duration of the interview was 14 minutes. Feedback from patients and interviewers indicated good practical feasibility. The agreement between GMHAT/PC interview-based diagnoses and consultant psychiatrists' ICD-10 criteria-based clinical diagnosis was good or excellent (κ = 0.76, sensitivity = 0.73, specificity = 0.90. The prevalence of mental disorders in this group was 22%, predominantly depression. Very few cases were on treatment. Conclusion GMHAT/PC can assist nurses in making accurate mental health assessments and diagnoses in a cardiac rehabilitation setting and is acceptable to cardiac patients. It can

  18. How Is Asthma Diagnosed?

    Science.gov (United States)

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

  19. Diagnosing pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Khosla Rahul

    2006-01-01

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

  20. Clinical significance of magnetic resonance cholangiopancreatography utilizing half-Fourier acquisition single-shot fast spin-echo in diagnosing bile duct diseases

    Institute of Scientific and Technical Information of China (English)

    张雪林; 颜志平; 邱士军

    2003-01-01

    Objective: To investigate the clinical significance of magnetic resonance cholangiopancreatography (MRCP) utilizing half-Fourier acquisition single-shot fast spin-echo (HASTE) in the diagnosis of bile duct diseases. Methods: Forty-three patients with obstructive jaundice and 4 without were enrolled in this study. The underlying diseases included bile duct calculi (13 cases), chronic cholangitis (14 cases) malignant tumors (18 cases) and congenital biliary cysts (2 cases). All patients underwent examinations with magnetic resonance imaging (MRI) and MRCP, and 39 were also examined with B-type ultrasonography, 33 with CT and 25 with ERCP and PTC. Three-dimensional image reconstruction was performed using volume-rendered technique (VRE) on the basis of the data obtained by MRCP. Results: The biliary calculi were displayed as circular filling defects in MRCP images, with the proximal end of dilated bile duct taking the form of the mouth of a cup. The bile duct of patients with chronic cholangitis showed distal end dilation and thinner proximal end without discontinuity. Interception of the bile ducts was most frequent (72.2%) in cases of malignant bile duct obstruction, in which the ducts may also be mastoid or resembling rat tails. 72.2% of the cases had severe dilation of the bile ducts, which occur in only 16.0% of the benign cases, with significant difference between them (P<0.01). In images of intrahepatic biliary cyst, intrahepatic duct dilated in the shape of a bursa in connection with the duct. By MRCP, 20 malignant obstructions of the bile ducts were identified with 2 misdiagnoses, and in 25 cases of benign obstructions identified by MRCP, only 1 misdiagnoses occurred. Thus MRCP had the sensitivity, specificity and accuracy of 90.0%, 96.3% and 93.6% respectively in discriminating benign and malignant diseases of the bile ducts, showing a total diagnostic accuracy of 94.0% that was similar to that of ERCP (92.0%) but significantly higher than those of both CT

  1. [Characteristics of children and adolescents with gender dysphoria referred to the Hamburg Gender Identity Clinic].

    Science.gov (United States)

    Becker, Inga; Gjergji-Lama, Voltisa; Romer, Georg; Möller, Birgit

    2014-01-01

    Given the increasing demand for counselling in gender dysphoria in childhood in Germany, there is a definite need for empirical data on characteristics and developmental trajectories of this clinical group. This study aimed to provide a first overview by assessing demographic characteristics and developmental trajectories of a group of gender variant boys and girls referred to the specialised Gender Identity Clinic in Hamburg. Data were extracted from medical charts, transcribed and analysed using qualitative content analysis methods. Categories were set up by inductive-deductive reasoning based on the patients' parents' and clinicians' information in the files. Between 2006 and 2010, 45 gender variant children and adolescents were seen by clinicians; 88.9% (n = 40) of these were diagnosed with gender identity disorder (ICD-10). Within this group, the referral rates for girls were higher than for boys (1:1.5). Gender dysphoric girls were on average older than the boys and a higher percentage of girls was referred to the clinic at the beginning of adolescence (> 12 years of age). At the same time, more girls reported an early onset age. More girls made statements about their (same-sex) sexual orientation during adolescence and wishes for gender confirming medical interventions. More girls than boys revealed self-mutilation in the past or present as well as suicidal thoughts and/or attempts. Results indicate that the presentation of clinically referred gender dysphoric girls differs from the characteristics boys present in Germany; especially with respect to the most salient age differences. Therefore, these two groups require different awareness and individual treatment approaches. PMID:25296510

  2. Validity of diagnostic codes and prevalence of physician-diagnosed psoriasis and psoriatic arthritis in southern Sweden--a population-based register study.

    Directory of Open Access Journals (Sweden)

    Sofia Löfvendahl

    Full Text Available OBJECTIVE: To validate diagnostic codes for psoriasis and psoriatic arthritis (PsA and estimate physician-diagnosed prevalence of psoriasis and PsA in the Skåne region, Sweden. METHODS: In the Skåne Healthcare Register (SHR, all healthcare consultations are continuously collected for all inhabitants in the Skåne region (population 1.2 million. During 2005-2010 we identified individuals with ≥1 physician-consultations consistent with psoriasis (ICD-10. Within this group we also identified those diagnosed with PsA. We performed a validation by reviewing medical records in 100 randomly selected cases for psoriasis and psoriasis with PsA, respectively. Further, we estimated the pre- and post-validation point prevalence by December 31, 2010. RESULTS: We identified 16 171 individuals (psoriasis alone: n = 13 185, psoriasis with PsA n = 2 986. The proportion of ICD-10 codes that could be confirmed by review of medical records was 81% for psoriasis and 63% for psoriasis with PsA with highest percentage of confirmed codes for cases diagnosed ≥2 occasions in specialized care. For 19% and 29% of the cases respectively it was not possible to determine diagnosis due to insufficient information. Thus, the positive predicted value (PPV of one ICD-10 code for psoriasis and psoriasis with PsA ranged between 81-100% and 63-92%, respectively. Assuming the most conservative PPV, the post-validation prevalence was 1.23% (95% CI: 1.21-1.25 for psoriasis (with or without PsA, 1.02% (95% CI: 1.00-1.03 for psoriasis alone and 0.21% (95% CI: 0.20-0.22 for psoriasis with PsA. The post-validation prevalence of PsA in the psoriasis cohort was 17.3% (95% CI: 16.65-17.96. CONCLUSIONS: The proportion of diagnostic codes in SHR that could be verified varied with frequency of diagnostic codes and level of care highlighting the importance of sensitivity analyses using different case ascertainment criteria. The prevalence of physician-diagnosed psoriasis and Ps

  3. Cases with manifestation of chemodectoma diagnosed in dogs in Department of Internal Diseases with Horses, Dogs and Cats Clinic, Veterinary Medicine Faculty, University of Environmental and Life Sciences, Wroclaw, Poland

    Directory of Open Access Journals (Sweden)

    Atamaniuk Wojciech

    2010-05-01

    Full Text Available Abstract In the period of 3 years, 9 tumours of chemodectoma were supravitally diagnosed and histopathologically verified in dogs. In this period 15 351 dogs were admitted to the Clinic of Dogs and Cats and 2 145 dogs were examined in the cardiological outpatient clinic for dogs. This tumour is located in a typical place - at the base of the heart. Most frequently the tumour manifested in older boxers. Only in one case such a tumour was diagnosed in another breed of dogs. The tumours ranged in size between 3 and 16 cm in diameter. The principal sign accompanying tumours of cardiac base involved dyspnoea but in 3 cases the tumours yielded no clinical signs. All the diagnoses were additionally verified using immunohistochemical examination. We used antibodies to chromogranin A (clone DAK-A3 1:100, synaptophysin (clone SY38 1:20 and neuron-specific enolase (clone BBS/NC/VI-H14 1:150. An immunohistochemical examination is vital for the diagnosis since it allows to differentiate histologically distinct types of neoplasia which may locate in the same site and may manifest a similar histological pattern.

  4. Comparison of the clinical characteristics of diabetes mellitus diagnosed using fasting plasma glucose and haemoglobin A1c: The 2011 Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Hong, Sangmo; Kang, Jun Goo; Kim, Chul Sik; Lee, Seong Jin; Lee, Chang Beom; Ihm, Sung-Hee

    2016-03-01

    We compared the characteristics of a Korean adult population diagnosed with diabetes using only a fasting plasma glucose criterion or an HbA1c criterion. The single difference between these two groups was age. Further studies should be undertaken to clarify whether age-specific diagnostic criteria would be appropriate in Korean populations. PMID:26972956

  5. Frequency of the HFE C282Y and H63D mutations in Danish patients with clinical haemochromatosis initially diagnosed by phenotypic methods

    DEFF Research Database (Denmark)

    Milman, Nils; Koefoed, Pernille; Pedersen, Palle;

    2003-01-01

    idiopathic haemochromatosis diagnosed by phenotypic methods (serum transferrin saturation, serum ferritin, liver biopsy and mobilisable body iron stores). In 32 unrelated patients, frozen blood samples were available for genetic analysis. In a subsequent series of 26 unrelated Danish patients, a phenotypic...

  6. A neurobehavioural-informed approach to the use of clinical competencies in supporting the community-based care of individuals with multi-axial diagnoses.

    Science.gov (United States)

    Sugarman, R

    2001-01-01

    Individuals with multiple diagnoses most often present with social difficulties, with either aggressive or withdrawn behaviour predominating. In individuals with behaviours that represent changes at a neural level, and in those with comorbid psychiatric diagnoses, these behaviours often represent obstacles to rehabilitation. Consequently there is little consensus as to how such patients can be assessed, treated and interacted with, and so too there is little potential to improve outcomes with guided training. When multiple agencies are involved, such patients may 'fall between the cracks' and undergo prolonged and disempowering interventions with poor outcomes in the absence of individual programmes. This article addresses the core issue of empowerment in the assessment and community-based rehabilitation of patients with multiple mental health issues, and utilises a case report format to illustrate the methodology. PMID:11842711

  7. O6-methylguanine DNA-methyltransferase methylation status can change between first surgery for newly diagnosed glioblastoma and second surgery for recurrence: clinical implications

    OpenAIRE

    Brandes, Alba A.; Franceschi, Enrico; Tosoni, Alicia; Bartolini, Stefania; Bacci, Antonella; Agati, Raffaele; Ghimenton, Claudio; Turazzi, Sergio; Talacchi, Andrea; Skrap, Miran; Marucci, Gianluca; Volpin, Lorenzo; Morandi, Luca; Pizzolitto, Stefano; Gardiman, Marina

    2010-01-01

    O6-methylguanine DNA-methyltransferase (MGMT) promoter methylation status is a prognostic factor in newly diagnosed glioblastoma patients. However, it is not yet clear whether, and if so how, MGMT methylation status may change. Moreover, it is unknown whether the prognostic role of this epigenetic feature is retained during the disease course. A retrospective analysis was made using a database of 614 glioblastoma patients treated prospectively from January 2000 to August 2008. We evaluated on...

  8. Infrared spectroscopy as a clinical diagnostic method for detection of disease states: developments and applications in kidney diseases and cancer diagnoses

    OpenAIRE

    Oliver, K. V.

    2015-01-01

    ATR-FTIR spectroscopy has been used to develop rapid and accurate methods for urine analyses and cancer diagnoses. Complications associated with analyses of dried samples by FTIR spectroscopy were found to arise because of the existence of partial hydration states of some substances. Recognition and accommodation of such states is necessary to ensure precise deconvolution of spectra. Dramatic hydration effects were observed in the IR spectrum of urea. Four forms of urea were identified in IR ...

  9. How Is COPD Diagnosed?

    Science.gov (United States)

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

  10. Behavioral and psychosocial effects of rapid genetic counseling and testing in newly diagnosed breast cancer patients: design of a multicenter clinical trial

    OpenAIRE

    Wevers, M R; Ausems, M.G.E.M.; Verhoef, S.; Bleiker, E. M. A.; Hahn, D.E.E.; Hogervorst, F B L; Luijt, van der, R.B.; Valdimarsdottir, H.B.; Hillegersberg, van, R.; Rutgers, E. J. T.; Aaronson, N.K.

    2011-01-01

    Background It has been estimated that between 5% and 10% of women diagnosed with breast cancer have a hereditary form of the disease, primarily caused by a BRCA1 or BRCA2 gene mutation. Such women have an increased risk of developing a new primary breast and/or ovarian tumor, and may therefore opt for preventive surgery (e.g., bilateral mastectomy, oophorectomy). It is common practice to offer high-risk patients genetic counseling and DNA testing after their primary treatment, with genetic te...

  11. A Clinical Pilot Study Comparing Sweet Bee Venom parallel treatment with only Acupuncture Treatment in patient diagnosed with lumbar spine sprain

    Directory of Open Access Journals (Sweden)

    Shin Yong-jeen

    2011-06-01

    Full Text Available Objectives: This study was carried out to compare the Sweet Bee Venom (referred to as Sweet BV hereafter acupuncture parallel treatment to treatment with acupuncture only for the patient diagnosed with lumbar spine sprain and find a better treatment. Methods: The subjects were patients diagnosed with lumbar spine sprain and hospitalized at Suncheon oriental medical hospital, which was randomly divided into sweet BV parallel treatment group and acupuncture-only group, and other treatment conditions were maintained the same. Then,VAS (Visual Analogue Scale was used to compare the difference in the treatment period between the two groups from VAS 10 to VAS 0, from VAS 10 to VAS 5, and from VAS 5 to VAS 0. Result & Conclusion: Sweet BV parallel treatment group and acupuncture-only treatment group were compared regarding the respective treatment period, and as the result, the treatment period from VAS 10 to VAS 5 was significantly reduced in sweet BV parallel treatment group compared to the acupuncture-only treatment group, but the treatment period from VAS 5 to VAS 0 did not show a significant difference. Therefore, it can be said that sweet BV parallel treatment is effective in shortening the treatment period and controlling early pain compared to acupuncture-only treatment.

  12. Therapy of Newly Diagnosed Follicular Lymphoma

    Directory of Open Access Journals (Sweden)

    Jason R. Westin

    2012-12-01

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

  13. Similar clinical features among patients with severe adult growth hormone deficiency diagnosed with insulin tolerance test or arginine or glucagon stimulation tests

    DEFF Research Database (Denmark)

    Toogood, Andrew; Brabant, Georg; Maiter, Dominique;

    2012-01-01

    To determine whether insulin tolerance tests (ITTs), arginine stimulation tests (ASTs), and glucagon stimulation tests (GST) identify patients who have similar clinical features of growth hormone (GH) deficiency when a diagnostic GH threshold of 3 μg/L is used.......To determine whether insulin tolerance tests (ITTs), arginine stimulation tests (ASTs), and glucagon stimulation tests (GST) identify patients who have similar clinical features of growth hormone (GH) deficiency when a diagnostic GH threshold of 3 μg/L is used....

  14. Factors associated with travel to non-local genitourinary medicine clinics for gonorrhoea: an analysis of patients diagnosed in London, 2009-10.

    Science.gov (United States)

    Le Polain de Waroux, Olivier; Hughes, Gwenda; Maguire, Helen; Crook, Paul D

    2014-03-01

    We analysed factors associated with travelling to non-local genitourinary medicine clinics for gonorrhoea care in London. We used surveillance data on London residents attending genitourinary medicine clinics in 2009-10 and calculated distances between patients' areas of residence and both the nearest genitourinary medicine clinic and the clinic attended. Non-local clinics were attended by 5408 (46.7%) patients. Men having sex with men attended non-local services more than heterosexuals (OR 3.83, p Asians less likely, to attend non-local services compared to whites (OR [95%CI] 1.33 [1.04-1.72], 1.36 [1.11-1.67] and 0.46 [0.31-0.70] respectively). Similar associations, although not statistically significant, were found in women. People were more likely to attend local services if their local clinic provided walk-in and young people's services, weekend consultations and long opening hours. These findings could help design services meeting local population needs and facilitate prompt and equitable access to care. PMID:23970635

  15. Challenges in diagnosing tuberculosis in children

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  16. Nursing diagnoses in women deprived of freedom

    OpenAIRE

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

    2016-01-01

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

  17. Diagnosing GORD in respiratory medicine

    Directory of Open Access Journals (Sweden)

    Chris James Timms

    2011-07-01

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

  18. Diagnosing GORD in Respiratory Medicine

    OpenAIRE

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

    2011-01-01

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

  19. How to diagnose a child? Atention Deficit-Hiperactivity Disorder diagnostic strategies from a critical discursive perspective

    Directory of Open Access Journals (Sweden)

    Mónica Peña Ochoa

    2015-03-01

    Full Text Available This work examines from the perspective of critical discourse analysis, the Attention Deficit with Hyperactivity Disorder diagnosis as stated by the DSM–IV and ICD-10. It considers as basis the difficulties posed by medical taxonomy of childhood as a distinct social category from adulthood, the using the sign of hyperkinesia as an evidence of the disorder, and the utilization of auxiliary instruments, external to the clinical “setting”, as the “Test of Conners”. The context of analysis refers to conditions present in Chile. Specifically, taking into consideration the diagnostic applications in the institutional space of the school. Finally, the diagnosis is analyzed from the uses and effects in regulating and self-government of individuals and bodies.

  20. Study on the clinical treatment of low - grade squamous intraepithelial lesion diagnosed by cytological test%宫颈细胞学诊断低度上皮内瘤变的临床处理探讨

    Institute of Scientific and Technical Information of China (English)

    张娟; 蔡林儿; 严杏

    2012-01-01

    目的:探讨宫颈细胞学诊断低度上皮内瘤变的意义及临床处理方法.方法:对2010年5月~2011年11月在广东省中医院就诊并经TCT检查为LSIL的195例女性病例进一步行HPV-DNA-PCR检测及阴道镜检查,观察其最终病理结果的构成及在不同年龄阶段的分布差异.结果:在195例LSIL患者中,高危HPV阳性144例(73.8%),病理诊断为癌前病变及癌者共87例(60.4%);高危HPV阴性51例(26.2%),病理诊断为癌前病变及癌者共8例(15.7%).在35岁以下的93例中,病理诊断为癌前病变及癌者共43例(46.2%);在35~45岁的69例中,病理诊断为癌前病变及癌者共41例(69.9%);45岁以上33例中,病理诊断为癌前病变及癌者共11例(33.3%).结论:在TCT诊断为LSIL的患者中,高危HPV阳性与高危HPV阴性患者的宫颈病变检出率差异有统计学意义,不同年龄段之间宫颈病变检出率差异有统计学意义,临床处理方法及随访计划的制定与年龄及HPV感染情况有关.%Objective: To explore the significance of cervical cytological test for diagnosis of low - grade squamous intraepithelial lesion (LSIL) and the clinical treatment. Methods: A total of 195 female cases who were diagnosed as low grade squamous intraepithelial lesion (LSIL) by TCT in the hospital from May 2010 to November 2011 further underwent HPV - DNA PCR and colposcopy, the proportion of finally pathological results and the difference of different age distributions were observed. Results: Among 195 patients with LSIL, 144 patients (73. 8% ) were found with positive high risk HPV, 87 patients (60. 4% ) were diagnosed as cervical precancerous lesion and cervical cancer by pathological diagnosis; 51 patients (26. 2% ) were found with negative high risk HPV, 8 patients (15. 7% ) were diagnosed as cervical precancerous lesion and cervical cancer by pathological diagnosis. Among 93 patients under 35 years old, 43 patients (46.2% ) were diagnosed as cervical precancerous

  1. Screening of a clinically and biochemically diagnosed SOD patient using exome sequencing: A case report with a mutations/variations analysis approach

    OpenAIRE

    Mohamad-Reza Aghanoori; Ghazaleh Mohammadzadeh Shahriary; Mahdi Safarpour; Ahmad Ebrahimi

    2016-01-01

    Background: Sulfite oxidase deficiency (SOD) is a rare neurometabolic inherited disorder causing severe delay in developmental stages and premature death. The disease follows an autosomal recessive pattern of inheritance and causes deficiency in the activity of sulfite oxidase, an enzyme that normally catalyzes conversion of sulfite to sulfate. Aim of the study: SOD is an underdiagnosed disorder and its diagnosis can be difficult in young infants as early clinical features and neuroimaging...

  2. Positive malignant margins in clinically diagnosed and excised benign breast lumps: a five year retrospective study at the Korle-Bu Teaching Hospital, Ghana

    International Nuclear Information System (INIS)

    This study was aimed at utilizing retrospective descriptive data to evaluate the percentage of clinically benign breast lumps that turned out to be histologically malignant and the prevalence of positive tumour margins among the malignant cases. A total of 2,917 registered cases of excised breast lump at the Department of Pathology spanning January 2005 to December 2009 were reviewed to evaluate the presence of malignancy and positive margins. Three hundred and twenty-two (11.0%) of the excised breast lumps were found to contain malignant tumours, out of which 142(44.1%) had positive tumour margins. Size of primary tumour (p=0.001) and histologic subtype (p=0.002) showed significant positive and negative associations in relation to positive tumour margins respectively. No significant association was observed between the positive tumour margins and histologic grade (p=0.363). The study showed that clinically benign breast lumps could be malignant and not completely excised, therefore increasing the risk of local recurrence. Thus, it is recommended that all women with breast lumps have the triad (diagnostic workup) of clinical and radiological assessment, followed with histological studies. (au)

  3. New quantitative total protein S-assay system for diagnosing protein S type II deficiency: clinical application of the screening system for protein S type II deficiency.

    Science.gov (United States)

    Tsuda, Tomohide; Jin, Xiuri; Tsuda, Hiroko; Ieko, Masahiro; Morishita, Eriko; Adachi, Tomoko; Hamasaki, Naotaka

    2012-01-01

    Venous thromboembolism (VTE) incidence is rising rapidly in Japan with lifestyle westernization and aging. Deficiency of protein S, an important blood coagulation regulator, is a risk factor for VTE. Protein S deficiency prevalence in Asians is approximately 10 times that in Caucasians and that of protein S type II deficiency, associated with the protein S Tokushima mutation (K155E), is quite high in Japan. However, currently available methods for measuring protein S are not precise enough for detection of this deficiency. We developed a novel assay system for precise simultaneous determinations of total protein S activity and total protein S antigen level, using a general-purpose automated analyzer, allowing protein S-specific activity (ratio of total protein S activity to total protein S antigen level) to be calculated. Mean specific activity was 0.99 for samples from healthy individuals but 0.69 or less (mean-3SD) in protein S type II-deficient and warfarin-treated samples, but was 1.0 in an estrogen-treated sample with significantly decreased protein S antigen. Protein S gene analyses in healthy individuals with specific activity 0.69 or less revealed the K155E mutation in all three. These results show our new assay system to be an effective screening tool for protein S type II deficiency. This system can also be used in an automated analyzer, facilitating numerous sample measurements, and is, thus, applicable to regular medical checkups and diagnosing VTE. Such applications would potentially contribute to early detection of protein S type II deficiency, and, thereby, to thrombosis prevention. PMID:22157257

  4. Epidemiological and clinical features, response to HAART, and survival in HIV-infected patients diagnosed at the age of 50 or more

    Science.gov (United States)

    Nogueras, MaMercedes; Navarro, Gemma; Antón, Esperança; Sala, Montserrat; Cervantes, Manel; Amengual, MaJosé; Segura, Ferran

    2006-01-01

    Background Over the last years, the mean age of subjects with HIV infection and AIDS is increasing. Moreover, some epidemiological and clinical differences between younger and older HIV-infected individuals have been observed. However, since introduction of HAART therapy, there are controversial results regarding their response to HAART. The aim of the present study is to evaluate epidemiological and clinical features, response to HAART, and survival in elderly HIV-infected patients with regard to younger HIV-infected patients. Methods A prospective cohort study (1998–2003) was performed on patients from Sabadell Hospital, in Northeast of Spain. The cohort includes newly attended HIV-infected patients since January 1, 1998. For the purpose of this analysis, data was censured at December 31, 2003. Taking into account age at time of diagnosis, it was considered 36 HIV-positive people aged 50 years or more (Group 1, G1) and 419 HIV-positive people aged 13–40 years (Group 2, G2). Epidemiological, clinical, biological and therapy data are recorded. Statistical analysis was performed using Chi-squared test and Fisher exact test, Mann-Whitney U test, Kaplan-Meier, Log Rank test, and Two-Way ANOVA from random factors. Results G1 showed higher proportion of men than G2. The most common risk factors in G1 were heterosexual transmission (P = 0.01) and having sex with men or women (P < 0.001). G1 and G2 show parallel profiles through the time regarding immunological response (P = 0.989) and virological response (P = 0.074). However, older people showed lower CD4 cell counts at first clinic visit (P < 0.001) and, eventually, they did not achieve the same counts as G2. G1 presented faster progression to AIDS (P < 0.001) and shorter survival (P < 0.001). Conclusion Older patients have different epidemiological features. Their immunological and virological responses are good. However, older patients do not achieve the same CD4 cell counts likely due to they have lower counts

  5. Diagnosing Sleep Disorders

    Science.gov (United States)

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

  6. Differential diagnoses to MS

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  7. ROLE OF RBC COUNT AND RBC INDICES IN DIAGNOSING AND DIFFERENTIATING ANEMIAS CAUSED DUE TO VARIOUS CLINICAL SITUATIONS IN A TERTIARY CARE HOSPITAL IN VADODARA, GUJARAT

    Directory of Open Access Journals (Sweden)

    Sandeep

    2015-11-01

    Full Text Available BACKGROUND : Latest technologies have made it easier for the pathologist and clinician to diagnose any case of anemia. Automated cell counters are widely used since last two decades that have further facilitated and made it easy for the clinicians to reach to the root cause of anemia. RBC count and entire RBC indices along with HB estimation gives a definite idea as to what could be the cause of anemia. The whole spectrum of RBC indices i.e. MCV, MCH and MCHC along with RBC count, PCV and Hemoglobin estimation plays a vital role to analyze the cause of anemia. MATERIAL AND METHODS: A cross sectional study was carried out at Parul Institute of Medical Science and Research, Limda, Vadodara, Gujarat. Investigations of RBC count and RBC indic es of patients were carried out on fully automated cell counter – by Merck diagnostics. Study included 700 patients with Hemoglobin <10gm% which included males and females of age group 15 - 50 years. RESULTS: Total 700 anemic patients with Hemoglobin < 10gm % were enrolled in the study. Among them 569 were females which included pregnant females also and 131 were males. Patients were of age group 15 - 50 years. Data revealed that 45 % of patients had iron deficiency anemia, 14 % had megaloblastic anemia, 13% ha d hemolytic anemia, 6 % had anemia due to chronic illness whereas 10 % had dimorphic type of anemia. In iron deficiency anemia, blood picture showed relatively high to normal RBC count and PCV i.e. hematocrit, typically low MCV and MCH values and low to no rmal MCHC. In megaloblastic anemia, RBC count was very low due to premature destruction of RBC’s and they had low PCV whereas high to very high MCV, MCH and MCHC values. In hemolytic anemia it is seen that RBC count is low and so is the PCV or hematocrit w hile such patients have normal to high MCV and normal MCH and MCHC. In anemia of chronic disease all parameters are relatively normal except low to normal MCV. CONCLUSION: RBC indices vary in

  8. Self-assessed and clinically diagnosed periodontal health status among patients visiting the outpatient department of a dental school in Bangalore, India

    Directory of Open Access Journals (Sweden)

    Nagarajan Sripriya

    2008-01-01

    Full Text Available Background: The purpose of the present cross-sectional study was to assess the extent of agreement between clinical and self-assessed periodontal health status among patients visiting the outpatient department of M.S. Ramaiah Dental College, Bangalore, India. Materials and Methods: The study population included 216 patients aged between 20 and 44 years who attended the outpatient department of the M.S. Ramaiah Dental College, Bangalore. The study population was subjected to a self-administered questionnaire (questions regarding bleeding gums, deposits on teeth, receding gums, swelling of gums, loose teeth, which was followed by periodontal examination. The clinical examination included an assessment of the periodontal condition, using the criteria of Loe and Silness Gingival Index, the Community Periodontal Index, and Mobility, respectively. Conclusion: The present study showed that the perceived periodontal health status was low and the discrepancy between the subjectively and objectively assessed needs was very distinct. The awareness of the periodontal problems has been reported to increase with increasing severity of the disease due to the destructive changes that set in.

  9. Screening of PRKAR1A and PDE4D in a Large Italian Series of Patients Clinically Diagnosed With Albright Hereditary Osteodystrophy and/or Pseudohypoparathyroidism.

    Science.gov (United States)

    Elli, Francesca Marta; Bordogna, Paolo; de Sanctis, Luisa; Giachero, Federica; Verrua, Elisa; Segni, Maria; Mazzanti, Laura; Boldrin, Valentina; Toromanovic, Alma; Spada, Anna; Mantovani, Giovanna

    2016-06-01

    The cyclic adenosine monophosphate (cAMP) intracellular signaling pathway mediates the physiological effects of several hormones and neurotransmitters, acting by the activation of G-protein coupled receptors (GPCRs) and several downstream intracellular effectors, including the heterotrimeric stimulatory G-protein (Gs), the cAMP-dependent protein kinase A (PKA), and cAMP-specific phosphodiesterases (PDEs). Defective G-protein-mediated signaling has been associated with an increasing number of disorders, including Albright hereditary osteodistrophy (AHO) and pseudohypoparathyroidism (PHP), a heterogeneous group of rare genetic metabolic disorders resulting from molecular defects at the GNAS locus. Moreover, mutations in PRKAR1A and PDE4D genes have been recently detected in patients with acrodysostosis (ACRDYS), showing a skeletal and endocrinological phenotype partially overlapping with AHO/PHP. Despite the high detection rate of molecular defects by currently available molecular approaches, about 30% of AHO/PHP patients still lack a molecular diagnosis, hence the need to screen patients negative for GNAS epi/genetic defects also for chromosomal regions and genes associated with diseases that undergo differential diagnosis with PHP. According to the growing knowledge on Gsα-cAMP signaling-linked disorders, we investigated our series of patients (n = 81) with a clinical diagnosis of PHP/AHO but negative for GNAS anomalies for the presence of novel genetic variants at PRKAR1A and PDE4D genes. Our work allowed the detection of 8 novel missense variants affecting genes so far associated with ACRDYS in 9 patients. Our data further confirm the molecular and clinical overlap among these disorders. We present the data collected from a large series of patients and a brief review of the literature in order to compare our findings with already published data; to look for PRKAR1A/PDE4D mutation spectrum, recurrent mutations, and mutation hot spots; and to identify specific

  10. El cuerpo como excusa: El diagnostico de la fibromialgia en una consulta de reumatología The body likes excuse: Diagnosing fibromyalgia in a rheumatologic clinic

    Directory of Open Access Journals (Sweden)

    Beatriz Tosal Herrero

    2008-03-01

    Full Text Available Introducción: El proceso de medicalización de la sociedad ha generado una dependencia de la biomedicina para entender, gestionar y legitimar la enfermedad. Como consecuencia surge una nueva forma de considerar los procesos corporales que transforma las identidades y subjetividades de los individuos y los grupos sociales. La enfermedad se concibe y se experimenta en el cuerpo en forma de signos y síntomas. Esta representación de la enfermedad compartida por expertos y enfermos durante el encuentro clínico se convierte en el lenguaje propio de la interacción. Esto ocurre incluso en casos, como el de la fibromialgia, en los que el diagnóstico se produce en ausencia de alteraciones ‘objetivas’ del cuerpo. Metodología: Observación participante, sobre la elaboración y comunicación del diagnóstico de fibromialgia en una consulta de reumatología. Resultados: Se analizan las representaciones sobre el cuerpo y la enfermedad que manejan tanto médicos como enfermos, y la utilización de los síntomas corporales como estrategia de legitimación e interacción durante el encuentro clínico. Conclusión: En la fibromialgia, a pesar de la ausencia de alteraciones biológicas ‘objetivas’, la relación sanitario-paciente se ve mediada por el cuerpo. Este es el lugar en el que se producen las intervenciones terapéuticas y el vehículo de la comunicación entre ambos.Introduction: The process of medicalization of the society has generated a dependence of the biomedicine to understand, to negotiate and to legitimate the illness. As consequence arises, a new form of considering the bodily processes that transforms the identities and the individuals' subjectivities. Persons conceive and experience the illness in the body as signs and symptoms. This representation of the illness shared by experts and patients during the clinical encounter it becomes the characteristic language of the interaction. This even happens in cases, as that of the

  11. 103例经纤支镜确诊肺癌病例的临床特点分析%Clinical features analysis of 103 cases of lung cancer diagnosed by fibrobronchoscope

    Institute of Scientific and Technical Information of China (English)

    胡绳; 田坤; 肖贞良; 张定涛; 陈章

    2014-01-01

    目的:探讨肺癌纤支镜下特征及临床特点。方法总结分析我科经纤支镜病理活检结果为阳性的103例肺癌的临床特点。结果患者男:女比为4.42:1;男性鳞癌多,占51.2%;女性腺癌多,占47.4%;50~69岁为发病高峰期。肿瘤多侵犯1个部位,以主支气管及肺上叶多见;肿瘤生长方式以管腔生长型常见,占64.1%。联合刷检阳性26例,占25.2%。结论纤支镜活检是确诊肺癌的最有效手段。%Objective To explore the clinical features of lung cancer under fibrobronchoscope(FBS). Methods The clinical features of lung cancer of 103 patients who were diagnosed as positive by pathological biopsy under FBS were summarized and analyzed. Results For the selected patients,the ratio of the male to female was 4. 42 :1. The ratio of squamous cell carcinoma in the male patients accounted for 51. 2% ,and the ratio of adenocarcinoma in the female patients accounted for 47. 4% . The patients of 50-69 years old had the peak incidence. Generally,most of tumors invaded one site,mainly in the main bronchus and upper lobe of lungs. Tumors usually grew in lumen,and accounted for 64. 1% . In combination with brush biopsy,26 ones were found positive and accounted for 25. 2% . Conclusion FBS biopsy is the most effective means to diagnose lung cancer.

  12. Clinical experience records of diagnosing and differentiating blackish facial patch from liver aspect%黧黑斑从肝辨治临证验案举隅

    Institute of Scientific and Technical Information of China (English)

    叶世龙; 刘爱芹

    2011-01-01

    This article lists specific cases, and describes clinical experiences on how the author makes good use of prescription of liver and spleen, clear air heat, nourishing, soothing heat and tonifying and recipe to treat blackish relate to depression, spleen & phase fire disturbance, liver blood deficiency following liver stagnation and intermingled.Though the recipe is mediocre, but certainly its efficacy is positive and suitable for the treatment of blackish lesions caused by the regional environment in Shenzhen area.%文章列举具体案例,介绍了笔者运用疏肝运脾、清化痰热、补气养血、疏肝清热及攻补兼施方药,治疗肝郁脾困、相火上扰、肝血虚继肝气郁以及虚实夹杂类黧黑斑之临床经验.所用方药虽平淡无奇,但临床疗效肯定,且适合深圳地域环境所致之黧黑斑病变.

  13. Diagnosing Psoriatic Arthritis

    Science.gov (United States)

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

  14. Diagnosing Delirium by Telephone

    OpenAIRE

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

    1998-01-01

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

  15. Diagnosing gestational diabetes

    OpenAIRE

    Ryan, E. A.

    2011-01-01

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

  16. 低场强磁共振对膝关节损伤的临床诊断价值%Clinical value of low-field MRI in diagnosing knee joint injuries

    Institute of Scientific and Technical Information of China (English)

    徐钐; 温生贵

    2014-01-01

    Objective To evaluate the clinical value of low-field MRI in diagnosing knee joint inju-ry. Methods The MRI and arthroscopy results of 84 cases of knee joint injuries were retrospectively analyzed and compared. Then the accuracy, sensibility and specificity of low-field MRI were evaluated. Results There were 84 cases with 88 knee joint injuries. The accuracy of low-field MRI was 82.95% in diagnosing meniscus tear, with the sensibility of 75.51%and the specificity of 85.83%. In diagnosing anterior cruciate ligament tear, the accuracy, sensi-bility and specificity of low-field MRI were 89.77%, 89.74%and 90.00%, respectively. Conclusion Low-field MRI can demonstrate knee joint injuries very clearly, and it has high clinical practical value.%目的:探讨低场强磁共振对膝关节损伤的临床诊断价值。方法回顾性对比84例膝关节损伤患者的低场强MRI图像和关节镜结果,统计低场强磁共振诊断的准确性、敏感性和特异性。结果84例患者共88个膝关节,MRI诊断半月板撕裂的准确性为82.95%、敏感性为75.51%、特异性为85.83%;诊断前交叉韧带撕裂的准确性、敏感性和特异性分别为89.77%、89.47%和90.00%。结论低场强磁共振能够清楚显示膝关节受损情况,具有较高的临床实用价值。

  17. 窄带成像内镜诊断食管上段胃黏膜异位症的临床分析%Clinical analysis of heterotopic gastric mucosa in the upper esophagus diagnosed by narrow band imaging endoscopy

    Institute of Scientific and Technical Information of China (English)

    宋敏; 吴杰; 王萍; 黄晓东

    2015-01-01

    Objective]To investigate the clinical features of heterotopic gastric mucosa in the upper esophagus(HGMUE)diagnosed by narrow band imaging(NBI)endoscopy.[Methods]The clinical manifesta‐tions ,endoscopic features and the histological characteristics of HGM UE patients in the Wuhan central hospital from 2013 to 2014 were retrospectively analyzed.[Results]Total 113 cases were diagnosed HG‐MUE by NBI endoscopy in 4 719 patients.The detection rate of HGMUE was 2.39%.Some patients had the clinical symptoms of retrosternal pain ,heartburn ,dysphagia ,globus sensation ,hoarseness ,et al.The pa‐thology of tissues was gastric epithelium.Fundic‐type gastric mucosa(68.14% )constituted the most com‐mon histology.[Conclusion]The use of NBI endoscopy can improve the detection rate of HGMUE which may help the secondary step of clinical treatment.%[目的]探讨窄带成像(narrow band imaging ,NBI)内镜诊断的食管上段胃黏膜异位症(heterotopic gastric mucosa in the upper esophagus ,HGMUE)的临床特点,以提高HGMUE的检出率。[方法]回顾性分析NBI内镜诊断为HGMUE的113例患者临床、内镜、病理表现。[结果]4719例患者中发现HGMUE患者113例,内镜检出率为2.39%。NBI内镜下,病变区域为棕褐色斑块,与周围正常食管上皮界限清晰,小凹形态以管状(93.81%)为主,未发现表面微血管扩张变异。部分患者临床表现为胸骨后疼痛、烧灼感、吞咽困难、咽部异物感等,病理为胃上皮组织,胃底型(68.14%)居多。[结论] NBI内镜可提高 HGMUE的检出率,从而为临床治疗提供帮助。

  18. Diagnosing Infectious Mononucleosis: Avoiding the Pitfalls

    OpenAIRE

    McSherry, J. A.

    1985-01-01

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

  19. DIAGNOSE AND MANAGEMENT TINEA FASCIALIS

    Directory of Open Access Journals (Sweden)

    I Pt Agus Suryantara P

    2014-01-01

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

  20. Clinical features of 11 cases diagnosed autoimmune pancreatitis%自身免疫性胰腺炎11例临床特征分析

    Institute of Scientific and Technical Information of China (English)

    陈雪; 张杰; 陈婧; 郭子皓; 李光; 郝建宇

    2012-01-01

    目的 探讨自身免疫性胰腺炎(AIP)的临床表现,血清学、影像学、组织学特征,诊断及治疗方案,以期提高对此病的认识.方法 回顾性分析2002~2012年收治的具有完整临床资料的AIP病例11例.结果 11例患者中,男7例,女4例,年龄49~77岁,平均年龄(65.2±8.9)岁,出现黄疸6例(54.5%),上腹部不适8例(72.7%),体重减轻8例(72.7%),无症状1例(9.1%).血清IgG4水平升高者10例(90.9%),CT显示胰腺弥漫肿大者8例(72.7%),胰头肿大2例(18.2%),胰腺体尾部肿大1例(9.1%),出现晕环征者7例(63.6%).6例行ERCP检查,显示主胰管不规则狭窄者6例(100%),胆管狭窄5例(83.3%),考虑为IgG4相关性胆管炎.8例行EUS-FNA,其中可见浆细胞、腺体及纤维素者3例(37.5%),见少量腺体、纤维素者4例(50%),仅见小簇状细胞者1例(12.5%).单纯激素治疗者7例(63.6%),激素联合熊去氧胆酸治疗4例(36.4%),因胆管狭窄放置支架4例,手术2例,其中胆肠吻合术1例,胰十二指肠切除术1例,经治疗后,所有患者黄疸消退,影像学显示胰腺恢复正常,9例血清IgG4恢复正常.结论 自身免疫性胰腺炎的诊断需要综合考虑,激素是首选的治疗方法,对于IgG4相关性胆管炎所致胆管狭窄,单用激素治疗效果不佳者,胆道支架植入或胆肠吻合手术可以作为减轻黄疸的有效方法.%Objective In order to increase the awareness of autoimmune pancreatitis(AIP) , we investigated the clinical manifestations, serological, radiological and histological features, diagnosis and treatment. Methods Clinical data of 11 cases from 2002 to 2012 in Beijing Chaoyang Hospital was reviewed. Results The age of AIP (male 7 ; female 4) ranged from 49 to 77 with a median age of (65.2±8.9) years in this series. Ofthell patients, 6 cases (54. 5% )had the symptom of painless jaundice, upper abdominal discomfort in 8 cases (72.7% ) , weight loss in 8 cases (72.7%), asymptom in 1 case (9. 1

  1. How a Stroke Is Diagnosed

    Science.gov (United States)

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

  2. Diagnosing and Treating Acute Bronchitis

    Science.gov (United States)

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

  3. Understanding Prostate Cancer: Newly Diagnosed

    Science.gov (United States)

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

  4. Evaluation of combined, conservative treatment impact on the clinical course, blood flow parameters and muscle perfusion in the group of patients with newly diagnosed, untreated peripheral arterial disease (PAD)

    International Nuclear Information System (INIS)

    Background: Epidemiological studies determined incidence of obliterative atherosclerosis as ranging between 2.45 -10 %. The course of disease is often asymptomatic and demonstration of symptoms occurs when vascular lesions are significantly advanced. This article discusses conservative treatment of patients with PAD whose key complaint was intermittent claudication. The Authors proposed multi-stage treatment regimen of this disease including lifestyle modification, treatment of comorbid disorders, and pharmacotherapy (aspirin, pentoxifylline, buflomedil, L-arginine). The study evaluated influence of 6-month treatment on clinical course, blood flow parameters as well as muscle perfusion. Material/Methods: The participants included 35 patients (14 women - 40.0 %, and 21 men - 60.0 %) aged from 49 to 80 (mean age 68.37 ± 10.25 years) first time in life diagnosed with PAD. Physical examination, standard vascular tests (ankle-brachial, thigh-ankle and thigh-shin indices, maximum flow velocity, PI and RI in selected arteries), perfusion scintigraphy of lower limbs muscles at rest and on exertion were carried out before and after 6 months of treatment. Results: Statistically significant increase of total walking distance (198.0 meters vs. 330.0 meters, p< 0.01) and improvement in average values of perfusion indices of all studied areas were detected at rest and after exercise. For shin perfusion index at rest (right and left) and for thigh perfusion index after exercise (right) the difference was statistically significant at p< 0.05. Conclusions: Combined medical treatment brought on positive effect on patients suffering from recently diagnosed, thus not yet treated atherosclerotic lower limb ischaemia of IIA and IIB stages according to Fontaines scale. (authors)

  5. Being publicly diagnosed

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  6. Validation studies of nursing diagnoses in neonatology

    Directory of Open Access Journals (Sweden)

    Pavlína Rabasová

    2016-03-01

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

  7. Clinical Trials

    Science.gov (United States)

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  8. 经支气管镜确诊的2168例肺癌的临床特点分析%Analysis of Clinical Features of 2 168 Confirmed Cases of Lung Cancer Diagnosed by Bronchoscopy

    Institute of Scientific and Technical Information of China (English)

    张宇; 于力克; 谢海燕; 胡韦华; 郝可可; 夏宁

    2011-01-01

    Objective To investigate the clinical characteristics of confirmed cases of lung cancer diagnosed by bronchoscopy. Methods A retrospective analysis was conducted to study the clinical features such as gender,age,pathologic type,lesion location,bronchoscopic image and sampling method of 2,168 confirmed cases of lung cancer diagnosed by bronchoscopy. Results The sex ratio (M/F) was 4.8 : 1 and the peak incidence was between 60 to 69 years of age. The most common pathologic type was squamous cell carcinoma (44.56%),followed by adenocarcinoma (25.92%) and small cell lung cancer (18.27%). Squamous cell carcinoma had the highest incidence rate (50.61%) a-mong men,while adenocarcinoma had the highest rate among women (56.18%). The positive rates diagnosed by forceps biopsy,brush biopsy,bronchial alveolar lavage and transbronchial needle aspiration were 81.60%,49.37%, 18.24% and 62.65% respectively. The positive rate by forceps biopsy combined with brush was 89.06%. Conclusion Bronchoscopy is an important approach in the diagnosis of lung cancer. The incidence and pathologic type of lung cancer vary depending on age and gender. Bronchoscopy and improving biopsy technique can markedly increase the diagnostic rate and help in early diagnosis of lung cancer.%分析经支气管镜确诊肺癌的临床特点.方法 回顾性分析经支气管镜确诊为肺癌的2 168例患者的性别、年龄、病理类型、病变部位、镜下表现、取材方法等特点.结果 该组患者男女比例为4.8:1,60~69岁为发病年龄高峰.鳞癌是最主要的病理类型(占44.56%),其次为腺癌(占25.92%)和小细胞癌(占18.27%).男性鳞癌发病率最高(占50.61%),女性腺癌发病率最高(占56.18%).钳检、刷检、支气管肺泡灌洗、经支气管镜针吸的诊断阳性率分别为81.60%、49.37%、18.24%和62.65%,钳检联合刷检阳性率为89.06%.结论 支气管镜检查是诊断肺癌的重要手段.不同年龄、不同性别的肺癌患者发病不同,病

  9. Clinical features and radiology for diagnoses of dural venous sinus thrombosis%颅内静脉窦血栓形成的临床及影像学诊断25例报道

    Institute of Scientific and Technical Information of China (English)

    杜红坚; 杨露春

    2001-01-01

    目的 研究颅内静脉窦血栓形成的病因、临床特点、特别是影像学的表现。方法 回顾性分析25例已确诊的静脉窦血栓形成患者(男 2例,女23例)的临床资料及影像学特点,包括发病原因、临床表现、实验室检查及影像学头部CT、磁共振成像( MRI)和磁共振血管成像(MRA)的异常表现。结果 25例本病患者除2例男性外,余23例均有明确病因,如妊娠期、产褥期、口服避孕药等,临床表现以亚急性颅压高症状为主;部分头部CT可见条索征及空三角征, MRI特征性表现为T1、T2加权像窦内异常高信号, MRA示栓塞的静脉窦未显影。结论 颅内静脉窦血栓形成患者多可找到明确病因,临床表现多样,无特异性,MRI/MRA 可帮助确诊。%Objective To study the etiology, clinical features and particular radiology of dural venous sinus thrombosis (DVST). Methods 25cases (2 males,23 females) of DVST were retrospectively reviewed, including etiology, clinical features, laboratory examinations and CT,MR imaging(MRI) and/or MR angiography of the venous sinuses. Results Except for the two males, all 23 females had definite causes, such as during pregnant or puerperium, or taking oral contraceptives.Clinical features included subacute intracranial hypertension, and so on. The CT of some patients showed cord signs and △ sign. The MRI with T1/T2- weighted showed high-intensity signals inside the thrombosed sinuses. MRA showed loss of plane signals of thrombosed sinuses. Conclusion Most of patients with DVST have definite causes and various clinical features and can be diagnosed with MRI and MRA.

  10. Meta-analysis of screening and case finding tools for depression in cancer: Evidence based recommendations for clinical practice on behalf of the Depression in Cancer Care consensus group

    DEFF Research Database (Denmark)

    Mitchell, A. J.; Meader, N.; Davies, E.;

    2012-01-01

    Background: To examine the validity of screening and case-finding tools used in the identification of depression as defined by an ICD10/DSM-IV criterion standard. Methods: We identified 63 studies involving 19 tools (in 33 publications) designed to help clinicians identify depression in cancer se...... unassisted clinical recognition. In clinical practice, all tools should form part of an integrated approach involving further follow-up, clinical assessment and evidence based therapy. (C) 2012 Elsevier B.V. All rights reserved....

  11. Eating Disorder Diagnoses: Empirical Approaches to Classification

    Science.gov (United States)

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

    2007-01-01

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

  12. Diagnosing and treating respiratory syncytial virus bronchiolitis.

    Science.gov (United States)

    Napierkowski, Daria B

    2016-09-22

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

  13. Diagnosing dementia: do we get it right?

    OpenAIRE

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

    1988-01-01

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

  14. Regional and temporal variations in coding of hospital diagnoses referring to upper gastrointestinal and oesophageal bleeding in Germany

    Directory of Open Access Journals (Sweden)

    Garbe Edeltraut

    2011-08-01

    Full Text Available Abstract Background Health insurance claims data are increasingly used for health services research in Germany. Hospital diagnoses in these data are coded according to the International Classification of Diseases, German modification (ICD-10-GM. Due to the historical division into West and East Germany, different coding practices might persist in both former parts. Additionally, the introduction of Diagnosis Related Groups (DRGs in Germany in 2003/2004 might have changed the coding. The aim of this study was to investigate regional and temporal variations in coding of hospitalisation diagnoses in Germany. Methods We analysed hospitalisation diagnoses for oesophageal bleeding (OB and upper gastrointestinal bleeding (UGIB from the official German Hospital Statistics provided by the Federal Statistical Office. Bleeding diagnoses were classified as "specific" (origin of bleeding provided or "unspecific" (origin of bleeding not provided coding. We studied regional (former East versus West Germany differences in incidence of hospitalisations with specific or unspecific coding for OB and UGIB and temporal variations between 2000 and 2005. For each year, incidence ratios of hospitalisations for former East versus West Germany were estimated with log-linear regression models adjusting for age, gender and population density. Results Significant differences in specific and unspecific coding between East and West Germany and over time were found for both, OB and UGIB hospitalisation diagnoses, respectively. For example in 2002, incidence ratios of hospitalisations for East versus West Germany were 1.24 (95% CI 1.16-1.32 for specific and 0.67 (95% CI 0.60-0.74 for unspecific OB diagnoses and 1.43 (95% CI 1.36-1.51 for specific and 0.83 (95% CI 0.80-0.87 for unspecific UGIB. Regional differences nearly disappeared and time trends were less marked when using combined specific and unspecific diagnoses of OB or UGIB, respectively. Conclusions During the study

  15. Stable feature selection for clinical prediction: exploiting ICD tree structure using Tree-Lasso.

    Science.gov (United States)

    Kamkar, Iman; Gupta, Sunil Kumar; Phung, Dinh; Venkatesh, Svetha

    2015-02-01

    Modern healthcare is getting reshaped by growing Electronic Medical Records (EMR). Recently, these records have been shown of great value towards building clinical prediction models. In EMR data, patients' diseases and hospital interventions are captured through a set of diagnoses and procedures codes. These codes are usually represented in a tree form (e.g. ICD-10 tree) and the codes within a tree branch may be highly correlated. These codes can be used as features to build a prediction model and an appropriate feature selection can inform a clinician about important risk factors for a disease. Traditional feature selection methods (e.g. Information Gain, T-test, etc.) consider each variable independently and usually end up having a long feature list. Recently, Lasso and related l1-penalty based feature selection methods have become popular due to their joint feature selection property. However, Lasso is known to have problems of selecting one feature of many correlated features randomly. This hinders the clinicians to arrive at a stable feature set, which is crucial for clinical decision making process. In this paper, we solve this problem by using a recently proposed Tree-Lasso model. Since, the stability behavior of Tree-Lasso is not well understood, we study the stability behavior of Tree-Lasso and compare it with other feature selection methods. Using a synthetic and two real-world datasets (Cancer and Acute Myocardial Infarction), we show that Tree-Lasso based feature selection is significantly more stable than Lasso and comparable to other methods e.g. Information Gain, ReliefF and T-test. We further show that, using different types of classifiers such as logistic regression, naive Bayes, support vector machines, decision trees and Random Forest, the classification performance of Tree-Lasso is comparable to Lasso and better than other methods. Our result has implications in identifying stable risk factors for many healthcare problems and therefore can

  16. 全身骨显像诊断肺癌骨转移的临床价值%Clinical value of the whole body bone imaging in diagnosing bone metastasis from lung cancer

    Institute of Scientific and Technical Information of China (English)

    贾莉; 夏正武; 马世兴

    2011-01-01

    Objective: To explore clinical value of the whole body bone imaging in diagnosing bone metastasis from lung cancer, in order to guide staging and treatment of patients with lung cancer. Methods: 126 patients with pathological diagnosis of lung cancer were performed whole body bone imaging, CT and ALP, blood calcium inspection. Probability of bone metastasis from lung cancer of the different pathological type and different clinical stage were counted. The whole body bone imaging and clinical factors of suspicious bone metastasis (including bone pain, alkaline phosphatase, high calcium lev -els, arbitrary or a few) for diagnosis accuracy of bone metastases were statistical compared. Results: The incidence of bone metastasis from lung cancer was 27.8%, and the bone metastases occurrence probability of peripheral lung cancer was higher than central lung cancer (P<0.01), bone metastases occurrence probability of lung adenocarcinoma was higher than lung squamous cell carcinoma (P<0.01), bone metastases occurrence probability of period Ⅲ, IV patients was obviously higher than that of period I , II (P<0.01). The sensitivity (94.3%), specific degrees (84.6%), accuracy (87.3%) of the whole body bone imaging diagnosis of bone metastases from lung cancer were higher than the clinical factors of suspicious bone metas -tasis diagnosis of bone metastases. Conclusion: Whole body bone imaging should be a routine examination in patients with lung cancer. The clinical significance is important to determine stage and treatment of lung cancer.%目的:探讨全身骨显像在诊断肺癌骨转移的临床价值,以便更好地指导肺癌患者的分期及治疗.方法:126例病理确诊为肺癌的患者均行全身骨显像、CT及碱性磷酸酶、血钙检查.统计肺癌患者不同病理类型、不同临床分期发生骨转移的几率,将全身骨显像与可疑骨转移临床因素(包括骨痛、碱性磷酸酶升高、高钙血症中任意一项或几项)诊断骨转移

  17. How Is Pulmonary Hypertension Diagnosed?

    Science.gov (United States)

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

  18. How Is Cystic Fibrosis Diagnosed?

    Science.gov (United States)

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

  19. Diagnosing Dementia--Positive Signs

    Science.gov (United States)

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

  20. Ankle Fractures Often Not Diagnosed

    Science.gov (United States)

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

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

    Science.gov (United States)

    Sedlak, C A; Ludwick, R

    1996-01-01

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

  2. Diagnoses and interventions in podiatry.

    OpenAIRE

    Zuijderduin, W.M.; Dekker, J

    1996-01-01

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

  3. Diagnosing Common Benign Skin Tumors.

    Science.gov (United States)

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

    2015-10-01

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

  4. Diagnosable structured logic array

    Science.gov (United States)

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

    2009-01-01

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

  5. Whipple's disease in Spain: a clinical review of 91 patients diagnosed between 1947 and 2001 Enfermedad de Whipple en España: Revisión clínica de 91 pacientes diagnosticados durante 1947-2001

    Directory of Open Access Journals (Sweden)

    E. Ojeda

    2010-02-01

    Full Text Available Background: to determine the epidemiological, clinical, diagnostic and therapeutic characteristics of Whipple's disease in Spain. Patients and method: cases of Whipple's disease reported in the Spanish literature between 1947 and 2001 which meet histological or PCR criteria are reviewed. Results: 91 cases were included, 87.5% of which were male. The maximum incidence was between 40 and 60 years of age (68%. There was no family clustering or susceptibility by profession or surroundings. The most common symptoms and signs were: weight loss (80%, diarrhoea (63%, adenopathies (35%, skin problems (32%, abdominal pain (27%, fever (23%, joint problems (20% and neurological problems (16%. Arthralgias, diarrhoea and fever were noted prior to diagnosis in 58, 18 and 13% of patients, respectively. Diagnosis was histological in all cases except two, which were diagnosed by PCR. Intestinal biopsy was positive in 94%. Adenopathic biopsies (mesenteric or peripheral were suggestive in 13% of cases, and treatment was effective in 89%. There were nine relapses, four of which were neurological, although all occurred before the introduction of cotrimoxazole. Conclusions: Whipple's disease is not uncommon, although it requires a high degree of suspicion to be diagnosed in the absence of digestive symptoms. The most common and most sensitive diagnostic method is duodenal biopsy. PCR is beginning to be introduced to confirm the diagnosis and as a therapeutic control. Initial antibiotic treatment with drugs that cross the blood-brain barrier, such as cotrimoxazole and ceftriaxone, is key to achieving a cure and avoiding relapses.Fundamento: conocer las características epidemiológicas, clínicas, diagnósticas y terapéuticas de la enfermedad de Whipple en España. Pacientes y método: se revisan los casos de enfermedad de Whipple de la literatura española que cumplen criterios histológicos o de PCR desde 1947 hasta 2001. Resultados: se incluyeron 91 casos. El 87

  6. Psychiatric diagnoses in patients with burning mouth syndrome and atypical odontalgia referred from psychiatric to dental facilities

    Directory of Open Access Journals (Sweden)

    Miho Takenoshita

    2010-10-01

    -related, and somatoform disorders in AO patients was significantly higher than in BMS patients. BMS patients were more frequently given a F3 classification (mood/affective disorders. However, 50.8% of BMS patients and 33.3% of AO patients had no specific psychiatric diagnoses.Conclusion: Although BMS and AO are both chronic pain disorders occurring in the absence of any organic cause, the psychiatric diagnoses of patients with BMS and AO differ substantially.Keywords: glossodynia, stomatodynia, ICD-10, somatoform disorder

  7. Clinical observation of intensive insulin aspart in the treatment of newly diagnosed type 2 diabetes%门冬胰岛素强化治疗新诊断2型糖尿病的临床观察

    Institute of Scientific and Technical Information of China (English)

    赵润年; 杨世民; 刘莲叶

    2011-01-01

    目的 观察门冬胰岛素与生物合成人胰岛素治疗2型糖尿病的临床疗效及安全性.方法 新诊断的2型糖尿病患者随机分为2组,应用每日4次胰岛素强化降糖治疗方案.治疗组:三餐前0-10 min皮下注射门冬胰岛素;对照组:三餐前15~30 min皮下注射生物合成人胰岛素,晚10时均用精蛋白生物合成人胰岛素皮下注射.对2组患者的血糖控制情况、低血糖发生率、胰岛素的使用量及住院天数进行比较.结果 门冬胰岛素组患者的低血糖发生率明显低于生物合成人胰岛素组(P0.05).结论 门冬胰岛素用于2型糖尿病的治疗,能更加安全有效地控制血糖.%Objective To observe the clinical effect and safety of insulin aspart and human insulin for type 2 diabetes. Methods The newly diagnosed type 2 diabetic patients were divided into two groups randomly and treated with intensive insulin therapy four times per day. Half of the patients were treated with thrice preprandial injection of insulin aspart Correspondingly, others were treated with human insulin. All the patients were treated with isophane protamine biosynthetic human insulin injection at bedtime. The blood glucose lever, occurrence of hypoglycemia, dosage of insulin, and therapeutic time were investigated. Results The incidence of hypoglycemia in the patients with insulin aspart therapy was lower remarkably than the control group. The dosage of insulin and therapeutic time were similar in two groups. Conclusion Insulin aspart is more effective and safe for type 2 diabetic patients.

  8. A Danish Twin Study of Schizophrenia Liability

    DEFF Research Database (Denmark)

    Kläning, Ulla; Trumbetta, Susan L; Gottesman, Irving I;

    2016-01-01

    whether variance in schizophrenia liability attributable to environmental factors may have decreased with successive cohorts exposed to improvements in public health. ICD-10 diagnoses were determined by clinical interview. Although the best-fitting, most parsimonious biometric model of schizophrenia...... in prenatal and perinatal care and with a secular decline in the prevalence of schizophrenia in that region....

  9. Measuring Money Mismanagement Among Dually Diagnosed Clients

    OpenAIRE

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

    2008-01-01

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

  10. Eosinophilic Pancreatitis Diagnosed With Endoscopic Ultrasound

    OpenAIRE

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

    2015-01-01

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

  11. 血清降钙素原在胆道感染中的诊断价值%Clinical application of serum procalcitonin level in diagnosing biliary tract infection

    Institute of Scientific and Technical Information of China (English)

    李惠; 高堃; 翟仁友; 戴定可; 黄强; 王剑锋

    2013-01-01

    Objective To discuss the clinical value of serum procalcitonin level in diagnosing biliary tract infection. Methods A total of 53 patients with obstructive jaundice were enrolled in this study. The serum procalcitonin level was determined in all patients by immunolofluoreseence sandwich method. Percutanous biliary drainage was performed in all patients. Based on the bile culture result and the clinical manifestations, the patients were divided into the bacterial infection group (n = 33) and the non-bacterial infection group (n = 20). The serum procalcitonin level, white blood cell (WBC) count and the percentage of neutrophilic granulocyte were determined, and the results were compared between the two groups. Results Taking 0.25 ng/ml as the positive threshold of serum procalcitonin level, the sensitivity and the specificity for the diagnosis of biliary tract bacterial infection were 91.9% and 87.5% respectively. When WBC of 8.89 × 109/L was taken as the positive threshold, the sensitivity and the specificity for the diagnosis of biliary tract bacterial infection were 54.8% and 83.3% respectively. If neutrophilic granulocyte of 74.25% was regarded as the positive threshold, the sensitivity and the specificity for the diagnosis of biliary tract bacterial infection were 66.1% and 70.8% respectively. The serum procalcitonin level in the bacterial infection group was significantly higher than that in the non-bacterial infection group (P < 0.05). Conclusion Determination of serum procalcitonin level is very helpful for the diagnosis of biliary tract bacterial infection with much higher sensitivity and specificity. Therefore, serum procalcitonin level can be used as an effective index for biliary tract bacterial infection.%目的 探讨血清降钙素原(PCT)浓度在胆道感染中的诊断价值.方法 采用荧光免疫夹心法检测53例梗阻性黄疸患者血清PCT浓度,所有患者均行经皮经肝穿刺胆管引流术,根据胆汁培养结果及临床症状

  12. Diagnosing mucopolysaccharidosis IVA

    OpenAIRE

    Wood, Timothy C.; Harvey, Katie; Beck, Michael; Burin, Maira Graeff; Chien, Yin-Hsiu; Church, Heather J.; D’Almeida, Vânia; van Diggelen, Otto P.; Fietz, Michael; Giugliani, Roberto; Harmatz, Paul; Hawley, Sara M.; Hwu, Wuh-Liang; Ketteridge, David; Lukacs, Zoltan

    2013-01-01

    Mucopolysaccharidosis IVA (MPS IVA; Morquio A syndrome) is an autosomal recessive lysosomal storage disorder resulting from a deficiency of N-acetylgalactosamine-6-sulfate sulfatase (GALNS) activity. Diagnosis can be challenging and requires agreement of clinical, radiographic, and laboratory findings. A group of biochemical genetics laboratory directors and clinicians involved in the diagnosis of MPS IVA, convened by BioMarin Pharmaceutical Inc., met to develop recommendations for diagnosis....

  13. Distribution of Severity of Injury/Illness Index according to ICD-10 groups

    DEFF Research Database (Denmark)

    Nielsen, Niels Dalsgaard; Dahl, Michael; Rostgaard-Knudsen, Martin; Thorgaard, Per; Knudsen, Flemming

    , Trauma and Poisoning. RESULTS:  8249 patients were included in the six main groups. 6061 patients (73,5%) were classified in groups 0-3. 2188 patients (26,5%) were classified in groups 4-7. Poisoning, diseases of the respiratory system and diseases of the circulatory system shows a more severe pattern...

  14. Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England

    Directory of Open Access Journals (Sweden)

    Wright F

    2012-10-01

    Full Text Available Abstract Background Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES in England, is increasingly used in medical research. Relatively little is known about the reliability of HES diagnostic information for epidemiological studies. In the United Kingdom (UK, general practitioners hold comprehensive records for individuals relating to their primary, secondary and tertiary care. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources. Methods Million Women Study participants with a HES record of hospital admission with vascular disease (ischaemic heart disease [ICD-10 codes I20-I25], cerebrovascular disease [G45, I60-I69] or venous thromboembolism [I26, I80-I82] between April 1st 1997 and March 31st 2005 were identified. In each broad diagnostic group and in women with no such HES diagnoses, a random sample of about a thousand women was selected for study. We asked each woman’s general practitioner to provide information on her history of vascular disease and this information was compared with the HES diagnosis record. Results Over 90% of study forms sent to general practitioners were returned and 88% of these contained analysable data. For the vast majority of study participants for whom information was available, diagnostic information from general practice and HES records was consistent. Overall, for 93% of women with a HES diagnosis of vascular disease, general practice records agreed with the HES diagnosis; and for 97% of women with no HES diagnosis of vascular disease, the general practitioner had no record of a diagnosis of vascular disease. For severe vascular disease, including myocardial infarction (I21-22, stroke, both overall (I60-64 and by subtype, and pulmonary embolism (I26, HES records appeared to be both reliable and complete. Conclusion Hospital admission data

  15. 分析同型半胱氨酸检测对慢性心力衰竭疾病诊断的临床价值%The clinical significance of the chronic heart failure diagnosed by Homocysteine testing

    Institute of Scientific and Technical Information of China (English)

    纪全江

    2014-01-01

    目的:通过检测慢性心力衰竭患者血清中同型半胱氨酸的浓度水平,分析探讨同型半胱氨酸在慢性心力衰竭诊断中的临床意义。方法选取2012年1月~2013年12月收治的慢性心力衰竭患者58例设为试验组,选择同期健康体检者60例设为对照组,纳入对象均按要求进行同型半胱氨酸浓度水平检测,同时检测心脏功能常规检测指标肌酸激酶和肌酸激酶同工酶,分析检测结果。结果与对照组进行比较,试验组患者血清中的同型半胱氨酸、肌酸激酶、肌酸激酶同工酶的浓度水平都有明显升高,差异具有统计学意义(P<0.05);各阶段慢性心力衰竭患者的同型半胱氨酸的阳性检出率均在70%以上,且对应阶段患者的肌酸激酶和肌酸激酶同工酶分别与同型半胱氨酸两两比较,差异无统计学意义(P>0.05)。结论同型半胱氨酸是一种诊断慢性心力衰竭疾病的具有较高阳性检出率的有效指标,其阳性检出率和其他两项常规心脏功能评价指标无显著性差异。%objective To explore the clinical significance of the chronic heart failure diagnosed by Homocysteine testing.Methods 58 cases of patients with chronic heart failure were chosen for the experimental group and 60 cases healthy check-up were for the control group, and tested the Homocysteine, Creatine Kinase, MB Iso Enzyme of Creatine Kinase of all the patients and the healthy people. Then analyzed the results comprehensively.Results Compared with the control group, there were significantly higher of the Homocysteine,Creatine Kinase, MB Iso Enzyme of Creatine Kinase results of the experimental group(P0.05).Conclusion Homocysteine is an effective diagnostic indicator, which has higher positive rate of chronic heart disease, and the positive rate and the other two regular evaluation of cardiac function was no significant difference.

  16. The Investigation of First Diagnosed Case and Analysis of Clinical Characteristics of Adolescent Depression%青少年抑郁症的首诊状况调查与临床特征分析

    Institute of Scientific and Technical Information of China (English)

    程道猛; 刘靖雯; 黄鹏; 徐世超; 王春江

    2013-01-01

    Objective :To investigate first diagnosed Case and clinical characteristics of adolescent Depression ,and to provide a reference for the early diagnosis .Methods :Make a retrospective analysis of 115 adolescent depression data ,all patients were judged by Depression Rating Scale (HAMD) and Homemade somatic symptoms questionnaire .Results:(1) 33 adolescents depression went to psychiatric when initial outbreak ,accounting for 28 .70% in 115 adolescents de-pression ;the other 82 adolescents depression went to non-psychiatric treatment when initial outbreak ,accounting for 71 .30% in 115 adolescents depression ;(2)82 adolescents depression which went to non-psychiatric treatment were misdiagnosed as autonomic dysfunction ,nervous headache;(3) all adolescents depression had physical discomfort ,11 patients (9 .57% ) had ≤ 11 somatic symptoms ,104 patients (90 .43% ) had > 11 somatic symptoms .Conclusion:The main symptoms of adolescent depression are somatic symptoms ,most adolescent depression go to non-psychiatric treat-ment when initial outbreak ,have high misdiagnosis rate and missed rate ,doctor should strengthen and enhance under-standing of somatic symptoms of adolescents depression ,take timely and reasonable scientific treatment ,improve clini-cian recognition rate ,diagnosis rate ,treatment rates .%  目的:调查分析青少年抑郁症的首诊状况与临床特征,为早期诊断提供借鉴。方法:回顾分析我院就诊的115例青少年抑郁症患者的临床资料,所有患者均采用密尔顿抑郁量表(HAMD)和自制躯体症状调查表进行评定。结果:(1)115例青少年抑郁患者中初次发病就到精神专科就诊者33例(28.70%),其他82例(71.30%)均为到非精神科就诊;(2)82例在非精神专科就诊患者主要被误诊为植物神经功能紊乱、神经性头痛;(3)所有患者就诊时均有躯体不适的突出主诉,11例(9.57%)患者伴有≤11

  17. How Is Aplastic Anemia Diagnosed?

    Science.gov (United States)

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

  18. Occurrence of ADHD in parents of ADHD children in a clinical sample

    Directory of Open Access Journals (Sweden)

    Starck M

    2016-03-01

    Full Text Available Martina Starck,1 Julia Grünwald,1 Angelika A Schlarb1,21Faculty of Science, Department of Psychology, University of Tuebingen, Tuebingen, 2Department of Psychology, Faculty for Psychology and Sport Science, University of Bielefeld, Bielefeld, GermanyBackground: Despite the fact that there is a large amount of research on childhood attention deficit hyperactivity disorder (ADHD treatment and an increasing amount of research on adult ADHD, little is known about the prevalence and influence of parental ADHD. Therefore, this study examined the frequency of parental ADHD in a clinical sample of German children suffering from ADHD. We also tried to find different levels of symptom severity for prognostic relevance. Furthermore, the association between subtypes of ADHD in children and their parents was investigated.Method: In this study, parents of 79 ADHD children were screened for ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition and International Classification of Diseases, 10th edition. The Wender Utah Rating Scale and the ADHS-Self-Report were given to 75 mothers and 49 fathers for retrospective and current symptoms. Frequency of ADHD symptoms and severity groups was calculated and relationship between parental and children’s ADHD was tested.Results: ADHD occurrence for mothers of children with ADHD was 41.3%, for fathers 51.0%. About 16.0% of the mothers had a mixed type, 9.3% had a hyperactive-impulsive subtype, and 16.0% had an inattentive subtype. Of the fathers, 18.4% had a mixed type, 10.2% had a hyperactive-impulsive subtype, and 22.4% had an inattentive subtype; 61% of the mothers and 46.9% of the fathers had low symptom severity. Medium symptom severity was reported by 37.7% mothers and 46.9% fathers, while 1.3% of the mothers and 6.2% of the fathers showed severe symptoms. No significant correlation between parental and child diagnoses was observed.Conclusion: As nearly half of the parents

  19. Diagnosing Autism Spectrum Disorder: Who Will Get a DSM-5 Diagnosis?

    Science.gov (United States)

    Kent, Rachel G.; Carrington, Sarah J.; Le Couteur, Ann; Gould, Judith; Wing, Lorna; Maljaars, Jarymke; Noens, Ilse; Berckelaer-Onnes, Ina; Leekam, Susan R.

    2013-01-01

    Background: Introduction of proposed criteria for DSM-5 Autism Spectrum Disorder (ASD) has raised concerns that some individuals currently meeting diagnostic criteria for Pervasive Developmental Disorder (PDD; DSM-IV-TR/ICD- 10) will not qualify for a diagnosis under the proposed changes. To date, reports of sensitivity and specificity of the new…

  20. How Is Polycythemia Vera Diagnosed?

    Science.gov (United States)

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

  1. Nursing diagnoses in overweight adolescents

    OpenAIRE

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

    2013-01-01

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

  2. Human immunodeficiency virus-associated malignant lymphoma in eastern Denmark diagnosed from 1990-1996: clinical features, histopathology, and association with Epstein-Barr virus and human herpesvirus-8

    DEFF Research Database (Denmark)

    Hansen, P B; Penkowa, M; Kirk, O;

    2000-01-01

    The clinicopathological features of human immunodeficiency virus (HIV)-associated lymphoma were investigated in a retrospective study of 85 adult patients in eastern Denmark diagnosed during the period 1990-1996. The possible pathogenetic role of Epstein-Barr virus (EBV) and human herpesvirus 8...... results provide further evidence that EBV plays a major role in the pathogenesis of large cell AIDS-related lymphoma, whereas HHV-8 does not appear to contribute significantly to the development of solid lymphomas in this group of patients....

  3. 神经性厌食症27例临床分析%ANOREXIA NERVOSA: CLINICAL ANALYSIS OF 27 CASES

    Institute of Scientific and Technical Information of China (English)

    席巧真; 刘小翠; 刘珊; 田博

    2011-01-01

    目的 探讨神经性厌食症(AN)病人的临床特点.方法 将符合国际疾病分类第10版(ICD-10)AN诊断标准的27例病人的临床资料进行分析.结果 AN以女性较多,惧怕肥胖是AN病人病态心理的核心;AN病人的躯体损害明显,社会功能损害严重.结论 AN不仅有躯体损害,而且伴有精神症状,应引起重视.%Objective To study the clinical features of patients with anorexia nervosa (AN).Methods The clinical data of 27 AN patients who met the criteria of the 10th Revision of International Classification of Diseases (ICD-10) were analyzed.Results More AN patients were female, fear of obesity being the core of their patienthood.The damage of their body and social activities were obvious.Conclusion AN presents have not only physical damage but also psychotic symptoms, a attention should be paid to this condition.

  4. A Knowledge Based System for Diagnosing Nosocomial Infections

    OpenAIRE

    Landry, Gail; Beyt, B. Eugene; Delcambre, Lois M.L.

    1987-01-01

    This paper describes the design, implementation, and evaluation of a knowledge based prototype for diagnosing nosocomial infections. The prototype uses a consultative session to diagnose three major types of infection: urinary tract infection, bacteremia, and surgical wound infection. The system evaluates the results of microbiology and laboratory testing, includes rules based on clinical events, and determines onset dates. The prototype was implemented in Prolog and was tested for its abilit...

  5. Knowledge and Lifestyle-Associated Prevalence of Obesity among Newly Diagnosed Type II Diabetes Mellitus Patients Attending Diabetic Clinic at Komfo Anokye Teaching Hospital, Kumasi, Ghana: A Hospital-Based Cross-Sectional Study.

    Science.gov (United States)

    Obirikorang, Yaa; Obirikorang, Christian; Odame Anto, Enoch; Acheampong, Emmanuel; Dzah, Nyalako; Akosah, Caroline Nkrumah; Nsenbah, Emmanuella Batu

    2016-01-01

    This study aimed to determine the knowledge and prevalence of obesity among Ghanaian newly diagnosed type 2 diabetics. This cross-sectional study was conducted among diagnosed type 2 diabetics. Structured questionnaire was used to obtain data. Anthropometric measurements and fasting blood sugar levels were also assessed. Participants had adequate knowledge about the general concept of obesity (72.0%) and method of weight measurement (98.6%) but were less knowledgeable of ideal body weight (4.2%). The commonly known cause, complication, and management of obesity were poor diet (76.9%), hypertension (81.8%), and diet modification (86.7%), respectively. The anthropometric measures were higher among females compared to males. Prevalence of obesity was 61.3% according to WHR classification, 40.8% according to WHtR classification, 26.1% according to WC, and 14.8% according to BMI classification. Being female was significantly associated with high prevalence of obesity irrespective of the anthropometric measure used (p food intake, and alcoholic beverage intake were associated with increased prevalence of obesity (p < 0.05). Prevalence of obesity is high among diabetic patient and thus increasing effort towards developing and making education programs by focusing on adjusting to lifestyle modifications is required. PMID:26881262

  6. Knowledge and Lifestyle-Associated Prevalence of Obesity among Newly Diagnosed Type II Diabetes Mellitus Patients Attending Diabetic Clinic at Komfo Anokye Teaching Hospital, Kumasi, Ghana: A Hospital-Based Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Yaa Obirikorang

    2016-01-01

    Full Text Available This study aimed to determine the knowledge and prevalence of obesity among Ghanaian newly diagnosed type 2 diabetics. This cross-sectional study was conducted among diagnosed type 2 diabetics. Structured questionnaire was used to obtain data. Anthropometric measurements and fasting blood sugar levels were also assessed. Participants had adequate knowledge about the general concept of obesity (72.0% and method of weight measurement (98.6% but were less knowledgeable of ideal body weight (4.2%. The commonly known cause, complication, and management of obesity were poor diet (76.9%, hypertension (81.8%, and diet modification (86.7%, respectively. The anthropometric measures were higher among females compared to males. Prevalence of obesity was 61.3% according to WHR classification, 40.8% according to WHtR classification, 26.1% according to WC, and 14.8% according to BMI classification. Being female was significantly associated with high prevalence of obesity irrespective of the anthropometric measure used (p<0.05. Taking of snacks in meals, eating meals late at night, physical inactivity, excessive fast food intake, and alcoholic beverage intake were associated with increased prevalence of obesity (p<0.05. Prevalence of obesity is high among diabetic patient and thus increasing effort towards developing and making education programs by focusing on adjusting to lifestyle modifications is required.

  7. Sharp interstitial Nefritis, Value Diagnoses of the Ultrasound

    International Nuclear Information System (INIS)

    Two cases of young patients are revised and they present a clinical picture of acute renal insufficiency of unknown aetiology. This fact was no suspected initially but thanks to the help of ultrasound and the clinical history it was possible to diagnose as an acute interstitial nephritis due to hypersensitivity to drugs. The classification of this illness is revised as well as its etiopathogenic clinical picture and ultrasound diagnosis

  8. Correlation and characteristics of self-rating and clinical rating of depression among alcoholics in the course of early abstinence

    Directory of Open Access Journals (Sweden)

    Mandić-Gajić Gordana

    2015-01-01

    Full Text Available Background/Aim. Depression is an alcoholism relapse risk factor, but frequently stays underdiagnosed among treated alcoholics. The correlation and characteristics of self-reported and clinically assessed depression in the course of early alcohol abstinence were explored. Methods. A total of 100 inpatient, primary male alcoholics (20-60 years diagnosed according to Classificaton of Mental and Behavioural Disorders (ICD-10 and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV were recruited consecutively. The Hamilton Depression Rating Scale (HDRS and Beck Depression Inventory (BDI were scored on admission (T1, after 4 weeks (T2 and after 8 weeks (T3. Student's t-test, repeated measures ANOVA and Pearson's correlation between the scores were done (p < 0.05. Factor analyses of symptoms were performed. Results: On HDRS T1, T2, T3 90,7%, 39.5%, 17.4% alcoholics were depressive, respectively. The mean HDRS vs BDI scores on T1, T2 and T3 were 15.16 ± 6.34, 7.35 ± 4.18, 4.23 ± 2.93 vs 14.20 ± 9.56, 8.14 ± 7.35, 5.30 ± 4.94, respectively. Depression severity significantly lowered in the course of abstinence (ANOVA. The HRDS and BDI correlations on T1, T2 and T3 were significant (r1 = 0.763, r2 = 0.684, r3 = 0.613 respectively. Dysphoric mood, anxious, vegetative and cognitive HDRS subscales on T1, T2 and T3 were detected, but not BDI factors, thus BDI symptoms were analysed. Conclusions. The majority of alcoholics had depression on admission. A predominant mild-degree with a significant lowering of depression severity and positive significant correlations between HRDS and BDI scores in the course of abstinence were detected. The dysphoric mood on the HDRS sub-scale, and self-blame, anhedonia and guilt BDI symptoms were most prominent and persisted. The BDI could be a useful tool not only for routine screening and reassessment of depression, but also for exploring emotional content during early abstinence and planning tailored

  9. Nursing diagnoses in overweight adolescents

    Directory of Open Access Journals (Sweden)

    Raphaela Santos do Nascimento Rodrigues

    2013-05-01

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

  10. Diagnosing and Treating Hantavirus Pulmonary Syndrome (HPS)

    Science.gov (United States)

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

  11. Ultrasonic findings in diagnosing renal colic

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-04-15

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

  12. Postnatal Treatment in Antenatally Diagnosed Meconium Peritonitis.

    Science.gov (United States)

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

    2015-01-01

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

  13. Immunological methods for diagnosing neurocysticercosis

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-01-31

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

  14. Juvenile myoclonic epilepsy: Under-diagnosed syndrome

    Directory of Open Access Journals (Sweden)

    Božić Ksenija

    2011-01-01

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

  15. Advice for the Newly Diagnosed

    Science.gov (United States)

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

  16. Diagnoses and interventions in podiatry.

    NARCIS (Netherlands)

    Zuijderduin, W.M.; Dekker, J.

    1996-01-01

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

  17. How Is Fanconi Anemia Diagnosed?

    Science.gov (United States)

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

  18. 精神分裂症首次发病未治疗患者血清脑源性神经营养因子水平测定%Clinical research of the relation of plasma levels of brain derived neurotrophic factor in the untreated illness in patients with first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    袁杰; 瞿正万; 蔡正宜; 杨建飞; 张洁; 金莹

    2015-01-01

    Objective:To explore the relation of plasma levels of brain derived neurotrophic factor in pa-tients with first-episode schizophrenia during untreated period . Provide a certain basis for clinical diagnosis and treatment. Method:We picked 66 untreated in-patients and out-patients who were newly diagnosed as schizo-phrenia according to ICD-10 as the study group and 40 normal people as the control group. After joining the group,the positive and negative symptoms scale( PANSS)was used to identify the degree of mental symptoms. Morning blood drawn and plasma concentrations of BDNF were also measured. Results:Plasma BDNF levels in patients with schizophrenia(21. 35 ± 3. 94)ug / L was lower than the normal control group(23. 68 ± 6. 14) ug/L,P<0. 05;The duration of untreated illness was related to serum BDNF levels(r=3. 216,P<0. 05). Conclusion:The longer duration of untreated illness,the more obvious BDNF levels decline,which suggest BD-NF levels may be an important indicator of disease development and prognosis.%目的:了解首发精神分裂症未治疗患者脑源性神经营养因子( BDNF)水平的变化,为临床诊治提供一定的依据。方法:抽取初诊的住院或门诊符合ICD-10精神分裂症诊断标准首发未治疗患者计66例,正常对照组40例。入组后使用阳性和阴性症状量表( PANSS)判别精神症状程度,抽取晨血,测定血清BDNF浓度。结果:精神分裂症患者血清BDNF水平(21.35±3.94)ug/L,显著低于正常对照组[(23.68±6.14)ug/L,P<0.05];未治疗时间与血清BDNF水平具有相关性(r=3.216,P<0.05)。结论:精神分裂症患者未治疗期越长,BDNF水平下降越明显,提示BDNF水平或许是精神分裂症患者发展的生物学指标之一。

  19. Challenges of Diagnosing Acute HIV-1 Subtype C Infection in African Women: Performance of a Clinical Algorithm and the Need for Point-of-Care Nucleic-Acid Based Testing

    OpenAIRE

    Mlisana, Koleka; Sobieszczyk, Magdalena; Werner, Lise; Feinstein, Addi; van Loggerenberg, Francois; NAICKER, Nivashnee; Williamson, Carolyn; Garrett, Nigel

    2013-01-01

    Background Prompt diagnosis of acute HIV infection (AHI) benefits the individual and provides opportunities for public health intervention. The aim of this study was to describe most common signs and symptoms of AHI, correlate these with early disease progression and develop a clinical algorithm to identify acute HIV cases in resource limited setting. Methods 245 South African women at high-risk of HIV-1 were assessed for AHI and received monthly HIV-1 antibody and RNA testing. Signs and symp...

  20. 儿童食物过敏的消化道临床表现及诊治%Clinical Manifestations,Diagnose and Treatment of Children′s Food Allergy

    Institute of Scientific and Technical Information of China (English)

    司徒爱明

    2011-01-01

    Food Allergy is an adverse reaction to food and caused by immune mechanisms. Infants and children are at a high risk of food allergy. Gastrointestinal tract is a main responflent organ of food allergy.Food allergy in children has a variety of symptoms and is difficult to be diagnosed. The diagnosis requires a detailed history and physical examination combined with specific IgE measurements, skin prick test, or even food challenge test. Food restriction is the most effective treatment and other treatments include management of complications , control of risk factors , supplement of probiotics , and immunotherapy.%食物过敏是人们对某些食物产生的一种不良反应,是由免疫机制介导的.食物过敏的高危人群为婴幼儿及儿童.消化道是食物过敏的主要效应器官,临床表现多样,诊断困难,需要依靠详细的病史、查体,并结合食物特异性血清IgE测定、皮肤点刺试验,甚至食物激发试验等综合分析才能作出诊断.严格的饮食回避是最有效的治疗,包括治疗并发症、控制危险因素、添加肠道益生菌及免疫疗法等.

  1. Completed Suicide among Adolescents with No Diagnosable Psychiatric Disorder.

    Science.gov (United States)

    Marttunen, Mauri J.; Henriksson, Markus M.; Isometsa, Erkki T.; Heikkinen, Martti E.; Aro, Hillevi M.; Lonnqvist, Jouko K.

    1998-01-01

    The characteristics of male adolescent suicide victims with (N=84) and without (N=8) diagnosable psychiatric disorder were compared. Psychological autopsy data were collected on all adolescent suicides in one year. Communication of suicidal intent and problems with discipline just before the suicide are among the few clinical warning signs found.…

  2. Recent advances in diagnosing pathogenic equine gastrointestinal helminths

    DEFF Research Database (Denmark)

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

    2013-01-01

    Parasites infecting horses are ubiquitous and clinically important across the world. The major parasitic threats to equine health are cyathostomins, Parascaris equorum, Anoplocephala perfoliata, and Strongylus vulgaris. Increasing levels of anthelmintic resistance reported world wide in equine...... cyathostomins holds great promise, and could become very useful in clinical practice. Several attempts have been made to construct assays for diagnosing the highly pathogenic migrating larvae of S. vulgaris, but none of these have performed sufficiently to make a useful test. The present review illustrates...

  3. The association between working alliance and clinical and functional outcome in a cohort of 400 patients with first-episode psychosis

    DEFF Research Database (Denmark)

    Melau, Marianne; Harder, Susanne; Jeppesen, Pia;

    2015-01-01

    OBJECTIVE: Working alliance between patients with a first-episode psychosis and their case manager is regarded as a key element in specialized early intervention services. The impact of this patient-case manager dyad on functional and clinical outcome is unknown. We aimed to investigate if a strong...... working alliance was associated with fewer clinical symptoms and better social functioning. METHOD: In a cross-sectional design, patients with first-episode schizophrenia spectrum disorders (ICD-10, F20-29) were included after 18 months of treatment (N = 400). Baseline data were collected between June...... between working alliance and better social functioning (β = 1.45; 95% CI, 0.55 to 2.36). General self-efficacy mediated the effect of working alliance, explaining 14%-18% of the variance in associated outcomes. Global level of cognitive functioning, compliance, and self-efficacy influenced clinical and...

  4. The Clinic significance of diagnosing polycystic ovary syndrome by AMH and B-ultrasonography%AMH联合B超检查诊断多囊卵巢综合征的临床意义分析

    Institute of Scientific and Technical Information of China (English)

    崔雪芳; 廖韦坚; 麦小妮

    2011-01-01

    Objective: To study the endocrinologic changes and ultrasonography changes of Polycystic ovary syndrome (PCOS) and their relationship.Methods: 50 cases of PCOS patients in Zhongshan city were enrolled in this study, and 23 normal female were taken as control group.E2, FSH, LH, PRL, T and AMH both of the two groups were tested, besides ultrasonography were given to count follicular number.Then differences and relationship between them were studied.Results: LH, FSH, T and AMH had significant difference between the two groups.And AMH had corelationship with FSH and follicular number.Conclusion: AMH and LH/FSH can be alternative parameters to diagnose PCOS.%目的:分析多囊卵巢综合征(Polycystic ovary syndrome,PCOS)患者的临床特点、内分泌改变和超声特征,并探讨相应指标的诊断意义.方法:研究组收集符合鹿特丹(2006)诊断标准的PCOS患者50例,检测其女性激素包括E2、FSH、LH、PRL、T,此外尚检测其抗苗勒氏管激素(AMH)水平,并使用B超检查测定其卵泡数量.同期选取正常女性23例,作为 对照组,亦对上述指标进行测定.比较两组间临床特点、内分泌水平及B超检查等的状况,同时分析AMH的诊断价值.结果:PCOS患者女性激素指标中的LH、LH/FSH和T均高于对照组(P<0.05),而FSH低于对照组(P<0.05),此外,AMH与卵泡数目高于对照组,差异均有统计学意义(P<0.05).AMH、B超指征与T水平三者联合诊断PCOS特异性最高.结论:测定AMH水平在临床工作中可以协助PCOS的诊疗.

  5. Comparação entre métodos clínicos e laboratoriais no diagnóstico das faringotonsilites estreptocócicas Comparative analysis of clinical and laboratory methods for diagnosing streptococcal sore throat

    Directory of Open Access Journals (Sweden)

    Ana Gabriela P. dos Santos

    2005-02-01

    Full Text Available OBJETIVOS: O diagnóstico e tratamento correto das faringotonsilites causadas pelo estreptococo beta-hemolítico do grupo A é importante, particularmente na prevenção das seqüelas não-supurativas. Achados clínicos continuam sendo utilizados para diferenciar infecção estreptocócica de faringotonsilite viral. A Academia Americana de Pediatria recomenda que o diagnóstico da faringotonsilite estreptocócica seja sempre confirmado por métodos de identificação microbiológica. O objetivo deste estudo foi avaliar a acurácia do diagnóstico clínico comparado com resultados de cultura e teste rápido no diagnóstico das faringotonsilites estreptocócicas. MÉTODOS: Crianças entre 2 e 13 anos com diagnóstico clínico de faringotonsilite avaliadas na unidade de emergência pediátrica da Santa Casa de São Paulo eram selecionadas, e aquelas com sintomas de infecção viral eram excluídas. Foram registrados achados clínicos e colhidos suabes para a realização de cultura e teste rápido para estreptococo do grupo A. RESULTADOS: Das 376 crianças avaliadas, a cultura foi positiva em 96 (24,4%. A presença de petéquias, exsudato e gânglios dolorosos foi mais comum nas crianças com culturas positivas, mas com baixa acurácia diagnóstica. A avaliação subjetiva do médico que assistia o paciente não identificou 21% dos casos positivos e recomendou antibióticos para 47% das crianças com cultura negativa, contra 3 e 6% identificados pelo teste rápido, respectivamente. CONCLUSÕES: Um método de diagnóstico microbiológico é necessário para a adequada prescrição de antibióticos em crianças com faringotonsilites estreptocócicas.OBJECTIVES: Diagnosis and correct treatment of group A streptococcal sore throat is important particularly to prevent non-suppurative sequelae. Clinical findings continue to be used to differentiate streptococcal infection from viral sore throat. The American Academy of Pediatrics recommends that

  6. Alternative diagnoses at paediatric appendicitis MRI

    International Nuclear Information System (INIS)

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

  7. Using saccades to diagnose covert hepatic encephalopathy.

    Science.gov (United States)

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

    2015-06-01

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

  8. The clinical significance of electrocardiogram changes to diagnose the left pneumothorax%心电图改变对左侧气胸的临床诊断意义

    Institute of Scientific and Technical Information of China (English)

    黄丽嫦; 谢再汉; 舒予静; 李飞; 贺晓

    2014-01-01

    目的:探讨左侧气胸患者心电图改变特点及临床意义。方法:回顾性分析43例经X线胸片证实为左侧气胸患者的心电图改变。结果:窦性心动过速15例(34.9%),V5、V6导联QRS波群低电压35例(81.4%),顺时针转位34例(79.1%)。结论:左侧气胸心电图有特征性改变,对气胸患者进行心电图检查,有助于临床医师进行诊断与鉴别诊断。%Objective:To study the electrocardiogram characteristics and clinical significance of the patients with left pneu-mothorax. Methods:The electrocardiogram changes of 43 cases with left pneumothorax confirmed by chest X-ray were ret-rospectively analyzed. Results:The electrocardiogram characteristic changes of patients with left pneumothorax included sinus tachycardia for 15 cases(34. 9%),the lower voltage of QRS in V5 and V6 for 35 cases(81. 4%),and revoled clockwise for 34 cases(79. 1%). Conclusions:The electrocardiogram of patients with left pneumothorax had characteris-tic changes. The examination of the electrocardiogram in patients with pneumothorax will help clinical doctors in diagnosis and differential diagnosis.

  9. 宫腹腔镜联合诊治女性不孕症500例临床分析%Clinical analysis on 500 infertile women diagnosed and treated with hysteroscopy combined with laparoscopy

    Institute of Scientific and Technical Information of China (English)

    郭政; 王丽英; 李华

    2011-01-01

    Objective: To explore the value of laparoscopy combined with hysteroscopy in diagnosis and treatment of women with infertility. Methods: The results of 500 infertile women receiving hysteroscopy combined with laparoscopy from January 2008 to December 2009 were analyzed retrospectively. Results; 445 women were found with pelvic abnormality by hysteroscopy combined with laparoscopy, accounting for 89. 0%. The main causes of female infertility were chronic pelvic inflammatory disease (58. 6% ) , polycystic ovary syndrome (18. 0% ) and endometriosis ( 14. 0% ) . The proportion of chronic pelvic inflammatory disease in women with secondary infertility was significantly higher than that in women with primary infertility (x = 8. 60, P < 0. 01 ) , while the proportion of polycystic ovary syndrome in women with secondary infertility was significantly lower than that in women with primary infertility (x2 = 17. 02, P <0. 01) . The major surgical methods were pelvic adhesiolysis, fimbrioplasty and salpingostomy, ovarian drilling and cauiery of endometriosis. Conclusion:Laparoscopy combined with hysteroscopy can confirm the causes of female infertility, corresponding minimal invasive surgery can be conducted targeting to the causes of female infertility, the advantages of laparoscopy and hysteroscopy are complementary, which are the optimal methods to diagnose and treat women with infertility induced by pelvic factor.%目的:探讨宫、腹腔镜联合检查在女性不孕症中的诊治价值.方法:对2008年1月~2009年12月500例女性不孕症的宫、腹腔镜联合检查结果进行回顾性分析.结果:宫、腹腔镜检查发现盆腔异常445例,占89.0%.女性不孕症的主要原因依次为慢性盆腔炎(58.6%)、多囊卵巢综合征(18.0%)、子宫内膜异位征(14.0%).继发性不孕症中,慢性盆腔炎的构成比高于原发不孕(x2=8.60,P<0.01),多囊卵巢综合征的构成比低于原发不孕(x2=17.02,P<0.01).盆腔粘连松解术、输卵管伞

  10. Challenges of diagnosing acute HIV-1 subtype C infection in African women: performance of a clinical algorithm and the need for point-of-care nucleic-acid based testing.

    Directory of Open Access Journals (Sweden)

    Koleka Mlisana

    Full Text Available BACKGROUND: Prompt diagnosis of acute HIV infection (AHI benefits the individual and provides opportunities for public health intervention. The aim of this study was to describe most common signs and symptoms of AHI, correlate these with early disease progression and develop a clinical algorithm to identify acute HIV cases in resource limited setting. METHODS: 245 South African women at high-risk of HIV-1 were assessed for AHI and received monthly HIV-1 antibody and RNA testing. Signs and symptoms at first HIV-positive visit were compared to HIV-negative visits. Logistic regression identified clinical predictors of AHI. A model-based score was assigned to each predictor to create a risk score for every woman. RESULTS: Twenty-eight women seroconverted after a total of 390 person-years of follow-up with an HIV incidence of 7.2/100 person-years (95%CI 4.5-9.8. Fifty-seven percent reported ≥1 sign or symptom at the AHI visit. Factors predictive of AHI included age <25 years (OR = 3.2; 1.4-7.1, rash (OR = 6.1; 2.4-15.4, sore throat (OR = 2.7; 1.0-7.6, weight loss (OR = 4.4; 1.5-13.4, genital ulcers (OR = 8.0; 1.6-39.5 and vaginal discharge (OR = 5.4; 1.6-18.4. A risk score of 2 correctly predicted AHI in 50.0% of cases. The number of signs and symptoms correlated with higher HIV-1 RNA at diagnosis (r = 0.63; p<0.001. CONCLUSIONS: Accurate recognition of signs and symptoms of AHI is critical for early diagnosis of HIV infection. Our algorithm may assist in risk-stratifying individuals for AHI, especially in resource-limited settings where there is no routine testing for AHI. Independent validation of the algorithm on another cohort is needed to assess its utility further. Point-of-care antigen or viral load technology is required, however, to detect asymptomatic, antibody negative cases enabling early interventions and prevention of transmission.

  11. Duplex ultrasound, clinical score, thrombotic risk, and D-dimer testing for evidence based diagnosis and management of deep vein thrombosis and alternative diagnoses in the primary care setting and outpatient ward.

    Science.gov (United States)

    Michiels, J J; Moosdorff, W; Maasland, H; Michiels, J M; Lao, M U; Neumann, H A; Dulicek, P; Stvrtinova, V; Barth, J; Palareti, G

    2014-02-01

    Deep vein thrombosis (DVT) has an annual incidence of 0.2% in the urban population. First episodes of calf vein thrombosis (CVT) and proximal DVT are frequently elicited by risk factors, including varicose veins, cancer, pregnancy/postpartum, oral contraceptives below the age of 50 years, immobility or surgery. Leg pain and tenderness in the calf and popliteal fossa on physical examination may result from other conditions than DVT labeled as alternative diagnosis (AD) Congenital venous thrombophilia is present in every third first DVT, increased FVIII in every fourth first DVT, and FV Leiden/FII mutation in 40% of women on oral anticonceptive pill before reaching the menopause. Routine thrombophilia testing for FV Leiden/prothrombin mutation and FVIII as main risk factor for venous thrombosis is recommended. Primary superficial venous thrombosis (SVT) and DVT patients with a autosomal dominant family history of DVT are candidates for thrombophilia testing for congenital AT, PC and PS deficiency. The requirement for a safe diagnostic strategy of CVT and DVT should be based on an objective post-test incidence of venous thromboembolism (VTE) of less than 0.1% with a negative predictive value for exclusion of DVT of 99.9% during 3 months follow-up. Modification of the Wells score by elimination of the "minus 2 points" for AD is mandatory and will improve the diagnostic accuracy of CVT/DVT suspicion in the primary care setting and outpatient ward. The sequential use of complete DUS, ELISA D-dimer testing and modified clinical Wells' score assessment is safe and effective for the exclusion and diagnosis of CVT, DVT and AD. About 10% to 20% of patients with DVT develop overt post-thrombotic syndrome (PTS) at one year post-DVT, and both PTS and DVT recurrences further increase to about 30% during long-term follow-up. Objective risk stratification of PTS complications using DUS for recanalization and reflux and D-dimer testing will become an integral part in routine

  12. Delayed diagnosed intermuscular lipoma causing a posterior interosseous nerve palsy in a patient with cervical spondylosis: the “priceless” value of the clinical examination in the technological era

    Science.gov (United States)

    COLASANTI, R.; IACOANGELI, M.; DI RIENZO, A.; DOBRAN, M.; DI SOMMA, L.; NOCCHI, N.; SCERRATI, M.

    2016-01-01

    Background Posterior interosseous nerve (PIN) palsy may present with various symptoms, and may resemble cervical spondylosis. Case report We report about a 59-year-old patient with cervical spondylosis which delayed the diagnosis of posterior interosseous nerve (PIN) palsy due to an intermuscular lipoma. Initial right hand paraesthesias and clumsiness, together with MR findings of right C5–C6 and C6–C7 foraminal stenosis, misled the diagnostic investigation. The progressive loss of extension of all right hand fingers brought to detect a painless mass compressing the PIN. Electrophysiological studies confirmed a right radial motor neuropathy at the level of the forearm. Results Surgical tumor removal and nerve decompression resulted in a gradual motor deficits recovery. Conclusions A thorough clinical examination is paramount, and electrophysiology may differentiate between cervical and peripheral nerve lesions. Ultrasonography and MR offer an effective evaluation of lipomas, which represent a rare cause of PIN palsy. Surgical decompression and lipoma removal generally determine excellent prognoses, with very few recurrences. PMID:27142825

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

    Science.gov (United States)

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

    2016-09-01

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

  14. Psychiatric diagnoses in a group of astronaut applicants

    Science.gov (United States)

    Santy, Patricia A.; Faulk, Dean M.; Holland, Al W.

    1991-01-01

    Between 1959 and 1987, the psychiatric evaluation of astronaut candidates evolved from a 30-h intensive examination evaluating applicants for psychopathology, and studying their performance under stress, to a 2-h clinical interview whose structure and contents were determined by the individual examiner. Evaluations done during these years applied both psychiatric (or, 'select-out') criteria and psychological (or, 'select-in') criteria. In an attempt to more rigorously define the psychiatric, 'select-out' component, a standardized, semistructured clinical interview was developed to identify the presence or history of psychiatric disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 3rd Ed. ('DSM-III'). A total of 117 astronaut applicants underwent this clinical interview as part of a comprehensive medical evaluation during a recent astronaut selection. Of the 117 applicants, 9 (7.7 percent) met DSM-III criteria for a variety of Axis I and Axis II diagnoses, including V-code diagnoses.

  15. Association among nursing diagnoses, demographic variables, and clinical characteristics of patients with high blood pressure Asociación entre diagnósticos de enfermería y variables sociales/clinicas en pacientes hipertensos Associação entre diagnósticos de enfermagem e variáveis sociais/clínicas em pacientes hipertensos

    Directory of Open Access Journals (Sweden)

    Francisca de Fátima Vasconcelos

    2007-09-01

    Full Text Available OBJECTIVES: To analyze the association among diagnoses, demographic variables, and clinical characteristics of patients with high blood pressure. METHODS: The data were collected in 67 patients from a primary care unit in Fortaleza, Brazil. The NANDA Taxonomy was used to determine the nursing diagnoses. Data analysis consisted of Fisher's exact test, Chi-square test, and likelihood ratio test. RESULTS: Fifty four nursing diagnoses were identified; fifteen were above the 75th percentile. Ineffective individual therapeutic regimen management and number of medication, sleep pattern disturbance and marital status, activity intolerance and education, activity intolerance and time of diagnoses, sexual dysfunction and gender, sexual dysfunction and education, risk for falls and age, marital status and time of diagnoses, chronic pain and marital status all had significant association coefficients. CONCLUSION: Some demographic characteristics were associated with nursing diagnoses.OBJETIVO: Analizar la asociación estadística entre diagnósticos y características sociales / clínicas de pacientes hipertensos. MÉTODOS: Los datos fueron recolectados en una unidad básica de salud de Fortaleza-Ceará con 67 pacientes. La identificación de los diagnósticos se llevó a cabo según la taxonomía de la NANDA. Para el análisis de los datos se utilizó test de Fisher, Chi-Cuadrado de Pearson y Razón de Verosemejanza. RESULTADOS: Se encontró 54 diagnósticos de enfermería y 15 sobre el percentil 75. Se verificó asociación estadística entre: Control eficaz del régimen terapéutico y número de medicamentos; Patrón de sueño perturbado y estado civil; Intolerancia a la actividad y escolaridad y años de diagnóstico; Disfunción sexual y sexo y escolaridad; Riesgo para caídas y edad, estado civil y tiempo de diagnóstico de la enfermedad; Dolor crónico y estado civil. CONCLUSIÓN: Algunas características demográficas están asociadas a la

  16. AGE AT ONSET TYPOLOGY IN OPIOID DEPENDENT MEN: AN EXPLORATORY STUDY

    OpenAIRE

    De, Biswajit; Surendra K Mattoo; Basu, Debasish

    2002-01-01

    This study attempted to apply age at onset typology in ICD-10 diagnosed opioid dependence. The sample comprised 80 men seeking treatment at an addiction clinic. The measures included socio-demographic and clinical profile, Severity of Opioid Dependence Questionnaire, Modified Sensation Seeking Scale, Multiphasic Personality Questionnaire (MPQ) and Family History Assessment Module. A cut-off age of 20/21 years for an early-onset late-onset typology of opioid dependence was obtained using two m...

  17. Health anxiety symptoms in children and adolescents diagnosed with OCD

    DEFF Research Database (Denmark)

    Villadsen, Anna; Thorgaard, Mette V; Hybel, Katja A;

    2016-01-01

    seen as part of obsessive-compulsive disorder (OCD) due to construct overlap and the diagnostic uncertainty of HA in this age group. In the present study, the extent of HA symptoms was investigated in 94 children and adolescents with a primary ICD-10 diagnosis of OCD. Self-reported HA symptoms were...... assessed using the Childhood Illness Attitude Scales. Clinician-rated OCD symptoms and severity were measured using the Children's Yale Brown Obsessive Compulsive Scale. Information on socio-demographics was obtained from the child's/adolescent's medical record. The distribution of HA symptoms resembled a......-rated illness worries and comorbid anxiety disorder were associated with high self-reported HA symptoms. The results contribute to the understanding of how HA and OCD overlap conceptually in young patients and bring attention to the need for improved recognition of OCD patients dominated by illness worries...

  18. Comparison between QEEG as a Neurofeedback Tool to Diagnose AD/HD Disorder and Hematological-biochemical Para-clinical Indicators on Children with AD/HD Disorder and Children without Such Symptoms

    Directory of Open Access Journals (Sweden)

    Fatemeh Nimrouzi

    2014-01-01

    Full Text Available This research is conducted to achieve two objectives. First, study of clinical suitability and diagnostic precision in paraclinical experiments and study of biochemical factors in the diagnosis of AD/HD and second, study of the effectiveness of blood tests in identification of iron panel factors, study of blood mercury level, study of SE in AD/HD and comparing it with control group (normal children. At the first stage of the study, after analysis by QEEG, all factors to be tested underwent paraclinical experiments. The diagnostic precision of QEEG is estimated at 94%. The results of the first stage demonstrated that the paraclinical experiments are an effective tool with a high diagnostic precision for the diagnosis of AD/HD. The results of the second stage of study demonstrated that both groups suffer from iron deficiency anemia and there is no significant relationship between development of AD/HD symptoms and the iron deficiency anemia. Also the blood Ferritin in the tested group was higher than that of control group. Statistically, no significant relationship was noted between the CBC and development of AD/HD symptoms, yet a significant relationship was observed between reduction of Hb level and development of AD/HD symptoms. It was also concluded that SE stool infection in AD/HD children was higher than that of normal children. In children with AD/HD, vitamin B was less than that of normal children and there was significant relationship between increase in the mercury level of blood and development of attention and concentration deficit disorder (AD/HD.

  19. How Is Alpha-1 Antitrypsin Deficiency Diagnosed?

    Science.gov (United States)

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

  20. How Is Thrombotic Thrombocytopenic Purpura Diagnosed?

    Science.gov (United States)

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

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

    Science.gov (United States)

    Mrgan, Monija; Taasti, Lena Merete

    2013-09-01

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

  2. How Is a Heart Attack Diagnosed?

    Science.gov (United States)

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

  3. Clinic Value of the High Frequency Ultrasound and CDFI in Diagnosing of Soft Tissue Masses%高频彩超诊断软组织肿块的临床价值

    Institute of Scientific and Technical Information of China (English)

    王保钢; 张婷; 孟祥扣; 项晓宇; 程遵华

    2009-01-01

    Objective To evaluate the clinic value of the high frequency probe and color Doppler flow imaging in the diagnosis of soft tissue masses.Methods One hundred and fifty-four patient with soft tissue masses were analyzed by high-frequency probe and color Doppler flow imaging. All of them were proved by operation, biopsy and pathology. Results Among them, 134 cases were benign lesions and the rest of 20 cases belonged to malignant, The shapes of the benign lesions usually were oval and the boundaries were dearly defined in many lesions. However, the malignant lesions generally were circular and their boundaries were hardly defined. The blood flows usually were less and the peak flow velocities were lower in benign lesions than that in malignant. Conclusion High frequency probe and color Doppler flow imaging are helpful in determining the soft tissue masses location, border, cystic or solid and differentiating from benign and malignant lesions.%目的 探讨高频彩超诊断软组织肿块的临床价值.方法 对154例软组织肿块应用高频探头实施二维灰阶及彩色多普勒超声检查分析,全部病例均经手术或活检后病理证实.结果 良性肿瘤及瘤样病变123例,恶性病变20例.通过灰阶超声比较,良性肿块多为卵圆形,周界清晰,而恶性肿瘤多呈圆形,周界不清.彩超方面,良性肿快较恶性肿瘤血流欠丰富,峰值流速较低.结论 高频彩超能对软组织肿块作出准确定位诊断,判断病变范围及物理性质定性诊断,并有助于鉴别肿瘤的良恶性.

  4. Diagnoses of corticobasal syndrome and corticobasal degeneration.

    Science.gov (United States)

    Shimohata, Takayoshi; Aiba, Ikuko; Nishizawa, Masatoyo

    2016-03-30

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

  5. Urinary incontinence nursing diagnoses in patients with stroke

    Directory of Open Access Journals (Sweden)

    Telma Alteniza Leandro

    2015-12-01

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

  6. Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014

    International Nuclear Information System (INIS)

    Records of 100 patients were revised with diagnosis of ischemic cerebrovascular event in the neurology and internal medicine at the Hospital Mexico since March 2013 to March 2014. A total of 46 patients were men and 54 were women. The overall mean age was 69 years, for men have been 66 years and for women from 71. Patients of all provinces were entered main of San Jose with 56% followed by 19% Alajuela. The hospital management by specialty was distributed 60% to internal medicine and 40% neurology. The risk factors most frequently found were: hypertension 85%, diabetes mellitus 40%, smoking 35%, and dyslipidemia 35%. Overweight was observed in 23% of patients and 22% obese. As for the initial clinical manifestations documented in the first physical examination, the 6 most frequently found have been: faciobrachiocrural hemiparesis 60%, delirium 22%, dysarthria 22%, headache 20%, nausea and/or vomiting 17% and aphasia 15%. A total of 13% of patients have altered the consciousness and 5% have required ventilatory support for first 24 hours of evolution. 27% of patients have arrived within the first 3 hours of onset of symptoms, 11% between 3 to 4.5 hours and the remaining 62% beyond 4.5 hours of duration. 70% of patients have had 1 or more comorbidities prior to the event, the top 5 have been: ischemic heart disease 31%, 29% atrial fibrillation, cerebrovascular disease 19%, 16% chronic kidney disease and congestive heart failure by 12%. Regarding the topographic classification of stokes, 16% were TACI, PACI 46%, 27% LACI and POCI only 11%. The average NIHSS scale has been 9 points to admission, 10 to 48 hours and 6 points at the time of discharge. Regarding brain scan on admission to 98% of the patients were performed while that between 48-72 hours alone to 74%. The most common initial tomographic CT findings have been: 49% lucency of more than 1/3 of middle cerebral artery territory, without alteration 46%, 8% cerebral edema data and 8% midline deviation. Hemorrhagic

  7. Transplantvaskulopathie - Pathophysiologie, Diagnose und Therapie

    Directory of Open Access Journals (Sweden)

    Pölzl G

    2009-01-01

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

  8. Diagnosing chronic thromboembolic pulmonary hypertension: current perspectives

    Directory of Open Access Journals (Sweden)

    Hadinnapola C

    2014-09-01

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

  9. Pitfalls in diagnosing diabetic foot infections.

    Science.gov (United States)

    Peters, Edgar J

    2016-01-01

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

  10. Diagnosing dopamine-responsive dystonias.

    Science.gov (United States)

    Malek, N; Fletcher, N; Newman, E

    2015-10-01

    The clinical spectrum of dopamine-responsive dystonias (DRDs) has expanded over the last decade to comprise several distinct disorders. At the milder end of the clinical spectrum is the autosomal-dominant guanosine triphosphate cyclohydrolase deficiency syndrome (GTPCH-DRD), and at the more severe end is the much less common autosomal recessive tyrosine hydroxylase deficiency syndrome (TH-DRD), with intermediate forms in between. Understanding the pathophysiology of DRDs can help in their optimal diagnosis and management. These are conditions with the potential to be either underdiagnosed when not considered or overdiagnosed if there is an equivocal L-dopa (levo-3,4-dihydroxyphenylalanine) response. In this article, we discuss the clinical phenotypes of these disorders, and we outline how investigations can help in confirming the diagnosis. PMID:26045581

  11. Are somatosensory evoked potentials of the tibial nerve the most sensitive test in diagnosing multiple sclerosis?

    OpenAIRE

    Djuric S; Djuric V; Zivkovic M; Milosevic V; Jolic M; Stamenovic J; Djordjevic G.; Calixto M

    2010-01-01

    Background : Multiple sclerosis (MS) is mostly diagnosed clinically, but the diagnosis has significantly improved through the use of brain magnetic resonance imaging (MRI), testing of cerebrospinal fluid, and multimodal evoked potentials (MEPs). Even though MRI is the superior method in diagnosing this illness, MEPs remain important because they can detect clinically silent lesions in the sensory and motor pathways of the central nervous system (CNS). Aim : The aim of the study is to test the...

  12. Diagnosing language impairment in bilinguals : professional experience and perception

    OpenAIRE

    O'Toole, Ciara; Hickey, Tina

    2013-01-01

    Diagnosing specific language impairment (SLI) in monolingual children is a complex task, with some controversy regarding criteria. Diagnosis of SLI in bilinguals is made more complex by the lack of standardized assessments and poor understanding of clinical markers in languages other than English. There is an added complexity when one of the languages being acquired is an endangered one, where the domains of use and input are restricted, and where input is affected by convergen...

  13. Papillary lesions of the breast diagnosed using core needle biopsies

    OpenAIRE

    TOKINIWA, HIDEAKI; Horiguchi, Jun; TAKATA, DAISUKE; Kikuchi, Mami; ROKUTANDA, NANA; NAGAOKA, RIN; Sato, Ayako; Odawara, Hiroki; TOZUKA, KATSUNORI; Oyama, Tetsunari; Takeyoshi, Izumi

    2011-01-01

    Papillary lesions of the breast include a broad spectrum of lesions, from benign papillomas to papillary carcinomas. It is difficult to determine whether a lesion is benign or malignant based on the fragmented material of a core needle biopsy (CNB). This study evaluated patients with papillary lesions examined using CNB. We retrospectively reviewed 31 papillary lesions diagnosed using CNB between 2004 and 2007. The clinical findings of benign and malignant papillary lesions were compared. The...

  14. Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy

    Institute of Scientific and Technical Information of China (English)

    Ertugrul Kayacetin; Serra Kayacetin

    2004-01-01

    Liver penetration is a rare but serious complication of peptic ulcer disease. Usually the diagnosis is made by operation or autopsy. Clinical and laboratory data were no specific. A 64-year-old man was admitted with upper gastrointestinal bleeding. Hepatic penetration was diagnosed as the cause of bleeding. Endoscopy showed a large gastric ulcer with a pseudotumoral mass protruding from the ulcer bed. Definitive diagnosis was established by endoscopic biopsies of the ulcer base.

  15. Motor regulation problems and pain in adults diagnosed with ADHD

    OpenAIRE

    Stray, Liv Larsen; Kristensen, Øistein; Lomeland, Martha; Skorstad, Mette; Stray, Torstein; Tønnessen, Finn Egil

    2013-01-01

    Background Most children who are diagnosed with attention deficit-hyperactivity disorder (ADHD) have moderate-to-severe motor problems using the Motor Function Neurological Assessment battery (MFNU). The MFNU focuses on specific muscle adjustment problems associated with ADHD, especially motor inhibition problems and high muscle tone. Here we investigated whether adults with ADHD/hyperkinetic disorder (HKD) have similar motor problems. In our clinical experience, adults with ADHD often compla...

  16. Diagnosing Psoriatic Arthritis from the Dermatologist’s View

    OpenAIRE

    Cho, Hyun-Ho; Kim, Byung-Soo

    2013-01-01

    Psoriatic arthritis is a chronic inflammatory arthropathy associated with skin psoriasis. It is considered a unique arthropathy with distinct clinical and radiologic features. Up to 40% of patients with psoriasis may develop psoriatic arthritis. Psoriasis usually precedes psoriatic arthritis, so dermatologists are in a critical position for screening patients of psoriatic arthritis early in the disease course. Psoriatic arthritis may be challenging to diagnose, especially for dermatologists, ...

  17. Ethical Dimensions of Diagnosing: Considerations for Clinical Mental Health Counselors

    Science.gov (United States)

    Kress, Victoria E.; Hoffman, Rachel M.; Eriksen, Karen

    2010-01-01

    There are numerous ethical considerations inherent within the process of assigning a "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; "DSM-IV-TR"; American Psychiatric Association, 2000) diagnosis. In this article, general ethics considerations such as informed consent and confidentiality, accuracy of diagnosis, and…

  18. [Hypokalemia, a key clinical data for diagnosing primary hyperaldosteronism].

    Science.gov (United States)

    Rodríguez Maya, B; Rodríguez Goncer, I; Diego Hernández, C

    2016-01-01

    We report a case of a 37 year-old man with a long history of hypertension under treatment, who was admitted at our institution with intense fatigue and weakness of lower limbs. The laboratory results at Emergency Department showed severe hypokalemia. A study of secondary hypertension was carried out. With the initial suspicion of primary hyperaldosteronism, complete blood test was done including plasma renine activity, which was completely suppressed, and plasma aldosterone concentration, which resulted normal. Likewise, an abdomen CT was performed and revealed a left adrenal mass consistent of suprarrenal adenoma. Therefore, a salt loading suppression test was done with subsequent measure of plasmatic renine activity, which was still suppressed, plasma aldosterone concentration, that persisted normal, and a 24-h urinary aldosterone excretion rate, which was clearly high, supporting the suspected diagnosis. After the adrenalectomy, the patient remained asymptomatic with normal blood pressure without treatment and with normal serum potassium levels. PMID:26869044

  19. Maternal characteristics and clinical diagnoses influence obstetrical outcomes in Indonesia.

    Science.gov (United States)

    Adisasmita, Asri; Smith, Carl V; El-Mohandes, Ayman A E; Deviany, Poppy Elvira; Ryon, Judith J; Kiely, Michele; Rogers-Bloch, Quail; Gipson, Reginald F

    2015-07-01

    This Indonesian study evaluates associations between near-miss status/death with maternal demographic, health care characteristics, and obstetrical complications, comparing results using retrospective and prospective data. The main outcome measures were obstetric conditions and socio-economic factors to predict near-miss/death. We abstracted all obstetric admissions (1,358 retrospective and 1,240 prospective) from two district hospitals in East Java, Indonesia between 4/1/2009 and 5/15/2010. Prospective data added socio-economic status, access to care and referral patterns. Reduced logistic models were constructed, and multivariate analyses used to assess association of risk variables to outcome. Using multivariate analysis, variables associated with risk of near-miss/death include postpartum hemorrhage (retrospective AOR 5.41, 95 % CI 2.64-11.08; prospective AOR 10.45, 95 % CI 5.59-19.52) and severe preeclampsia/eclampsia (retrospective AOR 1.94, 95 % CI 1.05-3.57; prospective AOR 3.26, 95 % CI 1.79-5.94). Associations with near-miss/death were seen for antepartum hemorrhage in retrospective data (AOR 9.34, 95 % CI 4.34-20.13), and prospectively for poverty (AOR 2.17, 95 % CI 1.33-3.54) and delivering outside the hospital (AOR 2.04, 95 % CI 1.08-3.82). Postpartum hemorrhage and severe preeclampsia/eclampsia are leading causes of near-miss/death in Indonesia. Poverty and delivery outside the hospital are significant risk factors. Prompt recognition of complications, timely referrals, standardized care protocols, prompt hospital triage, and structured provider education may reduce obstetric mortality and morbidity. Retrospective data were reliable, but prospective data provided valuable information about barriers to care and referral patterns. PMID:25656716

  20. The clinical study of diagnosing export obstruction with simulative dejecta

    International Nuclear Information System (INIS)

    Objective: To investigate the diagnostic value of two defecography contrast agents, artificial stool and liquid barium, in diagnosis of functional export obstruction. Methods: Defecography by using artificial stool (Artificial Stool Defecography, ASD) was compared with that by using liquid barium (Liquid Barium Defecography, BD). Both of which were conducted in 50 patients. Results: The average inside diameter of recta under ASD was 1.89cm larger than that under BD. The average recta volume ratio of ASD to BD was 2.1. 39 patients were detected as retention of contrast medium of more than 20% in ASD, whereas no patient was detected as that in BD. The number of inward invagination identified by ASD or BD respectively was 8 and 5, and that of Puborectalis Syndrome was 4 and 1. Average evacuate time was 10 seconds in ASD and 2.5 seconds in BD. Conclusion: Artificial stool defecography (ASD) is more beneficial than traditional barium defecography (BD) in diagnosis of export obstruction. Artificial stool defecography results in a higher diagnostic rate and is thus highly recommendable. (authors)

  1. ICD-10进食障碍分类和诊断标准在中国应用的几点修改建议%Amendment of ICD-10 Diagnostic Criteria for Eating Disorder

    Institute of Scientific and Technical Information of China (English)

    张大荣; 徐玉玉; 张卫华

    2009-01-01

    @@ 进食障碍(eating disorders,ED)是以进食行为异常为显著特征的一组综合征,主要包括神经性厌食和神经性贪食两大类,是主要发生于青少年和成年早期女性的心身疾病,患病率为 1%~4.2%,在美国、日本、西班牙、中国香港等地开展的研究显示,随着社会经济的发展,进食障碍的患病率呈增加的趋势[1].因此进食障碍的标准化诊断,就显得尤为重要.

  2. Body dysmorphic disorder and olfactory reference disorder: proposals for ICD-11

    Directory of Open Access Journals (Sweden)

    David Veale

    2014-01-01

    Full Text Available The article reviews the historical background and symptoms of body dysmorphic disorder (BDD and olfactory reference disorder, and describes the proposals of the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders related to these categories. This paper examines the possible classification of BDD symptoms in ICD-10. Four different possible diagnoses are found (hypochondriacal disorder, schizotypal disorder, delusional disorder, or other persistent delusional disorder. This has led to significant confusion and lack of clear identification in ICD-10. Olfactory reference disorder can also be classified as a delusional disorder in ICD-10, but there is no diagnosis for non-delusional cases. The Working Group reviewed the classification and diagnostic criteria of BDD in DSM-5, as well as cultural variations of BDD and olfactory reference disorder that include Taijin Kyofusho. The Working Group has proposed the inclusion of both BDD and olfactory reference disorder in ICD-11, and has provided diagnostic guidelines and guidance on differential diagnosis. The Working Group's proposals for ICD-11 related to BDD and olfactory reference disorder are consistent with available global evidence and current understanding of common mechanisms in obsessive-compulsive and related disorders, and resolve considerable confusion inherent in ICD-10. The proposals explicitly recognize cultural factors. They are intended to improve clinical utility related to appropriate identification, treatment, and resource allocation related to these disorders.

  3. Novel approaches in diagnosing tuberculosis

    Science.gov (United States)

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

    2011-06-01

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

  4. Pulmonale Hypertension, Pathophysiologie, Diagnose, Therapie

    Directory of Open Access Journals (Sweden)

    Lang I

    2001-01-01

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

  5. Radionuclide methods of diagnosing anthracycline - induced cardiotoxity

    International Nuclear Information System (INIS)

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

  6. Diagnosing clostridial enteric disease in poultry.

    Science.gov (United States)

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

    2013-05-01

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

  7. Fetal MRI clues to diagnose cloacal malformations

    International Nuclear Information System (INIS)

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

  8. PET in diagnosing exocrine pancreatic cancer

    International Nuclear Information System (INIS)

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

  9. Language disorders and cognitive functions in persons with schizophrenic disorders [Zaburzenia językowe a inne wybrane funkcje poznawcze u osób chorujących na zaburzenia schizofreniczne

    OpenAIRE

    Waszkiewicz, Justyna; Wciórka, Jacek; Anczewska, Marta; Chrostek, Anna; Świtaj, Piotr

    2012-01-01

    Aim. The aim of this study is to evaluate the relationship between clinical and neuropsychological measures of language disorders as well as characteristics of the mental condition of patients diagnosed as having schizophrenic disorders. Method. There were 45 persons with schizophrenic disorder (acc. ICD-10) examined with The Positive and Negative Syndrome Scale (PANSS), the side effect rating scale (UKU), Wisconsin Cards Storting Test (WCST), verbal fluency task, Ruff’s Test, “Similarities” ...

  10. 摂食障害患者における発症状況分類とその特徴についての検討

    OpenAIRE

    大村, 慶子

    1999-01-01

    The author examined groups of patients with eating disorders classified according to onset situation,and discussed the clinical features of each group. Forty-one female patients with anorexia nervosa or bulimia nervosa diagnosed by ICD-10 criteria were studied. The patients were classified into 3 types:diet, appetite loss and bulimic types. There were 25 patients in the diet type. The onset was dieting behavior. There were 10 patients in the appetite loss type. The onset was involuntary appet...

  11. First Rank Symptoms and Neurological Soft Signs in Schizophrenia

    OpenAIRE

    Mahesh Hembram; Jayati Simlai; Suprakash Chaudhury; Parthasarathi Biswas

    2014-01-01

    The aim of the study was to compare the neurological soft signs (NSS) in schizophrenia patients with and without first rank symptoms (FRS), their first degree relatives (FDR), and normal controls. The study was conducted on 60 schizophrenia patients diagnosed according to ICD 10 DCR and categorized into groups with and without FRS using Schedules for Clinical Assessment in Neuropsychiatry, 30 FDRs of the study sample, and 30 normal controls matched for age, education, and handedness. All the ...

  12. The psychophysiology of burnout

    OpenAIRE

    Mommersteeg, P.M.C.

    2006-01-01

    Burnout is characterized by emotional exhaustion, feelings of depersonalisation and reduced professional competence. It is an adverse health outcome to chronic work-related stress and insufficient recovery. The main aim of this thesis was to search for physiological disturbances in persons with severe burnout. HPA-axis function, salivary DHEAS, and in vitro immune function were investigated in clinically diagnosed burnout participants. Diagnosis was based on ICD-10 criteria for 'work-related ...

  13. 77 FR 40620 - AHRQ Workgroups on ICD-10-CM/PCS Conversion of Quality Indicators (QIs) - Extension Date for...

    Science.gov (United States)

    2012-07-10

    ... notice was previously published on June 4, 2012 ( http://www.gpo.gov/fdsys/pkg/FR-2012-06-04/pdf/2012..., neurologic disease, orthopedic and musculoskeletal disease, obstetrics and gynecologic disease, surgery... expertise (e.g., cardiovascular disease, neurologic disease, orthopedic and musculoskeletal...

  14. 78 FR 70558 - Review of Proposed Changes with ICD-10-CM/PCS; Conversion of Quality IndicatorsTM

    Science.gov (United States)

    2013-11-26

    ... rather than relying on mapping alone* * * (1) The measure steward's goal was to convert this measure to a... target codes* * *'' GEM files were the foundation of AHRQ's code mapping effort. 4. ``Assess for Material.... ``Solicit Stakeholder Comments: Conversion to new code sets requires involvement of many...

  15. Systematic review of validated case definitions for diabetes in ICD-9-coded and ICD-10-coded data in adult populations

    Science.gov (United States)

    Khokhar, Bushra; Jette, Nathalie; Metcalfe, Amy; Cunningham, Ceara Tess; Kaplan, Gilaad G; Butalia, Sonia; Rabi, Doreen

    2016-01-01

    Objectives With steady increases in ‘big data’ and data analytics over the past two decades, administrative health databases have become more accessible and are now used regularly for diabetes surveillance. The objective of this study is to systematically review validated International Classification of Diseases (ICD)-based case definitions for diabetes in the adult population. Setting, participants and outcome measures Electronic databases, MEDLINE and Embase, were searched for validation studies where an administrative case definition (using ICD codes) for diabetes in adults was validated against a reference and statistical measures of the performance reported. Results The search yielded 2895 abstracts, and of the 193 potentially relevant studies, 16 met criteria. Diabetes definition for adults varied by data source, including physician claims (sensitivity ranged from 26.9% to 97%, specificity ranged from 94.3% to 99.4%, positive predictive value (PPV) ranged from 71.4% to 96.2%, negative predictive value (NPV) ranged from 95% to 99.6% and κ ranged from 0.8 to 0.9), hospital discharge data (sensitivity ranged from 59.1% to 92.6%, specificity ranged from 95.5% to 99%, PPV ranged from 62.5% to 96%, NPV ranged from 90.8% to 99% and κ ranged from 0.6 to 0.9) and a combination of both (sensitivity ranged from 57% to 95.6%, specificity ranged from 88% to 98.5%, PPV ranged from 54% to 80%, NPV ranged from 98% to 99.6% and κ ranged from 0.7 to 0.8). Conclusions Overall, administrative health databases are useful for undertaking diabetes surveillance, but an awareness of the variation in performance being affected by case definition is essential. The performance characteristics of these case definitions depend on the variations in the definition of primary diagnosis in ICD-coded discharge data and/or the methodology adopted by the healthcare facility to extract information from patient records. PMID:27496226

  16. 葎草花粉变应原皮试液诊断葎草花粉变态反应的临床评价%Clinical Evaluation on Accuracy And Safety of Humulus Pollen Extract Used for Intradermal Test in the Diagnosing of Humulus Pollen Allergy

    Institute of Scientific and Technical Information of China (English)

    关凯; 岳凤敏; 程璇; 尹佳; 王良录; 李宏; 孙劲旅; 文利平; 顾建青; 青曼丽

    2013-01-01

    . Methods 1043 cases who had been prescribed both intradermal skin tests (IDT) and serum specific IgE ( sIgE) tests were collected and reviewed from Department of Allergy, PUMC hospital since Feb. 10th to Jul. 10th 2009. The accuracy of IDT with Humulus pollen extract was evaluated by using clinical diagnoses of allergists and slgE detection results as gold standards respectively. Adverse reactions were also recorded. Results IDT results≥ " + " was defined as the cutoff threshold for diagnosing. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and area under ROC curve was 88. 08% , 86. 03% , 72. 24% , 94. 59% , 86. 63% and 0. 92 (95% confidence interval; 0.896, 0.943) respectively by using clinical diagnoses of allergists as gold standard. Whereas slgE results ≥0. 35 KUA/L was defined as the cutoff threshold for diagnosing. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 87. 60% , 56. 86% , 83. 27% , 65. 17% and 78. 69% respectively by using sIgE results as gold standard. Coefficient of rank correlation between sIgE detection and IDT results is 0. 69143 in serum sIgE positive group. Local adverse reactions were recorded in 2. 59% (27/1043) patients. There was only one case who was attacked type I systemic adverse reaction, and the patient was also allergic to Artemisia and Sabina chinensis pollen. Conclusions IDT with 1 :20 000 w/v Humulus pollen extract is an accuracy and safe tool for the diagnosis of Humulus pollen allergy.

  17. From experience: applying the risk diagnosing methodology

    NARCIS (Netherlands)

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

    2002-01-01

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

  18. Gastric atrophy, diagnosing and staging

    Institute of Scientific and Technical Information of China (English)

    Hala MT El-Zimaity

    2006-01-01

    H pylori is now accepted as the cause of gastritis and gastritis-associated diseases, such as duodenal ulcer,gastric ulcer, gastric carcinoma, and gastric MALT lymphoma. The natural history of H pylori gastritis includes inflammation progressing from the antrum into the adjacent corpus resulting in an atrophic front of advancing injury leading to a reduction in acid secretion and eventual loss of parietal cells and development of atrophy. Sub-typing intestinal metaplasia has no clinical value to the patient, the pathologist, or the endoscopist.The pattern, extent, and severity of atrophy, with or without intestinal metaplasia, is a far more important predictor than is intestinal metaplasia subtype. The challenge remains to identify a reliable marker that relates to pre-malignant potential.

  19. Critical thinking and accuracy of nurses' diagnoses.

    Science.gov (United States)

    Lunney, Margaret

    2003-01-01

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

  20. Dysembryoplastic neuroepithelial tumor originally diagnosed as astrocytoma and oligodendroglioma

    Directory of Open Access Journals (Sweden)

    Diego Cassol Dozza

    2012-09-01

    Full Text Available Dysembryoplastic neuroepithelial tumor (DNT, described in 1988 and introduced in the WHO classification in 1993, affects predominantly children or young adults causing intractable complex partial seizures. Since it is benign and treated with surgical resection, its recognition is important. It has similarities with low-grade gliomas and gangliogliomas, which may recur and become malignant. OBJECTIVES: To investigate whether DNT was previously diagnosed as astrocytoma, oligodendroglioma, or ganglioglioma and to determine its frequency in a series of low-grade glial/glio-neuronal tumors. METHODS: Clinical, radiological, and histological aspects of 58 tumors operated from 1978 to 2008, classified as astrocytomas (32, including 8 pilocytic, oligodendrogliomas (12, gangliogliomas (7, and DNT (7, were reviewed. RESULTS: Four new DNT, one operated before 1993, previously classified as astrocytoma (3 and oligodendroglioma (1, were identified. One DNT diagnosed in 2002 was classified once more as angiocentric glioma. Therefore, 10 DNT (17.2% were identified. CONCLUSIONS: Clinical-radiological and histopathological correlations have contributed to diagnose the DNT.

  1. Early cardiovascular abnormalities in newly diagnosed obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Jean-Philippe Baguet

    2009-12-01

    Full Text Available Jean-Philippe Baguet1, Marie Nadra1, Gilles Barone-Rochette1, Olivier Ormezzano1, Hélène Pierre1, Jean-Louis Pépin21Department of Cardiology, University Hospital, Grenoble, France; 2Sleep Laboratory, EFCR, University Hospital, Grenoble, FranceAbstract: Obstructive sleep apnea (OSA is associated with high cardiovascular morbidity and mortality. Recent studies have shown that it is associated with atherosclerosis and left ventricular dysfunction markers. The aim of this study was to assess the cardiovascular effects of OSA depending on its severity, in patients without clinically diagnosed cardiovascular disease. One hundred thirty newly diagnosed, nondiabetic OSA patients (mean age 49 ± 10 years, without vasoactive treatment were included. They underwent clinical and ambulatory blood pressure measurements, echocardiography, carotid ultrasound examination, and a carotid–femoral pulse wave velocity (PWV measurement. Seventy-five percent of the subjects were hypertensive according to the clinical or ambulatory measurement. More patients with the most severe forms (respiratory disturbance index >37/hour had a nondipper profile (52% vs 34%; P = 0.025 and their left ventricular mass was higher (40 ± 7 vs 36 ± 8 g/m, p = 0.014. This last parameter was independently and inversely associated with mean nocturnal oxygen saturation (P = 0.004. PWV and carotid intima-media thickness did not differ between one OSA severity group to another, but the prevalence of carotid hypertrophy was higher when mean SaO2 was below 93.5% (29.5 vs 16%; P = 0.05. Our study shows that in OSA patients without clinically diagnosed cardiovascular disease, there is a significant left ventricular and arterial effect, which is even more marked when OSA is severe.Keywords: obstructive sleep apnea, hypertension, left ventricular hypertrophy, intima-media thickness, arterial stiffness

  2. APPLICATION OF POLYMERASE CHAIN REACTION FOR DIAGNOSING AMEBIC LIVER ABSCESS

    Institute of Scientific and Technical Information of China (English)

    郭增柱; 王正仪; 安亦军; 祝宏

    1996-01-01

    Polymerase chain reaction (PCR) has been applied in diagnosing amebic liver infection by detecting pathogenic Entamoeba histolytica DNA in liver aspirates. Oligonucleotide primers found to he specific for the gene encoding the 30 kDa molecule of this pathogenic ameba were used in the test. Liver aspirates obtained from 23 patients with amebic liver abscess substantiated by typical clinical rnanifastation or with very high titres of anti-E histtolytica antibodies by ELISA were found to he positive by PCR. Fourteen controlsamples (3 cases of bacterial liver abscess, I of liver cancer and 10 of other abscess) were all found to be negative to this reaction. The results suggested PCR to he a specific and sensitive tool for diagnosing amebic liver abscess infections.

  3. Lung cancer in patients diagnosed with silicosis should be investigated.

    Science.gov (United States)

    Güngen, Adil Can; Aydemir, Yusuf; Çoban, Hikmet; Düzenli, Hasan; Tasdemir, Canantan

    2016-01-01

    Silicosis is an interstitial lung disease developing as a result of inhalation of inorganic silica particles. In silicosis cases developing as a result of environmental and occupational exposure, an increase is observed in Turkey especially depending upon denim sandblasting. We present a 35-year-old female case who was applied to our hospital due to complaint of progressive dyspnea, had a history of working in denim sandblasting for 18 months, were diagnosed with silicosis as a result of high resolution computed tomography (HRCT) and diagnosed with lung adenocarcinoma as a result of transbronchial lung biopsy made due to clinical deterioration and radiological progression within three months. The purpose of this report was to point out that lung cancer can develop in patients followed up with diagnosis of silicosis or radiologic findings in silicosis can be confused with lung cancer. PMID:27330963

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

    OpenAIRE

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

    2013-01-01

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

  5. How Is Chronic Lymphocytic Leukemia Diagnosed?

    Science.gov (United States)

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

  6. How Are Lung Carcinoid Tumors Diagnosed?

    Science.gov (United States)

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

  7. How Is von Willebrand Disease Diagnosed?

    Science.gov (United States)

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

  8. How Is a Heart Murmur Diagnosed?

    Science.gov (United States)

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

  9. How Is Breast Cancer in Men Diagnosed?

    Science.gov (United States)

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

  10. How Do Health Care Providers Diagnose Endometriosis?

    Science.gov (United States)

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

  11. At få en diagnose

    DEFF Research Database (Denmark)

    Olesen, Birgitte Ravn; Jansbøl, Kirsten

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

  12. Diagnosing Diabetes and Learning about Prediabetes

    Science.gov (United States)

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

  13. Diagnosing Asthma in Very Young Children

    Science.gov (United States)

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

  14. Nursing diagnoses in persons with HIV/aids: an approach based on Horta’s conceptual model

    OpenAIRE

    Juliana de Oliveira Faria; Girlene Alves da Silva

    2013-01-01

    This study aims at identifying nursing diagnoses in hospitalized persons with HIV/AIDS. It is a cross-sectional study carried out with 30 patients admitted at an infectious and parasitic disease clinic inside a teaching hospital in the state of Minas Gerais from March to September 2011. In order to identify the diagnoses, the NANDA Taxonomy II system was applied, together with an instrument based on Horta’s conceptual model. The most common nursing diagnoses were: ineffective protection (100%...

  15. Influência das concavidades radiculares nas perdas clínicas de inserção, detectadas no exame clínico periodontal inicial The influence of root concavities on clinical attachment loss diagnosed at the initial evaluation of periodontal patients

    Directory of Open Access Journals (Sweden)

    Francisco Emilio PUSTIGLIONI

    1999-12-01

    Full Text Available O propósito deste estudo foi estabelecer a influência das concavidades radiculares na perda clínica de inserção (PCI diagnosticada no exame clínico periodontal inicial. Os dados de PCI foram obtidos dos primeiros e segundos pré-molares, caninos, incisivos laterais e centrais superiores e inferiores, de 163 pacientes. Os dados foram coletados das fichas periodontais dos pacientes que procuraram a Clínica do curso de Pós-Graduação em Periodontia da FOUSP. Foi realizada sondagem em todos os dentes para que se obtivesse as seguintes medidas: distância da linha esmalte cemento à margem gengival, profundidade clínica de sondagem (PCS nos sítios distovestibular (DV, centrovestibular (CV, mesiovestibular (MV, distolingual (DL, centrolingual (CL e mesiolingual (ML. Os dados foram incluídos no estudo quando pelo menos um dos sítios apresentasse PCI ³ 4 mm. Após a análise estatística (Friedman ANOVA test CV e CL mostraram valores de PCI estatisticamente menores para todos os dentes superiores e inferiores. Clinicamente CV mostrou os menores valores de perda clínica de inserção entre todos os dentes analisados, seguido de CL. Embora, baseados em nossos resultados, não exista correlação estatística entre PCI e a presença de concavidades radiculares, não podemos subestimar as últimas no exame clínico inicial, diagnóstico, prognóstico, planejamento cirúrgico e na fase de controle e manutenção do tratamento periodontal.The purpose of this study was to establish the influence of root concavities on clinical attachment loss (CAL that was diagnosed at the initial evaluation of periodontal patients. CAL data were analyzed in the following teeth of 163 patients: upper and lower second and first bicuspids, cuspids, lateral and central incisors. Data were retrieved from the initial dental chart of patients seeking treatment at the Periodontics Graduate Clinic, School of Dentistry, University of São Paulo. Probing was accomplished

  16. Concurrent validity of the GMS-AGECAT (A3) package in a Danish nursing home population

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth; Foldspang, Anders; Gulman, N.C.;

    1998-01-01

    Aim. To validate the Danish version of the GMS–AGECAT (A3), the Standardized Mini Mental State Examination (SMMSE) and the Geriatric Depression Scale-15 (GDS-15) by comparing them to clinical ICD-10 criteria in a Danish nursing home population. Methods. With a participation of 91%, the study....... The prevalence of clinical psychiatric ICD-10 main diagnoses was 56%. The non-accessibles had significantly higher psychiatric morbidity and lower ADL scores (modified Barthel ADL index) compared to those who were able to communicate. With the non-accessibles (N=100) included, the optimal screening...... residents were able to complete the SMMSE and 78% were able to complete the GDS-15. Conclusion. The Danish version of the GMS–AGECAT has relevant diagnostic and screening properties for organic disorders in Danish nursing home populations....

  17. CT-diagnosed emphysema and prognosis of chronic airflow obstruction: a retrospective study

    OpenAIRE

    Kurashima, Kazuyoshi; Fukuda, Chiaki; Nakamoto, Keitaro; Takaku, Yotaro; Hijikata, Naoya; Hoshi, Toshiko; Kanauchi, Tetsu; Ueda, Miyuki; Takayanagi, Noboru; Sugita, Yutaka; Araki, Ryuichiro

    2013-01-01

    Objective CT-diagnosed emphysema is associated with poor prognosis in chronic obstructive pulmonary disease (COPD). Its clinical impacts on prognoses of asthma with chronic airflow obstruction (CAO) are not well known. We sought to compare mortalities and prognostic factors in COPD and asthma with CAO by the presence or absence of CT-diagnosed emphysema. Design Retrospective cohort study. Setting Referral centre hospital for respiratory disease. Participants 1272 patients aged over 40 years w...

  18. Nursing diagnoses in hospitalized elderly, according to the International Classification of Nursing Practice

    OpenAIRE

    Marina Moralles Caldeira de Andrada; Marlon França; Ângela Maria Alvarez; Karina Silveira de Almeida Hammerschmidt

    2015-01-01

    Objective: to identify the nursing diagnoses characteristic of hospitalized elderly at the Medical Clinic of a university hospital in southern Brazil, according to the International Classification of Nursing Practice, version 1.0. Methods: it is a descriptive, cross-sectional study involving 24 elderly. Results: 158 nursing diagnoses were obtained gathered in 23 groups, grouped into 14 macro-groups presented by similarities: cardiovascular system, impaired self-care, compromised respiratory ...

  19. Accuracy of FibroScan for diagnosing liver fibrosis

    OpenAIRE

    Zhang, Jian; Han, Ping; SHAO, QING; Ji, Dong; Song-hai CHEN; Wang, Chun-Yan; Chen, Guo-Feng

    2011-01-01

    Objective To evaluate the accuracy of transient elastometry(FibroScan) for the detection of liver fibrosis.Methods A total of 323 patients diagnosed with chronic liver disease based on pathological examination in the 302 Hospital of the People’s Liberation Army from April to December of 2009 were involved in the current study.Among them,141 patients were subjected to liver biopsy.Their liver function,coagulant index,B-ultrasound and blood cell count were examined clinically.Four examinations ...

  20. How to manage a late diagnosed Hirschsprung′s disease

    Directory of Open Access Journals (Sweden)

    Mohamed Ouladsaiad

    2016-01-01

    Full Text Available Background: How to manage a late diagnosed Hirschsprung′s disease (HD and how to avoid calibre discrepancy? Subjects and Methods: A retrospective study of all patients diagnosed with HD over 2 years in our hospital from January 2009 to December 2012. Data were analysed for clinical presentations, investigations, surgical procedures and post-operative outcome. Results: Fifteen patients, operated by one single surgeon, were included in this study. The mean age was 6 years (2-16 years. Patients had an ultra-short segment type in 4 cases, rectosigmoid type in 9 cases and descending colonic aganglionosis in 2 cases. Rectal wash out was effective in 12 patients. A blowhole transverse colostomy was performed in 2 patients. Twelve patients underwent one single stage endorectal pull-through. Anastomosis incongruence was avoided by a plication procedure never described before. The assessment of post-operative outcomes by the paediatric incontinence and constipation scoring system revealed a normal continence function in all our patients, but 3 patients suffered from soiling secondary to constipation. Conclusion: One single stage pull-through can be safe and effective in children with late diagnosed HD. Routine rectal washout is a good way to prepare the colon. In some cases, blowhole colostomy can be an option. Anastomosis incongruence is a challenge; we describe a plication procedure to avoid it.

  1. 门冬胰岛素与生物合成人胰岛素治疗新诊断Ⅱ型糖尿病的对照研究%Comparative study on clinical therapeutic effect of insulin aspart and biosynthetic human insulin in the treatment of newly diagnosed type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    陈中英

    2012-01-01

    Objective To compare the clinical efficacy between insulin aspart and biosynthetic human insulin in the treatment of newly diagnosed type 2 diabetes. Methods Ninety-six newly diagnosed type 2 diabetic patients were randomly divided into insulin aspart group (treatment group, n=48) and biosynthetic human insulin group (control group, n =48). The patients received subcutaneous injection of insulin aspart or biosynthetic human insulin before daily meals, and they were treated with insulin glargine at the bedtime. The blood sugar levels, incidence of hypo-glycemic episodes and the dosage of insulin were compared between the two groups. Results After administration of the drugs, the blood sugar levels were significantly reduced, and the blood sugar levels was lower in insulin aspart group than in the control group. The incidence of hypoglycemia in the treatment group was lower than in the control group, and the difference was statistically significant. The dosage of insulin showed no significant difference in the two groups. Conclusion Insulin aspart was better in the control of blood sugar levels and more effective in the treatment of patients with type 2 diabetes.%目的 比较门冬胰岛素与生物合成人胰岛素治疗新诊断Ⅱ型糖尿病的临床疗效.方法 将新诊断的96例Ⅱ型糖尿病患者随机均分为2组,分别为门冬胰岛素(治疗)组和生物合成人胰岛素(对照)组.患者分别在每日餐前给予皮下注射门冬胰岛素和生物合成人胰岛素,且均每晚定时皮下注射一次甘精胰岛素.比较2组患者血糖、低血糖事件、胰岛素用量的差异.结果 用药后2组餐前及餐后的血糖含量均明显降低,且门冬胰岛素组餐前、餐后血糖均低于生物合成人胰岛素组;门冬胰岛素组患者低血糖发生次数低于生物合成人胰岛素组,差异有统计学意义;但2组胰岛素用量无显著差异.结论 门冬胰岛素能够更好地控制Ⅱ型糖尿病的血糖,对Ⅱ

  2. Progression and prognostic factors of motor impairment, disability and quality of life in newly diagnosed Parkinson's disease

    NARCIS (Netherlands)

    Post, B.; Muslimovic, D.; Geloven, N. van; Speelman, J.D.; Schmand, B.; Haan, R.J. de

    2011-01-01

    OBJECTIVE: To determine progression and prognostic factors of progression rate of motor impairment, disability, and quality of life (QoL) in patients with newly diagnosed Parkinson's disease. METHODS: A group of 126 patients with newly diagnosed PD recruited from outpatient clinics participated in t

  3. Progression and prognostic factors of motor impairment, disability and quality of life in newly diagnosed Parkinson's disease

    NARCIS (Netherlands)

    B. Post; D. Muslimovic; N. van Geloven; J.D. Speelman; B. Schmand; R.J. de Haan

    2011-01-01

    Objective: To determine progression and prognostic factors of progression rate of motor impairment, disability, and quality of life (QoL) in patients with newly diagnosed Parkinson's disease. Methods: A group of 126 patients with newly diagnosed PD recruited from outpatient clinics participated in t

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

    Science.gov (United States)

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

    2008-01-01

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

  5. Clinical significance of the combined determination of Tumour markes in bronchoalveolar lavage fluid to diagnose lung cancer%肺泡灌洗液中肿瘤标志物的联合检测在肺癌诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    张绍武; 宁洁

    2011-01-01

    目的:探讨支气管肺泡灌洗液(BALF)3种肿瘤标志物癌胚抗原(CEA)、细胞角蛋白片段211(CYFRA211) 、神经元特异性烯醇化酶(NSE)对肺癌的临床诊断价值.方法:采用电化学发光法分别检测90例肺癌患者、60例肺部良性病变患者血清及BALF中CEA、CYFRA 211和NSE的含量.结果:肺癌患者BALF中3种肿瘤标志物的含量明显高于肺部良性病变患者(P<0.05),且随着TNM临床分期升高,肿瘤标志物的含量也明显升高.在不同病理类型的肺癌中,3种肺癌肿瘤标志物升高的程度均有所不同.BALF中肿瘤标志物的含量与同期血清中的含量相比,出现更早且浓度更高.结论:肺癌患者BALF中CEA、CYFRA211、NSE联合检测对肺癌诊断有更高的临床参考价值.%Objective: To investigate the clinical value of 3 tumor markers [ carcinoma embryonic antigen ( CEA ),cytokeratin 19 fragments ( CYFRA211 ) and neuron specific enolase( NSE ) ]in bronchoalveolar lavage fluid ( BALF )to diagnose lung cancer. Methods:The levels of CEA、 CYFRA211 and NSE in BALF and serum were measured in 90 patients with lung cancer and 60 patients with benign lung disease by electro chemiluminescence. Results: The levels of 3 tumor markers in BALF were much higher in lung cancer group than that in benign lung disease group ( P <0.05 ) and they were higher in patients in stage Ⅲ and Ⅳ than those in stage Ⅰ and Ⅱ. The tumor markers increased to different degrees among the patients in various pathological classifications. It was also found that the levels of these tumor markers were higher and more sensitive in BALF than those in serum. Conclusion:The measurement of tumor markers in BALF is of more significant value than the measurement in serum, which helps early diagnosis, pathological classification and prognosis evaluation of lung cancer.

  6. Clinical Analysis of 48 Cases of Fetal Congenital Heart Disease Diagnosed by Color Doppler Ultrasound%彩色多普勒超声诊断48例胎儿先天性心脏病的临床分析

    Institute of Scientific and Technical Information of China (English)

    李蓉

    2015-01-01

    目的:探究分析彩色多普勒超声诊断在胎儿先天性心脏病中的临床效果。方法回顾性分析我院2014年2月~2015年3月拟诊有胎儿先天性心脏病的48例产妇超声诊断资料,同采用其他诊断方式进行对比分析。结果彩色多普勒超声共诊断出48例胎儿先天性心脏病,检出率为100%;其他诊断方法的综合检出率为75%,彩色多普勒超声诊断检出率高于其他诊断方式,数据之间差异显著(P<0.05)。结论彩色多普勒超声诊断胎儿先天性心脏病的检出率高,为早期诊断提供了真实可靠的依据。%Objective To explore the clinical effect of color Doppler ultrasound in the diagnosis of congenital heart disease in the fetus. MethodsA retrospective analysis of 48 cases of fetal congenital heart disease in our hospital from February 2014 to March 2015 were retrospectively analyzed.Results48 cases of fetal congenital heart disease were diagnosed by color Doppler ultrasound. The detection rate was 100%. The detection rate of other diagnostic methods was 75%. The diagnostic rate of color Doppler ultrasound was significantly higher than that of other diagnostic methods, and the difference was significant (P< 0.05).Conclusion Color Doppler ultrasound in the diagnosis of fetal congenital heart disease with high detection rate, which provides a reliable basis for early diagnosis of fetal congenital heart disease.

  7. Recognising early meningitis: a missed opportunity to diagnose meningitis.

    Science.gov (United States)

    Ponnampalam, Anusha; de Sousa, Paula; Carroll, Will

    2016-01-01

    There are ∼250 cases of neonatal bacterial meningitis each year in the UK. Clinical evaluation of signs and symptoms of meningitis is challenging, particularly, during the neonatal period. Although uncommon, it is recognised that bacterial meningitis can be present in a child with an apparently normal cerebrospinal fluid (CSF) initially.We report the case of a newborn baby girl who was admitted with concerns regarding 2 dusky episodes. She underwent blood tests, a lumbar puncture and was started on intravenous antibiotics. With negative cultures, normal blood results and following a significant clinical improvement, antibiotics were discontinued after 48 hours and the baby was discharged home. She re-presented to the children's emergency department 7 hours later with a history of an apnoeic episode. A second CSF sample was suggestive of bacterial meningitis. We will discuss the published literature and the potential drawbacks of lumbar punctures and ways to diagnose meningitis early. PMID:27516108

  8. Non-invasive method for assessment of liver fibrosis in clinically diagnosed chronic hepatitis B viruscarriers%临床诊断的慢性乙型肝炎病毒携带者肝纤维化程度的非创伤性评价

    Institute of Scientific and Technical Information of China (English)

    王伟; 杨方; 魏倪; 杨晴; 刘丹阳; 赵兵

    2012-01-01

    目的 评价常规实验室检测指标在判断慢性HBV携带者肝纤维化程度中的作用.方法 选择196例临床诊断的慢性HBV携带者行肝组织活检及常规实验室检查.观察血常规、AST/ALT、AST与PLT比值指数(APRI),年龄-PLT指数(API);以S0(112例)及S1~S3(84例)分组比较,计量资料采用Wilcoxon秩和检验,计数资料采用x2检验.结果 196例慢性HBV携带者HBV DNA均阳性,HBeAg阳性156例,占79.6%;S1~S3组与S0组比较,年龄偏大、ALT、AST、AST/ALT、APRI及API增高,而PLT和HBV DNA下降(统计值=7.705、6.33、7.095、4.977、11.059、8.936、10.196,均P<0.05);APRI和API的曲线下面积>0.70,分别为0.827和0.829.API灵敏度最高为70.46%,其阴性预测值为71.43%;APRI特异度最高为92.94%,阳性预测值为92.86%;以APRI≥0.30作为有肝纤维化的诊断,119例中包括了97.62%肝纤维化患者;以API≥4.0作为有肝纤维化的诊断,112例中包括了96.43%肝纤维化患者.结论 常规实验室检测可用于慢性HBV携带者的肝纤维化程度判断,APRI和API是具有简便、易得且较有价值的临床指标.%Objective To verify the value of routine laboratory markers for assessment of liver fibrosis status in chronic hepatitis B virus (HBV) carriers.Methods A total of 196 patients who were clinically diagnosed with chronic HBV carriers with liver biopsy and routine laboratory test were included in this study. The data of complete blood count, aspartate aminofransferase/alanine aminotransferase (AST/ALT),aspartate aminotransferase to platelet ratio index (APRI) and ageplatelet index (API) were collected and calculated.Patients were divided into group S0 (n=112) and group S1- S3 (n =84) based on liver fibrosis stages.Measurement data were analyzed by Wilcoxon rank sum test and enumeration data were analyzed by chi square test.Results All 196 enrolled HBV carriers were HBV DNA positive,with 156 (79.6%) HBe

  9. The Convergence of Personality Disorder Diagnoses across Different Methods among Monolingual (Spanish-speaking-only) Hispanic Patients in Substance Use Treatment

    OpenAIRE

    Samuel, Douglas B.; Añez, Luis M.; Paris, Manuel; Grilo, Carlos M.

    2013-01-01

    Methods for diagnosing personality disorders (PDs) within clinical settings typically diverge from those employed in treatment research. Treatment groups in research studies are routinely diagnosed using semi-structured interviews or self-report questionnaires, yet these methods show poor agreement with clinical diagnoses recorded in medical charts or assigned by treating clinicians, reducing the potential for evidence-based practice. Furthermore, existing research has been limited by focusin...

  10. Emergency route diagnosis of mucoepidermoid carcinoma initially diagnosed as a temporomandibular disorder.

    Science.gov (United States)

    Chmieliauskaite, Milda; Sollecito, Thomas P; Stoopler, Eric T

    2016-01-01

    Salivary gland malignancy (SGM) can affect both major and minor glands and manifests clinically with various presentations. The most common type of SGM is mucoepidermoid carcinoma (MEC), which has been previously reported to be associated with symptomatology associated with temporomandibular disorders (TMD). This case report describes a patient with an aggressive form of MEC of the parotid gland that was initially diagnosed as TMD. In addition, the patient's MEC was diagnosed emergently based on development of acute clinical symptomatology. To the best of our knowledge, emergency route diagnosis of MEC affecting the parotid gland has not been previously reported in the literature. PMID:26782364

  11. Perfil clínico-epidemiológico dos pacientes diagnosticados com hanseníase em um centro de referência na região nordeste do Brasil Clinical and epidemiological profile of patients diagnosed with leprosy in a reference center in the notheast of Brazil

    Directory of Open Access Journals (Sweden)

    Cícero Cláudio Dias Gomes

    2005-12-01

    Full Text Available FUNDAMENTOS: A hanseníase permanece sério problema de saúde pública mundial. O conhecimento das características epidemiológicas da doença é importante ferramenta para o controle da endemia. OBJETIVO: Descrever as características clínicas e epidemiológicas dos pacientes diagnosticados com hanseníase no ano de 2004 em um centro de referência da Região Nordeste do Brasil. MÉTODO: Foram avaliados prontuários de pacientes que deram entrada no registro ativo do Centro de Dermatologia Dona Libânia, em Fortaleza, Ceará, no período de janeiro a dezembro de 2004. RESULTADOS: dos 967 casos que deram entrada nesse Centro naquele ano, 909 foram casos novos. Cerca de 7,7% eram pacientes entre zero e 14 anos de idade, e a distribuição por gênero foi de 483 (49,95% homens e 484 (50,05% mulheres. A maioria apresentava a forma clínica dimorfa (54,6%, sendo 82,2% dos pacientes provenientes de Fortaleza, CE. Foi realizada a avaliação do grau de incapacidades no diagnóstico em 94,2% dos pacientes, com 21,7% apresentando grau diferente de zero no diagnóstico. CONCLUSÃO: Com base nos resultados obtidos, constatou-se a presença de elevado percentual (7,7% de casos detectados em menores de 15 anos, associado a baixo percentual (5,8% de pacientes diagnosticados na forma indeterminada e elevado percentual (21,7% de casos com incapacidade ao diagnóstico.BACKGROUND: Leprosy continues to represent a serious public health problem worldwide. Knowledge of epidemiological characteristics of the disease is an important tool for the endemy control. OBJECTIVES: To describe the clinical and epidemiological characteristics of patients diagnosed with leprosy during 2004, in a Reference Center in the Northeast of Brazil. METHODS: We analyzed the records referring to patients who entered de active register of the Center of Dermatology Dona Libânia, in Fortaleza, Ceará, from January to december 2004. RESULTS: Out of 967 cases that entered this Center in

  12. Clinical analysis of polycystic ovary syndrome in adolescence associated with homosexual precocious puberty diagnosed in girls%以女童同性性早熟起病的青春期多囊卵巢综合征诊疗分析

    Institute of Scientific and Technical Information of China (English)

    李豫川; 巩纯秀; 吴迪; 谷奕; 曹冰燕

    2014-01-01

    Objective The report was focused on polycystic ovary syndrome(PCOS) in female adolescents related to homosexual precocious puberty,and the new awareness of its influence on long-term health of homosexual precocious girls.Methods A girl with idiopathic central precocious puberty (ICPP) but diagnosed as PCOS in adolescence was reported and the data were reviewed.Results A girl was diagnosed as ICPP when she was near 8 years old with obesity,but without hyperinsulinemia,then she received the treatment of a 3.75 mg dose gonadotropin hormone analogues (GnRHa) every 28 days.Her gonads development was under control while her growth was arrested.Growth hormone(GH) injection started at 13 months.She stopped all medications when finished GH and GnRHa treatment for 12 months and 25 months.She went to see doctors again because of no menarche after discontinuing medication for nearly 2 years.She appeared obese and acne,hirsutism,athanens negricans and purple purple striae on the skin.Hyperinsulinemia and hypertestosterone were demonstrated.Pelvic B ultrasonography showed polycystic ovary,and she was diagnosed as PCOS.She was ordered to lose weight and to take metformin.And adrenocorticotropic hormone stimulating test was done,and B ultrasonography again ruled out atypical congenital adrenal hyperplasia and tumor of adrenal gland.She got her menarche 1 month later.Twelve months after the PCOS diagnosis and treatment,she had 4 menses,her insulin level decreased,glucose tolerance and her serum testosterone level turned normal.At the same time,the form of ovarian and follicular was significantly reduced.After taking mefformin for 20 months,her height and weight did not change,her menstrual was regular every 35-40 days,each time lasting about 7 days.She was followed up.We also reviewed literatures and learnt that precocious puberty might not be a benign situation and it might have an intrinsic relation to obesity,precocious puberty and PCOS.It might be the cofactors for causing PP

  13. Bordetella pertussis diagnosed by polymerase chain reaction

    DEFF Research Database (Denmark)

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

    1994-01-01

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

  14. Bilateral segmental neurofibromatosis diagnosed during pregnancy.

    Science.gov (United States)

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

    2011-01-01

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

  15. Diagnosing Functional Seizures in Children and Adolescent

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  16. Diagnosing risks in product-innovation projects

    NARCIS (Netherlands)

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

    1994-01-01

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

  17. Medicinalindustrien har brug for diagnoser som ADHD

    DEFF Research Database (Denmark)

    Fugl, Marie

    2008-01-01

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

  18. Diagnosing Febrile Illness in a Returned Traveler

    Centers for Disease Control (CDC) Podcasts

    2012-03-01

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

  19. Two Siblings Diagnosed as Lafora Disease

    Directory of Open Access Journals (Sweden)

    Yasemin Biçer Gömceli

    2010-03-01

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

  20. Prevalence of item level negative symptoms in first episode psychosis diagnoses.

    LENUS (Irish Health Repository)

    Lyne, John

    2012-03-01

    The relevance of negative symptoms across the diagnostic spectrum of the psychoses remains uncertain. The purpose of this study was to report on prevalence of item and subscale level negative symptoms across the first episode psychosis (FEP) diagnostic spectrum in an epidemiological sample, and to ascertain whether items and subscales were more prevalent in a schizophrenia spectrum diagnoses group compared to an \\'all other psychotic diagnoses\\' group. We measured negative symptoms in 330 patients presenting with FEP using the Scale for Assessment of Negative Symptoms (SANS), and ascertained diagnosis using the Structured Clinical Interview for DSM IV. Prevalence of SANS items and subscales were tabulated across all psychotic diagnoses, and logistic regression analysis determined which items and subscales were predictive of schizophrenia spectrum diagnoses. SANS items were most prevalent in schizophrenia spectrum conditions but frequently presented in other FEP diagnoses, particularly substance induced psychotic disorder and Major Depressive Disorder. Brief psychotic disorder and bipolar disorders had low levels of negative symptoms. SANS items and subscales which significantly predicted schizophrenia spectrum diagnoses, were also frequently present in some of the other psychotic diagnoses. Conclusions: SANS items have high prevalence in FEP, and while commonest in schizophrenia spectrum conditions are not restricted to this diagnostic subgroup.

  1. A Fast Test to Diagnose Flu

    Energy Technology Data Exchange (ETDEWEB)

    Hazi, A U

    2007-02-12

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

  2. Urine as a specimen to diagnose infections in XXI century: focus on analytical accuracy

    Directory of Open Access Journals (Sweden)

    Tamara eTuuminen

    2012-03-01

    Full Text Available Urine as a clinical specimen to diagnose infections has been used since ancient times. Many rapid technologies to assist diagnosis of infections are currently in use. Alongside traditional enzyme immunoassays (EIA, new technologies have emerged. Molecular analysis of transrenal DNA to diagnose infections is also a rapidly growing field. The majority of EIAs utilize the detection of excreted sugar compounds of the outer microbial cell wall shed into the bloodstream and excreted into the urine. This mini-review focuses on current knowledge on rapid urinary antigen detection tests to diagnose most common infections, and highlights their diagnostic utility. The past and the future of urinalysis are also briefly discussed. The analysis of the literature shows that some methods are not quantitative, and analytical sensitivity may remain suboptimal. In addition, the performance criteria and technical documentation of some commercial tests are insufficient. Clinical microbiologists and physicians should be alert to assay limitations.

  3. The appearance and clinical significance of persistent carotid-basilar artery anastomoses diagnosed by CT and MR angiography%永存颈内-基底动脉吻合血管的CTA、MRA 表现及临床意义

    Institute of Scientific and Technical Information of China (English)

    毛一朴; 马隆佰; 黄涛

    2015-01-01

    目的:探讨永存颈内-基底动脉吻合血管的 CT 血管造影(CTA)及 MR 血管造影(MRA)影像学表现并分析其临床意义。方法回顾性分析17例经头颈 CTA 及 MRA 诊断为永存颈内-基底动脉吻合血管患者的影像学资料。10例患者行头颈联合 CTA检查,7例患者行颅脑和颈部 MRA 检查,其中3例同时行 CTA 及 MRA 检查。结果永存三叉动脉(PTA)10例,按 Saltzman 分型:6例Ⅰ型,2例Ⅱ型,2例Ⅲ型。永存舌下动脉(PHA)3例,1例起始于右侧颈内动脉颈段,2例起始于左侧颈外动脉。寰前节间动脉(PIA)4例,2例位于右侧,2例位于左侧。1例 PTA 及1例 PHA 合并前交通动脉瘤。6例 PTA、2例 PHA 及1例 PIA 伴发基底动脉或椎动脉发育不良。结论CTA 及 MRA 能清楚显示永存颈内-基底动脉吻合血管的行程及其伴发颅内畸形血管合并症,为外科及介入手术提供准确的影像资料和指导作用。%Objective To explore the appearance of CT angiography(CTA)and magnetic resonance angiography (MRA)in persis-tent carotid-basilar artery anastomoses,and discuss its clinical significance.Methods 1 7 patients of persistent carotid-basilar artery anastomoses diagnosed by CT and MR angiography were retrospectively reviewed.10 patients were examined by craniocervical CTA, 7 patients were examined by cranial and cervical MRA,and 3 patients were examined by CTA and MRA.Results 10 patients had persistent trigeminal arteries (PTA).Based on Saltzman type:6 cases were Saltzman type Ⅰ,2 cases were Saltzman typeⅡ,and 2 cases were Saltzman type Ⅲ.1 case of 3 persistent hypoglossal arteries(PHA)originated from the right carotid artery,and 2 cases originated from the left external carotid artery.2 cases of 4 proatlantal intersegmental artery(PIA)were right ipsilateral,and 2 cases were left ipsilateral.1 case of PTA and 1 case of PHA associated with an aneurysm.6 cases of PTA,2 cases of PHA and 1 case of PIA complicated with ipsilateral

  4. 超声弹性成像技术在甲状腺良恶性肿瘤鉴别诊断中的临床应用价值%Clinical application value of ultrasound elastography technology in differentiation diagnosing thyroid tumor

    Institute of Scientific and Technical Information of China (English)

    杨舟; 郭鹏

    2013-01-01

    目的:探讨超声弹性成像在甲状腺良、恶性肿瘤鉴别诊断中的应用价值。方法对本院82例患者(103个甲状腺实性肿瘤)的常规超声及超声弹性成像特征进行对照分析(超声弹性成像诊断采用5级法),并将诊断结果与术后病理结果进行比较,评价两种方法对良、恶性甲状腺肿瘤的诊断准确性。结果103个甲状腺肿瘤中,经病理证实良性肿瘤86个,其中弹性成像5级法诊断1级64个,2级15个,3级5个,4级2个;恶性肿瘤17个,其中弹性成像5级法诊断3级1个,4级9个,5级7个,若以硬度评级≥4级为界值,超声弹性成像诊断甲状腺恶性肿瘤的敏感度、特异度和准确率分别为94.1%(16/17),97.7%(84/86),97.1%(100/103);常规超声诊断的敏感度、特异度、准确率分别为82.4%(14/17)、88.3%(76/86)、87.4%(90/103),差异具有统计学意义( P<0.05)。结论超声弹性成像通过评价组织相对硬度来判别甲状腺肿瘤的性质,对于提高甲状腺肿瘤良恶性诊断的准确性具有较大帮助。%Objective To discuss the clinical applications value of ultrasound elastography technology in diagnosing thyroid benign and malig-nant nodule .Methods Preoperative conventional ultrasonic nodules and ultrasound elastography characteristics By operation and pathology of 82 cases thyroid tumor patients (103 tumors) were retrospectively analyzed ,and compared with pathology .To evaluate the precision of the two dignon-sis way about thyroid tumor .Results All 86 benign tumors were confirmed by pathology in 103 thyroid nodule ,64 were I grade ,15 were Ⅱ grade , 5 were III grade ,2 were IV grade;17 benign tumors were confirmed by pathology in 103 thyroid tumors ,1 were III grade ,9 were IV grade ,7 were V grade ,The sensitivity ,Specificity and Precision Of the ultrasound elastosonography in differentiating benign and malignant thyroid tumors was

  5. 甘精胰岛素与格列本脲治疗初诊2型糖尿病的疗效对比%Comparison on the clinical effects of insulin glargine and glimepiride for newly diagnosed type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    班安然

    2013-01-01

    Objective To compare the therapeutic effects and safety of insulin glargine and glimepiride in the treatment of newly diagnosed type 2 diabetes mellitus (T2DM). Methods Sixty T2DM patients were randomly divided into 3 groups, 20 cases in each group. Group A was administered insulin glargine combined with metformin, group B glimepiride combined with metformin and group C Isophane Protamine Biosynthetic Human Insulin Injection (pre - mix 30R). Before and after treatment, the levels of fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2 hPG), glycosylated hemoglobin (HbAlc) and postprandial C peptide after meals in the patients of 3 groups as well as hypoglycemia incidences of groups A and B were compared. Results The improved condition of each index in group A was markedly superior to those in groups B and C. The improved conditions of group B showed the tendency of preceding group C, but there was no statistical significance among each indexes except for HbAlc. The hypoglycemia incidences of group A in both previous and later 6 weeks showed the tendency of being inferior to group B, but the difference showed no statistical significance. Conclusion Insulin glargine combined with metformin in the treatment of T2DM, can significantly reduce the blood sugar and ameliorate glycometabolism, with a low incidence of hypoglycemia, high safety and superior to glimepiride combined with metformin, so it is worthy of clinical promotion.%目的 比较甘精胰岛素与格列本脲对初诊2型糖尿病(T2DM)的疗效及安全性.方法 将60例T2DM患者随机分为3组,每组20例.A组给予甘精胰岛素联合二甲双胍,B组给予格列本脲联合二甲双胍,C组给予精蛋白生物合成人胰岛素注射液(预混30R).比较3组患者治疗前后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbAlc)、餐后C肽水平变化,以及A、B组低血糖发生率.结果 A组各指标改善情况均显著优于B、C组,B组各指标改善情况有

  6. An Appropriate Indicator for Diagnosing Gestational Diabetes

    OpenAIRE

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

    2005-01-01

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

  7. Best waveform score for diagnosing keratoconus

    OpenAIRE

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

    2013-01-01

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

  8. Talus avulsion fractures: are they accurately diagnosed?

    Science.gov (United States)

    Robinson, Karen P; Davies, Mark B

    2015-10-01

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

  9. An Appropriate Indicator for Diagnosing Gestational Diabetes

    Directory of Open Access Journals (Sweden)

    Jui-Hung Sun

    2005-12-01

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

  10. On Categorical Diagnoses in DSM-V : Cutting Dimensions at Useful Points?

    NARCIS (Netherlands)

    Kamphuis, Jan H.; Noordhof, Arjen

    2009-01-01

    The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V) will likely place more emphasis on dimensional representation of mental disorders. However, it is often argued that categorical diagnoses are preferable for professional communication, clinical decision-making, or distinguish

  11. A Giant Hydronephrosis Mistakenly Diagnosed as Ovarian Tumor in a Pregnant Woman

    Directory of Open Access Journals (Sweden)

    Rajendra B. Nerli

    2016-01-01

    Full Text Available We report a case of giant hydronephrosis that was wrongly diagnosed as an ovarian cyst and explored in a pregnant woman. Giant hydronephrosis are uncommon and need to be kept in mind as a differential diagnosis while making a clinical diagnosis.

  12. Comparative analysis of conventional PCR and real-time PCR to diagnose shrimp WSD

    OpenAIRE

    Leal, C. A. G.; Carvalho-Castro, G.A.; Cottorello, A.C.; Leite, R. C.; Figueiredo, H. C. P.

    2013-01-01

    The aims of this study were to standard and optimize a qPCR protocol with FAM-BHQ1 probe, and to compare its sensitivity against TaqMan qPCR and PCR methods to diagnose shrimp WSD. The FAM-BHQ1 qPCR presented higher clinical sensitivity and showed to be a robust alternative to detect WSSV in clinical samples.

  13. Leiomyomas and massive digestive hemorrhages: Case reports of patients diagnosed in 2004

    OpenAIRE

    Golubović Gradimir; Čeleketić Dušica; Kiurski Milosav; Tomašević Ratko; Stanković Dragana; Pavlović Aleksandar

    2007-01-01

    Introduction: During 2004, there were 6 patients with leiomyomas diagnosed and treated at the Department of Gastroenterology and Clinical Pathology of the Zemun Clinical Center. The most common location of these benign submucosal tumors is stomach, followed by small intestine and large intestine. Case report: The most common symptoms of these patients were massive intestinal hemorrhage, with haematemesis and melaena. Hemorrhages resulted from superficial lesions, caused by pressure of the tum...

  14. Stability of childhood anxiety disorder diagnoses: a follow-up naturalistic study in psychiatric care

    OpenAIRE

    Carballo, Juan J.; Baca-Garcia, Enrique; Blanco, Carlos; Perez-Rodriguez, M Mercedes; Jimenez Arriero, Miguel A.; Artes-Rodriguez, Antonio; Rynn, Moira; Shaffer, David; Oquendo, Maria A.

    2009-01-01

    Abstract Few studies have examined the stability of major psychiatric disorders in pediatric psychiatric clinical populations. The objective of this study was to examine the long-term stability of anxiety diagnoses starting with pre-school age children through adolescence evaluated at multiple time points. Prospective cohort study was conducted of all children and adolescents receiving psychiatric care at all pediatric psychiatric clinics belonging to two catchment areas in Madrid,...

  15. Hepatic hemangiomas as diagnosed by ultrasonography and computed tomography

    International Nuclear Information System (INIS)

    A total of 62 cases where the clinical diagnosis of hepatic hemangioma had been established during the period between 1981 and 1983 on the basis of computed tomography and sonography were subjected to retrospective analysis with the aim of evaluating the diagnostic reliability of these two methods. In 29 patients a typical distribution pattern of the contrast medium gave irrefutable evidence of the disease. Hemangiomas were predicted from the results of computed tomography for a further 5 patients with less revealing distribution patterns, although in 4 among these the preliminary diagnosis of hemangioma was disproved by additional diagnostic procedures (scintigraphy, laparoscopy, surgery and biopsy). Out of 16 patients, in which the hemangiomas were diagnosed from the typical patterns created by the contrast medium on the CT scans, 11 showed sonographic findings to confirm the presence of such tumours. This retrospective analysis showed that a correct and positive diagnosis could be established in no more than 7 patients on the basis of sonography alone, while 6 such diagnoses were definitely proven to be false-positive. As regards diagnostic accuracy, sonography clearly compares unfavourably with computed tomography. It may offer some advantages inasmuch as it requires no radiation exposure, is non-invasive and, last not least, less costly. (ECB)

  16. CT scanning for diagnosing blunt ureteral and ureteropelvic junction injuries

    Directory of Open Access Journals (Sweden)

    Chu Peter

    2008-02-01

    Full Text Available Abstract Background Blunt ureteral and ureteropelvic (UPJ injuries are extremely rare and very difficult to diagnose. Many of these injuries are missed by the initial trauma evaluation. Methods Trauma registry data was used to identify all blunt trauma patients with ureteral or UPJ injuries, from 1 April 2001 to 30 November 2006. Demographics, injury information and outcomes were determined. Chart review was then performed to record initial clinical and all CT findings. Results Eight patients had ureteral or UPJ injuries. Subtle findings such as perinephric stranding and hematomas, and low density retroperitoneal fluid were evident on all initial scans, and prompted delayed excretory scans in 7/8 cases. As a result, ureteral and UPJ injuries were diagnosed immediately for these seven patients. These findings were initially missed in the eighth patient because significant associated visceral findings mandated emergency laparotomy. All ureteral and UPJ injuries have completely healed except for the case with the delay in diagnosis. Conclusion Most blunt ureteral and UPJ injuries can be identified if delayed excretory CT scans are performed based on initial CT findings of perinephric stranding and hematomas, or the finding of low density retroperitoneal fluid.

  17. Radiographic diagnoses and treatment decisions on approximal caries

    International Nuclear Information System (INIS)

    Mineral loss which represents a threshold value for radiographic diagnosis, cannot be defined exactly. For clinical use 10% mineral loss in the direction of the X-ray beam may constitute a border line lesion for radiographic detection, and caries lesions without cavitation seemed to be beyond this diagnostic threshold. The degree of caries estimated by using radiographs is fairly closely related to the depth of the tissue changes recorded in the prepared cavity. Radiographic examinations more often lead to underestimation than overestimation of the degree of caries. Radiographic caries diagnoses made at different degrees of penetration toward the pulp showed insignificant variations with respect to quality, but the observers were more confident of caries being present (used more strict criterion) when they scored caries in inner dentin. Consensus on diagnostic criteria and improved diagnostic quality are considerably more important to the quality of therapeutic decisions on approximal caries than viewing conditions and film density. A semi-radiopaque material in Class II fillings seems to offer advantages compared to amalgam in respect of the diagnosis of secondary caries and marginal defects. There is a danger that dentists will restore approximal caries lesions too early and before these can be diagnosed in dentin radiographically

  18. Diagnosing gastrointestinal illnesses using fecal headspace volatile organic compounds.

    Science.gov (United States)

    Chan, Daniel K; Leggett, Cadman L; Wang, Kenneth K

    2016-01-28

    Volatile organic compounds (VOCs) emitted from stool are the components of the smell of stool representing the end products of microbial activity and metabolism that can be used to diagnose disease. Despite the abundance of hydrogen, carbon dioxide, and methane that have already been identified in human flatus, the small portion of trace gases making up the VOCs emitted from stool include organic acids, alcohols, esters, heterocyclic compounds, aldehydes, ketones, and alkanes, among others. These are the gases that vary among individuals in sickness and in health, in dietary changes, and in gut microbial activity. Electronic nose devices are analytical and pattern recognition platforms that can utilize mass spectrometry or electrochemical sensors to detect these VOCs in gas samples. When paired with machine-learning and pattern recognition algorithms, this can identify patterns of VOCs, and thus patterns of smell, that can be used to identify disease states. In this review, we provide a clinical background of VOC identification, electronic nose development, and review gastroenterology applications toward diagnosing disease by the volatile headspace analysis of stool. PMID:26819529

  19. Consulta de enfermagem ambulatorial e diagnósticos de enfermagem relacionados a características demográficas e clínicas Consulta en ambulatorio y diagnóstico de enfermería relacionados con las características demográficas y clínicas Outpatient nursing consultation and nursing diagnoses related to demographic and clinical characteristics

    Directory of Open Access Journals (Sweden)

    Elenara Franzen

    2012-09-01

    óreas. Se encontró una asociación significativa entre los diagnósticos más frecuentes con algunas características demográficas y clínicas. Este estudio confirma que la definición de los diagnósticos de enfermería durante la consulta puede proporcionar exactitud en el foco de la atención en el ambulatorio.This study was aimed at verifying the relationship between demographic and clinical features and nursing diagnoses established during a nurse consultation in a general hospital. This is a cross-sectional study that assessed 237 nursing consultations of patients in two different programs: Women's Health (46 in obstetrical nursing and 24 in mastology nursing and 167 in Diabetes Mellitus Education. A total of 49 nursing diagnoses were identified. The most frequent in the women's health program were: Knowledge Deficit, Impaired Comfort, Impaired Tissue Integrity and Anxiety; in the program of diabetes education were: Ineffective Therapeutic Regimen Management, and Imbalanced Nutrition: more than body requirements. There was a significant association between the most common diagnoses with certain demographic and clinical features. The results confirmed that the identification of the nursing diagnoses during the consultation may provide accuracy in the focus of outpatient care.

  20. Cycloid psychosis: Perris criteria revisited

    Directory of Open Access Journals (Sweden)

    Yadav Devender

    2010-01-01

    Full Text Available Cases presenting with recurrent confusion, alteration of psychomotor activity, and brief psychosis with good inter-episode recovery have many differing etiologies. Only rarely does one diagnose such cases as cycloid psychosis. Even among budding psychiatrists, there seems to be a lack of awareness of this unique disorder. This may be because the present international diagnostic classification systems, ICD10 and DSM IV, do not recognize it as a separate entity. A high index of suspicion is required to diagnose cycloid psychosis. Awareness and recognizing such cases would be helpful clinically as cycloid psychosis entails a distinct prognosis and may require a specific treatment.