WorldWideScience

Sample records for definitive diagnosis requires

  1. A transdisciplinary definition of diagnosis.

    Science.gov (United States)

    Maitland, Murray E

    2010-01-01

    Diagnosis is a fundamental abstract reasoning concept in healthcare. It forms the foundation for clinical guidelines, evidence-based practice, and healthcare interventions. The definition of diagnosis is evolving in a manner that may change patient care and clinical research. Currently, dictionary definitions of diagnosis fall into two broad categories, those that stress the original etymology and those that are based on classifying the patient problem according to preexisting labels. Many medical diagnoses are not sufficient to justify allied health, profession-specific interventions. Some authors have suggested profession-specific definitions of diagnosis and profession-specific nomenclature. However, a unique set of labels that are insulated from other health professions has been difficult to achieve because of the interdependence of pathology, impairments, and the patient's role in society. Coordinated interdisciplinary or transdisciplinary patient care, including clinical guidelines, and efficient delivery of services necessitate a definition that facilitates communication across health care professions. A solution to this dilemma may be to create a bridge, recognizing the multifactorial etiology of health and professional autonomy while explicitly stating the context of profession-specific interventions as a team approach. I propose that the definition of diagnosis be modified to: "the process of determining mechanisms by which the patient's health condition arises and the conclusions reached by doing so."

  2. Autism: definition, neurobiology, screening, diagnosis.

    Science.gov (United States)

    Rapin, Isabelle; Tuchman, Roberto F

    2008-10-01

    Autism (ie, the autism spectrum disorders) is now recognized in 1 in 150 children. This article highlights the definition, neurobiology, screening, and diagnosis of autism. The genetics, immunology, imaging, and neurophysiology of autism are reviewed, with particular emphasis on areas that impact pediatricians. Early recognition of the social deficits that characterize autism is key to maximizing the potential of these children.

  3. Vulvodynia. Definition, diagnosis and treatment

    DEFF Research Database (Denmark)

    Petersen, Christina Damsted; Lundvall, Lene; Kristensen, Ellids

    2008-01-01

    -physiological mechanisms underlying the disorder, methods of diagnosis and evidence and recommendations on clinical management. A critical examination of the literature regarding vulvodynia reveals numerous strategies and recommendations for treatment, many of which are not evidence-based, and a lack of effective...... that the problem is solely a psychological disorder have been abandoned, because inflammatory mechanisms and genetic factors have been found to be involved in the pathogenesis as well as psychosexual contributors. This article describes the terminology and definition of the condition, theories on patho...

  4. Sarcopenia: European consensus on definition and diagnosis

    Science.gov (United States)

    Cruz-Jentoft, Alfonso J.; Baeyens, Jean Pierre; Bauer, Jürgen M.; Boirie, Yves; Cederholm, Tommy; Landi, Francesco; Martin, Finbarr C.; Michel, Jean-Pierre; Rolland, Yves; Schneider, Stéphane M.; Topinková, Eva; Vandewoude, Maurits; Zamboni, Mauro

    2010-01-01

    The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia. EWGSOP included representatives from four participant organisations, i.e. the European Geriatric Medicine Society, the European Society for Clinical Nutrition and Metabolism, the International Association of Gerontology and Geriatrics—European Region and the International Association of Nutrition and Aging. These organisations endorsed the findings in the final document. The group met and addressed the following questions, using the medical literature to build evidence-based answers: (i) What is sarcopenia? (ii) What parameters define sarcopenia? (iii) What variables reflect these parameters, and what measurement tools and cut-off points can be used? (iv) How does sarcopenia relate to cachexia, frailty and sarcopenic obesity? For the diagnosis of sarcopenia, EWGSOP recommends using the presence of both low muscle mass + low muscle function (strength or performance). EWGSOP variously applies these characteristics to further define conceptual stages as ‘presarcopenia’, ‘sarcopenia’ and ‘severe sarcopenia’. EWGSOP reviewed a wide range of tools that can be used to measure the specific variables of muscle mass, muscle strength and physical performance. Our paper summarises currently available data defining sarcopenia cut-off points by age and gender; suggests an algorithm for sarcopenia case finding in older individuals based on measurements of gait speed, grip strength and muscle mass; and presents a list of suggested primary and secondary outcome domains for research. Once an operational definition of sarcopenia is adopted and included in the mainstream of comprehensive geriatric assessment, the next steps are to define the natural course of sarcopenia and to develop and define effective treatment. PMID:20392703

  5. Punctal stenosis: definition, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    Soiberman U

    2012-07-01

    Full Text Available Uri Soiberman,1 Hirohiko Kakizaki,2 Dinesh Selva,3 Igal Leibovitch11Division of Oculoplastic and Orbital Surgery, Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel; 2Department of Ophthalmology, Aichi Medical University, Nagakute, Japan; 3South Australian Institute of Ophthalmology and Discipline of Ophthalmology and Visual Sciences, University of Adelaide, South Australia, AustraliaAbstract: Acquired punctal stenosis is a condition in which the external opening of the lacrimal canaliculus is narrowed or occluded. This condition is a rare cause of symptomatic epiphora, but its incidence may be higher in patients with chronic blepharitis, in those treated with various topical medications, including antihypertensive agents, and especially in patients treated with taxanes for cancer. The purpose of this review is to cover the medical literature, focusing in particular on definition, incidence, risk factors, etiology and treatment options.Keywords: acquired punctal stenosis, definition, epiphora, etiology, treatment

  6. Punctal stenosis: definition, diagnosis, and treatment

    Science.gov (United States)

    Soiberman, Uri; Kakizaki, Hirohiko; Selva, Dinesh; Leibovitch, Igal

    2012-01-01

    Acquired punctal stenosis is a condition in which the external opening of the lacrimal canaliculus is narrowed or occluded. This condition is a rare cause of symptomatic epiphora, but its incidence may be higher in patients with chronic blepharitis, in those treated with various topical medications, including antihypertensive agents, and especially in patients treated with taxanes for cancer. The purpose of this review is to cover the medical literature, focusing in particular on definition, incidence, risk factors, etiology and treatment options. PMID:22848141

  7. Sarcopenia: European consensus on definition and diagnosis

    OpenAIRE

    Alfonso J Cruz-Jentoft; Baeyens, Jean Pierre; Jürgen M Bauer; Boirie, Yves; Cederholm, Tommy; Landi, Francesco; Martin, Finbarr C; Michel, Jean-Pierre; Rolland, Yves; Schneider, Stéphane M; Topinková, Eva; Vandewoude, Maurits; Zamboni, Mauro

    2010-01-01

    The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia. EWGSOP included representatives from four participant organisations, i.e. the European Geriatric Medicine Society, the European Society for Clinical Nutrition and Metabolism, the International Association of Gerontology and Geriatrics—European Region and the International Association of Nutrition and Aging. These organisation...

  8. Amyopathic dermatomyositis: definitions, diagnosis, and management.

    Science.gov (United States)

    Bailey, Elizabeth E; Fiorentino, David F

    2014-12-01

    Amyopathic dermatomyositis can be a challenging diagnosis because patients lack traditional muscle findings. "Clinically amyopathic" dermatomyositis (CADM) accounts for the presence of subclinical muscle disease in some of these patients. These patients represent a substantial minority of dermatomyositis cases and have similar co-morbidities to "classic" dermatomyositis patients, including interstitial lung disease and malignancy. Clinically amyopathic dermatomyositis patients should not be considered as a distinct clinical entity from "classic" dermatomyositis, as they share antibody sub-types and associated co-morbidities, likely representing clinical spectrum of a common disease. It is essential for the clinician to be familiar with the clinical presentation of clinically amyopathic dermatomyositis, in order to facilitate early, accurate diagnosis and appropriate clinical management.

  9. Definition and diagnosis of occupational asthma

    Energy Technology Data Exchange (ETDEWEB)

    Cartier, A. (Hopital du Sacre-Coeur, Gouin Ouest, Montreal, PQ (Canada))

    1994-01-01

    Asthma is the most frequent occupational lung disease. The diagnosis of occupational asthma, defined as variable airways narrowing, causally related to exposure in the working environment to specific airborne dusts, gases, vapour of fumes, needs to be confirmed by objective means. This article reviews the different steps of investigation which are: history, pulmonary function tests, immunological tests, monitoring of peak expiratory flows and nonallergic bronchial responsiveness and, finally, the gold standard, specific bronchial provocation. (au) (57 refs.)

  10. Nuclear chemistry counting facilities: requirements definition

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, D.W.; Baker, J.

    1979-04-05

    In an effort to upgrade outdated instrumentation and to take advantage of current and imminent technologies the Nuclear Chemistry Division at Lawrence Livermore Laboratory is about to undertake a major upgrade of their low level radiation counting and analysis facilities. It is expected that such a project will make a more coordinated data acquisition and data processing system, reduce manual data handling operations and speed up data processing throughput. Before taking on a systems design it is appropriate to establish a definition of the requirements of the facilities. This report examines why such a project is necessary in the context of the current and projected operations, needs, problems, risks and costs. The authors also address a functional specification as a prelude to a system design and the design constraints implicit in the systems implementation. Technical, operational and economic assessments establish necessary boundary conditions for this discussion. This report also establishes the environment in which the requirements definition may be considered valid. The validity of these analyses is contingent on known and projected technical, scientific and political conditions.

  11. 24 CFR 35.905 - Definitions and other general requirements.

    Science.gov (United States)

    2010-04-01

    ... Rehabilitation § 35.905 Definitions and other general requirements. Definitions and other general requirements... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Definitions and other general requirements. 35.905 Section 35.905 Housing and Urban Development Office of the Secretary, Department...

  12. [Diabetes mellitus: definition, classification and diagnosis].

    Science.gov (United States)

    Roden, Michael

    2016-04-01

    Diabetes mellitus comprises of a group of heterogeneous disorders, which have an increase in blood glucose concentrations in common. The current classifications for diabetes mellitus type 1-4 are described and the main features of type 1 and type 2 diabetes are compared to allow for better discrimination between these diabetes types. Furthermore, the criteria for the correct biochemical diagnosis during fasting and oral glucose tolerance tests as well as the use of hemoglobin A1c (HbA1c) are summarized. These data form the basis of the recommendations of the Austrian Diabetes Association for the clinical praxis of diabetes treatment.

  13. Copernicus Architecture, Phase I: Requirements Definition

    Science.gov (United States)

    1991-08-01

    training and education needs, we must start by envisioning and docu- menting the requirements most critical to the success of our SEW Navy professionals...who are trained and educated throughout their careers with emphasis on SEW. By increasing promotion opportunities, briefing screening boards about...COPERNICUS AS A NORMAL PART OF ACQUISITION REVIEW PROCESS — FOSTER COTS/COTS — NAVY SPOC FOR ARCHITECTURAL ISSUES WITH DOD, DCA, ET AL. ^ ä Navy’s C*I

  14. 9 CFR 317.2 - Labels: definition; required features.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Labels: definition; required features. 317.2 Section 317.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... labeling shall appear thereon in the English language: Provided, however, That in the case of products...

  15. Definition, Derivation, and Diagnosis of Barrett's Esophagus: Pathological Perspectives.

    Science.gov (United States)

    Lowes, H; Somarathna, T; Shepherd, Neil A

    More than 60 years have elapsed since Barrett described the condition that continues to bear his name. Despite much research, clinical and basic, the defining features and the diagnosis of columnar-lined esophagus (CLO) are still embroiled with controversy and uncertainty. For pathologists, these controversies are notorious. The disease has been defined by the pathological demonstration of "specialized intestinal metaplasia" and yet there is compelling evidence that this approach is flawed due to sampling issues, poor levels of agreement between expert pathologists as to what constitutes "goblet cells," and the fact that most glandular epithelium in the esophagus is "intestinalized," even if goblet cells are not demonstrable. We believe that reliance on such pathological features can result in erroneous diagnoses of CLO and that the endoscopic diagnosis of CLO is more reliable with pathology corroborative in uncertain cases, when there is stricturing and/or ulceration and in shorter segment disease. Intriguingly, there are recent research findings that elucidate our understanding of the pathogenesis and the derivation of CLO and the way that initial gastric metaplasia converts to the unstable and neoplasia-associated intestinal phenotype. Even so, more research is required to enable a better understanding of the pathogenesis of CLO and to further improve the current management of the disease and its neoplastic complications.

  16. Requirement for a standardised definition of advanced gastric cancer.

    Science.gov (United States)

    DE Sol, Angelo; Trastulli, Stefano; Grassi, Veronica; Corsi, Alessia; Barillaro, Ivan; Boccolini, Andrea; DI Patrizi, Micol Sole; DI Rocco, Giorgio; Santoro, Alberto; Cirocchi, Roberto; Boselli, Carlo; Redler, Adriano; Noya, Giuseppe; Kong, Seong-Ho

    2014-01-01

    Each year, ~988,000 new cases of stomach cancer are reported worldwide. Uniformity for the definition of advanced gastric cancer (AGC) is required to ensure the improved management of patients. Various classifications do actually exist for gastric cancer, but the classification determined by lesion depth is extremely important, as it has been shown to correlate with patient prognosis; for example, early gastric cancer (EGC) has a favourable prognosis when compared with AGC. In the literature, the definition of EGC is clear, however, there is heterogeneity in the definition of AGC. In the current study, all parameters of the TNM classification for AGC reported in each previous study were individually analysed. It was necessary to perform a comprehensive systematic literature search of all previous studies that have reported a definition of ACG to guarantee homogeneity in the assessment of surgical outcome. It must be understood that the term 'advanced gastric cancer' may implicate a number of stages of disease, and studies must highlight the exact clinical TNM stages used for evaluation of the study.

  17. Late HIV Diagnosis: Proposed Common Definitions and Associations With Short-Term Mortality.

    Science.gov (United States)

    Jiang, Hongbo; Xie, Nianhua; Liu, Jianhua; Zhang, Zhixia; Liu, Li; Yao, Zhongzhao; Wang, Xia; Nie, Shaofa

    2015-09-01

    The aim of this study was to present a definition of late presentation according to different time periods between initial diagnosis of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) diagnosis which would reliably identify individuals with high risk of mortality within 1 year of diagnosis, and could be used as a suggested common definition.Data of individuals diagnosed from 1994 to February 2012 in Wuhan, China were extracted retrospectively from the national HIV surveillance system. Four time periods (1, 3, 6, and 12 months) combined with the European consensus definition of advanced HIV disease (AHD) were compared. The predictive ability of each definition for identifying an individual who died within 1 year after HIV diagnosis was assessed.A total of 980 patients were included, of whom 289 (29.49%), 324 (33.06%), 353 (36.02%), and 387 (39.49%) were defined as AHD according to the definition of a CD4 count HIV diagnosis, respectively. One hundred twenty-seven (12.96%) patients died within 1 year of diagnosis. The highest Youden's index and largest area under the curve were presented in time period within 3 months. Time period within 1 month presented the highest consistency rate, positive likelihood ratio, and kappa value. Longer time periods increased the sensitivity but decreased the specificity.Given the European consensus definitions and the current results, we suggested that AHD could be defined as "a first-reported CD4 count HIV diagnosis." "Late presentation" could be defined as "a first-reported CD4 count HIV diagnosis."

  18. 78 FR 60898 - Regulation on Definition and Requirements for a Nationally Recognized Testing Laboratory...

    Science.gov (United States)

    2013-10-02

    ... Occupational Safety and Health Administration Regulation on Definition and Requirements for a Nationally..., ``definition and requirements for a nationally recognized testing laboratory'' (The Regulation). The Regulation... place all submissions, including any personal information provided, in the public docket...

  19. Cardiac device infections: definition, classification, differential diagnosis, and management.

    Science.gov (United States)

    Polewczyk, Anna; Janion, Marianna; Kutarski, Andrzej

    2016-04-13

    Cardiac device infections (CDIs) continue to be a serious clinical problem, with varying terminology and different classifications constituting one of the major diagnostic and therapeutic challenges in routine clinical practice. The problem invariably arises during an attempt to estimate the extent of the infection, which in consequence determines the choice of treatment strategy (duration of antibiotic therapy). The most serious form of CDI is lead-related infective endocarditis (LRIE). There are no clearly established diagnostic criteria for this disease; the available Duke University criteria are difficult to apply in patients with a suspicion of LRIE because of low sensitivity. As the treatment of LRIE is expensive and troublesome, there is a tendency to underdiagnose this condition and seek any intermediary forms between local pocket infection and definite LRIE. The present review includes suggestions for the systematization of CDIs with a clear definition of LRIE as a separate and most severe entity among CDIs.

  20. Definition of Model-based diagnosis problems with Altarica

    OpenAIRE

    Pencolé, Yannick; Chanthery, Elodie; Peynot, Thierry

    2016-01-01

    International audience; This paper presents a framework for modeling diagnosis problems based on a formal language called Altarica. The initial purpose of the language Altarica was to define a modeling language for safety analysis. This language has been developed as a collaboration between academics and industrial partners and is used in some industrial companies. The paper shows that the expres-sivity of this language, mixing event-based and state-based models, is sufficient to model classi...

  1. Peripartum cardiomyopathy: definition, incidence, etiopathogenesis, diagnosis, and management.

    Science.gov (United States)

    Garg, Jalaj; Palaniswamy, Chandrasekar; Lanier, Gregg M

    2015-01-01

    Peripartum cardiomyopathy (PPCM) is a serious pregnancy-associated disorder of unknown etiology. The precise cellular and molecular mechanisms underlying PPCM are unclear. A heightened awareness among health care providers can result in early diagnosis of heart failure in late pregnancy and the early postpartum period. Though the symptoms of dyspnea and fatigue can result from normal physiologic changes during pregnancy, an electrocardiogram and brain natriuretic peptide level should be obtained in these patients, in addition to baseline laboratory tests such as a complete blood count, and basic metabolic and hepatic function panels. If the electrocardiogram and brain natriuretic peptide level are abnormal, an echocardiogram should be obtained. The role of endomyocardial biopsy for the diagnosis of PPCM is controversial. Patients should be started on diuretics if volume overloaded, and beta-blockers (preferably metoprolol) if no contraindications exist; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy or lactation. There are no standard, universally accepted guidelines for the management of PPCM. Although experimental therapies like bromocriptine, pentoxifylline and immunoglobulins have shown promising results, large double-blind randomized trials are essential to confirm the results of smaller studies. In patients with persistent severe left ventricular (LV) dysfunction, advanced therapies like mechanical circulatory support and heart transplantation should be considered. Owing to recent data demonstrating deterioration of LV systolic function after initial recovery, it is essential to maintain long-term follow up of these patients regardless of initial recovery of LV function. We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of PPCM.

  2. 77 FR 5243 - Proposed Priority, Requirements, Definitions, and Selection Criteria-Arts in Education National...

    Science.gov (United States)

    2012-02-02

    ... Proposed Priority, Requirements, Definitions, and Selection Criteria--Arts in Education National Program... priority, requirements, definitions, and selection criteria under the Arts in Education National Program... or more of these definitions in any year in which we award grants for the AENP. Arts means...

  3. Leprosy. An update: definition, pathogenesis, classification, diagnosis, and treatment.

    Science.gov (United States)

    Eichelmann, K; González González, S E; Salas-Alanis, J C; Ocampo-Candiani, J

    2013-09-01

    Leprosy is a chronic granulomatous disease caused by the bacillus Mycobacterium leprae. It primarily affects the skin and peripheral nerves and is still endemic in various regions of the world. Clinical presentation depends on the patient's immune status at the time of infection and during the course of the disease. Leprosy is associated with disability and marginalization. Diagnosis is clinical and is made when the patient has at least 1 of the following cardinal signs specified by the World Health Organization: hypopigmented or erythematous macules with sensory loss; thickened peripheral nerves; or positive acid-fast skin smear or skin biopsy with loss of adnexa at affected sites. Leprosy is treated with a multidrug combination of rifampicin, clofazimine, and dapsone. Two main regimens are used depending on whether the patient has paucibacillary or multibacillary disease.

  4. Histological diagnosis of madura foot (mycetoma: A must for definitive treatment

    Directory of Open Access Journals (Sweden)

    Kiran Alam

    2009-01-01

    Full Text Available Mycetoma, an uncommon chronic infection of skin and subcutaneous tissues in tropical countries is caused by true fungi (eumycetoma or by filamentous bacteria (actinomycetoma. Since the treatment of these two etiologies is entirely different, a definite diagnosis after histopathological and microbiological examination is mandatory. We hereby present five cases of Madura foot.

  5. Taiwanese Dermatological Association consensus for the definition, classification, diagnosis, and management of urticaria.

    Science.gov (United States)

    Chung, Wen-Hung; Chu, Chia-Yu; Huang, Yu-Huei; Wang, Wei-Ming; Yang, Chih-Hsun; Tsai, Tsen-Fang

    2016-11-01

    This report describes the 2014 consensus of the Taiwanese Dermatological Association regarding the definition, classification, diagnosis, and management of urticaria. This consensus is distributed to practices throughout Taiwan to provide recommendations for diagnostic and therapeutic approaches for common subtypes of urticaria, in order to improve the quality of life of urticaria patients. The consensus, thus, serves as an important reference for dermatologists throughout Taiwan. All the consensus contents were voted on by the participating dermatologists, with approval by no less than 75% being required for inclusion. The consensus provides a comprehensive overview of urticaria, including recent advances in identifying its causes and the processes by which it develops. All the consensus meeting attendees agreed to a definition of urticaria, which states that it is characterized by the sudden appearance of wheals (also known as hives), angioedema, or both. Most of the experts (16 out of 19, or 84.2%) agreed that chronic urticaria is defined as the sudden occurrence of wheals and/or angioedema for a period of ≥ 6 weeks. In addition, the consensus attendees also approved the Urticaria Activity Score system or the Urticaria Activity Score for 7 days system as the recommended method for assessing disease activity in spontaneous urticaria. It was also determined that the treatment goal for patients with any form of urticaria should be complete cessation of suffering from all urticaria symptoms. The recommended treatment algorithms for chronic spontaneous urticaria and acute urticaria were finally proposed and approved by 100% (19/19) and 84.2% (16/19) of the consensus attendees, respectively. Copyright © 2015. Published by Elsevier B.V.

  6. [Food allergy:definitions, prevalence, diagnosis and therapy].

    Science.gov (United States)

    van Ree, Ronald; Poulsen, Lars K; Wong, Gary Wk; Ballmer-Weber, Barbara K; Gao, Zhongshan; Jia, Xudong

    2015-01-01

    Food allergy is phenotypically an extremely heterogeneous group of diseases affecting multiple organs, sometimes in an isolated way, sometimes simultaneously, with the severity of reactions ranging from mild and local to full-blown anaphylaxis. Mechanistically, it is defined as a Th2-driven immune disorder in which food-specific IgE antibodies are at the basis of immediate-type adverse reactions. The sites of sensitization and symptoms do not necessarily overlap. Food allergy, which is the theme of this paper, is often confused with other adverse reactions to food of both animmune (e.g., celiac disease) and non-immune (e.g., lactose intolerance) nature. To reliably diagnose food allergy, a careful history (immediate-type reactions) needs to be complemented with demonstration of specific IgE (immune mechanism) and confirmed by an oral challenge. Co-factors such as exercise, medication, and alcohol may help trigger food allergy and further complicate accurate diagnosis. Where food extract-based diagnostic tests are poorly correlated to symptom severity, new generation molecular diagnostics that measure IgE against individual food allergens provide clinicians and patients with more reliable symptom severity risk profiles. Molecular diagnostics also support establishing whether food sensitization originates directly from exposure to food or indirectly (cross-reactivity) from pollen sensitization. Epidemiological surveys have indicated that allergy to peach primarily originates from peach consumption in Europe, whereas in China it is the result of primary sensitization to mugwort pollen, in both cases mediated by an allergen molecule from the same family. Epidemiological surveys give insight into the etiology of food allergy, the size of the problem (prevalence), and the risk factors involved, which together support evidence-based strategies for prevention. Over the past decade, food allergy has increased in the affluent world. Economic growth and urbanization in

  7. 18 CFR 5.1 - Applicability, definitions, and requirement to consult.

    Science.gov (United States)

    2010-04-01

    ..., definitions, and requirement to consult. 5.1 Section 5.1 Conservation of Power and Water Resources FEDERAL... LICENSE APPLICATION PROCESS § 5.1 Applicability, definitions, and requirement to consult. (a) This part..., municipality, or state may develop and file a license application under this part. (d) Requirement to consult...

  8. The definition, aetiology, presentation, diagnosis and management of previous caesarean scar defects.

    Science.gov (United States)

    Allornuvor, G F N; Xue, M; Zhu, X; Xu, D

    2013-11-01

    Caesarean sections are the most commonly performed surgical procedures involving the uterus in fertile women. Typically, this surgery involves a transverse incision in the anterior lower uterine segment. The incidence of caesarean sections is on the increase worldwide, and consequently, the complications associated with them are becoming more common. One such complication that is gaining more attention is previous lower uterine segment caesarean scar defect (PCSD). In this review, we sought to explore the definition, aetiology, presentation, diagnosis and management of PCSD.

  9. 9 CFR 590.544 - Spray process powder; definitions and requirements.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Spray process powder; definitions and... INSPECTION ACT) Sanitary, Processing, and Facility Requirements § 590.544 Spray process powder; definitions... removed from the primary or main drying chamber while the drying unit is in operation. (2)...

  10. Evaluation of the use of laparoscopic-guided cholecystocholangiography and liver biopsy in definitive diagnosis of neonatal cholestatic jaundice

    Directory of Open Access Journals (Sweden)

    Khalid Shreef

    2016-01-01

    Full Text Available Background: Once it is established that a jaundiced infant has direct hyperbilirubinemia, the principal diagnostic concern is to differentiate hepatocellular from obstructive cholestasis. Traditional tests such as ultrasonography, percutaneous liver biopsy and technetium 99 m hepatobiliary iminodiacetic acid (HIDA scan are often not sufficiently discriminating. Definitive exclusion of biliary atresia (BA in the infant with cholestatic jaundice usually requires mini-laparotomy and intra-operative cholangiography. This approach has many drawbacks because those sick infants are subjected to a time-consuming procedure with the probability of negative surgical exploration. Aim of the Study: The aim of this study was to determine the feasibility of laparoscopic-guided cholecystocholangiography (LGCC and its accuracy and safety in the diagnosis of BA and thus preventing unnecessary laparotomy in infants whose cholestasis is caused by diseases other than BA. Patients and Methods: Twelve cholestatic infants with direct hyperbilirubinemia subjected to LGCC (age, 7–98 days; mean, 56 days after ultrasound scan and (99 mTc HIDA scan and percutaneous liver biopsy failed to provide the definitive diagnosis. Results: One patient had completely absent gall bladder (GB so the laparoscopic procedure was terminated and laparotomy was done (Kasai operation. Four patients had small size GB; they underwent LGCC that showed patent common bile duct with atresia of common hepatic duct, so laparotomy and Kasai operation was performed. Seven patients had well-developed GB, LGCC revealed patent biliary tree, so laparoscopic liver biopsies were taken for histopathology. Five of those patients had neonatal hepatitis, and two had cholestasis as a complication of prolonged TPN. No perioperative complications or mortalities were recorded. Conclusion: When the diagnosis neonatal cholestasis remains elusive after traditional investigations, LGCC is an accurate and simple method

  11. Honeycombing on CT; its definition, pathologic correlation, and future direction of its diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Johkoh, Takeshi, E-mail: johkoht@aol.com [Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, 3-1 Kurumazuka, Itami, Hyogo, 664-8533 (Japan); Sakai, Fumikazu [Department of Diagnostic Radiology, Saitama International Medical Center, Saitama Medical University, Hidaka (Japan); Noma, Satoshi [Department of Radiology, Tenri Hospital, Tenri (Japan); Akira, Masanori [Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai (Japan); Fujimoto, Kiminori [Department of Radiology and Center for Diagnostic Imaging, Kurume University School of Medicine, Kurume (Japan); Watadani, Takeyuki [Department of Radiology, University of Tokyo, Tokyo (Japan); Sugiyama, Yukihiko [Department of Internal Medicine, Jichi Medical University, Shimotsuke (Japan)

    2014-01-15

    Honeycombing on CT is the clue for the diagnosis of usual interstitial pneumonia (UIP) and its hallmark. According to the ATS-ERS-JRS-ALAT 2010 guideline, the patients with honeycombing on CT can be diagnosed as UIP without surgical biopsy. On CT scans, it is defined as clustered cystic airspaces, typically of comparable diameters of the order of 3–10 mm, which are usually subpleural and have well-defined walls. Pathologically, honeycombing consists of both collapsing of multiple fibrotic alveoli and dilation of alveolar duct and lumen Although the definition of honeycombing seems to be strict, recognition of honeycombing on CT is various among each observer Because typical honeycombing is frequently observed in the patients with UIP, we should judge clustered cysts as honeycombing when a diagnosis of UIP is suspected.

  12. Manage changes in the requirements definition through a collaborative effort

    CSIR Research Space (South Africa)

    Joseph-Malherbe, S

    2009-08-01

    Full Text Available Updating or changing the requirements statement during the systems engineering process may impact adversely on project parameters such as sequence, dependencies, effort, and duration of tasks, usually with an increase in development time and cost...

  13. Communication Challenges in Requirements Definition: A Classroom Simulation

    Science.gov (United States)

    Ramiller, Neil C.; Wagner, Erica L.

    2011-01-01

    Systems analysis and design is a standard course offering within information systems programs and often an important lecture topic in Information Systems core courses. Given the persistent difficulty that organizations experience in implementing systems that meet their requirements, it is important to help students in these courses get a tangible…

  14. Space station resistojet system requirements and interface definition study

    Science.gov (United States)

    Heckert, Bruce J.

    1987-01-01

    Preliminary resistojet design requirements were established based on initial technical requirements imposed by the results of NASA and Rocketdyne studies. The requirements are directed toward long life, simplicity, flexibility, and commonality with other space station components. The resistojet assembly is comprised of eight resistojets, fluid components downstream of the waste fluid storage system, a power controller, structure, and shielding. It consists of two identical subassemblies, one of which is redundant. Each subassembly consists of four 500-W resistojets, series redundant latch values, a power controller, a water vaporizer, two pressure regulators, filters, check valves, disconnects, fluid tubing, and electrical cables. All components are packaged at the end of the stinger aft of the JEM and Columbus modules. Different flow and power control methods were studied. A constant inlet pressure and a two-power setting controller were tentatively selected based on simplicity and reasonably high specific impulse for the range of waste gas compositions that are anticipated. The constant pressure is supplied by pressure regulators. The two set point power control includes individual power supplies to each resistojet heater and water vaporizer. An embedded data processor, a multiplexer-demultiplexer, and a network interface unit that are standard space station components are included in the power controller. The total dry weight of the resistojet assembly is approximately 172 lb. The total cost for design, development, test, evaluation, qualification, and flight hardware is estimated to be $16 million.

  15. The paradox of public health genomics: definition and diagnosis of familial hypercholesterolaemia in three European countries.

    Science.gov (United States)

    Aarden, Erik; Van Hoyweghen, Ine; Horstman, Klasien

    2011-08-01

    Considerable progress in public health is expected to occur from the application of genomic knowledge and technologies. This is the subject of a newly emerging field of public health genomics. In this paper we analyze differences in how public health genomics is developing in the Netherlands, the UK and Germany through the definition and diagnosis of familial hypercholesterolaemia (FH), an inherited predisposition for coronary heart disease. We analyzed the emergence of public health genomics within the framework of a project on the incorporation of genetics in western European healthcare schemes. Our analysis is based on document analysis and in-depth interviews. In the Netherlands, public health genomics takes shape through a genetic screening programme for FH, looking for mutations on two specific genes; in the UK it emerges through a strategy of ''mainstreaming'' genetics in health care that aims to identify hereditary predispositions by means of phenotypic diagnosis; and in Germany public health genomics is elaborated at a conceptual level, leaving a diagnosis of FH to individual physicians who occasionally prescribe genetic testing. Our analysis shows how public health genomics gets constituted differently in different countries and, moreover, produces particular patterns of inclusion and exclusion from care. These patterns indicate a paradox in public health genomics, which consists of an inverse relationship between the use of advanced molecular genetic testing technologies and the number and variety of individuals at risk included in the target population. This paradox presents a challenge for professionals and policy makers in public health genomics.

  16. 78 FR 72600 - Proposed Priorities, Requirements, and Definitions-Charter Schools Program (CSP) Grants for...

    Science.gov (United States)

    2013-12-03

    ... invite you to assist us in complying with the specific requirements of Executive Orders 12866 and 13563... priorities, requirements, and definitions. Please let us know of any further ways we could reduce potential...-need students (as defined in this notice). Proposed Priority 1--Improving Efficiency Through Economies...

  17. Time to definitive diagnosis of breast cancer in Latina and non-Hispanic white women: the six cities study.

    Science.gov (United States)

    Ramirez, Amelie G; Pérez-Stable, Eliseo J; Talavera, Gregory A; Penedo, Frank J; Carrillo, J Emilio; Fernandez, Maria E; Muñoz, Edgar; Long Parma, Dorothy; Holden, Alan Ec; San Miguel de Majors, Sandra; Nápoles, Anna; Castañeda, Sheila F; Gallion, Kipling J

    2013-12-01

    Time delay after an abnormal screening mammogram may have a critical impact on tumor size, stage at diagnosis, treatment, prognosis, and survival of subsequent breast cancer. This study was undertaken to evaluate disparities between Latina and non-Hispanic white (NHW) women in time to definitive diagnosis of breast cancer after an abnormal screening mammogram, as well as factors contributing to such disparities. As part of the activities of the National Cancer Institute (NCI)-funded Redes En Acción research network, clinical records of 186 Latinas and 74 NHWs who received abnormal screening mammogram results were reviewed to determine the time to obtain a definitive diagnosis. Data was obtained from participating clinics in six U.S. cities and included demographics, clinical history, and mammogram characteristics. Kaplan-Meier estimates and Cox proportional hazards models were used to test differences in median time to definitive diagnosis by ethnicity after adjusting for clinic site, demographics, and clinical characteristics. Time-to-event analysis showed that Latinas took 2.2 times longer to reach 50% definitively diagnosed with breast cancer relative to NHWs, and three times longer to reach 80% diagnosed (p=0.001). Latinas' median time to definitive diagnosis was 60 days compared to 27 for NHWs, a 59% gap in diagnosis rates (adjusted Hazard Ratio [aHR] = 1.59, 95% CI = 1.09, 2.31; p=0.015). BI-RADS-4/5 women's diagnosis rate was more than twice that of BI-RADS-3 (aHR = 2.11, 95% CI = 1.18, 3.78; p=0.011). Disparities in time between receipt of abnormal screening result and definitive diagnosis adversely affect Latinas compared to NHWs, and remain significant after adjusting for demographic and clinical variables. With cancer now the leading cause of mortality among Latinos, a greater need exists for ethnically and culturally appropriate interventions like patient navigation to facilitate Latinas' successful entry into, and progression through, the cancer care

  18. 78 FR 9815 - Final Priorities, Requirements, Definitions, and Selection Criteria-Supporting Effective Educator...

    Science.gov (United States)

    2013-02-12

    ... related to the outcomes of the project and will produce quantitative and qualitative data within the grant... produce quantitative and qualitative data. (3) The extent to which the evaluation will provide performance... CFR Subtitle A RIN 1855-AA08 Final Priorities, Requirements, Definitions, and Selection Criteria...

  19. Instability in the COPD Diagnosis upon Repeat Testing Vary with the Definition of COPD

    Science.gov (United States)

    Perez-Padilla, Rogelio; Wehrmeister, Fernando C.; Montes de Oca, Maria; Lopez, Maria Victorina; Jardim, Jose R.; Muino, Adriana; Valdivia, Gonzalo; Pertuze, Julio; Menezes, Ana Maria B.

    2015-01-01

    Background A low FEV1/FVC from post-bronchodilator spirometry is required to diagnose COPD. Both the FEV1 and the FVC can vary over time; therefore, individuals can be given a diagnosis of mild COPD at one visit, but have normal spirometry during the next appointment, even without an intervention. Methods We analyzed two population-based surveys of adults with spirometry carried out for the same individuals 5-9 years after their baseline examination. We determined the factors associated with a change in the spirometry interpretation from one exam to the next utilizing different criteria commonly used to diagnose COPD. Results The rate of an inconsistent diagnosis of mild COPD was 11.7% using FEV1/FVC <0.70, 5.9% using FEV1/FEV6 diagnosis of mild COPD. Further improvement could be obtained by defining a borderline zone around the LLN (e.g. plus or minus 0.6 SD), or repeating the test in patients with borderline results. PMID:25811461

  20. The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis

    Directory of Open Access Journals (Sweden)

    Phillips James

    2012-01-01

    Full Text Available Abstract In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1 the nature of a mental disorder; 2 the definition of mental disorder; 3 the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4 the role of pragmatic considerations in the construction of DSM-5; 5 the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6 the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.

  1. High-definition colonoscopy with i-Scan: Better diagnosis for small polyps and flat adenomas

    Institute of Scientific and Technical Information of China (English)

    Pier Alberto Testoni; Chiara Notaristefano; Cristian Vailati; Milena Di Leo; Edi Viale

    2012-01-01

    AIM:To investigate if high-definition (HD) colonoscope with i-Scan gave a higher detection rate of mucosal lesions vs standard white-light instruments.METHODS:Data were collected from the computerized database of the endoscopy unit of our tertiary referral center.We retrospectively analyzed 1101 consecutive colonoscopies that were performed over 1 year with standard white-light (n =849) or HD+ with i-Scan (n =252) instruments by four endoscopists,in an outpatient setting.Colonoscopy records included patients' main details and family history for colorectal cancer,indication for colonoscopy (screening,diagnostic or surveillance),type of instrument used (standard white-light or HD+ plus i-Scan),name of endoscopist and bowel preparation.Records for each procedure included whether the cecum was reached or not and the reason for failure,complications during or immediately after the procedure,and number,size,location and characteristics of the lesions.Polyps or protruding lesions were defined as sessile or pedunculated,and nonprotruding lesions were defined according to Paris classification.For each lesion,histological diagnosis was recorded.RESULTS:Eight hundred and forty-nine colonoscopies were carried with the standard white-light video colonoscope and 252 with the HD+ plus i-Scan video colonoscope.The four endoscopists did 264,300,276 and 261 procedures,respectively; 21.6%,24.0%,21.7% and 24.1% of them with the HD+ plus i-Scan technique.There were no significant differences between the four endoscopists in either the number of procedures done or the proportions of each imaging technique used.Both techniques detected one or more mucosal lesions in 522/1101 procedures (47.4%).The overall number of lesions recognized was 1266; 645 in the right colon and 621 in the left.A significantly higher number of colonoscopies recognized lesions in the HD+ plus i-Scan mode (171/252 =67.9%) than with the standard white-light technique (408/849 =48.1%) (P < 0.0001).HD

  2. Algorithm for the Diagnosis of Scleroderma. Early Systemic Sclerosis: Definitions and diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Domenico Galasso

    2013-04-01

    Full Text Available Introduction: The term scleroderma derives from the Greek words skleros, which means hard, and derma, which means skin. It refers to an acquired systemic inflammatory disease of the connective tissue –also known as systemic sclerosis (SSc– characterized by excessive collagen deposition in the skin and the internal organs that results in fibrosis. The typical vascular lesion in SSc leads to narrowing of the vessel lumen, intimal thickening, medial hypotrophy, and adventitial fibrosis of small muscular vessels, collagen deposition in the other matrix components of interstice, and the Raynaud phenomenon secondary to these widespread microvascular abnormalities. All these characteristics lead to a connective tissue re-modeling. Discussion: Several clinical studies utilize the American Rheumatology Association’s 1980 classification. However, these diagnostic criteria are unsatisfactory because they fail to take into consideration part of the disease spectrum. Early-phase SSc is characterized by the Raynaud phenomenon (in 90% of all patients, sclerodactyly, and positivity for SSc-specific autoantibodies (antinuclear antibodies, anti-topoisomerase I antibodies, anti-RNA polymerase I and III antibodies, anti-centromere antibodies, anti-fibrillarin antibodies, anti-PM-SCL antibodies.. It is necessary to reduce delays in the diagnosis of SSc. Conclusions: Patients with red-flag positivity (Raynaud phenomenon and digital edema require Phase I SSc screening, which consists in capillaroscopic assessment of possible microvascular abnormalities. The work-up will then focus on inflammatory indices, renal function tests, and internal organ involvement (echocardiography, high-resolution computed tomography of the chest, diffusing capacity of the lungs for carbon monoxide.

  3. Postpartum diagnosis demonstrates a high risk for metastasis and merits an expanded definition of pregnancy-associated breast cancer.

    Science.gov (United States)

    Callihan, Eryn B; Gao, Dexiang; Jindal, Sonali; Lyons, Traci R; Manthey, Elizabeth; Edgerton, Susan; Urquhart, Alexander; Schedin, Pepper; Borges, Virginia F

    2013-04-01

    Previous studies report conflicting data on outcomes of pregnancy-associated breast cancer (PABC). Our aim was to examine the effect of a postpartum diagnosis on maternal prognosis in a young women's breast cancer cohort. We conducted a retrospective cohort study of women age ≤45 years, diagnosed with breast cancer (n = 619) during 1981-2011 at the University of Colorado Hospital and The Shaw Cancer Center in Edwards, CO. Breast cancer cases were grouped according to time between giving birth and diagnosis: nulliparous (n = 125), pregnant (n = 24), 5-cancer during the first five-years postpartum confers poorer maternal prognoses after adjustment for biologic subtype, stage, and year of diagnosis. We propose that the definition of PABC should include cases diagnosed up to at least five-years postpartum to better delineate the increased risk imparted by a postpartum diagnosis. Based on emerging preclinical and epidemiologic data, we propose that pregnant and postpartum cases be researched as distinct subsets of PABC to clarify the risk imparted by pregnancy and the events subsequent to pregnancy, such as breast involution, on breast cancer. Further, we highlight the importance of postpartum breast cancer as an area for further research to reduce the increased metastatic potential and mortality of PABC.

  4. Osteonecrosis of the Jaw (ONJ in Osteoporosis Patients: Report of Delayed Diagnosis of a Multisite Case and Commentary about Risks Coming from a Restricted ONJ Definition

    Directory of Open Access Journals (Sweden)

    Mario Migliario

    2017-03-01

    Full Text Available Osteonecrosis of the jaws (ONJ in osteoporosis patients has been defined as rare, but the number of reported cases is increasing. We report a case of delayed ONJ diagnosis in a patient, who was being treated with alendronate, developing bone alterations both in maxilla and in mandible. Underestimation of ONJ incidence and missed or delayed ONJ diagnosis in osteoporosis patients might derive from lack of awareness of health providers as well as from an ONJ definition that is too restricted. The more recent definition of medication-related osteonecrosis of the jaws (MRONJ released in 2014 by the American Association of Oral Maxillofacial Surgeons (AAOMS accept fistula, besides bone exposure, as a major sign of disease, but it seems to be insufficient since it excludes all cases of ONJ disease without bone exposure. A new MRONJ definition is needed to avoid missing or delayed diagnosis.

  5. Electronic Nose Testing Procedure for the Definition of Minimum Performance Requirements for Environmental Odor Monitoring.

    Science.gov (United States)

    Eusebio, Lidia; Capelli, Laura; Sironi, Selena

    2016-09-21

    Despite initial enthusiasm towards electronic noses and their possible application in different fields, and quite a lot of promising results, several criticalities emerge from most published research studies, and, as a matter of fact, the diffusion of electronic noses in real-life applications is still very limited. In general, a first step towards large-scale-diffusion of an analysis method, is standardization. The aim of this paper is describing the experimental procedure adopted in order to evaluate electronic nose performances, with the final purpose of establishing minimum performance requirements, which is considered to be a first crucial step towards standardization of the specific case of electronic nose application for environmental odor monitoring at receptors. Based on the experimental results of the performance testing of a commercialized electronic nose type with respect to three criteria (i.e., response invariability to variable atmospheric conditions, instrumental detection limit, and odor classification accuracy), it was possible to hypothesize a logic that could be adopted for the definition of minimum performance requirements, according to the idea that these are technologically achievable.

  6. Electronic Nose Testing Procedure for the Definition of Minimum Performance Requirements for Environmental Odor Monitoring

    Directory of Open Access Journals (Sweden)

    Lidia Eusebio

    2016-09-01

    Full Text Available Despite initial enthusiasm towards electronic noses and their possible application in different fields, and quite a lot of promising results, several criticalities emerge from most published research studies, and, as a matter of fact, the diffusion of electronic noses in real-life applications is still very limited. In general, a first step towards large-scale-diffusion of an analysis method, is standardization. The aim of this paper is describing the experimental procedure adopted in order to evaluate electronic nose performances, with the final purpose of establishing minimum performance requirements, which is considered to be a first crucial step towards standardization of the specific case of electronic nose application for environmental odor monitoring at receptors. Based on the experimental results of the performance testing of a commercialized electronic nose type with respect to three criteria (i.e., response invariability to variable atmospheric conditions, instrumental detection limit, and odor classification accuracy, it was possible to hypothesize a logic that could be adopted for the definition of minimum performance requirements, according to the idea that these are technologically achievable.

  7. Electronic Nose Testing Procedure for the Definition of Minimum Performance Requirements for Environmental Odor Monitoring

    Science.gov (United States)

    Eusebio, Lidia; Capelli, Laura; Sironi, Selena

    2016-01-01

    Despite initial enthusiasm towards electronic noses and their possible application in different fields, and quite a lot of promising results, several criticalities emerge from most published research studies, and, as a matter of fact, the diffusion of electronic noses in real-life applications is still very limited. In general, a first step towards large-scale-diffusion of an analysis method, is standardization. The aim of this paper is describing the experimental procedure adopted in order to evaluate electronic nose performances, with the final purpose of establishing minimum performance requirements, which is considered to be a first crucial step towards standardization of the specific case of electronic nose application for environmental odor monitoring at receptors. Based on the experimental results of the performance testing of a commercialized electronic nose type with respect to three criteria (i.e., response invariability to variable atmospheric conditions, instrumental detection limit, and odor classification accuracy), it was possible to hypothesize a logic that could be adopted for the definition of minimum performance requirements, according to the idea that these are technologically achievable. PMID:27657086

  8. Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis

    DEFF Research Database (Denmark)

    Bugge, Anna; Grøntved, Anders; Tolstrup, Janne Schurmann

    2015-01-01

    -based prevalences was partly related to participants' age, followed by natural logarithm of per person gross domestic product, the year of survey, mean BMI, and whether the survey population was national, subnational, or from specific communities. Diabetes defined as HbA1c 6·5% or more had a pooled sensitivity......BACKGROUND: Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA1c. We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes...... and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions. METHODS: We used data from 96 population-based health examination surveys that had measured at least two...

  9. Diagnosis of moyamoya disease on magnetic resonance imaging: are flow voids in the basal ganglia an essential criterion for definitive diagnosis?

    Science.gov (United States)

    Mikami, Takeshi; Sugino, Toshiya; Ohtaki, Shunya; Houkin, Kiyohiro; Mikuni, Nobuhiro

    2013-08-01

    Flow voids in the basal ganglia cannot always be recognized on magnetic resonance imaging, even in patients with typical moyamoya disease. In this report, flow voids in the basal ganglia and cisternal flow voids of the sylvian valley were evaluated in patients with moyamoya disease, and their diagnostic value was verified. A total of 41 consecutive patients with moyamoya disease were included in this analysis. The number of flow voids in the basal ganglia and the sylvian valley were counted on each side by 3 observers. Then the numbers of flow voids were compared between the patients with moyamoya disease and controls. The patients with moyamoya disease had a significantly higher mean number of flow voids in the basal ganglia and the sylvian valley (P moyamoya disease. Comparative analysis using the area under the receiver operating curve indicated that the evaluation of flow voids in the sylvian valley was significantly superior method to that in the basal ganglia (P moyamoya disease was 6. Based on these findings, we recommend a definitive diagnosis of moyamoya disease should include assessment for abnormal vessels around the terminal portions of the internal carotid arteries.

  10. A review of the ongoing discussion about definition, diagnosis and pathomechanism of subclinical endometritis in dairy cows.

    Science.gov (United States)

    Wagener, Karen; Gabler, Christoph; Drillich, Marc

    2017-05-01

    In the last decade, several new aspects of the inflammation of the bovine endometrium have been investigated and described, including a new definition of subclinical endometritis. This review summarizes the recent discussion about the definition, diagnosis and pathomechanism of subclinical endometritis. Subclinical endometritis also referred to as cytological endometritis is defined by findings of endometrial cytology, which is usually performed with the cytobrush-technique or by low-volume flushing of the uterus. The sampling procedure is minimally invasive and has no negative impact on subsequent conception rate. The suggested threshold value for polymorphonuclear cells (PMN) as diagnostic for subclinical endometritis depends on the time postpartum and varies from 5 to 18%. It has also been shown that a general threshold of 5% PMN is eligible for all cows between 21 and 62 days postpartum. Accuracy and repeatability of counting PMN under the microscope have been evaluated and can be regarded as reliable. The impact of subclinical endometritis on reproductive performance is characterized by decreased conception rates, and prolonged days to first service and days open. In addition, it has been demonstrated that subclinical endometritis has an impact on survival and quality of the embryo. Some studies, however, did not confirm this negative effect of subclinical endometritis on fertility. More detailed analyses of the cytobrush samples revealed higher mRNA expression of several cytokines in cows with subclinical endometritis compared with healthy cows, and contributed to the understanding of detrimental effects of subclinical endometritis on fertility. In contrast to clinical endometritis, there are no predominant bacteria related to subclinical endometritis, but associations between the presence of α-hemolytic streptococci and Trueperella pyogenes and subclinical endometritis have been found. For the treatment of subclinical endometritis, intrauterine infusions

  11. 78 FR 53963 - Final Priorities, Requirements, Definitions, and Selection Criteria; Race to the Top-Early...

    Science.gov (United States)

    2013-08-30

    ... definitions of KEA, Program Standards, and Workforce Knowledge and Competency Frameworks, selection criterion... high-quality digital resources. Discussion: Although the Departments support the provision of professional development through high-quality digital resources, we believe adding this specific...

  12. Space station data system analysis/architecture study. Task 1: Functional requirements definition, DR-5. Appendix: Requirements data base

    Science.gov (United States)

    1985-01-01

    Appendix A contains data that characterize the system functions in sufficient depth as to determine the requirements for the Space Station Data System (SSDS). This data is in the form of: (1) top down traceability report; (2) bottom up traceability report; (3) requirements data sheets; and (4) cross index of requirements paragraphs of the source documents and the requirements numbers. A data base users guide is included that interested parties can use to access the requirements data base and get up to date information about the functions.

  13. "GOLD or lower limit of normal definition? a comparison with expert-based diagnosis of chronic obstructive pulmonary disease in a prospective cohort-study"

    Directory of Open Access Journals (Sweden)

    Güder Gülmisal

    2012-02-01

    Full Text Available Abstract Background The Global initiative for chronic Obstructive Lung Disease (GOLD defines COPD as a fixed post-bronchodilator ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC below 0.7. Age-dependent cut-off values below the lower fifth percentile (LLN of this ratio derived from the general population have been proposed as an alternative. We wanted to assess the diagnostic accuracy and prognostic capability of the GOLD and LLN definition when compared to an expert-based diagnosis. Methods In a prospective cohort study, 405 patients aged ≥ 65 years with a general practitioner's diagnosis of COPD were recruited and followed up for 4.5 (median; quartiles 3.9; 5.1 years. Prevalence rates of COPD according to GOLD and three LLN definitions and diagnostic performance measurements were calculated. The reference standard was the diagnosis of COPD of an expert panel that used all available diagnostic information, including spirometry and bodyplethysmography. Results Compared to the expert panel diagnosis, 'GOLD-COPD' misclassified 69 (28% patients, and the three LLNs misclassified 114 (46%, 96 (39%, and 98 (40% patients, respectively. The GOLD classification led to more false positives, the LLNs to more false negative diagnoses. The main predictors beyond the FEV1/FVC ratio for an expert diagnosis of COPD were the FEV1 % predicted, and the residual volume/total lung capacity ratio (RV/TLC. Adding FEV1 and RV/TLC to GOLD or LLN improved the diagnostic accuracy, resulting in a significant reduction of up to 50% of the number of misdiagnoses. The expert diagnosis of COPD better predicts exacerbations, hospitalizations and mortality than GOLD or LLN. Conclusions GOLD criteria over-diagnose COPD, while LLN definitions under-diagnose COPD in elderly patients as compared to an expert panel diagnosis. Incorporating FEV1 and RV/TLC into the GOLD-COPD or LLN-based definition brings both definitions closer to expert panel

  14. MEK kinase 1 activity is required for definitive erythropoiesis in the mouse fetal liver

    DEFF Research Database (Denmark)

    Bonnesen, Barbara; Ørskov, Cathrine; Rasmussen, Susanne

    2005-01-01

    KD) embryos have normal morphology but are anemic due to failure of definitive erythropoiesis. When Mekk1(DeltaKD) fetal liver cells were transferred to lethally irradiated wild-type hosts, mature red blood cells were generated from the mutant cells, suggesting that MEKK1 functions in a non......-cell-autonomous manner. Based on immunohistochemical and hemoglobin chain transcription analysis, we propose that the failure of definitive erythropoiesis is due to a deficiency in enucleation activity caused by insufficient macrophage-mediated nuclear DNA destruction....

  15. Communicative Competence for Individuals who require Augmentative and Alternative Communication: A New Definition for a New Era of Communication?

    CERN Document Server

    Light, Janice

    2014-01-01

    In 1989, Light defined communicative competence for individuals with complex communication needs who require augmentative and alternative communication (AAC) as a dynamic, interpersonal construct based on functionality of communication, adequacy of communication, and sufficiency of knowledge, judgment, and skills. Specifically, Light argued that in order to demonstrate communicative competence, individuals who required AAC had to develop and integrate knowledge, judgment, and skills in four interrelated domains: linguistic, operational, social, and strategic. In 2003, Light expanded this definition and argued that the attainment of communicative competence is influenced not just by linguistic, operational, social, and strategic competencies, but also by a variety of psychosocial factors (e.g., motivation, attitude, confidence, resilience) as well as by barriers and supports in the environment. In the 25 years since this definition of communicative competence for individuals who use AAC was originally proposed...

  16. 13 CFR 108.1830 - NMVC Company's Capital Impairment definition and general requirements.

    Science.gov (United States)

    2010-01-01

    ... ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM NMVC Company's Noncompliance With Terms of Leverage Computation of Nmvc Company's Capital Impairment § 108.1830 NMVC Company's Capital Impairment definition and... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false NMVC Company's Capital...

  17. Heart failure in the elderly- some aspects in pathophysiology, diagnosis and therapy that require special attention

    Institute of Scientific and Technical Information of China (English)

    Ernst R. Schwarz

    2007-01-01

    Approximately 50% of all heart failure patients in the US are above 75 years of age, which is almost similar to most European countries and the Middle and the Far East. Even though aging is an independent molecular process with a multitude of genetic predetermination and biochemical mediations, aging itself does not automatically result in cardiac insufficiency. On the other hand, with increasing age, cardioprotective mechanisms in response to stress are lost, and progressive cardiomyocyte degeneration with replacement fibrosis is often seen in older hearts, even though the exact triggers are not completely understood. Older patients with heart failure have distinct features that require special attention in diagnosis as well as therapy. The elderly more frequently suffer from multiple co-morbidities and might have atypical clinical presentations. Several precautions are essential in the treatment of heart failure in the elderly due to co-existing morbidities and the pharmacokinetic and pharmacodynamic changes related to increased age. Also, treatment expectations, compliance, mental status and cognitive function might play a major role regarding optimized treatment and monitoring options in the elderly suffering from heart failure. This review summarizes current issues of heart failure management in the elderly.

  18. Dizziness and neck pain: a correct diagnosis is required before consulting a physiotherapist.

    Science.gov (United States)

    van Leeuwen, Roeland B; van der Zaag-Loonen, Hester

    2017-03-01

    Patients with dizziness often present with concurrent neck complaints. Although there is no evidence that physiotherapy treatment of the neck reduces dizziness, many patients have been treated by a physiotherapist before they visit our tertiary dizziness centre. 1. How often do dizziness and neck complaints co-occur? and 2. how many patients have been treated by a physiotherapist for their neck complaints with a view to reduce the dizziness complaints? In a prospective observational study, the following data were collected: age, gender, neck complaints, and whether or not the dizziness had been treated by physiotherapy. From 455 non-consecutive patients with dizziness, 192 (42 %) patients had concurrent neck complaints in addition to dizziness. Within this group, 87 (45 %) had been treated with physiotherapy to reduce the dizziness. In 81 patients (94 %) who had been treated with physiotherapy, the doctors of the dizziness centre discovered a cause of the dizziness that could be treated medically. Neck complaints and dizziness often coincide. Treatment of the neck complaints with physiotherapy is frequently used. However, the causes of the dizziness are often vestibular (non-cervical) for which medical treatment is available. A correct diagnosis is required before consulting a physiotherapist.

  19. Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    Alfredo Pereira Leite de Albuquerque Filho

    2011-12-01

    Full Text Available INTRODUCTION: Leptospirosis is often mistaken for other acute febrile illnesses because of its nonspecific presentation. Bacteriologic, serologic, and molecular methods have several limitations for early diagnosis: technical complexity, low availability, low sensitivity in early disease, or high cost. This study aimed to validate a case definition, based on simple clinical and laboratory tests, that is intended for bedside diagnosis of leptospirosis among hospitalized patients. METHODS: Adult patients, admitted to two reference hospitals in Recife, Brazil, with a febrile illness of less than 21 days and with a clinical suspicion of leptospirosis, were included to test a case definition comprising ten clinical and laboratory criteria. Leptospirosis was confirmed or excluded by a composite reference standard (microscopic agglutination test, ELISA, and blood culture. Test properties were determined for each cutoff number of the criteria from the case definition. RESULTS: Ninety seven patients were included; 75 had confirmed leptospirosis and 22 did not. Mean number of criteria from the case definition that were fulfilled was 7.8±1.2 for confirmed leptospirosis and 5.9±1.5 for non-leptospirosis patients (p<0.0001. Best sensitivity (85.3% and specificity (68.2% combination was found with a cutoff of 7 or more criteria, reaching positive and negative predictive values of 90.1% and 57.7%, respectively; accuracy was 81.4%. CONCLUSIONS: The case definition, for a cutoff of at least 7 criteria, reached average sensitivity and specificity, but with a high positive predictive value. Its simplicity and low cost make it useful for rapid bedside leptospirosis diagnosis in Brazilian hospitalized patients with acute severe febrile disease.

  20. Diagnosis of Aortic Graft Infection: A Case Definition by the Management of Aortic Graft Infection Collaboration (MAGIC).

    Science.gov (United States)

    Lyons, O T A; Baguneid, M; Barwick, T D; Bell, R E; Foster, N; Homer-Vanniasinkam, S; Hopkins, S; Hussain, A; Katsanos, K; Modarai, B; Sandoe, J A T; Thomas, S; Price, N M

    2016-12-01

    The management of aortic graft infection (AGI) is highly complex and in the absence of a universally accepted case definition and evidence-based guidelines, clinical approaches and outcomes vary widely. The objective was to define precise criteria for diagnosing AGI. A process of expert review and consensus, involving formal collaboration between vascular surgeons, infection specialists, and radiologists from several English National Health Service hospital Trusts with large vascular services (Management of Aortic Graft Infection Collaboration [MAGIC]), produced the definition. Diagnostic criteria from three categories were classified as major or minor. It is proposed that AGI should be suspected if a single major criterion or two or more minor criteria from different categories are present. AGI is diagnosed if there is one major plus any criterion (major or minor) from another category. (i) Clinical/surgical major criteria comprise intraoperative identification of pus around a graft and situations where direct communication between the prosthesis and a nonsterile site exists, including fistulae, exposed grafts in open wounds, and deployment of an endovascular stent-graft into an infected field (e.g., mycotic aneurysm); minor criteria are localized AGI features or fever ≥38°C, where AGI is the most likely cause. (ii) Radiological major criteria comprise increasing perigraft gas volume on serial computed tomography (CT) imaging or perigraft gas or fluid (≥7 weeks and ≥3 months, respectively) postimplantation; minor criteria include other CT features or evidence from alternative imaging techniques. (iii) Laboratory major criteria comprise isolation of microorganisms from percutaneous aspirates of perigraft fluid, explanted grafts, and other intraoperative specimens; minor criteria are positive blood cultures or elevated inflammatory indices with no alternative source. This AGI definition potentially offers a practical and consistent diagnostic standard

  1. 78 FR 79650 - Definitions and Reporting Requirements for Shareholders of Passive Foreign Investment Companies

    Science.gov (United States)

    2013-12-31

    ... Shareholders of Passive Foreign Investment Companies AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... of a passive foreign investment company (PFIC), the annual filing requirements for shareholders of PFICs, and an exclusion from certain filing requirement for shareholders that constructively...

  2. Leber congenital amaurosis: comprehensive survey of the genetic heterogeneity, refinement of the clinical definition, and genotype-phenotype correlations as a strategy for molecular diagnosis.

    Science.gov (United States)

    Hanein, Sylvain; Perrault, Isabelle; Gerber, Sylvie; Tanguy, Gaëlle; Barbet, Fabienne; Ducroq, Dominique; Calvas, Patrick; Dollfus, Hélène; Hamel, Christian; Lopponen, Tuija; Munier, Francis; Santos, Louisa; Shalev, Stavit; Zafeiriou, Dimitrios; Dufier, Jean-Louis; Munnich, Arnold; Rozet, Jean-Michel; Kaplan, Josseline

    2004-04-01

    Leber congenital amaurosis (LCA) is the earliest and most severe form of all inherited retinal dystrophies, responsible for congenital blindness. Disease-associated mutations have been hitherto reported in seven genes. These genes are all expressed preferentially in the photoreceptor cells or the retinal pigment epithelium but they are involved in strikingly different physiologic pathways resulting in an unforeseeable physiopathologic variety. This wide genetic and physiologic heterogeneity that could largely increase in the coming years, hinders the molecular diagnosis in LCA patients. The genotyping is, however, required to establish genetically defined subgroups of patients ready for therapy. Here, we report a comprehensive mutational analysis of the all known genes in 179 unrelated LCA patients, including 52 familial and 127 sporadic (27/127 consanguineous) cases. Mutations were identified in 47.5% patients. GUCY2D appeared to account for most LCA cases of our series (21.2%), followed by CRB1 (10%), RPE65 (6.1%), RPGRIP1 (4.5%), AIPL1 (3.4%), TULP1 (1.7%), and CRX (0.6%). The clinical history of all patients with mutations was carefully revisited to search for phenotype variations. Sound genotype-phenotype correlations were found that allowed us to divide patients into two main groups. The first one includes patients whose symptoms fit the traditional definition of LCA, i.e., congenital or very early cone-rod dystrophy, while the second group gathers patients affected with severe yet progressive rod-cone dystrophy. Besides, objective ophthalmologic data allowed us to subdivide each group into two subtypes. Based on these findings, we have drawn decisional flowcharts directing the molecular analysis of LCA genes in a given case. These flowcharts will hopefully lighten the heavy task of genotyping new patients but only if one has access to the most precise clinical history since birth.

  3. Solid Waste Management Requirements Definition for Advanced Life Support Missions: Results

    Science.gov (United States)

    Alazraki, Michael P.; Hogan, John; Levri, Julie; Fisher, John; Drysdale, Alan

    2002-01-01

    Prior to determining what Solid Waste Management (SWM) technologies should be researched and developed by the Advanced Life Support (ALS) Project for future missions, there is a need to define SWM requirements. Because future waste streams will be highly mission-dependent, missions need to be defined prior to developing SWM requirements. The SWM Working Group has used the mission architecture outlined in the System Integration, Modeling and Analysis (SIMA) Element Reference Missions Document (RMD) as a starting point in the requirement development process. The missions examined include the International Space Station (ISS), a Mars Dual Lander mission, and a Mars Base. The SWM Element has also identified common SWM functionalities needed for future missions. These functionalities include: acceptance, transport, processing, storage, monitoring and control, and disposal. Requirements in each of these six areas are currently being developed for the selected missions. This paper reviews the results of this ongoing effort and identifies mission-dependent resource recovery requirements.

  4. 17 CFR 242.200 - Definition of “short sale” and marking requirements.

    Science.gov (United States)

    2010-04-01

    ... COMMISSION (CONTINUED) REGULATIONS M, SHO, ATS, AC, AND NMS AND CUSTOMER MARGIN REQUIREMENTS FOR SECURITY...) introductory text and adding paragraph (g)(2), effective May 10, 2010. For the convenience of the user,...

  5. Geosynchronous platform definition study. Volume 4, Part 1: Traffic analysis and system requirements for the baseline traffic model

    Science.gov (United States)

    1973-01-01

    The traffic analyses and system requirements data generated in the study resulted in the development of two traffic models; the baseline traffic model and the new traffic model. The baseline traffic model provides traceability between the numbers and types of geosynchronous missions considered in the study and the entire spectrum of missions foreseen in the total national space program. The information presented pertaining to the baseline traffic model includes: (1) definition of the baseline traffic model, including identification of specific geosynchronous missions and their payload delivery schedules through 1990; (2) Satellite location criteria, including the resulting distribution of the satellite population; (3) Geosynchronous orbit saturation analyses, including the effects of satellite physical proximity and potential electromagnetic interference; and (4) Platform system requirements analyses, including satellite and mission equipment descriptions, the options and limitations in grouping satellites, and on-orbit servicing criteria (both remotely controlled and man-attended).

  6. San Juan National Forest Land Management Planning Support System (LMPSS) requirements definition

    Science.gov (United States)

    Werth, L. F. (Principal Investigator)

    1981-01-01

    The role of remote sensing data as it relates to a three-component land management planning system (geographic information, data base management, and planning model) can be understood only when user requirements are known. Personnel at the San Juan National Forest in southwestern Colorado were interviewed to determine data needs for managing and monitoring timber, rangelands, wildlife, fisheries, soils, water, geology and recreation facilities. While all the information required for land management planning cannot be obtained using remote sensing techniques, valuable information can be provided for the geographic information system. A wide range of sensors such as small and large format cameras, synthetic aperture radar, and LANDSAT data should be utilized. Because of the detail and accuracy required, high altitude color infrared photography should serve as the baseline data base and be supplemented and updated with data from the other sensors.

  7. Decision Support System Requirements Definition for Human Extravehicular Activity Based on Cognitive Work Analysis.

    Science.gov (United States)

    Miller, Matthew James; McGuire, Kerry M; Feigh, Karen M

    2017-06-01

    The design and adoption of decision support systems within complex work domains is a challenge for cognitive systems engineering (CSE) practitioners, particularly at the onset of project development. This article presents an example of applying CSE techniques to derive design requirements compatible with traditional systems engineering to guide decision support system development. Specifically, it demonstrates the requirements derivation process based on cognitive work analysis for a subset of human spaceflight operations known as extravehicular activity. The results are presented in two phases. First, a work domain analysis revealed a comprehensive set of work functions and constraints that exist in the extravehicular activity work domain. Second, a control task analysis was performed on a subset of the work functions identified by the work domain analysis to articulate the translation of subject matter states of knowledge to high-level decision support system requirements. This work emphasizes an incremental requirements specification process as a critical component of CSE analyses to better situate CSE perspectives within the early phases of traditional systems engineering design.

  8. 77 FR 69579 - Proposed Requirements, Definitions, and Selection Criteria-Native American Career and Technical...

    Science.gov (United States)

    2012-11-20

    ... hourly wage established under the Fair Labor Standards Act. (3) A grantee may only award a stipend if the... the Fair Labor Standards Act. Example: If a grantee uses the Fair Labor Standards Act minimum hourly... require recipients of funds under the Act to develop challenging academic standards and improve career and...

  9. SOLERAS - Solar Controlled Environment Agriculture Project. Final report, Volume 5. Science Applications, Incorporated system requirements definition

    Energy Technology Data Exchange (ETDEWEB)

    1985-01-01

    This report sets forth the system requirements for a Solar Controlled-Environment Agriculture System (SCEAS) Project. In the report a conceptual baseline system description for an engineering test facility is given. This baseline system employs a fluid roof/roof filter in combination with a large storage tank and a ground water heat exchanger in order to provide cooling and heating as needed. Desalination is accomplished by pretreatment followed by reverse osmosis. Energy is provided by means of photovoltaics and wind machines in conjunction with storage batteries. Site and climatic data needed in the design process are given. System performance specifications and integrated system design criteria are set forth. Detailed subsystem design criteria are presented and appropriate references documented.

  10. 46 CFR 57.04-1 - Test specimen requirements and definition of ranges (modifies QW 202, QW 210, QW 451, and QB 202).

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Test specimen requirements and definition of ranges (modifies QW 202, QW 210, QW 451, and QB 202). 57.04-1 Section 57.04-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING WELDING AND BRAZING Procedure Qualification Range § 57.04-1 Test specimen requirements...

  11. Definition of variables required for comprehensive description of drug dosage and clinical pharmacokinetics.

    Science.gov (United States)

    Medem, Anna V; Seidling, Hanna M; Eichler, Hans-Georg; Kaltschmidt, Jens; Metzner, Michael; Hubert, Carina M; Czock, David; Haefeli, Walter E

    2017-05-01

    Electronic clinical decision support systems (CDSS) require drug information that can be processed by computers. The goal of this project was to determine and evaluate a compilation of variables that comprehensively capture the information contained in the summary of product characteristic (SmPC) and unequivocally describe the drug, its dosage options, and clinical pharmacokinetics. An expert panel defined and structured a set of variables and drafted a guideline to extract and enter information on dosage and clinical pharmacokinetics from textual SmPCs as published by the European Medicines Agency (EMA). The set of variables was iteratively revised and evaluated by data extraction and variable allocation of roughly 7% of all centrally approved drugs. The information contained in the SmPC was allocated to three information clusters consisting of 260 variables. The cluster "drug characterization" specifies the nature of the drug. The cluster "dosage" provides information on approved drug dosages and defines corresponding specific conditions. The cluster "clinical pharmacokinetics" includes pharmacokinetic parameters of relevance for dosing in clinical practice. A first evaluation demonstrated that, despite the complexity of the current free text SmPCs, dosage and pharmacokinetic information can be reliably extracted from the SmPCs and comprehensively described by a limited set of variables. By proposing a compilation of variables well describing drug dosage and clinical pharmacokinetics, the project represents a step forward towards the development of a comprehensive database system serving as information source for sophisticated CDSS.

  12. Should Excessive Worry Be Required for a Diagnosis of Generalized Anxiety Disorder? Results from the US National Comorbidity Survey Replication

    Science.gov (United States)

    Ruscio, Ayelet Meron; Lane, Michael; Roy-Byrne, Peter; Stang, Paul E.; Stein, Dan J.; Wittchen, Hans-Ulrich; Kessler, Ronald C.

    2007-01-01

    Background Excessive worry is required by DSM-IV, but not ICD-10, for a diagnosis of generalized anxiety disorder (GAD). No large-scale epidemiological study has ever examined the implications of this requirement for estimates of prevalence, severity, or correlates of GAD. Methods Data were analyzed from the US National Comorbidity Survey Replication, a nationally representative, face-to-face survey of adults in the US household population that was fielded in 2001–2003. DSM-IV GAD was assessed with Version 3.0 of the WHO Composite International Diagnostic Interview. Non-excessive worriers meeting all other DSM-IV criteria for GAD were compared with respondents who met full GAD criteria as well as with other survey respondents to consider the implications of removing the excessiveness requirement. Results The estimated lifetime prevalence of GAD increases by approximately 40% when the excessiveness requirement is removed. Excessive GAD begins earlier in life, has a more chronic course, and is associated with greater symptom severity and psychiatric comorbidity than non-excessive GAD. However, non-excessive cases nonetheless evidence substantial persistence and impairment of GAD as well as significantly elevated comorbidity compared to respondents without GAD. Non-excessive cases also have socio-demographic characteristics and familial aggregation of GAD comparable to excessive cases. Conclusions Although individuals who meet all criteria for GAD other than excessiveness have a somewhat milder presentation than those with excessive worry, their syndromes are sufficiently similar to those with excessive worry to warrant a GAD diagnosis. PMID:16300690

  13. 非特异性胸膜炎的定义和诊断%The definition and diagnosis of nonspecific pleuritis

    Institute of Scientific and Technical Information of China (English)

    安弘; 钱江; 邓俊亮; 吴健

    2014-01-01

    This article describes the definition and diagnosis of nonspecific pleuritis (NSP).NSP is generally applied to the patients with pleural effusion of which the cause is uncertain,and the histological finding in pleural biopsies is pleural inflammation (pleuritis/fibrosis),but there are not specific findings such as tuberculous or malignant disease.Certain causes of the majority of NSP patients can be subsequently found,including benign disease or inflammation,tuberculosis,mesothelioma and so on.The correct definition and diagnostic methods of NSP contribute to timely diagnosis and treatment towards these patients for clinical guidance.%本文介绍非特异性胸膜炎(NSP)的定义和诊断。NSP 一般指病因未明的渗出性胸腔积液,胸膜活检无结核及恶性疾病等特异性发现,仅有胸膜炎症的非特异性组织学改变。大部分胸膜活检诊断为 NSP 的患者可在随访中找到病因,包括肺及胸膜炎症或良性疾病、结核、恶性胸膜间皮瘤等。明确 NSP 的定义及诊断方法、探寻其具体病因有利于对患者及时进行诊断和干预,有积极的临床指导意义。

  14. [Neuropsychiatric systemic lupus erythematosus (1st part). Cases definitions and diagnosis and treatment of central nervous system and psychiatric manifestations of systemic lupus erythematosus].

    Science.gov (United States)

    Lefèvre, G; Zéphir, H; Warembourg, F; Michelin, E; Pruvo, J-P; Hachulla, E; Semah, F; Dubucquoi, S; Lenfant, P; Vermersch, P; Hatron, P-Y; Prin, L; Launay, D

    2012-09-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease, which primarily affects skin and joints. Peripheral neurologic syndrome and central nervous system (CNS) manifestations are common in lupus patients but are not always attributable to lupus itself. A classification, published in 1999 by the American College of Rheumatology (ACR) research committee, described 12 CNS syndromes and seven peripheral neurologic syndromes compatible with "neuropsychiatric systemic lupus erythematosus" (NPSLE). Despite this consensus, studies which have been published since 1999 have reported a prevalence of NPSLE varying from 20 to 97 %, which shows the diagnosis difficulty and the heterogeneity of neuropsychiatric manifestations in SLE. In order to understand the limits of this classification, we propose in this first part an exhaustive review of publications describing neuropsychiatric manifestations according to the ACR 1999 classification. We also detail case definitions, prevalence and risk factors, clinical characteristics and diagnosis of each lupus-related psychiatric and CNS manifestation. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  15. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Professional requirements and training.

    Science.gov (United States)

    Steele, R J C; Rey, J-F; Lambert, R

    2012-09-01

    Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on professional requirements and training includes 23 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of surveillance and other elements in the screening process, including multi-disciplinary diagnosis and management of the disease. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Nursing diagnosis

    OpenAIRE

    Ščavničar, Ema

    2015-01-01

    Nursing diagnosis is an integral part of nursing process approach. There are many definitions, which have one common theme: it's a stth status of a client.A nursing diagnostic statement has two or three parts. The article includes section on making of nursing diagnosis and a section on classification. Negovalna diagnoza je sestavni del v procesnem pristopu zdravstvene nege. Predstavljene so definicije, katere temeljijo na varovančevem stanju zdravja. Negovalna diagnoza ima dva ali tri dele...

  17. The Rome III criteria for the diagnosis of functional dyspepsia in secondary care are not superior to previous definitions.

    Science.gov (United States)

    Ford, Alexander C; Bercik, Premysl; Morgan, David G; Bolino, Carolina; Pintos-Sanchez, Maria Ines; Moayyedi, Paul

    2014-04-01

    Although the Rome III criteria for functional dyspepsia were defined 7 years ago, they have yet to be validated in a rigorous study. We addressed this issue in a secondary-care population. We analyzed complete symptom, upper gastrointestinal (GI) endoscopy, and histology data from 1452 consecutive adult patients with GI symptoms at 2 hospitals in Hamilton, Ontario, Canada. Assessors were blinded to symptom status. Individuals with normal upper GI endoscopy and histopathology findings from analyses of biopsy specimens were classified as having no organic GI disease. The reference standard used to define the presence of true functional dyspepsia was epigastric pain, early satiety or postprandial fullness, and no organic GI disease. Sensitivity, specificity, and positive and negative likelihood ratios (LRs), with 95% confidence intervals (CIs), were calculated. Of the 1452 patients, 722 (49.7%) met the Rome III criteria for functional dyspepsia. Endoscopy showed organic GI disease in 170 patients (23.5%) who met the Rome III criteria. The Rome III criteria identified patients with functional dyspepsia with 60.7% sensitivity, 68.7% specificity, a positive LR of 1.94 (95% CI, 1.69-2.22), and a negative LR of 0.57 (95% CI, 0.52-0.63). In contrast, the Rome II criteria identified patients with functional dyspepsia with 71.4% sensitivity, 55.6% specificity, a positive LR of 1.61 (95% CI, 1.45-1.78), and a negative LR of 0.51 (95% CI, 0.45-0.58). The area under a receiver operating characteristics curves did not differ significantly for any of the diagnostic criteria for functional dyspepsia. In a validation study of 1452 patients with GI symptoms, the Rome III criteria performed only modestly in identifying those with functional dyspepsia, and were not significantly superior to previous definitions. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  18. [The diagnosis of death].

    Science.gov (United States)

    Echeverría, Carlos; Goic, Alejandro; Lavados, Manuel; Quintana, Carlos; Rojas, Alberto; Serani, Alejandro; Vacarezza, Ricardo

    2004-01-01

    This paper undertakes an analysis of the scientific criteria used in the diagnosis of death and underscores the importance of intellectual rigor in the definition of medical concepts, particularly regarding such a critical issue as the diagnosis of death. Under the cardiorespiratory criterion, death is defined as "the irreversible cessation of the functioning of an organism as a whole", and the tests used to confirm this criterion (negative life-signs) are sensitive and specific. In this case, cadaverous phenomena appear immediately following the diagnosis of death. On the other hand, doubts have arisen concerning the theoretical and the inner consistency of the criterion of brain death, since it does not satisfy the definition of "the irreversible cessation of the functioning of an organism as a whole", nor the requirement of "total and irreversible cessation of all functions of the entire brain, including the brain stem". There is evidence to the effect that the tests used to confirm this criterion are not specific enough. It is clear that brain death marks the beginning of a process that eventually ends in death, though death does not occur at that moment. From an ethical point of view, the conflict arises between the need to provide an unequivocal diagnosis of death and the possibility of saving a life through organ transplantation. The sensitive issue of brain death calls for a more thorough and in-depth discussion among physicians and the community at large.

  19. {sup 18}F-fluorodeoxyglucose positron emission tomography combined with whole-body computed tomographic angiography in critically ill patients with suspected severe sepsis with no definite diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Mandry, Damien [CHU Nancy, Pole d' imagerie, Nancy (France); University of Lorraine, Faculty of Medicine, Nancy (France); INSERM, UMR 947, Nancy (France); Tatopoulos, Alexis; Lemarie, Jeremie; Bollaert, Pierre-Edouard; Gibot, Sebastien [University of Lorraine, Faculty of Medicine, Nancy (France); CHU de Nancy - Hopital Central, Service de Reanimation Medicale, Nancy (France); INSERM, UMR 1116, Nancy (France); Chevalier-Mathias, Elodie [CHU Nancy, Pole d' imagerie, Nancy (France); INSERM, UMR 947, Nancy (France); Nancyclotep, Experimental Imaging Platform, Nancy (France); Roch, Veronique [CHU Nancy, Pole d' imagerie, Nancy (France); Nancyclotep, Experimental Imaging Platform, Nancy (France); Olivier, Pierre [CHU Nancy, Pole d' imagerie, Nancy (France); University of Lorraine, Faculty of Medicine, Nancy (France); Nancyclotep, Experimental Imaging Platform, Nancy (France); Marie, Pierre-Yves [CHU Nancy, Pole d' imagerie, Nancy (France); University of Lorraine, Faculty of Medicine, Nancy (France); INSERM, UMR 1116, Nancy (France); Nancyclotep, Experimental Imaging Platform, Nancy (France)

    2014-10-15

    Timely identification of septic foci is critical in patients with severe sepsis or septic shock of unknown origin. This prospective pilot study aimed to assess {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET), combined with whole-body computed tomographic angiography (CTA), in patients with suspected severe sepsis and for whom the prior diagnostic workup had been inconclusive. Patients hospitalized in an intensive care unit with a suspected severe sepsis but no definite diagnosis after 48 h of extensive investigations were prospectively included and referred for a whole body FDG-PET/CTA. Results from FDG-PET/CTA were assessed according to the final diagnosis obtained after follow-up and additional diagnostic workup. Seventeen patients were prospectively included, all on mechanical ventilation and 14 under vasopressor drugs. The FDG-PET/CTA exam 1) was responsible for only one desaturation and one hypotension, both quickly reversible under treatment; 2) led to suspect 16 infectious sites among which 13 (81 %) could be confirmed by further diagnostic procedures; and 3) triggered beneficial changes in the medical management of 12 of the 17 study patients (71 %). The FDG-PET/CTA images showed a single or predominant infectious focus in two cases where CTA was negative and in three cases where CTA exhibited multiple possible foci. Whole-body FDG-PET/CTA appears to be feasible, relatively safe, and provides reliable and useful information, when prospectively planned in patients with suspected severe sepsis and for whom prior diagnostic workup had been inconclusive. The FDG-PET images are particularly helpful when CTA exhibits no or multiple possible sites. (orig.)

  20. New Sepsis and Septic Shock Definitions: Clinical Implications and Controversies.

    Science.gov (United States)

    Rhee, Chanu; Klompas, Michael

    2017-09-01

    New sepsis definitions shift emphasis from the systemic inflammatory response syndrome to organ dysfunction, quantified using the Sequential Organ Failure Assessment (SOFA) score. The new definitions also propose Quick SOFA criteria to rapidly identify potentially infected patients at risk for poor outcomes. The diagnosis of septic shock requires vasopressor dependence and increased lactate levels. Strengths of these definitions include their simplicity and clear association with adverse outcomes. However, their utility in identifying patients with serious infections before frank sepsis ensues remains to be seen. This article reviews challenges in defining sepsis, strengths and weaknesses of the new definitions, and unresolved issues. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Asia Pacific Consensus Statements on Crohn's disease. Part 1: Definition, diagnosis, and epidemiology: (Asia Pacific Crohn's Disease Consensus--Part 1).

    Science.gov (United States)

    Ooi, Choon Jin; Makharia, Govind K; Hilmi, Ida; Gibson, Peter R; Fock, Kwong Ming; Ahuja, Vineet; Ling, Khoon Lin; Lim, Wee Chian; Thia, Kelvin T; Wei, Shu-chen; Leung, Wai Keung; Koh, Poh Koon; Gearry, Richard B; Goh, Khean Lee; Ouyang, Qin; Sollano, Jose; Manatsathit, Sathaporn; de Silva, H Janaka; Rerknimitr, Rungsun; Pisespongsa, Pises; Abu Hassan, Muhamad Radzi; Sung, Joseph; Hibi, Toshifumi; Boey, Christopher C M; Moran, Neil; Leong, Rupert W L

    2016-01-01

    Inflammatory bowel disease (IBD) was previously thought to be rare in Asia, but emerging data indicate rising incidence and prevalence of IBD in the region. The Asia Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, at the Asia Pacific Digestive Week conference in 2006 under the auspices of the Asian Pacific Association of Gastroenterology with the goal of developing best management practices, coordinating research, and raising awareness of IBD in the region. The consensus group previously published recommendations for the diagnosis and management of ulcerative colitis with specific relevance to the Asia-Pacific region. The present consensus statements were developed following a similar process to address the epidemiology, diagnosis, and management of Crohn's disease. The goals of these statements are to pool the pertinent literature specifically highlighting relevant data and conditions in the Asia-Pacific region relating to the economy, health systems, background infectious diseases, differential diagnoses, and treatment availability. It does not intend to be all comprehensive and future revisions are likely to be required in this ever-changing field.

  2. Paraphilias: definition, diagnosis and treatment

    Science.gov (United States)

    Hargreaves, Paul; Rainbow, Lee; Alison, Laurence J.

    2013-01-01

    There is a great deal of controversy concerning paraphilia, and defining what is normal versus deviant or disordered, given that this is to some degree dependent on cultural views of acceptability. In this article, we outline these issues and describe recent progress in diagnosing and treating paraphilias. PMID:24049640

  3. Geosynchronous platform definition study. Volume 4, Part 2: Traffic analysis and system requirements for the new traffic model

    Science.gov (United States)

    1973-01-01

    A condensed summary of the traffic analyses and systems requirements for the new traffic model is presented. The results of each study activity are explained, key analyses are described, and important results are highlighted.

  4. Requirements for regional short-haul air service and the definition of a flight program to determine neighborhood reactions to small transport aircraft

    Science.gov (United States)

    Feher, K.; Bollinger, L.; Bowles, J. V.; Waters, M. H.

    1978-01-01

    An evaluation of the current status and future requirements of an intraregional short haul air service is given. A brief definition of the different types of short haul air service is given. This is followed by a historical review of previous attempts to develop short haul air service in high density urban areas and an assessment of the current status. The requirements for intraregional air service, the need for economic and environmental viability and the need for a flight research program are defined. A detailed outline of a research program that would determine urban community reaction to frequent operations of small transport aircraft is also given. Both the operation of such an experiment in a specific region (San Francisco Bay area) and the necessary design modifications of an existing fixed wing aircraft which could be used in the experiment are established. An estimate is made of overall program costs.

  5. Requirements analysis notebook for the flight data systems definition in the Real-Time Systems Engineering Laboratory (RSEL)

    Science.gov (United States)

    Wray, Richard B.

    1991-01-01

    A hybrid requirements analysis methodology was developed, based on the practices actually used in developing a Space Generic Open Avionics Architecture. During the development of this avionics architecture, a method of analysis able to effectively define the requirements for this space avionics architecture was developed. In this methodology, external interfaces and relationships are defined, a static analysis resulting in a static avionics model was developed, operating concepts for simulating the requirements were put together, and a dynamic analysis of the execution needs for the dynamic model operation was planned. The systems engineering approach was used to perform a top down modified structured analysis of a generic space avionics system and to convert actual program results into generic requirements. CASE tools were used to model the analyzed system and automatically generate specifications describing the model's requirements. Lessons learned in the use of CASE tools, the architecture, and the design of the Space Generic Avionics model were established, and a methodology notebook was prepared for NASA. The weaknesses of standard real-time methodologies for practicing systems engineering, such as Structured Analysis and Object Oriented Analysis, were identified.

  6. REQUIREMENTS DEFINITION AND IMPLEMENTATION OF THE APPARATUS FOR DATA COLLECTION FROM OPEN PACKETS OF WI-FI NETWORKS

    OpenAIRE

    Ivanov, D. A.; IVANOV A.L.; SUROVTSOVA T.G.

    2015-01-01

    Mobile devices actively use Wi-Fi for Internet connectivity. Low cost access points are required to allow data collection from open packets of the Wi-Fi networks. These access points are part of hardware and software based solution that monitors radio of the various mobile devices.

  7. Vaginitis: diagnosis and management.

    Science.gov (United States)

    Quan, Martin

    2010-11-01

    Vaginitis is one of the most common ambulatory problems to occur in women. It is a disorder responsible for > 10% of visits made to providers of women's health care. Although vaginal infections are the most common cause, other considerations include cervicitis, a normal vaginal discharge, foreign-body vaginitis, contact vaginitis, atrophic vaginitis, and desquamative inflammatory vaginitis. The medical history and examination are an important source of clues to the underlying diagnosis. However, making a definitive diagnosis requires skillful performance of office laboratory procedures, including the vaginal pool wet mount examination, determination of the vaginal pH, and the whiff test. Vaginal and cervical cultures, nucleic acid tests, and point-of-care tests are available and may be required in selected patients. Once a specific diagnosis is made, effective therapy can be prescribed. Candida vaginitis is generally treated with either the vaginal administration of an imidazole or triazole antifungal agent or the prescription of oral fluconazole. Oral nitroimidazole agents, metronidazole or tinidazole, are the only effective treatments for trichomoniasis in the United States. Bacterial vaginosis, which has been linked to important gynecologic and pregnancy complications, can be treated with an available oral or topical agent containing either a nitroimidazole or clindamycin.

  8. Monitoring and control requirement definition study for dispersed storage and generation (DSG). Volume II. Final report, Appendix A: selected DSG technologies and their general control requirements

    Energy Technology Data Exchange (ETDEWEB)

    1980-10-01

    A major aim of the US National Energy Policy, as well as that of the New York State Energy Research and Development Authority, is to conserve energy and to shift from oil to more abundant domestic fuels and renewable energy sources. Dispersed Storage and Generation (DSG) is the term that characterizes the present and future dispersed, relatively small (<30 MW) energy systems, such as solar thermal electric, photovoltaic, wind, fuel cell, storage battery, hydro, and cogeneration, which can help achieve these national energy goals and can be dispersed throughout the distribution portion of an electric utility system. The purpose of this survey and identification of DSG technologies is to present an understanding of the special characteristics of each of these technologies in sufficient detail so that the physical principles of their operation and the internal control of each technology are evident. In this way, a better appreciation can be obtained of the monitoring and control requirements for these DSGs from a remote distribution dispatch center. A consistent approach is being sought for both hardware and software which will handle the monitoring and control necessary to integrate a number of different DSG technologies into a common distribution dispatch network. From this study it appears that the control of each of the DSG technologies is compatible with a supervisory control method of operation that lends itself to remote control from a distribution dispatch center.

  9. Definition of Specific Functions and Procedural Skills Required by Cuban Specialists in Intensive Care and Emergency Medicine.

    Science.gov (United States)

    Véliz, Pedro L; Berra, Esperanza M; Jorna, Ana R

    2015-07-01

    INTRODUCTION Medical specialties' core curricula should take into account functions to be carried out, positions to be filled and populations to be served. The functions in the professional profile for specialty training of Cuban intensive care and emergency medicine specialists do not include all the activities that they actually perform in professional practice. OBJECTIVE Define the specific functions and procedural skills required of Cuban specialists in intensive care and emergency medicine. METHODS The study was conducted from April 2011 to September 2013. A three-stage methodological strategy was designed using qualitative techniques. By purposive maximum variation sampling, 82 professionals were selected. Documentary analysis and key informant criteria were used in the first stage. Two expert groups were formed in the second stage: one used various group techniques (focus group, oral and written brainstorming) and the second used a three-round Delphi method. In the final stage, a third group of experts was questioned in semistructured in-depth interviews, and a two-round Delphi method was employed to assess priorities. RESULTS Ultimately, 78 specific functions were defined: 47 (60.3%) patient care, 16 (20.5%) managerial, 6 (7.7%) teaching, and 9 (11.5%) research. Thirty-one procedural skills were identified. The specific functions and procedural skills defined relate to the profession's requirements in clinical care of the critically ill, management of patient services, teaching and research at the specialist's different occupational levels. CONCLUSIONS The specific functions and procedural skills required of intensive care and emergency medicine specialists were precisely identified by a scientific method. This product is key to improving the quality of teaching, research, administration and patient care in this specialty in Cuba. The specific functions and procedural skills identified are theoretical, practical, methodological and social contributions to

  10. Mutational definition of binding requirements of an hnRNP-like protein in Arabidopsis using fluorescence correlation spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Leder, Verena [Molecular Cell Physiology, Faculty of Biology, Bielefeld University (Germany); Biomolecular Photonics, Faculty of Physics, Bielefeld University (Germany); Lummer, Martina [Molecular Cell Physiology, Faculty of Biology, Bielefeld University (Germany); Tegeler, Kathrin [Molecular Cell Physiology, Faculty of Biology, Bielefeld University (Germany); Biomolecular Photonics, Faculty of Physics, Bielefeld University (Germany); Humpert, Fabian [Biomolecular Photonics, Faculty of Physics, Bielefeld University (Germany); Lewinski, Martin [Molecular Cell Physiology, Faculty of Biology, Bielefeld University (Germany); Schüttpelz, Mark [Biomolecular Photonics, Faculty of Physics, Bielefeld University (Germany); Staiger, Dorothee, E-mail: dorothee.staiger@uni-bielefeld.de [Molecular Cell Physiology, Faculty of Biology, Bielefeld University (Germany)

    2014-10-10

    Highlights: • We use FCS to investigate binding site requirements for the hnRNP-like protein AtGRP7. • We identify three nucleotides critical for AtGRP7 binding to its own intron. • Mutation of the conserved R{sup 49} abolishes binding altogether. • The paralogue AtGRP8 binds to an overlapping motif with different sequence requirement. • The glycine-rich stretch of a plant hnRNP-like protein contributes to binding. - Abstract: Arabidopsis thaliana glycine-rich RNA binding protein 7 (AtGRP7) is part of a negative feedback loop through which it regulates alternative splicing and steady-state abundance of its pre-mRNA. Here we use fluorescence correlation spectroscopy to investigate the requirements for AtGRP7 binding to its intron using fluorescently-labelled synthetic oligonucleotides. By systematically introducing point mutations we identify three nucleotides that lead to an increased K{sub d} value when mutated and thus are critical for AtGRP7 binding. Simultaneous mutation of all three residues abrogates binding. The paralogue AtGRP8 binds to an overlapping motif but with a different sequence preference, in line with overlapping but not identical functions of this protein pair. Truncation of the glycine-rich domain reduces the binding affinity of AtGRP7, showing for the first time that the glycine-rich stretch of a plant hnRNP-like protein contributes to binding. Mutation of the conserved R{sup 49} that is crucial for AtGRP7 function in pathogen defence and splicing abolishes binding.

  11. Requiring remission of undue influence of weight and shape on self-evaluation in the definition of recovery for bulimia nervosa.

    Science.gov (United States)

    Cogley, Catherine B; Keel, Pamela K

    2003-09-01

    The current study evaluated the concurrent validity of requiring remission of undue influence of weight and shape on self-evaluation (undue influence) in defining recovery from bulimia nervosa (BN). Three groups completed the Beck Depression Inventory, the Mood and Anxiety Symptom Questionnaire, the Body Shape Questionnaire, and the Social Adjustment Scale: 31 women were fully recovered from BN (FR), 28 women had no behavioral symptoms of BN (partially recovered [PR]), and 59 matched non-eating-disordered controls (MC). The PR group had more pathologic scores on depression, anxiety, body dissatisfaction, and social adjustment compared with both the FR and MC groups, which did not differ from each other. These findings suggest that including remission of cognitive symptoms in a standardized definition of recovery may prove to be clinically useful in establishing reliable prognostic indicators. Future research should evaluate the role played by cognitive symptoms in triggering relapse. Copyright 2003 by Wiley Periodicals, Inc.

  12. Spinal epidural abscess penetrating into retroperitoneal space in patient with diabetes mellitus type 2: early diagnosis and treatment requirement.

    Science.gov (United States)

    Grabysa, Radosław; Moczulska, Beata

    2008-01-01

    Spinal epidural abscess (SEA) is a rare condition with very serious prognosis. Predisposing factors for SEA include bacterial infections, immunocompromised states such as diabetes mellitus, intravenous drug abuse, alcoholism, AIDS, as well as spinal surgery and modern techniques of epidural anesthesia. The most common causative agent for SEA is Staphylococcus aureus. The typical clinical signs of SEA are back pain, fever and neurologic dysficit. Magnetic resonance (MR) of the spine and vertebral column is the best imaging diagnostic method in suspected cases. Emergency surgical decompression combined with intravenous antibiotics is the therapeutic method of choice. Conservative treatment may be appropriate in selected patients. Unless the typical presentation of SEA correct diagnosis of this illness is often overlooked and not considered initially. It delays suitable management and leads to poor outcome. We report a classic case of SEA in a woman with a history of diabetes mellitus.

  13. A universal strategy to interpret DNA profiles that does not require a definition of low-copy-number.

    Science.gov (United States)

    Gill, Peter; Buckleton, John

    2010-07-01

    In this paper we critically examine the causes of the underlying confusion that relates to the issue of low-template (LT) DNA profile interpretation. Firstly, there is much difficulty in attempting to distinguish between LT-DNA vs. conventional DNA because there is no discrete 'cut-off' point that can be reasonably defined or evaluated. LT-DNA is loosely characterised by drop-out (where alleles may be missing) and drop-in (where additional alleles may be present). We have previously described probabilistic methods that can be used to incorporate these phenomena using likelihood ratio (LR) principles. This is preferred to the random man not excluded (RMNE) method, because we cannot identify a coherent way forward within the restrictions provided by this framework. Most LT-DNA profiles are interpreted using a 'consensus' profile method, we called this the 'biological model', where only those alleles that are duplicated in consecutive tests are reported. We recognise that there is an increased need for probabilistic models to take precedence over the biological model. These models are required for all kinds of DNA profiles, not just those that are believed to be low-template. We also recognise that there is a need for education and training if the methods we recommend are to be widely introduced.

  14. Definition of the minimal viral components required for the initiation of unprimed RNA synthesis by influenza virus RNA polymerase.

    Science.gov (United States)

    Lee, M T Michael; Bishop, Konrad; Medcalf, Liz; Elton, Debra; Digard, Paul; Tiley, Laurence

    2002-01-15

    The first 11 nt at the 5' end of influenza virus genomic RNA were shown to be both necessary and sufficient for specific binding by the influenza virus polymerase. A novel in vitro transcription assay, in which the polymerase was bound to paramagnetic beads via a biotinylated 5'-vRNA oligonucleotide, was used to study the activities of different forms of the polymerase. Complexes composed of co-expressed PB1/PB2/PA proteins and a sub-complex composed of PB1/PA bound to the 5'-vRNA oligonucleotide, whereas PB1 expressed alone did not. The enriched 5'-vRNA/PB1/PB2/PA complex was highly active for ApG and globin mRNA primed transcription on a model 3'-vRNA template. RNA synthesis in the absence of added primers produced products with 5'-terminal tri- or diphosphate groups, indicating that genuine unprimed initiation of transcription also occurred. No transcriptase activity was detected for the PB1/PA complex. These results demonstrate a role for PA in the enhancement of 5' end binding activity of PB1, a role for PB2 in the assembly of a polymerase complex able to perform both cap-dependent and -independent synthesis and that NP is not required for the initiation of replicative transcription.

  15. Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331¿288 participants

    NARCIS (Netherlands)

    Kromhout, D.; Geleijnse, J.M.; et al.,

    2015-01-01

    Background Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA1c. We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and th

  16. Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331¿288 participants

    NARCIS (Netherlands)

    Kromhout, D.; Geleijnse, J.M.; et al.,

    2015-01-01

    Background Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA1c. We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and th

  17. New technologies for glaucoma diagnosis require evaluation of their clinical application%青光眼诊断新技术需要临床应用评价

    Institute of Scientific and Technical Information of China (English)

    任泽钦

    2009-01-01

    海德堡视网膜断层扫描仪、相干光断层扫描仪及偏振光激光扫描仪等检测技术广泛应用于青光眼临床诊断已有多年,但其实用价值和临床意义尚缺少明确而规范的评判标准.每种检测仪器均需要进行诊断试验评价,而评价方法应当正确、规范而严谨,重在早期诊断和不同指标诊断性能的具体分析.诊断技术只有在临床应用与应用评价相结合时,才能获得真正的发展,并进而解决实际问题.%Optical coherence tomography (OCT), Heidelberg Retinal Tomography (HRT-Ⅱ) and GDx have been used widely in glaucoma diagnosis for many years, but it is still uncertain in their practical value and clinical significance.Therefore, it requires an evaluation for the usefulness of each instrument in the diagnosis of glaucoma.The evaluation must be correct, standardized and strict in methodology, with emphasis on the early diagnosis and the concrete analysis of each parameter given by the different imaging instruments.Only if clinical application of these devices is combined with the practical evaluation, can these techniques make real progression and solve the clinical problems in the early diagnosis of primary open angle glaucoma.

  18. Common definition for categories of clinical research: a prerequisite for a survey on regulatory requirements by the European Clinical Research Infrastructures Network (ECRIN)

    LENUS (Irish Health Repository)

    Kubiak, Christine

    2009-10-16

    Abstract Background Thorough knowledge of the regulatory requirements is a challenging prerequisite for conducting multinational clinical studies in Europe given their complexity and heterogeneity in regulation and perception across the EU member states. Methods In order to summarise the current situation in relation to the wide spectrum of clinical research, the European Clinical Research Infrastructures Network (ECRIN) developed a multinational survey in ten European countries. However a lack of common classification framework for major categories of clinical research was identified, and therefore reaching an agreement on a common classification was the initial step in the development of the survey. Results The ECRIN transnational working group on regulation, composed of experts in the field of clinical research from ten European countries, defined seven major categories of clinical research that seem relevant from both the regulatory and the scientific points of view, and correspond to congruent definitions in all countries: clinical trials on medicinal products; clinical trials on medical devices; other therapeutic trials (including surgery trials, transplantation trials, transfusion trials, trials with cell therapy, etc.); diagnostic studies; clinical research on nutrition; other interventional clinical research (including trials in complementary and alternative medicine, trials with collection of blood or tissue samples, physiology studies, etc.); and epidemiology studies. Our classification was essential to develop a survey focused on protocol submission to ethics committees and competent authorities, procedures for amendments, requirements for sponsor and insurance, and adverse event reporting following five main phases: drafting, consensus, data collection, validation, and finalising. Conclusion The list of clinical research categories as used for the survey could serve as a contribution to the, much needed, task of harmonisation and simplification of the

  19. Common definition for categories of clinical research: a prerequisite for a survey on regulatory requirements by the European Clinical Research Infrastructures Network (ECRIN

    Directory of Open Access Journals (Sweden)

    Sanz Nuria

    2009-10-01

    Full Text Available Abstract Background Thorough knowledge of the regulatory requirements is a challenging prerequisite for conducting multinational clinical studies in Europe given their complexity and heterogeneity in regulation and perception across the EU member states. Methods In order to summarise the current situation in relation to the wide spectrum of clinical research, the European Clinical Research Infrastructures Network (ECRIN developed a multinational survey in ten European countries. However a lack of common classification framework for major categories of clinical research was identified, and therefore reaching an agreement on a common classification was the initial step in the development of the survey. Results The ECRIN transnational working group on regulation, composed of experts in the field of clinical research from ten European countries, defined seven major categories of clinical research that seem relevant from both the regulatory and the scientific points of view, and correspond to congruent definitions in all countries: clinical trials on medicinal products; clinical trials on medical devices; other therapeutic trials (including surgery trials, transplantation trials, transfusion trials, trials with cell therapy, etc.; diagnostic studies; clinical research on nutrition; other interventional clinical research (including trials in complementary and alternative medicine, trials with collection of blood or tissue samples, physiology studies, etc.; and epidemiology studies. Our classification was essential to develop a survey focused on protocol submission to ethics committees and competent authorities, procedures for amendments, requirements for sponsor and insurance, and adverse event reporting following five main phases: drafting, consensus, data collection, validation, and finalising. Conclusion The list of clinical research categories as used for the survey could serve as a contribution to the, much needed, task of harmonisation and

  20. Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331,288 participants

    OpenAIRE

    Gaspoz, Jean-Michel; Guessous, Idris

    2015-01-01

    Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA1c. We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions.

  1. Diagnosis of canine monocytotropic ehrlichiosis (Ehrlichia canis): an overview.

    Science.gov (United States)

    Harrus, Shimon; Waner, Trevor

    2011-03-01

    Canine monocytotropic ehrlichiosis (CME), caused by the rickettsia Ehrlichia canis, an important canine disease with a worldwide distribution. Diagnosis of the disease can be challenging due to its different phases and multiple clinical manifestations. CME should be suspected when a compatible history (living in or traveling to an endemic region, previous tick exposure), typical clinical signs and characteristic hematological and biochemical abnormalities are present. Traditional diagnostic techniques including hematology, cytology, serology and isolation are valuable diagnostic tools for CME, however a definitive diagnosis of E. canis infection requires molecular techniques. This article reviews the current literature covering the diagnosis of infection caused by E. canis.

  2. FGF signaling via MAPK is required early and improves Activin A-induced definitive endoderm formation from human embryonic stem cells

    Energy Technology Data Exchange (ETDEWEB)

    Sui, Lina, E-mail: linasui@vub.ac.be [Cell Differentiation Unit, Diabetes Research Center, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels (Belgium); Mfopou, Josue K. [Cell Differentiation Unit, Diabetes Research Center, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels (Belgium); Geens, Mieke; Sermon, Karen [Department of Embryology and Genetics, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels (Belgium); Bouwens, Luc [Cell Differentiation Unit, Diabetes Research Center, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels (Belgium)

    2012-09-28

    Highlights: Black-Right-Pointing-Pointer Deep study the FGF signaling role during DE specification in the context of hESCs. Black-Right-Pointing-Pointer DE differentiation from hESCs has an early dependence on FGF signaling. Black-Right-Pointing-Pointer A serum-free DE protocol is developed based on the findings. Black-Right-Pointing-Pointer The DE cells showed potential to differentiate into pancreatic progenitor cells. -- Abstract: Considering their unlimited proliferation and pluripotency properties, human embryonic stem cells (hESCs) constitute a promising resource applicable for cell replacement therapy. To facilitate this clinical translation, it is critical to study and understand the early stage of hESCs differentiation wherein germ layers are defined. In this study, we examined the role of FGF signaling in Activin A-induced definitive endoderm (DE) differentiation in the absence of supplemented animal serum. We found that activated FGF/MAPK signaling is required at the early time point of Activin A-induced DE formation. In addition, FGF activation increased the number of DE cells compared to Activin A alone. These DE cells could further differentiate into PDX1 and NKX6.1 positive pancreatic progenitors in vitro. We conclude that Activin A combined with FGF/MAPK signaling efficiently induce DE cells in the absence of serum. These findings improve our understanding of human endoderm formation, and constitute a step forward in the generation of clinical grade hESCs progenies for cell therapy.

  3. Proposed ICD-10-CM Surveillance Case Definitions for Injury Hospitalizations and Emergency Department Visits.

    Science.gov (United States)

    Hedegaard, Holly B; Johnson, Renee L; Ballesteros, Michael F

    2017-01-01

    This report describes a collaboration between the National Center for Health Statistics and the National Center for Injury Prevention and Control to develop proposed surveillance case definitions for injury hospitalizations and emergency department (ED) visits for use with administrative data sets coded using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). The proposed ICD-10-CM surveillance case definitions were developed by applying General Equivalence Mappings to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) definitions. As with the ICD-9-CM definitions, there are slight differences between the proposed ICD-10-CM surveillance case definition for injury hospitalizations and the one for ED visits. The inclusion criteria for an injury hospitalization requires a case to have a principal diagnosis of one of the included nature-of-injury (injury diagnosis) codes. The inclusion criteria for an injury ED visit requires the case to have either a principal diagnosis of one of the included nature-of-injury codes or the presence of selected external-cause codes. The ICD-10-CM nature-of-injury and external-cause codes included in the proposed definitions are presented and caveats for use of the proposed definitions are described.

  4. Diagnosis of MI after CABG with high-sensitivity troponin T and new ECG or echocardiogram changes: relationship with mortality and validation of the universal definition of MI.

    Science.gov (United States)

    Wang, Tom Km; Stewart, Ralph Ah; Ramanathan, Tharumenthiran; Kang, Nicholas; Gamble, Greg; White, Harvey D

    2013-12-01

    Criteria for diagnosing myocardial infarction (MI) after coronary artery bypass grafting (CABG) are controversial. Uncertainties remain around the optimal threshold for biomarker elevation and the need for associated criteria. There are no studies of high-sensitivity troponin (hs-TnT) after CABG. We assessed whether using hs-TnT to define MI after CABG was associated with 30-day and medium-term mortality and evaluated the utility of adding to the troponin criteria new Q-waves or imaging evidence of new wall motion abnormality as suggested in the Universal Definition of MI. Isolated CABG was performed in 818 patients from July 2010 to June 2012 and hs-TnT was measured 12-24 hours after CABG. Patients with rising baseline or missing troponins (n=258) were excluded. Thresholds of 140 ng/l (10-times 99th percentile upper reference limit) and 500 ng/l (10-times coefficient of variation of 10% for fourth-generation troponin T applied to hs-TnT) were prespecified. Mean follow up was 1.8±0.6 years. On multivariate analyses, isolated hs-TnT rise >140 ng/l (n=360) or >500 ng/l (n=162) were not associated with mortality. Additional ECG and/or echocardiographic criteria plus hs-TnT >140 ng/l was associated with 30-day mortality (hazard ratio, HR, 4.92, 95% CI 1.34-18.1; p=0.017) and medium-term mortality (HR 3.44, 95% CI 1.13-10.5; p=0.030), whereas ECG and/or echocardiographic abnormalities with hs-TnT >500 ng/l was not (p=0.281 and p=0.123 for 30-day and medium-term mortality, respectively). A definition for MI following CABG using hs-TnT with a cut point of 10-times 99th percentile upper reference limit and ECG and/or echocardiographic criteria predicts 30-day and medium-term mortality. These findings validate the Third Universal Definition of type 5 MI.

  5. Prenatal Diagnosis

    Directory of Open Access Journals (Sweden)

    Ozge Ozalp Yuregir

    2012-02-01

    Full Text Available Prenatal diagnosis is the process of determining the health or disease status of the fetus or embryo before birth. The purpose is early detection of diseases and early intervention when required. Prenatal genetic tests comprise of cytogenetic (chromosome assessment and molecular (DNA mutation analysis tests. Prenatal testing enables the early diagnosis of many diseases in risky pregnancies. Furthermore, in the event of a disease, diagnosing prenatally will facilitate the planning of necessary precautions and treatments, both before and after birth. Upon prenatal diagnosis of some diseases, termination of the pregnancy could be possible according to the family's wishes and within the legal frameworks. [Archives Medical Review Journal 2012; 21(1.000: 80-94

  6. Fault diagnosis

    Science.gov (United States)

    Abbott, Kathy

    1990-01-01

    The objective of the research in this area of fault management is to develop and implement a decision aiding concept for diagnosing faults, especially faults which are difficult for pilots to identify, and to develop methods for presenting the diagnosis information to the flight crew in a timely and comprehensible manner. The requirements for the diagnosis concept were identified by interviewing pilots, analyzing actual incident and accident cases, and examining psychology literature on how humans perform diagnosis. The diagnosis decision aiding concept developed based on those requirements takes abnormal sensor readings as input, as identified by a fault monitor. Based on these abnormal sensor readings, the diagnosis concept identifies the cause or source of the fault and all components affected by the fault. This concept was implemented for diagnosis of aircraft propulsion and hydraulic subsystems in a computer program called Draphys (Diagnostic Reasoning About Physical Systems). Draphys is unique in two important ways. First, it uses models of both functional and physical relationships in the subsystems. Using both models enables the diagnostic reasoning to identify the fault propagation as the faulted system continues to operate, and to diagnose physical damage. Draphys also reasons about behavior of the faulted system over time, to eliminate possibilities as more information becomes available, and to update the system status as more components are affected by the fault. The crew interface research is examining display issues associated with presenting diagnosis information to the flight crew. One study examined issues for presenting system status information. One lesson learned from that study was that pilots found fault situations to be more complex if they involved multiple subsystems. Another was pilots could identify the faulted systems more quickly if the system status was presented in pictorial or text format. Another study is currently under way to

  7. When psychiatric diagnosis becomes an overworked tool.

    Science.gov (United States)

    Szmukler, George

    2014-08-01

    A psychiatric diagnosis today is asked to serve many functions-clinical, research, medicolegal, delimiting insurance coverage, service planning, defining eligibility for state benefits (eg, for unemployment or disability), as well as providing rallying points for pressure groups and charities. These contexts require different notions of diagnosis to tackle the particular problem such a designation is meant to solve. In a number of instances, a 'status' definition (ie, a diagnostic label or category) is employed to tackle what is more appropriately seen as requiring a 'functional' approach (ie, how well the person is able to meet the demands of a test of performance requiring certain capabilities, aptitudes or skills). In these instances, a diagnosis may play only a subsidiary role. Some examples are discussed: the criteria for involuntary treatment; the determination of criminal responsibility; and, assessing entitlements to state benefits. I suggest that the distinction between 'status' versus 'function' has not been given sufficient weight in discussions of diagnosis. It is in the functional domain that some of the problematic relationships between clinical psychiatry and the social institutions with which it rubs shoulders are played out. A status, signified by a diagnosis, has often been encumbered with demands for which it is poorly equipped. It is a reductive way of solving problems of management, allocation or disposal for which a functional approach should be given greater weight.

  8. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update.

    Science.gov (United States)

    Zuberbier, T; Aberer, W; Asero, R; Bindslev-Jensen, C; Brzoza, Z; Canonica, G W; Church, M K; Ensina, L F; Giménez-Arnau, A; Godse, K; Gonçalo, M; Grattan, C; Hebert, J; Hide, M; Kaplan, A; Kapp, A; Abdul Latiff, A H; Mathelier-Fusade, P; Metz, M; Nast, A; Saini, S S; Sánchez-Borges, M; Schmid-Grendelmeier, P; Simons, F E R; Staubach, P; Sussman, G; Toubi, E; Vena, G A; Wedi, B; Zhu, X J; Maurer, M

    2014-07-01

    This guideline is the result of a systematic literature review using the 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) methodology and a structured consensus conference held on 28 and 29 November 2012, in Berlin. It is a joint initiative of the Dermatology Section of the European Academy of Allergy and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2) LEN), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO) with the participation of delegates of 21 national and international societies. Urticaria is a frequent, mast cell-driven disease, presenting with wheals, angioedema, or both. The life-time prevalence for acute urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria do not only cause a decrease in quality of life, but also affect performance at work and school and, as such, are members of the group of severe allergic diseases. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms. In addition, it outlines evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS).

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

    Science.gov (United States)

    Plontke, S K; Walther, L E

    2014-08-01

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

  10. Diagnosis of the Computer-Controlled Milling Machine, Definition of the Working Errors and Input Corrections on the Basis of Mathematical Model

    Science.gov (United States)

    Starikov, A. I.; Nekrasov, R. Yu; Teploukhov, O. J.; Soloviev, I. V.; Narikov, K. A.

    2016-10-01

    Manufactures, machinery and equipment improve of constructively as science advances and technology, and requirements are improving of quality and longevity. That is, the requirements for surface quality and precision manufacturing, oil and gas equipment parts are constantly increasing. Production of oil and gas engineering products on modern machine tools with computer numerical control - is a complex synthesis of technical and electrical equipment parts, as well as the processing procedure. Technical machine part wears during operation and in the electrical part are accumulated mathematical errors. Thus, the above-mentioned disadvantages of any of the following parts of metalworking equipment affect the manufacturing process of products in general, and as a result lead to the flaw.

  11. Higher percentage of in vitro apoptotic cells at time of diagnosis in patients with chronic lymphocytic leukemia indicate earlier treatment requirement: Ten years follow up

    Directory of Open Access Journals (Sweden)

    Kravić-Stevović Tamara

    2014-01-01

    Full Text Available Introduction. Chronic lymphocytic leukemia (CLL has an extremely variable clinical course. Biological reasons for that wide variation in clinical course and survival rates in CLL patients are not fully understood. Objective. The aim of the study was to evaluate the value of spontaneous apoptosis of CLL cells in vitro determined at presentation of disease, in prediction of treatment requirements and evolution of the CLL. Methods. Malignant B cells were isolated from the whole blood of 30 newly diagnosed CLL patients and cultured for 24 hours in RPMI-1640 medium supplemented with 10% of serum obtained from the same CLL patient. Cells were later fixed and processed for embedding in Epon, or cell smears were prepared and stained with TUNEL technique. Results. Ten-year follow-up revealed that patients with lower percentage of cells in apoptosis at presentation of disease had significant longer time treatment initiation (log rank test p0.05. Conclusion. The results of this study emphasize the importance of apoptosis of CLL cells at the time of the initial diagnosis in pathobiology of this disease. [Projekat Ministarstva nauke Republike Srbije, br. 41025

  12. The Johnson Space Center Management Information Systems (JSCMIS). 1: Requirements Definition and Design Specifications for Versions 2.1 and 2.1.1. 2: Documented Test Scenario Environments. 3: Security Design and Specifications

    Science.gov (United States)

    1986-01-01

    The Johnson Space Center Management Information System (JSCMIS) is an interface to computer data bases at NASA Johnson which allows an authorized user to browse and retrieve information from a variety of sources with minimum effort. This issue gives requirements definition and design specifications for versions 2.1 and 2.1.1, along with documented test scenario environments, and security object design and specifications.

  13. Survey Definitions of Gout for Epidemiologic Studies: Comparison With Crystal Identification as the Gold Standard.

    Science.gov (United States)

    Dalbeth, Nicola; Schumacher, H Ralph; Fransen, Jaap; Neogi, Tuhina; Jansen, Tim L; Brown, Melanie; Louthrenoo, Worawit; Vazquez-Mellado, Janitzia; Eliseev, Maxim; McCarthy, Geraldine; Stamp, Lisa K; Perez-Ruiz, Fernando; Sivera, Francisca; Ea, Hang-Korng; Gerritsen, Martijn; Scire, Carlo A; Cavagna, Lorenzo; Lin, Chingtsai; Chou, Yin-Yi; Tausche, Anne-Kathrin; da Rocha Castelar-Pinheiro, Geraldo; Janssen, Matthijs; Chen, Jiunn-Horng; Cimmino, Marco A; Uhlig, Till; Taylor, William J

    2016-12-01

    To identify the best-performing survey definition of gout from items commonly available in epidemiologic studies. Survey definitions of gout were identified from 34 epidemiologic studies contributing to the Global Urate Genetics Consortium (GUGC) genome-wide association study. Data from the Study for Updated Gout Classification Criteria (SUGAR) were randomly divided into development and test data sets. A data-driven case definition was formed using logistic regression in the development data set. This definition, along with definitions used in GUGC studies and the 2015 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) gout classification criteria were applied to the test data set, using monosodium urate crystal identification as the gold standard. For all tested GUGC definitions, the simple definition of "self-report of gout or urate-lowering therapy use" had the best test performance characteristics (sensitivity 82%, specificity 72%). The simple definition had similar performance to a SUGAR data-driven case definition with 5 weighted items: self-report, self-report of doctor diagnosis, colchicine use, urate-lowering therapy use, and hyperuricemia (sensitivity 87%, specificity 70%). Both of these definitions performed better than the 1977 American Rheumatism Association survey criteria (sensitivity 82%, specificity 67%). Of all tested definitions, the 2015 ACR/EULAR criteria had the best performance (sensitivity 92%, specificity 89%). A simple definition of "self-report of gout or urate-lowering therapy use" has the best test performance characteristics of existing definitions that use routinely available data. A more complex combination of features is more sensitive, but still lacks good specificity. If a more accurate case definition is required for a particular study, the 2015 ACR/EULAR gout classification criteria should be considered. © 2016, American College of Rheumatology.

  14. Bringing Definitions into High Definition

    Science.gov (United States)

    Mason, John

    2010-01-01

    Why do definitions play such a central role in mathematics? It may seem obvious that precision about the terms one uses is necessary in order to use those terms reasonably (while reasoning). Definitions are chosen so as to be definite about the terms one uses, but also to make both the statement of, and the reasoning to justify, theorems as…

  15. Negative serology: could exclude the diagnosis of brucellosis?

    Science.gov (United States)

    Çelik, Aygul Dogan; Yulugkural, Zerrin; Kilincer, Cumhur; Hamamcioglu, Mustafa Kemal; Kuloglu, Figen; Akata, Filiz

    2012-08-01

    Two cases of brucellar spondylodiscitis of the lumbar area were presented. Although both cases showed typical radiological changes, serological tests could not detect Brucella agglutinating antibodies. One of the patients was bacteremic and Brucella spp. was identified from blood culture. In the second patient needle biopsy was required for definite diagnosis. Although small, serologic tests have a certain rate of false negative results in brucellosis. Thus, a negative serology should not exclude the diagnosis of brucellosis, as it is demonstrated in the current cases.

  16. Diagnosis of employee engagement in metallurgical enterprise

    Directory of Open Access Journals (Sweden)

    B. Gajdzik

    2013-01-01

    Full Text Available In the theoretical part of the publication an overview of the definitions of employee engagement was conducted together with the analysis of the methods and techniques which influence the professional activity of the employees in the metallurgical enterprise. The practical part discusses the results of diagnosis of engagement in steelworks. Presented theories, as well as the research, fill the information gap concerning the engagement of the employees in metallurgical enterprises. This notion is important due to the fact that modern conditions of human resources management require the engagement of the employees as something commonly accepted and a designation of manufacturing enterprises.

  17. Food allergy: definitions, prevalence, diagnosis and therapy%食物过敏的定义、流行性、诊断及治疗

    Institute of Scientific and Technical Information of China (English)

    Ronaldvan Ree; Lars K.Poulsen; Gary WK Wong; Barbara K.Ballmer-Weber; 高中山; 贾旭东

    2015-01-01

    multiple organs,sometimes in an isolated way,sometimes simultaneously,with the severity of reactions ranging from mild and local to full-blown anaphylaxis.Mechanistically,it is defined as a Th2-driven immune disorder in which food-specific IgE antibodies are at the basis of immediate-type adverse reactions.The sites of sensitization and symptoms do not necessarily overlap.Food allergy,which is the theme of this paper,is often confused with other adverse reactions to food of both animmune (e.g.,celiac disease) and nonimmune (e.g.,lactose intolerance) nature.To reliably diagnose food allergy,a careful history (immediatetype reactions) needs to be complemented with demonstration of specific IgE (immune mechanism) and confirmed by an oral challenge.Co-factors such as exercise,medication,and alcohol may help trigger food allergy and further complicate accurate diagnosis.Where food extract-based diagnostic tests are poorly correlated to symptom severity,new generation molecular diagnostics that measure IgE against individual food allergens provide clinicians and patients with more reliable symptom severity risk profiles.Molecular diagnostics also support establishing whether food sensitization originates directly from exposure to food or indirectly (cross-reactivity) from pollen sensitization.Epidemiological surveys have indicated that allergy to peach primarily originates from peach consumption in Europe,whereas in China it is the result of primary sensitization to mugwort pollen,in both cases mediated by an allergen molecule from the same family.Epidemiological surveys give insight into the etiology of food allergy,the size of the problem (prevalence),and the risk factors involved,which together support evidence-based strategies for prevention.Over the past decade,food allergy has increased in the affluent world.Economic growth and urbanization in upcoming economies are likewise expected to lead to increased prevalence of food allergies,sometimes to different foods due to

  18. Definitely Life but not Definitively

    Science.gov (United States)

    Oliver, Joan D.; Perry, Randall S.

    2006-12-01

    Although there have been attempts at a definition of life from many disciplines, none is accepted by all as definitive. Some people believe that it is impossible to define ‘life’ adequately at the moment. We agree with this point of view on linguistic grounds, examining the different types of definition, the contexts in which they are used and their relative usefulness as aids to arriving at a scientific definition of life. We look at some of the more recent definitions and analyse them in the light of our criteria for a good definition. We argue that since there are so many linguistic and philosophical difficulties with such a definition of life, what is needed is a series of working descriptions, which are suited to the audience and context in which they are used and useful for the intended purpose. We provide some ideas and examples of the forms these may take.

  19. Discrepancy between presumptive and definite causes of chronic cough

    Institute of Scientific and Technical Information of China (English)

    YU Li; QIU Zhi-hong; WEI Wei-li; LIU Bo; XU Xiang-huai; L(U) Han-jing; QIU Zhong-min

    2011-01-01

    Background The current diagnostic algorithms for chronic cough require the establishment of the primary presumptive causes followed by the confirmation of diagnosis with the specific therapies.The aim of the study was to investigate the discrepancy between presumptive and definite causes and its clinical implication.Methods A total of 109 patients with chronic cough underwent laboratory investigations to identify the cause of cough; including sinus computerized tomography (if needed),histamine bronchial provocation,induced sputum cytology and 24-hour esophageal pH or multi-channel intraluminal impedance combined with pH monitoring.The presumptive causes were confirmed by treating them sequentially.The difference between presumptive and definite causes of chronic cough was compared.Results Single cause was more frequent in the definite diagnosis than in the presumptive diagnosis (78.9% vs.54.1%,x2=15.01,P=0.0001).In contrast,multiple causes were significantly fewer in definite diagnosis than in the presumptive diagnosis (15.6% vs.37.6%,x2=13.53,P=0.0002).There was a discrepancy between definite and presumptive causes in 30 patients (27.5%).Compared with the presumptive causes,definite upper airway cough syndrome (24.8% vs.11.9%,x2=6.0,P=0.01) and gastroesophageal reflux disease (6.4% vs.0,x2=7.23,P=0.007) was more frequent as a single cause of chronic cough while cough variant asthma plus gastroesophageal reflux disease (3.7% vs.11.9%,x2=5.17,P=0.02) and upper airway cough syndrome plus nonasthmatic eosinophilic bronchitis (0 vs.9.2%,x2=10.48,P=0.001) were fewer as multiple causes of chronic cough.Conclusions A discrepancy was common between presumptive and definite causes of chronic cough.To treat presumptive causes sequentially may be a suitable solution for avoidance of erroneous multiple causes and possible over-treatment.

  20. Pathways for Definitive Diagnosis of Solitary Pulmonary Nodule in France: A Multicentre Study in 18 French Districts%孤立性肺结节在法国的诊断:十八个法国社区医疗中心的多中心研究

    Institute of Scientific and Technical Information of China (English)

    申屠阳; 程华

    2009-01-01

    1文献来源Alzahouril K,Velten M,Arveux P,et al.Management of SPN in France.Pathways for definitive diagnosis of solitary pulmonary nodule:A multieentre study in 18 French districts[J].BMC Cancer,2008,8:93(http://www.biomedcentral.com/1471-2407/8/93).2证据水平2b。

  1. “医学无法解释症状”的界定:躯体化诊断的本土视角%Definition of“Medically Unexplained Symptoms”:A Chinese Perspective on Somatization Diagnosis

    Institute of Scientific and Technical Information of China (English)

    汪新建; 陈子晨

    2014-01-01

    Medically unexplained symptoms are functional somatic symptoms which cannot be reasona-bly explained by physiological causes of experimental medicine. They are also one of the core elements of the diagnostic criteria for identifying somatic psychological disorders like somatization. The defini-tion of medically unexplained symptoms and its history reflect the dualist division between general med-icine and psychiatry in the western medical system. From the Chinese perspective characterized by an integrated whole of body and mind and by the concept of holistic medicine,the dualist division of the medical sciences is not unavoidable. This difference constitutes one of the reasons why somatization di-agnosis is not applicable in China.%医学无法解释症状是指无法通过实验医学的生理性病因进行合理解释的功能性躯体症状,也是躯体化等躯体性心理障碍诊断标准的核心条件之一。医学无法解释症状的界定及其历史变迁反映了西方医学体系中普通医学和精神病学的二元分裂。而从本土身心合一和整体医学观的视角看,医学专科的二元分裂并不是天然存在的。这种差异也成为躯体化诊断在中国产生不适应性的原因之一。

  2. The definition and diagnosis of developmental prosopagnosia.

    Science.gov (United States)

    Bate, Sarah; Tree, Jeremy J

    2017-02-01

    Over the last 20 years much attention in the field of face recognition has been directed towards the study of developmental prosopagnosia (DP), with some authors investigating the behavioural characteristics of the condition, and many others using these individuals to further our theoretical understanding of the typical face-processing system. It is broadly agreed that the term "DP" refers to people who have failed to develop the ability to recognize faces in the absence of neurological illness or injury, yet more precise terminology in relation to potential subtypes of the population are yet to be confirmed. Furthermore, specific diagnostic techniques and inclusion and exclusion criteria have yet to be uniformly accepted across the field, making cross-paper comparisons and meta-analyses very difficult. This paper presents an overview of the current challenges that face research into DP and introduces a series of papers that attempt to further our understanding of the condition's characteristics. It is hoped that this special issue will provide a springboard for further research addressing these issues, improving the current state of the art by ensuring the quality of theoretical investigations into DP, and by posing advances that will assist those who have the condition.

  3. Punctal stenosis: definition, diagnosis, and treatment

    OpenAIRE

    Soiberman U; Kakizaki H; Selva D; Leibovitch I

    2012-01-01

    Uri Soiberman,1 Hirohiko Kakizaki,2 Dinesh Selva,3 Igal Leibovitch11Division of Oculoplastic and Orbital Surgery, Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel; 2Department of Ophthalmology, Aichi Medical University, Nagakute, Japan; 3South Australian Institute of Ophthalmology and Discipline of Ophthalmology and Visual Sciences, University of Adelaide, South Australia, AustraliaAbstract: Acquired punctal stenosis is a condition in which the exter...

  4. Stress fractures: definition, diagnosis and treatment☆

    Science.gov (United States)

    Astur, Diego Costa; Zanatta, Fernando; Arliani, Gustavo Gonçalves; Moraes, Eduardo Ramalho; Pochini, Alberto de Castro; Ejnisman, Benno

    2015-01-01

    Stress fractures were first described in Prussian soldiers by Breithaupt in 1855. They occur as the result of repeatedly making the same movement in a specific region, which can lead to fatigue and imbalance between osteoblast and osteoclast activity, thus favoring bone breakage. In addition, when a particular region of the body is used in the wrong way, a stress fracture can occur even without the occurrence of an excessive number of functional cycles. The objective of this study was to review the most relevant literature of recent years in order to add key information regarding this pathological condition, as an updating article on this topic. PMID:26962487

  5. [Chronic diarrhoea: Definition, classification and diagnosis].

    Science.gov (United States)

    Fernández-Bañares, Fernando; Accarino, Anna; Balboa, Agustín; Domènech, Eugeni; Esteve, Maria; Garcia-Planella, Esther; Guardiola, Jordi; Molero, Xavier; Rodríguez-Luna, Alba; Ruiz-Cerulla, Alexandra; Santos, Javier; Vaquero, Eva

    2016-10-01

    Chronic diarrhoea is a common presenting symptom in both primary care medicine and in specialized gastroenterology clinics. It is estimated that >5% of the population has chronic diarrhoea and nearly 40% of these patients are older than 60 years. Clinicians often need to select the best diagnostic approach to these patients and choose between the multiple diagnostic tests available. In 2014 the Catalan Society of Gastroenterology formed a working group with the main objective of creating diagnostic algorithms based on clinical practice and to evaluate diagnostic tests and the scientific evidence available for their use. The GRADE system was used to classify scientific evidence and strength of recommendations. The consensus document contains 28 recommendations and 6 diagnostic algorithms. The document also describes criteria for referral from primary to specialized care. Copyright © 2015 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

  6. Diabetes Part 1. Definition, Diagnosis and Prevention

    African Journals Online (AJOL)

    Skoludek_R

    Some population studies in Africa have suggested that type 1 diabetes is a rare condition. Sadly, this is ... mg/dl). Casual is defined as any time of day without regard to time since last meal. The .... Pregnancy. Pregnancy is another setting where patients not ... a pregnant woman has type 1 or type 2 diabetes which will, of.

  7. 50 CFR 300.201 - Definition.

    Science.gov (United States)

    2010-10-01

    ... Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED ACTIVITIES INTERNATIONAL FISHERIES REGULATIONS Definition of Illegal, Unreported, or Unregulated Fishing § 300.201 Definition. Illegal, unreported, or unregulated fishing means: (1) Fishing activities that violate conservation and management measures required...

  8. Definition and Facts for Irritable Bowel Syndrome

    Science.gov (United States)

    ... Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Definition & Facts for Irritable Bowel Syndrome What is IBS? ... physical and mental causes and isn’t a product of a person’s imagination. What are the four ...

  9. Feed tank transfer requirements

    Energy Technology Data Exchange (ETDEWEB)

    Freeman-Pollard, J.R.

    1998-09-16

    This document presents a definition of tank turnover; DOE responsibilities; TWRS DST permitting requirements; TWRS Authorization Basis (AB) requirements; TWRS AP Tank Farm operational requirements; unreviewed safety question (USQ) requirements; records and reporting requirements, and documentation which will require revision in support of transferring a DST in AP Tank Farm to a privatization contractor for use during Phase 1B.

  10. Achieving diagnosis by consensus

    LENUS (Irish Health Repository)

    Kane, Bridget

    2009-08-01

    This paper provides an analysis of the collaborative work conducted at a multidisciplinary medical team meeting, where a patient’s definitive diagnosis is agreed, by consensus. The features that distinguish this process of diagnostic work by consensus are examined in depth. The current use of technology to support this collaborative activity is described, and experienced deficiencies are identified. Emphasis is placed on the visual and perceptual difficulty for individual specialities in making interpretations, and on how, through collaboration in discussion, definitive diagnosis is actually achieved. The challenge for providing adequate support for the multidisciplinary team at their meeting is outlined, given the multifaceted nature of the setting, i.e. patient management, educational, organizational and social functions, that need to be satisfied.

  11. SeReM2--a meta-model for the structured definition of quality requirements for electronic health record services.

    Science.gov (United States)

    Hoerbst, Alexander; Hackl, Werner; Ammenwerth, Elske

    2010-01-01

    Quality assurance is a major task with regard to Electronic Health Records (EHR). Currently there are only a few approaches explicitly dealing with the quality of EHR services as a whole. The objective of this paper is to introduce a new Meta-Model to structure and describe quality requirements of EHRs. This approach should support the transnational quality certification of EHR services. The Model was developed based on interviews with 24 experts and a systematic literature search and comprises a service and requirements model. The service model represents the structure of a service whereas the requirements model can be used to assign specific predefined aims and requirements to a service. The new model differs from existing approaches as it accounts for modern software architectures and the special attributes of EHRs.

  12. Neuroretinitis -- definition

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007624.htm Neuroretinitis - definition To use the sharing features on this page, ... this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial ...

  13. Market Definition

    OpenAIRE

    Kaplow, Louis

    2014-01-01

    Market definition has long held a central place in competition law. This entry surveys recent analytical work that has called the market definition paradigm into question on a number of fronts: whether the process is feasible, whether market share threshold tests are coherent, whether the hypothetical monopolist test in merger guidelines is counterproductive, and whether and when the frequent focus on cross-elasticities is useful.

  14. Evolving Definitions of Mental Illness and Wellness

    OpenAIRE

    Tara W. Strine, MPH; Satvinder Dhingra, MPH; Lela R. McKnight-Eily, PhD; Carol D. Ryff, PhD; Elsie J. Freeman, MD, MPH; Ronald W. Manderscheid, PhD

    2010-01-01

    Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused definition of mental illnesses, and from an "absence of disease" model to one that stresses positive psychological function for mental health. Currently, wellness refers to the degree to which one feels positive and enthusiastic about oneself and life, whereas illness refers to the presence of disease. These definitions apply to ph...

  15. How many research nurses for how many clinical trials in an oncology setting? Definition of the Nursing Time Required by Clinical Trial-Assessment Tool (NTRCT-AT).

    Science.gov (United States)

    Milani, Alessandra; Mazzocco, Ketti; Stucchi, Sara; Magon, Giorgio; Pravettoni, Gabriella; Passoni, Claudia; Ciccarelli, Chiara; Tonali, Alessandra; Profeta, Teresa; Saiani, Luisa

    2017-02-01

    Few resources are available to quantify clinical trial-associated workload, needed to guide staffing and budgetary planning. The aim of the study is to describe a tool to measure clinical trials nurses' workload expressed in time spent to complete core activities. Clinical trials nurses drew up a list of nursing core activities, integrating results from literature searches with personal experience. The final 30 core activities were timed for each research nurse by an outside observer during daily practice in May and June 2014. Average times spent by nurses for each activity were calculated. The "Nursing Time Required by Clinical Trial-Assessment Tool" was created as an electronic sheet that combines the average times per specified activities and mathematic functions to return the total estimated time required by a research nurse for each specific trial. The tool was tested retrospectively on 141 clinical trials. The increasing complexity of clinical research requires structured approaches to determine workforce requirements. This study provides a tool to describe the activities of a clinical trials nurse and to estimate the associated time required to deliver individual trials. The application of the proposed tool in clinical research practice could provide a consistent structure for clinical trials nursing workload estimation internationally.

  16. Conforming STOP Violence Against Women Formula Grant Program Regulations to Statutory Change; Definitions and Confidentiality Requirements Applicable to All OVW Grant Programs. Final rule.

    Science.gov (United States)

    2016-11-29

    This rule amends the regulations for the STOP (ServicesTrainingOfficersProsecutors) Violence Against Women Formula Grant Program (STOP Program) and the general provisions governing Office on Violence Against Women (OVW) programs to comply with statutory changes and reduce repetition of statutory language. Also, this rule implements statutory requirements for nondisclosure of confidential or private information relating to all OVW grant programs.

  17. Common definition for categories of clinical research: a prerequisite for a survey on regulatory requirements by the European Clinical Research Infrastructures Network (ECRIN)

    DEFF Research Database (Denmark)

    Kubiak, Christine; de Andres-Trelles, Fernando; Kuchinke, Wolfgang

    2009-01-01

    BACKGROUND: Thorough knowledge of the regulatory requirements is a challenging prerequisite for conducting multinational clinical studies in Europe given their complexity and heterogeneity in regulation and perception across the EU member states. METHODS: In order to summarise the current situation...... with cell therapy, etc.); diagnostic studies; clinical research on nutrition; other interventional clinical research (including trials in complementary and alternative medicine, trials with collection of blood or tissue samples, physiology studies, etc.); and epidemiology studies. Our classification...

  18. Power Extension Package (PEP) system definition extension, orbital service module systems analysis study. Volume 7: PEP logistics and training plan requirements

    Science.gov (United States)

    1979-01-01

    Recommendations for logistics activities and logistics planning are presented based on the assumption that a system prime contractor will perform logistics functions to support all program hardware and will implement a logistics system to include the planning and provision of products and services to assure cost effective coverage of the following: maintainability; maintenance; spares and supply support; fuels; pressurants and fluids; operations and maintenance documentation training; preservation, packaging and packing; transportation and handling; storage; and logistics management information reporting. The training courses, manpower, materials, and training aids required will be identified and implemented in a training program.

  19. Reviewing the definition of crisis in dementia care

    Directory of Open Access Journals (Sweden)

    Vroomen Janet MacNeil

    2013-02-01

    Full Text Available Abstract Background Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice. Methods We systematically searched for articles containing definitions of crisis in the context of dementia care. We created an operational framework of crisis based on retrieved definitions. Recommendations to address crisis situations were reviewed and classified according to care settings. Results Abstracts and titles of 1,113 articles, screened from PubMed and EMBASE, were narrowed down to 27 articles. After review, crisis in dementia was defined as a process where a stressor causes an imbalance requiring an immediate decision to be made which leads to a desired outcome and therefore a resolution of the crisis. If the crisis is not resolved, the cycle continues. Recommendations for resolving crisis involving persons with dementia and their caregivers include awareness therapy after diagnosis and increased contact with general practitioners, case manager consultations, caregiver support and education. Furthermore, nursing home staff should be attuned to the environmental, physical and psychological needs of persons with dementia. Conclusions This is the first article to review the definition of crisis in the context of dementia care. A review of the literature indicated that the definition of a crisis is idiosyncratic. Therefore, it is difficult to prevent or plan for all crises. We used an operational framework to compile types of crisis stressors and recommendations from the crisis literature based on three different perspectives; the person with the dementia, the caregiver and the healthcare providers.

  20. 50 CFR 91.2 - Definitions.

    Science.gov (United States)

    2010-10-01

    ...) MISCELLANEOUS PROVISIONS MIGRATORY BIRD HUNTING AND CONSERVATION STAMP CONTEST Introduction § 91.2 Definitions... submitted to the contest that satisfies the requirements outlined in subpart B. Reproduction...

  1. Repetitive Delay in Diagnosis of Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    Zahra Nikyar

    2011-12-01

    Full Text Available Objective: Although ventricular septal defect (VSD is the most common congenital heart disease, it is usually diagnosed late. The presentation of the disease is variable; sometimes it is so quiet and silent that might even improve and heal spontaneously, and in some certain cases if the appropriate, on time and early treatment is not done, this would lead to irreparable complications and mortality even in the early life period. This study reviews the diagnostic process, treatment and follow-up of the patients. It is hoped that the results of the present study be used to improve the patients' condition.Methods: This was a cross-sectional study done on 145 patients with VSD during 54 months in Isfahan. The disease was identified through color Doppler echocardiogram, cardiac catheterization and angiography if necessary. The required data were collected at the time of definite diagnosis.Findings: Mean age at initial and definite diagnosis of the disease was 17 months and 44 months, respectively. Heart murmur led to initial diagnosis in 85% of the cases. In 27.5% VSD was associated with other cardiac anomalies. Pulmonary artery hypertension existed in 16.5% of the cases. Fifty nine surgeries were performed on 40 patients.Conclusion: In routine physical examination of the infants, the probability of heart disease should be considered; conducting echocardiogram in suspected cases would lead to early diagnosis and eventually timely treatment. Appropriate follow-up of the patients will provide optimal care and treatment at proper time.

  2. Definition of the minimal requirements within the human beta-globin gene and the dominant control region for high level expression.

    Science.gov (United States)

    Collis, P; Antoniou, M; Grosveld, F

    1990-01-01

    The human beta-globin dominant control region (DCR) was previously identified as a region from the 5' end of the human beta-globin locus which directs high level, site of integration-independent, copy number-dependent expression on a linked human beta-globin gene in transgenic mice and stably transfected mouse erythroleukaemia (MEL) cells. We have now analysed the elements comprising the DCR by systematic deletion mutagenesis in stable MEL transfectants. We have identified two independent elements within the DNase I hypersensitive sites 2 and 3, containing fragments which direct strong transcriptional inducibility of a beta-globin gene. Whilst the remaining two hypersensitive sites do not direct significant transcriptional induction, our data suggest that all four sites may be necessary for the fully regulated expression conferred by the DCR. We have also tested a number of beta-globin minigene constructs under the control of the DCR to assess if any of the local sequences from the gene may be removed without loss of expression. We find that the 3' enhancer may be removed without affecting expression, but there is an absolute requirement for the presence of the second intron, not related to the enhancer present in that intron. Images Fig. 2. Fig. 3. Fig. 4. Fig. 5. PMID:2295312

  3. Care ethics for guiding the process of multiple sclerosis diagnosis.

    Science.gov (United States)

    Krahn, Timothy Mark

    2014-12-01

    Multiple sclerosis (MS) is a chronic neurological disorder for which there is no definitive diagnostic test. Uncertainty characterises most of its features with diagnosis reached through a process of elimination. Coping with uncertainty has been recognised as a significant problem for MS patients. Discussions in the literature concerning the ethics of MS diagnosis have focused on an ethics of duty emphasising the rules for disclosure and healthcare professionals' obligations to provide information to patients. This narrow construal of the ethics at stake with MS diagnosis may be driven by a common misperception that diagnosis is an event, or series of events, rather than a process. Scant attention has been given to the dynamic, situated relational space between patient and physician as they journey potentially together (or apart) through the process of diagnosis. The healthcare provider cannot properly judge 'the how, what and when' of MS disclosure merely by applying rules pertaining to general professional duties to tell the truth and patients' rights to know their medical status. Proper disclosure and effective communication require the practice of flexible, caring responsibility and sustained, ongoing attention to the particular relational needs of 'this' patient in her own situational context. Accordingly, this article argues that care ethics is especially useful (but not without certain limitations) for attending to a broader swath of responsibilities (different from minimal duties) and affective components implicated in meeting patients' overall needs for care as the patient and physician cope with uncertainty through the process of establishing an MS diagnosis.

  4. 78 FR 78386 - Agency Information Collection Activities; Submission for OMB Review; Comment Request: Definition...

    Science.gov (United States)

    2013-12-26

    ... Administration (OSHA) sponsored information collection request (ICR) revision titled, ``Definition and...: Definition and Requirements for a Nationally Recognized Testing Laboratory ACTION: Notice. SUMMARY: On... specified in regulations 29 CFR 1910.7, Definition and Requirements for a Nationally Recognized...

  5. The Large Phenotypic Spectrum of Fabry Disease Requires Graduated Diagnosis and Personalized Therapy: A Meta-Analysis Can Help to Differentiate Missense Mutations

    Directory of Open Access Journals (Sweden)

    Valentina Citro

    2016-12-01

    Full Text Available Fabry disease is caused by mutations in the GLA gene and is characterized by a large genotypic and phenotypic spectrum. Missense mutations pose a special problem for graduating diagnosis and choosing a cost-effective therapy. Some mutants retain enzymatic activity, but are less stable than the wild type protein. These mutants can be stabilized by small molecules which are defined as pharmacological chaperones. The first chaperone to reach clinical trial is 1-deoxygalactonojirimycin, but others have been tested in vitro. Residual activity of GLA mutants has been measured in the presence or absence of pharmacological chaperones by several authors. Data obtained from transfected cells correlate with those obtained in cells derived from patients, regardless of whether 1-deoxygalactonojirimycin was present or not. The extent to which missense mutations respond to 1-deoxygalactonojirimycin is variable and a reference table of the results obtained by independent groups that is provided with this paper can facilitate the choice of eligible patients. A review of other pharmacological chaperones is provided as well. Frequent mutations can have residual activity as low as one-fourth of normal enzyme in vitro. The reference table with residual activity of the mutants facilitates the identification of non-pathological variants.

  6. The Large Phenotypic Spectrum of Fabry Disease Requires Graduated Diagnosis and Personalized Therapy: A Meta-Analysis Can Help to Differentiate Missense Mutations

    Science.gov (United States)

    Citro, Valentina; Cammisa, Marco; Liguori, Ludovica; Cimmaruta, Chiara; Lukas, Jan; Cubellis, Maria Vittoria; Andreotti, Giuseppina

    2016-01-01

    Fabry disease is caused by mutations in the GLA gene and is characterized by a large genotypic and phenotypic spectrum. Missense mutations pose a special problem for graduating diagnosis and choosing a cost-effective therapy. Some mutants retain enzymatic activity, but are less stable than the wild type protein. These mutants can be stabilized by small molecules which are defined as pharmacological chaperones. The first chaperone to reach clinical trial is 1-deoxygalactonojirimycin, but others have been tested in vitro. Residual activity of GLA mutants has been measured in the presence or absence of pharmacological chaperones by several authors. Data obtained from transfected cells correlate with those obtained in cells derived from patients, regardless of whether 1-deoxygalactonojirimycin was present or not. The extent to which missense mutations respond to 1-deoxygalactonojirimycin is variable and a reference table of the results obtained by independent groups that is provided with this paper can facilitate the choice of eligible patients. A review of other pharmacological chaperones is provided as well. Frequent mutations can have residual activity as low as one-fourth of normal enzyme in vitro. The reference table with residual activity of the mutants facilitates the identification of non-pathological variants. PMID:27916943

  7. Diagnosis of Clostridium difficile

    DEFF Research Database (Denmark)

    Jensen, M B F; Olsen, K E P; Nielsen, X C;

    2015-01-01

    The diagnosis of Clostridium difficile infection (CDI) requires the detection of toxigenic C. difficile or its toxins and a clinical assessment. We evaluated the performance of four nucleic acid amplification tests (NAATs) detecting toxigenic C. difficile directly from faeces compared to routine...... of PCR ribotypes 066 and 078. Furthermore, the presence of the PCR enhancer bovine serum albumin (BSA) was found to be related to high sensitivity and low inhibition rate. Rapid laboratory diagnosis of toxigenic C. difficile by RT PCR was accurate....

  8. Peritoneal tuberculosis: radiographic diagnosis

    Directory of Open Access Journals (Sweden)

    Carolina Ospina-Moreno

    2014-12-01

    Full Text Available Peritoneal tuberculosis (TB is an extrapulmonary form of presentation of tuberculosis. HIV infection is a primary risk factor for this condition. Diagnosis requires microbiological or histopathological confirmation in addition to supporting radiological imaging studies. Abdominal ultrasonography and CT are useful to obtain a radiographic diagnosis, with typical findings including diffuse peritoneal thickening, presence of ascites in varying volumes, adenopathies, and caseating nodes. We report 2 cases of patients with ascites and nodular peritoneal thickening on diagnostic images, as well as high CA-125 levels in laboratory tests. In both patients, a diagnosis of peritoneal tuberculosis was reached following a US-guided peritoneal biopsy.

  9. [Diagnosis of tuberous sclerosis complex].

    Science.gov (United States)

    Belousova, E D; Dorofeeva, M Yu; Pivovarova, A M; Katusheva, O V

    2015-01-01

    Tuberous sclerosis complex is a autosomal dominant instantly progressing disease, causing the development of benign tumors in all organs and tissues of human body. According to International Consensus Conference (2012), definite or possible TSC diagnosis can be made. For the definite diagnosis of TSC, two major criteria or one major criterion and ≥2 minor criteria have to be present. For a possible diagnosis, 1 major criterion or ≥2 minor criteria should be found. A pathogenic mutation in the TSC1 or TSC2 gene is by itself sufficient for a definite diagnosis. There are following major diagnostic criteria: angiofibromas (≥3) or forehead plaque; hypomelanotic macules (≥3); ungual fibromas (≥2); chagrin patch; multiple retinal hamartomas; cortical dysplasias (≥3, include tubers and cerebral white matter radial migration lines; subependymal nodules; subependymal giant cell astrocytoma; cardiac rhabdomyoma; lymphagioleiomatosis and renal angiomyolipomas (≥2). The minor criteria are the following ones: dental enamel pits (≥3); intraoral fibromas (≥2); non-renal hamartomas; retinal achromatic patch; confetti skin lesions; multiple renal cysts. Diagnosis of TSC is not difficult if a physician is familiar with clinical presentation of the disease.

  10. Approximations in diagnosis: motivations and techniques

    NARCIS (Netherlands)

    Harmelen, van F.A.H.; Teije, A. ten

    1995-01-01

    We argue that diagnosis should not be seen as solving a problem with a unique definition, but rather that there exists a whole space of reasonable notions of diagnosis. These notions can be seen as mutual approximations. We present a number of reasons for choosing among different notions of diagnos

  11. Approximations in diagnosis: motivations and techniques

    NARCIS (Netherlands)

    Harmelen, van F.A.H.; Teije, A. ten

    1995-01-01

    We argue that diagnosis should not be seen as solving a problem with a unique definition, but rather that there exists a whole space of reasonable notions of diagnosis. These notions can be seen as mutual approximations. We present a number of reasons for choosing among different notions of

  12. Delayed Diagnosis of Gastric Outlet Obstruction from Bouveret Syndrome in a Young Woman

    Directory of Open Access Journals (Sweden)

    Smith, Zachary

    2014-11-01

    Full Text Available Bouveret syndrome is a rare presentation of gastric outlet obstruction caused by a gallstone in the proximal duodenum via a bilioenteric fistula. This is an infrequent although clinically significant cause of abdominal pain, almost exclusively in the elderly. The clinical presentation is similar to that of a small bowel obstruction with abdominal pain, nausea and vomiting. Surgery or endoscopy is often required for definitive diagnosis and therapy. We describe the case of a young woman with this condition who had a delayed diagnosis in part because of her age and the rarity of the condition. [West J Emerg Med. 2015;16(1:151-153.

  13. Underestimated Rate of Status Epilepticus according to the Traditional Definition of Status Epilepticus

    Directory of Open Access Journals (Sweden)

    Cheung-Ter Ong

    2015-01-01

    Full Text Available Purpose. Status epilepticus (SE is an important neurological emergency. Early diagnosis could improve outcomes. Traditionally, SE is defined as seizures lasting at least 30 min or repeated seizures over 30 min without recovery of consciousness. Some specialists argued that the duration of seizures qualifying as SE should be shorter and the operational definition of SE was suggested. It is unclear whether physicians follow the operational definition. The objective of this study was to investigate whether the incidence of SE was underestimated and to investigate the underestimate rate. Methods. This retrospective study evaluates the difference in diagnosis of SE between operational definition and traditional definition of status epilepticus. Between July 1, 2012, and June 30, 2014, patients discharged with ICD-9 codes for epilepsy (345.X in Chia-Yi Christian Hospital were included in the study. A seizure lasting at least 30 min or repeated seizures over 30 min without recovery of consciousness were considered SE according to the traditional definition of SE (TDSE. A seizure lasting between 5 and 30 min was considered SE according to the operational definition of SE (ODSE; it was defined as underestimated status epilepticus (UESE. Results. During a 2-year period, there were 256 episodes of seizures requiring hospital admission. Among the 256 episodes, 99 episodes lasted longer than 5 min, out of which 61 (61.6% episodes persisted over 30 min (TDSE and 38 (38.4% episodes continued between 5 and 30 min (UESE. In the 38 episodes of seizure lasting 5 to 30 minutes, only one episode was previously discharged as SE (ICD-9-CM 345.3. Conclusion. We underestimated 37.4% of SE. Continuing education regarding the diagnosis and treatment of epilepsy is important for physicians.

  14. Feed tank transfer requirements

    Energy Technology Data Exchange (ETDEWEB)

    Freeman-Pollard, J.R.

    1998-09-16

    This document presents a definition of tank turnover. Also, DOE and PC responsibilities; TWRS DST permitting requirements; TWRS Authorization Basis (AB) requirements; TWRS AP Tank Farm operational requirements; unreviewed safety question (USQ) requirements are presented for two cases (i.e., tank modifications occurring before tank turnover and tank modification occurring after tank turnover). Finally, records and reporting requirements, and documentation which will require revision in support of transferring a DST in AP Tank Farm to a privatization contractor are presented.

  15. 42 CFR 435.540 - Definition of disability.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Definition of disability. 435.540 Section 435.540... ISLANDS, AND AMERICAN SAMOA Categorical Requirements for Eligibility Disability § 435.540 Definition of disability. (a) Definition. The agency must use the same definition of disability as used under SSI, except...

  16. 42 CFR 436.540 - Definition of disability.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Definition of disability. 436.540 Section 436.540... Requirements for Medicaid Eligibility Disability § 436.540 Definition of disability. (a) Definition. The agency must use the definition of permanent and total disability that is used in the State plan for APTD or...

  17. Herpetic esophagitis: a diagnosis to remember

    Directory of Open Access Journals (Sweden)

    Marina Pinheiro

    2016-02-01

    Full Text Available Introduction: Herpetic esophagitis is a well-recognized infection in immunocompromised hosts, having been rarely described in immunocompetent individuals. Case report: The authors describe a case of a 16-year-old female adolescent admitted to the emergency room with a threeday history of fever, odynophagia, dysphagia for liquid and solid food and retrosternal pain. The upper endoscopy revealed linear and round erosions in the distal esophagus and the histologic findings were compatible with herpetic esophagitis. Discussion/conclusion: Herpetic esophagitis is an underdiagnosed condition in immunocompetent children and adolescents, but it should not be overlooked. An esophagoscopy is required to make a definitive diagnosis. It is usually a selflimited infection and the mainstay of treatment is supportive care. The use of acyclovir is still controversial but its early initiation may shorten the clinical course of the disease.

  18. Successes and challenges: clarity of definition required.

    Science.gov (United States)

    Peachey, David K

    2013-01-01

    In the lead paper, Tomblin Murphy and MacKenzie advocate the application of population health needs in the planning and delivery of clinical services across Canadian healthcare systems. The authors are correct in urging the minimal use, if not abandonment, of legacy demand data as a relevant predictor for advancing a more effective and sustainable healthcare system. The primary challenge for a reader of their paper is the confusion of terminology and a resulting dissonance among the title, the abstract and the content. Expectations created by the title are not attained due to the unfortunate interchangeability of key phrases and the propriety of the case studies selected as examples. This commentary focuses on the choice of language and concerns of secondary uncertainty between "needs" and process management; this is framed by a brief review of terminology and the principles that underpin needs-based models.

  19. Requirements Definition for ORNL Trusted Corridors Project

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Randy M [ORNL; Hill, David E [ORNL; Smith, Cyrus M [ORNL; DeNap, Frank A [ORNL; White, James D [ORNL; Gross, Ian G [ORNL; Gorman, Bryan L [ORNL; Hively, Lee M [ORNL; Abercrombie, Robert K [ORNL

    2008-02-01

    The ORNL Trusted Corridors Project has several other names: SensorNet Transportation Pilot; Identification and Monitoring of Radiation (in commerce) Shipments (IMR(ic)S); and Southeastern Transportation Corridor Pilot (SETCP). The project involves acquisition and analysis of transportation data at two mobile and three fixed inspection stations in five states (Kentucky, Mississippi, South Carolina, Tennessee, and Washington DC). Collaborators include the State Police organizations that are responsible for highway safety, law enforcement, and incident response. The three states with fixed weigh-station deployments (KY, SC, TN) are interested in coordination of this effort for highway safety, law enforcement, and sorting/targeting/interdiction of potentially non-compliant vehicles/persons/cargo. The Domestic Nuclear Detection Office (DNDO) in the U.S. Department of Homeland Security (DHS) is interested in these deployments, as a Pilot test (SETCP) to identify Improvised Nuclear Devices (INDs) in highway transport. However, the level of DNDO integration among these state deployments is presently uncertain. Moreover, DHS issues are considered secondary by the states, which perceive this work as an opportunity to leverage these (new) dual-use technologies for state needs. In addition, present experience shows that radiation detectors alone cannot detect DHS-identified IND threats. Continued SETCP success depends on the level of integration of current state/local police operations with the new DHS task of detecting IND threats, in addition to emergency preparedness and homeland security. This document describes the enabling components for continued SETCP development and success, including: sensors and their use at existing deployments (Section 1); personnel training (Section 2); concept of operations (Section 3); knowledge discovery from the copious data (Section 4); smart data collection, integration and database development, advanced algorithms for multiple sensors, and network communications (Section 5); and harmonization of local, state, and Federal procedures and protocols (Section 6).

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

    Science.gov (United States)

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

    2014-03-01

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

  1. From diagnosis to social diagnosis.

    Science.gov (United States)

    Brown, Phil; Lyson, Mercedes; Jenkins, Tania

    2011-09-01

    In the past two decades, research on the sociology of diagnosis has attained considerable influence within medical sociology. Analyzing the process and factors that contribute to making a diagnosis amidst uncertainty and contestation, as well as the diagnostic encounter itself, are topics rich for sociological investigation. This paper provides a reformulation of the sociology of diagnosis by proposing the concept of 'social diagnosis' which helps us recognize the interplay between larger social structures and individual or community illness manifestations. By outlining a conceptual frame, exploring how social scientists, medical professionals and laypeople contribute to social diagnosis, and providing a case study of how the North American Mohawk Akwesasne reservation dealt with rising obesity prevalence to further illustrate the social diagnosis idea, we embark on developing a cohesive and updated framework for a sociology of diagnosis. This approach is useful not just for sociological research, but has direct implications for the fields of medicine and public health. Approaching diagnosis from this integrated perspective potentially provides a broader context for practitioners and researchers to understand extra-medical factors, which in turn has consequences for patient care and health outcomes.

  2. Autism: Diagnosis

    Science.gov (United States)

    ... history and input from parents, caregivers and/or teachers are important components of an accurate diagnosis. An educational determination is made by a multidisciplinary evaluation team of various school professionals. The evaluation results ...

  3. GENERAL DIAGNOSIS

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    2006133 Value of 18F-FDG dual-head coincidence imaging in the diagnosis of recurrent and metastatic oesophageal carcinoma. ZHANG Chun (张春), et al. Dept Nucl Med,Beijing Chaoyang Hosp,Capital Med Sci Univ,Beijing 100020. Chin J Nucl Med 2006;26(1):34-36. Objective:To explore the value of 18 F-fluorodeoxyglu-cose (FDG) dual-head coinci dence imaging in the diagnosis of recurrent and metastatic oesophageal carcinoma.

  4. A Metastatic Ovarian Angiosarcoma Mimicking Hematologic Neoplasia at Diagnosis

    Directory of Open Access Journals (Sweden)

    Rafael Dezen Gaiolla

    2014-04-01

    Full Text Available Angiosarcomas are rare aggressive neoplasms of vascular endothelial origin with a high metastatic rate and poor prognosis. Involvement of the bone marrow by the angiosarcoma is exceedingly uncommon, and there have only been a few cases reported in the literature to date. Clinical manifestations and common laboratory findings of bone marrow involvement can mimic other more common bone marrow-replacing neoplasias such as lymphomas and acute leukemia. A definitive diagnosis is difficult to make from cytologic material, probably due to an associated bone marrow fibrosis, and requires bone marrow trephine biopsy with an immunohistochemical profile. Here we had the opportunity to study a case of metastatic angiosarcoma with positive cytologic findings and an unusual presentation that challenged its primary diagnosis.

  5. Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound.

    Science.gov (United States)

    Liu, Roy; Adler, Douglas G

    2014-07-01

    Gastrointestinal tract duplication cysts are rare congenital gastrointestinal malformation in young patients and adults. They consist of foregut duplication cysts, small bowel duplication cysts, and large bowel duplication cysts. Endoscopic ultrasound (EUS) has been widely used as a modality for the evaluation and diagnosis of duplication cysts. EUS is the diagnostic tool of choice to investigate duplication cysts since it can distinguish between solid and cystic lesions. The question of whether or not to perform EUS-fine needle aspiration (EUS-FNA) on a lesion suspected of being a duplication cyst is controversial as these lesions can become infected with significant consequences, although EUS-FNA is often required to obtain a definitive diagnosis and to rule out more ominous lesions. This manuscript will review the literature on duplication cysts throughout the body and will also focus on the role of EUS and FNA with regards to these lesions.

  6. A Metastatic Ovarian Angiosarcoma Mimicking Hematologic Neoplasia at Diagnosis

    Science.gov (United States)

    Gaiolla, Rafael Dezen; Duarte, Ívison Xavier; Bacchi, Carlos Eduardo; Paiva, Carlos Eduardo

    2014-01-01

    Angiosarcomas are rare aggressive neoplasms of vascular endothelial origin with a high metastatic rate and poor prognosis. Involvement of the bone marrow by the angiosarcoma is exceedingly uncommon, and there have only been a few cases reported in the literature to date. Clinical manifestations and common laboratory findings of bone marrow involvement can mimic other more common bone marrow-replacing neoplasias such as lymphomas and acute leukemia. A definitive diagnosis is difficult to make from cytologic material, probably due to an associated bone marrow fibrosis, and requires bone marrow trephine biopsy with an immunohistochemical profile. Here we had the opportunity to study a case of metastatic angiosarcoma with positive cytologic findings and an unusual presentation that challenged its primary diagnosis. PMID:24847252

  7. Testing agile requirements models

    Institute of Scientific and Technical Information of China (English)

    BOTASCHANJAN Jewgenij; PISTER Markus; RUMPE Bernhard

    2004-01-01

    This paper discusses a model-based approach to validate software requirements in agile development processes by simulation and in particular automated testing. The use of models as central development artifact needs to be added to the portfolio of software engineering techniques, to further increase efficiency and flexibility of the development beginning already early in the requirements definition phase. Testing requirements are some of the most important techniques to give feedback and to increase the quality of the result. Therefore testing of artifacts should be introduced as early as possible, even in the requirements definition phase.

  8. Revisiting Narcolepsy: The Practical Diagnosis and Mythology

    Directory of Open Access Journals (Sweden)

    Vernon M Neppe

    2016-02-01

    Full Text Available Narcolepsy is a chronic neurological condition with impairments of the sleep-wake cycle. Narcolepsy manifests with four symptoms, the socalled classical tetrad: a Episodic irrepressible uncontrollable Day-Time Sleepiness (DTS is the key feature, and b Abnormal bilateral episodes of muscle tone loss with clear consciousness (cataplexy make the diagnosis definitive. Common but not necessarily required symptoms are c Sleep onset distortions (hypnagogic hallucinations, and d Awareness of being paralyzed when waking during the night (sleep paralysis. a This series of articles focuses on the areas where the mythology may need to be broken and where limitations may not necessarily be recognized. This article has several parts, each interrelated yet independent. As with all publications, information such as this must be considered only after consultation with physicians and any medical information recorded here should not substitute for such consultations. Diplopia and nocturnal insomnia are two other often ignored common symptoms. The classical standard narcolepsy research criteria confirming a narcolepsy diagnosis consist of either a positive multiple sleep-latency tests (MSLT, or an abnormally low cerebrospinal fluid (CSF Orexin (hypocretin level. I focus on some controversies: a First, the genes for narcolepsy have been largely ignored when applying the recognized criteria for diagnosing narcolepsy. These genes include particularly DQB1*0602. However, the DQA1*0102 gene should also be measured. b Secondly, the multiple sleep-latency test (MSLT may be overemphasized for definitive diagnosis, because the genetic test is as important or even more relevant. This is pertinent because, in the USA, insurance approval of costly medications such as modafinil, armodafinil and sodium oxybate are often dependent on the insurances applying a positive MSLT as a requirement; when it is negative, the insurances might tragically deny coverage of these medications

  9. Early definition of type, degree and audiogram shape in childhood hearing impairment

    National Research Council Canada - National Science Library

    Conti, G; Gallus, R; Fetoni, A R; Martina, B M; Muzzi, E; Orzan, E; Bastanza, G

    2016-01-01

    .... Audiological diagnosis consists schematically of three phases: identification of subjects at risk, definition of hearing loss and/or children features, verification of appropriateness of diagnosis itself and a rehabilitation programme...

  10. Diagnosis of acute neuropathies

    DEFF Research Database (Denmark)

    Crone, Clarissa; Krarup, Christian

    2007-01-01

    Acute and subacute polyneuropathies present diagnostic challenges since many require prompt initiation of treatment in order to limit axonal degeneration and since an exact and detailed diagnosis is a prerequisite for making the correct choice of treatment. It is for instance of utmost importance...... to recognize whether the underlying pathological changes are due to demyelination or to axonal degeneration and electrodiagnostic tests can thus in most cases contribute considerably to the securing of an exact diagnosis. The specific and characteristic electrophysiological findings in the different types...

  11. Radiological diagnosis of aggressive fibromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Wiesmann, W.; Galanski, M.; Peters, P.E.; Timm, C.

    1986-11-01

    Aggressive fibromatosis (desmoid, desmoid tumour) resembles, in its infiltrating and destructive growth, a fibrosarcoma, but does not metastasise. Because of its high recurrence rate, the tumour remains a surgical problem. Various imaging methods were evaluated retrospectively in 23 patients with histologically confirmed aggressive fibromatosis. Conventional radiological procedures are poor at demonstrating the extent and type of tumour. Modern tomographic methods are more able to determine the size of the lesion and a combination of angiography and CT can frequently provide a definite diagnosis.

  12. Neurofibromatoses: part 1 ? diagnosis and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Luiz Oswaldo Carneiro Rodrigues

    2014-03-01

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

  13. [Molecular diagnosis of melanocytic tumors].

    Science.gov (United States)

    Bauer, J

    2016-01-01

    Melanoma therapy has undergone a paradigm shift. Classic chemotherapies with poor treatment responses have been replaced by modern immune checkpoint blockades and targeted therapies with excellent responses. The latter require precise diagnosis of mutations in the melanoma genome as molecular targets for the small molecules. The diagnosis of melanomas has also been supplemented by molecular techniques. Differential diagnosis of melanoma and melanoma simulators such as atypical Spitz nevi can be supported by fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH). Here we review the indications and methods for molecular diagnosis of melanocytic tumors.

  14. Dual diagnosis

    OpenAIRE

    2013-01-01

    Dual diagnosis denotes intertwining of intellectual disabilities with mental disorders. With the help of systematic examination of literature, intellectual disabilities are determined (they are characterized by subaverage intellectual activity and difficulties in adaptive skills), along side mental disorders. Their influence is seen in changes of thinking, perception, emotionality, behaviour and cognition. Mental disorders often occur with people with intellectual disabilities (data differs f...

  15. 10 CFR 51.14 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... FUNCTIONS National Environmental Policy Act-Regulations Implementing Section 102(2) § 51.14 Definitions. (a... 10 Energy 2 2010-01-01 2010-01-01 false Definitions. 51.14 Section 51.14 Energy NUCLEAR REGULATORY.... Environmental Impact Statement means a detailed written statement as required by section 102(2)(C) of...

  16. 45 CFR 160.103 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... care, and counseling, service, assessment, or procedure with respect to the physical or mental... 45 Public Welfare 1 2010-10-01 2010-10-01 false Definitions. 160.103 Section 160.103 Public... GENERAL ADMINISTRATIVE REQUIREMENTS General Provisions § 160.103 Definitions. Except as otherwise...

  17. 48 CFR 408.701 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Definitions. 408.701... ACQUISITION PLANNING REQUIRED SOURCES OF SUPPLIES AND SERVICES Acquisition From Nonprofit Agencies Employing People Who Are Blind or Severely Disabled 408.701 Definitions. Committee Member is the...

  18. 48 CFR 27.301 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Definitions. 27.301... REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Patent Rights under Government Contracts 27.301 Definitions. As used in this subpart— Invention means any invention or discovery that is or may be patentable or...

  19. 7 CFR 550.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Definitions. 550.2 Section 550.2 Agriculture... Definitions. Accrued expenditures means the charges incurred by the Cooperator during a given period requiring... participating Federal agencies with the technology to electronically manage extramural invention portfolios...

  20. 48 CFR 8.1101 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Definitions. 8.1101 Section 8.1101 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION ACQUISITION PLANNING REQUIRED SOURCES OF SUPPLIES AND SERVICES Leasing of Motor Vehicles 8.1101 Definitions. As used in this subpart— Leasing, means the acquisition...

  1. 28 CFR 905.1 - Definition.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Definition. 905.1 Section 905.1 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL NATIONAL FINGERPRINT FILE (NFF) PROGRAM QUALIFICATION REQUIREMENTS § 905.1 Definition. “National Fingerprint File” means a database of fingerprints,...

  2. Cryogenic fluid management program flight concept definition

    Science.gov (United States)

    Kroeger, Erich

    1987-01-01

    The Lewis Research Center's cryogenic fluid management program flight concept definition is presented in viewgraph form. Diagrams are given of the cryogenic fluid management subpallet and its configuration with the Delta launch vehicle. Information is given in outline form on feasibility studies, requirements definition, and flight experiments design.

  3. Second opinion and discrepancy in the diagnosis of soft tissue lesions at surgical pathology

    Directory of Open Access Journals (Sweden)

    Sharif Muhammad

    2010-07-01

    Full Text Available Objective: To determine the frequency and magnitude of discrepancies in the surgical pathological diagnosis of soft tissue lesions on review and second opinion in a histopathology center. Study Design: Cross-sectional, observational. Place and Duration of Study: Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, from April 2006 to May 2007. Materials and Methods: All the cases of soft tissue as well as bone lesions, irrespective of age and gender, which were referred for second opinion or review after being reported elsewhere, were included in the study. A panel of antibodies of soft tissue, epithelial and lymphoid markers was applied according to the requirements of each case. The cases were categorized as category A where there was concurrence between initial diagnosis and diagnosis at review. Category B included cases where there was disagreement in the specific diagnostic entity as per WHO classifications without therapeutic implications. Category C was cases where the category of benign or malignant diagnosis remained the same but there was disagreement in the specific diagnosis with definite therapeutic implications. Category D had diagnosis of benign changed to malignant while category E had cases where diagnosis of malignancy was changed to a benign lesion. Results: During the study period, 34 cases of soft tissue lesions were received for review and second opinion. The mean age of the patients was 39 ΁ 22 years and immunohistochemistry was performed in 21 (62% of 34 cases. Concurrence between the review and initial diagnosis was seen in 18 (53% cases (category A. Discrepancy in the diagnosis at review and initial consultation was seen in 16 (47% cases. There were four (11.8% cases that were placed in category B as the diagnosis of benign and malignant remained the same but the specific diagnostic entity was changed. Category C included eight (23.5% cases where the review diagnosis changed the therapeutic

  4. Hints for diagnosis

    DEFF Research Database (Denmark)

    Poulsen, Lars K

    2015-01-01

    The diagnosis of food allergy requires responses to two important questions: Does the patient have a food allergy? If so, which foods will elicit allergic symptoms? The first question will most often have to be answered following a physical examination and an interview with the patient and....../or caretakers. Based on this, a provisional decision to pursue a food allergy diagnosis may be made after carefully considering other possible reasons for an adverse reaction to a food: aversion, infection, intoxication, or an underlying metabolic disease. To respond to the next question, the anamnesis...... is highly important in selecting which tests and, ultimately, oral food challenges the patient should undergo to reach the final diagnosis. For the diagnosing doctor, it is important to know and consider the regional pattern of inhalation and food allergies, the food consumption patterns in the local...

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

    Science.gov (United States)

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

    2009-09-01

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

  6. Improving Distributed Diagnosis Through Structural Model Decomposition

    Data.gov (United States)

    National Aeronautics and Space Administration — Complex engineering systems require efficient fault diagnosis methodologies, but centralized ap- proaches do not scale well, and this motivates the development of...

  7. 21 CFR 26.1 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN... Provisions for Pharmaceutical Good Manufacturing Practices § 26.1 Definitions. (a) Enforcement means action... require that the respective regulatory systems have identical procedures. (c) Good Manufacturing...

  8. 12 CFR 944.1 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... requirements of paragraph (1) of this definition. (3) A single parent who, except for owning a residence with... or renew any maturing advance for a term to maturity greater than one year. Single parent means...

  9. 33 CFR 175.3 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... EQUIPMENT REQUIREMENTS General § 175.3 Definitions. As used in this part: Boat means any vessel— (1... hull by guys or stays. State means a State or Territory of the United States of America, whether a...

  10. Content validation of the nursing diagnosis Nausea

    Directory of Open Access Journals (Sweden)

    Daniele Alcalá Pompeo

    2014-02-01

    Full Text Available This study aimed to evaluate the content validity of the nursing diagnosis of nausea in the immediate post-operative period, considering Fehring’s model. Descriptive study with 52 nurses experts who responded an instrument containing identification and validation of nausea diagnosis data. Most experts considered the domain 12 (Comfort, Class 1 (Physical Comfort and the statement (Nausea adequate to the diagnosis. Modifications were suggested in the current definition of this nursing diagnosis. Four defining characteristics were considered primary (reported nausea, increased salivation, aversion to food and vomiting sensation and eight secondary (increased swallowing, sour taste in the mouth, pallor, tachycardia, diaphoresis, sensation of hot and cold, changes in blood pressure and pupil dilation. The total score for the diagnosis of nausea was 0.79. Reports of nausea, vomiting sensation, increased salivation and aversion to food are strong predictors of nursing diagnosis of nausea.

  11. Product Structure, the Heart of Product Definition

    Science.gov (United States)

    DeHoog, C., Jr.

    1999-01-01

    This paper describes the LMMSS Product Definition System (PDS) philosophy and approach were the use of each item parts document or software can be traced to a specific end item (EI) serial/tail number of the product. It explains why a part-oriented approach to data organization and configuration management is required. The definition of part-oriented is that all appropriate product definition data products will be collected. Referenced and managed by their linkage/relationship to parts/items, The paper will touch upon how LMMSS store/controls product definition information under each project's top product designator in a two tiered approach. One tier for each product end item and another tier which contain/controls listings of drawings, documents. Specifications and standards that are required for hardware item definition.

  12. Evolving definitions of mental illness and wellness.

    Science.gov (United States)

    Manderscheid, Ronald W; Ryff, Carol D; Freeman, Elsie J; McKnight-Eily, Lela R; Dhingra, Satvinder; Strine, Tara W

    2010-01-01

    Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused definition of mental illnesses, and from an "absence of disease" model to one that stresses positive psychological function for mental health. Currently, wellness refers to the degree to which one feels positive and enthusiastic about oneself and life, whereas illness refers to the presence of disease. These definitions apply to physical as well as mental illness and wellness. In this article, we build on the essential concepts of wellness and illness, discuss how these definitions have changed over time, and discuss their importance in the context of health reform and health care reform. Health reform refers to efforts focused on health, such as health promotion and the development of positive well-being. Health care reform refers to efforts focused on illness, such as treatment of disease and related rehabilitation efforts.

  13. [Diagnosis of hereditary angioedema].

    Science.gov (United States)

    Bouillet, Laurence

    2015-01-01

    Hereditary angioedema is a rare disease, potentially life-threatening. It requires a specific treatment. Angioedema without wheals associated with abdominal attacks are very specific of this disease. Antigenemy and functional C1Inhibitor assays are necessary for the diagnosis. The hereditary angioedema with normal C1Inh (type III) is a diagnostic challenge. Bradykinin, secondary to kallikrein-kinin system activation is the key mediator of hereditary angioedema. Female are more symptomatic. Attacks can be induced by menstruations, pregnancies or contraceptive pills.

  14. [Diagnosis of bacterial vaginosis].

    Science.gov (United States)

    Djukić, Slobodanka; Ćirković, Ivana; Arsić, Biljana; Garalejić, Eliana

    2013-01-01

    Bacterial vaginosis is a common, complex clinical syndrome characterized by alterations in the normal vaginal flora. When symptomatic, it is associated with a malodorous vaginal discharge and on occasion vaginal burning or itching. Under normal conditions, lactobacilli constitute 95% of the bacteria in the vagina. Bacterial vaginosis is associated with severe reduction or absence of the normal H2O2-producing lactobacilli and overgrowth of anaerobic bacteria and Gardnerella vaginalis, Atopobium vaginae, Mycoplasma hominis and Mobiluncus species. Most types of infectious disease are diagnosed by culture, by isolating an antigen or RNA/DNA from the microbe, or by serodiagnosis to determine the presence of antibodies to the microbe. Therefore, demonstration of the presence of an infectious agent is often a necessary criterion for the diagnosis of the disease. This is not the case for bacterial vaginosis, since the ultimate cause of the disease is not yet known. There are a variety of methods for the diagnosis of bacterial vaginosis but no method can at present be regarded as the best. Diagnosing bacterial vaginosis has long been based on the clinical criteria of Amsel, whereby three of four defined criteria must be satisfied. Nugent's scoring system has been further developed and includes validation of the categories of observable bacteria structures. Up-to-date molecular tests are introduced, and better understanding of vaginal microbiome, a clear definition for bacterial vaginosis, and short-term and long-term fluctuations in vaginal microflora will help to better define molecular tests within the broader clinical context.

  15. 23 CFR 650.403 - Definition of terms.

    Science.gov (United States)

    2010-04-01

    ..., STRUCTURES, AND HYDRAULICS Highway Bridge Replacement and Rehabilitation Program § 650.403 Definition of... and functional obsolescence. (c) Rehabilitation. The major work required to restore the...

  16. Alexander disease : Diagnosis with MR imaging

    NARCIS (Netherlands)

    van der Knaap, MS; Naidu, S; Breiter, SN; Blaser, S; Stroink, H; Spinger, S; Begeer, JC; van Coster, R; Barth, PG; Thomas, NH; Powers, JM; Valk, J.

    2001-01-01

    BACKGROUND AND PURPOSE: To date, the demonstration of Rosenthal fibers on brain biopsy or autopsy specimens is considered a prerequisite for a definitive diagnosis of Alexander disease. We initiated a multiinstitutional survey of MR abnormalities in both presumed and confirmed cases of Alexander dis

  17. Metabolic syndrome: definitions and controversies

    Directory of Open Access Journals (Sweden)

    Kaltsas Gregory

    2011-05-01

    Full Text Available Abstract Metabolic syndrome (MetS is a complex disorder defined by a cluster of interconnected factors that increase the risk of cardiovascular atherosclerotic diseases and diabetes mellitus type 2. Currently, several different definitions of MetS exist, causing substantial confusion as to whether they identify the same individuals or represent a surrogate of risk factors. Recently, a number of other factors besides those traditionally used to define MetS that are also linked to the syndrome have been identified. In this review, we critically consider existing definitions and evolving information, and conclude that there is still a need to develop uniform criteria to define MetS, so as to enable comparisons between different studies and to better identify patients at risk. As the application of the MetS model has not been fully validated in children and adolescents as yet, and because of its alarmingly increasing prevalence in this population, we suggest that diagnosis, prevention and treatment in this age group should better focus on established risk factors rather than the diagnosis of MetS.

  18. Consensus on the Definition of Advanced Parkinson's Disease: A Neurologists-Based Delphi Study (CEPA Study)

    Science.gov (United States)

    Kulisevsky, Jaime; Tolosa, Eduardo S.

    2017-01-01

    To date, no consensus exists on the key factors for diagnosing advanced Parkinson disease (APD). To obtain consensus on the definition of APD, we performed a prospective, multicenter, Spanish nationwide, 3-round Delphi study (CEPA study). An ad hoc questionnaire was designed with 33 questions concerning the relevance of several clinical features for APD diagnosis. In the first-round, 240 neurologists of the Spanish Movement Disorders Group participated in the study. The results obtained were incorporated into the questionnaire and both, results and questionnaire, were sent out to and fulfilled by 26 experts in Movement Disorders. Review of results from the second-round led to a classification of symptoms as indicative of “definitive,” “probable,” and “possible” APD. This classification was confirmed by 149 previous participating neurologists in a third-round, where 92% completely or very much agreed with the classification. Definitive symptoms of APD included disability requiring help for the activities of daily living, presence of motor fluctuations with limitations to perform basic activities of daily living without help, severe dysphagia, recurrent falls, and dementia. These results will help neurologists to identify some key factors in APD diagnosis, thus allowing users to categorize the patients for a homogeneous recognition of this condition. PMID:28239501

  19. Endoscopic tissue diagnosis of cholangiocarcinoma.

    LENUS (Irish Health Repository)

    Harewood, Gavin C

    2008-09-01

    The extremely poor outcome in patients with cholangiocarcinoma, in large part, reflects the late presentation of these tumors and the challenging nature of establishing a tissue diagnosis. Establishing a diagnosis of cholangiocarcinoma requires obtaining evidence of malignancy from sampling of the epithelium of the biliary tract, which has proven to be challenging. Although endoscopic ultrasound-guided fine needle aspiration performs slightly better than endoscopic retrograde cholangiopancreatography in diagnosing cholangiocarcinoma, both endoscopic approaches demonstrate disappointing performance characteristics.

  20. Prebiotics: Definition and protective mechanisms.

    Science.gov (United States)

    Valcheva, Rosica; Dieleman, Levinus A

    2016-02-01

    The increase in chronic metabolic and immunologic disorders in the modern society is linked to major changes in the dietary patterns. These chronic conditions are associated with intestinal microbiota dysbiosis where important groups of carbohydrate fermenting, short-chain fatty acids-producing bacteria are reduced. Dietary prebiotics are defined as a selectively fermented ingredients that result in specific changes in the composition and/or activity of the gastrointestinal microbiota, thus conferring benefit(s) upon host health. Application of prebiotics may then restore the gut microbiota diversity and activity. Unlike the previously accepted prebiotics definition, where a limited number of bacterial species are involved in the prebiotic activity, new data from community-wide microbiome analysis demonstrated a broader affect of the prebiotics on the intestinal microbiota. These new findings require a revision of the current definition. In addition, prebiotics may exert immunomodulatory effects through microbiota-independent mechanisms that will require future investigations involving germ-free animal disease models.

  1. Image diagnosis in snapping syndromes; Diagnostico por imagem nas sindromes do estalido ou do ressalto

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Henrique Ribeiro da [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas; Simao, Marcelo Novelino [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Hospital das Clinicas. Servico de Radiodiagnostico; Elias Junior, Jorge; Muglia, Valdair Francisco; Nogueira-Barbosa, Marcello Henrique [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Hospital das Clinicas. Centro de Ciencias das Imagens e Fisica Medica]. E-mail: marcello@fmrp.usp.br

    2009-01-15

    Snapping syndromes occur during certain movements in several joints and may be accompanied by local pain and crepitation or audible snapping sensation. Snapping joints may eventually have no pathologic significance and in this case no treatment is required. There is an array of intra- and extra-articular causes of snapping syndrome and the lack of precise clinical findings impairs the definition of the most appropriate imaging method to confirm the diagnosis. The present study is aimed at discussing the most frequent causes of snapping syndrome in different joints, emphasizing the indications and limitations of each of the different diagnostic methods in specific situations of the clinical practice. (author)

  2. Laboratory tests for the diagnosis and management of chronic canine and feline enteropathies.

    Science.gov (United States)

    Berghoff, Nora; Steiner, Jörg M

    2011-03-01

    Chronic enteropathies are commonly encountered in both cats and dogs. Although definitive diagnosis often requires collection of gastrointestinal biopsies for histopathologic evaluation, less invasive laboratory tests can be highly informative and should be performed prior to biopsy collection. Tests for determination of infectious causes comprise those for helminthic, protozoal, bacterial, or fungal organisms. Intestinal function and disease may be assessed by measuring serum concentrations of cobalamin, folate, and C-reactive protein, and fecal concentrations of α(1)-proteinase inhibitor. Ongoing research has led to development of tests for serum perinuclear antineutrophilic cytoplasmic antibodies, and fecal inflammatory markers, including S100-proteins and N-methylhistamine.

  3. Definition of crisis state of enterprises

    Directory of Open Access Journals (Sweden)

    V.M. Danich

    2013-12-01

    Full Text Available The aim of the article. The aim of the article is to determine the critical situation at the enterprise for early diagnosis and prediction the crises; development of methodical approaches to the solution of problems in this sphere taking into account the prediction of financial crisis for enterprises of different branches of the business activity. The results of analysis. The approaches to the definition of crisis have been analyzed in the article. The considered approaches to the definition of the crisis make it possible to formulate the definition of crisis state of an enterprise. In order to identify the crisis state of enterprises it is suggested to use comparative analysis. The evaluation and the analysis of crisis state are performed in five blocks. First phase of analysis of the crisis defines the probability of the expression of the crisis at the enterprise. It includes criteria for evaluation of generalized probability bankruptcy and comprehensive economic analysis of the efficiency of industrial and financial activity. This analysis is supplied by coefficient, rating and factor methods of diagnosis of crisis. In the practice of prediction of crisis at the enterprise it is proposed to use the model of automata theory. At the second stage it is proposed to identify the main causes of the onset of crisis. The causal connections of a crisis are required sources of forming the necessary information to determine the probability of a crisis in the company. The information database to form a forecasting model of crisis was defined. The next stage in the analysis of the crisis is analysis of costs of the crisis. It has been propose for involves the assessment of the loss, determining the amount of liabilities, estimates of expected financial impact of a crisis. Analyze available resources that can be produced to prevent or overcome the crisis. The analysis of crisis is the use of suggested methodological approach that makes it possible to

  4. Development of the nursing diagnosis risk for pressure ulcer

    Directory of Open Access Journals (Sweden)

    Cássia Teixeira dos Santos

    Full Text Available OBJECTIVE: The study objective was to develop the definition and compile the risk factors for a new Nursing Diagnosis entitled "Risk for pressure ulcer". The process was guided using the research question, "What are the risk factors for development of a PU and what is its definition?" METHOD: An integrative literature review was conducted of articles published in Portuguese, English or Spanish from 2002 to 2012 and indexed on the Lilacs/SCIELO, MEDLINE/PubMed Central and Web of Science databases. The final sample comprised 21 articles that provided answers to the research question. These articles were analyzed and summarized in charts. RESULTS: A definition was constructed and 19 risk factors were selected for the new nursing diagnosis, "Risk for pressure ulcer". CONCLUSIONS: Identification and definition of the components of the new nursing diagnosis should aid nurses to prevent pressure ulcer events.

  5. Intellectual disability: definition, etiological factors, classification, diagnosis, treatment and prognosis Discapacidad intelectual: definición, factores etiológicos, clasificación, diagnóstico, tratamiento y prognosis

    Directory of Open Access Journals (Sweden)

    Gregorio Katz

    2008-01-01

    Full Text Available Etiology and classification: Causal factors related with cognitive disability are multiples and can be classified as follows: Genetic, acquired (congenital and developmental, environmental and sociocultural. Likewise, in relation to the classification, cognitive disability has as a common denominator a subnormal intellectual functioning level; nevertheless, the extent to which an individual is unable to face the demands established by society for the individual’s age group has brought about four degrees of severity: Mild, moderate, severe and profound. Diagnostic: The clinical history must put an emphasis on healthcare during the prenatal, perinatal and postnatal period and include the results of all previous studies, including a genealogical tree for at least three generations and an intentional search for family antecedents of mental delay, psychiatric illnesses and congenital abnormalities. The physical exam should focus on secondary abnormalities and congenital malformations, somatometric measurements and neurological and behavioral phenotype evaluations. If it is not feasible to establish a clinical diagnosis, it is necessary to conduct high-resolution cytogenetic studies in addition to metabolic clinical evaluations. In the next step, if no abnormal data are identified, submicroscopic chromosomal disorders are evaluated. Prognosis: Intellectual disability is not curable; and yet, the prognostic in general terms is good when using the emotional wellbeing of the individual as a parameter. Conclusions: Intellectual disability should be treated in a comprehensive manner. Nevertheless, currently, the fundamental task and perhaps the only one that applies is the detection of the limitation and abilities as a function of subjects’ age and expectations for the future, with the only goal being to provide the support necessary for each one of the dimensions or areas in which the person’s life is expressed and exposed.Etiología y clasificaci

  6. Diagnosis of incomplete Kawasaki disease

    Directory of Open Access Journals (Sweden)

    Jeong Jin Yu

    2012-03-01

    Full Text Available Several authors suggested that the clinical characteristics of incomplete presentation of Kawasaki disease are similar to those of complete presentation and that the 2 forms of presentation are not separate entities. Based on this suggestion, a diagnosis of incomplete Kawasaki disease in analogy to the findings of complete presentation is reasonable. Currently, the diagnosis of incomplete Kawasaki disease might be made in cases with fewer classical diagnostic criteria and with several compatible clinical, laboratory or echocardiographic findings on the exclusion of other febrile illness. Definition of incomplete presentation in which coronary artery abnormalities are included as a necessary condition, is restrictive and specific. The validity of the diagnostic criteria of incomplete presentation by the American Heart Association should be thoroughly tested in the immediate future.

  7. The relevance of uniform reporting in oral leukoplakia: definition, certainty factor and staging based on experience with 275 patients.

    Science.gov (United States)

    Brouns, Elisabeth-R E A; Baart, Jacques-A; Bloemena, Elisabeth; Karagozoglu, Hakki; van der Waal, Isaäc

    2013-01-01

    The aim of the present study was to evaluate the definition of oral leukoplakia, proposed by the WHO in 2005 and taking into account a previously reported classification and staging system, including the use of a Certainty factor of four levels with which the diagnosis of leukoplakia can be established. In the period 1997-2012 a hospital-based population of 275 consecutive patients with a provisional diagnosis of oral leukoplakia has been examined. In only 176 patients of these 275 patients a firm diagnosis of leukoplakia has been established based on strict clinicopathological criteria. The 176 patients have subsequently been staged using a classification and staging system based on size and histopathologic features. For use in epidemiological studies it seems acceptable to accept a diagnosis of leukoplakia based on a single oral examination (Certainty level 1). For studies on management and malignant transformation rate the recommendation is made to include the requirement of histopathologic examination of an incisional or excisional biopsy, representing Certainty level 3 and 4, respectively. This recommendation results in the following definition of oral leukoplakia: "A predominantly white lesion or plaque of questionable behaviour having excluded, clinically and histopathologically, any other definable white disease or disorder". Furthermore, we recommend the use of strict diagnostic criteria for predominantly white lesions for which a causative factor has been identified, e.g. smokers' lesion, frictional lesion and dental restoration associated lesion.

  8. Drill biopsy in the diagnosis of lung lesions.

    Science.gov (United States)

    Shatapathy, P; Sahoo, R C; Rao, K M; Krishnan, K V; Rau, P V; Padhee, A

    1987-11-01

    A high speed pneumatic drill was used to perform 190 percutaneous transthoracic biopsies in 161 patients. The resultant cores of tissue provided a definite diagnosis in 146 patients, giving a success rate of 90.7%. Complications occurred in 58 patients, subcutaneous emphysema being the most common, though only seven patients required active treatment, giving a rate of 3.7% for important complications. One patient died within 24 hours of the biopsy procedure owing to asphyxia resulting from aspiration of the contents of an acutely dilated stomach. Our experience clearly establishes that the drill biopsy as used by us is simple and safe and can be carried out in an outpatient department, yielding better overall results than any other procedure for closed biopsy of the lung currently practised.

  9. Venous malformations: classification, development, diagnosis, and interventional radiologic management.

    Science.gov (United States)

    Legiehn, Gerald M; Heran, Manraj K S

    2008-05-01

    Venous malformations are categorized as low-flow vascular malformations within the domain of vascular anomalies and are the most common vascular malformation encountered clinically. Venous malformations are by definition present at birth, undergo pari passu growth, and present clinically because of symptoms related to mass effect or stasis. Although diagnosis can usually be made by clinical history and examination, differentiation from other vascular and nonvascular entities often requires an imaging work-up that includes ultrasound, CT, MR imaging, and diagnostic phlebography. All decisions regarding imaging work-up and decision to treat must be coordinated though referral and discussions with a multidisciplinary team and be based on clearly defined clinical indications. Percutaneous image-guided sclerotherapy has become the mainstay of treatment for venous malformations and involves the introduction of any one of a number of endothelial-cidal sclerosants into the vascular spaces of the lesion, with each sclerosant possessing its own unique spectrum of advantages and disadvantages.

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

    Directory of Open Access Journals (Sweden)

    Toktam Beheshtian

    2015-05-01

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

  11. 42 CFR 417.911 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... Administration of Outstanding Loans and Loan Guarantees § 417.911 Definitions. As used in this subpart— Any 12... an operation or expansion that met any of the following requirements: (1) Under generally accepted..., was not a capital cost. (2) Was required by State regulatory authority to meet reserves or tangible...

  12. 12 CFR 6.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... definition of tangible equity. The OCC reserves the right to require a bank to compute and maintain its... requires, the terms used in this subpart have the same meanings as set forth in section 38 and section 3 of... person. (d) Leverage ratio means the ratio of Tier 1 capital to adjusted total assets, as calculated...

  13. 32 CFR 155.3 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE SECURITY DEFENSE INDUSTRIAL PERSONNEL SECURITY CLEARANCE PROGRAM § 155.3 Definitions. (a) Applicant. Any U.S. citizen who holds or requires a security clearance or any immigrant alien who holds or requires a limited access authorization for access...

  14. 31 CFR 103.175 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... REPORTING OF CURRENCY AND FOREIGN TRANSACTIONS Anti-Money Laundering Programs Special Due Diligence for...-money laundering program requirement; (viii) A broker or dealer in securities registered, or required to... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Definitions. 103.175 Section 103.175...

  15. 48 CFR 32.1102 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... means the payment advice provided by the Government to the contractor that identifies what the payment is for, any computations or adjustments made by the Government, and any information required by the... REQUIREMENTS CONTRACT FINANCING Electronic Funds Transfer 32.1102 Definitions. As used in this subpart...

  16. 40 CFR 61.221 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... Disposal of Uranium Mill Tailings § 61.221 Definitions. As used in this subpart, all terms not defined here... uranium mill tailings pile for the purpose of ensuring compliance with the requirements of 40 CFR 192.02(a... requirements of 40 CFR 192.02(a) have been met. (b) Operational means a uranium mill tailings pile that...

  17. The diagnosis of hematuria.

    Science.gov (United States)

    Abuelo, J G

    1983-05-01

    The causes of hematuria are briefly outlined and an approach to the diagnosis of this common finding is suggested. All cases require investigation, since even less than ten RBCs per high-power field may be the first sign of a malignant neoplasm or other serious disease. The most common causes are stones, malignant neoplasm, urethrotrigonitis, bacterial infection, prostatic hypertrophy, and glomerulonephritis; however, there are many other conditions to be kept in mind. A few simple laboratory tests will detect easily diagnosed problems such as bacterial infection, while more extensive and invasive studies are reserved to identify malignant neoplasms and other conditions in the remaining cases.

  18. Diagnosis of bacterial vaginosis

    Directory of Open Access Journals (Sweden)

    Đukić Slobodanka

    2013-01-01

    Full Text Available Bacterial vaginosis is a common, complex clinical syndrome characterized by alterations in the normal vaginal flora. When symptomatic, it is associated with a malodorous vaginal discharge and on occasion vaginal burning or itching. Under normal conditions, lactobacilli constitute 95% of the bacteria in the vagina. Bacterial vaginosis is associated with severe reduction or absence of the normal H2O2­producing lactobacilli and overgrowth of anaerobic bacteria and Gardnerella vaginalis, Atopobium vaginae, Mycoplasma hominis and Mobiluncus species. Most types of infectious disease are diagnosed by culture, by isolating an antigen or RNA/DNA from the microbe, or by serodiagnosis to determine the presence of antibodies to the microbe. Therefore, demonstration of the presence of an infectious agent is often a necessary criterion for the diagnosis of the disease. This is not the case for bacterial vaginosis, since the ultimate cause of the disease is not yet known. There are a variety of methods for the diagnosis of bacterial vaginosis but no method can at present be regarded as the best. Diagnosing bacterial vaginosis has long been based on the clinical criteria of Amsel, whereby three of four defined criteria must be satisfied. Nugent’s scoring system has been further developed and includes validation of the categories of observable bacteria structures. Up­to­date molecular tests are introduced, and better understanding of vaginal microbiome, a clear definition for bacterial vaginosis, and short­term and long­term fluctuations in vaginal microflora will help to better define molecular tests within the broader clinical context.

  19. Interactive tele-radiological segmentation systems for treatment and diagnosis.

    Science.gov (United States)

    Zimeras, S; Gortzis, L G

    2012-01-01

    Telehealth is the exchange of health information and the provision of health care services through electronic information and communications technology, where participants are separated by geographic, time, social and cultural barriers. The shift of telemedicine from desktop platforms to wireless and mobile technologies is likely to have a significant impact on healthcare in the future. It is therefore crucial to develop a general information exchange e-medical system to enables its users to perform online and offline medical consultations through diagnosis. During the medical diagnosis, image analysis techniques combined with doctor's opinions could be useful for final medical decisions. Quantitative analysis of digital images requires detection and segmentation of the borders of the object of interest. In medical images, segmentation has traditionally been done by human experts. Even with the aid of image processing software (computer-assisted segmentation tools), manual segmentation of 2D and 3D CT images is tedious, time-consuming, and thus impractical, especially in cases where a large number of objects must be specified. Substantial computational and storage requirements become especially acute when object orientation and scale have to be considered. Therefore automated or semi-automated segmentation techniques are essential if these software applications are ever to gain widespread clinical use. The main purpose of this work is to analyze segmentation techniques for the definition of anatomical structures under telemedical systems.

  20. Interactive Tele-Radiological Segmentation Systems for Treatment and Diagnosis

    Directory of Open Access Journals (Sweden)

    S. Zimeras

    2012-01-01

    Full Text Available Telehealth is the exchange of health information and the provision of health care services through electronic information and communications technology, where participants are separated by geographic, time, social and cultural barriers. The shift of telemedicine from desktop platforms to wireless and mobile technologies is likely to have a significant impact on healthcare in the future. It is therefore crucial to develop a general information exchange e-medical system to enables its users to perform online and offline medical consultations through diagnosis. During the medical diagnosis, image analysis techniques combined with doctor’s opinions could be useful for final medical decisions. Quantitative analysis of digital images requires detection and segmentation of the borders of the object of interest. In medical images, segmentation has traditionally been done by human experts. Even with the aid of image processing software (computer-assisted segmentation tools, manual segmentation of 2D and 3D CT images is tedious, time-consuming, and thus impractical, especially in cases where a large number of objects must be specified. Substantial computational and storage requirements become especially acute when object orientation and scale have to be considered. Therefore automated or semi-automated segmentation techniques are essential if these software applications are ever to gain widespread clinical use. The main purpose of this work is to analyze segmentation techniques for the definition of anatomical structures under telemedical systems.

  1. Fault diagnosis based on continuous simulation models

    Science.gov (United States)

    Feyock, Stefan

    1987-01-01

    The results are described of an investigation of techniques for using continuous simulation models as basis for reasoning about physical systems, with emphasis on the diagnosis of system faults. It is assumed that a continuous simulation model of the properly operating system is available. Malfunctions are diagnosed by posing the question: how can we make the model behave like that. The adjustments that must be made to the model to produce the observed behavior usually provide definitive clues to the nature of the malfunction. A novel application of Dijkstra's weakest precondition predicate transformer is used to derive the preconditions for producing the required model behavior. To minimize the size of the search space, an envisionment generator based on interval mathematics was developed. In addition to its intended application, the ability to generate qualitative state spaces automatically from quantitative simulations proved to be a fruitful avenue of investigation in its own right. Implementations of the Dijkstra transform and the envisionment generator are reproduced in the Appendix.

  2. Definition of postprandial lipaemia

    DEFF Research Database (Denmark)

    Kolovou, Genovefa D; Mikhailidis, Dimitri P; Nordestgaard, Børge G

    2011-01-01

    At the present time, there is no widely agreed definition of postprandial lipaemia (PPL). This lack of a shared definition limits the identification and treatment of patients with exaggerated PPL as well as the evaluation of potential therapeutic agents. PPL is a complex syndrome characterized...... by non-fasting hypertriglyceridaemia that is associated with an increased risk of vascular events. This review considers the definition of PPL and the methodology for assessing this process....

  3. Sociology of diagnosis: a preliminary review.

    Science.gov (United States)

    Jutel, Annemarie

    2009-03-01

    Diagnoses are the classification tools of medicine, and are pivotal in the ways medicine exerts its role in society. Their sociological study is commonly subsumed under the rubrics of medicalisation, history of medicine and theory of disease. Diagnosis is, however, a powerful social tool, with unique features and impacts which deserve their own specific analysis. The process of diagnosis provides the framework within which medicine operates, punctuates the values which medicine espouses, and underlines the authoritative role of both medicine and the doctor. Diagnosis takes place at a salient juncture between illness and disease, patient and doctor, complaint and explanation. Despite calls for its establishment, almost two decades ago (Brown 1990), there is not yet a clear sociology of diagnosis. This paper argues that there should be, and, as a first step, draws together a number of threads of medical sociology that potentially contribute to this proposed sociology of diagnosis, including the place of diagnosis in the institution of medicine, the social framing of disease definitions, the means by which diagnosis confers authority to medicine, and how that authority is challenged. Through this preliminary review, I encourage sociology to consider the specific role of diagnosis in view of establishing a specific sub-disciplinary field.

  4. Estimation of Cachexia among Cancer Patients Based on Four Definitions

    OpenAIRE

    2009-01-01

    Objectives. Estimate and compare the proportion of cancer patients with cachexia using different definitions from available clinical data. Methods. Electronic medical records were examined to estimate the proportion of cancer patients with cachexia using 4 definitions: (1) ICD-9 diagnostic code of 799.4 (cachexia), (2) ICD-9 diagnosis of cachexia, anorexia, abnormal weight loss, or feeding difficulties, (3) prescription for megestrol acetate, oxandrolone, somatropin, or dronabinol, and (4) ≥ ...

  5. Social Entrepreneurship: Definition and Boundaries

    Directory of Open Access Journals (Sweden)

    Samer Abu-Saifan

    2012-02-01

    Full Text Available While individuals may be publicly recognized as social entrepreneurs for their contributions to improve the welfare of communities, the field of social entrepreneurship continues to struggle to gain academic legitimacy. Social entrepreneurship is a term in search of a good definition. The current use of the term seems vague and limitless; it needs boundaries to demarcate its function. The lack of a common definition hinders research and raises questions about which social or profit-making activities fall within the spectrum of social entrepreneurship. To become an important stream in the entrepreneurship literature, social entrepreneurship needs to be properly defined and it requires a theoretical framework that links it to the theory of entrepreneurship. This article builds on the literature to define social entrepreneurship, discusses the boundaries of socially-oriented entrepreneurial activities, and positions the social entrepreneur in the spectrum of entrepreneurship.

  6. Fault diagnosis and fault-tolerant control and guidance for aerospace vehicles from theory to application

    CERN Document Server

    Zolghadri, Ali; Cieslak, Jerome; Efimov, Denis; Goupil, Philippe

    2014-01-01

    Fault Diagnosis and Fault-Tolerant Control and Guidance for Aerospace demonstrates the attractive potential of recent developments in control for resolving such issues as improved flight performance, self-protection and extended life of structures. Importantly, the text deals with a number of practically significant considerations: tuning, complexity of design, real-time capability, evaluation of worst-case performance, robustness in harsh environments, and extensibility when development or adaptation is required. Coverage of such issues helps to draw the advanced concepts arising from academic research back towards the technological concerns of industry. Initial coverage of basic definitions and ideas and a literature review gives way to a treatment of important electrical flight control system failures: the oscillatory failure case, runaway, and jamming. Advanced fault detection and diagnosis for linear and nonlinear systems are described. Lastly recovery strategies appropriate to remaining acuator/sensor/c...

  7. UNDESCENDED TESTIS, DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Winarta Lesmana Handrea

    2013-05-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Undescended testis (UDT or cryptorchidism is one of the commonest abnormalities in male infants. In this anomaly, testes are not located normally in the scrotum. The incidence of UDT is 4-5% of term male infants, and 20-33% of premature male infants. The occurrence of abnormalities of hormones control or anatomy process that is required in the normal process of lowering the testes can cause UDT. UDT can be differentiated into palpable and nonpalpable. The diagnosis of UDT can be known through physical examination. However, if the testes are impalpable, laparoscopy can be done to determine the position of the testis. Hormonal therapy to overcome UDT is still under controversy. The action that often done is surgery, called orchidopexy. The most serious complication of orchidopexy is testicular atrophy. It occurs in a small percentage, which is about 5-10%. Infertility may occur in 1 to 3 of 4 adult males and the risk of occurrence of malignancies is increased by as much as 5-10 times higher in men with a history of UDT. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  8. [Ultrasound diagnosis of the meniscus].

    Science.gov (United States)

    Casser, H R

    2002-03-01

    As a supplement to clinical findings, sonographic examination of the meniscus is an easily available, noninvasive imaging technique that can be used to optimize preoperative diagnosis and check the indication for arthroscopy. Careful consideration of the technical requirements and systematic performance of the dynamic examination should lead to further improvement of the examination results and to growing clinical significance in the future.

  9. Discrete event systems diagnosis and diagnosability

    CERN Document Server

    Sayed-Mouchaweh, Moamar

    2014-01-01

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

  10. An Event-based Distributed Diagnosis Framework using Structural Model Decomposition

    Data.gov (United States)

    National Aeronautics and Space Administration — Complex engineering systems require efficient on-line fault diagnosis methodologies to improve safety and reduce maintenance costs. Traditionally, diagnosis...

  11. Statin intolerance - a question of definition.

    Science.gov (United States)

    Algharably, Engi Abdel-Hady; Filler, Iris; Rosenfeld, Stephanie; Grabowski, Katja; Kreutz, Reinhold

    2017-01-01

    Statin therapy is the backbone of pharmacologic therapy for low-density lipoproteins cholesterol lowering and plays a pivotal role in cardiovascular disease prevention. Statin intolerance is understood as the inability to continue using a statin to reduce individual cardiovascular risk sufficiently, due to the development of symptoms or laboratory abnormalities attributable to the initiation or dose escalation of a statin. Muscle symptoms are the most common side effects observed. Areas covered: The main aim of this article is to present a review on published definitions of statin intolerance. In addition, a brief review on clinical aspects and risk factors of statin intolerance is provided and features for a common definition for statin intolerance are suggested. Expert opinion: A definition of statin intolerance by major drug regulatory agencies is not available. In clinical studies, different definitions are chosen and results are not comparable; different medical associations do not agree on one common definition. There is an unmet need to establish a common definition of statin intolerance to ensure an appropriate clinical use of this important drug class. Further work is required to develop a consensus definition on statin intolerance that could have significant positive impact on both research and clinical management.

  12. Molecular diagnosis of putative Stargardt disease probands by exome sequencing

    Directory of Open Access Journals (Sweden)

    Strom Samuel P

    2012-08-01

    Full Text Available Abstract Background The commonest genetic form of juvenile or early adult onset macular degeneration is Stargardt Disease (STGD caused by recessive mutations in the gene ABCA4. However, high phenotypic and allelic heterogeneity and a small but non-trivial amount of locus heterogeneity currently impede conclusive molecular diagnosis in a significant proportion of cases. Methods We performed whole exome sequencing (WES of nine putative Stargardt Disease probands and searched for potentially disease-causing genetic variants in previously identified retinal or macular dystrophy genes. Follow-up dideoxy sequencing was performed for confirmation and to screen for mutations in an additional set of affected individuals lacking a definitive molecular diagnosis. Results Whole exome sequencing revealed seven likely disease-causing variants across four genes, providing a confident genetic diagnosis in six previously uncharacterized participants. We identified four previously missed mutations in ABCA4 across three individuals. Likely disease-causing mutations in RDS/PRPH2, ELOVL, and CRB1 were also identified. Conclusions Our findings highlight the enormous potential of whole exome sequencing in Stargardt Disease molecular diagnosis and research. WES adequately assayed all coding sequences and canonical splice sites of ABCA4 in this study. Additionally, WES enables the identification of disease-related alleles in other genes. This work highlights the importance of collecting parental genetic material for WES testing as the current knowledge of human genome variation limits the determination of causality between identified variants and disease. While larger sample sizes are required to establish the precision and accuracy of this type of testing, this study supports WES for inherited early onset macular degeneration disorders as an alternative to standard mutation screening techniques.

  13. Food allergy: Definitions,prevalence,diagnosis and therapy

    DEFF Research Database (Denmark)

    van Ree, Ronald; Poulsen, Lars K; Wong, Gary Wk

    2015-01-01

    Food allergy is phenotypically an extremely heterogeneous group of diseases affecting multiple organs, sometimes in an isolated way, sometimes simultaneously, with the severity of reactions ranging from mild and local to full-blown anaphylaxis. Mechanistically, it is defined as a Th2-driven immune...... disorder in which food-specific IgE antibodies are at the basis of immediate-type adverse reactions. The sites of sensitization and symptoms do not necessarily overlap. Food allergy, which is the theme of this paper, is often confused with other adverse reactions to food of both animmune (e.g., celiac...... disease) and non-immune (e.g., lactose intolerance) nature. To reliably diagnose food allergy, a careful history (immediate-type reactions) needs to be complemented with demonstration of specific IgE (immune mechanism) and confirmed by an oral challenge. Co-factors such as exercise, medication...

  14. Engineering Definitional Interpreters

    DEFF Research Database (Denmark)

    Midtgaard, Jan; Ramsay, Norman; Larsen, Bradford

    2013-01-01

    A definitional interpreter should be clear and easy to write, but it may run 4--10 times slower than a well-crafted bytecode interpreter. In a case study focused on implementation choices, we explore ways of making definitional interpreters faster without expending much programming effort. We imp...

  15. Engineering Definitional Interpreters

    DEFF Research Database (Denmark)

    Midtgaard, Jan; Ramsay, Norman; Larsen, Bradford

    2013-01-01

    A definitional interpreter should be clear and easy to write, but it may run 4--10 times slower than a well-crafted bytecode interpreter. In a case study focused on implementation choices, we explore ways of making definitional interpreters faster without expending much programming effort. We imp...

  16. Definition of postprandial lipaemia

    DEFF Research Database (Denmark)

    Kolovou, Genovefa D; Mikhailidis, Dimitri P; Nordestgaard, Børge G

    2011-01-01

    At the present time, there is no widely agreed definition of postprandial lipaemia (PPL). This lack of a shared definition limits the identification and treatment of patients with exaggerated PPL as well as the evaluation of potential therapeutic agents. PPL is a complex syndrome characterized by...

  17. Productivity of Stream Definitions

    NARCIS (Netherlands)

    Endrullis, Jörg; Grabmayer, Clemens; Hendriks, Dimitri; Isihara, Ariya; Klop, Jan

    2007-01-01

    We give an algorithm for deciding productivity of a large and natural class of recursive stream definitions. A stream definition is called ‘productive’ if it can be evaluated continuously in such a way that a uniquely determined stream is obtained as the limit. Whereas productivity is undecidable

  18. Productivity of stream definitions

    NARCIS (Netherlands)

    Endrullis, J.; Grabmayer, C.A.; Hendriks, D.; Isihara, A.; Klop, J.W.

    2008-01-01

    We give an algorithm for deciding productivity of a large and natural class of recursive stream definitions. A stream definition is called ‘productive’ if it can be evaluated continually in such a way that a uniquely determined stream in constructor normal form is obtained as the limit. Whereas prod

  19. Diagnosis of ophthalmomyiasis externa by dermatoscopy.

    Science.gov (United States)

    Naimer, Sody A; Mumcuoglu, Kosta Y

    2014-10-01

    Ophthalmomyiasis in humans caused by the larvae of the sheep nasal botfly (Oestrus ovis) and is a rare phenomenon in Israel. We describe the utilization of the dermatoscope as a diagnostic tool for the facilitation of early diagnosis of conjunctivitis due to the infestation of the eyes by the sheep nasal botfly in two patients. After the physical removal of the larvae with the help of a cotton swab applicator under a slit lamp examination and the topical use of antibiotics, the clinical symptoms improved within 1-2 days. Undoubtedly the dermatoscope played a crucial role leading to the definitive diagnosis and immediate therapeutic intervention.

  20. Chromospheric diagnosis with forward scattering polarization

    CERN Document Server

    Carlin, E S

    2016-01-01

    Is it physically feasible to perform chromospheric diagnosis using spatial maps of scattering polarization at the solar disk center? To investigate it we synthesized polarization maps (in 8542 Angstroms) resulting from MHD solar models and NLTE radiative transfer calculations that consider Hanle effect and vertical macroscopic motions. After explaining the physical con- text of forward scattering and presenting our results, we arrive at the definition of Hanle polarity inversion lines. We show how such features can give support for a clearer chromospheric diagnosis in which the magnetic and dynamic effects in the scattering polarization could be disentangled.

  1. Definition of intractable epilepsy.

    Science.gov (United States)

    Sinha, Shobhit; Siddiqui, Khurram A

    2011-01-01

    Defining intractable epilepsy is essential not only to identify up to 40% of patients refractory to pharmacological management, but also to facilitate selection and comparison of such patients for research purposes. The ideal definition still eludes us. Multiple factors including number of antiepileptic drug (AED) failures, seizure frequency and duration of unresponsiveness, etiology, and epilepsy syndromes are considered in formulating the definition of pharmaco-resistant epilepsy. Most definitions used in the literature agree on the number of AED failures, which seem to be 2 or 3, however, the seizure frequency and time factor are varied. The International League Against Epilepsy proposed a definition of drug-resistant epilepsy as a failure of adequate trials of 2 tolerated and appropriately chosen and used AED schedules. This for now, could provide an operational definition for clinical and research settings. However, with emergence of new data and novel treatments the criteria for intractability may change.

  2. [Acute respiratory distress syndrome: a review of the Berlin definition].

    Science.gov (United States)

    de Luis Cabezón, N; Sánchez Castro, I; Bengoetxea Uriarte, U X; Rodrigo Casanova, M P; García Peña, J M; Aguilera Celorrio, L

    2014-01-01

    Acute Respiratory Distress Syndrome (ARDS) is due to many causes. The absence of a universal definition up until now has led to a series of practical problems for a definitive diagnosis. The incidences of ARDS and Acute Lung Injury (ALI) vary widely in the current literature. The American-European Consensus Conference definition has been applied since its publication in 1994 and has helped to improve knowledge about ARDS. However, 18 years later, in 2011, the European Intensive Medicine Society, requested a team of international experts to meet in Berlin to review the ARDS definition. The purpose of the Berlin definition is not to use it as a prognostic tool, but to improve coherence between research and clinical practice.

  3. Comparing Measures of Late HIV Diagnosis in Washington State

    Directory of Open Access Journals (Sweden)

    Laura Saganic

    2012-01-01

    Full Text Available As more US HIV surveillance programs routinely use late HIV diagnosis to monitor and characterize HIV testing patterns, there is an increasing need to standardize how late HIV diagnosis is measured. In this study, we compared two measures of late HIV diagnosis, one based on time between HIV and AIDS, the other based on initial CD4+ results. Using data from Washington's HIV/AIDS Reporting System, we used multivariate logistic regression to identify predictors of late HIV diagnosis. We also conducted tests for trend to determine whether the proportion of cases diagnosed late has changed over time. Both measures lead us to similar conclusions about late HIV diagnosis, suggesting that being male, older, foreign-born, or heterosexual increase the likelihood of late HIV diagnosis. Our findings reaffirm the validity of a time-based definition of late HIV diagnosis, while at the same time demonstrating the potential value of a lab-based measure.

  4. The definition of IVM is clear-variations need defining.

    Science.gov (United States)

    De Vos, Michel; Smitz, Johan; Thompson, Jeremy G; Gilchrist, Robert B

    2016-11-01

    Oocyte in vitro maturation (IVM) is currently defined as the maturation in vitro of immature cumulus-oocyte complexes collected from antral follicles. This is the original definition as first described by Pincus and Enzmann and then by Edwards many decades ago, and this clear and unambiguous definition has served us well ever since. In an attempt to clarify apparent differences among clinicians, the following revised definition of IVM was recently proposed: 'The retrieval of oocytes from small and intermediate sized follicles in an ovary before the largest follicle has surpassed 13 mm in mean diameter'. As such, this proposed definition should encompass the use of hCG triggering. To change the clear and long-serving definition of IVM to fit varying clinical practices requires a compelling justification based on solid scientific and clinical grounds. We are of the opinion that the proposed revised definition of IVM is counterintuitive as it includes protocols that are intended to mature oocytes in vivo The proposed definitions are cumbersome and indeed further complicate the situation. It is not scientifically rational to base the definition on follicular size, and the definition ignores the vast corporate knowledge acquired from the many decades and >6000 publications in animal research that universally practices IVM as per the existing definition. Furthermore, such a definition can lead to false results in interpreting the follow-up of children conceived using IVM. Hence, we see no rationale to change the existing definition of IVM. However, we agree that variations on IVM require alternative nomenclature-these definitions need to be intuitive and need to clearly distinguish themselves from the existing long-standing definition of IVM. This would help to clarify the recent confusion within the clinical ART community as to what is and what is not, IVM.

  5. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma.

    Science.gov (United States)

    Rajkumar, S Vincent; Dimopoulos, Meletios A; Palumbo, Antonio; Blade, Joan; Merlini, Giampaolo; Mateos, María-Victoria; Kumar, Shaji; Hillengass, Jens; Kastritis, Efstathios; Richardson, Paul; Landgren, Ola; Paiva, Bruno; Dispenzieri, Angela; Weiss, Brendan; LeLeu, Xavier; Zweegman, Sonja; Lonial, Sagar; Rosinol, Laura; Zamagni, Elena; Jagannath, Sundar; Sezer, Orhan; Kristinsson, Sigurdur Y; Caers, Jo; Usmani, Saad Z; Lahuerta, Juan José; Johnsen, Hans Erik; Beksac, Meral; Cavo, Michele; Goldschmidt, Hartmut; Terpos, Evangelos; Kyle, Robert A; Anderson, Kenneth C; Durie, Brian G M; Miguel, Jesus F San

    2014-11-01

    This International Myeloma Working Group consensus updates the disease definition of multiple myeloma to include validated biomarkers in addition to existing requirements of attributable CRAB features (hypercalcaemia, renal failure, anaemia, and bone lesions). These changes are based on the identification of biomarkers associated with near inevitable development of CRAB features in patients who would otherwise be regarded as having smouldering multiple myeloma. A delay in application of the label of multiple myeloma and postponement of therapy could be detrimental to these patients. In addition to this change, we clarify and update the underlying laboratory and radiographic variables that fulfil the criteria for the presence of myeloma-defining CRAB features, and the histological and monoclonal protein requirements for the disease diagnosis. Finally, we provide specific metrics that new biomarkers should meet for inclusion in the disease definition. The International Myeloma Working Group recommends the implementation of these criteria in routine practice and in future clinical trials, and recommends that future studies analyse any differences in outcome that might occur as a result of the new disease definition.

  6. Positive predictive value of a case definition for diabetes mellitus using automated administrative health data in children and youth exposed to antipsychotic drugs or control medications: a Tennessee Medicaid study

    Directory of Open Access Journals (Sweden)

    Bobo William V

    2012-08-01

    Full Text Available Abstract Background We developed and validated an automated database case definition for diabetes in children and youth to facilitate pharmacoepidemiologic investigations of medications and the risk of diabetes. Methods The present study was part of an in-progress retrospective cohort study of antipsychotics and diabetes in Tennessee Medicaid enrollees aged 6–24 years. Diabetes was identified from diabetes-related medical care encounters: hospitalizations, outpatient visits, and filled prescriptions. The definition required either a primary inpatient diagnosis or at least two other encounters of different types, most commonly an outpatient diagnosis with a prescription. Type 1 diabetes was defined by insulin prescriptions with at most one oral hypoglycemic prescription; other cases were considered type 2 diabetes. The definition was validated for cohort members in the 15 county region geographically proximate to the investigators. Medical records were reviewed and adjudicated for cases that met the automated database definition as well as for a sample of persons with other diabetes-related medical care encounters. Results The study included 64 cases that met the automated database definition. Records were adjudicated for 46 (71.9%, of which 41 (89.1% met clinical criteria for newly diagnosed diabetes. The positive predictive value for type 1 diabetes was 80.0%. For type 2 and unspecified diabetes combined, the positive predictive value was 83.9%. The estimated sensitivity of the definition, based on adjudication for a sample of 30 cases not meeting the automated database definition, was 64.8%. Conclusion These results suggest that the automated database case definition for diabetes may be useful for pharmacoepidemiologic studies of medications and diabetes.

  7. Initial Diagnosis and Management of Coma.

    Science.gov (United States)

    Traub, Stephen J; Wijdicks, Eelco F

    2016-11-01

    Coma represents a true medical emergency. Drug intoxications are a leading cause of coma; however, other metabolic disturbances and traumatic brain injury are also common causes. The general emergency department approach begins with stabilization of airway, breathing, and circulation, followed by a thorough physical examination to generate a limited differential diagnosis that is then refined by focused testing. Definitive treatment is ultimately disease-specific. This article presents an overview of the pathophysiology, causes, examination, and treatment of coma.

  8. ASSESSMENT OF CLINICAL CASE-DEFINITION FOR HIV/AIDS IN ...

    African Journals Online (AJOL)

    hi-tech

    2004-05-05

    May 5, 2004 ... Therefore, AIDS diagnosis based on clinical case definition alone without at least one positive HIV antibody ... is still increasing(1). Deficiency of the immune system ... and laboratory data of these subjects were recorded. The.

  9. Molecular Diagnosis of Phytoplasmas

    Directory of Open Access Journals (Sweden)

    C. Marzachì

    2004-08-01

    Full Text Available Phytoplasmas are wall-less prokaryotes associated with diseases in numerous plant species worldwide. In nature they are transmitted by phloem-sucking insects. Yellowing, decline, witches’ broom, leaf curl, floral virescence and phyllody are the most conspicuous symptoms associated with phytoplasmas, although infections are sometimes asymptomatic. Since phytoplasmas cannot be cultured in vitro, molecular techniques are needed for their diagnosis and characterization. The titer of phytoplasma cells in the phloem of infected plants may vary according to the season and the plant species, and it is often very low in woody hosts. Different DNA extraction procedures have therefore been tried out to obtain phytoplasma DNA at a concentration and purity high enough for effective diagnosis. DNA/DNA hybridization methods were reported in the nineties to be appropriate for the detection of phytoplasmas, but at present PCR is considered the most suitable. Universal and group-specific primers have been designed on the rRNA operon of the phytoplasma genome and on plasmid sequences. RFLP analysis of the obtained amplicons has classified these pathogens into major 16Sr RNA groups. Group-specific primers have also been designed on other genomic sequences. PCR is a very sensitive technique, but due to the low titre of phytoplasmas a further increase in sensitivity may be required for accurate diagnosis. This is routinely obtained with a second round of PCR (nested PCR. The drawback of nested PCR is that there is a greater chance of obtaining false positives due to contamination. Many authors have therefore developed protocols based on hybridization (PCR/dot blot or serological approaches (PCR/ELISA to increase the sensitivity and specificity of the direct PCR, reducing the risks due to nested PCR. Real time PCR protocols may also improve the sensitivity and specificity of the direct PCR assay.

  10. Laboratory diagnosis of thalassemia.

    Science.gov (United States)

    Brancaleoni, V; Di Pierro, E; Motta, I; Cappellini, M D

    2016-05-01

    The thalassemias can be defined as α- or β-thalassemias depending on the defective globin chain and on the underlying molecular defects. The recognition of carriers is possible by hematological tests. Both α- and β-thalassemia carriers (heterozygotes) present with microcytic hypochromic parameters with or without mild anemia. Red cell indices and morphology followed by separation and measurement of Hb fractions are the basis for identification of carriers. In addition, iron status should be ascertained by ferritin or zinc protoporphyrin measurements and the iron/total iron-binding capacity/saturation index. Mean corpuscular volume and mean corpuscular hemoglobin are markedly reduced (mean corpuscular volume: 60-70 fl; MCH: 19-23 pg) in β-thalassemia carriers, whereas a slight to relevant reduction is usually observed in α-carriers. HbA2 determination is the most decisive test for β-carrier detection although it can be disturbed by the presence of δ-thalassemia defects. In α-thalassemia, HbA2 can be lower than normal and it assumes significant value when iron deficiency is excluded. Several algorithms have been introduced to discriminate from thalassemia carriers and subjects with iron-deficient anemia; because the only discriminating parameter is the red cell counts, these formulas must be used consciously. Molecular analysis is not required to confirm the diagnosis of β-carrier, but it is necessary to confirm the α-thalassemia carrier status. The molecular diagnosis is essential to predict severe transfusion-dependent and intermediate-to-mild non-transfusion-dependent cases. DNA analysis on chorionic villi is the approach for prenatal diagnosis and the methods are the same used for mutations detection, according to the laboratory facilities and expertise.

  11. Metabolic syndrome in children and adolescents - criteria for diagnosis

    Directory of Open Access Journals (Sweden)

    Mancini Marcio C

    2009-10-01

    Full Text Available Abstract In recent years, there has been a greater concern about the presence of obesity and metabolic syndrome in children and adolescents. However, there is no consensus regarding the diagnosis of metabolic syndrome in children and adolescents. It is evident that each component of the syndrome must be identified as early as possible in order to prevent definitive lesions. The question is how to do this and which cut-offs must be adopted for this diagnosis. For a matter of convenience, the definition chosen as the most appropriate is the one proposed by the IDF, with cut-offs fixed for pressure, lipids and glycemia, and abdominal circumference points assessed by percentile. Although on the one hand this definition could fail to include some children in the diagnosis of Metabolic Syndrome, on the other hand, it would be of easier acceptance as it does not use multiple tables to assess several anthropometric and metabolic criteria.

  12. The definition of cross polarization

    DEFF Research Database (Denmark)

    Ludwig, Arthur

    1973-01-01

    There are at least three different definitions of cross polarization used in the literature. The alternative definitions are discussed with respect to several applications, and the definition which corresponds to one standard measurement practice is proposed as the best choice.......There are at least three different definitions of cross polarization used in the literature. The alternative definitions are discussed with respect to several applications, and the definition which corresponds to one standard measurement practice is proposed as the best choice....

  13. Sonographic diagnosis of

    Directory of Open Access Journals (Sweden)

    Stroever, Brigitte

    2005-11-01

    Full Text Available Introduction: The acute abdomen is the main term for an at first unclear emergency situation of the abdominal cavity. The acute abdomen belongs to the three most important reasons for the admission of patients into the emergency room. Further, this illness ranks 40% of all consultations in the ambulant care sector. The acute abdomen requires an early and direct diagnosis because of its potential of having a life threatening differential diagnosis. This HTA report aimed to assess the ultrasound diagnosis of the acute abdomen considering children and adults. This will be done from a medical and economic perspective. The differential diagnosis respectively the cause of the acute abdomen binds high direct treatment costs, especially in the stationary sector. Ultrasound diagnosis is a procedure that plays a big part in the differential diagnosis process and it is widely used in practise. Other research methods of diagnosing acute abdominal illness are: clinical examinations with inspection and palpation, surgical exploration and laparocopy as well as computer tomography and x-ray examination. Objectives: The main objective of this HTA report is to assess what significance sonography should have within the examination strategy of the acute abdomen from the medical and economical view. Second, this HTA report will evaluate under which circumstances the ultrasonographic diagnosis of the acute abdomen, considering medical and economical quality classifications, is the alternative of choice to comparable diagnostic measures. Methods: The target population this HTA report is aimed at are children and adults with acute abdomen or embedded differential diagnosis. A systematic literature search was conducted covering all relevant medical and HTA-databases. Furthermore, handsearch was conducted inside of the known data bases of HTA-institutions as well as from medical and economical journals. The following databases were searched in cooperation with DIMDI to

  14. DIAGNOSIS OF ACUTE PHARYNGITIS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    T. V. Kulichenko

    2014-01-01

    Full Text Available This literature review is dedicated to the issue of clinical and laboratory diagnosis of acute pharyngitis in children and adolescents. Relevance of the topic is justified by omnipresent (up to 70% of patients with acute pharyngitis unreasonable prescription of antibacterial drugs. Differential diagnosis of acute pharyngitis is aimed at identifying patients with the infection induced by group A-hemolytic streptococcus requiring antimicrobial therapy. The article presents current recommendations on microbial diagnosis of streptococcal tonsillitis and a potential of using express tests for rapid diagnosis verification. 

  15. Gout: Diagnosis and management

    Directory of Open Access Journals (Sweden)

    Zuljasri Albar

    2007-03-01

    Full Text Available Gout is a heterogeneous group of diseases resulting from monosodium urate (MSU crystal deposition in tissues or from supersaturation of uric acid in extracellular fluids. Clinical manifestations include 1 Recurrent attacks of articular and periarticular inflammation, also called gouty arthritis; 2 Accumulation of articular, osseous, soft tissue, and cartilaginous crystalline deposits, called tophi; 3 Uric acid calculi in the urinary tract; and 4 Interstitial nephropathy with renal function impairment, called gouty nephropathy. Gout predominantly is a disease of adult men, with a peak incidence in the fifth decade. In women usually found after menopause. The metabolic disorder underlying gout is hyperuricaemia. The duration and magnitude of hyperuricemia directly correlate with the likelihood of developing gouty arthritis and uric acid urolithiasis, and with age at onset of initial clinical gouty manifestations. The urate crystals induce phagocytes and synovial cells to generate and release such mediators as cyclooxygenase and lipoxygenase metabolites of arachidonic acid, phospholipase A2-activating protein, lysosomal proteases, tumor necrosis factor (TNF-α, interleukin (IL-1, IL-6, and IL-8. Definitive diagnosis of gout needs the demonstration of MSU crystals in synovial fluid or tophus. Gout is frequently associated with comorbidity such as obesity, hypertension, renal disease and dyslipidaemia. Therapeutic goals include terminating acute attacks; providing rapid, safe relief of pain and inflammation; averting future attacks; and preventing such complications as formation of tophi, kidney stones, and destructive arthropathy. Colchicine, nonsteroidal anti-inflammatory drugs and corticosteroid are drugs used for treating acute gouty arthritis. Colchicine is also used for prophylaxis. Urate lowering drugs also play a role in prophylactic management of gout. With early intervention, careful monitoring, and patient education, the prognosis is

  16. Cognitive and behavioral changes in Huntington disease before diagnosis.

    Science.gov (United States)

    Paulsen, Jane S; Miller, Amanda C; Hayes, Terry; Shaw, Emily

    2017-01-01

    Phenotypic manifestations of Huntington disease (HD) can be detected at least 15 years prior to the time when a motor diagnosis is given. Advances in clinical care and future research will require consistent use of HD definitions and HD premanifest (prodromal) stages being used across clinics, sites, and countries. Cognitive and behavioral (psychiatric) changes in HD are summarized and implications for ongoing advancement in our knowledge of prodromal HD are suggested. The earliest detected cognitive changes are observed in the Symbol Digit Modalities Test, Stroop Interference, Stroop Color and Word Test-interference condition, and Trail Making Test. Cognitive changes in the middle and near motor diagnostic stages of prodromal HD involve nearly every cognitive test administered and the greatest changes over time (i.e., slopes) are found in those prodromal HD participants who are nearest to motor diagnosis. Psychiatric changes demonstrate significant worsening over time and remain elevated compared with healthy controls throughout the prodromal disease course. Psychiatric and behavior changes in prodromal HD are much lower than that obtained using cognitive assessment, although the psychiatric and behavioral changes represent symptoms most debilitating to independent capacity and wellness. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. The role of skin biopsy in diagnosis of panniculitides.

    Science.gov (United States)

    Tomasini, C; Lentini, F; Borroni, G

    2013-08-01

    Several factors hamper the clinical and histologic diagnosis of panniculitis. Clinically the patients tend to present with erythematous subcutaneous nodules with quite a monotonous appearance, without additional symptoms. Histopathologically, as the subcutaneous fat responds to a variety of insults in a limited number of forms, there are sometimes subtle pathologic differences among the conditions. Although the biopsy plays a critical role in the diagnostic process of a panniculitis, a series of prerequisites must be met in order to obtain as much information as possible from this procedure. If the biopsy is inadequate, i.e., does not include sufficient subcutaneous fat or the site of sampling site/biopsy timing is wrong, histopathologic assessment is limited and the correct diagnosis may be delayed and further sampling may be required. This article introduces the reader to the field of panniculitides under the histopathologic perspective through a brief description of the normal histology of subcutaneous fat. I also includes the definition of the types of fat necrosis, role of biopsy of panniculitis and its rules and pitfalls, up to a microscopic approach of a slide.

  18. [Differential diagnosis of hoarseness].

    Science.gov (United States)

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

    2014-04-01

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

  19. [Cheilitis: Diagnosis and treatment].

    Science.gov (United States)

    Samimi, Mahtab

    2016-02-01

    The whole examination of oral cavity, other mucosae and skin is required when managing a cheilitis. Irritants (climatic, mechanical, caustic agents...) constitute the main aetiological factors of cheilitis. Allergic contact cheilitis should be investigated with a detailed anamnesis in order to search any causative agent in contact with the oral mucosae. Patch testing is required to confirm the diagnosis of delayed hypersensivity. Chronic actinic cheilitis occurs mostly in middle-aged, fair-skinned men. It is a potentially malignant condition that requires biopsies to exclude severe dysplasia or carcinoma. Angular cheilitis can occur spontaneously but is frequently related with several precipitating factors, such as systemic immune suppression, local irritation and moisture, fungal and/or bacterial infection. Cheilitis can also be seen in various systemic conditions such as lichen planus, lupus, atopic dermatitis and nutritional deficiencies. Erosive and crusty cheilitis and bullous erosive stomatitis are the main oral features of erythema multiforme and Stevens-Johnson syndrome. Granulomatous macrocheilitis (cheilitis granulomatosa) presents with intermittent or permanent lip swelling. It should be confirmed by a biopsy. It can be either isolated (Miescher macrocheilitis) or associated with various systemic conditions.

  20. Creep-Fatigue Failure Diagnosis

    Directory of Open Access Journals (Sweden)

    Stuart Holdsworth

    2015-11-01

    Full Text Available Failure diagnosis invariably involves consideration of both associated material condition and the results of a mechanical analysis of prior operating history. This Review focuses on these aspects with particular reference to creep-fatigue failure diagnosis. Creep-fatigue cracking can be due to a spectrum of loading conditions ranging from pure cyclic to mainly steady loading with infrequent off-load transients. These require a range of mechanical analysis approaches, a number of which are reviewed. The microstructural information revealing material condition can vary with alloy class. In practice, the detail of the consequent cracking mechanism(s can be camouflaged by oxidation at high temperatures, although the presence of oxide on fracture surfaces can be used to date events leading to failure. Routine laboratory specimen post-test examination is strongly recommended to characterise the detail of deformation and damage accumulation under known and well-controlled loading conditions to improve the effectiveness and efficiency of failure diagnosis.

  1. Celiac Disease Diagnosis and Management

    Science.gov (United States)

    Leffler, Daniel

    2012-01-01

    Celiac disease is one of the most prevalent autoimmune gastrointestinal disorders but as the case of Ms. J illustrates, diagnosis is often delayed or missed. Based on serology studies, the prevalence of celiac disease in many populations is estimated to be approximately 1% and has been increasing steadily over the last 50 years. Evaluation for celiac disease is generally straightforward, and uses commonly available serologic tests, however the signs and symptoms of celiac disease are nonspecific and highly heterogeneous making diagnosis difficult. While celiac disease is often considered a mild disorder treatable with simple dietary changes, in reality celiac disease imparts considerable risks including reduced bone mineral density, impaired quality of life, and increased overall mortality. In addition, the gluten free diet is highly burdensome and can profoundly affect patients and their families. For these reasons, care of individuals with celiac disease requires prompt diagnosis and ongoing multidisciplinary management. PMID:21990301

  2. The definition of HIV-associated neurocognitive disorders: are we overestimating the real prevalence?

    Directory of Open Access Journals (Sweden)

    Gisslén Magnus

    2011-12-01

    Full Text Available Abstract Background A substantial prevalence of mild neurocognitive disorders has been reported in HIV, also in patients treated with combination antiretroviral therapy (cART. This includes a new disorder that has been termed asymptomatic neurocognitive impairment (ANI. Discussion ANI is identified by performance on formal neuropsychological testing that is at least 1 SD below the mean of normative scores in at least two cognitive domains out of at least five examined in patients without associated symptoms or evident functional impairment in daily living. While two tests are recommended to assess each domain, only one is required to fulfill this diagnostic criterion. Unfortunately, this definition necessitates that about 20% of the cognitively normal HIV-infected population is classified as suffering ANI. This liberal definition raises important ethical concerns and has as well diagnostic and therapeutic implications. Since neither its biological substrate, prognostic significance nor therapeutic implications are clearly established, we recommend that this diagnosis be modified or applied cautiously. Summary The diagnoses of less severe forms of neurocognitive disorders in HIV relies on the outcomes of neuropsychological testing, and a high proportion of HIV-infected patients with effective cART may be classified as neurocognitively abnormal using the current criteria. The definition of ANI is not stringent, and results in approximately 20% of the population being classified as abnormal. To us this seems an unacceptable false-positive rate.

  3. The definition of HIV-associated neurocognitive disorders: are we overestimating the real prevalence?

    Science.gov (United States)

    Gisslén, Magnus; Price, Richard W; Nilsson, Staffan

    2011-12-28

    A substantial prevalence of mild neurocognitive disorders has been reported in HIV, also in patients treated with combination antiretroviral therapy (cART). This includes a new disorder that has been termed asymptomatic neurocognitive impairment (ANI). ANI is identified by performance on formal neuropsychological testing that is at least 1 SD below the mean of normative scores in at least two cognitive domains out of at least five examined in patients without associated symptoms or evident functional impairment in daily living. While two tests are recommended to assess each domain, only one is required to fulfill this diagnostic criterion. Unfortunately, this definition necessitates that about 20% of the cognitively normal HIV-infected population is classified as suffering ANI. This liberal definition raises important ethical concerns and has as well diagnostic and therapeutic implications. Since neither its biological substrate, prognostic significance nor therapeutic implications are clearly established, we recommend that this diagnosis be modified or applied cautiously. The diagnoses of less severe forms of neurocognitive disorders in HIV relies on the outcomes of neuropsychological testing, and a high proportion of HIV-infected patients with effective cART may be classified as neurocognitively abnormal using the current criteria. The definition of ANI is not stringent, and results in approximately 20% of the population being classified as abnormal. To us this seems an unacceptable false-positive rate.

  4. 49 CFR 385.3 - Definitions and acronyms.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Definitions and acronyms. 385.3 Section 385.3 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY... General § 385.3 Definitions and acronyms. Applicable safety regulations or requirements means 49 CFR...

  5. 15 CFR 904.2 - Definitions and acronyms.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Definitions and acronyms. 904.2 Section 904.2 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued... PROCEDURES General § 904.2 Definitions and acronyms. Unless the context otherwise requires, or as otherwise...

  6. 40 CFR 158.2100 - Microbial pesticides definition and applicability.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Microbial pesticides definition and...) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR PESTICIDES Microbial Pesticides § 158.2100 Microbial pesticides definition and applicability. (a) This subpart applies to all living or dead microbial pesticides as...

  7. [Clinical aspects and diagnosis of pleural fibromas].

    Science.gov (United States)

    Smati, B; Djilani, H; Boudaya, M S; Ghrib, B S; Mestiri, T; Mezni, F; Bouacha, H; Kilani, T

    2005-12-01

    Pleural fibromas are rare malignant or benign tumors requiring pathology study for certain diagnosis. From January 1985 to January 2001, 7 patients underwent surgery in our unit for pleural fibroma: 4 females and 3 males, mean age 60 years. The inaugural symptoms were chest pain (3 patients), dyspnea (2 patients), joint pain in a patient with Pierre-Marie pneumonic hypertrophic osteo-arthropathy, and acute hypoglycemia. Radiological investigations were decisive in orienting the diagnosis (chest X-ray, ultrasound, computed tomography and MRI). Surgical resection and pathological study of the surgical specimen is required to confirm the diagnosis. Patients should be carefully followed due to the risk of malignant recurrence.

  8. 16 CFR 1209.32 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... SAFETY STANDARD FOR CELLULOSE INSULATION Certification § 1209.32 Definitions. In addition to the... of cellulose insulation subject to the standard which bears a private label as defined in section 3(a... samples of the cellulose insulation being produced to demonstrate that the product meets the requirements...

  9. 32 CFR 22.105 - Definitions.

    Science.gov (United States)

    2010-07-01

    ..., or testing of specific products, systems or processes to be considered for sale or acquisition; these efforts are within the definition of “development.” Basic research. Efforts directed toward increasing...). It does not include development of military systems and hardware where specific requirements have...

  10. 7 CFR 2900.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Definitions. 2900.2 Section 2900.2 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ENERGY POLICY AND NEW USES, DEPARTMENT OF AGRICULTURE ESSENTIAL AGRICULTURAL USES AND VOLUMETRIC REQUIREMENTS-NATURAL GAS POLICY ACT §...

  11. 38 CFR 21.35 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... eligible veteran at any educational institution required by the Administrator of the Small Business... Small Business Act. (Authority: 15 U.S.C. 636(i)(1), 38 U.S.C. 3452(b)) (d) Program of independent... terminology. The following are primarily intended as explanations rather than definitions of terms to...

  12. 48 CFR 32.301 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... REQUIREMENTS CONTRACT FINANCING Loan Guarantees for Defense Production 32.301 Definitions. As used in this... guaranteed loan. Federal Reserve Board means the Board of Governors of the Federal Reserve System. Guaranteed... loans, through Federal Reserve Banks, for expediting national defense production. ...

  13. 20 CFR 655.302 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Definitions. 655.302 Section 655.302 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR TEMPORARY EMPLOYMENT OF... temporary or interim licensing requirements which authorize the nurse to be employed) governing the place...

  14. 41 CFR 51-1.3 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... disabilities (including blind) for not less than 75 percent of the work-hours of direct labor required to... COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 1-GENERAL § 51-1.3 Definitions. As... employment and training opportunities for persons who are blind or have other severe disabilities...

  15. 38 CFR 51.2 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... day health care, and hospital care. Hospital care may be provided only when the State home also... convalescents or other persons who are not acutely ill and not in need of hospital care, but who require skilled... NURSING HOME CARE OF VETERANS IN STATE HOMES General § 51.2 Definitions. For purposes of this...

  16. 40 CFR 158.3 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR PESTICIDES General Provisions § 158.3 Definitions. All terms defined in sec. 2 of the Federal Insecticide, Fungicide, and Rodenticide Act apply to this part and are used with the meaning given in the...

  17. 40 CFR 156.203 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS LABELING REQUIREMENTS FOR PESTICIDES AND DEVICES Worker Protection Statements § 156.203 Definitions. Terms in this subpart have the same meanings as they do in the Federal Insecticide, Fungicide, and Rodenticide Act,...

  18. 48 CFR 919.7002 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... the Secretary of Education to meet the requirements of 20 U.S.C. 1067k. Small business concern owned and controlled by service-disabled veterans means a small business concern as defined in Public Law... BUSINESS PROGRAMS The Department of Energy Mentor-Protege Program 919.7002 Definitions. Historically...

  19. 9 CFR 417.1 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... REQUIREMENTS UNDER THE FEDERAL MEAT INSPECTION ACT AND THE POULTRY PRODUCTS INSPECTION ACT HAZARD ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS § 417.1 Definitions. For purposes of this part, the following... property that may cause a food to be unsafe for human consumption. HACCP System. The HACCP plan...

  20. 12 CFR 13.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY GOVERNMENT SECURITIES SALES PRACTICES § 13.2 Definitions. (a) Bank that is a government securities broker or dealer means a national bank that has filed notice, or is required to file notice, as a government securities broker or dealer...

  1. Definition of a Storage Accounting Record

    CERN Document Server

    Jensen, H. T.; Müller-Pfefferkorn, R.; Nilsen, J. K.; Zsolt, M.; Zappi, R.

    2011-01-01

    In this document a storage accounting record StAR is defined reflecting practical, financial and legal requirements of storage location, usage and space and data flow. The definition might be the base for a standardized schema or an extension of an existing record like the OGF UR.

  2. 40 CFR 142.2 - Definitions.

    Science.gov (United States)

    2010-07-01

    ..., facilities, equipment, operation and maintenance for producing and distributing safe drinking water. Service... PRIMARY DRINKING WATER REGULATIONS IMPLEMENTATION General Provisions § 142.2 Definitions. As used in this... the requirements of subpart H of this part. National primary drinking water regulation means any...

  3. 22 CFR 513.105 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... implementing regulations, the equal employment opportunity acts and executive orders, or the environmental... GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (GRANTS) General § 513.105 Definitions. The following... possession of the United States, or any agency of a State, exclusive of institutions of higher education...

  4. 48 CFR 36.102 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS General 36.102 Definitions. As used in this part— Contract is intended to refer to a contract for construction or a contract for architect-engineer services, unless another meaning is clearly intended. Design means defining the construction requirement...

  5. 44 CFR 361.2 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... Earthquake Hazards Reduction Assistance Program § 361.2 Definitions. Cash Contribution means the State cash... approved budget. Certification represents the Governor's written assurance describing the steps State agencies will take toward meeting the 50 percent cash contribution required following the third year...

  6. 12 CFR 368.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY GOVERNMENT SECURITIES SALES PRACTICES § 368.2 Definitions. (a) Bank that is a government securities broker or dealer... required to file notice, as a government securities broker or dealer pursuant to section 15C of...

  7. 12 CFR 208.77 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... capital levels required to be well capitalized under the capital adequacy regulations or guidelines... Federal Deposit Insurance Act (12 U.S.C. 1813). (c) Capital-related definitions. (1) The terms “Tier 1 capital”, “tangible equity”, “risk-weighted assets” and “total assets” have the meanings given those...

  8. 40 CFR 97.102 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... record of the measured parameters in the measurement units required by subpart HH of this part. Biomass... definition shall equal the unit's total energy input from all fuel except biomass if the unit is a boiler... any petroleum-based fuel (including diesel fuel or petroleum derivatives such as oil tar) and...

  9. 17 CFR 248.120 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... trust, general or limited partnership, association, or similar organization. (f) Concise—(1) In general... disclosures required or authorized by Federal or State law. (g) Consumer means an individual. (h) Control of a... communication of which would be a consumer report if the exclusions from the definition of “consumer report”...

  10. 29 CFR 99.105 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... accepted government auditing standards (GAGAS). The term auditor does not include internal auditors of non... Definitions. Audit finding means deficiencies which the auditor is required by § 99.510(a) to report in the... which must be audited under this part. Auditor means an auditor that is a public accountant or a...

  11. The ALICE definition of primary particles

    CERN Document Server

    2017-01-01

    In this public note, we specify what we mean by the term ``primary particle''. The definition is motivated by what is in principle measurable by ALICE and that event generators and other such theoretical considerations must be able to reproduce the same requirements. To this end, we also provide a Rivet projection to be used in ALICE Rivet analyses.

  12. 16 CFR 315.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Definitions. 315.2 Section 315.2 Commercial... prescriber receives the prescription verification information from the seller, and shall conclude when eight... for which State or Federal law requires a prescription. Contact lens fitting means the process...

  13. Astronomical Catalogues - Definition Elements and Afterlife

    Science.gov (United States)

    Jaschek, C.

    1984-09-01

    Based on a look at the different meanings of the term catalogue (or catalog), a definition is proposed. In an analysis of the main elements, a number of requirements that catalogues should satisfy are pointed out. A section is devoted to problems connected with computer-readable versions of printed catalogues.

  14. 5 CFR 9701.404 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Definitions. 9701.404 Section 9701.404 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF... measurable or observable knowledge, skills, abilities, behaviors, and other characteristics required by a...

  15. 5 CFR 9701.603 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Definitions. 9701.603 Section 9701.603 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF... knowledge, skills, abilities, behaviors, and other characteristics required by a position. Current...

  16. 22 CFR 1007.2 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... Relations INTER-AMERICAN FOUNDATION SALARY OFFSET § 1007.2 Definitions. For the purposes of the part, the... remains from an employee's federal pay after the required deductions for social security, federal, state... be under the supervision or control of the President of the Inter-American Foundation. Paying...

  17. 42 CFR 137.280 - Construction Definitions.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Construction Definitions § 137... environmental assessment nor an environmental impact statement is required. Any procedures under this section... environmental effect. CEQ means Council on Environmental Quality in the Office of the President....

  18. 10 CFR 851.3 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... collocated. Occupational medicine provider means the designated site occupational medicine director (SOMD) or... 10 Energy 4 2010-01-01 2010-01-01 false Definitions. 851.3 Section 851.3 Energy DEPARTMENT OF... compliance with the requirements of this part. DOE means the United States Department of Energy,...

  19. 16 CFR 1512.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... REQUIREMENTS FOR BICYCLES Regulations § 1512.2 Definitions. For the purposes of this part: (a) Bicycle means...-wheeled vehicle with fully operable pedals and an electric motor of less than 750 watts (1 h.p.), whose... who weighs 170 pounds, is less than 20 mph. (b) Sidewalk bicycle means a bicycle with a seat height of...

  20. Elementary Analysis on the Technological Features of an Engineering Equipment Facile Diagnosis System

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    From the point of systemic engineering, the general properties of an engineering equipment fault diagnosis system and the studying object of diagnosis engineering were discussed. With the developing course of fault diagnosis technology, the relationship be-tween facile diagnosis system and diagnosis engineering were also discussed. The basic structure and feature of a facile diagnosis system were discussed, and the isomorphic of a facile diagnosis system and precise diagnosis system was presented. The facile diagnosis requires the perfection of method, pertinence and apriority of knowledge , adaptability of the object being diagnosed and the approach to the aim of the diagnosis result, as well as the outstanding of main functions.

  1. Measurement Decision Risk - The Importance of Definitions

    Science.gov (United States)

    Mimbs, Scott M.

    2008-01-01

    One of the more misunderstood areas of metrology is the Test Uncertainty Ratio (TUR) and the Test Accuracy Ratio (TAR). There have been many definitions over the years, but why are these definitions important to a discussion on measurement decision risk? The importance lies in the clarity of communication. Problems can immediately arise in the application (or misapplication) of the definition of these terms. In other words, while it is important to understand the definitions, it is more important to understand concepts behind the definitions and to be precise in how they are applied. The objective of any measurement is a decision. Measurement Decision Risk is a way to look at the quality of a measurement, and although it is not a new concept, it has generated a lot of attention since its addition as a requirement in the new U.S. National Standard, ANSIINCSL Z540.3-2006. In addition to Measurement Decision Risk as the prime method of managing measurement risk, Z540.3 has added, as a fall-back, an explicit definition for TUR. The impact these new requirements may have on calibration service providers has become the topic of much discussion and in some cases concern. This paper will look at the concepts behind the definitions and how they relate to Measurement Decision Risk. Using common examples, this paper will also provide a comparison of various elements of risk related to measurement science using the concepts of TAR, TUR, accuracy ratios, and Consumer Risk (False Accept Risk). The goal of this paper is to provide a better understanding of their relevance to the measurement decision process.

  2. Repeatability of Pulse Diagnosis and Body Constitution Diagnosis in Traditional Indian Ayurveda Medicine.

    Science.gov (United States)

    Kurande, Vrinda; Waagepetersen, Rasmus; Toft, Egon; Prasad, Ramjee; Raturi, Lokesh

    2012-11-01

    In Ayurveda, pulse diagnosis and body constitution diagnosis have a long historical use; still, there is lack of quantitative measure of the reliability of these diagnostic methods. Reliability means consistency of information. Consistent diagnosis leads to consistent treatment and is important for clinical practice, education, and research. The objective of this study is to study the methodology to evaluate the test-retest reliability (repeatability) of pulse diagnosis and body constitution diagnosis. A double-blinded, controlled, clinical trial was conducted in Copenhagen. The same doctor, an expert in Ayurvedic pulse diagnosis, examined the pulse and body constitution of 17 healthy participants twice, in random order without seeing them. A metric on pulse and body constitution variables was developed. Cohen's weighted kappa statistic was used as a measure of intra-rater reliability. Permutation tests were used to test the hypothesis of homogeneous diagnosis (ie, the doctor's diagnosis does not depend on the subject). The hypothesis of homogeneous classification was rejected on the 5% significance level (P values of .02 and .001, respectively, for pulse and body constitution diagnosis). According to the Landis and Koch scale, values of the weighted kappa for pulse diagnosis (P = .42) and body constitution diagnosis (P = .65) correspond to "moderate" and "substantial" agreement, respectively. There was a reasonable level of consistency between 2 pulse and body constitution diagnoses. Further studies are required to quantify inter-subject and intra-subject agreement for greater understanding of reliability of pulse and body constitution diagnosis.

  3. Repeatability of Pulse Diagnosis and Body Constitution Diagnosis in Traditional Indian Ayurveda Medicine

    Science.gov (United States)

    Waagepetersen, Rasmus; Toft, Egon; Prasad, Ramjee; Raturi, Lokesh

    2012-01-01

    In Ayurveda, pulse diagnosis and body constitution diagnosis have a long historical use; still, there is lack of quantitative measure of the reliability of these diagnostic methods. Reliability means consistency of information. Consistent diagnosis leads to consistent treatment and is important for clinical practice, education, and research. The objective of this study is to study the methodology to evaluate the test-retest reliability (repeatability) of pulse diagnosis and body constitution diagnosis. A double-blinded, controlled, clinical trial was conducted in Copenhagen. The same doctor, an expert in Ayurvedic pulse diagnosis, examined the pulse and body constitution of 17 healthy participants twice, in random order without seeing them. A metric on pulse and body constitution variables was developed. Cohen's weighted kappa statistic was used as a measure of intra-rater reliability. Permutation tests were used to test the hypothesis of homogeneous diagnosis (ie, the doctor's diagnosis does not depend on the subject). The hypothesis of homogeneous classification was rejected on the 5% significance level (P values of .02 and .001, respectively, for pulse and body constitution diagnosis). According to the Landis and Koch scale, values of the weighted kappa for pulse diagnosis (P = .42) and body constitution diagnosis (P = .65) correspond to “moderate” and “substantial” agreement, respectively. There was a reasonable level of consistency between 2 pulse and body constitution diagnoses. Further studies are required to quantify inter-subject and intra-subject agreement for greater understanding of reliability of pulse and body constitution diagnosis. PMID:27257530

  4. Distal symmetrical polyneuropathy: definition for clinical research.

    Science.gov (United States)

    England, J D; Gronseth, G S; Franklin, G; Miller, R G; Asbury, A K; Carter, G T; Cohen, J A; Fisher, M A; Howard, J F; Kinsella, L J; Latov, N; Lewis, R A; Low, P A; Sumner, A J

    2005-01-01

    The objective of this report was to develop a case definition of "distal symmetrical polyneuropathy" to standardize and facilitate clinical research and epidemiological studies. A formalized consensus process was employed to reach agreement after a systematic review and classification of evidence from the literature. The literature indicates that symptoms alone have relatively poor diagnostic accuracy in predicting the presence of polyneuropathy; signs are better predictors of polyneuropathy than symptoms; and single abnormalities on examination are less sensitive than multiple abnormalities in predicting the presence of polyneuropathy. The combination of neuropathic symptoms, signs, and electrodiagnostic findings provides the most accurate diagnosis of distal symmetrical polyneuropathy. A set of case definitions was rank ordered by likelihood of disease. The highest likelihood of polyneuropathy (useful for clinical trials) occurs with a combination of multiple symptoms, multiple signs, and abnormal electrodiagnostic studies. A modest likelihood of polyneuropathy (useful for field or epidemiological studies) occurs with a combination of multiple symptoms and multiple signs when the results of electrodiagnostic studies are not available. A lower likelihood of polyneuropathy occurs when electrodiagnostic studies and signs are discordant. For research purposes, the best approach for defining distal symmetrical polyneuropathy is a set of case definitions rank ordered by estimated likelihood of disease. The inclusion of this formalized case definition in clinical and epidemiological research studies will ensure greater consistency of case selection.

  5. Evolving Definitions of Mental Illness and Wellness

    Directory of Open Access Journals (Sweden)

    Tara W. Strine, MPH

    2010-01-01

    Full Text Available Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused definition of mental illnesses, and from an “absence of disease” model to one that stresses positive psychological function for mental health. Currently, wellness refers to the degree to which one feels positive and enthusiastic about oneself and life, whereas illness refers to the presence of disease. These definitions apply to physical as well as mental illness and wellness. In this article, we build on the essential concepts of wellness and illness, discuss how these definitions have changed over time, and discuss their importance in the context of health reform and health care reform. Health reform refers to efforts focused on health, such as health promotion and the development of positive well-being. Health care reform refers to efforts focused on illness, such as treatment of disease and related rehabilitation efforts.

  6. Prospective evaluation of three rapid diagnostic tests for diagnosis of human leptospirosis.

    Directory of Open Access Journals (Sweden)

    Marga G A Goris

    Full Text Available BACKGROUND: Diagnosis of leptospirosis by the microscopic agglutination test (MAT or by culture is confined to specialized laboratories. Although ELISA techniques are more common, they still require laboratory facilities. Rapid Diagnostic Tests (RDTs can be used for easy point-of-care diagnosis. This study aims to evaluate the diagnostic performance of the RDTs LeptoTek Dri Dot, LeptoTek Lateral Flow, and Leptocheck-WB, prospectively. METHODOLOGY: During 2001 to 2012, one or two of the RDTs at the same time have been applied prior to routine diagnostics (MAT, ELISA and culture on serum specimens from participants sent in for leptospirosis diagnosis. The case definition was based on MAT, ELISA and culture results. Participants not fulfilling the case definition were considered not to have leptospirosis. The diagnostic accuracy was determined based on the 1(st submitted sample and paired samples, either in an overall analysis or stratified according to days post onset of illness. RESULTS: The overall sensitivity and specificity for the LeptoTek Dri Dot was 75% respectively 96%, for the LeptoTek Lateral Flow 78% respectively 95%, and for the Leptocheck-WB 78% respectively 98%. Based on the 1(st submitted sample the sensitivity was low (51% for LeptoTek Dri Dot, 69% for LeptoTek Lateral Flow, and 55% for Leptocheck-WB, but substantially increased when the results of paired samples were combined, although accompanied by a lower specificity (82% respectively 91% for LeptoTek Dri Dot, 86% respectively 84% for LeptoTek Lateral Flow, and 80% respectively 93% for Leptocheck-WB. CONCLUSIONS: All three tests present antibody tests contributing to the diagnosis of leptospirosis, thus supporting clinical suspicion and contributing to awareness. Since the overall sensitivity of the tested RDTs did not exceed 80%, one should be cautious to rely only on an RDT result, and confirmation by reference tests is strongly recommended.

  7. An Einstein-Cartan Fine Structure Constant Definition

    Directory of Open Access Journals (Sweden)

    Stone R. A. Jr.

    2010-01-01

    Full Text Available The fine structure constant definition given in Stone R.A. Jr. Progress in Physics, 2010, v.1, 11-13 is compared to an Einstein-Cartan fine structure constant definition. It is shown that the Einstein-Cartan definition produces the correct pure theory value, just not the measure value. To produce the measured value, the pure theory Einstein-Cartan fine structure constant requires only the new variables and spin coupling of the fine structure constant definition in [1].

  8. Clinical Assessment And Diagnosis Of Dementia

    Directory of Open Access Journals (Sweden)

    Srikanth S

    2005-01-01

    Full Text Available Dementia is characterized by progressive decline in an alert individual, leading to loss of independence in day-to-day functioning. It is a generic term for a condition that has various causes and hence myriad clinical presentations. It has to be distinguished from age-related cognitive decline, depression and delirium all of which are common in the elderly population. Detailed history and mental status examination are necessary to identify dementia, fit it into one of the various bedside classifications and pursue the differential diagnosis. This teaching review summarizes current information on definition, differential diagnosis and classification of dementia and presents a brief elaboration of bedside cognitive testing pertaining to dementia. A bird′s eye view of the profiles of various dementia subtypes is also provided so that after reading this article the reader will able to recognize dementia, conduct clinical examination to identify the characteristic cognitive profile and formulate the differential diagnosis with confidence.

  9. Influenza outbreak during Sydney World Youth Day 2008: the utility of laboratory testing and case definitions on mass gathering outbreak containment.

    Directory of Open Access Journals (Sweden)

    Sebastiaan J van Hal

    Full Text Available BACKGROUND: Influenza causes annual epidemics and often results in extensive outbreaks in closed communities. To minimize transmission, a range of interventions have been suggested. For these to be effective, an accurate and timely diagnosis of influenza is required. This is confirmed by a positive laboratory test result in an individual whose symptoms are consistent with a predefined clinical case definition. However, the utility of these clinical case definitions and laboratory testing in mass gathering outbreaks remains unknown. METHODS AND RESULTS: An influenza outbreak was identified during World Youth Day 2008 in Sydney. From the data collected on pilgrims presenting to a single clinic, a Markov model was developed and validated against the actual epidemic curve. Simulations were performed to examine the utility of different clinical case definitions and laboratory testing strategies for containment of influenza outbreaks. Clinical case definitions were found to have the greatest impact on averting further cases with no added benefit when combined with any laboratory test. Although nucleic acid testing (NAT demonstrated higher utility than indirect immunofluorescence antigen or on-site point-of-care testing, this effect was lost when laboratory NAT turnaround times was included. The main benefit of laboratory confirmation was limited to identification of true influenza cases amenable to interventions such as antiviral therapy. CONCLUSIONS: Continuous re-evaluation of case definitions and laboratory testing strategies are essential for effective management of influenza outbreaks during mass gatherings.

  10. [Endoscopic diagnosis of enterobiasis].

    Science.gov (United States)

    Johansen, N; Petersen, H D

    2000-02-28

    This article describes two cases of worm-infestation with symptomatology, diagnosis and treatment. The cases are discussed in respect to the other cases in the literature emphasizing symptomatology and diagnosis by endoscopy.

  11. Acute disseminated encephalomyelitis in children: differential diagnosis from multiple sclerosis on the basis of clinical course

    Directory of Open Access Journals (Sweden)

    Yun Jin Lee

    2011-06-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM is a demyelinating disease of the central nervous system (CNS that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS. Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

  12. Erythroid Krüppel-like factor (EKLF) is active in primitive and definitive erythroid cells and is required for the function of 5'HS3 of the beta-globin locus control region.

    Science.gov (United States)

    Tewari, R; Gillemans, N; Wijgerde, M; Nuez, B; von Lindern, M; Grosveld, F; Philipsen, S

    1998-04-15

    Disruption of the gene for transcription factor EKLF (erythroid Krüppel-like factor) results in fatal anaemia caused by severely reduced expression of the adult beta-globin gene, while other erythroid-specific genes, including the embryonic epsilon- and fetal gamma-globin genes, are expressed normally. Thus, EKLF is thought to be a stage-specific factor acting through the CACC box in the beta-gene promoter, even though it is already present in embryonic red cells. Here, we show that a beta-globin gene linked directly to the locus control region (LCR) is expressed at embryonic stages, and that this is only modestly reduced in EKLF-/- embryos. Thus, embryonic beta-globin expression is not intrinsically dependent on EKLF. To investigate whether EKLF functions in the locus control region, we analysed the expression of LCR-driven lacZ reporters. This shows that EKLF is not required for reporter activation by the complete LCR. However, embryonic expression of reporters driven by 5'HS3 of the LCR requires EKLF. This suggests that EKLF interacts directly with the CACC motifs in 5'HS3 and demonstrates that EKLF is also a transcriptional activator in embryonic erythropoiesis. Finally, we show that overexpression of EKLF results in an earlier switch from gamma- to beta-globin expression. Adult mice with the EKLF transgene have reduced platelet counts, suggesting that EKLF levels affect the balance between the megakaryocytic and erythroid lineages. Interestingly, the EKLF transgene rescues the lethal phenotype of EKLF null mice, setting the stage for future studies aimed at the analysis of the EKLF protein and its role in beta-globin gene activation.

  13. 40 CFR 63.8 - Monitoring requirements.

    Science.gov (United States)

    2010-07-01

    ... standard(s) unless the Administrator— (i) Specifies or approves the use of minor changes in methodology for the specified monitoring requirements and procedures (see § 63.90(a) for definition); or (ii) Approves... (see § 63.90(a) for definition). (iii) Owners or operators with flares subject to § 63.11(b) are...

  14. Achalasia: from diagnosis to management.

    Science.gov (United States)

    Vaezi, Michael F; Felix, Valter N; Penagini, Roberto; Mauro, Aurelio; de Moura, Eduardo Guimarães Hourneaux; Pu, Leonardo Zorrón Cheng Tao; Martínek, Jan; Rieder, Erwin

    2016-10-01

    Achalasia is an esophageal motility disorder associated with abnormalities in peristalsis and lower esophageal sphincter (LES) relaxation. The etiology of the disease remains elusive. It is often misdiagnosed initially as gastroesophageal reflux disease. Patients with achalasia often complain of dysphagia to solids and liquids but may focus on regurgitation as the primary symptom, leading to the early misdiagnosis. Chest pain, weight loss, and occasional vomiting may be additional symptoms encountered in those with achalasia. The disease may be suspected on the basis of clinical presentation, but diagnosis depends on classic findings using high-resolution manometry, showing either failed or simultaneous contractions with associated normal or high LES pressures with no or incomplete relaxation with swallows. There are no cures for achalasia, and, in most patients, treatments have to be repeated over time. Definitive treatment options in achalasia include pneumatic dilation, surgical myotomy, and the new technique of per-oral endoscopic myotomy. Botulinum toxin (Botox) or other medical therapies are often reserved for those who cannot have definitive therapies owing to comorbid conditions. © 2016 New York Academy of Sciences.

  15. 40 CFR 98.40 - Definition of the source category.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electricity Generation § 98.40 Definition of the source... required to monitor and report to EPA CO2 emissions year-round according to 40 CFR part 75. (b) This...

  16. Analyzing Differences in Operational Disease Definitions Using Ontological Modeling

    NARCIS (Netherlands)

    Peelen, Linda; Klein, Michel; Schlobach, Stefan; Keizer, de Nicolette; Peek, Niels

    2007-01-01

    In medicine, there are many diseases which cannot be precisely characterized but are considered as natural kinds. In the communication between health care professionals, this is generally not problematic. In biomedical research, however, crisp definitions are required to unambiguously distinguish

  17. Planetary Protection Technology Definition Team: Tasks, Status, and Feedback

    Science.gov (United States)

    Meyer, M. A.; Rummel, J. D.

    2016-10-01

    A Planetary Protection and Technology Definition Team will assess challenges to meeting planetary protection requirements to instruments and will suggest technological solutions. Status and initial findings will be reported.

  18. Fetal cardiology: changing the definition of critical heart disease in the newborn.

    Science.gov (United States)

    Słodki, M; Respondek-Liberska, M; Pruetz, J D; Donofrio, M T

    2016-08-01

    Infants born with congenital heart disease (CHD) may require emergent treatment in the newborn period. These infants are likely to benefit the most from a prenatal diagnosis, which allows for optimal perinatal planning. Several cardiac centers have created guidelines for the management of these high-risk patients with CHD. This paper will review and compare several prenatal CHD classification systems with a particular focus on the most critical forms of CHD in the fetus and newborn. A contemporary definition of critical CHD is one which requires urgent intervention in the first 24 h of life to prevent death. Such cardiac interventions may be not only life saving for the infant but also decrease subsequent morbidity. Critical CHD cases may require delivery at specialized centers that can provide perinatal, obstetric, cardiology and cardiothoracic surgery care. Fetuses diagnosed in mid-gestation require detailed fetal diagnostics and serial monitoring during the prenatal period, in order to assess for ongoing changes and identify progression to a more severe cardiac status. Critical CHD may progress in utero and there is still much to be learned about how to best predict those who will require urgent neonatal interventions. Despite improved therapeutic capabilities, newborns with critical CHD continue to have significant morbidity and mortality due to compromise that begins in the delivery room. Fetal echocardiography is the best way to predict the need for specialized care at birth to improve outcome. Once the diagnosis is made of critical CHD, delivery at the proper time and in appropriate institution with specific care protocols should be initiated. More work needs to be done to better delineate the risk factors for progression of critical CHD and to determine which newborns will require specialized care. The most frequently described forms of critical CHD requiring immediate intervention include hypoplastic left heart syndrome with intact or severely restricted

  19. Direct Urease Test and Acridine Orange Staining on Bactec Blood Culture for Rapid Presumptive Diagnosis of Brucellosis

    Directory of Open Access Journals (Sweden)

    P Maleknejad

    2005-08-01

    Full Text Available Brucellosis is one of the most common zoonotic diseases in Iran and human brucellosis is endemic in all parts of the country. Growth of Brucella is slow and blood culture of these bacteria by use of classical methods is time-consuming. Furthermore, in endemic area culture is required for definitive diagnosis. In the present study, direct urease test and acridine orange staining were tried on the BACTEC blood culture broths for early presumptive identification of Brucella growth. Blood cultures were attempted in 102 seropositive patients. In the forty one blood cultures positive for Brucella, coccobacilli were seen in broth smears stained with acridine orange stain, and also were urease test positive, thus providing presumptive identification of Brucella growth. Urease test was negative and bacteria were not seen in the broth smears of the remaining 61 broths negative for Brucella growth. Because of simplicity, reliability and reproducibility, these tests can be routinely incorporated in the laboratory for diagnosis of brucellosis.

  20. Catalog of 199 register-based definitions of chronic conditions

    DEFF Research Database (Denmark)

    Hvidberg, Michael F; Johnsen, Søren P; Glümer, Charlotte

    2016-01-01

    definitions were proposed based on record linkage between multiple registers, including registers of prescribed drugs and use of general practitioners' services. CONCLUSIONS THIS STUDY PROVIDED A CATALOG OF REGISTER-BASED DEFINITIONS FOR CHRONIC CONDITIONS FOR USE IN HEALTHCARE PLANNING AND RESEARCH, WHICH IS......INTRODUCTION: The aim of the current study was to present and discuss a broad range of register-based definitions of chronic conditions for use in register research, as well as the challenges and pitfalls when defining chronic conditions by the use of registers. MATERIALS AND METHODS......: The definitions were defined based on information from nationwide Danish public healthcare registers. Medical and epidemiological specialists identified and grouped relevant diagnosis codes that covered chronic conditions, using the International Classification System version 10 (ICD-10). Where relevant...

  1. Postpartal nursing diagnosis.

    Science.gov (United States)

    Gorrie, T M

    1986-01-01

    The responsibility of nurses for postpartal patients has changed greatly in the past few years. No longer is it adequate to assess and manage only those physical problems that occur during the hospital stay. Today, potential psychosocial problems and consequences of parental knowledge deficit are part of nursing's domain of diagnosis and management. A review of the purpose of nursing diagnosis is important. Clarifying the difference between medical diagnosis and nursing diagnosis is also essential if one is to be comfortable with the process. Careful scrutiny of the unique needs of new parents will form the basis for formulating meaningful postpartal nursing diagnosis.

  2. High-Definition Medicine.

    Science.gov (United States)

    Torkamani, Ali; Andersen, Kristian G; Steinhubl, Steven R; Topol, Eric J

    2017-08-24

    The foundation for a new era of data-driven medicine has been set by recent technological advances that enable the assessment and management of human health at an unprecedented level of resolution-what we refer to as high-definition medicine. Our ability to assess human health in high definition is enabled, in part, by advances in DNA sequencing, physiological and environmental monitoring, advanced imaging, and behavioral tracking. Our ability to understand and act upon these observations at equally high precision is driven by advances in genome editing, cellular reprogramming, tissue engineering, and information technologies, especially artificial intelligence. In this review, we will examine the core disciplines that enable high-definition medicine and project how these technologies will alter the future of medicine. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. The International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of porcine islet products in type 1 diabetes--chapter 1: Key ethical requirements and progress toward the definition of an international regulatory framework.

    Science.gov (United States)

    Cozzi, Emanuele; Tallacchini, Mariachiara; Flanagan, Enda B; Pierson, Richard N; Sykes, Megan; Vanderpool, Harold Y

    2009-01-01

    The outstanding results recently obtained in islet xenotransplantation suggest that porcine islet clinical trials may soon be scientifically appropriate. Before the initiation of such clinical studies, however, it is essential that a series of key ethical and regulatory conditions are satisfied. As far as ethics is concerned, the fundamental requirements have been previously reported in a position paper of the Ethics Committee of the International Xenotransplantation Association. These include aspects related to the selection of adequately informed, appropriate recipients; animal breeding and welfare; safety issues and the need for a favorable risk/benefit assessment based on strong efficacy data in relevant xenotransplantation studies in the primate. As most diabetic patients are not at risk of short-term mortality without islet transplantation, only a small subset of patients could currently be considered for any type of islet transplant. However, there are potential advantages to xenotransplantation that could result in a favorable benefit-over-harm determination for islet xenotransplantation in this subpopulation and ultimately in a broader population of diabetic patients. With regard to regulatory aspects, the key concepts underlying the development of the regulatory models in existence in the United States, Europe and New Zealand are discussed. Each of these models provides an example of a well-defined regulatory approach to ensure the initiation of well-regulated and ethically acceptable clinical islet xenotransplantation trials. At this stage, it becomes apparent that only a well-coordinated international effort such as that initiated by the World Health Organization, aimed at harmonizing xenotransplantation procedures according to the highest ethical and regulatory standards on a global scale, will enable the initiation of clinical xenotransplantation trials under the best auspices for its success and minimize any risk of failure.

  4. Causas do retardo na confirmação diagnóstica de lesões mamárias em mulheres atendidas em um centro de referência do Sistema Único de Saúde no Rio de Janeiro Factors leading to delay in obtaining definitive diagnosis of suspicious lesions for breast cancer in a dedicated health unit in Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Magda Côrtes Rodrigues Rezende

    2009-02-01

    Full Text Available OBJETIVO: avaliar os fatores que levam ao retardo na confirmação diagnóstica de lesões mamárias suspeitas de câncer. MÉTODOS: foi realizado um estudo observacional de corte transversal. Foram incluídas 104 mulheres que procuraram um hospital de câncer, com diagnóstico ou suspeita de câncer de mama. Foi aplicado um questionário semiestruturado com perguntas referentes às características demográficas, clínicas e de utilização de serviços. As variáveis foram comparadas pelos testes t de Student, Mann-Whitney, χ2 de Pearson ou exato de Fisher, conforme a indicação. A fim de identificar as variáveis associadas ao retardo na confirmação diagnóstica do câncer de mama, foram calculadas as Odds Ratio (OR com intervalo com 95% de confiança (IC95% e um modelo de regressão logística foi elaborado. RESULTADOS: a média de idade foi de 54 anos (±12,6, predominando mulheres brancas (48,1%, casadas (63,5%, residentes no Município do Rio de Janeiro (57,7% e com baixo grau de escolaridade (60,6%. O tempo mediano entre o primeiro sinal ou sintoma da doença e a primeira consulta foi de um mês, e desta última até a confirmação diagnóstica de 6,5 meses. Em 51% das mulheres o diagnóstico foi tardio (estádios II a IV. Presença de sintomas, longo intervalo de tempo entre o início dos sintomas e a primeira avaliação e entre o início dos sintomas e a confirmação diagnóstica, mostraram-se fatores significantes (pPURPOSE: to evaluate the factors leading to delays in obtaining definitive diagnosis of suspicious lesions for breast cancer. METHODS: a cross-sectional, observational study was carried out with 104 women attending a cancer hospital with a diagnosis or suspected diagnosis of breast cancer. A semistructured questionnaire on the patients' demographic, clinical characteristics and the use of services was applied.Variables were compared using t-Student test, Mann-Whitney test, Pearson's χ2 test or Fisher's exact test

  5. A generalized definition of dosimetric quantities.

    Science.gov (United States)

    Kellerer, A M; Rossi, H H

    1990-04-01

    The current definitions of microdosimetric and dosimetric quantities use the notion of 'ionizing radiation'. However, this notion is not rigorously defined, and its definition would require the somewhat arbitrary choice of specified energy cut-off values for different types of particles. Instead of choosing fixed cut-off values one can extend the system of definitions by admitting the free selection of a category of types and energies of particles that are taken to be part of the field. In this way one extends the system of dosimetric quantities. Kerma and absorbed dose appear then as special cases of a more general dosimetric quantity, and an analogue to kerma can be obtained for charged particle fields; it is termed cema. A modification that is suitable for electron fields is termed reduced cema.

  6. Prebiotics: why definitions matter.

    Science.gov (United States)

    Hutkins, Robert W; Krumbeck, Janina A; Bindels, Laure B; Cani, Patrice D; Fahey, George; Goh, Yong Jun; Hamaker, Bruce; Martens, Eric C; Mills, David A; Rastal, Robert A; Vaughan, Elaine; Sanders, Mary Ellen

    2016-02-01

    The prebiotic concept was introduced twenty years ago, and despite several revisions to the original definition, the scientific community has continued to debate what it means to be a prebiotic. How prebiotics are defined is important not only for the scientific community, but also for regulatory agencies, the food industry, consumers and healthcare professionals. Recent developments in community-wide sequencing and glycomics have revealed that more complex interactions occur between putative prebiotic substrates and the gut microbiota than previously considered. A consensus among scientists on the most appropriate definition of a prebiotic is necessary to enable continued use of the term.

  7. Definition of Entity Authentication

    DEFF Research Database (Denmark)

    Ahmed, Naveed; Jensen, Christian D.

    2010-01-01

    Authentication is considered a pre-requisite for communication security, but the definition of authentication is generally not agreed upon. Many attacks on authentication protocols are the result of misunderstanding of the goals of authentication. This state of affairs indicate limitations...... in theoretical understanding of the meanings of authentication. We provide a new insight in this direction and formalize it in CFPS (Common Framework for authentication Protocols' Specifications). CFPS provides a precise scope of definition for authentication protocols, which could make the design and analysis...

  8. Prebiotics: why definitions matter

    Science.gov (United States)

    Hutkins, Robert W; Krumbeck, Janina A; Bindels, Laure B; Cani, Patrice D; Fahey, George; Goh, Yong Jun; Hamaker, Bruce; Martens, Eric C; Mills, David A; Rastal, Robert A; Vaughan, Elaine; Sanders, Mary Ellen

    2015-01-01

    The prebiotic concept was introduced twenty years ago, and despite several revisions to the original definition, the scientific community has continued to debate what it means to be a prebiotic. How prebiotics are defined is important not only for the scientific community, but also for regulatory agencies, the food industry, consumers and healthcare professionals. Recent developments in community-wide sequencing and glycomics have revealed that more complex interactions occur between putative prebiotic substrates and the gut microbiota than previously considered. A consensus among scientists on the most appropriate definition of a prebiotic is necessary to enable continued use of the term. PMID:26431716

  9. Definition of Information

    Directory of Open Access Journals (Sweden)

    Boris Sunik

    2011-12-01

    Full Text Available This definition can be applied to information of every kind, level and complexity. Information is considered as the feature manifesting itself in the relations between certain real world
    entities. The real world has to be seen in terms of objects, actions, relations and properties.. The defintion is used as the basis of the Theory of Meaningful Information [1] that explains the nature and functionality of information and enables the production of relevant definitions regarding language and knowledge, which remain operative also in the case of non-human languages and
    knowledge systems.

  10. 7 CFR 1780.3 - Definitions and grammatical rules of construction.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Definitions and grammatical rules of construction... and Requirements § 1780.3 Definitions and grammatical rules of construction. (a) Definitions. For the... bonds means bonds which have equal standing with other bonds of the same Issuer. Poverty line means the...

  11. 14 CFR 61.1 - Applicability and definitions.

    Science.gov (United States)

    2010-01-01

    ... requirements for a sport pilot certificate with powered parachute privileges or a private pilot certificate... definitions. (a) This part prescribes: (1) The requirements for issuing pilot, flight instructor, and ground...; and the privileges and limitations of those certificates and ratings. (2) The requirements for issuing...

  12. Communication issues in migraine diagnosis.

    Science.gov (United States)

    Edmeads, John

    2002-06-01

    To examine the importance of good communication when informing the patient of the diagnosis of migraine; to review the essentials of successful communication between physician and patient on the aspect of diagnosis; to survey learning resources for physicians on communicating information to patients. This paper is based on observations made by the author of the successful interactions of numerous international "headache experts" with their patients, on a review of the medical education literature pertaining to the teaching of communication skills, and on 30 years of not always successful communication with patients. Communicating the diagnosis of migraine is an opportunity to educate and reassure the patient, to lay the foundation for rational treatment and to help establish the successful doctor-patient relationship which is essential for effective management. No matter how accurate the diagnosis, failure to communicate it effectively to the patient (and often to significant others) may impair interactions with the patient and compromise therapy. Effective communication of a diagnosis requires clarity, relevance to the patient, a positive attitude, and reinforcement through repetition, questioning and dialogue. In terms of using the diagnosis to lay a foundation for therapy, it is useful to explain the symptoms as transient physical dysfunction of normal tissues, to indicate that there are multiple mechanisms underlying the dysfunction of which only some may presently be susceptible to treatment and to stress the relevance of emotions as factors which may powerfully affect, for better or worse, the underlying disturbed physiology of migraine. Into this model can be "plugged" all the relevant therapies for migraine. This is the ideal, but every day experience in the headache consultant's office suggest that in both primary care and specialist practice, it is infrequently attained. There are scant resources other than example for physicians to learn communication of

  13. Generalized metamaterials: Definitions and taxonomy.

    Science.gov (United States)

    Kim, Noori; Yoon, Yong-Jin; Allen, Jont B

    2016-06-01

    This article reviews the development of metamaterials (MM), starting from Newton's discovery of the wave equation, and ends with a discussion of the need for a technical taxonomy (classification) of these materials, along with a better defined definition of metamaterials. It is intended to be a technical definition of metamaterials, based on a historical perspective. The evolution of MMs began with the discovery of the wave equation, traceable back to Newton's calculation of the speed of sound. The theory of sound evolved to include quasi-statics (Helmholtz) and the circuit equations of Kirchhoff's circuit laws, leading to the ultimate development of Maxwell's equations and the equation for the speed of light. Be it light, or sound, the speed of the wave-front travel defines the wavelength, and thus the quasi-static (QS) approximation. But there is much more at stake than QSs. Taxonomy requires a proper statement of the laws of physics, which includes at least the six basic network postulates: (P1) causality (non-causal/acausal), (P2) linearity (non-linear), (P3) real (complex) time response, (P4) passive (active), (P5) time-invariant (time varying), and (P6) reciprocal (non-reciprocal). These six postulates are extended to include MMs.

  14. Age at diagnosis and breast cancer survival in iran

    NARCIS (Netherlands)

    Vostakolaei, F.A.; Broeders, M.J.M.; Rostami, N.; Dijck, J.A. van; Feuth, T.; Kiemeney, L.A.L.M.; Verbeek, A.L.M.

    2012-01-01

    Background. Tumour characteristics are the most important prognostic factors in breast cancer. Patient-related factors such as young age at diagnosis, obesity, and smoking behaviour may also modify disease outcome. Due to the absence of a unique definition for "young age breast cancer" and the

  15. Curriculum Guidelines for Postdoctoral Oral Diagnosis/Oral Medicine.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    The American Association of Dental Schools' Curriculum Guidelines for oral diagnosis and medicine include a definition of the discipline, its interrelationships with other disciplines, a curriculum overview, primary educational goals, prerequisites, a core content outline, specific behavioral objectives, and notes on sequencing, faculty, and…

  16. The Use of Neuroimaging in the Diagnosis of Mitochondrial Disease

    Science.gov (United States)

    Friedman, Seth D.; Shaw, Dennis W. W.; Ishak, Gisele; Gropman, Andrea L.; Saneto, Russell P.

    2010-01-01

    Mutations in nuclear and mitochondrial DNA impacting mitochondrial function result in disease manifestations ranging from early death to abnormalities in all major organ systems and to symptoms that can be largely confined to muscle fatigue. The definitive diagnosis of a mitochondrial disorder can be difficult to establish. When the constellation…

  17. Gliomatosis cerebri--an appropriate diagnosis? Case reports

    DEFF Research Database (Denmark)

    Fallentin, E; Skriver, E; Herning, Gudrun Margrethe

    1997-01-01

    and pathologically resembled gliomatosis cerebri. RESULTS AND CONCLUSION: Some astrocytomas have an immense potential for diffuse infiltration and they would seem to be more frequent than recognized hitherto. The definition of gliomatosis cerebri as a separate entity is questionable, and a diagnosis of diffusely...

  18. The Use of Homosexuality as a Psychiatric Diagnosis for Women.

    Science.gov (United States)

    Shachar, Sandra A.

    Although research on homosexuality has utilized psychiatric patients as subjects, few studies have examined the use of homosexuality as a psychiatric diagnosis. Using the Diagnostic and Statistical Manual of Mental Disorders (DSM) definition of homosexuality as a psychiatric disorder only when homosexuality is ego-dystonic, an intensive review of…

  19. Primary hyperparathyroidism, adrenal tumors and neuroendocrine tumors of the pancreas - clinical diagnosis and imaging requirements; Primaerer Hyperparathyreoidismus, Tumoren der Nebenniere und neuroendokrine Tumoren des Pankreas. Klinische Diagnostik und Anforderungen an die Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Auernhammer, C.J.; Engelhardt, D.; Goeke, B. [Medizinische Klinik II, Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Grosshadern (Germany)

    2003-04-01

    Diseases of the parathyroids, the adrenals and of neuroendocrine tumors of the pancreas are primarily diagnosed by clinical and endocrinological evaluation.The requirements concerning various imaging techniques and their relative importance in localization strategies of the different tumors are complex. Current literature search, using PubMed. Evaluation of primary hyperparathyroidism requires bone densitometry by DXA and search for nephrolithiasis by ultrasound or native CT examination.While ultrasound of the thyroid and parathyroids seems useful before any parathyroid surgery,more extensive preoperative localization strategies (sestamibi scintigraphy, MRI) should be restricted to minimal invasive parathyroid surgery or reoperations.For adrenal tumors CT and MRI are of similar diagnostic value. Imaging of pheochromocytomas should be completed by MIBG scintigraphy. Each adrenal incidentaloma requires an endocrinological work-up.A fine-needle aspiration or core needle biopsy of an adrenal tumor is rarely indicated.Before adrenal biopsy a pheochromocytoma has to be excluded.Successful localization strategies for neuroendocrine tumors of the pancreas include somatostatin receptor scintigraphy, endoscopic ultrasound and MRI.Discussion Specific localization strategies have been established for the aforementioned tumors.The continuous progress of different imaging techniques requires a regular reevaluation of these localization strategies. (orig.) [German] Die Diagnostik von Erkrankungen der Nebenschilddruese, der Nebenniere und von neuroendokrinen Tumoren des Pankreas erfolgt primaer klinisch-endokrinologisch.Die Anforderungen an die Bildgebung bei der nachfolgenden Lokalisationsdiagnostik sind komplex, und die verschiedenen bildgebenden Verfahren bei den jeweiligen Tumorentitaeten von unterschiedlichem Stellenwert.Material und Methodik Aktuelle Literaturrecherche mittels PubMed.Ergebnisse Beim primaeren Hyperparathyreoidismus sind die Bestimmung der Knochendichte

  20. Subjective poverty line definitions

    NARCIS (Netherlands)

    J. Flik; B.M.S. van Praag (Bernard)

    1991-01-01

    textabstractIn this paper we will deal with definitions of subjective poverty lines. To measure a poverty threshold value in terms of household income, which separates the poor from the non-poor, we take into account the opinions of all people in society. Three subjective methods will be discussed

  1. Definition of Entity Authentication

    DEFF Research Database (Denmark)

    Ahmed, Naveed; Jensen, Christian D.

    2010-01-01

    Authentication is considered a pre-requisite for communication security, but the definition of authentication is generally not agreed upon. Many attacks on authentication protocols are the result of misunderstanding of the goals of authentication. This state of affairs indicate limitations in the...

  2. Romanian definite article revisited

    Directory of Open Access Journals (Sweden)

    Sorin Paliga

    1999-12-01

    Full Text Available I shall attempt to resume a long, almost endless discussion: the origin of the Romanian definite article. Any grammar of Romanian or any comparative grammar the Romance languages (e. g. Tagliavini 1977 always observes that Romanian, an iso­ lated case in the Romance family, has an agglutinated definite article. The typology is not indeed rare: Bulgarian, Albanian, Armenian, Basque and Swedish witness the same mechanism. We cannot approach the topic by analysing all these languages, yet a comparative analysis would be finally useful. In our case, it is obvious that Romanian cannot be isolated from Albanian and Bulgarian. A potential solution must explain the situation in ALL these three "Balkanic" languages, even if Romanian is not Balkanic stricto sensu1. The paper shall focus on the deep roots of the Romanian and Albanian definite arti­ cle, its typological relations with other linguistic areas, and shall attempt to explain this isolated situation in the field of Romance linguistics. For sure, the Romanian definite article mainly reflects the Latin heritage. Nevertheless, by saying only this, the tableau is not complete: some forms are not Latin but Pre-Latin, Thracian. This paper will try to substantiate this assertion.

  3. Subjective poverty line definitions

    NARCIS (Netherlands)

    J. Flik; B.M.S. van Praag (Bernard)

    1991-01-01

    textabstractIn this paper we will deal with definitions of subjective poverty lines. To measure a poverty threshold value in terms of household income, which separates the poor from the non-poor, we take into account the opinions of all people in society. Three subjective methods will be discussed a

  4. The definition of sarcopenia

    NARCIS (Netherlands)

    Bijlsma, Astrid Y.

    2013-01-01

    Sarcopenia in old age has been associated with a higher mortality, poor physical functioning, poor outcome of surgery and higher drug toxicity. There is no general consensus on the definition of sarcopenia. The aim of the research presented in this thesis was to assess the implications of the use of

  5. Definition af primitiver

    DEFF Research Database (Denmark)

    Christensen, Morten

    1997-01-01

    tidspunkt, kan der spares meget tid senere, hvor det er besværligt at definerer primitiverne helt om.I denne rapport er de primitiver, der skal bruges til Sydkrafts net gennemgået. Der er taget stilling til hver enkelt tilstand for de forskellige primitiver. Dette er gjort for at få en definition, som er...

  6. Definition of Professional Development

    Science.gov (United States)

    Learning Forward, 2015

    2015-01-01

    President Obama signed into law the Every Student Succeeds Act, the reauthorization of the Elementary and Secondary Education Act, on December 10, 2015. "Learning Forward's focus in this new law is its improved definition of professional learning," said Stephanie Hirsh, executive director of Learning Forward. "We've long advocated…

  7. The definition of sarcopenia

    NARCIS (Netherlands)

    Bijlsma, Astrid Y.

    2013-01-01

    Sarcopenia in old age has been associated with a higher mortality, poor physical functioning, poor outcome of surgery and higher drug toxicity. There is no general consensus on the definition of sarcopenia. The aim of the research presented in this thesis was to assess the implications of the use of

  8. COPD: Definition and Phenotypes

    DEFF Research Database (Denmark)

    Vestbo, J.

    2014-01-01

    particles or gases. Exacerbations and comorbidities contribute to the overall severity in individual patients. The evolution of this definition and the diagnostic criteria currently in use are discussed. COPD is increasingly divided in subgroups or phenotypes based on specific features and association...

  9. Problems with the diagnosis of endometriosis.

    Science.gov (United States)

    Berker, Bulent; Seval, Murat

    2015-08-01

    Endometriosis is classically defined as the presence of endometrial glands and stroma in outside the uterine cavity. As the definition suggests that confirming the ectopic endometrial stroma and glands in ectopic location histopathologically should be necessary for the diagnosis of endometriosis. Therefore, this situation leads to the need for surgery like laparoscopy for diagnosis. However, this surgical diagnostic approach will not be reliable for all patients with suspected endometriosis. It seems to be an important problem that there is still no reliable clinically diagnostic method or pathognomonic clinical finding, which may allow accurate diagnosis of endometriosis without the need for surgery or histopathologic evaluation. While these clinical features are not pathognomonic for the endometriosis, they should be used as markers for creating high-risk population for endometriosis. Clinical features and the available diagnostic methods, their advantages and limitations for the endometriosis will be discussed in this article. The different options for clinical assessment, laboratory tests and imaging techniques will be summarized and the advantages and disadvantages of these methods will be evaluated. We will also discuss the gold standard definitive diagnostic options with their problematic aspects.

  10. Definitions of Acute-On-Chronic Liver Failure: The Past, the Present, and the Future

    Directory of Open Access Journals (Sweden)

    Roland Amathieu

    2015-01-01

    Full Text Available Acute-on-chronic liver failure (ACLF is an entity used to define patients with liver cirrhosis presenting with acute decompensation. For over 20 years, ACLF has taken multiple definitions and/or classifications. Unfortunately, to date, there has not been a universally accepted definition/classification of this entity. In this short review, we discuss the definition evolution of ACLF, the strengths and weaknesses of the existing definitions and classifications, and finally the potential role of the ‘omic’ approaches for the diagnosis of this complex syndrome.

  11. Definições operacionais das características definidoras do diagnóstico de enfermagem Volume de Líquidos Excessivo Definiciones operacionales de las características definidoras del diagnóstico de enfermería Volumen de Líquídos Excesivo Operational definitions of the defining characterístics of the nursing diagnosis Fluid Volume Excess

    Directory of Open Access Journals (Sweden)

    Rita Narriman Silva de Oliveira Boery

    2005-06-01

    Full Text Available As definições operacionais são requisitos importantes no ensino da Semiologia e Semiotécnica nos Cursos de Graduação e Pós-Graduação em Enfermagem. Este estudo descritivo, acerca das definições operacionais elaboradas para as características definidoras do diagnóstico de enfermagem Volume de Líquidos Excessivo em portadores de cardiopatias foi realizado a partir de revisão da literatura, no período de 1985 a 2001. As definições operacionais foram analisadas criticamente por quatro enfermeiros especialistas em diferentes campos clínicos de atuação. Após os ajustes sugeridos por esses especialistas, os dados foram enviados a uma consultora técnica, para avaliação conclusiva.Las definiciones operacionales son subsidios importantes para la ensveñanza de Semiologia y Semiotécnica en los cursos de pre y pós grado. Este estudio descriptivo, aurea de las caracteristicas definidoras del diagnóstico de enfermaria Volumen de Liquidos Excesivo en pacientes cardíacos, que realizado a partir de revision de literatura, del período de 1985 a 2001. las definiciones operacionales elaboradas fueron analizadas por cuatro enfermeros especialistas que actuavan en diferentes campos clínicos. Despues de realizar las correcciones sugeridas por esas especialistas, los dados fueron enviados a uma consultora técnica para evoluación final.Operational definitions are important tools for teaching Semiology and Semiotechuiques both for undergraduate and graduate nursing students. This descriptive study on the operational definitions of the defining characteristics of nursing diagnosis Fluid Volume Excess in cardiac patients was based on literature review regarding the period from 1985 to 2001. The operational definitions were analyzed by four expert nurses from different clinical areas. After the suggested corrections were made, the data was submitted to a technical consultant for final evaluation.

  12. Active fault diagnosis by controller modification

    DEFF Research Database (Denmark)

    Stoustrup, Jakob; Niemann, Hans Henrik

    2010-01-01

    Two active fault diagnosis methods for additive or parametric faults are proposed. Both methods are based on controller reconfiguration rather than on requiring an exogenous excitation signal, as it is otherwise common in active fault diagnosis. For the first method, it is assumed that the system...... in a way that guarantees the continuity of transition and global stability using a recent result on observer parameterization. An illustrative example inspired by a field study of a drag racing vehicle is given. For the second method, an active fault diagnosis method for parametric faults is proposed...

  13. Clinical approach to the patient with diabetes mellitus and very high insulin requirements.

    Science.gov (United States)

    Ovalle, F

    2010-12-01

    A number of patients with diabetes require very high (> 2 Ukg⁻¹ day⁻¹), or extremely high (> 3 Ukg⁻¹ day⁻¹), insulin doses for the management of their hyperglycemia. Unfortunately, many of the physicians who treat these patients limit themselves to prescribing ever higher doses of insulin, without questioning why. Furthermore, when the insulin requirements get to be extreme, demanding an explanation, clinicians are frequently lost in a sea of literature where there is not a single paper dealing with this problem systematically. A systematic approach to the evaluation of these patients is necessary to facilitate an appropriate diagnosis, select the most reasonable therapy, and hopefully improve the long-term outcome of these patients. This manuscript intends to provide the clinician with a review of the literature pertinent for the differential diagnosis, work-up, and management of these patients. We will review the definitions of insulin sensitivity during normality, the various degrees or categories of insulin resistance, and the expected insulin requirements during each of these states. Subsequently, we propose a simple alphabetic mnemonic approach to help remember the differential diagnosis, and a clinical algorithm to help guide the work-up of these patients. Lastly, we briefly discuss general management considerations in these conditions.

  14. On some positive definite functions

    OpenAIRE

    Bhatia, Rajendra; Jain, Tanvi

    2014-01-01

    We study the function $(1 - \\|x\\|)\\slash (1 - \\|x\\|^r),$ and its reciprocal, on the Euclidean space $\\mathbb{R}^n,$ with respect to properties like being positive definite, conditionally positive definite, and infinitely divisible.

  15. Definitions of Health Terms: Nutrition

    Science.gov (United States)

    ... gov/definitions/nutritiondefinitions.html Definitions of Health Terms: Nutrition To use the sharing features on this page, ... National Institutes of Health, Office of Dietary Supplements Nutrition This field of study focuses on foods and ...

  16. A practical method for clinical diagnosis of oral mucosal melanomas.

    Science.gov (United States)

    Delgado Azañero, Wilson A; Mosqueda Taylor, Adalberto

    2003-01-01

    To present a practical and technically simple method for clinical diagnosis of oral melanomas that allows to differentiate this neoplasm from other pigmented lesions. Thirteen oral pigmented lesions with suspected diagnosis of mucosal melanomas were submitted to a test named "rubbing with a gauze" the surface of the lesion. The test was considered positive when the gauze stained dark brown or black due to the presence of melanin-laden cells on the epithelial surface. In all cases definite diagnosis was confirmed by biopsy. Positive results were obtained in 11 out of 13 cases (84.6%). Our results establish that the test "rubbing with gauze" the surface of oral pigmented lesions demonstrates a high sensitivity to anticipate clinically the diagnosis of mucosal melanomas. However, a negative result does not exclude this neoplasm, since there are some cases in which malignant cells have not invaded the superficial epithelial layers. In every case the final diagnosis must be established by histopathologic or immunohistochemical analysis.

  17. A Difficult Diagnosis

    DEFF Research Database (Denmark)

    Primholdt, Nina; Primdahl, Jette; Hendricks, Oliver

    2017-01-01

    the onset of symptoms to diagnosis of 5.4 years. The analysis resulted in the following three themes: 'Daily living and psychological reactions', 'A difficult diagnosis' and 'Working life and identity'. CONCLUSIONS: It took a long time to make the correct diagnosis, and the period before diagnosis...... framework was grounded in critical psychology, and the analysis was based on Kvale and Brinkmann's meaning condensation. RESULTS: The five men interviewed were 21-37 years old. At the time of the interview, the participants had been diagnosed with AS for an average of 2.6 years, with an average time from...

  18. Preclinical diagnosis of Alzheimer's disease: Prevention or prediction?

    Directory of Open Access Journals (Sweden)

    Ricardo Nitrini

    Full Text Available Abstract The diagnosis of Alzheimer's disease (AD for cases with dementia may be too late to allow effective treatment. Criteria for diagnosis of preclinical AD suggested by the Alzheimer's Association include the use of molecular and structural biomarkers. Preclinical diagnosis will enable testing of new drugs and forms of treatment toward achieving successful preventive treatment. But what are the advantages for the individual? To know that someone who is cognitively normal is probably going to develop AD's dementia when there is no effective preventive treatment is definitely not good news. A research method whereby volunteers are assigned to receive treatment or placebo without knowing whether they are in the control or at-risk arm of a trial would overcome this potential problem. If these new criteria are used wisely they may represent a relevant milestone in the search for a definitive treatment for AD.

  19. Incidence, diagnosis and pathophysiology of amniotic fluid embolism.

    Science.gov (United States)

    Ito, F; Akasaka, J; Koike, N; Uekuri, C; Shigemitsu, A; Kobayashi, H

    2014-10-01

    Amniotic fluid embolism (AFE) is a rare clinical entity, sometimes fatal. A review was conducted to describe the frequency, diagnosis and pathophysiology of AFE. The reported incidences ranged from 1.9 cases per 100,000 maternities (UK) to 6.1 per 100,000 maternities (Australia), which can vary considerably, depending on the period, region of study and the definition. Although the development of amniotic fluid-specific markers would have an impact on early diagnosis, definition of AFE based on these markers is not widely accepted. To date, immunological mechanisms, amniotic fluid-dependent anaphylactic reaction and complement activation, have been proposed as potential pathogenetic and pathophysiological mechanisms. Immune cell activation induced through complement activation may be associated with the mechanism that immediately initiates maternal death, only in susceptible individuals. This review will focus on advances in the field of AFE biology and discuss the prevalence, diagnosis and pathophysiology of AFE.

  20. A New Definition of Creativity

    Science.gov (United States)

    Dorin, Alan; Korb, Kevin B.

    Creative artifacts can be generated by employing A-Life software, but programmers must first consider, explicitly or implicitly, what would count as creative. Most apply standard definitions that incorporate notions of novelty, value and appropriateness. Here we re-assess this approach. Some basic facts about creativity suggest criteria that guide us to a new definition of creativity. We briefly defend our definition against some plausible objections and explore the ways in which this new definition differs and improves upon the alternatives.

  1. A Definition of Artificial Intelligence

    OpenAIRE

    2012-01-01

    In this paper we offer a formal definition of Artificial Intelligence and this directly gives us an algorithm for construction of this object. Really, this algorithm is useless due to the combinatory explosion. The main innovation in our definition is that it does not include the knowledge as a part of the intelligence. So according to our definition a newly born baby also is an Intellect. Here we differs with Turing's definition which suggests that an Intellect is a person with knowledge gai...

  2. 42 CFR 409.3 - Definitions.

    Science.gov (United States)

    2010-10-01

    ...) demonstrates to CMS's satisfaction that a significant portion of its patients are low-income, and (2) requests... nursing care and related services for inpatients who require medical or nursing care; (c) Provides 24-hour... of doctors of medicine or osteopathy, inpatient services for the diagnosis, treatment, and care...

  3. 21 CFR 1270.3 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... human for the diagnosis, cure, mitigation, treatment, or prevention of any condition or disease; (2) Is...) Excludes kidney, liver, heart, lung, pancreas, or any other vascularized human organ; and (5) Excludes... all required infectious disease tests, and a listing of the documents reviewed as part of the...

  4. Application of the 2012 revised diagnostic definitions for paediatric multiple sclerosis and immune-mediated central nervous system demyelination disorders

    NARCIS (Netherlands)

    van Pelt, E. Danielle; Neuteboom, Rinze F.; Ketelslegers, Immy A.; Boon, Maartje; Catsman-Berrevoets, Coriene E.; Hintzen, Rogier Q.

    2014-01-01

    Background Recently, the International Paediatric Multiple Sclerosis Study Group (IPMSSG) definitions for the diagnosis of immune-mediated acquired demyelinating syndromes (ADS) of the central nervous system, including paediatric multiple sclerosis (MS), have been revised. Objective To evaluate the

  5. Diagnosis of bacterial infection

    African Journals Online (AJOL)

    History and examination to determine if a patient fits a clinical case definition is sometimes adequate to ... Division of Infectious Diseases and HIV Medicine, Department of Medicine, .... on a microarray with automated qualitative analysis.

  6. Definitions of Health Terms: Fitness

    Science.gov (United States)

    ... this page: https://medlineplus.gov/definitions/fitnessdefinitions.html Definitions of Health Terms: Fitness To use the sharing features on ... the most of your exercise routine. Find more definitions on Fitness | General Health | Minerals | Nutrition | Vitamins Activity Count Physical activity is ...

  7. Definitions of Health Terms: Minerals

    Science.gov (United States)

    ... this page: https://medlineplus.gov/definitions/mineralsdefinitions.html Definitions of Health Terms : Minerals To use the sharing features on ... of the minerals that you need. Find more definitions on Fitness | General Health | Minerals | Nutrition | Vitamins Antioxidants Antioxidants are substances that ...

  8. Antenatal and postnatal radiologic diagnosis of holocarboxylase synthetase deficiency: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Bandaralage, Sahan P.S. [Gold Coast Hospital and Health Service, Southport, Queensland (Australia); Griffith University, School of Medicine, Southport, Queensland (Australia); Farnaghi, Soheil [Caboolture Hospital, Caboolture, Queensland (Australia); Dulhunty, Joel M.; Kothari, Alka [Redcliffe Hospital, Redcliffe, Queensland (Australia); The University of Queensland, School of Medicine, Herston, Queensland (Australia)

    2016-03-15

    Holocarboxylase synthetase deficiency results in impaired activation of enzymes implicated in glucose, fatty acid and amino acid metabolism. Antenatal imaging and postnatal imaging are useful in making the diagnosis. Untreated holocarboxylase synthetase deficiency is fatal, while antenatal and postnatal biotin supplementation is associated with good clinical outcomes. Although biochemical assays are required for definitive diagnosis, certain radiologic features assist in the diagnosis of holocarboxylase synthetase deficiency. To review evidence regarding radiologic diagnostic features of holocarboxylase synthetase deficiency in the antenatal and postnatal period. A systematic review of all published cases of holocarboxylase synthetase deficiency identified by a search of Pubmed, Scopus and Web of Science. A total of 75 patients with holocarboxylase synthetase deficiency were identified from the systematic review, which screened 687 manuscripts. Most patients with imaging (19/22, 86%) had abnormal findings, the most common being subependymal cysts, ventriculomegaly and intraventricular hemorrhage. Although the radiologic features of subependymal cysts, ventriculomegaly, intraventricular hemorrhage and intrauterine growth restriction may be found in the setting of other pathologies, these findings should prompt consideration of holocarboxylase synthetase deficiency in at-risk children. (orig.)

  9. Pemphigus Vulgaris: Pentingnya Diagnosis Dini, Penatalaksanaan yang Komprehensif dan Adekuat (Laporan Kasus

    Directory of Open Access Journals (Sweden)

    Sri Rezeki

    2012-10-01

    Full Text Available Pemphigus vulgaris is an autoimmune–mediated disease of skin and mucous membran leading to progressive blistering and chronic erosions. It often begins with blister formations which easily rupture. The characteristic feature is positive nikolsky sign which may or not be presented simultaneously. Establishment of early definite diagnosis is critical and requires correlation of clinical and histopathological findings. Because of this conditon is a potentially life-threatening, the risk of complications and mortality rate increases if initial management is non comprehensive and inadequate. Treatment is directed at supression of autoimmune process, typically administration of corticosteroids. This article report a case in a 51 years old woman who had painful chronic oral ulcer and poor general health condition. Prior to the visit to Oral Medicine clinic, patient was treated by her general practitioners for several months, without either established diagnosis nor comprehensive and adequate management, so that she had no clinical improvement. Clinical examination at the first visit in Oral Medicine clinic Cipto Mangunkusumo Hospital, revealed bula in the skin, conjunctivitis, easily bleed oral mucosae, widespread erosions and ulcerations of the lips, gingiva, tongue, and buccal mucosae. Biopsy of one of skin erosions demonstarting suprabasal intraepithelial acantholysis. Multi divisions in Hospital, such as Oral Medicine, Dermatology, Internal Medicine, Ophtalmology, ENT, were involved in treating this case. Patient received high dose methylprednisolone sistemically and prednisone topically for the lips. General remission achieved in several days. Thus, establishment of early definite diagnosis and adequate management are important in management of Pemphigus vulgaris.DOI: 10.14693/jdi.v16i1.20

  10. Determining the date of diagnosis – is it a simple matter? The impact of different approaches to dating diagnosis on estimates of delayed care for ovarian cancer in UK primary care

    Directory of Open Access Journals (Sweden)

    Anderson Sarah R

    2009-06-01

    Full Text Available Abstract Background Studies of cancer incidence and early management will increasingly draw on routine electronic patient records. However, data may be incomplete or inaccurate. We developed a generalisable strategy for investigating presenting symptoms and delays in diagnosis using ovarian cancer as an example. Methods The General Practice Research Database was used to investigate the time between first report of symptom and diagnosis of 344 women diagnosed with ovarian cancer between 01/06/2002 and 31/05/2008. Effects of possible inaccuracies in dating of diagnosis on the frequencies and timing of the most commonly reported symptoms were investigated using four increasingly inclusive definitions of first diagnosis/suspicion: 1. "Definite diagnosis" 2. "Ambiguous diagnosis" 3. "First treatment or complication suggesting pre-existing diagnosis", 4 "First relevant test or referral". Results The most commonly coded symptoms before a definite diagnosis of ovarian cancer, were abdominal pain (41%, urogenital problems(25%, abdominal distension (24%, constipation/change in bowel habits (23% with 70% of cases reporting at least one of these. The median time between first reporting each of these symptoms and diagnosis was 13, 21, 9.5 and 8.5 weeks respectively. 19% had a code for definitions 2 or 3 prior to definite diagnosis and 73% a code for 4. However, the proportion with symptoms and the delays were similar for all four definitions except 4, where the median delay was 8, 8, 3, 10 and 0 weeks respectively. Conclusion Symptoms recorded in the General Practice Research Database are similar to those reported in the literature, although their frequency is lower than in studies based on self-report. Generalisable strategies for exploring the impact of recording practice on date of diagnosis in electronic patient records are recommended, and studies which date diagnoses in GP records need to present sensitivity analyses based on investigation, referral

  11. Determining the date of diagnosis--is it a simple matter? The impact of different approaches to dating diagnosis on estimates of delayed care for ovarian cancer in UK primary care.

    Science.gov (United States)

    Tate, A Rosemary; Martin, Alexander G R; Murray-Thomas, Tarita; Anderson, Sarah R; Cassell, Jackie A

    2009-06-23

    Studies of cancer incidence and early management will increasingly draw on routine electronic patient records. However, data may be incomplete or inaccurate. We developed a generalizable strategy for investigating presenting symptoms and delays in diagnosis using ovarian cancer as an example. The General Practice Research Database was used to investigate the time between first report of symptom and diagnosis of 344 women diagnosed with ovarian cancer between 01/06/2002 and 31/05/2008. Effects of possible inaccuracies in dating of diagnosis on the frequencies and timing of the most commonly reported symptoms were investigated using four increasingly inclusive definitions of first diagnosis/suspicion: 1. "Definite diagnosis" 2. "Ambiguous diagnosis" 3. "First treatment or complication suggesting pre-existing diagnosis", 4 "First relevant test or referral". The most commonly coded symptoms before a definite diagnosis of ovarian cancer, were abdominal pain (41%), urogenital problems(25%), abdominal distension (24%), constipation/change in bowel habits (23%) with 70% of cases reporting at least one of these. The median time between first reporting each of these symptoms and diagnosis was 13, 21, 9.5 and 8.5 weeks respectively. 19% had a code for definitions 2 or 3 prior to definite diagnosis and 73% a code for 4. However, the proportion with symptoms and the delays were similar for all four definitions except 4, where the median delay was 8, 8, 3, 10 and 0 weeks respectively. Symptoms recorded in the General Practice Research Database are similar to those reported in the literature, although their frequency is lower than in studies based on self-report. Generalizable strategies for exploring the impact of recording practice on date of diagnosis in electronic patient records are recommended, and studies which date diagnoses in GP records need to present sensitivity analyses based on investigation, referral and diagnosis data. Free text information may be essential in

  12. 76 FR 19980 - Funding Priorities, Requirements, and Definitions

    Science.gov (United States)

    2011-04-11

    ... want to schedule an appointment for this type of accommodation or auxiliary aid, please ] contact the..., bullying, and other problems in schools create conditions that negatively affect learning. The most recent... of public schools reported that bullying occurred among students on a daily or weekly basis, and...

  13. Foundations for the definition of MOX fuel quality requirements

    Science.gov (United States)

    Bairiot, H.; Deramaix, P.; Mostin, N.; Trauwaert, E.; Vanderborck, Y.

    1991-02-01

    The quality of uranium-plutonium mixed oxide (MOX) fuel, as of any nuclear fuel, depends on the design optimization and on the fabrication process stability. The design optimization is essentially based on feed-back from irradiation experience through engineering assessment of the results; the stability of the process is necessary to justify minimal uncertainty margins in the fuel design. Since MOX fuel is quite similar to UO 2 fuel, the lessons learned from UO 2 fuels can complement the MOX experimental data base. MOX is however different from UO 2 fuel in some respects, among others: - the industrial fabrication scale is a factor 10 lower than for UO 2 fuel, - the fuel enrichment process takes place in the manufacturing plant, - the radioactivity of Pu imposes handling constraints, - Pu ages quite rapidly, altering its isotopic composition during storage, - the incorporation of Pu alters the material physics and neutronic characteristics of the fuel. In this perspective, the paper outlines some quality attributes for which MOX fuel may or even must depart from UO 2 fuel.

  14. Requirement for erythroblast-macrophage protein (Emp) in definitive erythropoiesis.

    Science.gov (United States)

    Soni, Shivani; Bala, Shashi; Hanspal, Manjit

    2008-01-01

    Emp, erythroblast-macrophage protein was initially identified as a mediator of erythroblast-macrophage interactions during erythroid differentiation. More recent studies have shown that targeted disruption of Emp leads to abnormal erythropoiesis in the fetal liver, and fetal demise. To further address the activity of Emp in the hematopoietic lineage in adult bone marrow, we conducted fetal liver HSC reconstitution assay. Emp null fetal liver cells were transplanted into lethally irradiated wild-type sibling mice, and assessed the erythropoietic activity. We found that Emp null cells rescued lethally irradiated mice with efficiency comparable to that of wild-type cells. However, the recipients of Emp null cells showed abnormal erythropoiesis as indicated by the presence of persistent anemia, extensive extramedullary erythropoiesis, and increased apoptosis of erythroid precursors. Extramedullary erythropoiesis suggests perturbed interactions between the Emp-deficient hematopoietic cells and the wild-type niche. Furthermore, in spleen colony-forming unit assays, proliferation rates of the Emp null cells were greater than those of the wild-type cells. Similarly, in vitro burst-forming unit-erythroid and colony-forming unit-erythroid assays showed increased erythroid colony numbers from Emp null livers. Morphologic examination showed that Emp null CFU-E-derived erythroblasts were immature compared to those derived from wild-type CFU-Es, suggesting that loss of Emp function in erythroid cells results in impaired proliferation and terminal differentiation. These results demonstrate that Emp plays a cell intrinsic role in the erythroid lineage.

  15. Definition of requirements for geothermal power conversion system studies

    Energy Technology Data Exchange (ETDEWEB)

    1977-06-30

    Candidate power conversion systems and criteria for comparing these systems are listed. The elements of each conceptual design and standard approaches to equipment design are described. The methods used to calculate heat and mass balances and the data used in the calculations are described. The method used in developing the economics of each system is described and factors such as construction wage rates common to all systems are included. Standard methods for developing the conceptual designs and corresponding economics are defined so that the results of each system study can be readily compared to those of the others. The candidate conversion systems are: multistage flash/binary; two stage flash with scrubbing; total flow; multistage flash/direct contact (Bechtel patented process); four stage flash/binary; binary with direct contact heat exchangers; hybrid-flash/binary; hybrid-flash/total flow; and flash/dual cycle binary. (MHR)

  16. Plantar fascia rupture: diagnosis and treatment.

    Science.gov (United States)

    Rolf, C; Guntner, P; Ericsäter, J; Turan, I

    1997-01-01

    Two patients with spontaneous medial plantar fascia rupture due to a definite injury with no prior symptoms, were referred to our institution. Clinically, there was a tender lump in the sole, and magnetic resonance imaging confirmed the diagnosis. Nonoperative treatment was sufficient in curing the acute total rupture. Endoscopic release was used on the partially ruptured plantar fascia, but it is probably more optimal in the acute phase. The literature provides no comparative data on operative or nonoperative treatment efficacy for this rare condition.

  17. Diagnosis and management of colovesical fistulas.

    Science.gov (United States)

    Shatila, A H; Ackerman, N B

    1976-07-01

    Diagnosis and management may present difficult problems in patients with colovesical fistulas. Symptoms in the urinary tract are most common, and cystoscopy, and cystography are the most valuable diagnostic procedures. It may not always be possible to demonstrate the fistula by diagnostic tests, and a high index of suspicion should be maintained in patients with inflammatory or neoplastic disease of the rectosigmoid area or bladder with recurrent cystitis. Definitive treatment should include resection of the fistula and diseased segment of the intestine. Both one stage and multistage procedures have their place in the treatment of this condition. There are specific criteria for success for a one stage procedure.

  18. Epigenetics in diagnosis of colorectal cancer

    Directory of Open Access Journals (Sweden)

    Aga Syed Sameer

    2016-03-01

    Full Text Available Colorectal cancer (CRC is a third most common epithelial carcinoma. CRC is known to develop from the early precancerous lesion to full blown malignancy via definite phases due to cumulative mutations and aberrant methylation of number of genes. The use of serum biomarkers that is non-invasive to discriminate cancer patients from healthy persons will prove to be an important tool to improve the early diagnosis of CRC. This will serve as the boon to the clinical management of the disease.

  19. Maven The Definitive Guide

    CERN Document Server

    Company, Sonatype

    2009-01-01

    Written by Maven creator Jason Van Zyl and his team at Sonatype, Maven: The Definitive Guide clearly explains how this popular tool can bring order to your software development projects. The first part of the book demonstrates Maven's capabilities through the development of several sample applications from ideation to deployment, and the second part offers a complete reference guide. Concise and to the point, this is the only guide you need to manage your project.

  20. The Logic of Definition

    Science.gov (United States)

    2009-05-01

    Wittgenstein , in his Philosophical Investigations (1953), observed that, for many phenomena, there are no necessary conditions common to all members of... Wittgenstein 1953: §66, p.27e). Wittgenstein refers to these overlapping similarities as “family resemblances” (Ibid., §67, p.27e). Few, if any, of...that is, we may resort to stipulative definition). But this is not necessary for the concept to be usable. Indeed, as Wittgenstein says, sometimes

  1. XMPP The Definitive Guide

    CERN Document Server

    Saint-Andre, Peter; Smith, Kevin

    2009-01-01

    This practical book provides everything you need to know about the Extensible Messaging and Presence Protocol (XMPP) -- the open technology for real-time communication used in instant messaging, Voice over IP, real-time collaboration, social networking, microblogging, lightweight middleware, cloud computing, and more. XMPP: The Definitive Guide walks you through the thought processes and design decisions involved in building a complete XMPP-enabled application, and adding real-time interfaces to existing applications.

  2. Definition Study PHARUS

    Science.gov (United States)

    1991-11-01

    definitie studie zijn gebruikt in het voorontwerp van het PHARUS systeem . TNO report STUDelft Page 6 ABSTRACT 3 SAMENVAlTING 4 CONTENTS 6 1 INTRODUCTION 9...University of Technology, Laboratory for Telecommunication and Remote Sensing Technology. FEL-TNO had tke lead and was responsible for the project management ...Aerospace Programs in Delft was responsible for the program management . The definition study PHARUS was started in the first half of 1988 and ended

  3. Development and validation of a Decision Support System for the automatic diagnosis of medical images from brain MRI studies

    OpenAIRE

    2015-01-01

    Decision Support Systems (DSS) for assisted medical diagnosis are computer-based systems designed to assist clinicians with decision-making tasks by automatically determining diagnosis or improving diagnostic confidence. This could allow to perform early and differential diagnosis of neurological diseases, such as Alzheimer’s Disease (AD) and Parkinson’s Disease (PD), for which definite diagnosis still remains a crucial issue. Multivariate Machine Learning (ML) methods are gaining populari...

  4. From risk for trauma to unintentional injury risk: falls--a concept analysis. Nursing Diagnosis Extension and Classification Research Team.

    Science.gov (United States)

    Schoenfelder, D P; Crowell, C M

    1999-01-01

    Concept analysis of the nursing diagnosis risk for trauma. To examine the nursing diagnosis risk for trauma and to specify the risk factors for falling. Research and informational articles on falling, and NANDA Nursing Diagnoses: Definitions and Classification, 1999-2000. Replace the current nursing diagnosis risk for trauma with the more specific nursing diagnosis unintentional injury risk: falls. The other risks included in risk for trauma (e.g., burns) also will need to be developed.

  5. Hermes flight control center: Definition status

    Science.gov (United States)

    Letalle, Pierre

    1990-10-01

    The Hermes Flight Control Center (HFCC) located in Toulouse (France) is described. The center is the third in the world after the American center in Houston and the Soviet center in Kaliningrad. All the Hermes elements, both on board and on the ground will be coordinated by the HFCC for all phases of each mission. Aspects of the detailed definition phase still in the requirements analysis subphase are described. Diagrams are used to illustrate the interplay between the different systems.

  6. New Definition and Properties of Fuzzy Entropy

    Institute of Scientific and Technical Information of China (English)

    Qing Ming; Qin Yingbing

    2006-01-01

    Let X = (x1,x2 ,…,xn ) and F(X) be a fuzzy set on a universal set X. A new definition of fuzzy entropy about a fuzzy set A on F(X), e*, is defined based on the order relation "≤" on [0,1/2] n. It is proved that e* is a σ-entropy under an additional requirement. Besides, some entropy formulas are presented and related properties are discussed.

  7. Utility requirements for fusion

    Energy Technology Data Exchange (ETDEWEB)

    Vondrasek, R.J.

    1982-02-01

    This report describes work done and results obtained during performance of Task 1 of a study of Utility Requirements and Criteria for Fusion Options. The work consisted of developing a list of utility requirements for fusion optics containing definition of the requirements and showing their relative importance to the utility industry. The project team members developed a preliminary list which was refined by discussions and literature searches. The refined list was recast as a questionnaire which was sent to a substantial portion of the utility industry in this country. Forty-three questionnaire recipients responded including thirty-two utilities. A workshop was held to develop a revised requirements list using the survey responses as a major input. The list prepared by the workshop was further refined by a panel consisting of vice presidents of the three project team firms. The results of the study indicate that in addition to considering the cost of energy for a power plant, utilities consider twenty-three other requirements. Four of the requirements were judged to be vital to plant acceptability: Plant Capital Cost, Financial Liability, Plant Safety and Licensability.

  8. [Cluster headache differential diagnosis].

    Science.gov (United States)

    Guégan-Massardier, Evelyne; Laubier, Cécile

    2015-11-01

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

  9. Structural analysis for Diagnosis

    DEFF Research Database (Denmark)

    Izadi-Zamanabadi, Roozbeh; Blanke, M.

    2001-01-01

    Aiming at design of algorithms for fault diagnosis, structural analysis of systems offers concise yet easy overall analysis. Graph-based matching, which is the essential technique to obtain redundant information for diagnosis, is re-considered in this paper. Matching is re-formulated as a problem...

  10. Structural analysis for diagnosis

    DEFF Research Database (Denmark)

    Izadi-Zamanabadi, Roozbeh; Blanke, M.

    2002-01-01

    Aiming at design of algorithms for fault diagnosis, structural analysis of systems offers concise yet easy overall analysis. Graph-based matching, which is the essential tech-nique to obtain redundant information for diagnosis, is reconsidered in this paper. Matching is reformulated as a problem...

  11. A retrospective analysis of delays in the diagnosis of lung cancer and associated costs

    Directory of Open Access Journals (Sweden)

    Gildea TR

    2017-05-01

    Full Text Available Thomas R Gildea,1 Stacey DaCosta Byfield,2 D Kyle Hogarth,3 David S Wilson,4 Curtis C Quinn5 1Department of Pulmonary, Allergy, and Critical Care Medicine and Transplant Center, Cleveland Clinic, Cleveland, OH, 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, 3Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago Medical Center, Chicago, IL, 4The Lung Institute, Columbus Regional Hospital, Columbus, IN, 5Cardiothoracic Surgery/Thoracic Surgery, Cardiothoracic Surgery of Charleston, Roper St. Francis Physician Partners Group, Charleston, SC, USA Purpose: Diagnosis of lung cancer at advanced stages can result in missed treatment opportunities, worse outcomes, and higher health care costs. This study evaluated the wait time to diagnose non-small-cell lung cancer (NSCLC and the cost of diagnosis and treatment based on the stage at diagnosis. Patients and methods: Adult patients diagnosed with NSCLC between January 2007 and September 2011 were identified from a proprietary oncology registry and linked to health insurance claims from a large US health insurance company. Continuous enrollment in the health plan was required for at least 12 months prediagnosis (baseline and at least 3 months postdiagnosis (follow-up. Use of diagnostic tests and time to diagnosis were examined. The rates of health care utilization and per-patient per-month (PPPM health care costs were calculated. Results: A total of 1,210 patients with NSCLC were included in the analysis. Most patients (93.6% had evidence of diagnostic tests beginning 5 to 6 months prior to diagnosis, and most were diagnosed at an advanced stage (23% Stage IIIb and 46% Stage IV. The PPPM total health care costs in USD pre- and postdiagnosis were $2,407±$3,364 (mean±standard deviation and $16,577±$33,550, respectively. PPPM total health care costs and utilization after lung cancer diagnosis were significantly higher among patients diagnosed at Stage

  12. Controversy around the definition of waste

    CSIR Research Space (South Africa)

    Oelofse, Suzanna HH

    2009-11-20

    Full Text Available This paper presents the information concerning the definition of waste. Discussing the importance of the clear definition, ongoing debates, broad definition of waste, problems with the broad definition, interpretation, current waste management model...

  13. Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding (2015, Nanchang, China).

    Science.gov (United States)

    Bai, Yu; Li, Zhao Shen

    2016-02-01

    Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) is one of the most common medical emergencies in China and worldwide. In 2009, we published the "Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding" for the patients in China; however, during the past years numerous studies on the diagnosis and treatment of ANVUGIB have been conducted, and the management of ANVUGIB needs to be updated. The guidelines were updated after the databases including PubMed, Embase and CNKI were searched to retrieve the clinical trials on the management of ANVUGIB. The clinical trials were evaluated for high-quality evidence, and the advances in definitions, diagnosis, etiology, severity evaluation, treatment and prognosis of ANVUGIB were carefully reviewed, the recommendations were then proposed. After several rounds of discussions and revisions among the national experts of digestive endoscopy, gastroenterology, radiology and intensive care, the 2015 version of "Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding" was successfully developed by the Chinese Journal of Internal Medicine, National Medical Journal of China, Chinese Journal of Digestion and Chinese Journal of Digestive Endoscopy. It shall be noted that although much progress has been made, the clinical management of ANVUGIB still needs further improvement and refinement, and high-quality randomized trials are required in the future. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  14. Dual diagnosis, as described by those who experience the disorder: using the Internet as a source of data.

    Science.gov (United States)

    Edward, Karen-Leigh; Robins, Alan

    2012-12-01

    The complexity of providing treatment for people with dual diagnosis is well recognized. For the purpose of this paper, the World Health Organization definition of dual diagnosis was used; that is, a person diagnosed with an alcohol or drug use problem in addition to mental illness. This research explored the personal narratives of those who experience dual diagnosis using the Internet as a data source. An important consideration in using the Internet as a data source was that Web forums can offer a sense of anonymity, allowing people to share very detailed and personal information, and providing a rich source of qualitative data. The results produced five emergent themes: spiralling out of control - again!, getting help and giving support, treating both the addiction and mental illness, having meaning and being active, and being honest with self and others. The results indicate that individuals who experience dual diagnosis are often left to navigate their personal treatment requirements across two diverse systems, and were generally not satisfied with the conflictual advice received across these two systems (i.e. alcohol and other drug and mental health services). This study has produced valuable insights related to consumer-perceived service barriers and enablers.

  15. A New Definition of Virus

    Institute of Scientific and Technical Information of China (English)

    HE Hongjun; CAO Sihua; LUO Li; FENG Tao; PAN Li; ZOU Zhiji

    2006-01-01

    Security experts have not formally defined the distinction between viruses and normal programs. The paper takes user's intension as the criteria for malice, gives a formal definition of viruses that aim at stealing or destroying files, and proposes an algorithm to detect virus correctly. Compared with traditional definitions, this new definition is easy to understand, covers more malwares, adapts development of virus technology, and defines virus on the spot. The paper has also analyzed more than 250 real viruses and finds that they are all in the domain of the new definition, this implies that the new definition has great practical significance.

  16. Imaging in the diagnosis of chronic pancreatitis

    Directory of Open Access Journals (Sweden)

    Vasile D. Balaban

    2014-12-01

    Full Text Available Chronic pancreatitis is characterised by progressive and irreversible damage of the pancreatic parenchyma and ductal system, which leads to chronic pain, loss of endocrine and exocrine functions. Clinically, pancreatic exocrine insufficiency becomes apparent only after 90% of the parenchima has been lost. Despite the simple definition, diagnosing chronic pancreatitis remains a challenge, especially for early stage disease. Because pancreatic function tests can be normal until late stages and have significant limitations, there is an incresing interest in the role of imaging techniques for the diagnosis of chronic pancreatitis. In this article we review the utility and accuracy of different imaging methods in the diagnosis of chronic pancreatitis, focusing on the role of advanced imaging (magnetic resonance imaging, endoscopic retrograde cholangiopancreatography and endoscopic ultrasound.

  17. MRI in the diagnosis of diphallia

    Energy Technology Data Exchange (ETDEWEB)

    Ghafoori, Mahyar; Varedi, Peyman [Hazrat Rasoul Akram Hospital, Radiology Department, Tehran (Iran); Hosseini, Seyed J. [Shahid Beheshti University of Medical Sciences, Department of Urology, Faculty of Medicine, Tehran (Iran)

    2007-12-15

    Diphallia or duplication of the penis is an extremely rare but well-documented anomaly. According to the presence of one or two corpora cavernosa in each of the penises, diphallia is classified into two major groups of bifid phallus or true diphallia, respectively. We report a 5-year-old boy with duplication of the penis. Significant separation of the penises and their morphology made them appear as true complete phalluses, but MRI established the definitive diagnosis of bifid phallus by demonstrating the presence of one corpus cavernosum in each penis. MRI is a valuable method for achieving the accurate diagnosis of these anomalies and associated malformations. It also provides the appropriate knowledge regarding anatomical detail and assists the surgeon in decision making and preoperative planning for the optimal surgical approach. (orig.)

  18. Diagnosis, prevention, and treatment of scabies.

    Science.gov (United States)

    Shimose, Luis; Munoz-Price, L Silvia

    2013-10-01

    Scabies remains a public health problem, especially in developing countries, with a worldwide incidence of approximately 300 million cases each year. Prolonged skin-to-skin contact is necessary to allow the transmission of the causative mite, Sarcoptes scabiei. Classic scabies presents with burrows, erythematous papules, and generalized pruritus. Clinical variants include nodular scabies and crusted scabies, also called Norwegian scabies. The diagnosis is based mainly on history and physical examination, but definitive diagnosis depends on direct visualization of the mites under microscopy. Alternative diagnostic methods include the burrow ink test, video-dermatoscopy, newly serologic tests like PCR/ELISA, and specific IgE directed toward major mite components. Treatment of scabies consists of either topical permethrin or oral ivermectin, although the optimal regimen is still unclear.

  19. Utility of a novel lipoarabinomannan assay for the diagnosis of tuberculous meningitis in a resource-poor high-HIV prevalence setting

    Directory of Open Access Journals (Sweden)

    Ndung'u Thumbi

    2009-11-01

    Full Text Available Abstract Background In Africa, tuberculous meningitis (TBM is an important opportunistic infection in HIV-positive patients. Current diagnostic tools for TBM perform sub-optimally. In particular, the rapid diagnosis of TBM is challenging because smear microscopy has a low yield and PCR is not widely available in resource-poor settings. Methods We evaluated the performance outcome of a novel standardized lipoarabinomannan (LAM antigen-detection assay, using archived cerebrospinal fluid samples, in 50 African TBM suspects of whom 68% were HIV-positive. Results Of the 50 participants 14, 23 and 13 patients had definite, probable and non-TBM, respectively. In the non-TB group there were 5 HIV positive patients who were lost to follow-up and in whom concomitant infection with Mycobacterium tuberculosis could not be definitively excluded. The test sensitivities and specificities were as follows: LAM assay 64% and 69% (cut-point 0.22, smear microscopy 0% and 100% and PCR 93% and 77%, respectively. Conclusion In this preliminary proof-of-concept study, a rapid diagnosis of TBM could be achieved using LAM antigen detection. Although specificity was sub-optimal, the estimates provided here may be unreliable because of a classification bias inherent in the study design where it was not possible to exclude TBM in the presumed non-TBM cases owing to a lack of clinical follow-up. As PCR is largely unavailable, the LAM assay may well prove to be a useful adjunct for the rapid diagnosis of TBM in high HIV-incidence settings. These preliminary results justify further enquiry and prospective studies are now required to definitively establish the place of this technology for the diagnosis of TBM.

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

    Science.gov (United States)

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

    2015-03-01

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

  1. Ineffectiveness of acid-fast inclusions in diagnosis of lead poisoning in Canada geese

    Energy Technology Data Exchange (ETDEWEB)

    Locke, L.N.; Bagley, G.E.; Young, L.T.

    1967-10-01

    Kidney tissues have been examined from Canada geese that succumbed to lead poisoning in two separate outbreaks. The frequency of occurrence of acid-fast intranuclear inclusions in these birds was quite low. In cases in which coccidiosis and lead poisoning both were involved, acid-fast inclusions were found in the kidneys of only one of three geese although all had significant levels of lead in the liver. Results from various cases indicated that Canada geese receiving a large exposure to lead may succumb without the formation of intranuclear acid-fast inclusions in the kidneys. It was concluded that a period of exposure of several days was required before the bird could respond by producing these inclusions. Definite diagnosis is based on a chemical analysis of the tissues. 1 table.

  2. Cooperative Human-Machine Fault Diagnosis

    Science.gov (United States)

    Remington, Roger; Palmer, Everett

    1987-02-01

    Current expert system technology does not permit complete automatic fault diagnosis; significant levels of human intervention are still required. This requirement dictates a need for a division of labor that recognizes the strengths and weaknesses of both human and machine diagnostic skills. Relevant findings from the literature on human cognition are combined with the results of reviews of aircrew performance with highly automated systems to suggest how the interface of a fault diagnostic expert system can be designed to assist human operators in verifying machine diagnoses and guiding interactive fault diagnosis. It is argued that the needs of the human operator should play an important role in the design of the knowledge base.

  3. Application of Prussian blue staining in the diagnosis of ocular siderosis

    Institute of Scientific and Technical Information of China (English)

    Zhen; Yang; Xiao-Li; Yang; Li-Shuai; Xu; Le; Dai; Mei-Chao; Yi

    2014-01-01

    AIM:To explore the value of Prussian blue staining in the diagnosis of ocular siderosis.METHODS:Between January 2012 and January 2013,the Prussian blue stain used in anterior lens capsule and vitreous liquid after centrifugation from patients with definitive diagnosis and suspicious diagnosed of ocular siderosis. At the same time, give a negative control.RESULTS:Anterior lens capsule membrane and liquid of vitreous cavity from patients with definitive diagnosis and suspicious diagnosed of ocular siderosis revealed ferric ions that stained positively with Prussian blue. In the control group, there is no positive reaction.CONCLUSION:Prussian blue staining in the diagnosis of ocular siderosis has a very significant worth,suspected cases can be definitive diagnosed.

  4. Technical definition for nearly zero energy buildings nZEB

    DEFF Research Database (Denmark)

    Kurnitski, Jarek; Allard, Francis; Braham, Derrick

    or maximum harmonized requirements as well as details of energy performance calculation framework, it will be up to the Member States to define what these for them exactly constitute. In the definition local conditions are to be obviously taken into account, but the uniform methodology can be used in all...... energy factors should be used for primary energy indicator calculation. For the uniform methodology, a general system boundary definition was established with inclusion of active solar and wind energy, as well as the guidance for technical meaning of “nearby” in the directive.......This REHVA Task Force proposes a technical definition for nearly zero energy buildings required in the implementation of the Energy performance of buildings directive recast. Energy calculation framework and system boundaries associated with the definition are provided to specify which energy flows...

  5. Laryngopharyngeal Reflux: Diagnosis, Treatment, and Latest Research

    Directory of Open Access Journals (Sweden)

    Campagnolo, Andrea Maria

    2014-01-01

    Full Text Available Introduction Laryngopharyngeal reflux (LPR is a highly prevalent disease and commonly encountered in the otolaryngologist's office. Objective To review the literature on the diagnosis and treatment of LPR. Data Synthesis LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Molecular studies have tried to identify biomarkers of reflux such as interleukins, carbonic anhydrase, E-cadherin, and mucin. Conclusion Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.

  6. Reclaiming the definition of sustainability.

    Science.gov (United States)

    Johnston, Paul; Everard, Mark; Santillo, David; Robèrt, Karl-Henrik

    2007-01-01

    Since its inception two decades ago, the concept of sustainable development has suffered from a proliferation of definitions, such that it has increasingly come to mean many things to many different people. This has limited its credibility, called into question its practical application and the significance of associated achievements and, overall, limited the progress in environmental and social developments which it was designed to underpin. This viewpoint article is intended to re-open the concept of sustainable development for discussion 20 years on from the Brundtland Report, in the context of the current state of the world, our growing understanding of ecosystems and their response to stressors and the parallel increase in recognition of inherent limitations to that understanding. Following a brief review of the diverse manner in which the concept has developed over time, we present the case for application of a series of simple conditions for sustainability, originally developed by The Natural Step in the early 90s, which nevertheless still provide a sound basis on which progress towards sustainable development could be monitored. The paper also highlights the unavoidable links between sustainability and ethics, including those in the sensitive fields of population and quality of life. Overall we argue the need for the concept of sustainable development to be reclaimed from the plethora of economically-focused or somewhat vague and un-measurable definitions which have found increasing favour in recent years and which all too often accompany relatively minor progress against 'business as usual'. The vision encapsulated in the Brundtland Report was ground-breaking. If, however, true sustainability in human interactions with the biosphere is to be realised, a far stronger and more empirical interpretation of the original intent is urgently required. To be effective, such an interpretation must encompass and guide developments in political instruments and public

  7. DIAGNOSIS AND TREATMENT OF CESAREAN SCAR PREGNANCY

    Institute of Scientific and Technical Information of China (English)

    Lan-zhou Jiao; Jun Zhao; Xi-run Wan; Xin-yan Liu; Feng-zhi Feng; Tong Ren; Yang Xiang

    2008-01-01

    Objective To investigate the early diagnosis and treatment of cesarean sear pregnancy (CSP).Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the le-sion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed.Results CSP constituted 1.05% of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1:1 221. Themean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 weremisdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging (MRI). The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hyster-ectomy. The conservative treatment was successful in 24 eases. All of the 28 women were cured through individual ther-apies.Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP,and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.

  8. Software requirements

    CERN Document Server

    Wiegers, Karl E

    2003-01-01

    Without formal, verifiable software requirements-and an effective system for managing them-the programs that developers think they've agreed to build often will not be the same products their customers are expecting. In SOFTWARE REQUIREMENTS, Second Edition, requirements engineering authority Karl Wiegers amplifies the best practices presented in his original award-winning text?now a mainstay for anyone participating in the software development process. In this book, you'll discover effective techniques for managing the requirements engineering process all the way through the development cy

  9. MAT FOR LEPTOSPIROSIS DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    Esti Rahardianingtyas.

    2014-06-01

    Full Text Available Leptospirosis is a disease caused by bacterial infection leptospira interrogans.Leptospira bacteria is a spiral bacterium with solid strands with two flagella periplasmik.Septicaemic phase patient samples taken from the blood and cerebrospinal fluid, whereassamples taken at phase immune extracted from urine. The diagnosis of leptospirosis occurdirectly or indirectly. Diagnosis is done by directly isolate and identify the causative agents ofthe agent. Diagnosis is done indirectly by detecting specific antibodies from the patient's body.Gold Standard of the diagnosis of leptospirosis is MAT. Mat made by reacting antibodies toleptospira antigen. Positive results seen with clump formed.Key words: Leptospirosis, Leptospirosis Diagnostic, MAT (Microscopic Agglutination Test Leptospirosis merupakan penyakit yang disebabkan karena infeksi bakteri leptospirainterrogans. Bakteri leptospira merupakan bakteri spiral dengan untaian yang padat dengan duaflagella periplasmik. Sampel pasien pada fase septicaemic diambil dari darah dan cairanserebrospinal, sedangkan sampel yang diambil pada fase immune diambil dari urine. Diagnosisleptospirosis dilakukan secara langsung maupun tidak langsung. Diagnosis secara langsungdilakukan dengan cara mengisolasi agen penyebab dan mengidentifikasi agen tersebut. Diagnosissecara tidak langsung dilakukan dengan cara mendeteksi antibodi spesiflk dari dalam tubuhpasien. Gold Standart dari diagnosis leptospirosis adalah MAT. Mat dilakukan dengan caramereaksikan antibodi dengan antigen leptospira. Hasil positif dilihat dengan terbentuk gumpalanagglutinasiKata kunci: Leptospirosis, Leptospira, Leptospirosis Diagnosis.

  10. 40 CFR 3.3 - What definitions are applicable to this part?

    Science.gov (United States)

    2010-07-01

    ... ELECTRONIC REPORTING General Provisions § 3.3 What definitions are applicable to this part? The definitions... following: The person's employer or employer's corporate parent, subsidiary, or affiliate; the person's... Title 40. Federal reporting requirement means a requirement to report information directly to EPA...

  11. Analyzing Differences in Operational Disease Definitions Using Ontological Modeling

    OpenAIRE

    Peelen, Linda; Klein, Michel; Schlobach, Stefan; Keizer, de, Rob J.W.; Peek, Niels

    2007-01-01

    In medicine, there are many diseases which cannot be precisely characterized but are considered as natural kinds. In the communication between health care professionals, this is generally not problematic. In biomedical research, however, crisp definitions are required to unambiguously distinguish patients with and without the disease. In practice, this results in different operational definitions being in use for a single disease. This paper presents an approach to compare different operation...

  12. Analyzing Differences in Operational Disease Definitions Using Ontological Modeling

    OpenAIRE

    Peelen, Linda; Klein, Michel; Schlobach, Stefan; Keizer, de, M.; Peek,Niels

    2007-01-01

    In medicine, there are many diseases which cannot be precisely characterized but are considered as natural kinds. In the communication between health care professionals, this is generally not problematic. In biomedical research, however, crisp definitions are required to unambiguously distinguish patients with and without the disease. In practice, this results in different operational definitions being in use for a single disease. This paper presents an approach to compare different operation...

  13. Study of sonography sensitivity and specificity to the diagnosis of acute appendicitis in suspected patients referred to Khorramabad Ashayer hospital

    Directory of Open Access Journals (Sweden)

    mojtaba Ahmai Nejad

    2012-03-01

    Conclusion: As the study suggests, sonography before sugery can help and leads to definite diagnosis in suspected patients to appendicitis and it can prevent unnecessary surgeries, as well as it can prevent delay in treatment and related complications .

  14. Integrated product definition representation for agile numerical control applications

    Energy Technology Data Exchange (ETDEWEB)

    Simons, W.R. Jr.; Brooks, S.L.; Kirk, W.J. III; Brown, C.W.

    1994-11-01

    Realization of agile manufacturing capabilities for a virtual enterprise requires the integration of technology, management, and work force into a coordinated, interdependent system. This paper is focused on technology enabling tools for agile manufacturing within a virtual enterprise specifically relating to Numerical Control (N/C) manufacturing activities and product definition requirements for these activities.

  15. Electrical machines diagnosis

    CERN Document Server

    Trigeassou, Jean-Claude

    2013-01-01

    Monitoring and diagnosis of electrical machine faults is a scientific and economic issue which is motivated by objectives for reliability and serviceability in electrical drives.This book provides a survey of the techniques used to detect the faults occurring in electrical drives: electrical, thermal and mechanical faults of the electrical machine, faults of the static converter and faults of the energy storage unit.Diagnosis of faults occurring in electrical drives is an essential part of a global monitoring system used to improve reliability and serviceability. This diagnosis is perf

  16. Information Based Fault Diagnosis

    DEFF Research Database (Denmark)

    Niemann, Hans Henrik; Poulsen, Niels Kjølstad

    2008-01-01

    Fault detection and isolation, (FDI) of parametric faults in dynamic systems will be considered in this paper. An active fault diagnosis (AFD) approach is applied. The fault diagnosis will be investigated with respect to different information levels from the external inputs to the systems....... These inputs are disturbance inputs, reference inputs and auxilary inputs. The diagnosis of the system is derived by an evaluation of the signature from the inputs in the residual outputs. The changes of the signatures form the external inputs are used for detection and isolation of the parametric faults....

  17. Differential diagnosis of tonsillolith

    Directory of Open Access Journals (Sweden)

    Luisa Schertel Cassiano

    2010-07-01

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

  18. Development and validation of a case definition for epilepsy for use with administrative health data.

    Science.gov (United States)

    Reid, Aylin Y; St Germaine-Smith, Christine; Liu, Mingfu; Sadiq, Shahnaz; Quan, Hude; Wiebe, Samuel; Faris, Peter; Dean, Stafford; Jetté, Nathalie

    2012-12-01

    The objective of this study was to develop and validate coding algorithms for epilepsy using ICD-coded inpatient claims, physician claims, and emergency room (ER) visits. 720/2049 charts from 2003 and 1533/3252 charts from 2006 were randomly selected for review from 13 neurologists' practices as the "gold standard" for diagnosis. Epilepsy status in each chart was determined by 2 trained physicians. The optimal algorithm to identify epilepsy cases was developed by linking the reviewed charts with three administrative databases (ICD 9 and 10 data from 2000 to 2008) including hospital discharges, ER visits and physician claims in a Canadian health region. Accepting chart review data as the gold standard, we calculated sensitivity, specificity, positive, and negative predictive value for each ICD-9 and ICD-10 administrative data algorithm (case definitions). Of 18 algorithms assessed, the most accurate algorithm to identify epilepsy cases was "2 physician claims or 1 hospitalization in 2 years coded" (ICD-9 345 or G40/G41) and the most sensitive algorithm was "1 physician clam or 1 hospitalization or 1 ER visit in 2 years." Accurate and sensitive case definitions are available for research requiring the identification of epilepsy cases in administrative health data.

  19. [Pathologic diagnosis and clinical analysis of chronic extrinsic allergic alveolitis].

    Science.gov (United States)

    Diao, Xiao-li; Jin, Mu-lan; Dai, Hua-ping; Li, Xue; Wei, Ping; Zhang, Yun-gang

    2011-11-01

    To study the clinicopathologic features and diagnostic approach of chronic extrinsic allergic alveolitis (EAA). Seven cases of chronic EAA diagnosed by open lung biopsy or lung transplant were enrolled into the study. The clinical and pathologic features were analyzed and the literature was reviewed. There were altogether 4 men and 3 women. The age of the patients ranged from 30 to 65 years (mean = 48 years). All cases represented chronic form and five cases diagnosed by open lung biopsy also showed features of recent aggravation, leading to hospitalization. Four cases had known history of exposure to inciting gases, pollens and pets, and only 2 cases were positive for allergens. High-resolution CT scan showed ground-glass attenuation and reticular pattern that often had a patchy distribution and central predominance. Bronchoalveolar lavage analysis showed marked lymphocytosis, with CD4(+)/CD8(+) ratio less than 1. Lung function test demonstrated a restrictive ventilatory defect, with decreased compliance, reduced diffusion capacity and high airway obstruction. Five cases had open lung biopsy performed and two cases had undergone lung transplantation. Pathologic examination showed bronchiolocentric cellular interstitial pneumonia, interstitial fibrosis, non-caseating epithelioid granulomas, epithelioid histiocytic infiltrate in the respiratory bronchioles and intraluminal budding fibrosis. The five cases with open lung biopsy performed also showed neutrophilic infiltrate in the alveoli. The two lung transplant cases were complicated by severe fibrotic changes. Chronic EAA demonstrates characteristic pathologic features. Definitive diagnosis requires correlation with clinical and radiologic findings due to possible morphologic mimicry of other diffuse parenchymal lung diseases.

  20. Vascular injuries after blunt chest trauma: diagnosis and management

    Science.gov (United States)

    O'Connor, James V; Byrne, Christopher; Scalea, Thomas M; Griffith, Bartley P; Neschis, David G

    2009-01-01

    Background Although relatively rare, blunt injury to thoracic great vessels is the second most common cause of trauma related death after head injury. Over the last twenty years, the paradigm for management of these devastating injuries has changed drastically. The goal of this review is to update the reader on current concepts of diagnosis and management of blunt thoracic vascular trauma. Methods A review of the medical literature was performed to obtain articles pertaining to both blunt injuries of the thoracic aorta and of the non-aortic great vessels in the chest. Articles were chosen based on authors' preference and clinical expertise. Discussion Blunt thoracic vascular injury remains highly lethal, with most victims dying prior to reaching a hospital. Those arriving in extremis require immediate intervention, which may include treatment of other associated life threatening injuries. More stable injuries can often be medically temporized in order to optimize definitive management. Endovascular techniques are being employed with increasing frequency and can often significantly simplify management in otherwise very complex patient scenarios. PMID:19751511

  1. [Short bowel syndrome in children: a diagnosis and management update].

    Science.gov (United States)

    Valdovinos, D; Cadena, J; Montijo, E; Zárate, F; Cazares, M; Toro, E; Cervantes, R; Ramírez-Mayans, J

    2012-01-01

    Short bowel syndrome (SBS) refers to the sum of the functional alterations that are the result of a critical reduction in the length of the intestine, which in the absence of adequate treatment, presents as chronic diarrhea, chronic dehydration, malnutrition, weight loss, nutriment and electrolyte deficiency, along with a failure to grow that is present with greater frequency during the neonatal period. The aim was to carry out a review of the literature encompassing the definition and the most frequent causes of SBS, together with an understanding of its physiopathology, prognostic factors, and treatment. An Internet search of PubMed articles was carried out for the existing information published over the last 20 years on SBS in children, using the keywords "short bowel syndrome". From a total of 784 potential articles, 82 articles were chosen for the literature review. The treatment of patients presenting with SBS is quite a challenge and therefore it is necessary to establish multidisciplinary management with a focus on maintaining optimal nutritional support that covers the necessities of growth and development and at the same time provides a maximum reduction of short, medium, and long-term complications. The diagnosis and treatment of a child with SBS require a team of professionals that are experts in gastroenterologic, pediatric, and nutritional management. The outcome for the child will be directly related to opportune management, as well as to the length of the intestinal resection and the presence or absence of the ileocecal valve.

  2. Energy requirements

    NARCIS (Netherlands)

    Hulzebos, Christian V.; Sauer, Pieter J. J.

    2007-01-01

    The determination of the appropriate energy and nutritional requirements of a newborn infant requires a clear goal of the energy and other compounds to be administered, valid methods to measure energy balance and body composition, and knowledge of the neonatal metabolic capacities. Providing an appr

  3. Energy requirements

    NARCIS (Netherlands)

    Hulzebos, Christian V.; Sauer, Pieter J. J.

    The determination of the appropriate energy and nutritional requirements of a newborn infant requires a clear goal of the energy and other compounds to be administered, valid methods to measure energy balance and body composition, and knowledge of the neonatal metabolic capacities. Providing an

  4. Laboratory diagnosis of malaria -- overview.

    Science.gov (United States)

    Bhatt, K M

    1994-01-01

    Features of the laboratory diagnosis of malaria are described. Microscope equipment is absolutely essential. Clinical symptoms are inadequate for the proper diagnosis of malaria. Screening for malaria involves identification of all cases where high fever is present in endemic areas. Diagnosis is complicated because many people take antimalarial drugs which reduce the chances of detecting malarial parasites. Confirmation should be made before treatment is administered. A thick blood slide can be quickly and cheaply taken without much training of health personnel. The disadvantage of thick stains is the difficulty in identifying "plasmodium" strains. When a thin smear with Giemsa and Leishmanin stain is used, a light infection may be missed. Thin smears require trained personnel and time, which in peak seasons may be impractical. Urinary tract and viral infections may be confused with malaria. Evidence of parasites can be discerned from thick stains. Modern assay techniques are also available. There are enzyme linked immunosorbent assays (ELISA) and immunofluorescent assay techniques (IFAT), which are frequently used in large scale seroepidemiological studies. DNA probes have the limitation of radioisotope handling problems. Acridine orange fluorescent microscopy with capillary centrifuged blood is a technique which improves the viability of Giemsa stain procedures. This technique is desirable because of the sensitivity and speed of diagnosis. The quantitative buddy coat (GBC) technique is superior to Giemsa stained thick blood film in identifying malaria, but it is not reliable with mixed infections. Advanced techniques are not readily available in local settings. The recommendation is to continue use of thick or thin blood film and trained health personnel. Laboratory results must be interpreted in the context of when the flood film was prepared, prior drug administration, and clinical manifestations.

  5. Apache The Definitive Guide

    CERN Document Server

    Laurie, Ben

    2003-01-01

    Apache is far and away the most widely used web server platform in the world. This versatile server runs more than half of the world's existing web sites. Apache is both free and rock-solid, running more than 21 million web sites ranging from huge e-commerce operations to corporate intranets and smaller hobby sites. With this new third edition of Apache: The Definitive Guide, web administrators new to Apache will come up to speed quickly, and experienced administrators will find the logically organized, concise reference sections indispensable, and system programmers interested in customizin

  6. Jenkins The Definitive Guide

    CERN Document Server

    Smart, John

    2011-01-01

    Streamline software development with Jenkins, the popular Java-based open source tool that has revolutionized the way teams think about Continuous Integration (CI). This complete guide shows you how to automate your build, integration, release, and deployment processes with Jenkins-and demonstrates how CI can save you time, money, and many headaches. Ideal for developers, software architects, and project managers, Jenkins: The Definitive Guide is both a CI tutorial and a comprehensive Jenkins reference. Through its wealth of best practices and real-world tips, you'll discover how easy it is

  7. Cassandra the definitive guide

    CERN Document Server

    Hewitt, Eben

    2011-01-01

    What could you do with data if scalability wasn't a problem? With this hands-on guide, you'll learn how Apache Cassandra handles hundreds of terabytes of data while remaining highly available across multiple data centers -- capabilities that have attracted Facebook, Twitter, and other data-intensive companies. Cassandra: The Definitive Guide provides the technical details and practical examples you need to assess this database management system and put it to work in a production environment. Author Eben Hewitt demonstrates the advantages of Cassandra's nonrelational design, and pays special

  8. Hadoop The Definitive Guide

    CERN Document Server

    White, Tom

    2009-01-01

    Hadoop: The Definitive Guide helps you harness the power of your data. Ideal for processing large datasets, the Apache Hadoop framework is an open source implementation of the MapReduce algorithm on which Google built its empire. This comprehensive resource demonstrates how to use Hadoop to build reliable, scalable, distributed systems: programmers will find details for analyzing large datasets, and administrators will learn how to set up and run Hadoop clusters. Complete with case studies that illustrate how Hadoop solves specific problems, this book helps you: Use the Hadoop Distributed

  9. Automated Detection of Malarial Retinopathy in Digital Fundus Images for Improved Diagnosis in Malawian Children with Clinically Defined Cerebral Malaria

    Science.gov (United States)

    Joshi, Vinayak; Agurto, Carla; Barriga, Simon; Nemeth, Sheila; Soliz, Peter; MacCormick, Ian J.; Lewallen, Susan; Taylor, Terrie E.; Harding, Simon P.

    2017-02-01

    Cerebral malaria (CM), a complication of malaria infection, is the cause of the majority of malaria-associated deaths in African children. The standard clinical case definition for CM misclassifies ~25% of patients, but when malarial retinopathy (MR) is added to the clinical case definition, the specificity improves from 61% to 95%. Ocular fundoscopy requires expensive equipment and technical expertise not often available in malaria endemic settings, so we developed an automated software system to analyze retinal color images for MR lesions: retinal whitening, vessel discoloration, and white-centered hemorrhages. The individual lesion detection algorithms were combined using a partial least square classifier to determine the presence or absence of MR. We used a retrospective retinal image dataset of 86 pediatric patients with clinically defined CM (70 with MR and 16 without) to evaluate the algorithm performance. Our goal was to reduce the false positive rate of CM diagnosis, and so the algorithms were tuned at high specificity. This yielded sensitivity/specificity of 95%/100% for the detection of MR overall, and 65%/94% for retinal whitening, 62%/100% for vessel discoloration, and 73%/96% for hemorrhages. This automated system for detecting MR using retinal color images has the potential to improve the accuracy of CM diagnosis.

  10. Oral leukoplakia, the ongoing discussion on definition and terminology

    Science.gov (United States)

    2015-01-01

    In the past decades several definitions of oral leukoplakia have been proposed, the last one, being authorized by the World Health Organization (WHO), dating from 2005. In the present treatise an adjustment of that definition and the 1978 WHO definition is suggested, being : “A predominantly white patch or plaque that cannot be characterized clinically or pathologically as any other disorder; oral leukoplakia carries an increased risk of cancer development either in or close to the area of the leukoplakia or elsewhere in the oral cavity or the head-and-neck region”. Furthermore, the use of strict diagnostic criteria is recommended for predominantly white lesions for which a causative factor has been identified, e.g. smokers’ lesion, frictional lesion and dental restoration associated lesion. A final diagnosis of such leukoplakic lesions can only be made in retrospect after successful elimination of the causative factor within a somewhat arbitrarily chosen period of 4-8 weeks. It seems questionable to exclude “frictional keratosis” and “alveolar ridge keratosis” from the category of leukoplakia as has been suggested in the literature. Finally, brief attention has been paid to some histopathological issues that may cause confusion in establishing a final diagnosis of leukoplakia. Key words:Oral leukoplakia, potentially malignant oral disorders, definition. PMID:26449439

  11. Molecular diagnosis of familial hypercholesterolaemia.

    Science.gov (United States)

    Graham, Colin A; Latten, Mark J; Hart, Padraig J

    2017-08-01

    Familial hypercholesterolaemia is a hereditary disorder of lipoprotein metabolism which causes a lifelong increase in LDL-C levels resulting in premature coronary heart disease. The present review looks at some of the recent literature on how molecular methods can be used to assist in the definitive diagnosis of familial hypercholesterolaemia in a range of patient groups. Several recent studies have shown that the prevalence of clinical familial hypercholesterolaemia is higher than previously thought at 1/200 to 1/300, and that 2-5% of patients presenting with early myocardial infarction can be found to have a familial hypercholesterolaemia mutation. The present review then examines different approaches to molecular testing for familial hypercholesterolaemia including point mutation panels versus next-generation sequencing gene panels, and the range of genes tested by some of those panels. Finally, we review the recent evidence for polygenic hypercholesterolaemia within clinically defined familial hypercholesterolaemia patient populations. To identify patients with familial hypercholesterolaemia within clinically selected patient groups efficiently, a clinical scoring system should be combined with a molecular testing approach for mutations and for polygenic LDL-C single-nucleotide polymorphisms. Alternatively, a population screening methodology may be appropriate, using mutation testing at an early age before significant atherosclerosis has begun. The precise molecular testing method chosen may depend on the clinical presentation of the patient, and/or the population from which they arise.

  12. Frontotemporal Dementias: Diagnosis

    Science.gov (United States)

    ... Studies Observational Studies Sharing our Stories Stories and Poems Blogs Art and Multimedia Published Tributes Resources Comstock ... diagnosis of FTD. This often results in a long and frustrating process of testing for other disorders ...

  13. Diagnosis of Osteoporosis.

    Science.gov (United States)

    Wahner, H. W.

    1987-01-01

    Early recognition of osteoporosis is difficult because symptoms are lacking and there are no distinct, readily accessible diagnostic features. This article reviews the standard approach, radiographic and laboratory diagnosis, bone mass measurement techniques, and interpretation of bone mineral data. (MT)

  14. Preimplantation genetic diagnosis

    DEFF Research Database (Denmark)

    Bay, Bjorn; Ingerslev, Hans Jakob; Lemmen, Josephine Gabriela

    2016-01-01

    OBJECTIVE: To study whether women conceiving after preimplantation genetic diagnosis (PGD) and their children have greater risks of adverse pregnancy and birth outcomes compared with children conceived spontaneously or after IVF with or without intracytoplasmic sperm injection (ICSI). DESIGN...

  15. DSS FOR ORGANIZATIONAL DIAGNOSIS

    NARCIS (Netherlands)

    FROWEIN, JC; POSTMA, TJBM

    1992-01-01

    Information technology in relation to organizational diagnosis and organizational change is the subject of extensive and increasing discussion. A condition for change is insight into organizational problems. This paper discusses the relation between the concepts ''problem'', ''decision making'' and

  16. Physical Therapy Diagnosis

    National Research Council Canada - National Science Library

    Zimny, Nancy J; Goodman, Catherine C; Orest, Marianne; Delitto, Anthony; Snyder-Mackler, Lynn

    1995-01-01

    ...: Examples in Orthopedic Physical Therapy" (March 1995). I believe the article raised multiple issues that are important to address to move the discussion of diagnosis within the physical therapy profession forward...

  17. Diagnosis of Ataxia

    Science.gov (United States)

    ... Donate to the National Ataxia Foundation Diagnosis of Ataxia Being diagnosed with Ataxia can be overwhelming. Below ... help you to understand ataxia better. What is Ataxia? The word "ataxia", comes from the Greek word, " ...

  18. Diagnosis of Parasitic Diseases

    Science.gov (United States)

    ... Laboratory Diagnostic Assistance [DPDx] Parasites Home Diagnosis of Parasitic Diseases Recommend on Facebook Tweet Share Compartir On this ... the United States cannot diagnose parasites? How are parasitic diseases diagnosed? Many kinds of lab tests are available ...

  19. Plague Diagnosis and Treatment

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search the CDC Plague Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Plague Home Ecology & Transmission Symptoms Diagnosis & Treatment Maps & Statistics ...

  20. Gout: Symptoms, Diagnosis & Treament

    Science.gov (United States)

    ... Javascript on. Feature: Detecting and Treating Gout Gout: Symptoms, Diagnosis & Treament Past Issues / Winter 2012 Table of Contents ... Gout may be difficult to diagnose because the symptoms can be vague and could be from other ...

  1. PTSD: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Feature PTSD Symptoms, Diagnosis , Treatment Past Issues / Winter 2009 Table of Contents ... version of this page please turn Javascript on. Symptoms As with mild traumatic brain injury (TBI), PTSD ...

  2. Symptoms and Diagnosis

    Science.gov (United States)

    ... Differential Disorders Frequently Asked Questions Glossary Downloadable Publications Symptoms and Diagnosis If you are new to dystonia, it can ... be accounted for: ► The age at which the symptoms started. The age at which symptoms begin is ...

  3. Mixed-Variable Requirements Roadmaps and their Role in the Requirements Engineering of Adaptive Systems

    CERN Document Server

    Jureta, Ivan; Ernst, Neil A

    2011-01-01

    The requirements roadmap concept is introduced as a solution to the problem of the requirements engineering of adaptive systems. The concept requires a new general definition of the requirements problem which allows for quantitative (numeric) variables, together with qualitative (binary boolean) propositional variables, and distinguishes monitored from controlled variables for use in control loops. We study the consequences of these changes, and argue that the requirements roadmap concept bridges the gap between current general definitions of the requirements problem and its notion of solution, and the research into the relaxation of requirements, the evaluation of their partial satisfaction, and the monitoring and control of requirements, all topics of particular interest in the engineering of requirements for adaptive systems [Cheng et al. 2009]. From the theoretical perspective, we show clearly and formally the fundamental differences between more traditional conception of requirements engineering (e.g., Z...

  4. 42 CFR 440.2 - Specific definitions; definitions of services for FFP purposes.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Specific definitions; definitions of services for... Definitions § 440.2 Specific definitions; definitions of services for FFP purposes. (a) Specific definitions...) Definitions of services for FFP purposes. Except as limited in part 441, FFP is available in...

  5. Understanding a Breast Cancer Diagnosis

    Science.gov (United States)

    ... Cancer A-Z Breast Cancer Understanding a Breast Cancer Diagnosis If you’ve been diagnosed with breast cancer, ... Prevention Early Detection and Diagnosis Understanding a Breast Cancer Diagnosis Treatment Breast Reconstruction Surgery Living as a Breast ...

  6. Image diagnosis of hyperparathyroidism

    OpenAIRE

    森川, 満; 佐賀, 裕司; 渡部, 嘉彦; 藤沢, 真; 金子, 茂男; 徳中, 荘平; 八竹, 直

    1989-01-01

    Between January, 1983 and January 1988, the diagnosis of hyperparathyroidism was made on 14 patients (8 primary and 6 secondary), and was identified operatively in all. The procedures for image diagnosis were computed tomography (CT), ultrasonography and scintigraphy. Scintigraphy was performed using Tc-99m and Tl-201 by a subtraction technique. For primary hyperparathyroidism, the accuracy of localization was 100% by CT, 87.5% by ultrasonography, 100% by scintigraphy, and 100% by the combina...

  7. Diagnosis of urticaria.

    Science.gov (United States)

    Schoepke, Nicole; Doumoulakis, Georgios; Maurer, Marcus

    2013-05-01

    Acute urticaria do not need extensive diagnostic procedures. Urticaria activity score is a useful tool for evaluation of urticaria. Complete blood count, Erythrocyte sedimentation rate and C reactive protein are important investigations for diagnosis of infections in urticaria. Autologous serum skin test is a simple office procedure for diagnosis of auto reactive urticaria. Closed ball point pen tip is a simple test to diagnose dermographism.

  8. Diagnosis of urticaria

    Directory of Open Access Journals (Sweden)

    Nicole Schoepke

    2013-01-01

    Full Text Available Acute urticaria do not need extensive diagnostic procedures. Urticaria activity score is a useful tool for evaluation of urticaria. Complete blood count, Erythrocyte sedimentation rate and C reactive protein are important investigations for diagnosis of infections in urticaria. Autologous serum skin test is a simple office procedure for diagnosis of auto reactive urticaria. Closed ball point pen tip is a simple test to diagnose dermographism.

  9. Diagnosis of urticaria

    OpenAIRE

    Nicole Schoepke; Georgios Doumoulakis; Marcus Maurer

    2013-01-01

    Acute urticaria do not need extensive diagnostic procedures. Urticaria activity score is a useful tool for evaluation of urticaria. Complete blood count, Erythrocyte sedimentation rate and C reactive protein are important investigations for diagnosis of infections in urticaria. Autologous serum skin test is a simple office procedure for diagnosis of auto reactive urticaria. Closed ball point pen tip is a simple test to diagnose dermographism.

  10. Diagnosis of urticaria

    Science.gov (United States)

    Schoepke, Nicole; Doumoulakis, Georgios; Maurer, Marcus

    2013-01-01

    Acute urticaria do not need extensive diagnostic procedures. Urticaria activity score is a useful tool for evaluation of urticaria. Complete blood count, Erythrocyte sedimentation rate and C reactive protein are important investigations for diagnosis of infections in urticaria. Autologous serum skin test is a simple office procedure for diagnosis of auto reactive urticaria. Closed ball point pen tip is a simple test to diagnose dermographism. PMID:23723473

  11. [Diagnosis: synovial fluid analysis].

    Science.gov (United States)

    Gallo Vallejo, Francisco Javier; Giner Ruiz, Vicente

    2014-01-01

    Synovial fluid analysis in rheumatological diseases allows a more accurate diagnosis in some entities, mainly infectious and microcrystalline arthritis. Examination of synovial fluid in patients with osteoarthritis is useful if a differential diagnosis will be performed with other processes and to distinguish between inflammatory and non-inflammatory forms. Joint aspiration is a diagnostic and sometimes therapeutic procedure that is available to primary care physicians. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  12. Personality disorder diagnosis

    OpenAIRE

    Widiger, Thomas A

    2003-01-01

    Every person has a characteristic manner of thinking, feeling, and relating to others. Some of these personality traits can be so dysfunctional as to warrant a diagnosis of personality disorder. The World Health Organization's International Classification of Diseases (ICD- 10) includes ten personality disorder diagnoses. Three issues of particular importance for the diagnosis of personality disorders are their differentiation from other mental disorders, from general persona...

  13. Phenotype definition in epilepsy.

    Science.gov (United States)

    Winawer, Melodie R

    2006-05-01

    Phenotype definition consists of the use of epidemiologic, biological, molecular, or computational methods to systematically select features of a disorder that might result from distinct genetic influences. By carefully defining the target phenotype, or dividing the sample by phenotypic characteristics, we can hope to narrow the range of genes that influence risk for the trait in the study population, thereby increasing the likelihood of finding them. In this article, fundamental issues that arise in phenotyping in epilepsy and other disorders are reviewed, and factors complicating genotype-phenotype correlation are discussed. Methods of data collection, analysis, and interpretation are addressed, focusing on epidemiologic studies. With this foundation in place, the epilepsy subtypes and clinical features that appear to have a genetic basis are described, and the epidemiologic studies that have provided evidence for the heritability of these phenotypic characteristics, supporting their use in future genetic investigations, are reviewed. Finally, several molecular approaches to phenotype definition are discussed, in which the molecular defect, rather than the clinical phenotype, is used as a starting point.

  14. Definitions of oppression.

    Science.gov (United States)

    LeBlanc, R G

    1997-12-01

    How we begin to serve others as healthcare professionals and how it is we define underserved and oppressed peoples is important in understanding issues in the organization and allocation of health care. This exploration, based on feminist post-structuralist theory, explores how nurses formulate definitions of 'underserved' and 'vulnerable'. This study goes beyond prescribed definitions to locate meanings used to identify oppression. I present, through an analysis of a literature search, the context and construction of the terms 'vulnerable population' and 'medically underserved'. Professional nursing journals are the source of relevant text. The implications of working with particular understandings of the terms 'vulnerable' and 'underserved' is based on my assumption that healthcare providers need to critically focus on the personal and political meanings they attribute to the labels used to define the clients and communities with whom they work. The presentation of this material supports that the way we define 'vulnerable' and 'underserved' is related to how our work fighting racism, ageism, AIDS, poverty, homophobia, addiction, domestic violence, sexism and colonization is realized.

  15. [Prognosis in tumor diagnosis].

    Science.gov (United States)

    Bruns, G

    1983-01-01

    This essay on prognosis in tumor diagnosis pathology resp. tumor etiology, cancerogenesis and molecular oncology is the authors personal opinion. Generally tumor diagnosis improves with progress in histo- and cytological methods for example in tumors of the APUD-system and precancerous lesions especially of the breast. Fundamental principle of developed tumor diagnosis is the knowledge of malignant transformation. Its profits favours the etiology in cancerogenesis and e.g. non Hodgkin lymphomas (Burkitt lymphoma, adult T-cell lymphoma) and to result from new methods in molecular biology and viral genetics (DNS-hybridizing, -recombination and gene technology). With the beginning century a stepwise fitted diagnosis of malignant lymphomas is evident up to monoclonal dedifferentiated lymphoid cells and their multifarious phenotypical markers. This concept may be of general significance in tumor diagnosis already indicated in prelymphomas. Finally the present prognosis of tumor diagnosis is evaluated by contents, tasks and strategies of its corresponding research lines in clinical and experimental tumor pathology resp. its organization.

  16. Size definitions for particle sampling

    Energy Technology Data Exchange (ETDEWEB)

    1981-05-01

    The recommendations of an ad hoc working group appointed by Committee TC 146 of the International Standards Organization on size definitions for particle sampling are reported. The task of the group was to collect the various definitions of 'respirable dust' and to propose a practical definition on recommendations for handling standardization on this matter. One of two proposed cut-sizes in regard to division at the larynx will be adopted after a ballot.

  17. Formal Definition of Artificial Intelligence

    OpenAIRE

    Dobrev, Dimiter

    2005-01-01

    * This publication is partially supported by the KT-DigiCult-Bg project. A definition of Artificial Intelligence (AI) was proposed in [1] but this definition was not absolutely formal at least because the word "Human" was used. In this paper we will formalize the definition from [1]. The biggest problem in this definition was that the level of intelligence of AI is compared to the intelligence of a human being. In order to change this we will introduce some parameters to which AI ...

  18. Damage diagnosis and compatible repair mortars

    NARCIS (Netherlands)

    Hees, R.P.J. van

    1999-01-01

    Mortars for repair and maintenance of historic masonry have to meet specific requirements. Several authors have made contributions, however many cases of failure show that there still is quite a lack of knowledge on the compatibility of repair mortars for historic masonry. The diagnosis of the cause

  19. Diagnosis of Urinary Tract Infections in Children.

    Science.gov (United States)

    Doern, Christopher D; Richardson, Susan E

    2016-09-01

    Urinary tract infections (UTIs) are a common occurrence in children. The management and laboratory diagnosis of these infections pose unique challenges that are not encountered in adults. Important factors, such as specimen collection, urinalysis interpretation, culture thresholds, and antimicrobial susceptibility testing, require special consideration in children and will be discussed in detail in the following review.

  20. Diagnosis of Urinary Tract Infections in Children

    Science.gov (United States)

    2016-01-01

    Urinary tract infections (UTIs) are a common occurrence in children. The management and laboratory diagnosis of these infections pose unique challenges that are not encountered in adults. Important factors, such as specimen collection, urinalysis interpretation, culture thresholds, and antimicrobial susceptibility testing, require special consideration in children and will be discussed in detail in the following review. PMID:27053673

  1. Testing Person Fit in Cognitive Diagnosis

    Science.gov (United States)

    Liu, Ying; Douglas, Jeffrey A.; Henson, Robert A.

    2009-01-01

    In cognitive diagnosis, the test-taking behavior of some examinees may be idiosyncratic so that their test scores may not reflect their true cognitive abilities as much as that of more typical examinees. Statistical tests are developed to recognize the following: (a) nonmasters of the required attributes who correctly answer the item (spuriously…

  2. Requirements dilemma

    OpenAIRE

    2006-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. Knowing ‘what’ to build is an integral part of an Information System Development, and it is generally understood that this, which is known as Requirements, is achievable through a process of understanding, communication and management. It is currently maintained by the Requirements theorists that successful system design clarifies the interrelations between information and its representations...

  3. [What is death?--Definitions and diagnoses from 2500 years of natural philosophy and medicine].

    Science.gov (United States)

    Schäfer, D

    2013-12-01

    For very long medicine has been dealing with the question what death means and when it has occurred. The promotion of this debate is mainly owed to the new medical findings and the concrete requirements of the clinical practice; but other factors like social-historical influences (in particular the dispute over the secure determination of death) as well as the (de-)medicalization of the concept of death have also to be taken into account. In a concise historical overlook this study aims to demonstrate the development of the definition of death: In ancient Greece Aristotle, disregarding the transcendent teleology, describes the natural or non-natural death that occurs when the production of the vegetative warmth in the central organ - the heart - has ceased. In the Enlightenment Johann August Unzer (emulated later by Bichat and Hufeland) worked out the concept of the step-by-step process of death: In the attempt to explain sudden death, apparent death and reanimation the enlightened physiologist differentiated between the cessation of the senses (caused by heart death and brain death) and the vegetative functions. In the second half of the 20th century progress made in transplanting and intensive care generated a broadened medical definition of death that met strong opposition in the discussions on the autonomy of the patient and the worth of human life. Generally considered, the increasing differences in interpreting death between physicians and medical laymen, but also in medical practice and basic research are mainly due to the divergent demands regarding the definition and diagnosis of death. © Georg Thieme Verlag KG Stuttgart · New York.

  4. The definition and natural history of severe exacerbation of hepatitis B

    Directory of Open Access Journals (Sweden)

    GUO Wei

    2014-10-01

    Full Text Available Despite different opinions on its definition and classification in the past, a consensus has gradually been reached regarding the naming, classification, and clinical diagnosis of liver failure. The classification of liver failure is described, and the definition and natural history of severe exacerbation of hepatitis B are summarized. Antiviral treatment and artificial liver support in the early stage are beneficial for clinical outcomes and prognosis.

  5. Safe Public Debt: Towards an Operational Definition

    Directory of Open Access Journals (Sweden)

    Xavier Debrun

    2015-06-01

    Full Text Available The paper proposes an operational definition of safe public debt levels and discusses various concrete approaches to calculate them. A public debt level is considered safe if it is associated with a low probability of reaching levels likely to generate significant economic costs within a given time frame. Like debt sustainability assessments, implementing such a broad definition requires medium-term projections of the debt-to-GDP ratio. This implies that different sets of plausible assumptions can yield fairly different “safe” debt levels for the same country. However, the proposed framework has the merit to force policymakers and analysts to be explicit about the assumptions underlying their calculations.

  6. Neuropathologic confirmation of definitional criteria for human immunodeficiency virus-associated neurocognitive disorders.

    Science.gov (United States)

    Cherner, Mariana; Cysique, Lucette; Heaton, Robert K; Marcotte, Thomas D; Ellis, Ronald J; Masliah, Eliezer; Grant, Igor

    2007-01-01

    Research findings have suggested a need for modifications to the original nomenclature for human immunodeficiency virus (HIV)-associated neurocognitive disorders issued in 1991 by the American Academy of Neurology (AAN). The HIV Neurobehavioral Research Center (HNRC) proposed a diagnostic scheme that departs from the AAN 1991 criteria primarily in the inclusion of an asymptomatic neurocognitive impairment (ANI) category that relies on cognitive disturbances as a necessary criterion for diagnosis, without requiring declines in daily functioning, motor, or other behavioral abnormalities. In order to test the predictive validity of these two nomenclatures, the authors compared the correspondence between antemortem neurocognitive diagnoses resulting from AAN and HNRC criteria to a neuropathological diagnosis of HIV encephalitis (HIVE) made at autopsy. Agreement between the two sets of definitional criteria was 79% regarding the classification of cases as either neurocognitively normal or impaired, and 54% with regard to specific neurocognitive diagnoses. When pathological evidence of HIVE was considered as the external indicator of HIV-related brain involvement, 64% of cases were correctly classified by AAN criteria, compared to 72% by HNRC criteria. HNRC criteria had better positive predictive power (95% versus 88%), sensitivity (67% versus 56%), and specificity (92% versus 83%). Three cases with HIVE and were correctly identified by HNRC criteria for ANI but called normal by AAN criteria, supporting inclusion of an asymptomatic neurocognitive condition. The modifications to the AAN 1991 criteria proposed by the HNRC and others in the field have served as a point of departure for a recently revised consensus nomenclature.

  7. Separation anxiety disorder across the lifespan: DSM-5 lifts age restriction on diagnosis.

    Science.gov (United States)

    Silove, Derrick; Rees, Susan

    2014-10-01

    DSM-5 has lifted the age criterion in the definition of separation anxiety disorder thereby overturning the long-standing convention of restricting the diagnosis to childhood. Previously, adults with separation anxiety symptoms were assigned to other conventional categories such as panic disorder, agoraphobia or generalized anxiety disorder. Over the past two decades, an evolving body of research has identified separation anxiety disorder in adulthood, with 20-40% of adult psychiatric outpatients being assigned that diagnosis. In the US, the lifetime prevalence of the disorder in adulthood is 6.6%. The removal of the age restriction on diagnosis has important implications for clinical practice. Whereas parents (particularly mothers) of children with separation anxiety disorder commonly attracted the diagnosis of agoraphobia, the latter are more likely now to be diagnosed with the adult form of separation anxiety disorder, focusing attention on the importance of intervening with both members of the dyad to overcome mutual reinforcement of symptoms. In addition, adults with separation anxiety disorder have been found to manifest high levels of disability and they tend to show a poor response to conventional psychological and pharmacological treatments. There is an urgent need therefore to devise novel psychological and pharmacological interventions for the adult form of the disorder. The reformulation of separation anxiety disorder in DSM-5 therefore requires a paradigm shift in which clinicians are alerted to identifying and treating the condition in all age groups. Research across countries is needed to examine the new formulation of separation anxiety disorder amongst populations of diverse ethnic and cultural backgrounds.

  8. Diagnosis and Management of Human Cytomegalovirus Infection in the Mother, Fetus, and Newborn Infant

    Science.gov (United States)

    Revello, Maria Grazia; Gerna, Giuseppe

    2002-01-01

    Human cytomegalovirus (HCMV) is the leading cause of congenital viral infection and mental retardation. HCMV infection, while causing asymptomatic infections in most immunocompetent subjects, can be transmitted during pregnancy from the mother with primary (and also recurrent) infection to the fetus. Hence, careful diagnosis of primary infection is required in the pregnant woman based on the most sensitive serologic assays (immunoglobulin M [IgM] and IgG avidity assays) and conventional virologic and molecular procedures for virus detection in blood. Maternal prognostic markers of fetal infection are still under investigation. If primary infection is diagnosed in a timely manner, prenatal diagnosis can be offered, including the search for virus and virus components in fetal blood and amniotic fluid, with fetal prognostic markers of HCMV disease still to be defined. However, the final step for definite diagnosis of congenital HCMV infection is detection of virus in the blood or urine in the first 1 to 2 weeks of life. To date, treatment of congenital infection with antiviral drugs is only palliative both prior to and after birth, whereas the only efficacious preventive measure seems to be the development of a safe and immunogenic vaccine, including recombinant, subunit, DNA, and peptide-based vaccines now under investigation. The following controversial issues are discussed in the light of the most recent advances in the field: the actual perception of the problem; universal serologic screening before pregnancy; the impact of correct counseling on decision making by the couple involved; the role of prenatal diagnosis in ascertaining transmission of virus to the fetus; the impact of preconceptional and periconceptional infections on the prevalence of congenital infection; and the prevalence of congenitally infected babies born to mothers who were immune prior to pregnancy compared to the number born to mothers undergoing primary infection during pregnancy. PMID

  9. Bullying by Definition: An Examination of Definitional Components of Bullying

    Science.gov (United States)

    Goldsmid, Susan; Howie, Pauline

    2014-01-01

    Lack of definitional consensus remains an important unresolved issue within bullying research. This study examined the ability of definitional variables to predict overall level of victimisation (distress, power inequity, and provocation as predictors) and bullying (intention to harm, power inequity, and provocation as predictors) in 246…

  10. Dysplasia in Inflammatory Bowel Diseases: Definition and Clinical Impact

    Directory of Open Access Journals (Sweden)

    Karel Geboes

    1999-01-01

    Full Text Available Dysplasia is a morphological term that ethymologically means ‘malformation’. For the definition of inflammatory bowel disease-related dysplasia, the nature and origin of the malformation are stressed and the lesion is defined as an epithelial malformation that is unequivocally neoplastic but noninvasive. The use of a precise definition is necessary because of the clinical consequences related to the finding of dysplasia in IBD. The microscopic diagnosis of dysplasia, however, remains difficult. Clinically, it is important to make a proper differential diagnosis between polypoid IBD-related dysplasia and sporadic adenoma occurring in IBD, and between therapy-related ‘pseudodysplasia’ and genuine dysplasia. When dysplasia is diagnosed, a second opinion may be indicated because of the clinical consequences. Additional techniques to search for genetic defects associated with carcinogenesis can help to support the diagnosis. They can identify changes in DNA content and molecular changes resulting from defects of genes controlling cell proliferation and death or tissue structure. These changes can, however, be absent, appear early or late in the transition from normality toward dysplasia and cancer, or appear during repair. Positive findings indicate an increased cancer risk, but the magnitude of the risk remains to be defined. A positive diagnosis of genuine dysplasia necessitates clinical action – either follow-up of the patient or treatment. In practice, treatment means surgery because dysplasia can be a precursor and/or a marker of malignancy, except for sporadic adenomas, which can be removed locally.

  11. LABORATORY DIAGNOSIS OF LEPTOSPIROSIS : A REVIEW

    Directory of Open Access Journals (Sweden)

    Mythri

    2015-06-01

    Full Text Available Leptospirosis is a zoonosis of global distribution caused by infection with pathogenic spirochaetes of the genus Leptospira . Humans are accidental hosts and usually become infected through contact with water or soil contaminated by the urine of infected animals such as rodents , dogs , cattle and pigs. In developing countries such as India , leptospirosis is often underdiagnosed because of it s protean clinical manifestations leading to significant morbidity and mortality. It occurs as a self - limited illness in 85% to 90% of the cases and icteric leptospirosis or Weil’s syndrome , a more serious , potentially fatal syndrome which occurs in 5% to 10% of the cases. Microbiological diagnosis of leptospirosis aims at demonstrating the leptospires , by culturing them or by demonstrating an appreciable antibody response to them. A definite diagnosis of leptospirosis is based either on isolation of the or ganism from the patient or on seroconversion or a rise in antibody titre in the MAT. Leptospires may be visualized in clinical material by DGM or by IF or light microscopy after appropriate staining. The sensitivity of blood cultures is low; hence culture is primarily used for retrospective diagnosis. There are numerous serological tests available for diagnosis of leptospirosis like Macroscopic agglutination test (MSAT, Indirect fluorescent antibody test (IFAT, Sensitised erythrocyte lysis test (SEL, Com plement fixation test (CFT, Enzyme Linked Sorbent Assay (ELISA, Microcapsule agglutination test (MCAT, Lepto - Dipstick, Latex agglutination test, Dried Latex agglutination test (Lepto Tek Dri - Dot, but they are only genus specific. To identify the specif ic serovar Microscopic agglutination test (MAT or culture has to be done. The various available options for a diagnosis of leptospirosis have been explored in this article. A thorough literary search was done in the various published data available - pub m ed search was done as well as

  12. Diagnosis of acute surgical abdomen – The best diagnostic tool to reach a final diagnosiscin

    Directory of Open Access Journals (Sweden)

    CS Wong

    2012-01-01

    Conclusions: Appendicitis can be accurately diagnosed clinically based on history and clinical examination alone. Diagnosis of diverticular disease, gallstone disease, and bowel obstruction further requires radiology intervention to confirm the provisional diagnosis.

  13. Biochemical diagnosis and localization of pheochromocytoma: can we reach a consensus?

    NARCIS (Netherlands)

    Grossman, A.; Pacak, K.; Sawka, A.; Lenders, J.W.M.; Harlander, D.; Peaston, R.T.; Reznek, R.; Sisson, J.; Eisenhofer, G.

    2006-01-01

    Pheochromocytomas can have a highly variable presentation, making diagnosis challenging. To think of the tumor represents the crucial initial step, but establishing the diagnosis requires biochemical evidence of excessive catecholamine production and imaging studies to localize the source. Currently

  14. The diagnosis and management of Piriformis Syndrome: myths and facts.

    Science.gov (United States)

    Miller, T A; White, K P; Ross, D C

    2012-09-01

    Piriformis Syndrome (PS) is an uncommon, controversial neuromuscular disorder that is presumed to be a compression neuropathy of the sciatic nerve at the level of the piriformis muscle (PM). The diagnosis is hampered by a lack of agreed upon clinical criteria and a lack of definitive investigations such as imaging or electrodiagnostic testing. Treatment has focused on stretching, physical therapies, local injections, including botulinum toxin, and surgical management. This article explores the various sources of controversy surrounding piriformis syndrome including diagnosis, investigation and management. We conclude with a proposal for diagnostic criteria which include signs and symptoms, imaging, and response to therapeutic injections.

  15. Metabolic syndrome in children and adolescents - criteria for diagnosis

    OpenAIRE

    Mancini Marcio C

    2009-01-01

    Abstract In recent years, there has been a greater concern about the presence of obesity and metabolic syndrome in children and adolescents. However, there is no consensus regarding the diagnosis of metabolic syndrome in children and adolescents. It is evident that each component of the syndrome must be identified as early as possible in order to prevent definitive lesions. The question is how to do this and which cut-offs must be adopted for this diagnosis. For a matter of convenience, the d...

  16. Sociocultural definitions of risk

    Energy Technology Data Exchange (ETDEWEB)

    Rayner, S.

    1990-10-01

    Public constituencies frequently are criticized by technical experts as being irrational in response to low-probability risks. This presentation argued that most people are concerned with a variety of risk attributes other than probability and that is rather irrational to exclude these from the definition and analysis of technological risk. Risk communication, which is at the heart of the right-to-know concept, is described as the creation of shared meaning rather than the mere transmission of information. A case study of utilities, public utility commissions, and public interest groups illustrates how the diversity of institutional cultures in modern society leads to problems for the creation of shared meanings in establishing trust, distributing liability, and obtaining consent to risk. This holistic approach to risk analysis is most appropriate under conditions of high uncertainty and/or decision stakes. 1 fig., 5 tabs.

  17. [Definition of shock types].

    Science.gov (United States)

    Adams, H A; Baumann, G; Gänsslen, A; Janssens, U; Knoefel, W; Koch, T; Marx, G; Müller-Werdan, U; Pape, H C; Prange, W; Roesner, D; Standl, T; Teske, W; Werner, G; Zander, R

    2001-11-01

    Definitions of shock types. Hypovolaemic shock is a state of insufficient perfusion of vital organs with consecutive imbalance of oxygen supply and demand due to an intravascular volume deficiency with critically impaired cardiac preload. Subtypes are haemorrhagic shock, hypovolaemic shock in the narrow sense, traumatic-haemorrhagic shock and traumatic-hypovolaemic shock. Cardiac shock is caused by a primary critical cardiac pump failure with consecutive inadequate oxygen supply of the organism. Anaphylactic shock is an acute failure of blood volume distribution (distributive shock) and caused by IgE-dependent, type-I-allergic, classical hypersensibility, or a physically, chemically, or osmotically induced IgE-independent anaphylactoid hypersensibility. The septic shock is a sepsis-induced distribution failure of the circulating blood volume in the sense of a distributive shock. The neurogenic shock is a distributive shock induced by generalized and extensive vasodilatation with consecutive hypovolaemia due to an imbalance of sympathetic and parasympathetic regulation of vascular smooth muscles.

  18. Product definition data interface

    Science.gov (United States)

    Birchfield, B.; Downey, P.

    1984-01-01

    The development and application of advanced Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) technology in aerospace industry is discussed. New CAD/CAM capabilities provide the engineer and production worker with tools to produce better products and significantly improve productivity. This technology is expanding in all phases of engineering and manufacturing with large potential for improvements in productivity. The integration of CAD and CAM systematically to insure maximum utility throughout the U.S. Aerospace Industry, its large community of supporting suppliers, and the Department of Defense aircraft overhaul and repair facilities is outlined. The need for a framework for exchange of digital product definition data, which serves the function of the conventional engineering drawing is emphasized.

  19. Grouping Synonyms by Definitions

    CERN Document Server

    Falk, Ingrid; Jacquey, Evelyne; Venant, Fabienne

    2009-01-01

    We present a method for grouping the synonyms of a lemma according to its dictionary senses. The senses are defined by a large machine readable dictionary for French, the TLFi (Tr\\'esor de la langue fran\\c{c}aise informatis\\'e) and the synonyms are given by 5 synonym dictionaries (also for French). To evaluate the proposed method, we manually constructed a gold standard where for each (word, definition) pair and given the set of synonyms defined for that word by the 5 synonym dictionaries, 4 lexicographers specified the set of synonyms they judge adequate. While inter-annotator agreement ranges on that task from 67% to at best 88% depending on the annotator pair and on the synonym dictionary being considered, the automatic procedure we propose scores a precision of 67% and a recall of 71%. The proposed method is compared with related work namely, word sense disambiguation, synonym lexicon acquisition and WordNet construction.

  20. Viruses, definitions and reality

    Directory of Open Access Journals (Sweden)

    Libia Herrero-Uribe

    2011-09-01

    Full Text Available Viruses are known to be abundant, ubiquitous, and to play a very important role in the health and evolution of life organisms. However, most biologists have considered them as entities separate from the realm of life and acting merely as mechanical artifacts that can exchange genes between different organisms. This article reviews some definitions of life organisms to determine if viruses adjust to them, and additionally, considers new discoveries to challenge the present definition of viruses. Definitions of life organisms have been revised in order to validate how viruses fit into them. Viral factories are discussed since these mini-organelles are a good example of the complexity of viral infection, not as a mechanical usurpation of cell structures, but as a driving force leading to the reorganization and modification of cell structures by viral and cell enzymes. New discoveries such as the Mimivirus, its virophage and viruses that produce filamentous tails when outside of their host cell, have stimulated the scientific community to analyze the current definition of viruses. One way to be free for innovation is to learn from life, without rigid mental structures or tied to the past, in order to understand in an integrated view the new discoveries that will be unfolded in future research. Life processes must be looked from the complexity and trans-disciplinarity perspective that includes and accepts the temporality of the active processes of life organisms, their interdependency and interrelation among them and their environment. New insights must be found to redefine life organisms, especially viruses, which still are defined using the same concepts and knowledge of the fifties. Rev. Biol. Trop. 59 (3: 993-998. Epub 2011 September 01.Los virus son abundantes, ubicuos, y juegan un papel muy importante en la salud y en la evolución de los organismos vivos. Sin embargo, la mayoría de los biólogos los siguen considerado como entidades separadas

  1. Partial Remission Definition

    DEFF Research Database (Denmark)

    Andersen, Marie Louise Max; Hougaard, Philip; Pörksen, Sven

    2014-01-01

    of type 1 diabetes (T1D). Receiver operating characteristic curve (ROC) analysis was used to evaluate the predictive value of IDAA1c and age on partial C-peptide remission (stimulated C-peptide, SCP > 300 pmol/L). RESULTS: PR (IDAA1c ≤ 9) in the Danish and Hvidoere cohorts occurred in 62 vs. 61% (3 months......OBJECTIVE: To validate the partial remission (PR) definition based on insulin dose-adjusted HbA1c (IDAA1c). SUBJECTS AND METHODS: The IDAA1c was developed using data in 251 children from the European Hvidoere cohort. For validation, 129 children from a Danish cohort were followed from the onset...

  2. Comparative assessment of nanomaterial definitions and safety evaluation considerations.

    Science.gov (United States)

    Boverhof, Darrell R; Bramante, Christina M; Butala, John H; Clancy, Shaun F; Lafranconi, Mark; West, Jay; Gordon, Steve C

    2015-10-01

    Nanomaterials continue to bring promising advances to science and technology. In concert have come calls for increased regulatory oversight to ensure their appropriate identification and evaluation, which has led to extensive discussions about nanomaterial definitions. Numerous nanomaterial definitions have been proposed by government, industry, and standards organizations. We conducted a comprehensive comparative assessment of existing nanomaterial definitions put forward by governments to highlight their similarities and differences. We found that the size limits used in different definitions were inconsistent, as were considerations of other elements, including agglomerates and aggregates, distributional thresholds, novel properties, and solubility. Other important differences included consideration of number size distributions versus weight distributions and natural versus intentionally-manufactured materials. Overall, the definitions we compared were not in alignment, which may lead to inconsistent identification and evaluation of nanomaterials and could have adverse impacts on commerce and public perceptions of nanotechnology. We recommend a set of considerations that future discussions of nanomaterial definitions should consider for describing materials and assessing their potential for health and environmental impacts using risk-based approaches within existing assessment frameworks. Our intent is to initiate a dialogue aimed at achieving greater clarity in identifying those nanomaterials that may require additional evaluation, not to propose a formal definition. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  3. A definition and ethical evaluation of overdiagnosis: response to commentaries.

    Science.gov (United States)

    Carter, Stacy M; Doust, Jenny; Degeling, Chris; Barratt, Alexandra

    2016-08-29

    It is a privilege to have respected colleagues engage with our definition and ethical evaluation of overdiagnosis. In our response to the commentaries, we first deal with paradigmatic issues: the place of realism, the relationship between diagnostic standards and correctness and the distinction between overdiagnosis and both false-positives and medicalisation. We then discuss issues arising across the commentaries in turn. Our definition captures the range of different types of overdiagnosis, unlike a definition limited to diagnosis of harmless disease. Certain implications do flow from our definition, as noted by commentators, but we do not view them as problematic: overdiagnoses can become beneficial diagnoses as medical knowledge and practice changes over time; inadequate systems of healthcare can produce tragic overdiagnosis, and the effectiveness of treatment partly determines whether overdiagnosis occurs. Complexity and uncertainty in balancing benefits and harms is unfortunate, but not a reason to avoid making a judgement (ideally one that reflects multiple perspectives). We reaffirm that overdiagnosis, for the foreseeable future, must be estimated at a population level and defend the importance of good-quality risk communication for individuals. We acknowledge that a lot turns on the relevance of professional communities in our definition and expand our reasoning in this regard then conclude with a note on the difference between intentions and goals. We expect that it will be some time before these matters are settled and we look forward to continue debating these matters with our colleagues.

  4. Estimation of Cachexia among Cancer Patients Based on Four Definitions

    Directory of Open Access Journals (Sweden)

    Kathleen M. Fox

    2009-01-01

    Full Text Available Objectives. Estimate and compare the proportion of cancer patients with cachexia using different definitions from available clinical data. Methods. Electronic medical records were examined to estimate the proportion of cancer patients with cachexia using 4 definitions: (1 ICD-9 diagnostic code of 799.4 (cachexia, (2 ICD-9 diagnosis of cachexia, anorexia, abnormal weight loss, or feeding difficulties, (3 prescription for megestrol acetate, oxandrolone, somatropin, or dronabinol, and (4 ≥5% weight loss. Patients with cancer of the stomach, pancreas, lung, colon/rectum, head/neck, esophagus, prostate, breast, or liver diagnosed between 1999 and 2004 were followed for cachexia. Results. Of 8541 cancer patients (60% men and 55% Caucasian, cachexia was observed in 2.4% of patients using the cachexia diagnostic code, 5.5% expanded diagnoses, 6.4% prescription medication definition, and 14.7% with ≥5% weight loss. Conclusions. The proportion of patients with cachexia varied considerably depending upon the definition employed, indicating that a standard operational definition is needed.

  5. Diagnosis and Metaphor.

    Science.gov (United States)

    Hanne, Michael

    2015-01-01

    Human beings rely on metaphor as a primary cognitive device for interpreting the world around them. Metaphors figure especially strongly in discourse around health, illness, and medicine. It is not just that patients use metaphors to describe their personal experience of being unwell, or that medical professionals employ metaphor to convey a diagnosis, describe a treatment, or explain the function of an organ to their patients. Metaphor, it is argued, lies at the heart of the process of diagnosis. Moreover, diagnosticians employ competing metaphors in the early stages of diagnosis to speculate on alternative ways of viewing a puzzling set of symptoms. Diagnosis is often defined as a process of ordering and classifying, while metaphor is a device for playing with classifications. The medical systems of different cultures depend on different sets of fundamental metaphors. Modern Western biomedicine is organized around a series of basic metaphors: the body as machine, the body as the site of battle, and the body as a communication system. Traditional Chinese medicine, on the other hand, uses images of flow and blockage, balance and imbalance, and works by analogy with five elements: wood, fire, earth, metal, and water. Psychologists are sometimes able to detect from a patient's own use of metaphor, or inability to use or recognize metaphor, clues to a diagnosis of psychosis or autism. With conditions such as anorexia nervosa, therapists may actually work to modify the dysfunctional metaphors by which patients depict themselves, with the purpose of establishing positive metaphors for envisaging recovery.

  6. Obturator Definitive Mandibula Post Hemimandibulectomy Sinistra

    Directory of Open Access Journals (Sweden)

    Paul Sugiyo

    2012-12-01

    the mandible, various surgical treatment modalities like marginal, segmental, hemimandibulectomy, or total mandibulectomy. Purpose. This study was to deteminated of rehabilitation treatment by mandible definitive obturator. The clinicians must wait for extensive period of the time for completion of healing before considering the definitive prosthesis. During this initial healing period prosthodontic intervention is required for preventing the mandibular deviation. This case report describes management of a patient who has undergone a reconstructed hemimandibulectomy with mandible definitive obturator. The prosthesis help patient moving the mandible normally without deviation during functions like speech, mastication, and aesthetic. Case Report. On March 2012, a 46 years old man was referred from Dr. Sardjito Hospital Oral Surgery Department to Department of Prosthodontics RSGM Faculty of Dentistry Gadjah Mada University Yogyakarta, for prosthetic rehabilitation following a hemimandibulectomy sinintra reconstructed with plate reconstruction three months ago. Patient felt speech function, masticatory function, and impaired performance, lower lip frequently bitten. Results. After treated while 8 months till now by mandible definitive obturator, patient felt more comfortable and confident with recovery function of speech, mastication, and aesthetic. Conclusion. The deviation of mandible after hemimandibulectomy was reconstructed by reconstruction plate surgery. During this initial healing period early prosthodontic intervention by mandible definitive obturator.

  7. Clinical practice. Diagnosis and treatment of cow's milk allergy

    NARCIS (Netherlands)

    Kneepkens, C. M. Frank; Meijer, Yolanda

    2009-01-01

    Introduction Cow's milk allergy (CMA) is thought to affect 2-3% of infants. The signs and symptoms are nonspecific and may be difficult to objectify, and as the diagnosis requires cow's milk elimination followed by challenge, often, children are considered cow's milk allergic without proven diagnosi

  8. Complicated jejunal diverticulitis: A challenging diagnosis and difficult therapy

    Directory of Open Access Journals (Sweden)

    Erik Schloericke

    2012-01-01

    Full Text Available Background/Aim: In contrast to diverticulosis of the colon, jejunal diverticulosis is a rare entity that often becomes clinically relevant only after exacerbations occur. The variety of symptoms and low incidence make this disease a difficult differential diagnosis. Patients and Methods: Data from all patients who were treated in our surgical department for complicated jejunal diverticulitis, that is, gastrointestinal hemorrhage or a diverticula perforation were collected prospectively over a 6-year period (January 2004 to January 2010 and analyzed retrospectively. Results: The median age among the 9 patients was 82 years (range: 54-87. Except for 2 cases (elective operation for a status postjejunal peridiverticulitis and a re-perforation of a diverticula in a patient s/p segment resection with free perforation, the diagnosis could only be confirmed with an exploratory laparotomy. Perforation was observed in 5 patients, one of which was a retroperitoneal perforation. The retroperitoneal perforation was associated with transanal hemorrhage. Hemodynamically relevant transanal hemorrhage requiring transfusion were the reason for an exploratory laparotomy in 2 further cases. In one patient, the hemorrhage was the result of a systemic vasculitis with resultant gastrointestinal involvement. A singular jejunal diverticulum caused an adhesive ileus in one patient. The extent of jejunal diverticulosis varied between a singular diverticulum to complete jejunal involvement. A tangential, transverse excision of the diverticulum was carried out in 3 patients. The indication for segment resection was made in the case of a perforation with associated peritonitis (n=4 as well as the presence of 5 or more diverticula (n=2. Histological analysis revealed chronic pandiverticulitis in all patients. Median operating time amounted to 142 minutes (range: 65-210 and the median in-hospital stay was 12 days (range: 5-45. Lethality was 0%. Major complications included

  9. Industrial Chain: Industrial Vertical Definition

    Institute of Scientific and Technical Information of China (English)

    YifeiDu; GuojunJiang; ShimingLi

    2004-01-01

    Like value chain and supply chain, “industrial chain” becomes the focus of attention. The implication of “industrial chain” has gained a large range of extension. It not only expresses the industrial “chain” structure and relationship of “back and forward”in order or “up and down” in direction, but also it represents a cluster of large scale of firms in an area or colony. It is a network, or a community. Consequently, we conclude that “industrial chain” is a synthesis of industrial chain, industrial cluster, or industrial network.In this article, firstly we will distinguish industry chain from industry. An industry is the collection of firms that have the same attribute, so an industry can be defined by firm collection of certain attribute. We indicate that industrial chain is a kind of vertical and orderly industrial link. It is defined according to a series of specific product or service created. Secondly we analyze the vertical orderly defiinition process from the aspects of social division of labor and requirement division, self-organization system, and value analysis.Non-symmetry and depending on system or community of large scale of industrial units lead to entire industry to “orderly” structure. On the other hand, the draught of diversity and complexity of requirement simultaneously lead to entire industry to be more “orderly”. Along with processes of self-organization, industrial will appi'oach the state of more orderly and steady, and constantly make industrial chain upgrade. Each firm or unit, who will gain the value, has to establish channels of value, which we called “industrial value chain”. Lastly,we discuss the consequence of vertical and orderly definition, which is exhibited by a certain relationship body. The typical forms of industrial chain include industrial cluster, strategy alliance and vertical integration etc.

  10. 5 CFR 210.102 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Definitions. 210.102 Section 210.102 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS BASIC CONCEPTS AND DEFINITIONS (GENERAL) Applicability of Regulations; Definitions § 210.102 Definitions. (a) The definitions in paragraph...

  11. MARKETING CONCEPT - DEFINITION AND DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Krasimir Davchev

    2014-12-01

    Full Text Available The article deals with the connection between the historical development of the marketing concept and the impact this development has on the precise definition of the marketing concept. The author proposes his own version of the definition based on the current state of socio-economic reality.

  12. An Operational Definition of Learning

    Science.gov (United States)

    Harel, Guershon; Koichu, Boris

    2010-01-01

    An operational definition offered in this paper posits learning as a multi-dimensional and multi-phase phenomenon occurring when individuals attempt to solve what they view as a problem. To model someone's learning accordingly to the definition, it suffices to characterize a particular sequence of that person's disequilibrium-equilibrium phases in…

  13. 46 CFR Section 1 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Definitions. Section 1 Section 1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION B-CONTROL AND UTILIZATION OF PORTS RESTRICTIONS UPON THE TRANSFER OR CHANGE IN USE OR IN TERMS GOVERNING UTILIZATION OF PORT FACILITIES Section 1 Definitions. As used in this...

  14. Omani Students' Definitions of Geography

    Science.gov (United States)

    Al-Nofli, Mohammed Abdullah

    2014-01-01

    Very few studies have been conducted on students' definitions of geography. The purpose of the present study was to add to the existing literature by exploring Omani students' definitions of geography. Participants were 477 students of grade 6 (ages 11-12) and grade 10 (ages 15-16) in one school district in Oman. They had been taught geography…

  15. MARKETING CONCEPT - DEFINITION AND DEVELOPMENT

    OpenAIRE

    Krasimir Davchev

    2014-01-01

    The article deals with the connection between the historical development of the marketing concept and the impact this development has on the precise definition of the marketing concept. The author proposes his own version of the definition based on the current state of socio-economic reality.

  16. Use of fuzzy edge single-photon emission computed tomography analysis in definite Alzheimer's disease - a retrospective study

    Directory of Open Access Journals (Sweden)

    Rusina Robert

    2010-09-01

    Full Text Available Abstract Background Definite Alzheimer's disease (AD requires neuropathological confirmation. Single-photon emission computed tomography (SPECT may enhance diagnostic accuracy, but due to restricted sensitivity and specificity, the role of SPECT is largely limited with regard to this purpose. Methods We propose a new method of SPECT data analysis. The method is based on a combination of parietal lobe selection (as regions-of-interest (ROI, 3D fuzzy edge detection, and 3D watershed transformation. We applied the algorithm to three-dimensional SPECT images of human brains and compared the number of watershed regions inside the ROI between AD patients and controls. The Student's two-sample t-test was used for testing domain number equity in both groups. Results AD patients had a significantly reduced number of watershed regions compared to controls (p Conclusions Our non-invasive, relatively low-cost, and easy method can contribute to a more precise diagnosis of AD.

  17. [Myocardial infarction and acute coronary syndrome: definitions, classification, and diagnostic criteria].

    Science.gov (United States)

    Zaĭrat'iants, O V; Mishnev, O D; Kakturskiĭ, L V

    2014-01-01

    The review gives the definitions and classification of and diagnostic criteria for myocardial infarction and acute coronary syndrome in accordance with the "The third universal definition of myocardial infarction" adopted in 2012 (Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction, 2012). It also discusses the clinical and morphological comparisons of and the problems in the differential diagnosis of myocardial infarction as a nosological entity within coronary heart disease with other coronarogenic and non-coronarogenic necroses of the myocardium.

  18. Diagnosis of Pompe disease

    DEFF Research Database (Denmark)

    Vissing, John; Lukacs, Zoltan; Straub, Volker

    2013-01-01

    of the methods used in the diagnosis and differential diagnosis of late-onset Pompe disease. Muscle biopsy is commonly used as an early diagnostic tool in the evaluation of muscle disease. However, experience has shown that relying solely on visualizing a periodic acid-Schiff-positive vacuolar myopathy...... will improve patient outcomes as care standards including enzyme replacement therapy can be applied and complications can be anticipated. Increased awareness of the clinical phenotype of Pompe disease is therefore warranted to expedite diagnostic screening for this condition with blood-based enzymatic assays.......The diagnosis of Pompe disease (acid maltase deficiency, glycogen storage disease type II) in children and adults can be challenging because of the heterogeneous clinical presentation and considerable overlap of signs and symptoms found in other neuromuscular diseases. This review evaluates some...

  19. Human prenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Filkins, K.; Russo, R.J.

    1985-01-01

    The multiauthor text is written as a ''guide to rationalize and clarify certain aspects of diagnosis, general counseling and intervention'' for ''health professionals who provide care to pregnant women.'' The text is not aimed at the ultrasonographer but rather at the physicians who are clinically responsible for patient management. Chapters of relevance to radiologists include an overview of prenatal screening and counseling, diagnosis of neural tube defects, ultrasonographic (US) scanning of fetal disorders in the first and second trimesters of pregnancy, US scanning in the third trimester, multiple gestation and selective termination, fetal echo and Doppler studies, and fetal therapy. Also included are overviews of virtually all currently utilized prenatal diagnostic techniques including amniocentesis, fetal blood sampling, fetoscopy, recombinant DNA detection of hemoglobinopathies, chorionic villus sampling, embryoscopy, legal issues, and diagnosis of Mendelian disorders by DNA analysis.

  20. [Polar body diagnosis].

    Science.gov (United States)

    Montag, M; van der Ven, K; van der Ven, H

    2009-01-01

    Polar body diagnosis (PBD) is a diagnostic method for the indirect genetic analysis of oocytes. Polar bodies are by-products of the meiotic cell cycle which have no influence on further embryo development. The biopsy of polar bodies can be accomplished either by zona drilling or laser drilling within a very short time period. The paternal contribution to the genetic constitution of the developing embryo cannot be diagnosed by PBD. The major application of PBD is the detection of maternally derived chromosomal aneuploidies and translocations in oocytes. For these indications, PBD may offer a viable alternative to blastomere biopsy as the embryo's integrity remains unaffected in contrast to preimplantation genetic diagnosis by blastomere biopsy. The fast development in the field of molecular diagnostics will also influence PBD and probably allow a more general diagnosis in the future.