WorldWideScience

Sample records for diagnosing disease activity

  1. Characterization of peripartum rumination and activity of cows diagnosed with metabolic and uterine diseases.

    Science.gov (United States)

    Liboreiro, Daniela N; Machado, Karine S; Silva, Paula R B; Maturana, Milton M; Nishimura, Thiago K; Brandão, Alice P; Endres, Márcia I; Chebel, Ricardo C

    2015-10-01

    .2 vs. 461.3 ± 4.1 arbitrary unit). Occurrence of retained fetal membrane tended to and was associated with reduced prepartum (444.3 ± 11.0 vs. 466.5 ± 4.3 arbitrary unit) and postpartum (488.2 ± 14.5 vs. 538.8 ± 5.7 arbitrary unit) activity, respectively. Cows diagnosed with metritis had reduced postpartum DRT (415.9 ± 10.1 vs. 441.0 ± 5.2 min/d) and activity (512.5 ± 11.5 vs. 539.2 ± 6.0 arbitrary unit). Postpartum activity was reduced among cows that were diagnosed with subclinical ketosis (502.20 ± 16.5 vs. 536.6 ± 6.2 arbitrary unit). Although differences in DRT and activity between populations of cows that developed periparturient diseases and healthy cows were observed, further experiments are necessary to determine how DRT and activity data may be used to precociously diagnose individuals that will develop such periparturient diseases. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  2. Challenges with diagnosing and investigating suspected active tuberculosis disease in military trainees.

    Science.gov (United States)

    Chang, David; Webber, Bryant J; Hetrick, Steven M; Owen, Jerry B; Blasi, Audra A; Steele, Bernadette M; Yun, Heather C

    2017-08-01

    Between 1 January 2010 and 31 December 2016, a total of 14 U.S. and international military personnel in training at Joint Base San Antonio-Lackland, TX, were hospitalized due to suspected pulmonary tuberculosis (TB); of these, five personnel were diagnosed with active TB disease. Only one TB case had pulmonary symptoms, but these symptoms were not suggestive of TB. The incidence rate in the training population was 1.89 per 100,000 population (95% CI: 0.81, 4.42), with a higher rate when restricted to international military students attending the Defense Language Institute English Language Center. No instances of TB transmission were identified. The variety of atypical presentations and their resulting diagnostic and public health challenges prompted this retrospective review of all hospitalized cases. This case series highlights both the importance of a high index of clinical suspicion when TB is being considered in close congregate settings as well as the risk of overreliance on acid-fast bacilli staining and nucleic acid amplification testing for ruling out active pulmonary disease in young, otherwise healthy trainees. Practical solutions are suggested.

  3. Gaucher's disease diagnosed by splenectomy.

    Science.gov (United States)

    Adas, Mine; Adas, Gokhan; Karatepe, Oguzhan; Altiok, Merih; Ozcan, Deniz

    2009-08-01

    Splenectomy continues to find common therapeutic indications for hematologic disorders. In addition, recently it is also performed in surgical clinics to assist diagnose of some illnesses. Gaucher's disease, especially Type I, is the most frequently encountered lysosomal storage disorder in man. Manifestations of it are highly variable. The most frequently found symptoms include splenomegaly with anaemia and thrombocytopenia, mostly due to hypersplenism, hepatomegaly and bone disease. Four patients were reported in the present study. Three of them were easily diagnosed with Gaucher's disease via bone marrow cytology, and one with Gaucher's disease was detected by pathological examination following the splenectomy. For the pouse of diagnosis of the Gaucher's disease, performing surgery is generally not necessary. However, for the cases of difficult to diagnose by classical methods, the corect diagnosis of Gaucher's disease can only be made by a special operation.

  4. Clinical heterogeneity in newly diagnosed Parkinson's disease

    NARCIS (Netherlands)

    Post, Bart; Speelman, Johannes D.; de Haan, Rob J.

    2008-01-01

    OBJECTIVE: To determine clinical heterogeneity in newly diagnosed Parkinson's disease using cluster analysis and to describe the subgroups in terms of impairment, disability, perceived quality of life, and use of dopaminergic therapy. METHODS: We conducted a k-means cluster analysis in a prospective

  5. Simple Additive Weighting to Diagnose Rabbit Disease

    Directory of Open Access Journals (Sweden)

    Ramadiani

    2018-01-01

    Full Text Available Rabbit is one of the many pets maintained by the general public in Indonesia. Like other pet, rabbits are also susceptible to various diseases. Society in general does not understand correctly the type of rabbit disease and the way of treatment. To help care for sick rabbits it is necessary a decision support system recommendation diagnosis of rabbit disease. The purpose of this research is to make the application of rabbit disease diagnosis system so that can help user in taking care of rabbit. This application diagnoses the disease by tracing the symptoms and calculating the recommendation of the disease using Simple Additive Weighting method. This research produces a web-based decision support system that is used to help rabbit breeders and the general public.

  6. Simple Additive Weighting to Diagnose Rabbit Disease

    Science.gov (United States)

    Ramadiani; Marissa, Dyna; Jundillah, Muhammad Labib; Azainil; Hatta, Heliza Rahmania

    2018-02-01

    Rabbit is one of the many pets maintained by the general public in Indonesia. Like other pet, rabbits are also susceptible to various diseases. Society in general does not understand correctly the type of rabbit disease and the way of treatment. To help care for sick rabbits it is necessary a decision support system recommendation diagnosis of rabbit disease. The purpose of this research is to make the application of rabbit disease diagnosis system so that can help user in taking care of rabbit. This application diagnoses the disease by tracing the symptoms and calculating the recommendation of the disease using Simple Additive Weighting method. This research produces a web-based decision support system that is used to help rabbit breeders and the general public.

  7. Comparison of Biochemical Recurrence-Free Survival after Radical Prostatectomy Triggered by Grade Reclassification during Active Surveillance and in Men Newly Diagnosed with Similar Grade Disease.

    Science.gov (United States)

    Diniz, Clarissa P; Landis, Patricia; Carter, H Ballentine; Epstein, Jonathan I; Mamawala, Mufaddal

    2017-09-01

    We compared biochemical recurrence between men on active surveillance who underwent radical prostatectomy triggered by grade reclassification and men diagnosed with similar grade disease treated with immediate radical prostatectomy. We retrospectively analyzed the records of men who underwent surgery from 1995 to 2015 at our institution. We identified 4 groups, including 94 and 56 men on active surveillance who underwent radical prostatectomy following reclassification to Gleason 7 (3 + 4) or greater (grade groups 2 or greater) and Gleason 7 (3 + 4) (grade group 2), and 3,504 and 1,979 in the immediate prostatectomy group diagnosed with grade group 2 or greater and 2, respectively. Biochemical recurrence was assessed by Kaplan-Meir analysis and a multivariable Cox model. Men on active surveillance had a lower incidence of biochemical recurrence than men in the immediate radical prostatectomy groups for biopsy grade groups 2 or greater and 2 (each p <0.05). One, 5 and 10-year biochemical recurrence-free survival for men in the active surveillance group vs the immediate radical prostatectomy group was 97.9% vs 85.5%, 76.6% vs 65.1% and 69.0% vs 54.2% in biopsy grade groups 2 or greater (p = 0.009) and 96.4% vs 91.2%, 89.6% vs 74.0% and 89.6% vs 63.9%, respectively, in biopsy grade group 2 (p = 0.071). For biopsy grade groups 2 or greater there was no significant difference in the risk of biochemical recurrence between the groups after adjusting for age, biopsy extent of cancer and prostate specific antigen density. Patients on active surveillance reclassified to grade groups 2 or greater are at no greater risk for treatment failure than men newly diagnosed with similar grades. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. Transbronchial biopsies safely diagnose amyloid lung disease

    Science.gov (United States)

    Govender, Praveen; Keyes, Colleen M.; Hankinson, Elizabeth A.; O’Hara, Carl J.; Sanchorawala, Vaishali; Berk, John L.

    2018-01-01

    Background Autopsy identifies lung involvement in 58–92% of patients with the most prevalent forms of systemic amyloidoses. In the absence of lung biopsies, amyloid lung disease often goes unrecognized. Report of a death following transbronchial biopsies in a patient with systemic amyloidosis cautioned against the procedure in this patient cohort. We reviewed our experience with transbronchial biopsies in patients with amyloidosis to determine the safety and utility of bronchoscopic lung biopsies. Methods We identified patients referred to the Amyloidosis Center at Boston Medical Center with lung amyloidosis diagnosed by transbronchial lung biopsies (TBBX). Amyloid typing was determined by immunohistochemistry or mass spectrometry. Standard end organ assessments, including pulmonary function test (PFT) and chest tomography (CT) imaging, and extra-thoracic biopsies established the extent of disease. Results Twenty-five (21.7%) of 115 patients with lung amyloidosis were diagnosed by TBBX. PFT classified 33.3% with restrictive physiology, 28.6% with obstructive disease, and 9.5% mixed physiology; 9.5% exhibited isolated diffusion defects while 19% had normal pulmonary testing. Two view chest or CT imaging identified focal opacities in 52% of cases and diffuse interstitial disease in 48%. Amyloid type and disease extent included 68% systemic AL disease, 16% localized (lung limited) AL disease, 12% ATTR disease, and 4% AA amyloidosis. Fluoroscopy was not used during biopsy. No procedure complications were reported. Conclusions Our case series of 25 patients supports the use of bronchoscopic transbronchial biopsies for diagnosis of parenchymal lung amyloidosis. Normal PFTs do not rule out the histologic presence of amyloid lung disease. PMID:28393574

  9. Optical coherence tomography for diagnosing periodontal disease

    Science.gov (United States)

    Colston, Bill W., Jr.; Everett, Matthew J.; Da Silva, Luiz B.; Otis, Linda L.; Nathel, Howard

    1997-05-01

    We have, in this preliminary study, investigated the use of optical coherence tomography for diagnosis of periodontal disease. We took in vitro OCT images of the dental and periodontal tissues from a young pig and compared them to histological sections. These images distinguish tooth and soft tissue relationships that are important in diagnosing and assessing periodontal disease. We have imaged the attachment of gingiva to the tooth surface and located the cemento-enamel junction. This junction is an important reference point for defining attachment level in the diagnosis of periodontal disease. the boundary between enamel and dentin is also visible for most of the length of the anatomical crown, allowing quantitation of enamel thickness and character.

  10. Behavioral, normative and control beliefs underlying low-fat dietary and regular physical activity behaviors for adults diagnosed with type 2 diabetes and/or cardiovascular disease.

    Science.gov (United States)

    White, Katherine M; Terry, Deborah J; Troup, Carolyn; Rempel, Lynn A

    2007-08-01

    Promoting healthy lifestyle behaviors is an important aspect of interventions designed to improve the management of chronic diseases such as Type 2 diabetes and cardiovascular disease. The present study used Ajzen's (1991) theory of planned behavior as a framework to examine beliefs amongst adults diagnosed with these conditions who do and do not engage in low-fat dietary and regular physical activity behaviors. Participants (N = 192) completed a questionnaire assessing their behavioral, normative and control beliefs in relation to regular, moderate physical activity and eating foods low in saturated fats. Measures of self-reported behavior were also examined. The findings revealed that, in general, it is the underlying behavioral beliefs that are important determinants for both physical activity and low-fat food consumption with some evidence to suggest that pressure from significant others is an important consideration for low-fat food consumption. Laziness, as a barrier to engaging in physical activity, also emerged as an important factor. To encourage a healthy lifestyle amongst this population, interventions should address the perceived costs associated with behavioral performance and encourage people to maintain healthy behaviors in light of these costs.

  11. Automated diagnostic kiosk for diagnosing diseases

    Science.gov (United States)

    Regan, John Frederick; Birch, James Michael

    2014-02-11

    An automated and autonomous diagnostic apparatus that is capable of dispensing collection vials and collections kits to users interesting in collecting a biological sample and submitting their collected sample contained within a collection vial into the apparatus for automated diagnostic services. The user communicates with the apparatus through a touch-screen monitor. A user is able to enter personnel information into the apparatus including medical history, insurance information, co-payment, and answer a series of questions regarding their illness, which is used to determine the assay most likely to yield a positive result. Remotely-located physicians can communicate with users of the apparatus using video tele-medicine and request specific assays to be performed. The apparatus archives submitted samples for additional testing. Users may receive their assay results electronically. Users may allow the uploading of their diagnoses into a central databank for disease surveillance purposes.

  12. Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses.

    Science.gov (United States)

    Slatore, Christopher G; Falvo, Michael J; Nugent, Shannon; Carlson, Kathleen

    2018-05-01

    Many veterans of the wars in Afghanistan and Iraq have concomitant respiratory conditions and mental health conditions. We wanted to evaluate the association of mental health diagnoses with respiratory disease diagnoses among post-deployment veterans. We conducted a retrospective cohort study of all Afghanistan and Iraq War veterans who were discharged from the military or otherwise became eligible to receive Veterans Health Administration services. The primary exposure was receipt of a mental health diagnosis and the primary outcome was receipt of a respiratory diagnosis as recorded in the electronic health record. We used multivariable adjusted logistic regression to measure the associations of mental health diagnoses with respiratory diagnoses and conducted several analyses exploring the timing of the diagnoses. Among 182,338 post-deployment veterans, 14% were diagnosed with a respiratory condition, 77% of whom had a concomitant mental health diagnosis. The incidence rates were 5,363/100,000 person-years (p-y), 587/100,000 p-y, 1,450/100,000 p-y, and 233/100,000 p-y for any respiratory disease diagnosis, bronchitis, asthma, and chronic obstructive lung disease diagnoses, respectively, after the date of first Veterans Health Administration utilization. Any mental health diagnosis was associated with increased odds for any respiratory diagnosis (adjusted odds ratio 1.41, 95% confidence interval 1.37-1.46). The association of mental health diagnoses and subsequent respiratory disease diagnoses was stronger and more consistent than the converse. Many Afghanistan and Iraq War veterans are diagnosed with both respiratory and mental illnesses. Comprehensive plans that include care coordination with mental health professionals and treatments for mental illnesses may be important for many veterans with respiratory diseases.

  13. Degenerative cerebellar diseases and differential diagnoses

    International Nuclear Information System (INIS)

    Reith, W.; Roumia, S.; Dietrich, P.

    2016-01-01

    Cerebellar syndromes result in distinct clinical symptoms, such as ataxia, dysarthria, dysmetria, intention tremor and eye movement disorders. In addition to the medical history and clinical examination, imaging is particularly important to differentiate other diseases, such as hydrocephalus and multi-infarct dementia from degenerative cerebellar diseases. Degenerative diseases with cerebellar involvement include Parkinson's disease, multiple system atrophy as well as other diseases including spinocerebellar ataxia. In addition to magnetic resonance imaging (MRI), nuclear medicine imaging investigations are also helpful for the differentiation. Axial fluid-attenuated inversion recovery (FLAIR) and T2-weighted sequences can sometimes show a signal increase in the pons as a sign of degeneration of pontine neurons and transverse fibers in the basilar part of the pons. The imaging is particularly necessary to exclude other diseases, such as normal pressure hydrocephalus (NPH), multi-infarct dementia and cerebellar lesions. (orig.) [de

  14. [Degenerative cerebellar diseases and differential diagnoses].

    Science.gov (United States)

    Reith, W; Roumia, S; Dietrich, P

    2016-11-01

    Cerebellar syndromes result in distinct clinical symptoms, such as ataxia, dysarthria, dysmetria, intention tremor and eye movement disorders. In addition to the medical history and clinical examination, imaging is particularly important to differentiate other diseases, such as hydrocephalus and multi-infarct dementia from degenerative cerebellar diseases. Degenerative diseases with cerebellar involvement include Parkinson's disease, multiple system atrophy as well as other diseases including spinocerebellar ataxia. In addition to magnetic resonance imaging (MRI), nuclear medicine imaging investigations are also helpful for the differentiation. Axial fluid-attenuated inversion recovery (FLAIR) and T2-weighted sequences can sometimes show a signal increase in the pons as a sign of degeneration of pontine neurons and transverse fibers in the basilar part of the pons. The imaging is particularly necessary to exclude other diseases, such as normal pressure hydrocephalus (NPH), multi-infarct dementia and cerebellar lesions.

  15. How Is Paget's Disease of Bone Diagnosed?

    Science.gov (United States)

    ... Paget’s disease. Sometimes the disease is found by accident when one of these tests is done for ... contains a higher-than-usual level of a chemical substance called serum alkaline ... that is in the process of healing. However, a SAP level greater than ...

  16. Diagnosing extracranial atherosclerotic diseases with spiral CT

    International Nuclear Information System (INIS)

    Moran, C.J.; Vannier, M.W.; Erickson, K.K.; Broderick, D.F.; Kido, D.K.; Yoffie, R.L.

    1991-01-01

    This paper reports that this discovery study was performed to determine whether extracranial carotid artery plaques could be diagnosed with a new CT technique (spiral CT) that allows nondistorted three-dimensional (3D) reconstructions in the z axis. Twenty carotid arteries were examined with spiral CT in normal volunteers and in patients suspected of having atherosclerotic plaques in the extracranial carotid arteries. The Somatom Plus CT table was advanced at a constant rate, the x-ray tube was continuously rotated, and 3D data were continuously acquired. Sixty milliliters of nonionic contrast medium was injected intravenously previous to and during the acquisition of data. The carotid bifurcations were identified in all patients. Planar images, similar to conventional intraarterial angiograms, were routinely produced from the volumetric CT data

  17. Photostress Testing Device for Diagnosing Retinal Disease

    Directory of Open Access Journals (Sweden)

    Elizabeth Swan

    2014-08-01

    Full Text Available Retinal diseases such as Age-Related Macular Degeneration (ARMD affect nearly one in three elderly patients. ARMD damages the central vision photoreceptors in the fovea. The Photostress Test is a simple technique for testing for the early effects of ARMD. Here, the illumination sources in a novel self-administered Photostress Testing device were modeled for safety and distribution in illumination software. After satisfying the design constraints in the model, a prototype of the illumination system was fabricated and tested to confirm the modeling results. The resultant prototype can be used to aid in the diagnosis of retinal disease and is well within retinal safety levels.

  18. Retrospctive studies of small ruminant diseases diagnosed at the ...

    African Journals Online (AJOL)

    Retrospctive studies of small ruminant diseases diagnosed at the Veterinary Teaching Hospital, University of Agriculture, Makurdi, Nigeria. J.W. Jatfa, A.Y. Adenkola, I Victor, A Kisani, S.S. Adamu, P.A. Onyeyili ...

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

    OpenAIRE

    Singh, Jasvinder A.

    2009-01-01

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

  20. Treatment of clinically diagnosed laryngopharyngeal reflux disease.

    Science.gov (United States)

    Youssef, Tarek Fouad; Ahmed, Mohamed Rifaat

    2010-11-01

    To determine the incidence of Helicobacter pylori (HP) stool antigen (HPSA) in patients with laryngopharyngeal reflux disease (LPRD), and to make a comparison of 2 treatment regimens that have been used based on the presence or absence of HPSA positivity in patients with LPRD. Randomized controlled study. Suez Canal University Hospital, Ismalia, Egypt. A total of 212 patients with symptoms of LPRD. Patients were evaluated by laryngoscopy, ambulatory pH monitoring for 24 hours, and HPSA testing. Esomeprazole magnesium as a monotherapy was evaluated vs triple therapy in patients with HP infection. To determine the incidence of HPSA in patients with LPRD, and to make a comparison of 2 treatment regimens that have been used based on the presence or absence of HPSA positivity in patients with LPRD. Persistent dry cough and a feeling of a lump in the throat (globus sensation) were the most frequent symptoms of LPRD, while posterior laryngeal inflammation was the main laryngoscopic finding. Results from the HPSA test were positive in 57% of the studied group. Patients with negative HPSA were treated with esomeprazole as single modality with a reported improvement score of 96.6%. Patients with positive HPSA test results were divided into 2 groups: 1 received only esomeprazole, with reported improvement in 40%, whereas the second group was treated with esomeprazole, plus amoxicillin sodium and clarithromycin (triple therapy) and reported a 90% incidence of symptom improvement. The incidence of HP infection in patients with LPRD in our study was 57%. Triple therapy showed a higher cure rate in patients with HPSA-positive test results.

  1. Diagnosing Coronary Heart Disease using Ensemble Machine Learning

    OpenAIRE

    Kathleen H. Miao; Julia H. Miao; George J. Miao

    2016-01-01

    Globally, heart disease is the leading cause of death for both men and women. One in every four people is afflicted with and dies of heart disease. Early and accurate diagnoses of heart disease thus are crucial in improving the chances of long-term survival for patients and saving millions of lives. In this research, an advanced ensemble machine learning technology, utilizing an adaptive Boosting algorithm, is developed for accurate coronary heart disease diagnosis and outcome predictions. Th...

  2. Nursing diagnoses in children with congenital heart disease: a survival analysis.

    Science.gov (United States)

    Martins da Silva, Viviane; Lopes, Marcos Venícios de Oliveira; Leite de Araujo, Thelma

    2007-01-01

    To analyze the relationship between nursing diagnoses and survival rates in children with congenital heart disease. A total of 270 observations were carried out in 45 children with congenital heart disease who were followed for 15 days. Differences in mean survival times were identified in children not more than 4 months of age with respect to the following diagnoses: impaired gas exchange, ineffective breathing pattern, activity intolerance, delayed growth and development, and decreased cardiac output. The main diagnoses are identified early in the hospitalization period and are conditions resulting from hemodynamic alterations and prescribed medical treatment. Congenital heart disease provokes serious hemodynamic alterations that generate human responses, which should be treated proactively.

  3. Radiological Diagnoses in the Context of Emigration: Infectious diseases.

    Science.gov (United States)

    Stojkovic, Marija; Müller, Jan; Junghanss, Thomas; Weber, Tim Frederik

    2018-02-01

     Globalization and emigration impact on the spectrum of diseases challenging health care systems. Medical practitioners have to particularly prepare for infectious diseases.  The database of a health care center specialized on tropical medicine was screened for patients with history of migration and one of the following diagnoses: Cystic echinococcosis, tuberculosis, schistosomiasis, visceral leishmaniosis, and neurocysticercosis. Representative casuistics were prepared from select case histories. Radiological pertinent knowledge was compiled based on literature search.  A small selection of frequently imported infectious diseases covers a considerable fraction of health care problems associated with migration. For cystic echinococcosis, schistosomiasis, and neurocysticercosis imaging is the most relevant diagnostic procedure defining also disease stages. Tuberculosis and visceral leishmaniosis are important differentials for malignant diseases.  Imaging plays a meaningful role in diagnosis, treatment stratification, and follow-up of imported infectious diseases. Radiological skills concerning these diseases are important for providing health care for patients in context of migration.   · Imaging plays a meaningful role in multidisciplinary care for imported infectious diseases.. · A small selection covers a considerable fraction of infectious diseases expected in context of migration.. · Stojkovic M, Müller J, Junghanss T et al. Radiological Diagnoses in the Context of Emigration: Infectious diseases. Fortschr Röntgenstr 2018; 190: 121 - 133. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Estrogen-related and other disease diagnoses preceding Parkinson's disease

    DEFF Research Database (Denmark)

    Latourelle, Jeanne C; Dybdal, Merete; Destefano, Anita L

    2010-01-01

    Estrogen exposure has been associated with the occurrence of Parkinson's disease (PD), as well as many other disorders, and yet the mechanisms underlying these relations are often unknown. While it is likely that estrogen exposure modifies the risk of various diseases through many different...... mechanisms, some estrogen-related disease processes might work in similar manners and result in association between the diseases. Indeed, the association between diseases need not be due only to estrogen-related factors, but due to similar disease processes from a variety of mechanisms....

  5. Are we diagnosing too many people with coeliac disease?

    Science.gov (United States)

    Aziz, Imran; Sanders, David S

    2012-11-01

    This review will try to address the question of whether we are diagnosing too many people with coeliac disease. The key reasons for diagnosing coeliac disease may be that it is a common condition affecting up to 1% of the adult population. Delays in diagnosis are common. The average time delay reported by Coeliac UK (National Medical Patient Charity), for patients with symptoms prior to the diagnosis being made is 13 years. For every adult case detected, it is estimated that there are eight cases not detected. Patients with coeliac disease have an associated morbidity and mortality. In addition, quality of life studies suggest that the majority of patients benefit from a gluten-free diet (GFD). Furthermore, the GFD reduces or alleviates the risk of the associated complications. All of these facts could even be used to support the argument for screening! However, conversely the tests for coeliac disease are not 100% sensitive and specific. In addition, we do not know whether patients with milder symptoms will derive less benefit from treatment and are at less risk of complications. Furthermore, evidence presented in this review suggests that actual outcomes for screening studies in an adult population have revealed poor uptake and subsequently difficulties with adherence. What little published data that are available also infers that individuals recognised through screening programmes could have been detected if carefully questioned for symptoms. There is evidence to suggest that diagnosing celiac disease is cost-effective and that the diagnostic costs are offset by reduced medical expenditures, reduced hospital and general practice attendances, but this view depends on the population prevalence of coeliac disease. We believe on the basis of the evidence presented in this review that we are not diagnosing too many adults with coeliac disease. However, the authors consider case-finding with a low threshold for serological testing to be the optimal approach. If you

  6. Divorce and risk of hospital-diagnosed infectious diseases.

    Science.gov (United States)

    Nielsen, Nete Munk; Davidsen, Rie B; Hviid, Anders; Wohlfahrt, Jan

    2014-11-01

    Although, divorce is considered to have a negative impact on morbidity, very little is known concerning exposure to divorce and risk of infectious diseases. We aimed to investigate the association between divorce and subsequent hospital contacts with infectious diseases. We performed a nation-wide cohort study, including all Danish men and women (n≈5.6 million) alive on the 1 January 1982 or later, and followed them for infectious disease diagnosed in hospital settings from 1982 to 2010. The association between divorce and risk of infectious diseases was evaluated through rate ratios (RRs) comparing incidence rates of infectious diseases between divorced and married pesons. Compared with married persons, divorced persons were overall at a 1.48 fold (RR=1.48 (95% CI: 1.47-1.50)) increased risk of hospital-diagnosed infectious diseases (RR adjusted for sex, age, period, income and education). The risk of infectious diseases was slightly more pronounced for divorced women (RR=1.54 (1.52-1.56)) than divorced men ((RR=1.42 (1.41-1.44)). The increased risk remained almost unchanged even more than 15 years after the divorce. Young age at divorce, short duration of marriage and number of divorces further increased the risk of infectious diseases, whereas number of children at time of divorce had no impact on risk of hospital-diagnosed infectious diseases following the divorce. Divorce appears to have a moderate but long lasting impact on the risk of infectious diseases the underlying mechanism is unknown but shared risk factors predicting divorce and infectious diseases could contribute to our findings. © 2014 the Nordic Societies of Public Health.

  7. Creutzfeldt-Jakob disease: a case report and differential diagnoses.

    Science.gov (United States)

    Kojima, Gotaro; Tatsuno, Brent K; Inaba, Michiko; Velligas, Stephanie; Masaki, Kamal; Liow, Kore K

    2013-04-01

    Sporadic Creutzfeldt-Jakob disease is a rare neurodegenerative disorder of unknown etiology that causes rapidly progressive dementia. This disease is uniformly fatal and most patients die within 12 months. Clinical findings include myoclonus, visual disturbances, and cerebellar and pyramidal/extrapyramidal signs in addition to rapidly progressive cognitive and functional impairment. These findings are all non-specific and it is often difficult and challenging to diagnose premortem because of low awareness and clinical suspicion. We present a 66-year-old woman with a 5-month history of rapidly progressive dementia. After a series of extensive diagnostic examinations and continuous follow-up, she was diagnosed with probable sporadic Creutzfeldt-Jakob disease based on Centers for Disease Control and Prevention (CDC) criteria, with key findings of rapidly progressive dementia, blurry vision, extrapyramidal signs (cogwheel rigidity), and abnormal hyperintensity signals on diffusion-weighted MRI. Her symptoms progressively worsened and she died 7 months after the onset. The postmortem brain autopsy demonstrated the presence of abnormal protease-resistant prion protein by Western Blot analysis. A literature review was performed on differential diagnoses that present with rapidly progressive dementia and thereby mimic sporadic Creutzfeldt-Jakob disease. These include Alzheimer's disease, dementia with Lewy Bodies, frontotemporal dementia, meningoencephalitis, corticobasal degeneration, progressive supranuclear palsy, CADASIL, and paraneoplastic encephalomyelitis.

  8. Four Cases of Parkinson Disease Diagnosed During the Postpartum Period.

    Science.gov (United States)

    Maltête, David; Grangeon, Lou; Le Goff, Floriane; Ozel, Gulden; Fetter, Damien; Ahtoy, Patrick; Temgoua, Olivier; Rouillé, Audrey; Lefaucheur, Romain

    2017-07-01

    There is little experience with the effect of pregnancy on Parkinson disease because the number of women with Parkinson disease who are of childbearing age is small. We report four cases beginning during the postpartum period and discuss the potential contribution of different factors that may influence the occurrence of Parkinson disease in this time period. Four women aged 29-35 years developed arm tremor, shoulder pain, dizziness, or decreased dexterity of the hand in the first few days or months after childbirth. They were initially diagnosed with postpartum depression or psychogenic parkinsonism. Finally, dopamine transporter imaging confirmed the diagnosis of young-onset Parkinson disease. Early-onset Parkinson disease may present in postpartum women. In women with atypical motor symptoms in addition to depression, this diagnosis should be considered.

  9. [Subclinical and established kidney disease in recently diagnosed hypertensive patients].

    Science.gov (United States)

    Gómez-Marcos, Manuel Angel; Martínez-Salgado, Carlos; Grandes, Gonzalo; Recio-Rodríguez, José Ignacio; Castaño Sánchez, Yolanda; Rodríguez Sánchez, Emiliano; García-Ortiz, Luis

    2010-03-06

    To estimate renal disease in recently diagnosed hypertensive patients, and to identify factors related to renal disease. Cross-sectional study, with 425 hypertensive patients recently diagnosed in primary health care; renal disease was estimated with serum creatinine, albumin/creatinine index and glomerular filtration rate (GFR). We analyzed cardiovascular risk factors (CRF), subclinical organ injury and cardiovascular disease following the criteria of the 2007 European Guide of Hypertension. Average age: 58,96 +/- 12,73 years old, 63,3% male. We found dyslipemia in 80%, abdominal obesity in 49% and metabolic syndrome in 36% patients. These patients showed increased serum creatinine 3,3%, a reduction in GFR 9,6%, hidden renal disease 6,4%, microalbuminuria 7,5% and nephropathy 2,4%. Hypertensive patients with renal disease (17,88%) were older, with higher systolic pressure, higher incidence of metabolic syndrome, abnormal carotid intima-media thickness and ankle-arm index, and presence of cardiovascular disease. Variables associated with renal disease were metabolic syndrome (odds ratio = 11,12) and ankle-arm index (odds ratio = 17,55). Variables related to creatinina were sex, ankle-arm index and metabolic syndrome; variables related to GFR were sex, age, ankle-arm index, metabolic syndrome and body mass index (BMI); variables related with albumin/creatinine index included diabetes mellitus. Renal disease is detected in about 2 out of 10 hypertensive patients, when, besides serum creatinina, we analyze albumin/creatinine index and GFR. Metabolic syndrome and ankle-arm index are the main variables associated with renal disease. Copyright 2009 Elsevier España, S.L. All rights reserved.

  10. Introducing a multifaceted exercise intervention particular to older adults diagnosed with Parkinson's disease: a preliminary study.

    Science.gov (United States)

    Peacock, Corey A; Sanders, Gabriel J; Wilson, Kayla A; Fickes-Ryan, Emily J; Corbett, Duane B; von Carlowitz, Kyle-Patrick A; Ridgel, Angela L

    2014-08-01

    With a substantial increase in diagnosed Parkinson's disease, it is of great importance to examine tolerance and physical measures of evolving exercise interventions. Of particular importance, a multifaceted exercise intervention combining active-assisted cycling and resistance training to older adults diagnosed with Parkinson's disease is being assessed. Fourteen older adults diagnosed with Parkinson's disease and ten healthy older adults (67.5 ± 7.9 years of age) engaged in an 8-week, 24-session, multifaceted exercise protocol. The protocol consisted of both active-assisted cycling and resistance training. Tolerance was measured, as well as multiple indicators of health-related physical fitness. These indicators examined improvements in cardiovascular performance, muscular strength, muscular endurance, and flexibility. Twenty-two older adults and older adults diagnosed with Parkinson's disease tolerated the intervention by completing all 24 sessions. Repeated-measures analysis of variance demonstrated significant (P ≤ 0.003) improvements in cardiovascular performance, muscular strength, muscular endurance, and flexibility for both groups of individuals. The multifaceted intervention is the first to combine both active-assisted cycling and resistance training. The older adult and the older adult diagnosed with Parkinson's disease exhibited both tolerance and health-related improvements in physical fitness following the intervention.

  11. New testing options for diagnosing and grading dry eye disease.

    Science.gov (United States)

    Foulks, Gary N; Pflugfelder, Stephen C

    2014-06-01

    To describe new options for diagnosis and severity grading of dry eye disease. Perspective on technological advancements to identify tear dysfunction and their value in diagnosing and grading dry eye disease. Evidence is presented on new and evolving technologies to measure tear stability, composition, and meniscus height and their role in dry eye diagnosis and therapeutic efficacy grading is assessed. Evolving concepts regarding pathogenesis and new technologies to evaluate the tears and ocular surface have improved the ability to diagnose, classify, and grade the severity of dry eye disease. New technologies include noninvasive imaging of tear stability and tear meniscus height as a measure of tear volume and tear composition (osmolarity, lacrimal factors, inflammatory mediators, growth and differentiation factors). Approved tests, such as tear osmolarity and tear imaging, are being integrated into clinical practice and may eventually supplant certain traditional tests that have greater variability and less sensitivity. Other tests, such as molecular assays of tears and conjunctival cells, are currently being used in studies investigating pathogenesis and therapeutic mechanism of action. They may eventually translate to routine clinical practice. New technologies have emerged that can noninvasively evaluate the tears and measure disease-associated compositional changes. These tests are being integrated into clinical practice and therapeutic trials for diagnosis, classification, and severity grading of dry eye disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Thyroid disorders in patients with newly diagnosed rheumatoid arthritis is associated with poor initial treatment response evaluated by disease activity score in 28 joints-C-reactive protein (DAS28-CRP)

    DEFF Research Database (Denmark)

    Emamifar, Amir; Hangaard, Jørgen; Jensen Hansen, Inger Marie

    2017-01-01

    peptide antibody (anti-CCP), and antinuclear antibody (ANA), and also disease activity score in 28 joints-C-reactive protein at the time of diagnosis and after 4 months (±1–2 months) of treatment initiation were extracted from Danish Danbio Registry. Patients’ electronic hospital records for the past 10...... years were reviewed to reveal if they had been diagnosed with thyroid disorders or they had abnormal thyroid test.In all, 439 patients were included, female 60.1%, mean age 64.6 ± 15.0 years and disease duration 2.6 ± 1.7 years. Prevalence of thyroid disorders was 69/439 (15.7%) and hypothyroidism...... treatment compared with patients with isolated RA after 4 months of treatment (P = .02). There were no associations between thyroid disorders and age, disease duration, and also IgM RF positivity.Presence of thyroid disorders in RA patients is suggestive of a more aggressive disease and poor outcome...

  13. Visual System Involvement in Patients with Newly Diagnosed Parkinson Disease.

    Science.gov (United States)

    Arrigo, Alessandro; Calamuneri, Alessandro; Milardi, Demetrio; Mormina, Enricomaria; Rania, Laura; Postorino, Elisa; Marino, Silvia; Di Lorenzo, Giuseppe; Anastasi, Giuseppe Pio; Ghilardi, Maria Felice; Aragona, Pasquale; Quartarone, Angelo; Gaeta, Michele

    2017-12-01

    Purpose To assess intracranial visual system changes of newly diagnosed Parkinson disease in drug-naïve patients. Materials and Methods Twenty patients with newly diagnosed Parkinson disease and 20 age-matched control subjects were recruited. Magnetic resonance (MR) imaging (T1-weighted and diffusion-weighted imaging) was performed with a 3-T MR imager. White matter changes were assessed by exploring a white matter diffusion profile by means of diffusion-tensor imaging-based parameters and constrained spherical deconvolution-based connectivity analysis and by means of white matter voxel-based morphometry (VBM). Alterations in occipital gray matter were investigated by means of gray matter VBM. Morphologic analysis of the optic chiasm was based on manual measurement of regions of interest. Statistical testing included analysis of variance, t tests, and permutation tests. Results In the patients with Parkinson disease, significant alterations were found in optic radiation connectivity distribution, with decreased lateral geniculate nucleus V2 density (F, -8.28; P Parkinson disease and that the entire intracranial visual system can be involved. © RSNA, 2017 Online supplemental material is available for this article.

  14. Nuclear cardiology procedures to diagnose ischemia in coronary artery disease

    International Nuclear Information System (INIS)

    Kropp, J.

    1999-01-01

    Nuclear cardiology is equipped with a broad spectrum of diagnostic capabilities which allow the evaluation of ventricular performance, perfusion and metabolism of the heart. The principle of nuclear medicine procedures consists in the administration of free radioisotopes or radiopharmaceuticals to detect their spatial distribution within the body by detecting their y-rays from outside by gamma cameras. Myocardial perfusion scintigraphy is the most important procedure in nuclear cardiology and is performed on a routine basis with 201 Thallium-Chloride ( 201 Tl) since 1975. With the Single-Photon Emission Computerized Tomography (SPECT) technique it is possible to diagnose ischemia of the left ventricle on the basis of coronary artery disease with a sensitivity of 90-95% and a specificity of about 55%. Recently 99m Tc-tracers were developed for this purpose, which have many advantages due to their better physical properties, their easy handling and availability. The diagnostic accuracy is the same compared to ( 201 Tl). Free fatty acids labeled with 123 Iodine like 123 IPPA are alternative tracers to diagnose ischemia by the metabolic alteration and are pathognomonic tracers to diagnose the heart involvement in myopathies or metabolic defects related to fatty acid degradation which are the main fuel of the normal myocytes. Finally we should not forget the radionuclide ventriculography (RNVG) which is one of the oldest nuclear cardiology procedures providing us with very objective, reliable results of ventricular performance. (orig.)

  15. How to manage a late diagnosed Hirschsprung′s disease

    Directory of Open Access Journals (Sweden)

    Mohamed Ouladsaiad

    2016-01-01

    Full Text Available Background: How to manage a late diagnosed Hirschsprung′s disease (HD and how to avoid calibre discrepancy? Subjects and Methods: A retrospective study of all patients diagnosed with HD over 2 years in our hospital from January 2009 to December 2012. Data were analysed for clinical presentations, investigations, surgical procedures and post-operative outcome. Results: Fifteen patients, operated by one single surgeon, were included in this study. The mean age was 6 years (2-16 years. Patients had an ultra-short segment type in 4 cases, rectosigmoid type in 9 cases and descending colonic aganglionosis in 2 cases. Rectal wash out was effective in 12 patients. A blowhole transverse colostomy was performed in 2 patients. Twelve patients underwent one single stage endorectal pull-through. Anastomosis incongruence was avoided by a plication procedure never described before. The assessment of post-operative outcomes by the paediatric incontinence and constipation scoring system revealed a normal continence function in all our patients, but 3 patients suffered from soiling secondary to constipation. Conclusion: One single stage pull-through can be safe and effective in children with late diagnosed HD. Routine rectal washout is a good way to prepare the colon. In some cases, blowhole colostomy can be an option. Anastomosis incongruence is a challenge; we describe a plication procedure to avoid it.

  16. Nonalcoholic Fatty Liver Disease: Noninvasive Methods of Diagnosing Hepatic Steatosis

    Science.gov (United States)

    AlShaalan, Rasha; Aljiffry, Murad; Al-Busafi, Said; Metrakos, Peter; Hassanain, Mazen

    2015-01-01

    Hepatic steatosis is the buildup of lipids within hepatocytes. It is the simplest stage in nonalcoholic fatty liver disease (NAFLD). It occurs in approximately 30% of the general population and as much as 90% of the obese population in the United States. It may progress to nonalcoholic steatohepatitis, which is a state of hepatocellular inflammation and damage in response to the accumulated fat. Liver biopsy remains the gold standard tool to diagnose and stage NAFLD. However, it comes with the risk of complications ranging from simple pain to life-threatening bleeding. It is also associated with sampling error. For these reasons, a variety of noninvasive radiological markers, including ultrasound, computed tomography, magnetic resonance spectroscopy, and the controlled attenuation parameter using transient elastography and Xenon-133 scan have been proposed to increase our ability to diagnose NAFLD, hence avoiding liver biopsy. The aim of this review is to discuss the utility and accuracy of using available noninvasive diagnostic modalities for fatty liver in NAFLD. PMID:25843191

  17. Lymphogranuloma venereum proctitis: a differential diagnose to inflammatory bowel disease.

    Science.gov (United States)

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

    2011-04-01

    Lymphogranuloma venereum (LGV) is a sexually transmitted disease, endemic in tropical and subtropical areas for many years. After 2003 there have been several outbreaks in western countries, especially among HIV-positive men who have sex with men (MSM). An important manifestation of LGV is a proctitis, with a clinical presentation and endoscopic findings resembling those of inflammatory bowel diseases (IBDs). LGV is considered new in Scandinavia. This case report focuses on difficulties in differentiating LGV and IBD. This case report used a systematic search in the literature using PubMed and clinical cases from the Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark (Cases 1-3) and the Section of Surgery, Hamar Hospital, Norway (Case 4). Clinical and endoscopic findings in LGV and IBD resemble each other. All cases were MSM. Three out of four were HIV-positive. Three out of four contacted their general practitioner (GP) due to gastrointestinal (GI) symptoms, and were referred to a gastroenterologist (GE) with suspicion of IBD. Because of non-successful IBD treatment, control of HIV status, relapses of GI-symptoms or extended information concerning sexual habits, LGV was suspected and diagnosed. All patients responded with remission of GI-symptoms and endoscopic findings after oral treatment with doxycycline. Due to similarities between LGV and IBD, LGV should be considered as a differential diagnosis in patients with proctitis or IBD-related symptoms, especially among HIV-positive men. Hence LGV patients may be spared long-lasting examination, mistreatment and surgery.

  18. Voice acoustic patterns of patients diagnosed with vibroacoustic disease

    Directory of Open Access Journals (Sweden)

    Ana Mendes

    2006-07-01

    Full Text Available Background: Long-term low frequency noise exposure (LFN (≤ 500 Hz, including infrasound may lead to the development of vibroacoustic disease (VAD, a systemic pathology characterized by the abnormal growth of extra-cellular matrices. The respiratory system is a target for LFN. Fibrosis of the respiratory tract epithelia was observed in VAD patients through biopsy, and confirmed in animal models exposed to LFN. Voice acoustic analysis can detect vocal fold variations of mass, tension, muscular and neural activity. Frequency perturbation (jitter, amplitude perturbation (shimmer and harmonicto- noise ratio (HNR are used in the evaluation of the vocal function, and can be indicators of the presence and degree of severity of vocal pathology. Since the respiratory system is the energy source of the phonation process, this raises questions about the effects of VAD on voice production. The purpose of this study was to determine if voice acoustic parameters of VAD patients are different from normative data. Methods: Nine individuals (5 males and 4 females diagnosed with VAD were recorded performing spoken and sung tasks. The spoken tasks included sustaining vowels and fricatives. The sung tasks consisted of maximum phonational frequency range (MPFR. Voice acoustic parameters analysed were: fundamental frequency (F0, jitter, shimmer, HNR and temporal measures. Results: Compared with normative data, both males and females diagnosed with VAD exhibited increased F0, shimmer and HNR. Jitter, MPFR and one temporal measure were reduced. Conclusions: VAD individuals presented voice acoustic parameter differences in spectral, temporal and perturbation measures, which may be indicative of small morphological changes in the phonatory system. Resumo: Enquadramento: A exposição crónica ao ruído de baixa frequência (RBF (≤ 500 Hz, incluindo infra-sons pode conduzir ao desenvolvimento da doença vibroacústica (VAD

  19. Fitness, daily activity and body composition in children with newly diagnosed, untreated asthma

    DEFF Research Database (Denmark)

    Vahlkvist, S; Pedersen, S

    2009-01-01

    Background: Information about how the asthma disease affects the life style and health in children is sparse. Aim: To measure fitness, daily physical activity and body composition in children with newly diagnosed, untreated asthma and healthy controls, and to assess the association between...... the level of asthma control and these parameters. Methods: Daily physical activity measured using accelerometry, cardiovascular fitness and body composition (per cent fat, per cent lean tissue and bone mineral density) were measured in 57 children with newly diagnosed, untreated asthma and in 157 healthy...... fitness and daytime spent in intensive activity. Overweight children are physically less active than normal weight children....

  20. [Intravesical active prostate bleeding diagnosed in B-mode ultrasound].

    Science.gov (United States)

    Kirchgesner, T; Danse, E; Tombal, B

    2013-09-01

    Hematuria is one of the most frequent minor complications after prostatic biopsy. We would like to report the case of a 68-year-old patient with massive hematuria after prostatic biopsy and intravesical active prostate bleeding diagnosed in B-mode ultrasonography. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. Improving the Specificity of EEG for Diagnosing Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    François-B. Vialatte

    2011-01-01

    Full Text Available Objective. EEG has great potential as a cost-effective screening tool for Alzheimer's disease (AD. However, the specificity of EEG is not yet sufficient to be used in clinical practice. In an earlier study, we presented preliminary results suggesting improved specificity of EEG to early stages of Alzheimer's disease. The key to this improvement is a new method for extracting sparse oscillatory events from EEG signals in the time-frequency domain. Here we provide a more detailed analysis, demonstrating improved EEG specificity for clinical screening of MCI (mild cognitive impairment patients. Methods. EEG data was recorded of MCI patients and age-matched control subjects, in rest condition with eyes closed. EEG frequency bands of interest were θ (3.5–7.5 Hz, α1 (7.5–9.5 Hz, α2 (9.5–12.5 Hz, and β (12.5–25 Hz. The EEG signals were transformed in the time-frequency domain using complex Morlet wavelets; the resulting time-frequency maps are represented by sparse bump models. Results. Enhanced EEG power in the θ range is more easily detected through sparse bump modeling; this phenomenon explains the improved EEG specificity obtained in our previous studies. Conclusions. Sparse bump modeling yields informative features in EEG signal. These features increase the specificity of EEG for diagnosing AD.

  2. Clinical course of Crohn's disease first diagnosed at surgery for acute abdomen.

    Science.gov (United States)

    Latella, G; Cocco, A; Angelucci, E; Viscido, A; Bacci, S; Necozione, S; Caprilli, R

    2009-04-01

    The severity of clinical activity of Crohn's disease is high during the first year after diagnosis and decreases thereafter. Approximately 50% of patients require steroids and immunosuppressants and 75% need surgery during their lifetime. The clinical course of patients with Crohn's disease first diagnosed at surgery has never been investigated. To assess the clinical course of Crohn's disease first diagnosed at surgery for acute abdomen and to evaluate the need for medical and surgical treatment in this subset of patients. Hospital clinical records of 490 consecutive Crohn's disease patients were reviewed. Patients were classified according to the Vienna criteria. Sex, extraintestinal manifestations, family history of inflammatory bowel diseases, appendectomy, smoking habit and medical/surgical treatments performed during the follow-up period were assessed. Kaplan-Meier survival method and Cox proportional hazards regression model. Of the 490 Crohn's disease patients, 115 had diagnosis of Crohn's disease at surgery for acute abdomen (Group A) and 375 by conventional clinical, radiological, endoscopic and histologic criteria (Group B). Patients in Group A showed a low risk of further surgery (Log Rank test pacute abdomen showed a low risk for reintervention and less use of steroids and immunosuppressants during follow-up than those not operated upon at diagnosis. Early surgery may represent a valid approach in the initial management of patients with Crohn's disease, at least in the subset of patients with ileal and complicated disease.

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

    Science.gov (United States)

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

    2014-02-01

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

  4. Diagnosing and reporting of occupational diseases: a quality improvement study

    NARCIS (Netherlands)

    Spreeuwers, D.; de Boer, A. G. E. M.; Verbeek, J. H. A. M.; van Beurden, M. M.; van Dijk, F. J. H.

    2008-01-01

    AIM: To assess the need for quality improvement of diagnosing and reporting of noise-induced occupational hearing loss and occupational adjustment disorder. METHODS: Performance indicators and criteria for the quality of diagnosing and reporting were developed. Self-assessment questionnaires were

  5. Dry Eye Disease in Patients with Newly Diagnosed Depressive Disorder.

    Science.gov (United States)

    Tiskaoglu, Nesime Setge; Yazıcı, Alper; Karlıdere, Tunay; Sari, Esin; Oguz, Elif Yilmaz; Musaoglu, Musa; Aslan, Seyda; Samet Ermiş, Sıtkı

    2017-05-01

    Psychiatric conditions and not just the treatments themselves might be involved in the pathophysiology of dry eye disease (DED). The aim of our study was to evaluate the association between depression and DED using objective and subjective tests in patients with newly diagnosed depressive disorder who were not using any medication which may help us to determine the sole effect of depression on dry eye. Thirty-six patients from the psychiatry clinic with a new diagnosis of depressive disorder and 32 controls were included in the study. All met the Diagnostic and Statistical Manual IV criteria for depression. Beck Depression Inventory (BDI) was used to measure depression severity and the State-Trait Anxiety Inventory (Stai1, Stai2) for concomitant anxiety symptoms. The Ocular Surface Disease Index (OSDI) and Visual Functioning Questionnaires (VFQ25) were completed and used to confirm diagnosis of DED in conjunction with the tear break up time (TBUT), ocular surface vital dye staining, and Schirmer's test. The comparison of depressive and control groups revealed significantly lower Schirmer (20.3 ± 9.9 vs. 25.7 ± 9.3 mm) and TBUT (7.8 ± 5.7 vs. 12.5 ± 7.8 s) scores with a consistently higher Oxford score (1.8 ± 3.2 vs. 0.2 ± 0.4) in the depressive group. Although the parameters were affected in the depressive group, this did not influence OSDI (86.1 ± 13.6 vs. 86.6 ± 13.3) and VFQ25 (30.8 ± 21.6 vs. 38.5 ± 29.1) scores. In both groups, the three psychological test scores (Stai1-2 and BDI) were correlated to each other but none of these tests were correlated to OSDI, VRQL, Schirmer, TBUT, and Oxford staining scores. Our study shows a definite association between depression and DED. We feel that it is important that psychiatrists take this into account especially while prescribing antidepressants which may aggravate dry eye signs.

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

    Directory of Open Access Journals (Sweden)

    Tam Clarence C

    2009-05-01

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

  7. Finding aroma clues in the human breath to diagnose diseases

    Science.gov (United States)

    A. Dan Wilson

    2016-01-01

    History of human odor analysis in disease diagnosis The use of the sense of smell as an indicator of human disease probably originated with Hippocrates (circa 400 BC). Early medical practitioners recognized that the presence of human diseases changed the odors released from the body and breath. Physicians once relied heavily on their sense of smell to provide useful...

  8. Retrospective analysis of Newcastle disease diagnosed at the ...

    African Journals Online (AJOL)

    Newcastle disease (ND) is a highly contagious viral disease of domestic and wild birds with devastating impact on poultry health and production. Many vaccines and vaccination schedules are in use in controlling the disease but prevention and control are still a problem. A ten-year retrospective study (2002-2011) of ...

  9. THE FREQUENT SKIN DISEASES DIAGNOSED AT UNIVERSITY STUDENTS

    Directory of Open Access Journals (Sweden)

    Yesim KAYMAK

    2005-12-01

    Full Text Available The incidence of some skin diseases are increasing at adolescent and early adulthood period. The most frequent disease at this period is acne vulgaris whereas fungal diseases, dermatitis, dermatosis which are due to stress and other reasons, oral mucosal lesions and herpetic lesions of perioral region are also frequent. In this research we aim to determine the frequent dermatologic diseases of university students and 147 female, 74 male, a total of 221 students are included. We questioned the dermatologic complaints of students, then examined dermatologically in detail and registered ages, sexes, findings of the dermatological examination and dermatological diagnostic informations. As a result it is found out that the most frequent diseases are acne vulgaris (34.1%, allergic and pruritic dermatosis (16.6%, fungal diseases ( 13.0%, and eritamatous-squamous disease (8.3%. [TAF Prev Med Bull 2005; 4(6.000: 313-320

  10. X-ray diagnoses of metabolic bone diseases in infants

    International Nuclear Information System (INIS)

    Oestreich, A.E.; Missouri Univ., Columbia

    1979-01-01

    In X-ray pictures of patients with metabolic bone diseases, there are some important differences between adults and children due to the fact that childrens' skeletons are still graving. Metabolically induced changes to be observed by the radiologist in osteoporosis, rickets, and other metabolic diseases are described. In many cases, specific treatment of these diseases is necessary and also possible. (orig./MG) [de

  11. Fragile X syndrome – a common disease rarely diagnosed

    Directory of Open Access Journals (Sweden)

    Lisik Malgorzata Zofia

    2017-03-01

    Full Text Available Fragile X syndrome (FXS is a single-gene disorder with a broad spectrum of involvement, including cognitive and behavioural impairments of varying degrees with specific physical features and with strong association with autism. The study was conducted on 23 males (10-32 years old who had full mutation in the FMR1 gene. A complete medical evaluation, including medical history, family history, psychological testing and physical examination was conducted on each subject. Three of the FXS patients (13% were isolated cases of mental retardation in the family. The remaining 20 FXS patients belonged to 15 families, where there were other mentally retarded family members present. The degree of mental retardation (MR varied. Mild MR was diagnosed in 1/23 (4.35%, moderate MR in 12/23 (52.17%, severe MR in 10/23 (43.48 %. Moreover, autism spectrum disorder was diagnosed in 5/23 (21.74% FXS patients. Analysis of the BMI showed that in FXS patients, 14 of 23 (60.68% had too high body weight - 9/23 (39.13% were overweight and 5/23 (21.74% were obese. The diagnosis of FXS is difficult because of nonspecific symptoms, yet early diagnosis is crucial for early intervention and genetic counseling. The risk of recurrence is 50%.

  12. Diagnosing coeliac disease and the potential for serological markers

    DEFF Research Database (Denmark)

    Husby, Steffen; Murray, Joseph A

    2014-01-01

    The diagnosis of coeliac disease has advanced in the past decade owing to increased clinical awareness and improved tests. Coeliac disease is now regarded as a common disease presenting at any age with a broad spectrum of symptoms. Previous guidelines on diagnosis relied on the histological...... analysis of duodenal biopsy samples. However, contemporary antibody analysis is a diagnostic tool with a comparatively high accuracy that has reduced reliance on performing biopsies. Furthermore, determination of HLA-based genetic susceptibility to coeliac disease has become routine. European and North...... American guidelines utilize symptoms, coeliac antibodies (primarily tissue transglutaminase 2 IgA and endomysial IgA antibodies), HLA determination and histological analysis of biopsy tissue for diagnosis. Some guidelines conclude that the diagnostic accuracy of tissue transglutaminase 2 IgA antibodies...

  13. Early Lyme disease with spirochetemia - diagnosed by DNA sequencing

    Directory of Open Access Journals (Sweden)

    Jones William

    2010-11-01

    Full Text Available Abstract Background A sensitive and analytically specific nucleic acid amplification test (NAAT is valuable in confirming the diagnosis of early Lyme disease at the stage of spirochetemia. Findings Venous blood drawn from patients with clinical presentations of Lyme disease was tested for the standard 2-tier screen and Western Blot serology assay for Lyme disease, and also by a nested polymerase chain reaction (PCR for B. burgdorferi sensu lato 16S ribosomal DNA. The PCR amplicon was sequenced for B. burgdorferi genomic DNA validation. A total of 130 patients visiting emergency room (ER or Walk-in clinic (WALKIN, and 333 patients referred through the private physicians' offices were studied. While 5.4% of the ER/WALKIN patients showed DNA evidence of spirochetemia, none (0% of the patients referred from private physicians' offices were DNA-positive. In contrast, while 8.4% of the patients referred from private physicians' offices were positive for the 2-tier Lyme serology assay, only 1.5% of the ER/WALKIN patients were positive for this antibody test. The 2-tier serology assay missed 85.7% of the cases of early Lyme disease with spirochetemia. The latter diagnosis was confirmed by DNA sequencing. Conclusion Nested PCR followed by automated DNA sequencing is a valuable supplement to the standard 2-tier antibody assay in the diagnosis of early Lyme disease with spirochetemia. The best time to test for Lyme spirochetemia is when the patients living in the Lyme disease endemic areas develop unexplained symptoms or clinical manifestations that are consistent with Lyme disease early in the course of their illness.

  14. Radioisotope heart examination during exercise to diagnose ischemic heart disease

    International Nuclear Information System (INIS)

    Farsky, S.

    1986-01-01

    The radioisotope exercise test is discussed and its benefits characterized for the diagnosis of ischemic heart disease, namely the use of 99m Tc in scintiscanning heart ventricles and of 201 Tl in scintiscanning myocardial perfusion. The exercise ventricular function and perfusion scintigraphies are compared with the common exercise ECG examination, and their superior sensitivity and specificity emphasized. Considering the constraints of scintigraphic imaging, indications are outlined for patients including those with suspect serious ischemic heart disease in whom the exercise ECG test has been negative or inconclusive, patients with the so-called nondiagnostic ECG, patients with atypical symptoms, and healthy individuals for whom the exercise ECG test indicated with respect to their occupation has been positive. Both radionuclide imaging techniques are complementary and are shown to be valuable not only in improving the diagnosis of ischemic heart disease but also in identifying the high-risk patients in whom cardiac surgery is to be considered. (L.O.)

  15. Degenerative cerebellar diseases and differential diagnoses; Degenerative Kleinhirnerkrankungen und Differenzialdiagnosen

    Energy Technology Data Exchange (ETDEWEB)

    Reith, W.; Roumia, S.; Dietrich, P. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2016-11-15

    Cerebellar syndromes result in distinct clinical symptoms, such as ataxia, dysarthria, dysmetria, intention tremor and eye movement disorders. In addition to the medical history and clinical examination, imaging is particularly important to differentiate other diseases, such as hydrocephalus and multi-infarct dementia from degenerative cerebellar diseases. Degenerative diseases with cerebellar involvement include Parkinson's disease, multiple system atrophy as well as other diseases including spinocerebellar ataxia. In addition to magnetic resonance imaging (MRI), nuclear medicine imaging investigations are also helpful for the differentiation. Axial fluid-attenuated inversion recovery (FLAIR) and T2-weighted sequences can sometimes show a signal increase in the pons as a sign of degeneration of pontine neurons and transverse fibers in the basilar part of the pons. The imaging is particularly necessary to exclude other diseases, such as normal pressure hydrocephalus (NPH), multi-infarct dementia and cerebellar lesions. (orig.) [German] Klinisch imponieren Kleinhirnsyndrome durch Ataxie, Dysarthrie, Dysmetrie, Intentionstremor und Augenbewegungsstoerungen. Neben der Anamnese und klinischen Untersuchung ist die Bildgebung v. a. wichtig um andere Erkrankungen wie Hydrozephalus und Multiinfarktdemenz von degenerativen Kleinhirnerkrankungen zu differenzieren. Zu den degenerativen Erkrankungen mit Kleinhirnbeteiligung gehoeren der Morbus Parkinson, die Multisystematrophie sowie weitere Erkrankungen einschliesslich der spinozerebellaeren Ataxien. Neben der MRT sind auch nuklearmedizinische Untersuchungen zur Differenzierung hilfreich. Axiale Fluid-attenuated-inversion-recovery(FLAIR)- und T2-gewichtete Sequenzen koennen mitunter eine Signalsteigerung im Pons als Ausdruck einer Degeneration der pontinen Neuronen und transversalen Bahnen im Brueckenfuss zeigen. Die Bildgebung ist aber v. a. notwendig, um andere Erkrankungen wie Normaldruckhydrozephalus

  16. A biopsy is not always necessary to diagnose celiac disease

    NARCIS (Netherlands)

    Mubarak, Amani; Wolters, Victorien M.; Gerritsen, Susan A. M.; Gmelig-Meyling, Frits H. J.; ten Kate, Fiebo J. W.; Houwen, Roderick H. J.

    2011-01-01

    Small intestinal histology is the criterion standard for the diagnosis of celiac disease (CD). However, results of serological tests such as anti-endomysium antibodies and anti-tissue transglutaminase antibodies (tTGA) are becoming increasingly reliable. This raises the question of whether a small

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    Abstract Objective. Lymphogranuloma venereum (LGV) is a sexually transmitted disease, endemic in tropical and subtropical areas for many years. After 2003 there have been several outbreaks in western countries, especially among HIV-positive men who have sex with men (MSM). An important...

  18. Cerebrospinal Fluid Biomarkers in Diagnosing Alzheimer's Disease in Clinical Practice

    DEFF Research Database (Denmark)

    Slats, Diane; Spies, Petra E; Sjögren, Magnus J C

    2010-01-01

    Analysis of the brain specific biomarkers amyloid beta(42) (Abeta(42)) and total tau (t-tau) protein in cerebrospinal fluid (CSF) has a sensitivity and specificity of more than 85% for differentiating Alzheimer's Disease (AD) from non-demented controls. International guidelines are contradictory...

  19. Analysis of neurodegenerative Mendelian genes in clinically diagnosed Alzheimer Disease.

    Directory of Open Access Journals (Sweden)

    Maria Victoria Fernández

    2017-11-01

    Full Text Available Alzheimer disease (AD, Frontotemporal lobar degeneration (FTD, Amyotrophic lateral sclerosis (ALS and Parkinson disease (PD have a certain degree of clinical, pathological and molecular overlap. Previous studies indicate that causative mutations in AD and FTD/ALS genes can be found in clinical familial AD. We examined the presence of causative and low frequency coding variants in the AD, FTD, ALS and PD Mendelian genes, in over 450 families with clinical history of AD and over 11,710 sporadic cases and cognitive normal participants from North America. Known pathogenic mutations were found in 1.05% of the sporadic cases, in 0.69% of the cognitively normal participants and in 4.22% of the families. A trend towards enrichment, albeit non-significant, was observed for most AD, FTD and PD genes. Only PSEN1 and PINK1 showed consistent association with AD cases when we used ExAC as the control population. These results suggest that current study designs may contain heterogeneity and contamination of the control population, and that current statistical methods for the discovery of novel genes with real pathogenic variants in complex late onset diseases may be inadequate or underpowered to identify genes carrying pathogenic mutations.

  20. Retrospective analysis of Newcastle disease diagnosed at the ...

    African Journals Online (AJOL)

    ADEYEYE

    2015-10-22

    Solomon et al., 2012;. Snoeck et al., 2013). Vaccination is practiced widely and ... books. Postmortem examination, microbiology and haemagglutination activity of tracheal swabs or serology (haemagglutination inhibition test) was.

  1. Profile of nursing diagnoses of hospitalized patients in an infectious disease unit

    OpenAIRE

    Souza Neto, Vinicius Lino de; Andrade, Lidiane Lima de; Agra, Glenda; Costa, Marta Miriam Lopes; Silva, Richardson Augusto Rosendo da

    2015-01-01

    Objective: To define the profile of nursing diagnoses of hospitalized patients at an infectious diseases unit.Methods: This is a descriptive study based on the quantitative approach conducted at an infectious diseases unit in Paraiba, Brazil, from January to February 2014. The data collection instrument was based on the Theory of Basic Human Needs by Wanda de Aguiar Horta, followed by the classification system CIPE(r) version 2.0 to construct the diagnoses.Results: Data analysis resulted in 3...

  2. Biosensors to Diagnose Chagas Disease: A Brief Review.

    Science.gov (United States)

    Rocha-Gaso, María-Isabel; Villarreal-Gómez, Luis-Jesús; Beyssen, Denis; Sarry, Frédéric; Reyna, Marco-Antonio; Ibarra-Cerdeña, Carlos-Napoleón

    2017-11-15

    Chagas disease (CD), which mostly affects those living in deprived areas, has become one of Latin America's main public health problems. Effective prevention of the disease requires early diagnosis, initiation of therapy, and regular blood monitoring of the infected individual. However, the majority of the Trypanosoma cruzi infections go undiagnosed because of mild symptoms, limited access to medical attention and to a high variability in the sensitivity and specificity of diagnostic tests. Consequently, more affordable and accessible detection technologies capable of providing early diagnosis and T. cruzi load measurements in settings where CD is most prevalent are needed to enable enhanced intervention strategies. This work analyzes the potential contribution of biosensing technologies, reviewing examples that have been tested and contrasted with traditional methods, both serological and parasitological (i.e., molecular detection by PCR), and discusses some emerging biosensing technologies that have been applied for this public health issue. Even if biosensing technologies still require further research efforts to develop portable systems, we arrive at the conclusion that biosensors could improve the accuracy of CD diagnosis and the follow-up of patients' treatments in terms of the rapidity of results, small sample volume, high integration, ease of use, real-time and low cost detection when compared with current conventional technologies.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    each other. All cases were MSM. Three out of four were HIV-positive. Three out of four contacted their general practitioner (GP) due to gastrointestinal (GI) symptoms, and were referred to a gastroenterologist (GE) with suspicion of IBD. Because of non-successful IBD treatment, control of HIV status...... as a differential diagnosis in patients with proctitis or IBD-related symptoms, especially among HIV-positive men. Hence LGV patients may be spared long-lasting examination, mistreatment and surgery.......Abstract Objective. Lymphogranuloma venereum (LGV) is a sexually transmitted disease, endemic in tropical and subtropical areas for many years. After 2003 there have been several outbreaks in western countries, especially among HIV-positive men who have sex with men (MSM). An important...

  4. Susceptibility, likelihood to be diagnosed, worry and fear for contracting Lyme disease.

    Science.gov (United States)

    Fogel, Joshua; Chawla, Gurasees S

    Risk perception and psychological concerns are relevant for understanding how people view Lyme disease. This study investigates the four separate outcomes of susceptibility, likelihood to be diagnosed, worry, and fear for contracting Lyme disease. University students (n=713) were surveyed about demographics, perceived health, Lyme disease knowledge, Lyme disease preventive behaviors, Lyme disease history, and Lyme disease miscellaneous variables. We found that women were associated with increased susceptibility and fear. Asian/Asian-American race/ethnicity was associated with increased worry and fear. Perceived good health was associated with increased likelihood to be diagnosed, worry, and fear. Correct knowledge was associated with increased susceptibility and likelihood to be diagnosed. Those who typically spend a lot of time outdoors were associated with increased susceptibility, likelihood to be diagnosed, worry, and fear. In conclusion, healthcare providers and public health campaigns should address susceptibility, likelihood to be diagnosed, worry, and fear about Lyme disease, and should particularly target women and Asians/Asian-Americans to address any possible misconceptions and/or offer effective coping strategies. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  5. Classification of optical coherence tomography images for diagnosing different ocular diseases

    Science.gov (United States)

    Gholami, Peyman; Sheikh Hassani, Mohsen; Kuppuswamy Parthasarathy, Mohana; Zelek, John S.; Lakshminarayanan, Vasudevan

    2018-03-01

    Optical Coherence tomography (OCT) images provide several indicators, e.g., the shape and the thickness of different retinal layers, which can be used for various clinical and non-clinical purposes. We propose an automated classification method to identify different ocular diseases, based on the local binary pattern features. The database consists of normal and diseased human eye SD-OCT images. We use a multiphase approach for building our classifier, including preprocessing, Meta learning, and active learning. Pre-processing is applied to the data to handle missing features from images and replace them with the mean or median of the corresponding feature. All the features are run through a Correlation-based Feature Subset Selection algorithm to detect the most informative features and omit the less informative ones. A Meta learning approach is applied to the data, in which a SVM and random forest are combined to obtain a more robust classifier. Active learning is also applied to strengthen our classifier around the decision boundary. The primary experimental results indicate that our method is able to differentiate between the normal and non-normal retina with an area under the ROC curve (AUC) of 98.6% and also to diagnose the three common retina-related diseases, i.e., Age-related Macular Degeneration, Diabetic Retinopathy, and Macular Hole, with an AUC of 100%, 95% and 83.8% respectively. These results indicate a better performance of the proposed method compared to most of the previous works in the literature.

  6. Psychosocial covariates of physical activity in recently diagnosed Type 2 diabetes patients

    Directory of Open Access Journals (Sweden)

    Rajesh Nair

    2013-03-01

    Full Text Available Background Regular physical activity can be effective not only in preventing diabetes and managing its complications but also be effective in minimizing the risk of developing other chronic diseases among diabetics. The overall aim of study was to determine probable causes of change in physical activity so as to generate evidences for future interventions and to identify psychosocial covariates of self reported physical activity in recently diagnosed Type 2 diabetes cases. Methods Participants n=478 (239 intervention arm and 239 control arm of an observational cohort were randomized into the ADDITION Plus trial and were recruited from 36 practices in East Anglia region. Participants were people recently diagnosed with diabetes (screen detected and clinically diagnosed within the preceding 3 years were individually randomized and were between the age group of 40-69 years, (mean age 59.2 years. The self reported data regarding physical activity was measured at baseline and one year were used. Demographic and psychosocial (treatment control, consequences, anxiety covariates were assessed at the baseline. Linear univariate and multivariable linear regression analysis was used to quantify the associations between demographic and psychosocial correlates. Results: With regard to the psychosocial correlates(except for participants’ perceptions about the consequences of diabetes, no significant associations with physical activity were found. Treatment control and anxiety failed to predict physical activity. Conclusion The result suggests to further investigate the change in physical activity by including other variables related to demography, other psycho-social and environment influences. Based on the available literature, it is suggested that other factors were found consistently associated with physical activity such as self efficacy, attitude, sensation seeking, family-friend social support, goal orientation, motivation could be studied.

  7. Psychosocial covariates of physical activity in recently diagnosed Type 2 diabetes patients

    Directory of Open Access Journals (Sweden)

    Rajesh Nair

    2013-01-01

    Full Text Available Background Regular physical activity can be effective not only in preventing diabetes and managing its complications but also be effective in minimizing the risk of developing other chronic diseases among diabetics. The overall aim of study was to determine probable causes of change in physical activity so as to generate evidences for future interventions and to identify psychosocial covariates of self reported physical activity in recently diagnosed Type 2 diabetes cases. Methods Participantsn=478(239interventionarmand239controlarmof an observational cohort were randomized into the ADDITION Plus trial and were recruited from 36 practices in East Anglia region. Participants were people recently diagnosed with diabetes (screen detected and clinically diagnosed within the preceding 3 years were individually randomized and were between the age group of 40-69 years, (mean age 59.2 years. The self reported data regarding physical activity was measured at baseline and one year were used. Demographic and psychosocial (treatment control, consequences, anxiety covariates were assessed at the baseline. Linear univariate and multivariable linear regression analysis was used to quantify the associations between demographic and psychosocial correlates. Results: With regard to the psychosocial correlates(except for participants’ perceptions about the consequences of diabetes, no significant associations with physical activity were found. Treatment control and anxiety failed to predict physical activity. Conclusion The result suggests to further investigate the change in physical activity by including other variables related to demography, other psycho-social and environment influences. Based on the available literature, it is suggested that other factors were found consistently associated with physical activity such as self efficacy, attitude, sensation seeking, family-friend social support, goal orientation, motivation could be studied.

  8. Narratives of Self in Older Bilingual Adults Diagnosed with Alzheimer's Disease

    Science.gov (United States)

    López de Victoria Rodríguez, Patria C.

    2016-01-01

    As the boom in the older adult population continues to grow, so too grows the number of persons suffering from cognitive diseases, such as dementia of the Alzheimer's type (DAT). Older Latinos diagnosed with the disease make up 4 percent (200,000) of the current population; however, little research on bilinguals with DAT has been carried out…

  9. Early manifestations of type 1 Gaucher disease in presymptomatic children diagnosed after parental carrier screening.

    Science.gov (United States)

    Yang, Amy C; Bier, Louise; Overbey, Jessica R; Cohen-Pfeffer, Jessica; Desai, Khyati; Desnick, Robert J; Balwani, Manisha

    2017-06-01

    The overall published experience with pediatric type 1 Gaucher disease (GD1) has been based on ascertainment through clinical presentation of the disease. We describe the longitudinal follow-up in a presymptomatic pediatric cohort. The cohort includes children diagnosed with GD1, either prenatally or postnatally by molecular genetic testing, and followed for clinical care at our center from 1998 to 2016. All patients' parents were GBA mutation carriers identified through carrier screening programs. Longitudinal clinical, laboratory, and imaging data were obtained through chart review. Thirty-eight patients aged 1-18 years (mean at last visit 6.9 ± 4.1 years) were followed, including 32 p.N409S homozygotes and 6 p.N409S/p.R535H compound heterozygotes. At the last evaluation, a minority had hematological (5%), bone (15%), or linear growth (19%) issues. Only 12% had splenomegaly and 74% had moderate hepatomegaly. Chitotriosidase activity varied widely (6-5,640 nmol/hour/ml) and generally increased with age. Pediatric Gaucher severity scores (GSS) remained stable and within the mild-disease range for most (95%). Treatment for progressive disease during this period was recommended for four children. Most children with the p.N409S/p.N409S and p.N409S/p.R535H GD1 genotypes have minimal disease manifestations and progression during childhood and can be monitored using limited assessments. Those with other mutations may require additional monitoring. These data are valuable for newborn screening and counseling.Genet Med advance online publication 13 October 2016.

  10. Celiac disease diagnosed after uncomplicated pregnancy in a patient with history of bulimia nervosa.

    Science.gov (United States)

    Milisavljević, Nemanja; Cvetković, Mirjana; Nikolić, Goran; Filipović, Branka; Milinić, Nikola

    2013-01-01

    The association between celiac disease and eating disorders has been very rarely reported. This is the first report on celiac disease associated with bulimia in this part of Europe. An adult female patient with history of bulimia and one uncomplicated pregnancy was admitted to the Gastroenterology Department, due to long lasting dyspeptic symptoms, constipation, major weight loss and fatigue. After positive serological screening, the diagnosis of celiac disease was confirmed with histopathology examination of duodenal biopsy specimen. Complicated interactions between celiac disease and bulimia can make them difficult to diagnose and treat. It is important to consider the presence of celiac disease in patients with bulimia and gastrointestinal symptoms.

  11. Profile of nursing diagnoses of hospitalized patients in an infectious disease unit

    Directory of Open Access Journals (Sweden)

    Vinicius Lino de Souza Neto

    Full Text Available Objective: To define the profile of nursing diagnoses of hospitalized patients at an infectious diseases unit.Methods: This is a descriptive study based on the quantitative approach conducted at an infectious diseases unit in Paraiba, Brazil, from January to February 2014. The data collection instrument was based on the Theory of Basic Human Needs by Wanda de Aguiar Horta, followed by the classification system CIPE(r version 2.0 to construct the diagnoses.Results: Data analysis resulted in 36 nursing diagnoses statements, with a higher prevalence of impaired food intake, cachexia, impaired spontaneous bladder elimination, impaired oral cavity hygiene, exposure to contamination, rapid heart rate, insomnia, drug abuse, alcohol and tobacco abuse, social isolation, acceptance and fear.Conclusions: The identification of a diagnostics profile is critical to guide nursing interventions.

  12. Serum selenium is low in newly diagnosed Graves´disease: a population-based study

    DEFF Research Database (Denmark)

    Bülow Pedersen, Inge; Knudsen, Nils; Carle, Allan

    2013-01-01

    by a fluorimetric method. Patients with newly diagnosed Graves’ disease (GD) (n = 97) or autoimmune overt hypothyroidism (AIH) (n = 96), euthyroid subjects with high serum levels of thyroid peroxidase antibody (TPO‐Ab) (TPO‐Ab > 1500 U/ml, n = 92) and random controls (n = 830). Differences in s‐Se values. S...

  13. CTSH regulates β-cell function and disease progression in newly diagnosed type 1 diabetes patients

    DEFF Research Database (Denmark)

    Fløyel, Tina; Brorsson, Caroline; Nielsen, Lotte B

    2014-01-01

    expression and increased insulin secretion. Additionally, islets from Ctsh(-/-) mice contained less insulin than islets from WT mice. Importantly, the TT genotype was associated with higher daily insulin dose and faster disease progression in newly diagnosed T1D patients, indicating agreement between...

  14. Lived Experiences of Adult Children Who Have a Parent Diagnosed with Parkinson's Disease

    Science.gov (United States)

    Blanchard, Amy; Hodgson, Jennifer; Lamson, Angela; Dosser, David

    2009-01-01

    Little is known about the experience among adult children who have a parent with Parkinson's Disease (PD). The purpose of this study was to explore, appreciate, and describe their experiences using a phenomenological methodology. Narratives were collected from seven participants who have a parent diagnosed with PD and analyzed according to…

  15. Unexpectedly diagnosed Caroli's disease on HIDA scintigraphy in a patient with calculous cholecystitis

    Energy Technology Data Exchange (ETDEWEB)

    Shinto, A. S.; Selvakumar, J. [Amala Institute of Medical Sciences, Amalanagar (India)

    2010-12-15

    Caroli's disease, which is a rare condition with congenital dilatation if the intrahepatic bile ducts, is usually diagnosed postoperatively. The clinical suspicion in a patient with gallstones and choledocholithiasis presenting with dilated intrahepatic biliary radicles and jaundice is usually an obstructive etiology. However, scintigraphic evaluation of this entity, as in this case, gives additional information on liver function, biliary drainage and predisposing conditions like Caroli's disease, which could be missed otherwise

  16. The diagnose of oil palm disease using Naive Bayes Method based on Expert System Technology

    Science.gov (United States)

    Nababan, Marlince; Laia, Yonata; Sitanggang, Delima; Sihombing, Oloan; Indra, Evta; Siregar, Saut; Purba, Windania; Mancur, Roy

    2018-04-01

    Expert system is dealt with system that used computer-based human intelligence to overcome particular problem which is commonly conducted by an expert. Frequent problem faced by the farmers of oil palm is the difficulty in defining the type of plant disease. As a result, the delay treatment of plant disease brings out the declining of farm products. An application system is needed to deal with the obstacles and diagnosing the type of oil palm plant disease. The researcher designed an intelligence-based application with input-output plan which is able to diagnose the type of oil palm plant disease by applying naive bayes method. Based on the research result by conducting bayes method with recognized symptom, diagnose of oil palm plant disease could be accomplished. The data of symptoms found are leaves turned yellow 0.4, dead leaves 0.4, black and brown color among the veins of leaves 0.5, young and old fruit with whole space 0.4, and decay of bunches is 0.3. The roots are tender in the amount of 0.5, and damage on sheath is 0.3. Through the chosen symptoms as mentioned above, the value of bayes is 80% with the type of disease is rotten bunch.

  17. Using Brain Electrical Activity Mapping to Diagnose Learning Disabilities.

    Science.gov (United States)

    Torello, Michael, W.; Duffy, Frank H.

    1985-01-01

    Cognitive neuroscience assumes that measurement of brain electrical activity should relate to cognition. Brain Electrical Activity Mapping (BEAM), a non-invasive technique, is used to record changes in activity from one brain area to another and is 80 to 90 percent successful in classifying subjects as dyslexic or normal. (MT)

  18. Overweight and obesity in children with newly diagnosed inflammatory bowel disease.

    Science.gov (United States)

    Pituch-Zdanowska, Aleksandra; Banaszkiewicz, Aleksandra; Dziekiewicz, Marcin; Łazowska-Przeorek, Izabella; Gawrońska, Agnieszka; Kowalska-Duplaga, Kinga; Iwańczak, Barbara; Klincewicz, Beata; Grzybowska-Chlebowczyk, Urszula; Walkowiak, Jarosław; Albrecht, Piotr

    2016-03-01

    Determination of overweight and obesity prevalence in children with inflammatory bowel disease (IBD) at the time of diagnosis. This was a multicenter retrospective study. The study group consisted of children with new cases of IBD diagnosed in 2005-2013 according to the Porto criteria. Hospital admission records were reviewed for demographic and clinical characteristics. BMI-for-age and gender percentile charts were used to define overweight as ≥85th BMI percentile and obesity as ≥95th BMI percentile. 675 patients were evaluated: 368 with Crohn's disease (CD) and 307 with ulcerative colitis (UC). Of these, 54.8% were boys and 45.2% were girls. There were no statistically significant differences in age, weight, height and disease activity between the CD and UC patients. The UC patients had higher BMI values than the CD patients. The prevalence of overweight and obesity was higher in the UC than the CD patients (4.89% CI95 2.76-7.93 vs. 2.45% CI95 1.12-4.59 and 8.47% CI95 5.61-12.16 vs. 1.9% CI95 0.77-3.88, respectively); the differences were statistically significant (-2.44% CI95 -5.45 to 0.49 and -6.57% CI95 -10 to -3.1, respectively). The risk of overweight/obesity was 3.5 times higher for patients with UC (OR=0.272, CI95 0.14-0.49, p=0.0004). The prevalence of overweight and obesity in newly diagnosed children with IBD was 8.4% and was higher in patients with UC than in patients with CD. The results of this study have shown that not only malnourished children may suffer from IBD but also children who are overweight or obese at the time of diagnosis. Copyright © 2015 Medical University of Bialystok. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  19. A changing trend in the management of patients with newly diagnosed Crohn's disease.

    LENUS (Irish Health Repository)

    Qasim, A

    2012-02-01

    BACKGROUND: Epidemiologic shift with rising incidence of Crohn\\'s disease (CD) has been reported in recent studies. AIMS: To determine disease behaviour and therapeutic interventions undertaken in newly diagnosed patients with CD. METHODS: Patients diagnosed with CD between January 2006 and June 2008 were included. Disease type, location, degree of involvement and type of therapeutic interventions were recorded. RESULTS: A total of 78 patients were included. Colonic, ileo-colonic, terminal ileal and isolated small bowel disease were present in 37, 27, 9 and 5 patients, respectively. Disease phenotype was inflammatory, stenosing and fistulising in 42, 30 and 6 patients, respectively. Surgery was required in 22 patients, including right hemicolectomy (n = 8), subtotal colectomy (n = 4), segmental colonic resection (n = 2), segmental small bowel resection (n = 2), appendectomy (n = 2) and perianal surgery (n = 4). Fourteen patients underwent surgery at the time of diagnosis. Laparoscopic surgery was performed in 14 patients. CONCLUSIONS: A significant proportion of newly diagnosed patients with CD underwent surgical intervention on their first admission to hospital. This may signify a changing trend in the management approach.

  20. Activity of intraarterial carboplatin as a single agent in the treatment of newly diagnosed extremity osteosarcoma.

    Science.gov (United States)

    Petrilli, A S; Kechichian, R; Broniscer, A; Garcia, R J; Tanaka, C; Francisco, J; Lederman, H; Odone Filho, V; Camargo, O P; Bruniera, P; Pericles, P; Consentino, E; Ortega, J A

    1999-08-01

    Chemotherapy has dramatically improved the rates of cure and survival of patients with localized and metastatic osteosarcoma. Nonetheless, the number of chemotherapeutic agents active against osteosarcoma is limited to doxorubicin, cisplatin, high-dose methotrexate, and ifosfamide. Carboplatin, a cisplatin analogue, has been tested as a single agent in patients with recurrent osteosarcoma or as part of multiagent chemotherapy in newly diagnosed patients. We tested the activity and toxicity of two cycles of intraarterial carboplatin as a "window therapy" (600 mg/m2 per cycle) in 33 consecutive patients with extremity osteosarcoma before the start of multiagent chemotherapy. Response was based on clinical (tumor diameter, local inflammatory signs, and range of motion) and radiological parameters (plain local films and arteriographic studies prior to drug administration). Patients' age ranged between 8 and 18 years (median age 13 years). Primary tumor originated from the femur (15 patients), tibia (10 patients), fibula (4 patients), humerus (3 patients), and calcaneus (1 patient). Only 7 patients (21%) had metastatic disease at diagnosis (5 in the lung and 2 in other bones). A favorable clinical and radiological response was documented in 81% and 73% of the patients, respectively. Clinical and radiological progression occurred in 12% and 9% of the patients, respectively. Seventeen of the patients remain alive and disease-free. Survival and event-free survival at 3 years for nonmetastatic patients are 71% (SE = 9%) and 65% (SE = 9%), respectively; for metastatic patients, the figures are 17% (SE = 15%) and 14% (SE = 13%), respectively. We conclude that carboplatin is an active agent in the treatment of newly diagnosed extremity osteosarcoma. Copyright 1999 Wiley-Liss, Inc.

  1. A longitudinal study of gastrointestinal diseases in individuals diagnosed with infantile autism as children

    DEFF Research Database (Denmark)

    Mouridsen, Svend-Erik; Rich, B; Isager, T

    2009-01-01

    Abstract Background A number of studies have indicated a link between gastrointestinal (GI) diseases and autism spectrum disorders. Method The objective of this study was to compare the prevalence and types of GI diseases in a clinical sample of 118 individuals diagnosed as children with infantile...... autism (IA) with GI diseases in 336 matched controls from the general population, based on data from the nationwide Danish National Hospital Register (DNHR). The average observation time was 30.3 years (SD 0.4) (range 27-30 years), and mean age at the end of the observation period was 42.7 years (SD 7...

  2. Sensitivity of single contrast barium enema with regard to colorectal disease as diagnosed by colonoscopy

    International Nuclear Information System (INIS)

    Kaude, J.V.; Harty, R.F.

    1982-01-01

    The results of single contrast barium enema were retrospectively correlated with colonoscopically diagnosed colorectal disease in 54 patients (75 lesions). Altogether 66 lesions (88%) were correctly diagnosed. The sensitivity of barium enema for polyps was 81% (26/32). There were three perceptive errors and three polyps 5 mm or less in size were not demonstrated by barium enema. Twenty-nine cases of inflammatory disorders were all correctly diagnosed. One of 12 malignancies was missed by perceptive error. In two cases with vascular malformations the barium enema was normal. 4/9 (44%) of missed lesions were perceptive errors and could have been probably avoided by a second independent reading of films. (orig.)

  3. [Diseases diagnosed at a pneumology unit integrated with its health area. Comparison with historical controls].

    Science.gov (United States)

    Martín Escribano, P; López Encuentra, A; Martín García, I; Cienfuegos Agustín, M I; Caballero Borda, C

    1996-01-01

    An understanding of changes in pulmonology disease patterns observed at a general hospital before and after implantation of a population-based model of health care not only provides useful insight into the diseases treated but also aids adjustment of health care service organization. The aim of this study was to compare data collected after 1992 (when the new system was established) with records kept by the same pulmonology group in earlier years (1974-1986). Data after 1992 described patients attended in Health District 11 by the newly organized pneumologists. For the two periods the most common pneumological diagnoses were chronic air flow obstruction and chronic hypersecretory bronchitis. The most common non pneumological diagnoses were systemic arterial hypertension, obesity, diabetes, liver disease and hiatus hernia/gastroesophageal reflux. The prospective study covered a larger population and was closer to primary care, including as it did patients at clinics unattached to hospitals. In the earlier hospital-based experience the most common diagnoses were acute respiratory infection, chronic air flow obstruction and asthma, apart from those patients referred in whom no respiratory disease was found. With the organizational integration of hospital and health district pulmonology service, contact between patients and specialists has increased. Record systems have been established for a well-defined population to permit better forecasting at less cost and facilitate contact with primary care givers and epidemiological studies.

  4. Risk perception of future cardiovascular disease in women diagnosed with a hypertensive disorder of pregnancy.

    Science.gov (United States)

    Traylor, Jessica; Chandrasekaran, Suchitra; Limaye, Meghana; Srinivas, Sindhu; Durnwald, Celeste P

    2016-01-01

    The objective of this study is to evaluate a woman's risk perception for future cardiovascular disease (CVD) after being diagnosed with a hypertensive disorder of pregnancy. A prospective cohort of women diagnosed with a hypertensive disorder of pregnancy (HDP) was studied. Each woman completed two surveys, one prior to hospital discharge and one 2 weeks later, designed to assess knowledge of and risk perception for future CVD based on their recent diagnosis of a HDP. Rates of postpartum depression were also assessed. Of the 146 subjects included, 28% were diagnosed with preeclampsia with severe features, 52.1% with preeclampsia with mild features, and 19.9% had chronic hypertension. Women with severe features and those delivering preterm were more likely to report a perception of increased risk of both recurrent HDP in a future pregnancy (p = 0.004 and 0.005, respectively) and hypertension later in life (p = 0.01 and 0.03, respectively). Women delivering preterm were more likely to report an accurate perception of increased risk of myocardial infarction and stroke compared to those delivering at term (p = 0.006 and 0.002, respectively). Disease severity and preterm delivery were associated with a higher likelihood of the perception of an increased risk for both recurrent HDP and hypertension in the future. Only preterm delivery was associated with a higher risk perception for stroke and myocardial infarction. Interventions targeted at improved health awareness in women diagnosed with HDP are warranted.

  5. Celiac disease diagnosed after uncomplicated pregnancy in a patient with history of bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Milisavljević Nemanja

    2013-01-01

    Full Text Available Introduction. The association between celiac disease and eating disorders has been very rarely reported. This is the first report on celiac disease associated with bulimia in this part of Europe. Case report. An adult female patient with history of bulimia and one uncomplicated pregnancy was admitted to the Gastroenterology Department, due to long lasting dyspeptic symptoms, constipation, major weight loss and fatigue. After positive serological screening, the diagnosis of celiac disease was confirmed with histopathology examination of duodenal biopsy specimen. Conclusion. Complicated interactions between celiac disease and bulimia can make them difficult to diagnose and treat. It is important to consider the presence of celiac disease in patients with bulimia and gastrointestinal symptoms.

  6. An Expert System for Diagnosing Eye Diseases using Forward Chaining Method

    Science.gov (United States)

    Munaiseche, C. P. C.; Kaparang, D. R.; Rompas, P. T. D.

    2018-02-01

    Expert System is a system that seeks to adopt human knowledge to the computer, so that the computer can solve problems which are usually done by experts. The purpose of medical expert system is to support the diagnosis process of physicians. It considers facts and symptoms to provide diagnosis. This implies that a medical expert system uses knowledge about diseases and facts about the patients to suggest diagnosis. The aim of this research is to design an expert system application for diagnosing eye diseases using forward chaining method and to figure out user acceptance to this application through usability testing. Eye is selected because it is one of the five senses which is very sensitive and important. The scope of the work is extended to 16 types of eye diseases with 41 symptoms of the disease, arranged in 16 rules. The computer programming language employed was the PHP programming language and MySQL as the Relational Database Management System (RDBMS). The results obtained showed that the expert system was able to successfully diagnose eye diseases corresponding to the selected symptoms entered as query and the system evaluation through usability testing showed the expert system for diagnosis eye diseases had very good rate of usability, which includes learnability, efficiency, memorability, errors, and satisfaction so that the system can be received in the operational environment.

  7. Value of neuropsychological tests, neuroimaging, and biomarkers for diagnosing Alzheimer's disease in younger and older age cohorts

    NARCIS (Netherlands)

    Schmand, B.; Eikelenboom, P.; van Gool, W.A.

    2011-01-01

    OBJECTIVES: To examine the influence of age on the value of four techniques for diagnosing Alzheimer's disease (AD). DESIGN: Observational cohort study. SETTING: Alzheimer's Disease Neuroimaging Initiative. PARTICIPANTS: Individuals with mild cognitive impairment (MCI; n=179), individuals with AD

  8. How doctors diagnose diseases and prescribe treatments: an fMRI study of diagnostic salience

    OpenAIRE

    Melo, Marcio; Gusso, Gustavo D. F.; Levites, Marcelo; Amaro Jr., Edson; Massad, Eduardo; Lotufo, Paulo A.; Zeidman, Peter; Price, Cathy J.; Friston, Karl J.

    2017-01-01

    Understanding the brain mechanisms involved in diagnostic reasoning may contribute to the development of methods that reduce errors in medical practice. In this study we identified similar brain systems for diagnosing diseases, prescribing treatments, and naming animals and objects using written information as stimuli. Employing time resolved modeling of blood oxygen level dependent (BOLD) responses enabled time resolved (400 milliseconds epochs) analyses. With this approach it was possible t...

  9. Temperature oscillating regimes in Tore Supra diagnosed by MHD activity

    International Nuclear Information System (INIS)

    Maget, P.; Imbeaux, F.; Giruzzi, G.; Udintsev, V.S.; Huysmans, G.T.A.; Segui, J.-L.; Goniche, M.; Moreau, Ph.; Sabot, R.; Garbet, X.

    2006-01-01

    This paper describes what we can learn on the regimes of spontaneous electron temperature oscillations discovered in Tore Supra from the analysis of MHD activity. Since the first observations of this oscillating behaviour of plasma equilibrium, and its interpretation as a predator-prey system involving lower hybrid waves power deposition and electron confinement, analysis of MHD modes has confirmed the reality of safety factor profile oscillations. This points towards the importance of rational values of the safety factor in the transition to transport barriers in reversed magnetic shear plasmas

  10. Clinically Unsuspected Prion Disease Among Patients With Dementia Diagnoses in an Alzheimer's Disease Database.

    Science.gov (United States)

    Maddox, Ryan A; Blase, J L; Mercaldo, N D; Harvey, A R; Schonberger, L B; Kukull, W A; Belay, E D

    2015-12-01

    Brain tissue analysis is necessary to confirm prion diseases. Clinically unsuspected cases may be identified through neuropathologic testing. National Alzheimer's Coordinating Center (NACC) Minimum and Neuropathologic Data Set for 1984 to 2005 were reviewed. Eligible patients had dementia, underwent autopsy, had available neuropathologic data, belonged to a currently funded Alzheimer's Disease Center (ADC), and were coded as having an Alzheimer's disease clinical diagnosis or a nonprion disease etiology. For the eligible patients with neuropathology indicating prion disease, further clinical information, collected from the reporting ADC, determined whether prion disease was considered before autopsy. Of 6000 eligible patients in the NACC database, 7 (0.12%) were clinically unsuspected but autopsy-confirmed prion disease cases. The proportion of patients with dementia with clinically unrecognized but autopsy-confirmed prion disease was small. Besides confirming clinically suspected cases, neuropathology is useful to identify unsuspected clinically atypical cases of prion disease. © The Author(s) 2015.

  11. Who Can Diagnose Parkinson's Disease First? Role of Pre-motor Symptoms.

    Science.gov (United States)

    Rodríguez-Violante, Mayela; Zerón-Martínez, Rosalía; Cervantes-Arriaga, Amin; Corona, Teresa

    2017-04-01

    In 1817, James Parkinson described the disease which bears his name. The disease was defined as a neurological syndrome characterized by tremor, rigidity, and slowness of movements. Almost one hundred years later, degeneration of neurons in the substantia nigra and low levels of dopamine were identified as the putative cause of the disease, thus the disease remained as a pure neurological disorder. In the late 1990s, non-motor symptoms of the disease began to gain interest because of their clinical relevance, as well as for their potential role in broadening the understanding of the pathophysiological mechanisms involved. In the last decade, focus has shifted to the pre-motor symptoms, those non-motor symptoms that present years before the motor onset of the disease. The main premotor symptoms include rapid eye movement sleep behavior disorder, hyposmia, constipation and depression. Subjects with these symptoms usually are not initially seen by a neurologist, and by the time they are consulted neuronal loss in the substantia nigra is over 50%. This review summarizes the overall relevance of non-motor symptoms, their frequency and their pathophysiological implications. Also, the importance of pre-motor symptoms, and the role of specialists other than neurologists in diagnosing subjects with Parkinson's disease is discussed. Two hundred years after the first description of the disease, it is now evident that Parkinson's disease is a systemic disease and a multispecialty team approach is mandatory. Copyright © 2017 IMSS. Published by Elsevier Inc. All rights reserved.

  12. Diseases of the gastrointestinal tract in individuals diagnosed as children with atypical autism

    DEFF Research Database (Denmark)

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

    2013-01-01

    The purpose of this study is to compare the prevalence and types of diseases (International Classification of Mental and Behavioural Disorders, 10th Edition codes K20-K93) relating to the gastrointestinal tract in a clinical sample of 89 individuals diagnosed as children with atypical autism...... with atypical autism, a total of 22 (24.7%) were registered with at least one diagnosis of any disease of the gastrointestinal tract, against 47 of 258 (18.2%) in the comparison group (p = 0.22; odds ratio = 1.5; 95% confidence interval = 0.8-2.6). Without reaching statistical significance, the rate of diseases...... of the gastrointestinal tract was particularly high (odds ratio = 1.2) in those with intelligence quotient autism had about the same frequency of gastric, intestinal and hepatic diseases as had controls....

  13. A 27-year-old woman diagnosed as polycystic ovary syndrome associated with Graves' disease.

    Science.gov (United States)

    Jung, Jung Hwa; Hahm, Jong Ryeal; Jung, Tae Sik; Kim, Hee Jin; Kim, Ho Soo; Kim, Sungsu; Kim, Soo Kyoung; Lee, Sang Min; Kim, Deok Ryong; Choi, Won Jun; Seo, Yeong Mi; Chung, Soon Il

    2011-01-01

    Polycystic ovary syndrome (PCOS) and Graves' disease are the common causes of menstrual irregularity leading to infertility in women of child-bearing age. A 21-year-old female patient visited us with complaints of oligomenorrhea and hand tremor. She was diagnosed as having PCOS and hyperthyroid Graves' disease, simultaneously. She had low body weight (BMI: 16.4 kg/m(2)), mild hirsutism, and thyrotoxicosis. The patient was treated with anti-thyroid drug and beta-blocker for about two years, and then recovered to normal thyroid function. Although some studies have suggested a connection between PCOS and autoimmune thyroiditis, no study indicated that PCOS is associated with Graves' disease until now. Here, we describe the first case report of a lean woman with normal insulin sensitivity presenting PCOS and Graves' disease simultaneously.

  14. The characteristics of patients with pulmonary Mycobacterium avium-intracellulare complex disease diagnosed by bronchial lavage culture compared to those diagnosed by sputum culture.

    Science.gov (United States)

    Maekawa, Koichi; Naka, Megumi; Shuto, Saki; Harada, Yuka; Ikegami, Yumiko

    2017-09-01

    The utility of bronchoscopy for the diagnosis of pulmonary Mycobacterium avium-intracellulare complex (MAC) disease has been reported; however, which patients require bronchoscopy remains unclear. Our objective was to identify the characteristics of the patients in whom bronchoscopy is needed for the diagnosis of MAC disease. Fifty-four patients with pulmonary MAC disease were divided into two groups according to established diagnostic criteria: 39 patients were diagnosed by sputum culture and 15 patients were diagnosed by bronchial lavage culture. We analysed the differences in demographic and clinical characteristics as well as microbiological and radiological data between the two groups. There were no significant differences in age, sex, smoking status, MAC species, underlying diseases, or steroid use. Significantly more patients diagnosed by sputum culture than bronchial lavage culture had a positive sputum smear for acid-fast bacilli (79.5% vs. 0.0%, respectively; p disease, bronchiectasis, and cavities. However, more patients diagnosed by sputum culture than bronchial lavage culture had abnormalities in the left upper division (48.7% vs. 13.3%, respectively; p = 0.017) and higher numbers of affected lobes (4.3 ± 1.4 vs. 3.3 ± 1.6, respectively; p = 0.034). If patients suspected of having pulmonary MAC disease have a negative sputum smear, no symptoms, no abnormal findings in the left upper division, or fewer affected lobes on computed tomography, bronchoscopy might be needed for the diagnosis. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  15. Colour atlas on forest disease. Diagnosis of tree diseases. Farbatlas Waldschaeden. Diagnose von Baumkrankheiten

    Energy Technology Data Exchange (ETDEWEB)

    Hartmann, G.; Winter, K.; Nienhaus, F.; Butin, H.

    1988-01-01

    The 'Colour Atlas on Forest Disease' facilitates the diagnosis of syndromes due to different causes in 16 genera or species of forest trees. It contains a selection of more than 200 important, frequent, or conspicuous disease phenomena. These include: in a ratio of 8 percent partly novel, complex diseases due to causes not entirely elucidated, 35 percent known forms of damage of abiotic origin (extreme weather conditions, nutrient deficiency, classical damage due to environmental pollution and de-icing salt, damage through herbicides), and 57 percent diseases and harm of biotic origin (fungal infections, infestation with insect pest, bacterial, mycoplasmal, rickettsia-type and viral diseases, other damage). 418 colour photographs show characteristic features of tree diseases and provide clues to causes and possible alternative diseases liable to be mixed up with the actual one. The selection decided on is restricted to symptoms visible externally in the area of the crowns as far as they are distinguishable in the field. (orig./MG) With 418 colour photographs.

  16. A case of the Behcet's disease diagnosed by the panniculits after mesotherapy.

    Science.gov (United States)

    Babacan, Taner; Onat, Ahmet Mesut; Pehlivan, Yavuz; Comez, Gazi; Tutar, Ediz

    2010-11-01

    We herein report a case of 32-year-old woman who developed erythematous, indurated plaques, nodules on her lower back, hips and inguinal areas which had started after immunotherapy on the injection sites. She had a history of recurrent oral aphthous-like ulcers for 2 years and also had abdominal pain for 2 months. Colonoscopy revealed multiple aphthous ulcers on intestine. Diagnosis of lobular panniculitis was confirmed by histopathological finding of the skin biopsy and she was diagnosed as Behcet's disease. Eruptions due to mesotherapy accepted as hypersensitivity reaction. Before employing this technique, patients should be carefully examined for Behcet's pathognomonic clinical findings.

  17. Diseases of the circulatory system among adult people diagnosed with infantile autism as children

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: Research dealing with adult people with autism spectrum disorders (ASD) noticeably lags behind studies of children and young individuals with ASD. AIMS: The objective of this study was to compare the prevalence and types of diseases of the circulatory system in a clinical sample of 118...... adult people diagnosed with infantile autism (IA) as children with 336 sex and age matched controls from the general population. METHODS AND PROCEDURES: All participants were screened through the nationwide Danish National Hospital Register. The average observation time of both groups was 37.2 years...

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

    DEFF Research Database (Denmark)

    Rief, Winfried; Kaasa, Stein; Jensen, Rigmor

    2012-01-01

    The representation of pain diagnoses in current classification systems like International Classification of Diseases (ICD)-10 and Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV does not adequately reflect the state of the art of pain research, and does not sufficiently support...... the clinical management and research programs for pain conditions. Moreover, there is an urgent need to harmonize classification of pain syndromes of special expert groups (eg, International Classification of Headache Disorders) and general classification systems (eg, ICD-11, DSM-V). Therefore, this paper...

  19. Lyme Disease Diagnosed by Alternative Methods: A Phenotype Similar to That of Chronic Fatigue Syndrome.

    Science.gov (United States)

    Patrick, David M; Miller, Ruth R; Gardy, Jennifer L; Parker, Shoshana M; Morshed, Muhammad G; Steiner, Theodore S; Singer, Joel; Shojania, Kam; Tang, Patrick

    2015-10-01

    A subset of patients reporting a diagnosis of Lyme disease can be described as having alternatively diagnosed chronic Lyme syndrome (ADCLS), in which diagnosis is based on laboratory results from a nonreference Lyme specialty laboratory using in-house criteria. Patients with ADCLS report symptoms similar to those reported by patients with chronic fatigue syndrome (CFS). We performed a case-control study comparing patients with ADCLS and CFS to each other and to both healthy controls and controls with systemic lupus erythematosus (SLE). Subjects completed a history, physical exam, screening laboratory tests, 7 functional scales, reference serology for Lyme disease using Centers for Disease Control and Prevention criteria, reference serology for other tick-associated pathogens, and cytokine expression studies. The study enrolled 13 patients with ADCLS (12 of whom were diagnosed by 1 alternative US laboratory), 25 patients with CFS, 25 matched healthy controls, and 11 SLE controls. Baseline clinical data and functional scales indicate significant disability among ADCLS and CFS patients and many important differences between these groups and controls, but no significant differences between each other. No ADCLS patient was confirmed as having positive Lyme serology by reference laboratory testing, and there was no difference in distribution of positive serology for other tick-transmitted pathogens or cytokine expression across the groups. In British Columbia, a setting with low Lyme disease incidence, ADCLS patients have a similar phenotype to that of CFS patients. Disagreement between alternative and reference laboratory Lyme testing results in this setting is most likely explained by false-positive results from the alternative laboratory. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. ADAR2 editing activity in newly diagnosed versus relapsed pediatric high-grade astrocytomas

    International Nuclear Information System (INIS)

    Tomaselli, Sara; Galeano, Federica; Massimi, Luca; Di Rocco, Concezio; Lauriola, Libero; Mastronuzzi, Angela; Locatelli, Franco; Gallo, Angela

    2013-01-01

    High-grade (WHO grade III and IV) astrocytomas are aggressive malignant brain tumors affecting humans with a high risk of recurrence in both children and adults. To date, limited information is available on the genetic and molecular alterations important in the onset and progression of pediatric high-grade astrocytomas and, even less, on the prognostic factors that influence long-term outcome in children with recurrence. A-to-I RNA editing is an essential post-transcriptional mechanism that can alter the nucleotide sequence of several RNAs and is mediated by the ADAR enzymes. ADAR2 editing activity is particularly important in mammalian brain and is impaired in both adult and pediatric high-grade astrocytomas. Moreover, we have recently shown that the recovered ADAR2 activity in high-grade astrocytomas inhibits in vivo tumor growth. The aim of the present study is to investigate whether changes may occur in ADAR2-mediated RNA editing profiles of relapsed high-grade astrocytomas compared to their respective specimens collected at diagnosis, in four pediatric patients. Total RNAs extracted from all tumor samples and controls were tested for RNA editing levels (by direct sequencing on cDNA pools) and for ADAR2 mRNA expression (by qRT-PCR). A significant loss of ADAR2-editing activity was observed in the newly diagnosed and recurrent astrocytomas in comparison to normal brain. Surprisingly, we found a substantial rescue of ADAR2 editing activity in the relapsed tumor of the only patient showing prolonged survival. High-grade astrocytomas display a generalized loss of ADAR2-mediated RNA editing at both diagnosis and relapse. However, a peculiar Case, in complete remission of disease, displayed a total rescue of RNA editing at relapse, intriguingly suggesting ADAR2 activity/expression as a possible marker for long-term survival of patients with high-grade astrocytomas

  1. Risk of progression from mild memory impairment to clinically diagnosable Alzheimer's disease in a Japanese community (from the Nakayama Study).

    Science.gov (United States)

    Sonobe, Naomi; Hata, Ryuji; Ishikawa, Tomohisa; Sonobe, Kantaro; Matsumoto, Teruhisa; Toyota, Yasutaka; Mori, Takaaki; Fukuhara, Ryuji; Komori, Kenjiro; Ueno, Shu-Ichi; Tanimukai, Satoshi; Ikeda, Manabu

    2011-06-01

    Memory impairment has been proposed as the most common early sign of Alzheimer's disease (AD). The aims of this work were to evaluate the risk of progression from mild memory impairment/no dementia (MMI/ND) to clinically diagnosable AD in a community-based prospective cohort and to establish the risk factors for progression from MMI/ND to AD in the elderly. Elderly subjects aged over 65 years were selected from the participants in the first Nakayama study. MMI/ND was defined as memory deficit on objective memory assessment, without dementia, impairment of general cognitive function, or disability in activities of daily living. A total of 104 MMI/ND subjects selected from 1242 community-dwellers were followed longitudinally for five years. During the five-year follow-up, 11 (10.6%) subjects were diagnosed with AD, five (4.8%) with vascular dementia (VaD), and six (5.8%) with dementia of other etiology. Logistic regression analysis revealed that diabetes mellitus (DM) and a family history of dementia (within third-degree relatives) were positively associated with progression to AD, while no factor was significantly associated with progression to VaD or all types of dementia. DM and a family history of dementia were significant risk factors for progression from MMI/ND to clinically diagnosable AD in the elderly in a Japanese community.

  2. Comparison of the usefulness of selected formulas for GFR estimation in patients with diagnosed chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Paweł Wróbel

    2018-03-01

    Conclusions: CKD-EPI and abbreviated MDRD formulas have a similar usefulness in GFR value estimation in patients with diagnosed chronic kidney disease. Lower eGFR values achieved using abbreviated MDRD formula and CKD-EPI equation in comparison with Bjornsson’s formula may result in an increased number of patients diagnosed with CKD.

  3. Phylomedicine: An evolutionary telescope to explore and diagnose the universe of disease mutations

    Science.gov (United States)

    Kumar, Sudhir; Dudley, Joel T.; Filipski, Alan; Liu, Li

    2011-01-01

    Modern technologies have made the sequencing of personal genomes routine. They have revealed thousands of nonsynonymous (amino-acid altering) single nucleotide variants (nSNVs) of protein coding DNA per genome. What do these variants foretell about an individual’s predisposition to diseases? The experimental technologies required to carry out such evaluations at a genomic scale are not yet available. Fortunately, the process of natural selection has lent us an almost infinite set of tests in nature. During the long-term evolution, new mutations and existing variations have been evaluated for their biological consequences in countless species, and outcomes were readily revealed by multispecies genome comparisons. We review studies that have investigated evolutionary characteristics and in silico functional diagnoses of nSNVs found in thousands of disease-associated genes. We conclude that the patterns of long-term evolutionary conservation and permissible divergence are essential and instructive modalities for functional assessment of human genetic variations. PMID:21764165

  4. Computational Fluid Dynamics and Additive Manufacturing to Diagnose and Treat Cardiovascular Disease.

    Science.gov (United States)

    Randles, Amanda; Frakes, David H; Leopold, Jane A

    2017-11-01

    Noninvasive engineering models are now being used for diagnosing and planning the treatment of cardiovascular disease. Techniques in computational modeling and additive manufacturing have matured concurrently, and results from simulations can inform and enable the design and optimization of therapeutic devices and treatment strategies. The emerging synergy between large-scale simulations and 3D printing is having a two-fold benefit: first, 3D printing can be used to validate the complex simulations, and second, the flow models can be used to improve treatment planning for cardiovascular disease. In this review, we summarize and discuss recent methods and findings for leveraging advances in both additive manufacturing and patient-specific computational modeling, with an emphasis on new directions in these fields and remaining open questions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Laser photocoagulation at birth prevents blindness in Norrie's disease diagnosed using amniocentesis.

    Science.gov (United States)

    Chow, Clement C; Kiernan, Daniel F; Chau, Felix Y; Blair, Michael P; Ticho, Benjamin H; Galasso, John M; Shapiro, Michael J

    2010-12-01

    To report the first case of prophylactic laser treatment to prevent blindness in a patient who was diagnosed with Norrie's disease by genetic testing with amniocentesis. Case report. A 2-year-old white boy with Norrie's disease. A 37-week gestational age male with a family history of Norrie's disease was born via Cesarean section after the mother had undergone prenatal amniocentesis fetal-genetic testing at 23 weeks of gestation. A C520T (nonsense) mutation was found in the Norrie's disease gene. After examination under anesthesia confirmed the diagnosis on the first day of life, laser photocoagulation was applied to the avascular retina bilaterally. The patient was followed closely by ophthalmology, pediatrics, and occupational therapy departments. Functional outcome, as documented by Teller visual acuity and formal occupational therapy testing, and anatomic outcome, as documented by Retcam photography and fluorescein angiography. Complete regression of extraretinal fibrovascular proliferation was observed 1 month after laser treatment. No retinal detachment had occurred to date at 24 months. Teller visual acuity at 23 months of life was 20/100 in both eyes. The patient's vision and developmental milestones were age appropriate. Pre-term genetic diagnosis with immediate laser treatment after birth may preserve vision in individuals affected with Norrie's disease. Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  6. Genetic impact on cognition and brain function in newly diagnosed Parkinson’s disease: ICICLE-PD study

    Science.gov (United States)

    Rowe, James B.; Winder-Rhodes, Sophie E.; Hampshire, Adam; Owen, Adrian M.; Breen, David P.; Duncan, Gordon W.; Khoo, Tien K.; Yarnall, Alison J.; Firbank, Michael J.; Chinnery, Patrick F.; Robbins, Trevor W.; O’Brien, John T.; Brooks, David J.; Burn, David J.; Barker, Roger A.

    2014-01-01

    activation associated with memory encoding. This study demonstrates that neurocognitive deficits are common even in recently diagnosed patients with Parkinson’s disease, and that the associated regional brain activations are influenced by genotype. These data further support the dual syndrome hypothesis of cognitive change in Parkinson’s disease. Longitudinal data will confirm the extent to which these early neurocognitive changes, and their genetic factors, influence the long-term risk of dementia in Parkinson’s disease. The combination of genetics and functional neuroimaging provides a potentially useful method for stratification and identification of candidate markers, in future clinical trials against cognitive decline in Parkinson’s disease. PMID:25080285

  7. Evaluation of prolactin levels in patients with newly diagnosed pemphigus vulgaris and its correlation with pemphigus disease area index.

    Science.gov (United States)

    Lajevardi, Vahideh; Hallaji, Zahra; Daneshpazhooh, Maryam; Ghandi, Narges; Shekari, Peyman; Khani, Sepideh

    2016-06-01

    Prolactin is a hormone; in addition to it known roles, it has immunomodulatory effects on lymphocytes maturation and immunoglobulins production. Hyperprolactinemia has been demonstrated in various autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, type I diabetes mellitus, and Graves' disease. In view of the prolactin immunomodulatory roles, studying prolactin levels in pemphigus as an autoimmune blistering disease may introduce new ways of understanding disease etiology and developing treatment strategies. Our purpose was to determine the prolactin levels in patients with newly diagnosed pemphigus vulgaris and study its correlation with pemphigus disease area index. Our study was limited by the lack of a control group. In this cross-sectional study, prolactin and anti-desmoglein 1 and 3 autoantibodies levels were measured in 50 patients with newly diagnosed pemphigus vulgaris in Razi Dermatology Hospital. Pemphigus severity and extent was estimated using the Pemphigus Disease Area Index. Of the 50 patients, 18 were male and 32 were female with a mean age of 41.56 ± 13.66 years. Mean prolactin (PRL) level was 15.60 ± 11.72 ng/ml (10.68 in males and 18.37 in females). Mean anti-desmoglein 1 and 3 autoantibodies were 135.8 ± 119.8 and 245.8 ± 157.4 U/ml, respectively. Eleven out of 50 patients had a higher than normal prolactin range. No relation was found between prolactin level and disease activity ( p = .982). Also, correlation studies show no relation between prolactin and anti-desmoglein 1 and 3 autoantibodies levels (respectively, p = .771 and .738). In comparing the extent of the disease between the two groups with normal and high prolactin, paired t-test showed no significance ( p = .204). In our study, 22% of patients had hyperprolactinemia, which was greater among females. The highest PRL level was detected in mucocutaneous group. Although serum PRL levels were higher in patients with a greater Pemphigus Disease Area Index

  8. Value of the radiological study of the thorax for diagnosing left ventricular dysfunction in Chagas' disease

    Directory of Open Access Journals (Sweden)

    Perez Amanda Arantes

    2003-01-01

    Full Text Available OBJECTIVE: To determine the value of the radiological study of the thorax for diagnosing left ventricular dilation and left ventricular systolic dysfunction in patients with Chagas' disease. METHODS: A cross-sectional study of 166 consecutive patients with Chagas' disease and no other associated diseases. The patients underwent cardiac assessment with chest radiography and Doppler echocardiography. Sensitivity, specificity, and positive and negative predictive values of chest radiography were calculated to detect left ventricular dysfunction and the accuracy of the cardiothoracic ratio in the diagnosis of left ventricular dysfunction with the area below the ROC curve. The cardiothoracic ratio was correlated with the left ventricular ejection fraction and the left ventricular diastolic diameter. RESULTS: The abnormal chest radiogram had a sensitivity of 50%, specificity of 80.5%, and positive and negative predictive values of 51.2% and 79.8%, respectively, in the diagnosis of left ventricular dysfunction. The cardiothoracic ratio showed a weak correlation with left ventricular ejection fraction (r=-0.23 and left ventricular diastolic diameter (r=0.30. The area calculated under the ROC curve was 0.734. CONCLUSION: The radiological study of the thorax is not an accurate indicator of left ventricular dysfunction; its use as a screening method to initially approach the patient with Chagas' disease should be reevaluated.

  9. Adherence to secondary antibiotic prophylaxis for patients with rheumatic heart disease diagnosed through screening in Fiji.

    Science.gov (United States)

    Engelman, Daniel; Mataika, Reapi L; Kado, Joseph H; Ah Kee, Maureen; Donath, Susan; Parks, Tom; Steer, Andrew C

    2016-12-01

    Echocardiographic screening for rheumatic heart disease (RHD) can detect subclinical cases; however, adequate adherence to secondary antibiotic prophylaxis (SAP) is required to alter disease outcomes. We aimed to investigate the adherence to SAP among young people with RHD diagnosed through echocardiographic screening in Fiji and to investigate factors associated with adherence. Patients diagnosed with RHD through echocardiographic screening in Fiji from 2006 to 2014 were included. Dates of benzathine penicillin G injections were collected from 76 health clinics nationally from December 2011 to December 2014. Adherence was measured using the proportion of days covered (PDC). Multivariate logistic regression analysis was used to identify characteristics associated with any adherence (≥1 injection received) and adequate adherence (PDC ≥0.80). Of 494 patients, 268 (54%) were female and the median age was 14 years. Overall, 203 (41%) had no injections recorded and just 33 (7%) had adequate adherence. Multivariate logistic regression showed increasing age (OR 0.93 per year, 95% CI 0.87-0.99) and time since diagnosis ≥1.5 years (OR 0.53, 95% CI 0.37-0.79) to be inversely associated with any adherence. Non-iTaukei ethnicity (OR 2.58, 95%CI 1.04-6.33) and urban residence (OR 3.36, 95% CI 1.54-7.36) were associated with adequate adherence, whereas time since diagnosis ≥1.5 years (OR 0.38, 95%CI 0.17-0.83) was inversely associated with adequate adherence. Adherence to SAP after screening in Fiji is currently inadequate for individual patient protection or population disease control. Secondary prevention should be strengthened before further screening can be justified. © 2016 John Wiley & Sons Ltd.

  10. Prevalence of Attention Deficit Hyperactivity Disorder in Pediatrics Patients Newly Diagnosed with Gastroesophageal Reflux Disease

    Directory of Open Access Journals (Sweden)

    Mohammad Effatpanah

    2017-09-01

    Full Text Available Background: Gastroesophageal reflux disease (GERD is associated with a number of comorbidities in pediatrics. However, its association with attention deficit hyperactivity disorder (ADHD has not been reported. The aim of the present study was to investigate the prevalence of ADHD in pediatric patients newly diagnosed with GERD. Materials and Methods: Sixty newly-diagnosed treatment naive GERD patients and sixty healthy controls aging between 5 to 12 years referring to the Children and Adolescent’s medical center, Tehran, Iran were recruited in a case-control study during the year 2015. Then patients were evaluated for ADHD by a psychiatrist according to the DSM-IV criteria. The revised Conners' Parent Rating Scale (CPRS-R was used for assessment of the symptoms of ADHD. To screen for psychiatry disorders other than ADHD, the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL questionnaire was used. Logistic regression analysis was used for modeling the association between GERD and ADHD in the study sample. Results: The mean age of GERD patients was 5.77±2.27 and for non-GERD controls was 6.03±2.52 (P= 0.543. Thirty-three out of 60 (55% GERD patients and 37 out of 60(61.66% non-GERD controls were male (P: 0.579. Prevalence of ADHD was 33.60 (55% in GERD patients and 10.60 (16.66% in non-GERD (P

  11. Exploring the role of physical activity for people diagnosed with serious mental illness in Ireland.

    Science.gov (United States)

    Cullen, C; McCann, E

    2015-02-01

    The aim of the study was to elicit the views and opinions of people diagnosed with serious mental illness in relation to physical activity. Ten people who were attending a community mental health centre participated in semi-structured interviews. The main results showed that participants found physical activity beneficial in terms of psychological and social well-being and perceived clear gains in relation to recovery and quality of life. Physical activity should be routinely included in plans of care and mental health policy guidelines globally should contain physical activity as a key component. Mental health policy guidelines globally should contain physical activity as a key component. The aim of the current study was to explore the subjective experiences of people diagnosed with serious mental illness (SMI) in relation to physical activity. The study was conducted using a qualitative exploratory descriptive approach. The participants (n = 10), who were outpatients attending a day centre, were interviewed to elicit their views and opinions about physical activity. The data were thematically analysed using a recognized framework. The main themes that emerged included physical activity as a meaningful activity, physical activity as a mental activity, quality of life and recovery, and perceived challenges to physical activity. The unique perspectives of service users provides fresh insights on the topic and the findings support the justification for the inclusion of physical activity in plans of care and to be contained in global mental health policy directives. © 2014 John Wiley & Sons Ltd.

  12. Nuclear medicine methods used in diagnosing diseases of the gastrointestinal tract

    International Nuclear Information System (INIS)

    Kostadinova, I.

    2001-01-01

    Using physiologic tracer scintigraphy may give unique information on gastrointestinal (GI) motility and function, supplementing the findings of rather invasive methods. Conventional barium-contrast x-ray studies of the GI tract, computed tomography, ultrasonography and magnetic resonance imaging afford high resolution images of the GI anatomy, but have a serious shortcoming - hardly lending themselves to quantification. As shown by the results functional scintigraphy is a sensitive, quantitative and noninvasive procedure. The potential of nuclear medicine methods to diagnose successfully diseases of the salivary glands, esophagus, stomach and visualization of GI bleeding and hepatobiliary system are comprehensively discussed. The advantages and drawbacks of radionuclide techniques are outlined, and compared with other methods of visualization. (author)

  13. Diagnosing obesity by body mass index in chronic kidney disease: an explanation for the "obesity paradox?".

    Science.gov (United States)

    Agarwal, Rajiv; Bills, Jennifer E; Light, Robert P

    2010-11-01

    Although obesity is associated with poor outcomes, among patients with chronic kidney disease (CKD), obesity is related to improved survival. These results may be related to poor diagnostic performance of body mass index (BMI) in assessing body fat content. Accordingly, among 77 patients with CKD and 20 controls, body fat percentage was estimated by air displacement plethysmography (ADP), skinfold thickness, and body impedance analysis. Defined by BMI ≥30 kg/m(2), the prevalence of obesity was 20% in controls and 65% in patients with CKD. Defined by ADP, the prevalence increased to 60% among controls and to 90% among patients with CKD. Although sensitivity and positive predictive value of BMI to diagnose obesity were 100%, specificity was 72%, but the negative predictive value was only 30%. BMI correctly classified adiposity in 75%. Regardless of the presence or absence of CKD, subclinical obesity (defined as BMI value of BMI for obesity, our study may provide an explanation of the "obesity paradox."

  14. Avoiding pitfalls in diagnosing basilar artery occlusive disease: clinical and imaging clues - case report

    Directory of Open Access Journals (Sweden)

    Adriana Bastos Conforto

    Full Text Available CONTEXT: The aim of this paper was to report on the characteristics that aid in establishing the diagnosis of basilar artery occlusive disease (BAOD among patients with hemiparesis and few or minor symptoms of vertebrobasilar disease. CASE REPORT: This report describes two cases in a public university hospital in São Paulo, Brazil. We present clinical and imaging findings from two patients with hemiparesis and severe BAOD, but without clinically relevant carotid artery disease (CAD. One patient presented transient ischemic attacks consisting of spells of right hemiparesis that became progressively more frequent, up to twice a week. The neurological examination revealed slight right hemiparesis and right homonymous hemianopsia. Magnetic resonance imaging (MRI revealed pontine and occipital infarcts. Magnetic resonance angiography and digital subtraction angiography revealed severe basilar artery stenosis. The other patient presented sudden left-side hemiparesis and hypoesthesia. One year earlier, she had reported sudden onset of vertigo that, at that time, was attributed to peripheral vestibulopathy and was not further investigated. MRI showed a right-side pontine infarct and an old infarct in the right cerebellar hemisphere. Basilar artery occlusion was diagnosed. Both patients presented their symptoms while receiving aspirin, and became asymptomatic after treatment with warfarin. CONCLUSIONS: Misdiagnosing asymptomatic CAD as the cause of symptoms in BAOD can have disastrous consequences, such as unnecessary carotid endarterectomy and exposure to this surgical risk while failing to offer the best available treatment for BAOD. Clinical and imaging features provided important clues for diagnosis in the cases presented.

  15. Age-Dependent Fecal Bacterial Correlation to Inflammatory Bowel Disease for Newly Diagnosed Untreated Children

    Directory of Open Access Journals (Sweden)

    Felix Chinweije Nwosu

    2013-01-01

    Full Text Available The knowledge about correlation patterns between the fecal microbiota and inflammatory bowel diseases (IBD—comprising the two subforms Crohn's disease (CD and ulcerative colitis (UC—for newly diagnosed untreated children is limited. To address this knowledge gap, a selection of faecal specimens (CD, n=27 and UC, n=16 and non-IBD controls (n=30 children (age < 18 years was analysed utilising bacterial small subunit (SSU rRNA. We found, surprising age dependence for the fecal microbiota correlating to IBD. The most pronounced patterns were that E. coli was positively (R2=0.16, P=0.05 and Bacteroidetes, negatively (R2=0.15, P=0.05 correlated to age for CD patients. For UC, we found an apparent opposite age-related disease correlation for both Bacteroides and Escherichia. In addition, there was an overrepresentation of Haemophilus for the UC children. From our, results we propose a model where the aetiology of IBD is related to an on-going immunological development in children requiring different age-dependent bacterial stimuli. The impact of our findings could be a better age stratification for understanding and treating IBD in children.

  16. Diagnosing and Ranking Retinopathy Disease Level Using Diabetic Fundus Image Recuperation Approach

    Directory of Open Access Journals (Sweden)

    K. Somasundaram

    2015-01-01

    Full Text Available Retinal fundus images are widely used in diagnosing different types of eye diseases. The existing methods such as Feature Based Macular Edema Detection (FMED and Optimally Adjusted Morphological Operator (OAMO effectively detected the presence of exudation in fundus images and identified the true positive ratio of exudates detection, respectively. These mechanically detected exudates did not include more detailed feature selection technique to the system for detection of diabetic retinopathy. To categorize the exudates, Diabetic Fundus Image Recuperation (DFIR method based on sliding window approach is developed in this work to select the features of optic cup in digital retinal fundus images. The DFIR feature selection uses collection of sliding windows with varying range to obtain the features based on the histogram value using Group Sparsity Nonoverlapping Function. Using support vector model in the second phase, the DFIR method based on Spiral Basis Function effectively ranks the diabetic retinopathy disease level. The ranking of disease level on each candidate set provides a much promising result for developing practically automated and assisted diabetic retinopathy diagnosis system. Experimental work on digital fundus images using the DFIR method performs research on the factors such as sensitivity, ranking efficiency, and feature selection time.

  17. Diagnosing and ranking retinopathy disease level using diabetic fundus image recuperation approach.

    Science.gov (United States)

    Somasundaram, K; Rajendran, P Alli

    2015-01-01

    Retinal fundus images are widely used in diagnosing different types of eye diseases. The existing methods such as Feature Based Macular Edema Detection (FMED) and Optimally Adjusted Morphological Operator (OAMO) effectively detected the presence of exudation in fundus images and identified the true positive ratio of exudates detection, respectively. These mechanically detected exudates did not include more detailed feature selection technique to the system for detection of diabetic retinopathy. To categorize the exudates, Diabetic Fundus Image Recuperation (DFIR) method based on sliding window approach is developed in this work to select the features of optic cup in digital retinal fundus images. The DFIR feature selection uses collection of sliding windows with varying range to obtain the features based on the histogram value using Group Sparsity Nonoverlapping Function. Using support vector model in the second phase, the DFIR method based on Spiral Basis Function effectively ranks the diabetic retinopathy disease level. The ranking of disease level on each candidate set provides a much promising result for developing practically automated and assisted diabetic retinopathy diagnosis system. Experimental work on digital fundus images using the DFIR method performs research on the factors such as sensitivity, ranking efficiency, and feature selection time.

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

    International Nuclear Information System (INIS)

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

    1984-01-01

    The objective of this study was to compare the cost-effectiveness of four clinical policies (policies I to IV) in the diagnosis of the presence or absence of coronary artery disease. A model based on Bayes theorem and published clinical data was constructed to make these comparisons. Effectiveness was defined as either the number of patients with coronary disease diagnosed or as the number of quality-adjusted life years extended by therapy after the diagnosis of coronary disease. The following conclusions arise strictly from analysis of the model and may not necessarily be applicable to all situations. As prevalence of coronary disease in the population increased, it caused a linear increase in cost per patient tested, but a hyperbolic decrease in cost per effect, that is, increased cost-effectiveness. Thus, cost-effectiveness of all policies (I to IV) was poor in populations with a prevalence of disease below 10%. Analysis of the model also indicates that at prevalences less than 80%, exercise thallium scintigraphy alone as a first test (policy II) is a more cost-effective initial test than is exercise electrocardiography alone as a first test (policy I) or exercise electrocardiography first combined with thallium imaging as a second test (policy IV). Exercise electrocardiography before thallium imaging (policy IV) is more cost-effective than exercise electrocardiography alone (policy I) at prevalences less than 80%. 4) Noninvasive exercise testing before angiography (policies I, II and IV) is more cost-effective than using coronary angiography as the first and only test (policy III) at prevalences less than 80%. 5) Above a threshold value of prevalence of 80% (for example patients with typical angina), proceeding to angiography as the first test (policy III) was more cost-effective than initial noninvasive exercise tests (policies I, II and IV)

  19. Cerebral glucose metabolism and cognition in newly diagnosed Parkinson's disease: ICICLE-PD study.

    Science.gov (United States)

    Firbank, M J; Yarnall, A J; Lawson, R A; Duncan, G W; Khoo, T K; Petrides, G S; O'Brien, J T; Barker, R A; Maxwell, R J; Brooks, D J; Burn, D J

    2017-04-01

    To assess reductions of cerebral glucose metabolism in Parkinson's disease (PD) with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET), and their associations with cognitive decline. FDG-PET was performed on a cohort of 79 patients with newly diagnosed PD (mean disease duration 8 months) and 20 unrelated controls. PD participants were scanned while on their usual dopaminergic medication. Cognitive testing was performed at baseline, and after 18 months using the Cognitive Drug Research (CDR) and Cambridge Neuropsychological Test Automated Battery (CANTAB) computerised batteries, the Mini-Mental State Examination (MMSE), and the Montreal Cognitive Assessment (MoCA). We used statistical parametric mapping (SPM V.12) software to compare groups and investigate voxelwise correlations between FDG metabolism and cognitive score at baseline. Linear regression was used to evaluate how levels of cortical FDG metabolism were predictive of subsequent cognitive decline rated with the MMSE and MoCA. PD participants showed reduced glucose metabolism in the occipital and inferior parietal lobes relative to controls. Low performance on memory-based tasks was associated with reduced FDG metabolism in posterior parietal and temporal regions, while attentional performance was associated with more frontal deficits. Baseline parietal to cerebellum FDG metabolism ratios predicted MMSE (β=0.38, p=0.001) and MoCA (β=0.3, p=0.002) at 18 months controlling for baseline score. Reductions in cortical FDG metabolism were present in newly diagnosed PD, and correlated with performance on neuropsychological tests. A reduced baseline parietal metabolism is associated with risk of cognitive decline and may represent a potential biomarker for this state and the development of PD dementia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-09-15

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

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

    International Nuclear Information System (INIS)

    Kim, Ham-Gyum

    2006-01-01

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

  2. Value of neuropsychological tests, neuroimaging, and biomarkers for diagnosing Alzheimer's disease in younger and older age cohorts

    NARCIS (Netherlands)

    Schmand, Ben; Eikelenboom, Piet; van Gool, Willem A.

    2011-01-01

    To examine the influence of age on the value of four techniques for diagnosing Alzheimer's disease (AD). Observational cohort study. Alzheimer's Disease Neuroimaging Initiative. Individuals with mild cognitive impairment (MCI; n = 179), individuals with AD (n = 91), and normal controls (n = 105).

  3. Being active when you have heart disease

    Science.gov (United States)

    Heart disease - activity; CAD - activity; Coronary artery disease - activity; Angina - activity ... Getting regular exercise when you have heart disease is ... It may also help you be more active without chest pain or other ...

  4. Chronic kidney disease in Nigeria: an evaluation of the spatial accessibility to healthcare for diagnosed cases in Edo State

    Directory of Open Access Journals (Sweden)

    Osaretin Oviasu

    2016-05-01

    Full Text Available Chronic kidney disease (CKD is a growing problem in Nigeria, presenting challenges to the nation’s health and economy. This study evaluates the accessibility to healthcare in Edo State of CKD patients diagnosed between 2006 and 2009. Using cost analysis techniques within a geographical information system, an estimated travel time to the hospital was used to examine the spatial accessibility of diagnosed patients to available CKD healthcare in the state. The results from the study indicated that although there was an annual rise in the number of diagnosed cases, there were no significant changes in the proportion of patients that were diagnosed at the last stage of CKD. However, there were indications that the travel time to the hospital for CKD treatment might be a contributing factor to the number of diagnosed CKD cases. This implies that the current structure for CKD management within the state might not be adequate.

  5. Relapse and disease specific survival in 1143 Danish women diagnosed with borderline ovarian tumours (BOT).

    Science.gov (United States)

    Karlsen, Nikoline Marie Schou; Karlsen, Mona Aarenstrup; Høgdall, Estrid; Nedergaard, Lotte; Christensen, Ib Jarle; Høgdall, Claus

    2016-07-01

    The aim of the study was to evaluate the rate of relapse as well as disease-free, overall, and disease-specific survival in women with borderline ovarian tumour (BOT). Furthermore, the study aims to identify the clinical parameters correlated to relapse. National clinical data of women diagnosed with BOT from January 2005 to January 2013 constituted the basis for our study population. The prognostic influence of clinical variables was evaluated using univariate and multivariate analyses. A total of 1143 women were eligible for analysis, with 87.9% in FIGO stage I and 12.1% in FIGO stages II-IV. Relapse of BOT was detected in 3.7%, hereof 40.5% with malignant transformation. The five-year disease-free survival was 97.6% in FIGO stage I and 87.3% in FIGO stages II-IV. Younger age, laparoscopic surgical approach, fertility sparing surgery, FIGO stages II-IV, bilateral tumour presence, serous histology, implants and microinvasion of the tumour were significantly associated with relapse in univariate analyses. The overall five-year survival rate was 92.2% in FIGO stage I and 89.0% in FIGO stages II-IV. Out of 77 deaths in total, only seven women died from BOT. A general favourable prognosis in women with BOT was confirmed in our study. Our findings indicate that systematic, long-term follow-up does not seem necessary in women treated for FIGO stage IA BOT with no residual disease or microinvasion. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Limited value of transbronchial lung biopsy for diagnosing Mycobacterium avium complex lung disease.

    Science.gov (United States)

    Sekine, Akimasa; Saito, Takefumi; Satoh, Hiroaki; Morishita, Yukio; Tsunoda, Yoshiya; Tanaka, Toru; Yatagai, Yohei; Lin, Shih-Yuen; Miyazaki, Kunihiko; Miura, Yukiko; Hayashihara, Kenji

    2017-11-01

    It remains unclear whether transbronchial lung biopsy (TBLB) is useful for diagnosing Mycobacterium avium complex (MAC) lung disease. Thirty-eight consecutive patients with MAC lung disease, who were evaluated with TBLB tissue culture between June 2006 and May 2010, were included. Bronchial washing (BW) and histopathological evaluation were performed in all patients. The positivity rates of BW and TBLB tissue culture, and typical histopathological findings for MAC disease were investigated. Furthermore, all patients were divided into two groups according to the presence of intrabronchial purulent or mucopurulent secretion and the clinical, bacteriological and pathological characteristics were compared between the two groups. The positive culture rates of BW and TBLB specimens for MAC were 100% (38 patients) and 28.9% (11 patients). BW materials were much more sensitive for culture positivity than TBLB specimens (P present in the TBLB specimens of only 11 patients (28.9%). Intrabronchial secretion was identified in 15 patients (39.5%, secretion-positive group) and absent in 23 patients (60.5%, secretion-negative group). Typical histopathological findings for MAC disease were more common in the secretion-positive group than in the secretion-negative group (53.3% vs 13.0%, P = 0.01), although the radiological classification and smear positivity of BW were not different between the two groups. TBLB for pathological and bacterial investigations would provide only a limited value for MAC diagnosis. Moreover, the presence of intrabronchial secretion may be an important manifestation of ongoing airway damage, which would require early treatment. © 2016 John Wiley & Sons Ltd.

  7. Abnormalities in lung volumes and airflow in children with newly diagnosed connective tissue disease.

    Science.gov (United States)

    Peradzyńska, Joanna; Krenke, Katarzyna; Szylling, Anna; Kołodziejczyk, Beata; Gazda, Agnieszka; Rutkowska-Sak, Lidia; Kulus, Marek

    2016-01-01

    Connective tissue diseases (CTDs) of childhood are rare inflammatory disorders, involving various organs and tissues including respiratory system. Pulmonary involvement in patients with CTDs is uncommon but may cause functional impairment. Data on prevalence and type of lung function abnormalities in children with CTDs are scarce. Thus, the aim of this study was to asses pulmonary functional status in children with newly diagnosed CTD and follow the results after two years of the disease course. There were 98 children (mean age: 13 ± 3; 76 girls), treated in Department of Pediatric Rheumatology, Institute of Rheumatology, Warsaw and 80 aged-matched, healthy controls (mean age 12.7 ± 2.4; 50 girls) included into the study. Study procedures included medical history, physical examination, chest radiograph and PFT (spirometry and whole body-plethysmography). Then, the assessment of PFT was performed after 24 months. FEV₁, FEV₁/FVC and MEF50 were significantly lower in CTD as compared to control group, there was no difference in FVC and TLC. The proportion of patients with abnormal lung function was significantly higher in the study group, 41 (42%) vs 9 (11%). 24-months observation didn't reveal progression in lung function impairment. Lung function impairment is relatively common in children with CTDs. Although restrictive ventilatory pattern is considered typical feature of lung involvement in CTDs, airflow limitation could also be an initial abnormality.

  8. Pulse oximetry findings in newborns with antenatally diagnosed congenital heart disease.

    Science.gov (United States)

    Mawson, Isabel E; Babu, Pratusha L; Simpson, John M; Fox, Grenville F

    2018-05-01

    A retrospective review of admission preductal oxygen saturations of neonates with antenatally diagnosed critical congenital heart disease (CCHD) was performed to investigate the differences in newborn pulse oximetry (Pulsox) by specific CCHD diagnosis. Saturations were recorded at median of  34 weeks and birth weight > 1.8 kg. A statistically significant increase in the proportion with low admission saturations was seen using ≤ 95% saturation threshold (72% (95% CI 66-78)) compared to ≤ 92% (52% (95% CI 46-59)) and ≤ 90% (46% (95% CI 39-52)). Sub-group analysis found the proportion of neonates with low saturations varied according to the specific CCHD diagnosis with only 20-42% of neonates with aortic stenosis, coarctation of the aorta and pulmonary stenosis having saturations ≤ 95%. The proportion of neonates with low admission oxygen saturation varied by CCHD diagnosis with those without critically reduced pulmonary blood flow not having low admission saturations, in general, even using the ≤ 95% threshold which had the highest proportions of abnormal saturations. This data may assist developing Pulsox screening policies. What is Known: • The addition of pulse oximetry (Pulsox) screening to the routine newborn examination increases the sensitivity of CCHD detection. Pulsox screening is also highly specific for CCHD in asymptomatic neonates, with low false-positive rates. • Early diagnosis of CCHD improves patient outcomes in relation to both morbidity and mortality. What is New: • The proportion of affected infants with an abnormal Pulsox result varies by CCHD diagnosis and screening threshold. In our study using the ≤ 95% threshold gave the highest proportion of neonates with abnormal saturations at admission. • In general, Pulsox yield of abnormal results is low for CCHD diagnoses not associated with critically reduced pulmonary blood flow; however, increasing the Pulsox threshold increased the proportion of infants with an

  9. A PROSPECTIVE STUDY OF HYPOTHYROIDISM IN DIAGNOSED CASE OF GALLSTONE DISEASE

    Directory of Open Access Journals (Sweden)

    P. Sundareswar

    2016-11-01

    Full Text Available BACKGROUND Disturbances in lipid metabolism, which occur during hypothyroidism lead to the formation of gallstones. This study aims to evaluate the thyroid function pattern in patients with gallstones. The aim of this study was to investigate the association between hypothyroidism and gallstone disease. MATERIALS AND METHODS 200 patients admitted as inpatients for management of gallstone disease in Department of General Surgery, GRH, Madurai, between September 2014 to August 2015 were evaluated with details of cases, full history, clinical examination, symptoms and signs of hypothyroidism (loss of appetite, gaining weight, tiredness, constipation, cold intolerance, menstrual disturbances, bradycardia, presence or absence of goiter, etc. and investigations (USG abdomen, USG neck, thyroid function test (T3, T4, TSH. Patients are divided according to history, clinical examination, USG neck and lab estimation of T3, T4 and TSH. 1. Subclinical Hypothyroidism: Symptom free patient with TSH concentration above upper limit of normal range and T3/T4 or both decrease below normal limit. 2. Clinical Hypothyroidism: In which, there are symptoms of hypothyroidism with TSH level above the upper limit and T3/T4 or both decrease below normal limit. 3. Euthyroid Group: Where clinical and lab tests are within normal range (all these groups may present with or without goiter. RESULTS This study included 200 gallstone patients who were studied prospectively over a period of 1 year from September 2014 to August 2015. Among them, 18 patients had subclinical hypothyroidism and 6 patients had clinical hypothyroidism. A total of 12% of gallstone patients were diagnosed to have hypothyroidism showing that there is association of hypothyroidism with gallstone disease. CONCLUSION Thyroid dysfunction is more common among patients with gallstones and it maybe a risk factor for biliary stone formation. This may be attributed to the absence of the pro-relaxing effects of

  10. Newly diagnosed rheumatic heart disease among indigenous populations in the Pacific.

    Science.gov (United States)

    Mirabel, Mariana; Tafflet, Muriel; Noël, Baptiste; Parks, Tom; Axler, Olivier; Robert, Jacques; Nadra, Marie; Phelippeau, Gwendolyne; Descloux, Elodie; Cazorla, Cécile; Missotte, Isabelle; Gervolino, Shirley; Barguil, Yann; Rouchon, Bernard; Laumond, Sylvie; Jubeau, Thierry; Braunstein, Corinne; Empana, Jean-Philippe; Marijon, Eloi; Jouven, Xavier

    2015-12-01

    Rheumatic heart disease (RHD) remains the leading acquired heart disease in the young worldwide. We aimed at assessing outcomes and influencing factors in the contemporary era. Hospital-based cohort in a high-income island nation where RHD remains endemic and the population is captive. All patients admitted with newly diagnosed RHD according to World Heart Federation echocardiographic criteria were enrolled (2005-2013). The incidence of major cardiovascular events (MACEs) including heart failure, peripheral embolism, stroke, heart valve intervention and cardiovascular death was calculated, and their determinants identified. Of the 396 patients, 43.9% were male with median age 18 years (IQR 10-40)). 127 (32.1%) patients presented with mild, 131 (33.1%) with moderate and 138 (34.8%) with severe heart valve disease. 205 (51.8%) had features of acute rheumatic fever. 106 (26.8%) presented with at least one MACE. Among the remaining 290 patients, after a median follow-up period of 4.08 (95% CI 1.84 to 6.84) years, 7 patients (2.4%) died and 62 (21.4%) had a first MACE. The annual incidence of first MACE and of heart failure were 59.05‰ (95% CI 44.35 to 73.75) and 29.06‰ (95% CI 19.29 to 38.82), respectively. The severity of RHD at diagnosis (moderate vs mild HR 3.39 (0.95 to 12.12); severe vs mild RHD HR 10.81 (3.11 to 37.62), pdisease and no secondary prophylaxis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Comparison of 3T and 7T susceptibility-weighted angiography of the substantia nigra in diagnosing Parkinson disease.

    Science.gov (United States)

    Cosottini, M; Frosini, D; Pesaresi, I; Donatelli, G; Cecchi, P; Costagli, M; Biagi, L; Ceravolo, R; Bonuccelli, U; Tosetti, M

    2015-03-01

    Standard neuroimaging fails in defining the anatomy of the substantia nigra and has a marginal role in the diagnosis of Parkinson disease. Recently 7T MR target imaging of the substantia nigra has been useful in diagnosing Parkinson disease. We performed a comparative study to evaluate whether susceptibility-weighted angiography can diagnose Parkinson disease with a 3T scanner. Fourteen patients with Parkinson disease and 13 healthy subjects underwent MR imaging examination at 3T and 7T by using susceptibility-weighted angiography. Two expert blinded observers and 1 neuroradiology fellow evaluated the 3T and 7T images of the sample to identify substantia nigra abnormalities indicative of Parkinson disease. Diagnostic accuracy and intra- and interobserver agreement were calculated separately for 3T and 7T acquisitions. Susceptibility-weighted angiography 7T MR imaging can diagnose Parkinson disease with a mean sensitivity of 93%, specificity of 100%, and diagnostic accuracy of 96%. 3T MR imaging diagnosed Parkinson disease with a mean sensitivity of 79%, specificity of 94%, and diagnostic accuracy of 86%. Intraobserver and interobserver agreement was excellent at 7T. At 3T, intraobserver agreement was excellent for experts, and interobserver agreement ranged between good and excellent. The less expert reader obtained a diagnostic accuracy of 89% at 3T. Susceptibility-weighted angiography images obtained at 3T and 7T differentiate controls from patients with Parkinson disease with a higher diagnostic accuracy at 7T. The capability of 3T in diagnosing Parkinson disease might encourage its use in clinical practice. The use of the more accurate 7T should be supported by a dedicated cost-effectiveness study. © 2015 by American Journal of Neuroradiology.

  12. Reliability of the minimum basic dataset for diagnoses of cerebrovascular disease.

    Science.gov (United States)

    Hernández Medrano, I; Guillán, M; Masjuan, J; Alonso Cánovas, A; Gogorcena, M A

    2017-03-01

    The minimum basic dataset is the largest available hospital care administrative database that is used in clinical studies and hospital management in association with diagnosis-related groups (DRGs). In 2011, the quality of the national MBDS in hospital discharges was audited, in order to assess its reliability. This paper presents a sub-analysis of the results from that analysis which are referred to cerebrovascular disease (CVD). Using all discharge reports from the Spanish MBDS in 2009, a representative sample was obtained by stratified sampling and 11 209 records were evaluated. Outcome indicators were obtained to measure any differences observed between the national MBDS being evaluated and the hospital's original MBDS. Analysis of codes for CVD as a primary diagnosis was performed for ICD-9-CM diagnostic categories 430 through 438. We evaluated error rates in the selection and classification of main diagnoses, as well as in DRG assignment. There were 397 discharges of cases of CVD which included 21 different DRGs. Diagnostic coding showed a concordance rate of 81.87%; the selection error rate was 2.26% and the classification error rate was 15.87%. The error rate in the DRG was 16.12% and associated with the greatest impact on the mortality risk level. While the errors we observed must be taken into account, data suggest that the quality of the MBDS for CVD is sufficient to ensure delivery of valid information. The hospital discharge registry serves as a valuable tool for use in studies of this disease. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. The prevalence of Helicobacter pylori gastritis in newly diagnosed children with inflammatory bowel disease.

    Science.gov (United States)

    Roka, Kleoniki; Roubani, Aikaterini; Stefanaki, Kalliopi; Panayotou, Ioanna; Roma, Eleftheria; Chouliaras, Giorgos

    2014-10-01

    Recent studies have shown that patients with inflammatory bowel disease (IBD) are less likely to be infected with Helicobacter pylori compared with non-IBD patients. We aimed to study the prevalence of H. pylori-positive and H. pylori-negative gastritis in newly diagnosed children with IBD in comparison to those with non-IBD in Greece. All children who underwent first esophagogastroduodenal endoscopy between 2002 and 2011 were retrospectively included. Four groups were studied: patients with Crohn's disease (CD), ulcerative colitis (UC), IBD unclassified (IBDU), and non-IBD individuals (non-IBD). Helicobacter pylori infection was defined by positive culture or by positive histology and CLO test. Those children with negative or not available culture and only one positive test (histology or CLO) were further evaluated by urea breath test, and the positives were also included in the infected group. We studied 159 patients with IBD (66 CD, 34 UC, and 59 IBDU) and 1209 patients in non-IBD individuals. Helicobacter pylori gastritis was less frequent in the IBD group (3.8% vs 13.2% in the control group, p gastritis were 3.3 times more likely to belong in the IBD group compared with H. pylori-positive patients (p = .006). Occurrence of H. pylori gastritis is less frequent in children with IBD compared with controls. Our study confirms an inverse association between H. pylori and IBD. Future studies are needed to distinguish between a true protective role of H. pylori and a confounding effect due to previous antibiotic use in children with IBD. © 2014 John Wiley & Sons Ltd.

  14. Prevalence of chronic kidney disease in newly diagnosed patients with Human immunodeficiency virus in Ilorin, Nigeria.

    Science.gov (United States)

    Ayokunle, Dada Samuel; Olusegun, Olanrewaju Timothy; Ademola, Aderibigbe; Adindu, Chijioke; Olaitan, Rafiu Mojeed; Oladimeji, Ajayi Akande

    2015-01-01

    Human immunodeficiency virus (HIV) the causative agent of Acquired immunodeficiency syndrome (AIDS) is an important cause of renal diseases in sub-Saharan Africa. There is paucity of studies on the burden of chronic kidney disease (CKD) among patients with HIV/AIDS in the North-Central zone of Nigeria. This is a cross-sectional study of 227 newly-diagnosed, antiretroviral naïve patients with HIV/AIDS seen at the HIV clinic of the Medical Out-patient Department (MOPD) of University of Ilorin Teaching Hospital (UITH). They were matched with 108 control group. Laboratory investigations were performed for the participants. CKD was defined as estimated glomerular filtration rate (eGFR) 30 mg/g. There were 100 (44%) males among the patients and 47 (43.5%) among the control group. The mean ages of the patients and controls were 40.3 ± 10.3 years and 41.8 ± 9.5 years respectively. CKD was observed in 108 (47.6%) among the patients and 18 (16.7%) of the controls (p = 0.01). The median CD4 T-cell count was significantly lower in patients with CKD. Ninety-three (41.0%) of the patients had dipstick proteinuria of > 2 +. The median albumin creatinine ratio (ACR) was significantly higher among the HIV-positive patients (272.3 mg/g) compared with the HIV-negative controls (27.22 mg/g) p = 0.01. The CD4 T-cell count correlates positively with eGFR (r = 0.463, p = 0.001) and negatively with ACR (r = -0.806, p = 0.001). CKD is very common among patients with HIV/AIDS in Ilorin. Screening and early intervention for CKD should be part of the protocols in the management of these patients.

  15. Prediction of complicated disease course for children newly diagnosed with Crohn's disease: a multicentre inception cohort study.

    Science.gov (United States)

    Kugathasan, Subra; Denson, Lee A; Walters, Thomas D; Kim, Mi-Ok; Marigorta, Urko M; Schirmer, Melanie; Mondal, Kajari; Liu, Chunyan; Griffiths, Anne; Noe, Joshua D; Crandall, Wallace V; Snapper, Scott; Rabizadeh, Shervin; Rosh, Joel R; Shapiro, Jason M; Guthery, Stephen; Mack, David R; Kellermayer, Richard; Kappelman, Michael D; Steiner, Steven; Moulton, Dedrick E; Keljo, David; Cohen, Stanley; Oliva-Hemker, Maria; Heyman, Melvin B; Otley, Anthony R; Baker, Susan S; Evans, Jonathan S; Kirschner, Barbara S; Patel, Ashish S; Ziring, David; Trapnell, Bruce C; Sylvester, Francisco A; Stephens, Michael C; Baldassano, Robert N; Markowitz, James F; Cho, Judy; Xavier, Ramnik J; Huttenhower, Curtis; Aronow, Bruce J; Gibson, Greg; Hyams, Jeffrey S; Dubinsky, Marla C

    2017-04-29

    Stricturing and penetrating complications account for substantial morbidity and health-care costs in paediatric and adult onset Crohn's disease. Validated models to predict risk for complications are not available, and the effect of treatment on risk is unknown. We did a prospective inception cohort study of paediatric patients with newly diagnosed Crohn's disease at 28 sites in the USA and Canada. Genotypes, antimicrobial serologies, ileal gene expression, and ileal, rectal, and faecal microbiota were assessed. A competing-risk model for disease complications was derived and validated in independent groups. Propensity-score matching tested the effect of anti-tumour necrosis factor α (TNFα) therapy exposure within 90 days of diagnosis on complication risk. Between Nov 1, 2008, and June 30, 2012, we enrolled 913 patients, 78 (9%) of whom experienced Crohn's disease complications. The validated competing-risk model included age, race, disease location, and antimicrobial serologies and provided a sensitivity of 66% (95% CI 51-82) and specificity of 63% (55-71), with a negative predictive value of 95% (94-97). Patients who received early anti-TNFα therapy were less likely to have penetrating complications (hazard ratio [HR] 0·30, 95% CI 0·10-0·89; p=0·0296) but not stricturing complication (1·13, 0·51-2·51; 0·76) than were those who did not receive early anti-TNFα therapy. Ruminococcus was implicated in stricturing complications and Veillonella in penetrating complications. Ileal genes controlling extracellular matrix production were upregulated at diagnosis, and this gene signature was associated with stricturing in the risk model (HR 1·70, 95% CI 1·12-2·57; p=0·0120). When this gene signature was included, the model's specificity improved to 71%. Our findings support the usefulness of risk stratification of paediatric patients with Crohn's disease at diagnosis, and selection of anti-TNFα therapy. Crohn's and Colitis Foundation of America, Cincinnati

  16. Prediction of complicated disease course for children newly diagnosed with Crohn’s disease: a multicentre inception cohort study

    Science.gov (United States)

    Kugathasan, Subra; Denson, Lee A; Walters, Thomas D; Kim, Mi-Ok; Marigorta, Urko M; Schirmer, Melanie; Mondal, Kajari; Liu, Chunyan; Griffiths, Anne; Noe, Joshua D; Crandall, Wallace V; Snapper, Scott; Rabizadeh, Shervin; Rosh, Joel R; Shapiro, Jason M; Guthery, Stephen; Mack, David R; Kellermayer, Richard; Kappelman, Michael D; Steiner, Steven; Moulton, Dedrick E; Keljo, David; Cohen, Stanley; Oliva-Hemker, Maria; Heyman, Melvin B; Otley, Anthony R; Baker, Susan S; Evans, Jonathan S; Kirschner, Barbara S; Patel, Ashish S; Ziring, David; Trapnell, Bruce C; Sylvester, Francisco A; Stephens, Michael C; Baldassano, Robert N; Markowitz, James F; Cho, Judy; Xavier, Ramnik J; Huttenhower, Curtis; Aronow, Bruce J; Gibson, Greg; Hyams, Jeffrey S; Dubinsky, Marla C

    2017-01-01

    Summary Background Stricturing and penetrating complications account for substantial morbidity and health-care costs in paediatric and adult onset Crohn’s disease. Validated models to predict risk for complications are not available, and the effect of treatment on risk is unknown. Methods We did a prospective inception cohort study of paediatric patients with newly diagnosed Crohn’s disease at 28 sites in the USA and Canada. Genotypes, antimicrobial serologies, ileal gene expression, and ileal, rectal, and faecal microbiota were assessed. A competing-risk model for disease complications was derived and validated in independent groups. Propensity-score matching tested the effect of anti-tumour necrosis factor α (TNFα) therapy exposure within 90 days of diagnosis on complication risk. Findings Between Nov 1, 2008, and June 30, 2012, we enrolled 913 patients, 78 (9%) of whom experienced Crohn’s disease complications. The validated competing-risk model included age, race, disease location, and antimicrobial serologies and provided a sensitivity of 66% (95% CI 51–82) and specificity of 63% (55–71), with a negative predictive value of 95% (94–97). Patients who received early anti-TNFα therapy were less likely to have penetrating complications (hazard ratio [HR] 0·30, 95% CI 0·10–0·89; p=0·0296) but not stricturing complication (1·13, 0·51–2·51; 0·76) than were those who did not receive early anti-TNFα therapy. Ruminococcus was implicated in stricturing complications and Veillonella in penetrating complications. Ileal genes controlling extracellular matrix production were upregulated at diagnosis, and this gene signature was associated with stricturing in the risk model (HR 1·70, 95% CI 1·12–2·57; p=0·0120). When this gene signature was included, the model’s specificity improved to 71%. Interpretation Our findings support the usefulness of risk stratification of paediatric patients with Crohn’s disease at diagnosis, and selection of

  17. Prognostic factors for weight loss over 1-year period in patients recently diagnosed with mild Alzheimer Disease

    DEFF Research Database (Denmark)

    Hansen, M.L.; Waldorff, F.B.; Waldemar, G.

    2011-01-01

    The aim of the study was to identify prognostic factors for weight loss in patients recently diagnosed with mild Alzheimer disease (AD), with special emphasis on the patients' social participation and living arrangements. The data used in this study was part of the Danish Alzheimer Intervention...

  18. Dominant Fecal Microbiota in Newly Diagnosed Untreated Inflammatory Bowel Disease Patients

    Directory of Open Access Journals (Sweden)

    Lill Therese Thorkildsen

    2013-01-01

    Full Text Available Our knowledge about the microbiota associated with the onset of IBD is limited. The aim of our study was to investigate the correlation between IBD and the fecal microbiota for early diagnosed untreated patients. The fecal samples used were a part of the Inflammatory Bowel South-Eastern Norway II (IBSEN II study and were collected from CD patients (n=30, UC patients (n=33, unclassified IBD (IBDU patients (n=3, and from a control group (n=34. The bacteria associated with the fecal samples were analyzed using a direct 16S rRNA gene-sequencing approach combined with a multivariate curve resolution (MCR analysis. In addition, a 16S rRNA gene clone library was prepared for the construction of bacteria-specific gene-targeted single nucleotide primer extension (SNuPE probes. The MCR analysis resulted in the recovery of five pure components of the dominant bacteria present: Escherichia/Shigella, Faecalibacterium, Bacteroides, and two components of unclassified Clostridiales. Escherichia/Shigella was found to be significantly increased in CD patients compared to control subjects, and Faecalibacterium was found to be significantly reduced in CD patients compared to both UC patients and control subjects. Furthermore, a SNuPE probe specific for Escherichia/Shigella showed a significant overrepresentation of Escherichia/Shigella in CD patients compared to control subjects. In conclusion, samples from CD patients exhibited an increase in Escherichia/Shigella and a decrease in Faecalibacterium indicating that the onset of the disease is associated with an increase in proinflammatory and a decrease in anti-inflammatory bacteria.

  19. Concordance between brain 18F-FDG PET and cerebrospinal fluid biomarkers in diagnosing Alzheimer's disease.

    Science.gov (United States)

    Rubí, S; Noguera, A; Tarongí, S; Oporto, M; García, A; Vico, H; Espino, A; Picado, M J; Mas, A; Peña, C; Amer, G

    Cortical posterior hypometabolism on PET imaging with 18 F-FDG (FDG-PET), and altered levels of Aß 1-42 peptide, total Tau (tTau) and phosphorylated Tau (pTau) proteins in cerebrospinal fluid (CSF) are established diagnostic biomarkers in Alzheimer's disease (AD). An evaluation has been made of the concordance and relationship between the results of FDG-PET and CSF biomarkers in symptomatic patients with suspected AD. A retrospective review was carried out on 120 patients with cognitive impairment referred to our Cognitive Neurology Unit, and who were evaluated by brain FDG-PET and a lumbar puncture for CSF biomarkers. In order to calculate their Kappa coefficient of concordance, the result of the FDG-PET and the set of the three CSF biomarkers in each patient was classified as normal, inconclusive, or AD-compatible. The relationship between the results of both methods was further assessed using logistic regression analysis, including the Aß 1-42 , tTau and pTau levels as quantitative predictors, and the FDG-PET result as the dependent variable. The weighted Kappa coefficient between FDG-PET and CSF biomarkers was 0.46 (95% CI: 0.35-0.57). Logistic regression analysis showed that the Aß 1-42 and tTau values together were capable of discriminating an FDG-PET result metabolically suggestive of AD from one non-suggestive of AD, with a 91% sensitivity and 93% specificity at the cut-off line Aß 1-42 =44+1.3×tTau. The level of concordance between FDG-PET and CSF biomarkers was moderate, indicating their complementary value in diagnosing AD. The Aß 1-42 and tTau levels in CSF help to predict the patient FDG-PET cortical metabolic status. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  20. 99Tcm-MIBI imaging in diagnosing benign/malign pulmonary disease and analysis of lung cancer DNA content

    International Nuclear Information System (INIS)

    Feng Yanlin; Tan Jiaju; Yang Jie; Zhu Zheng; Yu Fengwen; He Xiaohong; Huang Kemin; Yuan Baihong; Su Shaodi

    2002-01-01

    Objective: To evaluate the value of 99 Tc m -methoxyisobutylisonitrile (MIBI) lung imaging in diagnosing benign/malign pulmonary disease and the relation of 99 Tc m -MIBI uptake ratio (UR) with lung cancer DNA content. Methods: Early and delay imaging were performed on 27 cases of benign lung disease and 46 cases of malign lung disease. Visual analysis of the images and T/N uptake ratio measurement were performed on every case. Cancer cell DNA content and DNA index (DI) were measured in 24 cases of malign pulmonary disease. Results: The delay phase UR was 1.13 ± 0.19 in benign disease group, and the delay phase UR was 1.45 ± 0.21 in malign disease group (t6.51, P 99 Tc m -MIBI is not an ideal imaging agent for differentiating pulmonary benign/malign disease. Lung cancer DNA content may be reflected by delay phase UR

  1. X-ray diagnostics of thorax diseases; Roentgendiagnostik von Thoraxerkrankungen. Von der Deskription zur Diagnose

    Energy Technology Data Exchange (ETDEWEB)

    Kulke, H.M. [Wuerzburg Univ. (Germany). Universitaetsklinikum

    2013-11-01

    The book on X-ray diagnostics of thorax diseases covers the following issues: diagnostic procedures, inflammatory thorax diseases, malign thorax diseases, heart and large blood vessels, hear insufficiency, pulmonary congestion, pulmonary edema, interstitial pulmonary diseases, intensive care and traumatology.

  2. Limitations of ADAMTS-13 activity level in diagnosing thrombotic thrombocytopenic purpura in pregnancy.

    Science.gov (United States)

    Ehsanipoor, Robert M; Rajan, Priya; Holcombe, Randall F; Wing, Deborah A

    2009-10-01

    In pregnancy, it may be difficult to differentiate the syndrome of hemolysis, elevated liver enzymes, and low platelets from thrombotic thrombocytopenia purpura. Severely depressed (present a case of a patient that presented at 20 weeks gestation with elevated liver enzymes and thrombocytopenia. The diagnosis was unclear at the time of presentation. She underwent induction of labor, and during the postpartum course, she was eventually diagnosed with thrombotic thrombocytopenia purpura; however, her activity level of a disintegrin and metalloproteinase with thrombospondin motifs-13 was only moderately depressed at 15% (normal pregnancy value 41%-105%).

  3. Trends in incidence of end-stage renal disease among persons with diagnosed diabetes--Puerto Rico, 1996-2010.

    Science.gov (United States)

    Burrows, Nilka Rios; Hora, Israel; Williams, Desmond E; Geiss, Linda S

    2014-03-07

    During 2010, approximately 6,091 persons aged ≥18 years in Puerto Rico were living with end-stage renal disease (ESRD) (i.e., kidney failure that requires regular dialysis or kidney transplantation for survival). This included 1,462 persons who began treatment for ESRD in 2010. Diabetes is the leading cause of ESRD in Puerto Rico, accounting for 66% of new cases in adults, followed by hypertension, which accounts for 15% of the cases. Although the number of adults initiating ESRD treatment (i.e., dialysis or kidney transplantation) in Puerto Rico each year who have diabetes listed as a primary cause (ESRD-D) has increased since 1996, ESRD-D incidence among adults with diagnosed diabetes has not shown a consistent trend. To assess recent trends in ESRD-D incidence among adults aged ≥18 years in Puerto Rico with diagnosed diabetes and to further examine trends by age group and sex, CDC analyzed 1996-2010 data from the U.S. Renal Data System (USRDS) and the Behavioral Risk Factor Surveillance System (BRFSS). After increasing in the late 1990s, ESRD-D incidence decreased during the 2000s among adult men and among persons aged 18-44 years with diagnosed diabetes in Puerto Rico. Throughout the period, ESRD-D incidence among adult women and among persons aged 45-64 and ≥75 years with diagnosed diabetes did not show a consistent trend, and ESRD-D incidence among persons aged 65-74 years with diagnosed diabetes increased. Increased awareness of the risk factors for kidney disease and implementation of effective interventions to prevent or delay kidney disease among persons with diagnosed diabetes might decrease ESRD incidence in Puerto Rico, particularly among women and older persons.

  4. Screening of coeliac disease in undetected adults and patients diagnosed with irritable bowel syndrome in Riyadh, Saudi Arabia.

    Science.gov (United States)

    Al-Ajlan, Abdulrahman S

    2016-07-01

    The present study is to determine the prevalence and implication of coeliac disease (CD) among adult Saudis and compared to those with diagnosed irritable bowel syndrome. This prospective study was conducted among 980 adults. Out of that, 482 subjects (staff and students of Riyadh Health Science College) were designated as control cohorts for undetected coeliac disease. Furthermore, another contingent of 498 subjects diagnosed with irritable bowel syndrome (IBS) at Prince Salman Hospital and Al-Iman General Hospital also constituted a segment of the overall initial 1020 subjects. Both cases and control were tested for serological markers of coeliac disease (tissues transglutaminase (tTGAs) and endomysial autoantibody (EMAs) and were confirmed by histopathology test. All the positive for cases of coeliac disease were screened for iron deficiency anaemia, Vitamin D deficiency, and osteoporosis and weight assessment. The percentage of coeliac disease in control subjects and patients diagnosed with irritable bowel syndrome (IBS) were found to be 1.9% and 9.6% respectively, about 38% of the total coeliac disease patients are among females of middle age (20-39-years) and 16% of the males in the same age range. Whereas, 20% and 25% of all coeliac disease cases with ages of 40-59 were remarked as females and males respectively. The identical nature and overlap of symptoms of the two conditions could possibly result in misdiagnosis of coeliac diseases or over-diagnosis of irritable bowel syndrome. The findings of the study might also give considerable implications of the disease in the nutritional level which is noticeable.

  5. Screening of coeliac disease in undetected adults and patients diagnosed with irritable bowel syndrome in Riyadh, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdulrahman S. Al-Ajlan

    2016-07-01

    Full Text Available The present study is to determine the prevalence and implication of coeliac disease (CD among adult Saudis and compared to those with diagnosed irritable bowel syndrome. This prospective study was conducted among 980 adults. Out of that, 482 subjects (staff and students of Riyadh Health Science College were designated as control cohorts for undetected coeliac disease. Furthermore, another contingent of 498 subjects diagnosed with irritable bowel syndrome (IBS at Prince Salman Hospital and Al-Iman General Hospital also constituted a segment of the overall initial 1020 subjects. Both cases and control were tested for serological markers of coeliac disease (tissues transglutaminase (tTGAs and endomysial autoantibody (EMAs and were confirmed by histopathology test. All the positive for cases of coeliac disease were screened for iron deficiency anaemia, Vitamin D deficiency, and osteoporosis and weight assessment. The percentage of coeliac disease in control subjects and patients diagnosed with irritable bowel syndrome (IBS were found to be 1.9% and 9.6% respectively, about 38% of the total coeliac disease patients are among females of middle age (20–39-years and 16% of the males in the same age range. Whereas, 20% and 25% of all coeliac disease cases with ages of 40–59 were remarked as females and males respectively. The identical nature and overlap of symptoms of the two conditions could possibly result in misdiagnosis of coeliac diseases or over-diagnosis of irritable bowel syndrome. The findings of the study might also give considerable implications of the disease in the nutritional level which is noticeable.

  6. Characterization of mortality in children with sickle cell disease diagnosed through the Newborn Screening Program.

    Science.gov (United States)

    Sabarense, Alessandra P; Lima, Gabriella O; Silva, Lívia M L; Viana, Marcos Borato

    2015-01-01

    To characterize the deaths of 193 children with sickle cell disease screened by a neonatal program from 1998 to 2012 and contrast the initial years with the final years. Deaths were identified by active surveillance of children absent to scheduled appointments in Blood Bank Clinical Centers (Hemominas). Clinical and epidemiological data came from death certificates, neonatal screening database, medical records, and family interviews. Between 1998 and 2012, 3,617,919 children were screened and 2,591 had sickle cell disease (1:1,400). There were 193 deaths (7.4%): 153 with SS/Sβ(0)-thalassemia, 34 SC and 6 Sβ(+)thalassemia; 76.7% were younger than five years; 78% died in the hospital and 21% at home or in transit. The main causes of death were infection (45%), indeterminate (28%), and acute splenic sequestration (14%). In 46% of death certificates, the term "sickle cell" was not recorded. Seven-year death rate for children born between 1998 and 2005 was 5.43% versus 5.12% for those born between 2005 and 2012 (p = 0.72). Medical care was provided to 75% of children; 24% were unassisted. Medical care was provided within 6 hours of symptom onset in only half of the interviewed cases. In 40.5% of cases, death occurred within the first 24 hours. Low family income was recorded in 90% of cases, and illiteracy in 5%. Although comprehensive and effective, neonatal screening for sickle cell disease was not sufficient to significantly reduce mortality in a newborn screening program. Economic and social development and increase of the knowledge on sickle cell disease among health professionals and family are needed to overcome excessive mortality. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  7. Characterization of mortality in children with sickle cell disease diagnosed through the Newborn Screening Program

    Directory of Open Access Journals (Sweden)

    Alessandra P. Sabarense

    2015-06-01

    Full Text Available OBJECTIVE: To characterize the deaths of 193 children with sickle cell disease screened by a neonatal program from 1998 to 2012 and contrast the initial years with the final years. METHODS: Deaths were identified by active surveillance of children absent to scheduled appointments in Blood Bank Clinical Centers (Hemominas. Clinical and epidemiological data came from death certificates, neonatal screening database, medical records, and family interviews. RESULTS: Between 1998 and 2012, 3,617,919 children were screened and 2,591 had sickle cell disease (1:1,400. There were 193 deaths (7.4%: 153 with SS/Sß0-talassemia, 34 SC and 6 Sß+thalassemia; 76.7% were younger than five years; 78% died in the hospital and 21% at home or in transit. The main causes of death were infection (45%, indeterminate (28%, and acute splenic sequestration (14%. In 46% of death certificates, the term "sickle cell" was not recorded. Seven-year death rate for children born between 1998 and 2005 was 5.43% versus 5.12% for those born between 2005 and 2012 (p = 0.72. Medical care was provided to 75% of children; 24% were unassisted. Medical care was provided within 6 hours of symptom onset in only half of the interviewed cases. In 40.5% of cases, death occurred within the first 24 hours. Low family income was recorded in 90% of cases, and illiteracy in 5%. CONCLUSIONS: Although comprehensive and effective, neonatal screening for sickle cell disease was not sufficient to significantly reduce mortality in a newborn screening program. Economic and social development and increase of the knowledge on sickle cell disease among health professionals and family are needed to overcome excessive mortality.

  8. Quantitative computed tomography measurements of emphysema for diagnosing asthma-chronic obstructive pulmonary disease overlap syndrome

    Science.gov (United States)

    Xie, Mengshuang; Wang, Wei; Dou, Shuang; Cui, Liwei; Xiao, Wei

    2016-01-01

    Initiative for Chronic Obstructive Lung Disease guidelines. Quantitative CT measurements of emphysema may help in diagnosing ACOS. PMID:27226711

  9. Newly diagnosed congenital factor VII deficiency and utilization of recombinant activated factor VII (NovoSeven(®)).

    Science.gov (United States)

    Bartosh, Nicole S; Tomlin, Tara; Cable, Christian; Halka, Kathleen

    2013-01-01

    This case report presents a newly diagnosed congenital factor VII deficiency treated with recombinant activated factor VII (rFVIIa). Congenital factor VII deficiency is a rare autosomal-recessive bleeding disorder that occurs in fewer than 1/500,000 persons. Its presentation can vary from epistaxis to hemarthroses and severe central nervous system bleeding, and correlates poorly with factor VII levels. Our patient had not had a significant hemostatic challenge prior to his presentation and therefore never had any symptomatology suggestive of this disease. He was treated with rFVIIa, and was able to undergo repair of his fractures without bleeding. A 19-year-old African-American male presented to the emergency room after an altercation that resulted in significant trauma. He sustained bilateral mandibular angle fractures and orbital floor fractures, requiring urgent surgical correction. On initial evaluation, he was noted to have a prolonged prothrombin time of 40.1 seconds, with an International Normalized Ratio of 4.0, a normal activated partial thromboplastin time of 29.9 seconds, and a platelet count of 241. After receiving vitamin K and fresh frozen plasma, he was taken to the operating room for a temporary rigid maxillomandibular fixation. A 1:1 mixing study with normal plasma corrected the prothrombin time (decreasing from 40.7 to 14.7 seconds) and a factor VII assay revealed 5% of the normal factor VII level. The patient was diagnosed with congenital factor VII deficiency. Due to his coagulopathy and the extensive surgical correction needed, rFVIIa was administered and surgery was accomplished without hemorrhagic sequelae. This case report and review describes a rare congenital disease, the history of rFVIIa use, and its mechanism. rFVIIA use in our patient provided a treatment option that allowed the necessary surgical correction, but further prospective studies on dose optimization would ensure adequate dosing with minimal risk of severe side effects.

  10. Newly diagnosed congenital factor VII deficiency and utilization of recombinant activated factor VII (NovoSeven®)

    Science.gov (United States)

    Bartosh, Nicole S; Tomlin, Tara; Cable, Christian; Halka, Kathleen

    2013-01-01

    This case report presents a newly diagnosed congenital factor VII deficiency treated with recombinant activated factor VII (rFVIIa). Congenital factor VII deficiency is a rare autosomal-recessive bleeding disorder that occurs in fewer than 1/500,000 persons. Its presentation can vary from epistaxis to hemarthroses and severe central nervous system bleeding, and correlates poorly with factor VII levels. Our patient had not had a significant hemostatic challenge prior to his presentation and therefore never had any symptomatology suggestive of this disease. He was treated with rFVIIa, and was able to undergo repair of his fractures without bleeding. Case report A 19-year-old African-American male presented to the emergency room after an altercation that resulted in significant trauma. He sustained bilateral mandibular angle fractures and orbital floor fractures, requiring urgent surgical correction. On initial evaluation, he was noted to have a prolonged prothrombin time of 40.1 seconds, with an International Normalized Ratio of 4.0, a normal activated partial thromboplastin time of 29.9 seconds, and a platelet count of 241. After receiving vitamin K and fresh frozen plasma, he was taken to the operating room for a temporary rigid maxillomandibular fixation. A 1:1 mixing study with normal plasma corrected the prothrombin time (decreasing from 40.7 to 14.7 seconds) and a factor VII assay revealed 5% of the normal factor VII level. The patient was diagnosed with congenital factor VII deficiency. Due to his coagulopathy and the extensive surgical correction needed, rFVIIa was administered and surgery was accomplished without hemorrhagic sequelae. Conclusion This case report and review describes a rare congenital disease, the history of rFVIIa use, and its mechanism. rFVIIA use in our patient provided a treatment option that allowed the necessary surgical correction, but further prospective studies on dose optimization would ensure adequate dosing with minimal risk of

  11. Clinical outcomes for young people with screening-detected and clinically-diagnosed rheumatic heart disease in Fiji.

    Science.gov (United States)

    Engelman, Daniel; Mataika, Reapi L; Ah Kee, Maureen; Donath, Susan; Parks, Tom; Colquhoun, Samantha M; Carapetis, Jonathan R; Kado, Joseph H; Steer, Andrew C

    2017-08-01

    Echocardiographic screening is under consideration as a disease control strategy for rheumatic heart disease (RHD). However, clinical outcomes of young people with screening-detected RHD are unknown. We aimed to describe the outcomes for a cohort with screening-detected RHD, in comparison to patients with clinically-diagnosed RHD. A retrospective cohort study included all young people with screening-detected RHD in the Central Division of Fiji in the primary cohort. Screen-negative and clinically-diagnosed comparison groups were matched 1:1 to the primary cohort. Data were collected on mortality, clinical complications and healthcare utilisation from the electronic and paper health records and existing databases. Seventy participants were included in each group. Demographic characteristics of the groups were similar (median age 11years, 69% female, median follow-up 7years). There were nine (12.9%) RHD-related deaths in the clinically-diagnosed group and one (1.4%) in the screening-detected group (Incident Rate Ratio: 9.6, 95% CI 1.3-420.6). Complications of RHD were observed in 39 (55.7%) clinically-diagnosed cases, four (20%) screening-detected cases and one (1.4%) screen-negative case. There were significant differences in the cumulative complication curves of the groups (pFiji. The prognosis of clinically-diagnosed RHD remains poor, with very high mortality and complication rates. Further studies in other settings will inform RHD screening policy. Comprehensive control strategies are required for disease prevention. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. [Satisfactory evolution of a patient diagnosed in childhood with Bruton's disease].

    Science.gov (United States)

    Román Jiménez, María Guadalupe; Yamazaki Nakashimada, Marco Antonio; Blancas Galicia, Lizbeth

    2010-01-01

    Bruton's agammaglobulinemia is a primary immunodeficiency with a disease onset during the first months of age, when the maternal serum immunoglobulin levels decrease. It is characterized by recurrent infections and agammaglobulinemia. We report the case of a 6-year-old male patient with third-degree consanguinity, product of a third pregnancy and complete immunization scheme. He had a history of oral candidiasis at the age of 3 months, chicken pox at the age of 7 months, and two episodes of complicated bronchopneumonia at the age of 1 year and 6 years. He was admitted to the hospital because of fever and cough. Examination of the chest showed rales and right basilar hypoventilation, and a blood cell count revealed leukocytosis and neutrophilia. The diagnosis of pneumonia was made. He was treated with IV antibiotics. Serum immunoglobulins were reported to be low (IgM 55 mg/dL, IgA 0.9 mg/dL, and IgG 199 mg/dL). With these findings the clinical diagnosis of X-linked agammaglobulinemia (ALX) was concluded. A molecular test was performed fining a BTK gene confirming the diagnosis of Bruton's disease. Therapy with intravenous IgG was started every 21 days. During his evolution, he presented three episodes of rhinosinusitis, one of suppurative otitis media, and four events of pneumonia that required 37 days of hospitalization. After hospital discharge, the patient was free of infections and he returned to his daily activities. In cases of recurrent and severe respiratory infections in children, we must consider primary immunodeficiency disease in the differential diagnosis, mainly antibiotic deficiency. Early diagnosis and treatment improves the survival and quality of life in these patients.

  13. Application of the pessimistic pruning to increase the accuracy of C4.5 algorithm in diagnosing chronic kidney disease

    Science.gov (United States)

    Muslim, M. A.; Herowati, A. J.; Sugiharti, E.; Prasetiyo, B.

    2018-03-01

    A technique to dig valuable information buried or hidden in data collection which is so big to be found an interesting patterns that was previously unknown is called data mining. Data mining has been applied in the healthcare industry. One technique used data mining is classification. The decision tree included in the classification of data mining and algorithm developed by decision tree is C4.5 algorithm. A classifier is designed using applying pessimistic pruning in C4.5 algorithm in diagnosing chronic kidney disease. Pessimistic pruning use to identify and remove branches that are not needed, this is done to avoid overfitting the decision tree generated by the C4.5 algorithm. In this paper, the result obtained using these classifiers are presented and discussed. Using pessimistic pruning shows increase accuracy of C4.5 algorithm of 1.5% from 95% to 96.5% in diagnosing of chronic kidney disease.

  14. [Pulmonary Mycobacterium Avium-Complex (MAC) Disease Differentially Diagnosed from Metastasis of Testicular Cancer : A Case Report].

    Science.gov (United States)

    Mori, Kohei; Teranishi, Jyn-Ichi; Yoneyama, Shuko; Ishida, Hiroaki; Hattori, Yusuke; Yumura, Yasushi; Miyoshi, Yasuhide; Kondo, Keiichi; Uemura, Hiroji; Noguchi, Kazumi

    2017-01-01

    A 45 year-old-man was admitted to our hospital because of discomfort in his left scrotum. He had a left testicular tumor. We performed high orchiectomy and pathological findings revealed testicular cancer. He was treated with bleomycin, etoposide and cisplatin. Computed tomography showed a new mass in the left lung after 3 cycles of the chemotherapy. Because of its rapid growth, the tumor was thought to be a metastasis lesion of testicular cancer or pulmonary infection. Transbronchial lung biopsy showed an invasion of multinucleated giant cells and granuloma. The culture and polymerase chain reaction of the bronchial sputum were positive for myobacterium avium-complex (MAC). From these findings, the left lung tumor was diagnosed as pulmonary MAC disease. He received partial resection of the left lung and the lesion was diagnosed as granuloma. There was no recurrence of testicular cancer or pulmonary disease after the surgery.

  15. EYE DISEASE IN NEWLY-DIAGNOSED LEPROSY PATIENTS IN EASTERN NEPAL

    NARCIS (Netherlands)

    LUBBERS, WJ; SCHIPPER, A; HOGEWEG, M; DESOLDENHOFF, R

    To determine the magnitude of eye lesions in newly diagnosed leprosy patients we examined their eyes. The Eastern Leprosy Control Project was supported by The Netherlands Leprosy Relief Association; we used the regional clinic in Biratnagar and 5 mobile clinics in surrounding districts as our survey

  16. COAGULATION ACTIVITY IN LIVER DISEASE

    Directory of Open Access Journals (Sweden)

    Dr. Sheikh Sajjadieh Mohammad Reza

    2009-07-01

    Full Text Available Patients with advanced hepatic failure may present with the entire spectrum of coagulation factor deficiencies. This study was designed to determine laboratory abnormalities in coagulation in chronic liver disease and the association of these abnormalities with the extent of chronic hepatitis and cirrhosis. Coagulation markers were assayed in 60 participants: 20 patients with chronic hepatitis, 20 patients with cirrhosis, and 20 healthy individuals (control. Plasma levels of anti-thrombin III were determined by a chromogenic substrate method, and plasma concentrations of fibrinogen were analyzed by the Rutberg method. Commercially available assays were used for laboratory coagulation tests. The levels of coagualation activity markers in patients with chronic liver disease were significantly different in comparison to those in healthy participants. These results indicate the utility of measuring markers for coagulation activity in determining which cirrhosis patients are more susceptible to disseminated intravascular coagulation.

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

    Directory of Open Access Journals (Sweden)

    Wright F

    2012-10-01

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

  18. [Evaluation of eating habits and nutritional behaviors of women in the perimenopausal period with the diagnosed celiac disease].

    Science.gov (United States)

    Friedrich, Mariola; Podlaszewska, Grazyna; Kuchlewska, Magdalena

    2012-01-01

    The aim of this study was to evaluate eating habits and nutritional behaviors of women in the perimenopausal period with celiac disease diagnosed within the last 4 years. The study covered a group of 26 women, at the age of 51-54 years, with celiac disease diagnosed in the last 4 years and staying on a gluten-free diet for 6 months to 4 years and agreed to participate in this studies. Information of nutrition were collected from the women, who, after an appropriate instruction, recorded the timing, type and amount of food consumed in the three days a week, selected at random. The amount of consumed portions was defined on the basis of the "Book of portions, products and dishes". The menus (78) were recorded in April and May. Collected data were prepared, based on a computer program Dietetyk 2009 Prof. The analysis of results achieved in this study enabled concluding that--from the viewpoint of the diagnosed disease--the nutritional patterns of the women were very appropriate. However, it failed to meet basic nutritional guidelines, which was reflected in, among other things, unsatisfactory intake of vegetables, fruits, oils and water, and in excessive intake of protein of animal origin. In addition, it did not cover demands resulting from the perimenopausal period the surveyed women were in, which is likely to facilitate, e.g. disorders in lipid metabolism and water-mineral balance, as well as development of osteoporosis. The general picture of behaviors, including the nutritional ones, pointed to a strong predominance of the diagnosed disease but also to the need of compensating for the resultant restrictions, with the latter being perceived by the surveyed women as health-promoting actions.

  19. Validation of celiac disease diagnoses recorded in the Danish National Patient Register using duodenal biopsies, celiac disease-specific antibodies, and human leukocyte-antigen genotypes

    DEFF Research Database (Denmark)

    Dydensborg Sander, Stine; Størdal, Ketil; Plato Hansen, Tine

    2016-01-01

    PURPOSE: The purpose of this study was to validate the celiac disease diagnoses recorded in the Danish National Patient Register. To validate the diagnoses, we used information on duodenal biopsies from a national register of pathology reports (the Patobank) and information on celiac disease......-specific antibodies and human leukocyte antigen (HLA) genotypes obtained from patient medical records. PATIENTS AND METHODS: We included all the children who were born from 1995 to 2012 and who were registered as having celiac disease in the Danish National Patient Register. We reviewed all the pathology reports...... on duodenal biopsies in the Patobank and the information in the medical records on celiac disease-specific antibodies (ie, anti-tissue transglutaminase 2 IgA and IgG, endomysial antibodies IgA, and anti-deamidated gliadin peptide IgG) and HLA genotypes. RESULTS: We identified 2,247 children who were...

  20. Long-Term Nationwide Follow-Up Study of Simple Congenital Heart Disease Diagnosed in Otherwise Healthy Children

    DEFF Research Database (Denmark)

    Videbæk, Jørgen; Laursen, Henning Bækgaard; Olsen, Morten

    2016-01-01

    BACKGROUND: Systematic follow-up is currently not recommended for patients with simple congenital heart disease; however, only a few data exist on the long-term prognosis of simple congenital heart disease. METHODS AND RESULTS: We undertook a nationwide follow-up study of a cohort of 1241 simple...... congenital heart disease patients, diagnosed from 1963 through 1973, in otherwise healthy children and alive at 15 years of age. We identified 10 age- and sex-matched general population controls per patient. We followed the study population through Danish public registries from the age of 15 years up...... with simple congenital heart disease in the 1960s have substantially increased long-term mortality and cardiac morbidity compared with the general population. Further studies on the effectiveness of systematic medical follow-up programs appear warranted....

  1. Regional differences in right versus left congenital heart disease diagnoses in neonates in the United States.

    Science.gov (United States)

    Nelson, Jennifer S; Strassle, Paula D

    2018-03-01

    Differences in the prevalence of left and right congenital heart defects (CHD) across the United States are unclear. This study evaluated the overall prevalence and the distribution of right versus left CHD across US regions and divisions in neonates. Newborns born from 2000 to 2014 diagnosed with CHD were identified using the National Inpatient Sample. Heart defects were stratified into right, left, and "neither" subtypes. The risk of right and left heart diagnoses between US Census regions and divisions was compared using multivariable binomial regression, adjusting for infant, and hospital characteristics. Two hundred forty thousand four hundred fifty-five newborns were included and 38,185 (15.9%) were classifiable as having either right or left subtypes. Between 2000 and 2014, the prevalence of right defects increased from 1.65 to 2.88 cases/1,000 live born infants (p right heart defect diagnosis compared to the West. When stratified by division, New England states had a significantly higher prevalence of right defects compared to the Pacific (RD adj .09, 95% CI .06, 0.11). No differences in the prevalence of left defects were seen. The prevalence of CHD diagnoses at birth in the US has increased, and regional differences in the prevalence of right defects appear to exist. © 2017 Wiley Periodicals, Inc.

  2. Determinants of Behavior Change Intention Among Heterosexual Thai Males Diagnosed with Sexually Transmitted Diseases.

    Science.gov (United States)

    Thato, Ratsiri; Daengsaard, Ekkachai

    2016-11-01

    This study sought to identify factors associated with intention to change sexual practices among heterosexual Thai males diagnosed with sexually transmitted infections (STIs). STI clinic patients (n = 247) reported their sexual behaviors and condom use during the previous 3 months. STI and HIV knowledge, motivation to change sexual practices, and behavioral skills were assessed. Then, self-reported behavior change intention, including consistent condom use, reducing number of sexual partners, not using drugs and alcohol when having sex, and refusal of condomless sex, was examined. Consistent condom use in the past 3 months by Thai males diagnosed with STIs was low across all types of sexual partners (lover 13.8%, casual partner 14.9%, and sex worker 2.5%). Risk reduction self-efficacy (p behavior change intention. Significant predictors of behavior change intention were risk reduction self-efficacy (p behavior change intention variance. Intervention aimed at enhancing motivation and behavioral skills to adopt preventive behaviors should be developed to prevent recurrent STIs, including HIV infection, among heterosexual Thai males diagnosed with STIs.

  3. Prevalence of Pain Diagnoses and Burden of Pain Among Active Duty Soldiers, FY2012.

    Science.gov (United States)

    Reif, Sharon; Adams, Rachel Sayko; Ritter, Grant A; Williams, Thomas V; Larson, Mary Jo

    2018-03-14

    Soldiers are at risk for acute and chronic pain due to the mental and physical challenges of military duties and ongoing training for force readiness. With the burden of pain on any individual attributable across pain sources, a broad perspective that goes beyond prior characterizations of pain is important. We aim to further the understanding of pain's effects among non-deployed active duty soldiers and the Military Health System (MHS), by describing prevalence of 10 painful conditions, reported pain levels, duration of pain and impact of pain on military duty limitations. Data are from the MHS Data Repository including outpatient MHS direct care encounters, claims for outpatient purchased care from civilian providers, and vital records, for all soldiers continuously enrolled in TRICARE and not deployed in FY 2012. Ten pain-related diagnostic categories were conceptually derived for this analysis and identified using ICD-9-CM diagnostic codes. We report the FY 2012 prevalence at the soldier-level (N = 297,120) for each pain category as a primary diagnosis, as well as in any diagnostic position, and at the soldier-level for reported pain level, duration, and military duty limitations. Institutional Review Board approval was obtained prior to analyses. Overall, 63% of soldiers had at least one pain diagnosis and 59% had a primary pain diagnosis during FY 2012. Back and neck pain (22%), non-traumatic joint disorders (28%), and other musculoskeletal pain (30%) were the most frequent categories for primary diagnosis. Nearly two-thirds of soldiers had a primary pain diagnosis in more than one category, and 23% in four or more categories. Moderate or severe pain levels were reported at least once during the year by 55% of soldiers who had a primary pain diagnosis. In the subsample of soldiers with primary pain in the first quarter, duration and chronicity of pain diagnoses varied by pain category: the back and neck pain category was the most common for both persistent

  4. Association of Thiazolidinedione with a Lower Risk of Parkinson's Disease in a Population with Newly-Diagnosed Diabetes Mellitus.

    Science.gov (United States)

    Lin, Hsiu-Li; Lin, Hsiu-Chen; Tseng, Yuan-Fu; Chao, Jane Chen-Jui; Hsu, Chien-Yeh

    2018-06-11

    We investigated the association of thiazolidinedione and its dose effect with the risk of Parkinson's disease (PD) in patients with diabetes mellitus (DM). This study enrolled 38,521 patients with newly-diagnosed DM between 2001 and 2013 and compared them to matched subjects without DM. The hazard ratios (HRs) for PD were compared between the thiazolidinedione-treated and non-thiazolidinedione-treated groups of the study cohort, and between subgroups who received different cumulative dosages of thiazolidinedione. We observed 544 (1.4%) patients with PD during the follow up of median duration of 6.2 years in patients with newly-diagnosed DM who had a higher risk for PD than patients without DM (HR = 1.150). In the study cohort, the risk of PD was significantly lower in the thiazolidinedione-treated group (HR = 0.399) compared to the non-thiazolidinedione-treated group. Thiazolidinedione reduced the risk of PD in a dose-dependent manner, with HRs ranging from 0.613 to 0.081 with defined daily doses of 0-90 to > 720, respectively. Thiazolidinedione use was associated with a significantly reduced risk of PD in patients with newly-diagnosed DM. Further studies to elucidate the common mechanism of PD and DM may provide novel therapies for these two diseases.

  5. The effects of obesity on doctor-diagnosed chronic diseases in Africa: empirical results from Senegal and South Africa.

    Science.gov (United States)

    Asfaw, Abay

    2006-01-01

    While inadequate food and communicable infectious diseases have been a concern of researchers and policy makers in Africa, little attention has been given to obesity and chronic, non-communicable diseases. Africa is not usually associated with obesity and chronic diseases. Yet there has been a sharp rise in the incidence of obesity and chronic diseases, a major public health problem in many countries. The paper examines the impact of obesity on the prevalence of four doctor-diagnosed chronic diseases in Senegal and South Africa. The results reveal that obese respondents were 4.7, 2.8, and 4.8% more likely to face the risks of arthritis, diabetes, and heart diseases in South Africa and 6.5 and 7.4% more likely to face the risks of heart disease and asthma in Senegal than their lean counterparts. Obesity imposes a real and substantial danger, affecting the prevalence of chronic diseases. Unchecked it can be a major public health problem, impose a serious challenge to the health sector, and can jeopardize future developments.

  6. Paraprotein–Related Kidney Disease: Diagnosing and Treating Monoclonal Gammopathy of Renal Significance

    Science.gov (United States)

    Rosner, Mitchell H.; Edeani, Amaka; Yanagita, Motoko; Glezerman, Ilya G.

    2016-01-01

    Paraprotein–related kidney disease represents a complex group of diseases caused by an abnormal paraprotein secreted by a clone of B cells. The disease manifestations range from tubulopathies, such as the Fanconi syndrome, to a spectrum of glomerular diseases that can present with varying degrees of proteinuria and renal dysfunction. Diagnosis of these diseases can be challenging because of the wide range of manifestations as well as the relatively common finding of a serum paraprotein, especially in elderly patients. Thus, renal biopsy along with detailed hematologic workup is essential to link the presence of the paraprotein to the associated renal disease. Recent advances in treatment with more effective and targeted chemotherapies, as well as stem cell transplantation, have improved the renal and overall prognosis for many of these disorders. PMID:27526705

  7. Complementary approaches to diagnosing marine diseases: a union of the modern and the classic

    Science.gov (United States)

    Burge, Colleen A.; Friedman, Carolyn S.; Getchell, Rodman G.; House, Marcia; Lafferty, Kevin D.; Mydlarz, Laura D.; Prager, Katherine C.; Sutherland, Kathryn P.; Renault, Tristan; Kiryu, Ikunari; Vega-Thurber, Rebecca

    2016-01-01

    Linking marine epizootics to a specific aetiology is notoriously difficult. Recent diagnostic successes show that marine disease diagnosis requires both modern, cutting-edge technology (e.g. metagenomics, quantitative real-time PCR) and more classic methods (e.g. transect surveys, histopathology and cell culture). Here, we discuss how this combination of traditional and modern approaches is necessary for rapid and accurate identification of marine diseases, and emphasize how sole reliance on any one technology or technique may lead disease investigations astray. We present diagnostic approaches at different scales, from the macro (environment, community, population and organismal scales) to the micro (tissue, organ, cell and genomic scales). We use disease case studies from a broad range of taxa to illustrate diagnostic successes from combining traditional and modern diagnostic methods. Finally, we recognize the need for increased capacity of centralized databases, networks, data repositories and contingency plans for diagnosis and management of marine disease.

  8. Resource allocation and the burden of co-morbidities among patients diagnosed with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Ahnfeldt-Mollerup, Peder; Lykkegaard, Jesper; Halling, Anders

    2016-01-01

    Background Chronic obstructive pulmonary disease is a leading cause of mortality, and associated with increased healthcare utilization and healthcare expenditure. In several countries, morbidity-based systems have changed the way resources are allocated in general practice. In primary care, fee......-for-services tariffs are often based on political negotiation rather than costing systems. The potential for comprehensive measures of patient morbidity to explain variation in negotiated expenditures for patients with chronic obstructive pulmonary disease has not previously been examined. The aim of this study...... is to analyze fee-for-service expenditure of patients diagnosed with chronic obstructive pulmonary disease visiting Danish general practice clinics and further to assess what proportion of fee-for-service expenditure variation was explained by patient morbidity and general practice clinic characteristics...

  9. Efficiency of the confocal method of laser endomicroscopy in complex diagnoses of diseases of common bile duct

    International Nuclear Information System (INIS)

    Anaskin, S G; Korniletsky, I D; Panchenkov, D N; Chertyuk, V B; Sazonov, D V; Zabozlayev, F G; Danilevskaya, O V; Mokshina, N V

    2017-01-01

    One of the more frequent manifestations of diseases of the bile ducts are its’ strictures or stenoses that could be of either malignant or benign nature. Current methods of diagnosing this pathology include computer tomography (CT) scan, magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). However, these methods are not always informative, which makes this a current and topical problem. A fundamentally new method that broadens the capabilities of ERCP when diagnosing diseases of the bile duct accompanied by the development of strictures or stenoses is probe-based confocal laser endomicroscopy (pCLE). The method is based on the principle of confocal fluorescence microscopy. The most elaborate complications arise with the presence of the pre-existing pancreatobiliary pathology: pseudotumoral chronic pancreatitis, acute cholangitis, etc. Early stage cholangiocarcinoma diagnosis can be difficult (and not always possible) even with the help of modern research methods. For the timely diagnostic it is advantageous to conduct pCLE and targeted biopsy of the zone with most manifested changes. In all instances, the first use of the pCLE method for diagnostic purposes allowed us to clarify and correctly verify the diagnosis. When concerning the diseases of the bile duct, the modern stage of pCLE development can be of critical importance when other methods are not effective. (paper)

  10. Comparative Analysis Of Dempster Shafer Method With Certainty Factor Method For Diagnose Stroke Diseases

    Directory of Open Access Journals (Sweden)

    Erwin Kuit Panggabean

    2018-02-01

    Full Text Available The development of artificial intelligence technology that has occurred has allowed expert systems to be applied in detecting disease using programming languages. One in terms of providing information about a variety of disease problems that have recently been feared by Indonesian society, namely stroke. Expert system method used is dempster shafer and certainty factor method is used to analyze the comparison of both methods in stroke.Based on the analysis result, it is found that certainty factor is better than demster shafer and more accurate in handling the knowledge representation of stoke disease according to the symptoms of disease obtained from one hospital in medan city, uniqueness of algorithm that exist in both methods.

  11. Diagnosing coronary artery disease after a positive coronary computed tomography angiography

    DEFF Research Database (Denmark)

    Nissen, L; Winther, S; Westra, J

    2018-01-01

    Aims: Perfusion scans after coronary computed tomography angiography (CCTA) in patients with suspected coronary artery disease (CAD) may reduce unnecessary invasive coronary angiographies (ICAs). However, the diagnostic accuracy of perfusion scans after primary CCTA is unknown. The aim...

  12. Gaucher disease diagnosed after bone marrow trephine biopsy — a report of two cases

    Directory of Open Access Journals (Sweden)

    Anna Dmoszyńska

    2011-07-01

    Full Text Available The hematologist is at the forefront of specialists to whom patients with Gaucher disease present because of cytopenia and hepatosplenomegaly. Usually, patients with such symptoms have undergone trephine biopsy. We present the cases of two patients in whom Gaucher disease was suspected because of the discovery of Gaucher cells in trephine biopsy, and subsequently confirmed via enzymatic and molecular investigations. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 2, pp. 352–356

  13. Hodgkin's disease: internal mammary lymph nodes relapse diagnosed by Gallium-67 scintigraphy

    International Nuclear Information System (INIS)

    Ruiz Hernandez, G.; Ampudia, J.; Castillo, F.J.; Romero, C.; Pallardo, Y.; Garcia Conde, J.; Ramos, D.

    1999-01-01

    This article presents the case of a 62-year-old man with treated Hodgkin's disease who had internal mammary lymph nodes relapse after a complete initial response. These masses were gallium avid. These findings were explained by histologically documented Hodgkin's relapse, the first such case reported in that localization without chest wall involvement. The literature on mediastinal Hodgkin's disease and diagnostic procedures are reviewed. (orig.) [de

  14. Subretinal Fluid Drainage and Vitrectomy Are Helpful in Diagnosing and Treating Eyes with Advanced Coats' Disease

    Directory of Open Access Journals (Sweden)

    Ayako Imaizumi

    2016-04-01

    Full Text Available Severe forms of Coats’ disease are often associated with total retinal detachment, and a differential diagnosis from retinoblastoma is critically important. In such eyes, laser- and/or cryoablation is often ineffective or sometimes impossible to perform. We report a case of advanced Coats’ disease in which a rapid pathological examination of subretinal fluid was effective for the diagnosis, and external subretinal drainage combined with vitrectomy was effective in preserving the eye.

  15. Bayesian probability analysis: a prospective demonstration of its clinical utility in diagnosing coronary disease

    International Nuclear Information System (INIS)

    Detrano, R.; Yiannikas, J.; Salcedo, E.E.; Rincon, G.; Go, R.T.; Williams, G.; Leatherman, J.

    1984-01-01

    One hundred fifty-four patients referred for coronary arteriography were prospectively studied with stress electrocardiography, stress thallium scintigraphy, cine fluoroscopy (for coronary calcifications), and coronary angiography. Pretest probabilities of coronary disease were determined based on age, sex, and type of chest pain. These and pooled literature values for the conditional probabilities of test results based on disease state were used in Bayes theorem to calculate posttest probabilities of disease. The results of the three noninvasive tests were compared for statistical independence, a necessary condition for their simultaneous use in Bayes theorem. The test results were found to demonstrate pairwise independence in patients with and those without disease. Some dependencies that were observed between the test results and the clinical variables of age and sex were not sufficient to invalidate application of the theorem. Sixty-eight of the study patients had at least one major coronary artery obstruction of greater than 50%. When these patients were divided into low-, intermediate-, and high-probability subgroups according to their pretest probabilities, noninvasive test results analyzed by Bayesian probability analysis appropriately advanced 17 of them by at least one probability subgroup while only seven were moved backward. Of the 76 patients without disease, 34 were appropriately moved into a lower probability subgroup while 10 were incorrectly moved up. We conclude that posttest probabilities calculated from Bayes theorem more accurately classified patients with and without disease than did pretest probabilities, thus demonstrating the utility of the theorem in this application

  16. Prognostic factors for weight loss over 1-year period in patients recently diagnosed with mild Alzheimer Disease

    DEFF Research Database (Denmark)

    Hansen, Marie-Louise H; Waldorff, Frans B; Waldemar, Gunhild

    2011-01-01

    The aim of the study was to identify prognostic factors for weight loss in patients recently diagnosed with mild Alzheimer disease (AD), with special emphasis on the patients' social participation and living arrangements. The data used in this study was part of the Danish Alzheimer Intervention......%. Furthermore, the results suggested a trend that for men, living alone was a risk factor for losing weight, whereas for women living with somebody was associated with a higher risk. However, further studies are pertinent within this area. As weight loss is a predictor of mortality in patients with AD...

  17. Newly Diagnosed Meniere's Disease: Clinical Course With Initiation of Noninvasive Treatment Including an Accounting of Vestibular Migraine.

    Science.gov (United States)

    Sbeih, Firas; Christov, Florian; Gluth, Michael B

    2018-05-01

    To describe the course of Meniere's disease with noninvasive treatment during the first few years after initial diagnosis. A retrospective review of consecutive patients with newly diagnosed definite Meniere's disease between 2013 and 2016 and a minimum follow-up of 1 year. Patients received a written plan for low sodium, water therapy, and treatment with a diuretic and/or betahistine. Subjects were screened and treated for vestibular migraine as needed. Vertigo control and hearing status at most recent follow-up were assessed. Forty-four subjects had an average follow up of 24.3 months. Thirty-four percent had Meniere's disease and vestibular migraine, and 84% had unilateral Meniere's disease. Seventy-five percent had vertigo well controlled at most recent follow-up, with only noninvasive treatments. Age, gender, body mass index, presence of vestibular migraine, bilateral disease, and duration of follow-up did not predict noninvasive treatment failure. Worse hearing threshold at 250 Hz and lower pure tone average (PTA) at the time of diagnosis did predict failure. Fifty-two percent of ears had improved PTA at most recent visit, 20% had no change, and 28% were worse Conclusions: Encountering excellent vertigo control and stable hearing after a new diagnosis of Meniere's disease is possible with noninvasive treatments. Worse hearing status at diagnosis predicted treatment failure.

  18. IgG4-related disease with cavernous sinus and intra-orbital lesions diagnosed by nasal mucosa biopsy.

    Science.gov (United States)

    Nakata, Ruka; Yoshimura, Shunsuke; Motomura, Masakatsu; Tsujino, Akira; Hayashi, Tomayoshi; Hara, Minoru

    2016-09-29

    IgG4-related disease is a systemic disease characterized by lesions with IgG4 positive plasma cell infiltration in the involved organs and a raised serum IgG4 level. We report a patient of 70-year-old male presented orbital inflammation of IgG4-related disease. The patient developed right eye pain, double vision, and reduced eye sight. MRI image revealed mild right ocular proptosis and swelling of right carvenous sinus, bilateral intraorbital extraocular muscles and right optic nerve. Right optic nerve showed ring-like enhancement. IgG4-related disease was suspected with increased serum IgG4 level of 355 mg/dl, mediastinal lymphadenopathy and prostate enlargement. Transbronchial lung biopsy and prostate needle biopsy were administered with negative results. The eye related symptoms resolved with time, but serum IgG4 continuously increased. IgG4-related disease was diagnosed by nasal mucosa biopsy, which showed IgG4 positive plasma cells within the inflammatory infiltrate. This report emphasizes the usefulness of nasal mucosa biopsy for the diagnosis of IgG4 related disease with lesions difficult to approach.

  19. Longer-term effects of ADAS use on speed and headway control in drivers diagnosed with Parkinson's disease.

    Science.gov (United States)

    Dotzauer, Mandy; Caljouw, Simone R; De Waard, Dick; Brouwer, Wiebo H

    2015-01-01

    An advanced driver assistance system (ADAS) provided information about speed limits, speed, speeding, and following distance. Information was presented to the participants by means of a head-up display. Effects of the information on speed and headway control were studied in a longer-term driving simulator study including 12 repeated measures spread out over 4 weeks. Nine healthy older drivers between the ages of 65 and 82 years and 9 drivers between the ages of 68 and 82 years diagnosed with Parkinson's disease (PD) participated in the study. Within the 4 weeks, groups completed 12 consecutive sessions (10 with ADAS and 2 without ADAS) in a driving simulator. Results indicate an effect of ADAS use on performance. Removing ADAS after short-term exposure led to deterioration of performance in all speed measures in the group of drivers diagnosed with PD. These results suggest that provision of traffic information was utilized by drivers diagnosed with PD in order to control their speed.

  20. Prevalence and predictors of chronic kidney disease in newly diagnosed human immunodeficiency virus patients in Owerri, Nigeria

    Directory of Open Access Journals (Sweden)

    E N Anyabolu

    2016-01-01

    Full Text Available Human immunodeficiency virus (HIV infection is a common cause of chronic kidney disease (CKD in Sub-Saharan Africa. This study aims at identifying the prevalence and predictors of CKD in newly diagnosed HIV patients in Owerri, South East Nigeria. This was a cross-sectional study consisting of 393 newly diagnosed HIV-seropositive subjects and 136 age- and sex-matched seronegative subjects as controls. CKD was defined as 24-hour urine protein (24-HUP ≥0.3 g and/or glomerular filtration rate (GFR < 60 ml/min. Subjects were recruited from the HIV clinic and the Medical Outpatient Department of Federal Medical Centre, Owerri. Clinical and anthropometric data were collected. Relevant investigations were performed, including HIV screening and relevant urine and blood investigations. The mean age of the HIV subjects was 38.84 ± 10.65 years. CKD was present in 86 (22.9% HIV subjects and 11 (8.l % controls. Low waist circumference (WC, high serum creatinine, high spot urine protein/creatinine ratio (SUPCR, high 24-HUP/creatinine Ratio (24-HUPCR, high 24-HUP/osmolality Ratio (24-HUPOR predicted CKD in HIV subjects. CKD prevalence is high (22.9% among newly diagnosed HIV patients in South East Nigeria. The predictors of CKD included WC, serum creatinine, SUPCR, 24-HUPCR, and 24-HUPOR.

  1. Diagnosing physical activity in 4D : Spatial-temporal physical activity behavior of Dutch adults aged 45-65 years

    NARCIS (Netherlands)

    Jansen, F.M.|info:eu-repo/dai/nl/370530071

    2017-01-01

    Insufficient physical activity (PA) is a major public health problem as it is one of the leading risk factors for death and it increases the risk of various non-communicable diseases. Therefore, the societal burden of physical inactivity due to morbidity, mortality, and the associated health care

  2. Living with idiopathic basal ganglia calcification 3: a qualitative study describing the lives and illness of people diagnosed with a rare neurological disease.

    Science.gov (United States)

    Takeuchi, Tomiko; Muraoka, Koko; Yamada, Megumi; Nishio, Yuri; Hozumi, Isao

    2016-01-01

    Idiopathic basal ganglia calcification (IBGC) is a rare, intractable disease with unknown etiology. IBGC3 is a familial genetic disease defined by genetic mutations in the major causative gene ( SLC20A2 ). People with IBGC3 experience distress from the uncommon nature of their illness and uncertainty about treatment and prognoses. The present study aimed to describe the lives and illness of people with IBGC3. Participants were recruited from patients aged 20 years or older enrolled in a genetic study, who were diagnosed with IBGC3 and wanted to share their experiences. In-depth semi-structured interviews were conducted with six participants. Interviews were conducted between December 2012 and February 2014, and were recorded and transcribed verbatim. Qualitative data analysis was performed to identify categories and subcategories. Efforts were made to ensure the credibility, transferability, dependability, conformability, and validity of the data. Six thematic categories, 17 subcategories, and 143 codes emerged. The six categories were: (1) Frustration and anxiety with progression of symptoms without a diagnosis; (2) Confusion about diagnosis with an unfamiliar disease; (3) Emotional distress caused by a genetic disease; (4) Passive attitude toward life, being extra careful; (5) Taking charge of life, becoming active and engaged; and (6) Requests for healthcare. The qualitative data analysis indicated a need for genetic counseling, access to disease information, establishment of peer and family support systems, mental health services, and improvement in early intervention and treatment for the disease.

  3. Genetics of Autosomal Recessive Polycystic Kidney Disease and Its Differential Diagnoses

    Directory of Open Access Journals (Sweden)

    Carsten Bergmann

    2018-02-01

    Full Text Available Autosomal recessive polycystic kidney disease (ARPKD is a hepatorenal fibrocystic disorder that is characterized by enlarged kidneys with progressive loss of renal function and biliary duct dilatation and congenital hepatic fibrosis that leads to portal hypertension in some patients. Mutations in the PKHD1 gene are the primary cause of ARPKD; however, the disease is genetically not as homogeneous as long thought and mutations in several other cystogenes can phenocopy ARPKD. The family history usually is negative, both for recessive, but also often for dominant disease genes due to de novo arisen mutations or recessive inheritance of variants in genes that usually follow dominant patterns such as the main ADPKD genes PKD1 and PKD2. Considerable progress has been made in the understanding of polycystic kidney disease (PKD. A reduced dosage of disease proteins leads to the disruption of signaling pathways underlying key mechanisms involved in cellular homeostasis, which may help to explain the accelerated and severe clinical progression of disease course in some PKD patients. A comprehensive knowledge of disease-causing genes is essential for counseling and to avoid genetic misdiagnosis, which is particularly important in the prenatal setting (e.g., preimplantation genetic diagnosis/PGD. For ARPKD, there is a strong demand for early and reliable prenatal diagnosis, which is only feasible by molecular genetic analysis. A clear genetic diagnosis is helpful for many families and improves the clinical management of patients. Unnecessary and invasive measures can be avoided and renal and extrarenal comorbidities early be detected in the clinical course. The increasing number of genes that have to be considered benefit from the advances of next-generation sequencing (NGS which allows simultaneous analysis of a large group of genes in a single test at relatively low cost and has become the mainstay for genetic diagnosis. The broad phenotypic and genetic

  4. Prevalence of chronic obstructive pulmonary disease (COPD) not diagnosed in a population with cardiovascular risk factors.

    Science.gov (United States)

    Montserrat-Capdevila, Josep; Seminario, María Asunción; Godoy, Pere; Marsal, Josep Ramon; Ortega, Marta; Pujol, Jesús; Castañ, Maria Teresa; Alsedà, Miquel; Betriu, Àngels; Lecube, Albert; Portero, Manel; Purroy, Francisco; Valdivielso, José Manuel; Barbé, Ferran

    2018-03-07

    The magnitude of undiagnosed COPD in our population with cardiovascular risk factors (CVRF) is unknown. The objective of this study was to estimate the prevalence of undiagnosed COPD and its specific characteristics in a population with CVRF. Study the prevalence of COPD in patients with CVRF. Spirometry was performed between 01/01/2015 and 12/31/2016 and the percentage of patients with COPD, who had not previously been diagnosed, was determined. Each patient's variables of interest were recorded; the records of patients who had spirometry showing COPD were checked to confirm whether a diagnosis had been recorded or not. The association of undiagnosed COPD with different independent variables was determined with adjusted odds ratio (aOR) by non conditional logistic regression models. 2,295 patients with CVRF were studied. The overall prevalence of COPD was 14.5%. An underdiagnosis of 73.3% was observed. Newly diagnosed COPD vs. undiagnosed COPD showed to be higher in women (74.1% vs. 36.0%; P=.081), non-smokers (21.3% vs. 12.4%; P=.577), mild cases (GOLD1) (42.6% vs. 32.4%, P=.008) and cases with lower than average HbA1c (5.5% vs. 5.6%; P=.008) and uric acid (5.1mg/dL vs. 5.6mg/dL; P=.011). The variables associated with undiagnosed COPD were: women (aOR=1.27; 95%CI: 0.74-2.17; P=.383); age (aOR=0.94; 95%CI: 0.87-0.99; P=.018); smokers (smoker/non-smoker) (aOR=0.47; 95%CI: 0.22-1.01; P=.054) and HbA1c (%) (aOR=0.45; 95%CI: 0.23-0.88; P=.019). The under-diagnosis of COPD is very high. The contact patients aged between 50 and 65 years-old who have CVRF with their health system should be reassessed, and they need to ask for a spirometry. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  5. Cardiac Complications in 38 Cases of Kawasaki Disease with Coronary Artery Aneurysm Diagnosed by Echocardiography.

    Science.gov (United States)

    Wei, Ya Juan; Zhao, Xiao Lan; Liu, Bao Min; Niu, Hua; Li, Qian

    2016-05-01

    The long-term prognosis of patients with Kawasaki disease (KD) complicated by coronary artery aneurysm (CAA) is unclear. The aim of this study was to evaluate the complications of KD with CAAs. We retrospectively analyzed the clinical data and complications of 38 KD patients with CAAs who were treated and underwent regular follow-up with echocardiography between January 1989 and May 2013. During a period of 29 days to 19 years after disease onset, complications seen included coronary stenosis and occlusion (six patients), thrombosis (17 patients), myocardial infarction (six patients), and calcification of CAAs (seven patients). Rupture of giant CAAs occurred in two patients and caused sudden death in one of these patients at 29 days and in the other patient at 5 months after disease onset. A total of seven deaths occurred, with five deaths caused by myocardial infarction. Three of these had undiagnosed incomplete KD or had not received regular treatment, while two experienced sudden death after several asymptomatic myocardial infarctions. Cardiac complications of KD with CAAs include thrombosis, coronary stenosis, myocardial infarction, sudden death, and calcification. Although rare, rupture of giant CAAs is fatal and might occur earlier after the onset of disease. Mortality occurred primarily in the earlier cases when anticoagulant therapy was insufficient and in patients who did not receive regular treatment. Echocardiography can provide reliable information for assessing the progression and prognosis of this condition. © 2015, Wiley Periodicals, Inc.

  6. Taking the Lab into the Field. Nuclear Applications Rapidly Diagnose Animal Disease

    International Nuclear Information System (INIS)

    Potterton, Louise

    2012-01-01

    Livestock supports the livelihoods and food security of almost a billion people worldwide. As populations increase, countries not only need to increase livestock production, but also need more efficient tools for the prevention, diagnosis and control of animal diseases. Nuclear and nuclear-related technologies have an essential role to play in maintaining animal health and protecting vulnerable communities.

  7. Rare and unusual ... or are they? Less commonly diagnosed encephalopathies associated with systemic disease.

    Science.gov (United States)

    Weathers, Allison L; Lewis, Steven L

    2009-04-01

    Encephalopathy due to hepatic or renal failure, electrolyte disturbances, or the administration of benzodiazepines and narcotics is commonly encountered, well reviewed in the literature, and, therefore, not usually missed. This article focuses on encephalopathies that were previously well described but may be overlooked by modern clinicians, as well as those that are still taught in the classroom but seldom thought of in practice. Due to the presumed relative rarity of these cases and emphasis on the well-memorized "classic" clinical presentations, these often treatable, and perhaps not so rare, encephalopathies due to systemic medical illness may go undiagnosed and untreated. Pancreatic encephalopathy, Wernicke's encephalopathy, and pellagra encephalopathy are reviewed in detail; cefepime and ifosfamide encephalopathies are discussed as examples of specific medication-induced encephalopathies. Septic encephalopathy, central pontine myelinolysis, and fat embolism syndrome are briefly reviewed. The encephalopathies reviewed have the potential for devastating neurological consequences if recognition and, therefore, treatment are delayed. Clinical improvement for many of these syndromes depends on prompt intervention. This article highlights some representative examples of less-commonly diagnosed metabolic and toxic encephalopathies.

  8. Left ventricular functions in children with newly diagnosed Graves' disease. A single-center study from Upper Egypt.

    Science.gov (United States)

    Metwalley, Kotb Abbass; Farghaly, Hekma Saad; Abdelhamid, Abdelrahman

    2018-01-01

    This study aimed to evaluate the left ventricular (LV) functions in a cohort of children with Graves' disease (GD). This is a cross-sectional case-control study. It included 36 children with GD and 36 healthy children matched for age and gender. Thyroid hormones (TSH, FT4, and FT3) and anti-thyroid autoantibodies [anti-thyroid peroxidase (anti-TPO), thyrotropin receptor (TRAbs), and thyroglobulin antibodies] were measured. Conventional and tissue Doppler imaging (TDI) echocardiographies were used to assess left ventricular systolic and diastolic functions. LV mass index (LVMI) and myocardial performance index (MPI) were also measured. Compared to healthy children, conventional echocardiography of patients with GD revealed higher LVMI (P = 0.001) indicating LV hypertrophy but normal LV functions while TDI revealed lower Em/Am ratio indicating LV diastolic dysfunction (P = 0.001). Significant correlations were reported between FT4 with LVMI (P = 0.05), Em/Am (P = 0.01), and MPI (P = 0.01). In multivariate analysis, a positive correlation was identified between FT4 with MPI (OR = 1.17; 95% CI = 1.09-1.15; P = 0.001). Children with newly diagnosed GD may have significant subclinical changes in LV structure and function (diastolic and global). TDI is more sensitive than conventional Doppler in detecting LV dysfunction. These findings highlight the importance of early monitoring of children with GD for left ventricular mass index and diastolic function. What is Known: • There is an increased risk for cardiac abnormalities in children with Graves' disease (GD). • Limited studies assessed left ventricular function in patients with GD. What is New: • Children with newly diagnosed GD may have significant subclinical changes in left ventricular structure and functions. • Children with newly diagnosed GD should be monitored for left ventricular mass index and diastolic function.

  9. Identification of laboratory markers of disease activity in rheumatoid arthritis abstract objective

    International Nuclear Information System (INIS)

    Naqi, N.; Ahmed, T.A.; Malik, J.M.

    2012-01-01

    To identify the laboratory markers of disease activity, by finding relationship of biochemical markers with clinical disease activity measurement in patients suffering from rheumatoid arthritis (RA). Study Design: Cross sectional analytical study. Place and duration of study: Department of Immunology, Armed Forces Institute of Pathology (AFIP), Rawalpindi from January 2009 to January 2010 in collaboration with Fauji Foundation Hospital and Military Hospital Rawalpindi. Patients and Methods: One hundred patients diagnosed as having rheumatoid arthritis (RA) as per American college of Rheumatology (ACR) revised criteria 1987 and fulfilling the study's inclusion criteria were studied. These patients were assessed clinically according to Simplified Disease Activity Index (SDAI) and divided into three groups which were mild, moderate and severe based on disease activity. These three groups were then assessed for disease activity by Rheumatoid factor (RA factor), Anti Cyclic Citrullinated Peptide antibodies (anti CCP antibodies), Erythrocyte Sedimentation Rate (ESR) and C- Reactive Proteins (CRP). The association of these laboratory markers with three groups of disease activity was analyzed to detect most sensitive disease activity markers for RA. Results: All the assessed laboratory markers that are RA factor, anti CCP antibodies, ESR and CRP are directly related with RA disease activity and any of them can be used to assess disease activity in RA. However a combination of the tests, analyzed in this study markers maybe used for better prediction of disease activity Conclusion: The identification of the laboratory markers of disease activity may help physician to diagnose aggressive disease early and evaluate prognosis in RA patients. (author)

  10. Artificial intelligence techniques applied to the development of a decision-support system for diagnosing celiac disease.

    Science.gov (United States)

    Tenório, Josceli Maria; Hummel, Anderson Diniz; Cohrs, Frederico Molina; Sdepanian, Vera Lucia; Pisa, Ivan Torres; de Fátima Marin, Heimar

    2011-11-01

    Celiac disease (CD) is a difficult-to-diagnose condition because of its multiple clinical presentations and symptoms shared with other diseases. Gold-standard diagnostic confirmation of suspected CD is achieved by biopsying the small intestine. To develop a clinical decision-support system (CDSS) integrated with an automated classifier to recognize CD cases, by selecting from experimental models developed using intelligence artificial techniques. A web-based system was designed for constructing a retrospective database that included 178 clinical cases for training. Tests were run on 270 automated classifiers available in Weka 3.6.1 using five artificial intelligence techniques, namely decision trees, Bayesian inference, k-nearest neighbor algorithm, support vector machines and artificial neural networks. The parameters evaluated were accuracy, sensitivity, specificity and area under the ROC curve (AUC). AUC was used as a criterion for selecting the CDSS algorithm. A testing database was constructed including 38 clinical CD cases for CDSS evaluation. The diagnoses suggested by CDSS were compared with those made by physicians during patient consultations. The most accurate method during the training phase was the averaged one-dependence estimator (AODE) algorithm (a Bayesian classifier), which showed accuracy 80.0%, sensitivity 0.78, specificity 0.80 and AUC 0.84. This classifier was integrated into the web-based decision-support system. The gold-standard validation of CDSS achieved accuracy of 84.2% and k=0.68 (pdiagnosis. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Gulhane Military Medical Academy Training Hospital, the applicant Determination of Healthy Lifestyle Behaviors in Individuals Diagnosed Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Nilgun Kuru

    2012-06-01

    Full Text Available AIM: The aim of the study, Coronary Artery Disease (CAD diagnosed with identification of individuals in specific behaviors to improve health, health status and related factors to determine the levels of detection. METHODS: This descriptive study of data types of the Gulhane Military Medical Academy (GATA Hospital cardiology clinic in December 2009 - February 2010 were collected. The study group, at least 6 months before the diagnosis of CAD area, between the ages of 20-65 individuals who accept and participate in the study (n = 300 formed. Sociodemographic characteristics and health behaviors of the personal information form for the 33-item, 52-item scale of a healthy lifestyle behaviors and health status of the single-item scale working group of the detection technique applied to the face-to-face interview. The aim of the study, Coronary Artery Disease (CAD for the development of health behaviors in the case of individuals diagnosed with the identification, health status and related factors to determine the levels of detection. The statistical analysis techniques such as Mann Whitney U and Kruskal-Wallis were used for the comparison. RESULTS: Of the group 57,7% were males, 46,3% were 50-59 years of age and 56,3% were higher education graduates. As regard to total Health Promotion Life-Style Profile Scale scores statistically significant differences had been found between age, gender, education, disease period, occupation and chronic condition groups. As regard to the average PHSS scores statistically significant differences had been found between age, education, body mass index, disease period, occupation, chronic condition and CAD related course groups (p<0.05. CONCLUSION: Healthy lifestyle behaviors before planning training programs, individual models of health behavior and the behavior of individuals using the analyzed factors affecting.. [TAF Prev Med Bull 2012; 11(3.000: 287-298

  12. Differential Diagnoses of Overgrowth Syndromes: The Most Important Clinical and Radiological Disease Manifestations

    International Nuclear Information System (INIS)

    Lacerda, L.S.; Alves, U.D.; Zanier, J.F.C.; Machado, D.C.; Camilo, G.B.; Machado, D.C.; Camilo, G.B.; Lopes, A.J.

    2014-01-01

    Overgrowth syndromes comprise a heterogeneous group of diseases that are characterized by excessive tissue development. Some of these syndromes may be associated with dysfunction in the receptor tyrosine kinase (RTK)/PI3K/AKT pathway, which results in an increased expression of the insulin receptor. In the current review, four overgrowth syndromes were characterized (Proteus syndrome, Klippel-Trenaunay-Weber syndrome, Made lung’s disease, and neurofibromatosis type I) and illustrated using cases from our institution. Because these syndromes have overlapping clinical manifestations and have no established genetic tests for their diagnosis, radiological methods are important contributors to the diagnosis of many of these syndromes. The correlation of genetic discoveries and molecular pathways that may contribute to the phenotypic expression is also of interest, as this may lead to potential therapeutic interventions

  13. New technologies to diagnose and monitor infectious diseases of livestock: Challenges for sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Donald P. King

    2012-06-01

    Effective control of infectious diseases is reliant upon accurate diagnosis of clinical cases using laboratory tests, together with an understanding of factors that impact upon the epidemiology of the infectious agent. A wide range of new diagnostic tools and nucleotide sequencing methods are used by international reference laboratories to detect and characterise the agents causing outbreaks of infectious diseases. In the past, high costs (initial capital expenses, as well as day-to-day maintenance and running costs and complexity of the protocols used to perform some of these tests have limited the use of these methods in smaller laboratories. However, simpler and more cost-effective formats are now being developed that offer the prospect that these technologies will be even more widely deployed into laboratories particularly those in developing regions of the world such as sub-Saharan Africa.

  14. Hodgkin`s disease: internal mammary lymph nodes relapse diagnosed by Gallium-67 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Hernandez, G.; Ampudia, J.; Castillo, F.J.; Romero, C. [Hospital Clinico Univ., Valencia (Spain). Servicio de Medicina Nuclear; Pallardo, Y. [Hospital Clinico Univ., Valencia (Spain). Servicio de Radiologia; Garcia Conde, J. [Hospital Clinico Univ., Valencia (Spain). Servicio de Hematologia y Oncologia Medica; Ramos, D. [Hospital Clinico Univ., Valencia (Spain). Servicio de Anatomia Patologica

    1999-04-01

    This article presents the case of a 62-year-old man with treated Hodgkin`s disease who had internal mammary lymph nodes relapse after a complete initial response. These masses were gallium avid. These findings were explained by histologically documented Hodgkin`s relapse, the first such case reported in that localization without chest wall involvement. The literature on mediastinal Hodgkin`s disease and diagnostic procedures are reviewed. (orig.) [Deutsch] Beschrieben wird der Fall eines 62jaehrigen Mannes, der nach initial erfolgreicher Therapie eines Morbus Hodgkin ein Lymphknotenrezidiv im Bereich der Brust aufweist. Die Lymphknoten reicherten Gallium an. Histologisch wurde das Hodgkinrezidiv gesichert. Es handelt sich um den ersten in diesem Bereich beschriebenen Fall ohne Infiltration der Brustwand. Die Literatur ueber mediastinalen Morbus Hodgkin und diagnostisches Vorgehen wurde ueberprueft. (orig.)

  15. Diagnosing skin disease in primary care: a qualitative study of GPs' approaches.

    Science.gov (United States)

    Rübsam, Marie-Luise; Esch, Maximilian; Baum, Erika; Bösner, Stefan

    2015-10-01

    Skin diseases are a common reason for consulting a GP. This regular occurrence happens despite most GPs' lack of knowledge and training in skin disease. We aimed to explore different diagnostic approaches of GPs in patients presenting with a dermatological problem. In addition, we aimed to identify strategies used by GPs to handle diagnostic uncertainty in these patients. We conducted interviews (20-40 minutes) with 14 GPs using a semi-structured guideline. Recalling encounters with patients with skin disease, GPs described their individual diagnostic strategies. Interviews were taped and transcribed verbatim. Qualitative analysis was conducted by two independent raters using a deductive-inductive approach. We identified several aspects of a complex decision-making process in GPs' diagnostic management of patients with dermatological problems. In the general diagnostic workup, GPs used a broad spectrum of different strategies such as spot diagnosis, stepwise refinement, pattern recognition trigger or test of treatment. GPs reduced diagnostic uncertainty through the identification of red flags, the application of the test of time, therapeutic trials and asking for further advice, including patient referral. GPs encounter a broad range of dermatological problems in their daily work using a variety of strategies in the workup of these patients. However, in a significant number of patients, there remains diagnostic uncertainty that is mainly reduced by specialist referral. Regular training in the diagnosis and treatment of common dermatological diseases should be offered to all GPs. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Neuropsychiatric and cardiometabolic comorbidities in patients with previously diagnosed Cushing's disease: a longitudinal observational study

    OpenAIRE

    Dimopoulou, C; Geraedts, V; Stalla, G K; Sievers, C

    2015-01-01

    INTRODUCTION: Only few studies have systematically investigated neuropsychiatric aspects in patients with Cushing's disease (CD). Pain syndromes have been described in patients with pituitary adenomas, but so far no systematical investigation has been conducted in patients with CD. Additionally, CD has an association with cardiometabolic comorbidities which ultimately leads to increased morbidity and mortality. Long-term treatment of the hypercortisolic state cannot prevent the persistence of...

  17. Relationships between diagnoses of sexually transmitted infections and urinary tract infections among male service members diagnosed with urethritis, active component, U.S. Armed Forces, 2000-2013.

    Science.gov (United States)

    2014-07-01

    A previous MSMR report found that 42.8% of all incident (first-time) urinary tract infections (UTIs) in males, but only 0.4% of such UTIs in females, were diagnosed as "urethritis, unspecified" (ICD-9: 597.80). This study explored the possibility that many of the diagnoses of urethritis in males represented sexually transmitted infections (STIs), even though ICD-9: 597.80 is explicitly reserved for cases of urethritis that are deemed to not be sexually transmitted. Examined were relationships between diagnoses of urethritis, diagnoses of STIs, and recurrent diagnoses of UTIs. Male service members who received a diagnosis of "urethritis, unspecified" (ICD-9: 597.80) had an increased risk of a subsequent UTI diagnosis, especially of "urethritis, unspecified," compared to all male service members. Most service members who were diagnosed with "urethritis, unspecified" had no documented diagnoses of an STI in their Military Health System health records; however, recurrent UTIs were more common among service members who did have documented STIs. The most commonly diagnosed STIs in this study were "other non-gonococcal urethritis" (which includes that caused by Chlamydia trachomatis) and gonorrhea.

  18. Cardiovascular Disease and Cancer: Student Awareness Activities.

    Science.gov (United States)

    Meyer, James H., Comp.

    Awareness activities pertaining to cancer and cardiovascular disease are presented as a supplement for high school science classes. The exercises can be used to enrich units of study dealing with the circulatory system, the cell, or human diseases. Eight activities deal with the following topics: (1) cardiovascular disease risk factors; (2)…

  19. Obstructive sleep apnea, diagnosed by the Berlin questionnaire and association with coronary artery disease severity

    Directory of Open Access Journals (Sweden)

    Abdullatef Ghazal

    2015-09-01

    Full Text Available BACKGROUND: Obstructive sleep apnea syndrome (OSAS is a highly prevalent sleep-related disorder that is associated with increased risk of hypertension (HTN and coronary heart disease. This study aimed to evaluate the correlation between the OSAS and coronary artery disease (CAD severity. METHODS: The cross-sectional study was conducted from September 2012 to December 2013. We enrolled 127 patients with chronic stable angina who were referred for coronary angiographic studies in Shahid Chamran and Nour Hospitals in Isfahan, Iran. The Berlin questionnaire (BQ was used for estimate the probability of OSAS in patients as a low or high probability. Demographic characteristics and metabolic risk factors including diabetes mellitus, HTN, obesity, and smoking also were recorded. The severity of CAD was assessed and compared based on the Gensini score with Mann–Whitney U statistical test. Independent t-test for continuous variables and chi-square test for categorical variables were used. RESULTS: Totally, 65.4% of subjects were considered as high and 34.6% as low probability for OSAS, which 81.1% of them had CAD. There was a significant difference between body mass index, systolic blood pressure, diastolic blood pressure, and ischemic heart disease drug consumption with OSAS probability (P < 0.0500. CAD was accompanied by OSAS significantly (P = 0.0260. The Gensini score was significantly higher in patients with high OSAS probability (100.4 ± 69.1 vs. 65.3 ± 68.9; P = 0.0030. OSAS also increase odds of CAD based on regression analysis (odds ratio, 95% confidence interval = 2.7. CONCLUSION: This study indicates that more severe CAD is associated with high OSAS probability identified by BQ.   

  20. Artificial intelligence techniques applied to the development of a decision–support system for diagnosing celiac disease

    Science.gov (United States)

    Tenório, Josceli Maria; Hummel, Anderson Diniz; Cohrs, Frederico Molina; Sdepanian, Vera Lucia; Pisa, Ivan Torres; de Fátima Marin, Heimar

    2013-01-01

    Background Celiac disease (CD) is a difficult-to-diagnose condition because of its multiple clinical presentations and symptoms shared with other diseases. Gold-standard diagnostic confirmation of suspected CD is achieved by biopsying the small intestine. Objective To develop a clinical decision–support system (CDSS) integrated with an automated classifier to recognize CD cases, by selecting from experimental models developed using intelligence artificial techniques. Methods A web-based system was designed for constructing a retrospective database that included 178 clinical cases for training. Tests were run on 270 automated classifiers available in Weka 3.6.1 using five artificial intelligence techniques, namely decision trees, Bayesian inference, k-nearest neighbor algorithm, support vector machines and artificial neural networks. The parameters evaluated were accuracy, sensitivity, specificity and area under the ROC curve (AUC). AUC was used as a criterion for selecting the CDSS algorithm. A testing database was constructed including 38 clinical CD cases for CDSS evaluation. The diagnoses suggested by CDSS were compared with those made by physicians during patient consultations. Results The most accurate method during the training phase was the averaged one-dependence estimator (AODE) algorithm (a Bayesian classifier), which showed accuracy 80.0%, sensitivity 0.78, specificity 0.80 and AUC 0.84. This classifier was integrated into the web-based decision–support system. The gold-standard validation of CDSS achieved accuracy of 84.2% and k = 0.68 (p < 0.0001) with good agreement. The same accuracy was achieved in the comparison between the physician’s diagnostic impression and the gold standard k = 0. 64 (p < 0.0001). There was moderate agreement between the physician’s diagnostic impression and CDSS k = 0.46 (p = 0.0008). Conclusions The study results suggest that CDSS could be used to help in diagnosing CD, since the algorithm tested achieved excellent

  1. Prevalence of colorectal neoplasm among patients with newly diagnosed coronary artery disease.

    Science.gov (United States)

    Chan, Annie On On; Jim, Man Hong; Lam, Kwok Fai; Morris, Jeffrey S; Siu, David Chun Wah; Tong, Teresa; Ng, Fook Hong; Wong, Siu Yin; Hui, Wai Mo; Chan, Chi Kuen; Lai, Kam Chuen; Cheung, Ting Kin; Chan, Pierre; Wong, Grace; Yuen, Man Fung; Lau, Yuk Kong; Lee, Stephen; Szeto, Ming Leung; Wong, Benjamin C Y; Lam, Shiu Kum

    2007-09-26

    Colorectal neoplasm and coronary artery disease (CAD) share similar risk factors, and their co-occurrence may be associated. To investigate the prevalence of colorectal neoplasm in patients with CAD in a cross-sectional study and to identify the predisposing factors for the association of the 2 diseases. Patients in Hong Kong, China, were recruited for screening colonoscopy after undergoing coronary angiography for suspected CAD during November 2004 to June 2006. Presence of CAD (n = 206) was defined as at least 50% diameter stenosis in any 1 of the major coronary arteries; otherwise, patients were considered CAD-negative (n = 208). An age- and sex-matched control group was recruited from the general population (n = 207). Patients were excluded for use of aspirin or statins, personal history of colonic disease, or colonoscopy in the past 10 years. The prevalence of colorectal neoplasm in CAD-positive, CAD-negative, and general population participants was determined. Bivariate logistic regression was performed to study the association between colorectal neoplasm and CAD and to identify risk factors for the association of the 2 diseases after adjusting for age and sex. The prevalence of colorectal neoplasm in the CAD-positive, CAD-negative, and general population groups was 34.0%, 18.8%, and 20.8% (P < .001 by chi2 test), prevalence of advanced lesions was 18.4%, 8.7%, and 5.8% (P < .001), and prevalence of cancer was 4.4%, 0.5%, and 1.4% (P = .02), respectively. Fifty percent of the cancers in CAD-positive participants were early stage. After adjusting for age and sex, an association still existed between colorectal neoplasm and presence of CAD (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.25-2.70; P = .002) and between advanced lesions and presence of CAD (OR, 2.51; 95% CI, 1.43-4.35; P = .001). The metabolic syndrome (OR, 5.99; 95% CI, 1.43-27.94; P = .02) and history of smoking (OR, 4.74; 95% CI, 1.38-18.92; P = .02) were independent factors for the

  2. Responsiveness of Endoscopic Indices of Disease Activity for Crohn's Disease

    NARCIS (Netherlands)

    Khanna, Reena; Zou, Guangyong; Stitt, Larry; Feagan, Brian G.; Sandborn, William J.; Rutgeerts, Paul; McDonald, John W. D.; Dubcenco, Elena; Fogel, Ronald; Panaccione, Remo; Jairath, Vipul; Nelson, Sigrid; Shackelton, Lisa M.; Huang, Bidan; Zhou, Qian; Robinson, Anne M.; Levesque, Barrett G.; D'Haens, Geert

    2017-01-01

    The Crohn's Disease Endoscopic Index of Severity (CDEIS) and the Simple Endoscopic Score for Crohn's Disease (SES-CD) are commonly used to assess Crohn's disease (CD) activity; however neither instrument is fully validated. We evaluated the responsiveness to change of the SES-CD and CDEIS using data

  3. "A gift wrapped in barbed wire" positive and negative life changes after being diagnosed with inflammatory bowel disease.

    Science.gov (United States)

    Purc-Stephenson, Rebecca; Bowlby, Desirae; Qaqish, S T

    2015-05-01

    A growing interest in posttraumatic growth among individuals who have experienced a traumatic event has given rise to measures such as the Posttraumatic Growth Inventory (PTGI; Tedeschi and Calhoun, 1996). However, such measures may not fully represent all dimensions of change among individuals diagnosed with a chronic disease and fail to highlight the negative changes that may also occur. This study explores the positive and negative changes patients with inflammatory bowel disease (IBD) have experienced since diagnosis. Three hundred and seventy-eight IBD patients provided answers to the qualitative question "Could you please describe the (positive/negative) effect(s) IBD has had on your life?" A grounded theory approach using NVivo was performed on participants' responses. Nearly 73 % of participants reported their disease positively affected their life in some way, and five themes related to positive changes emerged from the analysis: Interpersonal Relations, Personal Growth, Valuing Life, New Life Paths, and Spiritual Growth. However, almost 80 % of participants also reported their disease negatively affected their lives, with three themes emerging from the analysis: Freedom Restrictions, Psychological Side Effects, and Social Isolation. Our results support previous findings but also reveal that some dimensions related to the positive changes following adversity are not adequately assessed by the PTGI (e.g., appraising existing friendships, openness to try different forms of treatment or therapies, and psychological preparedness). The implications of these findings for future measurement and research of posttraumatic growth with IBD patients are discussed.

  4. Intrahemispheric subdural hematoma complicated with chronic neurologic diseases. Report of two cases diagnosed by CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Sakashita, Yasuo; Kuzuhara, Shigeki; Fuse, Shigeru; Yamanouchi, Hiroshi; Toyokura, Yasuo

    1987-01-01

    Two patients had interhemispheric subdural hematoma (ISH) without clinical signs or symptoms characteristic of ISH. The first patient, a 74-year-old woman with 7 years' history of Parkinson's disease, complained of unresponsiveness and akinesia. The treatment for suspected worsening of the disease failed to improve her conditions. Computed tomography (CT) showed hyperdensity along the falx from the frontal falx over the tentorium. Subsequent CT on the 23rd hospital day showed disappearance of hyperdensity, confirming ISH. The second patient, a 76-year-old woman with multiple cerebral infarction, was referred for loss of consciousness and vomiting. Neurological examination failed to reveal additional or augmented neurological deficits. Computed tomography showed a right parasagittal thin crescent hyperdensity with a flat medial border and a convex lateral border, extending from the anterior falx to the mid-falx. The hyperdensity disappeared on the 47th hospital day. These findings suggest the usefulness of CT as the only procedure when ISH features are not seen. (Namekawa, K.).

  5. Study of Nicorandil stress perfusion MRI in diagnosing ischemic heart disease

    International Nuclear Information System (INIS)

    Tateishi, Toshiki; Iwai, Mitsuhiro; Takeda, Soji; Hayashi, Ryuji

    2006-01-01

    The excellent spatial resolution of myocardial stress perfusion magnetic resonance imaging is effective for the diagnosis of ischemic heart disease. When dipyridamole or adenosine triphosphate is used as a pharmacological stress in cardiac MRI, non-magnetic instruments are required for infusion of these drugs in a MRI room. We attempted to use nicorandil as a pharmacological stressor. Nicorandil exhibited KATP channel opening and nitrate effects, and could be infused without any special instruments. Based on the coronary artery stenosis assessed by coronary angiography, according to the criteria of the American Heart Association (AHA), the sensitivity, specificity and diagnostic accuracy of nicorandil perfusion MRI for the detection of coronary artery stenosis was 85%, 57% and 74.3%, respectively. No major side effects were observed, except for mild hypotension (mean 10 mmHg) after infusion of the drug. It was concluded that myocardial perfusion MRI examination using nicorandil could be performed non-invasively and safely for the evaluation of coronary vessel disease in patients. (author)

  6. Beta-blocker therapy and cardiac events among patients with newly diagnosed coronary heart disease

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Shilane, David; Go, Alan S

    2014-01-01

    BACKGROUND: The effectiveness of beta-blockers for preventing cardiac events has been questioned for patients who have coronary heart disease (CHD) without a prior myocardial infarction (MI). OBJECTIVES: The purpose of this study was to assess the association of beta-blockers with outcomes among...... patients with new-onset CHD. METHODS: We studied consecutive patients discharged after the first CHD event (acute coronary syndrome or coronary revascularization) between 2000 and 2008 in an integrated healthcare delivery system who did not use beta-blockers in the year before entry. We used time......-varying Cox regression models to determine the hazard ratio (HR) associated with beta-blocker treatment and used treatment-by-covariate interaction tests (pint) to determine whether the association differed for patients with or without a recent MI. RESULTS: A total of 26,793 patients were included, 19...

  7. Magnetic resonance tomography and computed tomography of the brain for diagnosing Wilson's disease

    International Nuclear Information System (INIS)

    Uhlenbrock, D.; Straube, A.; Beyer, H.K.; Leopold, H.C.

    1985-01-01

    The authors report on two woman patients with confirmed Wilson's desease (hepatolenticular degeneration) who had neurological deficits and showed typical changes evident from laboratory data. Both computed tomography and magnetic resonance tomography revealed degenerative changes in the basal ganglia, especially of the lenticular nucleus, MR showing these defects more clearly than CT. There was a noticeable symmetrical enhancement of signals in the lenticular nucleus which was particularly evident on the image basing on the T 2 (spin-spin relaxation time constant) values. MR could be superior to CT with regard to showing up pathological changes in the basal ganglia. The future indication of MR could be the establishment of an exact correlation between clinical signs and symptoms on the one hand, and morphological findings on the other. Over and above this, it should be explored to what extent MR can already detect degenerative changes in the brain in primarily hepatic types of the disease even without prior neurological examination. (orig.) [de

  8. Anti-Nuclear antibodies: Current concepts and future direction for diagnosing connective tissue disease

    Directory of Open Access Journals (Sweden)

    K Gautam

    2015-03-01

    Full Text Available Identification of antinuclear antibodies has been used for the diagnosis of connective tissue diseases for more than fifty years. Indirect immunofluorescence on human epithelial (HEp-2 cells is considered the gold standard screening method for the detection of antinuclear autoantibodies. As the demand of ANA testing increased, the need for automation and standardization has also come forth. A high level of false positive and false negative cases is seen in various populations making it difficult to take clinical decisions. Newer technologies were introduced for the antibody detection to ensure high sensitivity and specificity. This article intends to provide an overview of the concepts on ANA testing, the different diagnostic methods available, the various patterns and clinical utility, the clinical guidelines to be followed, the drawbacks and what lies ahead in the future of ANA testing.Journal of Pathology of Nepal (2015 Vol. 5, 766-773

  9. Development of PCR method for diagnosing of honey bee American Foulbrood disease

    Directory of Open Access Journals (Sweden)

    Modirrousta, H.

    2012-06-01

    Full Text Available American foulbrood (AFB disease is caused by the sporeforming bacterium Paenibacillus larvae larvae. Traditional diagnosis is based on culture technique is time and laboratory work consuming. In this study with standard strain, PCR was developed by specific primers and PCR products were electrophoresed on 0.8 % agarose gel. The PCR primers were selected on the basis of the 16S rRNA gene and amplify a 700-bp amplicon. Detection limits were determined for suspensions of bacteria and spores and also honey and larvae experimentally contaminated. The lowest number of bacteria and spores that were able to detect were respectively 28, 33, 330 and 243 cfu /ml. This PCR technique can be used to identification of the presence of Paenibacillus larvae larvae spores in honey samples, brood samples or on the colonies that grow on medium.

  10. Diagnoses of gastric cancer and other gastric diseases by serum pepsinogen I and II levels

    International Nuclear Information System (INIS)

    Xiao Zhijian; Jiang Mengjun

    1998-01-01

    Serum pepsinogens I and II (PGI, PGII) levels were determined by PGI and PGII-RIA kits in 84 healthy controls and 128 patients of gastric diseases including 42 patients with gastric cancer. The results showed peptic ulcer cases had elevated PGI and PGII levels. The atrophic gastritis cases had low PGI levels and the gastric cancer cases had low PGI and low PGI/PGII ratio. Using the cut-off values of PGI<35 μg/L and PGI/PGII<1.5 for clinical purpose, the sensitivity and specificity of the test for gastric cancer was 73% and 78%, respectively. Combined with endoscope examination, the serum PGI and PGII levels are valuable for the early diagnosis of gastric cancer

  11. Pituitary tumor with gigantism, acromegaly and preclinical Cushing's disease diagnosed from the 10th row.

    Science.gov (United States)

    Tourtelot, John B; Vesely, David L

    2013-08-01

    A 7'3" basketball player was noted to have 2 to 3 times thicker tissue in his hands than 6'10" players by an endocrinologist sitting 10 rows above the player in a basketball arena. This led to the diagnosis of pituitary gigantism where the history revealed that he was 7'3" at 15 years of age. At age 19 when the acryl enlargement was noted, a diagnostic workup revealed elevated growth hormones and insulin-like growth factor 1 (IGF-1) with a 2 × 1.3 cm pituitary tumor. His history suggested that his epiphyseal plates had closed at age 15, and because he continued to produce IGF-1, he now has acromegaly. His elevated adrenocorticotropic hormone (ACTH) before surgery suggests that he also had preclinical Cushing's disease. After pituitary transsphenoidal surgery, all acryl enlargement in hands and ligaments disappeared. His growth hormone, IGF-1 and ACTH returned to normal 2 weeks after surgery.

  12. Peripheral vascular disease is associated with reduced glycosuria in newly diagnosed type 2 diabetic patients

    DEFF Research Database (Denmark)

    Olivarius, Niels de Fine; Holstein-Rathlou, N H; Siersma, V

    2004-01-01

    was 65.2 years. Urinary glucose concentration (UGC) was determined quantitatively in a freshly voided morning urine specimen. RESULTS: The over-all prevalence of peripheral vascular disease (PVD) was 16.5%. Bivariately, high values of UGC were associated with low prevalence of PVD (p...). The predictive value of PVD--together with HbA1c, glomerular filtration rate (GFR) and 10 other possible predictors--was confirmed in a logistic regression analysis with glycosuria (Y/N) as outcome variable (p=0.0004). CONCLUSION: Surprisingly, type 2 diabetic patients with PVD tend not to have glycosuria...... as compared to patients without PVD. PVD may be indicative of generalized atherosclerotic lesions in the major vessels, including the renal arteries. This could lead to a lowering of GFR and thereby of the amount of glucose filtered. Assuming no, or only a minor direct effect of PVD on tubular function...

  13. Relapse and disease specific survival in 1143 Danish women diagnosed with borderline ovarian tumours (BOT)

    DEFF Research Database (Denmark)

    Schou Karlsen, Nikoline Marie; Karlsen, Mona Aarenstrup; Høgdall, Estrid

    2016-01-01

    .1% in FIGO stages II-IV. Relapse of BOT was detected in 3.7%, hereof 40.5% with malignant transformation. The five-year disease-free survival was 97.6% in FIGO stage I and 87.3% in FIGO stages II-IV. Younger age, laparoscopic surgical approach, fertility sparing surgery, FIGO stages II-IV, bilateral tumour...... presence, serous histology, implants and microinvasion of the tumour were significantly associated with relapse in univariate analyses. The overall five-year survival rate was 92.2% in FIGO stage I and 89.0% in FIGO stages II-IV. Out of 77 deaths in total, only seven women died from BOT. CONCLUSIONS...

  14. [Vaccination against yellow fever among patients on immunosuppressors with diagnoses of rheumatic diseases].

    Science.gov (United States)

    Mota, Licia Maria Henrique da; Oliveira, Ana Cristina Vanderley; Lima, Rodrigo Aires Corrêa; Santos-Neto, Leopoldo Luiz dos; Tauil, Pedro Luiz

    2009-01-01

    Yellow fever is endemic in some countries. The anti-yellow fever vaccine is the only effective means of protection but is contraindicated for immunocompromised patients. The aim of this paper was to report on a case series of rheumatological patients who were using immunosuppressors and were vaccinated against this disease. This was a retrospective study by means of a questionnaire applied to these patients, who were vaccinated 60 days before the investigation. Seventy patients of mean age 46 years were evaluated. Most of them were female (90%). There were cases of rheumatoid arthritis (54), systemic lupus erythematosus (11), spondyloarthropathy (5) and systemic sclerosis (2). The therapeutic schemes included methotrexate (42), corticosteroids (22), sulfasalazine (26), leflunomide (18), cyclophosphamide (3) and immunobiological agents (9). Sixteen patients (22.5%) reported some minor adverse effect. Among the eight patients using immunobiological agents, only one presented a mild adverse effect. Among these patients using immunosuppressors, adverse reactions were no more frequent than among immunocompetent individuals. This is the first study on this topic.

  15. Identifying Medical Diagnoses and Treatable Diseases by Image-Based Deep Learning.

    Science.gov (United States)

    Kermany, Daniel S; Goldbaum, Michael; Cai, Wenjia; Valentim, Carolina C S; Liang, Huiying; Baxter, Sally L; McKeown, Alex; Yang, Ge; Wu, Xiaokang; Yan, Fangbing; Dong, Justin; Prasadha, Made K; Pei, Jacqueline; Ting, Magdalene Y L; Zhu, Jie; Li, Christina; Hewett, Sierra; Dong, Jason; Ziyar, Ian; Shi, Alexander; Zhang, Runze; Zheng, Lianghong; Hou, Rui; Shi, William; Fu, Xin; Duan, Yaou; Huu, Viet A N; Wen, Cindy; Zhang, Edward D; Zhang, Charlotte L; Li, Oulan; Wang, Xiaobo; Singer, Michael A; Sun, Xiaodong; Xu, Jie; Tafreshi, Ali; Lewis, M Anthony; Xia, Huimin; Zhang, Kang

    2018-02-22

    The implementation of clinical-decision support algorithms for medical imaging faces challenges with reliability and interpretability. Here, we establish a diagnostic tool based on a deep-learning framework for the screening of patients with common treatable blinding retinal diseases. Our framework utilizes transfer learning, which trains a neural network with a fraction of the data of conventional approaches. Applying this approach to a dataset of optical coherence tomography images, we demonstrate performance comparable to that of human experts in classifying age-related macular degeneration and diabetic macular edema. We also provide a more transparent and interpretable diagnosis by highlighting the regions recognized by the neural network. We further demonstrate the general applicability of our AI system for diagnosis of pediatric pneumonia using chest X-ray images. This tool may ultimately aid in expediting the diagnosis and referral of these treatable conditions, thereby facilitating earlier treatment, resulting in improved clinical outcomes. VIDEO ABSTRACT. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Is a linear probe helpful in diagnosing diseases of pulmonary interstitial spaces?

    Directory of Open Access Journals (Sweden)

    Natalia Buda

    2017-06-01

    Full Text Available In a lung ultrasound examination, interstitial lung lesions are visible as numerous B-line artifacts, and are best recorded with the use of a convex probe. Interstitial lung lesions may result from many conditions, including cardiogenic pulmonary oedema, non-cardiogenic pulmonary oedema, or interstitial lung disease. Hence difficulties in the differential diagnostics of the above clinical conditions. This article presents cases of patients suffering from interstitial lung lesions discovered in the course of lung ultrasound examination. The patients were examined with a 3.5–5.0 MHz convex probe and a 7.0–11.0 MHz linear probe. Ultrasound images have been analysed, and differences in the imaging with both probes in patients with interstitial lung lesions have been detailed. The use of a linear probe in patients with interstitial lung lesions (discovered with a convex or a micro-convex probe provides additional information on the source of the origin of the lesions.

  17. Usefulness of rCBF analysis in diagnosing Parkinson's disease. Supplemental role with MIBG myocardial scintigraphy

    International Nuclear Information System (INIS)

    Nagamachi, Shigeki; Wakamatsu, Hideyuki; Kiyohara, Shogo

    2008-01-01

    123 I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy is a useful tool for differentiating idiopathic Parkinson's disease (PD) from parkinsonism (PS) caused by other disorders. However, cardiac MIBG uptake is affected by various causes. Alternatively, hypoperfusion in the occipital lobe of PD is reported recently. The objective is to clarify the correlation between regional cerebral blood flow (rCBF) alteration and cardiac MIBG uptake in PD. In addition, we examined whether additional brain perfusion analysis improved the differential diagnostic ability for PD from PS when compared with MIBG scintigraphy alone. Forty-nine patients with PD (27 mild groups: Hoehn and Yahr stages I, II; 22 severe groups: Hoehn and Yahr stages III, IV) and 28 patients with PS participated. We compared absolute rCBF values between PD and PS. In addition, we determined correlation between MIBG parameters and each rCBF value. Finally, we compared the diagnostic ability for the differentiation of PD from PS between two diagnostic criteria, each MIBG index abnormality alone [heart-to-mediastinum ratio, H/M (E) 40%] and each MIBG index abnormality or occipital lobe hypoperfusion ( 123 I-MIBG myocardial imaging can be recommended. (author)

  18. Top Information Need Priorities of Older Adults Newly Diagnosed With Active Myeloma.

    Science.gov (United States)

    Tariman, Joseph D; Doorenbos, Ardith; Schepp, Karen G; Singhal, Seema; Berry, Donna L

    2015-01-01

    Prioritizing patients' information needs maximizes efficiency. This study examined the information sources and priorities in a sample of older adults newly diagnosed with symptomatic myeloma requiring immediate therapy. An association analysis of whether information needs were influenced by sociodemographic variables such as age, gender, education, marital status, and income was also conducted. The Information Needs Questionnaire (INQ) and an investigator-developed interview schedule were administered to 20 older adults diagnosed with symptomatic myeloma during a 30- to 45-minute semistructured interview. We found that older adults newly diagnosed with symptomatic myeloma have different priorities of information needs when compared with younger patients diagnosed with various types of cancer. The top three priorities related to treatment, prognosis, and self-care. Sociodemographic variables did not influence the priorities of information needs among older adults with symptomatic myeloma. The Internet, physicians, family, and friends were among the top sources of information. Advanced practitioners in oncology should support and identify interventions that can enhance patients' learning process from these sources. Well poised to assist patients in searching credible and reliable Internet sources, advanced practitioners in oncology can provide patient education about different treatments and the impact of such treatments on prognosis (e.g., overall survival and likelihood of cure).

  19. Biomarkers in rheumatic diseases: how can they facilitate diagnosis and assessment of disease activity?

    Science.gov (United States)

    Mohan, Chandra; Assassi, Shervin

    2015-11-26

    Serological and proteomic biomarkers can help clinicians diagnose rheumatic diseases earlier and assess disease activity more accurately. These markers have been incorporated into the recently revised classification criteria of several diseases to enable early diagnosis and timely initiation of treatment. Furthermore, they also facilitate more accurate subclassification and more focused monitoring for the detection of certain disease manifestations, such as lung and renal involvement. These biomarkers can also make the assessment of disease activity and treatment response more reliable. Simultaneously, several new serological and proteomic biomarkers have become available in the routine clinical setting--for example, a protein biomarker panel for rheumatoid arthritis and a myositis antibody panel for dermatomyositis and polymyositis. This review will focus on commercially available antibody and proteomic biomarkers in rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis (scleroderma), dermatomyositis and polymyositis, and axial spondyloarthritis (including ankylosing spondylitis). It will discuss how these markers can facilitate early diagnosis as well as more accurate subclassification and assessment of disease activity in the clinical setting. The ultimate goal of current and future biomarkers in rheumatic diseases is to enable early detection of these diseases and their clinical manifestations, and to provide effective monitoring and treatment regimens that are tailored to each patient's needs and prognosis. © BMJ Publishing Group Ltd 2015.

  20. Habitual physical activity in mitochondrial disease.

    Directory of Open Access Journals (Sweden)

    Shehnaz Apabhai

    Full Text Available Mitochondrial disease is the most common neuromuscular disease and has a profound impact upon daily life, disease and longevity. Exercise therapy has been shown to improve mitochondrial function in patients with mitochondrial disease. However, no information exists about the level of habitual physical activity of people with mitochondrial disease and its relationship with clinical phenotype.Habitual physical activity, genotype and clinical presentations were assessed in 100 patients with mitochondrial disease. Comparisons were made with a control group individually matched by age, gender and BMI.Patients with mitochondrial disease had significantly lower levels of physical activity in comparison to matched people without mitochondrial disease (steps/day; 6883±3944 vs. 9924±4088, p = 0.001. 78% of the mitochondrial disease cohort did not achieve 10,000 steps per day and 48% were classified as overweight or obese. Mitochondrial disease was associated with less breaks in sedentary activity (Sedentary to Active Transitions, % per day; 13±0.03 vs. 14±0.03, p = 0.001 and an increase in sedentary bout duration (bout lengths/fraction of total sedentary time; 0.206±0.044 vs. 0.187±0.026, p = 0.001. After adjusting for covariates, higher physical activity was moderately associated with lower clinical disease burden (steps/day; r(s = -0.49; 95% CI -0.33, -0.63, P<0.01. There were no systematic differences in physical activity between different genotypes mitochondrial disease.These results demonstrate for the first time that low levels of physical activity are prominent in mitochondrial disease. Combined with a high prevalence of obesity, physical activity may constitute a significant and potentially modifiable risk factor in mitochondrial disease.

  1. Habitual physical activity in mitochondrial disease.

    Science.gov (United States)

    Apabhai, Shehnaz; Gorman, Grainne S; Sutton, Laura; Elson, Joanna L; Plötz, Thomas; Turnbull, Douglass M; Trenell, Michael I

    2011-01-01

    Mitochondrial disease is the most common neuromuscular disease and has a profound impact upon daily life, disease and longevity. Exercise therapy has been shown to improve mitochondrial function in patients with mitochondrial disease. However, no information exists about the level of habitual physical activity of people with mitochondrial disease and its relationship with clinical phenotype. Habitual physical activity, genotype and clinical presentations were assessed in 100 patients with mitochondrial disease. Comparisons were made with a control group individually matched by age, gender and BMI. Patients with mitochondrial disease had significantly lower levels of physical activity in comparison to matched people without mitochondrial disease (steps/day; 6883±3944 vs. 9924±4088, p = 0.001). 78% of the mitochondrial disease cohort did not achieve 10,000 steps per day and 48% were classified as overweight or obese. Mitochondrial disease was associated with less breaks in sedentary activity (Sedentary to Active Transitions, % per day; 13±0.03 vs. 14±0.03, p = 0.001) and an increase in sedentary bout duration (bout lengths/fraction of total sedentary time; 0.206±0.044 vs. 0.187±0.026, p = 0.001). After adjusting for covariates, higher physical activity was moderately associated with lower clinical disease burden (steps/day; r(s) = -0.49; 95% CI -0.33, -0.63, Pphysical activity between different genotypes mitochondrial disease. These results demonstrate for the first time that low levels of physical activity are prominent in mitochondrial disease. Combined with a high prevalence of obesity, physical activity may constitute a significant and potentially modifiable risk factor in mitochondrial disease.

  2. Hemodialysis knowledge and medical adherence in African Americans diagnosed with end stage renal disease: results of an educational intervention.

    Science.gov (United States)

    Wells, Janie R

    2011-01-01

    The purpose of this three-group quasi-experimental research study was to describe the relationship between hemodialysis knowledge and perceived medical adherence to a prescribed treatment regimen in African Americans diagnosed with end stage renal disease and to determine if an educational intervention improved hemodialysis knowledge and medical adherence. Eighty-five African Americans participated in this study using the Life Options Hemodialysis Knowledge Test and the Medical Outcomes Study Measures of Patient Adherence tools. No significant correlation was found between hemodialysis knowledge and medical adherence. Paired sample t-tests revealed significantly higher hemodialysis knowledge scores in the post-test group compared to the pre-test group, t(26) = -3.79, p adherence. This study suggests that more education is needed to improve the knowledge level of African-American patients on hemodialysis.

  3. Diagnosing Sporadic Creutzfeldt-Jakob Disease in a Patient with a Suspected Status Epilepticus in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Harm J. van der Horn

    2013-01-01

    Full Text Available Objective. Several tests are available in the diagnostics of sporadic Creutzfeldt-Jakob disease (sCJD; however, none of these is conclusive. We review the values of these tests, from an intensive care unit (ICU perspective. Methods. Case report and review of the literature. Results. A 53-year-old woman initially presenting with psychiatric symptoms developed myoclonus and was admitted 1 month later to the ICU with a suspected nonconvulsive status epilepticus and respiratory insufficiency, probably due to extensive antiepileptic drug therapy. Typical MRI and EEG findings and a positive 14-3-3 protein led to the diagnosis of sCJD. All treatments were terminated, and autopsy confirmed sCJD. Conclusions. Clinical signs combined with MRI, EEG, and 14-3-3 and/or tau protein determination might be sufficient to diagnose or exclude sCJD and may therefore prevent the application of unnecessary diagnostic tests.

  4. Multidetector CT Findings and Differential Diagnoses of Malignant Pleural Mesothelioma and Metastatic Pleural Diseases in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoon Kyung [Department of Radiology, Gachon University Gil Medical Center, Incheon 21565 (Korea, Republic of); Kim, Jeung Sook [Department of Radiology, Dongguk University Ilsan Hospital, Goyang 10326 (Korea, Republic of); Lee, Kyung Won [Department of Radiology, Seoul National University Bundang Hospital, Seongnam 13620 (Korea, Republic of); Yi, Chin A [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351 (Korea, Republic of); Koo, Jin Mo [Department of Radiology, Seoul National University College of Medicine, Seoul 03080 (Korea, Republic of); Jung, Soon-Hee [Department of Pathology, Yonsei University Wonju College of Medicine, Wonju 26426 (Korea, Republic of)

    2016-11-01

    To compare the multidetector CT (MDCT) features of malignant pleural mesothelioma (MPM) and metastatic pleural disease (MPD). The authors reviewed the MDCT images of 167 patients, 103 patients with MPM and 64 patients with MPD. All 167 cases were pathologically confirmed by sonography-guided needle biopsy of pleura, thoracoscopic pleural biopsy, or open thoracotomy. CT features were evaluated with respect to pleural effusion, pleural thickening, invasion of other organs, lung abnormality, lymphadenopathy, mediastinal shifting, thoracic volume decrease, asbestosis, and the presence of pleural plaque. Pleural thickening was the most common CT finding in MPM (96.1%) and MPD (93.8%). Circumferential pleural thickening (31.1% vs. 10.9%, odds ratio [OR] 3.670), thickening of fissural pleura (83.5% vs. 67.2%, OR 2.471), thickening of diaphragmatic pleura (90.3% vs. 73.4%, OR 3.364), pleural mass (38.8% vs. 23.4%, OR 2.074), pericardial involvement (56.3% vs. 20.3%, OR 5.056), and pleural plaque (66.0% vs. 21.9%, OR 6.939) were more frequently seen in MPM than in MPD. On the other hand, nodular pleural thickening (59.2% vs. 76.6%, OR 0.445), hilar lymph node metastasis (5.8% vs. 20.3%, OR 0.243), mediastinal lymph node metastasis (10.7% vs. 37.5%, OR 0.199), and hematogenous lung metastasis (9.7% vs. 29.2%, OR 0.261) were less frequent in MPM than in MPD. When we analyzed MPD from extrathoracic malignancy (EMPD) separately and compared them to MPM, circumferential pleural thickening, thickening of interlobar fissure, pericardial involvement and presence of pleural plaque were significant findings indicating MPM than EMPD. MPM had significantly lower occurrence of hematogenous lung metastasis, as compared with EMPD. Awareness of frequent and infrequent CT findings could aid in distinguishing MPM from MPD.

  5. Multidetector CT findings and differential diagnoses of malignant pleural mesothelioma and metastatic pleural diseases in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoon Kyung [Dept. of Radiology, Gachon University Gil Medical Center, Incheon (Korea, Republic of); Kim, Jeung Sook [Dept. of Radiology, Dongguk University Ilsan Hospital, Goyang (Korea, Republic of); Lee, Kyung Won [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Yi, Chin A [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Koo, Jin Mo [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Jung, Soon Hee [Dept. of Pathology, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    2016-07-15

    To compare the multidetector CT (MDCT) features of malignant pleural mesothelioma (MPM) and metastatic pleural disease (MPD). The authors reviewed the MDCT images of 167 patients, 103 patients with MPM and 64 patients with MPD. All 167 cases were pathologically confirmed by sonography-guided needle biopsy of pleura, thoracoscopic pleural biopsy, or open thoracotomy. CT features were evaluated with respect to pleural effusion, pleural thickening, invasion of other organs, lung abnormality, lymphadenopathy, mediastinal shifting, thoracic volume decrease, asbestosis, and the presence of pleural plaque. Pleural thickening was the most common CT finding in MPM (96.1%) and MPD (93.8%). Circumferential pleural thickening (31.1% vs. 10.9%, odds ratio [OR] 3.670), thickening of fissural pleura (83.5% vs. 67.2%, OR 2.471), thickening of diaphragmatic pleura (90.3% vs. 73.4%, OR 3.364), pleural mass (38.8% vs. 23.4%, OR 2.074), pericardial involvement (56.3% vs. 20.3%, OR 5.056), and pleural plaque (66.0% vs. 21.9%, OR 6.939) were more frequently seen in MPM than in MPD. On the other hand, nodular pleural thickening (59.2% vs. 76.6%, OR 0.445), hilar lymph node metastasis (5.8% vs. 20.3%, OR 0.243), mediastinal lymph node metastasis (10.7% vs. 37.5%, OR 0.199), and hematogenous lung metastasis (9.7% vs. 29.2%, OR 0.261) were less frequent in MPM than in MPD. When we analyzed MPD from extrathoracic malignancy (EMPD) separately and compared them to MPM, circumferential pleural thickening, thickening of interlobar fissure, pericardial involvement and presence of pleural plaque were significant findings indicating MPM than EMPD. MPM had significantly lower occurrence of hematogenous lung metastasis, as compared with EMPD. Awareness of frequent and infrequent CT findings could aid in distinguishing MPM from MPD.

  6. Outcomes of patients hospitalized with peptic ulcer disease diagnosed in acute upper endoscopy.

    Science.gov (United States)

    Malmi, Hanna; Kautiainen, Hannu; Virta, Lauri J; Färkkilä, Martti A

    2017-11-01

    The incidence and complications of peptic ulcer disease (PUD) have declined, but mortality from bleeding ulcers has remained unchanged. The aims of the current study were to evaluate the significance of PUD among patients admitted for acute upper endoscopy and to evaluate the survival of PUD patients. In this prospective, observational cohort study, data on 1580 acute upper endoscopy cases during 2012-2014 were collected. A total of 649 patients were included with written informed consent. Data on patients' characteristics, living habits, comorbidities, drug use, endoscopy and short-term and long-term survival were collected. Of all patients admitted for endoscopy, 147/649 (23%) had PUD with the main symptom of melena. Of these PUD patients, 35% had major stigmata of bleeding (Forrest Ia-IIb) in endoscopy. Patients with major stigmata had significantly more often renal insufficiency, lower level of blood pressure with tachycardia and lower level of haemoglobin, platelets and ratio of thromboplastin time. No differences in drug use, Charlson comorbidity class, BMI, smoking or alcohol use were found. Of the PUD patients, 31% were Helicobacter pylori positive. The 30-day mortality was 0.7% (95% confidence interval: 0.01-4.7), 1-year mortality was 12.9% (8.4-19.5) and the 2-year mortality was 19.4% (13.8-26.8), with no difference according to major or minor stigmata of bleeding. Comorbidity (Charlson>1) was associated with decreased survival (P=0.029) and obesity (BMI≥30) was associated with better survival (P=0.023). PUD is still the most common cause for acute upper endoscopy with very low short-term mortality. Comorbidity, but not the stigmata of bleeding, was associated with decreased long-term survival.

  7. Controlled attenuation parameter for diagnosing steatosis in bariatric surgery candidates with suspected nonalcoholic fatty liver disease.

    Science.gov (United States)

    Naveau, Sylvie; Voican, Cosmin S; Lebrun, Amandine; Gaillard, Martin; Lamouri, Karima; Njiké-Nakseu, Micheline; Courie, Rodi; Tranchart, Hadrien; Balian, Axel; Prévot, Sophie; Dagher, Ibrahim; Perlemuter, Gabriel

    2017-09-01

    Steatosis in patients with nonalcoholic fatty liver disease (NAFLD) is often benign, but may progress to fibrosis. The accurate diagnosis of hepatic steatosis is therefore important for clinical decision-making and prognostic assessments. The controlled attenuation parameter (CAP), a noninvasive measurement obtained with Fibro-Scan, has been developed for liver steatosis assessment. CAP performs poorly in patients with high BMI. The XL probe was initially developed for measuring liver stiffness in overweight patients. We assessed the diagnostic value of CAP in candidates for bariatric surgery with suspected NAFLD examined with the XL probe. For the retrospective group, raw ultrasonic radiofrequency signals were stored prospectively in the Fibro-Scan examination file for offline CAP calculation in 194 consecutive obese patients undergoing liver stiffness measurement in the 15 days before liver biopsy. For the prospective group, CAP was calculated automatically and prospectively from the XL probe in 123 obese patients. In the retrospective group, the diagnostic accuracy of CAP was satisfactory for differentiating S3 from S0-S1-S2 (0.79±0.03; 95% confidence interval: 0.71-0.84) and S3 from S0 (0.85±0.05; 95% confidence interval: 0.73-0.92). The Obuchowski measure demonstrated a very good discriminatory performance: 0.87±0.02 in the retrospective group and 0.91±0.02 in the prospective group. CAP calculations from XL probe measurements efficiently detected severe steatosis in morbidly obese patients with suspected NAFLD. However, the cutoff values should now be confirmed in a larger prospective cohort.

  8. Value of amino-terminal pro B-natriuretic peptide in diagnosing Kawasaki disease.

    Science.gov (United States)

    McNeal-Davidson, Ariane; Fournier, Anne; Spigelblatt, Linda; Saint-Cyr, Claire; Mir, Thomas S; Nir, Amiram; Dallaire, Frédéric; Cousineau, Jocelyne; Delvin, Edgard; Dahdah, Nagib

    2012-10-01

    The aim of the present study was to investigate the diagnostic value of the N-terminal B-type natriuretic peptide (NT-proBNP) in acute Kawasaki disease (KD) given that the clinical criteria and the current basic laboratory tests lack the necessary specificity for accurate diagnosis. Basic biological tests and serum NT-proBNP levels obtained from acute KD patients were compared to that of febrile controls. NT-proBNP was considered abnormal based on the following definitions: above a cut-off determined on receiver operator characteristic (ROC) analysis, above the upper limit for age, or above 2 SD calculated from healthy children. Analyses were also performed for KD cases with complete or incomplete criteria combined and separately. There were 81 patients and 49 controls aged 3.60 ± 2.77 versus 4.25 ± 3.88 years (P= 0.69). ROC analysis yielded significant area under the curve for NT-proBNP. The sensitivity, specificity, positive and negative predictive values were 70.4-88.9%, 69.4-91.8%, 82.8-93.4%, and 65.2-79.1%. The odds ratios based on NT-proBNP definitions varied between 18.13 (95% confidence interval [CI]: 7.21-45.57), 20.82 (95%CI: 8.18-53.0), and 26.71 (95%CI: 8.64-82.57; P < 0.001). Results were reproducible for cases with complete or incomplete criteria separately. NT-proBNP is a reliable marker for the diagnosis of KD. Prospective clinical studies with emphasis on NT-proBNP in a diagnostic algorithm are needed. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.

  9. Development of a prediction model for residual disease in newly diagnosed advanced ovarian cancer.

    Science.gov (United States)

    Janco, Jo Marie Tran; Glaser, Gretchen; Kim, Bohyun; McGree, Michaela E; Weaver, Amy L; Cliby, William A; Dowdy, Sean C; Bakkum-Gamez, Jamie N

    2015-07-01

    To construct a tool, using computed tomography (CT) imaging and preoperative clinical variables, to estimate successful primary cytoreduction for advanced epithelial ovarian cancer (EOC). Women who underwent primary cytoreductive surgery for stage IIIC/IV EOC at Mayo Clinic between 1/2/2003 and 12/30/2011 and had preoperative CT images of the abdomen and pelvis within 90days prior to their surgery available for review were included. CT images were reviewed for large-volume ascites, diffuse peritoneal thickening (DPT), omental cake, lymphadenopathy (LP), and spleen or liver involvement. Preoperative factors included age, body mass index (BMI), Eastern Cooperative Oncology Group performance status (ECOG PS), American Society of Anesthesiologists (ASA) score, albumin, CA-125, and thrombocytosis. Two prediction models were developed to estimate the probability of (i) complete and (ii) suboptimal cytoreduction (residual disease (RD) >1cm) using multivariable logistic analysis with backward and stepwise variable selection methods. Internal validation was assessed using bootstrap resampling to derive an optimism-corrected estimate of the c-index. 279 patients met inclusion criteria: 143 had complete cytoreduction, 26 had suboptimal cytoreduction (RD>1cm), and 110 had measurable RD ≤1cm. On multivariable analysis, age, absence of ascites, omental cake, and DPT on CT imaging independently predicted complete cytoreduction (c-index=0.748). Conversely, predictors of suboptimal cytoreduction were ECOG PS, DPT, and LP on preoperative CT imaging (c-index=0.685). The generated models serve as preoperative evaluation tools that may improve counseling and selection for primary surgery, but need to be externally validated. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Predicting first fall in newly diagnosed Parkinson's disease: Insights from a fall-naïve cohort.

    Science.gov (United States)

    Lord, Sue; Galna, Brook; Yarnall, Alison J; Coleman, Shirley; Burn, David; Rochester, Lynn

    2016-12-01

    Falls are common and associated with reduced independence and mortality in Parkinson's disease. Previous research has been conducted on falls-prevalent or advanced disease cohorts. This study identifies risk factors for first fall for 36 months in a newly diagnosed, falls-naïve cohort. A total of 121 consecutive Parkinson's disease patients were recruited. Falls data were collected prospectively during 36 months from diagnosis via monthly falls diaries and telephone follow-up for 117 participants. Assessment comprised a comprehensive battery of clinical, gait, and cognitive measures. Significant predictors were identified from decision-tree analysis and survival analysis with time to first fall during 36 months as the dependent variable. At baseline, 26 (22%) participants reported retrospective falls. At 36 months, the remaining cohort (n = 91) comprised 47 fallers (52%) and 30 (33%) nonfallers and 14 (15%) participants with incomplete diaries. Fallers presented with a significantly higher disease severity, poorer ability to stand on one leg, slower gait speed, increased stance time variability, and higher swing time asymmetry. Median time to first fall was 847 days. Gait speed, stance time, and Hoehn & Yahr III stage emerged as significant predictors of first fall, hazard ratio 3.44 (95% confidence interval [CI] 1.58 to 7.48), 3.31(95% CI 1.40 to 7.80), and 2.80 (95% CI 1.38 to 5.65), respectively. The hazard ratio for risk factors combined was 7.82 (CI 2.80 to 21.84). Interventions that target gait deficit and postural control in early Parkinson's disease may limit the potential for first fall. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  11. The value of early wireless esophageal pH monitoring in diagnosing functional heartburn in refractory gastroesophageal reflux disease.

    Science.gov (United States)

    Park, Eun-Young; Choi, Myung-Gyu; Baeg, Meonggi; Lim, Chul-Hyun; Kim, Jinsu; Cho, Yukyung; Park, Jaemyung; Lee, Inseok; Kim, Sangwoo; Choi, Kyuyong

    2013-10-01

    It is difficult to differentiate functional heartburn from proton pump inhibitor (PPI) failure. The aims of this study were to assess the role of early wireless esophageal pH monitoring in patients referred with gastroesophageal reflux disease (GERD) and to identify differences in the clinical spectrum among GERD subtypes. We enrolled consecutive referred patients with suspected GERD. After endoscopy on the first visit, all underwent wireless esophageal pH monitoring when off the PPI. Two hundred thirty patients were enrolled. These patients were classified into a reflux esophagitis group (20, 8.7 %) and a normal endoscopic findings group (210, 91.3 %). Among the 210 patients in the normal endoscopic findings group, 63 (27.4 %) were diagnosed with pathological reflux, 35 (15.2 %) with hypersensitive esophagus, 87 (37.8 %) with normal acid exposure with negative symptom association, and 25 (10.9 %) with test failure. These groups did not differ in age, body mass index, smoking habit, alcohol consumption, symptom severity, quality of life, presence of atypical symptoms, overlap with irritable bowel syndrome, and the frequency of somatization, depression, and anxiety. PPI responses were evaluated in 135 patients. Fifty patients (37.0 %) were not responsive to the 4-week treatment; 26 (19.3 %) were diagnosed with refractory non-erosive gastroesophageal disease, and 24 (17.8 %) with functional heartburn. The demographics and clinical and psychological characteristics did not differ between the two groups. Demographic characteristics and symptom patterns alone cannot differentiate functional heartburn from various subtypes of GERD. Wireless esophageal pH monitoring should be considered for the initial evaluation of GERD in the tertiary referral setting.

  12. Objective measurements of activity patterns in people with newly diagnosed Type 2 diabetes demonstrate a sedentary lifestyle.

    Science.gov (United States)

    Cichosz, S L; Fleischer, J; Hoeyem, P; Laugesen, E; Poulsen, P L; Christiansen, J S; Ejskjær, N; Hansen, T K

    2013-09-01

    To evaluate physical activity in people with newly diagnosed Type 2 diabetes using objective measures. We analysed data from a study aimed at assessing carotid femoral pulse wave velocity in which a piezoelectric accelerometer was worn by 100 people with newly diagnosed Type 2 diabetes and by 100 age- and sex-matched control subjects. Differences in physical activity patterns were investigated. Compared with the control group, the people with Type 2 diabetes spent significantly more time engaged in sedentary or lower level activities during the day, with a mean (sd) time of 926 (44) vs 898 (70) min, P sedentary lifestyle compared with well-matched controls. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

  13. Validity of peptic ulcer disease and upper gastrointestinal bleeding diagnoses in administrative databases: a systematic review protocol.

    Science.gov (United States)

    Montedori, Alessandro; Abraha, Iosief; Chiatti, Carlos; Cozzolino, Francesco; Orso, Massimiliano; Luchetta, Maria Laura; Rimland, Joseph M; Ambrosio, Giuseppe

    2016-09-15

    Administrative healthcare databases are useful to investigate the epidemiology, health outcomes, quality indicators and healthcare utilisation concerning peptic ulcers and gastrointestinal bleeding, but the databases need to be validated in order to be a reliable source for research. The aim of this protocol is to perform the first systematic review of studies reporting the validation of International Classification of Diseases, 9th Revision and 10th version (ICD-9 and ICD-10) codes for peptic ulcer and upper gastrointestinal bleeding diagnoses. MEDLINE, EMBASE, Web of Science and the Cochrane Library databases will be searched, using appropriate search strategies. We will include validation studies that used administrative data to identify peptic ulcer disease and upper gastrointestinal bleeding diagnoses or studies that evaluated the validity of peptic ulcer and upper gastrointestinal bleeding codes in administrative data. The following inclusion criteria will be used: (a) the presence of a reference standard case definition for the diseases of interest; (b) the presence of at least one test measure (eg, sensitivity, etc) and (c) the use of an administrative database as a source of data. Pairs of reviewers will independently abstract data using standardised forms and will evaluate quality using the checklist of the Standards for Reporting of Diagnostic Accuracy (STARD) criteria. This systematic review protocol has been produced in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P) 2015 statement. Ethics approval is not required given that this is a protocol for a systematic review. We will submit results of this study to a peer-reviewed journal for publication. The results will serve as a guide for researchers validating administrative healthcare databases to determine appropriate case definitions for peptic ulcer disease and upper gastrointestinal bleeding, as well as to perform outcome research using

  14. Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity.

    Science.gov (United States)

    Haliloglu, Sema; Carlioglu, Ayse; Akdeniz, Derya; Karaaslan, Yasar; Kosar, Ali

    2014-09-01

    Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain and the presence of specific tender points. The prevalence of FM has been estimated at 2-7 % of the general global population. The presence of FM in several rheumatic diseases with a structural pathology has been reported as 11-30 %. The objectives of this study were to determine the prevalence of FM and to evaluate the possible relationship between FM existence and disease activity among rheumatic diseases. The study group included 835 patients--197 rheumatoid arthritis (RA), 67 systemic lupus erythematosus (SLE), 119 ankylosing spondylitis (AS), 238 osteoarthritis (OA), 14 familial Mediterranean fever (FMF), 53 Behçet's disease (BD), 71 gout, 25 Sjögren's syndrome (SS), 20 vasculitis, 29 polymyalgia rheumatica (PMR), and two polymyositis (PM)--with or without FM. Recorded information included age, gender, laboratory parameters, presence of fatigue, and disease activity indexes. The prevalence of FM in patients with rheumatologic diseases was found to be 6.6 % for RA, 13.4 % for SLE, 12.6 % for AS, 10.1 % for OA, 5.7 % for BD, 7.1 % for FMF, 12 % for SS, 25 % for vasculitis, 1.4 % for gout, and 6.9 % for PMR. One out of two patients with PM was diagnosed with FM. Some rheumatologic cases (AS, OA) with FM were observed mostly in female patients (p = 0.000). Also, there were significant correlations between disease activity indexes and Fibromyalgia Impact Questionnaire scores for most rheumatologic patients (RA, AS, OA, and BD) (p diseases, and its recognition is important for the optimal management of these diseases. Increased pain, physical limitations, and fatigue may be interpreted as increased activity of these diseases, and a common treatment option is the prescription of higher doses of biologic agents or corticosteroids. Considerations of the FM component in the management of rheumatologic diseases increase the likelihood of the success of the treatment.

  15. Massively parallel sequencing and targeted exomes in familial kidney disease can diagnose underlying genetic disorders.

    Science.gov (United States)

    Mallett, Andrew J; McCarthy, Hugh J; Ho, Gladys; Holman, Katherine; Farnsworth, Elizabeth; Patel, Chirag; Fletcher, Jeffery T; Mallawaarachchi, Amali; Quinlan, Catherine; Bennetts, Bruce; Alexander, Stephen I

    2017-12-01

    Inherited kidney disease encompasses a broad range of disorders, with both multiple genes contributing to specific phenotypes and single gene defects having multiple clinical presentations. Advances in sequencing capacity may allow a genetic diagnosis for familial renal disease, by testing the increasing number of known causative genes. However, there has been limited translation of research findings of causative genes into clinical settings. Here, we report the results of a national accredited diagnostic genetic service for familial renal disease. An expert multidisciplinary team developed a targeted exomic sequencing approach with ten curated multigene panels (207 genes) and variant assessment individualized to the patient's phenotype. A genetic diagnosis (pathogenic genetic variant[s]) was identified in 58 of 135 families referred in two years. The genetic diagnosis rate was similar between families with a pediatric versus adult proband (46% vs 40%), although significant differences were found in certain panels such as atypical hemolytic uremic syndrome (88% vs 17%). High diagnostic rates were found for Alport syndrome (22 of 27) and tubular disorders (8 of 10), whereas the monogenic diagnostic rate for congenital anomalies of the kidney and urinary tract was one of 13. Quality reporting was aided by a strong clinical renal and genetic multidisciplinary committee review. Importantly, for a diagnostic service, few variants of uncertain significance were found with this targeted, phenotype-based approach. Thus, use of targeted massively parallel sequencing approaches in inherited kidney disease has a significant capacity to diagnose the underlying genetic disorder across most renal phenotypes. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  16. Validation of celiac disease diagnoses recorded in the Danish National Patient Register using duodenal biopsies, celiac disease-specific antibodies, and human leukocyte-antigen genotypes

    Directory of Open Access Journals (Sweden)

    Dydensborg Sander S

    2016-12-01

    Full Text Available Stine Dydensborg Sander,1-3 Ketil Størdal,4,5 Tine Plato Hansen,6 Anne-Marie Nybo Andersen,7 Joseph A Murray,8 Søren Thue Lillevang,9 Steffen Husby1,2 1Hans Christian Andersen Children’s Hospital, Odense University Hospital, 2Institute of Clinical Research, University of Southern Denmark, 3Odense Patient Data Explorative Network (OPEN, Odense University Hospital, Odense, Denmark; 4Mental and Physical Health, Norwegian Institute of Public Health, Oslo, 5Department of Pediatrics, Ostfold Hospital Trust, Fredrikstad, Norway; 6Department of Pathology, Hvidovre Hospital, 7Department of Public Health, University of Copenhagen, Copenhagen, Denmark; 8Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA; 9Department of Clinical Immunology, Odense University Hospital, Odense, Denmark Purpose: The purpose of this study was to validate the celiac disease diagnoses recorded in the Danish National Patient Register. To validate the diagnoses, we used information on duodenal biopsies from a national register of pathology reports (the Patobank and information on celiac disease-specific antibodies and human leukocyte antigen (HLA genotypes obtained from patient medical records.Patients and methods: We included all the children who were born from 1995 to 2012 and who were registered as having celiac disease in the Danish National Patient Register. We reviewed all the pathology reports on duodenal biopsies in the Patobank and the information in the medical records on celiac disease-specific antibodies (ie, anti-tissue transglutaminase 2 IgA and IgG, endomysial antibodies IgA, and anti-deamidated gliadin peptide IgG and HLA genotypes.Results: We identified 2,247 children who were registered in the Danish National Patient Register with celiac disease. Duodenal biopsies for 1,555 of the children (69% were registered in the Patobank; 1,127 (50% had a biopsy that was compatible with celiac disease (ie, Marsh 2–3. We accessed the medical

  17. Comparison of Newly Diagnosed Ocular Hypertension and Open-Angle Glaucoma: Ocular Variables, Risk Factors, and Disease Severity

    Directory of Open Access Journals (Sweden)

    Yvonne M. Buys

    2012-01-01

    Full Text Available Purpose. To describe the distribution of ocular variables, risk factors, and disease severity in newly diagnosed ocular hypertension (OH or open-angle glaucoma (OAG. Methods. Eligible subjects underwent a complete history and examination. Adjusted odds ratios (ORs and 95% confidence intervals (CIs obtained from multiple logistic regression models were used to compare OAG to OH and advanced to early/moderate OAG. Results. 405 subjects were enrolled: 292 (72.1% with OAG and 113 (27.9% with OH. 51.7% had early, 27.1% moderate, and 20.9% advanced OAG. The OR for OAG versus OH was 8.19 (P<0.0001 for disc notch, 5.36 (P<0.0001 for abnormal visual field, 1.45 (P=0.001 for worsening mean deviation, 1.91 (P<0.0001 for increased cupping, 1.03 for increased age (P=0.030, and 0.36 (P=0.010 for smoking. Conclusions. Increased age was a risk for OAG, and smoking decreased the risk of OAG compared to OH. Almost half of the OAG subjects had moderate/advanced disease at diagnosis.

  18. Health-related quality of life is not impaired in children with undetected as well as diagnosed celiac disease: a large population based cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background Knowledge regarding the health-related quality of life (HRQoL) of children with celiac disease remains limited and inconclusive. We investigated the HRQoL of three groups of 12-year-olds with: i) undetected celiac disease ii) clinically diagnosed celiac disease, and iii) without celiac disease. Methods A school-based cross-sectional multicenter screening study invited 18 325 children, whereof 68% consented to participate. Participants provided a blood sample, which was later analyzed for anti-tissue-tranglutaminase antibodies, and alongside filled in a questionnaire. When anti-tissue-tranglutaminase antibodies were elevated, a small intestinal biopsy verified the screening-detected celiac disease diagnosis. Self-reported HRQoL was measured using Kidscreen, a generic 52 items instrument with proven reliability and validity. Scores were linearly transformed into a 0–100 scale with higher values indicating better HRQoL. Mean values with standard deviations (mean ± SD) were compared, and uni- and multivariate logistic regression models tested the odds of a low HRQoL among children with undetected or diagnosed celiac disease, respectively. Results Children with undetected celiac disease (n = 238) reported similar HRQoL as children without celiac disease (n = 12 037) (83.0 ± 11.0 vs. 82.5 ± 11.3, P = 0.51), and also similar HRQoL (82.2 ± 12.2, P = 0.28) to that of children with diagnosed celiac disease (n = 90), of whom 92% were adherent to treatment. Having undetected celiac disease did not increase the odds of low overall HRQoL, independent of sex, area of residence, study year and occurrence of gastrointestinal symptoms (adjusted odds ratio 0.77, 95% CI 0.54-1.10). Comparable results were seen for diagnosed celiac disease cases (adjusted odds ratio 1.11, 95% CI 0.67-1.85). Conclusion Children with undetected celiac disease reported comparable HRQoL as their peers with diagnosed celiac disease, and those without celiac disease

  19. Effect of diagnosis with a chronic disease on physical activity behavior in middle-aged women

    NARCIS (Netherlands)

    Dontje, Manon L.; Krijnen, Wim P.; de Greef, Mathieu H. G.; Peeters, Geeske G. M. E. E.; Stolk, Ronald P.; van der Schans, Cees P.; Brown, Wendy J.

    Objective. Although regular physical activity is an effective secondary prevention strategy for patients with a chronic disease, it is unclear whether patients change their daily physical activity after being diagnosed. Therefore, the aims of this study were to (1) describe changes in levels of

  20. Expression and Genetic Variation in Neuroendocrine Signaling Pathways in Lethal and Nonlethal Prostate Cancer among Men Diagnosed with Localized Disease.

    Science.gov (United States)

    Lu, Donghao; Carlsson, Jessica; Penney, Kathryn L; Davidsson, Sabina; Andersson, Swen-Olof; Mucci, Lorelei A; Valdimarsdóttir, Unnur; Andrén, Ove; Fang, Fang; Fall, Katja

    2017-12-01

    Background: Recent data suggest that neuroendocrine signaling pathways may play a role in the progression of prostate cancer, particularly for early-stage disease. We aimed to explore whether expression of selected genes in the adrenergic, serotoninergic, glucocorticoid, and dopaminergic pathways differs in prostate tumor tissue from men with lethal disease compared with men with nonlethal disease. Methods: On the basis of the Swedish Watchful Waiting Cohort, we included 511 men diagnosed with incidental prostate cancer through transurethral resection of the prostate during 1977-1998 with follow-up up to 30 years. For those with tumor tissue ( N = 262), we measured mRNA expression of 223 selected genes included in neuroendocrine pathways. Using DNA from normal prostate tissue ( N = 396), we genotyped 36 SNPs from 14 receptor genes. Lethal prostate cancer was the primary outcome in analyses with pathway gene expression and genetic variants. Results: Differential expression of genes in the serotoninergic pathway was associated with risk of lethal prostate cancer ( P = 0.007); similar but weaker associations were noted for the adrenergic ( P = 0.014) and glucocorticoid ( P = 0.020) pathways. Variants of the HTR2A (rs2296972; P = 0.002) and NR3CI (rs33388; P = 0.035) genes (within the serotoninergic and glucocorticoid pathways) were associated with lethal cancer in overdominant models. These genetic variants were correlated with expression of several genes in corresponding pathways ( P pathways, particularly serotoninergic pathway, are associated with lethal outcome in the natural course of localized prostate cancer. Impact: This study provides evidence of the role of neuroendocrine pathways in prostate cancer progression that may have clinical utility. Cancer Epidemiol Biomarkers Prev; 26(12); 1781-7. ©2017 AACR . ©2017 American Association for Cancer Research.

  1. INCREASED TISSUE TRANSGLUTAMINASE LEVELS ARE ASSOCIATED WITH INCREASED EPILEPTIFORM ACTIVITY IN ELECTROENCEPHALOGRAPHY AMONG PATIENTS WITH CELIAC DISEASE

    Directory of Open Access Journals (Sweden)

    Sedat IŞIKAY

    2015-12-01

    Full Text Available Background - Celiac disease is an autoimmune systemic disorder in genetically predisposed individuals precipitated by gluten ingestion. Objective - In this study, we aimed to determine asymptomatic spike-and-wave findings on electroencephalography in children with celiac disease. Methods - A total of 175 children with the diagnosis of celiac disease (study group and 99 age- and sex-matched healthy children as controls (control group were included in the study. In order to determine the effects of gluten free diet on laboratory and electroencephalography findings, the celiac group is further subdivided into two as newly-diagnosed and formerly-diagnosed patients. Medical histories of all children and laboratory findings were all recorded and neurologic statuses were evaluated. All patients underwent a sleep and awake electroencephalography. Results - Among 175 celiac disease patients included in the study, 43 were newly diagnosed while 132 were formerly-diagnosed patients. In electroencephalography evaluation of patients the epileptiform activity was determined in 4 (9.3% of newly diagnosed and in 2 (1.5% of formerly diagnosed patients; on the other hand the epileptiform activity was present in only 1 (1.0% of control cases. There was a statistically significant difference between groups in regards to the presence of epileptiform activity in electroencephalography. Pearson correlation analysis revealed that epileptiform activity in both sleep and awake electroencephalography were positively correlated with tissue transglutaminase levels (P=0.014 and P=0.019, respectively. Conclusion - We have determined an increased epileptiform activity frequency among newly-diagnosed celiac disease patients compared with formerly-diagnosed celiac disease patients and control cases. Moreover the tissue transglutaminase levels were also correlated with the presence of epileptiform activity in electroencephalography. Among newly diagnosed celiac disease patients

  2. Impact of an Activity-Based Program on Health, Quality of Life, and Occupational Performance of Women Diagnosed With Cancer.

    Science.gov (United States)

    Maher, Colleen; Mendonca, Rochelle J

    We evaluated the impact of a 1-wk activity program on the health, quality of life (QOL), and occupational performance of community-living women diagnosed with cancer. A one-group pretest-posttest repeated-measures design was used. Participants completed a functional health measure (36-Item Short Form Health Survey [SF-36]), a QOL measure (World Health Organization Quality of Life-Brief version [WHOQOL-BREF]), and an occupational performance and satisfaction measure (Canadian Occupational Performance Measure [COPM]) before and 6 wk after program completion. The COPM was also administered on Day 5. Paired t tests for the SF-36 and WHOQOL-BREF showed no significant differences, except for the WHOQOL-BREF's Social Relationships subscale (p occupational performance and satisfaction and social relationships of community-living women diagnosed with cancer. Copyright © 2018 by the American Occupational Therapy Association, Inc.

  3. Insulin autoantibodies: evidence of autoimmune disease among a group of Puerto Rican children with newly diagnosed type 1 diabetes mellitus.

    Science.gov (United States)

    González de Pijem, L; Nieves-Rivera, F

    2001-06-01

    Type 1 diabetes is a chronic disease caused by a cell-specific destruction of the insulin producing cells of the pancreas. Although Puerto Rico has the highest incidence of type 1 diabetes among Latin American countries, there is scanty data on the presence of antibodies against insulin producing cells. To this end, 20 children (8 males, 12 females), ages 1-15 years, admitted to the University Pediatric Hospital with type 1 diabetes de novo between November 2000 and April 2001 were prospectively studied to determine the presence of serum antibodies against Islet cells (ICA), glutamic acid decarboxylase (GAD-65) and insulin autoantibodies (IAA). IAA was found to be present in 45% of the subjects with 85% of positive rate in subjects under age 5. GAD-65 was present in 66% and ICA was present in 23% of the subjects. We found evidence of autoimmunity against islet cell surface and intracellular components among a cohort of Puerto Rican children with newly diagnosed type 1 diabetes. These findings compared favorably with reports from other ethnicities.

  4. Diseases due to intestinale protozoa diagnosed at Le Dantec University Hospital in Dakar, Senegal, from 2011 to 2015.

    Science.gov (United States)

    Diongue, K; Ndiaye, M; Seck, M C; Diallo, M A; Ndiaye, Y D; Badiane, A S; Ndiaye, D

    2017-11-01

    To identify the protozoa responsible for intestinal parasitosis diagnosed at Le Dantec University Hospital in Dakar, Senegal. The retrospective study included 2578 patients for whom stool samples were analyzed from 2011 to 2015. The sex ratio was 1.1. Patients' mean age was 28.5 years, with a range of 11 days to 91 years. Direct examination and the Ritchie technique were performed to search for parasites. In total, 317 patients had intestinal protozoa, for a prevalence of 12.3 %. Infections involved one (91%) or two parasites (9%). The most common species found alone were Entamoeba coli (51.5%), E. histolytica/E. dispar (17 %), and Giardia intestinalis (10.5%). The most common associations were E. coli with G. intestinalis (3.6 %) and with E. histolytica (2.4%). These infections affected significantly more outpatients than inpatients (65 %, p = 0.0049) and slightly more women (51.1%, p = 0.22) than men. Adults accounted for 67% of the confirmed intestinal protozoa: 39% aged 31-60 years, 28% aged 15-30, and only 7% older than 60 (p = 0.5). Most of the protozoa isolated were non-pathogenic. However, health education should be promoted in addition to the mass treatment program already begun to limit and even halt the spread of these neglected diseases.

  5. The added value of using mutational profiling in addition to cytology in diagnosing aggressive pancreaticobiliary disease: review of clinical cases at a single center

    Science.gov (United States)

    2014-01-01

    Background This study aimed to better understand the supporting role that mutational profiling (MP) of DNA from microdissected cytology slides and supernatant specimens may play in the diagnosis of malignancy in fine-needle aspirates (FNA) and biliary brushing specimens from patients with pancreaticobiliary masses. Methods Cytology results were examined in a total of 30 patients with associated surgical (10) or clinical (20) outcomes. MP of DNA from microdissected cytology slides and from discarded supernatant fluid was analyzed in 26 patients with atypical, negative or indeterminate cytology. Results Cytology correctly diagnosed aggressive disease in 4 patients. Cytological diagnoses for the remaining 26 were as follows: 16 negative (9 false negative), 9 atypical, 1 indeterminate. MP correctly determined aggressive disease in 1 false negative cytology case and confirmed a negative cytology diagnosis in 7 of 7 cases of non-aggressive disease. Of the 9 atypical cytology cases, MP correctly diagnosed 7 as positive and 1 as negative for aggressive disease. One specimen that was indeterminate by cytology was correctly diagnosed as non-aggressive by MP. When first line malignant (positive) cytology results were combined with positive second line MP results, 12/21 cases of aggressive disease were identified, compared to 4/21 cases identified by positive cytology alone. Conclusions When first line cytology results were uncertain (atypical), questionable (negative), or not possible (non-diagnostic/indeterminate), MP provided additional information regarding the presence of aggressive disease. When used in conjunction with first line cytology, MP increased detection of aggressive disease without compromising specificity in patients that were difficult to diagnose by cytology alone. PMID:25084836

  6. How are self-rated health and diagnosed disease related to early or deferred retirement? A cross-sectional study of employees aged 55-64

    Directory of Open Access Journals (Sweden)

    Kerstin Nilsson

    2016-08-01

    Full Text Available Abstract Background More people will probably continue working into old age in the future due to the increased size of aging populations in many countries. We therefore need to know more about older workers’ health in relation to their work situation and retirement. This study is a part of a theoretical development of older workers’ situations. Older workers’ situations are theoretically themed in nine areas by the authors of this study. The aims of the study were to investigate the relationship between: i diagnosed disease and factors in older workers’ situations, theoretically themed in nine areas; ii self-rated health and factors in older workers’ situations, theoretically themed in nine areas; iii diagnosed disease and self-rated health; and iv the relationships between these health measures and retirement. Methods A questionnaire-based cross-sectional study, using logistic regression, with 1,756 health care personnel aged 55–64 years. The questionnaire used gave an overview of most different areas in the older workers’ situations. Result There was a difference in the participants’ frequency of objectively specified diagnosed disease and their subjectively experienced self-rated health. A bad self-rated health was related higher to early retirement than diagnosed diseases. In the multivariate model, having ‘Diagnosed disease’ was not significantly related to whether older workers thought they could not work beyond 65 years of age. A bad ‘Self-rated health’ was also more highly related to whether older workers thought they could not work beyond 65 years, than if the respondents stated that a ‘Diagnosed disease is a hindrance in my daily work’ in the multivariate model. Conclusion This study showed an important difference between older workers’ own experiences and the effect of their self-rated health and their diagnosed diseases. Subjective self-rated health seems to be more important to people’s retirement

  7. 99 mTc antigranulocyte monoclonal antibody imaging for the detection and assessment of inflammatory bowel disease newly diagnosed by colonoscopy in children

    International Nuclear Information System (INIS)

    Charron, M.; Hickeson, M.P.

    2001-01-01

    Objective: This prospective study evaluated a 99m Tc antigranulocyte monoclonal antibody Fab' imaging agent (Sulesomab) in children with inflammatory bowel disease (IBD) newly diagnosed by colonoscopy. Materials and methods: Ten children (4 boys, 6 girls; mean age 14 years) with newly diagnosed Crohn's disease (n = 6) or ulcerative colitis (n = 4) were studied. Colonoscopy was performed in all of these patients. Within 24 h after colonoscopy, they underwent scintigraphy with 99 m Tc-Sulesomab. Abdominal/pelvic images were acquired at 30 min (planar) and 2-4 h (planar and SPECT) after injection of Sulesomab. Eighty bowel segments were evaluated semi-quantitatively by the investigators, using these three sets of images. The Pediatric Disease Activity (PDA) was correlated with the erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, albumin, Kirschner's score, the Sulesomab bowel segment with maximum uptake, and the sum of Sulesomab score in each segment. Results: The median PDA score was 26 (range 12.5-40). Three children had normal ESR and six normal WBC counts. All patients had at least one positive mucosal biopsy for IBD. While using the Kirschner's scale, the maximal severity of colonoscopy findings was graded as none (n = 2), mild (n = 4), moderate (n = 3), or severe (n = 1). Of the 59 segments evaluated with endoscopy, 35 were found to be endoscopically abnormal. The planar images identified 17 of these abnormal segments and the SPECT images 20. Nine of these ten children had abnormal bowel uptake by scintigraphy. Thus, the sensitivity of Sulesomab per patient was 90 % and per bowel segment 57 %. The correlation coefficient between the scintigraphic score for the segment with the Sulesomab maximum activity and the PDA was 0.3 (P = 0.41). Conclusion: In pediatric IBD assessment, planar imaging with Sulesomab did not prove very sensitive in detecting inflammation in each bowel segment. However, SPECT detected the presence of inflammation in the

  8. Active Vaccines for Alzheimer Disease Treatment.

    Science.gov (United States)

    Sterner, Rosalie M; Takahashi, Paul Y; Yu Ballard, Aimee C

    2016-09-01

    Vaccination against peptides specific to Alzheimer disease may generate an immune response that could help inhibit disease and symptom progression. PubMed and Scopus were searched for clinical trial articles, review articles, and preclinical studies relevant to the field of active Alzheimer disease vaccines and raw searches yielded articles ranging from 2016 to 1973. ClinicalTrials.gov was searched for active Alzheimer disease vaccine trials. Manual research and cross-referencing from reviews and original articles was performed. First generation Aβ42 phase 2a trial in patients with mild to moderate Alzheimer disease resulted in cases of meningoencephalitis in 6% of patients, so next generation vaccines are working to target more specific epitopes to induce a more controlled immune response. Difficulty in developing these vaccines resides in striking a balance between providing a vaccine that induces enough of an immune response to actually clear protein sustainably but not so much of a response that results in excess immune activation and possibly adverse effects such as meningoencephalitis. Although much work still needs to be done in the field to make this a practical possibility, the enticing allure of being able to treat or even prevent the extraordinarily impactful disease that is Alzheimer disease makes the idea of active vaccination for Alzheimer disease very appealing and something worth striving toward. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  9. Chronic Active Epstein-Barr Virus Disease.

    Science.gov (United States)

    Kimura, Hiroshi; Cohen, Jeffrey I

    2017-01-01

    Chronic active Epstein-Barr virus (CAEBV) disease is a rare disorder in which persons are unable to control infection with the virus. The disease is progressive with markedly elevated levels of EBV DNA in the blood and infiltration of organs by EBV-positive lymphocytes. Patients often present with fever, lymphadenopathy, splenomegaly, EBV hepatitis, or pancytopenia. Over time, these patients develop progressive immunodeficiency and if not treated, succumb to opportunistic infections, hemophagocytosis, multiorgan failure, or EBV-positive lymphomas. Patients with CAEBV in the United States most often present with disease involving B or T cells, while in Asia, the disease usually involves T or NK cells. The only proven effective treatment for the disease is hematopoietic stem cell transplantation. Current studies to find a cause of this disease focus on immune defects and genetic abnormalities associated with the disease.

  10. Chronic Active Epstein–Barr Virus Disease

    Directory of Open Access Journals (Sweden)

    Hiroshi Kimura

    2017-12-01

    Full Text Available Chronic active Epstein–Barr virus (CAEBV disease is a rare disorder in which persons are unable to control infection with the virus. The disease is progressive with markedly elevated levels of EBV DNA in the blood and infiltration of organs by EBV-positive lymphocytes. Patients often present with fever, lymphadenopathy, splenomegaly, EBV hepatitis, or pancytopenia. Over time, these patients develop progressive immunodeficiency and if not treated, succumb to opportunistic infections, hemophagocytosis, multiorgan failure, or EBV-positive lymphomas. Patients with CAEBV in the United States most often present with disease involving B or T cells, while in Asia, the disease usually involves T or NK cells. The only proven effective treatment for the disease is hematopoietic stem cell transplantation. Current studies to find a cause of this disease focus on immune defects and genetic abnormalities associated with the disease.

  11. LOW-BACK PAIN DISORDERS AS OCCUPATIONAL DISEASES IN THE CZECH REPUBLIC AND 22 EUROPEAN COUNTRIES: COMPARISON OF NATIONAL SYSTEMS, RELATED DIAGNOSES AND EVALUATION CRITERIA

    NARCIS (Netherlands)

    Laštovková, Andrea; Nakládalová, Marie; Fenclová, Zdenka; Urban, Pavel; Gad'ourek, Petr; Lebeda, Tomáš; Ehler, Edvard; Ridzoň, Petr; Hlávková, Jana; Boriková, Alena; Kuijer, P. Paul F. M.; Bátora, Igor; Scholz-Odermatt, Stefan M.; Moldovan, Horatiu; Godderis, Lode; Leijon, Ola; Campo, Giuseppe; Vaněčková, Manuela; Bonneterre, Vincent; Stikova, Elisaveta Jasna; Pelclová, Daniela

    2015-01-01

    Low-back pain diseases (LBPD) belong to the most frequent diagnoses determined by general practitioners, and constitute one of the most common reasons for sick leave and permanent disability pension in the Czech Republic and other European countries. Epidemiological studies have shown a

  12. Prevalence and clinical characteristics of non-alcoholic fatty liver disease in newly diagnosed patients with ketosis-onset diabetes.

    Science.gov (United States)

    Li, T-T; Wang, A-P; Lu, J-X; Chen, M-Y; Zhao, C-C; Tang, Z-H; Li, L-X; Jia, W-P

    2018-03-21

    As the prevalence and clinical characteristics of non-alcoholic fatty liver disease (NAFLD) are still unknown in ketosis-onset diabetes, the present study compared the characteristics of NAFLD in type 1 diabetes (T1D), ketosis-onset and non-ketotic type 2 diabetes (T2D) patients. This cross-sectional study was performed with newly diagnosed Chinese patients with diabetes, including 39 T1D, 165 ketosis-onset and 173 non-ketotic T2D, with 30 non-diabetics included as controls. NAFLD was determined by hepatic ultrasonography, then its clinical features were analyzed and its associated risk factors evaluated. NAFLD prevalence in patients with ketosis-onset diabetes (61.8%) was significantly higher than in controls (23.3%; P=0.003) and in T1D patients (15.4%; Pketosis-onset and non-ketotic T2D patients (52.6%; P=0.229), although BMI and alanine aminotransferase (ALT) proved to be independent risk factors for the presence of NAFLD in both these groups whereas, in T1D patients, serum uric acid levels were independent risk factors. NAFLD prevalence and risk factors in ketosis-onset diabetes were similar to those in non-ketotic T2D, but different from those in T1D. These data provide further evidence that ketosis-onset diabetes should be classified as a subtype of T2D rather than idiopathic T1D. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  13. Regional changes in psychotropic use among Finnish persons with newly diagnosed Alzheimer's disease in 2005-2011.

    Directory of Open Access Journals (Sweden)

    Anna-Maija Tolppanen

    Full Text Available To describe and compare temporal changes in prevalence and incidence of psychotropic use (antipsychotics, antidepressants and benzodiazepines and related drugs; BZDRs in persons with newly diagnosed Alzheimer's disease (AD between university hospital districts of Finland during 2005-2011.The MEDALZ study includes all community-dwellers of Finland who received a clinically verified AD diagnosis in 2005-2011 (N = 70,718. Prevalent and incident use of psychotropics among those who had received AD diagnosis less than one year ago were compared in 2005-2011.Regional differences in psychotropic use between university hospital districts were more evident in 2005 than 2011 for prevalent use of any psychotropic, antipsychotic and BZDRs and incident use of any psychotropic and antipsychotics. Regional differences in prevalent antidepressant use and incident BZDR use remained similar during the follow-up, while differences in incident antidepressant use increased during the follow-up. The prevalence of any psychotropic use in 2005 varied between 44.7-50.7% and between 45.0-47.9% in 2011. Incidence of any psychotropic use in 2005 was between 8.6-12.1% and 6.2-8.2% in 2011. In 2005, the distribution of incident psychotropic use followed a large scale spatial variation that, however, did not correspond to university hospital districts. During the study period from 2005 to 2011 the cyclic spatial variation disappeared. No sign of adjacent hospital districts being more or less closely related to each other compared to hospital districts in general was detected.Except for antidepressants, regional differences in psychotropic use have mainly diminished between 2005 and 2011. Our findings highlight the importance of acknowledging regional differences in a country with relatively homogeneous healthcare system and conducting future studies assessing the reasons behind these differences.

  14. Diagnosing Dementia—Positive Signs

    Science.gov (United States)

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

  15. Graves' disease: thyroid function and immunologic activity

    International Nuclear Information System (INIS)

    Gossage, A.A.R.; Crawley, J.C.W.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-01-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [ 9 -9μTc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity - TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p<0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

  16. Diagnosing Flu

    Science.gov (United States)

    ... Types Seasonal Avian Swine Variant Pandemic Other Diagnosing Flu Questions & Answers Language: English (US) Español Recommend on ... How do I know if I have the flu? Your respiratory illness might be the flu if ...

  17. Diagnose, behandling og prognose ved fibromyalgi

    DEFF Research Database (Denmark)

    Danneskiold-Samsøe, Bente; Bartels, Else Marie; Amris, Kirstine

    2010-01-01

    It is important to recognize the diagnosis of fibromyalgia (FM) to adequately advise patients with this chronic pain disease. FM coexists with other rheumatic diseases and may therefore serve as a confounder in connection with estimation of disease activity. The aetiology and pathogenesis of FM...... remain unknown, although central sensitisation seems to play a major role. Following exclusion of a number of differential diagnoses, the remaining patients have several treatment options including centrally-acting medication....

  18. [Prevalence of diseases diagnosed by the Program of Neonatal Screening in Maringá, Paraná, Brazil: 2001-2006].

    Science.gov (United States)

    Luz, Geisa dos Santos; Carvalho, Maria Dalva de Barros; Pelloso, Sandra Marisa; Higarashi, Ieda Harumi

    2008-09-01

    Irreversible sequels of some genetic diseases can be prevented by neonatal screening. The aim of this paper was to verify the prevalence of diseases diagnosed by the National Program of Neonatal Screening (PNTN) in Maringá, Paraná, Brazil, between 2001 and 2006. This cross-sectional descriptive study included 20,529 newborn infants screened by that program. Out of those, 859 were re-examined, and 21 had the disease confirmed. Considering all screened newborn infants and the number of diagnostics per disease, the following disease prevalence was determine: phenylketonuria--1:20,529; congenital hypothyrodism--1:2,281; hemoglobinopahies--1:3,421; cystic fibrosis--1:10,264; and biotinidase deficiency--1:6,843. Understanding disease status and prevalence of newborns in a population allows the establishment and the improvement of public policies aimed at the children.

  19. Skeletal and muscular status in juveniles with GFD treated clinical and newly diagnosed atypical celiac disease--preliminary data.

    Science.gov (United States)

    Płudowski, Paweł; Karczmarewicz, Elzbieta; Socha, Jerzy; Matusik, Halina; Syczewska, Małgorzata; Lorenc, Roman S

    2007-01-01

    Undiagnosed and untreated celiac disease (CD) constitutes an increasing skeletal health problem due to its association with low bone density and fractures. Examinations of skeletal status in children using dual-energy X-ray absorptiometry (DXA) are prone to size-related misinterpretation. In contrary, the analysis of muscle-bone relationship seems to limit a possibility of misdiagnosis because skeletal status is evaluated from the functional perspective. The study was aimed to assess skeletal status of children suffering from CD with the use of muscle-bone functional algorithm. The study group comprised 29 celiac patients (13.7yr+/-2.9) on gluten-free diet (GFD), and 24 newly diagnosed atypical celiac patients, including subgroup with normal height (n=14; 12.6yr+/-3.9) and subgroup with short stature (n=10; 12.2yr+/-2.9). Muscular and skeletal status was evaluated by DXA (DPX-L, GE). Anthropometry, total body bone mineral density (TBBMD, g/cm(2)). and total body bone mineral content (TBBMC, g) as well as lean body mass (LBM, g) were evaluated. Muscle-bone interactions were estimated using TBBMC/LBM ratio. Previously established references for healthy controls were used for the calculation of Z-scores (age-matched) and SD-scores (height-matched). GFD treated celiacs and atypical celiacs with normal body height had TBBMD, TBBMC, LBM, and TBBMC/LBM ratio Z-scores and SD-scores within normal range for healthy controls. In contrary, atypical celiacs with short stature had significantly lower Z-scores for TBBMD (-2.3+/-0.4), TBBMC (-2.1+/-0.3), LBM (-1.4+/-0.3). and TBBMC/LBM ratio (-2.3+/-0.6) when compared to respective values observed in GFD treated celiacs (pnormal height (pvalues observed in GFD treated celiacs (+0.04+/-0.2; pnormal height (-0.4+/-0.2; pvalues of DXA assessed indicators of bone and muscle status as well as normal muscle-bone interactions. Untreated atypical celiacs may present a broad spectrum of heterogeneous abnormalities from normal to markedly

  20. An Assessment of the AGA and CCFA Quality Indicators in a Sample of Patients Diagnosed with Inflammatory Bowel Disease.

    Science.gov (United States)

    Tkacz, Joseph; Brady, Brenna L; Meyer, Roxanne; Lofland, Jennifer H; Ruetsch, Charles; Coelho-Prabhu, Nayantara

    2015-11-01

    Inflammatory bowel disease (IBD) is a chronic relapsing disease characterized by activation of the mucosal immune system and inflammation of the gastrointestinal tract. Management of IBD places a significant burden on the health care system because of the complexity of treatment, variability in patient outcomes, and chronic nature of the disease.  To investigate the American Gastroenterological Association (AGA) and Crohn's and Colitis Foundation of America's (CCFA) quality measurement sets in a sample of IBD patients. Fourteen quality measures were restated for application to a claims database and calculated using Optum Clinformatics DataMart database. Selected measures were calculated over calendar year 2011. Performance measures ranged from 0.4% for AGA measure 9, prophylaxis for venous thromboembolism, to 66.9% for AGA measure 8, testing for Clostridium difficile. CCFA outcome measures ranged from 0.6% qualifying for CCFA O10, report of fecal incontinence, to 32.9% for CCFA O1, prednisone usage. In addition to Clostridium difficile testing, the use of appropriate corticosteroid-sparing therapy (51.1%) and testing for latent tuberculosis before initiating anti-tumor necrosis factor therapy (45.0%) were the highest achieved measures. This is the first examination of IBD quality measures using administrative claims. Rates of achievement across measures were variable and likely affected by the ability to calculate certain measures with claims data. Future studies should further examine measurement of IBD quality indicators in claims data to assess the validity of claims-based analyses and to ascertain whether measure attainment translates into better overall health or IBD-related outcomes.

  1. Serum Inflammatory Mediators as Markers of Human Lyme Disease Activity

    Science.gov (United States)

    Soloski, Mark J.; Crowder, Lauren A.; Lahey, Lauren J.; Wagner, Catriona A.

    2014-01-01

    Chemokines and cytokines are key signaling molecules that orchestrate the trafficking of immune cells, direct them to sites of tissue injury and inflammation and modulate their states of activation and effector cell function. We have measured, using a multiplex-based approach, the levels of 58 immune mediators and 7 acute phase markers in sera derived from of a cohort of patients diagnosed with acute Lyme disease and matched controls. This analysis identified a cytokine signature associated with the early stages of infection and allowed us to identify two subsets (mediator-high and mediator-low) of acute Lyme patients with distinct cytokine signatures that also differed significantly (pLyme disease (p = 0.01) and the decrease correlates with chemokine levels (p = 0.0375). The levels of CXCL9/10 did not relate to the size or number of skin lesions but elevated levels of serum CXCL9/CXCL10 were associated with elevated liver enzymes levels. Collectively these results indicate that the levels of serum chemokines and the levels of expression of their respective chemokine receptors on T cell subsets may prove to be informative biomarkers for Lyme disease and related to specific disease manifestations. PMID:24740099

  2. [A case report of early-onset Alzheimer's disease with multiple psychotic symptoms, finally diagnosed as APPV717I mutation by genetic testing].

    Science.gov (United States)

    Ishimaru, Takashi; Ochi, Shinichiro; Matsumoto, Teruhisa; Yoshida, Taku; Abe, Masao; Toyota, Yasutaka; Fukuhara, Ryuji; Tanimukai, Satoshi; Ueno, Shu-ichi

    2013-01-01

    It is difficult to confirm a diagnosis of early-onset Alzheimer's disease (EOAD) because patients sometimes have non-specific cortical features, such as psychiatric symptoms, executive functional impairment, and pyramidal symptoms, along with typical symptoms, such as recent memory impairment and disorientation. We encountered a patient with multiple psychotic symptoms, finally diagnosed with EOAD on genetic testing. A right-handed sixty-year-old man, whose mother was suspected of having dementia, developed memory impairment at the age of fifty, disorientation at the age of fifty-six, and both visual hallucination and dressing apraxia at the age of fifty-nine. After admission to a psychiatric hospital for treatment, his symptoms disappeared with antipsychotic medication. However, his ADL were declining and so he was referred to our university hospital. He had frontal lobe symptoms, pyramidal signs, and extrapyramidal signs with severe dementia. Neuropsychological examinations were not possible because of sedation. On brain MRI, he showed diffuse atrophy of the cerebral cortex and hippocampus. HMPO-SPECT showed hypoperfusion of cerebral cortices diffusely. We decided to perform genetic testing because he had both family and alcohol abuse histories. He showed EOAD with V717I mutation of the amyloid precursor protein gene. After the discontinuation of antipsychotics, excessive sedation and extrapyramidal signs disappeared. A dose of 10 mg of donepezil was effective to improve motivation and activity, and his mini mental examination score was calculable after recovery. The case supports usefulness of applying genetic testing for Alzheimer's disease to patients with early onset dementia, even when they do not have a family history.

  3. Maximum standard uptake value on pre-chemotherapeutic FDG-PET is a significant parameter for disease progression of newly diagnosed lymphoma

    International Nuclear Information System (INIS)

    Eo, Jae Seon; Lee, Won Woo; Chung, June Key; Lee, Myung Chul; Kim, Sang Eun

    2005-01-01

    F-18 FDG-PET is useful for detection and staging of lymphoma. We investigated the prognostic significance of maximum standard uptake (maxSUV) value of FDG-PET for newly diagnosed lymphoma patients before chemotherapy. Twenty-seven patients (male: female = 17: 10: age: 49±19 years) with newly diagnosed lymphoma were enrolled. Nine-teen patients suffered from B cell lymphoma, 6 Hodgkins disease and 2 T cell lymphoma. One patient was stage I, 9 stage II, 3 stage III, 1 stage IV and 13 others. All patients underwent FDG-PET before initiation of chemotherapy. MaxSUV values using lean body weight were obtained for main and largest lesion to represent maxSUV of the patients. The disease progression was defined as total change of the chemotherapeutic regimen or addition of new chemotherapeutic agent during follow up period. The observed period was 389±224 days. The value of maxSUV ranged from 3 to 18 (mean±SD = 10.6±4.4). The disease progressions occurred in 6 patients. Using Cox proportional-hazard regression analysis, maxSUV was identified as a significant parameter for the disease progression free survival (p=0.044). Kaplan-Meier survival curve analysis revealed that the group with higher maxSUV (=10.6, n=5) suffered from shorter disease progression free survival (median 299 days) than the group with lower maxSUV (<10.6, n = 22) (median 378 days, p=0.0146). We found that maxSUV on pre-chemotherapeutic F-18 FDG-PET for newly diagnosed lymphoma patients is a significant parameter for disease progression. Lymphoma patients can be stratified before initiation of chemotherapy in terms of disease progression by the value of maxSUV 10.6

  4. Complement Activation in Inflammatory Skin Diseases

    Directory of Open Access Journals (Sweden)

    Jenny Giang

    2018-04-01

    Full Text Available The complement system is a fundamental part of the innate immune system, playing a crucial role in host defense against various pathogens, such as bacteria, viruses, and fungi. Activation of complement results in production of several molecules mediating chemotaxis, opsonization, and mast cell degranulation, which can contribute to the elimination of pathogenic organisms and inflammation. Furthermore, the complement system also has regulating properties in inflammatory and immune responses. Complement activity in diseases is rather complex and may involve both aberrant expression of complement and genetic deficiencies of complement components or regulators. The skin represents an active immune organ with complex interactions between cellular components and various mediators. Complement involvement has been associated with several skin diseases, such as psoriasis, lupus erythematosus, cutaneous vasculitis, urticaria, and bullous dermatoses. Several triggers including auto-antibodies and micro-organisms can activate complement, while on the other hand complement deficiencies can contribute to impaired immune complex clearance, leading to disease. This review provides an overview of the role of complement in inflammatory skin diseases and discusses complement factors as potential new targets for therapeutic intervention.

  5. Addison's Disease Caused by Tuberculosis with Atypical Hyperpigmentation and Active Pulmonary Tuberculosis.

    Science.gov (United States)

    Namikawa, Hiroki; Takemoto, Yasuhiko; Kainuma, Shigeto; Umeda, Sakurako; Makuuchi, Ayako; Fukumoto, Kazuo; Kobayashi, Masanori; Kinuhata, Shigeki; Isaka, Yoshihiro; Toyoda, Hiromitsu; Kamata, Noriko; Tochino, Yoshihiro; Hiura, Yoshikazu; Morimura, Mina; Shuto, Taichi

    2017-01-01

    We herein report a case of Addison's disease caused by tuberculosis characterized by atypical hyperpigmentation, noted as exacerbation of the pigmentation of freckles and the occurrence of new freckles, that was diagnosed in the presence of active pulmonary tuberculosis. The clinical condition of the patient was markedly ameliorated by the administration of hydrocortisone and anti-tuberculosis agents. When exacerbation of the pigmentation of the freckles and/or the occurrence of new freckles are noted, Addison's disease should be considered as part of the differential diagnosis. In addition, the presence of active tuberculosis needs to be assumed whenever we treat patients with Addison's disease caused by tuberculosis, despite its rarity.

  6. Profile of chronic kidney disease related-mineral bone disorders in newly diagnosed advanced predialysis diabetic kidney disease patients: A hospital based cross-sectional study.

    Science.gov (United States)

    Ray, S; Beatrice, A M; Ghosh, A; Pramanik, S; Bhattacharjee, R; Ghosh, S; Raychaudhury, A; Mukhopadhyay, S; Chowdhury, S

    2017-12-01

    Chronic kidney disease related-mineral bone disorder (CKD-MBD) has been poorly studied in pre-dialysis Indian CKD population. There are limited data on the pattern of these disturbances in diabetic CKD patients. Therefore, a study was conducted to find out the profile of mineral bone disorders in T2DM patients with pre-dialysis CKD. In this cross-sectional design, diabetic patients with newly-diagnosed stage 4 and 5 CKD were evaluated. Serum levels of calcium, phosphorus, intact parathyroid hormone (iPTH), 25 hydroxy vitamin D and total alkaline phosphatase (ALP) were measured in all patients. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DXA). A total of 72 eligible patients participated (44 males, 28 females; age 54.2±11.7). Patients with CKD Stage 5 had a lower level of corrected serum calcium and significantly higher level of inorganic phosphorus, total ALP and iPTH as compared to stage 4 patients. Overall, 38.5% were hypocalcemic, 31.43% were hyperphosphatemic. 24.2% of CKD subjects were vitamin D deficient (110pg/ml) was detected in nearly 43% of patients. In stage 5, only 32% patients was found to have hyperparathyroidism (iPTH>300pg/ml). There was a good correlation between iPTH and total ALP (r=0.5, p=0.0001) in this cohort. 25 (OH) vitamin D was inversely correlated with ALP (r=-0.39, P=0.001) and showed negative correlation with urine ACR (r=-0.37, P=0.002). As a group, the osteoporotic CKD subjects exhibited higher iPTH (220.1±153.8 vs. 119±108pg/ml, p<0.05) as compared to those who were osteopenic or had normal bone density. There was significant correlation between BMD and iPTH (adjusted r=-0.436; P=0.001). In the multivariate regression model, we found intact PTH to predict BMD even after adjustment of all the confounders. The current study showed that adynamic bone disease is prevalent even in pre-dialysis CKD population. High bone turnover disease may not be the most prevalent type in diabetic CKD. However, it

  7. Patterns of 6-mercaptopurine and azathioprine maintenance therapy among a cohort of commercially insured individuals diagnosed with Crohn's disease in the United States

    Directory of Open Access Journals (Sweden)

    Lund JL

    2013-12-01

    Full Text Available Jennifer L Lund,1 Suzanne F Cook,2 Jeffery K Allen,2 Charlotte F Carroll,2 Michael D Kappelman3 1Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark; 2Worldwide Epidemiology, GlaxoSmithKline, Research Triangle Park, NC, USA; 3Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Background and aims: Thiopurines, including 6-mercaptopurine (6-MP and azathioprine (AZA, are the mainstay of maintenance therapy for Crohn's disease (CD. However, studies examining their effectiveness in routine practice among diverse patient populations are lacking. Among a cohort of new users of 6MP/AZA, we described treatment patterns and changes in subsequent therapy. Methods: Using the Truven Health Analytics databases, we identified all individuals diagnosed with CD and initiating 6-MP/AZA monotherapy from 2001–2008 (n=3,657. We estimated the proportion of CD patients remaining on 6-MP/AZA monotherapy, using Kaplan–Meier methods, and identified predictors of treatment noncontinuation, using multivariable Cox regression. Among the “noncontinuers,” we described subsequent patterns of maintenance therapy and summarized the diagnosis and procedure codes and prescription drug claims preceding treatment discontinuation. Results: The 1-year 6-MP/AZA treatment continuation rate was 42%. Children (age ≤18 years and individuals with no prior anti-tumor necrosis factor (TNF use were more likely to continue 6-MP/AZA, while those dispensed more (>4 outpatient prescriptions for any drug before initiation of 6-MP/AZA were less likely to continue maintenance treatment. Overall, 1,128 (39% and 105 (4% individuals experienced a clinical event potentially indicating active disease or 6-MP/AZA-intolerance prior to discontinuation, respectively. Most patients discontinued therapy; among the remaining patients who failed to continue 6-MP/AZA, most augmented with an anti-TNF. Conclusion: Most patients initiating 6-MP

  8. Histologic scoring indices for evaluation of disease activity in Crohn's disease.

    Science.gov (United States)

    Novak, Gregor; Parker, Claire E; Pai, Rish K; MacDonald, John K; Feagan, Brian G; Sandborn, William J; D'Haens, Geert; Jairath, Vipul; Khanna, Reena

    2017-07-21

    Histologic assessment of mucosal disease activity has been increasingly used in clinical trials of treatment for Crohn's disease. However, the operating properties of the currently existing histologic scoring indices remain unclear. A systematic review was undertaken to evaluate the development and operating characteristics of available histologic disease activity indices in Crohn's disease. Electronic searches of MEDLINE, EMBASE, PubMed, and the Cochrane Library (CENTRAL) databases from inception to 20 July 2016 were supplemented by manual reviews of bibliographies and abstracts submitted to major gastroenterology meetings (Digestive Disease Week, United European Gastroenterology Week, European Crohn's and Colitis Organisation). Any study design (e.g. randomised controlled trial, cohort study, case series) that evaluated a histologic disease activity index in patients with Crohn's disease was considered for inclusion. Study participants included adult patients (> 16 years), diagnosed with Crohn's disease using conventional clinical, radiographic or endoscopic criteria. Two authors independently reviewed the titles and abstracts of the studies identified from the literature search. The full text of potentially relevant citations were reviewed for inclusion and the study investigators were contacted as needed for clarification. Any disagreements regarding study eligibility were resolved by discussion and consensus with a third author.Two authors independently extracted and recorded data using a standard form. The following data were recorded from each eligible study: number of patients enrolled; number of patients per treatment arm; patient characteristics: age and gender distribution; description of histologic disease activity index utilized; and outcomes such as content validity, construct validity, criterion validity, responsiveness, intra-rater reliability, inter-rater reliability, and feasibility. Sixteen reports of 14 studies describing 14 different numerical

  9. Screening for thyroid cancer according to French recommendations with thyroid ultrasound in newly diagnosed Graves' disease without palpable nodule is not useful.

    Science.gov (United States)

    Nys, Pierre; Cordray, Jean-Pierre; Sarafian, Véronique; Lefort-Mossé, Ève; Merceron, Robert-Édouard

    2015-02-01

    The aim of the study was to evaluate systematic thyroid ultrasonography (US) relevance in newly diagnosed Graves' disease among patients presenting without palpable nodules. We consecutively recruited 208 cases of Graves' disease without palpable nodule. All patients were screened for thyroid antibodies and underwent a thyroid US. Ultrasonically guided biopsy was proposed for the assessment of all nodules upper or equal to 10mm in diameter. Two third of patients had an abnormal thyroid at palpation requiring an US. One third of patients had a normal thyroid at palpation and US was consequently unwarranted. Among all patients, US detected non-palpable nodules in 26% of cases. We found no smears suspected to be cancerous. In newly diagnosed Graves' disease, the US relevance is only questionable in patients without abnormal thyroid at palpation. Ultrasonography detected non-palpable nodules and none was suspected to be cancerous. These data suggest that US is not useful in patients without abnormal thyroid at palpation. Nevertheless, the recent Thyroid Imaging-Reporting And Data System classification (TI-RADS) might change our conclusions. The TI-RADS classification indeed improves the selection of nodules lower than 10mm in diameter requiring a biopsy. Nodules lower than 10mm in diameter were not biopsied in the present study. The other US data presented herein (echogenicity, vascularisation) provide no further relevance for systematic US in newly diagnosed patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  10. Inflammatory activity in Crohn disease: ultrasound findings.

    Science.gov (United States)

    Migaleddu, Vincenzo; Quaia, Emilio; Scano, Domenico; Virgilio, Giuseppe

    2008-01-01

    Improvements in the ultrasound examination of bowel disease have registered in the last years the introduction of new technologies regarding high frequency probes (US), highly sensitive color or power Doppler units (CD-US), and the development of new non-linear technologies that optimize detection of contrast agents. Contrast-enhanced ultrasound (CE-US) most importantly increases the results in sonographic evaluation of Crohn disease inflammatory activity. CE-US has become an imaging modality routinely employed in the clinical practice for the evaluation of parenchymal organs due to the introduction of new generation microbubble contrast agents which persist in the bloodstream for several minutes after intravenous injection. The availability of high frequency dedicated contrast-specific US techniques provide accurate depiction of small bowel wall perfusion due to the extremely high sensitivity of non-linear signals produced by microbubble insonation. In Crohn's disease, CE-US may characterize the bowel wall thickness by differentiating fibrosis from edema and may grade the inflammatory disease activity by assessing the presence and distribution of vascularity within the layers of the bowel wall (submucosa alone or the entire bowel wall). Peri-intestinal inflammatory involvement can be also characterized. CE-US can provide prognostic data concerning clinical recurrence of the inflammatory disease and evaluate the efficacy of drugs treatments.

  11. Medullary cystic disease of the kidney: report of a case diagnosed by ultrasonography and computed tomography examinations

    International Nuclear Information System (INIS)

    Carvalho, Tarcisio Nunes; Araujo Junior, Cyrillo Rodrigues de; Fraguas Filho, Sergio Roberto; Costa, Marlos Augusto Bittencourt; Teixeira, Kim-Ir-Sen Santos; Ribeiro, Flavia Aparecida de Souza

    2003-01-01

    The terms medullary cystic disease, juvenile nephronophthisis or medullary cystic disease complex refer to a group of similar diseases in which the basic pathological abnormality is progressive renal tubular atrophy with secondary glomerular sclerosis and medullary cystic formation. Medullary cystic disease is an important cause of renal failure in adolescent patients. Imaging methods play a primary role in the diagnosis of these diseases. Cysts are characteristically seen in the renal medulla and cortico medullary junction whereas kidneys may be of normal to small size. In this article we present the ultrasonography and computed tomography findings of a female adolescent patient with characteristic clinical picture of medullary cystic disease. (author)

  12. Multi-section CT angiography compared with digital subtraction angiography in diagnosing major arterial hemorrhage in inflammatory pancreatic disease

    International Nuclear Information System (INIS)

    Hyare, Harpreet; Desigan, Sharmini; Nicholl, Helen; Guiney, Michael J.; Brookes, Jocelyn A.; Lees, William R.

    2006-01-01

    Purpose: Major arterial hemorrhage is an uncommon but serious complication of pancreatitis with high morbidity and mortality. Digital subtraction angiography (DSA) has long been the gold standard for the detection of a visceral artery pseudoaneurysm or for the site of active bleeding in patients with pancreatitis. Multi-section CT angiography is a minimally invasive technique which can provide high-resolution and high-contrast images of the arterial lumen and wall, with a much lower risk of complication and morbidity compared to DSA. The aim of this study was to determine the accuracy of multi-section CT angiography for the diagnosis of arterial complications of inflammatory pancreatitic disease. Materials and methods: A retrospective analysis of all patients undergoing visceral angiography for major bleeding as a complication of pancreatitis between 1998 and 2004 was performed. Twenty-nine studies in 25 patients (20 males, 5 females) with a mean age of 50.9 years (range 11-67 years) were identified where multi-section CT angiography was performed in the 24 h preceding the digital subtraction angiogram. Results: Digital subtraction angiography detected a pseudoaneurysm or contrast extravasation in 19 studies and no bleeding was demonstrated in 9 studies. CT angiography correctly identified the site and type of bleeding in 18 of the 19 positive studies. CT angiography detected extravasation of contrast in one study that was not demonstrated on digital subtraction angiography. The sensitivity and specificity for multi-section CT angiography for the detection of major arterial bleeding on a background of pancreatitis were 0.947 and 0.900, respectively. Conclusion: Multi-section CT angiography is a sensitive and accurate technique for the detection of major arterial hemorrhage in inflammatory pancreatic disease and should be considered as the first investigation in the management of these patients

  13. Gastric emptying and disease activity in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Keller, Jutta; Binnewies, Ulrich; Rösch, Marie

    2015-01-01

    BACKGROUND: Gastric emptying (GE) is delayed in a subset of patients with inflammatory bowel disease (IBD). We have shown before that altered release of gastrointestinal hormones may contribute to GE disturbances, but overall effects of disease activity remain unclear. Thus, we aimed to evaluate GE...... test (baseline test). Plasma glucose, cholecystokinin (CCK), peptide YY (PYY) and glucagon-like peptide-1 (GLP-1) were measured periodically throughout the test. A total of 16 patients underwent a second GE test after 3-4 months of therapy. RESULTS: At baseline, nine patients with IBD had...... pathologically delayed GE half-time (T½ > 150 min) (P = 0·028 vs. HC). Moreover, T½ was significantly longer in the total group of patients with IBD than in HC (129 ± 12 min vs. 96 ± 7, P = 0·030). Postprandial GLP-1 responses were elevated in IBD (P = 0·002 vs. HC) and correlated with T½ (P = 0·05). Following...

  14. Physical activity, obesity and cardiovascular diseases.

    Science.gov (United States)

    Lakka, T A; Bouchard, C

    2005-01-01

    Sedentary lifestyle and overweight are major public health, clinical, and economical problems in modern societies. The worldwide epidemic of excess weight is due to imbalance between physical activity and dietary energy intake. Sedentary lifestyle, unhealthy diet, and consequent overweight and obesity markedly increase the risk of cardiovascular diseases. Regular physical activity 45-60 min per day prevents unhealthy weight gain and obesity, whereas sedentary behaviors such as watching television promote them. Regular exercise can markedly reduce body weight and fat mass without dietary caloric restriction in overweight individuals. An increase in total energy expenditure appears to be the most important determinant of successful exercise-induced weight loss. The best long-term results may be achieved when physical activity produces an energy expenditure of at least 2,500 kcal/week. Yet, the optimal approach in weight reduction programs appears to be a combination of regular physical activity and caloric restriction. A minimum of 60 min, but most likely 80-90 min of moderate-intensity physical activity per day may be needed to avoid or limit weight regain in formerly overweight or obese individuals. Regular moderate intensity physical activity, a healthy diet, and avoiding unhealthy weight gain are effective and safe ways to prevent and treat cardiovascular diseases and to reduce premature mortality in all population groups. Although the efforts to promote cardiovascular health concern the whole population, particular attention should be paid to individuals who are physically inactive, have unhealthy diets or are prone to weight gain. They have the highest risk for worsening of the cardiovascular risk factor profile and for cardiovascular disease. To combat the epidemic of overweight and to improve cardiovascular health at a population level, it is important to develop strategies to increase habitual physical activity and to prevent overweight and obesity in

  15. Diagnosing Borreliosis

    Czech Academy of Sciences Publication Activity Database

    Cutler, S.; Rudenko, Natalia; Golovchenko, Maryna; Cramaro, W. J.; Kirpach, J.; Savic, S.; Christova, I.; Amaro, A.

    2017-01-01

    Roč. 17, č. 1 (2017), s. 2-11 ISSN 1530-3667 Institutional support: RVO:60077344 Keywords : Lyme disease * Borrelia species * diagnosis * relapsing fever Subject RIV: FN - Epidemiology, Contagious Diseases ; Clinical Immunology OBOR OECD: Infectious Diseases Impact factor: 2.045, year: 2016

  16. Graves' disease: thyroid function and immunologic activity

    International Nuclear Information System (INIS)

    Gossage, A.A.; Crawley, J.C.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-01-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [/sup 99m/Tc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity--TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p less than 0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

  17. Adding liraglutide to the backbone therapy of biguanide in patients with coronary artery disease and newly diagnosed type-2 diabetes (the AddHope2 study)

    DEFF Research Database (Denmark)

    Anholm, Christian; Kumarathurai, Preman; Klit, Malene S

    2014-01-01

    INTRODUCTION: Newly diagnosed type 2 diabetes mellitus (T2DM) in patients with coronary artery disease (CAD) more than doubles the risk of death compared with otherwise matched glucose tolerant patients. The biguanide metformin is the drug of choice in treatment of T2DM and has shown to ameliorate...... cardiovascular morbidity in patients with T2DM and myocardial infarction (MI). The incretin hormone, glucagon-like peptide-1 (GLP-1) improves β-cell function, insulin sensitivity and causes weight loss and has been suggested to have beneficial effects on cardiac function. The GLP-1 receptor agonist (GLP-1RA......), liraglutide, is currently used for treatment of T2DM but its potential effect on cardiac function has not been investigated in detail. We hypothesised that liraglutide added to metformin backbone therapy in patients with CAD and newly diagnosed T2DM will improve β-cell function and left ventricular systolic...

  18. Symptoms in Inflammatory Bowel Disease: pathophysiologic aspects and their relation with disease activity

    NARCIS (Netherlands)

    Minderhoud, I.M.

    2007-01-01

    Symptoms in Inflammatory Bowel Disease: pathophysiologic aspects and their relation with disease activity Inflammatory bowel disease (IBD) comprises ulcerative colitis (UC) and Crohn's disease (CD). IBD patients frequently complain of fatigue, and a substantial proportion of the patients have

  19. Diagnosing diseases of the thyroid gland by means of scintiscanning and puncture cytology taking into consideration the nodular goitre

    International Nuclear Information System (INIS)

    Eitel, M.

    1981-01-01

    This paper contains the results of scintigraphical and puncture-cytological examinations carried out during an observation period of appr. 3 years on 548 patients with goiters from the Upper-Bavarien endemis region. In total, we had 484 thyroid gland scintigrams which showed 335 uninodular, 71 multinodular, and 78 diffuse goiters. The 335 solitary nodular goiters were allocated 278 cold, 36 warm, and 18 hot nodes; in three cases, the scintigram could not be assessed due to exogenous iodine contamination. In the 71 multinodular goiters, we found 118 cold, 28 warm, and 9 hot nodes. Cytological findings were established in 548 patients. In 484 cases, the findings were negative, in 19 cases suspicious, and in 17 cases positive. The efficiency of cytological diagnosis of malignant tumours can be stated to be 87.5%. The rate of falsely negative smears was 12.5%; cytologically, in 10.9% of the preparations falsely suspicious diagnoses were established, and in 1.6% the diagnoses were falsely positive. (orig./MG) [de

  20. Active Surveillance of Hansen's Disease (Leprosy): Importance for Case Finding among Extra-domiciliary Contacts

    Science.gov (United States)

    Moura, Maria L. N.; Dupnik, Kathryn M.; Sampaio, Gabriel A. A.; Nóbrega, Priscilla F. C.; Jeronimo, Ana K.; do Nascimento-Filho, Jose M.; Miranda Dantas, Roberta L.; Queiroz, Jose W.; Barbosa, James D.; Dias, Gutemberg; Jeronimo, Selma M. B.; Souza, Marcia C. F.; Nobre, Maurício L.

    2013-01-01

    Hansen's disease (leprosy) remains an important health problem in Brazil, where 34,894 new cases were diagnosed in 2010, corresponding to 15.3% of the world's new cases detected in that year. The purpose of this study was to use home visits as a tool for surveillance of Hansen's disease in a hyperendemic area in Brazil. A total of 258 residences were visited with 719 individuals examined. Of these, 82 individuals had had a previous history of Hansen's disease, 209 were their household contacts and 428 lived in neighboring residences. Fifteen new Hansen's disease cases were confirmed, yielding a detection rate of 2.0% of people examined. There was no difference in the detection rate between household and neighbor contacts (p = 0.615). The two groups had the same background in relation to education (p = 0.510), household income (p = 0.582), and the number of people living in the residence (p = 0.188). Spatial analysis showed clustering of newly diagnosed cases and association with residential coordinates of previously diagnosed multibacillary cases. Active case finding is an important tool for Hansen's disease control in hyperendemic areas, enabling earlier diagnosis, treatment, decrease in disability from Hansen's disease and potentially less spread of Mycobacterium leprae. PMID:23516645

  1. Increased plasma dipeptidyl peptidase-4 activities are associated with high prevalence of subclinical atherosclerosis in Chinese patients with newly diagnosed type 2 diabetes: a cross-sectional study.

    Science.gov (United States)

    Zheng, T P; Liu, Y H; Yang, L X; Qin, S H; Liu, H B

    2015-10-01

    Hyperglycemia, insulin resistance, dislipidemia, oxidative stress and inflammation are well-documented risk factors for subclinical atherosclerosis. Dipeptidyl peptidase-4(DPP4) is a newly identified adipokine related to these risk factors. Hence, we aimed to investigate the association between plasma DPP4 activities and subclinical atherosclerosis in type 2 diabetes. A total of 985 newly diagnosed type 2 diabetic subjects were studied. Plasma DPP4 activity, mannose 6-phosphate receptor (M6P-R), oxidative stress parameters, inflammatory markers and common carotid artery Intima-Media Thickness (c-IMT) were measured in all participants. Participants in the highest quartile of DPP4 activity had higher HbA1c, homeostatic model assessment of insulin resistance(HOMA-IR), triglyceride, low-density lipoprotein cholesterol(LDL-C), oxidized LDL, nitrotyrosine, 8-iso-PGF2a, interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), M6P-R, c-IMT compared with participants in the lowest quartile (all P dislipidemia, oxidative stress and inflammation were higher with increasing DPP4 quartiles (P < 0.001 for trend). In the highest DPP4 quartile, subclinical atherosclerosis risk was significantly higher (OR 4.97; 95% CI 3.03-8.17) than in the lowest quartile. This association remained strong (2.17; 1.21-3.89) after further controlling for HbA1c, HOMA-IR, triglyceride, oxidized LDL, nitrotyrosine, and IL-6. This study shows that increased DPP4 activities are positively and independently associated with subclinical atherosclerosis in type 2 diabetes. Our findings suggest of potential role of DPP4 in the pathogenesis of subclinical atherosclerosis and in the prevention and management of this disease. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Decision Support and Shared Decision Making About Active Surveillance Versus Active Treatment Among Men Diagnosed with Low-Risk Prostate Cancer: a Pilot Study.

    Science.gov (United States)

    Myers, Ronald E; Leader, Amy E; Censits, Jean Hoffman; Trabulsi, Edouard J; Keith, Scott W; Petrich, Anett M; Quinn, Anna M; Den, Robert B; Hurwitz, Mark D; Lallas, Costas D; Hegarty, Sarah E; Dicker, Adam P; Zeigler-Johnson, Charnita M; Giri, Veda N; Ayaz, Hasan; Gomella, Leonard G

    2018-02-01

    This study aimed to explore the effects of a decision support intervention (DSI) and shared decision making (SDM) on knowledge, perceptions about treatment, and treatment choice among men diagnosed with localized low-risk prostate cancer (PCa). At a multidisciplinary clinic visit, 30 consenting men with localized low-risk PCa completed a baseline survey, had a nurse-mediated online DS session to clarify preference for active surveillance (AS) or active treatment (AT), and met with clinicians for SDM. Participants also completed a follow-up survey at 30 days. We assessed change in treatment knowledge, decisional conflict, and perceptions and identified predictors of AS. At follow-up, participants exhibited increased knowledge (p decision. Perceived support of the decision facilitated patient choice of AS.

  3. Body composition as an indicator of the nutritional status in children with newly diagnosed ulcerative colitis and Crohn’s disease – a prospective study

    Directory of Open Access Journals (Sweden)

    Paweł Więch

    2016-12-01

    Full Text Available Introduction : The prevalence of nutritional status disorders in children with ulcerative colitis (UC is much lower than in the case of Crohn’s disease (CD. The largest variability in the components of body composition occurs at the time of a new diagnosis and in periods of disease exacerbation. Aim: Assessment of body composition in children with UC and CD. Material and methods: The preliminary study included 59 children with inflammatory bowel disease (IBD (34 children with UC vs. 25 children with CD aged 4–18 years. The final analysis included 26 newly diagnosed children (16 children with UC vs. 10 children with CD. The evaluation of body composition was conducted by means of BIA-101 bioimpedance analyser. Results : Decreased values of lean mass were found in children with newly diagnosed IBD (UC: 41.13 kg vs. control group: 42.06 kg; CD: 35.50 kg vs. control group: 45.50 kg. After a year interval, an increase in fat (UC 1: 7.67 kg vs. UC 2: 10.33 kg; CD 1: 7.36 kg vs. CD 2: 9.47 kg as well as lean body mass (UC 1: 35.22 kg vs. UC 2: 39.00 kg; CD 1: 35.99 kg vs. CD 2: 42.41 kg was found in children. Conclusions : Children with newly diagnosed IBD were highly vulnerable to nutritional status disturbances. The increase in fat and lean body mass in an annual interval may be due to the treatment regime and control of the children.

  4. [Acute Chagas' disease: transmission routes, clinical aspects and response to specific therapy in diagnosed cases in an urban center].

    Science.gov (United States)

    Shikanai-Yasuda, M A; Lopes, M H; Tolezano, J E; Umezawa, E; Amato Neto, V; Barreto, A C; Higaki, Y; Moreira, A A; Funayama, G; Barone, A A

    1990-01-01

    The authors report clinical features and therapeutic response of 24 outpatients with acute Chagas' disease, and 3 in the initial chronic phase, referred to the Clinic for Infectious and Parasitic Diseases of the FMUSP "Clínicas" Hospital between 1974 and 1987. The following transmission routes were involved: triatominae in 7 cases, blood transfusion in 9, kidney transplantation and/or blood transfusion in 4, accidental in 1, oral route in 3, probably breast feeding in 1, congenital or breast feeding in 1, and congenital or blood transfusion in 1. Six patients infected by triatominac acquired the disease between 1974 and 1980 and one in 1987. The blood transfusion infected patients acquired the disease in Greater São Paulo, seven of whom after 1983. The acute phase Chagas' disease was oligosymptomatic in 4 patients: three of such patients being immunocompromised by drugs or other diseases. Another two adult immunocompromised patients developed myocarditis and congestive heart failure. Clinical features were severe in 5 from 6 children under two years, irrespective of the transmission route. Evaluation of the acute phase patients treated with benznidazol (4-10 mg/kg/day) showed: therapeutic failure in 4/16 (25.0%); possible cure in 9/16 (53.2%) and inconclusive results in 3/16 (18.8%). The antibody and complement-mediated lysis reaction was in keeping with the xenodiagnosis in 18/22 cases, having shown negative results after treatment earlier than classical serological reactions. One aplastic anaemia patient receiving corticosteroid presented lymphoproliferative disease 6 years after being treated with benznidazol for acute Chagas' disease.

  5. Clinical Utility of Additional Measurement of Total Lung Capacity in Diagnosing Obstructive Lung Disease in Subjects With Restrictive Pattern of Spirometry.

    Science.gov (United States)

    Lee, Hyun; Chang, Boksoon; Kim, Kyunga; Song, Won Jun; Chon, Hae Ri; Kang, Hyung Koo; Kim, Jung Soo; Jeong, Byeong-Ho; Oh, Yeon-Mok; Koh, Won-Jung; Park, Hye Yun

    2016-04-01

    Total lung capacity (TLC), forced expiratory flow between 25 and 75% (FEF25-75%), peak expiratory flow (PEF), or post-bronchodilator volume response is recommended to detect obstructive abnormalities in the lung. The present study was performed to evaluate the usefulness of these pulmonary function test (PFT) parameters to diagnose obstructive lung disease in subjects with a restrictive pattern of spirometry. A retrospective study was conducted in 64 subjects with a restrictive pattern of spirometry (normal FEV1/FVC and low FVC) out of 3,030 patients who underwent all pre- and post-bronchodilator spirometry and lung volume measurement between April 2008 and December 2010. After subjects were clinically classified into those with obstructive lung disease, restrictive lung disease, and mixed lung disease, the agreements between the clinical diagnosis and PFT classification according to TLC, FEF(25-75%), PEF, and post-bronchodilator response criteria were compared. Of 64 subjects, 18 (28.1%) were classified with obstructive lung disease, 39 (60.9%) had restrictive lung disease, 1 (1.6%) had mixed lung disease, and 6 (9.4%) had no clinical lung disease. Among the 58 subjects with clinical lung disease, 22 (37.9%), 37 (63.8%), 33 (56.9%), and 3 (5.2%) were classified as having obstructive pattern based on TLC, FEF25-75%, PEF, and post-bronchodilator response criteria, respectively. The kappa coefficients for the agreement between the clinical classification and PFT classification using TLC, FEF25-75%, PEF, and post-bronchodilator response criteria in 58 subjects were 0.59, 0.18, 0.17, and spirometry, when obstructive lung disease is clinically suspected. Copyright © 2016 by Daedalus Enterprises.

  6. Antistress activation therapy for cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Miroshnik E.V.

    2016-12-01

    Full Text Available The cohort pilot study had been done. Aim: to study the effectiveness of an antistress activation therapy on the functional state of human with the purpose of formation of adaptive reactions of activation and training high levels of reactivity among the two groups of patients with cardiovascular problems, ranks first among causes of death population: arterial hypertension (AH and coronary heart disease (CHD. Material and methods. From the sub-sample of the Moscow population (396 were allocated to 2 groups of patients of 30 people in each (a control group and a group for anti-stress therapy for persons with hypertension and coronary artery disease that within 1 month took adaptogens (tincture of ginseng, Eleutherococcus, etc. is minimized by a specially developed algorithm. For stress diagnosis international integrated questionnaire Perceived Stress (PSS; as well as Hospital Anxiety and Depression Scale (HADS were used. Blood pressure, heart rate, body mass index, waist circumference were measured. In addition we used new methods "Antistress activation health improvement". Results. The average age in the intervention group was 59.4 years, and in the control group was 58.3 years, p>0.05. In compliance with results of the study has been marked that persons who were treated by methods "Antistress activation health improvement" sensed general and "internal" dumping, improving of duration and quality of sleeping. Irritability, level of stress, depression, and fatigability became rather less. Dynamics of emotions locked in psychometric scales showed distinct improvement of mood, decrease of fear, sorrow, anxiety, anger, emotional instability, increase of self-reliance, activity. Conclusion. The treatment of stress, anxiety, and depression must be complexes based on biological and psychological approaches.

  7. Magnetic resonance imaging perfusion is associated with disease severity and activity in multiple sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Sowa, Piotr [Oslo University Hospital, Department of Radiology and Nuclear Medicine, Oslo (Norway); University of Oslo, Institute of Clinical Medicine, Faculty of Medicine, Oslo (Norway); Owren Nygaard, Gro [Oslo University Hospital, Department of Neurology, Oslo (Norway); Bjoernerud, Atle [Intervention Center, Oslo University Hospital, Oslo (Norway); University of Oslo, Department of Physics, Oslo (Norway); Gulowsen Celius, Elisabeth [Oslo University Hospital, Department of Neurology, Oslo (Norway); University of Oslo, Institute of Health and Society, Faculty of Medicine, Oslo (Norway); Flinstad Harbo, Hanne [University of Oslo, Institute of Clinical Medicine, Faculty of Medicine, Oslo (Norway); Oslo University Hospital, Department of Neurology, Oslo (Norway); Kristiansen Beyer, Mona [Oslo University Hospital, Department of Radiology and Nuclear Medicine, Oslo (Norway); Oslo and Akershus University College of Applied Sciences, Department of Life Sciences and Health, Oslo (Norway)

    2017-07-15

    The utility of perfusion-weighted imaging in multiple sclerosis (MS) is not well investigated. The purpose of this study was to compare baseline normalized perfusion measures in subgroups of newly diagnosed MS patients. We wanted to test the hypothesis that this method can differentiate between groups defined according to disease severity and disease activity at 1 year follow-up. Baseline magnetic resonance imaging (MRI) including a dynamic susceptibility contrast perfusion sequence was performed on a 1.5-T scanner in 66 patients newly diagnosed with relapsing-remitting MS. From the baseline MRI, cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) maps were generated. Normalized (n) perfusion values were calculated by dividing each perfusion parameter obtained in white matter lesions by the same parameter obtained in normal-appearing white matter. Neurological examination was performed at baseline and at follow-up approximately 1 year later to establish the multiple sclerosis severity score (MSSS) and evidence of disease activity (EDA). Baseline normalized mean transit time (nMTT) was lower in patients with MSSS >3.79 (p = 0.016), in patients with EDA (p = 0.041), and in patients with both MSSS >3.79 and EDA (p = 0.032) at 1-year follow-up. Baseline normalized cerebral blood flow and normalized cerebral blood volume did not differ between these groups. Lower baseline nMTT was associated with higher disease severity and with presence of disease activity 1 year later in newly diagnosed MS patients. Further longitudinal studies are needed to confirm whether baseline-normalized perfusion measures can differentiate between disease severity and disease activity subgroups over time. (orig.)

  8. Magnetic resonance imaging perfusion is associated with disease severity and activity in multiple sclerosis

    International Nuclear Information System (INIS)

    Sowa, Piotr; Owren Nygaard, Gro; Bjoernerud, Atle; Gulowsen Celius, Elisabeth; Flinstad Harbo, Hanne; Kristiansen Beyer, Mona

    2017-01-01

    The utility of perfusion-weighted imaging in multiple sclerosis (MS) is not well investigated. The purpose of this study was to compare baseline normalized perfusion measures in subgroups of newly diagnosed MS patients. We wanted to test the hypothesis that this method can differentiate between groups defined according to disease severity and disease activity at 1 year follow-up. Baseline magnetic resonance imaging (MRI) including a dynamic susceptibility contrast perfusion sequence was performed on a 1.5-T scanner in 66 patients newly diagnosed with relapsing-remitting MS. From the baseline MRI, cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) maps were generated. Normalized (n) perfusion values were calculated by dividing each perfusion parameter obtained in white matter lesions by the same parameter obtained in normal-appearing white matter. Neurological examination was performed at baseline and at follow-up approximately 1 year later to establish the multiple sclerosis severity score (MSSS) and evidence of disease activity (EDA). Baseline normalized mean transit time (nMTT) was lower in patients with MSSS >3.79 (p = 0.016), in patients with EDA (p = 0.041), and in patients with both MSSS >3.79 and EDA (p = 0.032) at 1-year follow-up. Baseline normalized cerebral blood flow and normalized cerebral blood volume did not differ between these groups. Lower baseline nMTT was associated with higher disease severity and with presence of disease activity 1 year later in newly diagnosed MS patients. Further longitudinal studies are needed to confirm whether baseline-normalized perfusion measures can differentiate between disease severity and disease activity subgroups over time. (orig.)

  9. Body mass index in school-aged children and the risk of routinely diagnosed non-alcoholic fatty liver disease in adulthood

    DEFF Research Database (Denmark)

    Zimmermann, Esther; Gamborg, Michael; Holst, Claus

    2015-01-01

    OBJECTIVE: The relation between childhood overweight and adult non-alcoholic fatty liver disease (NAFLD) is largely unknown. We investigated if weight and weight gain in childhood increases the risk of being diagnosed with NAFLD in routine clinical settings in adulthood. PARTICIPANTS: We studied.......23) per 1-unit gain in BMI z-score in men and women, respectively. Associations were similar when adjusted for BMI z-score at age 13 years, and were consistent across birth years. CONCLUSIONS: A BMI gain in school-aged children is associated with adult NAFLD. Intriguingly, BMI gain appears to have...

  10. Association between age, IL-10, IFN¿, stimulated C-peptide and disease progression in children with newly diagnosed Type 1 diabetes

    DEFF Research Database (Denmark)

    Kaas, A; Pfleger, Claudia Christina; Kharagjitsingh, A V

    2012-01-01

    Aims: The relation of disease progression and age, serum interleukin 10 (IL-10) and interferon gamma (IFN¿) and their genetic correlates were studied in paediatric patients with newly diagnosed Type 1 diabetes. Methods: Two hundred and twenty-seven patients from the Hvidoere Study Group were...... classified in four different progression groups as assessed by change in stimulated C-peptide from 1 to 6 months. CA repeat variants of the IL-10 and IFN¿ gene were genotyped and serum levels of IL-10 and IFN¿ were measured at 1, 6 and 12 months. Results: IL-10 decreased (P...

  11. Serum inflammatory mediators as markers of human Lyme disease activity.

    Directory of Open Access Journals (Sweden)

    Mark J Soloski

    Full Text Available Chemokines and cytokines are key signaling molecules that orchestrate the trafficking of immune cells, direct them to sites of tissue injury and inflammation and modulate their states of activation and effector cell function. We have measured, using a multiplex-based approach, the levels of 58 immune mediators and 7 acute phase markers in sera derived from of a cohort of patients diagnosed with acute Lyme disease and matched controls. This analysis identified a cytokine signature associated with the early stages of infection and allowed us to identify two subsets (mediator-high and mediator-low of acute Lyme patients with distinct cytokine signatures that also differed significantly (p<0.0005 in symptom presentation. In particular, the T cell chemokines CXCL9 (MIG, CXCL10 (IP-10 and CCL19 (MIP3B were coordinately increased in the mediator-high group and levels of these chemokines could be associated with seroconversion status and elevated liver function tests (p = 0.027 and p = 0.021 respectively. There was also upregulation of acute phase proteins including CRP and serum amyloid A. Consistent with the role of CXCL9/CXCL10 in attracting immune cells to the site of infection, CXCR3+ CD4 T cells are reduced in the blood of early acute Lyme disease (p = 0.01 and the decrease correlates with chemokine levels (p = 0.0375. The levels of CXCL9/10 did not relate to the size or number of skin lesions but elevated levels of serum CXCL9/CXCL10 were associated with elevated liver enzymes levels. Collectively these results indicate that the levels of serum chemokines and the levels of expression of their respective chemokine receptors on T cell subsets may prove to be informative biomarkers for Lyme disease and related to specific disease manifestations.

  12. Incidence of end-stage renal disease attributed to diabetes among persons with diagnosed diabetes --- United States and Puerto Rico, 1996-2007.

    Science.gov (United States)

    2010-10-29

    During 2007, approximately 110,000 persons in the United States and Puerto Rico began treatment for end-stage renal disease (ESRD) (i.e., kidney failure requiring dialysis or transplantation). Diabetes is the leading cause of ESRD in the United States, accounting for 44% of new cases in 2007. Although the number of persons initiating treatment for kidney failure each year who have diabetes listed as a primary cause (ESRD-D) has increased since 1996, ESRD-D incidence among persons with diagnosed diabetes has declined since 1996. To determine whether this decline occurred in every U.S. region and in every state, CDC analyzed 1996-2007 data from the U.S. Renal Data System (USRDS) and the Behavioral Risk Factor Surveillance System (BRFSS). During the period, the age-adjusted rate of ESRD-D among persons with diagnosed diabetes declined 35% overall, from 304.5 to 199.1 per 100,000 persons with diagnosed diabetes, and declined in all U.S. regions and in most states. No state showed a significant increase in the age-adjusted ESRD-D rate. Continued awareness of risk factors for kidney failure and interventions to improve diabetes care are needed to sustain and improve these trends.

  13. Efforts by the CIEMAT to diagnose and treat Butterfly children. the CIEMAT in the CIBER of Rare Diseases

    International Nuclear Information System (INIS)

    Rio Nechaevsky, M. del

    2009-01-01

    The CIEMAT is one of the institutions associated with the Center for Online Biomedical Research of Rare Diseases (CIBERER). The CIBER of Rare diseases is one of the new public consortiums established at the initiative of the Carlos III Institute of Health. It is formed by 60 research groups linked to 30 different institutions. These research groups are the basic operating units and are grouped together in seven scientific areas. With this online structure, the CIBERER is a pioneering initiative to facilitate synergy's between cutting-edge groups and institutions in different areas and disciplines in the field of rare diseases, as well as to ensure that scientific findings are transferred from the laboratory to the clinic, based on the concept of Translational Research. (Author) 13 refs

  14. Utilization of gene mapping and candidate gene mutation screening for diagnosing clinically equivocal conditions: a Norrie disease case study.

    Science.gov (United States)

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

    2014-06-01

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

  15. Newly Diagnosed Breast Cancer: Comparison of Contrast-enhanced Spectral Mammography and Breast MR Imaging in the Evaluation of Extent of Disease.

    Science.gov (United States)

    Lee-Felker, Stephanie A; Tekchandani, Leena; Thomas, Mariam; Gupta, Esha; Andrews-Tang, Denise; Roth, Antoinette; Sayre, James; Rahbar, Guita

    2017-11-01

    Purpose To compare the diagnostic performances of contrast material-enhanced spectral mammography and breast magnetic resonance (MR) imaging in the detection of index and secondary cancers in women with newly diagnosed breast cancer by using histologic or imaging follow-up as the standard of reference. Materials and Methods This institutional review board-approved, HIPAA-compliant, retrospective study included 52 women who underwent breast MR imaging and contrast-enhanced spectral mammography for newly diagnosed unilateral breast cancer between March 2014 and October 2015. Of those 52 patients, 46 were referred for contrast-enhanced spectral mammography and targeted ultrasonography because they had additional suspicious lesions at MR imaging. In six of the 52 patients, breast cancer had been diagnosed at an outside institution. These patients were referred for contrast-enhanced spectral mammography and targeted US as part of diagnostic imaging. Images from contrast-enhanced spectral mammography were analyzed by two fellowship-trained breast imagers with 2.5 years of experience with contrast-enhanced spectral mammography. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were calculated for both imaging modalities and compared by using the Bennett statistic. Results Fifty-two women with 120 breast lesions were included for analysis (mean age, 50 years; range, 29-73 years). Contrast-enhanced spectral mammography had similar sensitivity to MR imaging (94% [66 of 70 lesions] vs 99% [69 of 70 lesions]), a significantly higher PPV than MR imaging (93% [66 of 71 lesions] vs 60% [69 of 115 lesions]), and fewer false-positive findings than MR imaging (five vs 45) (P contrast-enhanced spectral mammography depicted 11 of the 11 secondary cancers (100%) and MR imaging depicted 10 (91%). Conclusion Contrast-enhanced spectral mammography is potentially as sensitive as MR imaging in the evaluation of extent of disease in newly diagnosed

  16. Diagnosing Sporadic Creutzfeldt-Jakob Disease: Accuracy of CSF 14-3-3 Protein Test of the Spinal Fluid

    Science.gov (United States)

    ... at about age 60 years. Early symptoms include: • Memory problems • Behavior/personality changes • Loss of muscle coordination • Vision problems • Insomnia (difficulty falling asleep or staying asleep) • Depression • Unusual sensations As the disease progresses, the person usually develops ...

  17. Are Clinical Diagnoses of Alzheimer's Disease and Other Dementias Affected by Education and Self-Reported Race?

    Science.gov (United States)

    Teresi, Jeanne A.; Grober, Ellen; Eimicke, Joseph P.; Ehrlich, Amy R.

    2012-01-01

    A randomized controlled trial examined whether the diagnostic process for Alzheimer's disease and other dementias may be influenced by knowledge of the patient's education and/or self-reported race. Four conditions were implemented: diagnostic team knows (a) race and education, (b) education only, (c) race only, or (d) neither. Diagnosis and…

  18. Use of azathioprine and corticosteroids during pregnancy and birth outcome in women diagnosed with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Veie Plauborg, Anne; Hansen, Anne Vinkel; Garne, Ester

    2016-01-01

    BACKGROUND: The aim of this study was to describe prescription patterns for azathioprine and corticosteroids for pregnant women with inflammatory bowel diseases (IBD) before, during, and after pregnancy and to describe pregnancy outcomes. METHODS: A cohort composed of all singleton pregnancies in...

  19. [Bone scintigraphy with 99mTc-MDP in a patient with acute lymphoblastic leukemia initially diagnosed of Still's disease].

    Science.gov (United States)

    Benítez Velazco, A; González García, F M; Albalá González, M D; Pacheco Capote, C; Latre Romero, J M

    2005-01-01

    We present a 43-year-old male, who was admitted with the diagnosis of Adult-onset Still's disease, after several months of arthralgias, febricula and loss of weight. Chest x-ray, abdominal ultrasonography, chest, abdomen and pelvic CT scan and bone scintigraphy were performed. Scintigraphic findings oriented to the performance of a bone marrow biopsy with diagnosis of acute lymphoblastic leukemia.

  20. Spectrum analysis of common inherited metabolic diseases in Chinese patients screened and diagnosed by tandem mass spectrometry.

    Science.gov (United States)

    Han, Lianshu; Han, Feng; Ye, Jun; Qiu, Wenjuan; Zhang, Huiwen; Gao, Xiaolan; Wang, Yu; Ji, Wenjun; Gu, Xuefan

    2015-03-01

    Information concerning inherited metabolic diseases in China is scarce. We investigated the prevalence and age distributions of amino acid, organic acid, and fatty acid oxidation disorders in Chinese patients. Blood levels of amino acids and acylcarnitines (tandem mass spectrometry) were measured in 18,303 patients with suspected inherited metabolic diseases. Diagnosis was based on clinical features, blood levels of amino acids or acylcarnitines, urinary organic acid levels (gas chromatography-mass spectrometry), and (in some) gene mutation tests. Inherited metabolic diseases were confirmed in 1,135 patients (739 males, 396 females). Median age was 12 months (1 day to 59 years). There were 28 diseases: 12 amino acid disorders (580 patients, 51.1%), with hyperphenylalaninemia (HPA) being the most common; nine organic acidemias (408 patients, 35.9%), with methylmalonic acidemia (MMA) as the most common; and seven fatty acid oxidation defects (147 patients, 13.0%), with multiple acyl-coenzyme A dehydrogenase deficiency (MADD) being the most common. Onset was mainly at 1-6 months for citrin deficiency, 0-6 months for MMA, and in newborns for ornithine transcarbamylase deficiency (OTCD). HPA was common in patients aged 1-3 years, and MADD was common in patients >18 years. In China, HPA, citrin deficiency, MMA, and MADD are the most common inherited disorders, particularly in newborns/infants. © 2014 Wiley Periodicals, Inc.

  1. Evaluation of prolactin levels in patients with newly diagnosed pemphigus vulgaris and its correlation with pemphigus disease area index

    Directory of Open Access Journals (Sweden)

    Vahideh Lajevardi, MD

    2016-06-01

    Conclusion: In our study, 22% of patients had hyperprolactinemia, which was greater among females. The highest PRL level was detected in mucocutaneous group. Although serum PRL levels were higher in patients with a greater Pemphigus Disease Area Index, it did not reach statistical significance.

  2. Heart and skeletal muscle inflammation (HSMI disease diagnosed on a British Columbia salmon farm through a longitudinal farm study.

    Directory of Open Access Journals (Sweden)

    Emiliano Di Cicco

    Full Text Available Heart and skeletal muscle inflammation (HSMI is an emerging disease of marine-farmed Atlantic Salmon (Salmo salar, first recognized in 1999 in Norway, and later also reported in Scotland and Chile. We undertook a longitudinal study involving health evaluation over an entire marine production cycle on one salmon farm in British Columbia (Canada. In previous production cycles at this farm site and others in the vicinity, cardiac lesions not linked to a specific infectious agent or disease were identified. Histologic assessments of both live and moribund fish samples collected at the farm during the longitudinal study documented at the population level the development, peak, and recovery phases of HSMI. The fish underwent histopathological evaluation of all tissues, Twort's Gram staining, immunohistochemistry, and molecular quantification in heart tissue of 44 agents known or suspected to cause disease in salmon. Our analysis showed evidence of HSMI histopathological lesions over an 11-month timespan, with the prevalence of lesions peaking at 80-100% in sampled fish, despite mild clinical signs with no associated elevation in mortalities reported at the farm level. Diffuse mononuclear inflammation and myodegeneration, consistent with HSMI, was the predominant histologic observation in affected heart and skeletal muscle. Infective agent monitoring identified three agents at high prevalence in salmon heart tissue, including Piscine orthoreovirus (PRV, and parasites Paranucleospora theridion and Kudoa thyrsites. However, PRV alone was statistically correlated with the occurrence and severity of histopathological lesions in the heart. Immunohistochemical staining further localized PRV throughout HSMI development, with the virus found mainly within red blood cells in early cases, moving into the cardiomyocytes within or, more often, on the periphery of the inflammatory reaction during the peak disease, and reducing to low or undetectable levels later in

  3. 'A one-sided affair': unilateral pulmonary oedema and the role of cardiac MRI in diagnosing premature coronary artery disease in a patient with Prader-Willi syndrome.

    Science.gov (United States)

    Jabbar, Avais; Khan, Jamal N; Singh, Anvesha; McCann, Gerry P

    2013-05-22

    There is no formal association between premature coronary artery disease (CAD) and Prader-Willi syndrome despite its association with hyperlipidaemia, diabetes mellitus and hypertension. A 36-year-old man with Prader-Willi syndrome presented with acute breathlessness. Inflammatory markers were borderline elevated and chest radiography demonstrated unilateral diffuse alveolar shadowing. Bronchopneumonia was diagnosed and despite treatment with multiple courses of antimicrobial therapy, there was minimal symptomatic and radiographical improvement. A diagnosis of unilateral pulmonary oedema was suspected. Echocardiography was non-diagnostic due to body habitus and coronary angiography was deemed inappropriate due to uncertainty in diagnosis, invasiveness and pre-existing chronic kidney disease. Therefore, cardiac magnetic resonance was performed, confirming severe triple-vessel CAD. This case demonstrates a presentation of heart failure with unilateral chest radiograph changes in a young patient with Prader-Willi syndrome and severe premature CAD detected by multiparametric cardiac magnetic resonance imaging.

  4. Diagnoses of Cardiovascular Disease or Substance Addiction/Abuse in US Adults Treated for ADHD with Stimulants or Atomoxetine: Is Use Consistent with Product Labeling?

    Science.gov (United States)

    Fairman, Kathleen A; Davis, Lindsay E; Peckham, Alyssa M; Sclar, David A

    2018-03-01

    Among US adults, utilization of pharmacotherapy for attention-deficit hyperactivity disorder (ADHD) has increased more than ninefold since 1995-1996. Potential contraindications to ADHD pharmacotherapy include serious cardiovascular disease (CVD) and, for stimulants, addictions and bipolar disorder (BPD). To assess the prevalence of potential contraindications among adults treated with ADHD pharmacotherapy. A retrospective cohort analysis was performed using the Truven Health MarketScan ® database. Subjects filled ≥ 1 prescription for atomoxetine or ≥ 1 stimulant in 2014-2015, were aged 18-64 years, commercially insured throughout observation, and diagnosed with ADHD on two or more medical claims. Diagnoses and medical procedures were measured in the 12 months prior to pharmacotherapy initiation. Metrics included serious CVD (cardiomegaly, cardiomyopathy, cerebrovascular occlusion, congestive heart failure, myocardial infarction, pacemaker, or valvular disorder) and any CVD (serious CVD, other atherosclerotic CVD, arrhythmia, congenital heart anomaly, or hypertensive heart disease). Rates of substance addiction or abuse were measured in a range to address nonspecific diagnostic coding. Only 2.0% of treated adults (n = 91,588) had one or more diagnosis indicating serious CVD. CVD prevalence increased monotonically with age. Of patients aged 55-64 years (n = 5,237), 7.2% had serious CVD; 15.9% had any CVD; and 1.9% had been hospitalized with one or more CVD. Of patients treated with stimulants (n = 87,167), 11.3-18.5% were diagnosed with addiction/abuse and 4.1% with BPD. CVD prevalence is generally low among adults using ADHD medication but increases with age. Although difficult to estimate precisely, the rate of addiction/abuse among stimulant-treated patients appears unexpectedly high. Further research should assess cardiovascular events and other potential harms associated with contraindicated use in high-risk adults.

  5. LOW-BACK PAIN DISORDERS AS OCCUPATIONAL DISEASES IN THE CZECH REPUBLIC AND 22 EUROPEAN COUNTRIES: COMPARISON OF NATIONAL SYSTEMS, RELATED DIAGNOSES AND EVALUATION CRITERIA.

    Science.gov (United States)

    Laštovková, Andrea; Nakládalová, Marie; Fenclová, Zdenka; Urban, Pavel; Gad'ourek, Petr; Lebeda, Tomáš; Ehler, Edvard; Ridzoň, Petr; Hlávková, Jana; Boriková, Alena; Kuijer, P Paul F M; Bátora, Igor; Scholz-Odermatt, Stefan M; Moldovan, Horatiu; Godderis, Lode; Leijon, Ola; Campo, Giuseppe; Vaněčková, Manuela; Bonneterre, Vincent; Stikova, Elisaveta Jasna; Pelclová, Daniela

    2015-09-01

    Low-back pain diseases (LBPD) belong to the most frequent diagnoses determined by general practitioners, and constitute one of the most common reasons for sick leave and permanent disability pension in the Czech Republic and other European countries. Epidemiological studies have shown a statistically significant association between LBPD and certain types of occupational burden. However, in the Czech Republic, LBPD caused by overload and/or whole-body vibrations have not yet been included in the list of occupational diseases. The aim of this study was to collect and compare the systems, criteria and diagnoses used to recognize LBPD as occupational diseases in other European countries. A questionnaire focused on LBPD was distributed and answered by specialists in occupational diseases in European countries. It included items concerning LBPD in the national list of occupational diseases, and work-related and diagnostic criteria that need to be fulfilled for recognizing LBPD as occupational diseases and possible awarding compensations to the patients. In 13 countries out of the 23 countries studied, LBPD caused by overload can be recognized as occupational, providing that the diagnosis is sufficiently proven and exposure criteria and/or listed occupation are met and duration of exposure is confirmed (Belgium, Denmark, France, Germany, Hungary, Italy, Lithuania, Macedonia, Netherlands, Romania, Slovakia, Sweden, and Switzerland). LBPD due to vibrations can be also recognized as occupational in 14 countries. In 8 countries LBPD are not accepted as occupational unless they are caused by an injury at work. Specific criteria to evaluate occupational exposure of patients with LBPD were set in Belgium, Denmark, France, Germany, Lithuania, Macedonia, Netherlands, and Slovakia. In other countries, the evaluation is done at an individual basis. In practice, the assessment of occupational overload and its contribution to the development of LBPD as well as its inclusion in the

  6. Evaluation of Multiple Diagnostic Indicators in Comparison to the Intestinal Biopsy as the Golden Standard in Diagnosing Celiac Disease in Children

    Directory of Open Access Journals (Sweden)

    Elisabet Hollén

    2016-11-01

    Full Text Available Celiac disease (CD is a chronic small intestinal enteropathy triggered by gluten in genetically predisposed individuals. The susceptibility is strongly associated with certain human leukocyte antigen (HLA-genes, but efforts are being made in trying to find non-HLA genes that are predictive for the disease. The criteria for diagnosing CD were previously based primarily on histologic evaluation of small intestinal biopsies, but nowadays are often based only on blood tests and symptoms. In this context, we elucidated the accuracy of three diagnostic indicators for CD, alone or in combination. Genetic analyses of HLA-type and nine single nucleotide polymorphisms (SNPs known to be associated with CD were performed in 177 children previously investigated for the suspicion of CD. CD was confirmed in 109 children, while 68 were considered non-celiacs. The antibodies and urinary nitrite/nitrate concentrations of all of them were measured. The combinations of all the variables used in the study would classify 93% of the study population in the correct diagnostic group. The single best predictors were antibodies (i.e., anti-endomysium immunoglobulin A (IgA (EMA and transglutaminase IgA (TGA, followed by HLA-type and nitric oxide (NO-metabolites. The nine SNPs used did not contribute to the right diagnoses. Although our control group consisted of children with mostly gastrointestinal symptoms, the presented methodology predicted a correct classification in more than 90% of the cases.

  7. Lipid profile in patients with newly diagnosed coronary heart disease: 2012 and 2013 cross-sectional study in Luis Vernaza Hospital, Ecuador

    Directory of Open Access Journals (Sweden)

    Diego Antonio Vásquez-Cedeño

    2014-08-01

    Full Text Available Introduction Endothelial dysfunction is an early event in the progression of atherosclerosis, and it appears in pathologies such as dyslipidemias. Certain pro-inflammatory enzymes are associated negatively with high-density lipoproteins (HDL and positively with low-density lipoproteins (LDL. Calculating the atherogenic index greatly complements the study of these diseases. Lipid alterations have a high prevalence in Ecuadorian and Latin American populations. Better knowledge of which lipid alteration is the most prevalent would bring more attention to the subject, leading to early treatment. The goal of this study is to describe the complete lipid profile alterations in patients recently diagnosed with ischemic heart disease and find which of these is the most prevalent. Methods We designed a cross-sectional, descriptive study that included patients from the Cardiology Service of the “Hospital Luis Vernaza” who presented with the first episode of ischemic heart disease between January 2012 and 2013. There were 220 patients with that diagnosis. One-hundred and thirty-one (131 were excluded because they did not meet inclusion criteria. The final sample comprised 89 patients. Results We found 41 (46.06% patients with low HDL levels, 49 (55.05% with high LDL levels, 28 (31.46% with high triglycerides, 24 (26.96% with high cholesterol levels, 25 (28.08% with high VLDL levels, 26 (29.21% had values over 5 in the Castelli index, and 32 (35.95% had LDL/HDL values higher than 3. Discussion It is of great importance to have a complete lipid profile from patients recently diagnosed with ischemic heart disease in order to work on secondary prevention. The most prevalent alteration found in our study was high LDL levels. The percentage of patients with low HDL was similar to other Latin American populations. More studies are needed to gain a more accurate idea of the status of the general population in this regard.

  8. Altered modulation of prefrontal and subcortical brain activity in newly diagnosed schizophrenia and schizophreniform disorder. A regional cerebral blood flow study

    DEFF Research Database (Denmark)

    Rubin, P; Holm, S; Friberg, L

    1991-01-01

    To measure prefrontal and subcortical activity during a cognitive task, we examined 19 newly diagnosed schizophrenics and patients with schizophreniform psychosis. Seven healthy volunteers served as controls. The patients were drug naive or had received neuroleptics for a few days only. Cerebral ...

  9. EULAR Sjögren's syndrome disease activity index (ESSDAI)

    DEFF Research Database (Denmark)

    Seror, Raphaèle; Bowman, Simon J; Brito-Zeron, Pilar

    2015-01-01

    The EULAR Sjögren's syndrome (SS) disease activity index (ESSDAI) is a systemic disease activity index that was designed to measure disease activity in patients with primary SS. With the growing use of the ESSDAI, some domains appear to be more challenging to rate than others. The ESSDAI is now...

  10. Medical Expenditure for Chronic Diseases in Mexico: The Case of Selected Diagnoses Treated by the Largest Care Providers

    Science.gov (United States)

    Figueroa-Lara, Alejandro; Gonzalez-Block, Miguel Angel; Alarcon-Irigoyen, Jose

    2016-01-01

    Background Chronic diseases (CD) are a public health emergency in Mexico. Despite concern regarding the financial burden of CDs in the country, economic studies have focused only on diabetes, hypertension, and cancer. Furthermore, these estimated financial burdens were based on hypothetical epidemiology models or ideal healthcare scenarios. The present study estimates the annual expenditure per patient and the financial burden for the nine most prevalent CDs, excluding cancer, for each of the two largest public health providers in the country: the Ministry of Health (MoH) and the Mexican Institute of Social Security (IMSS). Methods Using the Mexican National Health and Nutrition Survey 2012 (ENSANUT) as the main source of data, health services consumption related to CDs was obtained from patient reports. Unit costs for each provided health service (e.g. consultation, drugs, hospitalization) were obtained from official reports. Prevalence data was obtained from the published literature. Annual expenditure due to health services consumption was calculated by multiplying the quantity of services consumed by the unit cost of each health service. Results The most expensive CD in both health institutions was chronic kidney disease (CKD), with an annual unit cost for MoH per patient of US$ 8,966 while for IMSS the expenditure was US$ 9,091. Four CDs (CKD, arterial hypertension, type 2 diabetes, and chronic ischemic heart disease) accounted for 88% of the total CDs financial burden (US$ 1.42 billion) in MoH and 85% (US$ 3.96 billion) in IMSS. The financial burden of the nine CDs analyzed represents 8% and 25% of the total annual MoH and IMSS health expenditure, respectively. Conclusions/Significance The financial burden from the nine most prevalent CDs, excluding cancer, is already high in Mexico. This finding by itself argues for the need to improve health promotion and disease detection, diagnosis, and treatment to ensure CD primary and secondary prevention. If the

  11. Medical Expenditure for Chronic Diseases in Mexico: The Case of Selected Diagnoses Treated by the Largest Care Providers.

    Science.gov (United States)

    Figueroa-Lara, Alejandro; Gonzalez-Block, Miguel Angel; Alarcon-Irigoyen, Jose

    2016-01-01

    Chronic diseases (CD) are a public health emergency in Mexico. Despite concern regarding the financial burden of CDs in the country, economic studies have focused only on diabetes, hypertension, and cancer. Furthermore, these estimated financial burdens were based on hypothetical epidemiology models or ideal healthcare scenarios. The present study estimates the annual expenditure per patient and the financial burden for the nine most prevalent CDs, excluding cancer, for each of the two largest public health providers in the country: the Ministry of Health (MoH) and the Mexican Institute of Social Security (IMSS). Using the Mexican National Health and Nutrition Survey 2012 (ENSANUT) as the main source of data, health services consumption related to CDs was obtained from patient reports. Unit costs for each provided health service (e.g. consultation, drugs, hospitalization) were obtained from official reports. Prevalence data was obtained from the published literature. Annual expenditure due to health services consumption was calculated by multiplying the quantity of services consumed by the unit cost of each health service. The most expensive CD in both health institutions was chronic kidney disease (CKD), with an annual unit cost for MoH per patient of US$ 8,966 while for IMSS the expenditure was US$ 9,091. Four CDs (CKD, arterial hypertension, type 2 diabetes, and chronic ischemic heart disease) accounted for 88% of the total CDs financial burden (US$ 1.42 billion) in MoH and 85% (US$ 3.96 billion) in IMSS. The financial burden of the nine CDs analyzed represents 8% and 25% of the total annual MoH and IMSS health expenditure, respectively. The financial burden from the nine most prevalent CDs, excluding cancer, is already high in Mexico. This finding by itself argues for the need to improve health promotion and disease detection, diagnosis, and treatment to ensure CD primary and secondary prevention. If the status quo remains, the financial burden could be higher.

  12. Review of the Ethical Issues of a Biomarker-Based Diagnoses in the Early Stage of Alzheimer's Disease.

    Science.gov (United States)

    Vanderschaeghe, Gwendolien; Dierickx, Kris; Vandenberghe, Rik

    2018-03-12

    Today, many healthcare or dementia organizations, clinicians, and companies emphasize the importance of detection of Alzheimer's disease in an early phase. This idea has gained considerable momentum due to the development of biomarkers, the recent FDA and EMA approval of three amyloid tracers, and the failure of a number of recent therapeutic trials conducted in the early dementia phase. On the one hand, an early etiological diagnosis can lead to early and more efficacious intervention. On the other hand, it is questioned how early an etiological diagnosis is beneficial to the patient. Here we consider ethical issues related to the process of biomarker testing and the impact on the diagnostic disclosure to patients with mild cognitive impairment due to prodromal Alzheimer's disease. A systematic review of the theoretical bioethics literature was performed by using electronic databases. The review was limited to articles published in English between 2003 and 2016. A total of twenty articles were included in our effort to make an analysis of the ethical challenges. One of the biggest challenges was the uncertainty and the predictive value of the biomarker-based diagnosis where patients can be amyloid positive without full certainty whether or when they will develop symptomatic decline due to Alzheimer's disease. Another challenge was the tension between the right to know versus the wish not to know, the limited efficacy of currently available treatment options, and the opportunities and consequences after receiving such an early diagnosis. Based on the results and the additional comments in the discussion, several unanswered questions emerged. Therefore, careful consideration of all these ethical issues is required before the disclosure of a biomarker-based diagnosis to the patient with mild cognitive impairment due to Alzheimer's disease.

  13. Medical Expenditure for Chronic Diseases in Mexico: The Case of Selected Diagnoses Treated by the Largest Care Providers.

    Directory of Open Access Journals (Sweden)

    Alejandro Figueroa-Lara

    Full Text Available Chronic diseases (CD are a public health emergency in Mexico. Despite concern regarding the financial burden of CDs in the country, economic studies have focused only on diabetes, hypertension, and cancer. Furthermore, these estimated financial burdens were based on hypothetical epidemiology models or ideal healthcare scenarios. The present study estimates the annual expenditure per patient and the financial burden for the nine most prevalent CDs, excluding cancer, for each of the two largest public health providers in the country: the Ministry of Health (MoH and the Mexican Institute of Social Security (IMSS.Using the Mexican National Health and Nutrition Survey 2012 (ENSANUT as the main source of data, health services consumption related to CDs was obtained from patient reports. Unit costs for each provided health service (e.g. consultation, drugs, hospitalization were obtained from official reports. Prevalence data was obtained from the published literature. Annual expenditure due to health services consumption was calculated by multiplying the quantity of services consumed by the unit cost of each health service.The most expensive CD in both health institutions was chronic kidney disease (CKD, with an annual unit cost for MoH per patient of US$ 8,966 while for IMSS the expenditure was US$ 9,091. Four CDs (CKD, arterial hypertension, type 2 diabetes, and chronic ischemic heart disease accounted for 88% of the total CDs financial burden (US$ 1.42 billion in MoH and 85% (US$ 3.96 billion in IMSS. The financial burden of the nine CDs analyzed represents 8% and 25% of the total annual MoH and IMSS health expenditure, respectively.The financial burden from the nine most prevalent CDs, excluding cancer, is already high in Mexico. This finding by itself argues for the need to improve health promotion and disease detection, diagnosis, and treatment to ensure CD primary and secondary prevention. If the status quo remains, the financial burden could be

  14. Serological IgG Testing to Diagnose Alimentary Induced Diseases and Monitoring Efficacy of an Individual Defined Diet in Dogs

    OpenAIRE

    Anne-Margré C. Vink

    2014-01-01

    Background. Food-related allergies and intolerances are frequently occurring in dogs. Diagnosis and monitoring according ‘Golden Standard’ of elimination efficiency is, however, time consuming, expensive, and requires expert clinical setting. In order to facilitate rapid and robust, quantitative testing of intolerance, and determining the individual offending foods, a serological test is implicated for Alimentary Induced Diseases and manifestations. Method. As we developed Medisynx IgG Human ...

  15. Being publicly diagnosed

    DEFF Research Database (Denmark)

    Konradsen, Hanne; Lillebaek, Troels; Wilcke, Torgny

    2014-01-01

    a patient with TB, and finally being in medical treatment. Before being diagnosed with TB, patients were weighing between biding their time and deciding to undergo an examination. Social pressure and feelings of social responsibility tended to affect the decision. Having undergone the examination......INTRODUCTION: Tuberculosis (TB) is a disease which affects people worldwide, but there is knowledge lacking about patients' experiences in low-prevalence and high-income countries. AIM: To provide a theoretical framework for the process of being diagnosed with tuberculosis in a Danish setting....... METHOD: A grounded theory design with field studies and qualitative interviews, following the recommendations from Glaser and Strauss. RESULT: A process of being publicly diagnosed was identified, which developed during the patient's trajectory from being on the way to becoming a patient, becoming...

  16. The endoscopic and clinical characteristics of patients with erosive reflux disease diagnosed in gastroscopy unit of a regional hospital

    Directory of Open Access Journals (Sweden)

    Mustafa Yakut

    2012-06-01

    Full Text Available Objectives: Gastroesophageal reflux disease (GERDis a common gastrointestinal disorder, presenting witha broad spectrum of symptoms and can be associatedwith a variety of complication. It has been defined intothree groups of patients: nonerosive reflux disease, erosiveesophagitis, and Barrett’s esophagus. The aim of thestudy was to evaluate patients with erosive reflux diseasein our endoscopic unit.Materials and methods: All patients underwent gastroscopywere evaluated retrospectively. H.pylori statuseswere evaluated in erosive reflux disease (ERD patients.All patients were evaluated by videoendoscopy. Evaluationwas made by the same operator at single center.Biopsy specimen was taken for H.pylori. Diagnosis ofesophagitis was done based on Los Angeles classificationcriteria.Results: All patients that underwent gastroscopy in ourEndoscopy Unit are evaluated. Endoscopically ERD wasdetected in 104 (13.5% of 773 patients. The mean age ofthe ERD patients evaluated in the study was 43.74±18.79years. Sixty five (62.3% patients were female, and 39(38.7% were male. In 104 patients with ERD, the slidinghiatal hernia and Barrett’s esophagus was seen in 18 and10 patients, respectively. H.pylori was positive in 50.9% of104 ERD patients.Conclusion: GERD is a common gastrointestinal disorderand should always be considered during gastroscopy.J Clin Exp Invest 2012; 3(2: 260-262

  17. Therapeutic preferences and outcomes in newly diagnosed patients with Crohn's diseases in the biological era in Hungary: a nationwide study based on the National Health Insurance Fund database.

    Science.gov (United States)

    Kurti, Zsuzsanna; Ilias, Akos; Gonczi, Lorant; Vegh, Zsuzsanna; Fadgyas-Freyler, Petra; Korponay, Gyula; Golovics, Petra A; Lovasz, Barbara D; Lakatos, Peter L

    2018-01-30

    Accelerated treatment strategy, including tight disease control and early aggressive therapy with immunosuppressives (IS) and biological agents have become increasingly common in inflammatory bowel disease (IBD). The aim of the present study was to estimate the early treatment strategy and outcomes in newly diagnosed patients with Crohn's disease (CD) between 2004 and 2008 and 2009-2015 in the whole IBD population in Hungary based on the administrative database of the National Health Insurance Fund (OEP). We used the administrative database of the OEP, the only nationwide state-owned health insurance provider in Hungary. Patients were identified through previously reported algorithms using the ICD-10 codes for CD in the out-, inpatient (medical, surgical) non-primary care records and drug prescription databases between 2004 and 2015. Patients were stratified according to the year of diagnosis and maximum treatment steps during the first 3 years after diagnosis. A total of 6173 (male/female: 46.12%/53.87%) newly diagnosed CD patients with physician-diagnosed IBD were found in the period of 2004-2015. The use of 5-ASA and steroids remained common in the biological era, while immunosuppressives and biologicals were started earlier and became more frequent among patients diagnosed after 2009. The probability of biological therapy was 2.9%/6.4% and 8.4%/13.7% after 1 and 3 years in patients diagnosed in 2004-2008/2009-2015. The probability of hospitalization in the first 3 years after diagnosis was different before and after 2009, according to the maximal treatment step (overall 55.7%vs. 47.4% (p = 0.001), anti-TNF: 73%vs. 66.7% (p = 0.103), IS: 64.6% vs. 56.1% (p = 0.001), steroid: 44.2%vs. 36.8% (p < 0.007), 5-ASA: 32.6% vs. 26.7% p = 0.157)). In contrast, surgery rates were not significantly different in patients diagnosed before and after 2009 according to the maximum treatment step (overall 16.0%vs.15.3%(p = 0.672) anti-TNF 26.7%vs.27

  18. MCID/Low Disease Activity State Workshop: low disease activity state in rheumatoid arthritis.

    NARCIS (Netherlands)

    Wells, G.A.; Boers, M.; Shea, B.; Anderson, J.; Felson, D.T.; Johnson, K.; Kirwan, J.; Lassere, M.N.; Robinson, V.; Simon, L.S.; Strand, V.; Riel, P.L.C.M. van; Tugwell, P.S.

    2003-01-01

    The MCID (minimal clinically important difference) module of OMERACT 5 developed a research agenda that led to the conclusion that a state of low disease activity for rheumatoid arthritis (RA) would need to be defined. To develop such a definition the various concepts and terminologies, the process

  19. MCP-1 in urine as biomarker of disease activity in Systemic Lupus Erythematosus.

    Science.gov (United States)

    Barbado, Julia; Martin, Debora; Vega, Luisa; Almansa, Raquel; Gonçalves, Lisbeth; Nocito, Mercedes; Jimeno, Antonio; Ortiz de Lejarazu, Raúl; Bermejo-Martin, Jesus F

    2012-11-01

    Conventional clinical parameters are not sensitive or specific enough for detecting ongoing disease activity in the Systemic Lupus Erythematosus (SLE). Measurement of cytokines in urine is an encouraging approach to detection of early flares in this disease. Here we have profiled 27 different cytokines, chemokines and celular growth factors in the urine of 48 patients previously diagnosed of SLE as potential biomarkers of disease activity. Correlation analysis with Bonferroni correction showed that MCP-1 was the only immune mediator which levels in urine correlated directly with the SLE Disease Activity Index 2000 (SLEDAI-2K) score (correlation coefficient, p): MCP-1 (0.45,0.003). MCP-1 correlated inversely with levels of C3 complement protein in serum (-0.50,0.001). MCP-1 showed significant higher levels in patients with severe disease activity in comparison with those exhibiting mild activity. Levels of this chemokine were also higher in patients with severe disease activity in comparison with patients with inactive disease and healthy controls. Areas under receiver operating characteristic curves (AUROC) for detection of severe disease (SLEDAI⩾8) was as follows for MCP-1: [AUROC, (IC95%), p]: [0.81 (0.65-0.96) 0.003]. In addition, MCP-1 showed a good result in the AUROC analysis for detecting renal involvement [0.70 (0.52-0.87) 0.050]. When correlation analysis were repeated excluding those patients with active renal disease (n=14), levels of MCP-1 in urine kept on showing a significant positive association with SLEDAI-2K score. In conclusion, multiplex-based cytokine profiling in urine demonstrated the superiority of MCP-1 over a wide range of cytokines as biomarker of disease activity in SLE. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Tay-Sachs and Sandhoff diseases: enzymatic diagnosis in dried blood spots on filter paper: retrospective diagnoses in newborn-screening cards.

    Science.gov (United States)

    Chamoles, Néstor A; Blanco, Mariana; Gaggioli, Daniela; Casentini, Carina

    2002-04-01

    Tay-Sachs disease (TSD), Sandhoff disease (SD) and variants are caused by deficient activity of the lysosomal enzymes hexosaminidase A (HA) and total hexosaminidase (TH) (hexosaminidase A plus B), respectively. For diagnosis, these enzymes are usually measured in plasma or extracts of leukocytes. We describe methods for the assay of hexosaminidase A and total hexosaminidase activities in dried blood spots (DBSs) on filter paper. We studied 163 healthy controls, 9 Tay-Sachs patients, 4 Sandhoff patients, 18 obligate carriers and the newborn-screening cards from two patients with Tay-Sachs and one patient with Sandhoff disease. To tubes containing a 3-mm-diameter blood spot, we added elution liquid and substrate solution. After incubation at 37 degrees C, the amount of hydrolyzed product was compared with a calibrator to allow the quantification of enzyme activity. The described methodology is useful to distinguish patients with Tay-Sachs disease or Sandhoff disease from carriers and controls using samples that are sufficiently stable to be transported to the testing laboratory by mail. The diagnosis of both diseases from a newborn-screening card (NSC) was clearly demonstrated, even after storage for up to 38 months at room temperature. The newborn-screening card has been added to the biological materials that allow the identification of patients with Tay-Sachs disease and Sandhoff disease.

  1. Imaging of vascular dynamics within the foot using dynamic diffuse optical tomography to diagnose peripheral arterial disease

    Science.gov (United States)

    Khalil, M. A.; Kim, H. K.; Hoi, J. W.; Kim, I.; Dayal, R.; Shrikande, G.; Hielscher, A. H.

    2013-03-01

    Peripheral Arterial Disease (PAD) is the narrowing of the functional area of the artery generally due to atherosclerosis. It affects between 8-12 million people in the United States and if untreated this can lead to ulceration, gangrene and ultimately amputation. The current diagnostic method for PAD is the ankle-brachial index (ABI). The ABI is a ratio of the patient's systolic blood pressure in the foot to that of the brachial artery in the arm, a ratio below 0.9 is indicative of affected vasculature. However, this method is ineffective in patients with calcified arteries (diabetic and end-stage renal failure patients), which falsely elevates the ABI recording resulting in a false negative reading. In this paper we present our results in a pilot study to deduce optical tomography's ability to detect poor blood perfusion in the foot. We performed an IRB approved 30 patient study, where we imaged the feet of the enrolled patients during a five stage dynamic imaging sequence. The patients were split up into three groups: 10 healthy subjects, 10 PAD patients and 10 PAD patients with diabetes and they were imaged while applying a pressure cuff to their thigh. Differences in the magnitude of blood pooling in the foot and rate at which the blood pools in the foot are all indicative of arterial disease.

  2. Disease activity in pregnant women with Crohn's disease and birth outcomes: a regional Danish cohort study

    DEFF Research Database (Denmark)

    Nørgård, Bente; Hundborg, Heidi H; Jacobsen, Bent Ascanius

    2007-01-01

    OBJECTIVES: CD is associated with increased risk of adverse birth outcomes, but existing studies have not assessed the impact of disease activity during pregnancy. We examined the impact of disease activity on birth outcomes: LBW, preterm birth, LBW at term, and CAs. METHODS: All births by CD wom...... disease activity). Further research is needed to assess the critical impact of disease activity in larger cohorts of CD women....

  3. The clinical study of serum PSA and fPSA assayed by CLIA in diagnosing prostate disease

    International Nuclear Information System (INIS)

    Xiong Jiang; Qian Xiaoyu; Ji Hong; Yang Su; Ding Ying; Zhu Ruisen; Chen Zhong

    2003-01-01

    The purpose of this study is to evaluate the clinical value of PSA (prostate specific antigen) and fPSA(free prostate specific antigen) in differentiating prostate disease. CLIA was used to quantitatively assay PSA, fPSA and fPSA/PSA in 30 cases of normal controls, 32 cases of prostate cancer patients and 76 cases of BPH patients. The result showed that if liminal value of PSA was set at 4 ng/mL, the diagnostic sensitivity and specificity of prostate cancer were 100% and 50.6% respectively. Meanwhile, if liminal value of fPSA/PSA set at 16% was added, the diagnostic sensitivity and specificity of prostate cancer were 100% and 85.3% respectively. It was concluded that the combining assay of PSA and fPSA could increase the diagnostic specificity of prostate cancer in a certain degree

  4. Caregiver burden and perceived health competence when caring for family members diagnosed with Alzheimer's disease and related dementia.

    Science.gov (United States)

    Bailes, Christine O; Kelley, Colleen M; Parker, Nadine M

    2016-10-01

    To identify if there is a relationship between perceived health competence and burden of care of informal caregivers of family members with Alzheimer's disease and related dementia (ADRD). Informal caregivers 18 years and older who received services from the Alzheimer's Resource of Alaska were invited to complete a survey. Findings indicate that there was a negative correlation between perceived health competence and burden of care (N = 64, r = -.54, p Scale: objective burden (r = -.65, p = competence, nurse practitioners (NPs) can play an important role in assessing caregiver burden. The results of this study enlighten NPs about informal caregiver burden and will help guide discussions and assessments during routine healthcare visits with the goal of achieving optimal health for informal caregivers. ©2016 American Association of Nurse Practitioners.

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

    Science.gov (United States)

    Bilcke, Joke; Coenen, Samuel; Beutels, Philippe

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Joke Bilcke

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

  7. Does Endometriosis Affect Sexual Activity and Satisfaction of the Man Partner? A Comparison of Partners From Women Diagnosed With Endometriosis and Controls.

    Science.gov (United States)

    Hämmerli, Silvan; Kohl Schwartz, Alexandra Sabrina; Geraedts, Kirsten; Imesch, Patrick; Rauchfuss, Martina; Wölfler, Monika Maria; Haeberlin, Felix; von Orelli, Stefanie; Eberhard, Markus; Imthurn, Bruno; Leeners, Brigitte

    2018-06-01

    Endometriosis-associated pain and dyspareunia influence female sexuality, but little is known about men's experiences in affected couples. To investigate how men partners experience sexuality in partnership with women with endometriosis. A multi-center case-control study was performed between 2010 and 2015 in Switzerland, Germany, and Austria. 236 Partners of endometriosis patients and 236 partners of age-matched control women without endometriosis with a similar ethnic background were asked to answer selected, relevant questions of the Brief Index of Sexual Functioning and the Global Sexual Functioning questionnaire, as well as some investigator-derived questions. We sought to evaluate sexual satisfaction of men partners of endometriosis patients, investigate differences in sexual activities between men partners of women with and without endometriosis, and identify options to improve partnership sexuality in couples affected by endometriosis. Many partners of endometriosis patients reported changes in sexuality (75%). A majority of both groups was (very) satisfied with their sexual relationship (73.8% vs 58.1%, P = .002). Nevertheless, more partners of women diagnosed with endometriosis were not satisfied (P = .002) and their sexual problems more strongly interfered with relationship happiness (P = .001) than in partners of control women. Frequencies of sexual intercourse (P < .001) and all other partnered sexual activities (oral sex, petting) were significantly higher in the control group. The wish for an increased frequency of sexual activity (P = .387) and sexual desire (P = .919) did not differ statistically between both groups. There is a need to evaluate qualitative factors that influence sexual satisfaction in endometriosis patients. This is one of the first studies to investigate male sexuality affected by endometriosis. The meticulous verification of diagnosis and disease stage according to operation reports and histology allows for a high

  8. Incidence of End-Stage Renal Disease Attributed to Diabetes Among Persons with Diagnosed Diabetes - United States and Puerto Rico, 2000-2014.

    Science.gov (United States)

    Burrows, Nilka Rios; Hora, Israel; Geiss, Linda S; Gregg, Edward W; Albright, Ann

    2017-11-03

    During 2014, 120,000 persons in the United States and Puerto Rico began treatment for end-stage renal disease (ESRD) (i.e., kidney failure requiring dialysis or transplantation) (1). Among these persons, 44% (approximately 53,000 persons) had diabetes listed as the primary cause of ESRD (ESRD-D) (1). Although the number of persons initiating ESRD-D treatment each year has increased since 1980 (1,2), the ESRD-D incidence rate among persons with diagnosed diabetes has declined since the mid-1990s (2,3). To determine whether ESRD-D incidence has continued to decline in the United States overall and in each state, the District of Columbia (DC), and Puerto Rico, CDC analyzed 2000-2014 data from the U.S. Renal Data System and the Behavioral Risk Factor Surveillance System. During that period, the age-standardized ESRD-D incidence among persons with diagnosed diabetes declined from 260.2 to 173.9 per 100,000 diabetic population (33%), and declined significantly in most states, DC, and Puerto Rico. No state experienced an increase in ESRD-D incidence rates. Continued awareness of risk factors for kidney failure and interventions to improve diabetes care might sustain and improve these trends.

  9. The occurrence of dynamic structural disorders in the pharynx and larynx, at rest and during exercise, in horses diagnosed with mild and moderate Equine Asthma (Inflammatory Airway Disease).

    Science.gov (United States)

    Wysocka, B; Kluciński, W

    2018-03-01

    The goal of the present study was to establish the occurrence of structural disorders in the larynx and pharynx during treadmill exercise tests in horses diagnosed with Equine Asthma (EA). Investigation was performed in 29 horses, patients of the Equine Clinic of the Warsaw University of Life Sciences in Poland, admitted with poor exercise performance. Upper and lower airway examinations were performed in all patients revealing both mild to moderate Equine Asthma (13 horses), and no lower airway abnormalities (16 animals). In the group of horses with EA, 11 did not have structural disorders of the pharynx and larynx at rest. During exercise two horses were free of abnormalities, while 11 had structural disorders, eight of them solely in the pharynx, two in the larynx, and one in both the pharynx and larynx. In the non- asthmatic group, 11 horses had no structural disorders during resting endoscopy. Endoscopy performed during exercise revealed disorders of the larynx in 10 horses, of the pharynx in three horses, and in both the larynx and pharynx in the remaining three horses. horses with diagnosed EA frequently have disorders of the pharynx during treadmill exercise tests, while without EA, often have disorders of the larynx. Endoscopy of upper airways during exercise testing is a valuable tool in the diagnosis of poor performance in horses with lower airway inflammatory disease. Copyright© by the Polish Academy of Sciences.

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

    Energy Technology Data Exchange (ETDEWEB)

    Neumann, C.H.

    1986-10-01

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

  11. Positive predictive values of the International Classification of Disease, 10th edition diagnoses codes for diverticular disease in the Danish National Registry of Patients

    Directory of Open Access Journals (Sweden)

    Rune Erichsen

    2010-10-01

    Full Text Available Rune Erichsen1, Lisa Strate2, Henrik Toft Sørensen1, John A Baron31Department of Clinical Epidemiology, Aarhus University Hospital, Denmark; 2Division of Gastroenterology, University of Washington, Seattle, WA, USA; 3Departments of Medicine and of Community and Family Medicine, Dartmouth Medical School, NH, USAObjective: To investigate the accuracy of diagnostic coding for diverticular disease in the Danish National Registry of Patients (NRP.Study design and setting: At Aalborg Hospital, Denmark, with a catchment area of 640,000 inhabitants, we identified 100 patients recorded in the NRP with a diagnosis of diverticular disease (International Classification of Disease codes, 10th revision [ICD-10] K572–K579 during the 1999–2008 period. We assessed the positive predictive value (PPV as a measure of the accuracy of discharge codes for diverticular disease using information from discharge abstracts and outpatient notes as the reference standard.Results: Of the 100 patients coded with diverticular disease, 49 had complicated diverticular disease, whereas 51 had uncomplicated diverticulosis. For the overall diagnosis of diverticular disease (K57, the PPV was 0.98 (95% confidence intervals [CIs]: 0.93, 0.99. For the more detailed subgroups of diagnosis indicating the presence or absence of complications (K573–K579 the PPVs ranged from 0.67 (95% CI: 0.09, 0.99 to 0.92 (95% CI: 0.52, 1.00. The diagnosis codes did not allow accurate identification of uncomplicated disease or any specific complication. However, the combined ICD-10 codes K572, K574, and K578 had a PPV of 0.91 (95% CI: 0.71, 0.99 for any complication.Conclusion: The diagnosis codes in the NRP can be used to identify patients with diverticular disease in general; however, they do not accurately discern patients with uncomplicated diverticulosis or with specific diverticular complications.Keywords: diverticulum, colon, diverticulitis, validation studies

  12. Prevalence of asymptomatic infections in sexually transmitted diseases attendees diagnosed with bacterial vaginosis, vaginal candidiasis, and trichomoniasis.

    Science.gov (United States)

    Rajalakshmi, R; Kalaivani, S

    2016-01-01

    Sexually transmitted diseases (STD) are a major health problem affecting mostly young people in both developing and developed countries. STD in women causes both acute morbidity and complications such as infertility, ectopic pregnancy, low-birth weight, and prematurity. The aim of the study is to assess the prevalence of bacterial vaginosis, vaginal candidiasis, and trichomoniasis among asymptomatic females attending STD outpatient department in a tertiary care hospital in South India. A retrospective analysis of data collected from clinical records of 3000 female patients of age 18 to 49 over a period of 12 months (July 2014 to June 2015) was carried out at the Institute of Venereology, Madras Medical College. Complete epidemiological, clinical, and investigational data were recorded and analyzed for the prevalence of bacterial vaginosis, vaginal candidiasis, and trichomoniasis among asymptomatic patients. About 48.37% (228/470) of bacterial vaginosis patients were asymptomatic. Nearly 45.38% (116/235) of vaginal candidiasis patients were asymptomatic and 30.35% (26/87) of trichomoniasis patients were asymptomatic. The above infections were common in the age group 25-35. Holistic screening protocol was incorporated for all female patients attending STD clinic even if asymptomatic and should be treated accordingly to prevent the acquisition of other serious sexually transmitted infections.

  13. Comparison of adenosine and exercise stress 201Tl myocardial perfusion imaging for diagnosing coronary heart disease in women

    International Nuclear Information System (INIS)

    Li Jiangjin; Ma Shuren; Meng Tao; Bao Zhi; Cui Jianhe

    2011-01-01

    Objective: To compare the diagnostic value of adenosine and exercise stress myocardial perfusion imaging (MPI) for detecting coronary heart disease (CHD) in women. Methods: One hundred and thirty-eight patients with CHD were randomly divided into two groups: adenosine stress group (n=69)and exercise stress group (n=69). All patients underwent myocardial SPECT evaluation. Coronary angiography (CAG), referred as 'gold standard' , was performed in each patient within 1 week before or after MPI. The diagnostic value of the two stress MPI was compared with χ 2 test or Fisher's exact test. Results: In adenosine stress group, the sensitivity, negative predictive value and accuracy were 88.2% (45/51), 72.7% (16/22), 88.4% (61/69), respectively, which were not significantly different from those of the exercise stress group (91.7% (44/48), 66.7% (8/12), 81.2% (52/64); χ 2 =0.571, 0.714, 0.249, P>0.05). However, the false positive rate of adenosine stress (11.1%, 2/18) was significantly lower than that of exercise stress (50.0%, 8/16), P=0.023. Conclusions: Adenosine and exercise stress MPI have similar value for CHD diagnosis in women, however, adenosine stress MPI may have an advantage of low false positive rate. (authors)

  14. Number of distal limb and brachial pressure measurements required when diagnosing peripheral arterial disease by laser Doppler flowmetry

    International Nuclear Information System (INIS)

    Høyer, C; Biurrun Manresa, J A; Petersen, L J

    2013-01-01

    We examine the reliability of single and repeated blood pressure measurements at ankle, toe, and arm levels for the diagnosis of peripheral arterial disease (PAD) by laser Doppler flowmetry. Segmental pressures were measured in 200 patients with known or suspected PAD. Segmental indices were calculated using (1) one measurement [M-1], two measurements [M-2], or by a predefined reproducibility criterion (RC) as well as (2) by using one brachial blood-pressure (BBP-one) or correspondent to each segmental pressure (BBP-all) as reference. The agreement in diagnosis of PAD by Cohen's Kappa was κ = 0.930 when comparing RC to M-1, and κ = 0.977 when comparing RC to M-2. The same comparison showed excellent relative reliability for segmental indices (all intra-class correlation coefficients (ICC) ≥ 0.980). Diagnostic classification agreement for BBP-all versus BBP-one were κ = 0.831 for RC, κ = 0.804 for M-1, and κ = 0.847 for M-2. The relative reliability analysis showed excellent correlation in segmental indices (all ICC ≥ 0.957). The study shows minimal difference in segmental indices and diagnostic classification when comparing calculations based on the listed strategies. However, the study indicated that it is important to measure BBPs correspondent to each segmental pressure. (paper)

  15. Implications of the Incidental Finding of a MYCN Amplified Adrenal Tumor: A Case Report and Update of a Pediatric Disease Diagnosed in Adults

    Directory of Open Access Journals (Sweden)

    Anna Koumarianou

    2013-01-01

    Full Text Available MYCN is a well-known oncogene overexpressed in different human malignancies including neuroblastoma, rhabdomyosarcoma, medulloblastoma, astrocytoma, Wilms’ tumor, and small cell lung cancer. While neuroblastoma is one of the most common childhood malignancies, in adults it is extremely rare and its treatment is based on pediatric protocols that take into consideration stage and genotypic features, such as MYCN amplification. Although neuroblastoma therapy has evolved, identification of early stage patients who need chemotherapy continues to pose a therapeutic challenge. The emerging prognostic role of MYCN phenotype of this disease is currently under investigation as it may redefine MYCN amplified subgroups. We describe an unusual case of adult neuroblastoma with MYCN amplification diagnosed incidentally and discuss possible therapeutic dilemmas.

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

    International Nuclear Information System (INIS)

    Lewinski, A.; Wajs, E.; Sewerynek, E.

    1991-01-01

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

  17. Validation of cardiac 123I-MIBG scintigraphy in patients with Parkinson's disease who were diagnosed with dopamine PET

    International Nuclear Information System (INIS)

    Ishibashi, Kenji; Saito, Yuko; Murayama, Shigeo; Kanemaru, Kazutomi; Oda, Keiichi; Ishiwata, Kiichi; Ishii, Kenji; Mizusawa, Hidehiro

    2010-01-01

    The aim of this study was to evaluate the diagnostic potential of cardiac 123 I-labelled metaiodobenzylguanidine ( 123 I-MIBG) scintigraphy in idiopathic Parkinson's disease (PD). The diagnosis was confirmed by positron emission tomography (PET) imaging with 11 C-labelled 2β-carbomethoxy-3β-(4-fluorophenyl)-tropane ( 11 C-CFT) and 11 C-raclopride (together designated as dopamine PET). Cardiac 123 I-MIBG scintigraphy and dopamine PET were performed for 39 parkinsonian patients. To estimate the cardiac 123 I-MIBG uptake, heart to mediastinum (H/M) ratios in early and delayed images were calculated. On the basis of established clinical criteria and our dopamine PET findings, 24 patients were classified into the PD group and 15 into the non-PD (NPD) group. Both early and delayed images showed that the H/M ratios were significantly lower in the PD group than in the NPD group. When the optimal cut-off levels of the H/M ratio were set at 1.95 and 1.60 in the early and delayed images, respectively, by receiver-operating characteristic analysis, the sensitivity of cardiac 123 I-MIBG scintigraphy for the diagnosis of PD was 79.2 and 70.8% and the specificity was 93.3 and 93.3% in the early and delayed images, respectively. In the Hoehn and Yahr 1 and 2 PD patients, the sensitivity decreased by 69.2 and 53.8% in the early and delayed images, respectively. In early PD cases, cardiac 123 I-MIBG scintigraphy is of limited value in the diagnosis, because of its relatively lower sensitivity. However, because of its high specificity for the overall cases, cardiac 123 I-MIBG scintigraphy may assist in the diagnosis of PD in a complementary role with the dopaminergic neuroimaging. (orig.)

  18. Diagnosing night sweats.

    Science.gov (United States)

    Viera, Anthon J; Bond, Michael M; Yates, Scott W

    2003-03-01

    Night sweats are a common outpatient complaint, yet literature on the subject is scarce. Tuberculosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practice. While these diseases remain important diagnostic considerations in patients with night sweats, other diagnoses to consider include human immunodeficiency virus, gastroesophageal reflux disease, obstructive sleep apnea, hyperthyroidism, hypoglycemia, and several less common diseases. Antihypertensives, antipyretics, other medications, and drugs of abuse such as alcohol and heroin may cause night sweats. Serious causes of night sweats can be excluded with a thorough history, physical examination, and directed laboratory and radiographic studies. If a history and physical do not reveal a possible diagnosis, physicians should consider a purified protein derivative, complete blood count, human immunodeficiency virus test, thyroid-stimulating hormone test, erythrocyte sedimentation rate evaluation, chest radiograph, and possibly chest and abdominal computed tomographic scans and bone marrow biopsy.

  19. Active and Passive Smoking, Chronic Disease and Poverty in China ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Active and Passive Smoking, Chronic Disease and Poverty in China. The globalization ... The impending burden of tobacco-related chronic disease will be significant in a population of 1.3 billion. ... Center for Health Statistics and Information.

  20. Established and emerging biological activity markers of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Nielsen, O H; Vainer, B; Madsen, S M

    2000-01-01

    Assessment of disease activity in inflammatory bowel disease (IBD), i.e., ulcerative colitis (UC) and Crohn's disease (CD), is done using clinical parameters and various biological disease markers. Ideally, a disease marker must: be able to identify individuals at risk of a given disorder......, be disease specific, mirror the disease activity and, finally, be easily applicable for routine clinical purposes. However, no such disease markers have yet been identified for IBD. In this article, classical disease markers including erythrocyte sedimentation rate, acute phase proteins (especially...... orosomucoid and CRP), leukocyte and platelet counts, albumin, neopterin, and beta2-microglobulin will be reviewed together with emerging disease markers such as antibodies of the ANCA/ASCA type, cytokines (e.g., IL-1, IL-2Ralpha, IL-6, IL-8, TNF-alpha, and TNF-alpha receptors) and with various adhesion...

  1. Established and emerging biological activity markers of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Nielsen, O H; Vainer, B; Madsen, S M

    2000-01-01

    orosomucoid and CRP), leukocyte and platelet counts, albumin, neopterin, and beta2-microglobulin will be reviewed together with emerging disease markers such as antibodies of the ANCA/ASCA type, cytokines (e.g., IL-1, IL-2Ralpha, IL-6, IL-8, TNF-alpha, and TNF-alpha receptors) and with various adhesion......Assessment of disease activity in inflammatory bowel disease (IBD), i.e., ulcerative colitis (UC) and Crohn's disease (CD), is done using clinical parameters and various biological disease markers. Ideally, a disease marker must: be able to identify individuals at risk of a given disorder......, be disease specific, mirror the disease activity and, finally, be easily applicable for routine clinical purposes. However, no such disease markers have yet been identified for IBD. In this article, classical disease markers including erythrocyte sedimentation rate, acute phase proteins (especially...

  2. Predicting the consumption of foods low in saturated fats among people diagnosed with Type 2 diabetes and cardiovascular disease. The role of planning in the theory of planned behaviour.

    Science.gov (United States)

    White, Katherine M; Terry, Deborah J; Troup, Carolyn; Rempel, Lynn A; Norman, Paul

    2010-10-01

    The present study tested the utility of an extended version of the theory of planned behaviour that included a measure of planning, in the prediction of eating foods low in saturated fats among adults diagnosed with Type 2 diabetes and/or cardiovascular disease. Participants (N=184) completed questionnaires assessing standard theory of planned behaviour measures (attitude, subjective norm, and perceived behavioural control) and the additional volitional variable of planning in relation to eating foods low in saturated fats. Self-report consumption of foods low insaturated fats was assessed 1 month later. In partial support of the theory of planned behaviour, results indicated that attitude and subjective norm predicted intentions to eat foods low in saturated fats and intentions and perceived behavioural control predicted the consumption of foods low in saturated fats. As an additional variable, planning predicted the consumption of foods low in saturated fats directly and also mediated the intention-behaviour and perceived behavioural control-behaviour relationships, suggesting an important role for planning as a post-intentional construct determining healthy eating choices. Suggestions are offered for interventions designed to improve adherence to healthy eating recommendations for people diagnosed with these chronic conditions with a specific emphasis on the steps and activities that are required to promote a healthier lifestyle.

  3. Effects of intensive induction and consolidation chemotherapy with idarubicin and high dose cytarabine on minimal residual disease levels in newly diagnosed adult precursor-B acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    Kenneth F. Bradstock

    2016-12-01

    Full Text Available An intensive induction regimen, consisting of idarubicin and high dose cytarabine, was assessed in 19 adult patients, median age 44 years, with newly diagnosed precursor-B acute lymphoblastic leukemia (ALL. Patients achieving a complete response (CR were given an attenuated consolidation course. The primary endpoints were induction death rate and incidence of serious non-hematological toxicity. Grades 3–4 diarrhoea occurred in 47% of patients during induction. Two patients (11% died during induction therapy, and 2 were withdrawn due to resistant disease or prolonged marrow hypoplasia. Fifteen patients achieved CR (79%, but levels of minimal residual disease (MRD after induction were comparable with those previously observed using a modified pediatric protocol. Overall survival at 5 years was 36.8% while leukemia-free survival was 44.1%. An intensive AML protocol used in adults with ALL resulted in substantial toxicity and provided similar levels of cytoreduction to conventional ALL protocols, without improving long-term outcomes.

  4. Epidemiology of inflammatory bowel disease in Málaga: incidence rate and follow-up of a cohort diagnosed between 2007-2008.

    Science.gov (United States)

    Cueto Torreblanca, Ignacio; Camargo Camero, Raquel; Andrade Bellido, Raúl; Romero Pérez, Eduardo; Alcaín Martínez, Guillermo

    2017-08-01

    The incidence of inflammatory bowel disease (IBD) in Spain has been traditionally lower than in Northern European countries. Recent epidemiological studies have found that these differences are diminishing. This study estimates the incidence of IBD in Málaga (Spain), a city in Southern Spain and relates its results to those found in our neighboring countries. This was a prospective study designed to collect new cases diagnosed during the period from 2007-2008 and follow up these patients. Incidence is expressed as number of patients per 100,000 population per year. The population distribution found in the European Collaborative Study was used to standardize incidence rates. The gross incidence rate of IBD in Málaga is 9/105, the standardized incidence rate is 12.3/105 (9.7-15.6). These data are similar to those found in our surroundings, although a higher incidence rate for Crohn's disease (CD) as compared to ulcerative colitis (UC) was found. The clinical characteristics and outcomes of our patients do not differ significantly from those described for other populations.

  5. Disease activity score in rheumatoid arthritis with or without secondary fibromyalgia

    International Nuclear Information System (INIS)

    Zammurrad, S.; Munir, W.; Farooqi, A.

    2013-01-01

    Objective: To correlate disease activity score (DAS-28) in the patients with rheumatoid arthritis (RA) with and without secondary fibromyalgia. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad, from November 2011 to April 2012. Methodology: Patients aged above 16 years diagnosed to have rheumatoid arthritis according to ACR/EULAR criteria 2010 were included in the study. Fibromyalgia (FM) was diagnosed by ACR 1990 criteria. Patients of other autoimmune diseases or psychiatric illnesses were excluded. DAS was determined and compared using t-test with significance at p < 0.05. Results: The mean age of study subjects was 42.9 years. Thirty one out of total 138 patients had fibromyalgia (22.4%). Female gender was predominant (92.0%); being 96.8% in patients with and in 88.2% without fibromyalgia. The average DAS score was high (5.3 + 1.5) in fibromyalgia patients compared to those without fibromyalgia (3.9 + 1.2); this difference in mean value was statistically significant (p = < 0.001). Conclusion: DAS-28 is a useful tool for assessing rheumatoid arthritis disease status in outpatient setting, however, increased disease activity must be assessed for possible co-existence of fibromyalgia which can spuriously give high DAS value and adversely affect treatment decision. (author)

  6. Effects of one-hour training course and spirometry on the ability of physicians to diagnose and treat chronic obstructive pulmonary disease.

    Science.gov (United States)

    Cai, Shan; Qin, Li; Tanoue, Lynn; Hu, Anmei; Jia, Xiujie; Luo, Hong; Chen, Yan; Chen, Ping; Peng, Hong

    2015-01-01

    In China, the prevalence of chronic obstructive pulmonary disease (COPD) in persons 40 years of age or older is estimated at 8.2%, but this is likely a substantial underestimate. Eight secondary hospitals which didn't have spirometries were chosen randomly in Hunan province of central south China. Physician subjects at these hospitals underwent a one-hour training course on the Chinese COPD guidelines. Physicians answered questionnaires assessing their knowledge of the guidelines before and after the training session. The mean correct scores of questionnaires were compared before and after training. Four out of the eight hospitals were given access to spirometry. Eligible patient subjects underwent spirometry testing prior to the physician visit. After seeing the patient, physicians were asked to answer a questionnaire relating to the diagnosis and severity of COPD. Physicians were then given the results of the spirometry, and asked to answer the same questionnaire. Physicians' responses before and after receiving the spirometry results were compared. 225 physicians participated in the training session. 207 questionnaires were completed. Mean scores (out of 100) before and after the training were 53.1 ± 21.7 and 93.3 ± 9.8, respectively. 18 physicians and 307 patient subjects participated in the spirometry intervention. Based on spirometric results, the prevalence of COPD was 38.8%. Physicians correctly identified the presence of COPD without spirometric data in 85 cases (76.6%); this increased to 117 cases (97.4%) once spirometric data were available. Without spirometric data, physicians incorrectly diagnosed COPD in 38 patients; this decreased to 6 patients once spirometric data were available. Spirometric data also improved the ability of physicians to correctly grade COPD severity. Simple educational training can substantially improve physicians' knowledge relating to COPD. Spirometry combined with education improves the ability of physicians to diagnose COPD

  7. Active Crohn's disease is associated with low vitamin D levels

    DEFF Research Database (Denmark)

    Jørgensen, Søren Peter; Hvas, Christian Lodberg; Agnholt, Jørgen

    2013-01-01

    activity is associated with low vitamin D levels. METHODS: In a cross-sectional study of 182 CD patients and 62 healthy controls, we measured serum 25-OH vitamin D. Stratified analysis was used to compare 25-OH vitamin D levels with Crohn's disease activity index, C-reactive protein, smoking status, intake...... of oral vitamin D supplements and seasonal variation in CD patients and healthy controls. RESULTS: Serum 25-OH vitamin D was inversely associated with disease activity: Median 25-OH vitamin D levels of Crohn's disease in remission, mildly, and moderately active diseases evaluated by Crohn's disease...... D levels (51nmol/l) than patients who did not smoke (76nmol/l), plevels. CONCLUSIONS: Active Crohn's disease was associated with low serum 25-OH vitamin D. Patients who smoked had lower 25-OH...

  8. How Is Wilson Disease Diagnosed?

    Science.gov (United States)

    ... News & Announcements Wilson's Warriors Events Back The Big WOW 2018 Annual Conference WDA Publications Back Downloads Corporate Sponsorship Forms Membership Forms Resources The Big WOW Newsletters News Copper Connection Newsletter Resources Centers of ...

  9. Changes in cardiac function and structure in newly diagnosed Graves' disease. A conventional and 2D-speckle tracking echocardiography study.

    Science.gov (United States)

    Aroditis, K; Pikilidou, M; Vourvouri, E; Hadjistavri, L; Zebekakis, P; Yovos, J; Efthimiadis, G; Karvounis, H

    2017-02-01

    Overproduction of thyroid hormones leads to structural as well as functional cardiac changes. Conventional echocardiography but also recently developed sophisticated two-dimensional echocardiography speckle (2D-STE) tracking allow elaborate evaluation of these changes. Our purpose was to investigate the effects of thyroid hormones overproduction on the heart in patients with Graves' disease and changes that occur after 6 months thyrostatic therapy. We conducted a prospective, case-control study of 6 months duration. Full echocardiographic assessment at diagnosis and after 6 months of thyrostatic therapy were performed in 44 patients with Graves' disease, aged 37.6 ± 9.1 years. Additionally, 43 euthyroid controls were studied for the same time period. Left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) were higher in the patient group while triscupid annular plane systolic excursion (TAPSE) was lower in the patient group. Moreover, left ventricular (LV) mass index and left atrium (LA) volume index were higher in the Graves' disease group. Diastolic impairment as assessed with conventional echocardiography including tissue Doppler was present in the patient group (E/A ratio 0.87 ± 0.10,). 2D-STE analysis, revealed an increase in the strain rate at the isovolumic relaxation time (SRIVRT, 0.310 ± 0.07 patients versus 0.298 ± 0.09 s -1 controls). Improvement in diastolic and right systolic function as well as in left ventricular structural parameters was observed after restoration of euthyroidism (E/A ratio from 0.87 ± 0.10 versus 0.9 ± 0.08, p < 0.05). Patients with newly diagnosed Graves' showed an improvement in diastolic function, right systolic function and structural parameters after 6 months of thyrostatic treatment.

  10. Continuity of care with physicians and risk of subsequent hospitalization and end-stage renal disease in newly diagnosed type 2 diabetes mellitus patients.

    Science.gov (United States)

    Chang, Po-Ya; Chien, Li-Nien; Bai, Chyi-Huey; Lin, Yuh-Feng; Chiou, Hung-Yi

    2018-01-01

    Effective management for type 2 diabetes mellitus (DM) can slow the progression of kidney outcomes and reduce hospital admissions. Better continuity of care (COC) was found to improve patients' adherence and self-management. This study examined the associations between COC, hospitalization, and end-stage renal disease (ESRD) in DM patients. In the cohort study, data from 1996 to 2012 were retrieved from the Longitudinal Health Insurance Database, using inverse probability weighted analysis. A total of 26,063 patients with newly diagnosed type 2 DM who had been treated with antihyperglycemic agents were included. COC is to assess the extent to which a DM patient visited the same physician during the study period. This study categorized COC into 3 groups - low, intermediate, and high, - according to the distribution of scores in our sample. The number of ESRD patients in the high, intermediate, and low COC groups were 92 (22.33%), 130 (31.55%), and 190 (46.12%), respectively, and the mean follow-up periods for the 3 groups were 7.13, 7.12, and 7.27 years, respectively. After using inverse probability weighting, the intermediate and low COC groups were significantly associated with an increased risk of ESRD compared with the high COC group (adjusted hazard ratio (aHR) 1.36 [95% CI, 1.03-1.80] and aHR 1.76 [95% CI, 1.35-2.30], respectively). The intermediate and low COC groups were also significantly associated with the subsequent hospitalization compared with the high COC group (aHR 1.15 [95% CI, 0.99-1.33] and aHR 1.72 [95% CI, 1.50-1.97], respectively). COC is related to ESRD onset and subsequent hospitalization among patients with DM. This study suggested that when DM patients keep visiting the same physician for managing their diseases, the progression of renal disease can be prevented.

  11. Kansas City Cardiomyopathy Questionnaire Score Is Associated With Incident Heart Failure Hospitalization in Patients With Chronic Kidney Disease Without Previously Diagnosed Heart Failure: Chronic Renal Insufficiency Cohort Study.

    Science.gov (United States)

    Mishra, Rakesh K; Yang, Wei; Roy, Jason; Anderson, Amanda H; Bansal, Nisha; Chen, Jing; DeFilippi, Christopher; Delafontaine, Patrice; Feldman, Harold I; Kallem, Radhakrishna; Kusek, John W; Lora, Claudia M; Rosas, Sylvia E; Go, Alan S; Shlipak, Michael G

    2015-07-01

    Chronic kidney disease is a risk factor for heart failure (HF). Patients with chronic kidney disease without diagnosed HF have an increased burden of symptoms characteristic of HF. It is not known whether these symptoms are associated with occurrence of new onset HF. We studied the association of a modified Kansas City Cardiomyopathy Questionnaire with newly identified cases of hospitalized HF among 3093 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study who did not report HF at baseline. The annually updated Kansas City Cardiomyopathy Questionnaire score was categorized into quartiles (Q1-4) with the lower scores representing the worse symptoms. Multivariable-adjusted repeated measure logistic regression models were adjusted for demographic characteristics, clinical risk factors for HF, N-terminal probrain natriuretic peptide level and left ventricular hypertrophy, left ventricular systolic and diastolic dysfunction. Over a mean (±SD) follow-up period of 4.3±1.6 years, there were 211 new cases of HF hospitalizations. The risk of HF hospitalization increased with increasing symptom quartiles; 2.62, 1.85, 1.14, and 0.74 events per 100 person-years, respectively. The median number of annual Kansas City Cardiomyopathy Questionnaire assessments per participant was 5 (interquartile range, 3-6). The annually updated Kansas City Cardiomyopathy Questionnaire score was independently associated with higher risk of incident HF hospitalization in multivariable-adjusted models (odds ratio, 3.30 [1.66-6.52]; P=0.001 for Q1 compared with Q4). Symptoms characteristic of HF are common in patients with chronic kidney disease and are associated with higher short-term risk for new hospitalization for HF, independent of level of kidney function, and other known HF risk factors. © 2015 American Heart Association, Inc.

  12. Positive predictive value and completeness of prenatally assigned International Classification of Disease-10 kidney anomaly diagnoses in the Danish National Patient Registry

    Directory of Open Access Journals (Sweden)

    Rasmussen M

    2016-01-01

    Full Text Available Maria Rasmussen,1 Morten Smærup Olsen,2 Lone Sunde,1,3 Lars Pedersen,2 Olav Bjørn Petersen4 1Department of Clinical Genetics, Aarhus University Hospital, Skejby, 2Department of Clinical Epidemiology, Aarhus University Hospital, Skejby, 3Department of Biomedicine, Aarhus University, Aarhus, 4Department of Gynecology and Obstetrics, Aarhus University Hospital, Skejby, Denmark Objective: Restricting studies of severe congenital malformations to live-born children may introduce substantial bias. In this study, we estimated the attendance to the second-trimester fetal malformation screening program. We also estimated the positive predictive value (PPV of prenatally assigned International Classification of Disease-10 diagnoses recorded in the Danish National Patient Registry (DNPR and the completeness of case registration. We used kidney anomalies as an example. Methods: We identified the proportion of all Danish live-born children from January 1, 2007 to December 31, 2012, who were scanned during the second trimester using the DNPR and the Civil Registration System. Details of all fetuses with specific kidney anomaly diagnoses according to the DNPR were retrieved. The PPV was estimated using the nationwide Astraia database of pregnancy medical charts or traditional medical charts, as gold standard. The completeness was assessed using the total number of cases estimated by the capture–recapture method. Results: Of 372,263 live born infants, 97.3% were scanned during the second trimester. We identified 172 fetuses in the DNPR. Of these, 149 had kidney anomalies according to Astraia or medical chart review, corresponding to a PPV of 87% (95% CI: 81%–91%. The estimated completeness was 43% (95% CI: 38%–49% for the DNPR and 75% (95% CI: 70%–79% for Astraia. Conclusion: Almost all live-born children were scanned during the second trimester in Denmark. However, low completeness may hamper the use of the DNPR for studies of prenatally detected

  13. Can salivary creatinine and urea levels be used to diagnose chronic kidney disease in children as accurately as serum creatinine and urea levels? A case-control study.

    Science.gov (United States)

    Renda, Rahime

    2017-11-01

    Children with chronic kidney disease (CKD) develop many metabolic changes in blood that often necessitate frequent biochemical analysis. Serum analysis is an invasive and painful procedure. It would be highly beneficial if a noninvasive alternative process to serum analysis in children were identified. Saliva can be collected noninvasively, repeatedly, and without the use of healthcare personnel. The aims of this study were to compare serum and salivary urea and creatinine levels in children with CKD and healthy controls, and to determine if salivary creatinine and urea levels can be used to diagnose CKD in children as accurately as serum creatinine and urea levels. This case-control study included 35 children with CKD and 28 healthy children as controls. Saliva and blood samples were collected for measurement of urea and creatinine levels. The urea and creatinine levels in serum and saliva in the CKD and control groups were compared using the independent samples Mann-Whitney U test. Correlations between the serum and salivary urea and creatinine levels were determined using Pearson's correlation coefficient. Receiver operating characteristic analysis was used to assess the diagnostic performance of salivary creatinine and cutoff values were identified. In the CKD group, the mean salivary creatinine level was 0.45 mg/dL and the mean salivary urea level was 0.11 mg/dL, versus 28.83 mg/dL and 21.78 mg/dL, respectively, in the control group. Stage 4 and 5 CKD patients had a mean salivary urea level of 31.35 mg/dL, as compared to 17.78 mg/dL in the control group. Serum urea and creatinine, and salivary creatinine were significantly higher in the CKD patients (regardless of disease stage) than in the controls (p creatinine. The area under the curve for salivary creatinine was 0.805. The cutoff value for salivary creatinine was 0.125 mg/dL, with a sensitivity of 82.9% and specificity of 78.6%. Based on the positive correlation between the serum and saliva

  14. Accuracy of 3 T versus 1.5 T breast MRI for pre-operative assessment of extent of disease in newly diagnosed DCIS

    Energy Technology Data Exchange (ETDEWEB)

    Rahbar, Habib, E-mail: hrahbar@uw.edu; DeMartini, Wendy B.; Lee, Amie Y.; Partridge, Savannah C.; Peacock, Sue; Lehman, Constance D.

    2015-04-15

    Highlights: •We compared sizes of known ductal carcinoma in situ (DCIS) on pre-operative breast MRI at 3 T and 1.5 T with final pathology sizes. •DCIS sizes on 3 T MRI correlated better with pathologic sizes than 1.5 T MRI. •Imaging features of DCIS, including morphology and kinetics, were similar at 3 T and 1.5 T MRI. -- Abstract: Objectives: While 3 T breast magnetic resonance imaging has increased in use over the past decade, there is little data comparing its use for assessing ductal carcinoma in situ (DCIS) versus 1.5 T. We sought to compare the accuracies of DCIS extent of disease measures on pre-operative 3 T versus 1.5 T MRI. Methods: This institutional review board-approved prospective study included 20 patients with ductal carcinoma in situ diagnosed by core needle biopsy (CNB) who underwent pre-operative breast MRI at both 3 T (resolution = 0.5 mm × 0.5 mm × 1.3 mm) and 1.5 T (0.85 mm × 0.85 mm × 1.6 mm). All patients provided informed consent, and the study was HIPPA compliant. Lesion sizes and imaging characteristics (morphologic and kinetic enhancement) were recorded for the 3 T and 1.5 T examinations. Lesion size measures at both field strengths were correlated to final pathology, and imaging characteristics also were compared. Results: Of the initial cohort of 20 patients with CNB-diagnosed DCIS, 19 underwent definitive surgery. Median DCIS sizes of these 19 patients were 6 mm (range: 0–67 mm) on 3 T, 13 mm (0–60 mm) on 1.5 T, and 6 mm (0–55 mm) on surgical pathology. Size correlation between MRI and pathology was higher for 3 T (Spearman's ρ = 0.66, p = 0.002) than 1.5 T (ρ = 0.36, p = 0.13). In 10 women in which a residual area of suspicious enhancement was identified on both field strengths, there was agreement of morphologic description (NME vs. mass) in nine, and no significant difference in dynamic contrast enhanced kinetics at 3 T compared to 1.5 T. Conclusions: Pre-operative breast MRI at 3 T provided higher

  15. Effectiveness of motivational interviewing on lifestyle modification and health outcomes of clients at risk or diagnosed with cardiovascular diseases: A systematic review.

    Science.gov (United States)

    Lee, Windy W M; Choi, K C; Yum, Royce W Y; Yu, Doris S F; Chair, S Y

    2016-01-01

    Clinically, there is an increasing trend in using motivational interviewing as a counseling method to help clients with cardiovascular diseases to modify their unhealthy lifestyle in order to decrease the risk of disease occurrence. As motivational interviewing has gained increased attention, research has been conducted to examine its effectiveness. This review attempts to identify the best available evidence related to the effectiveness of motivational interviewing on lifestyle modification, physiological and psychological outcomes for clients at risk of developing or with established cardiovascular diseases. Systematic review of studies incorporating motivational interviewing in modifying lifestyles, improving physiological and psychological outcomes for clients at risk of or diagnosed with cardiovascular diseases. Major English and Chinese electronic databases were searched to identify citations that reported the effectiveness of motivational interviewing. The searched databases included MEDLINE, British Nursing Index, CINAHL Plus, PsycINFO, SCOPUS, CJN, CBM, HyRead, WanFang Data, Digital Dissertation Consortium, and so on. Two reviewers independently assessed the relevance of citations based on the inclusion criteria. Full texts of potential citations were retrieved for more detailed review. Critical appraisal was conducted by using the standardized critical appraisal checklist for randomized and quasi-randomized controlled studies from the Joanna Briggs Institute - Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStaRI). After eligibility screening, 14 articles describing 9 studies satisfied the inclusion criteria and were included in the analysis. Only certain outcomes in certain studies were pooled for meta-analysis because of the large variability of the studies included, other findings were presented in narrative form. For lifestyle modification, the review showed that motivational interviewing could be more effective than usual care on

  16. Construct and concurrent validity of the Cambridge neuropsychological automated tests in Portuguese older adults without neuropsychiatric diagnoses and with Alzheimer's disease dementia.

    Science.gov (United States)

    Matos Gonçalves, Marta; Pinho, Maria Salomé; Simões, Mário R

    2018-03-01

    We aimed to analyze the construct and concurrent validity of the Rapid Visual Information Processing (RVP), Paired Associates Learning (PAL), Reaction Time (RTI), and Spatial Working Memory (SWM) tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB®). Inclusion criteria were checked in a first session. The CANTAB and additional pencil-and-paper tests were administered within 1 week. The participants (aged 69-96 years) were 137 Portuguese adults without neuropsychiatric diagnoses and 37 adults with mild-to-moderate Alzheimer's disease dementia. Comparisons were made between the CANTAB tests and between these tests and the Rey Complex Figure Test (RCFT), Verbal Fluency (VF) test, and some Wechsler Memory Scale-III and Wechsler Adult Intelligence Scale-III subtests. Most intra-test correlations were stronger than the CANTAB inter-test correlations. The RVP correlated more with VF animals (.44), the PAL with RCFT immediate recall (-.52), the RTI with RVP mean latency (.42), and the SWM with Spatial Span backward (-.39).

  17. How Are Learning Disabilities Diagnosed?

    Science.gov (United States)

    ... Research Information Research Goals Activities and Advances Scientific Articles Find a Study Resources and Publications For Patients and Consumers For Researchers and Health Care Providers Home Health A to Z List Learning Disabilities Condition Information How is it diagnosed? Share ...

  18. Vascular endothelial growth factor in systemic lupus erythematosus - correlations with disease activity and nailfold capillaroscopy changes.

    Science.gov (United States)

    Bărbulescu, Andreea Lili; Vreju, Ananu Florentin; Bugă, Ana Maria; Sandu, Raluca Elena; Criveanu, Cristina; Tudoraşcu, Diana Rodica; Gheonea, Ioana Andreea; Ciurea, Paulina Lucia

    2015-01-01

    Our study aimed to quantify serum VEGF (vascular endothelial growth factor) and its inter-relation with the severity of microvascular damage, assessed by nailfold capillaroscopy (NC), and to establish the possible relationship with disease activity score. We included 18 patients, diagnosed with systemic lupus erythematosus (SLE) and 17 gender and age-matched control subjects. For determining serum VEGF, we used a Human VEGF Assay kit-IBL. NC was performed, according to the standard method, using a video-capillaroscope Videocap 3.0, DS Medica, by the same examiner, blinded to clinical and laboratory data. Serum VEGF registered a mean value of 68.99±71.06 pg/mL for SLE patients and 31.84±11.74 pg/mL for controls, differences statistically significant; depending on disease activity, we found a mean value of 60.11±57.74 pg/mL, for patients with moderate disease activity vs. 30.96±11.51 pg/mL for the ones with a low activity (p=0.014). We found a moderately positive correlation, statistically significant (p=0.015), between serum level of VEGF and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Performing NC, we found changes in 88.88% of the patients; the most frequent were increased tortuosity, dilated capillaries, an increased length and a prominent subpapillary plexus. The presence of nailfold capillaroscopy changes and serum level of VEGF, correlated moderately, positive. Since serum levels of VEGF are higher in SLE patients, compared to controls, significantly different according to disease activity degree, and directly inter-related to abnormal NC patterns and a more active disease, we can include these accessible parameters in the routine evaluation, in order to better quantify the systemic damage, individualize the treatment, improve the outcome and life quality for these patients.

  19. Ebola Virus Disease Is Characterized by Poor Activation and Reduced Levels of Circulating CD16+ Monocytes.

    Science.gov (United States)

    Lüdtke, Anja; Ruibal, Paula; Becker-Ziaja, Beate; Rottstegge, Monika; Wozniak, David M; Cabeza-Cabrerizo, Mar; Thorenz, Anja; Weller, Romy; Kerber, Romy; Idoyaga, Juliana; Magassouba, N'Faly; Gabriel, Martin; Günther, Stephan; Oestereich, Lisa; Muñoz-Fontela, César

    2016-10-15

    A number of previous studies have identified antigen-presenting cells (APCs) as key targets of Ebola virus (EBOV), but the role of APCs in human Ebola virus disease (EVD) is not known. We have evaluated the phenotype and kinetics of monocytes, neutrophils, and dendritic cells (DCs) in peripheral blood of patients for whom EVD was diagnosed by the European Mobile Laboratory in Guinea. Acute EVD was characterized by reduced levels of circulating nonclassical CD16 + monocytes with a poor activation profile. In survivors, CD16 + monocytes were activated during recovery, coincident with viral clearance, suggesting an important role of this cell subset in EVD pathophysiology. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  20. Paraoxonase 1 Activity in Endocrine Diseases

    OpenAIRE

    Özlem Tarçın; Dilek Gogas Yavuz

    2011-01-01

    Paraoxonase is an esterase bound to high-density lipoproteins which by metabolizing lipid peroxides, prevents their accumulation on low-density lipoproteins. It also hydrolyzes various organophosphorus compounds. Considering the role of PON1 in hydrolyzing phospholipid and cholesteryl-ester hydroperoxides and thus protecting lipoproteins against oxidative modification, it can be concluded that PON1 may be an indicator of the risk of atherosclerosis/coronary artery disease development. Recent ...

  1. Remote Physical Activity Monitoring in Neurological Disease: A Systematic Review.

    Science.gov (United States)

    Block, Valerie A J; Pitsch, Erica; Tahir, Peggy; Cree, Bruce A C; Allen, Diane D; Gelfand, Jeffrey M

    2016-01-01

    To perform a systematic review of studies using remote physical activity monitoring in neurological diseases, highlighting advances and determining gaps. Studies were systematically identified in PubMed/MEDLINE, CINAHL and SCOPUS from January 2004 to December 2014 that monitored physical activity for ≥24 hours in adults with neurological diseases. Studies that measured only involuntary motor activity (tremor, seizures), energy expenditure or sleep were excluded. Feasibility, findings, and protocols were examined. 137 studies met inclusion criteria in multiple sclerosis (MS) (61 studies); stroke (41); Parkinson's Disease (PD) (20); dementia (11); traumatic brain injury (2) and ataxia (1). Physical activity levels measured by remote monitoring are consistently low in people with MS, stroke and dementia, and patterns of physical activity are altered in PD. In MS, decreased ambulatory activity assessed via remote monitoring is associated with greater disability and lower quality of life. In stroke, remote measures of upper limb function and ambulation are associated with functional recovery following rehabilitation and goal-directed interventions. In PD, remote monitoring may help to predict falls. In dementia, remote physical activity measures correlate with disease severity and can detect wandering. These studies show that remote physical activity monitoring is feasible in neurological diseases, including in people with moderate to severe neurological disability. Remote monitoring can be a psychometrically sound and responsive way to assess physical activity in neurological disease. Further research is needed to ensure these tools provide meaningful information in the context of specific neurological disorders and patterns of neurological disability.

  2. Remote Physical Activity Monitoring in Neurological Disease: A Systematic Review

    Science.gov (United States)

    Block, Valerie A. J.; Pitsch, Erica; Tahir, Peggy; Cree, Bruce A. C.; Allen, Diane D.; Gelfand, Jeffrey M.

    2016-01-01

    Objective To perform a systematic review of studies using remote physical activity monitoring in neurological diseases, highlighting advances and determining gaps. Methods Studies were systematically identified in PubMed/MEDLINE, CINAHL and SCOPUS from January 2004 to December 2014 that monitored physical activity for ≥24 hours in adults with neurological diseases. Studies that measured only involuntary motor activity (tremor, seizures), energy expenditure or sleep were excluded. Feasibility, findings, and protocols were examined. Results 137 studies met inclusion criteria in multiple sclerosis (MS) (61 studies); stroke (41); Parkinson's Disease (PD) (20); dementia (11); traumatic brain injury (2) and ataxia (1). Physical activity levels measured by remote monitoring are consistently low in people with MS, stroke and dementia, and patterns of physical activity are altered in PD. In MS, decreased ambulatory activity assessed via remote monitoring is associated with greater disability and lower quality of life. In stroke, remote measures of upper limb function and ambulation are associated with functional recovery following rehabilitation and goal-directed interventions. In PD, remote monitoring may help to predict falls. In dementia, remote physical activity measures correlate with disease severity and can detect wandering. Conclusions These studies show that remote physical activity monitoring is feasible in neurological diseases, including in people with moderate to severe neurological disability. Remote monitoring can be a psychometrically sound and responsive way to assess physical activity in neurological disease. Further research is needed to ensure these tools provide meaningful information in the context of specific neurological disorders and patterns of neurological disability. PMID:27124611

  3. Changes Over Time in the Utilization of Disease-Related Internet Information in Newly Diagnosed Breast Cancer Patients 2007 to 2013

    Science.gov (United States)

    Kahana, Eva; Kuhr, Kathrin; Ansmann, Lena; Pfaff, Holger

    2014-01-01

    Background As the number of people with Internet access rises, so does the use of the Internet as a potentially valuable source for health information. Insight into patient use of this information and its correlates over time may reveal changes in the digital divide based on patient age and education. Existing research has focused on patient characteristics that predict Internet information use and research on treatment context is rare. Objective This study aims to (1) present data on the proportion of newly diagnosed breast cancer patients treated in German breast centers from 2007 to 2013 who used the Internet for information on their disease, (2) look into correlations between Internet utilization and sociodemographic characteristics and if these change over time, and (3) determine if use of Internet information varies with the hospitals in which the patients were initially treated. Methods Data about utilization of the Internet for breast cancer–specific health information was obtained in a postal survey of breast cancer patients that is conducted annually in Germany with a steady response rate of 87% of consenting patients. Data from the survey were combined with data obtained by hospital personnel (eg, cancer stage and type of surgery). Data from 27,491 patients from 7 consecutive annual surveys were analyzed for this paper using multilevel regression modeling to account for clustering of patients in specific hospitals. Results Breast cancer patients seeking disease-specific information on the Internet increased significantly from 26.96% (853/3164) in 2007 to 37.21% (1485/3991) in 2013. Similar patterns of demographic correlates were found for all 7 cohorts. Older patients (≥70 years) and patients with <10 years of formal education were less likely to use the Internet for information on topics related to their disease. Internet use was significantly higher among privately insured patients and patients living with a partner. Higher cancer stage and a

  4. Metabolism features in the active rheumatoid disease

    Energy Technology Data Exchange (ETDEWEB)

    Cossermelli, W; Carvalho, N; Papaleo Netto, M [Sao Paulo Univ. (Brazil). Centro de Medicina Nuclear

    1974-02-01

    The /sup 131/I-labelled albumin metabolism was studied in fourteen female patients with rheumatoid arthritis. The half-life of distribution was increased while the turnover half-life and turnover rate was within normal limits. These results led to assume that synthesis and catabolism may not change this disease, not being the responsible mechanism of hypoalbuminemia. Hypoalbuminemia would appear as compensatory mechanism in view of other protein alterations, as hypergammaglobulinemia, without changes of stabilizing and metabolic properties of albumin, perhaps due to albumin molecular alterations.

  5. Metabolism features in the active rheumatoid disease

    International Nuclear Information System (INIS)

    Cossermelli, W.; Carvalho, N.; Papaleo Netto, M.

    1974-01-01

    It was studied the 131 I-labelled albumin metabolism in fourteen female patients with rheumatoid arthritis. The half-life of distribution was increased while the turnover half-life and turnover rate was within normal limits. These results led to assume that synthesis and catabolism may not change this disease, not being the responsible mechanism of hypoalbuminemia. Hypoalbuminemia would appear as compensatory mechanism in view of other protein alterations, as hypergammaglobulinemia, without changes of stabilizing and metabolic properties of albumin, perhaps due to albumin molecular alterations [pt

  6. Creating a Magnetic Imaging System for Diagnosing Infant Brain Activity Based on NI PXI and LabVIEW

    Directory of Open Access Journals (Sweden)

    Christopher G. Atwood

    2006-11-01

    Full Text Available Developing a noninvasive magnetic imaging system to spatially and temporally map the magnetic fields generated by brain activity in infants at severe risk of developing cerebral palsy and epilepsy, so that medical doctors can intervene at an early stage.

  7. The Moderating Role of Sensory Overresponsivity in HPA Activity: A Pilot Study with Children Diagnosed with ADHD

    Science.gov (United States)

    Reynolds, Stacey; Lane, Shelly J.; Gennings, Chris

    2010-01-01

    Objective: To determine if sensory overresponsivity (SOR) is a moderating condition impacting the activity of the Hypothalamic Pituitary Adrenal (HPA) Axis in children with ADHD. Method: Participants were children with (n = 24) and without ADHD (n = 24). Children in the ADHD group were divided into SOR (ADHDs) and non-SOR (ADHDt) groups using the…

  8. Amino-Terminal proB-Type Natriuretic Peptide Levels in the Umbilical Cord Blood of Neonates Differ According to the Type of Prenatally Diagnosed Congenital Heart Disease.

    Science.gov (United States)

    Bae, Jin Young; Cha, Hyun-Hwa; Seong, Won Joon

    2015-12-01

    The aim of this study was to investigate differences in amino-terminal proB-type natriuretic peptide (NT-proBNP) levels in the cord blood of neonates according to the type of congenital heart disease (CHD) and to evaluate the usefulness of NT-proBNP as a prognostic marker. We included 76 neonates with prenatally diagnosed CHD and 45 controls without CHD. Neonates were classified into five groups based on echocardiographic findings. The levels of NT-proBNP in the cord blood were examined and analyzed according to the neonatal outcomes. The levels of NT-proBNP were significantly elevated in the cord blood of neonates with CHD compared with that in the cord blood of controls. The levels of NT-proBNP in the group with right ventricular outflow tract obstruction without a ventricular septal defect were significantly increased compared to that in the other groups. The neonates that required acute surgical correction had higher levels of NT-proBNP in the cord blood, though they were not statistically significant. Meanwhile, NT-proBNP levels in the cord blood of neonates with functional single ventricle were significantly higher than that in the cord blood of those with functional biventricles. Significant differences in the levels of NT-proBNP between survivors and nonsurvivors were observed within 1 year of birth. In this study, we found that the levels of NT-proBNP in the cord blood of neonates with CHD were higher than the levels in controls. This finding was striking in the group with right ventricular outflow tract obstruction, and it was associated with surgery for functional single ventricle and 1-year survival.

  9. Diagnostic Value of Electrocardiographic T Wave Inversion in Lead aVL in Diagnosing Coronary Artery Disease in Patients with Chronic Stable Angina

    Directory of Open Access Journals (Sweden)

    Hatem L. Farhan

    2010-04-01

    Full Text Available Objectives: The clinical value of T wave inversion in lead aVL in diagnosing coronary artery disease (CAD remains unclear. This study aims to investigate the correlation between aVL T wave inversion and CAD in patients with chronic stable angina.Methods: Electrocardiograms (ECGs of 257 consecutive patients undergoing coronary angiography were analyzed. All patients had chronic stable angina. All patients with secondary T wave inversion had been excluded (66 patients. The remaining 191 patients constituted the study population. Detailed ECG interpretation and coronary angiographic findings were conducted by experienced cardiologists.Results: T wave inversion in aVL was identified in 89 ECGs (46.8% with definite ischemic Q-ST-T changes in different leads in 97 ECGs (50.8%. Stand alone aVL T wave inversion was found in 27 ECGs (14.1% while ischemic changes in other leads with normal aVL were identified in 36 ECGs (18.8%. The incidence of CAD was 86.3%. Single, two- and multi-vessel CAD were found in 38.8%, 28.5% and 32.7% of cases respectively. The prevalence of left main, left anterior descending, left circumflex and right coronary arteries were 4.7%, 61.2%, 29.3% and 44.5%, respectively. T wave inversion in aVL was found to be the only ECG variable significantly predicting mid segment left anterior descending artery (LAD lesions (Odds Ratio 2.93, 95% Confidence Interval 1.59-5.37, p=0.001.Conclusion: This study provides new information relating to T wave inversion in lead aVL to mid segment LAD lesions. Implication of this simple finding may help in bedside diagnosis of CAD typically mid LAD lesions. However, further studies are needed to corroborate this finding.

  10. An observational cohort study of patients with newly diagnosed digital ulcer disease secondary to systemic sclerosis registered in the EUSTAR database.

    Science.gov (United States)

    Brand, Monika; Hollaender, Rebecca; Rosenberg, Daniel; Scott, Martin; Hunsche, Elke; Tyndall, Alan; Denaro, Valentina; Carreira, Patricia; Varju, Cecilia; Gabrielli, Barbara; Zingarelli, Stefania; Caramaschi, Paola; Simic-Pasalic, Katarina; Müller-Ladner, Ulf; Vasile, Massimiliano; Mihai, Carina; Rosato, Edoardo; Vacca, Alessandra; Zenone, Thierry; Mohamed, Walid A; Ancuta, Codrina; Zampogna, Giuseppe; Rednic, Simona; Jabaar, Nadia; Belloli, Laura; Pozzi, Maria R; Foti, Rosario; Walker, Ulrich A

    2015-01-01

    This study describes clinical characteristics, prognostic factors, and quality of life in patients with newly diagnosed (incident) digital ulcers (DU). Observational cohort study of 189 consecutive SSc patients with incident DU diagnosis identified from the EUSTAR database (22 centres in 10 countries). Data were collected from medical charts and during one prospective visit between 01/2004 and 09/2010. Median age at DU diagnosis was 51 years, majority of patients were female (88%), and limited cutaneous SSc was the most common subtype (61%). At incident DU diagnosis, 41% of patients had one DU and 59% had ≥2 DU; at the prospective visit 52% had DU. Pulmonary arterial hypertension (PAH) and multiple DU at diagnosis were associated with presence of any DU at the prospective visit (odds ratios: 4.34 and 1.32). During the observation period (median follow-up was 2 years) 127 patients had ≥1 hospitalisation. The event rate of new DU per person-year was 0.66, of DU-associated complications was 0.10, and of surgical or diagnostic procedures was 0.12. At the prospective visit, patients with ≥1 DU reported impairment in daily activities by 57%, those with 0 DU by 37%. The mean difference between patients with or without DU in the SF-36 physical component was 2.2, and in the mental component 1.4. DU patients were not routinely prescribed endothelin receptor antagonists or prostanoids. This real world cohort demonstrates that DU require hospital admission, and impair daily activity. PAH and multiple DU at diagnosis were associated with future occurrence of DU.

  11. Comparison of the performance of four different tools in diagnosing disease-associated anorexia and their relationship with nutritional, functional and clinical outcome measures in hospitalized patients.

    Science.gov (United States)

    Arezzo di Trifiletti, Adriana; Misino, Paola; Giannantoni, Patrizia; Giannantoni, Barbara; Cascino, Antonia; Fazi, Lucia; Rossi Fanelli, Filippo; Laviano, Alessandro

    2013-08-01

    In hospitalized patients, lack of appetite, i.e., disease-associated anorexia, is the main factor determining insufficient food intake and weight loss, which in turn increase morbidity and mortality. Controversies exist on which tool should be preferred when diagnosing anorexia. Aim of the study was to evaluate in hospitalized medical patients, the performance of 4 different tools [i.e., self-assessment of appetite, FAACT-ESPEN score, visual analog scale (VAS), and the Anorexia Questionnaire (AQ)] in assessing disease-associated anorexia and predicting nutritional and clinical variables. Hospitalized patients consecutively admitted to the Internal Medicine ward at our institution were considered. After informed consent was obtained, patients were asked to self-assess their appetite vs the previous month. The VAS, the FAACT-ESPEN score and the Anorexia Questionnaire were also submitted. Food intake immediately following the interview was recorded. Nutritional (i.e., body weight, height), functional (i.e., handgrip strength) and clinical variables (i.e., length of stay) were registered upon admission and before discharge. We studied 105 patients (74M:31F; 66.2 ± 16.3 yrs). The prevalence of anorexia as assessed by patients' self assessment, FAACT-ESPEN score, and the Anorexia Questionnaire was 23%, 10% and 48%, respectively. VAS did not show any correlation with food intake. Anorexic patients as identified by the self assessment of appetite showed reduced food intake and weaker handgrip strength than non-anorexic. The FAACT-ESPEN score correlated with body weight, food intake and handgrip strength, but was not related with length of stay. Anorexic patients as identified by the Anorexia Questionnaire showed reduced food intake, lower body weight, weaker handgrip strength and longer hospital stay than non-anorexic patients. The prevalence of anorexia significantly varies according to the diagnostic tool used. Except for VAS, all the tested tools identify patients with

  12. Physical Activity Recommendations in Patients with Chronic Obstructive Pulmonary Disease

    NARCIS (Netherlands)

    Hartman, Jorine E.; Boezen, H. Marike; Zuidema, Menno J.; de Greef, Mathieu H. G.; ten Hacken, Nick H. T.; Boezen, Hendrika

    2014-01-01

    Background: Physical activity recommendations are hardly studied in patients with chronic obstructive pulmonary disease (COPD), and specifically recommendations that are individualized to a patient's aerobic fitness level are not studied. Objectives: To compare individualized (relative) and

  13. How Do Health Care Providers Diagnose Vaginitis?

    Science.gov (United States)

    ... used to diagnose vaginitis. 1 Centers for Disease Control and Prevention. (2010). Self-study STD ... Halvorson New Chief of Gynecologic Health and Disease Branch Division of Epidemiology, Statistics, ...

  14. Effects of physical activity on life expectancy with cardiovascular disease

    NARCIS (Netherlands)

    O.H. Franco (Oscar); C.E.D. de Laet (Chris); A. Peeters (Andrea); J. Jonker (Joost); J.P. Mackenbach (Johan); W.J. Nusselder (Wilma)

    2005-01-01

    textabstractBackground: Physical inactivity is a modifiable risk factor for cardiovascular disease. However, little is known about the effects of physical activity on life expectancy with and without cardiovascular disease. Our objective was to calculate the consequences of different physical

  15. Microbial enrichment to enhance the disease suppressive activity of compost

    NARCIS (Netherlands)

    Postma, J.; Montenari, M.; Boogert, van den P.H.J.F.

    2003-01-01

    Compost amended soil has been found to be suppressive against plant diseases in various cropping systems. The level and reproducibility of disease suppressive properties of compost might be increased by the addition of antagonists. In the present study, the establishment and suppressive activity of

  16. Measures of rheumatoid arthritis disease activity in Australian clinical practice.

    Science.gov (United States)

    Taylor, Andrew; Bagga, Hanish

    2011-01-01

    Objectives. To investigate which rheumatoid arthritis (RA) disease activity measures are being collected in patients receiving glucocorticoids, non-biologic or biologic disease-modifying antirheumatic drugs (DMARDs) in Australian rheumatology practice. Methods. A retrospective audit of medical records was conducted from eight rheumatology practices around Australia. Each rheumatologist recruited 30 consecutive eligible patients into the review, 10 of whom must have been receiving a biological agent for rheumatoid arthritis. Disease activity measures and radiographic assessments were collected from each patient's last consultation. For biologic patients, disease activity measures were also collected from when the patient was first initiated on the biological agent. Results. At last consultation, the disease measures that were recorded most often were ESR (89.2%), haemoglobin (87.5%), and CRP (84.2%). DAS28 was infrequently recorded (16.3%). The rate of recording disease activity measures for patients receiving biologic DMARDs decreased over time (mean 27 months). Conclusion. This review has shown inconsistency of RA activity measures being recorded in Australian rheumatology clinical practice. An accurate assessment of the disease process is necessary to effectively target rheumatoid arthritis patients to treat in order to achieve optimal outcomes.

  17. PET imaging of putative microglial activation in individuals at ultra-high risk for psychosis, recently diagnosed and chronically ill with schizophrenia.

    Science.gov (United States)

    Di Biase, M A; Zalesky, A; O'keefe, G; Laskaris, L; Baune, B T; Weickert, C S; Olver, J; McGorry, P D; Amminger, G P; Nelson, B; Scott, A M; Hickie, I; Banati, R; Turkheimer, F; Yaqub, M; Everall, I P; Pantelis, C; Cropley, V

    2017-08-29

    We examined putative microglial activation as a function of illness course in schizophrenia. Microglial activity was quantified using [ 11 C](R)-(1-[2-chrorophynyl]-N-methyl-N-[1-methylpropyl]-3 isoquinoline carboxamide ( 11 C-(R)-PK11195) positron emission tomography (PET) in: (i) 10 individuals at ultra-high risk (UHR) of psychosis; (ii) 18 patients recently diagnosed with schizophrenia; (iii) 15 patients chronically ill with schizophrenia; and, (iv) 27 age-matched healthy controls. Regional-binding potential (BP ND ) was calculated using the simplified reference-tissue model with four alternative reference inputs. The UHR, recent-onset and chronic patient groups were compared to age-matched healthy control groups to examine between-group BP ND differences in 6 regions: dorsal frontal, orbital frontal, anterior cingulate, medial temporal, thalamus and insula. Correlation analysis tested for BP ND associations with gray matter volume, peripheral cytokines and clinical variables. The null hypothesis of equality in BP ND between patients (UHR, recent-onset and chronic) and respective healthy control groups (younger and older) was not rejected for any group comparison or region. Across all subjects, BP ND was positively correlated to age in the thalamus (r=0.43, P=0.008, false discovery rate). No correlations with regional gray matter, peripheral cytokine levels or clinical symptoms were detected. We therefore found no evidence of microglial activation in groups of individuals at high risk, recently diagnosed or chronically ill with schizophrenia. While the possibility of 11 C-(R)-PK11195-binding differences in certain patient subgroups remains, the patient cohorts in our study, who also displayed normal peripheral cytokine profiles, do not substantiate the assumption of microglial activation in schizophrenia as a regular and defining feature, as measured by 11 C-(R)-PK11195 BP ND .

  18. Enfermedad celiaca materna no diagnosticada y riesgo de tener hijos con bajo peso al nacimiento Maternal non-diagnosed celiac disease and risk of low birth weight

    Directory of Open Access Journals (Sweden)

    G. Solís Sánchez

    2008-06-01

    cases and 526 controls. We diagnosed 4 celiac disease cases, 2 in the case group and 2 in the control group. These 4 mothers had 3 term newborns (1 case in each 235 mothers; prevalence 0.42% and 1 preterm newborn (1 case in each 389 mothers; prevalence 0.26%. Two cases had babies with adequate birth weight for their gestational age (1 case in each 419 mothers; prevalence 0.24% and two cases had babies with low birth weight for their gestational age (1 in each 132 mothers; prevalence 0.75%. The odds ratio for low birth weight was 0.91 (95% CI: 0.12-6.49, the odds ratio for preterm birth was 0.61 (95% CI: 0.06-5.89, ad the odds ratio for low birth weight for gestational age was 3.19 (95% CI: 0.44-22.79. Conclusions: the prevalence of celiac disease in fertile women in our geographic area was 0.36% (1 case in each 275 mothers, and no differences were found between study groups.

  19. Active and passive cigarette smoking and mortality among Hispanic and non-Hispanic white women diagnosed with invasive breast cancer.

    Science.gov (United States)

    Boone, Stephanie D; Baumgartner, Kathy B; Baumgartner, Richard N; Connor, Avonne E; John, Esther M; Giuliano, Anna R; Hines, Lisa M; Rai, Shesh N; Riley, Elizabeth C; Pinkston, Christina M; Wolff, Roger K; Slattery, Martha L

    2015-11-01

    Women who smoke at breast cancer diagnosis have higher risk of breast cancer-specific and all-cause mortality than nonsmokers; however, differences by ethnicity or prognostic factors and risk for noncancer mortality have not been evaluated. We examined associations of active and passive smoke exposure with mortality among Hispanic (n = 1020) and non-Hispanic white (n = 1198) women with invasive breast cancer in the Breast Cancer Health Disparities Study (median follow-up of 10.6 years). Risk of breast cancer-specific (HR = 1.55, 95% CI = 1.11-2.16) and all-cause (HR = 1.68, 95% CI = 1.30-2.17) mortality was increased for current smokers, with similar results stratified by ethnicity. Ever smokers had an increased risk of noncancer mortality (HR = 1.68, 95% CI = 1.12-2.51). Associations were strongest for current smokers who smoked for 20 years or more were postmenopausal, overweight and/or obese, or reported moderate and/or high alcohol consumption; however, interactions were not significant. Breast cancer-specific mortality was increased two fold for moderate and/or high recent passive smoke exposure among never smokers (HR = 2.12, 95% CI = 1.24-3.63). Findings support associations of active-smoking and passive-smoking diagnosis with risk of breast cancer-specific and all-cause mortality and ever smoking with noncancer mortality, regardless of ethnicity, and other factors. Smoking is a modifiable lifestyle factor and effective smoking cessation, and maintenance programs should be routinely recommended for women with breast cancer. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Minimal Disease Activity as a Treatment Target in Psoriatic Arthritis

    DEFF Research Database (Denmark)

    Gossec, Laure; McGonagle, Dennis; Korotaeva, Tatiana

    2018-01-01

    As in other inflammatory rheumatic diseases, the objective of psoriatic arthritis (PsA) treatment is the achievement of a defined target. Recent recommendations propose aiming for remission or low disease activity; however, a consensual definition of remission is lacking. A state of minimal disease....... Since its development, MDA has been used increasingly in studies and clinical trials. In this article, the potential use of MDA as a treatment target in PsA is reviewed. The frequencies of MDA achievement with biologic disease-modifying antirheumatic drugs are summarized based on data from registries...

  1. A Survey of Agreement Rate between Simple MTC and Post Contrast T1 Sequence MRI for Diagnosing Active Multiple Sclerosis Plaques

    Directory of Open Access Journals (Sweden)

    N. Farshchian

    2016-07-01

    Full Text Available Introduction & Objective: MS is the most common disabling neurological disorder. Identifying new active MS plaques at the onset and clinical status and faster onset of treatment as well as evaluating the response to treatment is important and MRI with contrast is the best indicator for these measures. Materials & Methods: This study was cross-sectional including 62 patients with diagnosed MS. Whose clinical symptoms suggested the recurrence of MS. They were referred to the radiol-ogy department to undergo brain MRI with injection for the diagnosis of active plaques by a neurologist,The Data were analyzed using statistical tests and SPSS 21 software. Results: Based on the sequences of post contrast T1, pre contrast MTC and post contrast MTC 74, 272 and 271 plaques were respectively discovered. Detection of active MS plaques on T1 sequences after injection were in poor accordance and had significant difference with MTC before and after injection. Moreover, detection of active MS plaques on MTC sequences be-fore injection were in good accordance and did not show significant difference with MTC se-quences after injection. Conclusion: Based on these results, it seems that the purpose of MRI in MS patients is deter-mining the amount of active plaques. Sequences of pre contrast and post contrast MTC are significantly more than sequences of post contrast T1. Therefore, using sequences of MTC can be helpful in MRI. (Sci J Hamadan Univ Med Sci 2016; 23 (2:97-102

  2. QuantiFERON®-TB gold in-tube performance for diagnosing active tuberculosis in children and adults in a high burden setting.

    Directory of Open Access Journals (Sweden)

    Michala V Rose

    Full Text Available AIM: To determine whether QuantiFERON®-TB Gold In-Tube (QFT can contribute to the diagnosis of active tuberculosis (TB in children in a high-burden setting and to assess the performance of QFT and tuberculin skin test (TST in a prospective cohort of TB suspect children compared to adults with confirmed TB in Tanzania. METHODS: Sensitivity and specificity of QFT and TST for diagnosing active TB as well as indeterminate QFT rates and IFN-γ levels were assessed in 211 TB suspect children in a Tanzanian district hospital and contrasted in 90 adults with confirmed pulmonary TB. RESULTS: Sensitivity of QFT and TST in children with confirmed TB was 19% (5/27 and 6% (2/31 respectively. In adults sensitivity of QFT and TST was 84% (73/87 and 85% (63/74. The QFT indeterminate rate in children and adults was 27% and 3%. Median levels of IFN-γ were lower in children than adults, particularly children <2 years and HIV infected. An indeterminate result was associated with age <2 years but not malnutrition or HIV status. Overall childhood mortality was 19% and associated with an indeterminate QFT result at baseline. CONCLUSION: QFT and TST showed poor performance and a surprisingly low sensitivity in children. In contrast the performance in Tanzanian adults was good and comparable to performance in high-income countries. Indeterminate results in children were associated with young age and increased mortality. Neither test can be recommended for diagnosing active TB in children with immature or impaired immunity in a high-burden setting.

  3. Contrast-enhanced ultrasonography for the determination of Crohn’s disease activity – preliminary experience

    Science.gov (United States)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Summary Background Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn’s disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Material/Methods Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Results Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. Conclusions CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn’s disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI. PMID:24723988

  4. Contrast-enhanced ultrasonography for the determination of Crohn's disease activity - preliminary experience.

    Science.gov (United States)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn's disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn's disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI.

  5. Contrast-enhanced ultrasonography for the determination of Crohn’s disease activity – preliminary experience

    International Nuclear Information System (INIS)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn’s disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn’s disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI

  6. Serum Renalase Levels Correlate with Disease Activity in Lupus Nephritis.

    Directory of Open Access Journals (Sweden)

    Chaojun Qi

    Full Text Available Lupus nephritis (LN is among the most serious complications of systemic lupus erythematosus (SLE, which causes significant morbidity and mortality. Renalase is a novel, kidney-secreted cytokine-like protein that promotes cell survival. Here, we aimed to investigate the relationship of serum renalase levels with LN and its role in the disease progression of LN.For this cross-sectional study, 67 LN patients and 35 healthy controls were enrolled. Seventeen active LN patients who received standard therapies were followed up for six months. Disease activity was determined by the SLE Disease Activity-2000 (SLEDAI-2K scoring system and serum renalase amounts were determined by ELISA. Predictive value of renalase for disease activity was assessed. Furthermore, the expression of renalase in the kidneys of patients and macrophage infiltration was assessed by immunohistochemistry.Serum renalase amounts were significantly higher in LN patients than in healthy controls. Moreover, patients with proliferative LN had more elevated serum renalase levels than Class V LN patients. In proliferative LN patients, serum renalase levels were significantly higher in patients with active LN than those with inactive LN. Serum renalase levels were positively correlated with SLEDAI-2K, 24-h urine protein excretion, ds-DNA and ESR but inversely correlated with serum albumin and C3. Renalase amounts decreased significantly after six-months of standard therapy. The performance of renalase as a marker for diagnosis of active LN was 0.906 with a cutoff value of 66.67 μg/ml. We also observed that the amount of renalase was significantly higher in glomerular of proliferative LN along with the co-expression of macrophages.Serum renalase levels were correlated with disease activity in LN. Serum renalase might serve as a potential indicator for disease activity in LN. The marked increase of glomerular renalase and its association with macrophages suggest that it might play an

  7. Prevalencia de enfermedad cardiovascular en personas recién diagnosticadas de diabetes mellitus tipo 2 Cardiovascular disease prevalence in recent diagnosed type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Manuel Mata-Cases

    2009-04-01

    diabetes mellitus. Methods: Retrospective observational study in an urban primary health care centre between 1991 and 2000. Review of clinical patient characteristics, cardiovascular disease and risk factors, in the year of diabetes diagnosis. Patients without any glycaemia recorded before diagnostic were excluded. Logistic regression was done to identify the variables associated to cardiovascular events. Results: From 598 cases of diabetes diagnosed, 487 with previous glycaemia were included for the analysis (mean age [SD], 60.4 [10.9]; 53% women. The prevalence of cardiovascular risk factors was: obesity 61.1%, hypertension 71.9%, hypercholesterolemia 52%, hypertriglyceridemia 35.3% and present or previous smoking habit (24 and 16,6%. 96.9% of them presented at least one of the studied cardiovascular risk factors and 53.4% three or more. 78 patients (16%; CI95%: 12.8-19.3 had cardiovascular disease before or during the first year of diagnosis (men 21.4% and women 11.2%. The prevalence of cardiovascular disease increased progressively with the number of cardiovascular risk factors. The significant predictive variables of cardiovascular disease (logistic regression were: age >55 years (OR=2.91; CI95%: 1.46-5.80, smoking habit (OR=2.28; CI95%: 1.15-4.51 and HbA1c >7% (OR=1.8; CI95%: 1.1-3.1. Conclusions: A high prevalence of cardiovascular disease and cardiovascular risk factors at diabetes diagnosis was observed. Age, smoking habit and elevated glycated haemoglobin were the variables related to cardiovascular disease.

  8. Evaluation of the Usability of Selected Questionnaires Assessing Physical Activity in the Prophylaxis of Cardiovascular Diseases.

    Science.gov (United States)

    Czeczelewska, Ewa; Czeczelewski, Jan; Wasiluk, Agnieszka; Saczuk, Jerzy

    2016-01-01

    The main health problem of the Polish population is posed by cardiovascular diseases (CDVD), coronary artery disease (CAD) in particular. Respectively higher physical activity linked with energy expenditure of at least 1000 kcal/week may significantly reduce the risk of CAD development. The protective effect of exercise applies not only to persons from high-risk groups and with diagnosed chronic diseases that increase the risk of the incidence of atherosclerosis and its complications, but also to healthy individuals. The aim of this study was to evaluate the usability of the Seven-Day Physical Activity Recall (SDPAR) and International Physical Activity Questionnaire (IPAQ) in research on the correlation between physical activity and risk factors of cardiovascular diseases. A screening survey, conducted in 2012, included students (n = 340) of the Division of the Academy of Physical Education in Biała Podlaska, aged 18-29 years. Total cholesterol, triglycerides and glucose levels were analyzed, and arterial blood pressure and heart rate were measured. The physical activity of the students was estimated using IPAQ and SDPAR questionnaires. The effect of physical activity on the biochemical blood markers, arterial blood pressure and heart rate was analyzed in groups differing in weekly energy expenditure (WEE). Along with increasing WEE values, calculated with IPAQ and SDPAR questionnaires, tangible descending tendencies were observed in cholesterol concentration in both genders. Significant differences were demonstrated in mean values of the resting heart rate between terciles of women ranked according to the increasing WEE values calculated using IPAQ (p physical activity; however the SDPAR seems to be a more useful tool in CDVD prevention screening.

  9. Physical activity and cardiovascular disease risk factors among ...

    African Journals Online (AJOL)

    Background: Cardiovascular diseases (CVD) risk factors are increasing at an unprecedented rate in developing countries. However, fewer studies have evaluated the role of physical activity in preventing CVD in these countries. We assessed level physical activity and its relationship with CVD risk factors among young and ...

  10. Increased active von Willebrand factor during disease development in the aging diabetic patient population.

    Science.gov (United States)

    Chen, Shuang Feng; Xia, Zuo Li; Han, Ji Ju; Wang, Yi Ting; Wang, Ji Yue; Pan, Shao Dong; Wu, Ya Ping; Zhang, Bin; Li, Guang Yao; Du, Jing Wei; Gao, Hen Qiang; de Groot, Philip G; de Laat, Bas; Hollestelle, Martine J

    2013-02-01

    Type 2 diabetes is known to cause endothelial activation resulting in the secretion of von Willebrand factor (VWF). We have shown that levels of VWF in a glycoprotein Ib-binding conformation are increased in specific clinical settings. The aim of the current study is to investigate whether active VWF levels increase during aging and the development of diabetes within the population of patients suffering from type 2 diabetes. Patients and controls were divided into two groups based on age: older and younger than 60 years of age. VWF antigen, VWF propeptide, VWF activation factor and total active VWF were measured. Patients older than 60 years of age had increased levels of total active VWF, VWF activation factor and VWF propeptide compared to younger patients and controls. All measured VWF parameters were associated with age in diabetic patients. Total active VWF and VWF propeptide correlated with the period of being diagnosed with diabetes. Regression analyses showed that especially the VWF activation factor was strongly associated with diabetes in patients older than 60 years of age. In conclusion, we found that the conformation of VWF could be involved in the disease process of diabetes and that the VWF in a glycoprotein Ib-binding conformation could play a role as risk marker during the development of diabetes in combination with an increase in age. Our study shows that the active quality of VWF was more important than the quantity.

  11. Direct comparison study between FDG-PET and IMP-SPECT for diagnosing Alzheimer's disease using 3D-SSP analysis in the same patients

    International Nuclear Information System (INIS)

    Nihashi, Takashi; Hayasaka, Kazumasa; Yatsuya, Hiroshi

    2007-01-01

    The purpose of this study was to evaluate and compare the diagnostic ability of 2-[ 18 F]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) and N-isopropyl-p- 123 I iodoamphetamine single photon emission computed tomography (IMP-SPECT) using three-dimensional stereotactic surface projections (3D-SSP) in patients with moderate Alzheimer's disease (AD). FDG-PET and IMP-SPECT were performed within 3 months in 14 patients with probable moderate AD. Z-score maps of FDG-PET and IMP-SPECT images of a patient were obtained by comparison with data obtained from control subjects. Four expert physicians evaluated and graded the glucose hypometabolism and regional cerebral blood flow (rCBF), focusing in particular on the posterior cingulate gyri/precunei and parietotemporal regions, and determined the reliability for AD. Receiver operating characteristic (ROC) curves were applied to the results for clarification. To evaluate the correlation between two modalities, the regions of interest (ROIs) were set in the posterior cingulate gyri/precunei and parietotemporal region on 3D-SSP images, and mean Z-values were calculated. No significant difference was observed in the area under the ROC curve (AUC) between FDG-PET and IMP-SPECT images (FDG-PET 0.95, IMP-SPECT 0.94). However, a significant difference (P<0.05) was observed in the AUC for the posterior cingulate gyri/precuneus (FDG-PET 0.94, IMP-SPECT 0.81). The sensitivity and specificity of each modality were 86%, and 97% for FDG-PET and 70% and 100% for IMP-SPECT. We could find no significant difference between FDG-PET and IMP-SPECT in terms of diagnosing moderate AD using 3D-SSP. There was a high correlation between the two modalities in the parietotemporal region (Spearman's r=0.82, P<0.001). The correlation in the posterior cingulate gyri/precunei region was lower than that in the parietotemporal region (Spearman's r=0.63, P<0.016). (author)

  12. Liposomes for Targeted Delivery of Active Agents against Neurodegenerative Diseases (Alzheimer's Disease and Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Carlos Spuch

    2011-01-01

    Full Text Available Neurodegenerative diseases, such as Alzheimer's disease and Parkinson's disease represent a huge unmet medical need. The prevalence of both diseases is increasing, but the efficacy of treatment is still very limited due to various factors including the blood brain barrier (BBB. Drug delivery to the brain remains the major challenge for the treatment of all neurodegenerative diseases because of the numerous protective barriers surrounding the central nervous system. New therapeutic drugs that cross the BBB are critically needed for treatment of many brain diseases. One of the significant factors on neurotherapeutics is the constraint of the blood brain barrier and the drug release kinetics that cause peripheral serious side effects. Contrary to common belief, neurodegenerative and neurological diseases may be multisystemic in nature, and this presents numerous difficulties for their potential treatment. Overall, the aim of this paper is to summarize the last findings and news related to liposome technology in the treatment of neurodegenerative diseases and demonstrate the potential of this technology for the development of novel therapeutics and the possible applications of liposomes in the two most widespread neurodegenerative diseases, Alzheimer's disease and Parkinson's disease.

  13. PET activation in basal ganglia disorders: Parkinson's disease and dystonia

    International Nuclear Information System (INIS)

    Ceballos-Baumann, A.O.; Boecker, H.; Conrad, B.

    1997-01-01

    This article reviews PET activation studies with performance of different motor paradigms (joy-stick movements, imagination of movement, writing) in patients with movement disorders. The focus will be on Parkinson's disease (PD) and dystonia. PET findings will be related to clinical and electrophysiological observations. PET activation studies before and after therapeutic interventions such as pallidotomy in Parkinson's disease and botulinum toxin in writer's cramp are described. The contribution of PET activation studies to the understanding of the pathophysiology of dystonia and PD is discussed. (orig.) [de

  14. Histologic scoring indices for evaluation of disease activity in Crohn's disease

    NARCIS (Netherlands)

    Novak, Gregor; Parker, Claire E.; Pai, Rish K.; Macdonald, John K.; Feagan, Brian G.; Sandborn, William J.; D'Haens, Geert; Jairath, Vipul; Khanna, Reena

    2017-01-01

    Histologic assessment of mucosal disease activity has been increasingly used in clinical trials of treatment for Crohn's disease. However, the operating properties of the currently existing histologic scoring indices remain unclear. A systematic review was undertaken to evaluate the development and

  15. Magnetic resonance imaging for evaluation of disease activity in Crohn's disease: a systematic review

    NARCIS (Netherlands)

    Horsthuis, Karin; Bipat, Shandra; Stokkers, Pieter C. F.; Stoker, Jaap

    2009-01-01

    To systematically review the evidence on the accuracy of MRI for grading disease activity in Crohn's disease (CD). The MEDLINE, EMBASE, CINAHL and Cochrane databases were searched for studies on the accuracy of MRI in grading CD compared to a predefined reference standard. Two independent observers

  16. Identification and Characterization of Novel Variations in Platelet G-Protein Coupled Receptor (GPCR Genes in Patients Historically Diagnosed with Type 1 von Willebrand Disease.

    Directory of Open Access Journals (Sweden)

    Jacqueline Stockley

    Full Text Available The clinical expression of type 1 von Willebrand disease may be modified by co-inheritance of other mild bleeding diatheses. We previously showed that mutations in the platelet P2Y12 ADP receptor gene (P2RY12 could contribute to the bleeding phenotype in patients with type 1 von Willebrand disease. Here we investigated whether variations in platelet G protein-coupled receptor genes other than P2RY12 also contributed to the bleeding phenotype. Platelet G protein-coupled receptor genes P2RY1, F2R, F2RL3, TBXA2R and PTGIR were sequenced in 146 index cases with type 1 von Willebrand disease and the potential effects of identified single nucleotide variations were assessed using in silico methods and heterologous expression analysis. Seven heterozygous single nucleotide variations were identified in 8 index cases. Two single nucleotide variations were detected in F2R; a novel c.-67G>C transversion which reduced F2R transcriptional activity and a rare c.1063C>T transition predicting a p.L355F substitution which did not interfere with PAR1 expression or signalling. Two synonymous single nucleotide variations were identified in F2RL3 (c.402C>G, p.A134 =; c.1029 G>C p.V343 =, both of which introduced less commonly used codons and were predicted to be deleterious, though neither of them affected PAR4 receptor expression. A third single nucleotide variation in F2RL3 (c.65 C>A; p.T22N was co-inherited with a synonymous single nucleotide variation in TBXA2R (c.6680 C>T, p.S218 =. Expression and signalling of the p.T22N PAR4 variant was similar to wild-type, while the TBXA2R variation introduced a cryptic splice site that was predicted to cause premature termination of protein translation. The enrichment of single nucleotide variations in G protein-coupled receptor genes among type 1 von Willebrand disease patients supports the view of type 1 von Willebrand disease as a polygenic disorder.

  17. Identification and Characterization of Novel Variations in Platelet G-Protein Coupled Receptor (GPCR) Genes in Patients Historically Diagnosed with Type 1 von Willebrand Disease.

    Science.gov (United States)

    Stockley, Jacqueline; Nisar, Shaista P; Leo, Vincenzo C; Sabi, Essa; Cunningham, Margaret R; Eikenboom, Jeroen C; Lethagen, Stefan; Schneppenheim, Reinhard; Goodeve, Anne C; Watson, Steve P; Mundell, Stuart J; Daly, Martina E

    2015-01-01

    The clinical expression of type 1 von Willebrand disease may be modified by co-inheritance of other mild bleeding diatheses. We previously showed that mutations in the platelet P2Y12 ADP receptor gene (P2RY12) could contribute to the bleeding phenotype in patients with type 1 von Willebrand disease. Here we investigated whether variations in platelet G protein-coupled receptor genes other than P2RY12 also contributed to the bleeding phenotype. Platelet G protein-coupled receptor genes P2RY1, F2R, F2RL3, TBXA2R and PTGIR were sequenced in 146 index cases with type 1 von Willebrand disease and the potential effects of identified single nucleotide variations were assessed using in silico methods and heterologous expression analysis. Seven heterozygous single nucleotide variations were identified in 8 index cases. Two single nucleotide variations were detected in F2R; a novel c.-67G>C transversion which reduced F2R transcriptional activity and a rare c.1063C>T transition predicting a p.L355F substitution which did not interfere with PAR1 expression or signalling. Two synonymous single nucleotide variations were identified in F2RL3 (c.402C>G, p.A134 =; c.1029 G>C p.V343 =), both of which introduced less commonly used codons and were predicted to be deleterious, though neither of them affected PAR4 receptor expression. A third single nucleotide variation in F2RL3 (c.65 C>A; p.T22N) was co-inherited with a synonymous single nucleotide variation in TBXA2R (c.6680 C>T, p.S218 =). Expression and signalling of the p.T22N PAR4 variant was similar to wild-type, while the TBXA2R variation introduced a cryptic splice site that was predicted to cause premature termination of protein translation. The enrichment of single nucleotide variations in G protein-coupled receptor genes among type 1 von Willebrand disease patients supports the view of type 1 von Willebrand disease as a polygenic disorder.

  18. Alcoholic liver disease patients’ perspective on coping and physical activity-oriented rehabilitation intervention after hepatic encephalopathy

    DEFF Research Database (Denmark)

    Mikkelsen, Maria Rudkjær; Hendriksen, Carsten; Schiødt, Frank

    2016-01-01

    Aim and objective: To identify and describe the impact of a coping and physical activity-oriented rehabilitation intervention on alcoholic liver disease patients after hepatic encephalopathy in terms of their interaction with professionals and relatives. Background: Patients who have experienced...... were conducted with 10 alcoholic liver disease patients who were diagnosed with hepatic encephalopathy and participated in a coping and physical activity-oriented rehabilitation intervention. Richard S. Lazarus's theory of stress and coping inspired the interview guide. Results: The significance...... of a coping and physical activity-oriented rehabilitation intervention on alcoholic liver disease patients’ ability to cope with problems after surviving alcohol-induced hepatic encephalopathy in terms of their interaction with professionals and relatives was characterised by the core category ‘regain control...

  19. Diagnosing Tic Disorders

    Science.gov (United States)

    ... Submit" /> Information For… Media Policy Makers Diagnosing Tic Disorders Language: English (US) Español (Spanish) Recommend on ... or postviral encephalitis). Persistent (Chronic) Motor or Vocal Tic Disorder To be diagnosed with a persistent tic ...

  20. Measures of Rheumatoid Arthritis Disease Activity in Australian Clinical Practice

    OpenAIRE

    Taylor, Andrew; Bagga, Hanish

    2011-01-01

    Objectives. To investigate which rheumatoid arthritis (RA) disease activity measures are being collected in patients receiving glucocorticoids, non-biologic or biologic disease-modifying antirheumatic drugs (DMARDs) in Australian rheumatology practice. Methods. A retrospective audit of medical records was conducted from eight rheumatology practices around Australia. Each rheumatologist recruited 30 consecutive eligible patients into the review, 10 of whom must have been receiving a biological...

  1. Antibacterial Activity of Hawaiian Corals: Possible Protection from Disease?

    Science.gov (United States)

    Gochfeld, D. J.; Aeby, G. S.; Miller, J. D.

    2006-12-01

    Reports of coral diseases in the Caribbean have appeared with increasing frequency over the past two decades; however, records of coral diseases in the Pacific have lagged far behind. Recent surveys of coral disease in the Hawaiian Islands indicate relatively low, but consistent, levels of disease throughout the inhabited Main and uninhabited Northwestern Hawaiian Islands, and demonstrate variation in levels of disease among the major genera of Hawaiian corals. Although little is known about immune defense to disease in corals, one potential mechanism of defense is the production of antimicrobial compounds that protect corals from pathogens. A preliminary survey of antibacterial chemical defenses among three dominant species of Hawaiian corals was undertaken. Crude aqueous extracts of Porites lobata, Pocillopora meandrina and Montipora capitata were tested against nine strains of bacteria in a growth inhibition assay. Inhibitory extracts were further tested to determine whether their effects were cytostatic or cytotoxic. The bacteria selected included known coral pathogens, potential marine pathogens found in human waste and strains previously identified from the surfaces of Hawaiian corals. Extracts from all three species of coral exhibited a high degree of antibacterial activity, but also a high degree of selectivity against different bacterial strains. In addition, some extracts were stimulatory to some bacteria. In addition to interspecific variability, extracts also exhibited intraspecific variability, both within and between sites. Hawaiian corals have significant antibacterial activity, which may explain the relatively low prevalence of disease in these corals; however, further characterization of pathogens specifically responsible for disease in Hawaiian corals is necessary before we can conclude that antibacterial activity protects Hawaiian corals from disease.

  2. Sleep disorders and inflammatory disease activity: chicken or the egg?

    Science.gov (United States)

    Parekh, Parth J; Oldfield Iv, Edward C; Challapallisri, Vaishnavi; Ware, J Catsby; Johnson, David A

    2015-04-01

    Sleep dysfunction is a highly prevalent condition that has long been implicated in accelerating disease states characterized by having an inflammatory component such as systemic lupus erythematosus, HIV, and multiple sclerosis. Inflammatory bowel disease (IBD) is a chronic, debilitating disease that is characterized by waxing and waning symptoms, which are a direct result of increased circulating inflammatory cytokines. Recent studies have demonstrated sleep dysfunction and the disruption of the circadian rhythm to result in an upregulation of inflammatory cytokines. Not only does this pose a potential trigger for disease flares but also an increased risk of malignancy in this subset of patients. This begs to question whether or not there is a therapeutic role of sleep cycle and circadian rhythm optimization in the prevention of IBD flares. Further research is needed to clarify the role of sleep dysfunction and alterations of the circadian rhythm in modifying disease activity and also in reducing the risk of malignancy in patients suffering from IBD.

  3. Oral-Fluid Thiol-Detection Test Identifies Underlying Active Periodontal Disease Not Detected by the Visual Awake Examination.

    Science.gov (United States)

    Queck, Katherine E; Chapman, Angela; Herzog, Leslie J; Shell-Martin, Tamara; Burgess-Cassler, Anthony; McClure, George David

    Periodontal disease in dogs is highly prevalent but can only be accurately diagnosed by performing an anesthetized oral examination with periodontal probing and dental radiography. In this study, 114 dogs had a visual awake examination of the oral cavity and were administered an oral-fluid thiol-detection test prior to undergoing a a full-mouth anesthetized oral examination and digital dental radiographs. The results show the visual awake examination underestimated the presence and severity of active periodontal disease. The thiol-detection test was superior to the visual awake examination at detecting the presence and severity of active periodontal disease and was an indicator of progression toward alveolar bone loss. The thiol-detection test detected active periodontal disease at early stages of development, before any visual cues were present, indicating the need for intervention to prevent periodontal bone loss. Early detection is important because without intervention, dogs with gingivitis (active periodontal disease) progress to irreversible periodontal bone loss (stage 2+). As suggested in the current AAHA guidelines, a thiol-detection test administered in conjunction with the visual awake examination during routine wellness examinations facilitates veterinarian-client communication and mitigates under-diagnosis of periodontal disease and underutilization of dental services. The thiol-detection test can be used to monitor the periodontal health status of the conscious patient during follow-up examinations based on disease severity.

  4. Hepatic and erythrocytic glutathione peroxidase activity in liver diseases.

    Science.gov (United States)

    Cordero, R; Ortiz, A; Hernández, R; López, V; Gómez, M M; Mena, P

    1996-09-01

    Hepatic and erythrocytic glutathione peroxidase activity, together with malondialdehyde levels, were determined as indicators of peroxidation in 83 patients from whom liver biopsies had been taken for diagnostic purposes. On histological study, the patients were classified into groups as minimal changes (including normal liver), steatosis, alcoholic hepatitis, hepatic cirrhosis, light to moderately active chronic hepatitis, and severe chronic active hepatitis. The glutathione peroxidase activity in erythrocytes showed no significant changes in any liver disease group. In the hepatic study, an increased activity was observed in steatosis with respect to the minimal changes group, this increased activity induced by the toxic agent in the initial stages of the alcoholic hepatic disease declining as the hepatic damage progressed. There was a negative correlation between the levels of hepatic malondialdehyde and hepatic glutathione peroxidase in subjects with minimal changes. This suggested the existence of an oxidative equilibrium in this group. This equilibrium is broken in the liver disease groups as was manifest in a positive correlation between malondialdehyde and glutathione peroxidase activity.

  5. The role of 18F-FDG PET in characterising disease activity in Takayasu arteritis

    International Nuclear Information System (INIS)

    Webb, Myles; Chambers, Anthony; AL-Nahhas, Adil; Maudlin, Lucy; Rahman, Lucy; Frank, John; Mason, Justin C.

    2004-01-01

    Takayasu arteritis (TA) is a rare, sporadic and chronic inflammatory arteritis, which predominantly affects the aorta and its branches. Diagnosis can be difficult and there are limitations to the current diagnostic work-up. By detecting areas of active glucose metabolism present in active vasculitis, imaging with fluorine-18 fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) could potentially have a role in the management of TA. Our aim was to assess this role by reviewing 28 18 F-FDG PET scans performed on 18 patients suspected of having TA. All patients had full clinical and laboratory assessment, cross-sectional imaging and angiography, and 16/18 satisfied the American College of Rheumatologists' criteria for TA. 18 F-FDG PET achieved a sensitivity of 92%, a specificity of 100%, and negative and positive predictive values of 85% and 100% respectively in the initial assessment of active vasculitis in TA. We conclude that 18 F-FDG PET can be used to diagnose early disease, to detect active disease (even within chronic changes) and to monitor the effectiveness of treatment. (orig.)

  6. The role of {sup 18}F-FDG PET in characterising disease activity in Takayasu arteritis

    Energy Technology Data Exchange (ETDEWEB)

    Webb, Myles; Chambers, Anthony; AL-Nahhas, Adil; Maudlin, Lucy; Rahman, Lucy; Frank, John [Department of Nuclear Medicine, Hammersmith Hospital, Du Cane Road, W12 0HS, London (United Kingdom); Mason, Justin C. [Department of Rheumatology, Hammersmith Hospital, London (United Kingdom)

    2004-05-01

    Takayasu arteritis (TA) is a rare, sporadic and chronic inflammatory arteritis, which predominantly affects the aorta and its branches. Diagnosis can be difficult and there are limitations to the current diagnostic work-up. By detecting areas of active glucose metabolism present in active vasculitis, imaging with fluorine-18 fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG PET) could potentially have a role in the management of TA. Our aim was to assess this role by reviewing 28 {sup 18}F-FDG PET scans performed on 18 patients suspected of having TA. All patients had full clinical and laboratory assessment, cross-sectional imaging and angiography, and 16/18 satisfied the American College of Rheumatologists' criteria for TA. {sup 18}F-FDG PET achieved a sensitivity of 92%, a specificity of 100%, and negative and positive predictive values of 85% and 100% respectively in the initial assessment of active vasculitis in TA. We conclude that {sup 18}F-FDG PET can be used to diagnose early disease, to detect active disease (even within chronic changes) and to monitor the effectiveness of treatment. (orig.)

  7. Surveillance for Neisseria meningitidis Disease Activity and Transmission Using Information Technology.

    Directory of Open Access Journals (Sweden)

    S Sohail Ahmed

    Full Text Available While formal reporting, surveillance, and response structures remain essential to protecting public health, a new generation of freely accessible, online, and real-time informatics tools for disease tracking are expanding the ability to raise earlier public awareness of emerging disease threats. The rationale for this study is to test the hypothesis that the HealthMap informatics tools can complement epidemiological data captured by traditional surveillance monitoring systems for meningitis due to Neisseria meningitides (N. meningitides by highlighting severe transmissible disease activity and outbreaks in the United States.Annual analyses of N. meningitides disease alerts captured by HealthMap were compared to epidemiological data captured by the Centers for Disease Control's Active Bacterial Core surveillance (ABCs for N. meningitides. Morbidity and mortality case reports were measured annually from 2010 to 2013 (HealthMap and 2005 to 2012 (ABCs.HealthMap N. meningitides monitoring captured 80-90% of alerts as diagnosed N. meningitides, 5-20% of alerts as suspected cases, and 5-10% of alerts as related news articles. HealthMap disease alert activity for emerging disease threats related to N. meningitides were in agreement with patterns identified historically using traditional surveillance systems. HealthMap's strength lies in its ability to provide a cumulative "snapshot" of weak signals that allows for rapid dissemination of knowledge and earlier public awareness of potential outbreak status while formal testing and confirmation for specific serotypes is ongoing by public health authorities.The underreporting of disease cases in internet-based data streaming makes inadequate any comparison to epidemiological trends illustrated by the more comprehensive ABCs network published by the Centers for Disease Control. However, the expected delays in compiling confirmatory reports by traditional surveillance systems (at the time of writing, ABCs data

  8. Ramiprilate inhibits functional matrix metalloproteinase activity in Crohn's disease fistulas

    DEFF Research Database (Denmark)

    Efsen, Eva; Saermark, Torben; Hansen, Alastair

    2011-01-01

    Increased expression of matrix metalloproteinase (MMP)-2, -3 and -9 has been demonstrated in Crohn's disease fistulas, but it is unknown whether these enzymes are biologically active and represent a therapeutic target. Therefore, we investigated the proteolytic activity of MMPs in fistula tissue...... from six controls were also included. Total functional MMP activity was measured by a high-pressure liquid chromatography (HPLC)-based, fluorogenic MMP-substrate cleavage assay, and the specific activity of MMP-2, -3 and -9 by the MMP Biotrak Activity Assay. The MMP inhibitors comprised ethylene......-9.83) compared with non-Crohn's fistulas, [0.32 ng/ml, range 0-2.66, (p MMP-9 activity [0.64 ng/ml, range 0-5.66 and 0.17 ng/ml, range 0-1.1, respectively (p MMP activity level by 42% and suppressed the specific MMP-3...

  9. Subjective Word-Finding Difficulty Reduces Engagement in Social Leisure Activities in Alzheimer’s Disease

    Science.gov (United States)

    Farrell, Meagan T.; Zahodne, Laura B.; Stern, Yaakov; Dorrejo, Jhedy; Yeung, Philip; Cosentino, Stephanie

    2014-01-01

    Objectives To assess the influence of subjective word-finding difficulty on Alzheimer’s disease (AD) patients’ likelihood of engaging in social leisure activities. Design Analysis of data collected from the second cohort of the Multicenter Study of Predictors of Disease Course in Alzheimer’s disease. Setting Four study sites in the U.S. and France. Participants Individuals diagnosed with mild to moderate AD (N = 236) Measurements On separate questionnaires, patients were asked to 1) report whether had trouble finding the right word when speaking (subjective word-finding difficulty), and 2) rate their frequency and enjoyment of both social and nonsocial leisure activities. Objective language measures included object naming and verbal fluency. Measures of dependence, depression, cognitive status, age, sex, and education were also included as covariates in regression analyses. Results Over half (52%) of the sample reported word-finding difficulty, and subjective complaints were correlated with poorer verbal fluency scores. Subjective word-finding difficulty was uniquely related to social activity measures. Endorsers of word-finding difficulty reported reduced frequency and enjoyment of social leisure activities, controlling for covariates. In contrast, engagement in nonsocial activities was associated with higher age and depression scores, but was not related to word-finding complaints. These results were corroborated by the caregivers’ reports, and occurred above and beyond the effect of objective word-finding ability. Conclusion AD patients who are aware of increasing word-finding failures are less likely to participate in and enjoy socially-oriented leisure activities. This finding may have significant implications for clinical and health outcomes in AD. A failure to evaluate subjective language complaints could result in social withdrawal symptoms, thereby threatening the patient’s quality of life as well as increasing caregiver burden. Importantly

  10. Interactions between stress and physical activity on Alzheimer's disease pathology

    Directory of Open Access Journals (Sweden)

    Carla M. Yuede

    2018-02-01

    Full Text Available Physical activity and stress are both environmental modifiers of Alzheimer's disease (AD risk. Animal studies of physical activity in AD models have largely reported positive results, however benefits are not always observed in either cognitive or pathological outcomes and inconsistencies among findings remain. Studies using forced exercise may increase stress and mitigate some of the benefit of physical activity in AD models, while voluntary exercise regimens may not achieve optimal intensity to provide robust benefit. We evaluated the findings of studies of voluntary and forced exercise regimens in AD mouse models to determine the influence of stress, or the intensity of exercise needed to outweigh the negative effects of stress on AD measures. In addition, we show that chronic physical activity in a mouse model of AD can prevent the effects of acute restraint stress on Aβ levels in the hippocampus. Stress and physical activity have many overlapping and divergent effects on the body and some of the possible mechanisms through which physical activity may protect against stress-induced risk factors for AD are discussed. While the physiological effects of acute stress and acute exercise overlap, chronic effects of physical activity appear to directly oppose the effects of chronic stress on risk factors for AD. Further study is needed to identify optimal parameters for intensity, duration and frequency of physical activity to counterbalance effects of stress on the development and progression of AD. Keywords: Alzheimer's disease, Amyloid, Stress, Exercise, Physical activity

  11. [Evaluation of the usefulness of laryngeal vocal efficiency tests during noise load for diagnosing occupational diseases of the larynx in teachers].

    Science.gov (United States)

    Loś-Spychalska, T

    1997-01-01

    A growing incidence of the voice organ occupational diseases has recently become one of major health problems. There is a need to objective diagnostic examinations performed in teachers who apply for occupational disease certification. The aim of our study was to assess the feasibility of larynx vocal efficiency test during noise load in diagnosis of the voice organ occupational diseases in teachers.

  12. Distribution and Molecular Characterization of Human Adenovirus and Epstein-Barr Virus Infections in Tonsillar Lymphocytes Isolated from Patients Diagnosed with Tonsillar Diseases.

    Science.gov (United States)

    Assadian, Farzaneh; Sandström, Karl; Bondeson, Kåre; Laurell, Göran; Lidian, Adnan; Svensson, Catharina; Akusjärvi, Göran; Bergqvist, Anders; Punga, Tanel

    2016-01-01

    Surgically removed palatine tonsils provide a conveniently accessible source of T and B lymphocytes to study the interplay between foreign pathogens and the host immune system. In this study we have characterised the distribution of human adenovirus (HAdV), Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in purified tonsillar T and B cell-enriched fractions isolated from three patient age groups diagnosed with tonsillar hypertrophy and chronic/recurrent tonsillitis. HAdV DNA was detected in 93 out of 111 patients (84%), while EBV DNA was detected in 58 patients (52%). The most abundant adenovirus type was HAdV-5 (68%). None of the patients were positive for HCMV. Furthermore, 43 patients (39%) showed a co-infection of HAdV and EBV. The majority of young patients diagnosed with tonsillar hypertrophy were positive for HAdV, whereas all adult patients diagnosed with chronic/recurrent tonsillitis were positive for either HAdV or EBV. Most of the tonsils from patients diagnosed with either tonsillar hypertrophy or chronic/recurrent tonsillitis showed a higher HAdV DNA copy number in T compared to B cell-enriched fraction. Interestingly, in the majority of the tonsils from patients with chronic/recurrent tonsillitis HAdV DNA was detected in T cells only, whereas hypertrophic tonsils demonstrated HAdV DNA in both T and B cell-enriched fractions. In contrast, the majority of EBV positive tonsils revealed a preference for EBV DNA accumulation in the B cell-enriched fraction compared to T cell fraction irrespective of the patients' age.

  13. Nutrition and Physical Activity in Nonalcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Claudia P. Oliveira

    2016-01-01

    Full Text Available Nonalcoholic fatty liver disease (NAFLD is the most common liver disease worldwide and it is associated with other medical conditions such as diabetes mellitus, metabolic syndrome, and obesity. The mechanisms of the underlying disease development and progression are not completely established and there is no consensus concerning the pharmacological treatment. In the gold standard treatment for NAFLD weight loss, dietary therapy, and physical activity are included. However, little scientific evidence is available on diet and/or physical activity and NAFLD specifically. Many dietary approaches such as Mediterranean and DASH diet are used for treatment of other cardiometabolic risk factors such as insulin resistance and type-2 diabetes mellitus (T2DM, but on the basis of its components their role in NAFLD has been discussed. In this review, the implications of current dietary and exercise approaches, including Brazilian and other guidelines, are discussed, with a focus on determining the optimal nonpharmacological treatment to prescribe for NAFLD.

  14. Assessment of disease activity in large-vessel vasculitis

    DEFF Research Database (Denmark)

    Aydin, Sibel Z.; Direskeneli, Haner; Merkel, Peter A.

    2017-01-01

    Objective. To arrive at consensus for candidate outcomes for disease activity assessment in largevessel vasculitis (LVV) in clinical trials. Methods.A Delphi survey including 99 items was circulated among international experts for 3 rounds. Results. Fifty-seven items were accepted for both giant ...

  15. Neural activities during affective processing in people with Alzheimer's disease

    NARCIS (Netherlands)

    Lee, Tatia M. C.; Sun, Delin; Leung, Mei-Kei; Chu, Leung-Wing; Keysers, Christian

    This study examined brain activities in people with Alzheimer's disease when viewing happy, sad, and fearful facial expressions of others. A functional magnetic resonance imaging and a voxel-based morphometry methodology together with a passive viewing of emotional faces paradigm were employed to

  16. Seasonal disease activity and serum vitamin D levels in rheumatoid ...

    African Journals Online (AJOL)

    Background: Vitamin D is a steroid hormone that plays essential roles in calcium and phosphorus metabolism, bone formation and mineralization homeostasis, also has a role in the maintenance of immune-homeostasis. Objective: We aimed to investigate seasonal serum vitamin D levels and seasonal disease activity in ...

  17. Tea and coronary heart disease : protection through estrogenlike activity?

    NARCIS (Netherlands)

    Geleijnse, J.M.; Witteman, J.C.; Launer, L.J.; Lamberts, S.J.; Pols, H.A.

    2000-01-01

    Tea drinking appears to be protective against coronary heart disease in a number of epidemiologic studies. It has been suggested that tea flavonols with antioxidative activity, including quercetin, kaempferol, and myricetin,1 could account for the favorable effect on cardiovascular health. In the

  18. Minimal disease activity for rheumatoid arthritis: a preliminary definition

    NARCIS (Netherlands)

    Wells, George A.; Boers, Maarten; Shea, Beverley; Brooks, Peter M.; Simon, Lee S.; Strand, C. Vibeke; Aletaha, Daniel; Anderson, Jennifer J.; Bombardier, Claire; Dougados, Maxime; Emery, Paul; Felson, David T.; Fransen, Jaap; Furst, Dan E.; Hazes, Johanna M. W.; Johnson, Kent R.; Kirwan, John R.; Landewé, Robert B. M.; Lassere, Marissa N. D.; Michaud, Kaleb; Suarez-Almazor, Maria; Silman, Alan J.; Smolen, Josef S.; van der Heijde, Desiree M. F. M.; van Riel, Piet L. C. M.; Wolfe, Fred; Tugwell, Peter S.

    2005-01-01

    Agreement on response criteria in rheumatoid arthritis (RA) has allowed better standardization and interpretation of clinical trial reports. With recent advances in therapy, the proportion of patients achieving a satisfactory state of minimal disease activity (MDA) is becoming a more important

  19. Minimal disease activity for rheumatoid arthritis: a preliminary definition.

    NARCIS (Netherlands)

    Wells, G.A.; Boers, M.; Shea, B.; Brooks, P.M.; Simon, L.S.; Strand, C.V.; Aletaha, D.; Anderson, J.; Bombardier, C.; Dougados, M.; Emery, P.; Felson, D.T.; Fransen, J.; Furst, D.E.; Hazes, J.M.W.; Johnson, K.; Kirwan, J.; Landewe, R.B.; Lassere, M.N.; Michaud, K.; Suarez-Almazor, M.; Silman, A.J.; Smolen, J.S.; Heijde, D.M.F.M. van der; Riel, P.L.C.M. van; Wolfe, F.; Tugwell, P.S.

    2005-01-01

    Agreement on response criteria in rheumatoid arthritis (RA) has allowed better standardization and interpretation of clinical trial reports. With recent advances in therapy, the proportion of patients achieving a satisfactory state of minimal disease activity (MDA) is becoming a more important

  20. Alcoholic liver disease patients' perspective of a coping and physical activity-oriented rehabilitation intervention after hepatic encephalopathy.

    Science.gov (United States)

    Mikkelsen, Maria Rudkjaer; Hendriksen, Carsten; Schiødt, Frank Vinholt; Rydahl-Hansen, Susan

    2016-09-01

    To identify and describe the impact of a coping and physical activity-oriented rehabilitation intervention on alcoholic liver disease patients after hepatic encephalopathy in terms of their interaction with professionals and relatives. Patients who have experienced alcohol-induced hepatic encephalopathy have reduced quality of life, multiple complications, and social problems, and rehabilitation opportunities for these patients are limited. A grounded theory study and an evaluation study of a controlled intervention study. Semi-structured interviews were conducted with 10 alcoholic liver disease patients who were diagnosed with hepatic encephalopathy and participated in a coping and physical activity-oriented rehabilitation intervention. Richard S. Lazarus's theory of stress and coping inspired the interview guide. The significance of a coping and physical activity-oriented rehabilitation intervention on alcoholic liver disease patients' ability to cope with problems after surviving alcohol-induced hepatic encephalopathy in terms of their interaction with professionals and relatives was characterised by the core category 'regain control over the diseased body'. This is subdivided into three separate categories: 'the experience of being physically strong', 'togetherness' and 'self-control', and they impact each other and are mutually interdependent. Alcoholic liver disease patients described the strength of the rehabilitation as regaining control over the diseased body. Professionals and relatives of patients with alcoholic liver disease may need to focus on strengthening and preserving patients' control of their diseased body by facilitating the experience of togetherness, self-control and physical strength when interacting with and supporting patients with alcoholic liver disease. A coping and physical activity-oriented rehabilitation intervention may help alcoholic liver disease patients to regain control over their diseased body and give patients the experience

  1. Identification and characterization of a novel P2Y 12 variant in a patient diagnosed with type 1 von Willebrand disease in the European MCMDM-1VWD study.

    Science.gov (United States)

    Daly, Martina E; Dawood, Ban B; Lester, William A; Peake, Ian R; Rodeghiero, Francesco; Goodeve, Anne C; Makris, Michael; Wilde, Jonathan T; Mumford, Andrew D; Watson, Stephen P; Mundell, Stuart J

    2009-04-23

    We investigated whether defects in the P2Y(12) ADP receptor gene (P2RY12) contribute to the bleeding tendency in 92 index cases enrolled in the European MCMDM-1VWD study. A heterozygous mutation, predicting a lysine to glutamate (K174E) substitution in P2Y(12), was identified in one case with mild type 1 von Willebrand disease (VWD) and a VWF defect. Platelets from the index case and relatives carrying the K174E defect changed shape in response to ADP, but showed reduced and reversible aggregation in response to 10 muM ADP, unlike the maximal, sustained aggregation observed in controls. The reduced response was associated with an approximate 50% reduction in binding of [(3)H]2MeS-ADP to P2Y(12), whereas binding to the P2Y(1) receptor was normal. A hemagglutinin-tagged K174E P2Y(12) variant showed surface expression in CHO cells, markedly reduced binding to [(3)H]2MeS-ADP, and minimal ADP-mediated inhibition of forskolin-induced adenylyl cyclase activity. Our results provide further evidence for locus heterogeneity in type 1 VWD.

  2. Awareness of Mild Cognitive Impairment and Mild Alzheimer's Disease Dementia Diagnoses Associated With Lower Self-Ratings of Quality of Life in Older Adults.

    Science.gov (United States)

    Stites, Shana D; Karlawish, Jason; Harkins, Kristin; Rubright, Jonathan D; Wolk, David

    2017-10-01

    This study examined how awareness of diagnostic label impacted self-reported quality of life (QOL) in persons with varying degrees of cognitive impairment. Older adults (n = 259) with normal cognition, Mild Cognitive Impairment (MCI), or mild Alzheimer's disease dementia (AD) completed tests of cognition and self-report questionnaires that assessed diagnosis awareness and multiple domains of QOL: cognitive problems, activities of daily living, physical functioning, mental wellbeing, and perceptions of one's daily life. We compared measures of QOL by cognitive performance, diagnosis awareness, and diagnostic group. Persons with MCI or AD who were aware of their diagnosis reported lower average satisfaction with daily life (QOL-AD), basic functioning (BADL Scale), and physical wellbeing (SF-12 PCS), and more difficulties in daily life (DEM-QOL) than those who were unaware (all p ≤ .007). Controlling for gender, those expecting their condition to worsen over time reported greater depression (GDS), higher stress (PSS), lower quality of daily life (QOL-AD, DEM-QOL), and more cognitive difficulties (CDS) compared to others (all p cognitive impairment. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Positive correlation between disease activity index and matrix metalloproteinases activity in a rat model of colitis.

    Science.gov (United States)

    Oliveira, Luiz Gustavo de; Cunha, André Luiz da; Duarte, Amaury Caiafa; Castañon, Maria Christina Marques Nogueira; Chebli, Júlio Maria Fonseca; Aguiar, Jair Adriano Kopke de

    2014-01-01

    Inflammatory bowel disease, including ulcerative colitis and Crohn's disease, comprising a broad spectrum of diseases those have in common chronic inflammation of the gastrointestinal tract, histological alterations and an increased activity levels of certain enzymes, such as, metalloproteinases. Evaluate a possible correlation of disease activity index with the severity of colonic mucosal damage and increased activity of metalloproteinases in a model of ulcerative colitis induced by dextran sulfate sodium. Colitis was induced by oral administration of 5% dextran sulfate sodium for seven days in this group (n=10), whereas control group (n=16) received water. Effects were analyzed daily by disease activity index. In the seventh day, animals were euthanized and hematological measurements, histological changes (hematoxylin and eosin and Alcian Blue staining), myeloperoxidase and metalloproteinase activities (MMP-2 and MMP-9) were determined. Dextran sulfate sodium group showed elevated disease activity index and reduced hematological parameters. Induction of colitis caused tissue injury with loss of mucin and increased myeloperoxidase (Pcorrelation with the degree of histopathological changes after induction of colitis, and this result may be related mainly to the increased activity of MMP-9 and mieloperoxidase.

  4. Dynamic Measurement of Disease Activity in Acute Pancreatitis: The Pancreatitis Activity Scoring System.

    Science.gov (United States)

    Wu, Bechien U; Batech, Michael; Quezada, Michael; Lew, Daniel; Fujikawa, Kelly; Kung, Jonathan; Jamil, Laith H; Chen, Wansu; Afghani, Elham; Reicher, Sonya; Buxbaum, James; Pandol, Stephen J

    2017-07-01

    Acute pancreatitis has a highly variable course. Currently there is no widely accepted method to measure disease activity in patients hospitalized for acute pancreatitis. We aimed to develop a clinical activity index that incorporates routine clinical parameters to assist in the measurement, study, and management of acute pancreatitis. We used the UCLA/RAND appropriateness method to identify items for inclusion in the disease activity instrument. We conducted a systematic literature review followed by two sets of iterative modified Delphi meetings including a panel of international experts between November 2014 and November 2015. The final instrument was then applied to patient data obtained from five separate study cohorts across Southern California to assess profiles of disease activity. From a list of 35 items comprising 6 domains, we identified 5 parameters for inclusion in the final weighted clinical activity scoring system: organ failure, systemic inflammatory response syndrome, abdominal pain, requirement for opiates and ability to tolerate oral intake. We applied the weighted scoring system across the 5 study cohorts comprising 3,123 patients. We identified several distinct patterns of disease activity: (i) overall there was an elevated score at baseline relative to discharge across all study cohorts, (ii) there were distinct patterns of disease activity related to duration of illness as well as (iii) early and persistent elevation of disease activity among patients with severe acute pancreatitis defined as persistent organ failure. We present the development and initial validation of a clinical activity score for real-time assessment of disease activity in patients with acute pancreatitis.

  5. Pain intensity in patients with juvenile idiopathic arthritis with respect to the level of their activity and disease acceptance

    Directory of Open Access Journals (Sweden)

    Grażyna Cepuch

    2014-11-01

    Full Text Available Objectives: Being diagnosed with a chronic disease, such as juvenile idiopathic arthritis (JIA, may adversely affect the activity of a young person. Additionally, the pain associated with the disease may cause difficulty accepting it. The aim was to assess the intensity of pain as well as the degree of activity and acceptance of the disease in young people aged 14–18 years with JIA. Material and methods : The study group consisted of youth of both genders suffering from JIA aged 14–18 years during remission of the disease. The study included 50 people and used the following: numerical rating scale (NRS 0–10, Cantril ladder, activity scale of own authorship (grouped items of the questionnaire form subscales of: tiredness, physical activity, social and intellectual activity and Acceptance of Illness Scale (AIS. Statistical analysis included the following tests: Mann-Whitney U test, Wilcoxon’s, χ2 test, Fisher’s, and Spearman rank correlation. The statistical significance level was set as p value below 0.05. Results : The majority of the respondents observed currently do not feel pain or feel pain of low intensity. The young people are physically, psychologically and socially active. The majority of patients accept their illness. The patients who suffer from pain on the NRS scale within 4–7 points do not adapt to living with the disease as do patients without pain or experiencing pain of low intensity. There was a strong correlation between acceptance of the disease at the time of the study determined by the Cantril ladder and AIS. Conclusions : 1. The pain suffered by patients with juvenile idiopathic arthritis (JIA has undoubtedly a negative impact on their activity and acceptance of the disease. 2. It seems to be crucial to recognize pain as a significant determinant of acceptance of the disease.

  6. Disease activity indices in coeliac disease: systematic review and recommendations for clinical trials.

    Science.gov (United States)

    Hindryckx, Pieter; Levesque, Barrett G; Holvoet, Tom; Durand, Serina; Tang, Ceen-Ming; Parker, Claire; Khanna, Reena; Shackelton, Lisa M; D'Haens, Geert; Sandborn, William J; Feagan, Brian G; Lebwohl, Benjamin; Leffler, Daniel A; Jairath, Vipul

    2018-01-01

    Although several pharmacological agents have emerged as potential adjunctive therapies to a gluten-free diet for coeliac disease, there is currently no widely accepted measure of disease activity used in clinical trials. We conducted a systematic review of coeliac disease activity indices to evaluate their operating properties and potential as outcome measures in registration trials. MEDLINE, EMBASE and the Cochrane central library were searched from 1966 to 2015 for eligible studies in adult and/or paediatric patients with coeliac disease that included coeliac disease activity markers in their outcome measures. The operating characteristics of histological indices, patient-reported outcomes (PROs) and endoscopic indices were evaluated for content and construct validity, reliability, responsiveness and feasibility using guidelines proposed by the US Food and Drug Administration (FDA). Of 19 123 citations, 286 studies were eligible, including 24 randomised-controlled trials. Three of five PROs identified met most key evaluative criteria but only the Celiac Disease Symptom Diary (CDSD) and the Celiac Disease Patient-Reported Outcome (CeD PRO) have been approved by the FDA. All histological and endoscopic scores identified lacked content validity. Quantitative morphometric histological analysis had better reliability and responsiveness compared with qualitative scales. Endoscopic indices were infrequently used, and only one index demonstrated responsiveness to effective therapy. Current best evidence suggests that the CDSD and the CeD PRO are appropriate for use in the definition of primary end points in coeliac disease registration trials. Morphometric histology should be included as a key secondary or co-primary end point. Further work is needed to optimise end point configuration to inform efficient drug development. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Circulating ACE2 activity correlates with cardiovascular disease development

    Directory of Open Access Journals (Sweden)

    Katalin Úri

    2016-12-01

    Full Text Available It was shown recently that angiotensin-converting enzyme activity is limited by endogenous inhibition in vivo, highlighting the importance of angiotensin II (ACE2 elimination. The potential contribution of the ACE2 to cardiovascular disease progression was addressed. Serum ACE2 activities were measured in different clinical states (healthy, n=45; hypertensive, n=239; heart failure (HF with reduced ejection fraction (HFrEF n=141 and HF with preserved ejection fraction (HFpEF n=47. ACE2 activity was significantly higher in hypertensive patients (24.8±0.8 U/ml than that in healthy volunteers (16.2±0.8 U/ml, p=0.01. ACE2 activity further increased in HFrEF patients (43.9±2.1 U/ml, p=0.001 but not in HFpEF patients (24.6±1.9 U/ml when compared with hypertensive patients. Serum ACE2 activity negatively correlated with left ventricular systolic function in HFrEF, but not in hypertensive, HFpEF or healthy populations. Serum ACE2 activity had a fair diagnostic value to differentiate HFpEF from HFrEF patients in this study. Serum ACE2 activity correlates with cardiovascular disease development: it increases when hypertension develops and further increases when the cardiovascular disease further progresses to systolic dysfunction, suggesting that ACE2 metabolism plays a role in these processes. In contrast, serum ACE2 activity does not change when hypertension progresses to HFpEF, suggesting a different pathomechanism for HFpEF, and proposing a biomarker-based identification of these HF forms.

  8. Immunological methods for diagnosing neurocysticercosis

    Energy Technology Data Exchange (ETDEWEB)

    Kuhn, R.E.; Estrada, J.J.; Grogl, M.

    1989-01-31

    A method is described for diagnosing active human neurocysticercosis by detecting the presence of at least one Taenia solium larval antigen in cerebrospinal fluid, which comprises: contacting cerebrospinal fluid from a human to be diagnosed with a solid support, wherein the support binds with a Taenia solium larval antigen if present, contacting the support with a first antibody, wherein the first antibody binds with a larval Taenia solium antigen if present in the cerebrospinal fluid, contacting the solid support with a detectable second antibody which will bind with the first antibody, and detecting the second antibody bound to the support.

  9. Physical activity and neuropsychiatric symptoms of Parkinson disease.

    Science.gov (United States)

    Abrantes, Ana M; Friedman, Joseph H; Brown, Richard A; Strong, David R; Desaulniers, Julie; Ing, Eileen; Saritelli, Jennifer; Riebe, Deborah

    2012-09-01

    Neuropsychiatric symptoms of Parkinson disease (PD) such as fatigue, depression, and apathy are common and detract from quality of life. There is little published on the impact of physical activity on the neuropsychiatric symptoms of PD. A convenience sample of 45 patients with PD (mean age = 66.1 years; 33% female) completed questionnaires on physical activity, neuropsychiatric symptoms, and specific exercise preferences. Covarying for age and gender, higher levels of physical activity were associated with significantly less fatigue, as well as a trend for less apathy and depression and greater positive affect. Exercise preferences included moderate intensity (73%), at home (56%), in the morning (73%), scheduled (69%), options for varied activities (73%), and preference for both structured/supervised (50%), and unsupervised/self-paced (50%) programs. Preferred activities included the use of aerobic exercise equipment, resistance training, and yoga. Developing and tailoring exercise programs that incorporate specific preferences may result in more effective interventions for patients with PD.

  10. Mycobacterium tuberculosis: Active disease and latent infection in a renal transplant cohort.

    Science.gov (United States)

    Rafiei, Nastaran; Williams, Jackie; Mulley, William R; Trauer, James M; Jenkin, Grant A; Rogers, Benjamin A

    2018-04-16

    Tuberculosis (TB) is a serious opportunistic infection in renal transplant recipients associated with high mortality. Screening and treatment of latent Mycobacterium tuberculosis infection (LTBI) offers an opportunity to prevent subsequent active disease. We retrospectively reviewed the records of all adult patients who underwent renal transplantation at our centre from 2005 to 2014 to assess current screening practices, the risks for and burden of active TB. A total of 660 individuals underwent renal transplantation during this period, totalling 3647 person years of follow up. Three patients were diagnosed with active TB after renal transplant, resulting in an incidence of 82 per 100,000 person-years. Of 656 transplant recipients, 102 (15.5%) were born in high TB incidence countries and 89 (13.5%) had an interferon gamma release assay (IGRA) at any point. Individuals born in high TB risk countries had a much higher incidence of active TB (530 per 100,000 person-years). Ten individuals had positive IGRA tests, of whom two were treated for active TB, two received chemoprophylaxis and six were not treated. In the absence of formal guidelines, IGRA-based screening for LTBI was infrequently performed. Our data suggests that screening and treatment of renal transplant recipients born in high incidence countries is an important preventive measure. This article is protected by copyright. All rights reserved.

  11. Reliability and sensitivity of the self-report of physician-diagnosed gout in the campaign against cancer and heart disease and the atherosclerosis risk in the community cohorts.

    Science.gov (United States)

    McAdams, Mara A; Maynard, Janet W; Baer, Alan N; Köttgen, Anna; Clipp, Sandra; Coresh, Josef; Gelber, Allan C

    2011-01-01

    gout is often defined by self-report in epidemiologic studies. Yet the validity of self-reported gout is uncertain. We evaluated the reliability and sensitivity of the self-report of physician-diagnosed gout in the Campaign Against Cancer and Heart Disease (CLUE II) and the Atherosclerosis Risk in the Community (ARIC) cohorts. the CLUE II cohort comprises 12,912 individuals who self-reported gout status on either the 2000, 2003, or 2007 questionnaires. We calculated reliability as the percentage of participants reporting having gout on more than 1 questionnaire using Cohen's κ statistic. The ARIC cohort comprises 11,506 individuals who self-reported gout status at visit 4. We considered a hospital discharge diagnosis of gout or use of a gout-specific medication as the standard against which to calculate the sensitivity of self-reported, physician-diagnosed gout. of the 437 CLUE II participants who self-reported physician-diagnosed gout in 2000, and subsequently answered the 2003 questionnaire, 75% reported gout in 2003 (κ = 0.73). Of the 271 participants who reported gout in 2000, 73% again reported gout at the 2007 followup questionnaire (κ = 0.63). In ARIC, 196 participants met the definition for gout prior to visit 4 and self-reported their gout status at visit 4. The sensitivity of a self-report of physician-diagnosed gout was 84%. Accuracy was similar across sex and race subgroups, but differed across hyperuricemia and education strata. these 2 population-based US cohorts suggest that self-report of physician-diagnosed gout has good reliability and sensitivity. Thus, self-report of a physician diagnosis of gout is appropriate for epidemiologic studies.

  12. The green turtle Chelonia mydas as a marine and coastal environmental sentinels: anthropogenic activities and diseases

    Directory of Open Access Journals (Sweden)

    Isabela Guarnier Domiciano

    2017-10-01

    Full Text Available The green turtle Chelonia mydas is a widely distributed, slowly maturing species with a complex life cycle, using both oceanic and coastal environments. The species is exposed to different threats and is considered an environmental sentinel that indicates variation among, and the severity of hazards to marine ecosystems. This study aimed to describe both anthropogenic impacts, and infectious and parasitic diseases in C. mydas - including cases along the Brazilian coast - and implications for conservation. Bycatch is reported as the main threat to the conservation of this species, followed by debris ingestion, collisions with boats, dredging, and chronic environmental contamination. All of these impacts may directly or indirectly cause death, by facilitating contact with pathological agents and by increasing vulnerability to secondary diseases. The pathological agents associated with lesions include viruses, bacteria, fungi, protozoa, and helminths. Fibropapillomatosis is an example of a chronic disease characterized by cutaneous and visceral tumors that affects mostly juvenile C. mydas worldwide and is associated with the Chelonid herpesvirus 5. The bacterias Vibrio alginolyticus, Aeromonas hydrophila, and Pseudomonas fluorescens are found in the aquatic environment and among C. mydas lesions in various organs. Trematode adults and eggs of the family Spirorchiidae are also frequent in systemic cardiovascular diseases of C. mydas. The direct impacts of anthropogenic activities and diseases are synergistic and may affect the specie’s health and conservation. Therefore, the monitoring and systematic diagnosing of diseases and causes of death - including necropsy, histopathology, and molecular exams - are necessary to assess a population’s health, to support appropriate decisions of coastal management and to target future research topics that optimize C. mydas conservation.

  13. Mental health status can reflect disease activity in rheumatoid arthritis.

    Science.gov (United States)

    Sokolovic, Sekib; Dervisevic, Vedina; Fisekovic, Saida

    2014-06-01

    A significant number of patients with rheumatoid arthritis (RA) link the start of illness with psychological trauma or severe stress. Impaired mental health (IMH), defined as depression and anxiety with psychoneuroimmunological factors, can play a significant role in RA. The main objective of this research was to investigate the mutual correlation of IMH and RA activity, estimated by the laboratory and clinical parameters in RA patients. An open clinical prospective study that lasted for 6 months was designed. There were 72 patients included, 58 women and 14 men, aged 34 to 80 years and screened for mental health status. The study population was randomized following the Brief Symptoms Inventory (BSI) scale, comprised of 53 questions with a range from 0 (no symptoms) to 4 (severe). This mental test was done only once during the study. Following the results from the BSI scale, RA patients were divided into mentally stable and mentally unstable patients to investigate the influence of RA activity on mental health. The following laboratory and clinical parameters were analyzed: sex, age, erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), anti-cyclic citrullinated peptide (anti-CCP) antibody, and disease activity score (DAS28). All RA patients did not express extra-articular manifestations or Sjögren's syndrome. The chi-square test, ANOVA, Pearson's coefficient, and IBM Statistics - SPSS v19 were used. From a total of 72 RA patients, there were 44 mentally stable and 28 mentally unstable patients. All patients had either moderate or severe active disease. The only significant correlation of IMH and activity of RA was found in CRP and DAS28, but no significance was observed in ESR, RF, and anti-CCP. The DAS28 showed high disease activity with an average of 5.3 and CRP of 20.9 mg/L in patients with unstable mental health compared to stable mental health patients, where RA was associated with a moderate DAS average value of 4.35 and

  14. Assessment of disease activity in juvenile idiopathic arthritis. The number and the size of joints matter

    DEFF Research Database (Denmark)

    Berntson, Lillemor; Wernroth, Lisa; Fasth, Anders

    2007-01-01

    Variables for assessment of disease activity of juvenile idiopathic arthritis (JIA) were studied, in order to develop a disease activity score for children with JIA.......Variables for assessment of disease activity of juvenile idiopathic arthritis (JIA) were studied, in order to develop a disease activity score for children with JIA....

  15. Adult Congenital Heart Disease Patients Experience Similar Symptoms of Disease Activity.

    Science.gov (United States)

    Cedars, Ari M; Stefanescu Schmidt, Ada; Broberg, Craig; Zaidi, Ali; Opotowsky, Alexander; Grewal, Jasmine; Kay, Joseph; Bhatt, Ami B; Novak, Eric; Spertus, John

    2016-03-01

    There is a lack of objective data on the symptoms characterizing disease activity among adults with congenital heart disease (ACHD). The purpose of this study was to elicit the most important symptoms from patients across the spectrum of ACHD and to examine whether reported symptoms were similar across the spectrum of ACHD as a foundation for creating a patient-reported outcome measure(s). We constructed a 39-item survey using input from physicians specializing in ACHD to assess the symptoms patients associate with disease activity. Patients (n=124) prospectively completed this survey, and the results were analyzed based on underlying anatomy and disease complexity. A confirmatory cohort of patients (n=40) was then recruited prospectively to confirm the validity of the initial data. When grouped based on underlying anatomy, significant differences in disease-related symptom rankings were found for only 6 of 39 symptoms. Six symptoms were identified which were of particular significance to patients, regardless of underlying anatomy. Patients with anatomy of great complexity experienced greater overall symptom severity than those with anatomy of low or moderate complexity, attributable exclusively to higher ranking of 5 symptoms. The second patient cohort had symptom experiences similar to those of the initial cohort, differing in only 5 of 39 symptoms. This study identified 6 symptoms relevant to patients across the spectrum of ACHD and remarkable homogeneity of patient experience, suggesting that a single disease-specific patient-reported outcome can be created for quality and outcome assessments. © 2016 American Heart Association, Inc.

  16. MULTI DISCIPLINARY APPROACH IN TREATING A GIRL CHILD DIAGNOSED WITH ATTENTION DEFICIT HYPER ACTIVE DISORDER AND OPPOSITIONAL DEFIANT DISORDER. A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Rahul Shaik

    2015-08-01

    Full Text Available Background: The principle features of Attention deficit hyperactivity disorder (ADHD are hyperactivity, inattention and impulsivity. There is little evidence that confirms that Attention deficit hyperactivity disorder (ADHD is arising purely from child rearing methods or social factors.76 % of children with ADHD has a family history, and the similar cases can be seen in the family. The symptoms of more than 50 % of ADHD children will continue in adulthood which requires treatment. Most of the causes appear for ADHD are categorizing the condition in a group of neurobiological and genetic disorders. This does not mean to say that the influence of environmental factors on the severity of disorder, impairment and suffering the child may experience is nil, but those factors do not give rise to the condition by themselves. The chances of getting associated problems like Oppositional Defiant Disorder (ODD in children with ADHD is one-third to one-half and ODD is more common in boys with ADHD. These children are often non compliant, stubborn, defiant, have outbursts of temper, or become belligerent. Case description: This is a case report of a child who diagnosed as attention deficit hyper active disordered and Oppositional Defiant Disordered (ODD child, with finger contractures of right hand, which treated with medications, behavioral therapy, physiotherapy, relaxation techniques and music therapy as the means of rehabilitation. Outcome measures: The evaluation measures used are Nine-hole peg test, behavioral rating scale and a seven items temperament evaluation scale. Discussion: A holistic rehabilitation therapy increased attention, listening to suggestions, short stories and sleeping in time. Oppositional behaviors were also reduced both at home and school. Her relationships with parent, teachers and school mates were improved. Listening skills, attention, daily activities such as wake up, brushing, bathing, going to school in time were also

  17. Graves' disease: diagnostic and therapeutic challenges (multimedia activity).

    Science.gov (United States)

    Kahaly, George J; Grebe, Stefan K G; Lupo, Mark A; McDonald, Nicole; Sipos, Jennifer A

    2011-06-01

    Graves' disease is the most common cause of hyperthyroidism in the United States. Graves' disease occurs more often in women with a female:male ratio of 5:1 and a population prevalence of 1% to 2%. A genetic determinant to the susceptibility to Graves' disease is suspected because of familial clustering of the disease, a high sibling recurrence risk, the familial occurrence of thyroid autoantibodies, and the 30% concordance in disease status between identical twins. Graves' disease is an autoimmune thyroid disorder characterized by the infiltration of immune effector cells and thyroid antigen-specific T cells into the thyroid and thyroid-stimulating hormone receptor expressing tissues, with the production of autoantibodies to well-defined thyroidal antigens, such as thyroid peroxidase, thyroglobulin, and the thyroid-stimulating hormone receptor. The thyroid-stimulating hormone receptor is central to the regulation of thyroid growth and function. Stimulatory autoantibodies in Graves' disease activate the thyroid-stimulating hormone receptor leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Below-normal levels of baseline serum thyroid-stimulating hormone receptor, normal to elevated serum levels of T4, elevated serum levels of T3 and thyroid-stimulating hormone receptor autoantibodies, and a diffusely enlarged, heterogeneous, hypervascular (increased Doppler flow) thyroid gland confirm diagnosis of Graves' disease (available at: http://supplements.amjmed.com/2010/hyperthyroid/faculty.php). This Resource Center is also available through the website of The American Journal of Medicine (www.amjmed.com). Click on the “Thyroid/Graves' Disease” link in the “Resource Centers” section, found on the right side of the Journal homepage. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Challenges in diagnosing tuberculosis in children

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  19. TGF-β1 and granulocyte elastase in the evaluation of activity of inflammatory bowel disease. A pilot study

    Directory of Open Access Journals (Sweden)

    Irena Ciećko-Michalska

    2014-01-01

    Full Text Available Introduction: The aim was to assess the usefulness of TGF-β1 and elastase in the evaluation of activity of ulcerative colitis (UC and Crohn’s disease (CD.Material and Methods: 32 patients diagnosed with UC, 31 with CD and 30 healthy volunteers were enrolled in this study. Diagnosis of the disease was confirmed by videocolonoscopy and histopathological evaluation of intestinal biopsies. Disease activity was assessed by use of the Mayo Scoring System for Assessment of Ulcerative Colitis Activity in UC patients and by CDAI in CD patients. hsCRP was determined by the immunonephelometric method, TGF-β1 and elastase plasma concentration by ELISA. The results of the study were analyzed using Statistica and R statistical language.Results: In UC a positive correlation between disease activity and platelet level, hsCRP and TGF-β1 concentration was noted. Elastase concentration in UC patients was significantly higher than in CD, but there was no correlation with the activity of the disease. In CD patients we observed a positive correlation between disease activity and leukocytes, platelet levels and elastase concentration, and a very low correlation with hsCRP and TGF-β1.Discussion: Determination of TGF-β1 can be used for evaluation of inflammatory activity in UC and it is connected with elevated concentrations of CRP and platelets. To a lower extent TGF-β1 can also be used for evaluation of inflammatory activity in CD. Examination of elastase concentration may be useful in the assessment of CD activity. Plasma elastase concentration may be helpful in UC and CD differentiation. The preliminary results of this investigation seem promising; nevertheless, more studies are necessary.

  20. Pilot study of a three-step diagnostic pathway for young and old patients with Parkinson's disease dementia: screen, test and then diagnose.

    NARCIS (Netherlands)

    Robben, S.H.M.; Sleegers, M.J.; Dautzenberg, P.LJ.; Bergen, F.S. van; Bruggen, J.P.; Olde Rikkert, M.G.M.

    2010-01-01

    OBJECTIVE: To pilot a three-step diagnostic model for young and old patients with Parkinson's disease dementia (PDD). METHODS: Prospective investigator-blinded study. We developed a screening questionnaire for patients with Parkinson's disease (PD) and their caregivers. Further, patients were

  1. Twintig jaar coeliakie bij kinderen in Nederland: Meer diagnosen en een veranderde verschijningsvorm [Twenty years of childhood coeliac disease in the Netherlands: More diagnoses and changed clinical picture

    NARCIS (Netherlands)

    George, E.K.; Mearin, M.L.; Kanhai, Sh.M.; Franken, H.C.M.; Houwen, R.H.J.; Hirasing, R.A.; Vandenbroucke, J.P.

    1998-01-01

    Objective. To assess the incidence of childhood coeliac disease in the Netherlands and to study the clinical features. Design. Prospective. Setting. Leiden University Medical Centre, Leiden, the Netherlands. Method. Cases of childhood coeliac disease in the Netherlands in 1993-1995 were identified

  2. Comparison of Fixed versus Calculated Activity of Radioiodine for the Treatment of Graves Disease in Adults

    Directory of Open Access Journals (Sweden)

    Abigail U. Canto

    2016-03-01

    Full Text Available BackgroundRadioactive iodine as a treatment modality has been shown in several studies to be a safe and effective therapy for Graves disease. However, there is still no uniformity regarding optimal dosing method. The aim of this study is to compare the efficacy of calculated and fixed dosing of radioiodine for the treatment of Graves disease.MethodsA hundred twenty-two patients diagnosed with Graves disease were randomized to receive either fixed or calculated dose of radioiodine. Those randomized to fixed activity received either low fixed activity at 9.9 mCi for thyroid gland size <40 g or high fixed activity at 14.9 mCi for thyroid gland size 40 to 80 g, and those grouped to calculated activity received 160 µCi/g of thyroid tissue adjusted for 24 hours radioiodine uptake. Thyroid function tests (free thyroxine [T4] and thyroid stimulating hormone [TSH] were monitored at 10, 16, and 24 weeks after radioactive iodine therapy. The primary outcome, treatment failure was defined as persistently elevated free T4 and low TSH.ResultsOf the 122 patients randomized, 56 in the fixed dose group and 56 in the calculated dose group completed the follow-up. At the end of 6 months, the percentage of treatment failure was 37.50% in the calculated dose group versus 19.64% in the fixed dose group with a relative risk of 0.53 (95% confidence interval, 0.28 to 0.98 favoring the fixed dose group.ConclusionFixed dose radioiodine has a significantly lower incidence of persistent hyperthyroidism at 6 months post-radioactive therapy.

  3. Dietary patterns, involvement in physical activity and body mass index of Romanian adults having cardio-vascular diseases

    Directory of Open Access Journals (Sweden)

    Lucia Maria Lotrean

    2016-05-01

    Full Text Available Promotion of a healthy diet, an active lifestyle and appropriate body weight are important components of cardio-vascular disease prevention and control. This study aimed to assess several dietary patterns, involvement in physical activity and body mass index (BMI of Romanian adults hospitalized because of diagnoses of cardio-vascular diseases (CVD. The study was performed in 2014 in 1 hospital setting from Cluj-Napoca, Romania. It involved 80 adult patients (45 to 78 years old hospitalized with diagnoses of CVD. Anonymous questionnaire assessing several lifestyle related behaviours were filled in by the participants; based on their weight and height, the BMI was calculated. The results show that 76.2% of the participants recognize the role of consumption of fruits and vegetables for cardio-vascular diseases prevention and control, but only 5% meet the recommendations of eating at least 5 portions of fruits and vegetables (around 400 g daily. The majority of the subjects know that the consumption of animal fat increases the risk for cardio-vascular diseases, but, only one out of two patients declared their constant preoccupation for avoiding products rich in saturated fatty acids, such as animal fat, high fat dairy products and high fat meat. Around 80% of the participants know the risk of obesity for cardio-vascular diseases, but 81.2% have a BMI higher than 25. A percentage of 60% of the patients declared that they received general information from health care professionals about diet, physical activity and cardio-vascular disease prevention, while one quarter followed an educational program for this issue and only one out of ten patients followed a personalized program for loosing weight. Comprehensive educational and counselling programs for promoting healthy nutrition and achievement of an appropriate body weight are needed for Romanian adults having CVD

  4. Usefulness of {sup 18}F FDG PET/CT in evaluating disease activity at different times in a patient with chronic periaortitis

    Energy Technology Data Exchange (ETDEWEB)

    Treglia, Giorgio; Stefanelli, Antonella; Mattoli, Maria Vittoria; Leccisotti, Lucia; Muoio, Barbara [Catholic Univ. of the Sacred Heart, Rome (Italy); Bertagna, Francesco [Univ. of Brescia, Brescia (Italy)

    2012-03-15

    We report the case of a 53 year old man with a chronic periaortitis (CP) in whom Fluorine 18 Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has been useful in assessing the disease extent at diagnosis, in evaluating the treatment response, in diagnosing the relapse, and in monitoring the disease activity during follow up. This case highlights the usefulness of FDG PET/CT at different times in patients with CP. CP is a rare inflammatory disorder that affects the abdominal aorta and the retroperitoneum. Imaging procedures are essential to diagnose and monitor the disease course. Ultrasonography may be used as first line screening test, and is particularly useful to monitor patients with hydronephrosis and aortic aneurysms. However, CT or magnetic resonance imaging (MRI) of the abdomen are currently considered the investigations of choice to diagnose CP. In active CP, the periaortic mass usually enhances on CT and MRI. Both these methods can be used to monitor the disease course of CP and to evaluate response to treatment. A note of caution: signs of vasculitis seen on MRI and CT may persist for some time, despite achievement of clinical remission. A further limitation of abdominal CT and MRI is that neither technique can detect vasculitis in vessels other than the abdominal aorta, which has been described in 43% of patients with CP. FDG PET/CT has been proposed as useful tool in inflammatory diseases, such as aortitis, because metabolic changes assessed by FDG PET/CT usually precede morphological changes assessed by conventional imaging methods. Our case highlights the usefulness of FDG PET/CT at different times in patients with CP. This method may be useful in assessing disease activity and extent at diagnosis, in evaluating the treatment response, in diagnosing the relapse, and in monitoring the disease during follow up.

  5. CD4 T cell activation and disease activity at onset of multiple sclerosis

    DEFF Research Database (Denmark)

    Jensen, J; Langkilde, Annika Reynberg; Fenst, C

    2004-01-01

    We studied CD4 T cell activation in patients with clinically isolated syndromes (CIS) suggesting an initial attack of multiple sclerosis. The percentage of blood CD26+ CD4 T cells was increased in these patients, and correlated with magnetic resonance imaging disease activity and clinical disease...... severity. In contrast, the percentage of CD25+ CD4 T cells in cerebrospinal fluid correlated negatively with the cerebrospinal fluid concentration of myelin basic protein and the presence of IgG oligoclonal bands. These results suggest that distinct systemic and intrathecal T cell activation states...

  6. Physical Activity and Risk of Cardiovascular Disease Among Older Adults

    Directory of Open Access Journals (Sweden)

    Sho-Jen Cheng

    2013-09-01

    Full Text Available Cardiovascular disease (CVD represents a leading cause of mortality and morbidity especially among the elder people, and therefore the need of effective preventive strategies is imperative. Despite limited data among the elderly people, the majority of published studies have demonstrated that physically active elderly people have lower rates of CVD. In this article, we provide an overview of the epidemiology studies that investigate this association and analyze the relevant underlying biological mechanisms. We also discuss the types and amounts of physical activity recommended for the primary prevention of CVD in older adults.

  7. MR imaging in adults with Gaucher disease type I: evulation of marrow involvement and disease activity

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, G. (Dept. of Radiology, Mount Sinai Medical Center, City Univ. of New York, NY (United States)); Shaprio, R.S. (Dept. of Radiology, Mount Sinai Medical Center, City Univ. of New York, NY (United States)); Abdelwahab, I.F. (Dept. of Radiology, Mount Sinai Medical Center, City Univ. of New York, NY (United States)); Grabowski, G. (Dept. of Pediatrics, Mount Sinai Medical Center, City Univ. of New York, NY (United States))

    1993-05-01

    An investigation was conducted to determine the usefulness of magnetic resonance imaging (MRI) in the evaluation of bone marrow involvement in patients with Gaucher disease type I. T1- and T2-weighted images were obtained of the lower extremities of 29 adult patients. Patients were classified into one of three groups based on marrow signal patterns on T1- and T2-weighted images as well as change in signal intensity from T1- to T2-weighted images. An increase in signal intensity from T1- to T2-weighted images was the criterion for an 'active process' within the bone marrow. Classification of the 29 patients produced the following results: Group A: Normal, 4 patients; group B: Marrow infiltration, 16 patients; group C: Marrow infiltration plus active marrow process, 9 patients. Correlation with clinical findings revealed that all nine patients with evidence of an active marrow process on MRI (group C) had acute bone pain. Conversely, only one of the remaining 20 patients (groups A and B) had bone pain. There was no correlation between disease activity and findings on conventional radiographs. We conclude the MRI provides an excellent noninvasive assessment of the extent and activity of marrow involvement in type I Gaucher disease. (orig.)

  8. MR imaging in adults with Gaucher disease type I: evulation of marrow involvement and disease activity

    International Nuclear Information System (INIS)

    Hermann, G.; Shaprio, R.S.; Abdelwahab, I.F.; Grabowski, G.

    1993-01-01

    An investigation was conducted to determine the usefulness of magnetic resonance imaging (MRI) in the evaluation of bone marrow involvement in patients with Gaucher disease type I. T1- and T2-weighted images were obtained of the lower extremities of 29 adult patients. Patients were classified into one of three groups based on marrow signal patterns on T1- and T2-weighted images as well as change in signal intensity from T1- to T2-weighted images. An increase in signal intensity from T1- to T2-weighted images was the criterion for an 'active process' within the bone marrow. Classification of the 29 patients produced the following results: Group A: Normal, 4 patients; group B: Marrow infiltration, 16 patients; group C: Marrow infiltration plus active marrow process, 9 patients. Correlation with clinical findings revealed that all nine patients with evidence of an active marrow process on MRI (group C) had acute bone pain. Conversely, only one of the remaining 20 patients (groups A and B) had bone pain. There was no correlation between disease activity and findings on conventional radiographs. We conclude the MRI provides an excellent noninvasive assessment of the extent and activity of marrow involvement in type I Gaucher disease. (orig.)

  9. Participation in novelty-seeking leisure activities and Alzheimer's disease.

    Science.gov (United States)

    Fritsch, Thomas; Smyth, Kathleen A; Debanne, Sara M; Petot, Grace J; Friedland, Robert P

    2005-09-01

    The objective was to study the associations between participation in different types of mentally stimulating leisure activities and status as Alzheimer's disease (AD) case or normal control. Research suggests that participation in leisure activities, especially mentally stimulating activities, is associated with a lower risk for AD. However, no study has yet evaluated associations between AD and different types of mental leisure activities, especially those involving "novelty seeking." The authors used a case-control design to compare participation in activities across the life span in persons with AD and normal controls. Cases (n = 264) were recruited from clinical settings and from the community. Controls were drawn from 2 populations. Control group A members (n = 364) were the friends or neighbors of the cases or members of the same organizations to which the cases belonged. Control group B members (n = 181) were randomly drawn from the community. The 2 control groups did not differ in their responses to most activity questions, so they were combined. Factor analysis of activity questions identified 3 activity factors: (1) novelty seeking; (2) exchange of ideas; and (3) social. Logistic regression analysis indicated that, adjusting for control variables, greater participation in novelty-seeking and exchange-of-ideas activities was significantly associated with decreased odds of AD. The odds of AD were lower among those who more often participated in activities involving exchange of ideas and were lower yet for those who more frequently participated in novelty-seeking activities. We conclude that participation in a variety of mental activities across the life span may lower one's chances of developing AD.

  10. Unsuspected Active Sarcoidosis Diagnosed by {sup 18}F-FDG PET/CT During the Search for a Primary Tumour in a Patient with Bone Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Caobelli, Federico; Pizzocaro, Claudio; Soffientini, Alberto; Guerra, Ugo Paolo [Fondazion Poliambulanza, Brescia (Italy); Gabanelli, Sara Vincenzina; Brucato, Antonio [Ospedali Riuniti, Bergamo (Italy); Giubbini, Raffaele [Univ. of Brescia, Brescia (Italy)

    2013-09-15

    Sarcoidosis is a systemic chronic inflammatory disease of unknown aetiology, characterised by granulomatous lesions with heterogeneous clinical manifestations affecting multiple organs and tissues. Although the respiratory system is most commonly affected, the disease may also present with bone lesions. We report the case of a 31-year old woman who presented with low back pain and no history of cancer and who was found to have suspicious lesions involving the entire spine on magnetic resonance imaging (MRI). The patient underwent {sup 18}F-fluorodeoxyglucose (FDG) PET/CT to search for a primary tumour and for staging purposes. {sup 18}F-FDG PET/CT revealed a pattern of hypermetabolic activity in widespread skeletal lesions and in a single left cervical lymph node. The primary tumour was not found, thus suggesting a haematologic disorder. Subsequent biopsies of a cervical lymph node and of bone tissue from L4 revealed active sarcoidosis with no evidence of cancer. This underlines the importance of considering all alternatives when hypermetabolic lesions are found on {sup 18}F-FDG PET/CT. Furthermore, {sup 18}F-FDG PET can be very useful to indicate accessible sites for guiding fine-needle aspiration cytology (FNAC)

  11. Unsuspected Active Sarcoidosis Diagnosed by 18F-FDG PET/CT During the Search for a Primary Tumour in a Patient with Bone Lesions

    International Nuclear Information System (INIS)

    Caobelli, Federico; Pizzocaro, Claudio; Soffientini, Alberto; Guerra, Ugo Paolo; Gabanelli, Sara Vincenzina; Brucato, Antonio; Giubbini, Raffaele

    2013-01-01

    Sarcoidosis is a systemic chronic inflammatory disease of unknown aetiology, characterised by granulomatous lesions with heterogeneous clinical manifestations affecting multiple organs and tissues. Although the respiratory system is most commonly affected, the disease may also present with bone lesions. We report the case of a 31-year old woman who presented with low back pain and no history of cancer and who was found to have suspicious lesions involving the entire spine on magnetic resonance imaging (MRI). The patient underwent 18 F-fluorodeoxyglucose (FDG) PET/CT to search for a primary tumour and for staging purposes. 18 F-FDG PET/CT revealed a pattern of hypermetabolic activity in widespread skeletal lesions and in a single left cervical lymph node. The primary tumour was not found, thus suggesting a haematologic disorder. Subsequent biopsies of a cervical lymph node and of bone tissue from L4 revealed active sarcoidosis with no evidence of cancer. This underlines the importance of considering all alternatives when hypermetabolic lesions are found on 18 F-FDG PET/CT. Furthermore, 18 F-FDG PET can be very useful to indicate accessible sites for guiding fine-needle aspiration cytology (FNAC)

  12. Relation between myocardial damage and disease activity in patients with systemic lupus erythematosus by exercise {sup 201}Tl scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Kuzumoto, Masayuki [Nara Medical Univ. (Japan)

    1997-08-01

    Myocardial damage in patients with systemic lupus erythematosus (SLE) was evaluated using exercise thallium-201 myocardial scintigraphy, and the relationship between myocardial damage and disease activity of SLE was examined. Twenty-seven patients (26 women and 1 man, mean age 43 years), in whom extramural coronary artery lesions were excluded by coronary angiogram or presumed to be excluded by exercise electrocardiogram, were enrolled in this study. The mean duration of disease and the mean duration of corticosteroid therapy in these patients were 94 and 77 months, respectively. Exercise thallium-201 scintigraphy was performed twice (mean interval, 30 months) to evaluate the progression of myocardial damage. Myocardial ischemia as an index of myocardial damage was evaluated by visual analysis and ischemic score (IS). The changes in myocardial ischemia were categorized into 3 groups: improved, unchanged or worsened. The disease activity of SLE was determined by the SLE Disease Activity Index (SLEDAI), and the changes in this index were classified into the same three categories, as evaluated every six months between the two scintigraphic examinations. Disease activity was significantly correlated with myocardial ischemia (p<0.05), and with myocardial ischemia as diagnosed by {Delta}IS (difference in ischemic score between the first and second thallium-201 scintigrams: p<0.005). But neither the duration of disease nor the duration of corticosteroid therapy was correlated with IS at the first scintigraphy. These results indicate that control of SLE disease activity may be critical in the treatment of myocardial damage resulting from vascular lesions, especially intramyocardial small-artery disease, in patients with SLE. (author)

  13. [Physical activity in basic and primary prevention of cardiovascular disease].

    Science.gov (United States)

    Sobieszczańska, Małgorzata; Kałka, Dariusz; Pilecki, Witold; Adamus, Jerzy

    2009-06-01

    On account of the frequency of appearing and character of atherosclerosis cardiac vascular disease, one of the most crucial elements of effective fight against it is preparation of complex preventive programs including as vast number of population as possible. Consequently, Benjamin and Smitch suggested attaching the notion of basic prevention to the standard division into primary and secondary one. The basic prevention, carrying out in the general population, should concern genetic predisposition, psychosocial factors, keeping up proper body weight, healthy eating and physical activity. Especially high hopes are connected with high efficiency, simplicity and low money-consumption of preventive activities associated with physical activity modification, which has a crucial influence on reducing negative impact of atherosclerosis hazard. The results of numerous scientific research, carried out in many countries and on various, large groups, proved undoubtedly that at the healthy adult people of both sex the systematic physical activity of moderate intensification plays an essential part in preventing CVD and decreasing the death risk because of that reason as well. Moreover, systematic physical exercises show many other health-oriented actions, thanks to which they have an influence on decreasing premature and total death rate. The risk of incidence of civilization-related diseases such as diabetes type II, hypertension, obesity, osteoporosis, tumors (of large intestine, breast, prostatic gland) and depression has decreased significantly. Unequivocally positive influence has been proved at many observations dedicated to health recreational physical activity and physical activity connected with professional work based on aerobe effort. The positive effects have been also observed at children population and senior population which is more and more numerous and the most at risk. The beneficial action of physical activity is connected with direct effect on organism

  14. Childhood-onset systemic lupus erythematosus in Singapore: clinical phenotypes, disease activity, damage, and autoantibody profiles.

    Science.gov (United States)

    Tan, J H T; Hoh, S F; Win, M T M; Chan, Y H; Das, L; Arkachaisri, T

    2015-08-01

    Childhood-onset systemic lupus erythematosus (cSLE) is a multisystem autoimmune disease characterized by immune dysregulation affecting patients less than 18 years old. One-fifth of SLE cases are diagnosed during childhood. cSLE presents differently from adults and has a more severe and aggressive course. We describe the clinical and antibody profiles in our cSLE Singapore cohort. All cSLE patients who satisfied the 1997 American College of Rheumatology diagnostic criteria were captured in our lupus registry from January 2009 to January 2014. Data including demographic, cumulative clinical, serologic data, and damage indices were collected. Adjusted mean SLEDAI-2K (AMS) was used to summarize disease activity over multiple visits. Cluster analysis using non-hierarchical K-means procedure was performed on eight selected antibodies. The 64 patients (female:male ratio 5:1; Chinese 45.3%, Malay 28.1%, Indian 9.4%, and other races 17.2%) had a mean onset age of 11.5 years (range 2.1-16.7) and mean age at diagnosis was 11.9 years (range 2.6-18.0). Our study demonstrated differences in clinical manifestations for which hematologic involvement was the most common manifestation with less renal disease and uncommon neurologic manifestation as compared to other cSLE cohorts reported in our region. Antibody clusters were identified in our cohort but their clinical association/discrimination and outcome prediction required further validation study. Outcomes of our cohort in regard to disease activity after therapy and organ damages were comparable if not better to other cSLE cohorts elsewhere. Steroid-related damage, including symptomatic multifocal avascular necrosis and cataract, were not uncommon locally. Infection remains the major cause of death for the continent. Nevertheless, the five year survival rate of our cohort (98.4%) was high. © The Author(s) 2015.

  15. Psychological distress as a mediator of the association between disease severity and occupational functioning among employed spouses of women recently diagnosed with breast cancer.

    Science.gov (United States)

    Manne, Sharon L; Siegel, Scott; Heckman, Carolyn J; Kashy, Deborah A

    2015-11-01

    The purpose was to evaluate whether patient and spouse cancer-specific distress mediated the association between cancer severity and occupational functioning among employed spouses of women diagnosed with breast cancer. We examined whether sociodemographic characteristics, lower spouse-reported marital quality, and lower spouse self-rated health were associated with poorer spouse occupational functioning. One hundred forty-three currently employed spouses of women diagnosed with breast cancer were administered measures of socioeconomic status, occupational functioning (work absenteeism, low productivity, and poor performance), cancer-specific distress, marital quality, and self-rated health. Patients completed measures of cancer-related distress and functional impairment and cancer stage were collected from medical charts. In the model evaluating work absenteeism, greater patient functional impairment was associated with more absenteeism, but there was no evidence of a mediating effect for either partners' cancer-specific distress. Higher cancer stage and more functional impairment were associated with higher spouse cancer-specific distress, which in turn predicted poorer work productivity. Patient cancer-specific distress did not mediate the association between patient functional impairment or cancer stage and spouse work productivity. Finally, higher cancer stage was associated with more spouse cancer-specific distress, which in turn predicted poorer work performance. There were no direct or indirect effects of the patient's functional impairment on spouse work performance. Distressed spouses are more likely to have poorer work productivity after their partners' breast cancer diagnosis. These spouses may need assistance in managing their distress and the patient's functional impairment to ensure that their work productivity is not adversely affected. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Diagnosing suffering: a perspective.

    Science.gov (United States)

    Cassell, E J

    1999-10-05

    The alleviation of suffering is crucial in all of medicine, especially in the care of the dying. Suffering cannot be treated unless it is recognized and diagnosed. Suffering involves some symptom or process that threatens the patient because of fear, the meaning of the symptom, and concerns about the future. The meanings and the fear are personal and individual, so that even if two patients have the same symptoms, their suffering would be different. The complex techniques and methods that physicians usually use to make a diagnosis, however, are aimed at the body rather than the person. The diagnosis of suffering is therefore often missed, even in severe illness and even when it stares physicians in the face. A high index of suspicion must be maintained in the presence of serious disease, and patients must be directly questioned. Concerns over the discomfort of listening to patients' severe distress are usually more than offset by the gratification that follows the intervention. Often, questioning and attentive listening, which take little time, are in themselves ameliorative. The information on which the assessment of suffering is based is subjective; this may pose difficulties for physicians, who tend to value objective findings more highly and see a conflict between the two kinds of information. Recent advances in understanding how physicians increase the utility of information and make inferences allow one to reliably use the subjective information on which the diagnosis and treatment of suffering depend. Knowing patients as individual persons well enough to understand the origin of their suffering and ultimately its best treatment requires methods of empathic attentiveness and nondiscursive thinking that can be learned and taught. The relief of suffering depends on physicians acquiring these skills.

  17. Prevalence of hepatitis C virus and human immunodeficiency virus in a group of patients newly diagnosed with active tuberculosis in Porto Alegre, Southern Brazil

    Directory of Open Access Journals (Sweden)

    Cintia Costi

    Full Text Available BACKGROUND Porto Alegre is the Brazilian state capital with second highest incidence of tuberculosis (TB and the highest proportion of people infected with human immunodeficiency virus (HIV among patients with TB. Hepatitis C virus (HCV infection increases the risk of anti-TB drug-induced hepatotoxicity, which may result in discontinuation of the therapy. OBJECTIVES The aim of this study was (i to estimate prevalence of HCV and HIV in a group of patients newly diagnosed with active TB in a public reference hospital in Porto Alegre and (ii to compare demographic, behavioural, and clinical characteristics of patients in relation to their HCV infection status. METHODS One hundred and thirty-eight patients with TB were tested for anti-HCV antibody, HCV RNA, and anti-HIV1/2 antibody markers. HCV RNA from real-time polymerase chain reaction (PCR-positive samples was submitted to reverse transcription and PCR amplification. The 5′ non-coding region of the HCV genome was sequenced, and genotypes of HCV isolates were determined. FINDINGS Anti-HCV antibody, HCV RNA, and anti-HIV antibodies were detected in 27 [20%; 95% confidence interval (CI, 13-26%], 17 (12%; 95% CI, 7-18%, and 34 (25%; 95% CI, 17-32% patients, respectively. HCV isolates belonged to genotypes 1 (n = 12 and 3 (n = 4. Some characteristics were significantly more frequent in patients infected with HCV. Among them, non-white individuals, alcoholics, users of illicit drugs, imprisoned individuals, and those with history of previous TB episode were more commonly infected with HCV (p < 0.05. MAIN CONCLUSIONS HCV screening, including detection of anti-HCV antibody and HCV RNA, will be important to improving the management of co-infected patients, given their increased risk of developing TB treatment-related hepatotoxicity.

  18. Prevalence of hepatitis C virus and human immunodeficiency virus in a group of patients newly diagnosed with active tuberculosis in Porto Alegre, Southern Brazil.

    Science.gov (United States)

    Costi, Cintia; Grandi, Tarciana; Halon, Maria Laura; Silva, Márcia Susana Nunes; Silva, Cláudia Maria Dornelles da; Gregianini, Tatiana Schäffer; Possuelo, Lia Gonçalves; Jarczewski, Carla Adriane; Niel, Christian; Rossetti, Maria Lucia Rosa

    2017-04-01

    Porto Alegre is the Brazilian state capital with second highest incidence of tuberculosis (TB) and the highest proportion of people infected with human immunodeficiency virus (HIV) among patients with TB. Hepatitis C virus (HCV) infection increases the risk of anti-TB drug-induced hepatotoxicity, which may result in discontinuation of the therapy. The aim of this study was (i) to estimate prevalence of HCV and HIV in a group of patients newly diagnosed with active TB in a public reference hospital in Porto Alegre and (ii) to compare demographic, behavioural, and clinical characteristics of patients in relation to their HCV infection status. One hundred and thirty-eight patients with TB were tested for anti-HCV antibody, HCV RNA, and anti-HIV1/2 antibody markers. HCV RNA from real-time polymerase chain reaction (PCR)-positive samples was submitted to reverse transcription and PCR amplification. The 5' non-coding region of the HCV genome was sequenced, and genotypes of HCV isolates were determined. Anti-HCV antibody, HCV RNA, and anti-HIV antibodies were detected in 27 [20%; 95% confidence interval (CI), 13-26%], 17 (12%; 95% CI, 7-18%), and 34 (25%; 95% CI, 17-32%) patients, respectively. HCV isolates belonged to genotypes 1 (n = 12) and 3 (n = 4). Some characteristics were significantly more frequent in patients infected with HCV. Among them, non-white individuals, alcoholics, users of illicit drugs, imprisoned individuals, and those with history of previous TB episode were more commonly infected with HCV (p < 0.05). HCV screening, including detection of anti-HCV antibody and HCV RNA, will be important to improving the management of co-infected patients, given their increased risk of developing TB treatment-related hepatotoxicity.

  19. Biomarkers of disease activity in vitiligo: A systematic review.

    Science.gov (United States)

    Speeckaert, R; Speeckaert, M; De Schepper, S; van Geel, N

    2017-09-01

    The pathophysiology of vitiligo is complex although recent research has discovered several markers which are linked to vitiligo and associated with disease activity. Besides providing insights into the driving mechanisms of vitiligo, these findings could reveal potential biomarkers. Activity markers can be used to monitor disease activity in clinical trials and may also be useful in daily practice. The aim of this systematic review was to document which factors have been associated with vitiligo activity in skin and blood. A second goal was to determine how well these factors are validated in terms of sensitivity and specificity as biomarkers to determine vitiligo activity. Both in skin (n=43) as in blood (n=66) an adequate number of studies fulfilled the predefined inclusion criteria. These studies used diverse methods and investigated a broad range of plausible biomarkers. Unfortunately, sensitivity and specificity analyses were scarce. In skin, simple histopathology with or without supplemental CD4 and CD8 stainings can still be considered as the gold standard, although more recently chemokine (C-X-C motif) ligand (CXCL) 9 and NLRP1 have demonstrated a good and possibly even better association with progressive disease. Regarding circulating biomarkers, cytokines (IL-1β, IL-17, IFN-γ, TGF-β), autoantibodies, oxidative stress markers, immune cells (Tregs), soluble CDs (sCD25, sCD27) and chemokines (CXCL9, CXCL10) are still competing. However, the two latter may be preferable as both chemokines and soluble CDs are easy to measure and the available studies display promising results. A large multicenter study could make more definitive statements regarding their sensitivity and specificity. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Non-alcoholic fatty liver disease in a rural, physically active, low income population in Sri Lanka

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    Pinidiyapathirage M

    2011-11-01

    Full Text Available Abstract Background Non-alcoholic fatty liver disease (NAFLD is recognized as a metabolic disorder largely seen in urbanized populations. The purpose of this study was to assess prevalence and risk factors for NAFLD in a rural, physically active, economically deprived population in Sri Lanka. Methods By visiting individual households in the community, 35-64 year old adults resident in two selected estates in the Nuwara Eliya District of Sri Lanka, were invited to participate in the study. Blood pressure and anthropometric measurements were made on all participants. Blood samples were obtained for the assay of fasting glucose, serum lipids, serum insulin and alanine aminotransferase. NAFLD was diagnosed on established ultrasound criteria for fatty liver in the absence of hepatitis B and C markers and high alcohol consumption. Results Of those invited, 403 (65% participated in the study. Almost all participants were either Indian or Sri Lankan Tamils and 53% were females. Prevalence of NAFLD was 18% in this population. Twice as many males were diagnosed as having NAFLD compared to females. Male sex, high BMI, high waist circumference, high diastolic blood pressure and high plasma glucose levels were significant predictors of NAFLD. Conclusion Nearly one in five people in this predominantly Indian Tamil, rural, physically active, economically deprived population had NAFLD. The condition was associated with constituent features of the metabolic syndrome. These results support studies reporting ethnic variations in disease susceptibility and suggest that genetic factors may also play a role in determining disease risk.

  1. Global alliance against chronic respiratory diseases in Italy (GARD-Italy): strategy and activities.

    Science.gov (United States)

    Laurendi, Giovanna; Mele, Sonia; Centanni, Stefano; Donner, Claudio F; Falcone, Franco; Frateiacci, Sandra; Lazzeri, Marta; Mangiacavallo, Antonino; Indinnimeo, Luciana; Viegi, Giovanni; Pisanti, Paola; Filippetti, Giuseppe

    2012-01-01

    The steady increase in incidence of chronic respiratory disease (CRD) now constitutes a serious public health problem. CRDs are often underdiagnosed and many patients are not diagnosed until the CRD is too severe to prevent normal daily activities. The prevention of CRDs and reducing their social and individual impacts means modifying environmental and social factors and improving diagnosis and treatment. Prevention of risk factors (tobacco smoke, allergens, occupational agents, indoor/outdoor air pollution) will significantly impact on morbidity and mortality. The Italian Ministry of Health (MoH) has made respiratory disease prevention a top priority and is implementing a comprehensive strategy with policies against tobacco smoking, indoor/outdoor pollution, obesity, and communicable diseases. Presently these actions are not well coordinated. The Global Alliance against Chronic Respiratory Diseases (GARD), set up by the World Health Organization, envisages national bodies; the GARD initiative in Italy, launched 11/6/2009, represents a great opportunity for the MoH. Its main objective is to promote the development of a coordinated CRD program in Italy. Effective prevention implies setting up a health policy with the support of healthcare professionals and citizen associations at national, regional, and district levels. What is required is a true inter-institutional synergy: respiratory diseases prevention cannot and should not be the responsibility of doctors alone, but must involve politicians/policymakers, as well as the media, local institutions, and schools, etc. GARD could be a significant experience and a great opportunity for Italy to share the GARD vision of a world where all people can breathe freely. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. The presence of anti-endomysial antibodies and the level of anti-tissue transglutaminases can be used to diagnose adult coeliac disease without duodenal biopsy.

    Science.gov (United States)

    Tortora, R; Imperatore, N; Capone, P; De Palma, G D; De Stefano, G; Gerbino, N; Caporaso, N; Rispo, A

    2014-11-01

    The new ESPGHAN guidelines for diagnosis of paediatric coeliac disease suggest to avoid biopsy in genetically pre-disposed and symptomatic individuals with positive anti-endomysial antibodies (EMA) and anti-tissue transglutaminases (a-tTG). However, duodenal biopsy remains the gold standard in adult coeliac disease. To establish the cut-off values of a-tTG, which would: predict the presence of duodenal histology (Marsh ≥2) diagnostic for coeliac disease; and predict the presence of villous atrophy (Marsh 3) in adults. We performed an observational prospective study including all consecutive adult patients with suspected coeliac disease. All subjects were tested for EMA and a-tTG. Coeliac disease diagnosis was made in presence of Marsh ≥2, a-tTG >7 U/mL and positive EMA. A ROC curve was constructed to establish the best specificity cut-off of a-tTG levels, which would predict the presence of Marsh ≥2 and Marsh 3 at histology. The study included 310 patients with positive antibodies. Histology showed Marsh 1 in 8.7%, Marsh 2 in 3.5%, Marsh 3 in 87.7%. The best cut-off value of a-tTG for predicting Marsh ≥2 was 45 U/mL (sensitivity 70%; specificity 100%; PPV 100%; NPV 24.1%); the best cut-off for predicting villous atrophy was 62.4 U/mL (sensitivity 69%, specificity 100%; PPV 100%; NPV 31%). The diagnosis of coeliac disease can be reached without histology in adult patients with positive EMA and a-tTG levels >45 U/mL. An a-tTG level >62.4 was diagnostic for villous atrophy. These results could contribute to improving the diagnosis of coeliac disease by allowing for a significant reduction in diagnosis-related costs. © 2014 John Wiley & Sons Ltd.

  3. Medicinal plant activity on Helicobacter pylori related diseases.

    Science.gov (United States)

    Wang, Yuan-Chuen

    2014-08-14

    More than 50% of the world population is infected with Helicobacter pylori (H. pylori). The bacterium highly links to peptic ulcer diseases and duodenal ulcer, which was classified as a group I carcinogen in 1994 by the WHO. The pathogenesis of H. pylori is contributed by its virulence factors including urease, flagella, vacuolating cytotoxin A (VacA), cytotoxin-associated gene antigen (Cag A), and others. Of those virulence factors, VacA and CagA play the key roles. Infection with H. pylori vacA-positive strains can lead to vacuolation and apoptosis, whereas infection with cagA-positive strains might result in severe gastric inflammation and gastric cancer. Numerous medicinal plants have been reported for their anti-H. pylori activity, and the relevant active compounds including polyphenols, flavonoids, quinones, coumarins, terpenoids, and alkaloids have been studied. The anti-H. pylori action mechanisms, including inhibition of enzymatic (urease, DNA gyrase, dihydrofolate reductase, N-acetyltransferase, and myeloperoxidase) and adhesive activities, high redox potential, and hydrophilic/hydrophobic natures of compounds, have also been discussed in detail. H. pylori-induced gastric inflammation may progress to superficial gastritis, atrophic gastritis, and finally gastric cancer. Many natural products have anti-H. pylori-induced inflammation activity and the relevant mechanisms include suppression of nuclear factor-κB and mitogen-activated protein kinase pathway activation and inhibition of oxidative stress. Anti-H. pylori induced gastric inflammatory effects of plant products, including quercetin, apigenin, carotenoids-rich algae, tea product, garlic extract, apple peel polyphenol, and finger-root extract, have been documented. In conclusion, many medicinal plant products possess anti-H. pylori activity as well as an anti-H. pylori-induced gastric inflammatory effect. Those plant products have showed great potential as pharmaceutical candidates for H. pylori

  4. Ileal Crohn disease: mural microvascularity quantified with contrast-enhanced US correlates with disease activity.

    Science.gov (United States)

    De Franco, Antonio; Di Veronica, Alessandra; Armuzzi, Alessandro; Roberto, Italia; Marzo, Manuela; De Pascalis, Barbara; De Vitis, Italo; Papa, Alfredo; Bock, Enrico; Danza, Francesco M; Bonomo, Lorenzo; Guidi, Luisa

    2012-02-01

    To quantitatively assess microvascular activation in the thickened ileal walls of patients with Crohn disease (CD) by using contrast-enhanced ultrasonography (US) and evaluate its correlation with widely used indexes of CD activity. This prospective study was approved by the ethics committee, and written informed consent was obtained from all patients. The authors examined 54 consecutively enrolled patients (mean age, 35.29 years; age range, 18-69 years; 39 men, 15 women) with endoscopically confirmed CD of the terminal ileum. Ileal wall segments thicker than 3 mm were examined with low-mechanical-index contrast-enhanced US and a second-generation US contrast agent. The authors analyzed software-plotted time-enhancement intensity curves to determine the maximum peak intensity (MPI) and wash-in slope coefficient (β) and evaluated their correlation with (a) the composite index of CD activity (CICDA), (b) the CD activity index (CDAI), and (c) the simplified endoscopic score for CD (SES-CD, evaluated in 37 patients) for the terminal ileum. Statistical analysis was performed with the Mann-Whitney test, Spearman rank test, and receiver operating characteristic (ROC) analysis. MPI and β coefficients were significantly increased in the 36 patients with a CICDA indicative of active disease (P<.0001 for both), the 33 patients with a CDAI of at least 150 (P<.032 and P<.0074, respectively), and the 26 patients with an SES-CD of at least 1 (P<.0001 and P<.002, respectively). ROC analysis revealed accurate identification (compared with CICDA) of active CD with an MPI threshold of 24 video intensity (VI) (sensitivity, 97%; specificity, 83%) and a β coefficient of 4.5 VI/sec (sensitivity, 86%; specificity, 83%). Contrast-enhanced US of the ileal wall is a promising method for objective, reproducible assessment of disease activity in patients with ileal CD. © RSNA, 2011

  5. Validation of the "German Inflammatory Bowel Disease Activity Index (GIBDI)": An Instrument for Patient-Based Disease Activity Assessment in Crohn's Disease and Ulcerative Colitis.

    Science.gov (United States)

    Hüppe, Angelika; Langbrandtner, Jana; Häuser, Winfried; Raspe, Heiner; Bokemeyer, Bernd

    2018-05-09

     Assessment of disease activity in Crohn's disease (CD) and ulcerative colitis (UC) is usually based on the physician's evaluation of clinical symptoms, endoscopic findings, and biomarker analysis. The German Inflammatory Bowel Disease Activity Index for CD (GIBDI CD ) and UC (GIBDI UC ) uses data from patient-reported questionnaires. It is unclear to what extent the GIBDI agrees with the physicians' documented activity indices.  Data from 2 studies were reanalyzed. In both, gastroenterologists had documented disease activity in UC with the partial Mayo Score (pMS) and in CD with the Harvey Bradshaw Index (HBI). Patient-completed GIBDI questionnaires had also been assessed. The analysis sample consisted of 151 UC and 150 CD patients. Kappa coefficients were determined as agreement measurements.  Rank correlations were 0.56 (pMS, GIBDI UC ) and 0.57 (HBI, GIBDI CD ), with p < 0.001. The absolute agreement for 2 categories of disease activity (remission yes/no) was 74.2 % (UC) and 76.6 % (CD), and for 4 categories (none/mild/moderate/severe) 60.3 % (UC) and 61.9 % (CD). The kappa values ranged between 0.47 for UC (2 categories) and 0.58 for CD (4 categories).  There is satisfactory agreement of GIBDI with the physician-documented disease activity indices. GIBDI can be used in health care research without access to assessments of medical practitioners. In clinical practice, the index offers a supplementary source of information. © Georg Thieme Verlag KG Stuttgart · New York.

  6. A rare case report of simultaneous presentation of myopathy, Addison's disease, primary hypoparathyroidism, and Fanconi syndrome in a child diagnosed with Kearns-Sayre syndrome.

    Science.gov (United States)

    Tzoufi, Meropi; Makis, Alexandros; Chaliasos, Nikolaos; Nakou, Iliada; Siomou, Ekaterini; Tsatsoulis, Agathoklis; Zikou, Anastasia; Argyropoulou, Maria; Bonnefont, Jean Paul; Siamopoulou, Antigone

    2013-04-01

    Kearns-Sayre syndrome (KSS) is a rare mitochondrial DNA deletion syndrome defined as the presence of ophthalmoplegia, pigmentary retinopathy, onset less than age 20 years, and one of the following: cardiac conduction defects, cerebellar syndrome, or cerebrospinal fluid protein above 100 mg/dl. KSS may affect many organ systems causing endocrinopathies, encephalomyopathy, sensorineural hearing loss, and renal tubulopathy. Clinical presentation at diagnosis is quite heterogeneous and, usually, few organs are affected with progression to generalized disease early in adulthood. We present the case of a boy with KSS presenting at the age of 5 years with myopathy, Addison's disease, primary hypoparathyroidism, and Fanconi syndrome. The proper replacement treatment along with the administration of mitochondrial metabolism-improving agents had a brief ameliorating effect, but gradual severe multisystemic deterioration was inevitable over the next 5 years. This report highlights the fact that in case of simultaneous presentation of polyendocrinopathies and renal disease early in childhood, KSS should be considered.

  7. Large-scale identification of clinical and genetic predictors of motor progression in patients with newly diagnosed Parkinson's disease: a longitudinal cohort study and validation.

    Science.gov (United States)

    Latourelle, Jeanne C; Beste, Michael T; Hadzi, Tiffany C; Miller, Robert E; Oppenheim, Jacob N; Valko, Matthew P; Wuest, Diane M; Church, Bruce W; Khalil, Iya G; Hayete, Boris; Venuto, Charles S

    2017-11-01

    Better understanding and prediction of progression of Parkinson's disease could improve disease management and clinical trial design. We aimed to use longitudinal clinical, molecular, and genetic data to develop predictive models, compare potential biomarkers, and identify novel predictors for motor progression in Parkinson's disease. We also sought to assess the use of these models in the design of treatment trials in Parkinson's disease. A Bayesian multivariate predictive inference platform was applied to data from the Parkinson's Progression Markers Initiative (PPMI) study (NCT01141023). We used genetic data and baseline molecular and clinical variables from patients with Parkinson's disease and healthy controls to construct an ensemble of models to predict the annual rate of change in combined scores from the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) parts II and III. We tested our overall explanatory power, as assessed by the coefficient of determination (R 2 ), and replicated novel findings in an independent clinical cohort from the Longitudinal and Biomarker Study in Parkinson's disease (LABS-PD; NCT00605163). The potential utility of these models for clinical trial design was quantified by comparing simulated randomised placebo-controlled trials within the out-of-sample LABS-PD cohort. 117 healthy controls and 312 patients with Parkinson's disease from the PPMI study were available for analysis, and 317 patients with Parkinson's disease from LABS-PD were available for validation. Our model ensemble showed strong performance within the PPMI cohort (five-fold cross-validated R 2 41%, 95% CI 35-47) and significant-albeit reduced-performance in the LABS-PD cohort (R 2 9%, 95% CI 4-16). Individual predictive features identified from PPMI data were confirmed in the LABS-PD cohort. These included significant replication of higher baseline MDS-UPDRS motor score, male sex, and increased age, as well as a novel Parkinson's disease

  8. Routine use of standard breast MRI compared to axillary ultrasound for differentiating between no, limited and advanced axillary nodal disease in newly diagnosed breast cancer patients

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    Nijnatten, T.J.A. van, E-mail: Thiemovn@gmail.com [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); GROW – School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht (Netherlands); Ploumen, E.H. [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); Schippe