Early and Periodic Screening, Diagnosis and Treatment

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U.S. Department of Health & Human Services — The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who...

Stages of syphilis in South China - a multilevel analysis of early diagnosis.

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Wong, Ngai Sze; Huang, Shujie; Zheng, Heping; Chen, Lei; Zhao, Peizhen; Tucker, Joseph D; Yang, Li Gang; Goh, Beng Tin; Yang, Bin

2017-01-31

Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015) accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21), adjusted for age at diagnosis and gender. Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

Ultrasonography in Early Diagnosis of Heterotopic Ossification

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Shan-Hui Lin

2014-12-01

Full Text Available We report here the case of a 32-year-old man with a history of traumatic brain injury who presented with swelling of his right thigh. Soft tissue ultrasonography performed 3 days after the onset of symptoms showed a heterogeneous hyperechoic lesion with the formation of cysts and hypervascularity in the right iliopsoas abutting the surface of the femoral bone. This became a diffuse echogenic plaque with a posterior acoustic shadowing 12 days later. A diagnosis of heterotopic ossification was made on the basis of the presence of typical ultrasonographic findings and was confirmed by pathology. We emphasize that an early diagnosis of heterotopic ossification can be made with ultrasonography and can lead to early treatment.

Early diagnosis and successful treatment of disseminated toxoplasmosis after cord blood transplantation.

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Kurihara, Taro; Sumi, Masahiko; Kaiume, Hiroko; Takeda, Wataru; Kirihara, Takehiko; Sato, Keijiro; Ueki, Toshimitsu; Hiroshima, Yuki; Ueno, Mayumi; Ichikawa, Naoaki; Kaneko, Yumi; Hikosaka, Kenji; Norose, Kazumi; Kobayashi, Hikaru

2016-06-01

A 66-year-old woman with refractory angioimmunoblastic T-cell lymphoma underwent cord blood transplantation. Prior to transplantation, a serological test for Toxoplasma gondii-specific IgG antibodies was positive. On day 96, she exhibited fever and dry cough. Chest CT showed diffuse centrilobular ground glass opacities in both lungs. The reactivation of T. gondii was identified by the presence of parasite DNA in peripheral blood and bronchoalveolar lavage fluid. Moreover, brain MRI revealed a space occupying lesion in the right occipital lobe. Therefore, disseminated toxoplasmosis was diagnosed. She received pyrimethamine and sulfadiazine from day 99. The lung and brain lesions both showed improvement but the PCR assay for T. gondii DNA in peripheral blood was positive on day 133. On day 146, she developed blurred vision and reduced visual acuity, and a tentative diagnosis of toxoplasmic retinochoroiditis was made based on ophthalmic examination results. As agranulocytosis developed on day 158, we decided to discontinue pyrimethamine and sulfadiazine and the treatment was thus switched to atovaquone. Moreover, we added spiramycin to atovaquone therapy from day 174, and her ocular condition gradually improved. In general, the prognosis of disseminated toxoplasmosis after hematopoietic stem cell transplantation (HSCT) is extremely poor. However, early diagnosis and treatment may contribute to improvement of the fundamentally dismal prognosis of disseminated toxoplasmosis after HSCT.

Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods

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Ahmed R

2014-03-01

Full Text Available Rafay Ahmed,1 Matthew J Oborski,2 Misun Hwang,1 Frank S Lieberman,3 James M Mountz11Department of Radiology, 2Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; 3Department of Neurology and Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USAAbstract: Malignant gliomas consist of glioblastomas, anaplastic astrocytomas, anaplastic oligodendrogliomas and anaplastic oligoastrocytomas, and some less common tumors such as anaplastic ependymomas and anaplastic gangliogliomas. Malignant gliomas have high morbidity and mortality. Even with optimal treatment, median survival is only 12–15 months for glioblastomas and 2–5 years for anaplastic gliomas. However, recent advances in imaging and quantitative analysis of image data have led to earlier diagnosis of tumors and tumor response to therapy, providing oncologists with a greater time window for therapy management. In addition, improved understanding of tumor biology, genetics, and resistance mechanisms has enhanced surgical techniques, chemotherapy methods, and radiotherapy administration. After proper diagnosis and institution of appropriate therapy, there is now a vital need for quantitative methods that can sensitively detect malignant glioma response to therapy at early follow-up times, when changes in management of nonresponders can have its greatest effect. Currently, response is largely evaluated by measuring magnetic resonance contrast and size change, but this approach does not take into account the key biologic steps that precede tumor size reduction. Molecular imaging is ideally suited to measuring early response by quantifying cellular metabolism, proliferation, and apoptosis, activities altered early in treatment. We expect that successful integration of quantitative imaging biomarker assessment into the early phase of clinical trials could provide a novel approach for testing new therapies

Stages of syphilis in South China – a multilevel analysis of early diagnosis

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Ngai Sze Wong

2017-01-01

Full Text Available Abstract Background Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. Methods In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015 accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21, adjusted for age at diagnosis and gender. Results Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. Conclusions To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

Multifunctional nanoparticle developments in cancer diagnosis and treatment

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Sepideh Parvanian

2017-04-01

Full Text Available Nanotechnology, although still in the early stages, has the potential to revolutionize the early diagnosis, treatment, and monitoring of disease progression. Technological application of nanometer molecules in medicine with the aim of fighting and curing ailments is the globally definition of nanomedicine. The success of nanotechnology in the healthcare part is driven by the possibility to work at the same scale of several biological processes, cellular mechanisms, and organic molecules. With the growing understanding of methods to functionalize nanoparticles and the continued efforts of creative scientists to advance this technology, it is likely that functionalized nanoparticles will become an important tool in the above mentioned areas. This paper describes the role of multifunctional nanoparticle in diagnosis and treatment of cancer. Therefore, the aim of this review is to provide basic information on nanoparticles, describe previously developed methods to functionalize nanoparticles and discuss their potential applications in biomedical sciences and finally mention the therapeutic nanoparticle commercialization challenges. Keywords: Multifunctional nanoparticle, Cancer, Diagnosis, Treatment, Therapy

Effect of Early Diagnosis and Treatment on the Prognosis of Children with Epilepsy Accompanied by Continuous Spikes and Waves during Slow Wave Sleep

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Jiahua Ju

2014-03-01

Full Text Available Objective: To emphasize the importance of early diagnosis and treatment on the prognosis of children with epilepsy accompanied by continuous spikes and waves during slow wave sleep (CSCW. Methods: The clinical characteristics, electroencephalogram (ECG features, treatment and prognosis of 12 children with CSCW in our hospital were retrospectively analyzed, and the followup of 6 months to 4 years was given. Results: Imaging showed that 8 children suffered from brain lesions, while other 4 were normal. The initial onset of 10 children was at night, whereas 2 began with absence seizure in lucid interval, and they gradually appeared comprehensive brain function decline, meanwhile, ECG was characterized by continuous discharge during slow wave sleep. After 3 months of treatment with valproic acid, clonazepam, lamotrigine and hormones, the clinical symptoms and ECG of 10 children improved significantly, in which 3 ones recurred after 6 months of comprehensive treatment. Conclusion: The early manifestation of CSWS is untypical, and hence, early diagnosis and treatment can ameliorate the epileptic seizures of children, effectively inhibit epileptic electrical activity and has favorable prognosis.

Early Pregnancy Diagnosis in Bovines: Current Status and Future Directions

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Ashok K. Balhara

2013-01-01

Full Text Available An early and accurate diagnosis of reproductive dysfunctions or aberrations is crucial to better reproductive management in livestock. High reproductive efficiency is a prerequisite for high life-time production in dairy animals. Early pregnancy diagnosis is key to shorten the calving interval through early identification of open animals and their timely treatment and rebreeding so as to maintain a postpartum barren interval close to 60 days. A buffalo, the most important dairy animal in the Indian subcontinent, is known for problems related to high calving interval, late puberty, and high incidence of anestrus. Lack of reliable cow-side early pregnancy diagnosis methods further aggravates the situation. Several methods of pregnancy diagnosis are being practiced in bovine species, yet none qualifies as the ideal pregnancy diagnosis method due to the inherent limitations of sensitivity, accuracy, specificity, speed, and ease of performing the test. The advancement of molecular techniques like proteomics and their applications in animal research has given a new hope to look for pregnancy biomarker molecules in these animals. This review attempts to examine common pregnancy diagnosis methods available for dairy animals, while assessing the usefulness of the modern technologies in detecting novel pregnancy markers and designing future strategies for research in this area.

EARLY DIAGNOSIS AS DETERMINATING FACTOR FOR PROFESSIONAL, RATIONAL AND EFFECTIVE TREATMENT OF CHILDREN WITH DEVELOPMENTAL DIFFICULTIES

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Goran AJDINSKI; S. BOSNJAKOVSKA; L..UGRINOVSKA; M. DUKOVSKI; M. CAKAR; L. BOGOEVSKA

1997-01-01

Early diagnosis of children with developmental difficulties is one of the most important segments in the process of rehabilitation. It is not only an assessment and evaluation of the functional conditions, but also and detection of the possibilities for treatment and it’s improvement.In our presentation we give the first noticing for diagnostics of children with developmental difficulties in the Republic of Macedonia, the present capacities, possibilities, needs and suggestions for it’s impr...

Early diagnosis and empiric therapy for cirrhosis associated with infection

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NAN Yuemin

2015-03-01

Full Text Available Infection is a frequent complication of cirrhosis, which often occurs in the lungs, chest, abdomen, biliary tract, urinary tract, soft tissue, and skin, and occasionally causes spontaneous bacteremia in patients. This paper reviews the risk factors and common types of infection in cirrhosis associated with infection, and the early diagnosis and symptomatic treatment of different types of infection. Moreover, this paper points out that cirrhosis associated with infection is a key factor for disease progression and the early diagnosis and treatment are essential for successful treatment. The third-generation cephalosporins are the first-line antibiotic agents. Drug-resistant bacteria should be treated with antibiotic compound containing β-lactamase inhibitors or carbapenems. Methicillin-resistant Staphylococcus aureus should be treated with glycopeptide antibiotics or combination therapies. Pulmonary mycoses are mainly treated with caspofungin or voriconazole. Antibiotics combined with supportive therapies including the administration of albumin can improve the treatment outcome and prognosis.

Lyme disease: clinical diagnosis and treatment

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Hatchette, TF; Davis, I; Johnston, BL

2014-01-01

Background Lyme disease is an emerging zoonotic infection in Canada. As the Ixodes tick expands its range, more Canadians will be exposed to Borrelia burgdorferi, the bacterium that causes Lyme disease. Objective To review the clinical diagnosis and treatment of Lyme disease for front-line clinicians. Methods A literature search using PubMed and restricted to articles published in English between 1977 and 2014. Results Individuals in Lyme-endemic areas are at greatest risk, but not all tick bites transmit Lyme disease. The diagnosis is predominantly clinical. Patients with Lyme disease may present with early disease that is characterized by a “bull’s eye rash”, fever and myalgias or with early disseminated disease that can manifest with arthralgias, cardiac conduction abnormalities or neurologic symptoms. Late Lyme disease in North America typically manifests with oligoarticular arthritis but can present with a subacute encephalopathy. Antibiotic treatment is effective against Lyme disease and works best when given early in the infection. Prophylaxis with doxycyline may be indicated in certain circumstances. While a minority of patients may have persistent symptoms, evidence does not demonstrate that prolonged courses of antibiotics improve outcome. Conclusion Clinicians need to be aware of the signs and symptoms of Lyme disease. Knowing the regions where Borrelia infection is endemic in North America is important for recognizing patients at risk and informing the need for treatment. PMID:29769842

Endoscopic Management of Early Adenocarcinoma and Squamous Cell Carcinoma of the Esophagus: Screening, Diagnosis, and Therapy.

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di Pietro, Massimiliano; Canto, Marcia I; Fitzgerald, Rebecca C

2018-01-01

Because the esophagus is easily accessible with endoscopy, early diagnosis and curative treatment of esophageal cancer is possible. However, diagnosis is often delayed because symptoms are not specific during early stages of tumor development. The onset of dysphagia is associated with advanced disease, which has a survival at 5 years lower than 15%. Population screening by endoscopy is not cost-effective, but a number of alternative imaging and cell analysis technologies are under investigation. The ideal screening test should be inexpensive, well tolerated, and applicable to primary care. Over the past 10 years, significant progress has been made in endoscopic diagnosis and treatment of dysplasia (squamous and Barrett's), and early esophageal cancer using resection and ablation technologies supported by evidence from randomized controlled trials. We review the state-of-the-art technologies for early diagnosis and minimally invasive treatment, which together could reduce the burden of disease. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

[Symptoms diagnosis and treatment of dyscalulia].

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Ise, Elena; Schulte-Körne, Gerd

2013-07-01

Children with dyscalculia show deficits in basic numerical processing which cause difficulties in the acquisition of mathematical skills. This article provides an overview of current research findings regarding the symptoms, cause, and prognosis of dyscalculia, and it summarizes recent developments in the diagnosis, early intervention, and treatment thereof. Diagnosis has improved recently because newly developed tests focus not only on the math curriculum, but also on basic skills found to be impaired in dyscalculia. A controversial debate continues with regard to IQ achievement discrepancy. International studies have demonstrated the effectiveness of specialized interventions. This article summarizes the research findings from intervention studies, describes different treatment approaches, and discusses implications for clinical practice.

A possible new diagnostic biomarker in early diagnosis of Alzheimer's disease

DEFF Research Database (Denmark)

Kork, Felix; Holthues, Jan; Hellweg, Rainer

2009-01-01

Early diagnosis in patients with Alzheimer's disease (AD) is of great importance since only a sufficient treatment in early stages of this disease helps to keep patients in an autonomous state for as long as possible. Until now, there is no single diagnostic biomarker for AD derived from material...

Contributions to early HIV diagnosis among patients linked to care vary by testing venue

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Trott Alexander T

2008-06-01

Full Text Available Abstract Objective Early HIV diagnosis reduces transmission and improves health outcomes; screening in non-traditional settings is increasingly advocated. We compared test venues by the number of new diagnoses successfully linked to the regional HIV treatment center and disease stage at diagnosis. Methods We conducted a retrospective cohort study using structured chart review of newly diagnosed HIV patients successfully referred to the region's only HIV treatment center from 1998 to 2003. Demographics, testing indication, risk profile, and initial CD4 count were recorded. Results There were 277 newly diagnosed patients meeting study criteria. Mean age was 33 years, 77% were male, and 46% were African-American. Median CD4 at diagnosis was 324. Diagnoses were earlier via partner testing at the HIV treatment center (N = 8, median CD4 648, p = 0.008 and with universal screening by the blood bank, military, and insurance companies (N = 13, median CD4 483, p = 0.05 than at other venues. Targeted testing by health care and public health entities based on patient request, risk profile, or patient condition lead to later diagnosis. Conclusion Test venues varied by the number of new diagnoses made and the stage of illness at diagnosis. To improve the rate of early diagnosis, scarce resources should be allocated to maximize the number of new diagnoses at screening venues where diagnoses are more likely to be early or alter testing strategies at test venues where diagnoses are traditionally made late. Efforts to improve early diagnosis should be coordinated longitudinally on a regional basis according to this conceptual paradigm.

Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service.

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Devescovi, Raffaella; Monasta, Lorenzo; Mancini, Alice; Bin, Maura; Vellante, Valerio; Carrozzi, Marco; Colombi, Costanza

2016-01-01

Early diagnosis combined with an early intervention program, such as the Early Start Denver Model (ESDM), can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, in a small group of toddlers, delivered at low intensity by the Italian Public Health System. Twenty-one toddlers at risk for autism spectrum disorders, aged 20-36 months, received 3 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents' and teachers' active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months) and post-intervention (Time 1 [T1]; mean age =42 months). Children made statistically significant improvements in the language and cognitive domains, as demonstrated by a series of nonparametric Wilcoxon tests for paired data. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment. Our results are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children. Particularly in toddlers, it seems that an intervention model based on the ESDM principles, involving the active engagement of parents and nursery school teachers, may be effective even when the individual treatment is delivered at low intensity. Furthermore, our study supports the adaptation and the positive impact of the ESDM entirely sustained by the Italian Public Health System.

Clinical, genetic, and neuroimaging features of Early Onset Alzheimer Disease: the challenges of diagnosis and treatment.

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Alberici, Antonella; Benussi, Alberto; Premi, Enrico; Borroni, Barbara; Padovani, Alessandro

2014-01-01

Early Onset Alzheimer Disease (EOAD) is a rare condition, frequently associated with genetic causes. The dissemination of genetic testing along with biomarker determinations have prompted a wider recognition of EOAD in experienced clinical settings. However, despite the great efforts in establishing the contribution of causative genes to EOAD, atypical disease presentation and clinical features still makes its diagnosis and treatment a challenge for the clinicians. This review aims to provide an extensive evaluation of literature data on EOAD, in order to improve understanding and knowledge of EOAD, underscore its significant impact on patients and their caregivers and influence public policies. This would be crucial to define the urgency of evidence-based treatment approaches.

Gene expression profiles reveal key genes for early diagnosis and treatment of adamantinomatous craniopharyngioma.

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Yang, Jun; Hou, Ziming; Wang, Changjiang; Wang, Hao; Zhang, Hongbing

2018-04-23

Adamantinomatous craniopharyngioma (ACP) is an aggressive brain tumor that occurs predominantly in the pediatric population. Conventional diagnosis method and standard therapy cannot treat ACPs effectively. In this paper, we aimed to identify key genes for ACP early diagnosis and treatment. Datasets GSE94349 and GSE68015 were obtained from Gene Expression Omnibus database. Consensus clustering was applied to discover the gene clusters in the expression data of GSE94349 and functional enrichment analysis was performed on gene set in each cluster. The protein-protein interaction (PPI) network was built by the Search Tool for the Retrieval of Interacting Genes, and hubs were selected. Support vector machine (SVM) model was built based on the signature genes identified from enrichment analysis and PPI network. Dataset GSE94349 was used for training and testing, and GSE68015 was used for validation. Besides, RT-qPCR analysis was performed to analyze the expression of signature genes in ACP samples compared with normal controls. Seven gene clusters were discovered in the differentially expressed genes identified from GSE94349 dataset. Enrichment analysis of each cluster identified 25 pathways that highly associated with ACP. PPI network was built and 46 hubs were determined. Twenty-five pathway-related genes that overlapped with the hubs in PPI network were used as signatures to establish the SVM diagnosis model for ACP. The prediction accuracy of SVM model for training, testing, and validation data were 94, 85, and 74%, respectively. The expression of CDH1, CCL2, ITGA2, COL8A1, COL6A2, and COL6A3 were significantly upregulated in ACP tumor samples, while CAMK2A, RIMS1, NEFL, SYT1, and STX1A were significantly downregulated, which were consistent with the differentially expressed gene analysis. SVM model is a promising classification tool for screening and early diagnosis of ACP. The ACP-related pathways and signature genes will advance our knowledge of ACP pathogenesis

To Know or Not to Know: Ethical Issues Related to Early Diagnosis of Alzheimer's Disease

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Niklas Mattsson

2010-01-01

Full Text Available In Alzheimer's disease (AD, pathological processes start in the brain long before clinical dementia. Biomarkers reflecting brain alterations may therefore indicate disease at an early stage, enabling early diagnosis. This raises several ethical questions and the potential benefits of early diagnosis must be weighted against possible disadvantages. Currently, there are few strong arguments favouring early diagnosis, due to the lack of disease modifying therapy. Also, available diagnostic methods risk erroneous classifications, with potentially grave consequences. However, a possible benefit of early diagnosis even without disease modifying therapy is that it may enable early decision making when patients still have full decision competence, avoiding problems of hypothetical consents. It may also help identifying patients with cognitive dysfunction secondary to other diseases that may be responsive to treatment already today.

[Early diagnosis of autism: Phenotype-endophenotype].

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Kotsopoulos, S

2015-01-01

Autism Spectrum Disorders have for some time been the focus of intense interest for clinicians and researchers because of the high prevalence of the disorders among children in the community (approximately 1%), their severity and pervasiveness. Particular attention has been paid to the early diagnosis of the disorder and to the intensive therapeutic intervention. Currently the best prognosis for autism lays in the early diagnosis and intervention. Postponing the diagnosis and the intervention beyond infancy is considered loss of precious time. The diagnosis of autism, which begins early in life, was until recently considered that could be reliability made at the age of 3 years. Recent follow up studies however on children at risk for autism (children who had an older sibling with autism) have shown that the clinical signs of autism emerge at the end of the first year and become distinct by the end of the second year when the diagnosis can reliably be made. From a clinical perspective it is noted that the early clinical signs of risk for autism are related to social communication (e.g. limited or absent response when calling his/her name and to joint attention), stereotype behaviours and body movements or unusual handling of objects (e.g. intensive observation of objects and stereotype movements of hands and tapping or spinning), incongruent regulation of emotions (reduced positive and increased negative emotion). There is also delay in developmental characteristics such as the language (both receptive and expressive) and motor (particularly in postural control - characteristic is the drop of the head backwards when the infant is held in horizontal position). Studies on various aspects of the endophenotype of certain clinical signs among infants at risk for Autism Spectrum Disorders, such as avoidance of eye contact, delay in verbal communication and increase of the head circumference, may provide useful information and may assist the clinician on follow up in the

Multiple sclerosis presented as clinically isolated syndrome: the need for early diagnosis and treatment

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Sigliti-Henrietta Pelidou

2008-06-01

Full Text Available Sigliti-Henrietta Pelidou, Sotirios Giannopoulos, Sotiria Tzavidi, Georgios Lagos, Athanassios P KyritsisDepartment of Neurology, University of Ioannina School of Medicine, GreeceObjective: To aid in the timely diagnosis of patients who present with clinically isolated syndrome (CIS.Patients and methods: We studied 25 patients (18 women, 7 men, originally presented in our clinic with a CIS suggestive of multiple sclerosis (MS. All patients underwent the full investigation procedure including routine tests, serology, cerebrospinal fluid (CSF examinations, evoked potentials (EPs, and magnetic resonance imaging (MRI of brain and cervical spinal cord. Patients were imaged at baseline, and every three months thereafter up to a year.Results: The CIS was consisted of optic neuritis in 12 cases, incomplete transverse myelitis (ITM in 7 cases, Lhermitte sign in 2 cases, internuclear ophthalmoplegia (INO in 2 cases, mild brainstem syndrome in 1 case, and tonic-clonic seizures in 1 case. Using the baseline and three-month scans 18/25 (72% patients developed definite MS in one year of follow up while 7 (28% had no further findings during this observation period. Immunomodulatory treatments were applied to all definite MS patients.Conclusion: In light of new treatments available, MRIs at 3 month intervals are helpful to obtain the definite diagnosis of MS as early as possible.Keywords: multiple sclerosis, clinically isolated syndrome, optic neuritis, transverse myelitis

Oral squamocellular carcinoma with early diagnosis

International Nuclear Information System (INIS)

Napier de SouzaI, Leandro; Albuquerque de Brito, Antonio

2010-01-01

The squamocellular carcinoma is a malignant neoplasm commonest in the buccal cavity. The more frequently involved anatomical sites are the lower lip, the tongue's lateral edges and the mouth floor. Its etiology is multifactor although it is closely related to smoking and alcoholism. Clinical picture is generally characterized by the presence of different types of white, erythematous, between erythematous and white plaques, ulcers with raised edges and exophytic masses. Treatment includes surgical removal, radiotherapy, chemotherapy or both. In present paper the case of a man aged 70 presenting with buccal squamous carcinoma describing the clinical, and the histopathologic findings and its corresponding treatment. The early and appropriate diagnosis allowed the cure of this case. (author)

Problems of diagnosis and treatment of echinococcosis

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Тунзала Али кызы Велиева

2015-05-01

Full Text Available The lack of specificity of clinical and laboratory manifestations of echinococcosis allocates to the fore diagnostic tool methods of research, which are at present leading in identifying the disease.The widespread introduction into clinical practice of modern highly informative instrumental methods such as ultrasonography (US and computed tomography (CT, significantly improved the early detection of liver echinococcosis. In conjunction with the serological reactions to echinococcosis they allow in most cases the diagnosis of the disease. However, false-negative results of serological tests in more than 10–20 % of the patients and the difficulty of differential diagnosis with small brush size and "pseudotumoral" forms of ultrasound often lead to delayed diagnosis, and thus to a deterioration of treatment results. Moreover, failure to identify at an early stage of echinococcosis virtually eliminates the possibility of conservative treatment of echinococcosis without performing surgery.It is given the profound immune disorders in patients with echinococcosis, treatment should be complex and along with the surgical removal of hydatid cyst should be included in it and biostimulating. Immunocorrecting lechebnye event. Recent require further development.Methods. The work is based on an analysis of 25 cases operated on echinococcosis in the period from January 2013 to December 2014. To confirm the diagnosis using tools (ultrasound, computed tomography, X-ray, serology (detection of antibodies to echinococcus ELISA, histological (after removal of cysts methods. The data are processed by the method of variation statistics.Results. An analysis of 25 cases of echinococcosis showed that among the 15 cases dominated by women (60 % versus 10 (40 % men. Treatment – removal of cysts of 25 patients with echinococcosis is made surgically. Among the analyzed cases in 6 (20.4 % patients had the relapsing form of the disease. The factors leading to relapse of the

Disclosure of Diagnosis in Early Recognition of Psychosis.

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Blessing, Andreas; Studer, Anna; Gross, Amelie; Gruss, L Forest; Schneider, Roland; Dammann, Gerhard

2017-10-01

There is a debate concerning risks and benefits of early intervention in psychosis, especially concerning diagnosis disclosure. The present study reports preliminary findings on self-reported locus of control and psychological distress after the disclosure of diagnosis in an early recognition center. We compared the ratings of the locus of control and psychological distress before and after communication of diagnosis. The study included individuals with an at-risk mental state (ARMS) (n = 10), schizophrenia (n = 9), and other psychiatric disorders (n = 11). Results indicate greater endorsement of the internal locus of control in individuals with ARMS after communication of diagnosis in contrast to the other groups. Our results suggest that disclosure of diagnosis in an early recognition center leads to a reduction of psychological distress and increased feelings of control over one's health. Persons with ARMS seem to particularly benefit from disclosure of diagnosis as part of early intervention.

Early diagnosis of autism and impact on prognosis: a narrative review

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Fernell E

2013-02-01

Full Text Available Elisabeth Fernell,1 Mats Anders Eriksson,1,2 Christopher Gillberg11Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2Department of Women's and Children's Health, Karolinska Institute, Stockholm, SwedenAbstract: Autism spectrum disorders involve a set of clinical phenotypes that mirror an early onset of neurodevelopmental deviations, with core symptoms that can probably be related to a deficiency in the social instinct. Underlying the cognitive impairments there are physiological brain problems, caused by a large number of medical factors. This narrative review of systematic reviews and meta-analyses from the last 5 years (2008–2012 presents aspects from many areas in autism spectrum disorder research, with a particular focus on early intervention and the subsequent impact on prognosis. Other major areas discussed are epidemiology, early symptoms and screening, early diagnosis, neuropsychology, medical factors, and the existence of comorbidities. There is limited evidence that any of the broadband “early intervention” programs are effective in changing the natural long-term outcome for many individuals with an early diagnosis of autism. However, there is some evidence that Early Intensive Behavioral Intervention (EIBI is an effective treatment for some children with ASD. Nevertheless, there is emerging consensus that early diagnosis and information are needed in order that an autism-friendly environment be “created” around affected individuals.Keywords: autism spectrum disorder, epidemiology, screening, etiology, intervention, outcome

Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service

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Devescovi R

2016-06-01

Full Text Available Raffaella Devescovi,1 Lorenzo Monasta,2 Alice Mancini,3 Maura Bin,1 Valerio Vellante,1 Marco Carrozzi,1 Costanza Colombi4 1Division of Child Neurology and Psychiatry, 2Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health – IRCCS “Burlo Garofolo”, Trieste, 3Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 4Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA Background: Early diagnosis combined with an early intervention program, such as the Early Start Denver Model (ESDM, can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, in a small group of toddlers, delivered at low intensity by the Italian Public Health System.Methods: Twenty-one toddlers at risk for autism spectrum disorders, aged 20–36 months, received 3 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents’ and teachers’ active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months and post-intervention (Time 1 [T1]; mean age =42 months.Results: Children made statistically significant improvements in the language and cognitive domains, as demonstrated by a series of nonparametric Wilcoxon tests for paired data. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment.Conclusion: Our results are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children

[Infective endocarditis : Update on prophylaxis, diagnosis, and treatment].

Science.gov (United States)

Dietz, S; Lemm, H; Janusch, M; Buerke, M

2016-05-01

The diagnosis of infective endocarditis is often delayed in clinical practice. Timely diagnosis and rapid antibiotic treatment is important. Higher age of patients, new risk factors, and increasing use of intravascular prosthetic materials resulted in changes in microbial spectrum. Nowadays, nonspecific symptoms, critically ill patients, and immunocompromised patients require a high level of diagnostic expertise.The new guidelines from the European Society of Cardiology provide various diagnostic algorithms and recommendations for antibiotic treatment. The new guidelines also recommend the formation of an endocarditis team with various medical disciplines, including a cardiac surgeon, to improve treatment because in half of all endocarditis patients, antibiotic therapy alone does not result in successful management of the infection. If complications occur, early surgical treatment should be performed.In this overview, diagnostic strategies and therapeutic approaches for the treatment of infectious endocarditis according to the current guidelines and aspects of surgical treatment are provided.

Use of radionuclide imaging in the early diagnosis and treatment of renal allograft rejection

International Nuclear Information System (INIS)

Mandel, S.R.; Mattern, W.D.; Staab, E.; Johnson, G. Jr.

1975-01-01

Data are presented on the clinical application of radionuclide imaging to evaluate changes in cadaver transplant function in the immediate postoperative period. The method uses orthoiodohippuric acid (hippuran) administered IV, with scintillation imaging, and curve analysis by a digital computer. An initial study is always obtained 24 hours after transplantation. Serial studies are then obtained, as needed, to interpret the clinical course. Selected cases are presented which illustrate the use of this protocol in various clinical settings. In the oliguric patient serial studies have been of particular value. They have identified ATN so that overenthusiastic treatment for rejection could be avoided. They have also identified acute rejection complicating ATN so that high dose steroid therapy could be administered appropriately. In the nonoliguric patient they have frequently contributed to the early diagnosis of acute rejection, and they have been useful in monitoring the effect and duration of treatment for severe rejection crisis. It is concluded that radionuclide imaging studies, when carefully applied and interpreted, are a valuable adjunct to the management of patients in this complex clinical setting

Early diagnosis of leptospirosis

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Andrea Babic-Erceg

2014-06-01

Full Text Available A 25-years old man from Zagreb, Croatia, was admitted to the University Hospital for Infectious Diseases four days after the onset of symptoms such as fever, intense pain in the calves and anuria. The patient owned a rabbit and, before the onset of the disease, repaired some rubber pipes damaged by rodents. At admission, he had a severe clinical picture with fever, hypotension, jaundice, immobility, and pain in leg muscles. Treatment with ceftriaxone was initiated in combination with volume restitution. Renal failure soon ensued. Consequently continuous venovenous hemodiaphiltration therapy was performed. Due to acute respiratory distress syndrome, the patient was mechanically ventilated. The patient’s condition gradually improved and he recovered fully from multi-organ failure. Diagnosis was confirmed by a microscopic agglutination test (MAT covering 15 leptospira serovars and real-time polymerase-chain reaction (PCR. The first serum sample taken on day 6 tested negative for leptospira, while PCR showed positive results for leptospiral DNA. The second serum sample taken on day 13 tested positive for serovar Canicola serogroup Canicola, serovar Patoc, serovar Grippotyphosa serogroup Grippotyphosa and serovar Tarassovi serogroup Tarassovi (titre 4000, 4000, 1000 and 2000, respectively, while PCR was negative. This report highlights the benefits of combining MAT and PCR methods in early diagnosis of leptospirosis.

Early Radiosurgery Improves Hearing Preservation in Vestibular Schwannoma Patients With Normal Hearing at the Time of Diagnosis

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Akpinar, Berkcan [University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (United States); Mousavi, Seyed H., E-mail: mousavish@upmc.edu [Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); McDowell, Michael M.; Niranjan, Ajay; Faraji, Amir H. [Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Flickinger, John C. [Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Lunsford, L. Dade [Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)

2016-06-01

Purpose: Vestibular schwannomas (VS) are increasingly diagnosed in patients with normal hearing because of advances in magnetic resonance imaging. We sought to evaluate whether stereotactic radiosurgery (SRS) performed earlier after diagnosis improved long-term hearing preservation in this population. Methods and Materials: We queried our quality assessment registry and found the records of 1134 acoustic neuroma patients who underwent SRS during a 15-year period (1997-2011). We identified 88 patients who had VS but normal hearing with no subjective hearing loss at the time of diagnosis. All patients were Gardner-Robertson (GR) class I at the time of SRS. Fifty-seven patients underwent early (≤2 years from diagnosis) SRS and 31 patients underwent late (>2 years after diagnosis) SRS. At a median follow-up time of 75 months, we evaluated patient outcomes. Results: Tumor control rates (decreased or stable in size) were similar in the early (95%) and late (90%) treatment groups (P=.73). Patients in the early treatment group retained serviceable (GR class I/II) hearing and normal (GR class I) hearing longer than did patients in the late treatment group (serviceable hearing, P=.006; normal hearing, P<.0001, respectively). At 5 years after SRS, an estimated 88% of the early treatment group retained serviceable hearing and 77% retained normal hearing, compared with 55% with serviceable hearing and 33% with normal hearing in the late treatment group. Conclusions: SRS within 2 years after diagnosis of VS in normal hearing patients resulted in improved retention of all hearing measures compared with later SRS.

Early Radiosurgery Improves Hearing Preservation in Vestibular Schwannoma Patients With Normal Hearing at the Time of Diagnosis

International Nuclear Information System (INIS)

Akpinar, Berkcan; Mousavi, Seyed H.; McDowell, Michael M.; Niranjan, Ajay; Faraji, Amir H.; Flickinger, John C.; Lunsford, L. Dade

2016-01-01

Purpose: Vestibular schwannomas (VS) are increasingly diagnosed in patients with normal hearing because of advances in magnetic resonance imaging. We sought to evaluate whether stereotactic radiosurgery (SRS) performed earlier after diagnosis improved long-term hearing preservation in this population. Methods and Materials: We queried our quality assessment registry and found the records of 1134 acoustic neuroma patients who underwent SRS during a 15-year period (1997-2011). We identified 88 patients who had VS but normal hearing with no subjective hearing loss at the time of diagnosis. All patients were Gardner-Robertson (GR) class I at the time of SRS. Fifty-seven patients underwent early (≤2 years from diagnosis) SRS and 31 patients underwent late (>2 years after diagnosis) SRS. At a median follow-up time of 75 months, we evaluated patient outcomes. Results: Tumor control rates (decreased or stable in size) were similar in the early (95%) and late (90%) treatment groups (P=.73). Patients in the early treatment group retained serviceable (GR class I/II) hearing and normal (GR class I) hearing longer than did patients in the late treatment group (serviceable hearing, P=.006; normal hearing, P<.0001, respectively). At 5 years after SRS, an estimated 88% of the early treatment group retained serviceable hearing and 77% retained normal hearing, compared with 55% with serviceable hearing and 33% with normal hearing in the late treatment group. Conclusions: SRS within 2 years after diagnosis of VS in normal hearing patients resulted in improved retention of all hearing measures compared with later SRS.

Early infant diagnosis and post-exposure prophylaxis for HIV- exposed infants.

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Gawde, Nilesh Chandrakant

2016-01-01

Recent scientific evidence suggests that early initiation of antiretroviral therapy (ART) among infants exposed perinatally to HIV has beneficial effects on their health and survival, and may even induce remission. This has led to the roll-out of early infant diagnosis (EID) of HIV and early treatment. Also, there is talk of using ART as post-exposure prophylaxis (PEP) to prevent mother-to-child transmission. EID involves carrying out diagnostic tests before initiating ART. In India, current programme design of centralised diagnosis has been resulting in poor access to diagnosis and treatment. To save the lives of HIV-infected infants, it is important to prevent delay. Another issue to be kept in mind is that the results of HIV tests may turn negative after the initiation of ART. This could be due to viral remission induced by ART or false positive initial results. Differentiating between the two is difficult. To deal with such cases, we need to develop a clinical algorithm and tools for capacity-building in counselling. The use of ART as PEP is expected to encounter further challenges. Between ART as PEP and EID, the later has advantages from an ethical perspective. There is a need to address the ethical issues within the EID programme by strengthening the current mechanisms for protecting the rights of HIV-exposed infants.

[Improving diagnosis and treatment of tunnel upper limb neuropathies in miners with vibration disease].

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Kir'ianov, V A; Zheglova, A V; Aliev, A F; Krylova, I V; Sukhova, A V

2011-01-01

The article presents results of research aimed to diagnosis and treatment of tunnel upper limb neuropathies in mining industry workers subjected to vibration factor. The authors specified diagnostic criteria for early diagnosis of tunnel neuropathies affecting median, ulnar and radial nerves, with the severity evaluation for further adequate treatment.

Early diagnosis and early intervention in cerebral palsy

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Mijna eHadders-Algra

2014-09-01

Full Text Available This paper reviews the opportunities and challenges for early diagnosis and early intervention in cerebral palsy (CP. CP describes a group of disorders of the development of movement and posture, causing activity limitation, that are attributed to disturbances that occurred in the fetal or infant brain. Therefore the paper starts with a summary of relevant information from developmental neuroscience. Most lesions underlying CP occur in the second half of gestation, when developmental activity in the brain reaches its summit. Variations in timing of the damage not only result in different lesions, but also in different neuroplastic reactions and different associated neuropathologies. This turns CP into a heterogeneous entity. This may mean that the best early diagnostics and the best intervention methods may differ for various subgroups of children with CP. Next, the paper addresses possibilities for early diagnosis. It discusses the predictive value of neuromotor and neurological exams, neuro-imaging techniques and neurophysiological assessments. Prediction is best when complementary techniques are used in longitudinal series. Possibilities for early prediction of CP differ for infants admitted to neonatal intensive care and other infants. In the former group best prediction is achieved with the combination of neuro-imaging and the assessment of general movements, in the latter group best prediction is based on carefully documented milestones and neurological assessment. The last part reviews early intervention in infants developing CP. Most knowledge on early intervention is based on studies in high risk infants without CP. In these infants early intervention programs promote cognitive development until preschool age; motor development profits less. The few studies on early intervention in infants developing CP suggest that programs that stimulate all aspects of infant development by means of family coaching are most promising. More research is

Mandibular Symmetrical Bilateral Canine-Lateral Incisors Transposition: Its Early Diagnosis and Treatment Considerations.

Science.gov (United States)

Shapira, Yehoshua; Finkelstein, Tamar; Kadry, Rana; Schonberger, Shirley; Shpack, Nir

2016-01-01

Bilateral mandibular tooth transposition is a relatively rare dental anomaly caused by distal migration of the mandibular lateral incisors and can be detected in the early mixed dentition by radiographic examination. Early diagnosis and interceptive intervention may reduce the risk of possible transposition between the mandibular canine and lateral incisor. This report illustrates the orthodontic management of bilateral mandibular canine-lateral incisor transposition. Correct positioning of the affected teeth was achieved on the left side while teeth on the right side were aligned in their transposed position. It demonstrates the outcome of good alignment of the teeth in the dental arch.

[The diagnosis and treatment of myxedema coma].

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Aoki, Chie; Kasai, Kikuo

2012-11-01

Myxedema coma is defined as severe hypothyroidism leading to decreased mental status, hypothermia, and other symptoms related to dysfunction in multiple organs. It is very rare disease with high mortality rate. Early recognition and therapy of myxedema coma are essential, and treatment should be begun on the basis of clinical suspection. However, regimen of myxedema is not well established even now, especially about thyroid hormone supplementation. Japan Thyroid Association is drawing up "The diagnostic criteria of myxedema coma (3rd draft) and preliminary guide to treatment of it". According to this criteria and preliminary guide, the clinical presentation, diagnosis, and treatment of myxedema coma will be reviewed here.

Diagnosis and treatment of hepatocellular carcinoma: An update

Science.gov (United States)

Tejeda-Maldonado, Javier; García-Juárez, Ignacio; Aguirre-Valadez, Jonathan; González-Aguirre, Adrián; Vilatobá-Chapa, Mario; Armengol-Alonso, Alejandra; Escobar-Penagos, Francisco; Torre, Aldo; Sánchez-Ávila, Juan Francisco; Carrillo-Pérez, Diego Luis

2015-01-01

Hepatocellular carcinoma (HCC) is one of the most common malignancies leading to high mortality rates in the general population; in cirrhotic patients, it is the primary cause of death. The diagnosis is usually delayed in spite of at-risk population screening recommendations, i.e., patients infected with hepatitis B or C virus. Hepatocarcinogenesis hinges on a great number of genetic and molecular abnormalities that lead to tumor angiogenesis and foster their dissemination potential. The diagnosis is mainly based on imaging studies such as computed tomography and magnetic resonance, in which lesions present a characteristic classical pattern of early arterial enhancement followed by contrast medium “washout” in late venous phase. On occasion, when imaging studies are not conclusive, biopsy of the lesion must be performed to establish the diagnosis. The Barcelona Clinic Liver Cancer staging method is the most frequently used worldwide and recommended by the international guidelines of HCC management. Currently available treatments include tumor resection, liver transplant, sorafenib and loco-regional therapies (alcoholization, radiofrequency ablation, chemoembolization). The prognosis of hepatocarcinoma is determined according to the lesion’s stage and in cirrhotic patients, on residual liver function. Curative treatments, such as liver transplant, are sought in patients diagnosed in early stages; patients in more advanced stages, were not greatly benefitted by chemotherapy in terms of survival until the advent of target molecules such as sorafenib. PMID:25848464

Lived experiences of breast cancer survivors after diagnosis, treatment and beyond: qualitative study

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Williams, Faustine; Jeanetta, Stephen C.

2015-01-01

Abstract Background The number of breast cancer survivors has increased since 1990 due to advances in biomedical technology that lead to an increase in early diagnosis and treatment. Research on survivorship has focused on the psychological and treatment aspects of the disease. The goal of this study was focused on exploring the lived experiences of breast cancer survivors from diagnosis, treatment and beyond. Objective To understand the lived experiences of women who are breast cancer surviv...

Tattoo-Associated Skin Reaction: The Importance of an Early Diagnosis and Proper Treatment

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Bassi, Andrea; Campolmi, Piero; Cannarozzo, Giovanni; Conti, Rossana; Bruscino, Nicola; Gola, Massimo; Ermini, Stefano; Massi, Daniela; Moretti, Silvia

2014-01-01

Tattoo is going to be a very common practice especially among young people and we are witnessing a gradual increase of numerous potential complications to tattoo placement which are often seen by physicians, but generally unknown to the public. The most common skin reactions to tattoo include a transient acute inflammatory reaction due to trauma of the skin with needles and medical complications such as superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis, granulomatous and lichenoid reactions, and skin diseases localized on tattooed area (eczema, psoriasis, lichen, and morphea). Next to these inflammatory skin reactions we have to consider also the possibility of the development of cutaneous conditions such as pseudolymphomatous reactions and pseudoepitheliomatous hyperplasia. The aim of this study is to underline the importance of an early diagnosis by performing a histological examination especially when we are in front of suspected papulonodular lesions arising from a tattoo, followed by a proper treatment, since cutaneous neoplastic evolution is known to be a rare but possible complication. PMID:25147796

From darkening urine to early diagnosis of alkaptonuria

Directory of Open Access Journals (Sweden)

Peker Erdal

2008-01-01

Full Text Available Alkaptonuria is a rare disorder of metabolism characterized by deficiency of homogentisic acid oxidase. Characteristic features include darkening of urine, ochronosis, and arthropathy. Darkening of urine is the only sign of the disorder in the pediatric age group, and it occurs at very early stage of the disorder, as reported by the parents. A 4-year-old boy presented to our clinic with the complaint of dark urine and bluish black staining of clothes. This darkening pointed to a positive physical history of bluish discoloration of sclerae which occurred off and on. We initiated treatment with ascorbic acid and a protein diet with restriction of phenylalanine and tyrosine (1.6 g/kg/d. This case report is significant because of the early diagnosis made.

Prostate Cancer: Symptoms, Diagnosis and Treatment | NIH MedlinePlus the Magazine

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... of this page please turn Javascript on. Feature: Prostate Cancer Prostate Cancer: Symptoms, Diagnosis and Treatment Past Issues / Winter 2010 Table of Contents Symptoms Prostate cancer has no symptoms in its early stages. They ...

Can Biomarkers Help the Early Diagnosis of Parkinson's Disease?

Institute of Scientific and Technical Information of China (English)

Weidong Le; Jie Dong; Song Li; Amos D.Korczyn

2017-01-01

Parkinson's disease (PD) is a complex neurodegenerative disease with progressive loss of dopamine neurons.PD patients usually manifest a series of motor and non-motor symptoms.In order to provide better early diagnosis and subsequent disease-modifying therapies for PD patients,there is an urgent need to identify sensitive and specific biomarkers.Biomarkers can be divided into four categories:clinical,imaging,biochemical,and genetic.Ideal biomarkers not only improve our understanding of PD pathogenesis and progression,but also provide benefits for early risk evaluation and clinical diagnosis of PD.Although many efforts have been made and several biomarkers have been extensively investigated,few if any have been found useful for early diagnosis.Here,we summarize recent developments in the discovered biomarkers of PD and discuss their merits and limitations for the early diagnosis of PD.

Palatal radicular groove: Clinical implications of early diagnosis and surgical sealing

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P Corrêa-Faria

2011-01-01

Full Text Available Palatal radicular groove is a discreet alteration in tooth morphology, characterized by an invagination that begins near the cingulum of the tooth and moves in an apical direction. Clinically, palatal radicular groove may be associated with periodontal and/or endodontic problems. This paper describes a clinical case of a young patient with palatal radicular groove with no signs of periodontal disease or endodontic impairment. An early diagnosis was made and treatment consisted of surgical sealing of the defect. After a 2-year period, reexaminations demonstrated adequate hygiene, maintenance of tooth vitality and periodontal health. The early diagnosis and sealing of the groove observed surgically made the root surface smooth, avoiding subgingival bacterial plaque buildup, and preventing possible periodontal and/or pulp impairment stemming from the defect.

Mandibular Symmetrical Bilateral Canine-Lateral Incisors Transposition: Its Early Diagnosis and Treatment Considerations

Directory of Open Access Journals (Sweden)

Yehoshua Shapira

2016-01-01

Full Text Available Bilateral mandibular tooth transposition is a relatively rare dental anomaly caused by distal migration of the mandibular lateral incisors and can be detected in the early mixed dentition by radiographic examination. Early diagnosis and interceptive intervention may reduce the risk of possible transposition between the mandibular canine and lateral incisor. This report illustrates the orthodontic management of bilateral mandibular canine-lateral incisor transposition. Correct positioning of the affected teeth was achieved on the left side while teeth on the right side were aligned in their transposed position. It demonstrates the outcome of good alignment of the teeth in the dental arch.

Pain in Fabry Disease: Practical Recommendations for Diagnosis and Treatment.

Science.gov (United States)

Politei, Juan M; Bouhassira, Didier; Germain, Dominique P; Goizet, Cyril; Guerrero-Sola, Antonio; Hilz, Max J; Hutton, Elspeth J; Karaa, Amel; Liguori, Rocco; Üçeyler, Nurcan; Zeltzer, Lonnie K; Burlina, Alessandro

2016-07-01

Patients with Fabry disease (FD) characteristically develop peripheral neuropathy at an early age, with pain being a crucial symptom of underlying pathology. However, the diagnosis of pain is challenging due to the heterogeneous and nonspecific symptoms. Practical guidance on the diagnosis and management of pain in FD is needed. In 2014, experts met to discuss recent advances on this topic and update clinical guidance. Emerging disease-specific tools, including FabryScan, Fabry-specific Pediatric Health and Pain Questionnaire, and Würzburg Fabry Pain Questionnaire, and more general tools like the Total Symptom Score can aid diagnosis, characterization, and monitoring of pain in patients with FD. These tools can be complemented by more objective and quantifiable sensory testing. In male and female patients of any age, pain related to FD can be an early indication to start disease-specific enzyme replacement therapy before potentially irreversible organ damage to the kidneys, heart, or brain occurs. To improve treatment outcomes, pain should be diagnosed early in unrecognized or newly identified FD patients. Treatment should include: (a) enzyme replacement therapy controlling the progression of underlying pathology; (b) adjunctive, symptomatic pain management with analgesics for chronic neuropathic and acute nociceptive, and inflammatory or mixed pain; and (c) lifestyle modifications. © 2016 The Authors. CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.

Hepatorenal Syndrome: Aetiology, Diagnosis, and Treatment

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G. Low

2015-01-01

Full Text Available Acute renal impairment is common in patients with chronic liver disease, occurring in approximately 19% of hospitalised patients with cirrhosis. A variety of types of renal impairment are recognised. The most important of these is the hepatorenal syndrome, a functional renal impairment due to circulatory and neurohormonal abnormalities that underpin cirrhosis. It is one of the most severe complications of cirrhosis with survival often measured in weeks to months. A variety of treatment options exist with early diagnosis and appropriate treatment providing the best hope for cure. This paper provides a comprehensive and up-to-date review of hepatorenal syndrome and lays out the topic according to the following sections: pathophysiology, historical developments, diagnostic criteria and limitations, epidemiology, precipitating factors, predictors, clinical and laboratory findings, prognosis, treatment options, prophylaxis, and conclusion.

Dengue fever: diagnosis and treatment.

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Wiwanitkit, Viroj

2010-07-01

Dengue fever is a common tropical infection. This acute febrile illness can be a deadly infection in cases of severe manifestation, causing dengue hemorrhagic shock. In this brief article, I will summarize and discuss the diagnosis and treatment of this disease. For diagnosis of dengue, most tropical doctors make use of presumptive diagnosis; however, the definite diagnosis should be based on immunodiagnosis or viral study. Focusing on treatment, symptomatic and supportive treatment is the main therapeutic approach. The role of antiviral drugs in the treatment of dengue fever has been limited, but is currently widely studied.

Impact of early diagnosis of breast cancer on treatment and outcome

International Nuclear Information System (INIS)

Kogelnik, H.D.

1986-01-01

The detection of non-palpable and small breast cancers by mammography in asymptomatic women is the really decisive contribution of medical imaging to the treatment and outcome of this by far most common malignant tumor in females. Early detection of the disease not only leads to a significant increase in overall cure rates, but also offers patients the enormous advantage of conservative therapy (conservation surgery and radiotherapy), which practically yields the same long-term results as mutilating radical operations. In the past decade a marked increase in early stages of breast cancer has occured. According to the established selection criteria for conservative treatment, over 70% of all newly diagnosed patients would therefore be candidates for this treatment modality. More than 80% are likely to have excellent cosmetic results. For precision radiotherapy of women with breast cancer, individual pretreatment tomographies (computerized tomograpy or transversal analog tomography) should be obtained for treatment planning in exactly the position to be used for subsequent radiotherapy. Useful images for this purpose can only be recorded in the planning unit of a radiotherapy center. Diagnostic procedures for staging of breast cancer will be discussed as well as the problems of locoregional recurrences and follow-up mammographies after conservative treatment. (Author)

Diagnosis and Treatment of Lower Extremity Deep Vein Thrombosis: Korean Practice Guidelines

Science.gov (United States)

Min, Seung-Kee; Kim, Young Hwan; Joh, Jin Hyun; Kang, Jin Mo; Park, Ui Jun; Kim, Hyung-Kee; Chang, Jeong-Hwan; Park, Sang Jun; Kim, Jang Yong; Bae, Jae Ik; Choi, Sun Young; Kim, Chang Won; Park, Sung Il; Yim, Nam Yeol; Jeon, Yong Sun; Yoon, Hyun-Ki; Park, Ki Hyuk

2016-01-01

Lower extremity deep vein thrombosis is a serious medical condition that can result in death or major disability due to pulmonary embolism or post-thrombotic syndrome. Appropriate diagnosis and treatment are required to improve symptoms and salvage the affected limb. Early thrombus clearance rapidly resolves symptoms related to venous obstruction, restores valve function and reduces the incidence of post-thrombotic syndrome. Recently, endovascular treatment has been established as a standard method for early thrombus removal. However, there are a variety of views regarding the indications and procedures among medical institutions and operators. Therefore, we intend to provide evidence-based guidelines for diagnosis and treatment of lower extremity deep vein thrombosis by multidisciplinary consensus. These guidelines are the result of a close collaboration between interventional radiologists and vascular surgeons. The goals of these guidelines are to improve treatment, to serve as a guide to the clinician, and consequently to contribute to public health care. PMID:27699156

Novel PET molecular probes for early diagnosis of Alzheimer's disease

International Nuclear Information System (INIS)

Kong Yanyan; Guan Yihui; Wu Ping

2012-01-01

Alzheimer disease (AD) is the most common type of dementia and will become increasingly prevalent with population aging. It is accepted that the pathologic changes underlying AD appear in the brain years to decades before the symptomatic stages. Clinical measures of cognitive impairment, as used for definition of dementia, will not allow early diagnosis of AD-pathology in the mild or asymptomatic stages. There has been growing interest in early diagnosis of this disease, particularly regarding the initiation of new treatment strategies ahead of the onset of irreversible neuronal damage. Brain imaging markers are among the most promising candidates for this diagnostic challenge. PET has been demonstrated to be a most sensitive, specific, noninvasive, objective and quantitative method for early identification of AD-pathology and molecular biology, thus for prediction of dementia of the Alzheimer type, even in the mild and asymptomatic stages. (authors)

Research Progress of Exosomes in Lung Cancer Diagnosis and Treatment

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Hongbo ZOU

2016-11-01

Full Text Available As the leading cause of morbidity and cancer related-death worldwide, lung cancer has a serious threat to human health. Exosomes are nanoscale lipid membrane vesicles derived from multivesicles, which containing active biomolecules including proteins, lipids, nucleic acids and etc. Exosomes play important roles in lung cancer initiation and progression by promoting the formation of tumor microenvironment, enhancing tumor invasive and metastasis capability, leading to immunosuppression and resistance to chemoradiotherapy, and also have the application value in early diagnosis and treatment. This review summarizes the research progress of exosomes in tumor initiation and progression, and its roles in diagnosis and treatment of lung cancer.

Early diagnosis of the Spondyloarthropathies

International Nuclear Information System (INIS)

Gonzalez Naranjo, Luis Alonso; Londono, John D; Valle, Rafael Raul

2005-01-01

Spondyloarthropathies are a cluster of chronic inflammatory diseases that primarily include ankylosing spondylitis, reactive arthritis, psoriatic arthritis; arthritis associated with inflammatory bowel diseases and undifferentiated spondyloarthropathies. The most common subgroups of spondyloarthropathies are ankylosing spondylitis and undifferentiated spondyloarthropathy. The diagnosis of ankylosing spondylitis is mainly based on unequivocal radiographic sacroiliitis of at least grade 2 bilaterally or grade 3 unilaterally. How ever, in the early phase of disease, conventional radiographs are often too insensitive to show sacroiliitis and it usually takes several years for definite radiographic sacroiliitis to evolve. Thus, the diagnosis of ankylosing spondylitis is a commonly delayed by 8 to 11 years after the onset of symptoms. As a result, diagnosing axial spondyloarthropathy in the absence of radiographic sacroiliitis is very difficult to rheumatologists. In the early phase of disease, HLA B27 test and magnetic resonance imaging of sacroiliac joints may be helpful to the early diagnosis. In the presence of chronic low back pain the probability of axial spondyloarthropathy is about 5% and is about 14% if the back pain is inflammatory. The presence of = 3 features of spondyloarthropathy (heel pain, uveitis, dactylitis, positive family history, alternating buttock pain, psoriasis, inflammatory bowel disease, asymmetrical arthritis, positive response to anti-inflammatory drugs) increase the probability of axial spondyloarthropathy to 90%. Both, the positive HLA B27 and magnetic resonance imaging with signs of sacroiliitis increase the probability of spondyloarthropathy, particularly in patients without spondyloarthropathies features or with only 1 or 2 features. Since ankylosing spondylitis in association with psoriasis and inflammatory bowel disease is often HLA B27 negative, this test is of limited value under theses circumstances. Is important to consider that

Early Diagnosis of HIV Infection in Infants - One Caribbean and Six Sub-Saharan African Countries, 2011-2015.

Science.gov (United States)

Diallo, Karidia; Kim, Andrea A; Lecher, Shirley; Ellenberger, Dennis; Beard, R Suzanne; Dale, Helen; Hurlston, Mackenzie; Rivadeneira, Molly; Fonjungo, Peter N; Broyles, Laura N; Zhang, Guoqing; Sleeman, Katrina; Nguyen, Shon; Jadczak, Steve; Abiola, Nadine; Ewetola, Raimi; Muwonga, Jérémie; Fwamba, Franck; Mwangi, Christina; Naluguza, Mary; Kiyaga, Charles; Ssewanyana, Isaac; Varough, Deyde; Wysler, Domercant; Lowrance, David; Louis, Frantz Jean; Desinor, Olbeg; Buteau, Josiane; Kesner, Francois; Rouzier, Vanessa; Segaren, Nat; Lewis, Tessa; Sarr, Abdoulaye; Chipungu, Geoffrey; Gupta, Sundeep; Singer, Daniel; Mwenda, Reuben; Kapoteza, Hilary; Chipeta, Zawadi; Knight, Nancy; Carmona, Sergio; MacLeod, William; Sherman, Gayle; Pillay, Yogan; Ndongmo, Clement B; Mugisa, Bridget; Mwila, Annie; McAuley, James; Chipimo, Peter J; Kaonga, Wezi; Nsofwa, Dailess; Nsama, Davy; Mwamba, Fales Zulu; Moyo, Crispin; Phiri, Clement; Borget, Marie-Yolande; Ya-Kouadio, Leonard; Kouame, Abo; Adje-Toure, Christiane A; Nkengasong, John

2016-11-25

Pediatric human immunodeficiency virus (HIV) infection remains an important public health issue in resource-limited settings. In 2015, 1.4 million children aged 50% decline. The most common challenges for access to testing for early infant diagnosis included difficulties in specimen transport, long turnaround time between specimen collection and receipt of results, and limitations in supply chain management. Further reductions in HIV mortality in children can be achieved through continued expansion and improvement of services for early infant diagnosis in PEPFAR-supported countries, including initiatives targeted to reach HIV-exposed infants, ensure access to programs for early infant diagnosis of HIV, and facilitate prompt linkage to treatment for children diagnosed with HIV infection.

Low Dopamine Function in Attention Deficit/Hyperactivity Disorder: Should Genotyping Signify Early Diagnosis in Children?

Science.gov (United States)

Gold, Mark S.; Blum, Kenneth; Oscar-Berman, Marlene; Braverman, Eric R.

2014-01-01

Attention deficit/hyperactivity disorder (ADHD) is present in 8% to 12% of children, and 4% of adults worldwide. Children with ADHD can have learning impairments, poor self-esteem, social dysfunction, and an increased risk of substance abuse, including cigarette smoking. Overall, the rate of treatment with medication for patients with ADHD has been increasing since 2008, with > 2 million children now being treated with stimulants. The rise of adolescent prescription ADHD medication abuse has occurred along with a concomitant increase of stimulant medication availability. Of adults presenting with a substance use disorder (SUD), 20% to 30% have concurrent ADHD, and 20% to 40% of adults with ADHD have a history of SUD. Following a brief review of the etiology of ADHD, its diagnosis and treatment, we focus on the benefits of early and appropriate testing for a predisposition to ADHD. We suggest that by genotyping patients for a number of known, associated dopaminergic polymorphisms, especially at an early age, misdiagnoses and/or over-diagnosis can be reduced. Ethical and legal issues of early genotyping are considered. As many as 30% of individuals with ADHD are estimated to either have secondary side-effects or are not responsive to stimulant medication. We also consider the benefits of non-stimulant medication and alternative treatment modalities, which include diet, herbal medications, iron supplementation, and neurofeedback. With the goals of improving treatment of patients with ADHD and SUD prevention, we encourage further work in both genetic diagnosis and novel treatment approaches. PMID:24393762

Results of a multinational study suggest the need for rapid diagnosis and early antiviral treatment at the onset of herpetic meningoencephalitis

DEFF Research Database (Denmark)

Erdem, Hakan; Cag, Yasemin; Ozturk-Engin, Derya

2015-01-01

survived, with sequelae. Age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02 to 1.05), Glasgow Coma Scale score (OR, 0.84; 95% CI, 0.77 to 0.93), and symptomatic periods of 2 to 7 days (OR, 1.80; 95% CI, 1.16 to 2.79) and >7 days (OR, 3.75; 95% CI, 1.72 to 8.15) until the commencement...... of treatment predicted unfavorable outcomes. The outcome in HME patients is related to a combination of therapeutic and host factors. This study suggests that rapid diagnosis and early administration of antiviral treatment in HME patients are keys to a favorable outcome....

Delay in Presentation, Diagnosis, and Treatment for Breast Cancer Patients in Jordan.

Science.gov (United States)

Abu-Helalah, Ahmad Munir; Alshraideh, Hussam Ahmad; Al-Hanaqtah, Mo'tasem; Da'na, Moh'd; Al-Omari, Asim; Mubaidin, Rasmi

2016-01-01

Breast cancer is the most common cancer, and one of the leading causes of death for females in Jordan and many countries in the world. Studies have shown that delay in symptoms presentation, diagnosis or treatment would result in poor prognosis. There has been no published study from Jordan on delays in patient presentation, delays in diagnosis, or delays in treatment. Therefore, we conducted this study to assess these important quality indicators aiming to improve prognosis for breast cancer patients in Jordan. This project was a cross-sectional study on female breast cancer patients in Jordan. The total number of participants was 327. The proportion of patients with presentation delay, diagnosis delay, and treatment delay was 32.2%, 49.1%, or 32.4%, respectively. The main reported reasons for delay in presentation were ignorance of the nature of the problem (65.6%), limited/lack of knowledge that symptoms were suggestive of cancer diagnosis (16.7%), and misdiagnosis (16.7%). Predictors of delay and mean time for presentation, diagnosis, and treatment were identified. Our results reveal that breast cancer patients in Jordan are experiencing delays in presentation, diagnosis, and treatment. This could justify the advanced stages at diagnosis and poor outcomes for breast cancer patients in Jordan. We recommend revising the current early detection and down-staging programs in Jordan. © 2015 Wiley Periodicals, Inc.

Prune-belly syndrome: case series and review of the literature regarding early prenatal diagnosis, epidemiology, genetic factors, treatment, and prognosis.

Science.gov (United States)

Tonni, Gabriele; Ida, Vito; Alessandro, Ventura; Bonasoni, Maria Paola

2013-02-01

Prune-belly syndrome (PBS) is a rare congenital syndrome characterized by deficient abdominal muscles, urinary tract malformation, and in males, cryptorchidism and has an estimated incidence of 1 in 35,000 to 1 in 50,000 live births. The syndrome might be due to severe bladder outlet obstruction or to abdominal muscle deficiency secondary to a migrational defect of the lateral mesoblast between weeks 6 and 7 of pregnancy. The current review of the medical record reports a special focus on epidemiology, genetic factors, early prenatal diagnosis clusters, treatment, and prognosis of PBS.

Detection of Circulating Mucorales DNA in Critically Ill Burn Patients: Preliminary Report of a Screening Strategy for Early Diagnosis and Treatment.

Science.gov (United States)

Legrand, Matthieu; Gits-Muselli, Maud; Boutin, Louis; Garcia-Hermoso, Dea; Maurel, Véronique; Soussi, Sabri; Benyamina, Mourad; Ferry, Axelle; Chaussard, Maïté; Hamane, Samia; Denis, Blandine; Touratier, Sophie; Guigue, Nicolas; Fréalle, Emilie; Jeanne, Mathieu; Shaal, Jean-Vivien; Soler, Charles; Mimoun, Maurice; Chaouat, Marc; Lafaurie, Matthieu; Mebazaa, Alexandre; Bretagne, Stéphane; Alanio, Alexandre

2016-11-15

 Invasive wound mucormycosis (IWM) is associated with an extremely poor outcome among critically ill burn patients. We describe the detection of circulating Mucorales DNA (cmDNA) for the early diagnosis of IWM in those patients and report the potential value of detecting cmDNA for treatment guidance.  Severely ill burn patients admitted to our tertiary referral center between October 2013 and February 2016 were included. Retrospective plasma samples were tested for the presence of cmDNA by quantitative real-time polymerase chain reaction (qPCR). Patients were then prospectively screened twice a week, and liposomal amphotericin-B therapy initiated based on a positive qPCR. The primary endpoint was the time between cmDNA detection and standard diagnosis. Secondary endpoints were the time from cmDNA detection and treatment initiation and mortality.  Seventy-seven patients (418 samples) were included. The average age was 46 (28-60) years, abbreviated burn severity index was 8 (7-10), and simplified acute physiology score was 33 (23-46). The total body surface area was 33% (22%-52%). cmDNA was detected 11 (4.5-15) days before standard diagnosis. The in-hospital mortality was 62% for patients with IWM and 24% for those without (P = .03). The mortality due to IWM was 80% during period A and 33% during period B (P = .46).  This study suggests that the detection of cmDNA allows earlier diagnosis of IWM in severely ill burn patients and earlier initiation of treatment. Further studies are needed to confirm the impact of earlier treatment initiation on patient outcome. © 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.

Early diagnosis of breast cancer

International Nuclear Information System (INIS)

Semiglazov, V.F.

1989-01-01

Modern data are presentd on epidemology etiopathogensis and statistics of breast cancer. Home and international clinical and histological classifications is given. Much attention is paid to the methods for early diagnosis of pretumor diseases and breast cancer: clinical roentgenomammography, thrmography and computerized tomomammography. The role of self-examination in cancer early detection has been analyzed. Special attention is paid to system of detection of minimal and unpalpable form of breast cancer, screening of these tumors. 113 refs.; 60 figs.; 6 tabs

Early diagnosis of lung cancer

International Nuclear Information System (INIS)

Scherrer, M.

1982-01-01

Unanimity does not exist about the utility and organisation of screening procedures for early diagnosis of lung cancer. We describe a low cost structue of screening, requiring only a minimum of compliance from the elderly smoker and ex-smoker. At 4 months interval, radiographs, sputum cytologies and eventual fiberbronchoscopies are realized in all that elderly smokers and ex-smokers which begin to present one of the first early lung cancer signs or symptoms (loss of weight, hemoptoe, thoracic pain and others). (orig.) [de

Diagnosis and treatment of traumatic pancreatic injury

International Nuclear Information System (INIS)

Hirakawa, Akihiko; Isayama, Kenji; Nakatani, Toshio

2011-01-01

The diagnosis of traumatic pancreatic injury in the acute stage is difficult to establish blood tests and abdominal findings alone. Moreover, to determine treatment strategies, it is important not only that a pancreatic injury is diagnosed but also whether a pancreatic ductal injury can be found. At our center, to diagnose isolated pancreatic injuries, we actively perform endoscopic retrograde pancreatography (ERP) in addition to abdominal CT at the time of admission. For cases with complications such as abdominal and other organ injuries, we perform a laparotomy to ascertain whether a pancreatic duct injury is present. In regard to treatment options, for grade III injuries to the pancreatic body and tail, we basically choose distal pancreatectomy, but we also consider the Bracy method depending on the case. As for grade III injuries to the pancreatic head, we primarily choose pancreaticoduodenectomy, but also apply drainage if the situation calls for it. However, pancreatic injuries are often complicated by injuries of other regions of the body. Thus, diagnosis and treatment of pancreatic injury should be based on a comprehensive decision regarding early prioritization of treatment, taking hemodynamics into consideration after admission, and how to minimize complications such as anastomotic leak and pancreatic fistulas. (author)

Diagnosis of early stomach cancer (Lecture)

International Nuclear Information System (INIS)

Vinner, M.G.

1989-01-01

Problems concerning diagnosis of early stomach cancer using X-ray and endoscopic investigation techniques are stated. Classification of early stomach cancer suggested by the Japan Endoscopy Society and division system of early stomach cancer into two main foms: depth (erosive-ulcerous) one and elevated (polypoid) one-is presented X-ray and endoscopic investigation techniques are shown to be high efficiency concerning revealingation of stomach mucous variations using biopsy, which allow to determine for certain whother the process is benign or malignant one

Diagnosis and treatment of invasive fungal diseases in patients with severe liver diseases

Directory of Open Access Journals (Sweden)

ZANG Hong

2016-09-01

Full Text Available Invasive fungal diseases (IFDs are an important factor affecting the prognosis of patients with severe liver diseases, and their early diagnosis remains a challenge for clinicians. The four most commonly seen IFDs are candidiasis, aspergillosis, cryptococcosis, and pneumocystis pneumonia. We should pay attention to the risk of developing IFDs in patients with severe liver diseases during clinical management. Particularly, early diagnosis and proper treatment of IFDs are important in high-risk patients. These are vital to improving the prognosis of patients with severe liver diseases.

Improving outcomes in patients with melanoma: strategies to ensure an early diagnosis

Directory of Open Access Journals (Sweden)

Voss RK

2015-11-01

Full Text Available Rachel K Voss,1 Tessa N Woods,1 Kate D Cromwell,1 Kelly C Nelson,2 Janice N Cormier1 1Department of Surgical Oncology, 2Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: Patients with thin, low-risk melanomas have an excellent long-term prognosis and higher quality of life than those who are diagnosed at later stages. From an economic standpoint, treatment of early stage melanoma consumes a fraction of the health care resources needed to treat advanced disease. Consequently, early diagnosis of melanoma is in the best interest of patients, payers, and health care systems. This review describes strategies to ensure that patients receive an early diagnosis through interventions ranging from better utilization of primary care clinics, to in vivo diagnostic technologies, to new “apps” available in the market. Strategies for screening those at high risk due to age, male sex, skin type, nevi, genetic mutations, or family history are discussed. Despite progress in identifying those at high risk for melanoma, there remains a lack of general consensus worldwide for best screening practices. Strategies to ensure early diagnosis of recurrent disease in those with a prior melanoma diagnosis are also reviewed. Variations in recurrence surveillance practices by type of provider and country are featured, with evidence demonstrating that various imaging studies, including ultrasound, computed tomography, positron emission tomography, and magnetic resonance imaging, provide only minimal gains in life expectancy, even for those with more advanced (stage III disease. Because the majority of melanomas are attributable to ultraviolet radiation in the form of sunlight, primary prevention strategies, including sunscreen use and behavioral interventions, are reviewed. Recent international government regulation of tanning beds is described, as well as issues surrounding the continued use artificial ultraviolet

Magnetic resonance imaging for early diagnosis of rheumatoid arthritis

International Nuclear Information System (INIS)

Uhl, M.; Allmann, K.H.; Hauer, M.P.; Laubenberger, J.; Kempis, J. v.; Langer, M.

1997-01-01

Nuclear magnetic resonance tomography (MRI) represents essential progress in the diagnostic means for evaluation of lesions of the muskuloskeletal system. The imaging of bone joints including material and structures like cartilage, tendons, ligaments, effusions, pannus, cortical bone and marrow offers essential advantages for diagnosis, differential diagnosis, follow-up control and detection of local complications in rheumatics radiology. The review article discusses the achievements of MRI for detection of early signs of rheumatoid arthritis and the current indications for MRI examination for early diagnosis. (Orig./AJ) [de

HRCT in the evaluation and diagnosis of the early/active pulmonary tuberculosis

International Nuclear Information System (INIS)

Tan Gao; Liu Xueguo; Zhang Qingwen; Wang Ying; Li Zhanjun; Zhang Cuiyun; Wang Jian; He Yanli; Hong Guobin

2003-01-01

Objective: To evaluate the HRCT findings of early/active pulmonary tuberculosis before and after antituberculous chemotherapy. Methods: One hundred tuberculous patients were studied prospectively and they were divided into 2 groups according to the history. The diagnosis of early active pulmonary tuberculosis was based on positive acid-fast bacilli in sputum (75 patients) and changes on serial radiographs obtained during treatment (25 patients). The correlation between pathology and imaging was done in the lungs from the cadavers of five other patients who died of pulmonary tuberculosis. Results: Comparing with the presence of other HRCT findings, the presence of centrilobular lesions (93.0%), tree-in-bud appearance (76.0%), and wall thickening of bronchioles (70.0%) were most common signs in both the first group consisting of 66 patients with newly diagnosed pulmonary tuberculosis and the second group consisting of 34 patients with recent reactivation of pulmonary tuberculosis at examination by HRCT, and there was significant difference between the presence of those signs and other signs (P<0.001). Conclusion: Centrilobular lesion appeared to be the most commonly seen characteristic HRCT features of early active tuberculosis, and it may be helpful to the diagnosis and (or ) differential diagnosis if combined with other commonly seen characteristic HRCT features as well as clinical information

Magnetic resonance imaging markers for early diagnosis of Parkinson's disease

Institute of Scientific and Technical Information of China (English)

Silvia Marino; Rosella Ciurleo; Giuseppe Di Lorenzo; Marina Barresi; Simona De Salvo; Sabrina Giacoppo; Alessia Bramanti; Pietro Lanzafame; Placido Bramanti

2012-01-01

Parkinson's disease (PD) is a neurodegenerative disorder characterized by selective and progressive degeneration, as well as loss of dopaminergic neurons in the substantia nigra. In PD, approximately 60-70% of nigrostriatal neurons are degenerated and 80% of content of the striatal dopamine is reduced before the diagnosis can be established according to widely accepted clinical diagnostic criteria. This condition describes a stage of disease called "prodromal", where non-motor symptoms, such as olfactory dysfunction, constipation, rapid eye movement behaviour disorder, depression, precede motor sign of PD. Detection of prodromal phase of PD is becoming an important goal for determining the prognosis and choosing a suitable treatment strategy. In this review, we present some non-invasive instrumental approaches that could be useful to identify patients in the prodromal phase of PD or in an early clinical phase, when the first motor symptoms begin to be apparent. Conventional magnetic resonance imaging (MRI) and advanced MRI techniques, such as magnetic resonance spectroscopy imaging, diffusion-weighted and diffusion tensor imaging and functional MRI, are useful to differentiate early PD with initial motor symptoms from atypical parkinsonian disorders, thus, making easier early diagnosis. Functional MRI and diffusion tensor imaging techniques can show abnormalities in the olfactory system in prodromal PD.

The role of ultrasound in the diagnosis and follow-up of early inflammatory arthritis

International Nuclear Information System (INIS)

Spencer, S.P.; Ganeshalingam, S.; Kelly, S.; Ahmad, M.

2012-01-01

The inflammatory arthritides are a group of chronic, often debilitating disorders characterized by synovial inflammation and progressive joint destruction. The primary diagnostic aim is to recognize the inflammatory arthritis at an early stage, such that therapies may be implemented before irreversible joint destruction has occurred. The radiologist now plays a pivotal role both in making an accurate and early diagnosis of inflammatory arthritis as well as assessing treatment response. This article reviews the current literature and presents our approach to the sonographic assessment of early inflammatory arthritis.

The diagnosis and treatment of non-occlusive gut ischaemia

International Nuclear Information System (INIS)

Schindler, G.; Bruch, H.P.; Wuerzburg Univ.

1991-01-01

Non-occlusive gut ischaemia is a disease of advanced age. Its causes are reduced cardiac output or shock, facilitated by digitalis, adrenaline, ergotamine and diuretics. The persisting microcirculation and development of gut necrois leads to an increase in certain serum enzymes, such as lactate, LDH and CK-NB. The early application of mesenteric angiography using a DSA technique reveals four grades of under-perfusion. Early and correct diagnosis of the disease should lead to intra-arterial treatment with prostaglandin. In 10 out of 42 cases, conservative therapy led to re-perfusion of the gut. (orig.) [de

Effectiveness of near-infrared transillumination in early caries diagnosis

Directory of Open Access Journals (Sweden)

Mirela Marinova-Takorova

2016-11-01

Full Text Available Early caries detection is essential for minimal intervention dentistry, since it could give the opportunity to reverse the process and eliminate or at least postpone the surgical treatment. The aim of the present study was to evaluate the effectiveness of near-infrared transillumination in early caries diagnosis for both occlusal and proximal lesions. Thirty-eight adult patients were included in the study. The results from the visual, radiological and near-infrared transillumination examination for proximal caries lesions were compared. The diagnostic abilities of these methods for occlusal lesions were assayed on 60 teeth. The three methods showed a very high level of correlation when there were caries lesions involving the enamel and dentin. Concerning proximal caries involving only the enamel, the visual--tactile diagnosis proved to be insufficiently sensitive even with the use of magnification. Radiographic examination and near-infrared transillumination correlated significantly, but the latter was more sensitive. Radiographic examination proved to be insufficiently sensitive for occlusal lesions. The results obtained with the near-infrared fluorescence correlated most with the visual–tactile examination. These results suggest that near-infrared transillumination is an effective method for diagnosis of lesions both involving only the enamel and involving the enamel and dentin. It could be used for both occlusal and proximal caries lesions and it could eventually substitute radiographic bitewings, especially in children and pregnant women, due to its efficiency as a diagnostic tool and the absence of radiation.

Diagnosis and Treatment of Hypopituitarism

Science.gov (United States)

2015-01-01

Hypopituitarism is a chronic endocrine illness that caused by varied etiologies. Clinical manifestations of hypopituitarism are variable, often insidious in onset and dependent on the degree and severity of hormone deficiency. However, it is associated with increased mortality and morbidity. Therefore, early diagnosis and prompt treatment is necessary. Hypopituitarism can be easily diagnosed by measuring basal pituitary and target hormone levels except growth hormone (GH) and adrenocorticotropic hormone (ACTH) deficiency. Dynamic stimulation tests are indicated in equivocal basal hormone levels and GH/ACTH deficiency. Knowledge of the use and limitations of these stimulation tests is mandatory for proper interpretation. It is necessary for physicians to inform their patients that they may require lifetime treatment. Hormone replacement therapy should be individualized according to the specific needs of each patient, taking into account possible interactions. Long-term endocrinological follow-up of hypopituitary patients is important to monitor hormonal replacement regimes and avoid under- or overtreatment. PMID:26790380

Glutaric aciduria type 1--importance of early diagnosis and treatment.

Science.gov (United States)

Afroze, Bushra; Yunus, Zabedah Mohammad

2014-05-01

Glutaric aciduria type 1 is a rare inherited organic academia. Untreated patients characteristically develop dystonia secondary to striatal injury during early childhood, which results in high morbidity and mortality. In patients diagnosed during neonatal period, striatal injury can be prevented by metabolic treatment including low lysine diet, carnitine supplementation and aggressive emergency treatment during acute episode of inter current illnesses. However, after the onset of neurological damage initiation of treatment is generally not effective. Therefore; glutaric aciduria type 1 is included in newborn screening panel for inherited metabolic diseases in many countries. We describe two children in a family with glutaric aciduria type 1 and their different long term outcomes. The first child was diagnosed late leading to severe neurological damage. The second child was diagnosed in the neonatal period as a result of selective high-risk screening and was treated appropriately giving a normal growth.

Contemporary treatment principles for early rheumatoid arthritis: a consensus statement.

Science.gov (United States)

Kiely, Patrick D W; Brown, Andrew K; Edwards, Christopher J; O'Reilly, David T; Ostör, Andrew J K; Quinn, Mark; Taggart, Allister; Taylor, Peter C; Wakefield, Richard J; Conaghan, Philip G

2009-07-01

RA has a substantial impact on both patients and healthcare systems. Our objective is to advance the understanding of modern management principles in light of recent evidence concerning the condition's diagnosis and treatment. A group of practicing UK rheumatologists formulated contemporary management principles and clinical practice recommendations concerning both diagnosis and treatment. Areas of clinical uncertainty were documented, leading to research recommendations. A fundamental concept governing treatment of RA is minimization of cumulative inflammation, referred to as the inflammation-time area under the curve (AUC). To achieve this, four core principles of management were identified: (i) detect and refer patients early, even if the diagnosis is uncertain: patients should be referred at the first suspicion of persistent inflammatory polyarthritis and rheumatology departments should provide rapid access to a diagnostic and prognostic service; (ii) treat RA immediately: optimizing outcomes with conventional DMARDs and biologics requires that effective treatment be started early-ideally within 3 months of symptom onset; (iii) tight control of inflammation in RA improves outcome: frequent assessments and an objective protocol should be used to make treatment changes that maintain low-disease activity/remission at an agreed target; (iv) consider the risk-benefit ratio and tailor treatment to each patient: differing patient, disease and drug characteristics require long-term monitoring of risks and benefits with adaptations of treatments to suit individual circumstances. These principles focus on effective control of the inflammatory process in RA, but optimal uptake may require changes in service provision to accommodate appropriate care pathways.

Applications of nanotechnology for melanoma treatment, diagnosis, and theranostics

Directory of Open Access Journals (Sweden)

Chen J

2013-07-01

Full Text Available Jiezhong Chen,1,2 Renfu Shao,3 Xu Dong Zhang,4 Chen Chen1 1School of Biomedical Sciences, University of Queensland, Brisbane, QLD, Australia; 2Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia; 3GeneCology Research Centre, School of Science, Education and Engineering, University of the Sunshine Coast, Maroochydore, QLD, Australia; 4School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia Abstract: Melanoma is the most aggressive type of skin cancer and has very high rates of mortality. An early stage melanoma can be surgically removed, with a survival rate of 99%. However, metastasized melanoma is difficult to cure. The 5-year survival rates for patients with metastasized melanoma are still below 20%. Metastasized melanoma is currently treated by chemotherapy, targeted therapy, immunotherapy and radiotherapy. The outcome of most of the current therapies is far from optimistic. Although melanoma patients with a mutation in the oncogene v-Raf murine sarcoma viral oncogene homolog B1 (BRAF have an initially higher positive response rate to targeted therapy, the majority develop acquired drug resistance after 6 months of the therapy. To increase treatment efficacy, early diagnosis, more potent pharmacological agents, and more effective delivery systems are urgently needed. Nanotechnology has been extensively studied for melanoma treatment and diagnosis, to decrease drug resistance, increase therapeutic efficacy, and reduce side effects. In this review, we summarize the recent progress on the development of various nanoparticles for melanoma treatment and diagnosis. Several common nanoparticles, including liposome, polymersomes, dendrimers, carbon-based nanoparticles, and human albumin, have been used to deliver chemotherapeutic agents, and small interfering ribonucleic acids (siRNAs against signaling molecules have also been tested for the treatment of melanoma. Indeed

Predictors for early diagnosis of cerebral palsy from national registry data

DEFF Research Database (Denmark)

Granild-Jensen, Jakob Bie; Rackauskaite, Gija; Flachs, Esben Meulengracht

2015-01-01

AIM: As early intervention is important in cerebral palsy (CP), an early diagnosis is desirable. The aim of this study was to establish the median diagnostic age of CP and to identify predictors of an early diagnosis in a population-based cohort. METHOD: Using the Danish National Cerebral Palsy...... of motor disability, cerebral ultrasonography results, epilepsy, gestational age, and degree of cognitive impairment. RESULTS: We found the overall median corrected diagnostic age of CP to be 11 months. Early diagnosis was associated with the type of CP, presence of epilepsy, a high degree of motor...... disability, and abnormalities in the cerebral ultrasonography. The gestational age was not associated with the diagnostic age. INTERPRETATION: The median diagnostic age implies that half of the Danish children with CP will be able to enter an early intervention program before 1 year of age. A late diagnosis...

Attitudes of the German general population toward early diagnosis of dementia--results of a representative telephone survey.

Directory of Open Access Journals (Sweden)

Tobias Luck

Full Text Available BACKGROUND: Early detection of dementia has clearly improved. Even though none of the currently available treatments for the most common form of dementia, Alzheimer's dementia, promises a cure, early diagnosis provides several benefits for patients, caregivers, and health care systems. This study aimed to describe attitudes toward early diagnosis of dementia in the German general population. METHODS: A representative telephone survey of the German population aged 18+ years (n = 1,002 was conducted in 2011. RESULTS: The majority of respondents (69% would be willing to be examined for early diagnosis of dementia. Almost two thirds reported that they would prefer their general practitioner (GP as the first source of professional help. More than half of the respondents (55% stated their belief that dementia could be prevented. Respondents mostly indicated psychosocial prevention options. CONCLUSIONS: Our findings suggest that the general population in Germany is very open to early diagnosis of dementia; however, this seems connected with large expectations on the effectiveness of prevention options. Dementia awareness campaigns may be employed to carefully inform the public about the prevention options currently available and their efficacy. To exploit GPs' potential as a gatekeeper for early detection of dementia, their ability to identify patients with antecedent and mild stages of the disease must be improved.

Early X-ray diagnosis of coxarthrosis

International Nuclear Information System (INIS)

Lingg, G.; Nebel, G.

1982-01-01

Radiological and pathological comparisons on specimen of femurhead and neck at autopsy have shown a statistical relationship between osteophytosis of the femoral head and ulcerations of the joint cartilage. Especially there are highly significant relationships between the length of osteophytes and the diameter of the ulcera. The 'plaque'-sign shows to be a very sensitive indicator of early arthrosis. So there exist semiquantitative parameters for the X-ray diagnosis of early coxarthrosis. (orig.) [de

Effect of deferred or no treatment with ursodeoxycholic acid in patients with early primary biliary cholangitis.

Science.gov (United States)

Tanaka, Atsushi; Hirohara, Junko; Nakano, Toshiaki; Yagi, Minami; Namisaki, Tadashi; Yoshiji, Hitoshi; Nakanuma, Yasuni; Takikawa, Hajime

2018-02-06

As primary biliary cholangitis (PBC) is a heterogeneous disease, we hypothesized that there is a population of patients with early PBC who do not require prompt treatment with ursodeoxycholic acid (UDCA). In this study, we analyzed data from a large-scale PBC cohort in Japan, and retrospectively investigated whether outcomes of early PBC patients were affected with prompt or deferred/no UDCA treatment. We defined early PBC as asymptomatic, serum alkaline phosphatase early PBC patients between the treatment regimens; prompt treatment group (UDCA was initiated within 1 year after diagnosis) and deferred/no treatment group (UDCA initiated >1 year after diagnosis or never initiated). Furthermore, we examined the outcomes of early PBC patients alternatively defined only with symptomatology and biochemistry. We identified 562 early PBC patients (prompt: n = 509; deferred/no treatment: n = 53). Incidence rates (per 1000 patient-years) for liver-related mortality or liver transplantation and decompensating events were 0.5 and 5.4, respectively, in the prompt treatment group, and 0 and 8.7, respectively, in the deferred/no treatment group. Multivariate analyses showed that age and bilirubin were significantly associated with developing decompensating events, whereas the prompt and deferred/no treatments were not. We obtained similar results in early PBC patients defined without histological examination. We showed that deferred/no treatment for early PBC patients did not affect the outcomes. This study provides a rationale for a future prospective, randomized study. © 2018 The Japan Society of Hepatology.

Clinical impact of early diagnosis of autism on the prognosis and parent-child relationships

Directory of Open Access Journals (Sweden)

Elder JH

2017-08-01

Full Text Available Jennifer Harrison Elder,1 Consuelo Maun Kreider,2 Susan N Brasher,3 Margaret Ansell4 1Department of Family and Community Health Nursing Science, 2Department of Occupational Therapy, University of Florida, Gainesville, FL, 3Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 4Health Science Center Libraries, University of Florida, Gainesville, FL, USA Abstract: Autism spectrum disorder (ASD refers to a lifelong condition that usually appears in late infancy or early childhood, and is characterized by social and communication deficits that impede optimal functioning. Despite widespread research and greater public awareness, ASD has an unclear etiology and no known cure, making it difficult to acquire accurate and timely diagnoses. In addition, once an ASD diagnosis is made, parents find it challenging to navigate the healthcare system and determine which interventions are most effective and appropriate for their child. A growing body of evidence supports the value of early diagnosis and treatment with evidence-based interventions, which can significantly improve the quality of life of individuals with ASD as well as of their carers and families. Particularly noteworthy are early interventions that occur in natural surroundings and can be modified to address age-related goals throughout the lifespan. Therefore, the purpose of this review is to: 1 provide readers with a brief background related to ASD; 2 describe commonly used screening instruments and tools for early diagnosis; 3 describe early interventions that have empirical support; and 4 discuss how the parent–child and family relationships can be affected through this process. This information can provide professionals with information they can use to assist families who make critical and potentially life-changing decisions for children with ASD. Keywords: autism spectrum disorder, ASD, early diagnosis, early intervention, parent–child relationship

Pediatric Hypothyroidism: Diagnosis and Treatment.

Science.gov (United States)

Wassner, Ari J

2017-08-01

Thyroid hormone has important physiologic functions in nearly every organ system. The critical role of thyroid hormone in growth and in physical and neurologic development lends particular importance to the prompt diagnosis and appropriate treatment of hypothyroidism in infants and children. Congenital hypothyroidism is common and has potentially devastating neurologic consequences. While the approach to diagnosis and treatment of severe congenital hypothyroidism is well established, data continue to emerge about the genetic causes, clinical significance, and prognosis of the milder forms of congenital hypothyroidism that are increasingly being diagnosed by newborn screening. Similarly, the diagnosis and treatment of severe acquired hypothyroidism is straightforward and clearly of clinical benefit, but uncertainty remains about the optimal management of mild subclinical hypothyroidism. This review summarizes current knowledge of the causes, clinical manifestations, diagnosis, treatment, and prognosis of hypothyroidism in infants and children, with a focus on recent developments and areas of uncertainty in this field.

Diagnosis and treatment of Alzheimer's disease

International Nuclear Information System (INIS)

Hampel, H.; Padberg, F.; Koetter, H.U.; Teipel, S.J.; Ehrhardt, T.; Hegerl, U.; Stuebner, S.; Moeller, H.J.

1997-01-01

Alzheimer's disease is often diagnosed too late. Its etiology is still largely unknown and remains one of the big challenges in neurobiological fundamental research. Optimized early and differential diagnosis can be ensured by a dynamic concept of multidisciplinary diagnosis in cooperation between practitioners specializing in brain disorders, clinical psychogeriatric deprtments, and general practitioners. This, in turn, will enable individualized planning of further living conditions and care of Alzheimer patients and their relations as well as efficient and early pharmacotherapy and psychological intervention. (orig) [de

Clinical impact of early diagnosis of autism on the prognosis and parent-child relationships.

Science.gov (United States)

Elder, Jennifer Harrison; Kreider, Consuelo Maun; Brasher, Susan N; Ansell, Margaret

2017-01-01

Autism spectrum disorder (ASD) refers to a lifelong condition that usually appears in late infancy or early childhood, and is characterized by social and communication deficits that impede optimal functioning. Despite widespread research and greater public awareness, ASD has an unclear etiology and no known cure, making it difficult to acquire accurate and timely diagnoses. In addition, once an ASD diagnosis is made, parents find it challenging to navigate the healthcare system and determine which interventions are most effective and appropriate for their child. A growing body of evidence supports the value of early diagnosis and treatment with evidence-based interventions, which can significantly improve the quality of life of individuals with ASD as well as of their carers and families. Particularly noteworthy are early interventions that occur in natural surroundings and can be modified to address age-related goals throughout the lifespan. Therefore, the purpose of this review is to: 1) provide readers with a brief background related to ASD; 2) describe commonly used screening instruments and tools for early diagnosis; 3) describe early interventions that have empirical support; and 4) discuss how the parent-child and family relationships can be affected through this process. This information can provide professionals with information they can use to assist families who make critical and potentially life-changing decisions for children with ASD.

Delay in Diagnosis and Treatment of Breast Cancer among Women Attending a Reference Service in Brazil

Science.gov (United States)

Romeiro Lopes, Tiara Cristina; Gravena, Angela Andréia França; Demitto, Marcela de Oliveira; Borghesan, Deise Helena Pelloso; Dell`Agnolo, Cátia Millene; Brischiliari, Sheila Cristina Rocha; Carvalho, Maria Dalva de Barros; Pelloso, Sandra Marisa

2017-11-26

Background: Cancer is a major public health problem. Early diagnosis and treatment are essential for reducing mortality. This study aimed to analyze factors associated with delay in breast cancer diagnosis and treatment among women attending a reference cancer service. Methods: This retrospective, cross-sectional study was performed with data collected from medical records and interviews conducted with women diagnosed with breast cancer and treated from October 2013 to October 2014 at a cancer reference hospital in Paraná, Southern Brazil. Results: A total of 82 participants were enrolled during the study period; their average age was 58.2 ± 11.5 years. The average time taken for final diagnosis of breast cancer was 102.5 ± 165.5 days. Treatment onset was delayed in the majority of cases, and the average time elapsing from diagnostic biopsy to onset of primary treatment was 72.3 ± 54.0 days. The odds of treatment delay were higher among the women with a low educational level. Conclusions: The results underline the need for proposals aimed at early detection, identification of risk factors and timely provision of treatment by health managers that focus on this group. Creative Commons Attribution License

Early x-ray diagnosis of coxarthrosis

Energy Technology Data Exchange (ETDEWEB)

Lingg, G.; Nebel, G.

Radiological and pathological comparisons on specimen of femur head and neck at autopsy have shown a statistical relationship between osteophytosis of the femoral head and ulcerations of the joint cartilage. Especially, there are highly significant relationships between the length of osteophytes and the diameter of the ulcera. The 'plaque'-sign is shown to be a very sensitive indicator of early arthrosis. So there exist semiquantitative parameters for the X-ray diagnosis of early coxarthrosis.

[Early diagnosis and therapy in pulmonary hypertension--aspects of a vision].

Science.gov (United States)

Ewert, R; Olschewski, H; Ghofrani, H A; Opitz, C F

2013-07-01

In patients with pulmonary hypertension progressive vascular changes in the lung precede the clinical and hemodynamic manifestations of the disease. Therefore, early diagnosis and timely treatment of the disease are crucial. This has been the topic of an expert meeting in Greifswald, Germany in June 2012. The current definition of pulmonary hypertension requires a mean pulmonary artery pressure ≥ 25 mmHg at rest, a hemodynamic abnormality already reflecting pulmonary vascular changes beyond early disease. There is increasing evidence supporting the concept that a lower pressure threshold at rest or an abnormal pressure response with exercise better characterize early disease. While right heart catheterization at rest remains the diagnostic gold standard other methods for detecting early disease are explored with echocardiography being the most frequently used technique. Targeted therapy has been approved for patients with pulmonary arterial hypertension (PAH, WHO-group I) in functional class II-IV. Preliminary data in functional class I patients suggest therapeutic potential of theses drugs in early disease as well. Current guidelines propose therapeutic goals based on parameters with prognostic importance. However, these recommendations are based on mostly retrospective analyses of pre-treatment data obtained in patients with pulmonary hypertension in functional class II-IV. Therefore, evidence-based therapeutic goals for early interventions in functional class I patients are lacking. © Georg Thieme Verlag KG Stuttgart · New York.

Change in cardiovascular risk factors following early diagnosis of type 2 diabetes: a cohort analysis of a cluster-randomised trial

OpenAIRE

Black, James A; Sharp, Stephen J; Wareham, Nicholas J; Sandbæk, Annelli; Rutten, Guy EHM; Lauritzen, Torsten; Khunti, Kamlesh; Davies, Melanie J; Borch-Johnsen, Knut; Griffin, Simon J; Simmons, Rebecca K

2014-01-01

Background There is little evidence to inform the targeted treatment of individuals found early in the diabetes disease trajectory. Aim To describe cardiovascular disease (CVD) risk profiles and treatment of individual CVD risk factors by modelled CVD risk at diagnosis; changes in treatment, modelled CVD risk, and CVD risk factors in the 5 years following diagnosis; and how these are patterned by socioeconomic status. Design and setting Cohort analysis of a cluster-randomised trial (ADDITION-...

[The new concept of osteoporosis. Early diagnosis, prevention and therapy are possible today].

Science.gov (United States)

Hesch, R D; Harms, H; Rittinghaus, E F; Brabant, G

1990-04-15

A paradigma of osteoporosis pathology is discussed, at the center of which is the hormone-related disturbance of the osteoblast/osteoclast functional unit. A liberal replacement of estrogen-gestagen in post-menopausal women is advocated. Early diagnosis with the aid of quantitative computed tomography makes it possible to establish the indication for timely hormonal treatment in the future, which can result in a measureable increase in bone mass. Late therapy, that is, treatment initiated after the occurrence of fractures, has proven largely ineffective.

Early diagnosis and successful treatment of paraneoplastic melanocytic proliferation.

Science.gov (United States)

Jansen, Joyce C G; Van Calster, Joachim; Pulido, Jose S; Miles, Sarah L; Vile, Richard G; Van Bergen, Tine; Cassiman, Catherine; Spielberg, Leigh H; Leys, Anita M

2015-07-01

Paraneoplastic melanocytic proliferation (bilateral diffuse uveal melanocytic proliferation, BDUMP) is a rare but devastating disease that causes progressive visual loss in patients who usually have an occult malignancy. Visual loss occurs as a result of paraneoplastic changes in the uveal tissue. In a masked fashion, the serum of two patients with BDUMP was evaluated for the presence of cultured melanocyte elongation and proliferation (CMEP) factor using cultured human melanocytes. We evaluated the efficacy of plasmapheresis as a treatment modality early in the disease in conjunction with radiation and chemotherapy. The serum of the first case patient was investigated after plasmapheresis and did not demonstrate proliferation of cultured human melanocytes. The serum of the second case was evaluated prior to treatment with plasmapheresis and did induce this proliferation. These findings are in accordance with the diminution of CMEP factor after plasmapheresis. Treatment with plasmapheresis managed to stabilise the ocular disease progression in both patients. In the past, visual loss due to paraneoplastic melanocytic proliferation was considered progressive and irreversible. We treated two patients successfully with plasmapheresis and demonstrated a relation between CMEP factor in the serum of these patients and proliferation of cultured melanocytes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Morbidity in early Parkinson's disease and prior to diagnosis

DEFF Research Database (Denmark)

Frandsen, Rune; Kjellberg, Jakob; Ibsen, Rikke

2014-01-01

BACKGROUND: Nonmotor symptoms are probably present prior to, early on, and following, a diagnosis of Parkinson's disease. Nonmotor symptoms may hold important information about the progression of Parkinson's disease. OBJECTIVE: To evaluated the total early and prediagnostic morbidities in the 3......, poisoning and certain other external causes, and other factors influencing health status and contact with health services. It was negatively associated with neoplasm, cardiovascular, and respiratory diseases. CONCLUSIONS: Patients with a diagnosis of Parkinson's disease present significant differences...

Predictors of successful early infant diagnosis of HIV in a rural district hospital in Zambézia, Mozambique.

Science.gov (United States)

Cook, Rebecca E; Ciampa, Philip J; Sidat, Mohsin; Blevins, Meridith; Burlison, Janeen; Davidson, Mario A; Arroz, Jorge A; Vergara, Alfredo E; Vermund, Sten H; Moon, Troy D

2011-04-01

A key challenge inhibiting the timely initiation of pediatric antiretroviral treatment is the loss to follow-up of mothers and their infants between the time of mothers' HIV diagnoses in pregnancy and return after delivery for early infant diagnosis of HIV. We sought to identify barriers to follow-up of HIV-exposed infants in rural Zambézia Province, Mozambique. We determined follow-up rates for early infant diagnosis and age at first test in a retrospective cohort of 443 HIV-infected mothers and their infants. Multivariable logistic regression models were used to identify factors associated with successful follow-up. Of the 443 mother-infant pairs, 217 (49%) mothers enrolled in the adult HIV care clinic, and only 110 (25%) infants were brought for early infant diagnosis. The predictors of follow-up for early infant diagnosis were larger household size (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.09-1.53), independent maternal source of income (OR, 10.8; 95% CI, 3.42-34.0), greater distance from the hospital (OR, 2.14; 95% CI, 1.01-4.51), and maternal receipt of antiretroviral therapy (OR, 3.15; 95% CI, 1.02-9.73). The median age at first test among 105 infants was 5 months (interquartile range, 2-7); 16% of the tested infants were infected. Three of four HIV-infected women in rural Mozambique did not bring their children for early infant HIV diagnosis. Maternal receipt of antiretroviral therapy has favorable implications for maternal health that will increase the likelihood of early infant diagnosis. We are working with local health authorities to improve the linkage of HIV-infected women to HIV care to maximize early infant diagnosis and care.

Early diagnosis and research of high myopia with primary open angle glaucoma

Directory of Open Access Journals (Sweden)

Yan Guo

2014-04-01

Full Text Available People with high myopia are high risk populations to have primary open angle glaucoma. Clinically, we found that patients with primary open angle glaucoma and high myopia is closely related. So to understand the clinical features of high myopia with primary open angle glaucoma and the importance of early diagnosis, to avoiding missed diagnosis or lower misdiagnosed rate, can help to improve the vigilance and level of early diagnosis of the clinicians. In this paper, high myopia with clinical features of primary open angle glaucoma, and the research progress on the main points of early diagnosis were reviewed.

EARLY DIAGNOSIS OF IMMUNE DISTURBANCES AND ITS CORRECTION IN THE TREATMENT OF MULTIORGAN FAILURE AND SEPTIC COMPLICATIONS AFTER OPERATIONS WITH ARTIFICIAL AND ASSIST CIRCULATION

Directory of Open Access Journals (Sweden)

V. S. Suskova

2009-01-01

Full Text Available The study has shown that early diagnosis of the type and degree of immune disturbances in preparation for the operation and the first signs of multiorgan failure and septic complications in the postoperative period in cardiac surgery patients were the rationale for the earlier substitution immunocorrection by immunomodulators of cytokine nature and intravenous immunoglobulin. It allowed increasing the efficiency of the treatment of postoperative complications and lower mortality after operations with artificial and assist circulation. 

Seasonal Allergies: Diagnosis, Treatment & Research

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... this page please turn JavaScript on. Feature: Seasonal Allergies Diagnosis, Treatment & Research Past Issues / Spring 2015 Table of Contents Diagnosis Testing for Allergies Knowing exactly what you are allergic to can ...

Breast cancer: Diagnosis and treatment

International Nuclear Information System (INIS)

Ariel, I.M.; Clearly, J.B.

1987-01-01

This is a publication about the diagnosis and treatment of breast cancer with an appeal for unified reporting of end results. Nine chapters cover historical reviews, risk factors, pathology-receptors-immunology, detection and diagnosis, treatment of the potentially curable patient, and treatment of the patient with advanced disease. The three concluding chapters discuss reconstruction, special clinical situations, and support for the patient. The role of radiation therapy is presented well. The current status of chemotherapy, hormonal therapy and combined therapies is also addressed by authoritative authors

Antenatal Hydronephrosis: Differential Diagnosis, Evaluation, and Treatment Options

Science.gov (United States)

Herndon, C.D. Anthony

2006-01-01

The diagnosis, evaluation and management of antenatal hydronephrosis has undergone a two stage paradigm shift since the advent of prenatal ultrasonography in the early 1980s. Initially the identification of a large number of asymptomatic infants appeared to afford the surgeon the opportunity for preemptive intervention. However, it has now become apparent that antenatal hydronephrosis (AH) is far more difficult to interpret thanoriginally perceived. The initial enthusiasm for surgery has now been replaced by a much more conservative approach to ureteropelvic junction(UPJ) obstruction, multi-cystic dysplastic kidney(MCDK), vesicoureteral reflux and the non-refluxing megaureter. This review will highlight the postnatal evaluation of AH and include an overview of the Society for Fetal Urology grading system for hydronephrosis. The differential diagnosis and treatment options for UPJ obstruction, vesicoureteral reflux, MCDK, duplication anomalies, megaureter, and posterior urethral valves will be discussed. PMID:17619702

Ventricular Septal Defect: Peculiarities of Early Neonatal and Postnatal Diagnosis, Clinical Manifestations, Treatment and Prognosis at the Contemporary Stage

Directory of Open Access Journals (Sweden)

K.A. Kalashnikova

2016-05-01

Full Text Available The article presents the literature data on the incidence, the main clinical manifestations, modern methods for early neonatal and postnatal diagnosis and treatment of ventricular septal defect in children, as well as the prognosis of this disease. According to the International Classification of Diseases, 10th revision, ventricular septal defect is classified as Q21.0 Ventricular septal defect. Incidence. In the overall structure of congenital malformations of the cardiovascular system, ventricular septal defect has about 20 %. Diagnosis. Moderate ventricular septal defect is manifested by shortness of breath, rapid fatigability during feeding, delay in physical development. Significant arterial-venous shunt in the first month of life is accompanied by a transient mild cyanosis when the baby is fed and cries. Infants develop high pulmonary hypertension, circulatory failure, malnutrition. Small noise intensity is typical for newborns in the first weeks or even months of life, which is due to physiologically increased intravascular pulmonary resistance. Systolic murmur is extended to the entire systole with maximum amplitude at the left edge of the sternum at the level of III–IV intercostal spaces. Sclerotic phase of pulmonary hypertension with ventricular septal defect is defined as Eisenmenger reaction. The clinical picture of this disorder depends on the degree of hemodynamic instability caused by the defect parameters, the pressure level in the pulmonary artery, vascular pulmonary resistance, the magnitude and direction of the shunt through the defect. Diagnosis is confirmed by characteristic changes in the electrocardiogram, echocardiography and chest radiograph. Treatment. Small muscular ventricular septal defects often close spontaneously during the first 2 years of life. Drug correction is needed in the development of congestive heart failure. The optimum age for surgery — 5–9 years.

Early dementia diagnosis and the risk of suicide and euthanasia.

Science.gov (United States)

Draper, Brian; Peisah, Carmelle; Snowdon, John; Brodaty, Henry

2010-01-01

Diagnosis of dementia is occurring earlier, and much research concerns the identification of predementia states and the hunt for biomarkers of Alzheimer's disease. Reports of suicidal behavior and requests for euthanasia in persons with dementia may be increasing. We performed a selective literature review of suicide risk in persons with dementia and the ethical issues associated with euthanasia in this population. In the absence of any effective treatments for Alzheimer's disease or other types of dementia, there is already evidence that persons with mild cognitive change and early dementia are at risk of suicidal behavior, often in the context of comorbid depression. The ensuing clinical, ethical, and legal dilemmas associated with physician-assisted suicide and euthanasia in the context of dementia are a subject of intense debate. By analogy, the preclinical and early diagnoses of Huntington's disease are associated with an increased risk of suicidal behavior. Thus there is the potential for a preclinical and early diagnosis of Alzheimer's disease (through biomarkers, neuroimaging, and clinical assessment) to result in increased suicide risk and requests for physician-assisted suicide. Although dementia specialists have long recognized the importance of a sensitive approach to conveying bad news to patients and families and the possibility of depressive reactions, suicidal behavior has not been regarded as a likely outcome. Such preconceptions will need to change, and protocols to monitor and manage suicide risk will need to be developed for this population. 2010 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Risk of early surgery for Crohn's disease: implications for early treatment strategies.

Science.gov (United States)

Sands, Bruce E; Arsenault, Joanne E; Rosen, Michael J; Alsahli, Mazen; Bailen, Laurence; Banks, Peter; Bensen, Steven; Bousvaros, Athos; Cave, David; Cooley, Jeffrey S; Cooper, Herbert L; Edwards, Susan T; Farrell, Richard J; Griffin, Michael J; Hay, David W; John, Alex; Lidofsky, Sheldon; Olans, Lori B; Peppercorn, Mark A; Rothstein, Richard I; Roy, Michael A; Saletta, Michael J; Shah, Samir A; Warner, Andrew S; Wolf, Jacqueline L; Vecchio, James; Winter, Harland S; Zawacki, John K

2003-12-01

In this study we aimed to define the rate of early surgery for Crohn's disease and to identify risk factors associated with early surgery as a basis for subsequent studies of early intervention in Crohn's disease. We assembled a retrospective cohort of patients with Crohn's disease diagnosed between 1991 and 1997 and followed for at least 3 yr, who were identified in 16 community and referral-based practices in New England. Chart review was performed for each patient. Details of baseline demographic and disease features were recorded. Surgical history including date of surgery, indication, and procedure were also noted. Risk factors for early surgery (defined as major surgery for Crohn's disease within 3 yr of diagnosis, exclusive of major surgery at time of diagnosis) were identified by univariate analysis. Multiple logistic regression was used to identify independent risk factors. Of 345 eligible patients, 69 (20.1%) required surgery within 3 yr of diagnosis, excluding the 14 patients (4.1%) who had major surgery at the time of diagnosis. Overall, the interval between diagnosis and surgery was short; one half of all patients who required surgery underwent operation within 6 months of diagnosis. Risk factors identified by univariate analysis as significantly associated with early surgery included the following: smoking; disease of small bowel without colonic involvement; nausea and vomiting or abdominal pain on presentation; neutrophil count; and steroid use in the first 6 months. Disease localized to the colon only, blood in the stool, use of 5-aminosalicylate, and lymphocyte count were inversely associated with risk of early surgery. Logistic regression confirmed independent associations with smoking as a positive risk factor and involvement of colon without small bowel as a negative risk factor for early surgery. The rate of surgery is high in the first 3 yr after diagnosis of Crohn's disease, particularly in the first 6 months. These results suggest that

Early breeding and pregnancy diagnosis in Syrian awassi sheep yearlings

International Nuclear Information System (INIS)

Al-Merestani, M. R.; Zarkawi, M.; Wardeh, M.

2000-01-01

Fifty-nine female yearlings of local Awassi sheep were randomly divided into 2 groups. Animals in group T (treated) were fitted with intravaginal sponges containing 60 mg of medroxyprogesterone acetate for 14 days followed by 400 IU of pregnant mare's serum gonadotrophin (PMSG) at sponge withdrawal, whereas group C (control) received no treatment. Oestrus rate was 92.7% and 11.2% for groups T and C, respectively. Lambing rate was 78% and 5.6% for groups T and C, respectively. Twinning rate was 31.3% in group T compared to zero in group C. Average birth weight for single born lams (4.7 ± 0.6 kg) was significantly (P > 0.05) higher than twin born lams (3.0 ± 0.5 kg) in group T. The average concentration of blood progesterone collected between days 17-19 after mating was 19.30 nmol/1 and the accuracy of early pregnancy diagnosis was 100%. It was concluded that, it is possible to induce synchronized oestrus, and to increase the twinning rate in Syrian Awassi sheep yearlings outside the breeding season, using intravaginal sponges and PMSG. In addition, early pregnancy diagnosis could be successfully determined in female Awassi sheep yearlings between days 17-19 after-mating. (author)

[Clinical guidelines for diagnosis, treatment and monitoring of patients with non-invasive breast cancer].

Science.gov (United States)

Brnijć, Zoran; Brkljacić, Boris; Drinković, Ivan; Jakić-Razumović, Jasminka; Kardum-Skelin, Ika; Krajina, Zdenko; Margaritoni, Marko; Strnad, Marija; Sarcević, Bozena; Tomić, Snjezana; Zic, Rado

2012-01-01

Breast cancer is the most common malignancy in women. Early diagnosis and more effective treatment of invasive breast cancer resulted in significant mortality reduction, improvement of survival and the quality of life of the patients. The management od non-invasive breast cancer, on the contrary, is still controversial and the problem of overdiagnosis and overtreatment of patients come to evidence. In the following text a multidisciplinary team of experts brings the first consensus guidelines aimed to standardize and optimize the criteria and management in diagnosis, treatment and monitoring of non-invasive breast cancer patients in the Republic of Croatia.

Lived experiences of breast cancer survivors after diagnosis, treatment and beyond: qualitative study.

Science.gov (United States)

Williams, Faustine; Jeanetta, Stephen C

2016-06-01

The number of breast cancer survivors has increased since 1990 due to advances in biomedical technology that lead to an increase in early diagnosis and treatment. Research on survivorship has focused on the psychological and treatment aspects of the disease. The goal of this study was focused on exploring the lived experiences of breast cancer survivors from diagnosis, treatment and beyond. To understand the lived experiences of women who are breast cancer survivors. A purposive sampling strategy was used to recruit participants from two Missouri cancer centres. A total of 15 women breast cancer survivors were interviewed. Three major themes emerged that described the lived experiences of the women. These were factors from the diagnosis and treatment management impacting survivorship, relationship and support system and implication of survivorship. Participants noted that coping with the diagnosis and treatment was a stressful journey and required lots of adjustment and changes. Some developed various techniques such as journaling their activities which provided comfort. In addition, support from family was shared as the key which gave them strength and courage through the different stages of treatment. However, they found it difficult to articulate what survivorship meant. Using in-depth interview techniques, this study shed light on the experiences of women who were diagnosed with breast cancer and have completed treatment. They acknowledged frustration with their diagnosis and body changes. Support received from family and friends helped them cope through their treatment. However, they felt abandoned once the treatment phase was over and were uncertain what survivorhood meant to them. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Acute abdomen in early pregnancy due to ovarian torsion following successful in vitro fertilization treatment

Directory of Open Access Journals (Sweden)

Hsing-Chun Tsai

2015-08-01

Conclusion: Ovarian hyperstimulation during IVF–embryo transfer treatment is a risk factor for developing adnexal torsion. Early diagnosis and prompt surgical intervention is the only way to protect the ovary and preserve the pregnancy. Laparoscopic surgery in early pregnancy causes no harm to the fetus and should be encouraged once the diagnosis is confirmed. Delaying surgery may induce serious infection and jeopardize the lives of both the fetus and mother.

Diagnosis and treatment of haemorrhoids

DEFF Research Database (Denmark)

Buntzen, Steen; Christensen, Peter Quist; Khalid, Ali

2013-01-01

These guidelines provide a review of diagnosis, conservative and surgical treatment of haemorrhoids with primary focus on the surgical treatment. In symptomatic hemorrhoids it is recommended, that conservative treatment is used as basic treatment regardless of grading. The vast majority of grade II...

Symptoms, Diagnosis & Treatment

Science.gov (United States)

... Bar Home Current Issue Past Issues Cover Story: Leukemia/Lymphoma Symptoms, Diagnosis & Treatment Past Issues / Summer 2008 Table of Contents For an enhanced version of this page please turn Javascript on. Leukemia Symptoms Frequent infections Fever and chills Anemia Easy ...

Clinical implications in laboratory parameter values in acute Kawasaki disease for early diagnosis and proper treatment.

Science.gov (United States)

Seo, Yu-Mi; Kang, Hyun-Mi; Lee, Sung-Churl; Yu, Jae-Won; Kil, Hong-Ryang; Rhim, Jung-Woo; Han, Ji-Whan; Lee, Kyung-Yil

2018-05-01

This study aimed to analyse laboratory values according to fever duration, and evaluate the relationship across these values during the acute phase of Kawasaki disease (KD) to aid in the early diagnosis for early-presenting KD and incomplete KD patients. Clinical and laboratory data of patients with KD (n=615) were evaluated according to duration of fever at presentation, and were compared between patients with and without coronary artery lesions (CALs). For evaluation of the relationships across laboratory indices, patients with a fever duration of 5 days or 6 days were used (n=204). The mean fever duration was 6.6±2.3 days, and the proportions of patients with CALs was 19.3% (n=114). C-reactive proteins (CRPs) and neutrophil differential values were highest and hemoglobin, albumin, and lymphocyte differential values were lowest in the 6-day group. Patients with CALs had longer total fever duration, higher CRP and neutrophil differential values and lower hemoglobin and albumin values compared to patients without CALs. CRP, albumin, neutrophil differential, and hemoglobin values at the peak inflammation stage of KD showed positive or negative correlations each other. The severity of systemic inflammation in KD was reflected in the laboratory values including CRP, neutrophil differential, albumin, and hemoglobin. Observing changes in these laboratory parameters by repeated examinations prior to the peak of inflammation in acute KD may aid in diagnosis of early-presenting KD patients.

Early diagnosis of autism spectrum disorder: stability and change in clinical diagnosis and symptom presentation.

Science.gov (United States)

Guthrie, Whitney; Swineford, Lauren B; Nottke, Charly; Wetherby, Amy M

2013-05-01

Although a diagnosis of autism spectrum disorder (ASD) appears to be stable in children as young as age three, few studies have explored stability of a diagnosis in younger children. Predictive value of diagnostic tools for toddlers and patterns of symptom change are important considerations for clinicians making early diagnoses. Most findings come from high-risk samples, but reports on children screened in community settings are also needed. Stability of diagnosis and Autism Diagnostic Observation Schedule – Toddler Module (ADOS-T) classifications and scores was examined across two time points in a sample of 82 children identified through the FIRST WORDS Project.Children received two comprehensive diagnostic evaluations at average ages of 19.39 (SD = 2.12) and 36.89 (SD = 3.85) months. Stability was 100% when confirming and ruling out a diagnosis of ASD based on a comprehensive diagnostic evaluation that included clinic and home observations,although diagnosis was initially deferred for 17% of the sample. Receiver Operating Characteristic curves revealed excellent sensitivity and acceptable specificity for the ADOS-T compared to concurrent diagnosis. Logistic regressions indicated good predictive value of initial ADOS-T scores for follow-up diagnosis. Finally, both ASD and Non-ASD children demonstrated a decrease in Social Affect scores (i.e.,improvement), whereas children with ASD demonstrated an increase in Restricted and Repetitive Behavior scores (i.e., worsening), changes that were accounted for by nonverbal developmental level in mixed model analyses. Short-term stability was documented for children diagnosed at 19 months on average, although a minority of children initially showed unclear diagnostic presentations.Findings highlight utility of the ADOS-T in making early diagnoses and predicting follow-up diagnoses. Children with ASD demonstrated improvement in social communication behaviors and unfolding of repetitive behaviors, suggesting that certain

HIV screening at health facilities and community pharmacies in Kenya : Enhancing test uptake and early diagnosis

NARCIS (Netherlands)

Mugo, P.M.

2017-01-01

Despite a tremendous scale-up of antiretroviral therapy, as many as 54% of HIV-infected persons globally remain undiagnosed hence are not on treatment. This thesis presents findings from a series of studies conducted in Coastal Kenya aiming to enhance HIV test uptake and early diagnosis. We found

Prenatal Diagnosis

Directory of Open Access Journals (Sweden)

Ozge Ozalp Yuregir

2012-02-01

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

Cerebrotendinous xanthomatosis: Need for early diagnosis

Directory of Open Access Journals (Sweden)

Muhammed K

2006-01-01

Full Text Available Cerebrotendinous xanthomatosis is a rare autosomal recessive lipid storage disease characterized by widespread tissue deposition of two neutral sterols, cholestanol and cholesterol, resulting in tendinous xanthomas, juvenile cataracts, progressive neurological defects and premature death from arteriosclerosis. The primary biochemical defect is deficiency of hepatic mitochondrial enzyme sterol-27-hydroxylase which catalyses the hydroxylation of cholestanol (5-alpha dehydro derivative of cholesterol and this deficiency decreases bile acid synthesis. Substantial elevation of serum cholestanol and urinary bile alcohols with low to normal plasma cholesterol concentration establishes the diagnosis. Cerebrotendinous xanthomatosis is exceptionally rare in the Indian population. We are reporting a woman with this rare disorder, who was on antiepileptic and antipsychotic drugs for a prolonged period and whose original condition went undiagnosed. She presented with xanthomas on the Achilles tendons and the upper end of tibia. She was mentally subnormal and her serum cholestanol level was raised. Her younger sister too was severely affected by this disorder. Early treatment with chenodeoxycholic acid is known to prevent disease progression.

Early Diagnosis of Autism Spectrum Disorder: Stability and Change in Clinical Diagnosis and Symptom Presentation

Science.gov (United States)

Guthrie, Whitney; Swineford, Lauren B.; Nottke, Charly; Wetherby, Amy M.

2013-01-01

Background: Although a diagnosis of autism spectrum disorder (ASD) appears to be stable in children as young as age three, few studies have explored stability of a diagnosis in younger children. Predictive value of diagnostic tools for toddlers and patterns of symptom change are important considerations for clinicians making early diagnoses. Most…

Early diagnosis of retinopathy in juvenile diabetes by fluorescence angiography

International Nuclear Information System (INIS)

Krzywicki, S.; Slankiewicz, A.; Jablonska-Budaj, U.

1980-01-01

The authors defined the usefulness of the fluorescein angiography of the retina and choroid in the early stage diagnosis of diabetic retinopathy in children comparing its results to the traditional ophthalmoscopy. Examination involved 50 children from 4 to 18 (30 boys and 20 girls) on insulin treatment. The duration of the disease was 1 to 14 years (average 7.36 years). Ophthalmoscopy showed pathological changes in 24% of the children. The fluorescein angiography visualized more microaneurysms compared to ophthalmoscopy and showed them sometimes in the eyes where they had not been found in eye fundus studies. By means of angiography the early and advanced stages of vascular complications were found in 64% of patients. Comparing to ophthalmoscopy a 40% increase was noted. Fluorescein angiography can lead to the decrease in the number of patients with markedly impaired visual acuity and cases of blindness in the diabetic population. (author)

Early diagnosis of retinopathy in juvenile diabetes by fluorescence angiography

Energy Technology Data Exchange (ETDEWEB)

Krzywicki, S; Slankiewicz, A; Jablonska-Budaj, U [Szpital-Pomnik Centrum Zdrowia Dziecka, Warsaw (Poland). Zespol Problemowy Okulistiky

1980-09-01

The authors defined the usefulness of the fluorescein angiography of the retina and choroid in the early stage diagnosis of diabetic retinopathy in children comparing its results to the traditional ophthalmoscopy. Examination involved 50 children from 4 to 18 (30 boys and 20 girls) on insulin treatment. The duration of the disease was 1 to 14 years (average 7.36 years). Ophthalmoscopy showed pathological changes in 24% of the children. The fluorescein angiography visualized more microaneurysms compared to ophthalmoscopy and showed them sometimes in the eyes where they had not been found in eye fundus studies. By means of angiography the early and advanced stages of vascular complications were found in 64% of patients. Comparing to ophthalmoscopy a 40% increase was noted. Fluorescein angiography can lead to the decrease in the number of patients with markedly impaired visual acuity and cases of blindness in the diabetic population.

Utility of ultrasound in the early diagnosis of childhood neutropenic enterocolitis

International Nuclear Information System (INIS)

Muro, D.; Sanguesa, C.; Bermudez, M.; Verdeguer, A.

1999-01-01

To determine the utility of ultrasound in the diagnosis of neutropenic enterocolitis (NEC) in children with cancer or AIDS, and to establish the differential diagnosis with respect to more common causes of acute abdomen. We studied eight patients diagnosed as having NEC over a ten-year period, gathering the clinical data and imaging studied for each. Seven of the children were cancer patients and the remaining child had AIDS. The imaging methods used were plain radiography, B-mode ultrasound and color Doppler ultrasound: in addition, one patient underwent a barium enema. All eight patients presented abdominal pain, predominantly in right iliac fossa, and fever; the neutrophil count was under 100/mm''3. The most common plain abdominal X-ray image was the absence of air in right iliac fossa and dilation of the small bowel loops. One child presented submucosal and subserosal ectopic air colon and cecum, air in the intrahepatic portal system and in peritoneum. Abdominal ultrasound revealed thickening of the cecal mucosa in every case, and color Doppler ultrasound disclosed increased vascularization of the intestinal wall. Six children received medical treatment and two underwent surgery. Three patients died, one a few hours after the surgical procedure and the other two a few days after onset of NEC and initiation of medical treatment. Abdominal ultrasound is the best imaging technique for early diagnosis of NEC and assessment of the response to medical treatment, Moreover, it can be performed at bedside, making it unnecessary to move the patient from his room. (Author) 26 refs

Diagnosis, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: A Review.

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Sanchez, Edgar; Vannier, Edouard; Wormser, Gary P; Hu, Linden T

2016-04-26

Lyme disease, human granulocytic anaplasmosis (HGA), and babesiosis are emerging tick-borne infections. To provide an update on diagnosis, treatment, and prevention of tick-borne infections. Search of PubMed and Scopus for articles on diagnosis, treatment, and prevention of tick-borne infections published in English from January 2005 through December 2015. The search yielded 3550 articles for diagnosis and treatment and 752 articles for prevention. Of these articles, 361 were reviewed in depth. Evidence supports the use of US Food and Drug Administration-approved serologic tests, such as an enzyme immunoassay (EIA), followed by Western blot testing, to diagnose extracutaneous manifestations of Lyme disease. Microscopy and polymerase chain reaction assay of blood specimens are used to diagnose active HGA and babesiosis. The efficacy of oral doxycycline, amoxicillin, and cefuroxime axetil for treating Lyme disease has been established in multiple trials. Ceftriaxone is recommended when parenteral antibiotic therapy is recommended. Multiple trials have shown efficacy for a 10-day course of oral doxycycline for treatment of erythema migrans and for a 14-day course for treatment of early neurologic Lyme disease in ambulatory patients. Evidence indicates that a 10-day course of oral doxycycline is effective for HGA and that a 7- to 10-day course of azithromycin plus atovaquone is effective for mild babesiosis. Based on multiple case reports, a 7- to 10-day course of clindamycin plus quinine is often used to treat severe babesiosis. A recent study supports a minimum of 6 weeks of antibiotics for highly immunocompromised patients with babesiosis, with no parasites detected on blood smear for at least the final 2 weeks of treatment. Evidence is evolving regarding the diagnosis, treatment, and prevention of Lyme disease, HGA, and babesiosis. Recent evidence supports treating patients with erythema migrans for no longer than 10 days when doxycycline is used and prescription

Automatic CDR Estimation for Early Glaucoma Diagnosis

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Sarmiento, A.; Sanchez-Morillo, D.; Jiménez, S.; Alemany, P.

2017-01-01

Glaucoma is a degenerative disease that constitutes the second cause of blindness in developed countries. Although it cannot be cured, its progression can be prevented through early diagnosis. In this paper, we propose a new algorithm for automatic glaucoma diagnosis based on retinal colour images. We focus on capturing the inherent colour changes of optic disc (OD) and cup borders by computing several colour derivatives in CIE L∗a∗b∗ colour space with CIE94 colour distance. In addition, we consider spatial information retaining these colour derivatives and the original CIE L∗a∗b∗ values of the pixel and adding other characteristics such as its distance to the OD centre. The proposed strategy is robust due to a simple structure that does not need neither initial segmentation nor removal of the vascular tree or detection of vessel bends. The method has been extensively validated with two datasets (one public and one private), each one comprising 60 images of high variability of appearances. Achieved class-wise-averaged accuracy of 95.02% and 81.19% demonstrates that this automated approach could support physicians in the diagnosis of glaucoma in its early stage, and therefore, it could be seen as an opportunity for developing low-cost solutions for mass screening programs. PMID:29279773

Diagnosis and treatment of superficial esophageal cancer.

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Barret, Maximilien; Prat, Frédéric

2018-01-01

Endoscopy allows for the screening, early diagnosis, treatment and follow up of superficial esophageal cancer. Endoscopic submucosal dissection has become the gold standard for the resection of superficial squamous cell neoplasia. Combinations of endoscopic mucosal resection and radiofrequency ablation are the mainstay of the management of Barrett's associated neoplasia. However, protruded, non-lifting or large lesions may be better managed by endoscopic submucosal dissection. Novel ablation tools, such as argon plasma coagulation with submucosal lifting and cryoablation balloons, are being developed for the treatment of residual Barrett's esophagus, since iatrogenic strictures still hamper the development of extensive circumferential resections in the esophagus. Optimal surveillance modalities after endoscopic resection are still to be determined. The assessment of the risk of lymph-node metastases, as well as of the need for additional treatments based on qualitative and quantitative histological criteria, balanced to the patient's condition, requires a dedicated multidisciplinary team decision process. The need for trained endoscopists, expert pathologists and surgeons, and specialized multidisciplinary meetings underlines the role of expert centers in the management of superficial esophageal cancer.

Rhabdomyolysis: Pathogenesis, Diagnosis, and Treatment

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Torres, Patrick A.; Helmstetter, John A.; Kaye, Adam M.; Kaye, Alan David

2015-01-01

Background Rhabdomyolysis is a complex medical condition involving the rapid dissolution of damaged or injured skeletal muscle. Methods This review focuses on the epidemiology, pathophysiology, causes, presentation, diagnosis, complications, management, and anesthetic considerations related to rhabdomyolysis. Results Any form of muscle damage––and by extension any entity that causes muscle damage––can initiate rhabdomyolysis. One of the most important treatment goals when rhabdomyolysis is suspected is avoiding acute kidney injury. Conclusion All clinicians should be aware of common causes, diagnosis, and treatment options. PMID:25829882

Early diagnosis of acoustic neuroma by the vestibular test

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Haid, T; Rettinger, G; Berg, M; Wigand, M E

1981-11-01

In a series of 390 cases with suspicion of acoustic neurinomas 78 such tumors could be diagnosed, including 12 early stage neurinomas. This relatively high detection quote of small neurinomas is due to a special diagnostical programme: Every patient with unilateral and sensoneural hearingloss, independent of vertigo anamnesis or of the result of X-rays must be further examined by a vestibular test. All 78 patients with acoustic neuroma had pathological vestibular findings. The positional test turned out to be the most sensitive examination in the early diagnosis of acoustic neuromas and yields a still higher incidence than the thermic test: 95% of the patients with a neuroma showed pathological findings in the positional test. Every patient suffering from an unidentified unilateral and sensoneural hearingloss combined with a pathological result in the positional test must be further checked by a cisternomeatography or computerized tomography using airinsufflation. Every fifth of these patients showed typical signs of an acoustic neuroma in the neuroradiological tests. 68 neuromas are operated today and verfied histologically, 10 patients are still waiting for surgical treatment.

Autism spectrum disorders: an overview on diagnosis and treatment

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Helena Brentani

2013-01-01

Full Text Available Pervasive developmental disorders are now commonly referred to as autism spectrum disorders (ASDs. ASDs present with a range of severity and impairments, and often are a cause of severe disability, representing a major public health concern. The diagnostic criteria require delays or abnormal functioning in social interaction, language, and/or imaginative play within the first 3 years of life, resulting in a deviation from the developmental pattern expected for the age. Because establishing a diagnosis of ASD is possible as early as 18-24 months of age, clinicians should strive to identify and begin intervention in children with ASD as soon as signs are manifest. Increasing efforts are underway to make ASD screening universal in pediatric healthcare. Given the crucial importance of early identification and multiple modalities of treatment for ASD, this review will summarize the diagnostic criteria, key areas for assessment by clinicians, specific scales and instruments for assessment, and discussion of evidence-based treatment programs and the role of specific drug therapies for symptom management.

The Impact of Next-Generation Sequencing on the Diagnosis and Treatment of Epilepsy in Paediatric Patients.

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Mei, Davide; Parrini, Elena; Marini, Carla; Guerrini, Renzo

2017-08-01

Next-generation sequencing (NGS) has contributed to the identification of many monogenic epilepsy syndromes and is favouring earlier and more accurate diagnosis in a subset of paediatric patients with epilepsy. The cumulative information emerging from NGS studies is rapidly changing our comprehension of the relations between early-onset severe epilepsy and the associated neurological impairment, progressively delineating specific entities previously gathered under the umbrella definition of epileptic encephalopathies, thereby influencing treatment choices and limiting the most aggressive drug regimens only to those conditions that are likely to actually benefit from them. Although ion channel genes represent the gene family most frequently causally related to epilepsy, other genes have gradually been associated with complex developmental epilepsy conditions, revealing the pathogenic role of mutations affecting diverse molecular pathways that regulate membrane excitability, synaptic plasticity, presynaptic neurotransmitter release, postsynaptic receptors, transporters, cell metabolism, and many formative steps in early brain development. Some of these discoveries are being followed by proof-of-concept laboratory studies that might open new pathways towards personalized treatment choices. No specific treatment is available for most of the monogenic disorders that can now be diagnosed early using NGS, and the main benefits of knowing the specific cause include etiological diagnosis, better prognostication and genetic counselling; however, for a limited number of disorders, timely treatment based on their known molecular pathology is already possible and sometimes decisive. Discovery of a causative gene defect associated with a non-progressive course may reduce the need for further diagnostic investigations in the search for a progressive disorder at the biochemical and imaging level. NGS has also improved the turnaround time for molecular diagnosis and allowed more

Early diagnosis of Alzheimer's disease. Clinical significance and future perspectives

International Nuclear Information System (INIS)

Buerger, K.; Teipel, S.J.; Hampel, H.

2000-01-01

Early diagnosis of Alzheimer's disease describes the recognition and diagnosis in patients with very mild dementia. Internationally accepted diagnostic criteria support the diagnosis based on clinical evaluation. Recent advances in structural and functional neuroimaging as well as studies on specific proteins in the cerebro-spinal fluid that are related to distinct pathophysiological disease processes are most promising approaches to defining biological markers of Alzheimer's disease. (orig.) [de

Early Chest Computed Tomography Scan to Assist Diagnosis and Guide Treatment Decision for Suspected Community-acquired Pneumonia.

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Claessens, Yann-Erick; Debray, Marie-Pierre; Tubach, Florence; Brun, Anne-Laure; Rammaert, Blandine; Hausfater, Pierre; Naccache, Jean-Marc; Ray, Patrick; Choquet, Christophe; Carette, Marie-France; Mayaud, Charles; Leport, Catherine; Duval, Xavier

2015-10-15

Clinical decision making relative to community-acquired pneumonia (CAP) diagnosis is difficult. Chest radiograph is key in establishing parenchymal lung involvement. However, radiologic performance may lead to misdiagnosis, rendering questionable the use of chest computed tomography (CT) scan in patients with clinically suspected CAP. To assess whether early multidetector chest CT scan affects diagnosis and management of patients visiting the emergency department with suspected CAP. A total of 319 prospectively enrolled patients with clinically suspected CAP underwent multidetector chest CT scan within 4 hours. CAP diagnosis probability (definite, probable, possible, or excluded) and therapeutic plans (antibiotic initiation/discontinuation, hospitalization/discharge) were established by emergency physicians before and after CT scan results. The adjudication committee established the final CAP classification on Day 28. Chest radiograph revealed a parenchymal infiltrate in 188 patients. CAP was initially classified as definite in 143 patients (44.8%), probable or possible in 172 (53.8%), and excluded in 4 (1.2%). CT scan revealed a parenchymal infiltrate in 40 (33%) of the patients without infiltrate on chest radiograph and excluded CAP in 56 (29.8%) of the 188 with parenchymal infiltrate on radiograph. CT scan modified classification in 187 (58.6%; 95% confidence interval, 53.2-64.0), leading to 50.8% definite CAP and 28.8% excluded CAP, and 80% of modifications were in accordance with adjudication committee classification. Because of CT scan, antibiotics were initiated in 51 (16%) and discontinued in 29 (9%), and hospitalization was decided in 22 and discharge in 23. In CAP-suspected patients visiting the emergency unit, early CT scan findings complementary to chest radiograph markedly affect both diagnosis and clinical management. Clinical trial registered with www.clinicaltrials.gov (NCT 01574066).

Diagnosis, treatment and prognosis of neuroendocrine tumor in stomach and duodenum

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Xiang-yao WANG

2016-04-01

Full Text Available Objective 　To investigate the clinicopathological characteristics and prognosis of patients with neuroendocrine tumor in stomach and duodenum for early diagnosis. Methods 　The clinical, endoscopic and pathological data of 20 patients admitted to the PLA General Hospital from Jan. 2012 to Jan. 2015 and diagnosed as gastric and duodenal neuroendocrine tumor were collected for retrospective analysis. The histopathological classification of the disease was made according to the WHO 2010 Classification of the Neuroendocrine Neoplasms. Result 　Ten male and 10 female patients aged between 35 and 77 (mean 55.5±10.6 years old were recruited in the present study. Tumor located in the stomach in 13 cases, and in duodenum in 7 cases. The maximum diameter of the tumor was 0.2-2.5cm. Endoscopic features included polypoid protrusion, hemispheric submucosal protrusion, and mucosal erosion. All the patients were treated endoscopically, among them, four patients were treated with electrocoagulation and electrosection, 10 by endoscopic resection (EMR, and 6 by endoscopic submucosal dissection (ESD. In one patient, surgical excision was done after ESD. Biopsy under gastroscopy and endoscopic ultrasonography were conducive to the diagnosis and treatment. According to the histopathological classification, 19 cases were classified as NET grade 1, and another one as NET grade 2. The follow-up study showed no metastasis and recurrence. Conclusions 　The early diagnosis and treatment for gastric and duodenal neuroendocrine tumor can lead to satisfactory results. DOI: 10.11855/j.issn.0577-7402.2016.03.12

CURRENT PROBLEMS OF DIAGNOSIS AND TREATMENT OF MILD COGNITIVE IMPAIRMENTS IN CHILDREN

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G.A. Karkashadze

2011-01-01

Full Text Available In practical pediatrics specialists paid wrongly little attention to identification and treatment of cognitive disorders in children. At the same time it is difficult to overestimate the influence of cognitive functions on the formation of human personality and social maladjustment in this part of population. The paper is devoted to the diagnosis and treatment of cognitive impairments. In addition, the classification of this pathology, highlighting aetiopathogenetic factors, prognosis are showed. One of the important problems of early revealing of cognitive impairments and appropriate management of children with this pathology according to the authors opinion are the following: the deficiency of educational programs for training specialists in neurology, lack of knowledge concerning the possibilities of psychological-pedagogical correction, inefficient system of neurological techniques for primary care. Key words: cognitive function, mild cognitive impairment, classification, diagnosis, treatment, prognosis, social maladjustment, psychopedagogical support, children. (Pediatric Pharmacology. — 2011; 8 (5: 37–41.

Experience of diagnosis and treatment of Gitelman syndrome

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Shuo TIAN

2017-12-01

Full Text Available Objective To analyze the clinical characteristics and provide the experiences in diagnosis and treatment of 3 cases of Gitelman syndrome (GitS. Methods Three patients diagnosed as GitS were selected as the objects in Tangshan gongren Hospital from Aug. 2010 to Jan. 2017. Their clinical data were retrospectively analyzed and combined with the related literatures, and the clinical characteristics and treatment experiences of the disease were discussed. Results Of the 3 patients, 2 were teenager onset and another one was adult onset. The blood pressure of the 3 patients was normal, and the clinical features were as paroxysmal weakness, tetany, polyuria and nocturia increased. Laboratory tests revealed low potassium, low sodium, low chlorine, hypomagnesemia, occasionally hypocalcemia, high urinary potassium, metabolic alkalosis, urine Ca/Cr ≤0.2, plasma rennin activity increased significantly and plasma aldosterone was normal. Being eliminated symptoms and phenomena were the potassium intake inadequate, loss of potassium in digestive tract, taking potassium excretion drugs, primary aldosteronism and Cushing syndrome. etc. Patients got symptoms relief and serum potassium level rose to near normal level after receiving the combined potassium and magnesium supplement. Conclusions The clinical characteristics of GitS manifest as fatigue, tetany, normal blood pressure, hypokalemia, hypomagnesemia, metabolic alkalosis, plasma rennin activity increases significantly and plasma aldosterone rises or normal. Treatment with combined potassium and magnesium supplement may lead to a good prognosis, but hypomagnesemia is harder to correct. Kidney damage can be avoided by early diagnosis and treatment. DOI: 10.11855/j.issn.0577-7402.2017.12.13

Induction of synchronized oestrous and early pregnancy diagnosis in Syrian awassi ewes, outside the breeding season

International Nuclear Information System (INIS)

Zarkawi, M.; Al-Merstani, M.R.; Wardeh, M.

2000-01-01

An experiment was conducted on indigenous awassi ewes to evaluate the effect of intravaginal progestogen sponges containing 60 mg of medroxyprogesterone acetate (MAP) followed by treatment with pregnant mare serum gonadotrophin (PMSG) on inducing synchronized oestrous outside the normal breeding season, improving fecundity and on early diagnosis of pregnancy using progesterone profiles. 96 awassi ewes were divided into 2 groups. ewes in the Group T, were fitted with MAP for 14 days and injected with 600 IU PMSG at the sponge withdrawal, whereas ewes in the control Group C, received no treatment. The results indicated that oestrous was induced within 36-48 h post sponge withdrawal in 82% of the treated ewes. There were significant (p<0.05) differences between groups T and C in total oestrous response, lambing rate, and fecundity. The means being 96% and 32.6%; 80% and 32.6% and 137.5% and 106.7%, respectively. The accuracy of early diagnosis of pregnancy at 17-19 days post-mating was 100%. The mean birth weight of lambs was similar in both groups (4.3 and 4,4 Kg for groups T and C, respectively).However, single born lambs were significantly (p<0.05) heavier at birth than individual twins (5.0 versus 3.9 Kg). It was concluded that it is possible to induce synchronized and fertile oestrous, successful pregnancy and lambing, and that serum progesterone measurement determinations are useful tool for early pregnancy diagnosis in awassi ewes induced oestrous and bred out of season. (author)

EARLY DIAGNOSIS OF CRANIOSYNOSTOSIS IN INFANTS AT PRIMARY HEALTH CARE

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Skoric Jasmina

2014-12-01

Full Text Available Craniosynostosis or premature fusion of one or more cranial sutures in infants disturbs normal brain growth. This condition causes abnormal skull configuration, increased intracranial pressure, headache, strabismus, blurred vision, blindness, psychomotor retardation. The diagnosis of craniosynostosis is very simple. Pediatricians should routinely assess neurological status and measure head circumference and anterior fontanelle. When necessary, ultrasound of CNS, X-ray and cranial CT scan can be done. When it comes to this condition, early diagnosis and surgical intervention are of utmost importance. In this paper, we have presented a case on craniosynostosis in a female infant, discovered in the third month of life during systematic review that included measurement of head circumference, palpation of anterior fontanelle and cranial sutures. The child was referred to a neurosurgeon who performed the CT scan of endocranium and confirmed the initial diagnosis of craniosynostosis. With head circumference of 40 cm and fused anterior fontanelle, the surgery was timely performed at the sixth month of life due to early diagnosis.

Early diagnosis of craniosynostosis in infants at primary health care

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Skoric Jasmina

2014-12-01

Full Text Available Craniosynostosis or premature fusion of one or more cranial sutures in infants disturbs normal brain growth. This condition causes abnormal skull configuration, increased intracranial pressure, headache, strabismus, blurred vision, blindness, psychomotor retardation. The diagnosis of craniosynostosis is very simple. Pediatricians should routinely assess neurological status and measure head circumference and anterior fontanelle. When necessary, ultrasound of CNS, X-ray and cranial CT scan can be done. When it comes to this condition, early diagnosis and surgical intervention are of utmost importance. In this paper, we have presented a case on craniosynostosis in a female infant, discovered in the third month of life during systematic review that included measurement of head circumference, palpation of anterior fontanelle and cranial sutures. The child was referred to a neurosurgeon who performed the CT scan of endocranium and confirmed the initial diagnosis of craniosynostosis. With head circumference of 40 cm and fused anterior fontanelle, the surgery was timely performed at the sixth month of life due to early diagnosis.

Early diagnosis of slipped capital femoral epiphysis on magnetic resonance imaging: A case report with review of literature

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Sanjay M Khaladkar

2015-01-01

Full Text Available Slipped capital femoral epiphysis (SCFE is a common hip condition occurring in adolescents, with a prevalence of 10 cases per 100,000 children. It usually affects younger age group from 10 to 17 years. The condition is usually found to be coexistent with various other conditions such as obesity, growth surges, and endocrine disorders such as hypothyroidism, growth hormone supplementation, hypogonadism, and pan-hypopituitarism. Patients present with limping and a poorly localized pain in the hip, groin, thigh, or knee. Diagnosis of the condition is often delayed due to its nonassociation with trauma and hence increases the chances of developing various complications such as avascular necrosis, chondrolysis and deformity. Majority of researches of SCFE are from Europe and North America, while studies in Asian populations are rare. Delay in diagnosis of SCFE is usually due to patients presenting with knee pain. Imaging can thus aid in early diagnosis and appropriate treatment of the disease, which in turn reduces incidence of deformity and disability in the affected children. Bilateral hip radiography - anteroposterior and frog′s-leg lateral views and magnetic resonance imaging (MRI are the radiological techniques that help in early diagnosis. MRI detects early physeal changes of both preslip and SCFE even when radiographs and computed tomography are normal. MRI should be routinely used to diagnose early SCFE in preslip stage to avoid further complications.

Techniques for early diagnosis of oral squamous cell carcinoma: Systematic review

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Carreras-Torras, Clàudia

2015-01-01

Background and objectives The diagnosis of early oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) is of paramount clinical importance given the mortality rate of late stage disease. The aim of this study is to review the literature to assess the current situation and progress in this area. Material and Methods A search in Cochrane and PubMed (January 2006 to December 2013) has been used with the key words “squamous cell carcinoma”, “early diagnosis” “oral cavity”, “Potentially Malignant Disorders” y “premalignant lesions”. The inclusion criteria were the use of techniques for early diagnosis of OSCC and OPMD, 7 years aged articles and publications written in English, French or Spanish. The exclusion criteria were case reports and studies in other languages. Results Out of the 89 studies obtained initially from the search 60 articles were selected to be included in the systematic review: 1 metaanalysis, 17 systematic reviews, 35 prospective studies, 5 retrospective studies, 1 consensus and 1 semi-structured interviews. Conclusions The best diagnostic technique is that which we have sufficient experience and training. Definitely tissue biopsy and histopathological examination should remain the gold standard for oral cancer diagnose. In this systematic review it has not been found sufficient scientific evidence on the majority of proposed techniques for early diagnosis of OSCC, therefore more extensive and exhaustive studies are needed. Key words: Squamous cell carcinoma, early diagnosis, oral cavity, potentially malignant disorders, premalignant lesions. PMID:25662554

Ophthalmic examination in early diagnosis of Alzheimer's disease

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Xin Li

2018-02-01

Full Text Available Alzheimer's disease is a progressive neurodegenerative disorder causing irreversible deterioration in memory and loss of self-care ability, which is seriously affecting the quality of life. There is no cure for Alzheimer's disease. Medication only can control the progression of the disease. Early diagnosis and control of disease progress is of great significance in improving the quality of life of the patients and reducing the burden of family and society. Ophthalmic examination is seen as a window which can “see” brain directly, and some changes in the eye can reflect the changes of the brain most directly. This paper reviews the ophthalmic examination of Alzheimer's disease, including optical coherence tomography(OCT, visual field, contrast sensitivity and eye movements, et al. We hope to provide a new idea for the early diagnosis of Alzheimer's disease.

Anxiety disorders: diagnosis and treatment.

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Jack, R A; Mathew, R J

1985-07-01

Pathologic anxiety, marked by inappropriate apprehension and/or fear, causes patients to seek help. Anxiety is associated with a wide variety of physical illnesses, and these must be initially considered when making a diagnosis. Similarly, anxiety associated with a wide variety of psychiatric syndromes must also be considered. Finally, the possibility of transient situational anxiety is ever present. Once it is determined that a primary anxiety disorder exists, then the presence or absence of phobias, panic attacks, and chronic "free-floating" anxiety will fully characterize the disorder. With an accurate diagnosis in hand, a multifaceted treatment approach can be designed. Effective treatments now exist for phobic and panic disorders, and more effective treatment for chronic generalized anxiety may be forthcoming.

Plague Diagnosis and Treatment

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

Pediatric urinary tract infections: diagnosis and treatment.

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Bitsori, Maria; Galanakis, Emmanouil

2012-10-01

Urinary tract infection (UTI) is the most common serious bacterial infection in childhood. Prompt diagnosis and treatment are required for the optimal clinical outcome and the prevention of long-term morbidity and sequelae. Diagnosis and treatment of UTI may seem to be easy tasks, but they remain among the most controversial issues in pediatrics. Consequently, children suspected for UTIs are investigated and treated differently in different settings. The absence of typical clinical presentation and the uncertainties in setting the index of suspicion, collecting appropriate urine samples and interpreting results, combined with different antibiotic policies in the face of increasing resistance of uropathogens, contribute to the controversy. Recently issued guidelines have attempted to settle several thorny aspects in diagnosis and treatment, but quite a few issues still remain controversial. In this review, the authors explore the current situation on diagnosis and treatment of childhood UTI in better understanding their pathogenesis and prevalence in different child populations, discuss recently evaluated diagnostic tests and the new management guidelines.

Discussion of difficult problems of early diagnosis of pancreatic cancer

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GUO Xiaozhong

2014-08-01

Full Text Available Pancreatic cancer is a common malignant neoplasm of the pancreas with an extremely high mortality. Currently, the early diagnosis of pancreatic cancer is still not ideal. Attention should be paid to some clinical warning symptoms, such as unexplained abdominal and back pain, jaundice, and unexpected diabetes. Additionally, the combined use of CA19-9, CEA, and other tumor markers, the attention to biochemical indicators, the detection of mutation in KAI1 or p53 gene, and the exploration of the value of miRNA in clinical diagnosis are of great significance. On the other hand, ultrasound, CT, MRCP, ERCP, PET-CT, and other imaging methods, as well as effective collection of cytology specimens, should be performed. Thus, there is hope for the early diagnosis of pancreatic cancer.

Bilateral Medial Medullary Stroke: A Challenge in Early Diagnosis

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Amir M. Torabi

2013-01-01

Full Text Available Bilateral medial medullary stroke is a very rare type of stroke, with catastrophic consequences. Early diagnosis is crucial. Here, I present a young patient with acute vertigo, progressive generalized weakness, dysarthria, and respiratory failure, who initially was misdiagnosed with acute vestibular syndrome. Initial brain magnetic resonance imaging (MRI that was done in the acute phase was read as normal. Other possibilities were excluded by lumbar puncture and MRI of cervical spine. MR of C-spine showed lesion at medial medulla; therefore a second MRI of brain was requested, showed characteristic “heart appearance” shape at diffusion weighted (DWI, and confirmed bilateral medial medullary stroke. Retrospectively, a vague-defined hyperintense linear DWI signal at midline was noted in the first brain MRI. Because of the symmetric and midline pattern of this abnormal signal and similarity to an artifact, some radiologists or neurologists may miss this type of stroke. Radiologists and neurologists must recognize clinical and MRI findings of this rare type of stroke, which early treatment could make a difference in patient outcome. The abnormal DWI signal in early stages of this type of stroke may not be a typical “heart appearance” shape, and other variants such as small dot or linear DWI signal at midline must be recognized as early signs of stroke. Also, MRI of cervical spine may be helpful if there is attention to brainstem as well.

Opportunity cost for early treatment of Chagas disease in Mexico.

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Janine M Ramsey

2014-04-01

Full Text Available BACKGROUND: Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations. METHODOLOGY/PRINCIPAL FINDINGS: A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment. CONCLUSIONS/SIGNIFICANCE: In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life.

Opportunity cost for early treatment of Chagas disease in Mexico.

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Ramsey, Janine M; Elizondo-Cano, Miguel; Sanchez-González, Gilberto; Peña-Nieves, Adriana; Figueroa-Lara, Alejandro

2014-04-01

Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations. A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment. In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life.

[Recommendations for the diagnosis and treatment of classic forms of 21-hydroxylase-deficient congenital adrenal hyperplasia].

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Rodríguez, Amparo; Ezquieta, Begoña; Labarta, José Igancio; Clemente, María; Espino, Rafael; Rodriguez, Amaia; Escribano, Aranzazu

2017-08-01

Congenital adrenal hyperplasia due to 21-hydroxylase deficiency is an autosomal recessive disorder caused by mutations in the CYP21A2 gene. Cortisol and aldosterone synthesis are impaired in the classic forms (adrenal insufficiency and salt-wasting crisis). Females affected are virilised at birth, and are at risk for genital ambiguity. In this article we give recommendations for an early as possible diagnosis and an appropriate and individualised treatment. A patient and family genetic study is essential for the diagnosis of the patient, and allows genetic counselling, as well as a prenatal diagnosis and treatment for future pregnancy. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Early diagnosis of asthma in young children by using non-invasive biomarkers of airway inflammation and early lung function measurements: study protocol of a case-control study

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van de Kant, Kim DG; Klaassen, Ester MM; Jöbsis, Quirijn; Nijhuis, Annedien J; van Schayck, Onno CP; Dompeling, Edward

2009-01-01

Background Asthma is the most common chronic disease in childhood, characterized by chronic airway inflammation. There are problems with the diagnosis of asthma in young children since the majority of the children with recurrent asthma-like symptoms is symptom free at 6 years, and does not have asthma. With the conventional diagnostic tools it is not possible to differentiate between preschool children with transient symptoms and children with asthma. The analysis of biomarkers of airway inflammation in exhaled breath is a non-invasive and promising technique to diagnose asthma and monitor inflammation in young children. Moreover, relatively new lung function tests (airway resistance using the interrupter technique) have become available for young children. The primary objective of the ADEM study (Asthma DEtection and Monitoring study), is to develop a non-invasive instrument for an early asthma diagnosis in young children, using exhaled inflammatory markers and early lung function measurements. In addition, aetiological factors, including gene polymorphisms and gene expression profiles, in relation to the development of asthma are studied. Methods/design A prospective case-control study is started in 200 children with recurrent respiratory symptoms and 50 control subjects without respiratory symptoms. At 6 years, a definite diagnosis of asthma is made (primary outcome measure) on basis of lung function assessments and current respiratory symptoms ('golden standard'). From inclusion until the definite asthma diagnosis, repeated measurements of lung function tests and inflammatory markers in exhaled breath (condensate), blood and faeces are performed. The study is registered and ethically approved. Discussion This article describes the study protocol of the ADEM study. The new diagnostic techniques applied in this study could make an early diagnosis of asthma possible. An early and reliable asthma diagnosis at 2–3 years will have consequences for the management of

Detection, modeling and matching of pleural thickenings from CT data towards an early diagnosis of malignant pleural mesothelioma

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Chaisaowong, Kraisorn; Kraus, Thomas

2014-03-01

Pleural thickenings can be caused by asbestos exposure and may evolve into malignant pleural mesothelioma. While an early diagnosis plays the key role to an early treatment, and therefore helping to reduce morbidity, the growth rate of a pleural thickening can be in turn essential evidence to an early diagnosis of the pleural mesothelioma. The detection of pleural thickenings is today done by a visual inspection of CT data, which is time-consuming and underlies the physician's subjective judgment. Computer-assisted diagnosis systems to automatically assess pleural mesothelioma have been reported worldwide. But in this paper, an image analysis pipeline to automatically detect pleural thickenings and measure their volume is described. We first delineate automatically the pleural contour in the CT images. An adaptive surface-base smoothing technique is then applied to the pleural contours to identify all potential thickenings. A following tissue-specific topology-oriented detection based on a probabilistic Hounsfield Unit model of pleural plaques specify then the genuine pleural thickenings among them. The assessment of the detected pleural thickenings is based on the volumetry of the 3D model, created by mesh construction algorithm followed by Laplace-Beltrami eigenfunction expansion surface smoothing technique. Finally, the spatiotemporal matching of pleural thickenings from consecutive CT data is carried out based on the semi-automatic lung registration towards the assessment of its growth rate. With these methods, a new computer-assisted diagnosis system is presented in order to assure a precise and reproducible assessment of pleural thickenings towards the diagnosis of the pleural mesothelioma in its early stage.

Nanotechnology-Based Detection of Novel microRNAs for Early Diagnosis of Prostate Cancer

Science.gov (United States)

2017-08-01

AWARD NUMBER: W81XWH-15-1-0157 TITLE: Nanotechnology -Based Detection of Novel microRNAs for Early Diagnosis of Prostate Cancer PRINCIPAL...TITLE AND SUBTITLE Nanotechnology -Based Detection of Novel microRNAs for Early Diagnosis of Prostate Cancer 5a. CONTRACT NUMBER 5b. GRANT NUMBER...identify novel differentially expressed miRNAs in the body fluids (blood, urine, etc.) for an early detection of PCa. Advances in nanotechnology and

Sharing information about diagnosis and outcome of first-episode psychosis in patients presenting to early intervention services.

Science.gov (United States)

Farooq, Saeed; Green, Debra J; Singh, Swaran P

2018-05-04

First-episode psychosis (FEP) can be a serious and debilitating disease, but there is limited literature on how to inform patients and carers about its diagnosis and outcome. We aimed to examine the attitudes, practices and views of clinicians working in Early Intervention Service about sharing information on diagnosis and outcome of FEP. A 26-item questionnaire was sent electronically to clinical staff who have been involved in the discussion of FEP diagnosis in Early Intervention Services in the West Midlands, UK. A total of 51 clinicians completed the questionnaire. All respondents stated that patients or carers of those presenting with FEP wish to be informed of their diagnosis, and three-quarters (76%) felt there is a need to develop guidelines on how to inform about diagnosis; 57% stated that they usually use broad diagnostic groups such as psychosis when discussing diagnosis, and only 11% use the term schizophrenia. A total of 40% thought that the therapeutic relationship and treatment adherence (58%) would improve if patients know about their diagnosis; 42 (88%) respondents felt that the likely outcome of the illness should also be discussed with patients when the diagnosis is communicated. The clinicians were aware that service users wished to be informed about the diagnosis and outcome of FEP but had no guidance on the subject. Despite the limitations of an online self-administered survey, the study highlights the need for guidance and improving clinical practice in discussing the diagnosis of FEP in a vulnerable population. © 2018 John Wiley & Sons Australia, Ltd.

PROBLEM OF DIAGNOSIS OF EARLY CONGENITAL SYPHILIS

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G. P. Martynova

2013-01-01

Full Text Available The paper presents a case of delayed diagnosis of early congenital syphilis in a child whose mother was observed in prenatal clinic starting from the 14th week of pregnancy. The child had specific skin rash already in maternity. The child was discharged home without examination in the hospital. Only manifestations of nephritis lead to admission of the child into an inpatient hospital. Only at the age of 1 month and 23 days the child was suspected of early congenital syphilis with severe polisimptomnym, and the patient was transferred to specialized hospital. 

Rheumatoid Arthritis: Early diagnosis and treatment outcomes.

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Heidari, Behzad

2011-01-01

Rheumatoid arthritis (RA) is an inflammatory progressive disease which in the absence of appropriate treatment can lead to joint destruction and disability. Prognosis of RA may be predicted based on the presence of some clinical and laboratory evidences. New criteria for classification of RA provide opportunity for earlier treatment. Initiation of treatment particularly by combination of DMARDs concurrent with short duration of corticosteroid is expected to prevent progressive course and even change the natural course of RA. At present any patients with clinical synovitis in at least one joint may have definite RA, requiring agressive treatment.

Help-seeking intentions for early dementia diagnosis in a sample of Irish adults.

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Devoy, Susan; Simpson, Ellen Elizabeth Anne

2017-08-01

To identify factors that may increase intentions to seek help for an early dementia diagnosis. Early dementia diagnosis in Ireland is low, reducing the opportunity for intervention, which can delay progression, reduce psychological distress and increase social supports. Using the theory of planned behaviour (TPB), and a mixed methods approach, three focus groups were conducted (N = 22) to illicit attitudes and beliefs about help seeking for an early dementia diagnosis. The findings informed the development of the Help Seeking Intentions for Early Dementia Diagnosis (HSIEDD) questionnaire which was piloted and then administered to a sample of community dwelling adults from Dublin and Kildare (N = 95). Content analysis revealed participants held knowledge of the symptoms of dementia but not about available interventions. Facilitators of help seeking were family, friends and peers alongside well informed health professionals. Barriers to seeking help were a lack of knowledge, fear, loss, stigma and inaccessible services. The quantitative findings suggest the TPB constructs account for almost 28% of the variance in intentions to seek help for an early diagnosis of dementia, after controlling for sociodemographic variables and knowledge of dementia. In the final step of the regression analysis, the main predictors of help seeking were knowledge of dementia and subjective norm, accounting for 6% and 8% of the variance, respectively. Future interventions should aim to increase awareness of the support available to those experiencing early memory problems, and should highlight the supportive role that family, friends, peers and health professionals could provide.

X-ray diagnosis and treatment for severe respiratory complications during cardiac catheterizations on pediatric congenital heart disease

International Nuclear Information System (INIS)

Wang Cheng; Zhao Shihua; Jiang Shiliang; Huang Lianjun; Xu Zhongying; Ling Jian; Zheng Hong; Xie Ruolan; Lu Minjie

2005-01-01

Objective: To study the radiological features of severe respiratory complications during cardiac catheterizations on pediatric congenital heart disease so as to make early diagnosis and treatment. We also intend to find the mechanism of these complications. Methods: A total of 9 pediatric cases with severe respiratory complications during cardiac catheterizations were included in the study. The clinical manifestations, radiological features, and corresponding treatments were reviewed. Results: Most of the cases had severe hypoxia, with 6 cases presenting with bradycardia. Opacification of two lung fields was found in 7 cases, pulmonary edema in 1 case, and atelectasis of the upper right lung in 1 case. With intubation, oxygen inhalation and administration of certain drugs, all cases were saved except 1 case with pulmonary edema. Conclusion: Severe respiratory complications during cardiac catheterizations on pediatric congenital heart disease are emergent and critical, and they often presented with various manifestations. Early diagnosis and correct treatment are the key to successful salvage. (authors)

Sigmoid volvulus. Diagnosis and interdisciplinary treatment

International Nuclear Information System (INIS)

Schoen, G.; Offer, C.; Glaser, K.

1991-01-01

Sigmoid volvolus is an emergency which requires rapid diagnosis and immediate adequate treatment. Diagnosis is primarily radiological. Emergency laparotomy carries a high mortality and should therefore not be the immediate treatment. In our opinion, detorsion by colonoscopy under radiological control is a promising form of treatment. Selective resection of the sigmoid, thereby removing the cause of the abnormality, should not be forgotten, since this prevents recurrences. For this method, mortality after adequate gut preparation is only 5.4%. An exception to the above is gangrene of the bowel, when an emergency laparotomy cannot be avoided. (orig.) [de

Application of Metabonomics in Early Diagnosis of Diseases

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Qiao LIU

2015-06-01

Full Text Available With the development of life sciences, people have changed their focus from local research to systematic biology, thus contributing to the development of a series of “omics”, including genomics, transcriptomics, proteomics and metabonomics, etc. Metabonomics is a presently developed new branch of science that can provide qualitative and quantitative analysis on all metabolites with low-molecular quality in the body, tissues or cells of an organism. It recognizes the changes and rules of the biological endogenous substance under the impact of internal and external factors by generally and quantitatively detecting multiple small molecular compounds in biological samples, in hope of finding out the metabolic marker clusters in the early stage of diseases so as to provide new pathways for the early diagnosis of the diseases and the realization of individualized drug administration. Additionally, metabonomics research on clinical diseases has become a hot topic and made great achievement in the developmental condition, diagnostic methods, pathogenic mechanism and pharmaceutical efficacy evaluation of diseases. This study mainly reviewed the application and advances of metabonomics in the early diagnosis of malignant tumors, cardiovascular and respiratory diseases, hoping to provide references and prompts for metabonomics-associated researches.

Autoimmune hepatitis : Pathogenesis, diagnosis and treatment

NARCIS (Netherlands)

van den Berg, AP

Background: Autoimmune hepatitis (AIH) is a chronic necro-inflammatory disease of the liver. Early recognition is important in order to prevent the development of cirrosis. This review discusses recent developments in the fields of diagnosis, pathophysiology and management of AIH. Methods: Relevant

Early diagnosis and screening for colorectal cancer

International Nuclear Information System (INIS)

Laufer, I.

1986-01-01

The barium enema has been a neglected tool in the diagnosis of early colon cancer. With appropriate attention to technical detail, the double contrast enema is capable of detecting the smallest malignant and pre-malignant lesions. Many of these early colon cancers are found in asymptomatic patients and these lesions are curable. The goal of a screening program should be to identify by history or by fecal occult blood testing patients at high risk for the development of colon cancer. These patients should be examined by high-quality double contrast enema in the search for these potentially lethal but curable lesions. In addition, we believe that any patient undergoing radiologic examination of the colon for whatever reason, should receive an examination of adequate quality to rule out an early colon cancer. (Author)

Novel approaches to diagnosis and treatment of Juvenile Myelomonocytic Leukemia.

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Locatelli, Franco; Algeri, Mattia; Merli, Pietro; Strocchio, Luisa

2018-02-01

Juvenile myelomonocytic leukemia (JMML) is a clonal hematopoietic disorder of infancy/early childhood, resulting from oncogenic mutations in genes involved in the Ras pathway. As JMML often exhibits an aggressive course, the timing of diagnosis and treatment is critical to outcome. Areas covered: This review summarizes current approaches to diagnosis and treatment of JMML, highlighting most recent insights into genetic and epigenetic mechanisms underlying the disease, and providing an overview of novel potential therapeutic strategies. Expert commentary: At present, allogeneic HSCT remains the only potentially effective therapy, being able to cure more than 50% of patients, relapse representing the main cause of treatment failure. Prompt HSCT is recommended for all children with NF1, somatic PTPN11 and KRAS mutations, and for most children with somatic NRAS mutations. Conversely, a 'watch and wait' strategy should be adopted in children with germline CBL mutations, specific somatic NRAS mutation, and in Noonan syndrome patients, since spontaneous resolution has been reported to occur. Novel drugs targeting relevant nodes of JMML leukemogenesis have been explored in pre-HSCT window or at relapse. The use of 5-azacytidine, a DNA-hypomethylating agent reported to induce hematologic and molecular remission in some JMML children, is currently being investigated in clinical trials.

The early clinical features of dengue in adults: challenges for early clinical diagnosis.

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Jenny G H Low

Full Text Available BACKGROUND: The emergence of dengue throughout the tropical world is affecting an increasing proportion of adult cases. The clinical features of dengue in different age groups have not been well examined, especially in the context of early clinical diagnosis. METHODOLOGY/PRINCIPAL FINDINGS: We structured a prospective study of adults (≥ 18 years of age presenting with acute febrile illness within 72 hours from illness onset upon informed consent. Patients were followed up over a 3-4 week period to determine the clinical outcome. A total of 2,129 adults were enrolled in the study, of which 250 (11.7% had dengue. Differences in the rates of dengue-associated symptoms resulted in high sensitivities when the WHO 1997 or 2009 classification schemes for probable dengue fever were applied to the cohort. However, when the cases were stratified into age groups, fewer older adults reported symptoms such as myalgia, arthralgia, retro-orbital pain and mucosal bleeding, resulting in reduced sensitivity of the WHO classification schemes. On the other hand, the risks of severe dengue and hospitalization were not diminished in older adults, indicating that this group of patients can benefit from early diagnosis, especially when an antiviral drug becomes available. Our data also suggests that older adults who present with fever and leukopenia should be tested for dengue, even in the absence of other symptoms. CONCLUSION: Early clinical diagnosis based on previously defined symptoms that are associated with dengue, even when used in the schematics of both the WHO 1997 and 2009 classifications, is difficult in older adults.

Key factors impacting on diagnosis and treatment for vulvar cancer for Indigenous women: findings from Australia.

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McGrath, Pam; Rawson, Nicole

2013-10-01

To date, there has been limited research on the topic of vulvar cancer. This paper provides findings from a qualitative study conducted with Indigenous women in East Arnhem Land, Northern Territory, Australia on the psychosocial impact of diagnosis and treatment for vulvar cancer. The insights from the study outlined in this paper not only make a contribution to deepening our understanding of the experience of vulvar cancer for Indigenous women, but provide practical recommendations to ensure effective and early engagement for diagnosis and treatment. A qualitative research method was employed through in-depth, open-ended interviews. The participants of the study were a purposive sample of Indigenous women with the condition, health professionals, and Aboriginal health workers. There were a total of 40 participants; with twelve (n = 12) Indigenous women affected with the condition, fourteen (n = 14) Aboriginal Health Workers, ten (n = 10) nurses, three (n = 3) doctors, and one (n = 1) community member. This paper addresses three key issues highlighted by the participants which include the fact that the private nature of the disease makes the condition 'women's business', that there is a sense of shame associated with the condition, and that there is fear and worry generated by the seriousness of the condition. The private nature of the disease and the sense of shame associated with the condition impact upon the diagnosis and treatment for many Indigenous women. In addition, the limitation of resources for health service delivery for East Arnhem Land exacerbates the problems faced by these communities. This paper puts forward suggestions to facilitate early diagnosis and treatment for women affected with the condition.

Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura ...

African Journals Online (AJOL)

Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura. ... by features of microangiopathic hemolytic anemia and thrombocytopenia. ... Current knowledge in the etiopathogenesis, epidemiology, trends in the diagnosis and ...

Current diagnosis and treatment of cryptococcal meningitis without acquired immunodeifciency syndrome

Institute of Scientific and Technical Information of China (English)

Xiao-Su Guo; Ze-Yan Zhao; Hui Bu; Jun-Ying He; Yue-Li Zou; Yue Zhao; Yuan-Yuan Li; Jun-Zhao Cui; Ming-Ming Zheng; Wei-Xin Han

2016-01-01

Cryptococcal meningitis (CM) is a central nervous system infectious disease caused by Cryptococcus. It is the most common fungal infection in the central nervous system, accounting for about 48% of fungal infection. The disease occurs mainly in acquired immunodeifciency syndrome (AIDS) patients and concentrates in the immunocompromised people without AIDS. There are nearly one million new cases of CM each year, and about 70% of them died. In China, CM occurs mainly in people without AIDS and there is an increasing trend in recent years. Early diagnosis and treatment is the key to reducing morbidity and mortality associated with CM. The diagnosis mainly depends on laboratory examination such as morphological examination, fungal culture and antigen detection. History, clinical manifestation and imaging examination are the important parts of auxiliary examination. The initial combined antifungal treatment is emphasized, and the principle of fractional treatment including induction, consolidation and maintenance therapy should be followed. The high intracranial pressure must be reduced actively at the same time. In addition, it is proved that the novel immunotherapy combined with antifungal agents can improve the curative effect and limit the chance of antimicrobial resistance. Large-scale clinical trials are needed for further study.

Research advances in indicators for early diagnosis of liver cirrhosis patients with renal impairment

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LU Lifang

2016-09-01

Full Text Available The liver is closely associated with the kidney, and liver injury in various stages can cause various kidney diseases to varying degrees, which further lead to renal impairment. Such renal impairment in the early stage is often functional and can be reversed by drugs, otherwise it can progress to hepatorenal syndrome, cause acute renal failure, and even threaten human life. The indicators such as serum creatinine and urea nitrogen have a limited effect in the early diagnosis of renal impairment and cannot be used for early monitoring and diagnosis of liver cirrhosis patients with renal impairment. Therefore, early monitoring of liver cirrhosis patients with renal impairment has always been a hot topic in this field. This article summarizes the research advances in the indicators for early diagnosis of renal impairment.

Clinical diagnosis and treatment of thyroid microcarcinoma

International Nuclear Information System (INIS)

Gao Xuemei; Zhang Yajing; Gao Zairong

2013-01-01

Thyroid cancer is the most common malignant carcinoma in the endocrine system. With the increasing incidence of thyroid cancer, the incidence of thyroid microcarcinoma has been elevating gradually. But there is still a large ambiguity on thyroid microcarcinoma about the diagnosis and treatment. The epidemiology, clinical diagnosis, biological behavior and treatment programs of thyroid microcarcinoma were reviewed in this article. (authors)

Classic galactosemia: features of diagnosis and treatment

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N.O. Pichkur

2018-02-01

Full Text Available Background. Galactosemia type I, or classic galactosemia (CG, is the most severe form of hereditary disorders of carbohydrate metabolism, in particular, galactose. Galactosemia is not included in the program of massive neonatal screening in Ukraine. The CG is characterized by the non-specific onset symptoms and leads to high mortality among infants in the neonatal period. The problem of early diagnosis and treatment of infants with CG in the absence of a program for massive neonatal screening in Ukraine requires solution. The purpose was to analyse the clinical and laboratory, molecular genetic features of patients with CG; to define a set of clinical symptoms and to form selective groups of patients for administration of diet therapy and laboratory diagnosis; to develop schemes-stages of effective early diagnosis and treatment of patients with CG in the absence of mass neonatal screening in order to reduce infant mortality and prevent the disability of patients with this pathology. Materials and methods. In 2014–2017, 317 patients with a diagnosis of hepatitis of uncertain origin were examined. The age of patients ranged from 3 days to 16 years; 145 (45 % of them were males, 172 (55 % — females. In all patients, a polysyndromic clinical picture with predominant lesion in the liver function was observed. All patients were examined for the activity of galactose-1-phosphate uridylyltransferase (GALT enzyme in the red blood cells and underwent DNA diagnosis for the detection of major mutations in the GALT gene. All patients were examined for viral hepatitis, underwent biochemical blood tests for hepatic transaminases, alkaline phosphatase, bilirubin levels, and coagulopathy. Tandem mass spectrometry was also performed to exclude or confirm the metabolic imbalance of amino acids, organic acids, and mitochondrial beta-oxi­dation of fatty acids. Five patients with suspected glycogenosis have been subjected to a quantitative glycogen test in the

Use of mobile phones and text messaging to decrease the turnaround time for early infant HIV diagnosis and notification in rural Zambia: An observational study

NARCIS (Netherlands)

C.G. Sutcliffe (Catherine); P.E. Thuma (Phil); J.H. van Dijk (Janneke); Sinywimaanzi, K. (Kathy); Mweetwa, S. (Sydney); Hamahuwa, M. (Mutinta); W.J. Moss (William)

2017-01-01

textabstractBackground: Early infant diagnosis of HIV infection is challenging in rural sub-Saharan Africa as blood samples are sent to central laboratories for HIV DNA testing, leading to delays in diagnosis and treatment initiation. Simple technologies to rapidly deliver results to clinics and

Adiposity, post-diagnosis weight change, and risk of cardiovascular events among early-stage breast cancer survivors.

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Cespedes Feliciano, Elizabeth M; Kwan, Marilyn L; Kushi, Lawrence H; Weltzien, Erin K; Castillo, Adrienne L; Caan, Bette J

2017-04-01

Little research examines whether adiposity or post-diagnosis weight changes influence Cardiovascular disease (CVD) among breast cancer patients for whom effects may differ due to treatment and recovery. We studied Stage I-III breast cancer survivors 18 to  diagnosis and weight and waist circumference (WC) around 24 months post diagnosis. Using Cox models for time to incident coronary artery disease, heart failure, valve abnormality, arrhythmia, stroke, or CVD death, we examined at-diagnosis body mass index (BMI, n = 3109) and post-diagnosis WC (n = 1898) and weight change (n = 1903, stable, ±5 to  diagnosis, 25% of women gained and 14% lost ≥10-lbs; mean (SD) WC was 90 (15) cm. Over a median of 8.28 years, 915 women developed CVD. BMI 25-30-kg/m 2 (vs. BMI diagnosis weight change had no association with CVD. Extreme adiposity and any elevation in WC increased risk of CVD among breast cancer survivors; however, changes in weight in the early post-diagnosis period were not associated with CVD. Survivors with high WC and existing CVD risk factors should be monitored.

Project for the National Program of Early Diagnosis of Endometrial Cancer Part I.

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Bohîlțea, R E; Ancăr, V; Cirstoiu, M M; Rădoi, V; Bohîlțea, L C; Furtunescu, F

2015-01-01

Endometrial cancer recorded a peak incidence in ages 60-64 years in Romania, reaching in 2013 the average value of 8.06/ 100,000 women, and 15.97/ 100,000 women within the highest risk age range, having in recent years an increasing trend, being higher in urban than in rural population. Annually, approximately 800 new cases are registered in our country. The estimated lifetime risk of a woman to develop endometrial cancer is of about 1,03%. Based on an abnormal uterine bleeding, 35% of the endometrial cancers are diagnosed in an advanced stage of the disease, with significantly diminished lifetime expectancy. Drafting a national program for the early diagnosis of endometrial cancer. We proposed a standardization of the diagnostic steps and focused on 4 key elements for the early diagnosis of endometrial cancer: investigation of abnormal uterine bleeding occurring in pre/ post-menopausal women, investigating features/ anomalies of cervical cytology examination, diagnosis, treatment and proper monitoring of precursor endometrial lesions or cancer associated endometrial lesions and screening high risk populations (Lynch syndrome, Cowden syndrome). Improving medical practice based on diagnostic algorithms addresses the four risk groups, by improving information system reporting and record keeping. Improving addressability cases by increasing the health education of the population will increase the rate of diagnosis of endometrial cancer in the early stages of the disease. ACOG = American Society of Obstetricians and Gynecologists, ASCCP = American Society for Colposcopy and Cervical Pathology, PATT = Partial Activated Thromboplastin Time, BRCA = Breast Cancer Gene, CT = Computerized Tomography, IFGO = International Federation of Gynecology and Obstetrics, HLG = Hemoleucogram, HNPCC = Hereditary Nonpolyposis Colorectal Cancer (Lynch syndrome), IHC = Immunohistochemistry, BMI = Body Mass Index, INR = International Normalized Ratio, MSI = Microsatellites instability, MSI

Use of multimodality imaging and artificial intelligence for diagnosis and prognosis of early stages of Alzheimer's disease.

Science.gov (United States)

Liu, Xiaonan; Chen, Kewei; Wu, Teresa; Weidman, David; Lure, Fleming; Li, Jing

2018-04-01

Alzheimer's disease (AD) is a major neurodegenerative disease and the most common cause of dementia. Currently, no treatment exists to slow down or stop the progression of AD. There is converging belief that disease-modifying treatments should focus on early stages of the disease, that is, the mild cognitive impairment (MCI) and preclinical stages. Making a diagnosis of AD and offering a prognosis (likelihood of converting to AD) at these early stages are challenging tasks but possible with the help of multimodality imaging, such as magnetic resonance imaging (MRI), fluorodeoxyglucose (FDG)-positron emission topography (PET), amyloid-PET, and recently introduced tau-PET, which provides different but complementary information. This article is a focused review of existing research in the recent decade that used statistical machine learning and artificial intelligence methods to perform quantitative analysis of multimodality image data for diagnosis and prognosis of AD at the MCI or preclinical stages. We review the existing work in 3 subareas: diagnosis, prognosis, and methods for handling modality-wise missing data-a commonly encountered problem when using multimodality imaging for prediction or classification. Factors contributing to missing data include lack of imaging equipment, cost, difficulty of obtaining patient consent, and patient drop-off (in longitudinal studies). Finally, we summarize our major findings and provide some recommendations for potential future research directions. Copyright © 2018 Elsevier Inc. All rights reserved.

Biomarkers in the early diagnosis of Parkinson's disease

Directory of Open Access Journals (Sweden)

CHEN Sheng-di

2013-08-01

Full Text Available Parkinson's disease (PD is a chronic and progressive neurodegenerative disorder. It has become clear that PD can have a preclinical phase, a period during which neurodegeneration has already begun years before the onset of typical motor symptoms. Consequently, if the early neurodegeneration in PD can be timely diagnosed, it will significantly slow down the progression of the disease and improve the quality of life. To date, there is no fully reliable and validated biomarker for the early diagnosis of PD, but some promising biomarker candidates exist.

Prenatal and Early Postnatal Diagnosis of Congenital Toxoplasmosis in a Setting With No Systematic Screening in Pregnancy

Science.gov (United States)

Stajner, Tijana; Bobic, Branko; Klun, Ivana; Nikolic, Aleksandra; Srbljanovic, Jelena; Uzelac, Aleksandra; Rajnpreht, Irena; Djurkovic-Djakovic, Olgica

2016-01-01

Abstract To determine the risk of congenital toxoplasmosis (CT) and provide early (pre- or postnatal) identification of cases of CT in the absence of systematic screening in pregnancy. In the presented cross-sectional study, serological criteria were used to date Toxoplasma gondii infection versus conception in 80 pregnant women with fetal abnormalities or referred to as suspected of acute infection, and in 16 women after delivery of symptomatic neonates. A combination of serological, molecular (qPCR), and biological (bioassay) methods was used for prenatal and/or postnatal diagnosis of CT. Most (77.5%) pregnant women were examined in advanced pregnancy. Of all the examined seropositive women (n = 90), infection could not be ruled out to have occurred during pregnancy in 93.3%, of which the majority (69%) was dated to the periconceptual period. CT was diagnosed in 25 cases, of which 17 prenatally and 8 postnatally. Molecular diagnosis proved superior, but the diagnosis of CT based on bioassay in 7 instances and by Western blot in 2 neonates shows that other methods remain indispensable. In the absence of systematic screening in pregnancy, maternal infection is often diagnosed late, or even only when fetal/neonatal infection is suspected. In such situations, use of a complex algorithm involving a combination of serological, biological, and molecular methods allows for prenatal and/or early postnatal diagnosis of CT, but lacks the preventive capacity provided by early maternal treatment. PMID:26945416

The value of combined detection of serum β-HCG and progesterone in diagnosis of early ectopic pregnancy

International Nuclear Information System (INIS)

Lu Yanting; Wang Taisong

2011-01-01

To explore the value of combined detection of serum β-HCG and P in diagnosis of early ectopic pregnancy and expectant therapeutic efficacy. Serum levels of β-HCG and P of 324 patients with early ectopic pregnancy and 146 normal early pregnant women were determined and compared by RIA, Serum β-HCG and P were compared between before and after treatment. The required time when serum β-HCG and P decreased to the normal rang of the patients treated successfully were observed respectively. The results showed that the serum β-HCG and P value in ectopic pregnancy group were significantly lower than those in intrauterine gestation group (P<0.05). The variation of P was significant between success and failure groups of drug conservative treatment, but β-HCG had no significant difference. The required time when serum P decreased to the normal was significantly less than the serum β-HCG dropped to normal. Combined detection of serum levels of β-HCG and P is an adjunctive method to diagnose early ectopic pregnancy, so it giants opportunity for treatment of early ectopic pregnancy and is of positive clinical application value for observation therapeutic effect and prognosis of the disease. P values may be one of the more important reference index to predict whether conservative treatment is successful or not than β-HCG. (authors)

Roentgenoendoscopic diagnosis of early stomach cancer

International Nuclear Information System (INIS)

Vinner, M.G.; Kopytov, I.I.

1984-01-01

Some potentialities of the X-ray and endoscopic methods in the recognition of early stomach cancer are analysed. Both methods are provided by a roentgenotogist. Of 396 operated patients with stomach cancer, early forms were detected in 78 which is equal to 8% of the detected number and 19.7% of the operated cancer pasients. Two macroscopic forms of early cancer were detected: cancer with ulceration (erosion-ulcerative form) and polypoidcancer. The first form is interpreted as primary-ulcerative cancer, malignant ulcers and cancer in the form of erosions, the second one as polyps, polypoid and patchlike cancer, malignant polyps. X-ray changes were detected in 80% of the patients, in the rest of 20% by the endoscopic method only. With the help of the roentgenological and endoscopic methods (without cytological examination) one cannot be sure of accurate differential diagnosis between malignant and benign variants of ulcerations and polypoid changes in early cancer. The potentialities of the X-ray method ir the detection of ulcerative and polypoid changes of the stomach make it possible to improve it, though under a strict condition of performing subsequent obligatory endoscopy and getting tissue specimens for biopsy. The organization of the common roentgenoendoscopic centers is found appropriate

Early mortality in children with acute lymphoblastic leukemia in a developing country: the role of malnutrition at diagnosis. A multicenter cohort MIGICCL study.

Science.gov (United States)

Martín-Trejo, Jorge Alfonso; Núñez-Enríquez, Juan Carlos; Fajardo-Gutiérrez, Arturo; Medina-Sansón, Aurora; Flores-Lujano, Janet; Jiménez-Hernández, Elva; Amador-Sanchez, Raquel; Peñaloza-Gonzalez, José Gabriel; Alvarez-Rodriguez, Francisco Javier; Bolea-Murga, Victoria; Espinosa-Elizondo, Rosa Martha; de Diego Flores-Chapa, José; Pérez-Saldivar, Maria Luisa; Rodriguez-Zepeda, María Del Carmen; Dorantes-Acosta, Elisa María; Núñez-Villegas, Nora Nancy; Velazquez-Aviña, Martha Margarita; Torres-Nava, José Refugio; Reyes-Zepeda, Nancy Carolina; González-Bonilla, César Raúl; Flores-Villegas, Luz Victoria; Rangel-López, Angélica; Rivera-Luna, Roberto; Paredes-Aguilera, Rogelio; Cárdenas-Cardós, Rocío; Martínez-Avalos, Armando; Gil-Hernández, Ana Elena; Duarte-Rodríguez, David Aldebarán; Mejía-Aranguré, Juan Manuel

2017-04-01

The role of malnutrition at diagnosis as a predictor of early mortality in Mexican leukemia children remains controversial. The objective of present study was to investigate whether malnutrition was a predictor of early mortality during the first year of treatment in Mexican acute lymphoblastic leukemia (ALL) children through the first population-based study. A total of 794 newly diagnosed ALL pediatric patients from public hospitals of Mexico City were enrolled. A multivariate Cox proportional hazards regression model was constructed and adjusted by patient's age at diagnosis, gender, hospital of treatment, and socioeconomic status. Early mortality was high (12.1%) and malnutrition by different indicators was not associated with mortality at induction phase and at 6th month; a high risk of dying (RR = 2.08; 95% CI: 1.08-4.01) was observed in the group of malnourished children with a high-risk ALL.

Early Infant Diagnosis of HIV Infection in Southeastern Nigeria ...

African Journals Online (AJOL)

METHODS: HIV-exposed infants were recruited for DNA PCR (early infant diagnosis). ... Mothers were given pre-test counselling. ... their mothers received PARV but the babies had no post-exposure prophylaxis (PEP), while two (12.5%) of 16 ...

Roentgenographic diagnosis of early stomach cancer

Energy Technology Data Exchange (ETDEWEB)

Suh, Jung Ho; Choi, Byung Sook; Choi, Heung Jai [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1970-10-15

The most significant feature of early carcinoma, be defined as the gastric carcinoma confined in mucosa and submucosal regardless of its size and shape, is its excellent prognosis; 5 year survival rate after operation in early stomach carcinoma amounts to 93 percent in comparison with around 25 percent in advanced carcinoma, and so the detection of this early stomach carcinoma is most important subject to minimize the mortality from stomach carcinoma at the present time. For the diagnosis of the early stomach carcinoma the radiographic study, cytology and gastroscopic examination are practised, and of those the radiographic study has been revealed commonly best results, but by usual method of upper G-I study it is often difficult to diagnose accurately. Therefore, we have been employed the barium and air double contrast method by insertion of the gastric tube. This method is simple and by this method, the adequate amount of air may introduced into the stomach for the best visualization of the mucosal pattern and gastric juice may also aspirated in a case of which the stomach wall could not be coated by barium because of excessive gastric juice. Summary of the results of this studies of early carcinoma detection at the department of radiology, Severance Hospital during 6 months since May 1969 are as followings; of 1407 cases taken upper G-I study with double contrast method, 17 cases were diagnosed as possible early stomach carcinoma radiographically, and then only 6 cases had surgical resection of stomach. Of these 2 cases were confirmed pathologically and one was considered as precancerots lesion.

Roentgenographic diagnosis of early stomach cancer

International Nuclear Information System (INIS)

Suh, Jung Ho; Choi, Byung Sook; Choi, Heung Jai

1970-01-01

The most significant feature of early carcinoma, be defined as the gastric carcinoma confined in mucosa and submucosal regardless of its size and shape, is its excellent prognosis; 5 year survival rate after operation in early stomach carcinoma amounts to 93 percent in comparison with around 25 percent in advanced carcinoma, and so the detection of this early stomach carcinoma is most important subject to minimize the mortality from stomach carcinoma at the present time. For the diagnosis of the early stomach carcinoma the radiographic study, cytology and gastroscopic examination are practised, and of those the radiographic study has been revealed commonly best results, but by usual method of upper G-I study it is often difficult to diagnose accurately. Therefore, we have been employed the barium and air double contrast method by insertion of the gastric tube. This method is simple and by this method, the adequate amount of air may introduced into the stomach for the best visualization of the mucosal pattern and gastric juice may also aspirated in a case of which the stomach wall could not be coated by barium because of excessive gastric juice. Summary of the results of this studies of early carcinoma detection at the department of radiology, Severance Hospital during 6 months since May 1969 are as followings; of 1407 cases taken upper G-I study with double contrast method, 17 cases were diagnosed as possible early stomach carcinoma radiographically, and then only 6 cases had surgical resection of stomach. Of these 2 cases were confirmed pathologically and one was considered as precancerots lesion

Initial diagnosis and treatment in first-episode psychosis: can an operationalized diagnostic classification system enhance treating clinicians' diagnosis and the treatment chosen?

LENUS (Irish Health Repository)

Coentre, Ricardo

2011-05-01

Diagnosis during the initial stages of first-episode psychosis is particularly challenging but crucial in deciding on treatment. This is compounded by important differences in the two major classification systems, International Classification of Diseases, 10th revision (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). We aimed to compare the concordance between an operationalized diagnosis using Operational Criteria Checklist (OPCRIT) and treating clinician-generated diagnosis in first episode psychosis diagnosis and its correlation with treatment prescribed.

Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research

Science.gov (United States)

... of this page please turn Javascript on. Feature: Glaucoma Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research Past Issues / Fall 2009 Table of Contents Symptoms and Diagnosis Glaucoma can develop in one or both eyes. Often ...

Feature Hepatitis: Hepatitis Symptoms, Diagnosis, Treatment & Prevention

Science.gov (United States)

... Navigation Bar Home Current Issue Past Issues Feature Hepatitis Hepatitis: Symptoms, Diagnosis, Treatment & Prevention Past Issues / Spring 2009 ... No appetite Fever Headaches Diagnosis To check for hepatitis viruses, your doctor will test your blood. You ...

[Economic evaluation od the value of early diagnosis and management of hypothyroidism in hypercholesterolemia].

Science.gov (United States)

Lenne, X; Allenet, B; Laurent, P; Lebrun, T; Wemeau, J L

1999-11-01

The aim of the study was to assess the economic consequences of the early screening and management for overt hypothyrodism in elderly women suffering from hypercholesterolaemia. A cost analysis was performed using screening decision tree followed by a Markov model, targeted on an hypothetical cohort of elderly women (i.e. > or = 55 years of age) suffering from hypercholesterolaemia. Two arms were compared, "no diagnosis", patients being treated by lipid lowering drugs in the long run, "diagnosis", patients being screened for thyroid disturbance and proposed adequate correction by hormone treatment. Relevant clinical data introduced into the model were obtained from published data and from experts. At the end of the initial diagnostic, patients could enter three different health states: euthyroidism, subclinical hypothyroidism or overt hypothyroidism. During 30 years, patients were assumed to be seen each year by a general practitioner for clinical examination and cholesterol dosage, plus, according to the health state evolution, TSH and T4 screening. In the baseline analysis, euthyroidian patients who had a inexplicable degradation of hypercholesterolaemia control were tested for TSH and, if abnormal, T4 serum; for subclinical hypothyroidian patients, TSH and T4 were measured every year. The direct costs taken into account were concerning medical supervision, drug treatment and biologic exams. Costs were analysed from the societal perspective and were expressed in 1998 French Francs (FF) with an accounting rate of 5% by year. A sensitivity analysis was also performed. The total cost at 30-year was equal to 25,006 F for "diagnosis" strategy, to 24,390 F for "no diagnosis" strategy. The incremental cost of the first strategy decreased according to the time horizon. It was 6.8% at 5-year and 2.5% at 30-year. Results were sensitive to variation in response rate of hypercholesterolaemic patients to hormone treatment of hypothyroidism (0.25 in base-case). The investment

Diagnosis and treatment of breast cancer

International Nuclear Information System (INIS)

Doihara, Hiroyoshi; Taira, Naruhito

2008-01-01

This paper explains the outline of the present diagnosis and treatment of breast cancer essentially based on its therapeutic guideline by the Japan Breast Cancer Society (2005) and on authors' experiences. The diagnosis item contains the medical interview of patients, observatory and palpating examinations, mammography (for this, Japan-Breast Imaging Recording and Data System), ultrasonography (guideline for sonographic diagnosis of mammary gland, 2004), fine needle aspiration (FNA) or aspiration biopsy cytology, bases of triple test (palpation, mammography and FNA) for the cancer diagnosis, core needle biopsy, and mammotome biopsy of non-palpable calcified lesion. The treatment item contains the surgery involving conservation, sentinel lymph node biopsy (for this, lymphoscintigraphy with Tc-phytate is illustrated), radiofrequency ablation, adjuvant chemotherapy essentially using anthracycline and taxane, endocrinological therapy using tamoxifen, LH-RH analogues and aromatase inhibitors, and molecular target therapy with HER2 monoclonal antibody like trastuzumab. Recent progress of systemic therapy with medicals is remarkable, and the educational promotion of experts and medicare circumstances are concluded to be important. (R.T.)

The value of magnetic resonance imaging in the early diagnosis of Creutzfeldt-Jakob disease – own experience

International Nuclear Information System (INIS)

Bekiesińska-Figatowska, Monika; Kuczyńska-Zardzewiały, Arleta; Pomianowska, Barbara; Kajdana, Katarzyna; Szpak, Grażyna M.; Iwanowska, Beata; Mądzik, Jarosław

2012-01-01

Creutzfeldt-Jakob disease (CJD) is a rare progressive neurodegenerative disorder, caused by the deposition of the pathological isoform of prion protein PrPsc in the central nervous system. The classic triad of symptoms consists of: rapidly progressive dementia, myoclonus and typical electroencephalographic findings (intermittent rhythmic delta activity and periodic sharp wave complexes). Detection of 14-3-3 protein in the cerebrospinal fluid plays an important diagnostic role as well. Magnetic resonance (MR) images of the brain have been recently incorporated into the diagnostic criteria of sporadic Creutzfeldt-Jakob disease. MR examinations were performed in a 65-year-old man and a 54-year-old woman with delusional disorder and cognitive dysfunction, respectively. Diffusion restriction (hyperintense signal in DWI) was shown in the cortex of the left parietal and occipital lobe in the first patient and symmetrically in the cortex of both cerebral hemispheres except for precentral gyri in the second one. In both cases, the first examinations were misread, with the suspicion of ischemic infarcts as the first differential diagnosis. Consultations and subsequent MR examinations in which lesions in subcortical nuclei appeared allowed for a diagnosis of probable CJD. In the first case it was confirmed by clinical picture, EEG and finally – autopsy. In the second case, EEG was not typical for CJD but the clinical course of the disease confirmed that diagnosis. The authors present the cases of two patients with characteristic MR images that allowed early diagnosis of probable Creutzfeldt-Jakob disease before the characteristic clinical picture appeared. Early diagnosis is nowadays important for the prevention of disease transmission and in the future – hopefully – for early treatment

Cost-effectiveness of magnetic resonance imaging with a new contrast agent for the early diagnosis of Alzheimer's disease.

Directory of Open Access Journals (Sweden)

Maria Biasutti

Full Text Available Used as contrast agents for brain magnetic resonance imaging (MRI, markers for beta-amyloid deposits might allow early diagnosis of Alzheimer's disease (AD. We evaluated the cost-effectiveness of such a diagnostic test, MRI+CLP (contrastophore-linker-pharmacophore, should it become clinically available.We compared the cost-effectiveness of MRI+CLP to that of standard diagnosis using currently available cognition tests and of standard MRI, and investigated the impact of a hypothetical treatment efficient in early AD. The primary analysis was based on the current French context for 70-year-old patients with Mild Cognitive Impairment (MCI. In alternative "screen and treat" scenarios, we analyzed the consequences of systematic screenings of over-60 individuals (either population-wide or restricted to the ApoE4 genotype population. We used a Markov model of AD progression; model parameters, as well as incurred costs and quality-of-life weights in France were taken from the literature. We performed univariate and probabilistic multivariate sensitivity analyses. The base-case preferred strategy was the standard MRI diagnosis strategy. In the primary analysis however, MRI+CLP could become the preferred strategy under a wide array of scenarios involving lower cost and/or higher sensitivity or specificity. By contrast, in the "screen and treat" analyses, the probability of MRI+CLP becoming the preferred strategy remained lower than 5%.It is thought that anti-beta-amyloid compounds might halt the development of dementia in early stage patients. This study suggests that, even should such treatments become available, systematically screening the over-60 population for AD would only become cost-effective with highly specific tests able to diagnose early stages of the disease. However, offering a new diagnostic test based on beta-amyloid markers to elderly patients with MCI might prove cost-effective.

Radiographic caries diagnosis and restorative treatment decision making

International Nuclear Information System (INIS)

Mileman, P.A.

1985-01-01

This thesis is concerned with a single diagnostic technique: the bitewing radiograph, and the way it is used by dentists to decide on patient treatment need for interproximal caries. The variation in caries diagnosis and treatment decisions using bitewing radiographs is described and the radiographic criteria of choice for minimizing over and undertreatment according to a norm are investigated. Three possible diagnostic strategies in interproximal caries diagnosis using a decision analysis approach are described and evaluated, and the effect of the reported diagnostic behaviour and knowledge of practicing Dutch dentists in their use of bitewing radiographs for the diagnosis and treatment of interproximal caries is described and analyzed. (Auth.)

Usefulness of high-resolution sonography in early diagnosis of rabbit clonorchiasis

International Nuclear Information System (INIS)

Lim, Jae Hoon; Choi, Don Gil; Chung, Il Gyu; Phyun, Lae Hyun; Pyeun, Yong Seon; Hong, Sung Tae; Lee, Me Jeong

1999-01-01

To determine the role of high-resolution sonography in the early diagnosis of experimentally induced clonorchiasis in rabbits. We performed sonographic examination weekly in 22 lightly-infected rabbits (10 rabbits infected with 10 metacercariae, 6 rabbits infected with 20 metacercariae, and 6 rabbits infected with 40 metacercariae), and 10 heavily-infected rabbits (500 metacercariae). The sonographic criterion of diagnosis with dilatation of the intrahepatic ducts. We sacrificed lightly-infected rabbits and counted numbers of adult worms of clonorchis sinensis 9 weeks after infection. Sonographic abnormalities were found 3 weeks after infection in 2 lightly-infected rabbits and 5 heavily-infected rabbits. On sonography at 9 weeks after infection, we observed dilatation of the intrahepatic ducts in 11 (65%) of 17 lightly-infected rabbits and all of 10 heavily-infected rabbits. High-resolution sonography is very useful in early diagnosis of rabbits clonorchiasis.

Usefulness of high-resolution sonography in early diagnosis of rabbit clonorchiasis

Energy Technology Data Exchange (ETDEWEB)

Lim, Jae Hoon; Choi, Don Gil; Chung, Il Gyu; Phyun, Lae Hyun; Pyeun, Yong Seon [Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of); Hong, Sung Tae; Lee, Me Jeong [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1999-09-15

To determine the role of high-resolution sonography in the early diagnosis of experimentally induced clonorchiasis in rabbits. We performed sonographic examination weekly in 22 lightly-infected rabbits (10 rabbits infected with 10 metacercariae, 6 rabbits infected with 20 metacercariae, and 6 rabbits infected with 40 metacercariae), and 10 heavily-infected rabbits (500 metacercariae). The sonographic criterion of diagnosis with dilatation of the intrahepatic ducts. We sacrificed lightly-infected rabbits and counted numbers of adult worms of clonorchis sinensis 9 weeks after infection. Sonographic abnormalities were found 3 weeks after infection in 2 lightly-infected rabbits and 5 heavily-infected rabbits. On sonography at 9 weeks after infection, we observed dilatation of the intrahepatic ducts in 11 (65%) of 17 lightly-infected rabbits and all of 10 heavily-infected rabbits. High-resolution sonography is very useful in early diagnosis of rabbits clonorchiasis.

Social Awareness on Early Diagnosis and Treatment of Bladder Cancer: Importance of Age and Education

Directory of Open Access Journals (Sweden)

Doğan Değer

2017-03-01

Full Text Available Objective: We aimed to evaluate the recognition level of bladder cancer in the society by conducting a survey with regards to social awareness in early diagnosis of bladder cancer in this study. Materials and Methods: The survey was conducted on 100 randomly selected patients who were admitted to our clinic in May 2016 for any complaints. In the survey, the main focus was hematuria which is the first and the most common symptom of bladder cancer and questions and statements on this subject was used. Results: Of 100 patients, 67 (66.7% were male, and 33 (33.3% were female. Thirty six of the patients were younger than 50 (36%, and 64 of them (64% were 50 years and older. Education level of 40 (40% patients was found to be university level, and 60 (60% patients we high school graduates or lower. Twenty seven (27% patients had complains about blood in the urine, while 67 (67% of them had no such complaint. Of 27 patients that had complaint about hematuria, which is the most important symptom of bladder cancer 22 (81% were male and 5 (19% were female. We divided the patients into two groups based on 50 age limit. Group 1 included patients who were below 50, while the group 2 consisted of patients who were 50 years old and above. The rates of immediate consultation were determined to be significantly higher in group 2 than group 1. The rate of consulting urology department in the presence of hematuria, and the rates of considering the risk of bladder cancer as a possible diagnosis were higher in group 2, but the difference was not statistically significant. There was no significant difference found between the two groups who were separated by age in terms of required diagnostic tests. The patients were divided into two more groups based on their education level. Group 3 included patients of university graduates, and group 4 included patients with high school graduates or lower. The rates of immediate consultation were significantly higher in group 4

Hydroxychloroquine-induced cardiomyopathy: case report, pathophysiology, diagnosis, and treatment.

Science.gov (United States)

Yogasundaram, Haran; Putko, Brendan N; Tien, Julia; Paterson, D Ian; Cujec, Bibiana; Ringrose, Jennifer; Oudit, Gavin Y

2014-12-01

Drug-induced heart and vascular disease remains an important health burden. Hydroxychloroquine and its predecessor chloroquine are medications commonly used in the treatment of systemic lupus erythematosus, rheumatoid arthritis, and other connective tissue disorders. Hydroxychloroquine interferes with malarial metabolites, confers immunomodulatory effects, and also affects lysosomal function. Clinical monitoring and early recognition of toxicity is an important management strategy in patients who undergo long-term treatment with hydroxychloroquine. Retinal toxicity, neuromyopathy, and cardiac disease are recognized adverse effects of hydroxychloroquine. Immediate withdrawal of hydroxychloroquine is essential if toxicity is suspected because of the early reversibility of cardiomyopathy. In addition to recommended ophthalmological screening, regular screening with 12-lead electrocardiogram and transthoracic echocardiography to detect conduction system disease and/or biventricular morphological or functional changes should be considered in hydroxychloroquine-treated patients. Cardiac magnetic resonance imaging and endomyocardial biopsy are valuable tools to provide prognostic insights and confirm the diagnosis of hydroxychloroquine-induced cardiomyopathy. In conclusion, chronic use of hydroxychloroquine can result in an acquired lysosomal storage disorder, leading to a drug-induced cardiomyopathy characterized by concentric hypertrophy and conduction abnormalities associated with increased adverse clinical outcomes and mortality. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

[Practice guideline. Diagnosis and treatment of type 2 diabetes mellitus].

Science.gov (United States)

Gil-Velázquez, Luisa Estela; Sil-Acosta, María Juana; Domínguez-Sánchez, Elia R; Torres-Arreola, Laura del Pilar; Medina-Chávez, Juan Humberto

2013-01-01

Our objective was to develop a guide based on the best available evidence that allow family physicians to establish criteria for screening, diagnosis, prevention, treatment of disease, early detection and management of complications; to standardize the organizing processes of the diabetic patient's care in the primary care level; and to achieve lifestyle modification for patients and promote self-care. Clinical questions were stated according to the diagram and structured patient-intervention-comparison-outcome. We used a mixed methodology-adoption adjustment, and include 32 guides. For recommendations not included in these, the search process was conducted in PubMed and Cochrane Library Plus with these terms: diabetes mellitus type 2, epidemiology, detection and diagnosis, classification, drug therapy, effects, prevention, control and complication. The clinical practice guideline emphasizes the fundamental change in lifestyle (diet and exercise), self-care and proactive participation of the patient, in addition to the dynamic prescription of medications that would achieve metabolic control in order to reduce late complications.

Risk factors for pancreatic cancer and early diagnosis of pancreatic cancer

International Nuclear Information System (INIS)

Yamao, Kenji; Mizuno, Nobumasa; Sawaki, Akira; Shimizu, Yasuhiro; Chang, K.J.

2008-01-01

This paper describes the strategy for improving the poor prognosis of the pancreatic (P) cancer by its early imaging diagnosis followed by resection, based on recent findings on its high risk group. Epidemiological studies have revealed that patients with diabetes, chronic pancreatitis, intraductal papillary-mucious tumor, P cyst, familial history of P cancer, and hereditary P cancer syndrome are involved in the high risk group of P cancer. Imaging diagnosis with CT and/or endoscopic ultrasonography (EUS) followed by histological confirmation for resection can be a useful approach to improve the prognosis in those high risk, asymptomatic individuals with abnormal levels of P enzyme and tumor marker, and with US findings of P ductal dilation and cyst. The guideline 2006 for P cancer by Japan Pancreas Society shows the algorithm leading to the final diagnosis for the positive high risk group: firstly, CT and/or MRCP (MR cholangiopancreatography (CP)); or, in case of uncertainty, EUS and/or ERCP (E retrograde CP) and/or PET; and finally, cytological, histological diagnosis. The newer approach proposed recently for the group is: multi detector row (MD)-CT and EUS; then cytodiagnosis guided by ERCP and/or with fine needle aspiration by EUS, also a promising early diagnosis. As well, molecular biological approaches are supposedly useful for the future diagnosis. (R.T.)

Early diagnosis in primary oral cancer: is it possible?

NARCIS (Netherlands)

van der Waal, I.; de Bree, R.; Brakenhoff, R.; Coebergh, J.W.

2011-01-01

In this treatise oral carcinogenesis is briefly discussed, particularly with regard to the number of cell divisions that is required before cancer reaches a measurable size. At that stage, metastatic spread may have already taken place. Therefore, the term "early diagnosis" is somewhat misleading.

Diagnosis and treatment of central diabetes insipidus

Directory of Open Access Journals (Sweden)

Ekaterina Aleksandrovna Pigarova

2014-11-01

Full Text Available Diabetes insipidus represents a serious disease that dramatically interferes with the everyday life of patients due to the need to constantly replenish of fluid lost in the urine, which comes amid shortage of synthesis, secretion or action of pituitary hormone vasopressin. The main difficulty is the differential diagnosis of types of diabetes insipidus in patients with the syndrome of polydipsia-polyuria as the correct differential diagnosis of these forms predetermine the safety and efficacy of further treatment. This lecture presents the current concepts of etiology, diagnosis and treatment of central diabetes insipidus (CDI. We give the comparative characteristics of various preparations of desmopressin for the treatment of the central form of the disease. We also consider the features of the management of selected patient populations with CDI: during pregnancy and lactation, pathology of the thirst sensation, after traumatic brain injury and neurosurgery.

Potential of the Antibody Against cis-Phosphorylated Tau in the Early Diagnosis, Treatment, and Prevention of Alzheimer Disease and Brain Injury.

Science.gov (United States)

Lu, Kun Ping; Kondo, Asami; Albayram, Onder; Herbert, Megan K; Liu, Hekun; Zhou, Xiao Zhen

2016-11-01

Alzheimer disease (AD) and chronic traumatic encephalopathy (CTE) share a common neuropathologic signature-neurofibrillary tangles made of phosphorylated tau-but do not have the same pathogenesis or symptoms. Although whether traumatic brain injury (TBI) could cause AD has not been established, CTE is shown to be associated with TBI. Until recently, whether and how TBI leads to tau-mediated neurodegeneration was unknown. The unique prolyl isomerase Pin1 protects against the development of tau-mediated neurodegeneration in AD by converting the phosphorylated Thr231-Pro motif in tau (ptau) from the pathogenic cis conformation to the physiologic trans conformation, thereby restoring ptau function. The recent development of antibodies able to distinguish and eliminate both conformations specifically has led to the discovery of cis-ptau as a precursor of tau-induced pathologic change and an early driver of neurodegeneration that directly links TBI to CTE and possibly to AD. Within hours of TBI in mice or neuronal stress in vitro, neurons prominently produce cis-ptau, which causes and spreads cis-ptau pathologic changes, termed cistauosis. Cistauosis eventually leads to widespread tau-mediated neurodegeneration and brain atrophy. Cistauosis is effectively blocked by the cis-ptau antibody, which targets intracellular cis-ptau for proteasome-mediated degradation and prevents extracellular cis-ptau from spreading to other neurons. Treating TBI mice with cis-ptau antibody not only blocks early cistauosis but also prevents development and spreading of tau-mediated neurodegeneration and brain atrophy and restores brain histopathologic features and functional outcomes. Thus, cistauosis is a common early disease mechanism for AD, TBI, and CTE, and cis-ptau and its antibody may be useful for early diagnosis, treatment, and prevention of these devastating diseases.

Xenon ventilation-perfusion lung scans. The early diagnosis of inhalation injury

International Nuclear Information System (INIS)

Schall, G.L.; McDonald, H.D.; Carr, L.B.; Capozzi, A.

1978-01-01

The use of xenon Xe-133 ventilation-perfusion lung scans for the early diagnosis of inhalation injury was evaluated in 67 patients with acute thermal burns. Study results were interpreted as normal if there was complete pulmonary clearance of the radioactive gas by 150 seconds. Thirty-two scans were normal, 32 abnormal, and three technically inadequate. There were three true false-positive study results and one false-negative study result. Good correlation was found between the scan results and various historical, physical, and laboratory values currently used to evaluate inhalation injury. The scans appeared to be the most sensitive method for the detection of early involvement, often being abnormal several days before the chest roentgenogram. Xenon lung scanning is a safe, easy, accurate, and sensitive method for the early diagnosis of inhalation injury and has important therapeutic and prognostic implications as well

Analysis pilot of the early diagnosis of congenital hyperthyroidism

International Nuclear Information System (INIS)

Torres J, E.J.; Higuera R, B.O.; Sanchez de E, R.; Lema I, A.

1997-01-01

The purpose of this article is to inform the results of the Pilot Study on the early diagnosis of congenital hypothyroidism, in a population of 11303 newborn, born over one year in Santa fe de Bogota. The disease was diagnosed in six neonates, who are currently under treatment and continuos medical supervision. Besides, a deficiency of Thyroxin-Binding-Globulin (TBG) was found in two newborns. The Radioimmunoassay (RIA) and Immunoradiometric Assay (IRMA) methodologies were employed in the screening test to quantify the Thyroxin hormone (T4) in umbilical cord blood samples and to determine the Thyroid Stimulating Hormone (TSH) in blood obtained in the heel prick at 24 hours of life of the newborn. Samples were collected in a filter paper Schleicher and Schuell 903 (SS 903). Reagent kits locally developed according to the required standards of specificity, sensitivity and reproducibility of the RIA and IRMA methodologies were also used. When results of the screening test either for total T4 were less than 6.5 ug/dl, or TSH were greater than 25 uUI/ml, the infants were recalled and the diagnosis was confirmed by measurement of serum TSH and total T4. The statistical analysis allows the adjustment of the cut-off point for total T4 and TSH in newborn according to the gestation phase and the sampling time, which can be used in future screening programs

[Recent developments in biopsy diagnosis of early and undefined liver tumors].

Science.gov (United States)

Longerich, T; Schirmacher, P

2009-01-01

Biopsy diagnosis of early and highly differentiated liver tumors is difficult and complex. Modern pathology has met this challenge by several different means; elaborate morphological algorithms and novel immunohistological markers support the differential diagnosis of highly differentiated HCC and a new, predictive molecular pathological and histological classification of liver cell adenoma was developed. By these new diagnostic tools together with the so-called 'matrix diagnosis' a reliable diagnostic classification is now feasible in the vast majority of these difficult cases.

Pneumothorax: from definition to diagnosis and treatment.

Science.gov (United States)

Zarogoulidis, Paul; Kioumis, Ioannis; Pitsiou, Georgia; Porpodis, Konstantinos; Lampaki, Sofia; Papaiwannou, Antonis; Katsikogiannis, Nikolaos; Zaric, Bojan; Branislav, Perin; Secen, Nevena; Dryllis, Georgios; Machairiotis, Nikolaos; Rapti, Aggeliki; Zarogoulidis, Konstantinos

2014-10-01

Pneumothorax is an urgent situation that has to be treated immediately upon diagnosis. Pneumothorax is divided to primary and secondary. A primary pneumothorax is considered the one that occurs without an apparent cause and in the absence of significant lung disease. On the other hand secondary pneumothorax occurs in the presence of existing lung pathology. There is the case where an amount of air in the chest increases markedly and a one-way valve is formed leading to a tension pneumothorax. Unless reversed by effective treatment, this situation can progress and cause death. Pneumothorax can be caused by physical trauma to the chest or as a complication of medical or surgical intervention (biopsy). Symptoms typically include chest pain and shortness of breath. Diagnosis of a pneumothorax requires a chest X-ray or computed tomography (CT) scan. Small spontaneous pneumothoraces typically resolve without treatment and require only monitoring. In our current special issue we will present the definition, diagnosis and treatment of pneumothorax from different experts in the field, different countries and present different methods of treatment.

Barriers to early presentation and diagnosis of breast cancer among African women living in sub-Saharan Africa.

Directory of Open Access Journals (Sweden)

Cynthia Pomaa Akuoko

Full Text Available Breast cancer (BC has been described as the leading cause of cancer deaths among women especially in the developing world including sub Saharan Africa (SSA. Delayed presentation and late diagnosis at health facilities are parts of the contributing factors of high BC mortality in Africa. This review aimed to appraise the contributing factors to delayed breast cancer presentation and diagnosis among SSA women.Five databases encompassing medical and social sciences were systematically searched using predefined search terms linked with breast cancer presentation and diagnosis and sub Saharan Africa. Reference lists of relevant papers were also hand searched. Quality of quantitative and qualitative articles were assessed using the National Institute of Health (NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Critical Appraisal Skills Programme (CASP quality appraisal checklist. Thematic analysis was used to synthesize the qualitative studies to integrate findings.Fourteen (14 quantitative studies, two (2 qualitative studies and one (1 mixed method study merited inclusion for analysis. This review identified low knowledge of breast cancer among SSA women. This review also found lack of awareness of early detection treatment, poor perception of BC, socio-cultural factors such as belief, traditions and fear as factors impacting African women's health seeking behavior in relation to breast cancer.Improving African women's knowledge and understanding will improve behaviors related to breast cancer and facilitate early presentation and detection and enhance proper management and treatment of breast cancer.

Barriers to early presentation and diagnosis of breast cancer among African women living in sub-Saharan Africa

Science.gov (United States)

Akuoko, Cynthia Pomaa; Armah, Ernestina; Sarpong, Theresa; Quansah, Dan Yedu; Amankwaa, Isaac

2017-01-01

Background Breast cancer (BC) has been described as the leading cause of cancer deaths among women especially in the developing world including sub Saharan Africa (SSA). Delayed presentation and late diagnosis at health facilities are parts of the contributing factors of high BC mortality in Africa. This review aimed to appraise the contributing factors to delayed breast cancer presentation and diagnosis among SSA women. Methods Five databases encompassing medical and social sciences were systematically searched using predefined search terms linked with breast cancer presentation and diagnosis and sub Saharan Africa. Reference lists of relevant papers were also hand searched. Quality of quantitative and qualitative articles were assessed using the National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Critical Appraisal Skills Programme (CASP) quality appraisal checklist. Thematic analysis was used to synthesize the qualitative studies to integrate findings. Results Fourteen (14) quantitative studies, two (2) qualitative studies and one (1) mixed method study merited inclusion for analysis. This review identified low knowledge of breast cancer among SSA women. This review also found lack of awareness of early detection treatment, poor perception of BC, socio-cultural factors such as belief, traditions and fear as factors impacting African women’s health seeking behavior in relation to breast cancer. Conclusion Improving African women’s knowledge and understanding will improve behaviors related to breast cancer and facilitate early presentation and detection and enhance proper management and treatment of breast cancer. PMID:28192444

[Value of optimization of bedside Gram staining of sputum smear in the early diagnosis and treatment of ventilator-associated pneumonia].

Science.gov (United States)

Liao, Xinyan; Ran, Yu; Bian, Shichang; Wang, Chao; Xu, Lei

2014-12-01

To investigate the significance of optimization of bedside Gram staining of sputum smear in the early diagnosis and antimicrobial treatment for ventilator-associated pneumonia (VAP) patients. The data of patients with VAP undergoing mechanical ventilation over 48 hours in the Department of Critical Care Medicine of Tianjin Fourth Central Hospital from June 2009 to June 2014 were analyzed. The patients were divided into two groups according to whether or not bedside Gram staining of sputum smear was used or not. The sputum samples from lower respiratory tract of all VAP patients were collected daily with tracheal catheter. In empirical examination group (from June 2009 to December 2011, n=43), the patients received antibiotics at the time of onset of VAP, selection of antibiotics depended on the information of bacterial epidemiology of the intensive care unit (ICU), and also existence of high risk factors of multi-drug resistant bacteria. In target treatment group (from January 2012 to June 2014, n=43), the patients received antibiotics according to the results of bedside instant sputum smear examination and empirical antibiotic regime. The correlation between the results of sputum smear examination and culture result was analyzed. The levels of body temperature, white blood cell (WBC) count, procalcitonin (PCT) level,and high sensitivity C- reactive protein (hs-CRP) were measured on the 1st day and 3rd day. The length of antibiotics treatment, duration of mechanical ventilation, and the time of ICU stay were recorded for both groups. There were 512 qualified sputum specimens for culture, from which 336 pathogens were found, and 358 strains of pathogenic bacteria were found from microscopic examination of 512 qualified sputum smear. The coincidence rate of results of bedside examination of sputum smear and that of sputum culture was 78.32%(401/512). The diagnostic acumen of the former was 85.42% (287/336), specificity was 64.77% (114/176), positive predictive value

[Practice guideline 'Prostate cancer: diagnosis and treatment'

NARCIS (Netherlands)

Reijke, T.M. de; Battermann, J.J.; Moorselaar, R.J.A. van; Jong, I.J. de; Visser, A.P.; Burgers, J.S.

2008-01-01

--A national, multidisciplinary practice guideline was developed concerning diagnosis and treatment of patients with prostate cancer. Because of the lack of sufficient scientific evidence at this moment no practice guideline on screening is included. --The diagnosis of prostate cancer is made by

Parkinson's Disease: Diagnosis and Treatment

Science.gov (United States)

... of this page please turn JavaScript on. Feature: Parkinson's Disease Parkinson's Disease: Diagnosis and Treatment Past Issues / Winter 2014 ... live productive lives and maintain mobility. How is Parkinson's Diagnosed? There are no blood or laboratory tests ...

Initial Treatment for Nonsyndromic Early-Life Epilepsy: An Unexpected Consensus.

Science.gov (United States)

Shellhaas, Renée A; Berg, Anne T; Grinspan, Zachary M; Wusthoff, Courtney J; Millichap, John J; Loddenkemper, Tobias; Coryell, Jason; Saneto, Russell P; Chu, Catherine J; Joshi, Sucheta M; Sullivan, Joseph E; Knupp, Kelly G; Kossoff, Eric H; Keator, Cynthia; Wirrell, Elaine C; Mytinger, John R; Valencia, Ignacio; Massey, Shavonne; Gaillard, William D

2017-10-01

There are no evidence-based guidelines on the preferred approach to treating early-life epilepsy. We examined initial therapy selection in a contemporary US cohort of children with newly diagnosed, nonsyndromic, early-life epilepsy (onset before age three years). Seventeen pediatric epilepsy centers participated in a prospective cohort study of children with newly diagnosed epilepsy with onset under 36 months of age. Details regarding demographics, seizure types, and initial medication selections were obtained from medical records. About half of the 495 enrolled children with new-onset, nonsyndromic epilepsy were less than 12 months old at the time of diagnosis (n = 263, 53%) and about half (n = 260, 52%) had epilepsy with focal features. Of 464 who were treated with monotherapy, 95% received one of five drugs: levetiracetam (n = 291, 63%), oxcarbazepine (n = 67, 14%), phenobarbital (n = 57, 12%), topiramate (n = 16, 3.4%), and zonisamide (n = 13, 2.8%). Phenobarbital was prescribed first for 50 of 163 (31%) infants less than six months old versus seven of 300 (2.3%) of children six months or older (P epilepsy presentation (focal, generalized, mixed/uncertain). Between the first and second treatment choices, 367 (74%) of children received levetiracetam within the first year after diagnosis. Without any specific effort, the pediatric epilepsy community has developed an unexpectedly consistent approach to initial treatment selection for early-life epilepsy. This suggests that a standard practice is emerging and could be utilized as a widely acceptable basis of comparison in future drug studies. Copyright © 2017 Elsevier Inc. All rights reserved.

Early fault detection and diagnosis for nuclear power plants

International Nuclear Information System (INIS)

Berg, O.; Grini, R.; Masao Yokobayashi

1988-01-01

Fault detection based on a number of reference models is demonstrated. This approach is characterized by the possibility of detecting faults before a traditional alarm system is triggered, even in dynamic situations. Further, by a proper decomposition scheme and use of available process measurements, the problem area can be confined to the faulty process parts. A diagnosis system using knowledge engineering techniques is described. Typical faults are classified and described by rules involving alarm patterns and variations of important parameters. By structuring the fault hypotheses in a hierarchy the search space is limited which is important for real time diagnosis. Introduction of certainty factors improve the flexibility and robustness of diagnosis by exploring parallel problems even when some data are missing. A new display proposal should facilitate the operator interface and the integration of fault detection and diagnosis tasks in disturbance handling. The techniques of early fault detection and diagnosis are presently being implemented and tested in the experimental control room of a full-scope PWR simulator in Halden

Diagnosis and treatment of gastroesophageal reflux disease complicated by Barrett's esophagus.

Science.gov (United States)

Stasyshyn, Andriy

2017-08-31

The aim of the study was to evaluate the effectiveness of a diagnostic and therapeutic algorithm for gastroesophageal reflux disease complicated by Barrett's esophagus in 46 patients. A diagnostic and therapeutic algorithm for complicated GERD was developed. To describe the changes in the esophagus with reflux esophagitis, the Los Angeles classification was used. Intestinal metaplasia of the epithelium in the lower third of the esophagus was assessed using videoendoscopy, chromoscopy, and biopsy. Quality of life was assessed with the Gastro-Intestinal Quality of Life Index. The used methods were modeling, clinical, analytical, comparative, standardized, and questionnaire-based. Results and their discussion. Among the complications of GERD, Barrett's esophagus was diagnosed in 9 (19.6 %), peptic ulcer in the esophagus in 10 (21.7 %), peptic stricture of the esophagus in 4 (8.7 %), esophageal-gastric bleeding in 23 (50.0 %), including Malory-Weiss syndrome in 18, and erosive ulcerous bleeding in 5 people. Hiatal hernia was diagnosed in 171 (87.7 %) patients (sliding in 157 (91.8%), paraesophageal hernia in 2 (1.2%), and mixed hernia in 12 (7.0%) cases). One hundred ninety-five patients underwent laparoscopic surgery. Nissen fundoplication was conducted in 176 (90.2%) patients, Toupet fundoplication in 14 (7.2%), and Dor fundoplication in 5 (2.6%). It was established that the use of the diagnostic and treatment algorithm promoted systematization and objectification of changes in complicated GERD, contributed to early diagnosis, helped in choosing treatment, and improved quality of life. Argon coagulation and use of PPIs for 8-12 weeks before surgery led to the regeneration of the mucous membrane in the esophagus. The developed diagnostic and therapeutic algorithm facilitated systematization and objectification of changes in complicated GERD, contributed to early diagnosis, helped in choosing treatment, and improved quality of life.

Early Identification and Treatment of Communication and Swallowing Deficits in Parkinson Disease

Science.gov (United States)

Ciucci, Michelle R.; Grant, Laura M.; Paul Rajamanickam, Eunice S.; Hilby, Breanna L.; Blue, Katherine V.; Jones, Corinne A.; Kelm-Nelson, Cynthia A.

2015-01-01

Parkinson disease (PD) is a complex, progressive, neurodegenerative disorder that leads to a wide range of deficits including fine and gross sensorimotor impairment, autonomic dysfunction, mood disorders, and cognitive decline. Traditionally, the focus for diagnosis and treatment has been on sensorimotor impairment related to dopamine depletion. It is now widely recognized, however, that PD-related pathology affects multiple central nervous system neurotransmitters and pathways. Communication and swallowing functions can be impaired even in the early stages, significantly affecting health and quality of life. The purpose of this article is to review the literature on early intervention for communication and swallowing impairment in PD. Overarching themes were that (1) studies and interpretation of data from studies in early PD are limited; (2) best therapy practices have not been established, in part due to the heterogeneous nature of PD; and (3) as communication and swallowing problems are pervasive in PD, further treatment research is essential. PMID:24166192

Practical Aspects Regarding the Histopathological Diagnosis of Early Mycosis Fungoides

Directory of Open Access Journals (Sweden)

Tebeică T.

2016-03-01

Full Text Available Mycosis fungoides is the most common primary T-cell lymphoma of skin. The disease has a protean clinical and histological presentation in its early patch and plaque stages, when distinction from mimicking inflammatory dermatoses is difficult. Since no single criterion is specific enough, a reliable diagnosis in early stages requires integration of clinical, histopathological and molecular findings. In skin biopsies, the most helpful histologic features are the detection of atypical lymphocytes in the epidermis with minimal epidermal changes, basal alignment of lymphocytes along dermal-epidermal junction and formation of Pautrier microabscesses. An aberrant immunophenotype of T cells and molecular detection of a clonal T-cell population are factors that could allow a more specific diagnosis. This work recapitulates and discusses these features from a practical perspective.

Circulating microRNAs as novel biomarkers for the early diagnosis of acute coronary syndrome.

Science.gov (United States)

Deddens, J C; Colijn, J M; Oerlemans, M I F J; Pasterkamp, G; Chamuleau, S A; Doevendans, P A; Sluijter, J P G

2013-12-01

Small non-coding microRNAs (miRNAs) are important physiological regulators of post-transcriptional gene expression. miRNAs not only reside in the cytoplasm but are also stably present in several extracellular compartments, including the circulation. For that reason, miRNAs are proposed as diagnostic biomarkers for various diseases. Early diagnosis of acute coronary syndrome (ACS), especially non-ST elevated myocardial infarction and unstable angina pectoris, is essential for optimal treatment outcome, and due to the ongoing need for additional identifiers, miRNAs are of special interest as biomarkers for ACS. This review highlights the nature and cellular release mechanisms of circulating miRNAs and therefore their potential role in the diagnosis of myocardial infarction. We will give an update of clinical studies addressing the role of circulating miRNA expression after myocardial infarction and explore the diagnostic value of this potential biomarker.

Early fault detection and on-line diagnosis in real-time environments

Directory of Open Access Journals (Sweden)

Andreas Bye

1993-01-01

Full Text Available This paper describes an approach to fault detection and diagnosis involving the simultaneous employment of quantitative and qualitative reasoning techniques. We show that early identification of process anomalies by means of a separate fault detection module paves the way for a fast and accuratc follow-up diagnosis. The diagnosis task is dramatically simplified because the diagnostic inferences can be performed at the soonest possible time: when the detection module first spots deviations between its calculated reference points and the corresponding measurements from the process.

Diagnosis and Treatment of Pityriasis Rubra Pilaris

Directory of Open Access Journals (Sweden)

Kubanov Alexey

2014-12-01

Full Text Available The article deals with clinical diagnosis and treatment of pityriasis rubra pilaris (PRP. The authors analyze the diagnostic errors, present literature review, and their own observations. The clinical study included 23 patients with pityriasis rubra pilaris: 18 women and 5 men, average age of 54 ± 7.2. The clinical diagnosis of all examined patients was subsequently confirmed by histological analysis of the skin. The primary clinical diagnosis was psoriasis in 15 (65.2% patients, 6 (26% patients received treatment for toxic exanthema, and only 2 (8.8% patients were presumptively diagnosed with pityriasis rubra pilaris. In conclusion, pityriasis rubra pilaris was initially misdiagnosed in 91.2% of patients. Considering the great number of diagnostic errors, we analyzed the main diagnostic and differential diagnostic features of PRP. The most effective of all synthetic retinoids in PRP treatment is acitretin. Although symptomatic improvement in PRP occurs within a month, substantial improvement, even clearing is possible within 4 - 6 months.

Ambiguous diagnosis, futile treatments and temporary recovery ...

African Journals Online (AJOL)

Ambiguous diagnosis, futile treatments and temporary recovery: Meanings of medical treatment among HIV/AIDS family caregivers providing care without ARVs. ... to understand unstable treatment outcomes; and policy makers should strengthen home-based care by developing policies that integrate palliative care into HIV ...

The diagnosis and treatment of the gummy smile.

Science.gov (United States)

Levine, R A; McGuire, M

1997-08-01

The diagnosis and treatment of the "gummy smile" (altered passive eruption, excessive gingival display) help the periodontist to provide the most beautiful smiles possible for patients. This article describes diagnosis, surgical planning, and case reports that show the benefits of treatment of this common clinical problem for the patient and restorative dentist who can now provide ideal cosmetic results for their patients.

Tiny But Mighty: Promising Roles of MicroRNAs in the Diagnosis and Treatment of Parkinson's Disease

Institute of Scientific and Technical Information of China (English)

Ying Wang; Zhaofei Yang; Weidong Le

2017-01-01

Parkinson's disease (PD) is the second most common age-related neurodegenerative disorder after Alzheimer's disease.To date,the clinical diagnosis of PD is primarily based on the late onset of motor impairments.Unfortunately,at this stage,most of the dopaminergic neurons may have already been lost,leading to the limited clinical benefits of current therapeutics.Therefore,early identification of PD,especially at the prodromal stage,is still a main challenge in the diagnosis and management of this disease.Recently,microRNAs (miRNAs) in cerebrospinal fluid or peripheral blood have been proposed as putative biomarkers to assist in PD diagnosis and therapy.In this review,we systematically summarize the changes of miRNA expression profiles in PD patients,and highlight their putative roles in the diagnosis and treatment of this devastating disease.

Computed Tomography Perfusion Usefulness in Early Imaging Diagnosis of Herpes Simplex Virus Encephalitis

International Nuclear Information System (INIS)

Marco de Lucas, E.; Mandly, Gonzalez A.; Gutierrez, A.; Sanchez, E.; Arnaiz, J.; Piedra, T.; Rodriguez, E.; Diez, C.

2006-01-01

An early diagnosis is crucial in herpes simplex virus encephalitis patients in order to institute acyclovir therapy and reduce mortality rates. Magnetic resonance imaging (MRI) is considered the gold standard for evaluation of these patients, but is frequently not available in the emergency setting. We report the first case of a computed tomography (CT) perfusion study that helped to establish a prompt diagnosis revealing abnormal increase of blood flow in the affected temporoparietal cortex at an early stage

Clinical features and early treatment response of central nervous system involvement in childhood acute lymphoblastic leukemia

DEFF Research Database (Denmark)

Levinsen, Mette; Taskinen, Mervi; Abrahamsson, Jonas

2014-01-01

BACKGROUND: Central nervous system (CNS) involvement in childhood acute lymphoblastic leukemia (ALL) remains a therapeutic challenge. PROCEDURE: To explore leukemia characteristics of patients with CNS involvement at ALL diagnosis, we analyzed clinical features and early treatment response of 744...... leukemia and patients without such characteristics (0.50 vs. 0.61; P = 0.2). CONCLUSION: CNS involvement at diagnosis is associated with adverse prognostic features but does not indicate a less chemosensitive leukemia....

Characteristics of seroconversion and implications for diagnosis of post-treatment Lyme disease syndrome: acute and convalescent serology among a prospective cohort of early Lyme disease patients.

Science.gov (United States)

Rebman, Alison W; Crowder, Lauren A; Kirkpatrick, Allison; Aucott, John N

2015-03-01

Two-tier serology is often used to confirm a diagnosis of Lyme disease. One hundred and four patients with physician diagnosed erythema migrans rashes had blood samples taken before and after 3 weeks of doxycycline treatment for early Lyme disease. Acute and convalescent serologies for Borrelia burgdorferi were interpreted according to the 2-tier antibody testing criteria proposed by the Centers for Disease Control and Prevention. Serostatus was compared across several clinical and demographic variables both pre- and post-treatment. Forty-one patients (39.4%) were seronegative both before and after treatment. The majority of seropositive individuals on both acute and convalescent serology had a positive IgM western blot and a negative IgG western blot. IgG seroconversion on western blot was infrequent. Among the baseline variables included in the analysis, disseminated lesions (p Lyme disease. Furthermore, these findings underline the difficulty for rheumatologists in identifying a prior exposure to Lyme disease in caring for patients with medically unexplained symptoms or fibromyalgia-like syndromes.

Nursing diagnosis Noncompliance to treatment in men with hypertension

Directory of Open Access Journals (Sweden)

Talliton Uchôa de Araújo

2016-01-01

Full Text Available Objective : to identify the frequency of occurrence of nursing diagnosis Noncompliance of treatment in men with high blood pressure, its defining characteristics, and related factors. Methods : a Cross-sectional study involving 44 men with hypertension by applying a validated instrument for identification of nursing diagnosis. Results : the diagnosis frequency of occurrence was 56.8%, the most present defining characteristics were the inadequate management of nonpharmacological treatment (p=0.000 and adherence failure of indicative behavior (p=0.000. The most common related factors were deficient knowledge for the monitor of the non- drug treatment regimen (p=0.000 and insufficient teaching ability of health staff (p=0.002. Conclusion : it was found a high frequency of diagnosis in men and the data point to the need for training of health professionals for the development of skills in promoting adherence of men to the treatment of hypertension.

Early versus late diagnosis in community-acquired bacterial meningitis

DEFF Research Database (Denmark)

Bodilsen, J; Brandt, C T; Sharew, A

2018-01-01

OBJECTIVES: To examine clinical characteristics and outcome of patients with late diagnosis of community-acquired bacterial meningitis (CABM). METHODS: We conducted a chart review of all adults with proven CABM in three centres in Denmark from 1998 through to 2014. Patients were categorized...... as early diagnosis of CABM immediately on admission, or late diagnosis if CABM was not listed in referral or admission records and neither lumbar puncture nor antibiotic therapy for meningitis was considered immediately on admission. We used modified Poisson regression analysis to compute adjusted relative...... differences (p 65 years (56/113, 50% versus 67/245, 27%), neck stiffness (35/97, 36% versus 183/234, 78%), concomitant pneumonia (26/113, 23% versus 26/245, 11%), and meningococcal meningitis (6/113, 5% versus 52/245, 21%). These variables...

Acute Pancreatitis: Etiology, Pathology, Diagnosis, and Treatment.

Science.gov (United States)

Majidi, Shirin; Golembioski, Adam; Wilson, Stephen L; Thompson, Errington C

2017-11-01

Acute pancreatitis is a fascinating disease. In the United States, the two most common etiologies of acute pancreatitis are gallstones and excessive alcohol consumption. The diagnosis of acute pancreatitis is made with a combination of history, physical examination, computed tomography scan, and laboratory evaluation. Differentiating patients who will have a benign course of their pancreatitis from patients who will have severe pancreatitis is challenging to the clinician. C-reactive protein, pro-calcitonin, and the Bedside Index for Severity of Acute Pancreatitis appeared to be the best tools for the early and accurate diagnosis of severe pancreatitis. Early laparoscopic cholecystectomy is indicated for patients with mild gallstone pancreatitis. For patients who are going to have a prolonged hospitalization, enteral nutrition is preferred. Total parenteral nutrition should be reserved for patients who cannot tolerate enteral nutrition. Prophylactic antibiotics are not indicated for patients with pancreatic necrosis. Surgical intervention for infected pancreatic necrosis should be delayed as long as possible to improve patient outcomes.

Hyperprolactinemia: causes, diagnosis, and treatment

International Nuclear Information System (INIS)

Karasek, M.; Pawlikowski, M.; Lewinski, A.

2006-01-01

The basic data on hyperprolactinemia (i.e. an excess of PRL above a reference laboratory's upper limits), the most common endocrine disorder of the hypothalamic-pituitary axis are given in this review. The following issues are discussed: regulation of prolactin (Prl) secretion, definition of hyperprolactinemia, its etiology and pathogenesis as well as its symptoms, diagnosis, and treatment (including medical and surgical therapy). It should be stressed that finding of elevated PRL serum concentrations constitute the beginning of diagnostic procedure and, after exclusion of physiologic, pharmacologic, and other organic causes of increased PRL levels, should be followed by detailed diagnosis including MRI. In patients in whom hyperprolactinemia has been confirmed the treatment with dopamine agonists (with prevalence of cabergoline, followed by quinagoline) is currently considered first-choice therapy. Surgery should be performed only in the patients resistant or intolerant to these agents, or in patients who refuse long-term therapy. (author)

Diagnosis and treatment of upper limb apraxia.

Science.gov (United States)

Dovern, A; Fink, G R; Weiss, P H

2012-07-01

Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients' everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients' prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed and ill-treated entity. Based on a systematic literature search, this review summarizes the current tools of diagnosis and treatment strategies for upper limb apraxia. It furthermore provides clinicians with graded recommendations. In particular, a short screening test for apraxia, and a more comprehensive diagnostic apraxia test for clinical use are recommended. Although currently only a few randomized controlled studies investigate the efficacy of different apraxia treatments, the gesture training suggested by Smania and colleagues can be recommended for the therapy of apraxia, the effects of which were shown to extend to activities of daily living and to persist for at least 2 months after completion of the training. This review aims at directing the reader's attention to the ecological relevance of apraxia. Moreover, it provides clinicians with appropriate tools for the reliable diagnosis and effective treatment of apraxia. Nevertheless, this review also highlights the need for further research into how to improve diagnosis of apraxia based on neuropsychological models and to develop new therapeutic strategies.

Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment

Science.gov (United States)

Bellato, Enrico; Marini, Eleonora; Castoldi, Filippo; Barbasetti, Nicola; Mattei, Lorenzo; Bonasia, Davide Edoardo; Blonna, Davide

2012-01-01

Fibromyalgia syndrome is mainly characterized by pain, fatigue, and sleep disruption. The etiology of fibromyalgia is still unclear: if central sensitization is considered to be the main mechanism involved, then many other factors, genetic, immunological, and hormonal, may play an important role. The diagnosis is typically clinical (there are no laboratory abnormalities) and the physician must concentrate on pain and on its features. Additional symptoms (e.g., Raynaud's phenomenon, irritable bowel disease, and heat and cold intolerance) can be associated with this condition. A careful differential diagnosis is mandatory: fibromyalgia is not a diagnosis of exclusion. Since 1990, diagnosis has been principally based on the two major diagnostic criteria defined by the ACR. Recently, new criteria have been proposed. The main goals of the treatment are to alleviate pain, increase restorative sleep, and improve physical function. A multidisciplinary approach is optimal. While most nonsteroidal anti-inflammatory drugs and opioids have limited benefit, an important role is played by antidepressants and neuromodulating antiepileptics: currently duloxetine (NNT for a 30% pain reduction 7.2), milnacipran (NNT 19), and pregabalin (NNT 8.6) are the only drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. In addition, nonpharmacological treatments should be associated with drug therapy. PMID:23213512

Accessibility of services for early infant diagnosis of Human ...

African Journals Online (AJOL)

Accessibility of services for early infant diagnosis of Human Immunodeficiency Virus in sub-Saharan Africa: a systematic review. ... infants who received a virological test within the first 2 months of life in sub-Saharan Africa varied from 3 to 58%, far below the 80% recommended level by the World Health Organization.

Nailfold capillaroscopy in primary biliary cirrhosis: a useful tool for the early diagnosis of scleroderma.

Science.gov (United States)

Tovoli, Francesco; Granito, Alessandro; Giampaolo, Luca; Frisoni, Magda; Volta, Umberto; Fusconi, Marco; Masi, Chiara; Lenzi, Marco

2014-03-01

Primary biliary cirrhosis (PBC) is frequently associated with other autoimmune diseases, including systemic sclerosis (SSc). In the last years many efforts have been dedicated to the research of widely accepted criteria for the early diagnosis of SSc. Since studies on the prevalence of early SSc in PBC patients are lacking, our aim was to investigate its hitherto unknown prevalence in a large cohort of PBC patients. We studied 80 PBC patients and 72 patients with other chronic liver diseases. Diagnostic workup included research into signs of connective tissue disease, determination of autoantibody profile, and examination of capillary abnormalities through nailfold videocapillaroscopy. Ten PBC patients (12.5%) satisfied diagnostic criteria for early SSc and 5 (6.3%) had definite SSc. None of the patients in the control group were diagnosed either with early or definite SSc. No differences were observed in terms of aminotransferases, alkaline phosphatase, and liver function tests between PBC patients with and without associated SSc. Early SSc is significantly frequent in PBC patients. The detection of early SSc in PBC patients may lead to a prompt treatment of its complications, preventing inabilities and preserving the chance of liver transplantation.

Osteochondritis dissecans of the knee joint: A diagnosis not to miss

Directory of Open Access Journals (Sweden)

Rahul R Bagul

2014-01-01

Full Text Available Osteochondritis dissecans (OCD is the most common cause of a loose body in the joint space in adolescent patients. Diagnosis requires a high index of suspicion as clinical findings are often subtle. Limited range of motion may be the only notable clinical sign. The diagnosis is made by thorough clinical examination, radiographic examination and magnetic resonance imaging (MRI. Early diagnosis and treatment can change the prognosis of the disease. If not diagnosed early, OCD can lead to the development of osteoarthritis at an early age. Conservative management is the mainstay of treatment for stable lesions. While the majority of patients respond to conservative treatment, those with unstable lesions require arthroscopic management.

[Submucosal endoscopic dissection in the treatment of early esophageal cancer].

Science.gov (United States)

Ughelli, Liliana; Miranda, Carolina; Galeano, Carlos; Blasco, María Del Carmen; Boselli, Guliano; Cubilla, Antonio; Sakai, Paulo; Blasco, Carmelo

2017-01-01

We report the case of a male patient, 80 years old, with a history of dyspepsia and no family history of neoplasias. In the upper digestive endoscopy in the distal esophagus, a flat depressed lesion with the appearance of early carcinoma, type IIC of Paris classification, was diagnosed by biopsy as a squamous carcinoma in situ, infiltrating, moderately differentiated non-keratinizing grade II carcinoma. He underwent submucosal endoscopic dissection without complications. Histopathology concluded: carcinoma of squamous cells, predominantly in situ of distal esophagus, measuring 0.6 cm, with focus of 0.1 cm of infiltration in the own lamina; absence of angiolymphatic or perineural invasion. The histopathology specimen had margins of surgical resection free of neoplasia. Stage pT1a. Three months later, in the endoscopy control with biopsy of the area, there was no evidence of carcinoma. We present the case because it is still a challenge to establish the diagnosis of esophageal cancer at an early stage, especially in patients without symptoms, highlighting the importance of chromoendoscopy and a good endoscopic examination to reach the diagnosis. Submucosal endoscopy dissection could be considered as a safe and effective alternative treatment to radical surgery.

Early prenatal diagnosis of ischiopagus conjoined twins

Directory of Open Access Journals (Sweden)

Ahmet Mete Ergenoğlu

2014-03-01

Full Text Available Introduction: Conjoined twins are very rare and the incidence of them vary about 1/50,000 and 1/100,000. They are named according to the joint parts. Embryos are conjoined at the level of ischium in ischiopagus. A case of ischiopagus will be presented in this article. Case: A twenty-seven year old women who is 9-10 weeks pregnant with a history of 1 abortus applied to the Ege University Department of Obstetrics and Gynecology for routine follow-up. Ultrasonography revealed a twin pregnancy but the embryos were attached at the pelvic region. 3D Doppler sonography confirmed the diagnosis of ischiopagus tetrapus. The patient's decision of termination of pregnancy is concluded at Perinatology Council of the clinic. Conclusion: Ischiopagus conjoined twins are very rare. Early prenatal diagnosis will prevent the maternal complications during the termination of the pregnancy.

Mental Retardation: Diagnosis and Treatment.

Science.gov (United States)

Poser, Charles M., Ed.

A collection of writings by 17 authors, the text includes the following discussions: general principles of diagnosis and management of mental retardation, neurologic evaluation of the infant and child, psychological evaluation, educational information, and treatment of pseudoretardation, communicative disorders, and metabolic and endocrine causes.…

[Diagnosis and treatment characteristics of head-wind sha in She medicine].

Science.gov (United States)

Zou, Guangyi; Xu, Xiangdong; Zheng, Songming; Yan, Lianhe; Lei, Houxing; Zhang, Qiao-ling; Xiang, Yingmei; Ye, Yiping; Song, Liwei

2015-03-01

The diagnosis and treatment characteristics of head-wind sha in She medicine were analyzed and summarized. By visiting She-nationality villages and towns in Zhejiang province and Fujian province and interviewing hundreds of doctors of She medicine, the sha diagnosis, sha differentiation, experience and theory of treatment were arranged, and a comprehensive summary on theory and application of head-wind sha in She medicine such as pathogeny, name of disease, mechanism, diagnosis, differential diagnosis and treatment was made. It is believed that the methods of diagnosis and treatment in She medicine for head-wind sha could effectively enhance curative effect, safety and patients' quality of life, and the further research should be carried out.

Mammography combined with breast dynamic contrast-enhanced-magnetic resonance imaging for the diagnosis of early breast cancer

Institute of Scientific and Technical Information of China (English)

Yakun He; Guohui Xu; Jin Ren; Bin Feng; Xiaolei Dong; Hao Lu; Changjiu He

2016-01-01

Objective The aim of this study was to investigate the application of mammography combined with breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the diagnosis of early breast cancer. Methods Mammography and DCE-MRI were performed for 120 patients with breast cancer (malignant, 102; benign; 18). Results The sensitivity of mammography for early diagnosis of breast cancer was 66.67%, specificity was 77.78%, and accuracy was 68.33%. The sensitivity of MRI for early diagnosis of breast cancer was 94.12%, specificity was 88.89%, and accuracy was 93.33%. However, the sensitivity of mammography combined with DCE-MRI volume imaging with enhanced water signal (VIEWS) scanning for early diagnosis of breast cancer was 97.06%, specificity was 94.44%, and accuracy was 96.67%. Conclusion Mammography combined with DCE-MRI increased the sensitivity, specificity, and accuracy of diagnosing early breast cancer.

Osteogenesis imperfecta: diagnosis and treatment.

Science.gov (United States)

Palomo, Telma; Vilaça, Tatiane; Lazaretti-Castro, Marise

2017-12-01

Here we summarize the diagnosis of osteogenesis imperfecta, discuss newly discovered genes involved in osteogenesis imperfecta, and review the management of this disease in children and adults. Mutations in the two genes coding for collagen type I, COL1A1 and COL1A2, are the most common cause of osteogenesis imperfecta. In the past 10 years, defects in at least 17 other genes have been identified as responsible for osteogenesis imperfecta phenotypes, with either dominant or recessive transmission. Intravenous bisphosphonate infusions are the most widely used medical treatment. This has a marked effect on vertebra in growing children and can lead to vertebral reshaping after compression fractures. However, bisphosphonates are less effective for preventing long-bone fractures. At the moment, new therapies are under investigation. Despite advances in the diagnosis and treatment of osteogenesis imperfecta, more research is needed. Bisphosphonate treatment decreases long-bone fracture rates, but such fractures are still frequent. New antiresorptive and anabolic agents are being investigated but efficacy and safety of these drugs, especially in children, need to be better established before they can be used in clinical practice.

Knowledge and practice on magnitude, diagnosis, treatment and ...

African Journals Online (AJOL)

There is lack of information on the burden, risk factors, diagnosis modalities, ... HCC is clinically characterized by exhaustion, loss of appetite, rapid loss of weight, ... strategy on health education and early case detection is of critical importance.

Prenatal radiographic diagnosis of alpha-fetoprotein positive malformations in early pregnancy

International Nuclear Information System (INIS)

Probst, F.P.; Sigurd, J.

1980-01-01

Early diagnosis of two malformed fetuses with positive alpha-fetoprotein test of the amniotic fluid with the aid of amniography is reported. Radiographic, diagnostic and prognostic aspects are discussed. (Auth.)

Cardiorenal Syndrome: Diagnosis and Treatment

Directory of Open Access Journals (Sweden)

O.O. Melnyk

2017-02-01

Full Text Available In the diagnosis of cardiorenal syndrome (CRS, the biological markers are widely used, they can be applied to identify the pathophysiological stages of CRS, to assess the amount of risk, prognosis and outcome, as well as to monitor the effectiveness of treatment. CRS therapy includes diuretics, vasodilators, angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists, nitrates and cardiac glycosides. One of the most effective methods of CRS treatment is the use of renal replacement therapy.

Induction of oestrus and early pregnancy diagnosis in Awassi sheep

International Nuclear Information System (INIS)

Al-Merestani, M.R.; Zarkawi, M.; Wardeh, M.

1997-12-01

An experiment on Syrian Awassi ewes and yearlings was conducted out-side the normal breeding season to study the possibility of inducing oestrus and increasing birth rate as an attempt to improve the reproductive efficiency, in addition to evaluating the possibility of early pregnancy diagnosis using progesterone radioimmunoassay kits. One-hundred-and fifty-five local female awassi sheep (96 ewes and 59 ewe lambs) were divided into 4 groups. Group T1 (n= 50 ewes) were fitted with itravaginal sponges containing 60 mg of medroxy progesterone acetate (MAP) for 14 days followd by 600 IU of pregnant mare's serum gonadotrophin (PMSG) at sponge withdrawal, whereas the control group C1 (n= 46 ewes) received no treatment. Group T2 (n= 41 yearlings) were fitted with itravaginal sponges containing 60 mg of MAP for 14 days followed by 400 IU PMSG at sponge withdrawal, whereas the control group C2 (n= 18 yearlings) received no treatment. The females in both T1 and T2 groups responded to the hormonal treatment, and showed oestrus behaviour within 36-48 h of sponge withdrawal. Total oestrus rate was 96% and 92.7% for groups T1 and T2, respectively. Lambing rates were 80%, 32.6%, 78.0% and 5.6% for groups T1, C1, T2 and C2, respectively. Twinning rates increased to 32.5% and 33.3% for groups T1 and T2, respectively, compared to 6.7% and 0% for groups C1 and C2, respectively. There were no significant differences in pregnancy duration between groups T1 (151.7 ± 1.7 days), and T2 (154.4 ± 1.5 days), and between single (154.4 ± 1.8 daus and 151.5 ± 1.6 days) and twin-born lambs (151.7 ± 1.5 days and 150.8 ± 1.3 days) for single and twin born lambs in groups T1 and T2, respectively. Hormonal treatment had no effect on the overall average lamb birth weight, which was 4.3 ± 1.0 Kg, 4.4 ± 0.7 Kg and 3.9 ± 1.0 Kg for groups T1, C1, and T2, respectively, and the birth weight for the only lamb born in group C2 was 4.0 kg. However, average birth weight for single born lambs was

Diagnosis as the First Critical Point in the Treatment Trajectory

DEFF Research Database (Denmark)

Missel, Malene; Pedersen, Jesper H; Hendriksen, Carsten

2015-01-01

sociology. RESULTS: The findings are presented as themes that summarize and express the ways in which a diagnosis affects patients' daily lives: the cancer diagnosis comes as a shock, it changes everyday awareness; it presents the patient with an unfamiliar body, disturbs social relationships, forces......BACKGROUND: Significant advances have been made in the surgical treatment of lung cancer while patient experiences with diagnosis, treatment, and rehabilitation remain only sparsely researched. OBJECTIVE: The objective of this study was to investigate how the diagnosis affects the daily lives...... of patients with operable lung cancer in order to identify their needs for care interventions from the point of diagnosis to hospitalization. METHODS: We investigated patients' lived experiences from a longitudinal perspective at 4 critical time points during the treatment trajectory; we present here...

Diagnosis and Early Warning of Wind Turbine Faults Based on Cluster Analysis Theory and Modified ANFIS

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Quan Zhou

2017-07-01

Full Text Available The construction of large-scale wind farms results in a dramatic increase of wind turbine (WT faults. The failure mode is also becoming increasingly complex. This study proposes a new model for early warning and diagnosis of WT faults to solve the problem of Supervisory Control And Data Acquisition (SCADA systems, given that the traditional threshold method cannot provide timely warning. First, the characteristic quantity of fault early warning and diagnosis analyzed by clustering analysis can obtain in advance abnormal data in the normal threshold range by considering the effects of wind speed. Based on domain knowledge, Adaptive Neuro-fuzzy Inference System (ANFIS is then modified to establish the fault early warning and diagnosis model. This approach improves the accuracy of the model under the condition of absent and sparse training data. Case analysis shows that the effect of the early warning and diagnosis model in this study is better than that of the traditional threshold method.

Diagnosis and treatment of cervico-omo-brachialgia

International Nuclear Information System (INIS)

Ogihara, Masahiro

2008-01-01

Described is the importance of exact diagnosis by complaint, physical and imaging findings, and of effective conservative or open surgical treatment in cervico-omo-branchialgia (COB). COB derives from diseases at cervical vertebra, thoracic outlet, upper limb and others. Imaging in the diagnosis involves the flat plate roentgenography, and MRI for lesions in the cervical vertebra, disk, vertebral canal, spinal cord, nerve root tube and muscle to evaluate hernia, tumor, infection, fracture, pressures of nerve root and spinal cord. CT is excellent for bony lesions of the cervical vertebra and ligament. Treatment with nerve block is done usually under X-ray fluoroscopy. Conservative treatment is usual and evaluation is important in its process not to miss the surgical timing. (R.T.)

Geographic access to radiation therapy facilities and disparities of early-stage breast cancer treatment

Directory of Open Access Journals (Sweden)

Yan Lin

2018-05-01

Full Text Available Few studies of breast cancer treatment have focused on the Northern Plains of the United States, an area with a high mastectomy rate. This study examined the association between geographic access to radiation therapy facilities and receipt of breast cancer treatments among early-stage breast cancer patients in South Dakota. Based on 4,209 early-stage breast cancer patients diagnosed between 2001 and 2012 in South Dakota, the study measured geographic proximity to radiation therapy facilities using the shortest travel time for patients to the closest radiation therapy facility. Two-level logistic regression models were used to estimate for early stage cases i the odds of mastectomy versus breast conserving surgery (BCS; ii the odds of not receiving radiation therapy after BCS versus receiving follow-up radiation therapy. Covariates included race/ethnicity, age at diagnosis, tumour grade, tumour sequence, year of diagnosis, census tract-level poverty rate and urban/rural residence. The spatial scan statistic method was used to identify geographic areas with significantly higher likelihood of experiencing mastectomy. The study found that geographic accessibility to radiation therapy facilities was negatively associated with the likelihood of receiving mastectomy after adjustment for other covariates, but not associated with radiation therapy use among patients receiving BCS. Compared with patients travelling less than 30 minutes to a radiation therapy facility, patients travelling more than 90 minutes were about 1.5 times more likely to receive mastectomy (odds ratio, 1.51; 95% confidence interval, 1.08-2.11 and patients travelling more than 120 minutes were 1.7 times more likely to receive mastectomy (odds ratio, 1.70; 95% confidence interval, 1.19-2.42. The study also identified a statistically significant cluster of patients receiving mastectomy who were located in south-eastern South Dakota, after adjustment for other factors. Because

New and chronic use of hypnotics after diagnosis with early breast cancer

DEFF Research Database (Denmark)

Andersen, Lærke Toftegård; Suppli, Nis Frederik Palm; Dalton, Susanne Oksbjerg

2015-01-01

BACKGROUND: To determine use and investigate factors associated with use of hypnotics the first year after a diagnosis with breast cancer. MATERIAL AND METHODS: A retrospective registry based cohort study linking clinical data from the Danish Breast Cancer Group with the National Prescription Drug...... Database and other health and administrative registries. We included 26 082 women diagnosed with early breast cancer as first time primary cancer during 1996-2006. Use of hypnotics was measured as redeemed prescriptions in the first year after diagnosis of early breast cancer. Prior use of hypnotics.......21-1.42)] and use of antidepressants the year before breast cancer diagnosis [HR 1.97 (95% CI 1.85-2.10)]. CONCLUSION: This study detected a group of patients at great risk for initiating and increasing use of hypnotics and preventive and prophylactic mechanism should be investigated and initiated when this group...

Early Diagnosis of Breast Cancer using Molecular, Biochemical and Pathological Markers

OpenAIRE

Salah E.D. El-Assal; Adel A. El-Tarras; Samir M. Abd-alla

2011-01-01

Problem statement: Laboratory diagnosis of breast cancer in most of the hospitals has traditionally been performed using cell culture and the direct hormone receptor assay, which are money and time consuming. Approach: This study was performed in order to direct the attention toward increasing the efficiency of early diagnosis in clinical laboratories at the western region of KSA and Egypt using recent PCR-dependent protocols i.e., Randomly Amplified Polymorphic DNA (RAPDs) and Reverse Transc...

EARLY DIAGNOSIS AS A PRECONDITION FOR A SUCCESSFUL COCHLEAR IMPLANTATION

OpenAIRE

Zora JACHOVA; Aleksandra KAROVSKA

2007-01-01

All researches point to the fact that the early de­tection and diagnosis are still performed late (after the third year of life), so in the first three years of life there is no establishment of the developmental changes in a way that they include the interrelation aspects of the human development and its natural sequences. With the start of early rehabilitation procedures we encourage the positive manner of communication in the small deaf child, so that it manufactures and processes informat...

[Treatment program for dual-diagnosis substance abusers].

Science.gov (United States)

Kandel, Isack

2007-01-01

Dual-diagnosis mentally ill patients, i.e. those characterized with substance abuse problems combined with mental health problems, are a challenge both for systems treating substance abusers and for mental health services. These patients are not easily integrated in either of these healthcare systems and/or are treated only for one aspect of their problem by each of these systems. For such patients it is necessary to create a separate treatment model, combining care of the problem of substance abuse and attention to the patient's mental pathology, according to his individual personality traits. For purposes of this programme a treatment setting operating on the model of a therapeutic community is proposed. This setting will open an affiliated treatment programme for dual-diagnosed patients in a separate treatment programme that is not part of the therapeutic community but will be affiliated with it and will accept dual-diagnosis patients.

Malabsorption: causes, consequences, diagnosis and treatment

African Journals Online (AJOL)

2011-06-06

Jun 6, 2011 ... Review Article: Malabsorption: causes, consequences, diagnosis and treatment. 2011;24(3) ... and osteopenia (malabsorption of calcium, vitamin D, phosphate and magnesium .... A lipase dosage in excess of 75 000 IU per.

PULMONARY HEMORRHAGE. ENDOSCOPIC DIAGNOSIS AND TREATMENT

Directory of Open Access Journals (Sweden)

A. M. Gasanov

2016-01-01

Full Text Available In the article, we report the incidence and etiology of pulmonary hemorrhage, and modern classifications according to the literature data. Methods of endoscopic diagnosis and treatment of pulmonary hemorrhage are analyzed.

Early endoscopic treatment of blunt traumatic pancreatic injury.

Science.gov (United States)

Björnsson, Bergthor; Kullman, Eric; Gasslander, Thomas; Sandström, Per

2015-01-01

Blunt pancreatic trauma is a rare and challenging situation. In many cases, there are other associated injuries that mandate urgent operative treatment. Morbidity and mortality rates are high and complications after acute pancreatic resections are common. The diagnosis of pancreatic injuries can be difficult and often requires multimodal approach including Computed Tomography scans, Magnetic resonance imaging and Endoscopic retrograde cholangiopancreaticography (ERCP). The objective of this paper is to review the application of endoprothesis in the settings of pancreatic injury. A review of the English literature available was conducted and the experience of our centre described. While the classical recommended treatment of Grade III pancreatic injury (transection of the gland and the pancreatic duct in the body/tail) is surgical resection this approach carries high morbidity. ERCP was first reported as a diagnostic tool in the settings of pancreatic injury but has in recent years been used increasingly as a treatment option with promising results. This article reviews the literature on ERCP as treatment option for pancreatic injury and adds further to the limited number of cases reported that have been treated early after the trauma.

Comprehensive Analysis of Cancer-Proteogenome to Identify Biomarkers for the Early Diagnosis and Prognosis of Cancer.

Science.gov (United States)

Shukla, Hem D

2017-10-25

During the past century, our understanding of cancer diagnosis and treatment has been based on a monogenic approach, and as a consequence our knowledge of the clinical genetic underpinnings of cancer is incomplete. Since the completion of the human genome in 2003, it has steered us into therapeutic target discovery, enabling us to mine the genome using cutting edge proteogenomics tools. A number of novel and promising cancer targets have emerged from the genome project for diagnostics, therapeutics, and prognostic markers, which are being used to monitor response to cancer treatment. The heterogeneous nature of cancer has hindered progress in understanding the underlying mechanisms that lead to abnormal cellular growth. Since, the start of The Cancer Genome Atlas (TCGA), and the International Genome consortium projects, there has been tremendous progress in genome sequencing and immense numbers of cancer genomes have been completed, and this approach has transformed our understanding of the diagnosis and treatment of different types of cancers. By employing Genomics and proteomics technologies, an immense amount of genomic data is being generated on clinical tumors, which has transformed the cancer landscape and has the potential to transform cancer diagnosis and prognosis. A complete molecular view of the cancer landscape is necessary for understanding the underlying mechanisms of cancer initiation to improve diagnosis and prognosis, which ultimately will lead to personalized treatment. Interestingly, cancer proteome analysis has also allowed us to identify biomarkers to monitor drug and radiation resistance in patients undergoing cancer treatment. Further, TCGA-funded studies have allowed for the genomic and transcriptomic characterization of targeted cancers, this analysis aiding the development of targeted therapies for highly lethal malignancy. High-throughput technologies, such as complete proteome, epigenome, protein-protein interaction, and pharmacogenomics

Diagnosis and emergency treatment of human exposures to ionizing radiations: practical aspects

International Nuclear Information System (INIS)

Martin, A.

1980-01-01

In case of accidental exposure, occupational physicians in nuclear power plants are faced with problems of diagnosis and early treatment. External irradiation, external and internal contamination will be considered successively. The experience is large as the first unit of the nuclear plant, the second in the world for the capacity, was started up 8 years ago. Of course, problems of radiation protection are different from those encountered in a research center or a hospital and cannot be solved in the same manner. The information gathered should be useful to all those that are faced with such problems [fr

Hyperthyroidism: Diagnosis and Treatment.

Science.gov (United States)

Kravets, Igor

2016-03-01

Hyperthyroidism is an excessive concentration of thyroid hormones in tissues caused by increased synthesis of thyroid hormones, excessive release of preformed thyroid hormones, or an endogenous or exogenous extrathyroidal source. The most common causes of an excessive production of thyroid hormones are Graves disease, toxic multinodular goiter, and toxic adenoma. The most common cause of an excessive passive release of thyroid hormones is painless (silent) thyroiditis, although its clinical presentation is the same as with other causes. Hyperthyroidism caused by overproduction of thyroid hormones can be treated with antithyroid medications (methimazole and propylthiouracil), radioactive iodine ablation of the thyroid gland, or surgical thyroidectomy. Radioactive iodine ablation is the most widely used treatment in the United States. The choice of treatment depends on the underlying diagnosis, the presence of contraindications to a particular treatment modality, the severity of hyperthyroidism, and the patient's preference.

Measuring patients' perceptions of the outcomes of treatment for early prostate cancer.

Science.gov (United States)

Clark, Jack A; Bokhour, Barbara G; Inui, Thomas S; Silliman, Rebecca A; Talcott, James A

2003-08-01

Compared with careful attention to the physical (eg, urinary, bowel, sexual) dysfunction that may follow treatment, little attention has been given to the behavioral, emotional, and interpersonal changes that the diagnosis of early prostate cancer and subsequent physical dysfunction may bring. To construct patient-centered measures of the outcomes of treatment for early prostate cancer. Qualitative study followed by survey of early prostate cancer patients and group of comparable patients with no history of prostate cancer. Analysis of focus groups identified relevant domains of quality of life, which were represented by Likert scale items included in survey questionnaires. Psychometric analyses of survey data defined scales evaluated with respect to internal consistency and validity. Qualitative analysis identified three domains: urinary control, sexuality, and uncertainty about the cancer and its treatment. Psychometric analysis defined 11 scales. Seven were generically relevant to most older men: urinary control (eg, embarrassment with leakage), sexual intimacy (eg, anxiety about completing intercourse), sexual confidence (eg, comfort with sexuality), marital affection (eg, emotional distance from spouse/partner), masculine self esteem (eg, feeling oneself a whole man), health worry (eg, apprehensiveness about health changes), and PSA concern (eg, closely attending to one's PSA). Four scales were specific to the treatment experience: perceived cancer control, quality of treatment decision making, regret of treatment choice, and cancer-related outlook. The scales provide definition and metrics for patient-centered research in this area. They complement measures of physical dysfunction and bring into resolution outcomes of treatment that have gone unnoticed in previous studies.

Anorexia nervosa in children and adolescents: diagnosis, treatment and the role of the pediatrician.

Science.gov (United States)

Silber, T J

2013-02-01

The diagnosis and treatment of anorexia nervosa (AN) in children and adolescents has some commonality but also differs from that of this condition in adults. A new understanding of AN is emerging: research data from the fields of epidemiology, genetics, and brain biology, suggest that there may be an underlying brain diathesis predisposing towards AN. It is now proposed that that what starts as a harmless diet, once it turns into a more prolonged food restriction may trigger an eating disorder in a genetically neurobiologically predisposed population. The condition may be then perpetuated by the biochemical changes induced by weight loss, ketosis, and the impact of the ensuing malnutrition on the brain (starvation illness). This change of paradigm from a psychological understanding to a neurobiological conceptualization calls for an early intervention to assure nutritional rehabilitation as soon as an eating disorder is suspected in children, without needing to wait for all the classical features of the diagnosis as seen in adults. This new model is agnostic about the origins of the disease and questions the classic assumption of "an underlying family pathology". It gives strong support to treatments such as Family Based Treatment, also referred to as the "Maudsley method". Essentially this consists of empowering parents to monitor and supervise the nutritional rehabilitation of their children. Hence pediatricians no longer need to be bystanders when treating these children and adolescents. They now have a clearly defined role: early diagnosticians, clinical monitors (of potential medical complications), nutrition advisors, and as members of a multidisciplinary team, patient and family advocates and educators.

Bowel obstruction in obturator hernia: A challenging diagnosis

Directory of Open Access Journals (Sweden)

L. Conti

2018-01-01

Conclusion: Obturator hernia is a rare type of hernia due to his diagnosis, which is often unclear; a prompt suspect based for the non-specific symptoms is crucial for the diagnosis. Surgical management depends on early diagnosis and it is the only possible treatment for this pathology.

Clinical Guidelines for the Diagnosis and Treatment of Cushing's Disease in Korea

Directory of Open Access Journals (Sweden)

Kyu Yeon Hur

2015-03-01

Full Text Available Cushing's disease (CD is a rare disorder characterized by the overproduction of adrenocorticotropic hormone due to a pituitary adenoma that ultimately stimulates excessive cortisol secretion from the adrenal glands. Prior to the detection of pituitary adenomas, various clinical signs of CD such as central obesity, moon face, hirsutism, and facial plethora are usually already present. Uncontrolled hypercortisolism is associated with metabolic, cardiovascular, and psychological disorders that result in increased mortality. Hence, the early detection and treatment of CD are not only important but mandatory. Because its clinical manifestations vary from patient to patient and are common in other obesity-related conditions, the precise diagnosis of CD can be problematic. Thus, the present set of guidelines was compiled by Korean experts in this field to assist clinicians with the screening, diagnoses, and treatment of patients with CD using currently available tests and treatment modalities.

Return to work after early-stage breast cancer : A cohort study into the effects of treatment and cancer-related symptoms

NARCIS (Netherlands)

Balak, Fulya; Roelen, Corne A. M.; Koopmans, Petra C.; ten Berge, Elike E.; Groothoff, Johan W.

Introduction Earlier diagnosis and better treatment have increased the survival rates of cancer patients. This warrants research on return to work of cancer survivors. What is the return to work rate following early-stage breast cancer? What is the effect of the type of treatment and cancer-related

Importance of radiologic early symptoms in diagnosis and therapy of necrosis of the head of the femur

International Nuclear Information System (INIS)

Stahl, C.; Kang, C.H.; Phlvers, E.; Haasters, J.; Thuemler, P.

1985-01-01

Early roentgenographic signs of aseptic necrosis are changes after infarction without flattening of the femoral head or subchondral decalcification (crescent sign). 121 patients with femoral head necrosis, in 99 of idiopathic origin and in 22 after cortisone treatment, were examined. The first sign of infarction is represented by the intensification of the bright regions at the lateral and medial aspect of the femoral head with emphasis on the lateral aspect near to the femoral neck. Special radiographic changes after infarction are discussed. The diagnosis of bilateral involvement determines the prognosis of the disease and its treatment. A careful study of the anamnesis is most important for prognostic reasons. (author)

Importance of radiologic early symptoms in diagnosis and therapy of necrosis of the head of the femur

Energy Technology Data Exchange (ETDEWEB)

Stahl, C; Kang, C H; Phlvers, E; Haasters, J; Thuemler, P [Essen Univ. (Gesamthochschule) (Germany, F.R.)

1985-02-01

Early roentgenographic signs of aseptic necrosis are changes after infarction without flattening of the femoral head or subchondral decalcification (crescent sign). 121 patients with femoral head necrosis, in 99 of idiopathic origin and in 22 after cortisone treatment, were examined. The first sign of infarction is represented by the intensification of the bright regions at the lateral and medial aspect of the femoral head with emphasis on the lateral aspect near to the femoral neck. Special radiographic changes after infarction are discussed. The diagnosis of bilateral involvement determines the prognosis of the disease and its treatment. A careful study of the anamnesis is most important for prognostic reasons.

Delays before Diagnosis and Initiation of Treatment in Patients Presenting to Mental Health Services with Bipolar Disorder.

Directory of Open Access Journals (Sweden)

Rashmi Patel

Full Text Available Bipolar disorder is a significant cause of morbidity and mortality. Although existing treatments are effective, there is often a substantial delay before diagnosis and treatment initiation. We sought to investigate factors associated with the delay before diagnosis of bipolar disorder and the onset of treatment in secondary mental healthcare.Retrospective cohort study using anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust (SLaM Biomedical Research Centre (BRC Case Register on 1364 adults diagnosed with bipolar disorder between 2007 and 2012. The following predictor variables were analysed in a multivariable Cox regression analysis: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder. The outcomes were time to recorded diagnosis from first presentation to specialist mental health services (the diagnostic delay, and time to the start of appropriate therapy (treatment delay.The median diagnostic delay was 62 days (interquartile range: 17-243 and median treatment delay was 31 days (4-122. Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18-3.06 and treatment delay (4.40, 3.63-5.62. Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33-0.41 and substance misuse disorders (0.44, 0.31-0.61. Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay.Some individuals experience a significant delay in diagnosis and treatment of bipolar disorder after initiation of specialist mental healthcare, particularly those who have prior diagnoses of alcohol and substance misuse disorders. These findings highlight a need for further study on strategies to better identify underlying symptoms and offer appropriate treatment

Delays before Diagnosis and Initiation of Treatment in Patients Presenting to Mental Health Services with Bipolar Disorder.

Science.gov (United States)

Patel, Rashmi; Shetty, Hitesh; Jackson, Richard; Broadbent, Matthew; Stewart, Robert; Boydell, Jane; McGuire, Philip; Taylor, Matthew

2015-01-01

Bipolar disorder is a significant cause of morbidity and mortality. Although existing treatments are effective, there is often a substantial delay before diagnosis and treatment initiation. We sought to investigate factors associated with the delay before diagnosis of bipolar disorder and the onset of treatment in secondary mental healthcare. Retrospective cohort study using anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust (SLaM) Biomedical Research Centre (BRC) Case Register on 1364 adults diagnosed with bipolar disorder between 2007 and 2012. The following predictor variables were analysed in a multivariable Cox regression analysis: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder. The outcomes were time to recorded diagnosis from first presentation to specialist mental health services (the diagnostic delay), and time to the start of appropriate therapy (treatment delay). The median diagnostic delay was 62 days (interquartile range: 17-243) and median treatment delay was 31 days (4-122). Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18-3.06) and treatment delay (4.40, 3.63-5.62). Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33-0.41) and substance misuse disorders (0.44, 0.31-0.61). Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay. Some individuals experience a significant delay in diagnosis and treatment of bipolar disorder after initiation of specialist mental healthcare, particularly those who have prior diagnoses of alcohol and substance misuse disorders. These findings highlight a need for further study on strategies to better identify underlying symptoms and offer appropriate treatment sooner

Pattern of Breast Cancer Distribution in Ghana: A Survey to Enhance Early Detection, Diagnosis, and Treatment

Directory of Open Access Journals (Sweden)

Frank Naku Ghartey Jnr

2016-01-01

Full Text Available Background. Nearly 70% of women diagnosed with breast cancer in Ghana are in advanced stages of the disease due especially to low awareness, resulting in limited treatment success and high death rate. With limited epidemiological studies on breast cancer in Ghana, the aim of this study is to assess and understand the pattern of breast cancer distribution for enhancing early detection and treatment. Methods. We randomly selected and screened 3000 women for clinical palpable breast lumps and used univariate and bivariate analysis for description and exploration of variables, respectively, in relation to incidence of breast cancer. Results. We diagnosed 23 (0.76% breast cancer cases out of 194 (6.46% participants with clinically palpable breast lumps. Seventeen out of these 23 (0.56% were premenopausal (<46.6 years with 7 (0.23% being below 35 years. With an overall breast cancer incidence of 0.76% in this study, our observation that about 30% of these cancer cases were below 35 years may indicate a relative possible shift of cancer burden to women in their early thirties in Ghana, compared to Western countries. Conclusion. These results suggest an age adjustment for breast cancer screening to early twenties for Ghanaian women and the need for a nationwide breast cancer screening to understand completely the pattern of breast cancer distribution in Ghana.

Early definitive treatment rate as a quality indicator of care in acute gallstone pancreatitis.

Science.gov (United States)

Green, R; Charman, S C; Palser, T

2017-11-01

Early definitive treatment (cholecystectomy or endoscopic sphincterotomy in the same admission or within 2 weeks after discharge) of gallstone disease after a biliary attack of acute pancreatitis is standard of care. This study investigated whether compliance with early definitive treatment for acute gallstone pancreatitis can be used as a care quality indicator for the condition. A retrospective cohort study was conducted using the Hospital Episode Statistics database. All emergency admissions to National Health Service hospitals in England with a first time diagnosis of acute gallstone pancreatitis in the financial years 2008, 2009 and 2010 were examined. Trends in early definitive treatment between hospital trusts were examined and patient morbidity outcomes were determined. During the study interval there were 19 510 patients with an overall rate of early definitive treatment at 34·7 (range 9·4-84·7) per cent. In the 1-year follow-up period, 4661 patients (23·9 per cent) had one or more emergency readmissions for complications related to gallstone pancreatitis. Of these, 2692 (57·8 per cent) were readmissions for acute pancreatitis; 911 (33·8 per cent) were within the first 2 weeks of discharge, with the remaining 1781 (66·2 per cent) occurring after the point at which definitive treatment should have been received. Early definitive treatment resulted in a 39 per cent reduction in readmission risk (adjusted risk ratio (RR) 0·61, 95 per cent c.i. 0·58 to 0·65). The risk was further reduced for acute pancreatitis readmissions to 54 per cent in the early definitive treatment group (adjusted RR 0·46, 0·42 to 0·51). In acute gallstone pancreatitis, compliance with recommended early definitive treatment varied considerably, with associated variation in outcomes. Compliance should be used as a quality indicator to improve care. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

Social barriers to diagnosis and treatment of breast cancer in patients presenting at a teaching hospital in Ibadan, Nigeria.

Science.gov (United States)

Pruitt, Liese; Mumuni, Tolulope; Raikhel, Eugene; Ademola, Adeyinka; Ogundiran, Temidayo; Adenipekun, Adeniyi; Morhason-Bello, Imran; Ojengbede, Oladosu A; Olopade, Olufunmilayo I

2015-01-01

Globally, breast cancer is the most frequent malignancy in women, and stage at diagnosis is a key determinant of outcome. In low- to middle-income countries, including Nigeria, advanced stage diagnosis and delayed treatment represent a significant problem. That social barriers contribute to delay has been noted in previous research; however, few specific factors have been studied. Using semi-structured interviews, this study identifies social barriers to diagnosis and treatment for patients who presented at University College Hospital Ibadan, Nigeria. Transcripts from the interviews were coded and analysed thematically. Thirty-one patients and five physicians were interviewed. The median age of patients was 51 (range: 28 to above 80), 83% were Christian and 17% were Muslim. Preliminary analysis showed that delays in diagnosis reflected a lack of education as well as the utilisation of non-physician medical services such as pharmacists. Delays in treatment were often due to fear of unanticipated surgery and cost. The majority of women did not know the cause of their breast cancer, but some believed it was caused by a spiritual affliction. This study suggests that further education and awareness of breast cancer for both patients and providers is needed in order to increase early stage diagnosis.

Diagnosis and Treatment of Chest Injury and Emergency Diseases of Chest Organs

Directory of Open Access Journals (Sweden)

A. M. Khadjibaev

2016-01-01

Full Text Available Goal of research: to evaluate efficiency of videothoracoscopy in diagnosis and treatment of patients with injuries and emergency diseases ща chest organs.Material and methods: Study wasbased on treatment results analysis of 2111 patients with injuries and chest organs emergency diseases, who were treated at Republican Research Centre of Emergency Medicine in 2001-2014. Chest trauma made up 1396 (66,1% victims. There were 477 (22,6% patients with spontaneous pneumothorax. At the stages of initial diagnosis, the radiologic evaluations, CT investigations and videothoracoscopies were performed. In chest trauma patients the videothoracoscopy underwent in 844 cases, in spontaneous pneu#mothorax this method was employed in 290 patients. Complicated forms of lung echinococcosis were observed in 238 (11,3% patients and complicated forms of lung echinococcosis were evident in 72 patients.Results. Videothoracoscopy and video-assisted interventions allowed to eliminate lungs and pleura pathology in 1206 (57,1% patients, whereas the traditional methods were effective only in 905 cases (42,9%.Conclusions. Investigation methods such as multiplanar radioscopy, radiography, chest CT and videothora-coscopy must be included into algorithm of diagnosis and surgical treatment of chest injuries and emergency diseases of chest organs. At chest trauma the videothoracoscopy allows to avoid broad thoracotomy from 9,4% to 4,7% of cases, to reduce the frequency of repeated interventions from 17,4% to 0,5% and diminish a number of early postsurgery complications from 25,4% to 10,9%. Videothoracoscopy of chest traumas allows to reduce frequency of repeated interventions from 19,8 to 1,7%.

Computational Intelligence Method for Early Diagnosis Dengue Haemorrhagic Fever Using Fuzzy on Mobile Device

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Salman Afan

2014-03-01

Full Text Available Mortality from Dengue Haemorrhagic Fever (DHF is still increasing in Indonesia particularly in Jakarta. Diagnosis of the dengue shall be made as early as possible so that first aid can be given in expectation of decreasing death risk. The Study will be conducted by developing expert system based on Computational Intelligence Method. On the first year, study will use the Fuzzy Inference System (FIS Method to diagnose Dengue Haemorrhagic Fever particularly in Mobile Device consist of smart phone. Expert system application which particularly using fuzzy system can be applied in mobile device and it is useful to make early diagnosis of Dengue Haemorrhagic Fever that produce outcome faster than laboratory test. The evaluation of this application is conducted by performing accuracy test before and after validation using data of patient who has the Dengue Haemorrhagic Fever. This expert system application is easy, convenient, and practical to use, also capable of making the early diagnosis of Dengue Haemorraghic to avoid mortality in the first stage.

Decreased early mortality associated with the treatment of acute myeloid leukemia at National Cancer Institute-designated cancer centers in California.

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Ho, Gwendolyn; Wun, Ted; Muffly, Lori; Li, Qian; Brunson, Ann; Rosenberg, Aaron S; Jonas, Brian A; Keegan, Theresa H M

2018-05-01

To the authors' knowledge, few population-based studies to date have evaluated the association between location of care, complications with induction therapy, and early mortality in patients with acute myeloid leukemia (AML). Using linked data from the California Cancer Registry and Patient Discharge Dataset (1999-2014), the authors identified adult (aged ≥18 years) patients with AML who received inpatient treatment within 30 days of diagnosis. A propensity score was created for treatment at a National Cancer Institute-designated cancer center (NCI-CC). Inverse probability-weighted, multivariable logistic regression models were used to determine associations between location of care, complications, and early mortality (death ≤60 days from diagnosis). Of the 7007 patients with AML, 1762 (25%) were treated at an NCI-CC. Patients with AML who were treated at NCI-CCs were more likely to be aged ≤65 years, live in higher socioeconomic status neighborhoods, have fewer comorbidities, and have public health insurance. Patients treated at NCI-CCs had higher rates of renal failure (23% vs 20%; P = .010) and lower rates of respiratory failure (11% vs 14%; P = .003) and cardiac arrest (1% vs 2%; P = .014). After adjustment for baseline characteristics, treatment at an NCI-CC was associated with lower early mortality (odds ratio, 0.46; 95% confidence interval, 0.38-0.57). The impact of complications on early mortality did not differ by location of care except for higher early mortality noted among patients with respiratory failure treated at non-NCI-CCs. The initial treatment of adult patients with AML at NCI-CCs is associated with a 53% reduction in the odds of early mortality compared with treatment at non-NCI-CCs. Lower early mortality may result from differences in hospital or provider experience and supportive care. Cancer 2018;124:1938-45. © 2018 American Cancer Society. © 2018 American Cancer Society.

Efficacy of T2*-Weighted Gradient-Echo MRI in Early Diagnosis of Cerebral Venous Thrombosis with Unilateral Thalamic Lesion

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Shingo Mitaki

2013-01-01

Full Text Available Cerebral venous thrombosis (CVT is an uncommon cause of stroke with diverse etiologies and varied clinical presentations. Because of variability in clinical presentation and neuroimaging, CVT remains a diagnostic challenge. Recently, some studies have highlighted the value of T2*-weighted gradient-echo MRI (T2*WI in the diagnosis of CVT. We report the case of a 79-year-old woman with CVT due to a hypercoagulable state associated with cancer. On the initial T2-weighted image (T2WI, there was a diffuse high-intensity lesion in the right thalamus, extending into the posterior limb of the internal capsule and midbrain. T2*WI showed diminished signal and enlargement of the right basilar vein and the vein of Galen. Even though there is a wide range of differential diagnoses in unilateral thalamic lesions, and a single thalamus lesion is a rare entity of CVT, based on T2*WI findings we could make an early diagnosis and perform treatment. Our case report suggests that T2*WI could detect thrombosed veins and be a useful method of early diagnosis in CVT.

The clinical significance of serum SCC-Ag combined with CD105 in patients with cervical cancer during the early stage diagnosis

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Ru-Chan Ma

2016-09-01

Full Text Available Objective: To invest the clinical significance of serum SCC-Ag combined with CD105 in early diagnosis of cervical cancer to provide new ideas for early diagnosis and clinical treatment of cervical cancer. Methods: A total of 74 cases cervical cancer patients were selected as cervical cancer group, and 52 cases uterine fibroids patients were selected as normal cervical group, serum samples were collected in the early morning fasting condition, SCC-Ag and CD105 were checked by ELISA method, SCC-Ag and CD105 of two groups were analyzed by t-test, and to compare SCC-Ag and CD105 in different TMN staging, lymph gland metastasis and non-lymph gland metastasis in patients with cervical cancer, the correlation analysis was used by Pearson correlation analysis method. Results: These results came from ELISA method, comparing with normal cervical group, the SCC-Ag and CD105 of cervical cancer group increased, the difference was statistically significant. Comparing with Ⅰ period of TMN staging, SCC-Ag and CD105 of Ⅱ period increased, Ⅲ, Ⅳ period increased, the difference was statistically significant. Comparing with Ⅱ period, SCC-Ag and CD105 of Ⅲ, Ⅳ period increased, the difference was statistically significant. Comparing with non-lymph gland metastasis, SCC-Ag and CD105 of lymph gland metastasis increased in cervical cancer with surgical treatment, the difference was statistically significant. According to Pearson correlation analysis, SCC-Ag and CD105 were positively correlated. Conclusion: SCC-Ag and CD105 in patients with cervical cancer increase highly, it has important clinical value that of serum SCCAg combined with CD105 in the early diagnosis of cervical cancer, especially it has clinical guiding significance to staging and lymph gland metastasis of cervical cancer, and it is worthy of clinical reference.

Prenatal Diagnosis of Congenital Adrenal Hyperplasia.

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Yau, Mabel; Khattab, Ahmed; New, Maria I

2016-06-01

Congenital adrenal hyperplasia (CAH) owing to 21-hydroxylase deficiency is a monogenic disorder of adrenal steroidogenesis. To prevent genital ambiguity, in girls, prenatal dexamethasone treatment is administered early in the first trimester. Prenatal genetic diagnosis of CAH and fetal sex determination identify affected female fetuses at risk for genital virilization. Advancements in prenatal diagnosis are owing to improved understanding of the genetic basis of CAH and improved technology. Cloning of the CYP21A2 gene ushered in molecular genetic analysis as the current standard of care. Noninvasive prenatal diagnosis allows for targeted treatment and avoids unnecessary treatment of males and unaffected females. Copyright © 2016 Elsevier Inc. All rights reserved.

Diagnosis and treatment of hand-arm vibration syndrome and its relationship to carpal tunnel syndrome.

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Falkiner, Sonja

2003-07-01

Hand-arm vibration syndrome (HAVS) is a condition associated with the use of vibrating tools that occurs mainly in men. It consists primarily of 'occupational' Raynaud disease and digital polyneuropathy. Carpal tunnel syndrome (CTS) is also associated with hand transmitted vibration exposure and can coexist with HAVS. This article examines recent papers on causation, diagnosis, relationship to CTS and treatment. A Medline search was conducted, as was a search of UK, USA and Australian government occupational health and safety websites. Published papers that were single case studies or of poor design were not included. There are no 'gold standard' diagnostic tests for HAVS. It can mimic CTS in temperate climates and can occur with CTS. This is the diagnostic challenge when a male worker presents with apparent CTS symptoms. If he has worked with vibrating tools for many years, a diagnosis of HAVS or co-diagnosis of HAVS should be considered before a diagnosis of pure CTS is made. Nonwork risk factors for HAVS are predisposition, smoking, and exposure to vibration outside work. Cessation of exposure (and smoking) and redeployment is a critical part of treatment due to the dose response relationship of HAVS. This contrasts with adequately treated CTS, where the vast majority of workers can return to pre-injury duties. In severe cases, calcium antagonists are also used, but treatment is often ineffective. Few workplaces in Australia manage vibration risk or conduct screening to identify workers with early HAVS who should be redeployed. Local doctors have an important opportunity to diagnose HAVS and to make recommendations to the workplace on redeployment as part of treatment before symptoms become irreversible.

Metabolomics as a promising tool for early osteoarthritis diagnosis

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E.B. de Sousa

2017-09-01

Full Text Available Osteoarthritis (OA is the main cause of disability worldwide, due to progressive articular cartilage loss and degeneration. According to recent research, OA is more than just a degenerative disease due to some metabolic components associated to its pathogenesis. However, no biomarker has been identified to detect this disease at early stages or to track its development. Metabolomics is an emerging field and has the potential to detect many metabolites in a single spectrum using high resolution nuclear magnetic resonance (NMR techniques or mass spectrometry (MS. NMR is a reproducible and reliable non-destructive analytical method. On the other hand, MS has a lower detection limit and is more destructive, but it is more sensitive. NMR and MS are useful for biological fluids, such as urine, blood plasma, serum, or synovial fluid, and have been used for metabolic profiling in dogs, mice, sheep, and humans. Thus, many metabolites have been listed as possibly associated to OA pathogenesis. The goal of this review is to provide an overview of the studies in animal models and humans, regarding the use of metabolomics as a tool for early osteoarthritis diagnosis. The concept of osteoarthritis as a metabolic disease and the importance of detecting a biomarker for its early diagnosis are highlighted. Then, some studies in plasma and synovial tissues are shown, and finally the application of metabolomics in the evaluation of synovial fluid is described.

Allergy Diagnosis and Treatment | NIH MedlinePlus the Magazine

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... this page please turn Javascript on. Feature: Managing Allergies Allergy Diagnosis and Treatment Past Issues / Spring 2013 Table of Contents Diagnosis Testing for Allergies Knowing exactly what you are allergic to can ...

Acute Fatty Liver of Pregnancy: Analysis on the Diagnosis and Treatment of 15 Cases.

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Liu, Guoyan; Shang, Xiaobin; Yuan, Bibo; Han, Cha; Wang, Yingmei

2016-01-01

To describe our experience with the diagnosis and management of acute fatty liver of pregnancy (AFLP). The medical records of pregnant women with AFLP were reviewed for symptoms, laboratory findings, treatment, and maternal and fetal outcomes during a 10-year period between January 2003 and December 2013. During the study period 15 women had AFLP as their discharge diagnosis. The mean gestational age at onset was 36 ± 1 weeks. Eleven cases were primigravidas, and 2 had multiple gestations. All patients presented with nausea, vomiting, and epigastric distress followed by jaundice in the third trimester of pregnancy. Raised transaminases and serum bilirubin as well as coagulopathy were found in all patients (100%), while hypoglycemia was found in 8 patients (53%). Ultrasound examination showed enhanced echo or fatty liver in 11 patients. Maternal morbidity included hepatic encephalopathy (n = 1), renal failure (n = 3), ascites (n = 6), hypoglycemia (n = 8), postpartum hemorrhage (n = 6), upper gastrointestinal hemorrhage (n = 1), and preeclampsia (n = 1). Emergency cesarean section was performed in 12 cases and supracervical hysterectomy was performed in 1 patient due to postpartum hemorrhage and disseminated intravascular coagulation (DIC); all patients survived. All neonates survived except for 2 fetal death cases before admission. Early diagnosis and prompt progressive management, including early termination of pregnancy and comprehensive supportive care, are crucial for improving the prognoses of both mother and newborn.

Chlorophyll as a biomarker for early disease diagnosis

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Manzoor Atta, Babar; Saleem, M.; Ali, Hina; Arshad, Hafiz Muhammad Imran; Ahmed, M.

2018-06-01

The current study was designed to identify the stage for the diagnosis of disease before visible symptoms appeared. Fluorescence spectroscopy has been employed to identify disease signatures for its early diagnosis in rice plant leaves. Bacterial leaf blight (BLB) diseased and healthy leaf samples were collected from the rice fields in September, 2017 which were then used to record spectra using an excitation wavelength at 410 nm. The spectral range of emission was set from 420 to 800 nm which covers the blue–green and the chlorophyll bands. It was found that diseased leaves have a narrower ‘chlorophyll a’ band than healthy ones, and furthermore, that the emission band at 730 nm was either declined or depleted in the sample with high infection symptoms. In contrast, the blue–green region was observed to increase due to the emergence of disease. As the band intensity of chlorophyll decreases during infection, this decrease in chlorophyll content and increase in the blue–green spectral region could provide a new approach for predicting BLB at an early stage. The important finding was that the chlorophyll degradation and rise in the blue–green region take place in leaves with BLB or during BLB infection. Principal component analysis has been applied to spectral data which successfully separated diseased samples from healthy ones even with very small spectral variations.

Early diagnosis of Gorlin-Goltz syndrome: case report.

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Casaroto, Ana R; Loures, Daniela C N Rocha; Moreschi, Eduardo; Veltrini, Vanessa C; Trento, Cleverson L; Gottardo, Vilmar D; Lara, Vanessa S

2011-01-25

The Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS), is an infrequent multisystemic disease inherited in a dominant autosomal way, which shows a high level of penetrance and variable expressiveness. It is characterized by keratocystic odontogenic tumors (KCOT) in the jaw, multiple basal cell nevi carcinomas and skeletal abnormities. This syndrome may be diagnosed early by a dentist by routine radiographic exams in the first decade of life, since the KCOTs are usually one of the first manifestations of the syndrome. This article paper reports the case of a patient, a 10-year-old boy with NBCCS, emphasizing its clinical and radiographic manifestations. This study highlights the importance of health professionals in the early diagnosis of NBCCS and in a preventive multidisciplinary approach to provide a better prognosis for the patient.

Diagnosis and Treatment of Premature Ejaculation by Urologists in South Korea

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Deok Ha Seo

2016-12-01

Full Text Available Purpose: This study discusses the treatment of premature ejaculation (PE using various approaches with the goal of evaluating the methods of diagnosis and treatment of PE in clinical practice in 2014 in South Korea. Materials and Methods: We surveyed 200 urologists and andrologists who treated patients with PE from July 1, 2014 to July 29, 2014 using an online questionnaire. The questionnaire was composed of 4 parts: disease, comorbidities, diagnosis, and treatment. Using the answers to this survey, current trends in the diagnosis and treatment of PE were investigated using weighted averages. Results: The median number per month of patients who were diagnosed with PE was 14 patients (interquartile range, 7∼24. The time to ejaculation necessary for a diagnosis of PE was considered to be ＜1 minute by 12% of respondents, ＜2 minutes by 27%, ＜3 minutes by 28%, ＜5 minutes by 13%, and 20% stated that diagnosis was based on a patient’s subjective complaint. The treatment methods preferred by PE patients were reported to be pharmacological treatment (87%, surgical treatment (9.5%, and behavioral management (3.5%. The treatment methods used by respondents were pharmacological treatment (77%, surgical treatment (15%, and behavioral management (14%. The most commonly used pharmacological treatment was the oral administration of dapoxetine (97%. Conclusions: In 2014 in South Korea, various methods were used to diagnose and treat PE. The most commonly used treatment for PE was the oral administration of dapoxetine. It was also found that surgical treatment was applied in some cases.

Guidelines for diagnosis and treatment of Hunter Syndrome for clinicians in Latin America

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Roberto Giugliani

2014-06-01

Full Text Available This review aims to provide clinicians in Latin America with the most current information on the clinical aspects, diagnosis, and management of Hunter syndrome, a serious and progressive disease for which specific treatment is available. Hunter syndrome is a genetic disorder where iduronate-2-sulfatase (I2S, an enzyme that degrades glycosaminoglycans, is absent or deficient. Clinical manifestations vary widely in severity and involve multiple organs and tissues. An attenuated and a severe phenotype are recognized depending on the degree of cognitive impairment. Early diagnosis is vital for disease management. Clinical signs common to children with Hunter syndrome include inguinal hernia, frequent ear and respiratory infections, facial dysmorphisms, macrocephaly, bone dysplasia, short stature, sleep apnea, and behavior problems. Diagnosis is based on screening urinary glycosaminoglycans and confirmation by measuring I2S activity and analyzing I2S gene mutations. Idursulfase (recombinant I2S (Elaprase®, Shire enzyme replacement therapy (ERT, designed to address the underlying enzyme deficiency, is approved treatment and improves walking capacity and respiratory function, and reduces spleen and liver size and urinary glycosaminoglycan levels. Additional measures, responding to the multi-organ manifestations, such as abdominal/inguinal hernia repair, carpal tunnel surgery, and cardiac valve replacement, should also be considered. Investigational treatment options such as intrathecal ERT are active areas of research, and bone marrow transplantation is in clinical practice. Communication among care providers, social workers, patients and families is essential to inform and guide their decisions, establish realistic expectations, and assess patients' responses.

Recent advances in the diagnosis and treatment of cancer

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Mai Trong Khoa

2015-01-01

Incidence and mortality rates of cancer are currently on the top of disease pattern and the number is increasing and increasing worldwide. The impact of screening program for early diagnosis has been proved their important roles in the war against cancer because it helps increase the cure rates, decrease the mortality and morbidity rates, and therefore reduces the economic-social burden. Advances in diagnostic imaging techniques, especially the hybrid imaging (X-ray and Nuclear Medicine) such as PET/CT, SPECT/CT, PET/MRI, is important in accurate staging and these help choose the optimized treatment options to prolong survival while improve the quality of life. The treatment outcomes of cancer has certain remarkable advances based on variety of research to modify, promote and strengthen the traditional treatments (surgery-chemotherapy-radiation) such as laparoscopic surgery, combined chemo-regimens, intensity modulated radiation therapy, volumetric modulated arc therapy, stereotactic radiation therapy, radio surgery, PET/CT simulation, radioactive seeds implant, selective internal radiation therapy, intra-operative radiation therapy, etc. as well as the emerge of new methods such as targeted therapy, immune therapy, radio immunotherapy, proton therapy and heavy ion. Treatment of cancer is now the “individualized treatment” with the advances of biochemistry and histopathology. To achieve the most optimal outcomes, cancer should be approached by a multi professional team including biochemistry, immunology, histopathology, surgical oncology, medical oncology and radiation oncology. (author)

Renal amyloidosis: a synopsis of its clinical presentation, diagnosis and treatment

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Elena V. Zakharova

2015-04-01

Full Text Available Amyloidosis is a heterogeneous group of hereditary and acquired diseases in which normally soluble plasma proteins are deposited in the extracellular and/or intracellular space in abnormal, insoluble, fibrillar form. Renal damage is one of the most common features of systemic amyloidosis, and the presentation is most commonly due to the consequences of renal involvement, with proteinuria and progressive renal decline. Progression to end-stage renal failure is common. Early diagnosis of systemic amyloidosis is difficult. Renal amyloidosis typically presents with nephrotic syndrome and/or renal failure. Treatment of AL amyloidosis aims to reduce production of the monoclonal immunoglobulin precursor via chemotherapy. Current options for treatment include melphalan+dexamethasone or cyclophosphamide-bortezomib-dexamethasone regimens, or in selected patients, high-dose melphalan with autologous stem cell transplantation. The focus of current research is on pharmacological therapy to solubilize amyloid fibrils and increase tissue catabolism of amyloid deposits.

Anxiety disorders. Part 1: Diagnosis and treatment.

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Labelle, A.; Lapierre, Y. D.

1993-01-01

Anxiety disorders often take second priority in clinical practice because many physicians do not understand them or their treatment. This paper reviews the diagnostic groupings of anxiety disorders according to the American Psychiatric Association's Revised Diagnostic and Statistical Manual of Mental Disorders (DSM 3-R) and discusses differential diagnosis and treatment.

Echocardiography diagnosis of myocardial infarction complications

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N.D. Oryshchyn

2016-03-01

Full Text Available Diagnosis and management of myocardial infarction complications are discussed in this article. These complications are associated with high level of mortality and surgery is a main treatment method. High level of suspicion and early diagnosis are essential for appropriate treatment and improvement of prognosis. Echocardiography is a main diagnostic method. Analysis of literature about contemporary management of mechanical complications of myocardial infarction has been performed, case reports are presented.

Current Diagnosis, Treatment and Etiology of Status Epilepticus

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Çetin Kürşad Akpınar

2014-03-01

Full Text Available Status Epilepticus (SE is a medical emergency that causes significant morbidity and mortality and requires prompt diagnosis and treatment. Although SE can be divided into two subgroups as convulsive and nonconvulsive, treatment principles are generally similar. Treatment should be prompt and underlying cause should be corrected. Although intravenous lorazepam is the first-line treatment due to a lower risk of relapse, diazepam becomes the first choice since loeazepan is not available in our country. Even though intravenous benzodiazepine stops seizures, intravenous antiepileptic drug (phenytoin, etc. should be administered at a loading dose. Patients with refractory status epilepticus should be supported with respect to vital, respiratory, metabolic and hemodynamic aspects and followed up in an intensive care unit to monitor cerebral electrical activity. The most common cause in the etiology is the cessation of antiepileptic drugs. The aim of SE treatment is to stop seizures and prevent complications and recurrence. In this paper, current diagnosis, treatment and etiology of SE are reviewed.

Early diagnosis of adenylosuccinate lyase deficiency using a high-throughput screening method and a trial of oral S-adenosyl-l-methionine as a treatment method.

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van Werkhoven, Michiel A; Duley, John A; McGown, Ivan; Munce, Teresa; Freeman, Jeremy L; Pitt, James J

2013-11-01

The aim of this study was to develop a high-throughput urine screening technique for adenylosuccinate lyase (ADSL) deficiency and to evaluate S-adenosyl-l-methionine (SAMe) as a potential treatment for this disorder. Testing for succinyladenosine (S-Ado), a marker of ADSL deficiency, was incorporated into a screening panel for urine biomarkers for inborn errors of metabolism using electrospray tandem mass spectrometry. Liquid chromatography-mass spectrometry and high-performance liquid chromatography were used to confirm and monitor the response of metabolites to oral SAMe treatment. Increased levels of S-Ado were detected in a 3-month-old male infant with hypotonia and seizures. ADSL gene sequencing revealed a previously described c.-49T>C mutation and a novel c.889_891dupAAT mutation, which was likely to disrupt enzyme function. After 9 months of SAMe treatment, there was no clear response evidenced in urine metabolite levels or clinical parameters. These results demonstrate proof of the principle for the high-throughput urine screening technique, allowing earlier diagnosis of patients with ADSL deficiency. However, early treatment with SAMe does not appear to be effective in ADSL deficiency. It is suggested that although SAMe treatment may ameliorate purine nucleotide deficiency, it cannot correct metabolic syndromes in which a toxic nucleotide is present, in this case presumed to be succinylaminoimidazole carboxamide ribotide. © 2013 Mac Keith Press.

Exosomes: novel implications in diagnosis and treatment of gastrointestinal cancer.

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Rahbari, Mohammad; Rahbari, Nuh; Reissfelder, Christoph; Weitz, Juergen; Kahlert, Christoph

2016-12-01

Amongst all cancer subtypes, gastrointestinal tumours are responsible for most cancer-related deaths. In most of the cases, the limitation of the prognosis of patients with malignant gastrointestinal tumours can be attributed to delayed diagnosis of the disease. In the last decade, secondary prevention strategies, in particular tumour screenings, have been identified to significantly improve the identification of patients with early-stage disease, leading to more effective therapeutic interventions. Therefore, new screening methods and further innovative treatment approaches may lead to an increase in progression-free and overall survival rates. Exosomes are small microvesicles with a size of 50-150 nm. They are formed in the endosomal system of many different cell types, where they are packed with nucleotides and proteins from the parental cell. After their release into the extracellular space, exosomes can deliver their cargo into recipient cells. By this mechanism, tumour cells can recruit and manipulate the adjacent and systemic microenvironment in order to support invasion and dissemination. Cancer-derived exosomes in the blood may provide detailed information about the tumour biology of each individual patient. Moreover, tumour-derived exosomes can be used as targetable factors and drug delivery agents in clinical practice. In this review, we summarise new aspects about novel implications in the diagnosis and treatment of gastrointestinal cancer and show how circulating exosomes have come into the spotlight of research as a high potential source of 'liquid biopsies'.

High-frequency audiometry: A means for early diagnosis of noise-induced hearing loss

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Amir H Mehrparvar

2011-01-01

Full Text Available Noise-induced hearing loss (NIHL, an irreversible disorder, is a common problem in industrial settings. Early diagnosis of NIHL can help prevent the progression of hearing loss, especially in speech frequencies. For early diagnosis of NIHL, audiometry is performed routinely in conventional frequencies. We designed this study to compare the effect of noise on high-frequency audiometry (HFA and conventional audiometry. In a historical cohort study, we compared hearing threshold and prevalence of hearing loss in conventional and high frequencies of audiometry among textile workers divided into two groups: With and without exposure to noise more than 85 dB. The highest hearing threshold was observed at 4000 Hz, 6000 Hz and 16000 Hz in conventional right ear audiometry, conventional left ear audiometry and HFA in each ear, respectively. The hearing threshold was significantly higher at 16000 Hz compared to 4000. Hearing loss was more common in HFA than conventional audiometry. HFA is more sensitive to detect NIHL than conventional audiometry. It can be useful for early diagnosis of hearing sensitivity to noise, and thus preventing hearing loss in lower frequencies especially speech frequencies.

Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm

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Hans Polzer

2012-01-01

Full Text Available Acute ankle injuries are among the most common injuries in emergency departments. However, a standardized examination and an evidence-based treatment are missing. Therefore, aim of this study was to systematically search the current literature, classify the evidence and develop an algorithm for diagnosis and treatment of acute ankle injuries. We systematically searched PubMed and the Cochrane Database for randomized controlled trials, meta-analysis, systematic reviews, or if applicable observational studies and classified them according to their level of evidence. According to the currently available literature, the following recommendations are given. The Ottawa Ankle/Foot Rule should be applied in order to rule out fractures, Physical examination is sufficient for diagnosing injuries to the lateral ligament complex. Classification into stable and unstable injuries is applicable and of clinical importance. The squeeze-, crossed leg- and external rotation test are indicative for injuries of the syndesmosis. Magnetic resonance imaging is recommended to verify such injuries. Stable ankle sprains have a good prognosis, while for unstable ankle sprains conservative treatment is at least as effective as operative treatment without carrying possible complications. Early functional treatment leads to the fastest recovery and the least rate of re-injury. Supervised rehabilitation reduces residual symptoms and re-injuries. Taken these recommendations into account, we here present an applicable and evidence-based step by step decision pathway for the diagnosis and treatment of acute ankle injuries, which can be implemented in any emergency department or doctor’s practice. It provides quality assurance for the patient and confidence for the attending physician.

Application of serum TGF-β1 determination for early diagnosis of diabetic nephropathy

International Nuclear Information System (INIS)

Jiang Zhonglin; Jiang Guoliang

2005-01-01

Objective: To investigate the feasibility of obtaining early diagnosis of diabetic nephropathy (DN) with determination of serum transforming growth factor-β 1 (TGF- β 1 ). Methods: Serum TGF-β 1 (with ELISA) and β 2 -microglobulin (β 2 -m, with RIA) levels as well as urinany β 2 -m, albumin and mciro-amount of proteins were determined in 35 controls and 84 diabetic patients with different degrees of albuminuria (Group A: urinary albumin excretion UAE 300mg/24h, n=28). Results: The serum TGF-β 1 , β 2 -m and urinary β 2 -m contents were correlated well with UAE in the diabetic patients. Conclusion: TGF-β 1 and β 2 -m were sensitive markers for early renal function injury in diabetic patients and determination of serum TGF-β 1 levels was clinically useful for diagnosis of early DN. (authors)

New insights in diagnosis and treatment for Retinopathy of Prematurity.

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Cernichiaro-Espinosa, Linda A; Olguin-Manriquez, Francisco J; Henaine-Berra, Andree; Garcia-Aguirre, Gerardo; Quiroz-Mercado, Hugo; Martinez-Castellanos, Maria A

2016-10-01

The purpose of this study was to review current perspectives on diagnosis and treatment of Retinopathy of Prematurity (ROP). We performed a systematic review of how much has been produced in research published online and on print regarding ROP in different settings around the world. Early Treatment for ROP (ETROP) classification is the currently accepted classification of ROP. Fluorescein angiography and spectral domain optical coherence tomography (SD-OCT) may eventually lead to changes in the definition of ROP, and as a consequence, they will serve as a guide for treatment. Intravitreal anti-VEGF therapy has proven to be more effective in terms of lowering recurrence, allowing growth of the peripheral retina, and diminishing the incidence of retinal detachment when proliferative ROP is diagnosed. Whether anti-VEGF plus laser are better than any of these therapies separately remains a subject of discussion. Telemedicine is evolving everyday to allow access to remote areas that do not count with a retina specialist for treatment. A management algorithm is proposed according to our reference center experience. ROP is an evolving subject, with a vulnerable population of study that, once treated with good results, leads to a reduction in visual disability and in consequence, in a lifetime improvement.

Diagnosis and Treatment of Neurocysticercosis

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Christina M. Coyle

2009-01-01

Full Text Available Neurocysticercosis, the infection caused by the larval form of the tapeworm Taenia solium, is the most common parasitic disease of the central nervous system and the most common cause of acquired epilepsy worldwide. This has primarily been a disease that remains endemic in low-socioeconomic countries, but because of increased migration neurocysticercosis is being diagnosed more frequently in high-income countries. During the past three decades improved diagnostics, imaging, and treatment have led to more accurate diagnosis and improved prognosis for patients. This article reviews the current literature on neurocysticercosis, including newer diagnostics and treatment developments.

The radiographic diagnosis of early attacking congenital syphilis of bone

International Nuclear Information System (INIS)

Ji Yaping; Zhuge Moyi

2005-01-01

Objective: To explore the method of radiological diagnosis of early attacking congenital syphilis. Methods: Seven cases of early attacking congenital syphilis of bone were retrospectively analyzed, diagnosed serologically, and were taken X-rays of the long bones. Results: Bone radiographs abnormalities were identified in 6 of 7 cases. Five cases suffered periotities, six cases metaphysitis, and three cases combined with diaphysitis. Seven cases had swollen soft tissue. The vertebraes, craniums and epiphysitis were not found abnormal in 7 cases. Diffusion, multiple and symmetric metaphysitis, periosteitis and osteitis were the radiological characters of congenital syphilis of bone. Conclusion: Radiography can affirm the diagnose of early attacking congenital syphilis and definite the arrange and depth. Radiographs of the extremities should be routinely taken in suspected infants. (authors)

New developments in epidemiology, diagnosis, and treatment of fascioliasis.

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Cabada, Miguel M; White, A Clinton

2012-10-01

This review focuses on the recent developments in the epidemiology, burden of disease, diagnostic tests, and treatment of fascioliasis. Recent epidemiologic data suggest that either the endemic areas are expanding or disease is being recognized in areas where it was not previously observed. In addition, recent data highlight the effects of fascioliasis on childhood anemia and nutrition. Diagnosis remains problematic, but newer diagnostic tests including antibody, antigen, and DNA detection tests may facilitate earlier diagnosis. Recent studies suggest that point-of-care testing may soon be possible. Treatment with triclabendazole is effective, but resistance is emerging in livestock and may pose a threat for patients. Fascioliasis continues to emerge as an important neglected disease, with new studies highlighting the under-recognized burden of disease. Further studies are needed on burden of disease, improved diagnosis, and alternative to triclabendazole treatment.

Insurance status effects on stage of diagnosis and surgical options used in the treatment of breast cancer.

Science.gov (United States)

Lukavsky, Robert; Sariego, Jack

2015-05-01

Insurance status has the potential to play a significant role in an individual's health care by affecting the time of diagnosis and the treatment options used. Our study reviewed insurance status as a determinant of the time of a breast cancer diagnosis as well as the surgical treatment options offered. The American College of Surgeons' National Cancer Database benchmark reports were used to examine first-course surgery stratified by the stage of breast cancer diagnosed between 2000 and 2010. The data were stratified according to insurance status with a focus on insured patients versus underinsured patients. The relations among insurance status, breast cancer stage at the time of presentation, and initial treatment offered were then evaluated. There was a statistically significant relation between breast cancer stage at the time of diagnosis and insurance status. There also was a relation between insurance status and the treatment offered. Adequately insured patients presented at an earlier stage than did underinsured patients. In addition, in patients who present with early-stage disease, insured patients had a higher rate of breast-conserving surgery than did underinsured patients, 62.4% and 55.5%, respectively. This trend continued in late-stage breast cancer, in which mastectomy was the predominant treatment option overall. Despite this, insured patients underwent breast-conserving therapy more frequently than did underinsured patients, 24.2% and 21.2%, respectively. The discrepancy of the stage of diagnosis between insured patients and underinsured patients can be attributed to a host of factors, among which are access to regular office visits and screening tests for breast cancer. In addition, the surgical treatment options used may depend on the cost of treatment and accessibility to and compliance with follow-up care.

Early diagnosis of Gorlin-Goltz syndrome: case report

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Trento Cleverson L

2011-01-01

Full Text Available Abstract The Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS, is an infrequent multisystemic disease inherited in a dominant autosomal way, which shows a high level of penetrance and variable expressiveness. It is characterized by keratocystic odontogenic tumors (KCOT in the jaw, multiple basal cell nevi carcinomas and skeletal abnormities. This syndrome may be diagnosed early by a dentist by routine radiographic exams in the first decade of life, since the KCOTs are usually one of the first manifestations of the syndrome. This article paper reports the case of a patient, a 10-year-old boy with NBCCS, emphasizing its clinical and radiographic manifestations. This study highlights the importance of health professionals in the early diagnosis of NBCCS and in a preventive multidisciplinary approach to provide a better prognosis for the patient.

Adolescence and polycystic ovary syndrome: current concepts on diagnosis and treatment.

Science.gov (United States)

Spritzer, P M; Motta, A B

2015-11-01

Adolescence is a time characterised by changes in reproductive hormones and menstrual patterns, which makes it difficult to diagnose polycystic ovary syndrome (PCOS) in this population. The diagnosis of PCOS has a great physical and psychosocial impact on the young person. Despite the importance of a diagnosis of PCOS at adolescence, data available are limited. This review focuses on analysing markers of PCOS diagnosis and possible treatments in adolescence. Although, during adolescence, diagnosis criteria of PCOS overlap with physiological changes including clinical manifestations of hyperandrogenism (acne and hirsutism), oligo/amenorrhoea, anovulation and ovarian microcysts, there is agreement that irregular menses and hyperandrogenaemia should be used to diagnose PCOS in this population. Moreover, considering that PCOS phenotype could change through the reproductive age and that adolescents display heterogeneous ovarian morphology, it has been proposed that diagnosis of PCOS should be confirmed after the age of 18. The first-line treatment for menstrual irregularity and hirsutism are oral contraceptive pills (OCPs) and for obesity and metabolic abnormalities are lifestyle changes. Insulin-sensitizer drugs, such as metformin, may be added to the treatment in the presence of metabolic alterations. Antiandrogen drugs may also be associated for treating moderate to severe hirsutism. During adolescence, physiological changes overlap with signs and symptoms of PCOS; thus the diagnosis criteria should be carefully considered. Regarding the treatment of adolescents with PCOS, non-pharmacological interventions include lifestyle changes. Pharmacological treatments comprise OCPs, antiandrogens and metformin, used isolated or combined. During adolescence, physiological changes overlap with signs and symptoms of PCOS; thus the diagnosis criteria should be carefully considered. Regarding the treatment of adolescents with PCOS, non-pharmacological interventions include

Computer modeling of lung cancer diagnosis-to-treatment process.

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Ju, Feng; Lee, Hyo Kyung; Osarogiagbon, Raymond U; Yu, Xinhua; Faris, Nick; Li, Jingshan

2015-08-01

We introduce an example of a rigorous, quantitative method for quality improvement in lung cancer care-delivery. Computer process modeling methods are introduced for lung cancer diagnosis, staging and treatment selection process. Two types of process modeling techniques, discrete event simulation (DES) and analytical models, are briefly reviewed. Recent developments in DES are outlined and the necessary data and procedures to develop a DES model for lung cancer diagnosis, leading up to surgical treatment process are summarized. The analytical models include both Markov chain model and closed formulas. The Markov chain models with its application in healthcare are introduced and the approach to derive a lung cancer diagnosis process model is presented. Similarly, the procedure to derive closed formulas evaluating the diagnosis process performance is outlined. Finally, the pros and cons of these methods are discussed.

Introduction of technologies for the diagnosis and treatment of cancer in Cuba

International Nuclear Information System (INIS)

Guerrero Cancio, Mayka Caridad; Romero Pérez, Teresa de la Caridad

2016-01-01

Cancer is a serious health problem for humanity and is expected to increase rapidly in the coming years. In Cuba, malignancies became the leading cause of death in 2012 and each year about 30 to 36 thousand new cases are diagnosed. Given the importance to our social system for medical care and the quality of life of patients, the Government and the Ministry of Health designed a project to introduce five new technologies for the diagnosis and treatment of cancer in Cuba. Two technologies are for diagnosing cancer and three for the treatment of this disease. In order to guarantee the technical requirements of this project, the planning of the introduction process of the new technology and training of human resources, working groups, made up by experts from hospitals, regulatory bodies and the Ministry of Public Health (Minsap) were created. These working groups shall take into account the needed equipment, the regulations in force as well as staff training required by the new technologies. At present three of these technologies are already installed and by the end of 2017, the introduction of all the new technology is expected to be completed, which will have a significant social impact both on the early diagnosis of malignant diseases, and on their control in all age groups. (author)

Comprehensive Analysis of Cancer-Proteogenome to Identify Biomarkers for the Early Diagnosis and Prognosis of Cancer

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Hem D. Shukla

2017-10-01

Full Text Available During the past century, our understanding of cancer diagnosis and treatment has been based on a monogenic approach, and as a consequence our knowledge of the clinical genetic underpinnings of cancer is incomplete. Since the completion of the human genome in 2003, it has steered us into therapeutic target discovery, enabling us to mine the genome using cutting edge proteogenomics tools. A number of novel and promising cancer targets have emerged from the genome project for diagnostics, therapeutics, and prognostic markers, which are being used to monitor response to cancer treatment. The heterogeneous nature of cancer has hindered progress in understanding the underlying mechanisms that lead to abnormal cellular growth. Since, the start of The Cancer Genome Atlas (TCGA, and the International Genome consortium projects, there has been tremendous progress in genome sequencing and immense numbers of cancer genomes have been completed, and this approach has transformed our understanding of the diagnosis and treatment of different types of cancers. By employing Genomics and proteomics technologies, an immense amount of genomic data is being generated on clinical tumors, which has transformed the cancer landscape and has the potential to transform cancer diagnosis and prognosis. A complete molecular view of the cancer landscape is necessary for understanding the underlying mechanisms of cancer initiation to improve diagnosis and prognosis, which ultimately will lead to personalized treatment. Interestingly, cancer proteome analysis has also allowed us to identify biomarkers to monitor drug and radiation resistance in patients undergoing cancer treatment. Further, TCGA-funded studies have allowed for the genomic and transcriptomic characterization of targeted cancers, this analysis aiding the development of targeted therapies for highly lethal malignancy. High-throughput technologies, such as complete proteome, epigenome, protein–protein interaction

Childhood night terrors and sleepwalking: diagnosis and treatment

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Sachin Ratan Gedam

2017-12-01

Full Text Available Night terrors and sleepwalking are arousal disorders that occur during the first third of night. Combined existence of sleep disorders are rare phenomenon and found to be associated with behavioural and emotional problems. It becomes difficult to diagnose among sleep disorders and epilepsy is an important differential diagnosis. Management with combined approach of pharmacotherapy and psychological counselling is safe and effective. Here, we present a case of night terrors and sleepwalking to highlight the importance of diagnosis and treatment in this condition. To conclude, all medical professionals need to be aware of different parasomnias and its treatment options.

Magnetic resonance imaging in the diagnosis of Fournier's gangrene

International Nuclear Information System (INIS)

Kickuth, R.; Adams, S.; Kirchner, J.; Simon, S.; Liermann, D.; Pastor, J.

2001-01-01

Magnetic resonance imaging and ultrasound are the imaging modalities recommended in the early diagnosis of Fournier's gangrene. Because of the high mortality of this inflammatory disease early diagnosis is essential to initiate adequate surgical and medical treatment. In the clinical literature only a handful of cases, in which diagnosis of Fournier's gangrene is based on MRI findings, have been reported; therefore, we report another case which shows the ability of MRI especially to determine the point of origin and extension of disease. (orig.)

Diagnosis and treatment of abnormal dental pain

OpenAIRE

Fukuda, Ken-ichi

2016-01-01

Most dental pain is caused by an organic problem such as dental caries, periodontitis, pulpitis, or trauma. Diagnosis and treatment of these symptoms are relatively straightforward. However, patients often also complain of abnormal dental pain that has a non-dental origin, whose diagnosis is challenging. Such abnormal dental pain can be categorized on the basis of its cause as referred pain, neuromodulatory pain, and neuropathic pain. When it is difficult to diagnose a patient's dental pain, ...

Time-Lag between Diagnosis of Autism Spectrum Disorder and Onset of Publicly-Funded Early Intensive Behavioral Intervention: Do Race-Ethnicity and Neighborhood Matter?

Science.gov (United States)

Yingling, Marissa E.; Hock, Robert M.; Bell, Bethany A.

2018-01-01

Health coverage of early intensive behavioral intervention (EIBI) for children with autism spectrum disorder (ASD) is rapidly expanding across the United States. Yet we know little about the time-lag between diagnosis and treatment onset. We integrated administrative, Medicaid claims, and Census data for children in an EIBI Medicaid waiver (n =…

EARLY DIAGNOSIS AS DETERMINATING FACTOR FOR PROFESSIONAL, RATIONAL AND EFFECTIVE TREATMENT OF CHILDREN WITH DEVELOPMENTAL DIFFICULTIES

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Goran AJDINSKI

1997-06-01

Full Text Available Early diagnosis of children with developmental difficulties is one of the most important segments in the process of rehabilitation. It is not only an assessment and evaluation of the functional conditions, but also and detection of the possibilities for treatment and it’s improvement.In our presentation we give the first noticing for diagnostics of children with developmental difficulties in the Republic of Macedonia, the present capacities, possibilities, needs and suggestions for it’s improvement and advancement. Speaking about that we stress the need of multidisciplinary and complete professional team in the present institutions and solving out a number of problems that exist on that plan. It especially relates to the unique terminology, the procedure and involvement of defectologists in the diagnostic process.Having in mind the bio-psycho and social aspects of the personality of children with developmental difficulties, together with the need of a complex diagnostic procedure, we have tried to give the professional activities of all the profiles of professionals that take part in the diagnostic process. So, we give a review of the work of:· physician-pediatrician who is involved in the diagnostics of all children· audiologist who is involved in the diagnostics of children with damaged hearing from a medical point of view.· the clinical psychologist who works in the institute for medical rehabilitation and whose task is to prepare and realize all the necessary tests for the personality of the child with developmental difficulties.· physiologist for children with somatic damages.· neuropsychiatrist for children with psychological difficulties· specialist for eye diseases giving his report about the child’s damaged eyesight etc.We consider that we shouldn’t neglect the role of the defectologist, his examinations on psycho-motor status, speech, i. e. the functions of the individual in relation to the social aspect in a close

Comparison of simultaneous splenic sample PCR with blood sample PCR for diagnosis and treatment of experimental Ehrlichia canis infection.

Science.gov (United States)

Harrus, Shimon; Kenny, Martin; Miara, Limor; Aizenberg, Itzhak; Waner, Trevor; Shaw, Susan

2004-11-01

This report presents evidence that dogs recover from acute canine monocytic ehrlichiosis (CME) after 16 days of doxycycline treatment (10 mg/kg of body weight every 24 h). Blood PCR was as valuable as splenic aspirate PCR for early diagnosis of acute CME. Splenic aspirate PCR was, however, superior to blood PCR for the evaluation of ehrlichial elimination.

Early unexpected diagnosis of fetal life-limiting malformation; antenatal palliative care and parental decision.

Science.gov (United States)

Mariona, Federico; Burnett, Marianne; Zoma, Melody; Blake, Janice; Khouri, Hanna

2017-11-02

Conjoined twins are an infrequent occurrence in obstetric practice. Live-conjoined twins on a late preterm triplet pregnancy is an even rarer event. The objective of this study is to emphasize the critical importance of perinatal palliative care and non-directive parental counseling, informed decision making and respect for autonomy following full disclosure of findings, fetal life-limiting diagnosis, treatment alternatives, maternal-fetal potential complications, and most likely perinatal outcomes. Early surprise prenatal diagnosis, comprehensive parental counseling, palliative care, and perinatal care of a set of conjoined twins and a singleton. Cesarean delivery of a set of conjoined twins and a singleton at 34 weeks' gestation. Immediate neonatal death of the conjoined twins, intact survival, and discharge of the singleton. Review of the database on previously reported similar cases. It is very important to utilize simple and direct language for parents to understand the grave prognosis to the pregnancy. Care alternatives in view of the maternal physical risks and psychological impact of carrying a high order abnormal multiple pregnancy, along with the possible side effects on the singleton.

Diagnosis, monitoring and treatment of tuberous sclerosis complex ...

African Journals Online (AJOL)

Diagnosis, monitoring and treatment of tuberous sclerosis complex: A South African consensus response to international guidelines. ... inhibitors to treat subependymal giant cell astrocytomas not amenable to surgery and renal angiomyolipomas larger than 3 cm, and as adjunctive treatment for refractory focal seizures.

A new Brief computerized cognitive screening battery (CompCogs for early diagnosis of Alzheimer's disease

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Helenice Charchat Fichman

Full Text Available Abstract Screening tests for early diagnosis of dementia are of great clinical relevance. The ideal test set must be brief and reliable, and should probe cognitive components impaired in Alzheimer's disease (AD. Objectives: To develop a new Computerized Cognitive Screening test (CompCogs, and to investigate its validity for the early diagnosis of AD, and evaluate its heuristic value in understanding the processing of information in AD. Methods: The computerized neuropsychological performance battery, originally including six tests, was applied in forty seven patients with probable mild AD and 97 controls matched for age and education. This computerized neuropsychological test battery, developed with MEL Professional, allows control of timing and order of stimuli presentation, as well as recording of response type and latency. A brief-screening version, CompCogs, was selected using the most discriminative neuropsychological test variables derived from logistic regression analysis. Full battery administration lasted about 40 minutes, while the CompCogs took only 15 minutes. Results: CompCogs included the Face test (correct response and Word and Forms with Short term memory tests (reaction time. CompCogs presented 91.8% sensitivity and 93.6% specificity for the diagnosis of AD using ROC analyses of AD diagnosis probability derived by logistic regression. Conclusions: CompCogs showed high validity for AD early diagnosis and, therefore, may be a useful alternative screening instrument.

[Diagnosis and treatment of pediatric anismus].

Science.gov (United States)

Ding, Shu-qing; Ding, Yi-jiang; Chen, Yong-tian; Ye, Hui

2006-11-01

To explore the diagnosis and treatment methods of pediatric anismus. Twenty-nine patients with idiopathic chronic constipation, diagnosed with anismus by colon barium contrast and anorectal manometry from Nov. 2001 to Nov. 2004 in our hospital, were investigated retrospectively. This group consisted of 13 men and 16 women whose mean age was (6.7+/-4.0) years. Hirschsprung diseases were excluded from the patients by colon barium contrast and rectoanal inhibitory reflex (RAIR) examination. Normal RAIR (5-10 ml elicited) was showed on 21 cases while weakened RAIR (15-30 ml elicited) was showed on 8 cases. After the diagnosis, the patients were treated by toilet training, diet regulation and laxative for 1-2 months. 4 cases were recovered, 5 cases were improved and 20 cases were relied on glycerin suppository. Four cases, relied on glycerin suppository, underwent Lynn procedure and had good results after 5-24 months follow-up. Two cases were re-examined by anorectal manometry 3 and 6 months after surgery, the resting pressure and the high pressure zone (HPZ) decreased, but the simulation defecation reflex was still abnormal. The diagnosis of pediatric anismus relies on history of constipation, combined with anorectal manometry and colon barium contrast. Lynn procedure could be chosen for the patients unsatisfied in toilet training and other non-operative treatment.

Ocular Tuberculosis II: Diagnosis and Treatment

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Sumru Önal

2011-06-01

Full Text Available Recent studies on the clinical importance of tuberculin skin tests (TST, interferon-gamma release assays (IGRAs, chest computed tomography (CT and polymerase chain reaction have provided a new approach to diagnosing ocular tuberculosis (TBC. However, both TST and IGRAs cannot distinguish between latent TBC infection and active disease. Another corroborative test in the diagnosis of intraocular TBC is the evaluation of the lungs by either chest radiography or CT. Direct evidence for the diagnosis can be obtained by examination of smears and staining for acid-fast organisms, cultures of intraocular tissue/fluid for Mycobacterium tuberculosis, and nucleic acid amplification analysis. In recent years, guidelines have been suggested for the diagnosis of intraocular TBC. The current treatment of intraocular TBC consists of use of four drugs (isoniazid, rifampicin, ethambutol and pyrazinamide taken for a long period of time (total 9-15 months. (Turk J Ophthalmol 2011; 41: 182-90

Multiple giant succular and fusiform right and left coronary artery aneurysms after early and adequate treatment of atypical kawasaki disease with unusual presentation.

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Mostafa Behjati-Ardakani

2014-06-01

Full Text Available The major complication of Kawasaki disease is coronary artery dilatation and aneurysm. It occurs in approximately 15-25% of untreated children with Kawasaki Disease. Early diagnosis and treatment with Intravenous immune globulin (IVIG and aspirin (ASA can reduce the incidence of coronary artery abnormality to 2%-5%. We report one case of Atypical Kawasaki Disease with Multiple giant coronary artery aneurysms despite early adequate treatment with IVIG and ASA.

Case study of physiotherapeutic treatment of patient with diagnosis facial nerve peripheral palsy

OpenAIRE

Zahrádková, Tereza

2015-01-01

Title of Bachelorʼs thesis: Case study of physiotherapeutic treatment of patient with diagnosis facial nerve peripheral palsy. Aim of thesis: Summary of theoretical findings of patientʼs diagnosis, study metodology of physiotherapeutic care, treatment design, monitoring of treatment, and evaluate the effect of patient with diagnosis facial nerve peripheral palsy. Summary: This thesis comprehensively summarizes the findings of of peripheral facial nerve palsy and it's treatment with physiotera...

Ethylene glycol poisoning in three dogs: Importance of early diagnosis and role of hemodialysis as a treatment option.

Science.gov (United States)

Schweighauser, A; Francey, T

2016-02-01

Poisoning with ethylene glycol as contained in antifreeze can rapidly lead to irreversible acute renal failure and other organ damage. It carries a grave prognosis unless diagnosed early and adequate treatment is initiated within 8 hours of ingestion. Toxicity of ethylene glycol is related to the production of toxic metabolites by the enzyme alcohol dehydrogenase (ADH), leading to early signs of severe polyuria (PU) and polydipsia (PD), gastritis, ataxia and central nervous depression, followed by progressive dehydration, and ultimately oligoanuric renal failure. In addition to general supportive care, therapeutic interventions must include either antidotes blocking ADH-mediated metabolism or blood purification techniques to remove both the parent compound and the toxic metabolites. The goal of this case report is to describe three cases of acute antifreeze intoxication in dogs, and to discuss treatment options available for this poisoning.

Diagnosis and treatment of radioactive poisoning. Proceedings of the scientific meeting on the diagnosis and treatment of radioactive poisoning

International Nuclear Information System (INIS)

1963-01-01

The increasing use of atomic energy generated by nuclear fission is necessarily accompanied by the production of large quantities of radioactive isotopes. This, together with the growing use of radioactive materials in many fields, has given added importance to practical considerations of how best to deal with accidents - should they occur - involving radioactive contamination of individuals. Such considerations require knowledge of the metabolic behaviour of various radionuclides in man and of methods of increasing their elimination from the body. Information of this type is limited, and it is therefore essential to make maximum use of those data which, are available. Analyses of earlier accidents are one important source of such data; another is experience gained from the medical administration of radioisotopes for therapeutic or diagnostic purposes. The World Health Organization and the International Atomic Energy Agency jointly sponsored a scientific meeting on the Diagnosis and Treatment of Radioactive Poisoning, in Vienna from 15 to 18 October 1962. The aim of the meeting, which followed an earlier one (The Diagnosis and Treatment of Acute Radiation Injury) sponsored by the two organizations in 1960 on another aspect of radiation protection, was to review the present state of knowledge on the diagnosis, evaluation and treatment of persons who have accidentally incorporated radioactive materials. It brought together three groups of persons: those experienced in various methods of diagnosis and treatment of patients who have been exposed (occupationally or accidentally) to radioactive material; those engaged in the clinical administration of radionuclides and the study of their behaviour in man; and those working on related problems with experimental animals. In view of the great interest of many of the topics discussed at the meeting, it was felt desirable that the information presented in the papers and brought out in the ensuing discussions should be

HIV / AIDS: Symptoms, Diagnosis, Prevention and Treatment

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Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: Symptoms , Diagnosis, Prevention and Treatment Past Issues / ... Most people who have become recently infected with HIV will not have any symptoms. They may, however, ...

Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

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... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

Wolfram Syndrome: Diagnosis, Management, and Treatment.

Science.gov (United States)

Urano, Fumihiko

2016-01-01

Wolfram syndrome is a rare genetic disorder characterized by juvenile-onset diabetes mellitus, diabetes insipidus, optic nerve atrophy, hearing loss, and neurodegeneration. Although there are currently no effective treatments that can delay or reverse the progression of Wolfram syndrome, the use of careful clinical monitoring and supportive care can help relieve the suffering of patients and improve their quality of life. The prognosis of this syndrome is currently poor, and many patients die prematurely with severe neurological disabilities, raising the urgency for developing novel treatments for Wolfram syndrome. In this article, we describe natural history and etiology, provide recommendations for diagnosis and clinical management, and introduce new treatments for Wolfram syndrome.

Advances in diagnosis and treatment of hepatorenal syndrome type of acute kidney injury in patients with liver cirrhosis

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SONG Tingxue

2017-03-01

Full Text Available Acute kidney injury (AKI is a common complication of liver cirrhosis and mainly manifests as a rapidly elevated serum creatinine level, a reduced glomerular filtration rate, and oliguria or anuria. Type 1 hepatorenal syndrome (HRS-1 is a special type of AKI, and patients with untreated HRS-1 have an extremely high risk of death. Early diagnosis and treatment are of great importance. This paper summarizes the latest diagnostic criteria for hepatorenal syndrome (HRS type of AKI and research advances in the treatment of HRS-1.

686 mE DIAGNOSIS AND TREATMENT OF ACUTE MENINGITIS ...

African Journals Online (AJOL)

1971-06-26

Jun 26, 1971 ... non-tuberculous meningitis in infants and children admitted during 1967 to The ... The emphasis on early diagnosis, and general therapeutic ... genes (1) and 2 cases of cerebral vein thrombosis yielded .... or paralysis. 7. 8 ..... preparation for yeast forms, unstained or with methylene ... Physical examination.

Contrast-enhanced FLAIR in the early diagnosis of infectious meningitis

International Nuclear Information System (INIS)

Splendiani, Alesssandra; Puglielli, Edoardo; Amicis, Rosanna De; Masciocchi, Carlo; Gallucci, Massimo; Necozione, Stefano

2005-01-01

We investigated the accuracy of MRI in the early diagnosis of infectious meningitis with emphasis on the value of gadolinium-enhanced fluid-attenuated inversion recovery (FLAIR) sequence. Twenty-seven patients with clinical suspicion of infectious meningitis were included. MRI was performed within 3 h of clinical evaluation. For all patients, T1-weighted spin-echo, dual-echo T2-weighted fast-spin-echo and FLAIR sequences were performed, followed by gadolinium-enhanced T1-weighted spin-echo and FLAIR sequences. Final diagnosis was based on the clinical findings and the analysis of cerebrospinal fluid, obtained by lumbar puncture after the MRI. Infectious meningitis was confirmed in 12 patients. In all of these patients of the plain studies, FLAIR was positive in only four patients. MRI gadolinium-enhanced FLAIR showed abnormal meningeal enhancement in all 12 patients, while gadolinium-enhanced T1-weighted spin-echo was positive only in six cases. There were no false-positive or false-negative results. It is concluded that MRI could have an important role in the early screening for infectious meningitis, provided a gadolinium-enhanced FLAIR sequence is used. (orig.)

Contrast-enhanced FLAIR in the early diagnosis of infectious meningitis

Energy Technology Data Exchange (ETDEWEB)

Splendiani, Alesssandra; Puglielli, Edoardo; Amicis, Rosanna De; Masciocchi, Carlo; Gallucci, Massimo [University of L' Aquila, Department of Radiology, L' Aquila (Italy); Necozione, Stefano [University of L' Aquila, Department of Statistic, L' Aquila (Italy)

2005-08-01

We investigated the accuracy of MRI in the early diagnosis of infectious meningitis with emphasis on the value of gadolinium-enhanced fluid-attenuated inversion recovery (FLAIR) sequence. Twenty-seven patients with clinical suspicion of infectious meningitis were included. MRI was performed within 3 h of clinical evaluation. For all patients, T1-weighted spin-echo, dual-echo T2-weighted fast-spin-echo and FLAIR sequences were performed, followed by gadolinium-enhanced T1-weighted spin-echo and FLAIR sequences. Final diagnosis was based on the clinical findings and the analysis of cerebrospinal fluid, obtained by lumbar puncture after the MRI. Infectious meningitis was confirmed in 12 patients. In all of these patients of the plain studies, FLAIR was positive in only four patients. MRI gadolinium-enhanced FLAIR showed abnormal meningeal enhancement in all 12 patients, while gadolinium-enhanced T1-weighted spin-echo was positive only in six cases. There were no false-positive or false-negative results. It is concluded that MRI could have an important role in the early screening for infectious meningitis, provided a gadolinium-enhanced FLAIR sequence is used. (orig.)

Early syphilis affects markers of HIV infection.

Science.gov (United States)

Kotsafti, Ourania; Paparizos, Vassilios; Kourkounti, Sofia; Chatziioannou, Argiro; Nicolaidou, Electra; Kapsimali, Violetta; Antoniou, Christina

2016-08-01

The objective of this study was to investigate if early syphilis infection affects markers of HIV infection; CD4 T cells and viral load (VL). A retrospective study was performed on 160 HIV-positive patients (111 receiving antiretroviral therapy [ART] and 49 without ART). Early syphilis diagnosis was made in HIV patients during their follow-up at the HIV/AIDS Unit at a Greek Dermatology and Venereology Unit. The patients' blood tests were available at the time of diagnosis, as well as before and 12 weeks after early syphilis diagnosis. CD4 T cell counts and VL levels were measured. It was found that syphilis infection had a negative impact on the CD4 T cell counts in both groups, with reduced CD4 T cell counts observed in 84.6% (99/111) and 79.5% (39/49) of patients receiving and not receiving ART, respectively. After treatment for syphilis, CD4 T cell counts returned to pre-treatment levels in most patients, especially those receiving ART. There was a slight and transient VL increase. Patients receiving ART had a 27% increase in VL, compared to 71.4% among patients not receiving ART. Although the VL increase was slight (41-14,000 copies/ml) in the group under treatment, 4-5% (5/111) patients did not return to pre-treatment levels. Moreover, viral mutations associated with treatment resistance were identified in these patients. Early syphilis accelerates and complicates the progression of HIV infection. Early diagnosis and treatment of syphilis may prevent infection-associated complications in most instances. Consequently, prevention of syphilis and other sexually transmitted infections is of great importance for patients infected with HIV. © The Author(s) 2016.

Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo

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Muhammed Dagkiran

2015-12-01

Full Text Available Benign paroxysmal positional vertigo is the cause of peripheral vertigo, which only takes seconds posed by certain head and body position and led to severe attacks of vertigo. Therefore, it is a disturbance that causes a continuous fear of fall and anxiety in some patients. Although benign paroxysmal positional vertigo is the most common cause of peripheral vertigo, it may cause unnecessary tests, treatment costs and the loss of labor due to the result of the delay in the diagnosis and treatment stages. Diagnosis and treatment of this disease is easy. High success rates can be achieved with appropriate repositioning maneuvers after taking a detailed medical history and accurate assessment of accompanying nystagmus. The aim of this paper was to review the updated information about benign paroxysmal positional vertigo. [Archives Medical Review Journal 2015; 24(4.000: 555-564

Applied Ecosystem Analysis - Background : EDT the Ecosystem Diagnosis and Treatment Method.

Energy Technology Data Exchange (ETDEWEB)

Mobrand, Lars E.

1996-05-01

This volume consists of eight separate reports. We present them as background to the Ecosystem Diagnosis and Treatment (EDT) methodology. They are a selection from publications, white papers, and presentations prepared over the past two years. Some of the papers are previously published, others are currently being prepared for publication. In the early to mid 1980`s the concern for failure of both natural and hatchery production of Columbia river salmon populations was widespread. The concept of supplementation was proposed as an alternative solution that would integrate artificial propagation with natural production. In response to the growing expectations placed upon the supplementation tool, a project called Regional Assessment of Supplementation Project (RASP) was initiated in 1990. The charge of RASP was to define supplementation and to develop guidelines for when, where and how it would be the appropriate solution to salmon enhancement in the Columbia basin. The RASP developed a definition of supplementation and a set of guidelines for planning salmon enhancement efforts which required consideration of all factors affecting salmon populations, including environmental, genetic, and ecological variables. The results of RASP led to a conclusion that salmon issues needed to be addressed in a manner that was consistent with an ecosystem approach. If the limitations and potentials of supplementation or any other management tool were to be fully understood it would have to be within the context of a broadly integrated approach - thus the Ecosystem Diagnosis and Treatment (EDT) method was born.

Applied Ecosystem Analysis - Background EDT - The Ecosystem Diagnosis and Treatment Method

International Nuclear Information System (INIS)

Mobrand, L.E.; Lichatowich, J.A.; Howard, D.A.; Vogel, T.S.

1996-05-01

This volume consists of eight separate reports. We present them as background to the Ecosystem Diagnosis and Treatment (EDT) methodology. They are a selection from publications, white papers, and presentations prepared over the past two years. Some of the papers are previously published, others are currently being prepared for publication. In the early to mid 1980's the concern for failure of both natural and hatchery production of Columbia river salmon populations was widespread. The concept of supplementation was proposed as an alternative solution that would integrate artificial propagation with natural production. In response to the growing expectations placed upon the supplementation tool, a project called Regional Assessment of Supplementation Project (RASP) was initiated in 1990. The charge of RASP was to define supplementation and to develop guidelines for when, where and how it would be the appropriate solution to salmon enhancement in the Columbia basin. The RASP developed a definition of supplementation and a set of guidelines for planning salmon enhancement efforts which required consideration of all factors affecting salmon populations, including environmental, genetic, and ecological variables. The results of RASP led to a conclusion that salmon issues needed to be addressed in a manner that was consistent with an ecosystem approach. If the limitations and potentials of supplementation or any other management tool were to be fully understood it would have to be within the context of a broadly integrated approach - thus the Ecosystem Diagnosis and Treatment (EDT) method was born

On-line early fault detection and diagnosis of municipal solid waste incinerators

International Nuclear Information System (INIS)

Zhao Jinsong; Huang Jianchao; Sun Wei

2008-01-01

A fault detection and diagnosis framework is proposed in this paper for early fault detection and diagnosis (FDD) of municipal solid waste incinerators (MSWIs) in order to improve the safety and continuity of production. In this framework, principal component analysis (PCA), one of the multivariate statistical technologies, is used for detecting abnormal events, while rule-based reasoning performs the fault diagnosis and consequence prediction, and also generates recommendations for fault mitigation once an abnormal event is detected. A software package, SWIFT, is developed based on the proposed framework, and has been applied in an actual industrial MSWI. The application shows that automated real-time abnormal situation management (ASM) of the MSWI can be achieved by using SWIFT, resulting in an industrially acceptable low rate of wrong diagnosis, which has resulted in improved process continuity and environmental performance of the MSWI

Laryngopharyngeal Reflux: Diagnosis, Treatment, and Latest Research

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Campagnolo, Andrea Maria

2014-01-01

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

Unsuccessful outcomes after posterior urethroplasty: definition, diagnosis, and treatment.

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Koraitim, Mamdouh M

2012-05-01

To establish some guidelines for the definition, diagnosis, and treatment of failed posterior urethroplasty. We identified 20 successive patients who required a secondary endoscopic or surgical procedure after anastomotic repair of a postpelvic fracture urethral injury from 1979 to 2010. Of the 20 patients, 18 had undergone perineal repair and 2 a perineo-abdominal procedure. Their medical records were reviewed with a focus on 6 postoperative items: symptoms, onset of unsuccessful result, urethral calibration, urethrocystography, urethroscopy, and treatment. Follow-up ranged from 1 to 25 years (mean 14). Of the 20 patients, 11 (55%) presented shortly after removal of the urethral stent with failure to void (n = 9) or incontinence (n = 2), and 9 (45%) presented 1 month to 12 years after surgery with a weak stream. Early failures resulted from obstruction at the site of repair in 5 patients, retraction of the bulbar urethra in 3, wrong anastomosis to a false tract in 1, and an open bladder neck in 2. Correction was accomplished by salvage urethroplasty in 8 patients and bladder neck repair in 2. Late failures resulted from narrowing of the anastomosis and were corrected by direct visual internal urethrotomy in 7 patients and surgery in 2. Unsuccessful outcomes can be encountered shortly after removal of the urethral stent or delayed for several months or years after surgery. Early cases present by an inability to void or incontinence and usually require salvage urethroplasty or bladder neck repair. Late cases present by a weak urinary stream, are due to narrowing of the anastomosis, and are usually corrected by direct visual internal urethrotomy. Copyright © 2012 Elsevier Inc. All rights reserved.

Has introduction of rapid drug susceptibility testing at diagnosis impacted treatment outcomes among previously treated tuberculosis patients in Gujarat, India?

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Paresh Dave

Full Text Available Revised National TB Control Programme (RNTCP in India recommends that all previously-treated TB (PT patients are offered drug susceptibility testing (DST at diagnosis, using rapid diagnostics and screened out for rifampicin resistance before being treated with standardized, eight-month, retreatment regimen. This is intended to improve the early diagnosis of rifampicin resistance and its appropriate management and improve the treatment outcomes among the rest of the patients. In this state-wide study from Gujarat, India, we assess proportion of PT patients underwent rapid DST at diagnosis and the impact of this intervention on their treatment outcomes.This is a retrospective cohort study involving review of electronic patient-records maintained routinely under RNTCP. All PT patients registered for treatment in Gujarat during January-June 2013 were included. Information on DST and treatment outcomes were extracted from 'presumptive DR-TB patient register' and TB treatment register respectively. We performed a multivariate analysis to assess if getting tested is independently associated with unfavourable outcomes (death, loss-to-follow-up, failure, transfer out.Of 5,829 PT patients, 5306(91% were tested for drug susceptibility with rapid diagnostics. Overall, 71% (4,113 TB patients were successfully treated - 72% among tested versus 60% among non-tested. Patients who did not get tested at diagnosis had a 34% higher risk of unsuccessful outcomes as compared to those who got tested (aRR - 1.34; 95% CI 1.20-1.50 after adjusting for age, sex, HIV status and type of TB. Unfavourable outcomes (particularly failure and switched to category IV were higher among INH-resistant patients (39% as compared to INH-sensitive (29%.Offering DST at diagnosis improved the treatment outcomes among PT patients. However, even among tested, treatment outcomes remained suboptimal and were related to INH resistance and high loss-to-follow-up. These need to be addressed

Computer Aided Diagnosis System for Early Lung Cancer Detection

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Fatma Taher

2015-11-01

Full Text Available Lung cancer continues to rank as the leading cause of cancer deaths worldwide. One of the most promising techniques for early detection of cancerous cells relies on sputum cell analysis. This was the motivation behind the design and the development of a new computer aided diagnosis (CAD system for early detection of lung cancer based on the analysis of sputum color images. The proposed CAD system encompasses four main processing steps. First is the preprocessing step which utilizes a Bayesian classification method using histogram analysis. Then, in the second step, mean shift segmentation is applied to segment the nuclei from the cytoplasm. The third step is the feature analysis. In this step, geometric and chromatic features are extracted from the nucleus region. These features are used in the diagnostic process of the sputum images. Finally, the diagnosis is completed using an artificial neural network and support vector machine (SVM for classifying the cells into benign or malignant. The performance of the system was analyzed based on different criteria such as sensitivity, specificity and accuracy. The evaluation was carried out using Receiver Operating Characteristic (ROC curve. The experimental results demonstrate the efficiency of the SVM classifier over other classifiers, with 97% sensitivity and accuracy as well as a significant reduction in the number of false positive and false negative rates.

Efficiency of clinical and combined diagnosis of breast cancer

International Nuclear Information System (INIS)

Solov'ev, I.E.

1986-01-01

Problems on clinical, instrumental, laboratory diagnosis of mammary glands cancer are described. Efficiency of clinical examination, mammography, cytological examination, ultrasonic, radioisotopic diagnosis, some biochemical tests are estimated. The conclusion concerning advisability of complex diagnosis of mammary glands cancer especially its early forms is made. Perspectivity of application of polyamine test in diagnosis of primary cancer of the mammary gland is mark to estimate efficiency of its treatment

Characteristics of early psychosis

NARCIS (Netherlands)

Schothorst, P.F.; Emck, C.; van Engeland, H.

2006-01-01

There is little research on characteristics related to course and prognosis of early-onset psychosis. The present article aims to advance our knowledge of this disorder for the purpose of proper diagnosis and treatment. It focuses on premorbid and prodromal characteristics, treatment history,

Radiopharmaceuticals for diagnosis and treatment of arthritis

International Nuclear Information System (INIS)

Hosain, F.; Haddon, M.J.; Hosain, H.; Drost, J.K.; Spencer, R.P.

1990-01-01

A brief review is given of radiopharmaceuticals for the diagnosis and treatment of arthritis. Topics covered include the pathophysiology of arthritis and the basis for the use of radiotracers, diagnostic procedures and radiotracer applications and therapeutic approaches and radionuclide applications. (UK)

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

International Nuclear Information System (INIS)

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

2011-01-01

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

Disclosure, stigma of HIV positive child and access to early infant diagnosis in the rural communities of OR Tambo District, South Africa: a qualitative exploration of maternal perspective.

Science.gov (United States)

Adeniyi, Vincent Oladele; Thomson, Elza; Ter Goon, Daniel; Ajayi, Idowu Anthony

2015-08-26

their communities. Despite the good knowledge of mothers about infant HIV infection and the availability of treatment, the knowledge of the optimal time for early infant diagnosis is lacking. Fear of infant HIV diagnosis and stigma are challenges for universal coverage of early infant diagnosis in these rural communities. Hence, community education and intensive counselling of pregnant women about early infant diagnosis are urgently needed.

Recent Advances in the Diagnosis and Treatment of Niemann-Pick Disease Type C in Children: A Guide to Early Diagnosis for the General Pediatrician

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Hanna Alobaidy

2015-01-01

Full Text Available Niemann-Pick disease (NP-C is a lysosomal storage disease in which impaired intracellular lipid transport leads to accumulation of cholesterol and glycosphingolipids in various neurovisceral tissues. It is an autosomal recessive disorder, caused by mutations in the NPC1 or NPC2 genes. The clinical spectrum is grouped by the age of onset and onset of neurological manifestation: pre/perinatal; early infantile; late infantile; and juvenile periods. The NP-C Suspicion Index (SI screening tool was developed to identify suspected patients with this disease. It is especially good at recognizing the disease in patients older than four years of age. Biochemical tests involving genetic markers and Filipin staining of skin fibroblast are being employed to assist diagnosis. Therapy is mostly supportive and since 2009, the first specific therapy approved for use was Miglustat (Zavesca aimed at stabilizing the rate of progression of neurological manifestation. The prognosis correlates with age at onset of neurological signs; patients with early onset form progress faster. The NP-C disease has heterogeneous neurovisceral manifestations. A SI is a screening tool that helps in diagnostic process. Filipin staining test is a specific biomarker diagnostic test. Miglustat is the first disease-specific therapy.

DIAGNOSIS AND TREATMENT OF ADHD DURING ADOLESCENCE IN THE PRIMARY CARE SETTING: REVIEW AND FUTURE DIRECTIONS

Science.gov (United States)

Brahmbhatt, Khyati; Hilty, Donald M.; Hah, Mina; Han, Jaesu; Angkustsiri, Kathy; Schweitzer, Julie

2017-01-01

Introduction Attention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder with a worldwide prevalence of about 5% in school age children. Objective The goal of this review is to assist primary care providers (PCPs) in diagnosing and treating ADHD in adolescents. Methods PubMed, PsychInfo and Science Citation Index databases were searched from March 1990–2015 with the key words: attention deficit hyperactivity disorder, primary care/pediatrics and children/adolescents, abstracts addressing diagnosis and/or treatment with 105 citations identified including supplementary treatment guidelines/books. Results Adolescent ADHD presents with significant disturbances in attention, academic performance and family relationships with unique issues associated with this developmental period. Diagnostic challenges include the variable symptom presentation during adolescence, complex differential diagnosis and limited training and time for PCPs to conduct thorough evaluations. The evidence-base for treatments in adolescence in comparison to those in children or adults with ADHD is relatively weak. Providers should be cognizant of prevention, early identification and treatment of conditions associated with ADHD that emerge during adolescence as substance use disorders. Conclusions Adolescent ADHD management for the PCP is complex, requires further research, and perhaps new primary care-psychiatric models, to assist in determining the optimal care for patients at this critical period. PMID:27209327

Laboratory Diagnosis of Congenital Toxoplasmosis

Science.gov (United States)

Pomares, Christelle

2016-01-01

Recent studies have demonstrated that screening and treatment for toxoplasmosis during gestation result in a decrease of vertical transmission and clinical sequelae. Early treatment was associated with improved outcomes. Thus, laboratory methods should aim for early identification of infants with congenital toxoplasmosis (CT). Diagnostic approaches should include, at least, detection of Toxoplasma IgG, IgM, and IgA and a comprehensive review of maternal history, including the gestational age at which the mother was infected and treatment. Here, we review laboratory methods for the diagnosis of CT, with emphasis on serological tools. A diagnostic algorithm that takes into account maternal history is presented. PMID:27147724

Delay in the diagnosis and treatment of pulmonary tuberculosis in Uzbekistan: a cross-sectional study.

Science.gov (United States)

Belkina, Tatiana V; Khojiev, Doniyor S; Tillyashaykhov, Mirzagaleb N; Tigay, Zinaida N; Kudenov, Marat U; Tebbens, Jurjen Duintjer; Vlcek, Jiri

2014-11-25

Early diagnosis and prompt effective therapy are crucial for the prevention of tuberculosis (TB) transmission, particularly in regions with high levels of multi-drug resistant TB. This study aimed to evaluate the extent of delay in diagnosis and treatment of TB in Uzbekistan and identify associated risk factors. A cross-sectional study was performed on hospital patients with newly diagnosed TB. The time between the onset of respiratory symptoms and initiation of anti-TB treatment was assessed and delays were divided into patient, health system and total delays. Univariable and multivariable logistic regression analysis was used to evaluate determinants of diagnostic and treatment delay. Among 538 patients enrolled, the median delay from onset of symptoms until treatment with anti-TB drugs was 50 days. Analysis of the factors affecting health-seeking behaviour and timely treatment showed the presence of the patient factor. Self-medication was the first health-seeking action for 231 (43%) patients and proved to be a significant predictor of delay (p = 0.005), as well as coughing (p = 0.009), loss of weight (p = 0.001), and visiting private and primary healthcare facilities (p = 0.03 and p = 0.02, respectively). TB diagnostic and treatment delay was mainly contributed to by patient delay and should be reduced through increasing public awareness of TB symptoms and improving public health-seeking behaviour for timely initiation of anti-TB treatment. Efforts should be made to minimise irrational use of antibiotics and support interventions to restrict over-the-counter availability of antibiotics.

[Tardive dyskinesia--diagnosis and treatment].

Science.gov (United States)

Kazamatsuri, H

1993-11-01

Tardive dyskinesia is defined as a syndrome consisting of abnormal, stereotypical involuntary movements usually of choreoathetoid type, principally affected the mouth, face, limbs and trunk, which occurs relatively late in the course of neuroleptic drug treatment and in the etiology of which the drug treatment is a necessary factor. Presently, the prevalence of tardive dyskinesia in the hospitalized patients in psychiatric hospitals in Japan is estimated to be 20-30%. Epidemiology, possible pathophysiology and symptomatology of tardive dyskinesia are briefly described. Differential diagnosis between this syndrome and other involuntary movements such as psychotic mannerism, senile orofacial dyskinesia, rabbit's syndrome, Pisa syndrome or Meige's syndrome is discussed. Several drugs to suppress involuntary movements of tardive dyskinesia are described. However, there appears to be no consistently reliable therapies for patients who develop the tardive dyskinesia. Treatment for this syndrome, other than neuroleptic withdrawal, are still uncertain.

The diagnosis and treatment of non-occlusive gut ischaemia. Aktueller Stand der Diagnostik und Therapie der nicht-okklusiven Darmischaemie (NOD)

Energy Technology Data Exchange (ETDEWEB)

Schindler, G.; Bruch, H.P. (Wuerzburg Univ. (Germany). Abt. fuer Roentgendiagnostik Wuerzburg Univ. (Germany). Chirurgische Universitaetsklinik)

1991-08-01

Non-occlusive gut ischaemia is a disease of advanced age. Its causes are reduced cardiac output or shock, facilitated by digitalis, adrenaline, ergotamine and diuretics. The persisting microcirculation and development of gut necrois leads to an increase in certain serum enzymes, such as lactate, LDH and CK-NB. The early application of mesenteric angiography using a DSA technique reveals four grades of under-perfusion. Early and correct diagnosis of the disease should lead to intra-arterial treatment with prostaglandin. In 10 out of 42 cases, conservative therapy led to re-perfusion of the gut. (orig.).

Surveillance and monitoring experiences of chemical water-steam cycle in combined-cycle power plants (CCCs in Spanish acronyms) for early diagnosis of failures

International Nuclear Information System (INIS)

Santaolalla losada, E.

2010-01-01

In the present work is made a brief comparative review of the treatments effected in water of the cycle, their purpose, types, monitoring and tracking. Moreover, are described the most important failure mechanisms that can be related to the chemistry of cycle with the aim to establish monitoring guidelines to increase the reliability of the power plant and enable an early diagnosis. (Author)

[Diagnosis of upper urinary tract tumors. A pending challenge].

Science.gov (United States)

Westendarp, M; Laguna, M P; de la Rosette, J J M C

2014-07-01

Early diagnosis of upper urinary tract tumors is not easy. The development of endoscopic equipment has expanded the group of patients candidates for minimally invasive treatment. Only by providing accurate tumor staging and grading can clinicians decide which patients should be offered conservative therapies. We need diagnostic methods that allow us to make an early and accurate diagnosis for these lesions, as well as safe follow-up. Our proposal is to present a review of the most used diagnostic method, their features, and future diagnostic tools. The diagnostic arsenal requires further improvement. Only through accurate diagnosis, we will be able to safely provide conservative treatment. Developing new diagnostic techniques seem to move us closer to this goal even more. We propose a working algorithm on the management of these lesions.

Pre-eclampsia Diagnosis and Treatment Options: A Review of Published Economic Assessments.

Science.gov (United States)

Zakiyah, Neily; Postma, Maarten J; Baker, Philip N; van Asselt, Antoinette D I

2015-10-01

Pre-eclampsia is a pregnancy complication affecting both mother and fetus. Although there is no proven effective method to prevent pre-eclampsia, early identification of women at risk of pre-eclampsia could enhance appropriate application of antenatal care, management and treatment. Very little is known about the cost effectiveness of these and other tests for pre-eclampsia, mainly because there is no clear treatment path. The aim of this study was to provide a comprehensive overview of the existing evidence on the health economics of screening, diagnosis and treatment options in pre-eclampsia. We searched three electronic databases (PubMed, EMBASE and the Cochrane Library) for studies on screening, diagnosis, treatment or prevention of pre-eclampsia, published between 1994 and 2014. Only full papers written in English containing complete economic assessments in pre-eclampsia were included. From an initial total of 138 references, six papers fulfilled the inclusion criteria. Three studies were on the cost effectiveness of treatment of pre-eclampsia, two of which evaluated magnesium sulphate for prevention of seizures and the third evaluated the cost effectiveness of induction of labour versus expectant monitoring. The other three studies were aimed at screening and diagnosis, in combination with subsequent preventive measures. The two studies on magnesium sulphate were equivocal on the cost effectiveness in non-severe cases, and the other study suggested that induction of labour in term pre-eclampsia was more cost effective than expectant monitoring. The screening studies were quite diverse in their objectives as well as in their conclusions. One study concluded that screening is probably not worthwhile, while two other studies stated that in certain scenarios it may be cost effective to screen all pregnant women and prophylactically treat those who are found to be at high risk of developing pre-eclampsia. This study is the first to provide a comprehensive overview

Continuous glucose monitoring system and new era of early diagnosis of diabetes in high risk groups

Directory of Open Access Journals (Sweden)

Ashraf Soliman

2014-01-01

Full Text Available Continuous glucose monitoring (CGM systems are an emerging technology that allows frequent glucose measurements to monitor glucose trends in real time. Their use as a diagnostic tool is still developing and appears to be promising. Combining intermittent glucose self-monitoring (SGM and CGM combines the benefits of both. Significant improvement in the treatment modalities that may prevent the progress of prediabetes to diabetes have been achieved recently and dictates screening of high risk patients for early diagnosis and management of glycemic abnormalities. The use of CGMS in the diagnosis of early dysglycemia (prediabetes especially in high risk patients appears to be an attractive approach. In this review we searched the literature to investigate the value of using CGMS as a diagnostic tool compared to other known tools, namely oral glucose tolerance test (OGTT and measurement of glycated hemoglobin (HbA1C in high risk groups. Those categories of patients include adolescents and adults with obesity especially those with family history of type 2 diabetes mellitus, polycystic ovary syndrome (PCO, gestational diabetes, cystic fibrosis, thalassemia major, acute coronary syndrome (ACS, and after renal transplantation. It appears that the ability of the CGMS for frequently monitoring (every 5 min glucose changes during real-life settings for 3 to 5 days stretches the chance to detect more glycemic abnormalities during basal and postprandial conditions compared to other short-timed methods.

Pre- and post-diagnosis costs of tuberculosis to patients on Directly Observed Treatment Short course in districts of southwestern Ethiopia: a longitudinal study.

Science.gov (United States)

Asres, Abyot; Jerene, Degu; Deressa, Wakgari

2018-05-21

incur substantial cost for care seeking and treatment despite "free service" for TB. Therefore, promoting early care seeking, decentralizing efficient diagnosis, and treatment services within reach of peoples, and introducing reimbursement system for direct costs can help minimize financial burden to the patient.

Early diagnosis of influenza virus a using surface-enhanced Raman scattering-based lateral flow assay

International Nuclear Information System (INIS)

Park, Hyun Ji; Choo, Jae Bum; Yang, Sung Chul

2016-01-01

We report a surface-enhanced Raman scattering (SERS)-based lateral flow assay (LFA) kit for the rapid diagnosis of influenza virus A. Influenza virus A is highly infectious and causes acute respiratory diseases. Therefore, it is important to diagnose the virus early to prevent a pandemic and to provide appropriate treatment to the patient and vaccination of high-risk individuals. Conventional diagnostic tests, including virus cell culture and real-time polymerase chain reaction, take longer than 1 day to confirm the disease. In contrast, a commercially available rapid influenza diagnostic test can detect the infection within 30 min, but it is hard to confirm viral infection using only this test because of its low sensitivity. Therefore, the development of a rapid and simple test for the early diagnosis of influenza infection is urgently needed. To resolve these problems, we developed a SERS-based LFA kit in which the gold nanoparticles in the commercial rapid kit were replaced with SERS-active nano tags. It is possible to quantitatively detect the influenza virus A with high sensitivity by measuring the enhanced Raman signal of these SERS nano tags on the LFA strip. The limit of detection (LOD) using our proposed SERS-based LFA kit was estimated to be 1.9 × 10"4 PFU/mL, which is approximately one order of magnitude more sensitive than the LOD determined from the colorimetric LFA kit

Early diagnosis of influenza virus a using surface-enhanced Raman scattering-based lateral flow assay

Energy Technology Data Exchange (ETDEWEB)

Park, Hyun Ji; Choo, Jae Bum [Dept. of Bionano Technology, Hanyang University, Ansan (Korea, Republic of); Yang, Sung Chul [School of Architectural Engineering, Hongik University, Sejong (Korea, Republic of)

2016-12-15

We report a surface-enhanced Raman scattering (SERS)-based lateral flow assay (LFA) kit for the rapid diagnosis of influenza virus A. Influenza virus A is highly infectious and causes acute respiratory diseases. Therefore, it is important to diagnose the virus early to prevent a pandemic and to provide appropriate treatment to the patient and vaccination of high-risk individuals. Conventional diagnostic tests, including virus cell culture and real-time polymerase chain reaction, take longer than 1 day to confirm the disease. In contrast, a commercially available rapid influenza diagnostic test can detect the infection within 30 min, but it is hard to confirm viral infection using only this test because of its low sensitivity. Therefore, the development of a rapid and simple test for the early diagnosis of influenza infection is urgently needed. To resolve these problems, we developed a SERS-based LFA kit in which the gold nanoparticles in the commercial rapid kit were replaced with SERS-active nano tags. It is possible to quantitatively detect the influenza virus A with high sensitivity by measuring the enhanced Raman signal of these SERS nano tags on the LFA strip. The limit of detection (LOD) using our proposed SERS-based LFA kit was estimated to be 1.9 × 10{sup 4} PFU/mL, which is approximately one order of magnitude more sensitive than the LOD determined from the colorimetric LFA kit.

PLATEAU IRIS--DIAGNOSIS AND TREATMENT.

Science.gov (United States)

Stefan, Cornel; Iliescu, Daniela Adriana; Batras, Mehdi; Timaru, Cristina Mihaela; De Simone, Algerino

2015-01-01

The objective of our study was to review the current knowledge on the diagnosis and treatment options of plateau iris configuration and syndrome. Relevant publications on plateau iris that were published until 2014. Plateau iris syndrome is a form of primary angle closure glaucoma caused by a large or anteriorly positioned ciliary body that leads to mechanical obstruction of trabecular meshwork. This condition is most often found in younger patients. Plateau iris has been considered an abnormal anatomic variant of the iris that can be diagnosed on ultrasound biomicroscopy or optical coherence tomography of anterior segment. Patients with plateau iris syndrome can be recognized by the lack of response in angle opening after iridotomy. The treatment of choice in these cases is argon laser peripheral iridoplasty.

Cancer treatment - early menopause

Science.gov (United States)

Premature menopause; Ovarian insufficiency - cancer ... Cancer treatments that can cause early menopause include: Surgery. Having both ovaries removed causes menopause to happen right away. If you are age 50 or younger, your provider may ...

[Drug treatment of early-stage (de novo and "honeymoon") Parkinson disease].

Science.gov (United States)

Cesaro, P; Defebvre, L

2014-04-01

In this article, we discuss the management of motor symptoms during the early phases of Parkinson's disease, excluding that of any other clinical manifestation. We relied primarily upon recently published data and do not describe older publications relating to anticholinergic drugs or amantadine. The initial pharmacological treatment of idiopathic Parkinson's disease (IPD) is symptomatic and remains based upon dopaminergic drugs. However, the development of new drugs has broadened the range of strategic options and improved overall patient management. Announcing the diagnosis is a critical moment, as pointed out by patients' associations. Patients should be advised to maintain personal, professional, social and physical activities as long as possible. The potential benefit of early pharmacological treatment should be explained, focusing on the possible disease-modifying effect of drugs such as rasagiline. According to current guidelines, L-Dopa is preferred in patients above 65years of age, while those below 65 should be treated with dopamine agonists. Like monoamine oxidase inhibitors B (MAOI-B), synthetic dopamine agonists exhibit several advantages: easy-to-use treatment with a once-daily administration, delayed L-Dopa initiation, significant efficacy on motor symptoms (although lower than that of L-Dopa). MOAI can be prescribed in association with L-Dopa or dopamine agonists. Rasagiline also delays L-Dopa initiation, and consequently motor complications. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Comparison of clinical and paraclinical parameters as tools for early diagnosis of classical swine fever

DEFF Research Database (Denmark)

Lohse, Louise; Uttenthal, Åse; Nielsen, Jens

Comparison of clinical and paraclinical parameters as tools for early diagnosis of classical swine fever. Louise Lohse, Åse Uttenthal, Jens Nielsen. National Veterinary Institute, Division of Virology, Lindholm, Technical University of Denmark. Introduction: In order to limit the far-reaching socio......-economic as well as the animal welfare consequences of an outbreak of classical swine fever (CSF), early diagnosis is essential. However, host-virus interactions strongly influence the course of CSF disease, and the clinical feature is not clear, thus complicating the diagnostic perspective. At the National...... Veterinary Institute, in Denmark, we are conducting a series of animal experiments under standardized conditions in order to investigate new parameters of clinical as well as paraclinical nature that holds the potential as diagnostic tools to improve early detection of CSF. In three recent studies, weaned...

Role of cytology in early diagnosis of cerebrotendinous xanthomas

Directory of Open Access Journals (Sweden)

Shreosee Roy

2017-01-01

Full Text Available Cerebrotendinous xanthomatosis is a rare autosomal recessive lipid storage disease characterized by widespread tissue deposition of two neutral sterols, cholestenol and cholesterol, resulting in tendinous xanthomas, juvenile cataracts, progressive neurological defects, and premature death from arteriosclerosis. Because it is a treatable cause of cerebellar ataxia and dementia, its early diagnosis is desirable. Here, we have reported the case of an 11-year-old boy with this disorder who was diagnosed based on the cytological findings of fine needle aspiration and clinical features.

Hepatic Encephalopathy: Early Diagnosis in Pediatric Patients With Cirrhosis

OpenAIRE

DARA, Naghi; SAYYARI, Ali-Akbar; IMANZADEH, Farid

2014-01-01

How to Cite This Article: Dara N, Sayyari AA, Imanzadeh F. Hepatic Encephalopathy: Early Diagnosis in Pediatric Patients With Cirrhosis. Iran J Child Neurol. 2014 Winter; 8(1):1-11.ObjectiveAs acute liver failure (ALF) and chronic liver disease (cirrhosis) continue to increase in prevalence, we will see more cases of hepatic encephalopathy.Primary care physician are often the first to suspect it, since they are familiar with the patient’s usual physical and mental status. This serious complic...

Bipolar Disorder in Adolescence: Diagnosis and Treatment.

Science.gov (United States)

Wilkinson, Great Buyck; Taylor, Priscilla; Holt, Jan R.

2002-01-01

Due to developmental issues and overlapping symptoms with other disorders, diagnosing bipolar disorder in adolescents is often a confusing and complex process. This article highlights diagnostic criteria, symptoms and behaviors, and the differential diagnosis process. Treatment options are also discussed. (Contains 17 references.) (GCP)

Cancer Cachexia: Cause, Diagnosis, and Treatment.

Science.gov (United States)

Mattox, Todd W

2017-10-01

Patients with cancer frequently experience unintended weight loss due to gastrointestinal (GI) dysfunction caused by the malignancy or treatment of the malignancy. However, others may present with weight loss related to other symptoms not clearly associated with identifiable GI dysfunction such as anorexia and early satiety. Cancer cachexia (CC) is a multifactorial syndrome that is generally characterized by ongoing loss of skeletal muscle mass with or without fat loss, often accompanied by anorexia, weakness, and fatigue. CC is associated with poor tolerance of antitumor treatments, reduced quality of life (QOL), and negative impact on survival. Symptoms associated with CC are thought to be caused in part by tumor-induced changes in host metabolism that result in systemic inflammation and abnormal neurohormonal responses. Unfortunately, there is no single standard treatment for CC. Nutrition consequences of oncologic treatments should be identified early with nutrition screening and assessment. Pharmacologic agents directed at improving appetite and countering metabolic abnormalities that cause inefficient nutrient utilization are currently the foundation for treating CC. Multiple agents have been investigated for their effects on weight, muscle wasting, and QOL. However, few are commercially available for use. Considerations for choosing the most appropriate treatment include effect on appetite, weight, QOL, risk of adverse effects, and cost and availability of the agent.

Sirenomelia with oligodactylia: early ultrasonographic and hysteroscopic embryoscopic diagnosis during the first trimester of gestation.

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Clemente, Claudia Maria; Farina, Marco; Cianci, Antonio; Iraci Sareri, Marco

2010-01-01

The case we describe reports the early sonographic findings of sirenomelia with oligodactylia at 9 weeks of gestation by transvaginal two-dimensional color Doppler ultrasonography imaging and its confirmation by hysteroscopic embryoscopy at 12 weeks to further characterize the findings. The embryo showed increased nuchal translucency and fused lower limbs with a large intra-abdominal vessel and two-vessel umbilical cords. The pregnancy was terminated by medical abortion induction after the patient viewed the embryoscopic images. Diagnosis is commonly made later in the second trimester of pregnancy, oligohydramnios being a warning signal, which usually makes the diagnosis difficult. Survival, only possible in the absence of renal agenesis, is extremely rare. In view of the extremely poor prognosis, early diagnosis allows for earlier counseling and less traumatic therapeutic termination of pregnancy. Copyright 2010 S. Karger AG, Basel.

Advances in the diagnosis and treatment of pancreatic neuroendocrine neoplasms in Japan.

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Ito, Tetsuhide; Hijioka, Susumu; Masui, Toshihiko; Kasajima, Atsuko; Nakamoto, Yuji; Kobayashi, Noritoshi; Komoto, Izumi; Hijioka, Masayuki; Lee, Lingaku; Igarashi, Hisato; Jensen, Robert Thomas; Imamura, Masayuki

2017-01-01

Several new developments have occurred in the field of pancreatic neuroendocrine neoplasm (PNEN) recently in Japan. First, the utility of chromogranin A (CgA), useful for the diagnosis and monitoring of the treatment response of neuroendocrine neoplasm (NEN), has been demonstrated in Japan. For PNEN diagnosis and treatment, grading and correct histological diagnosis according to the WHO 2010 classification is important. Regarding the histological diagnosis, the advent of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has enabled correct pathological diagnosis and suitable treatment for the affected tissue. Furthermore, EUS-FNA has also facilitates the assessment of the presence or absence of gene mutations. In addition, patients who have a well-differentiated neuroendocrine tumor (NET) showing a Ki-67 index of higher than 20 % according to the WHO 2010 classification, have also been identified, and their responses to treatment were found to be different from those of patients with poorly differentiated neuroendocrine carcinoma (NEC). Therefore, the concept of NET G3 was proposed. Additionally, somatostatin receptor type 2 is expressed in several cases of NET, and somatostatin receptor scintigraphy ( 111 In-octreoscan) has also been approved in Japan. This advancement will undoubtedly contribute to the localization diagnosis, the identification of remote metastasis, and assessments of the treatment responses of PNEN. Finally, regarding the treatment strategy for PNEN, the management of liver metastasis is important. The advent of novel molecular-targeted agents has dramatically improved the prognosis of advanced PNEN. Multimodality therapy that accounts for the tumor stage, degree of tumor differentiation, tumor volume, and speed of tumor growth is required.

Diagnosis and treatment of antisperm antibody

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abolreza Kheirollahi

2011-08-01

There are several methods to detect ASA. In the past, the clinical interest in ASA was hampered by the fact that a standardized assay for the detection of ASA was lacking. However, it has to be clarified whether each antibody binding to an antigen, which is identified on the sperm surface, also influences sperm function. Several methods have been reported for treatment of immunoinfertility. Most of the available techniques have side effects, are invasive and expensive, have low efficacy, or provide conflicting results.This review article will help to increase our knowledge about diagnosis and treatment methods of ASA.

Mialgias: Approaches to differential diagnosis, treatment

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Nadezhda Aleksandrovna Shostak

2013-01-01

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

Importance of the dentist in early diagnosis of pemphigus vulgaris

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Thiago de Santana Santos

2009-10-01

Full Text Available The vulgar pemphigus is a chronic, rare, vesicle-bubble disease of autoimmune origin and with a possibility of following a dangerous clinical course when it is not diagnosed and treated in its initial stage. It usually affects people from 40 to 60 years old, being rare in children. In the majority of cases, oral manifestations are the first signs of the disease, so that dentists play an important rol in its early diagnosis. The authors present a case report of vulgar pemphigus in a 17 year-old patient, attended by the Bucco-Maxillo-Facial Surgery Service of the “Fundação de Beneficência Hospital de Cirurgia” in Aracaju-SE, Brazil. The patient was admitted with a complaint of the presence of numerous scattered painful ulcers in the mouth that had developed in approximately two months, and reported that at first, blisters that broke quickly appeared, leading to extremely painful ulcerations. Incisional biopsies were performed in the jugal mucosa and retromolar regions, and also a complete hemogram to discard the hypothesis of leukemia. In view of the clinical and histopathological findings, the final diagnosis of pemphigus vulgaris was made. Before receiving specialized treatment, the patient presented marked worsening of the clinical condition, with exacerbation of intraoral signs and symptoms and development of skin lesions around the body surface. The patient was hospitalized in the “Hospital Universitário da Universidade Federal de Sergipe” and treated with prednisone, cimetidine and nystatin, showing significant improvement of symptoms in approximately two weeks. At present, the patient is under the care of an interdisciplinary team that includes dermatologists and dentists.

Application evaluation of MR diffusion weighted imaging in the diagnosis and differential diagnosis of early prostate cancer

International Nuclear Information System (INIS)

Shen Junkang; Lu Yanli; Yang Yi; Zhao Wenlu; Jiang Zhen; Zhang Caiyuan; Ma Qi; Zhang Yongsheng; Shan Yuxi

2014-01-01

Objective: To evaluate the value of diffusion weighted imaging (DWI) in the diagnosis and differential diagnosis of early prostate cancer. Methods: The data of 106 patients [35 with early prostate cancer (PCa), 55 with benign prostatic hyperplasia (BPH) and 16 with prostatitis] were retrospectively analyzed, who underwent T 2 WI, DWI, and T 2 WI + DWI examination and all patients were confirmed by pathology. The data obtained from T 2 WI, DWI, and a combination of T 2 WI and DWI were scored and compared with pathological findings. The receiver operating characteristic (ROC) curves were analyzed for the area under the curve (Az) using Z test. Specificities, sensitivities and accuracies of the three protocols to diagnose PCa were evaluated. The ADC values of each prostate lesion were measured and compared with ANOVA test. Results: DWI missed 7 in 35 early prostate cancer, misdiagnosed 2 in 55 BPH, and 11 in 16 prostatitis. The Az values of T 2 WI, DWI, and T 2 WI + DWI for the detection of early prostate cancer were 0.846, 0.874, and 0.947, respectively. There was significant differences between T 2 WI + DWI and T 2 WI alone (Z=3.262, P=0.001), and between T 2 WI + DWI and DWI alone (Z=2.402, P=0.016). There was no significant difference between T 2 WI alone and DWI alone (Z=0.630, P=0.528). The sensitivities, specificities, and accuracies of T 2 WI, DWI, and a combination of T 2 WI and DWI for the detection of early prostate cancer were 51.43% (18/35), 80.00% (28/35), and 85.71% (30/35); 90.14% (64/71), 81.69% (58/71), and 88.73% (63/71); 77.36% (82/106), 81.13% (86/106), and 87.74% (93/106) respectively. The ADC values for detecting early PCa, BPH, and prostatitis were (723 ± 183) ×10 -3 , (1 381 ± 117) × 10 -3 , and (957 ± 175) × 10 -3 mm 2 /s.These ADC values showed statistical significance (F=131.94, P<0.01) among the three groups and also reached statistical significance between each two groups. Conclusions: DWI is valuable in detecting early prostate

Strategy of diagnosis and treatment for pediatric solid tumor patients using FDG-PET

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Hosono, Ako; Watanabe, Atsuko; Tsuji, Naoko; Kawamoto, Hiroshi; Makimoto, Atsushi; Tateishi, Ukihide; Terauthi, Takashi

2006-01-01

Usefulness of FDG-PET (18F-deoxyglucose PET) was investigated in diagnosis and therapeutic planning of childhood and adolescence malignant solid tumors. Evidence was based on 46 patients (25 males) of ages 5-30 y, involving those with rhabdomyosarcoma (17 cases), Ewing's sarcoma (13), osteosarcoma (5), neuroblastoma (4), Wilms' tumor (2), germinoma (2), and each 1 case of ganglioblastoma, retinoblastoma and hepatoblastoma. In total, they underwent 104 FDG-PET examinations for diagnosis before and during treatment in authors' hospital in the period from January 2005 to February 2006. Evaluations were done with the standard uptake value (SUV, 1 x 1 cm ROI of abnormally high distribution area of radioactivity in the lesion/FDG dose/kg body wt.), by recurrence, by early detection of exacerbation and by follow up of residual tumors, of which typical image findings were herein presented. From the aspects of the present purposes, it was concluded that FDG-PET had advantages of high resolution, short imaging time, quantitative diagnosis (SUV) as well as the tumor detection, and had defects of difficulty of detection of tumors of <1 cm size, of distribution to normal or benign tissues and of difficulty of central nervous system (CNS) imaging. (T.I.)

[The value of PHI/PCA3 in the early diagnosis of prostate cancer].

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Tan, S J; Xu, L W; Xu, Z; Wu, J P; Liang, K; Jia, R P

2016-01-12

To investigate the value of prostate health index (PHI) and prostate cancer gene 3 (PCA3) in the early diagnosis of prostate cancer (PCa). A total of 190 patients with abnormal serum prostate specific antigen (PSA) or abnormal digital rectal examination were enrolled. They were all underwent initial biopsy and 11 of them were also underwent repeated biopsy. In addition, 25 healthy cases (with normal digital rectal examination and PSAPHI and PCA3 were detected by using immunofluorescence and Loop-Mediated Isothermal Amplification (LAMP). The sensitivity and specificity of diagnosis were determined by ROC curve.In addition, the relationship between PHI/PSA and the Gleason score and clinical stage were analyzed. A total of 89 patients were confirmed PCa by Pathological diagnosis. The other 101 patients were diagnosed as benign prostatic hyperplasia (BPH). The sensitivity and specificity of PCA3 test were 85.4% was 92.1%. Area under curve (AUC) of PHI is higher than AUC of PSA (0.727>0.699). The PHI in peripheral blood was positively correlated with Gleason score and clinical stage. The detection of PCA3 and PHI shows excellent detecting effectiveness. Compared with single PSA, the combined detection of PHI and PCA3 improved the diagnostic specificity. It can provide a new method for the early diagnosis in prostate cancer and avoid unnecessary biopsies.

Examination of level of knowledge in Italian general practitioners attending an education session on diagnosis and management of the early stage of Alzheimer's disease: pass or fail?

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Veneziani, Federica; Panza, Francesco; Solfrizzi, Vincenzo; Capozzo, Rosa; Barulli, Maria Rosaria; Leo, Antonio; Lozupone, Madia; Fontana, Andrea; Arcuti, Simona; Copetti, Massimiliano; Cardinali, Valentina; Grasso, Alessandra; Tursi, Marianna; Iurillo, Annalisa; Imbimbo, Bruno Pietro; Seripa, Davide; Logroscino, Giancarlo

2016-07-01

We detected the general level of knowledge about the early diagnosis of Alzheimer's disease (AD) and subsequent care in general practitioners (GPs) from Southern Italy. We explored also the GP perception about their knowledge and training on diagnosis and management of AD. On a sample of 131 GPs, we administered two questionnaires: the GP-Knowledge, evaluating GPs' expertise about AD epidemiology, differential diagnosis, and available treatments, and the GP-QUestionnaire on Awareness of Dementia (GP-QUAD), assessing the GPs' attitudes, awareness, and practice regarding early diagnosis of dementia. Specific screening tests or protocols to diagnose and manage dementia were not used by 53% of our GPs. The training on the recognition of early AD signs and symptoms was considered inadequate by 55% of the participants. Females were more likely to consider their training insufficient (58%) compared to males (53%). Female GPs were less likely to prescribe antipsychotic drugs to control neuropsychiatric symptoms (NPS) and suggest specialist advice in late stage of cognitive impairment. Multiple Correspondence Analysis (MCA) performed only on GP-QUAD suggested two dimensions explaining 26.1% ("GP attitude") and 20.1% ("GP knowledge") of the inertia for a total of 46.2%, In our survey on GP clinical practice, several problems in properly recognizing early AD symptoms and subsequently screening patients to be referred to secondary/tertiary care centers for diagnosis confirmation have emerged. In the future, specific training programs and educational projects for GPs should be implemented also in Italy to improve detection rates and management of dementia in primary care.

Early melanoma diagnosis with mobile imaging.

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Do, Thanh-Toan; Zhou, Yiren; Zheng, Haitian; Cheung, Ngai-Man; Koh, Dawn

2014-01-01

We research a mobile imaging system for early diagnosis of melanoma. Different from previous work, we focus on smartphone-captured images, and propose a detection system that runs entirely on the smartphone. Smartphone-captured images taken under loosely-controlled conditions introduce new challenges for melanoma detection, while processing performed on the smartphone is subject to computation and memory constraints. To address these challenges, we propose to localize the skin lesion by combining fast skin detection and fusion of two fast segmentation results. We propose new features to capture color variation and border irregularity which are useful for smartphone-captured images. We also propose a new feature selection criterion to select a small set of good features used in the final lightweight system. Our evaluation confirms the effectiveness of proposed algorithms and features. In addition, we present our system prototype which computes selected visual features from a user-captured skin lesion image, and analyzes them to estimate the likelihood of malignance, all on an off-the-shelf smartphone.

Early diagnosis of atherosclerosis with panoramic radiographs: a review

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Daiane Landim Borba

Full Text Available Abstract Carotid artery disease has been linked with cerebral vascular accident, also known as stroke, cerebral hemorrhage, or cerebral ischemia. It is caused by narrowing or obstruction of arteries in the neck (the carotid arteries that are responsible for transporting blood from the aorta to the brain. Panoramic radiographs are used in dentistry to show both dental arches as a supplement to the clinical dental examination. The objective of this study is to highlight the importance of panoramic radiographs for diagnosis of arterial disease, by means of a bibliographic review. The PubMed database was searched using the keywords “atherosclerosis” and “panoramic”, with the filters “last 5 years” and “humans”. Twenty articles were identified, six of which were chosen for this study because they were open access. The review concluded that panoramic radiographs enable early diagnosis of carotid artery calcification, resulting in earlier interventions, and offer an accessible cost.

[Status of diagnosis and treatment devices of acupuncture based on SooPAT and bibliometrics in China].

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Bai, Lin; Ren, Yulan; Guo, Taipin; Chen, Lin; Zhou, Yumei; Feng, Shuwei; Li, Ji; Liang, Fanrong

2016-11-12

To perform a bibliometrics analysis on patent literature regarding diagnosis and treatment devices of acupuncture in China, aiming to provide references for the development of diagnosis and treatment devices of acupuncture. Based on SooPAT, a patent database, the patent literature regarding diagnosis and treatment devices of acupuncture in China was collected. With bibliometrics methods, the annual distribution of type, quantity, classification and content of diagnosis and treatment devices of acupuncture were analyzed. The number of acupuncture diagnosis and treatment devices reached its peak in 2012 and 2013 in China. The A61N in patent and utility model patent were the most, which were mainly related to electrotherapy, magnetic therapy, radioactive therapy and ultrasound therapy, etc. The main content was acupuncture treatment devices and meridian treatment devices. The 24-01 in design patent was the most, involving fixation devices used by doctors, hospitals and laboratories, etc. Currently the majority of diagnosis and treatment devices of acupuncture is therapeutic apparatus, while the acupuncture diagnosis devices are needed.

Plantar fascia: imaging diagnosis and guided treatment.

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McNally, Eugene G; Shetty, Shilpa

2010-09-01

Plantar fasciopathy is a common cause of heel pain. This article covers the imaging anatomy of the hindfoot, the imaging findings on ultrasound and magnetic resonance imaging (MRI) of plantar fasciopathy, plantar fibromas, trauma, Achilles tendonopathy, neural compression, stress fractures of the os calcis and other heel pad lesions. Thickening of the plantar fascia insertion more than 5 mm either on ultrasound or MRI is suggestive of plantar fasciopathy. Ultrasound is superior to MRI for diagnosis of plantar fibroma as small low signal lesions on MRI are similar to the normal plantar fascia signal. Ultrasound demonstrates low echogenicity compared with the echogenic plantar fascia. Penetrating injuries can appear bizarre due to associated foreign body impaction and infection. Achilles tendonopathy can cause heel pain and should be considered as a possible diagnosis. Treatment options include physical therapy, ECSWT, corticosteroid injection, and dry needling. Percutaneous US guided treatment methods will be described. Thieme Medical Publishers.

Gram staining of protected pulmonary specimens in the early diagnosis of ventilator-associated pneumonia.

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Mimoz, O; Karim, A; Mazoit, J X; Edouard, A; Leprince, S; Nordmann, P

2000-11-01

We evaluated prospectively the use of Gram staining of protected pulmonary specimens to allow the early diagnosis of ventilator-associated pneumonia (VAP), compared with the use of 60 bronchoscopic protected specimen brushes (PSB) and 126 blinded plugged telescopic catheters (PTC) obtained from 134 patients. Gram stains were from Cytospin slides; they were studied for the presence of microorganisms in 10 and 50 fields by two independent observers and classified according to their Gram stain morphology. Quantitative cultures were performed after serial dilution and plating on appropriate culture medium. A final diagnosis of VAP, based on a culture of > or = 10(3) c.f.u. ml-1, was established after 81 (44%) samplings. When 10 fields were analysed, a strong relationship was found between the presence of bacteria on Gram staining and the final diagnosis of VAP (for PSB and PTC respectively: sensitivity 74 and 81%, specificity 94 and 100%, positive predictive value 91 and 100%, negative predictive value 82 and 88%). The correlation was less when we compared the morphology of microorganisms observed on Gram staining with those of bacteria obtained from quantitative cultures (for PSB and PTC respectively: sensitivity 54 and 69%, specificity 86 and 89%, positive predictive value 72 and 78%, negative predictive value 74 and 84%). Increasing the number of fields read to 50 was associated with a slight decrease in specificity and positive predictive value of Gram staining, but with a small increase in its sensitivity and negative predictive value. The results obtained by the two observers were similar to each other for both numbers of fields analysed. Gram staining of protected pulmonary specimens performed on 10 fields predicted the presence of VAP and partially identified (using Gram stain morphology) the microorganisms growing at significant concentrations, and could help in the early choice of the treatment of VAP. Increasing the number of fields read or having the Gram

2014 CODEPEH recommendations: Early detection of late onset deafness, audiological diagnosis, hearing aid fitting and early intervention.

Science.gov (United States)

Núñez-Batalla, Faustino; Jáudenes-Casaubón, Carmen; Sequí-Canet, Jose Miguel; Vivanco-Allende, Ana; Zubicaray-Ugarteche, Jose

2016-01-01

The latest scientific literature considers early diagnosis of deafness as the key element to define the educational and inclusive prognosis of the deaf child, because it allows taking advantage of the critical period of development (0-4 years). Highly significant differences exist between deaf people who have been stimulated early and those who have received late or improper intervention. Early identification of late-onset disorders requires special attention and knowledge on the part of every childcare professional. Programs and additional actions beyond neonatal screening should be designed and planed to ensure that every child with a significant hearing loss is detected early. For this purpose, the CODEPEH would like to highlight the need for continuous monitoring of children's auditory health. Consequently, CODEPEH has drafted the recommendations included in the present document. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

Targeted treatment in early rheumatoid arthritis

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Klarenbeek, Naomi Bertine

2013-01-01

With the implementation of new treatment options, including biologicals and the early, agressive start of target-steered treatment the outlook for rheumatoid arthritis patients improved considerably the past decades. This thesis describes several aspects of modern rheumatoid arthritis treatment from

Risk factors of mesenteric venous thrombosis and current situation of diagnosis and treatment in China

International Nuclear Information System (INIS)

Zhuang Zhiwei; Zhu Huanxing; Xu Changsheng

2010-01-01

Objective: To investigate risk factors of mesenteric venous thrombosis and current situation of diagnosis and treatment in China. Methods: One hundred and seven case of mesenteric venous thrombosis reported in literature were analyzed. The literature from 2003 to 2007 were retrieved from Chinese Scientific and Technical Periodical Database and Wanfangdata. Results: One hundred and seven papers included 978 MVT patients, male: female = 1. 9:1, the average age was 47. 9. The most common risk factors were portal hypertension (28. 9% ), splenectomy (18. 8%) and thrombophlebitis (11. 5%) in 833 cases with integrated medical history. Final diagnosis was established by medical imageology (40. 0%) and exploratory laparotomy (60. 0%). The achievement ratio of thrombolysis therapy was 83. 9% (73 /87) by peripheral vein and 90. 0% (63 /70) by superior mesenteric artery. 34. 7% patients took warfarin orally after discharge. Conclusions: Portal hypertension, splenectomy and thrombophlebitis may be the most common risk factor for MVT; through peripheral vein or superior mesenteric artery urokinase thrombolytic therapy is an effective means of treatment of early MVT; MVT diagnostic awareness and anticoagulant therapy after surgery awareness of the importance is to be strengthened. (authors)

Magnetic resonance imaging in the diagnosis of Fournier's gangrene

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Kickuth, R.; Adams, S.; Kirchner, J.; Simon, S.; Liermann, D. [Dept. of Radiology, Marienhospital Herne, University of Bochum, Herne (Germany); Pastor, J. [Dept. of Urology, Marienhospital Herne, University of Bochum, Herne (Germany)

2001-05-01

Magnetic resonance imaging and ultrasound are the imaging modalities recommended in the early diagnosis of Fournier's gangrene. Because of the high mortality of this inflammatory disease early diagnosis is essential to initiate adequate surgical and medical treatment. In the clinical literature only a handful of cases, in which diagnosis of Fournier's gangrene is based on MRI findings, have been reported; therefore, we report another case which shows the ability of MRI especially to determine the point of origin and extension of disease. (orig.)

Exploring new strategies in diagnosis and treatment of hilar cholangiocarcinoma

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Mantel, Hendrik Teunis Johannes

2016-01-01

Hilar cholangiocarcinoma is a rare form of cancer arising at the confluence of the right and left bile duct. The disease is known for its difficult diagnosis and treatment. The chapters in this thesis describe different aspects of hilar cholangiocarcinoma with the aim to improve diagnosis and

An Approach to Diagnosis and Endovascular Treatment of Refractory Ascites in Liver Transplant: A Pictorial Essay and Clinical Practice Algorithm.

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Pereira, Keith; Salsamendi, Jason; Fan, Ji

2015-10-01

Recipients of liver transplant are surviving longer as both the surgical procedure and postsurgical care have improved. Despite improvements, serious complications from the procedure remain that significantly affect patient outcome and may result in retransplant. Refractory ascites is one complication, occurring in about 5.6% of transplant recipients. Management of refractory ascites after liver transplant presents a challenge to the multidisciplinary team caring for these patients. We discuss approaches to the diagnosis and treatment of refractory ascites after liver transplant, based on a literature review, with a primary focus on vascular causes. These approaches are illustrated by case examples highlighting our experiences at an academic tertiary medical center. We propose a clinical practice algorithm for optimal endovascular treatment of refractory ascites after liver transplant. The cornerstone of refractory ascites care is diagnosis and treatment of the cause. Vascular causes are not infrequently encountered and, if not treated early, are associated with graft loss and high morbidity and mortality and are major indications for retransplant. For patients with recurrent disease or graft rejection needing large volume paracentesis, the use of a transjugular intrahepatic portosystemic shunt may serve as a bridge to more definitive treatment (retransplant), although it may not be as effective for managing ascites as splenic artery embolization, arguably underused, which is emerging as a potential alternative treatment option. A multidisciplinary strategy for the diagnosis and care of patients with refractory ascites after liver transplant is crucial, with endovascular treatment playing an important role. The aim is for this document to serve as a concise and informative reference to be used by those who may care for patients with this rare yet serious diagnosis.

[Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management of three cases].

Science.gov (United States)

Arteche, E; Ostiz, S; Miranda, L; Caballero, P; Jiménez López de Oñate, G

2005-01-01

Pylephlebitis is thrombophlebitis of the portal vein and/or of its branches; it is acute and generally arises as a complication of inflammatory intra-abdominal processes or of surgical interventions in patients with blood discrasies. As its clinical picture is fairly non-specific, radiological findings, while not pathognomonic, are of great use in early diagnosis and improved vital prognosis of these patients. The aims of this study are to review the pathophysiology of this entity and its clinical and radiological presentation, which allow for early clinical suspicion. Three cases of pylephlebitis are presented, two of them post-surgical, in which the only common clinical data for suspicion were the febricula and leucocytosis. Diagnosis was obtained from the finding of helicoidal computer tomography with IV contrast - Somaton Siemens - and abdominal echography - Ellegra Siemens - carried out on the three. The result of these tests was decisive for an early diagnosis, efficient treatment and satisfactory evolution in the three cases. We wish to emphasize the importance of clinical suspicion and early radiology for an early diagnosis of this entity, which make it possible to establish an efficient treatment.

PERIPROSTHETIC JOINT INFECTION IN PATIENTS WITH RHEUMATIC DISEASES: THE PROBLEMS OF DIAGNOSIS, PREVENTION, AND TREATMENT

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A. E. Khramov

2015-01-01

Full Text Available One of the most menacing complications of large joint total endoprosthesis (TE in patients with rheumatic diseases (RD is the development of periprosthetic infection (PI, progression of which may give rise not only to limb loss, but also death. At the same time, early diagnosis and adequate surgical care make it possible not only to arrest the infectious process, but also to preserve an implanted joint.Objective: to define criteria for the diagnosis, prevention, and treatment of PI after hip and knee joint (HJ and KJ TE in patients with RD.Subjects and methods. In 2009 to 2013, 654 KJ and 549 HJ TE was performed in the V.A. Nasonova Research Instituteof Rheumatology performed KJ (n = 654 and HJ (n = 549 joint ERs.Results and discussion. PI developed in 12 (3.63% and 8 (2.95% patients after KJ and HJ ER, respectively. Early, delayed, and late PI was seen in 11, 6, and 3 patients, respectively. Eleven patients with early PI underwent joint revision/ debridement with preservation of an endoprosthesis and replacement of HJ endoprosthetic inserts and heads. The operations were completed with the collagen hemobiotics being left in the wound and its drainage. Systemic antibiotic therapy was used for 4–6 weeks. No recurrent infection was observed in 9 cases. Two patients underwentresurgery, by setting suction-irrigation systems. Nine patients with delayed or late PI had the following operations: A single-stage revision operation (the endoprosthesis was removed and a new one was implanted was performed in two cases of stable endoprosthetic components and accurately verified low-virulent microorganisms susceptible to certain antibiotics. It was imperative to use cement with an antibiotic, collagen hemobiotics, and systemic antibiotic therapy for 6 weeks. The other 7 patients with unstable endoprosthetic components underwent two-stage revision: Stage 1, endoprosthetic removal and antibiotic-loaded spacer implantation; 6-12 weeks after

The Challenge in Diagnosis and Current Treatment of Chronic Thromboembolic Pulmonary Hypertension

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Anggoro Budi Hartopo

2017-04-01

Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is currently underdiagnosis and consequently undertreatment in the clinical practice. A deficient in diagnostic modality and treatment availability especially in developing countries makes the CTEPH diagnosis unlikely to confirm. However, high index of clinical suspicion of CTEPH will lead to proper diagnosis and correct treatment  with significant reduction in morbidity and mortality. Left untreated, the mean survival time is 6.8 years and the three year mortality rate may be as high as 90 %. The pathophysiology, diagnosis and treatment of CTEPH are necessary to be shared among internists and primary care physicians, in order to improve the overall outcome of the patients.

A review on the diagnosis and treatment of patients with clinically nonfunctioning pituitary adenoma by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism

International Nuclear Information System (INIS)

Vieira Neto, Leonardo; Gadelha, Monica R.; Boguszewski, Cesar L.; Bronstein, Marcello D.; Musolino, Nina R. de C.; Miranda, Paulo Augusto C.; Nave, Luciana A.; Vilar, Lucio; Oliveira Junior, Antonio Ribeiro

2016-01-01

Clinically nonfunctioning pituitary adenomas (NFPA) are the most common pituitary tumors after prolactinomas. The absence of clinical symptoms of hormonal hypersecretion can contribute to the late diagnosis of the disease. Thus, the majority of patients seek medical attention for signs and symptoms resulting from mass effect, such as neuro-ophthalmologic symptoms and hypopituitarism. Other presentations include pituitary apoplexy or an incidental finding on imaging studies. Mass effect and hypopituitarism impose high morbidity and mortality. However, early diagnosis and effective treatment minimizes morbidity and mortality. In this publication, the goal of the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism is to provide a review of the diagnosis and treatment of patients with NFPA, emphasizing that the treatment should be performed in reference centers. This review is based on data published in the literature and the authors' experience. (author)

A review on the diagnosis and treatment of patients with clinically nonfunctioning pituitary adenoma by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism

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Vieira Neto, Leonardo; Gadelha, Monica R., E-mail: mgadelha@hucff.ufrj.br [Hospital Universitario Clementino Fraga Filho (HUCFF/UFRJ), Rio de Janeiro, RJ (Brazil); Boguszewski, Cesar L. [Universidade Federal do Parana (SEMPR/UFPN), Curitiba, PR (Brazil). Hospital de Clinicas; Araujo, Luiz Antonio de [Centro de Endocrinologia e Diabetes de Joinville (Endoville), Joinville, SC (Brazil); Bronstein, Marcello D.; Musolino, Nina R. de C. [Universidade de Sao Paulo (FM/USP), Sao Paulo, SP (Brazil). Servico de Endocrinologia; Miranda, Paulo Augusto C. [Santa Casa de Belo Horizonte, Belo Horizonte, MG (Brazil). Servico de Endocrinologia e Metabologia; Nave, Luciana A. [Universidade de Brasilia (UnB), Brasilia, DF (Brazil). Hospital Universitario. Servico de Endocrinologia; Vilar, Lucio [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Servico de Endocrinologia; Oliveira Junior, Antonio Ribeiro [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital das Clinicas. Servico de Endocrinologia

2016-11-01

Clinically nonfunctioning pituitary adenomas (NFPA) are the most common pituitary tumors after prolactinomas. The absence of clinical symptoms of hormonal hypersecretion can contribute to the late diagnosis of the disease. Thus, the majority of patients seek medical attention for signs and symptoms resulting from mass effect, such as neuro-ophthalmologic symptoms and hypopituitarism. Other presentations include pituitary apoplexy or an incidental finding on imaging studies. Mass effect and hypopituitarism impose high morbidity and mortality. However, early diagnosis and effective treatment minimizes morbidity and mortality. In this publication, the goal of the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism is to provide a review of the diagnosis and treatment of patients with NFPA, emphasizing that the treatment should be performed in reference centers. This review is based on data published in the literature and the authors' experience. (author)

Oral lichen planus: A look from diagnosis to treatment.

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Pablo Córdova

2014-03-01

Full Text Available Oral lichen planus (OLP is a chronic mucocutaneous disease of unknown etiology. Its pathogenesis is multifactorial and it may affect the oral mucosa, skin and other mucous membranes. Diagnosis is based on clinic and histopathology; direct immunofluorescence techniques can also be of use. It affects about one to two percent of the population, mainly women between the fifth and sixth decades of life. In the mouth, the most affected area is the buccal mucosa, followed by the gums, tongue and/or palate. Its three most representative clinical forms are reticular, erythematous and erosive; evolution depends on the type it is. Lesion treatment is determined by the clinical form and, since no fully effective treatment has been found yet, it is directed towards controlling the disease. The treatment of choice involves topical or systemic corticosteroids, but other drugs may also be used.The aim of this paper is to gather current and relevant information about oral lichen planus: its pathogenesis, diagnosis, treatment and management.

Cost-Saving Early Diagnosis of Functional Pain in Nonmalignant Pain: A Noninferiority Study of Diagnostic Accuracy.

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Cámara, Rafael J A; Merz, Christian; Wegmann, Barbara; Stauber, Stefanie; von Känel, Roland; Egloff, Niklaus

2016-01-01

Objectives. We compared two index screening tests for early diagnosis of functional pain: pressure pain measurement by electronic diagnostic equipment, which is accurate but too specialized for primary health care, versus peg testing, which is cost-saving and more easily manageable but of unknown sensitivity and specificity. Early distinction of functional (altered pain perception; nervous sensitization) from neuropathic or nociceptive pain improves pain management. Methods. Clinicians blinded for the index screening tests assessed the reference standard of this noninferiority diagnostic accuracy study, namely, comprehensive medical history taking with all previous findings and treatment outcomes. All consenting patients referred to a university hospital for nonmalignant musculoskeletal pain participated. The main analysis compared the receiver operating characteristic (ROC) curves of both index screening tests. Results. The area under the ROC curve for peg testing was not inferior to that of electronic equipment: it was at least 95% as large for finger measures (two-sided p = 0.038) and at least equally as large for ear measures (two-sided p = 0.003). Conclusions. Routine diagnostic testing by peg, which is accessible for general practitioners, is at least as accurate as specialized equipment. This may shorten time-to-treatment in general practices, thereby improving the prognosis and quality of life.

An integrated treatment model for dual diagnosis of psychosis and addiction.

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Minkoff, K

1989-10-01

A model that integrates the treatment of patients with a dual diagnosis of psychosis and addiction has been developed on a general hospital psychiatric unit. The model emphasizes the parallels between the standard biopsychosocial illness-and-rehabilitation model for treatment of serious psychiatric disorders and the 12-step disease-and-recovery model of Alcoholics Anonymous for treatment of addiction. Dual-diagnosis patients are viewed as having two primary, chronic, biologic mental illnesses, each requiring specific treatment to stabilize acute symptoms and engage the patient in a recovery process. An integrated treatment program is described, as are the steps taken to alleviate psychiatric clinicians' concerns about patient involvement in AA and addiction clinicians' discomfort with patients' use of medication.

Early diagnosis of junior school age children’s posture disorders

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N.S. Razumeiko

2015-01-01

Purpose: to describe specificities of early diagnosis method for junior school age children’s posture disorders. Material: in pedagogic experiment 156 junior school age children (boys and girls of 7-10 years’ age) participated. All children had no experience of training in sport circles. For determination of uniformity of the tested we fulfilled experts’ examination for presence or absence of external signs of posture disorders in frontal plane. The children’s examination was conducted by qua...

Current approaches to diagnosis, treatment, support and rehabilitation of patients after a stroke

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K. V. Aymedov

2016-03-01

Full Text Available The authors focus their attention on the relevance and prevalence of cardiovascular diseases among whom a significant percentage is occupied by strokes. For every 100 million people there are about 500 thousand strokes and cerebral vascular crises per year. The urgency of this problem causes a high percentage of disability patients (15-30%. Primary diagnosis and early intervention play an important role in the further rehabilitation of stroke patients. The authors note the urgent need to revise the methods of early diagnosis and the use of modern technologies in diagnosis. Synthesis and analysis of scientific and theoretical achievements and the results of experimental studies was aimed at examining modern research methods with the aim of choosing an adequate diagnostic method and isolating the main neurosurgical markers in individuals who had suffered a stroke.

The Role of mf-ERG in the Diagnosis and Treatment of Age-Related Macular Degeneration: Electrophysiological Features of AMD.

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Moschos, Marilita M; Nitoda, Eirini

2018-01-01

Age-related macular cegeneration (AMD) is the leading cause of visual dysfunction worldwide, affecting 9-25% of individuals between 65 and 75 years old. We have reviewed the published articles investigating the role of multifocal electroretinogram (mf-ERG) in the diagnosis and treatment of AMD. Visual evoked potentials have revealed decreased amplitudes and higher latencies in patients with AMD, while the degeneration of photoreceptors and abnormalities of retinal pigment epithelium can be identified by electro-oculogram recordings. Moreover, ERG can detect the functional abnormalities observed in AMD and evaluate each therapeutic approach. The record of local electrophysiological responses coming from different retinal areas can be accurately performed by mfERG. The accuracy of mfERG in detecting the degeneration of photoreceptors, as well the disturbances of macular function, could be useful both in the early diagnosis of AMD and the assessment of treatment efficacy.

[Advance in the methods of preimplantation genetic diagnosis for single gene diseases].

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Ren, Yixin; Qiao, Jie; Yan, Liying

2017-06-10

More than 7000 single gene diseases have been identified and most of them lack effective treatment. As an early form of prenatal diagnosis, preimplantation genetic diagnosis (PGD) is a combination of in vitro fertilization and genetic diagnosis. PGD has been applied in clinics for more than 20 years to avoid the transmission of genetic defects through analysis of embryos at early stages of development. In this paper, a review for the recent advances in PGD for single gene diseases is provided.

Prognosis of cerebral vein thrombosis presenting as isolated headache: Early vs. late diagnosis

NARCIS (Netherlands)

Gameiro, Joana; Ferro, José M.; Canhão, Patricia; Stam, Jan; Barinagarrementeria, Fernando; Lindgren, Arne

2012-01-01

Objective: To analyse the outcome of cerebral venous thrombosis (CVT) patients presenting with isolated headache, specifically to compare isolated headache patients with early vs. late CVT diagnosis. Method: In the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) database we

High-sensitivity troponin assays for the early rule-out or diagnosis of acute myocardial infarction in people eith acute chest pain: a systematic review and cost-effectiveness analysis

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M. Westwood (Marie); T. van Asselt (Thea); B. Ramaekers (Bram); P. Whiting (Penny); P. Tokala (Praveen); M.A. Joore (Manuela); N. Armstrong (Nigel); J. Ross (Janine); J.L. Severens (Hans); J. Kleijnen (Jos)

2015-01-01

textabstractBackground: Early diagnosis of acute myocardial infarction (AMI) can ensure quick and effective treatment but only 20% of adults with emergency admissions for chest pain have an AMI. High-sensitivity cardiac troponin (hs-cTn) assays may allow rapid rule-out of AMI and avoidance of

High-sensitivity troponin assays for the early rule-out or diagnosis of acute myocardial infarction in people with acute chest pain : a systematic review and cost-effectiveness analysis

NARCIS (Netherlands)

Westwood, Marie; van Asselt, Thea; Ramaekers, Bram; Whiting, Penny; Thokala, Praveen; Joore, Manuela; Armstrong, Nigel; Ross, Janine; Severens, Johan; Kleijnen, Jos

BACKGROUND: Early diagnosis of acute myocardial infarction (AMI) can ensure quick and effective treatment but only 20% of adults with emergency admissions for chest pain have an AMI. High-sensitivity cardiac troponin (hs-cTn) assays may allow rapid rule-out of AMI and avoidance of unnecessary

[Joint Prosthetic Infection: UpDate Approaches to Diagnosis and Treatment].

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Belov, B S; Makarov, S A; Byalik, E I

2015-01-01

At present endoprosthetics of the joints is considered as a progressive and ever developing method in the surgical treatment of patients with affection of the locomotor system of any genesis. Hence, increasing of the number of endoprosthetic results in increasing of the number of patients with periprosthetic infection. Polymorphism of the clinical picture and inspecificity of the diagnostic tests often cause a delay in the diagnosis of the joint prosthetic infection (JPI) and consequently the late treatment. The contemporary data on the etiology, epidemiology, clinical picture and diagnosis of JPI are presented. The importance of cooperated treatment of JPI, i.e. combination of the surgical management and etiotropic antibacterial therapy is indicated. The choice of the concrete treatment method is defined by the patient state, comorbid pathology, the infection severity and duration.

Early diagnosis of skeletal disorders in childhood and adolescence by MRI; Fruehdiagnose orthopaedischer Erkrankungen des Kindes- und Jugendalters mit der MRT

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Meurer, A.; Schwitalle, M.; Engelhardt, O.; Heine, J. [Johannes Gutenberg-Univ. Mainz (Germany). Orthopaedische Klinik und Poliklinik; Kreitner, K.F. [Johannes Gutenberg-Univ. Mainz (Germany). Inst. fuer Klinische Strahlenkunde

1998-09-18

The early diagnosis of such disorders is of major importance because, in most cases, severe consequences can only be averted by early treatment. The value of magnetic resonance imaging (MRI) in many orthopaedic and traumatological conditions is generally accepted. The value of MRI in this particular field is illustrated by typical case reports on common clinical problems [Deutsch] Der Fruehdiagnose von Erkrankungen des Kindes- und Jugendalters kommt grosse Bedeutung zu, da oftmals nur durch eine daraus resultierende Fruehbehandlung schwerwiegende Folgen vermieden werden koennen. Die Kernspintomographie (Magnetresonanztomographie=MRT) ist in zahlreichen orthopaedischen-traumatologischen Fragestellungen bereits etabliert. An ausgewaehlten Fallbeispielen haeufiger klinischer Problemstellungen soll in der vorliegenden Arbeit der Stellenwert der MRT dargestellt werden. (orig.)

Costs of providing tuberculosis diagnosis and treatment services in Viet Nam.

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Minh, H V; Mai, V Q; Nhung, N V; Hoi, L V; Giang, K B; Chung, L H; Kien, V D; Duyen, N T; Ngoc, N B; Anh, T T; Phuong, T B; Ngan, T T; Khanh, P H

2017-09-01

To estimate the cost of providing tuberculosis (TB) diagnosis and treatment packages at different levels of health facilities in Viet Nam. This was a retrospective costing study from the providers' perspective using a standard costing approach. We included typical services for TB diagnosis and treatment based on standard protocols. The least expensive TB service was the 6-month isoniazid preventive therapy regimen for latent tuberculous infection provided by district health centres (US$7.20-14.30, accounting for 0.3-0.7% of Viet Nam's per capita gross domestic product [GDP] of US$2052.30 in 2014). The cost of diagnosing and treating a patient with drug-susceptible TB (the most common type of TB) ranged between US$51.20 and US$180.70, and represented 2.5-8.8% of Viet Nam's per capita GDP in 2014. The most expensive TB service was the diagnosis and treatment of a multidrug-resistant TB case (US$1568.20-2391.20), accounting for 76.4-116.5% of Viet Nam's per capita GDP in 2014). The cost of TB diagnosis and treatment services in Viet Nam varied according to level of health facility, type of TB, different costing options, and different staff cost scenarios.

Metrics for evaluating patient navigation during cancer diagnosis and treatment: crafting a policy-relevant research agenda for patient navigation in cancer care.

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Guadagnolo, B Ashleigh; Dohan, Daniel; Raich, Peter

2011-08-01

Racial and ethnic minorities as well as other vulnerable populations experience disparate cancer-related health outcomes. Patient navigation is an emerging health care delivery innovation that offers promise in improving quality of cancer care delivery to these patients who experience unique health-access barriers. Metrics are needed to evaluate whether patient navigation can improve quality of care delivery, health outcomes, and overall value in health care during diagnosis and treatment of cancer. Information regarding the current state of the science examining patient navigation interventions was gathered via search of the published scientific literature. A focus group of providers, patient navigators, and health-policy experts was convened as part of the Patient Navigation Leadership Summit sponsored by the American Cancer Society. Key metrics were identified for assessing the efficacy of patient navigation in cancer diagnosis and treatment. Patient navigation data exist for all stages of cancer care; however, the literature is more robust for its implementation during prevention, screening, and early diagnostic workup of cancer. Relatively fewer data are reported for outcomes and efficacy of patient navigation during cancer treatment. Metrics are proposed for a policy-relevant research agenda to evaluate the efficacy of patient navigation in cancer diagnosis and treatment. Patient navigation is understudied with respect to its use in cancer diagnosis and treatment. Core metrics are defined to evaluate its efficacy in improving outcomes and mitigating health-access barriers. Copyright © 2011 American Cancer Society.

Advancements in diagnosis and treatment of meningeal carcinomatosis in solid cancer

Institute of Scientific and Technical Information of China (English)

Jun-Zhao Cui; Ze-Yan Zhao; Yuan-Yuan Li; Ming-Ming Zheng; Ya-Juan Liu; Li-Tian Yan; Jun-Ying He; Qing Li; Xiao-Qing Li; Rui-Ping Gao; Hui Bu; Yue-Li Zou; Xiao-Su Guo; Wei-Xin Han

2017-01-01

Meningeal carcinomatosis (MC) is a disease that malignant tumor cells cultivate in the cerebrospinal fluid or meninges. With the development of therapy methods and new techniques, survival time of patients with tumor is prolonged, and the incidence of MC is increasing. Diagnosis is based on the evaluation of clinical manifestations, cerebrospinal fluid and neuroimaging findings. Furthermore, in recent years, the diagnostic value of the tumor-derived cell-free DNA in the cerebrospinal fluid (CSF) is promising and may improve the diagnostic yield of CSF analysis. Traditional treatments of MC include surgery, radiation therapy, systemic therapy, and intrathecal therapy. Recently, molecular targeted therapy and immunotherapy have received more and more attention. The authors review the epidemiology, pathogenesis, clinical manifestation, diagnosis and treatment of MC in solid cancer, and discuss the diagnosis and treatment options currently available as well as those under investigation.

Breath analysis based on micropreconcentrator for early cancer diagnosis

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Lee, Sang-Seok

2018-02-01

We are developing micropreconcentrators based on micro/nanotechnology to detect trace levels of volatile organic compound (VOC) gases contained in human and canine exhaled breath. The possibility of using exhaled VOC gases as biomarkers for various cancer diagnoses has been previously discussed. For early cancer diagnosis, detection of trace levels of VOC gas is indispensable. Using micropreconcentrators based on MEMS technology or nanotechnology is very promising for detection of VOC gas. A micropreconcentrator based breath analysis technique also has advantages from the viewpoints of cost performance and availability for various cancers diagnosis. In this paper, we introduce design, fabrication and evaluation results of our MEMS and nanotechnology based micropreconcentrators. In the MEMS based device, we propose a flower leaf type Si microstructure, and its shape and configuration are optimized quantitatively by finite element method simulation. The nanotechnology based micropreconcentrator consists of carbon nanotube (CNT) structures. As a result, we achieve ppb level VOC gas detection with our micropreconcentrators and usual gas chromatography system that can detect on the order of ppm VOC in gas samples. In performance evaluation, we also confirm that the CNT based micropreconcentrator shows 115 times better concentration ratio than that of the Si based micropreconcentrator. Moreover, we discuss a commercialization idea for new cancer diagnosis using breath analysis. Future work and preliminary clinical testing in dogs is also discussed.

Diagnóstico precoce do câncer infantil: responsabilidade de todos Early diagnosis of childhood cancer: a team responsibility

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Karla Emilia Rodrigues

2003-01-01

Full Text Available OBJETIVO: Alertar para a necessidade do conhecimento e investigação dos sinais e sintomas iniciais do câncer infantil, bem como para a responsabilidade de todos envolvidos no processo do seu diagnóstico precoce a fim de melhorar os nossos índices de cura. MÉTODOS: Revisão da literatura através de consulta ao Medline. RESULTADOS: O diagnóstico do câncer infantil é um processo complexo e muitas são as variáveis que parecem influenciá-lo. A detecção precoce e o pronto início do tratamento têm importante papel na redução da mortalidade e morbidade do tratamento. O melhor entendimento da relação entre estes fatores é de fundamental importância para o desenvolvimento de estratégias de saúde pública para detecção precoce do câncer infantil. CONCLUSÃO: Muitos fatores parecem estar associados ao atraso do diagnóstico do câncer infantil. O tempo que decorre entre o primeiro sintoma e o diagnóstico depende da idade da criança e do tipo do tumor, principalmente. Determinar os sinais e sintomas que devem alertar para a possibilidade de doenças malignas ainda é um desafio.OBJECTIVES: To call attention for necessity of the knowledge of the early symptoms of childhood cancer and for the responsibility of the parents, physicians and teachers rendering health supervision to the children and to alert that the early detection and prompt treatment is of paramount importance in achieving cures in childhood cancer. SOURCES: Literature review using Medline. SUMMARY: The diagnosis of childhood cancer is complex and many variables play an important role. Early detection and prompt therapy have the potential to reduce mortality and treatment morbidity. A better understanding of the relationship between symptoms and diagnosis is important for the development of effective public health strategies. CONCLUSIONS: There are several factors that may be associated with length of time between symptoms and diagnosis. Lag time to diagnosis

Early diagnosis of sub-clinical stage of diabetic retinopathy

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Xing-Hui Xu

2014-12-01

Full Text Available AIM: To evaluate the early diagnosis of sub-clinic stage of diabetic retinopathy.METHODS: This was cross sectional study,multifocal retina electroretinogram(mf-ERG, contrast sensitivity(CSand central retinal artery color Doppler examination were recorded from 30 cases(30 eyesmatched control subjects, 35 cases(35 eyeswith type 2 diabetes mellitus(DMwithout diabetic retinopathy(NDRand 38 cases(38 eyeswith non-prolifera tive diabetic retinopathy(NPDR. One-way ANOVA and SNK-q test were used for data analysis.RESULTS: P1 response density of NDR patients were found decrease, N1 implicit time were delayed. Which were related with the degree of retinopathy(PPPP>0.05, The differences between normal group, NDR group and NPDR group were found statistically significant(PCONCLUSION: mf-ERG and CS are sensitive indexes for early evaluation of visual function in patients with diabetes mellitus, with development of the disease, CRA blood flow also appears to decline.

Laboratory testing improves diagnosis and treatment outcomes in primary health care facilities

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Jane Y. Carter

2012-10-01

Setting: Six rural health centres in Kenya. Design: Cross-sectional study to observe change in diagnosis and treatment made by clinical officers after laboratory testing in outpatients attending six rural health centres in Kenya. Subject: The diagnosis and treatment of 1134 patients attending outpatient services in six rural health centres were compared before and after basic laboratory testing. Essential clinical diagnostic equipment and laboratory tests were established at each health centre. Clinical officers and laboratory technicians received on-site refresher training in good diagnostic practices and laboratory procedures before the study began. Results: Laboratory tests were ordered on 704 (62.1% patients. Diagnosis and treatment were changed in 45% of tested patients who returned with laboratory results (21% of all patients attending the clinics. 166 (23.5% patients did not return to the clinician for a final diagnosis and management decision after laboratory testing. Blood slide examination for malaria parasites, wet preparations, urine microscopy and stool microscopy resulted in most changes to diagnosis. There was no significant change in drug costs after laboratory testing. The greatest changes in numbers of recorded diseases following laboratory testing was for intestinal worms (53% and malaria (21%. Conclusion: Effective use of basic laboratory tests at primary health care level significantly improves diagnosis and patient treatment. Use of laboratory testing can be readily incorporated into routine clinical practice. On-site refresher training is an effective means of improving the quality of patient care and communication between clinical and laboratory staff.

Subphenotype-Dependent Disease Markers for Diagnosis and Personalized Treatment of Autism Spectrum Disorders

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Valerie W. Hu

2012-01-01

Full Text Available Autism spectrum disorders (ASD are a collection of neurodevelopmental disorders that are currently diagnosed solely on the basis of abnormal reciprocal language and social development as well as stereotyped behaviors. Without genetic or molecular markers for screening, individuals with ASD are typically not diagnosed before the age of 2, with milder cases diagnosed much later. Because early diagnosis is tantamount to early behavioral intervention which has been shown to improve individual outcomes, an objective biomarker test that can diagnose at-risk children perinatally is a medical imperative. The rapidly increasing prevalence of ASD in the United States (now estimated at 1 in 88 individuals also makes early diagnosis and intervention a public health imperative. This article reviews recent genome-wide (genomic approaches to the identification of disease markers that may be used not only for diagnosis of ASD, but also for the informed development of novel drugs that target specific core symptoms of ASD. Because of the heterogeneity of clinical manifestations associated with the ASD population, this review also addresses the importance of dividing individuals with ASD into clinically relevant subphenotypes in the quest to identify appropriate biomarkers.

Assessment, Diagnosis, and Treatment of Binge Eating Disorder.

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Ambrogne, Janet A

2017-08-01

Binge eating disorder (BED) is the most prevalent eating disorder in the United States, believed to affect an estimated 2.8 million adults. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, BED was recognized as a separate diagnosis. The purpose of the current article is to provide an overview of BED including assessment, diagnosis, and current pharmacological and nonpharmacological treatment options. Implications for nursing are also addressed. [Journal of Psychosocial Nursing and Mental Health Services, 55(8), 32-38.]. Copyright 2017, SLACK Incorporated.

CLINIC, DIFFERENTIAL DIAGNOSIS AND TREATMENT OF GALACTOSEMIA