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Sample records for facilitate early diagnosis

  1. Identification of factors for physicians to facilitate early differential diagnosis of scrub typhus, murine typhus, and Q fever from dengue fever in Taiwan.

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    Chang, Ko; Lee, Nan-Yao; Ko, Wen-Chien; Tsai, Jih-Jin; Lin, Wei-Ru; Chen, Tun-Chieh; Lu, Po-Liang; Chen, Yen-Hsu

    2017-02-01

    Dengue fever, rickettsial diseases, and Q fever are acute febrile illnesses with similar manifestations in tropical areas. Early differential diagnosis of scrub typhus, murine typhus, and Q fever from dengue fever may be made by understanding the distinguishing clinical characteristics and the significance of demographic and weather factors. We conducted a retrospective study to identify clinical, demographic, and meteorological characteristics of 454 dengue fever, 178 scrub typhus, 143 Q fever, and 81 murine typhus cases in three Taiwan hospitals. Case numbers of murine typhus and Q fever correlated significantly with temperature and rainfall; the scrub typhus case number was only significantly related with temperature. Neither temperature nor rainfall correlated with the case number of dengue fever. The rarity of dengue fever cases from January to June in Taiwan may be a helpful clue for diagnosis in the area. A male predominance was observed, as the male-to-female rate was 2.1 for murine typhus and 7.4 for Q fever. Multivariate analysis revealed the following six important factors for differentiating the rickettsial diseases and Q fever group from the dengue fever group: fever ≥8 days, alanine aminotransferase > aspartate aminotransferase, platelets >63,000/mL, C-reactive protein >31.9 mg/L, absence of bone pain, and absence of a bleeding syndrome. Understanding the rarity of dengue in the first half of a year in Taiwan and the six differentiating factors may help facilitate the early differential diagnosis of rickettsial diseases and Q fever from dengue fever, permitting early antibiotic treatment. Copyright © 2015. Published by Elsevier B.V.

  2. Enabling occupation through facilitating the diagnosis of developmental coordination disorder.

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    Missiuna, Cheryl; Pollock, Nancy; Egan, Mary; DeLaat, Denise; Gaines, Robin; Soucie, Helen

    2008-02-01

    The largest proportion of children seen within school-based occupational therapy is referred for handwriting difficulties. Many of these children have Developmental Coordination Disorder (DCD), a disorder that often goes undiagnosed, making if difficult for children, parents, and teachers to access resources. The purpose of this article is to outline the important role of occupational therapists in recognizing and facilitating the diagnosis of DCD. In this paper, a case is made for an expansion of the role of school-based occupational therapists in facilitating diagnosis for children with DCD. Through a review of the literature, we establish the importance of a diagnosis for children and families and critically reflect on issues that may make therapists reluctant to become involved in facilitating this diagnosis. Occupational therapists working in schools are able to recognize children with DCD, an important first step in accessing key resources useful to improve occupational performance and quality of life.

  3. [Early diagnosis of ectopic pregnancy].

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    Belics, Zoran; Gérecz, Balázs; Csákány, M György

    2014-07-20

    Ectopic pregnancy is a high-risk condition that occurs in 2% of reported pregnancies. This percentage is fivefold higher than that registered in the 1970s. Since 1970 there has been a two-fold increase in the ratio of ectopic pregnancies to all reported pregnancies in Hungary and in 2012 7.4 ectopic pregnancies per thousand registered pregnancies were reported. Recently, the majority (80%) of cases can be diagnosed in early stage, and the related mortality objectively decreased in the past few decades to 3.8/10,000 ectopic pregnancies. If a woman with positive pregnancy test has abdominal pain and/or vaginal bleeding the physician should perform a work-up to safely exclude the possibility of ectopic pregnancy. The basis of diagnosis is ultrasonography, especially vaginal ultrasound examination and measurement of the β-subunit of human chorionic gonadotropin. The ultrasound diagnosis is based on the visualization of an ectopic mass rather than the inability to visualize an intrauterine pregnancy. In some questionable cases the diagnostic uterine curettage or laparoscopy may be useful. The actuality of this topic is justified by practical difficulties in obtaining correct diagnosis, especially in the early gestational time.

  4. Early diagnosis of early stage lung cancer

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    Andrej Debeljak

    2005-11-01

    Full Text Available Background: For the detection of premalignant changes of bronchial mucosa and early stages of lung cancer frequent chest X-ray, spiral low dose computed tomography, fluorescence bronchoscopy, sputum cytology (also with automated systems with genetic and molecular changes in the sputum cells and bronchial mucosa were used. These screening methods of the high-risk groups for lung cancer achieved: earlier diagnosis of lung cancer in lower stage, higher operability, longer 5-year survival, but without mortality reduction.Conclusions: In the clinical practice we can examine higher risk groups for lung cancer in randomised control trials with multimodality approach: frequent chest low-dose fast spiral computed tomography, sputum cytology with genetic and molecular examinations and fluorescence bronchoscopy. Smoking cessation remains the best means to achieve mortality reduction from lung cancer.

  5. Breast Cancer Early Detection and Diagnosis

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    ... En Español Category Cancer A-Z Breast Cancer Breast Cancer Early Detection and Diagnosis Breast cancer is sometimes ... cancer screening is so important. Learn more. Can Breast Cancer Be Found Early? Breast cancer is sometimes found ...

  6. Early Lung Cancer Diagnosis by Biosensors

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    Lianhui Wang

    2013-07-01

    Full Text Available Lung cancer causes an extreme threat to human health, and the mortality rate due to lung cancer has not decreased during the last decade. Prognosis or early diagnosis could help reduce the mortality rate. If microRNA and tumor-associated antigens (TAAs, as well as the corresponding autoantibodies, can be detected prior to clinical diagnosis, such high sensitivity of biosensors makes the early diagnosis and prognosis of cancer realizable. This review provides an overview of tumor-associated biomarker identifying methods and the biosensor technology available today. Laboratorial researches utilizing biosensors for early lung cancer diagnosis will be highlighted.

  7. Sound Symbolism Facilitates Early Verb Learning

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    Imai, Mutsumi; Kita, Sotaro; Nagumo, Miho; Okada, Hiroyuki

    2008-01-01

    Some words are sound-symbolic in that they involve a non-arbitrary relationship between sound and meaning. Here, we report that 25-month-old children are sensitive to cross-linguistically valid sound-symbolic matches in the domain of action and that this sound symbolism facilitates verb learning in young children. We constructed a set of novel…

  8. How interpersonal synchrony facilitates early prosocial behavior.

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    Cirelli, Laura K

    2017-08-09

    When infants and children affiliate with others, certain cues may direct their social efforts to 'better' social partners. Interpersonal synchrony, or when two or more people move together in time, can be one such cue. In adults, experiencing interpersonal synchrony encourages affiliative behaviors. Recent studies have found that these effects also influence early prosociality-for example, 14-month-olds help a synchronous partner more than an asynchronous partner. These effects on helping are specifically directed to the synchronous movement partner and members of that person's social group. In older children, the prosocial effects of interpersonal synchrony may even cross group divides. How synchrony and other cues for group membership influence early prosociality is a promising avenue for future research. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Thrombocytopenic purpura: Importance of early diagnosis

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    Linklater, David M.; Voth, Arnold

    1996-01-01

    Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome are important diagnostic considerations for family physicians because therapy can be lifesaving. Treatment with plasmapheresis is usually successful. Therefore, early diagnosis is essential. A patient with microangiopathic hemolytic anemia is described. Diagnosis of Hodgkin's disease was confirmed after the initial episode. The case highlights the important role of family physicians in the diagnosis and treatment of uncommon he...

  10. New Method for Early Cancer Diagnosis

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ The NSFC funded Key Program project"A real-time analysis of the early diagnosis of cancer mark-ers",undertaken by Changchun Institute of Applied Chemistry,Chinese Academy of Sciences (CAS),re-cently received recognition from an expert team for assessment.Experts pointed out that the research was of great value for the fast ascertain of cancer markers and the early warning and diagnosis.The research team was headed by Academician Wang Erkang,CAS and Prof.Kong Jilie,Fudan University.

  11. 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.

  12. Potential screening and early diagnosis method for cancer: Tongue diagnosis.

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    Han, Shuwen; Yang, Xi; Qi, Quan; Pan, Yuefen; Chen, Yongchao; Shen, Junjun; Liao, Haihong; Ji, Zhaoning

    2016-06-01

    Tongue diagnosis, as a unique method of traditional Chinese medicine (TCM), was used to discriminate physiological functions and pathological conditions by observing the changes of the tongue and tongue coating. The aims of the present study were to explore a potential screening and early diagnosis method of cancer through evaluating the differences of the images of tongue and tongue coating and the microbiome on the tongue coating. The DS01-B tongue diagnostic information acquisition system was used to photograph and analyze the tongue and tongue coating. The next-generation sequencing technology was used to determine the V2-V4 hypervariable regions of 16S rDNA to investigate the microbiome on the tongue coating. Bioinformatics and statistical methods were used to analyze the microbial community structure and diversity. Comparing with the healthy people, the number of mirror-like tongue, thick tongue coating and the moisture of tongue were increased in cancers. The dominant color of the tongue in the healthy people was reddish while it was purple in the cancers. The relative abundance of Neisseria, Haemophilus, Fusobacterium and Porphyromonas in the healthy people were higher than that in the cancers. We also found 6 kinds of special microorganisms at species level in cancers. The study suggested that tongue diagnosis may provide potential screening and early diagnosis method for cancer.

  13. 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. 

  14. Early diagnosis of severe combined immunodeficiency syndrome.

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    Hague, R A; Rassam, S; Morgan, G; Cant, A. J.

    1994-01-01

    Infants with severe combined immunodeficiency syndrome (SCIDS) have a greatly improved prognosis if diagnosed and treated before they develop overwhelming infection. Clinical and laboratory data on 45 patients with SCIDS were retrospectively reviewed to assess the value of absolute lymphocyte counts in making an early diagnosis. Ninety infants matched for age, sex, and presenting symptoms were used as controls. Thirteen (29%) infants with SCIDS were diagnosed at birth as previous siblings had...

  15. 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

  16. Early diagnosis crucial in ankylosing spondylitis.

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    Malaviya, Anshuman P; Ostor, Andrew J K

    2011-12-01

    Ankylosing spondylitis (AS) is an inflammatory autoimmune disorder that predominantly affects the spine. If untreated it may cause significant morbidity. Early diagnosis is particularly important as newer therapies are able to contain this condition and even induce remission. AS affects about 0.2-0.5% of the population. It is at least twice as common in men and most often manifests in the third to fifth decades. It is estimated that up to 5% of patients with chronic lower back pain in primary care have inflammatory disease. Although only 1% of patients with HLA-B27 develop AS, 90-95% of patients with AS are positive for HLA-B27. Immune dysfunction is the hallmark of this condition and it may be triggered by infection. The primary site of inflammation in AS is the entheses, the sites of insertion of tendons and ligaments into bone. If the inflammation remains untreated, there is resultant fibrosis and ultimately ossification at the entheseal sites. AS should be suspected in patients who report back pain and stiffness with rest, especially in the morning, which improves with exercise. Although the condition affects both the sacroiliac joints, a proportion of patients report pain radiating into the buttocks which may be unilateral or alternate, particularly in the early stages. In addition to the spine, large joint synovitis may develop as well as features of entheseal involvement. New classification criteria take into account early sacroiliitis evident on MRI scan and allow a diagnosis to be made far earlier than was previously possible. A proportion of patients respond well to NSAIDs coupled with a structured physiotherapy and exercise programme. However, about half these patients need escalation to biologic therapy. Patients with a suspected diagnosis should be referred to secondary care in order to confirm the diagnosis and commence treatment.

  17. [Oral cavity cancer: epidemiology and early diagnosis].

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    Ghantous, Y; Yaffi, V; Abu-Elnaaj, I

    2015-07-01

    Cancer of the oral cavity (Oral cancer) is the 11th most common malignancy in the world, despite the general global trend of a slight decrease in the incidence of oral cancer, tongue cancer incidence is increasing. About 90% of tumors are subtyped to oral Squamous cell carcinoma (OSCC). The incidence and mortality of this tumor shows variability according to the geographic location in which it is diagnosed, however in the last decade an increase was seen in the percentage of young patients, especially patients with tongue cancer. The overall prognosis of this cancer is roughly 55-65%, this is probably due to late diagnosis. Early diagnosis of oral cancer is the most important factor affecting the overall survival and prognosis, thus several diagnosis methods have been developed in the past few years. Still, the prognosis did not improve as expected. Oral cancer biomarkers in saliva is as easy body fluid, for noninvasive detection. Several researches identified several possible biomarkers, but none was specific. In our review, the incidence and mortality of oral tumors pose a main health problem in many aspects all around the world, as well as differences in behavior of these tumors. We witnessed more cases of anterior tongue cancers affecting mainly the young age patient group, a two decades younger than the normal risk group of oral cancer. Several countries in Europe showed a significant increase of oral cancer prevalence, such as Germany, especially in men. Similar behavior was also reported in the United States, which showed a change in the risk groups. Studies have reported an alarming lack of awareness about oral cancer, its symptoms and early diagnosis. These gaps in knowledge need to be addressed by further public education, possibly targeted at high-risk groups. With the knowledge of possible, specific, early biomarkers, primary detection could improve the prognosis tremendously. Research on the salivary biomarkers of the disease would help to develop

  18. EARLY DIAGNOSIS OF PERVASIVE DEVELOPMENTAL DISORDERS

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    Jelica ERCEG-DJURACIC

    1997-09-01

    Full Text Available Pervasive developmental disorders represent obviously a heterogeneous group of disorders, whose clinical expressions, courses and prospects differ significantly. Common to all these disorders, expect essential diagnostic characteristics, is the fact that they are life-long problems, thus, these are disorders without possibility of complete relief. Although measures of secondary prevention in these disorders do exert a limited effect, it is possible to achieve indubitable improvements in three fields:· well-timed application of adequate treatment may influence the essential characteristics of a disorder in the direction of adaptation to requirements of social environment, improvement of communication and enrichment of poor activity repertoire;· slowing down and delaying of unfavorable disorder evolution and· helping in understanding, accepting and adapting of child’s family to a pervasive developmental disorder.Value of early established diagnosis is not reflected only in foundation of organized adequate treatment. Early established diagnosis enables a well-timed giving of genetic advice to the family which is, as a rule, young, and without genetic load. On the other hand, well-timed diagnosis enables planning of life-long complete care for the patient with the disorder.

  19. Breast cancer. Present perspective of early diagnosis

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    Brunner, S.

    1987-01-01

    The Third International Copenhagen Symposium on Detection of Breast Cancer afforded a further opportunity for scientists from all over the world to come together and present important papers concerning breast cancer and early diagnosis procedures. The symposium was an opportunity to learn from extensive screening procedures carried out at outstanding centers in the United States, Sweden, the Netherlands, and England. Furthermore, the symposium dealt with new modalities such as ultra-sonography, magnification techniques, and magnetic resonance; and significant contributions concerning self-examination, fine needle aspiration biopsy, and radiation risks were presented. A whole section was also dedicated to the highly important cooperation between radiologist, surgeon, and pathologist.

  20. [The importance of early diagnosis in acromegaly].

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    Valkusz, Zsuzsanna; Tóth, Miklós; Boda, Judit; Nagy, Endre; Julesz, János

    2011-05-01

    The authors review the historical and epidemiological aspects, clinical features and complications of acromegaly while emphasizing the importance of the early diagnosis and treatment. Acromegaly is a rare and mostly sporadic disorder due to excessive production of growth hormone. It is characterized by progressive somatic disfigurement (mainly involving the face and extremities) and systemic manifestations. The prevalence is estimated between 40 and 125 cases/million. Generally, it is diagnosed in middle-aged adults (mean age 40 years, men and women equally affected). Due to its insidious onset and slow progression, acromegaly is often diagnosed 7 to more than 10 years after its onset. The disease has cardiovascular, rheumatological, respiratory and metabolic consequences which highly determine its prognosis. Acromegaly is associated with a number of complications resulting in a two- or four-fold increase of mortality and a decrease of life expectancy by about 10 years. The major causes of death include cardiovascular and cerebrovascular events, respiratory diseases and malignancies. The duration of the disease before the introduction of effective therapy may be a major predictor of increased mortality mainly due to complications . The early diagnosis is important for timely commencement of treatment and for prevention of serious complications of the disease.

  1. The Potential of Gait Analysis to Contribute to Differential Diagnosis of Early Stage Dementia: Current Research and Future Directions

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    Morgan, Debra; Funk, Melanie; Crossley, Margaret; Basran, Jenny; Kirk, Andrew; Bello-Haas, Vanina Dal

    2007-01-01

    Early differential diagnosis of dementia is becoming increasingly important as new pharmacologic therapies are developed, as these treatments are not equally effective for all types of dementia. Early detection and differential diagnosis also facilitates informed family decision making and timely access to appropriate services. Information about…

  2. Segmental pneumatosis cystoides coli: computed tomography-facilitated diagnosis

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    Dorota Ksiadzyna

    Full Text Available Background: Intestinal pneumatosis is a rare entity of unclear etiopathogenesis characterized by the presence of gaseous cystic or linear collections within the intestinal wall. Intestinal pneumatosis may be primary and idiopathic in origin or, more frequently, it accompanies various clinical conditions. Rarely, the development of intestinal pneumatosis is attributed to the pharmacotherapy with different drugs. Case report: This is a case report of cystic pneumatosis limited to the large intestine with predominant clinical presentation of chronic watery diarrhea in a 64-year-old man suffering from diabetes mellitus treated with metformin and acarbose. The patient had been referred to the outpatient gastroenterology clinic for further investigation of numerous polyp-like lesions found on colonoscopy. There was no history of cigarette smoking, drug abuse or extraintestinal complaints. The patient was in a good general condition and his laboratory tests were normal. No relevant abnormalities were found on chest X-ray, esophagogastroduodenoscopy or abdominal ultrasound, but computed tomography showed intramural gas-filled bubbles in the cecum and splenic flexure without signs of perforation or any other significant pathology in the abdominal cavity. The final diagnosis of pneumatosis cystoides coli (PCC, possibly related to treatment with acarbose, was established. On a follow-up visit after discontinuation of acarbose the patient reported no complaints and remained asymptomatic for the next 12 months. Discussion: To conclude, drug-related PCC should be considered in a differential diagnosis of gastrointestinal symptoms and/or polyp-like lesions disclosed on colonoscopy in diabetic patients treated with acarbose.

  3. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment.

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    Novak, Iona; Morgan, Cathy; Adde, Lars; Blackman, James; Boyd, Roslyn N; Brunstrom-Hernandez, Janice; Cioni, Giovanni; Damiano, Diane; Darrah, Johanna; Eliasson, Ann-Christin; de Vries, Linda S; Einspieler, Christa; Fahey, Michael; Fehlings, Darcy; Ferriero, Donna M; Fetters, Linda; Fiori, Simona; Forssberg, Hans; Gordon, Andrew M; Greaves, Susan; Guzzetta, Andrea; Hadders-Algra, Mijna; Harbourne, Regina; Kakooza-Mwesige, Angelina; Karlsson, Petra; Krumlinde-Sundholm, Lena; Latal, Beatrice; Loughran-Fowlds, Alison; Maitre, Nathalie; McIntyre, Sarah; Noritz, Garey; Pennington, Lindsay; Romeo, Domenico M; Shepherd, Roberta; Spittle, Alicia J; Thornton, Marelle; Valentine, Jane; Walker, Karen; White, Robert; Badawi, Nadia

    2017-09-01

    Cerebral palsy describes the most common physical disability in childhood and occurs in 1 in 500 live births. Historically, the diagnosis has been made between age 12 and 24 months but now can be made before 6 months' corrected age. To systematically review best available evidence for early, accurate diagnosis of cerebral palsy and to summarize best available evidence about cerebral palsy-specific early intervention that should follow early diagnosis to optimize neuroplasticity and function. This study systematically searched the literature about early diagnosis of cerebral palsy in MEDLINE (1956-2016), EMBASE (1980-2016), CINAHL (1983-2016), and the Cochrane Library (1988-2016) and by hand searching. Search terms included cerebral palsy, diagnosis, detection, prediction, identification, predictive validity, accuracy, sensitivity, and specificity. The study included systematic reviews with or without meta-analyses, criteria of diagnostic accuracy, and evidence-based clinical guidelines. Findings are reported according to the PRISMA statement, and recommendations are reported according to the Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument. Six systematic reviews and 2 evidence-based clinical guidelines met inclusion criteria. All included articles had high methodological Quality Assessment of Diagnostic Accuracy Studies (QUADAS) ratings. In infants, clinical signs and symptoms of cerebral palsy emerge and evolve before age 2 years; therefore, a combination of standardized tools should be used to predict risk in conjunction with clinical history. Before 5 months' corrected age, the most predictive tools for detecting risk are term-age magnetic resonance imaging (86%-89% sensitivity), the Prechtl Qualitative Assessment of General Movements (98% sensitivity), and the Hammersmith Infant Neurological Examination (90% sensitivity). After 5 months' corrected age, the most predictive tools for detecting risk are magnetic resonance imaging (86

  4. Pompe disease: early diagnosis and early treatment make a difference.

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    Chien, Yin-Hsiu; Hwu, Wuh-Liang; Lee, Ni-Chung

    2013-08-01

    Pompe disease (glycogen storage disease type II or acid maltase deficiency) is a lysosomal disorder in which acid α-glucosidase (GAA) deficiencies lead to intralysosomal accumulation of glycogen in all tissues; most notably in skeletal muscles. Both the patient's age at the onset of Pompe disease symptoms and the rate of deterioration caused by the disease can vary considerably. In classical infant-onset Pompe disease (IOPD), symptoms start very early in life, and death occurs soon afterward if the disease remains untreated. In later-onset Pompe disease, symptoms are slower to appear, and patients often progress to wheelchair confinement and eventual respiratory failure. A diagnosis can be made by screening for GAA in dried blood samples, followed either by GAA assessment in lymphocytes or in fibroblasts or by the genetic analysis of mutations. Treatment by enzyme replacement therapy (ERT) with alglucosidase alfa was approved for human use in 2006. In classical IOPD, treatment significantly lengthens survival and improves motor development and cardiac function. The sooner ERT begins, the better are the results. Newborn screening aims to take advantage of different technologies for diagnosing and treating newborns early on and it yields better outcomes. However, newborns diagnosed early and other long-term survivors may encounter fresh problems, making up a new phenotype of IOPD patients. Further modifications of the treatment, such as a decrease in immune responses to ERT, a higher dosage, a better uptake formulation, and gene therapy delivered locally or systemically are being explored.

  5. Pompe Disease: Early Diagnosis and Early Treatment Make a Difference

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    Yin-Hsiu Chien

    2013-08-01

    Full Text Available Pompe disease (glycogen storage disease type II or acid maltase deficiency is a lysosomal disorder in which acid α-glucosidase (GAA deficiencies lead to intralysosomal accumulation of glycogen in all tissues; most notably in skeletal muscles. Both the patient's age at the onset of Pompe disease symptoms and the rate of deterioration caused by the disease can vary considerably. In classical infant-onset Pompe disease (IOPD, symptoms start very early in life, and death occurs soon afterward if the disease remains untreated. In later-onset Pompe disease, symptoms are slower to appear, and patients often progress to wheelchair confinement and eventual respiratory failure. A diagnosis can be made by screening for GAA in dried blood samples, followed either by GAA assessment in lymphocytes or in fibroblasts or by the genetic analysis of mutations. Treatment by enzyme replacement therapy (ERT with alglucosidase alfa was approved for human use in 2006. In classical IOPD, treatment significantly lengthens survival and improves motor development and cardiac function. The sooner ERT begins, the better are the results. Newborn screening aims to take advantage of different technologies for diagnosing and treating newborns early on and it yields better outcomes. However, newborns diagnosed early and other long-term survivors may encounter fresh problems, making up a new phenotype of IOPD patients. Further modifications of the treatment, such as a decrease in immune responses to ERT, a higher dosage, a better uptake formulation, and gene therapy delivered locally or systemically are being explored.

  6. Auxilin facilitates membrane traffic in the early secretory pathway.

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    Ding, Jingzhen; Segarra, Verónica A; Chen, Shuliang; Cai, Huaqing; Lemmon, Sandra K; Ferro-Novick, Susan

    2016-01-01

    Coat protein complexes contain an inner shell that sorts cargo and an outer shell that helps deform the membrane to give the vesicle its shape. There are three major types of coated vesicles in the cell: COPII, COPI, and clathrin. The COPII coat complex facilitates vesicle budding from the endoplasmic reticulum (ER), while the COPI coat complex performs an analogous function in the Golgi. Clathrin-coated vesicles mediate traffic from the cell surface and between the trans-Golgi and endosome. While the assembly and structure of these coat complexes has been extensively studied, the disassembly of COPII and COPI coats from membranes is less well understood. We describe a proteomic and genetic approach that connects the J-domain chaperone auxilin, which uncoats clathrin-coated vesicles, to COPII and COPI coat complexes. Consistent with a functional role for auxilin in the early secretory pathway, auxilin binds to COPII and COPI coat subunits. Furthermore, ER-Golgi and intra-Golgi traffic is delayed at 15°C in swa2Δ mutant cells, which lack auxilin. In the case of COPII vesicles, we link this delay to a defect in vesicle fusion. We propose that auxilin acts as a chaperone and/or uncoating factor for transport vesicles that act in the early secretory pathway.

  7. Cerebrotendinous xanthomatosis: Need for early diagnosis

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    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.

  8. Medical students' and facilitators' experiences of an Early Professional Contact course: Active and motivated students, strained facilitators

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    Gunnarsson Ronny

    2008-12-01

    Full Text Available Abstract Background Today, medical students are introduced to patient contact, communication skills, and clinical examination in the preclinical years of the curriculum with the purpose of gaining clinical experience. These courses are often evaluated from the student perspective. Reports with an additional emphasis on the facilitator perspective are scarce. According to constructive alignment, an influential concept from research in higher education, the learning climate between students and teachers is also of great importance. In this paper, we approach the learning climate by studying both students' and facilitators' course experiences. In 2001, a new "Early Professional Contact" longitudinal strand through term 1–4, was introduced at the Sahlgrenska Academy, University of Gothenburg, Sweden. General practitioners and hospital specialists were facilitators. The aim of this study was to assess and analyse students' and clinical facilitators' experiences of the Early Professional Contact course and to illuminate facilitators' working conditions. Methods Inspired by a Swedish adaptation of the Course Experience Questionnaire, an Early Professional Contact Questionnaire was constructed. In 2003, on the completion of the first longitudinal strand, a student and facilitator version was distributed to 86 students and 21 facilitators. In the analysis, both Chi-square and the Mann-Whitney tests were used. Results Sixty students (70% and 15 facilitators (71% completed the questionnaire. Both students and facilitators were satisfied with the course. Students reported gaining iiration for their future work as doctors along with increased confidence in meeting patients. They also reported increased motivation for biomedical studies. Differences in attitudes between facilitators and students were found. Facilitators experienced a greater workload, less reasonable demands and less support, than students. Conclusion In this project, a new Early

  9. Differential Training Facilitates Early Consolidation in Motor Learning

    Science.gov (United States)

    Henz, Diana; Schöllhorn, Wolfgang I.

    2016-01-01

    Current research demonstrates increased learning rates in differential learning (DL) compared to repetitive training. To date, little is known on the underlying neurophysiological processes in DL that contribute to superior performance over repetitive practice. In the present study, we measured electroencephalographic (EEG) brain activation patterns after DL and repetitive badminton serve training. Twenty-four semi-professional badminton players performed badminton serves in a DL and repetitive training schedule in a within-subjects design. EEG activity was recorded from 19 electrodes according to the 10–20 system before and immediately after each 20-min exercise. Increased theta activity was obtained in contralateral parieto-occipital regions after DL. Further, increased posterior alpha activity was obtained in DL compared to repetitive training. Results indicate different underlying neuronal processes in DL and repetitive training with a higher involvement of parieto-occipital areas in DL. We argue that DL facilitates early consolidation in motor learning indicated by post-training increases in theta and alpha activity. Further, brain activation patterns indicate somatosensory working memory processes where attentional resources are allocated in processing of somatosensory information in DL. Reinforcing a somatosensory memory trace might explain increased motor learning rates in DL. Finally, this memory trace is more stable against interference from internal and external disturbances that afford executively controlled processing such as attentional processes.

  10. Preliminary criteria for the very early diagnosis of systemic sclerosis

    DEFF Research Database (Denmark)

    Avouac, J; Fransen, Julie Munk; Walker, U A

    2011-01-01

    To identify a core set of preliminary items considered as important for the very early diagnosis of systemic sclerosis (SSc).......To identify a core set of preliminary items considered as important for the very early diagnosis of systemic sclerosis (SSc)....

  11. Early diagnosis of masked hypertension in adolescents

    Directory of Open Access Journals (Sweden)

    Ledyaev M.Ya.

    2016-12-01

    Full Text Available Objective: to improve diagnosis of latent arterial hypertension by studying the characteristics of hemodynamics and the rigidity of the vascular walls of the arteries in adolescents with this phenomenon. Material and Methods. The study involved 147 children aged 11 to 18 years who did not have heart rhythm disorders, congenital heart defects, endocrine diseases and diseases of the kidneys. They were divided into three groups on the basis of blood pressure values (BP obtained during three measurements of blood pressure according to the method of N. S. Korotkov and when conducting 24-hours ambulatory blood pressure monitoring (ABPM. Group 1 included children with blood pressure values in the range from 5 to 95 percentile. Group 2 was composed children with masked hypertension (values of office blood pressure in the range from 5 to 95 percentile but indicators of ABPM of blood pressure is greater than 95 percentile. Group 3 included children with stable arterial hypertension (blood pressure values exceeded the 95 percentile. The study was a comparative analysis of the hemodynamic and rigidity (stiffness of the arteries. Results: Most hemodynamic parameters in children with masked hypertension were higher than in children of group 1. However, these figures were lower than in children with stable arterial hypertension. Among the indicators of the rigidity of the arteries, the most sensitive indicator (dP/dt max was maximum rate of pressure rise. Children with masked hypertension had increased arterial stiffness, however it was lower than in children with stable arterial hypertension. Conclusion: The use of BPLab monitor with technology Vasotens allows physicians to evaluate the daily profile of arterial pressure, the hemodynamics and stiffness of blood vessels, which is an important step for early diagnostics of latent arterial hypertension in children

  12. The early diagnosis of lung cancer.

    Science.gov (United States)

    Petty, T L

    2001-06-01

    Lung cancer is the most common fatal malignancy in both men and women, both in the United States and elsewhere in the world. Today, lung cancer is most often diagnosed on the basis of symptoms of advanced disease or when chest x-rays are taken for a variety of purposes unrelated to lung cancer detection. Unfortunately, in the United States no society or governmental agency recommends screening, even for patients with high risks, such as smokers with airflow obstruction or people with occupational exposures, including asbestos. The origins of this negative attitude toward lung cancer screening are found in 3 studies sponsored by the National Cancer Institute in the mid-1970s and conducted at Johns Hopkins University School of Medicine, the Mayo Clinic, and the Memorial Sloan-Kettering Center. These studies concluded that early identification of lung cancer through chest x-rays and cytologic diagnosis of sputum did not alter disease-specific mortality. However, patients with earlier stage disease were found through screening, which resulted in a higher resectability rate and improved survival in the screening group compared with a control group of patients receiving ordinary care. Patients in the control group often received annual chest x-rays during the course of this study, which was the standard of care at the time. Thus no true nonscreening control group resulted. The patients at highest risk were not enrolled in this study. No specific amount of pack-years of smoking intensity was required. Only men were screened. The studies were inadequately powered to show an improvement in mortality rate of less than 50%. Ninety percent of lung cancer occurs in smokers. The prevalence of lung cancer is 4 to 6 times greater when smokers have airflow obstruction than with normal airflow, when all other background factors, including smoking history, occupational risk, and family history, are the same. Screening heavy smokers (ie, > or = 30 pack-years) with airflow obstruction

  13. Early breast cancer: diagnosis, treatment and survivorship.

    LENUS (Irish Health Repository)

    Meade, Elizabeth

    2013-01-11

    Breast cancer is the most common female cancer and globally remains a major public health concern. The diagnosis and treatment of breast cancer continues to develop. Diagnosis is now more precise, surgery is less mutilating and women now have the option of breast conserving therapy with better cosmesis, and without sacrificing survival. Radiotherapy is more targeted and the selection of patients for adjuvant chemotherapy is based not only on prognostic and predictive factors, but also on newer molecular profiling that will ensure that chemotherapy is given to the patients who need and respond to it. These developments all provide a more tailored approach to the treatment of breast cancer. Management now involves a multidisciplinary team approach in order to provide the highest standard of care for patients throughout their cancer journey from diagnosis through treatment and into follow-up care.

  14. Myocardial infarction : early diagnosis and cardioprotective strategies

    NARCIS (Netherlands)

    Oerlemans, M.I.F.J.

    2012-01-01

    In this thesis, we have investigated novel diagnostic and cardioprotective strategies to limit myocardial cell death and improve cardiac function after myocardial infarction. We demonstrated a new way to speed up the diagnosis of acute MI by using very small pieces of RNA (microRNAs). Using these mi

  15. Early and Periodic Screening, Diagnosis and Treatment

    Data.gov (United States)

    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...

  16. [Diagnosis and early treatment of juvenile delinquency].

    Science.gov (United States)

    Barbagallo, A; Bellia, A; Benvenuto, G; Cosentino, F; Riggio, T M

    1975-09-12

    Longitudinal research has shown that social failure to adjust can be prevented by early removal of ambiental factors encouraging pathological development of the Ego, and the detection and treatment of psychological tendencies towards the acquisition of deviant stimuli.

  17. 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…

  18. 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…

  19. Diagnosis of Late Stage, Early Onset, Small Fiber Polyneuropathy

    Science.gov (United States)

    2016-10-01

    additionally discovered SFPN that affects adolescents and adults [2]. This early-onset SFPN usually begins in adolescence or early adulthood but can...promote early diagnosis. What was the impact on other disciplines? Nothing to report. What was the impact on technology transfer? Nothing to report...What was the impact on society beyond science and technology ? As described above, Veterans’ health and, by extension, public health will be

  20. Early Childhood Professionals' Experience of Time to Facilitate Children's Thinking

    Science.gov (United States)

    Fumoto, Hiroko; Robson, Sue

    2006-01-01

    This paper reports on the second phase of the Froebel Research Fellowship project "Ownership and Autonomy in Early Childhood" (2003-5). Based on the first phase of the project (Robson and Hargreaves, 2005), a questionnaire survey of 80 professionals working in the Foundation Stage (age 3-5) in England was conducted to obtain an overview…

  1. A New Tool to Facilitate Learning Reading for Early Childhood

    Science.gov (United States)

    Puspitasari, Cita; Subiyanto

    2017-01-01

    This paper proposes a new android application for early childhood learning reading. The description includes a design, development, and an evaluation experiment of an educational game for learning reading on android. Before developing the game, Unified Modeling Language (UML) diagrams, interfaces, animation, narrative or audio were designed.…

  2. Early Pregnancy Diagnosis in Bovines: Current Status and Future Directions

    Directory of Open Access Journals (Sweden)

    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.

  3. Early diagnosis of tendon pathologies with sonoelastography

    Directory of Open Access Journals (Sweden)

    Zeynep ilerisoy Yakut

    2015-04-01

    RESULTS: Achilles tendon thicknesses measured at three segments (proximal, middle ,distal. did not show any statistically significant difference in both painless and symptomatic side. Proximal part of achilles tendon's elasticity did not show any difference in both side (p=0.31. In middle and distal segment , the elasticity was statistically different in symptomatic side than normal side p=0.005 and p=0.001 respectively. CONCLUSION: Sonoelastographic examination of Achilles tendons in patients with FMF suffering from talalgia may be useful for determining early dejenerative changes in tendons either in the absence of B-mode ultrasound findings. [TAF Prev Med Bull 2015; 14(2.000: 75-80

  4. Gastric cancer: prevention, screening and early diagnosis.

    Science.gov (United States)

    Pasechnikov, Victor; Chukov, Sergej; Fedorov, Evgeny; Kikuste, Ilze; Leja, Marcis

    2014-10-14

    Gastric cancer continues to be an important healthcare problem from a global perspective. Most of the cases in the Western world are diagnosed at late stages when the treatment is largely ineffective. Helicobacter pylori (H. pylori) infection is a well-established carcinogen for gastric cancer. While lifestyle factors are important, the efficacy of interventions in their modification, as in the use of antioxidant supplements, is unconvincing. No organized screening programs can be found outside Asia (Japan and South Korea). Although several screening approaches have been proposed, including indirect atrophy detection by measuring pepsinogen in the circulation, none of them have so far been implemented, and more study data is required to justify any implementation. Mass eradication of H. pylori in high-risk areas tends to be cost-effective, but its adverse effects and resistance remain a concern. Searches for new screening biomarkers, including microRNA and cancer-autoantibody panels, as well as detection of volatile organic compounds in the breath, are in progress. Endoscopy with a proper biopsy follow-up remains the standard for early detection of cancer and related premalignant lesions. At the same time, new advanced high-resolution endoscopic technologies are showing promising results with respect to diagnosing mucosal lesions visually and targeting each biopsy. New histological risk stratifications (classifications), including OLGA and OLGIM, have recently been developed. This review addresses the current means for gastric cancer primary and secondary prevention, the available and emerging methods for screening, and new developments in endoscopic detection of early lesions of the stomach.

  5. Liaison neurologists facilitate accurate neurological diagnosis and management, resulting in substantial savings in the cost of inpatient care.

    LENUS (Irish Health Repository)

    Costelloe, L

    2012-02-01

    BACKGROUND: Despite understaffing of neurology services in Ireland, the demand for liaison neurologist input into the care of hospital inpatients is increasing. This aspect of the workload of the neurologist is often under recognised. AIMS\\/METHODS: We prospectively recorded data on referral and service delivery patterns to a liaison neurology service, the neurological conditions encountered, and the impact of neurology input on patient care. RESULTS: Over a 13-month period, 669 consults were audited. Of these, 79% of patients were seen within 48 h and 86% of patients were assessed by a consultant neurologist before discharge. Management was changed in 69% cases, and discharge from hospital expedited in 50%. If adequate resources for neurological assessment had been available, 28% could have been seen as outpatients, with projected savings of 857 bed days. CONCLUSIONS: Investment in neurology services would facilitate early accurate diagnosis, efficient patient and bed management, with substantial savings.

  6. [Cerebrospinal fluid biomarkers for the early diagnosis of Parkinson's disease].

    Science.gov (United States)

    da Costa, Andreia Gomes; Gago, Miguel Fernandes; Garrett, Carolina

    2011-12-01

    In current medical practice, the diagnosis of Parkinson's disease remains essentially clinical. This practice determines that the diagnosis of Parkinson's disease is done in an already advanced neuropathological stage of the disease. The aim of this study is to review the validity of cerebrospinal fluid protein biological markers in the early diagnosis of Parkinson's disease. The a-synuclein and DJ-1 proteins, due to their role in the hereditary Parkinson's disease, have been the most widely studied cerebrospinal biomarkers. Nevertheless, they have had divergent results mostly owing to different processing, identification and control of laboratory techniques. The new proteomic techniques, directed to the detection of multiple undifferentiated proteins in cerebrospinal fluid (eg. ceruloplasmin, chromogranin B, apoH), are promising. The early diagnosis of Parkinson's disease is imperious as it is a progressive neurodegenerative disorder that causes extensive morbidity. Most of current scientific research in Parkinson's disease is focused on the discovery of neuroprotective drugs. Thus, the definition of biomarkers for the early diagnosis of Parkinson's disease is highly relevant.

  7. Use of proteomics for the early diagnosis fo breast cancer

    NARCIS (Netherlands)

    van Winden, A.W.J.

    2010-01-01

    Breast cancer mortality rates in The Netherlands are among the highest in Europe. To improve breast cancer survival, early detection is of vital importance. The introduction of the national breast cancer screening program has led to an improvement in stage distribution at diagnosis of breast cancer.

  8. 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. T

  9. 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.

  10. 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. T

  11. 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...... years before a hospital contact leading to a diagnosis of Parkinson's disease. METHODS: Retrospective morbidity data from Danish National Patient Registry records (1997-2007) of 10,490 adult patients with a secondary care diagnosis of Parkinson's disease were compared with 42,505 control cases. RESULTS......: Parkinson's disease was associated with significantly higher morbidity rates associated with conditions in the following categories: mental and psychiatric, nervous system, gastrointestinal, musculoskeletal system and connective tissue, genitourinary, abnormal clinical and laboratory findings, injury...

  12. Early Stage Disease Diagnosis System Using Human Nail Image Processing

    Directory of Open Access Journals (Sweden)

    Trupti S. Indi

    2016-07-01

    Full Text Available Human’s hand nail is analyzed to identify many diseases at early stage of diagnosis. Study of person hand nail color helps in identification of particular disease in healthcare domain. The proposed system guides in such scenario to take decision in disease diagnosis. The input to the proposed system is person nail image. The system will process an image of nail and extract features of nail which is used for disease diagnosis. Human nail consist of various features, out of which proposed system uses nail color changes for disease diagnosis. Here, first training set data is prepared using Weka tool from nail images of patients of specific diseases. A feature extracted from input nail image is compared with the training data set to get result. In this experiment we found that using color feature of nail image average 65% results are correctly matched with training set data during three tests conducted.

  13. Endoluminal Diagnosis of Early Gastric Cancer and Its Precursors: Bridging the Gap Between Endoscopy and Pathology.

    Science.gov (United States)

    Uedo, Noriya; Yao, Kenshi

    Although dye-based and image-enhanced endoscopic techniques have revolutionized endoscopic diagnosis, conventional white light endoscopy still plays an important role in the diagnosis of early gastric cancer (EGC) during routine endoscopy. Chromoendoscopy reveals morphological characteristics of the mucosal lesions by enhancing mucosal contrast, while narrow-band imaging (NBI) facilitates detailed evaluation of the vascular architecture and surface features. Positive diagnostic findings of EGC on white light imaging and indigo carmine chromoendoscopy are a sharply demarcated lesion and irregularity in surface morphology or color. Magnifying NBI further improves diagnostic accuracy of white light imaging and chromoendoscopy. We review our approach to the endoscopic diagnosis of (pre-)malignant lesions in the stomach and discuss in detail novel endoscopic microvascular architectural patterns which further leverage diagnostic biopsy yield. We expect that further improvement of endoscopic techniques and correlative studies will close the gap between endoscopy and pathology.

  14. Label-free nanoplasmonic sensing of tumor-associate autoantibodies for early diagnosis of colorectal cancer.

    Science.gov (United States)

    Soler, Maria; Estevez, M-Carmen; Villar-Vazquez, Roi; Casal, J Ignacio; Lechuga, Laura M

    2016-08-03

    Colorectal cancer is treatable and curable when detected at early stages. However there is a lack of less invasive and more specific screening and diagnosis methods which would facilitate its prompt identification. Blood circulating autoantibodies which are immediately produced by the immune system at tumor appearance have become valuable biomarkers for preclinical diagnosis of cancer. In this work, we present the rapid and label-free detection of colorectal cancer autoantibodies directly in blood serum or plasma using a recently developed nanoplasmonic biosensor. Our nanoplasmonic device offers sensitive and real-time quantification of autoantibodies with excellent selectivity and reproducibility, achieving limits of detection around 1 nM (150-160 ng mL(-1)). A preliminary evaluation of clinical samples of colorectal cancer patients has shown good correlation with ELISA. These results demonstrate the reliability of the nanobiosensor strategy and pave the way towards the achievement of a sensitive diagnostic tool for early detection of colorectal cancer.

  15. The Importance of Early Diagnosis and Treatment in Congenital Scoliosis

    Directory of Open Access Journals (Sweden)

    Safak Ekinci

    2011-08-01

    Full Text Available SUMMARY AIM: this study evaluates how early diagnosis of congenital scoliosis affects results and complication rates of of surgical treatment. METHOD: We have evaluated the efficiency and effectivity of modern posterior spinal instrumentation methods in congenital scoliosis cases who were diagnosed and treated in Gulhane Military Medical Academy Orthopaedics and Traumatology Department. We have evaluated 53 patients (13 male,29 female who were operated for congenital scoliosis between 1995 and 2009. Patients were divided into two groups according to the time of diagnosis to evaluate fusion levels, numbers of surgery, surgery methods, reduction rate, intraspinous and other system abnormalities and complications. RESULTS: 9 of 24 patients with diagnosis age before 5 and 11 of 29 patients with diagnosis age after 5 treated with single operation. Correction of main curve was %35.4 and compensatory curve was %13. Main curve correction of patients under 5 age was %36,3 and main curve correction of older group was %34,8 (p>0.05. Average number of fused levels in first group was 2,3±2,1 and in the older group 7,5±3,1. CONCLUSION: In patients before 5 age less invasive surgeries were needed to accomplish succesful treatment and early diagnosis of congenital scoliosis is the most important part of the treatment. KEY WORDS: Congenital ,Scoliosis, Posterior, Instrumentation [TAF Prev Med Bull 2011; 10(4.000: 441-446

  16. 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.

  17. Early Diagnosis of Keratoconus with Orbscan- Ⅱ Anterior System

    Institute of Scientific and Technical Information of China (English)

    李新宇; 刘磊; 邱良秀

    2002-01-01

    Summary: Orbscan- Ⅱ anterior system was used for early diagnosis of keratoconus. 48 Eyes of 24patients with suspicious keratoconus were examined by Orbscan-Ⅱ anterior system from Dec.1999 to Dec. 2000 and followed up. The values of Diff and anterior chamber depth (ACD) wererecorded. Results indicated that values of Diff and ACD were increased in 4 eyes of 2 patients withkeratoconus trend during follow-up. Taking advantage of Orbscan- Ⅱ anterior system to observethe values of Diff and ACD can early diagnose the sub-clinical keratoconus. The values of Diff andACD can sensitively report the progression of keratoconus.

  18. 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.

  19. Early diagnosis and empiric therapy for cirrhosis associated with infection

    Directory of Open Access Journals (Sweden)

    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.

  20. Relevance of deep learning to facilitate the diagnosis of HER2 status in breast cancer

    Science.gov (United States)

    Vandenberghe, Michel E.; Scott, Marietta L. J.; Scorer, Paul W.; Söderberg, Magnus; Balcerzak, Denis; Barker, Craig

    2017-04-01

    Tissue biomarker scoring by pathologists is central to defining the appropriate therapy for patients with cancer. Yet, inter-pathologist variability in the interpretation of ambiguous cases can affect diagnostic accuracy. Modern artificial intelligence methods such as deep learning have the potential to supplement pathologist expertise to ensure constant diagnostic accuracy. We developed a computational approach based on deep learning that automatically scores HER2, a biomarker that defines patient eligibility for anti-HER2 targeted therapies in breast cancer. In a cohort of 71 breast tumour resection samples, automated scoring showed a concordance of 83% with a pathologist. The twelve discordant cases were then independently reviewed, leading to a modification of diagnosis from initial pathologist assessment for eight cases. Diagnostic discordance was found to be largely caused by perceptual differences in assessing HER2 expression due to high HER2 staining heterogeneity. This study provides evidence that deep learning aided diagnosis can facilitate clinical decision making in breast cancer by identifying cases at high risk of misdiagnosis.

  1. Palmomental reflex a relevant sign in early Alzheimer's disease diagnosis?

    OpenAIRE

    Gabelle, Audrey; Gutierrez, Laure-Anne; Dartigues, Jean-François; Ritchie, Karen,; Touchon, Jacques; Berr, Claudine

    2016-01-01

    International audience; AbstractBackground: Sophisticated and expensive biomarkers are proposed for the diagnostic of Alzheimer disease (AD). Amyloid process seems to be early in AD and brain amyloid load affects the frontal lobe. Our objective is to determine if certain simple clinical signs especially frontal-related signs could help reach an earlier and better diagnosis. Methods: In the frame of the 3-City cohort, we conducted a nested case-control study comparing incident cases of Alzheim...

  2. Improved early diagnosis of cystadenocarcinoma of the pancreas

    Institute of Scientific and Technical Information of China (English)

    Hong Wu; Nan-Sheng Cheng; Yan-Ge Zhang; Hong-Zhi Luo; Lu-Nan Yan; Jin Li

    2007-01-01

    BACKGROUND:Cystadenocarcinoma of the pancreas is insensitive to radiotherapy and chemotherapy, and surgery is at present the deifnitive treatment. Early and accurate diagnosis of cystadenocarcinoma is crucial for increasing the ifve-year survival rate and the resectable rate. There is no deifnitive and effective method of early diagnosis of cystadenocarcinoma of the pancreas in China and other countries. METHODS: We compared endoscopic ultrasonography-guided (EUS-guided) ifne needle aspiration biopsy combined with cyst lfuid carcinoembryonic antigen (CEA), CA19-9 examination with computed tomography (CT), B-ultrasonography (B-US) and serum CEA and CA19-9, to explore methods of early diagnosis of cystadenocarcinoma of the pancreas. Retrospective analysis was made on the clinical data of 126 cases of benign pancreatic lesion (90 cases) and cystadenocarcinoma (36). RESULTS: The sensitivity of B-US and CT for cystadeno-carcinoma was 52.8%and 77.8%, while the speciifcity was 78.9%and 86.7%, respectively. When measurement of CEA and CA19-9 of cyst lfuid was combined with EUS-guided ifne needle aspiration biopsy, the sensitivity was 94.4%, higher than that of B-US and CT (P CONCLUSIONS: EUS-guided ifne needle aspiration biopsy combined with examination of cyst lfuid CEA, CA19-9 is a credible means for early diagnosis of cystadenocarcinoma of the pancreas. B-US, CT and serum CEA, CA19-9 measurements are in common use, their ifndings are also very important.

  3. Early diagnosis of craniosynostosis in infants at primary health care

    Directory of Open Access Journals (Sweden)

    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.

  4. EARLY DIAGNOSIS OF CRANIOSYNOSTOSIS IN INFANTS AT PRIMARY HEALTH CARE

    Directory of Open Access Journals (Sweden)

    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.

  5. When "Simon Says" Doesn't Work: Alternatives to Imitation for Facilitating Early Speech Development

    Science.gov (United States)

    DeThorne, Laura S.; Johnson, Cynthia J.; Walder, Louise; Mahurin-Smith, Jamie

    2009-01-01

    Purpose: To provide clinicians with evidence-based strategies to facilitate early speech development in young children who are not readily imitating sounds. Relevant populations may include, but are not limited to, children with autism spectrum disorders, childhood apraxia of speech, and late-talking toddlers. Method: Through multifaceted search…

  6. When "Simon Says" Doesn't Work: Alternatives to Imitation for Facilitating Early Speech Development

    Science.gov (United States)

    DeThorne, Laura S.; Johnson, Cynthia J.; Walder, Louise; Mahurin-Smith, Jamie

    2009-01-01

    Purpose: To provide clinicians with evidence-based strategies to facilitate early speech development in young children who are not readily imitating sounds. Relevant populations may include, but are not limited to, children with autism spectrum disorders, childhood apraxia of speech, and late-talking toddlers. Method: Through multifaceted search…

  7. [Early diagnosis of gastric cancer, a utopian idea? (author's transl)].

    Science.gov (United States)

    Seifert, E

    1981-05-01

    In order to improve the prognosis of gastric cancer it is necessary to discover the lesions at an early stage of the disease. Early gastric cancer has an excellent prognosis with a postoperative survival rate of 77 to 99%. Since 1970 we have diagnosed 76 cases of early gastric cancer and the percentage of early cancer out of all gastric cancers increased from 10 to 23%. This improvement is based on selected examinations of high-risk patients, on better diagnostic methods and on our better knowledge of macroscopic and histological appearance. In particular, the use of snare biopsy in protruding lesions and the implementation of continuous endoscopic-bioptic follow-up of all gastric ulcers until complete healing is achieved have improved the accuracy of histological verification. In 16 out of 76 cases of early gastric cancer a multicentric growth was observed. The diagnosis of gastric cancer at an early stage is not an utopian idea. It is reality when we pay attention to the aspects mentioned before.

  8. How can neuroimaging facilitate the diagnosis and stratification of patients with psychosis?

    Science.gov (United States)

    Kempton, Matthew J; McGuire, Philip

    2015-05-01

    Early diagnosis and treatment of patients with psychosis are associated with improved outcome in terms of future functioning, symptoms and treatment response. Identifying neuroimaging biomarkers for illness onset and treatment response would lead to immediate clinical benefits. In this review we discuss if neuroimaging may be utilised to diagnose patients with psychosis, predict those who will develop the illness in those at high risk, and stratify patients. State-of-the-art developments in the field are critically examined including multicentre studies, longitudinal designs, multimodal imaging and machine learning as well as some of the challenges in utilising future neuroimaging biomarkers in clinical trials. As many of these developments are already being applied in neuroimaging studies of Alzheimer's disease, we discuss what lessons have been learned from this field and how they may be applied to research in psychosis. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  9. Patterns of retinal damage facilitate differential diagnosis between Susac syndrome and MS.

    Directory of Open Access Journals (Sweden)

    Alexander U Brandt

    Full Text Available Susac syndrome, a rare but probably underdiagnosed combination of encephalopathy, hearing loss, and visual deficits due to branch retinal artery occlusion of unknown aetiology has to be considered as differential diagnosis in various conditions. Particularly, differentiation from multiple sclerosis is often challenging since both clinical presentation and diagnostic findings may overlap. Optical coherence tomography is a powerful and easy to perform diagnostic tool to analyse the morphological integrity of retinal structures and is increasingly established to depict characteristic patterns of retinal pathology in multiple sclerosis. Against this background we hypothesised that differential patterns of retinal pathology facilitate a reliable differentiation between Susac syndrome and multiple sclerosis. In this multicenter cross-sectional observational study optical coherence tomography was performed in nine patients with a definite diagnosis of Susac syndrome. Data were compared with age-, sex-, and disease duration-matched relapsing remitting multiple sclerosis patients with and without a history of optic neuritis, and with healthy controls. Using generalised estimating equation models, Susac patients showed a significant reduction in either or both retinal nerve fibre layer thickness and total macular volume in comparison to both healthy controls and relapsing remitting multiple sclerosis patients. However, in contrast to the multiple sclerosis patients this reduction was not distributed over the entire scanning area but showed a distinct sectorial loss especially in the macular measurements. We therefore conclude that patients with Susac syndrome show distinct abnormalities in optical coherence tomography in comparison to multiple sclerosis patients. These findings recommend optical coherence tomography as a promising tool for differentiating Susac syndrome from MS.

  10. Perspectives on using des-γ-carboxyprothrombin (DCP) as a serum biomarker: facilitating early detection of hepatocellular carcinoma in China.

    Science.gov (United States)

    Song, Peipei; Feng, Xiaobin; Zhang, Keming; Song, Tianqiang; Ma, Kuansheng; Kokudo, Norihiro; Dong, Jiahong; Tang, Wei

    2013-08-01

    Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths in China. Evidence has shown that surgical resection and liver transplantation may offer the best potential for treating HCC but are only available to patients whose tumors are detected early. Over the past few decades, although a series of measures for standardized management of HCC has been implemented in China, most patients with HCC in China still present with advanced-stage disease, thus strategies to screen for and diagnose HCC at an earlier stage are urgently needed in China when curable interventions can be offered to achieve long-term disease-free survival for patients with HCC. In China, the serum biomarker α-fetoprotein (AFP) is considered a useful and feasible tool for HCC screening and early diagnosis. However, the sensitivity and specificity of AFP vary widely, and the total AFP is not always specific, especially when HCC is in its early stages. Globally, numerous studies have reported that the combination of des-γ-carboxyprothrombin (DCP) and AFP may have a higher sensitivity than AFP alone, and suggested DCP could also be used to assess the progression of HCC. However, DCP has not been approved in China until now. Differ from most of Western countries, people with HBV infection are the largest population at risk of developing HCC China. In order to assess the screening and diagnostic value of DCP in Chinese patients with HCC, a first large-scale, multi-center study was launched in China in 2012, results showed that DCP can help to detect HCC in its early stages and facilitate definitive treatment. The clinical use of DCP is urgently needed to facilitate early detection of HCC in China.

  11. 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.

  12. Application of Metabonomics in Early Diagnosis of Diseases

    Institute of Scientific and Technical Information of China (English)

    LIU Qiao

    2015-01-01

    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 ifnding 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 efifcacy 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.

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

    Science.gov (United States)

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

    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. PMID:25745453

  14. Salivaomics - A promising future in early diagnosis of dental diseases.

    Science.gov (United States)

    Koneru, Suneetha; Tanikonda, Rambabu

    2014-01-01

    Human saliva plays an important role in the health of the oral cavity and of the body as a whole. Salivary diagnostics is a dynamic and emerging field in the diagnosis of oral and systemic diseases. Saliva reflects the physiologic state of the body, including emotional, endocrinal, nutritional, and metabolic variations. The collection of saliva samples is noninvasive, safe, and inexpensive. Traditional clinical criteria are insufficient for determining sites of active disease, for monitoring the response to therapy, or for measuring the degree of susceptibility to future disease progression. Salivaomics includes five diagnostic alphabets proteins, mRNAs, miRNAs, metabolic compounds, and microbes offering substantial advantages because disease states may be accompanied by detectable changes. Salivaomics, the future of saliva-based techniques for early diagnosis of dental diseases, is promising and may offer a robust alternative for clinicians to use in the near future to make clinical decisions.

  15. Salivaomics - A promising future in early diagnosis of dental diseases

    Directory of Open Access Journals (Sweden)

    Suneetha Koneru

    2014-01-01

    Full Text Available Human saliva plays an important role in the health of the oral cavity and of the body as a whole. Salivary diagnostics is a dynamic and emerging field in the diagnosis of oral and systemic diseases. Saliva reflects the physiologic state of the body, including emotional, endocrinal, nutritional, and metabolic variations. The collection of saliva samples is noninvasive, safe, and inexpensive. Traditional clinical criteria are insufficient for determining sites of active disease, for monitoring the response to therapy, or for measuring the degree of susceptibility to future disease progression. Salivaomics includes five diagnostic alphabets proteins, mRNAs, miRNAs, metabolic compounds, and microbes offering substantial advantages because disease states may be accompanied by detectable changes. Salivaomics, the future of saliva-based techniques for early diagnosis of dental diseases, is promising and may offer a robust alternative for clinicians to use in the near future to make clinical decisions.

  16. Improving diagnosis of appendicitis. Early autologous leukocyte scanning.

    Science.gov (United States)

    DeLaney, A R; Raviola, C A; Weber, P N; McDonald, P T; Navarro, D A; Jasko, I

    1989-10-01

    A prospective nonrandomized study investigating the accuracy and utility of autologous leukocyte scanning in the diagnosis of apendicitis was performed. One hundred patients in whom the clinical diagnosis of appendicitis was uncertain underwent indium 111 oxyquinoline labelling of autologous leukocytes and underwent scanning 2 hours following reinjection. Of 32 patients with proved appendicitis, three scans revealed normal results (false-negative rate, 0.09). Of 68 patients without appendicitis, three scans had positive results (false-positive rate, 0.03; sensitivity, 0.91; specificity, 0.97; predictive value of positive scan, 0.94; predictive value of negative scan, 0.96; and overall accuracy, 0.95). Scan results altered clinical decisions in 19 patients. In 13 cases, the scan produced images consistent with diagnoses other than appendicitis, expediting appropriate management. Early-imaging111 In oxyquinoline autologous leukocyte scanning is a practical and highly accurate adjunct for diagnosing appendicitis.

  17. Early diagnosis of atherosclerosis with panoramic radiographs: a review

    Directory of Open Access Journals (Sweden)

    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.

  18. [Hypertension: prevalence, early diagnosis, control and trends in Mexican adults].

    Science.gov (United States)

    Campos-Nonato, Ismael; Hernández-Barrera, Lucía; Rojas-Martínez, Rosalba; Pedroza, Adolfo; Medina-García, Catalina; Barquera-Cervera, Simón

    2013-01-01

    The present study aims to describe the prevalence, distribution and trends of hypertension (HT) in Mexican adults ≥20 years, and to describe the prevalence of early diagnosis and treatment of HT. A total of 10 898 adults were considered. The measurement of blood pressure was performed following the procedures recommended by the American Heart Association. An adult was considered, hypertensive when he met the diagnostic criteria of JNC-7. The prevalence of HT was 31.5%, of which 47.3% were unaware of their condition. Pharmacological treatment was not associated with a higher percentage of subjects under control. Prevalences from 2000, 2006 and 2012 suggest that there is a stabilization. A health problem of this magnitude requires better diagnosis, care and training of the medical sector so that appropriate treatments are prescribed and HT control can be enhanced.

  19. Barriers and facilitators to reaching a diagnosis of PNES from the patients' perspective: Preliminary findings.

    Science.gov (United States)

    Pretorius, Chrisma

    2016-05-01

    This qualitative study aimed at examining the subjective experiences of patients during the complicated and often prolonged diagnostic process of psychogenic non-epileptic seizures (PNES). Thematic analyses were used to explore the semi-structured interviews that were conducted with ten individuals who have been diagnosed with PNES. Six main themes, namely inexpert healthcare providers, limited medical insurance and loss of independence were identified as barriers, while social support, comprehensive medical insurance and knowledgeable healthcare providers were identified as facilitators through the process of thematic analysis. The patients' perspectives revealed that an earlier diagnosis of PNES is essential to address the loss of independence and limit inappropriate and potentially harmful treatment as well as the costly burden of this condition on both the patient and the healthcare system. It was evident in this study that healthcare providers play an essential role in the subjective experiences of these individuals during the diagnostic process. The implementation of continuous education programmes for healthcare providers in particular could contribute positively to the diagnostic process of PNES for patients. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  20. Anthropogenic Habitats Facilitate Dispersal of an Early Successional Obligate: Implications for Restoration of an Endangered Ecosystem.

    Directory of Open Access Journals (Sweden)

    Katrina E Amaral

    Full Text Available Landscape modification and habitat fragmentation disrupt the connectivity of natural landscapes, with major consequences for biodiversity. Species that require patchily distributed habitats, such as those that specialize on early successional ecosystems, must disperse through a landscape matrix with unsuitable habitat types. We evaluated landscape effects on dispersal of an early successional obligate, the New England cottontail (Sylvilagus transitionalis. Using a landscape genetics approach, we identified barriers and facilitators of gene flow and connectivity corridors for a population of cottontails in the northeastern United States. We modeled dispersal in relation to landscape structure and composition and tested hypotheses about the influence of habitat fragmentation on gene flow. Anthropogenic and natural shrubland habitats facilitated gene flow, while the remainder of the matrix, particularly development and forest, impeded gene flow. The relative influence of matrix habitats differed between study areas in relation to a fragmentation gradient. Barrier features had higher explanatory power in the more fragmented site, while facilitating features were important in the less fragmented site. Landscape models that included a simultaneous barrier and facilitating effect of roads had higher explanatory power than models that considered either effect separately, supporting the hypothesis that roads act as both barriers and facilitators at all spatial scales. The inclusion of LiDAR-identified shrubland habitat improved the fit of our facilitator models. Corridor analyses using circuit and least cost path approaches revealed the importance of anthropogenic, linear features for restoring connectivity between the study areas. In fragmented landscapes, human-modified habitats may enhance functional connectivity by providing suitable dispersal conduits for early successional specialists.

  1. Anthropogenic Habitats Facilitate Dispersal of an Early Successional Obligate: Implications for Restoration of an Endangered Ecosystem.

    Science.gov (United States)

    Amaral, Katrina E; Palace, Michael; O'Brien, Kathleen M; Fenderson, Lindsey E; Kovach, Adrienne I

    2016-01-01

    Landscape modification and habitat fragmentation disrupt the connectivity of natural landscapes, with major consequences for biodiversity. Species that require patchily distributed habitats, such as those that specialize on early successional ecosystems, must disperse through a landscape matrix with unsuitable habitat types. We evaluated landscape effects on dispersal of an early successional obligate, the New England cottontail (Sylvilagus transitionalis). Using a landscape genetics approach, we identified barriers and facilitators of gene flow and connectivity corridors for a population of cottontails in the northeastern United States. We modeled dispersal in relation to landscape structure and composition and tested hypotheses about the influence of habitat fragmentation on gene flow. Anthropogenic and natural shrubland habitats facilitated gene flow, while the remainder of the matrix, particularly development and forest, impeded gene flow. The relative influence of matrix habitats differed between study areas in relation to a fragmentation gradient. Barrier features had higher explanatory power in the more fragmented site, while facilitating features were important in the less fragmented site. Landscape models that included a simultaneous barrier and facilitating effect of roads had higher explanatory power than models that considered either effect separately, supporting the hypothesis that roads act as both barriers and facilitators at all spatial scales. The inclusion of LiDAR-identified shrubland habitat improved the fit of our facilitator models. Corridor analyses using circuit and least cost path approaches revealed the importance of anthropogenic, linear features for restoring connectivity between the study areas. In fragmented landscapes, human-modified habitats may enhance functional connectivity by providing suitable dispersal conduits for early successional specialists.

  2. Hepatic Encephalopathy: Early Diagnosis in Pediatric Patients With Cirrhosis

    OpenAIRE

    2013-01-01

    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...

  3. Perception from Barrier and Facilitator for Providing of Early Rehabilitation Care for RTI Victims

    Directory of Open Access Journals (Sweden)

    Pashaei Sabet

    2015-08-01

    Full Text Available Background Road traffic injuries (RTIs are a major public health problem and the most important cause of disability, morbidity and mortality worldwide. Early rehabilitation can play a significant role in minimizing complications, morbidity and mortality. Objectives The aim of this study was to describe perceptions of barriers precluding provision of early rehabilitation care for RTI victims. Patients and Methods A qualitative content analysis was carried out on 15 nurses with at least one year experience caring for RTI victims. The nurses were selected from various wards (emergency, orthopedic, neurosurgery, and clinic of Sina and Imam Khomeini Hospitals via targeted sampling. Data were collected through semi-structured interviews and targeted sampling until data saturation. Data were analyzed and assessed. Results After continuous analysis and comparison of data, major causes precluding nurses from early rehabilitation of RTI patients were retrieved. These barriers included: (a lack of insight, (b lack of comprehensive care (c excessive costs; facilitating factors included (d training for cooperation and (e support for coping. Conclusions The findings of this study show that the need for early rehabilitation in the hospital phase of care for RTI victims is needed. Knowledge about the barriers precluding nurses from early rehabiltiation of RTI patients and facilitators that can help health care workers and policy makers eliminate the barriers precluding early rehabilitation can help health care workers, especially nurses enable patients get over their disability and gain social and family support.

  4. Kidney diseases in children - early diagnosis and prevention.

    Science.gov (United States)

    Polenakovic, Momir; Gucev, Zoran; Tasic, Velibor

    2016-01-01

    Pediatric kidney diseases were in the focus of the World Kidney Day 2016. Macedonian pediatric nephrologists gave their contribution with public appearance in kindergartens, primary and secondary schools, with interactive lectures and discussion with the youngest about the kidney function, healthy life style and simple measures to prevent kidney and urinary tract diseases. Besides promotive appearance in the media, series of lectures were presented in front of the health professionals. The aim was to attract the attention of the professionals for early diagnosis and prevention of kidney disease. The action starts in utero, followed by early postnatal imaging and assessment, conservative treatment and in selected cases surgical treatment. The emphasis is on the multidisciplinary and comprehensive approach to children and adolescents with kidney diseases.

  5. Barriers and facilitators to effective communication experienced by patients with malignant lymphoma at all stages after diagnosis

    NARCIS (Netherlands)

    Bruinessen, I.R. van; Weel-Baumgarten, E.M. van; Gouw, H.; Zijlstra, J.M.; Albada, A.; Dulmen, S. van

    2013-01-01

    OBJECTIVE: This study aims to gain insight into patient-perceived communication barriers and facilitators at different stages after the diagnosis of malignant lymphoma. We have detected patterns to explain when these factors influence communication predominantly. METHOD: A qualitative approach was

  6. Barriers and facilitators to effective communication experienced by patients with malignant lymphoma at all stages after diagnosis.

    NARCIS (Netherlands)

    Bruinessen, I.R. van; Weel, E.M. van; Gouw, H.; Zijlstra, J.M.; Albada, A.; Dulmen, S. van

    2013-01-01

    Objective: This study aims to gain insight into patient-perceived communication barriers and facilitators at different stages after the diagnosis of malignant lymphoma. We have detected patterns to explain when these factors influence communication predominantly. Method: A qualitative approach was

  7. Barriers and facilitators to effective communication experienced by patients with malignant lymphoma at all stages after diagnosis.

    NARCIS (Netherlands)

    Bruinessen, I.R. van; Weel, E.M. van; Gouw, H.; Zijlstra, J.M.; Albada, A.; Dulmen, S. van

    2013-01-01

    Objective: This study aims to gain insight into patient-perceived communication barriers and facilitators at different stages after the diagnosis of malignant lymphoma. We have detected patterns to explain when these factors influence communication predominantly. Method: A qualitative approach was a

  8. Neonatal Respiratory Distress Syndrome: Early Diagnosis, Prevention, and Treatment

    Directory of Open Access Journals (Sweden)

    S. A. Perepelitsa

    2012-01-01

    Full Text Available to improve treatment results in premature infants with neonatal respiratory distress syndrome (NRDS, by establishing developmental mechanisms and elaborating methods for its early diagnosis, treatment, and prevention. Material and methods. The paper analyzes the results of a clinical observation and laboratory, instrumental, immunological, morphological, and radiological studies of 320 premature neonates at 26—35 weeks gestational age. The following groups of neonates were identified: 1 40 premature neonatal infants without NRDS and with the physiological course of an early neonatal period (a comparison group; 2 190 premature neonates with severe NRDS in whom the efficiency of therapy with exogenous surfactants, such as surfactant BL versus curosurf, was evaluated; 3 90 premature newborn infants who had died from NRDS at its different stages. Results. The poor maternal somatic, obstetric, and gynecological histories in the early periods of the current pregnancy create prerequisites for its termination, favor the development of severe acute gestosis, and cause abnormal placental changes. Each gestational age is marked by certain placental changes that promote impaired uterineplacentalfetal blood flow and premature birth. Alveolar and bronchial epithelial damages, including those ante and intranatally, microcircula tory disorders play a leading role in the tanatogenesis of NRDS. Intranatal hypoxia and amniotic fluid aspiration are one of the important factors contributing to alveolar epithelial damage and NRDS in premature neonates. Exogenous surfactants prevent the development of hyaline membranes and are useful in the normalization of ventilation-perfusion relationships and lung biomechanical properties. Conclusion. This study could improve the diagnosis and treatment of NRDS, which assisted in reducing the duration of mechanical ventilation from 130±7.6 to 65±11.6 hours, the number of complications (the incidence of intragastric

  9. Bilateral Medial Medullary Stroke: A Challenge in Early Diagnosis

    Directory of Open Access Journals (Sweden)

    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.

  10. Massively parallel DNA sequencing facilitates diagnosis of patients with Usher syndrome type 1.

    Directory of Open Access Journals (Sweden)

    Hidekane Yoshimura

    Full Text Available Usher syndrome is an autosomal recessive disorder manifesting hearing loss, retinitis pigmentosa and vestibular dysfunction, and having three clinical subtypes. Usher syndrome type 1 is the most severe subtype due to its profound hearing loss, lack of vestibular responses, and retinitis pigmentosa that appears in prepuberty. Six of the corresponding genes have been identified, making early diagnosis through DNA testing possible, with many immediate and several long-term advantages for patients and their families. However, the conventional genetic techniques, such as direct sequence analysis, are both time-consuming and expensive. Targeted exon sequencing of selected genes using the massively parallel DNA sequencing technology will potentially enable us to systematically tackle previously intractable monogenic disorders and improve molecular diagnosis. Using this technique combined with direct sequence analysis, we screened 17 unrelated Usher syndrome type 1 patients and detected probable pathogenic variants in the 16 of them (94.1% who carried at least one mutation. Seven patients had the MYO7A mutation (41.2%, which is the most common type in Japanese. Most of the mutations were detected by only the massively parallel DNA sequencing. We report here four patients, who had probable pathogenic mutations in two different Usher syndrome type 1 genes, and one case of MYO7A/PCDH15 digenic inheritance. This is the first report of Usher syndrome mutation analysis using massively parallel DNA sequencing and the frequency of Usher syndrome type 1 genes in Japanese. Mutation screening using this technique has the power to quickly identify mutations of many causative genes while maintaining cost-benefit performance. In addition, the simultaneous mutation analysis of large numbers of genes is useful for detecting mutations in different genes that are possibly disease modifiers or of digenic inheritance.

  11. Nested polymerase chain reaction for early diagnosis of typhoid fever.

    Science.gov (United States)

    Sultana, S; Hossain, M A; Alam, M A; Paul, S K; Mahmud, C; Kabir, M R; Haque, N; Yesmin, T; Kayes, M T; Maruf, A A; Kobayashi, N

    2012-01-01

    Typhoid fever, caused by Salmonella typhi, is an important cause of morbidity and mortality in many developing countries. A rapid and sensitive method for the detection of S. typhi is essential for early diagnosis. This was a study to prospectively evaluate the sensitivity and specificity of nested polymerase chain reaction (PCR) to identify the S. typhi using flagellin gene related primers. The study was carried out in the department of Microbiology, Mymensingh Medical College, Mymensingh between July, 2010 and June, 2011, including 82 individuals of different age and sex. Of them, 62 were clinically suspected cases of typhoid fever and remaining 20 were apparently healthy controls. Cultures as well as PCR of blood specimens were performed for each of the cases. Among the 62 suspected typhoid fever cases, 8(12.9%) were blood culture positive and 55(88.7%) were PCR positive for S. typhi. All culture positive cases were positive by PCR and among 54 culture negative cases, 47(87%) were positive by PCR. Neither of the healthy controls was positive by PCR or blood culture. The sensitivity, specificity, positive predictive value and negative predictive value of PCR using blood culture as gold standard were 88.7%, 100%, 100% and 74% respectively for typhoid fever. In this study, the PCR appears highly specific, very sensitive and superior to blood culture for the early diagnosis of typhoid fever.

  12. Spatial-temperature high resolution map for early cancer diagnosis

    Science.gov (United States)

    Gavriloaia, Gheorghe V.; Hurduc, Anca; Ghimigean, Ana-Maria; Fumarel, Radu

    2009-02-01

    Heat is one of the most important parameters of living beings. Skin temperature is not the same on the entire body and so, a thermal signature can be got. Infrared map on serial imaging can constitute an early sign of an abnormality. Thermography detects changes in tissue that appear before and accompany many diseases including cancer. As this map has a better resolution an early cancer diagnosis can be done. The temperature of neoplasic tissue is different up to 1.5 °C than that of the healthy tissue as a result of the specific metabolic rate. The infrared camera images show very quickly the heat transferred by radiation. A lot of factors disturb the temperature conversion to pixel intensity. A sensitive temperature sensor with a 10 Mpixels video camera, showing its spatial position, and a computer fusion program were used for the map with high spatial-temperature resolution. A couple of minutes are necessary to get a high resolution map. The asymmetry and borders were the main parameters analyzed. The right cancer diagnosis was for about 78.4% of patients with thyroid cancer, and more than 89.6% from patients with breast cancer. In the near future, the medical prognosis will be improved by fractal analysis.

  13. EARLY DIAGNOSIS OF MYELODYSPLASTIC SYNDROMES USING CLONAL ANALYSES

    Institute of Scientific and Technical Information of China (English)

    钱军; 薛永权; 虞斐; 吴亚芳; 潘金兰; 陆定伟

    2002-01-01

    Objective: To study the value of clonal analysis to the early diagnosis of myelodysplastic syndrome (MDS). Methods: Four types of clonal analyses were performed on the bone marrow samples from 50 patients suspected of MDS: (1) Conventional Cytogenetics (CC) for clonal chromosomal abnormalities; (2) BrdU-Sister Chromatid Differentiation (BrdU-SCD) for cell cycle kinetics; (3) Fluorescence in Situ Hybridization (FISH) for trisomy 8; (4) Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) for N-ras mutation. Results: The diagnosis of forty-three patients was compatible with the FAB criteria for MDS. The other seven cases didn't meet the FAB criteria, with only one lineage of dyspoiesis or with no obvious dysplastic changes. Among these seven cases, two were morphologically diagnosed with suspicious refractory anemia, one with sideroblastic anemia, one with leukemoid reaction, one with hypercellular anemia and two with chronic aplastic anemia. Clonal analyses of the 7 patients showed that six cases had clonal karyotype abnormalities, four had prolonged cell cycle patterns, four had trisomy 8 of different proportions and one had mutation of the exon 1 of N-RAS. Thus, they were revaluated as MDS patients. Conclusion: The untypical MDS patients with one lineage dyspoiesis or without obvious dysplastic changes can be diagnosed early by combining multiple clonal analysis techniques such as CC, SCD, FISH and PCR-SSCR.

  14. Interdisciplinary facilitation of the minimal participation of patients with severe brain injury in early rehabilitation

    DEFF Research Database (Denmark)

    Pallesen, Hanne; Buhl, Inge

    2016-01-01

    ABSTRACT Aim: The purpose of the study was to shed light on the participatory aspect of early rehabilitation, when contact, communication and interaction between the patients and the professionals is minimal, because of the patients’ severe brain injury and complex conditions. Methodology...... by a combination of the clinicians’ professional skills, their ability to create a rehabilitation environment in which patients can perform activities, the right framework for the meeting, and a suitable approach, to facilitate fruitful interaction with the patients....

  15. Advances in early diagnosis and therapy of pancreatic cancer

    Institute of Scientific and Technical Information of China (English)

    Qiang Xu; Tai-Ping Zhang; Yu-Pei Zhao

    2011-01-01

    BACKGROUND: Pancreatic cancer remains a devastating disease with a 5-year survival rate of less than 5%. Recent advances in diagnostic methods and therapeutic approaches have increased the possibility of improving the existing poor prognosis. DATA  SOURCES: English-language articles reporting early diagnosis and therapy of pancreatic cancer were searched from the MEDLINE and PubMed databases, Chinese-language articleswerefromCHKD(ChinaHospitalKnowledgeDatabase). RESULT: The current literature about pancreatic cancer was reviewed from three aspects: statistics, screening and early detection, and therapy. CONCLUSIONS: Early detection and screening of pancreatic cancer currently should be limited to high risk patients. Surgical resection is the only curative approach available, with some recent improvement in outcomes. Gemcitabine has been a standard treatment during the last decade. Gemcitabine-based combination treatment, especially combined with newer molecular targeted agents, is promising. The rationale for radiotherapy is controversial, but with the recent development of modern radiation delivery techniques, radiotherapy should be intensified. Patients with borderline pancreatic cancer could benefit from neoadjuvant therapy but more evidence is needed and the best neoadjuvant regimen is still to be determined.

  16. [Malignant neuroleptic syndrome--a possibility for early diagnosis].

    Science.gov (United States)

    Rasmussen, K T; Scherling, A

    1991-10-21

    A 17-year-old man developed the malignant neuroleptic syndrome and recovered after the neuroleptic drug was discontinued. When the treatment with the neuroleptic was resumed four weeks later, an elevated serum creatine kinase level was found without any other symptoms of the malignant neuroleptic syndrome. The neuroleptic was discontinued and the serum creatine kinase level was normalized. In both episodes, serum creatine kinase level was followed daily. The elimination of creatine kinase followed a first order kinetic, indicating that release of the enzyme to the blood stopped as soon the neuroleptic was discontinued. In the second episode, the increase in serum creatine kinase level was found before the symptoms of malignant neuroleptic syndrome appeared. This opens a possible way to early diagnosis and in that way prevention of severe symptoms.

  17. GEAR CRACK EARLY DIAGNOSIS USING BISPECTRUM DIAGONAL SLICE

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    A study of bispectral analysis in gearbox condition monitoring is presented.The theory of bispectrum and quadratic phase coupling (QPC) is first introduced, and then equations for computing bispectrum slices are obtained.To meet the needs of online monitoring, a simplified method of computing bispectrum diagonal slice is adopted.Industrial gearbox vibration signals measured from normal and tooth cracked conditions are analyzed using the above method.Experiments results indicate that bispectrum can effectively suppress the additive Gaussian noise and chracterize the QPC phenomenon.It is also shown that the 1-D bispectrum diagonal slice can capture the non-Gaussian and nonlinear feature of gearbox vibration when crack occurred, hence, this method can be employed to gearbox real time monitoring and early diagnosis.

  18. PSA Isoforms' Velocities for Early Diagnosis of Prostate Cancer.

    Science.gov (United States)

    Heidegger, Isabel; Klocker, Helmut; Pichler, Renate; Horninger, Wolfgang; Bektic, Jasmin

    2015-06-01

    Free prostate-specific antigen (fPSA) and its molecular isoforms are suggested for enhancement of PSA testing in prostate cancer (PCa). In the present study we evaluated whether PSA isoforms' velocities might serve as a tool to improve early PCa diagnosis. Our study population included 381 men who had undergone at least one ultrasound-guided prostate biopsy whose pathologic examination yielded PCa or showed no evidence of prostatic malignancy. Serial PSA, fPSA, and proPSA measurements were performed on serum samples covering 7 years prior to biopsy using Beckmann Coulter Access immunoassays. Afterwards, velocities of PSA (PSAV), fPSA% (fPSA%V), proPSA% (proPSA%V) and the ratio proPSA/PSA/V were calculated and their ability to discriminate cancer from benign disease was evaluated. Among 381 men included in the study, 202 (53%) were diagnosed with PCa and underwent radical prostatectomy at our Department. PSAV, fPSA%V, proPSA%V as well as proPSA/PSA/V were able to differentiate significantly between PCa and non-cancerous prostate. The highest discriminatory power between cancer and benign disease has been observed two and one year prior to diagnosis with all measured parameters. Among all measured parameters, fPSA%V showed the best cancer specificity of 45.3% with 90% of sensitivity. In summary, our results highlight the value of PSA isoforms' velocity for early detection of PCa. Especially fPSA%V should be used in the clinical setting to increase cancer detection specificity.

  19. Clinical diagnosis and management in early Huntington's disease: a review

    Directory of Open Access Journals (Sweden)

    Schiefer J

    2015-03-01

    Full Text Available Johannes Schiefer,1,* Cornelius J Werner,1,* Kathrin Reetz1,2 1Euregional Huntington Center, 2Jülich Aachen Research Alliance (JARA – Translational Brain Medicine, Department of Neurology, RWTH Aachen University, Aachen, Germany *These authors contributed equally to this work Abstract: This review focuses on clinical diagnosis and both pharmacological and nonpharmacological therapeutic options in early stages of the autosomal dominant inherited neurodegenerative Huntington's disease (HD. The available literature has been reviewed for motor, cognitive, and psychiatric alterations, which are the three major symptom domains of this devastating progressive disease. From a clinical point of view, one has to be aware that the HD phenotype can vary highly across individuals and during the course of the disease. Also, symptoms in juvenile HD can differ substantially from those with adult-onset of HD. Although there is no cure of HD and management is limited, motor and psychiatric symptoms often respond to pharmacotherapy, and nonpharmacological approaches as well as supportive care are essential. International treatment recommendations based on study results, critical statements, and expert opinions have been included. This review is restricted to symptomatic and supportive approaches since all attempts to establish a cure for the disease or modifying therapies have failed so far. Keywords: Neurodegeneration, clinical picture, early symptoms, therapy, treatment

  20. Early diagnosis of acoustic neuroma by the vestibular test

    Energy Technology Data Exchange (ETDEWEB)

    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.

  1. Barriers and facilitators to early mobilisation in Intensive Care: a qualitative study.

    Science.gov (United States)

    Barber, Elizabeth A; Everard, Tori; Holland, Anne E; Tipping, Claire; Bradley, Scott J; Hodgson, Carol L

    2015-11-01

    To determine the barriers and facilitators of early mobilisation in the Intensive Care Unit. It is well established that mobilising critically ill patients has many benefits, however it is not occurring as frequently as expected. The causes and ways to change this are not clearly understood. A qualitative descriptive study involving focus groups with medical, nursing and physiotherapy clinicians, from an Australian quaternary hospital Intensive Care Unit. The major themes related to barriers included the culture of the Intensive Care Unit; communication; and a lack of resources. Major themes associated with facilitating early mobilisation included organisational change; improved communication between medical units; and improved resources. Early mobilisation was considered an important aspect of critically ill patient's care by all clinicians. Several major barriers to mobilisation were identified, which included unit culture, lack of resources, prioritisation and leadership. A dedicated mobility team led by physiotherapists in the ICU setting could be a viable option to address the identified barriers related to mobility. Copyright © 2014 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  2. Postoperative intussusception in pediatric abdominal malignancies: early diagnosis and management

    Institute of Scientific and Technical Information of China (English)

    Maged M. Elshafiey; Gehad T. Meselhy; Amal Refaat; Alaa A. Younes

    2012-01-01

    Objective: The aim of this study was to review the incidence of postoperative intussusception (POI) in our patients with pediatric abdominal malignancies and the end result of management of these cases. Methods: From November2007 till the end of December 2011, a total of 538 patients with different abdominal malignancies were operated upon by laparotomies in our hospital. Reoperations were required in 12 patients for post operative intestinal obstruction developed in the 1st postoperative month. Review of the identified cases focused on patient's characteristics, the primary tumor type, the primary surgical procedure, clinical and imaging features of the intussusceptions, timing and findings at the 2nd laparotomy and the end result of subsequent interventions. Results: Early post operative intestinal obstruction (within 1 month) developed in 12 patients of whom 8 patients had POI. Five patients had adhesive intestinal obstruction (one patient developed POI then adhesive obstruction). The median duration between the primary surgery and the onset of intestinal obstruction symptoms was 5 days (range 4-12 days) in the POI group and 24 days (range 10-30 days) in the adhesion group. Abdominal CT was done in all cases and it could properly diagnose POI and detect its site in the POI group while in the adhesion group it showed evidence of complete obstruction. Plain radiograph failed to detect signs of intestinal obstruction in 3 cases (two in the POI group and one in the adhesion group). In POI group simple reduction was done in 7 cases while resection anastmosis was done in 1 case due to gangrene of the ileocecal region. Adhesiolysis was done in the 5 cases of intestinal adhesion group.Conclusion: Early POI in pediatric abdominal cancer is a rare complication; however it should be kept in mind with high index of suspicion. Early diagnosis and intervention is essential for successful management. Abdominal CT is very helpful as it can detect the level and possible cause of

  3. Importance of the dentist in early diagnosis of pemphigus vulgaris

    Directory of Open Access Journals (Sweden)

    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.

  4. A multiple classifier system for early melanoma diagnosis.

    Science.gov (United States)

    Sboner, Andrea; Eccher, Claudio; Blanzieri, Enrico; Bauer, Paolo; Cristofolini, Mario; Zumiani, Giuseppe; Forti, Stefano

    2003-01-01

    Melanoma is the most dangerous skin cancer and early diagnosis is the key factor in its successful treatment. Well-trained dermatologists reach a diagnosis via visual inspection, and reach sensitivity and specificity levels of about 80%. Several computerised diagnostic systems were reported in the literature using different classification algorithms. In this paper, we will illustrate a novel approach by which a suitable combination of different classifiers is used in order to improve the diagnostic performances of single classifiers. We used three different kinds of classifiers, namely linear discriminant analysis (LDA), k-nearest neighbour (k-NN) and a decision tree, the inputs of which are 38 geometric and colorimetric features automatically extracted from digital images of skin lesions. Multiple classifiers were generated by combining the diagnostic outputs of single classifiers with appropriate voting schemata. This approach was evaluated on a set of 152 digital skin images. We compared the performances of multiple classifiers (2- and 3-classifier groups) between them and with respect to single ones (1-classifier group). We further compared the classifiers' performances with those of eight dermatologists. Classifiers' performances were measured in terms of distance from the ideal classifier. Compared with 1- and 2-classifier groups, performances of 3-classifier systems were significantly higher (Pclassifier groups (P=0.352). While the dermatologists group showed a level of performances significantly higher than the 1-classifier systems (Pclassifier groups and the dermatologists groups, indicating comparable performances. This work suggests that a suitable combination of different kinds of classifiers can improve the performances of an automatic diagnostic system.

  5. 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

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Early Oscillation Detection for DC/DC Converter Fault Diagnosis

    Science.gov (United States)

    Wang, Bright L.

    2011-01-01

    The electrical power system of a spacecraft plays a very critical role for space mission success. Such a modern power system may contain numerous hybrid DC/DC converters both inside the power system electronics (PSE) units and onboard most of the flight electronics modules. One of the faulty conditions for DC/DC converter that poses serious threats to mission safety is the random occurrence of oscillation related to inherent instability characteristics of the DC/DC converters and design deficiency of the power systems. To ensure the highest reliability of the power system, oscillations in any form shall be promptly detected during part level testing, system integration tests, flight health monitoring, and on-board fault diagnosis. The popular gain/phase margin analysis method is capable of predicting stability levels of DC/DC converters, but it is limited only to verification of designs and to part-level testing on some of the models. This method has to inject noise signals into the control loop circuitry as required, thus, interrupts the DC/DC converter's normal operation and increases risks of degrading and damaging the flight unit. A novel technique to detect oscillations at early stage for flight hybrid DC/DC converters was developed.

  8. Necrobiosis Lipoidica: Early Diagnosis and Treatment with Tacrolimus

    Directory of Open Access Journals (Sweden)

    A. Patsatsi

    2011-04-01

    Full Text Available We present a case of necrobiosis lipoidica (NL with atypical early lesions and good response to topical tacrolimus. NL is a disease with clinical features that are seldom misinterpreted. Often histology just confirms the clinician’s diagnosis. Only in rare cases, the clinical presentation and the involved body sites may be misleading. A 67-year-old diabetic woman was admitted to our department with a well-defined, persistent plaque on her left arm and on her right shin. Histologic examination of both lesions revealed features of NL despite the dissimilar clinical presentation. The patient was treated with 0.1% topical tacrolimus ointment twice daily for 8 weeks and once daily for 8 weeks. A significant improvement and no further lesions were observed after 1 year of follow-up. A high index of suspicion regarding NL lesions with atypical clinical presentation on different body sites is advised in order to avoid misdiagnosis, wrong treatment decisions and ulceration. Additionally, it appears that topical tacrolimus treatment is an effective therapeutic option in patients with recent, non-ulcerated NL lesions.

  9. Sonographic markers for early diagnosis of fetal malformations

    Institute of Scientific and Technical Information of China (English)

    Maria; Daniela; Renna; Paola; Pisani; Francesco; Conversano; Emanuele; Perrone; Ernesto; Casciaro; Gian; Carlo; Di; Renzo; Marco; Di; Paola; Antonio; Perrone; Sergio; Casciaro

    2013-01-01

    Fetal malformations are very frequent in industrialized countries.Although advanced maternal age may affect pregnancy outcome adversely,80%-90%of fetal malformations occur in the absence of a specific risk factor for parents.The only effective approach for prenatal screening is currently represented by an ultrasound scan.However,ultrasound methods present two important limitations:the substantial absence of quantitative parameters and the dependence on the sonographer experience.In recent years,together with the improvement in transducer technology,quantitative and objective sonographic markers highly predictive of fetal malformations have been developed.These markers can be detected at early gestation(11-14 wk)and generally are not pathological in themselves but have an increased incidence in abnormal fetuses.Thus,prenatal ultrasonography during the second trimester of gestation provides a"genetic sonogram",including,for instance,nuchal translucency,short humeral length,echogenic bowel,echogenic intracardiac focus and choroid plexus cyst,that is used to identify morphological features of fetal Down’s syndrome with a potential sensitivity of more than 90%.Other specific and sensitive markers can be seen in the case of cardiac defects and skeletal anomalies.In the future,sonographic markers could limit even more the use of invasive and dangerous techniques of prenatal diagnosis(amniocentesis,etc.).

  10. Proteomics for the early diagnosis and treatment of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Autor OJS

    2007-02-01

    Full Text Available

    The incidence of primary cancer has been increasing globally and now-a-days it constitutes the 5th most frequent cancer of humans representing around 5% of all cancers worldwide. Chronic HBV infection assumes greater significance because of its reported association with cirrhosis, and more ominously hepatocellular carcinoma or HCC. Hepatitis B infection constitutes a major global problem with nearly 400 million infected individuals. It contributes to a significant degree of morbidity on account of the associated chronicity that develops in 5-10% of infected adults and more than 90% of infected neonates. Globally, around one million people suffering from HBVrelated chronic heptatitis and HCC die per year. Despite the availability of an effective prophylactic vaccine against hepatitis B for over 20 years, effective treatment of the chronic disease and associated HCC remains elusive. Therefore, identification of the cellular mediators and effectors of HCC is an important medical objective for developing new diagnostic tools and therapeutic strategies against it. Molecular biomarkers hold great promise for refining our ability to establish early diagnosis and prognosis for HCC, and to predict response to therapy. Proteomics is a rapidly expanding discipline that is expected to change the way in which disease can be diagnosed, treated and monitored in the near future. The proteomic analysis of serum and tumors should allow accurate prediction of what is happening at the protein level in a cancer cell or a body fluid proteome. It is the hope that, by deciphering the alterations in serum and liver proteome, biomarkers and patterns of biomarkers will be found that should be helpful in improving early detection, diagnosis and treatment monitoring of HCC. In the last few years, HCC has been extensively investigated using different proteomic approaches on HCC cell lines

  11. Early diagnosis of acute myocardial infarction using high-sensitivity troponin I

    Science.gov (United States)

    Ojeda, Francisco; Renné, Thomas; Schnabel, Renate B.; Zeller, Tanja; Karakas, Mahir; Blankenberg, Stefan; Westermann, Dirk

    2017-01-01

    Objective There is a clinical need for early and accurate diagnosis of acute myocardial infarction (AMI). Current European Society of Cardiology (ESC) guidelines recommend diagnosis of non-ST-elevation AMI based on serial troponin measurements. We aimed to challenge the ESC guidelines using 1) a high-sensitivity troponin I (hs-TnI) baseline cutoff, 2) an absolute hs-TnI change after 1 hour and 3) additional application of an ischemic ECG. Methods 1,516 patients with suspected AMI presenting to the emergency department were included. Hs-TnI was measured directly at admission, after 1 and 3 hours. We investigated baseline concentrations, absolute changes of hs-TnI and additional application of an ischemic ECG to diagnose AMI. A positive predictive value (PPV) of more than 85% was targeted. Results The median age of the study population was 65 years; 291 patients were diagnosed with AMI. The PPV of the 3-hours ESC algorithm was 85.5% (CI 79.7, 90.1) and 65.8% (CI 60.5,70.8) for the 1-hour algorithm. Using a high baseline hs-TnI concentration of 150 ng/L resulted in a PPV of 87.8% (CI 80.9,92.9). Alternatively, a hs-TnI change of 20 ng/L after 1 hour, resulted in a PPV of 86.5% (80.9,91.0), respectively for the diagnosis of AMI. Additional use of an ischemic ECG increased the PPV to 90.5% (CI 83.2,95.3), while reducing the efficacy. Conclusion The diagnosis of AMI based on hs-TnI is challenging. The application of absolute hs-TnI changes after 1 hour may facilitate rapid rule-in of patients. Trial registration www.clinicaltrials.gov (NCT02355457). PMID:28333976

  12. Barriers and facilitators to partnership working between Early Intervention Services and the voluntary and community sector.

    Science.gov (United States)

    Lester, Helen; Birchwood, Max; Tait, Lynda; Shah, Sonal; England, Elizabeth; Smith, Jo

    2008-09-01

    Partnership working between health and the voluntary and community sector has become an increasing political priority. This paper describes and explores the extent and patterns of partnership working between health and the voluntary and community sector in the context of Early Intervention Services for young people with a first episode of psychosis. Data were collected from 12 Early Intervention Services and through semistructured interviews with 47 voluntary and community sector leads and 42 commissioners across the West Midlands of England. Most partnerships were described as ad hoc and informal in nature although four formal partnerships between Early Intervention Services and voluntary and community sector organizations had been established. Shared agendas, the ability to refer clients onto an organization that could provide a service they could not and shared training facilitated partnership working in this context. Barriers to closer working included differences in culture such as managing risk, the time required to make and maintain relationships and recognition of the advantages of remaining a small and autonomous organization. The four more formal partnerships were also built on the organizations' experience of working together informally, in one case through a specific pilot project. The voluntary and community organizations involved were also branches of larger national organizations for whom finding sustainable funding was less of an issue. In theoretical terms, eight Early Intervention Service: voluntary and community sector partnerships were at a stage of 'pre-partnership collaboration', three at 'partnership creation and consolidation' and one at 'partnership programme delivery'. The empirical data viewed through the lens of the partnership life-cycle model could help early intervention services, and voluntary and community sector professionals better understand where they are, why they are there and the conditions needed to realise the full

  13. Risk factors and early diagnosis of cerebral venous sinus occlusion secondary to traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Jun Li

    2015-01-01

    Conclusions: Paying close attention to the past medical history of DVT, skull fracture, and the imaging finding of an epidural hematoma that crosses the sinus are necessary for the early diagnosis of CVSO. CTV and MRV help in making an early diagnosis of CVSO.

  14. EARLY COMPLICATIONS IN BARIATRIC SURGERY: incidence, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Marco Aurelio SANTO

    2013-03-01

    Full Text Available Context Bariatric surgery has proven to be the most effective method of treating severe obesity. Nevertheless, the acceptance of bariatric surgery is still questioned. The surgical complications observed in the early postoperative period following surgeries performed to treat severe obesity are similar to those associated with other major surgeries of the gastrointestinal tract. However, given the more frequent occurrence of medical comorbidities, these patients require special attention in the early postoperative follow-up. Early diagnosis and appropriate treatment of these complications are directly associated with a greater probability of control. Method The medical records of 538 morbidly obese patients who underwent surgical treatment (Roux-en-Y gastric bypass surgery were reviewed. Ninety-three (17.2% patients were male and 445 (82.8% were female. The ages of the patients ranged from 18 to 70 years (average = 46, and their body mass indices ranged from 34.6 to 77 kg/m2. Results Early complications occurred in 9.6% and were distributed as follows: 2.6% presented bleeding, intestinal obstruction occurred in 1.1%, peritoneal infections occurred in 3.2%, and 2.2% developed abdominal wall infections that required hospitalization. Three (0.5% patients experienced pulmonary thromboembolism. The mortality rate was 0,55%. Conclusion The incidence of early complications was low. The diagnosis of these complications was mostly clinical, based on the presence of signs and symptoms. The value of the clinical signs and early treatment, specially in cases of sepsis, were essential to the favorable surgical outcome. The mortality was mainly related to thromboembolism and advanced age, over 65 years. Contexto A cirurgia bariátrica tem mostrado ser o método mais eficaz de tratamento da obesidade grave. No entanto, sua aceitação como terapia padrão-ouro ainda é questionada. As complicações cirúrgicas observadas no início do período p

  15. The TIM Barrel Architecture Facilitated the Early Evolution of Protein-Mediated Metabolism.

    Science.gov (United States)

    Goldman, Aaron David; Beatty, Joshua T; Landweber, Laura F

    2016-01-01

    The triosephosphate isomerase (TIM) barrel protein fold is a structurally repetitive architecture that is present in approximately 10% of all enzymes. It is generally assumed that this ubiquity in modern proteomes reflects an essential historical role in early protein-mediated metabolism. Here, we provide quantitative and comparative analyses to support several hypotheses about the early importance of the TIM barrel architecture. An information theoretical analysis of protein structures supports the hypothesis that the TIM barrel architecture could arise more easily by duplication and recombination compared to other mixed α/β structures. We show that TIM barrel enzymes corresponding to the most taxonomically broad superfamilies also have the broadest range of functions, often aided by metal and nucleotide-derived cofactors that are thought to reflect an earlier stage of metabolic evolution. By comparison to other putatively ancient protein architectures, we find that the functional diversity of TIM barrel proteins cannot be explained simply by their antiquity. Instead, the breadth of TIM barrel functions can be explained, in part, by the incorporation of a broad range of cofactors, a trend that does not appear to be shared by proteins in general. These results support the hypothesis that the simple and functionally general TIM barrel architecture may have arisen early in the evolution of protein biosynthesis and provided an ideal scaffold to facilitate the metabolic transition from ribozymes, peptides, and geochemical catalysts to modern protein enzymes.

  16. Red Ginseng Extract Facilitates the Early Differentiation of Human Embryonic Stem Cells into Mesendoderm Lineage

    Directory of Open Access Journals (Sweden)

    Yoon Young Kim

    2011-01-01

    Full Text Available Human embryonic stem cells (hESCs have capacities to self-renew and differentiate into all cell types in vitro. Red ginseng (RG is known to have a wide range of pharmacological effects in vivo; however, the reports on its effects on hESCs are few. In this paper, we tried to demonstrate the effects of RG on the proliferation and differentiation of hESCs. Undifferentiated hESCs, embryoid bodies (EBs, and hESC-derived cardiac progenitors (CPs were treated with RG extract at 0.125, 0.25, and 0.5 mg/mL. After treatment of undifferentiated hESCs from day 2 to day 6 of culture, BrdU labeling showed that RG treatment increased the proliferation of hESCs, and the expression of Oct4 and Nanog was increased in RG-treated group. To find out the effects of RG on early differentiation stage cells, EBs were treated with RG extract for 10 days and attached for further differentiation. Immunostaining for three germ layer markers showed that RG treatment increased the expressions of Brachyury and HNF3β on EBs. Also, RG treatment increased the expression of Brachyury in early-stage and of Nkx2.5 in late-stage hESC-derived CPs. These results demonstrate facilitating effects of RG extract on the proliferation and early differentiation of hESC.

  17. Importance of early diagnosis of pancreaticobiliary maljunction without biliary dilatation

    Institute of Scientific and Technical Information of China (English)

    Kensuke Takuma; Terumi Kamisawa; Taku Tabata; Seiichi Hara; Sawako Kuruma; Yoshihiko Inaba; Masanao Kurata

    2012-01-01

    AIM:To clarify the strategy for early diagnosis of pancreaticobiliary maljunction (PBM) without biliary dilatation and to pathologically examine gallbladder before cancer develops.METHODS:The anatomy of the union of the pancreatic and bile ducts was assessed by using endoscopic retrograde cholangiopancreatography (ERCP).Patients with a long common channel in which communication between the pancreatic and bile ducts was maintained even during sphincter contraction were diagnosed as having PBM.Of these,patients in which the maximal diameter of the bile duct was less than 10 mm were diagnosed with PBM without biliary dilatation.The process of diagnosing 54 patients with PBM without biliary dilatation was retrospectively investigated.Histopathological analysis of resected gallbladder specimens from 8 patients with PBM without biliary dilatation or cancer was conducted.RESULTS:Thirty-six PBM patients without biliary dilatation were diagnosed with gallbladder cancer after showing clinical symptoms such as abdominal or back pain (n =16) or jaundice (n =12).Radical surgery for gallbladder cancer was only possible in 11 patients (31%)and only 4 patients (11%) survived for 5 years.Eight patients were suspected as having PBM without biliary dilatation from the finding of gallbladder wall thickening on ultrasound and the diagnosis was confirmed by ERCP and/or magnetic resonance cholangiopancreatography (MRCP).The median age of these 8 patients was younger by a decade than PBM patients with gallbladder cancer.All 8 patients underwent prophylactic cholecystectomy and bile duct cancer has not occurred.Wall thickness and mucosal height of the 8 resected gallbladders were significantly greater than controls,and hyperplastic changes,hypertrophic muscular layer,subserosal fibrosis,and adenomyomatosis were detected in 7 (88%),5 (63%),7 (88%) and 5 (63%) patients,respectively.Ki-67 labeling index was high and K-ras mutation was detected in 3 of 6 patients

  18. Cytologic and DNA-Cytometric Early Diagnosis of Oral Cancer

    Directory of Open Access Journals (Sweden)

    Torsten W. Remmerbach

    2001-01-01

    Full Text Available Objective. The aim of this prospective study was to report on the diagnostic accuracy of conventional oral exfoliative cytology taken from white‐spotted, ulcerated or other suspicious oral lesions in our clinic. In addition we checked DNA‐image cytometry as an adjuvant diagnostic tool. Our hypothesis is that DNA‐aneuploidy is a sensitive and specific marker for the early identification of tumor cells in oral brushings. Study design. 251 cytological diagnoses obtained from exfoliative smears of 181 patients from macroscopically suspicious lesions of the oral mucosa and from clinically seemingly benign oral lesions which were exisiced for establishing histological diagnoses were compared with histological and/or clinical follow‐ups of the respective patients. Additionally nuclear DNA‐contents were measured after Feulgen restaining using a TV image analysis system. Results. Sensitivity of our cytological diagnosis on oral smears for the detection of cancer cells was 94.6%, specificity 99.5%, positive predictive value 98.1% and negative predictive value 98.5%. DNA‐aneuploidy was assumed if abnormal DNA‐stemlines or cells with DNA‐content greater 9c were observed. On this basis the prevalence of DNA‐aneuploidy in smears of oral squamous cell carcinomas in situ or invasive carcinomas was 96.4%. Sensitivity of DNA‐aneuploidy in oral smears for the detection of cancer cells was 96.4%, specificity 100%, positive predictive value 100% and negative 99.0%. The combination of both techniques increased the sensivity to 98.2%, specificity to 100%, positive predictive value to 100% and negative to 99.5%. Conclusions. Brush cytology of all visible oral lesions, if they are clinically considered as suspicious for cancer, are an easily practicable, cheap, non‐invasive, painless, safe and accurate screening method for detection of oral precancerous lesions, carcinoma in situ or invasive squamous cell carcinoma in all stages. We conclude that

  19. Volatile signature for the early diagnosis of lung cancer.

    Science.gov (United States)

    Gasparri, Roberto; Santonico, Marco; Valentini, Claudia; Sedda, Giulia; Borri, Alessandro; Petrella, Francesco; Maisonneuve, Patrick; Pennazza, Giorgio; D'Amico, Arnaldo; Di Natale, Corrado; Paolesse, Roberto; Spaggiari, Lorenzo

    2016-02-09

    Exhaled breath contains hundreds of volatile organic compounds (VOCs). Several independent researchers point out that the breath of lung cancer patients shows a characteristic VOC-profile which can be considered as lung cancer signature and, thus, used for diagnosis. In this regard, the analysis of exhaled breath with gas sensor arrays is a potential non-invasive, relatively low-cost and easy technique for the early detection of lung cancer. This clinical study evaluated the gas sensor array response for the identification of the exhaled breath of lung cancer patients. This study involved 146 individuals: 70 with lung cancer confirmed by computerized tomography (CT) or positron emission tomography-(PET) imaging techniques and histology (biopsy) or with clinical suspect of lung cancer and 76 healthy controls. Their exhaled breath was measured with a gas sensor array composed of a matrix of eight quartz microbalances (QMBs), each functionalized with a different metalloporphyrin. The instrument produces, for each analyzed sample, a vector of signals encoding the breath (breathprint). Breathprints were analyzed with multivariate analysis in order to correlate the sensor signals to the disease. Breathprints of the lung cancer patients were differentiated from those of the healthy controls with a sensitivity of 81% and specificity of 91%. Similar values were obtained in patients with and without metabolic comorbidities, such as diabetes, obesity and dyslipidemia (sensitivity 85%, specificity 88% and sensitivity 76%, specificity 94%, respectively). The device showed a large sensitivity to lung cancer at stage I with respect to stage II/III/IV (92% and 58% respectively). The sensitivity for stage I did not change for patients with or without metabolic comorbidities (90%, 94%, respectively). Results show that this electronic nose can discriminate the exhaled breath of the lung cancer patients from those of the healthy controls. Moreover, the largest sensitivity is observed

  20. An automatic scanning method for high throughput microscopic system to facilitate medical genetic diagnosis: an initial study

    Science.gov (United States)

    Qiu, Yuchen; Chen, Xiaodong; Li, Zheng; Li, Yuhua; Chen, Wei R.; Zheng, Bin; Li, Shibo; Liu, Hong

    2012-03-01

    The purpose of this paper is to report a new automatic scanning scheme for high throughput microscopic systems aiming to facilitate disease diagnosis in genetic laboratories. To minimize the impact of the random vibration and mechanical drifting of the scanning stage in microscopic image acquisition, auto-focusing operations are usually applied repeatedly during the scanning process. Such methods ensure the acquisition of well focused images for clinical diagnosis, but are time consuming. The technique investigated in this preliminary study applies the auto-focusing operations at a limited number of locations on the slide. For the rest of the imaging field, the focusing position is quickly adjusted through linear interpolation. In this initial validation study, blood pathological slides containing both metaphase and interphase cells are scanned. For a selected area of 6.9mm×6.9mm, a number of 2×2, 3×2, 3×3, and 4×4 positions are evenly sampled for auto-focusing operations. Respectively, 25, 29, 40, and 41 clinically meaningful cells are identified for each sampling scheme. For the specific case investigated, the results demonstrate that the 4 position auto-focusing scheme could obtain the adequate number of clinically meaningful cells for the diagnosis. The schemes with more auto-focusing operations provide an option for high reliability diagnosis when clinically necessary. More comprehensive research is planned, and that may lead to optimal design of trade-off for developing the scanning scheme of the high throughput microscopic systems.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Melanoma-specific marker expression in skin biopsy tissues as a tool to facilitate melanoma diagnosis.

    Science.gov (United States)

    Alexandrescu, Doru T; Kauffman, C Lisa; Jatkoe, Timothy A; Hartmann, Dan P; Vener, Tatiana; Wang, Haiying; Derecho, Carlo; Rajpurohit, Yashoda; Wang, Yixin; Palma, John F

    2010-07-01

    Diagnosis of cutaneous melanoma requires accurate differentiation of true malignant tumors from highly atypical lesions, which lack the capacity to develop uncontrolled proliferation and to metastasize. We used melanoma markers from previous work to differentiate benign and atypical lesions from melanoma using paraffin-embedded tissue. This critical step in diagnosis generates the most uncertainty and discrepancy between dermatopathologists. A total of 193 biopsy tissues were selected: 47 melanomas, 48 benign nevi, and 98 atypical/suspicious, including 48 atypical nevi and 50 melanomas as later assigned by expert dermatopathologists. Performance for SILV, GDF15, and L1CAM normalized to TYR in unequivocal melanoma versus benign nevi resulted in an area under the curve (AUC) of 0.94, 0.67, and 0.5, respectively. SILV also differentiated atypical cases classified as melanoma from atypical nevi with an AUC=0.74. Furthermore, SILV showed a significant difference between suspicious melanoma and each suspicious atypia group: melanoma versus severe atypia and melanoma versus moderate atypia had P-values of 0.0077 and 0.0009, respectively. SILV showed clear discrimination between melanoma and benign unequivocal cases as well as between different atypia subgroups in the group of suspicious samples. The role and potential utility of this molecular assay as an adjunct to the morphological diagnosis of melanoma are discussed.

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

    Directory of Open Access Journals (Sweden)

    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

  4. 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...... 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...... Registry (NCPR), we identified 1291 children with CP (764 males, 527 females) born between 1995 and 2003. The date of diagnosis was defined as the day the parents were told that their child was spastic or had CP. We calculated the age of diagnosis and analysed the following predictors: type of CP, degree...

  5. Barriers and facilitators to effective communication experienced by patients with malignant lymphoma at all stages after diagnosis.

    Science.gov (United States)

    van Bruinessen, Inge Renske; van Weel-Baumgarten, Evelyn M; Gouw, Hans; Zijlstra, Josée M; Albada, Akke; van Dulmen, Sandra

    2013-12-01

    This study aims to gain insight into patient-perceived communication barriers and facilitators at different stages after the diagnosis of malignant lymphoma. We have detected patterns to explain when these factors influence communication predominantly. A qualitative approach was applied, derived from the context mapping framework. A total of 28 patients completed a set of assignments about their experiences with provider-patient communication during medical consultations. Subsequently, these patients and nine companions shared their experiences during a semistructured (group) interview, which was recorded on audiotape. The audiotapes and assignments were analysed with MAXQDA software. From the patients' viewpoint, communicating effectively appears to depend on their own attributes (e.g. emotions), the health care professionals' attributes (e.g. attitude) and external factors (e.g. time pressure). Three patient communication states were identified: (i) overwhelmed, passive; (ii) pro-active, self-motivated; and (iii) proficient, empowered. Patients seem to behave differently in the three communication states. This study lists patient-perceived communication barriers and facilitators and identifies three different communication states, which indicate when certain barriers and facilitators are encountered. These findings may support health care professionals to tailor the provision of support and information and remove communication barriers accordingly. Additionally, they provide input for interventions to support patients in effective communication. Copyright © 2013 John Wiley & Sons, Ltd.

  6. Changes in sensitivity to ethanol-induced social facilitation and social inhibition from early to late adolescence.

    Science.gov (United States)

    Varlinskaya, Elena I; Spear, Linda P

    2004-06-01

    Adolescent rats are more sensitive than adults to ethanol-induced social facilitation, but are less sensitive to the suppression of social interactions seen at higher ethanol doses. Given recent findings that point to age differences in ethanol responsiveness, even within the adolescent period, the present study assessed acute effects of low to moderate doses of ethanol on social behavior of early, mid- or late adolescent rats. Age-related changes in responsiveness to the effects of ethanol on social behavior were apparent even within the adolescent period, with early adolescents being more sensitive to ethanol-induced social facilitation and less sensitive to ethanol-induced social inhibition than mid- and late adolescents. Given that ethanol-induced social facilitation as well as a lower sensitivity to the adverse effects of ethanol may contribute to heavy drinking, this pattern of early adolescent responsiveness to ethanol's social consequences may put them at higher risk for extensive alcohol use.

  7. Application of a real time Polymerase Chain Reaction (PCR) assay for the early diagnosis of human leptospirosis in Sri Lanka.

    Science.gov (United States)

    Denipitiya, D T H; Chandrasekharan, N V; Abeyewickreme, W; Hartskeerl, C M; Hartskeerl, R A; Jiffrey, A M; Hapugoda, M D

    2016-11-01

    Leptospirosis has a major impact on health in Sri Lanka but is probably grossly under-recognized due to difficulties in clinical diagnosis and lack of diagnostic laboratory services. The objective of this study was to establish and evaluate a SYBR Green-based real-time Polymerase Chain Reaction (rt-PCR) assay for early, rapid and definitive laboratory diagnosis of leptospirosis in Sri Lanka. The rt-PCR assay was established and analytical specificity and sensitivity were determined using reference DNA samples. Evaluation of the assay for diagnosis of clinical samples was performed using two panels of serum samples obtained from 111 clinically suspected adult patients. Patients were confirmed as leptospirosis (n = 65) and non-leptospirosis (n = 30) by the Patoc - MAT. Other 16 samples gave ambiguous results. The analytical sensitivity of the rt-PCR was approximately 60 genome copies and no cross-reactivity was observed with saprophytic Leptospira spp. and other pathogenic microorganisms. Based on confirmation with Patoc-MAT on paired samples this corresponds to a diagnostic sensitivity and specificity of 67.7% (44/65) and 90.0% (27/30), respectively. This study showed that rt-PCR has the potential to facilitate rapid and definitive diagnosis of leptospirosis during early phase of infection in Sri Lanka. Copyright © 2016 International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

  8. Early auditory change detection implicitly facilitated by ignored concurrent visual change during a Braille reading task.

    Science.gov (United States)

    Aoyama, Atsushi; Haruyama, Tomohiro; Kuriki, Shinya

    2013-09-01

    Unconscious monitoring of multimodal stimulus changes enables humans to effectively sense the external environment. Such automatic change detection is thought to be reflected in auditory and visual mismatch negativity (MMN) and mismatch negativity fields (MMFs). These are event-related potentials and magnetic fields, respectively, evoked by deviant stimuli within a sequence of standard stimuli, and both are typically studied during irrelevant visual tasks that cause the stimuli to be ignored. Due to the sensitivity of MMN/MMF to potential effects of explicit attention to vision, however, it is unclear whether multisensory co-occurring changes can purely facilitate early sensory change detection reciprocally across modalities. We adopted a tactile task involving the reading of Braille patterns as a neutral ignore condition, while measuring magnetoencephalographic responses to concurrent audiovisual stimuli that were infrequently deviated either in auditory, visual, or audiovisual dimensions; 1000-Hz standard tones were switched to 1050-Hz deviant tones and/or two-by-two standard check patterns displayed on both sides of visual fields were switched to deviant reversed patterns. The check patterns were set to be faint enough so that the reversals could be easily ignored even during Braille reading. While visual MMFs were virtually undetectable even for visual and audiovisual deviants, significant auditory MMFs were observed for auditory and audiovisual deviants, originating from bilateral supratemporal auditory areas. Notably, auditory MMFs were significantly enhanced for audiovisual deviants from about 100 ms post-stimulus, as compared with the summation responses for auditory and visual deviants or for each of the unisensory deviants recorded in separate sessions. Evidenced by high tactile task performance with unawareness of visual changes, we conclude that Braille reading can successfully suppress explicit attention and that simultaneous multisensory changes can

  9. Distraction by emotion in early adolescence: affective facilitation and interference during the attentional blink

    Directory of Open Access Journals (Sweden)

    Sabine eHeim

    2013-09-01

    Full Text Available This study examined the extent to which early adolescents (aged 10 to 13 years differ from adults in their sensitivity to attention capture by affective stimuli during rapid processing. A rapid serial visual presentation paradigm (RSVP was implemented as a dual task, requiring the report of two green target stimuli embedded in a stream of distractors. Known as the attentional blink (AB, task performance is typically impaired when the first and second targets (T1 and T2, respectively are separated by at least one distractor and about 200 ms of time. Here we used written verbs of pleasant, neutral, and unpleasant content as T1 items, while affectively neutral exemplars served as T2 and distractor events. The temporal distance between T1 and T2 was manipulated to contain either one distractor (intertarget interval 232 ms or five distractors (intertarget interval 696 ms. Students reported pleasant T1 words more accurately, compared to neutral and unpleasant words, indicating facilitation of appetitive content on performance during RSVP. Emotional relevance of T1 was at the expense of T2 accuracy: At an intertarget interval of 232 ms (i.e., during the AB period, identification of (neutral T2 words was impaired when preceded by pleasant and unpleasant T1s. No interference across targets was observed, however, beyond the blink period, in which T1 and T2 were separated by 696 ms. Thus, emotionally relevant events capture and hold attentional resources, at the cost of attentive processing in subsequent episodes. Contrary to our findings in adults, these capture effects were most obvious when the available capacity was limited, i.e., during the critical interval of the AB. The findings are discussed in light of the use of alternative cognitive strategies as development proceeds beyond early adolescence into adulthood.

  10. Ultrasound imaging of embedded shrapnel facilitates diagnosis and management of myofascial pain syndrome.

    Science.gov (United States)

    Shankar, Hariharan; Cummings, Craig

    2013-06-01

    Trigger points can result from a variety of inciting events including muscle overuse, trauma, mechanical overload, and psychological stress. When the myofascial trigger points occur in cervical musculature, they have been known to cause headaches. Ultrasound imaging is being increasingly used for the diagnosis and interventional management of various painful conditions. A veteran was referred to the pain clinic for management of his severe headache following a gunshot wound to the neck with shrapnel embedded in the neck muscles a few years prior to presentation. He had no other comorbid conditions. Physical examination revealed a taut band in the neck. An ultrasound imaging of the neck over the taut band revealed the deformed shrapnel located within the levator scapulae muscle along with an associated trigger point in the same muscle. Ultrasound guided trigger point injection, followed by physical therapy resolved his symptoms. This is a unique report of embedded shrapnel and coexisting myofascial pain syndrome revealed by ultrasound imaging. The association between shrapnel and myofascial pain syndrome requires further investigation.

  11. The Importance of an Early Diagnosis in Systemic Lupus Erythematosus.

    Science.gov (United States)

    Sebastiani, Gian D; Prevete, Immacolata; Iuliano, Annamaria; Minisola, Giovanni

    2016-01-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease with a high degree of variability at onset, making it difficult to reach a correct and prompt diagnosis. To present the difficulties faced by the clinician in making a SLE diagnosis, based on the characteristics at study entry of an Italian cohort of SLE patients with recent onset as compared to two similar cohorts. Beginning on 1 January 2012 all patients with a diagnosis of SLE (1997 ACR criteria) and disease duration of less than 12 months were consecutively enrolled in a multicenter prospective study. Information on clinical and serological characteristics was collected at study entry and every 6 months thereafter. Our cohort consisted of 122 patients, of whom 103 were females. Among the manifestations included in the 1997 American College of Rheumatology (ACR) criteria, cutaneous, articular and hematologic symptoms were the most prevalent symptoms at study entry. Data from the literature confirm that the diagnosis of SLE is challenging, and that SLE is a severe disease even at onset when a prompt diagnosis is necessary for initiating the appropriate therapy.

  12. Diagnosis and minimally invasive treatment of early stage breast carcinoma

    NARCIS (Netherlands)

    van Esser, S.

    1979-01-01

    In this thesis the diagnostic work up and minimally invasive surgical treatment of early stage breast carcinoma is studied. Although the surgical treatment of breast carcinoma has improved significantly over the past decades, there is still room for improvement. On the one hand the focus is on early

  13. Reduced plantar sole sensitivity facilitates early adaptation to a visual rotation pointing task when standing upright

    Directory of Open Access Journals (Sweden)

    Maxime Billot

    2016-09-01

    Full Text Available Humans are capable of pointing to a target with accuracy. However, when vision is distorted through a visual rotation or mirror-reversed vision, the performance is initially degraded and thereafter improves with practice. There are suggestions this gradual improvement results from a sensorimotor recalibration involving initial gating of the somatosensory information from the pointing hand. In the present experiment, we examined if this process interfered with balance control by asking participants to point to targets with a visual rotation from a standing posture. This duality in processing sensory information (i.e., gating sensory signals from the hand while processing those arising from the control of balance could generate initial interference leading to a degraded pointing performance. We hypothesized that if this is the case, the attenuation of plantar sole somatosensory information through cooling could reduce the sensorimotor interference, and facilitate the early adaptation (i.e. improvement in the pointing task. Results supported this hypothesis. These observations suggest that processing sensory information for balance control interferes with the sensorimotor recalibration process imposed by a pointing task when vision is rotated.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Amir H Mehrparvar; Seyyed J Mirmohammadi; Abbas Ghoreyshi; Abolfazl Mollasadeghi; Ziba Loukzadeh

    2011-01-01

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    Marco de Lucas, E.; Mandly, Gonzalez A.; Gutierrez, A.; Sanchez, E.; Arnaiz, J.; Piedra, T.; Rodriguez, E.; Diez, C. [Hospital Univ. Marques de Valdecilla, Santander (Spain). Depts. of Radiology and Neurology

    2006-10-15

    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.

  17. Integrated proteo-genomic approach for early diagnosis and prognosis of cancer.

    Science.gov (United States)

    Shukla, Hem D; Mahmood, Javed; Vujaskovic, Zeljko

    2015-12-01

    Cancer is the leading cause of mortality among men and women worldwide. Despite the availability of numerous diagnostic techniques for various cancers, the overall survival rate remains low and the majority of patients die due to late diagnosis and advanced stage of the disease. Diagnosing and treating cancer at its early stages ideally during the precancerous phase could significantly increase survival rate with the possibility of cure and prolong survival. Cancer is a genetic disease and it is illicitly activated by the acquisition of somatic DNA lesions and aberrations in genome structure and defects in maintenance and repair. These somatic DNA mutations known as driver mutations seem to be the prime cause in initiating tumorigenesis. The advances in genomic technologies have immensely facilitated the understanding of cancer progression and metastasis, and the discovery of novel biomarkers. However, changes in somatic mutational landscape of the oncogenome are translated into aberrantly regulated oncoproteome which drives the cancer initiation. Thus, combination of proteomic and genomic technologies is urgently required to discover biomarkers for early diagnosis. The recent advances in human genome based detection of cancer using advanced genomic technologies like NextGen Sequencing, digital PCR, cfDNA technology have shown promise; for example oncogenic somatic mutation variants, transcriptomic analysis, copy number variant, and methylation data from the Cancer Genome Atlas. Similarly, oncoproteomics has the potential to revolutionize clinical management of the disease, including cancer diagnosis and screening based on new proteomic database which embodies somatic variants and post translational modifications, thus devising proteomic technologies as a complement to histopathology. Further, the use of multiple proteomic and genomic biomarkers rather than a single gene or protein could greatly improve diagnostic accuracy and enhance the predictive power for

  18. Turnaround time for early infant HIV diagnosis in rural Zambia: A chart review

    NARCIS (Netherlands)

    C.G. Sutcliffe (Catherine); J.H. van Dijk (Janneke); F. Hamangaba (Francis); F. Mayani (Felix); W.J. Moss (William)

    2014-01-01

    textabstractBackground: Early infant HIV diagnosis is challenging in sub-Saharan Africa, particularly in rural areas where laboratory capacity is limited. Specimens must be transported to central laboratories for testing, leading to delays in diagnosis and initiation of antiretroviral therapy. This

  19. A Proposed Framework for the Implementation of Early Infant Diagnosis Point-of-Care

    Science.gov (United States)

    Modi, Surbhi; Hurlston, Mackenzie; Beard, R. Suzanne; Nkengasong, John N.

    2017-01-01

    Abstract Early diagnosis of HIV infection in infants and children remains a challenge in resource-limited settings, with approximately half of all HIV-exposed infants receiving virological testing for HIV by the recommended age of 2 months in 2015. To reduce morbidity and mortality among HIV-infected children and close the treatment gap for HIV-infected children, there is an urgent need to evaluate existing programmatic and laboratory practices for early infant diagnosis and introduce strategies to improve identification of HIV-exposed infants and ensure access to systematic, early HIV testing, with early linkage to treatment for HIV-infected infants. This article describes progress made in follow-up of HIV-exposed infants since 2006, including remaining unmet laboratory and programmatic needs, and recommends strategies for improvement, especially those related to the implementation of point-of-care technology for early infant diagnosis. PMID:27758117

  20. Getting Early Childhood Educators Up and Running: Creating Strong Technology Curators, Facilitators, Guides, and Users. Policy Brief

    Science.gov (United States)

    Daugherty, Lindsay; Dossani, Rafiq; Johnson, Erin-Elizabeth; Wright, Cameron

    2014-01-01

    Providers of early childhood education (ECE) are well positioned to help ensure that technology is used effectively in ECE settings. Indeed, the successful integration of technology into ECE depends on providers who have the ability to curate the most appropriate devices and content, "facilitate" effective patterns of use, guide families…

  1. Getting Early Childhood Educators Up and Running: Creating Strong Technology Curators, Facilitators, Guides, and Users. Policy Brief

    Science.gov (United States)

    Daugherty, Lindsay; Dossani, Rafiq; Johnson, Erin-Elizabeth; Wright, Cameron

    2014-01-01

    Providers of early childhood education (ECE) are well positioned to help ensure that technology is used effectively in ECE settings. Indeed, the successful integration of technology into ECE depends on providers who have the ability to curate the most appropriate devices and content, "facilitate" effective patterns of use, guide families…

  2. Plasma-Enabled Carbon Nanostructures for Early Diagnosis of Neurodegenerative Diseases

    Directory of Open Access Journals (Sweden)

    Shafique Pineda

    2014-06-01

    Full Text Available Carbon nanostructures (CNs are amongst the most promising biorecognition nanomaterials due to their unprecedented optical, electrical and structural properties. As such, CNs may be harnessed to tackle the detrimental public health and socio-economic adversities associated with neurodegenerative diseases (NDs. In particular, CNs may be tailored for a specific determination of biomarkers indicative of NDs. However, the realization of such a biosensor represents a significant technological challenge in the uniform fabrication of CNs with outstanding qualities in order to facilitate a highly-sensitive detection of biomarkers suspended in complex biological environments. Notably, the versatility of plasma-based techniques for the synthesis and surface modification of CNs may be embraced to optimize the biorecognition performance and capabilities. This review surveys the recent advances in CN-based biosensors, and highlights the benefits of plasma-processing techniques to enable, enhance, and tailor the performance and optimize the fabrication of CNs, towards the construction of biosensors with unparalleled performance for the early diagnosis of NDs, via a plethora of energy-efficient, environmentally-benign, and inexpensive approaches.

  3. Salivaomics - A promising future in early diagnosis of dental diseases

    OpenAIRE

    Suneetha Koneru; Rambabu Tanikonda

    2014-01-01

    Human saliva plays an important role in the health of the oral cavity and of the body as a whole. Salivary diagnostics is a dynamic and emerging field in the diagnosis of oral and systemic diseases. Saliva reflects the physiologic state of the body, including emotional, endocrinal, nutritional, and metabolic variations. The collection of saliva samples is noninvasive, safe, and inexpensive. Traditional clinical criteria are insufficient for determining sites of active disease, for monitoring ...

  4. [Lugol's solution in endoscopic diagnosis of early esophageal cancer].

    Science.gov (United States)

    Wang, G; Zhou, M; Cong, Q

    1995-07-01

    About 1500 high-risk subjects of esophageal cancer were found during screening by balloon cytology and all of them were examined endoscopically. Among them, 120 were considered as having early esophageal cancer and precancerous lesions. During the examination, Lugol's solution staining was used and guiding biopsy was taken. 98 subjects with unstained lesions were found, and biopsy showed early esophageal cancer in 60 (61.2%) and moderate and severe dysplasia in 38 (38.8%). It is usually extremely difficult to detect and localize the very early esophageal mucosal and submucosal carcinoma. But endoscopic examination and using Lugol's solution staining with multiple spots biopsy from unstained area are of great assistance. Minute malignant lesions may not be overlooked.

  5. 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...

  6. 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

  7. Hepatic Encephalopathy: Early Diagnosis in Pediatric Patients With Cirrhosis

    Directory of Open Access Journals (Sweden)

    Naghi DARA*

    2014-01-01

    Full Text Available 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 complication typically occurs in patients with severe comorbidities and needs multidisciplinary evaluation and care. Hepatic encephalopathy should be considered in any patient with acute liver failure and cirrhosis who presents with neuropsychiatric manifestations, decrease level of consciousness (coma, change of personality, intellectualand behavioral deterioration, speech and motor dysfunction.Every cirrhotic patient may be at risk; potential precipitating factors should be addressed in regular clinic visits. The encephalopathy of liver disease may be prominent, or can be present in subtle forms, such as decline of school performance, emotional outbursts, or depression.“Subtle form” of hepatic encephalopathy may not be obvious on clinical examination, but can be detected by neurophysiologic and neuropsychiatric testing.References:Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei AT. Hepatic encephalopathy definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998.Hepatology 2002;35:716-21.BleiAT,Cordoba J. Hepatic encephalopathy. AmJ Gastroenterol 2001;96:1968–76.Vaquero J,Chung C, Cahill ME, BleiAT. Pathogenesis of hepatic encephalopathy in acute liver failure. Semin Liver Dis 2003;23:259-69.Bajaj JS, Wade JB, Sanyal AJ. Spectrum of neurocognitive impairment in cirrhosis: Implications for the assessment of hepatic encephalopathy

  8. [Systemic diseases--the significance of early diagnosis exemplified by systemic lupus erythematosus and Wegener's granulomatosis].

    Science.gov (United States)

    Türk, H

    1993-12-01

    New therapeutic modalities have shown remarkable advances in the fields of systemic lupus erythematosus and Wegener's granulomatosis. For an optimal clinical outcome therapy has to be started early and must be adapted to disease activity. Concerning these two points early diagnosis is essential. This aim can be reached by a detailed evaluation of the patient's history by focusing on early symptoms and on typical clinical constellations, taking into account that both diseases show a great variability and sometimes even an insidious course. Immunological tests, capillary microscopy, echocardiography and computed tomography can be very helpful in the diagnosis of these diseases.

  9. [Early diagnosis of a newborn with a mediastinal mass].

    Science.gov (United States)

    Flores-Hernández, Salomón Sergio; Ahumada Mendoza, Héctor; Santana-Montero, Blanca Lilia; González Flores, María de Lourdes

    2005-01-01

    Neuroblastoma is an embryonal tumour that evolves from the neural crest cell. This neoplasm may arise at any site in the sympathetic nervous system, including the brain, the cervical region, the posterior mediastinum, the para-aortic sympathetic ganglia, the pelvis, and the adrenal medulla. The clinical presentation in neonatal age is rare and the differential diagnosis includes congenital lung malformations, pneumoniae, atelectasia, etc. The case of a newborn with a mediastinal neuroblastoma is presented. This case illustrates how a patient with an X-ray image compatible with a thoracic tumor should be studied.

  10. Hepatobiliary scintigraphy for early diagnosis of biliary atresia

    DEFF Research Database (Denmark)

    Brittain, Jane Maestri; Kvist, Nina; Johansen, Lars Søndergaard;

    2016-01-01

    INTRODUCTION: The aim of this study was to evaluate the validity of (99m)Technetium-trimethylbromo-iminodiacetic acid hepatobiliary scintigraphy (HS) for the diagnosis of biliary atresia (BA). METHODS: From January 2005 to December 2009, a total of 47 infants with conjugated hyperbilirubinaemia...... sensitivity and NPV prevent un-necessary surgery. Because of the low specificity of HS in diagnosing BA, it should be part of a multimodality imaging strategy when the result supports a clinical suspicion of BA. In cases with non-draining HS and normal GGTP blood levels, supplemental imaging modalities...

  11. Early Diagnosis and Treatment of Traumatic Vestibulopathy and Postconcussive Dizziness.

    Science.gov (United States)

    Hoffer, Michael E; Schubert, Michael C; Balaban, Carey D

    2015-08-01

    Mild traumatic brain injury (mTBI) is a common health condition in amateur and professional sports and in military operations but can occur in everyday life. Dizziness is the most common disorder seen after mTBI followed closely by headache. This article examines the diagnosis and treatment of vestibular disorders after mTBI. Data are included from the literature, and conclusions are drawn from the literature review and the experience of the authors. Much of what is known about this disorder comes from recent military experience, but the link to more common civilian injuries is detailed in this article.

  12. 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...... were investigated for their potential as indicators for early diagnosis of CSF. Together, they constitute a promising panel for detection of CSF, however, one single parameter does not by itself hold the potential as a safe indicator of CSF in the early phase of infection. In addition, the results...

  13. Early lipoedema diagnosis and the RCGP e-learning course.

    Science.gov (United States)

    Fetzer, Amy; Fetzer, Sharie

    2015-04-01

    Frequently misdiagnosed as obesity, lipoedema is chronic condition involving an abnormal build-up of fat cells in the legs, thighs and buttocks that cannot be shifted by exercise or dieting. Estimated to affect up to 11% of the female population, the condition is widely unknown by health professionals. This means women typically wait for many years before diagnosis. This allows the condition to progress unchecked, resulting in unnecessary deterioration and the development of associated comorbidities, as well as significant pain and mental anguish. A free, 30-minute Royal College of General Practitioners (RCGP) e-learning course created in partnership with Lipoedema UK aims to rectify this situation by educating nurses, GPs and other health professionals on how to diagnose and manage lipoedema in primary care. This article aims to describe the condition of lipoedema, how to recognise/diagnose it, current treatment options and the findings of a 240-patient survey carried out by Lipoedema UK in 2013 that included documenting the difficulties for patients in obtaining a diagnosis as well as the mental and physical effects of the condition.

  14. Early diagnosis of diabetic retinopathy in primary care

    Science.gov (United States)

    Jimenez-Baez, Maria Valeria; Barcenas-Contreras, Rodolfo; Morales Montoya, Carlos; Espinosa-Garcia, Laura Fatima

    2015-01-01

    Objective: To evaluate the impact of a strategy for early detection of diabetic retinopathy in patients with type 2 diabetes mellitus (DMT2) in Quintana Roo, México. Methods: Study transversal, observational, prospective, analytical, eight primary care units from Mexican Social Security Institute in the northern delegation of the State of Quintana Roo, Mexico were included. A program for early detection of diabetic retinopathy (DR) in adult 376,169 was designed. Were diagnosed 683 cases of type 2 diabetes, in 105 patients randomized was conducted to direct ophthalmoscopy were subjected to a secondary hospital were assigned. Will determine the degree of diabetic retinopathy and macular edema was performed. Results: In population were 55.2% female, mean age 48+11.1 years, 23.8 % had some degree of DR, 28.0% with mild non- proliferative diabetic retinopathy 48.0 % moderate 16.0% and severe and 8.0% showed proliferative diabetic retinopathy. Those over age 30 are 2.8 times more risk of developing DR, OR= 2.8; 95%CI: 0.42-18.0, and OR= 1.7; 95%CI: 1.02-2.95 women. Conclusions: The implementation of programs aimed at the early detection of debilitating conditions such as diabetic retinopathy health impact beneficiaries, effective links between primary care systems and provide second level positive health outcomes for patient diseases. PMID:26019380

  15. Early diagnosis of diabetic retinopathy in primary care

    Directory of Open Access Journals (Sweden)

    María Valeria Jiménez-Báez

    2015-03-01

    Full Text Available Objective:To evaluate the impact of a strategy for early detection of diabetic retinopathy in patients with type 2 diabetes mellitus (DMT2 in Quintana Roo, México.Methods:Study transversal, observational, prospective, analytical, eight primary care units from Mexican Social Security Institute in the northern delegation of the State of Quintana Roo, Mexico were included. A program for early detection of diabetic retinopathy (DR in adult 376,169 was designed. Were diagnosed 683 cases of type 2 diabetes, in 105 patients randomized was conducted to direct ophthalmoscopy were subjected to a secondary hospital were assigned. Will determine the degree of diabetic retinopathy and macular edema was performed.Results:In population were 55.2% female, mean age 48+11.1 years, 23.8 % had some degree of DR, 28.0% with mild non- proliferative diabetic retinopathy 48.0 % moderate 16.0% and severe and 8.0% showed proliferative diabetic retinopathy. Those over age 30 are 2.8 times more risk of developing DR, OR= 2.8; 95%CI: 0.42-18.0, and OR= 1.7; 95%CI: 1.02-2.95 women.Conclusions:The implementation of programs aimed at the early detection of debilitating conditions such as diabetic retinopathy health impact beneficiaries, effective links between primary care systems and provide second level positive health outcomes for patient diseases.

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

    Directory of Open Access Journals (Sweden)

    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

  17. Early diagnosis of teeth erosion using polarized laser speckle imaging

    Science.gov (United States)

    Nader, Christelle Abou; Pellen, Fabrice; Loutfi, Hadi; Mansour, Rassoul; Jeune, Bernard Le; Brun, Guy Le; Abboud, Marie

    2016-07-01

    Dental erosion starts with a chemical attack on dental tissue causing tooth demineralization, altering the tooth structure and making it more sensitive to mechanical erosion. Medical diagnosis of dental erosion is commonly achieved through a visual inspection by the dentist during dental checkups and is therefore highly dependent on the operator's experience. The detection of this disease at preliminary stages is important since, once the damage is done, cares become more complicated. We investigate the difference in light-scattering properties between healthy and eroded teeth. A change in light-scattering properties is observed and a transition from volume to surface backscattering is detected by means of polarized laser speckle imaging as teeth undergo acid etching, suggesting an increase in enamel surface roughness.

  18. Posterior reversible encephalopathy syndrome: the importance of early diagnosis.

    Science.gov (United States)

    Teotónio, Rute; Marmoto, Dina; Januário, Cristina; Bento, Conceição

    2012-09-17

    A 14-year-old boy was submitted to cardiac transplant due to a dilated cardiomyopathy. On the fourth day of immunosuppression (corticosteroids, mycophenolate mofetil and tacrolimus), he developed right focal seizures and drowsiness. Blood pressure was in the normal range and laboratory findings in cerebral spinal fluid and blood were unremarkable, with drugs in non-toxic levels. The EEG showed a slow background rhythm more pronounced on the right and a seizure onset in the right occipital region. MRI revealed a diffuse hyperintense subcortical white-matter lesion on fluid attenuated inversion recovery, with lesser involvement of left temporal-occipital region. There was no enhancement with gadolinium and MRI diffusion-weighted imaging was consistent with vasogenic oedema. Tacrolimus was stopped with regression of MRI abnormalities and clinical recovery. Posterior reversible encephalopathy associated with tacrolimus is a rare but potentially serious complication of solid organ transplants. A prompt diagnosis and correct treatment is essential to avoid irreversible brain damage.

  19. Histopathological diagnosis of acral lentiginous melanoma in early stages.

    Science.gov (United States)

    Fernandez-Flores, Angel; Cassarino, David S

    2017-02-01

    Acral lentiginous melanoma is a rare variant of melanoma that is associated with a relatively low survival rate. The latter is partly due to the advanced stage in which the tumor is usually diagnosed. The diagnostic delay is mainly due to difficulties in identifying the very early histopathological signs of acral melanoma. The current article is a review of diagnostic clues, concepts, and definitions from the literature, as well as illustrating examples from our own archives. We have sought to provide an article that can be easily consulted in difficult cases of acral lentiginous melanoma.

  20. Development of an assisting detection system for early infarct diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Sim, K. S.; Nia, M. E.; Ee, C. S. [Faculty of Engineering and Technology, Multimedia University, Melaka (Malaysia)

    2015-04-24

    In this paper, a detection assisting system for early infarct detection is developed. This new developed method is used to assist the medical practitioners to diagnose infarct from computed tomography images of brain. Using this assisting system, the infarct could be diagnosed at earlier stages. The non-contrast computed tomography (NCCT) brain images are the data set used for this system. Detection module extracts the pixel data from NCCT brain images, and produces the colourized version of images. The proposed method showed great potential in detecting infarct, and helps medical practitioners to make earlier and better diagnoses.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    Fernell, Elisabeth; Eriksson, Mats Anders; Gillberg, Christopher

    2013-01-01

    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.

  3. PRENATAL DIAGNOSIS AND SCREENING OF GENETIC ABNORMALITIES IN EARLY PREGNANCY

    Directory of Open Access Journals (Sweden)

    Jyothi Kiran Kohli

    2016-11-01

    Full Text Available BACKGROUND Genetic diseases are one of the major causes of hospital admissions due to disability and mortality particularly among children (1:5 children of hospital admission either partially/completely as distribution of genetic diseases is not related to socioeconomic background, which implies that developing world has a large number of genetic diseases largely left uncared for, i.e. overall incidence of foetal/neonatal loss due to genetic/genetic environmental causes are as follows: 1:50 newborns have major congenital abnormality, 1:100 have a unifactorial disorder, 1:200 have a major chromosomal abnormality before birth. Diagnosis of chromosomal anomalies in foetus is one of the most important challenges in modern perinatology as invasive or noninvasive methods. The aim of the study is to review on cytogenetic evaluation of CVS obtained (transcervically during first trimester of pregnancy by direct karyotyping of tissue. MATERIALS AND METHODS This study was conducted in 2001 in Department of Anatomy along with Obstetrics and Gynaecology Department, LNJP Hospital. 37 healthy cases with 6-12 weeks of gestational age coming for medical termination of pregnancy were included in the study. After written informed consent for procedure, ultrasound-guided transcervical chorionic villus sampling was done (Brambati’s method. Tissue procured was then processed for direct karyotyping and studied. Metaphase spreads were photographed and karyotypes prepared and studied. RESULTS Out of 37 pregnant females, 30 samples were successfully prepared and processed by Direct method out of which 23 were normal female (46, XX and 7 were normal male (46, XY. No normal anomaly was detected. Best biopsies were obtained with 8-12 weeks gestation. G Banding could not be performed as chromosome obtained were found to be resistant to banding. CONCLUSIONS To summarise chromosome preparations obtained from CVS by Direct method has advantage of providing sufficient number

  4. Novel endoscopic imaging system for early cancer diagnosis

    Science.gov (United States)

    Igarashi, Makoto; Gono, Kazuhiro

    2007-02-01

    We have developed the novel video endoscope imaging techniques; Narrow band imaging (NBI), Auto-Fluorescence Imaging (AFI), Infra-Red Imaging (IRI) and Endo-Cytoscopy System (ECS). The purpose of these imaging techniques is to emphasize the important tissue features associated with early stage of lesions. We have already launched the new medical endoscope system including NBI, AFI and IRI (EVIS LUCERA SPECTRUM, OLYMPUS MEDICAL SYSTEMS Co., Ltd., Fig.1). Moreover ECS, which has enough magnification to observe cell nuclei on a superficial mucosa under methylene blue dye staining, is the endoscopic instrument with ultra-high optical zoom. In this paper we demonstrate the concepts and the medical efficacy of each technology.

  5. Inferior Alveolar Nerve Injuries Following Implant Placement - Importance of Early Diagnosis and Treatment: a Systematic Review

    OpenAIRE

    Ilana Shavit; Gintaras Juodzbalys

    2014-01-01

    ABSTRACT Objectives The purpose of this article is to systematically review diagnostic procedures and risk factors associated with inferior alveolar nerve injury following implant placement, to identify the time interval between inferior alveolar nerve injury and its diagnosis after surgical dental implant placement and compare between outcomes of early and delayed diagnosis and treatment given based on case series recorded throughout a period of 10 years. Material and Methods We performed li...

  6. Early Diagnosis and Monitoring of Neurodegenerative Langerhans Cell Histiocytosis.

    Directory of Open Access Journals (Sweden)

    Elena Sieni

    Full Text Available Neurodegenerative Langerhans Cell Histiocytosis (ND-LCH is a rare, unpredictable consequence that may devastate the quality of life of patients cured from LCH. We prospectively applied a multidisciplinary diagnostic work-up to early identify and follow-up patients with ND-LCH, with the ultimate goal of better determining the appropriate time for starting therapy.We studied 27 children and young adults with either ND-LCH verified by structural magnetic resonance imaging (MRI (group 1 or specific risk factors for (diabetes insipidus, craniofacial bone lesions, but no evidence of, neurodegenerative MRI changes (group 2. All patients underwent clinical, neurophysiological and MRI studies.Seventeen patients had MRI alterations typical for ND-LCH. Nine showed neurological impairment but only three were symptomatic; 11 had abnormal somatosensory evoked potentials (SEPs, and five had abnormal brainstem auditory evoked potentials (BAEPs. MR spectroscopy (MRS showed reduced cerebellar NAA/Cr ratio in nine patients. SEPs showed sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV for predicting ND-LCH of 70.6% (95%CI, 44.0%-89.7%, 100% (69.2%-100%, 100% (73.5%-100%, and 66.7% (38.4%-88.2%, respectively. Repeated investigations in group 1 revealed increasingly abnormal EP parameters, or neurological examination, or both, in nine of fifteen patients while MRI remained unchanged in all but one patient.A targeted MRI study should be performed in all patients with risk factors for ND-LCH for early identification of demyelination. The combined use of SEPs and careful neurological evaluation may represent a valuable, low-cost, well-tolerated and easily available methodology to monitor patients from pre-symptomatic to symptomatic stages. We suggest a multidisciplinary protocol including clinical, MRS, and neurophysiological investigations to identify a population target for future therapeutic trials.

  7. Early Diagnosis and Monitoring of Neurodegenerative Langerhans Cell Histiocytosis

    Science.gov (United States)

    Mortilla, Marzia; Savelli, Sara; Grisotto, Laura; Di Giacomo, Gianpiero; Romano, Katiuscia; Fonda, Claudio; Biggeri, Annibale; Guerrini, Renzo; Aricò, Maurizio

    2015-01-01

    Background Neurodegenerative Langerhans Cell Histiocytosis (ND-LCH) is a rare, unpredictable consequence that may devastate the quality of life of patients cured from LCH. We prospectively applied a multidisciplinary diagnostic work-up to early identify and follow-up patients with ND-LCH, with the ultimate goal of better determining the appropriate time for starting therapy. Methods We studied 27 children and young adults with either ND-LCH verified by structural magnetic resonance imaging (MRI) (group 1) or specific risk factors for (diabetes insipidus, craniofacial bone lesions), but no evidence of, neurodegenerative MRI changes (group 2). All patients underwent clinical, neurophysiological and MRI studies. Results Seventeen patients had MRI alterations typical for ND-LCH. Nine showed neurological impairment but only three were symptomatic; 11 had abnormal somatosensory evoked potentials (SEPs), and five had abnormal brainstem auditory evoked potentials (BAEPs). MR spectroscopy (MRS) showed reduced cerebellar NAA/Cr ratio in nine patients. SEPs showed sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for predicting ND-LCH of 70.6% (95%CI, 44.0%-89.7%), 100% (69.2%-100%), 100% (73.5%-100%), and 66.7% (38.4%-88.2%), respectively. Repeated investigations in group 1 revealed increasingly abnormal EP parameters, or neurological examination, or both, in nine of fifteen patients while MRI remained unchanged in all but one patient. Conclusion A targeted MRI study should be performed in all patients with risk factors for ND-LCH for early identification of demyelination. The combined use of SEPs and careful neurological evaluation may represent a valuable, low-cost, well-tolerated and easily available methodology to monitor patients from pre-symptomatic to symptomatic stages. We suggest a multidisciplinary protocol including clinical, MRS, and neurophysiological investigations to identify a population target for future

  8. The Use of Frozen Section in the Early Diagnosis of Acute Invasive Fungal Sinusitis.

    Science.gov (United States)

    Melancon, C Claire; Clinger, John D

    2017-08-01

    Objectives Acute invasive fungal sinusitis (AIFS) remains a significant cause of morbidity and mortality in the immunocompromised patient population. Early diagnosis is key to improving patient outcomes. Frozen section biopsies have been shown to decrease time to diagnosis when compared with permanent pathology. However, its accuracy has not been adequately described in the literature, specifically in regard to AIFS. The aim of this study is to evaluate the statistical diagnostic accuracy of frozen sections and to review the etiology, clinical presentation, and current diagnostic protocols in management of AIFS. Study Design Case series with chart review. Setting Tertiary referral center. Subjects and Methods Retrospective review included 67 pathologic records in Co-Path, with search criteria including invasive fungal, clinical history, frozen section, and final diagnosis between the dates of 2006 and 2015. Results Sixty-seven cases were reviewed per the search criteria in Co-Path. Of these, 31 met further criteria of having had frozen section analysis. Variables such as sensitivity, specificity, positive predictive value, and negative predictive value were assessed. All 21 positive frozen sections correlated with positive permanent pathology, giving a positive predictive value of 100%. Frozen section biopsies were 87.5% sensitive and 100% specific. Conclusion Early diagnosis of AIFS has been shown to decrease morbidity and mortality. Frozen section biopsies remain key in obtaining an early diagnosis among patients with a high clinical suspicion for invasive fungal sinusitis. Frozen section biopsies positive for invasive fungal pathology were universally consistent with definitive diagnosis.

  9. Early diagnosis of Gaucher disease in pediatric patients: proposal for a diagnostic algorithm.

    Science.gov (United States)

    Di Rocco, Maja; Andria, Generoso; Deodato, Federica; Giona, Fiorina; Micalizzi, Concetta; Pession, Andrea

    2014-11-01

    Gaucher disease (GD) is caused by an enzyme deficiency that leads to the accumulation of glycolipids in various organs. Although the signs and symptoms of GD emerge in childhood in the majority of patients, the disease often remains unrecognized for many years with delay of benefits of therapy or development of irreversible complications. Based on published data and data from the International Collaborative Gaucher Group Registry, an algorithm has been drafted for early diagnosis of GD in pediatric patients. It will help hematologists in promoting a timely diagnosis and early access to therapy for pediatric patients with GD.

  10. Epidemiology and early diagnosis of primary liver cancer in China

    Energy Technology Data Exchange (ETDEWEB)

    Yen, F.S.; Shen, K.N.

    1986-01-01

    Epidemiological studies in different areas in China have revealed several outstanding risk factors of PLC, i.e., HBV infection, pollution of drinking water, contamination of food by AFB1 and/or nitrosamines, and family predisposition. Accordingly, a program of HBV vaccination, improved supply of drinking water, better preservation and storage of food, and possibly chemoprevention for high-risk populations should be effective preventive measures. Studies have shown that frequent AFP screening in high-risk populations is highly recommended to detect early cases of PLC. According to research in Qidong, careful follow-up of the dynamic changes of AFP in individuals with persistent low levels of positive AFP is important for distinguishing other conditions from true PLC. Newer means for the localization of small-size PLC (under 5 cm), such as type B ultrasonography, nuclide scanning, computerized tomography, and hepatoangiography, represent remarkable progress in improving markedly the success of surgery and hence the survival rate of PLC patients. The advances in knowledge of PLC have been encouraging. Although much work remains to be done on the etiological agents and the mechanism of oncogenesis, it is time that larger scale control measures be put into effect in high-incidence areas to discover if one of the most common cancers in the world can be controlled. 62 references.

  11. [Lipids composition diet in phenylketonuric children with early diagnosis].

    Science.gov (United States)

    Cornejo, Verónica; Concha, Miluska; Cabello, Juan Francisco; Raimann, Erna

    2005-12-01

    Phenylketonuria (PKU) is a genetic disorder caused by a partial or complete mutation of the enzyme phenylalanine hydroxylase (PHA), fact that produces high levels of phenylalanine in blood resulting in mental retardation if not diagnosed during the neonatal period. Treatment consists of a phenylalanine (Phe) restricted diet. Several studies have shown that due to restriction of animal protein, this diet is deficient in fatty acids such as alfalinolenic acid (ALA) and provides high levels of linoleic acid (LA). The objective of this study was to determine the lipid composition of the diet consumed by children with early-diagnosed PKU. Lipid composition of the Phenylalanine restricted diet consumed by 29 children with PKU and in follow-up at INTA, University of Chile, were analyzed. Children were paired by sex and age with a control group. A twenty-four hour dietary recall was performed for 3 consecutive days and total fatty acid intake, including saturated, monounsaturated, polyunsaturated, LA and ALA, were calculated. In the restricted diet of children with PKU, 31.8% of total calories are from fat, 13% of which are LA and 0.2% ALA, showing significant differences as compared to the control group. The ratio of saturated:monounsaturated:polyunsaturated fatty acids was 1:1.7:3.9 and the ratio of LA:ALA was ten-fold higher than the recommended ratio of 115:1. It is concluded that the Phenyalanine restricted diet of Chilean children with PKU is high in LA and low in ALA.

  12. CRITERIA FOR LABORATORY DIAGNOSIS OF VARIOUS FORMS EARLY CONGENITAL SYPHILIS

    Directory of Open Access Journals (Sweden)

    G. P. Martynova

    2014-01-01

    Full Text Available The results of clinical and laboratory (blood count and serological monitoring of 156 children with various forms of early congenital syphilis in the initial period and the dynamics on the background of specific therapy. Violations in haemogram characterized hypochromic anemia, thrombocytopenia, leukocytosis, neytrofillezom stab shift with a sharP increase in ESR, which prevailed among the most children with the disease over polisimptomnym and significantly exceeded the level of the norm even after specific therapy. For serological examination in 84.62 % cases registered positive results in microprecipitation reaction (RMR to 56.52% — IgM, and 97.83% — IgG reaction Enzymeimmuno assay (EIA and 100 % — Treponema pallidum hemagglutination assay (ТРHА. On the background of specific therapy indicated positive results in the growth of bladder cancer (85.19 %, in the formulation of IgM EIA (72.22 % and IgG (100%, thus, recorded a decline titer positivity serological RMR 2 times , IgM EIA reaction 12 times with simultaneous increase IgG positivity 4 times and 2 times in the ТРHА in the formulation of these reactions in the dynamics.

  13. Value of sympathetic skin response test in the early diagnosis of diabetic neuropathy

    Institute of Scientific and Technical Information of China (English)

    黄一宁; 贾志荣; 石昕; 孙相如

    2004-01-01

    Background Diabetic neuropathy is common in diabetes mellitus. The early stage of diabetic neuropathy is often symptomless and difficult to be treated. The aim of this study was to assess the correlation between the results of the sympathetic skin response (SSR) test and the development of diabetic neuropathy, and explore the use of SSR as an objective basis for the early diagnosis of diabetic neuropathy.Methods The latencies and amplitudes of initiation and of the N and P waves were determined by SSR testing of the extremities of 80 diabetic patients and 30 healthy controls. Results The latencies of initiation and of the N and P waves were significantly (P0.05). All but two patients (97.5%) demonstrated abnormal SSR in at least one limb. Conclusions SSR can detect early dysfunction of the small sympathetic fibers in people affected by diabetes mellitus, and may be a useful electrophysiological test for the early diagnosis of diabetic neuropathy.

  14. 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.

  15. Contributions of Early Language and Maternal Facilitation Variables to Later Language and Reading Abilities

    Science.gov (United States)

    Fewell, Rebecca; Deutscher, Barbara

    2004-01-01

    This study investigated the contributions of four variables (children's expressive language scores at 30 months of age, mother's facilitation of child language, mother's education, and group assignment) to the prediction of IQ at age 3, verbal IQ at ages 5 and 8, and reading at age 8 for 571 children of low-birthweight. Four separate multiple…

  16. Directing and Facilitating Distributed Pedagogical Leadership: Best Practices in Early Childhood Education

    Science.gov (United States)

    Bøe, Marit; Hognestad, Karin

    2017-01-01

    This paper uses a hybrid leadership framework to examine how formal teacher leaders at the middle management level direct and facilitate staff resources for distributed pedagogical leadership. By conducting qualitative shadowing, involving video observation, field notes and stimulated recall interviews, and abductive analysis, this study…

  17. Fanconi Syndrome Secondary to Deferasirox in Diamond-Blackfan Anemia: Case Series and Recommendations for Early Diagnosis.

    Science.gov (United States)

    Papneja, Koyelle; Bhatt, Mihir D; Kirby-Allen, Melanie; Arora, Steven; Wiernikowski, John T; Athale, Uma H

    2016-08-01

    Deferasirox is an oral iron chelator used to treat patients with transfusion-related iron overload. We report, from two institutions, two children with Diamond-Blackfan anemia who developed Fanconi syndrome secondary to deferasirox administration, along with a review of the literature. The current recommendation for the laboratory monitoring of patients receiving deferasirox does not include serum electrolytes or urine analysis. Thus, despite routine clinic visits and bloodwork, these two patients presented with life-threatening electrolyte abnormalities requiring hospitalization. Hence, we propose the inclusion of serum electrolytes and urine analysis as part of routine monitoring to facilitate the early diagnosis of Fanconi syndrome in the context of high doses of deferasirox therapy.

  18. Diagnosis of invasive aspergillus tracheobronchitis facilitated by endobronchial ultrasound-guided transbronchial needle aspiration: a case report

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    Casal Roberto F

    2009-11-01

    Full Text Available Abstract Introduction Invasive pulmonary aspergillosis is the most common form of infection by Aspergillus species among immunocompromised patients. Although this infection frequently involves the lung parenchyma, it is unusual to find it limited to the tracheobronchial tree, a condition known as invasive aspergillus tracheobronchitis. Case presentation A 65 year-old Hispanic man from Bolivia with a history of chronic lymphocytic leukemia developed cough and malaise eight months after having an allogenic stem cell transplant. A computed tomography of the chest revealed an area of diffuse soft tissue thickening around the left main stem bronchus, which was intensely fluorodeoxyglucose-avid on positron emission tomography scanning. An initial bronchoscopic exam revealed circumferential narrowing of the entire left main stem bronchus with necrotic and friable material on the medial wall. Neither aspirates from this necrotic area nor bronchial washing were diagnostic. A second bronchoscopy with endobronchial ultrasound evidenced a soft tissue thickening on the medial aspect of the left main stem bronchus underlying the area of necrosis visible endoluminally. Endobronchial ultrasound-guided transbronchial needle aspiration performed in this area revealed multiple fungal elements suggestive of Aspergillus species. Conclusion We describe the first case of invasive aspergillus tracheobronchitis in which the diagnosis was facilitated by the use of endobronchial ultrasound guided trans-bronchial needle aspiration. To the best of our knowledge, we are also presenting the first positron emission tomography scan images of this condition in the literature. We cautiously suggest that endobronchial ultrasound imaging may be a useful tool to evaluate the degree of invasion and the involvement of vascular structures in these patients prior to bronchoscopic manipulation of the affected areas in an effort to avoid potentially fatal hemorrhage.

  19. PAX8 and PAX2 immunostaining facilitates the diagnosis of primary epithelial neoplasms of the male genital tract.

    Science.gov (United States)

    Tong, Guo-Xia; Memeo, Lorenzo; Colarossi, Cristina; Hamele-Bena, Diane; Magi-Galluzzi, Cristina; Zhou, Ming; Lagana, Stephen M; Harik, Lara; Oliver-Krasinski, Jennifer M; Mansukhani, Mahesh; Falcone, Lorenzo; Hibshoosh, Hanina; O'Toole, Kathleen

    2011-10-01

    PAX8 and PAX2 are cell-lineage-specific transcription factors that are essential for the development of Wolffian and Müllerian ducts and have recently emerged as specific diagnostic markers for tumors of renal or Müllerian origin. Little is known about their expression in the Wolffian duct-derived human male genital tract. We report our findings of PAX8 and PAX2 expression in the epithelium of the normal male genital tract and in epithelial tumors derived therefrom using immunohistochemistry (IHC). We found that PAX8 and PAX2 were expressed in the epithelium of the male genital tract from the rete testis to the ejaculatory duct. Rare glands in the prostatic central zone, a tissue of purported Wolffian duct origin, were focally positive for PAX2, but no PAX8 was detected in this area, a finding that may warrant further study. We found diffuse expression of PAX8 and PAX2 in 1 case each of serous cystadenoma of the epididymis, carcinoma of the rete testis, Wolffian adnexal tumor of the seminal vesicle, and endometrioid carcinoma of the seminal vesicle. Neither PAX8 nor PAX2 was detected in the seminiferous tubules and interstitium of the normal testis, nor in Leydig cell tumors (n=6), Sertoli cell tumors (n=2), or 48 of 49 germ cell tumors. One pediatric yolk sac tumor showed focal and weak staining for PAX8. Tumors of mesothelial origin, that is, adenomatoid tumors (n=3) and peritoneal malignant mesotheliomas (n=37) in men, were negative for PAX2 and PAX8. Neither PAX2 nor PAX8 was present in other areas of the prostate. Expression of PAX8 and PAX2 in these primary epithelial neoplasms of the male genital tract is due to their histogenetic relationship with Wolffian or Müllerian ducts. PAX8 and PAX2 IHC may facilitate the diagnosis of these tumors and should be included in the differential diagnostic IHC panel.

  20. Prenatal Diagnosis

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    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

  1. 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.

  2. Early diagnosis of dementia based on intersubject whole-brain dissimilarities

    DEFF Research Database (Denmark)

    Klein, S.; Loog, M.; Lijn, F. van der;

    2010-01-01

    . A kNN classifier was trained on the dissimilarity matrix and the performance was tested in a leave-one-out experiment. A classification accuracy of 81% was attained (spec. 83%, sens. 79%). This demonstrates the potential of whole-brain intersubject dissimilarities to aid in early diagnosis of dementia....

  3. A Case Report of Probable Sporadic Creutzfeldt-Jakob Disease: How to Approach Early Diagnosis?

    Science.gov (United States)

    Tan, Bowei; Morales Mangual, Carlos; Mahmud, Iftekhar; Tongo, Nosakhare D; Mararenko, Larisa; Kay, Arthur

    2017-05-30

    Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare and fatal spongiform encephalopathy characterized by rapidly progressive dementia and myoclonus. The rarity of this disease and varied initial symptoms make the early diagnosis fairly challenging. Here, we present a case initially admitted for confusion and bizarre behaviors. She had acute deterioration of mental status, akinetic mutism, and myoclonus jerks four weeks later. Cerebrospinal fluid (CSF) analysis was positive for protein 14-3-3. Brain magnetic resonance imaging (MRI) showed hyperintensities in the bilateral cortex, basal ganglia, and thalami in diffusion-weighted imaging (DWI). Electroencephalogram (EEG) showed bihemispheric periodic lateralizing epileptiform discharges. The probable diagnosis of sCJD was reached based on the clinical features, characteristic findings in her MRI, the EEG, and a positive 14-3-3 CSF assay. The literature was also reviewed for early diagnosis of sCJD.

  4. Chinese consensus on early diagnosis of primary lung cancer (2014 version).

    Science.gov (United States)

    Hu, Jie; Qian, Gui-Sheng; Bai, Chun-Xue

    2015-09-01

    The incidence and mortality of lung cancer in China have rapidly increased. Lung cancer is the leading cause of cancer death in China, possibly because of the inadequate early diagnosis of lung cancer. Reaching a consensus on early diagnostic strategies for lung cancer in China is an unmet needed. Recently, much progress has been made in lung cancer diagnosis, such as screening in high-risk populations, the application of novel imaging technologies, and the use of minimally invasive techniques for diagnosis. However, systemic reviews of disease history, risk assessment, and patients' willingness to undergo invasive diagnostic procedures also need to be considered. A diagnostic strategy for lung cancer should be proposed and developed by a multidisciplinary group. A comprehensive evaluation of patient factors and clinical findings should be completed before treatment.

  5. 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...

  6. [Advancement in the research of early detection of bacterial nucleic acid in molecular diagnosis of sepsis].

    Science.gov (United States)

    Liu, Xiao; Ren, Hui; Peng, Dai-zhi

    2013-04-01

    Early diagnosis of sepsis helps make effective clinical decisions and improve the survival rate of patients with severe infection. However, the timely and accurate diagnosis of sepsis is still a great challenge in clinic. In order to settle the very problem, the scientists in the world have made a lot of exploration and research in the field of rapid molecular identification of pathogens. Nowadays, the nucleic acid detection of sepsis is mainly composed of 3 types of methodological strategies, either based on positive blood culture, single colonies, or directly on blood specimens. This paper presents a comprehensive overview of advances in the research of early detection of bacterial nucleic acid as molecular diagnosis of sepsis.

  7. Current studies of biomarkers for the early diagnosis of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Chandrashekara S

    2014-09-01

    Full Text Available S Chandrashekara ChanRe Rheumatology and Immunology Center and Research, Basaveshwaranagar, Bangalore, India Abstract: Early treatment of rheumatoid arthritis (RA with disease-modifying antirheumatic drugs will improve the outcome significantly. Early diagnosis of RA continues to be a challenge. The disease needs to be distinguished from other self-limiting arthritis and connective tissue disease. Currently available autoantibodies like rheumatoid factors and anticitrullinated cyclic peptide have limited sensitivity and specificity. RA, being a heterogeneous disease, with no unique or distinct defect that has been described, is less likely to have a single pathognomonic marker. There are defined predisposing genetic factors, cell characteristics, cytokine changes, autoantibodies, and products of disease process that have been demonstrated to distinguish rheumatoid from normal and other arthritis. Studies have demonstrated that combinations of factors allow for more specific RA diagnosis; however, when considerations are given to the factors separately, sensitivity increases at the cost of specificity. The present review briefly describes the value of some of the candidate factors and their combinations as diagnostic markers of early RA. Well-designed multicenter studies to evaluate these combinations using a scoring system are recommended for the development of precise and widely applicable biomarkers for early diagnosis of RA. Keywords: autoantibodies, combination, early RA, specificity

  8. Developing a Computer Workshop To Facilitate Computer Skills and Minimize Anxiety for Early Childhood Educators.

    Science.gov (United States)

    Wood, Eileen; Willoughby, Teena; Specht, Jacqueline; Stern-Cavalcante, Wilma; Child, Carol

    2002-01-01

    Early childhood educators were assigned to one of three instructional conditions to assess the impact of computer workshops on their level of computer anxiety, knowledge, and comfort with technology. Overall, workshops provided gains that could translate into more effective and efficient computer use in the classroom. (Author)

  9. Listening for Details of Talk: Early Childhood Parent-Teacher Conference Communication Facilitators

    Science.gov (United States)

    Cheatham, Gregory A.; Ostrosky, Michaelene M.

    2009-01-01

    In this article, the authors present parent-educator conversations, which were selected to illustrate common communication patterns and provide links to some of the Division for Early Childhood of the Council for Exceptional Children's recommended practices for communicating and collaborating with parents. Using conversation analysis, researchers…

  10. [Mycosis fungoides or inflammatory dermatitis: differential diagnosis between early lymphoma and inflammation in skin biopsies].

    Science.gov (United States)

    Oschlies, I; Klapper, W

    2013-05-01

    Mycosis fungoides is a cutaneous T-cell lymphoma with protracted clinical course and progression in different stages with increasing aggressiveness. The clinical picture as well as the histopathology of mycosis fungoides within the early patch and plaque phase is difficult to delineate from some inflammatory skin diseases. Thus, the diagnosis of these early stages of the lymphoma is only possible when clinical, histopathological, and molecular features are integrated into the diagnosis, especially as none of the individual disease criteria is specific. Important clues towards the diagnosis of mycosis fungoides are cytologically abnormal epidermotropic CD4-positive T-cells causing only minor epidermal alterations, the formation of Pautrier-abscesses and basal alignment of the epidermotropic T-cells. The findings of an aberrant T-cell immunophenotype of the intraepidermal lymphoid component as well as the molecular proof of T-cell clonality are important further features. In the differential diagnosis between early stage mycosis fungoides and parapsoriasis, there remains nevertheless a diagnostic and maybe also a true biological grey zone.

  11. Promoting early dementia diagnosis: a video designed by patients, for patients.

    Science.gov (United States)

    Baruch, Nina; Allan, Charlotte L; Cundell, Maureen; Clark, Samuel; Murray, Brian

    2017-05-01

    Early diagnosis of dementia allows people to access effective treatment and make advance decisions while they still have capacity. We aimed to encourage people to attend memory clinic, in order to boost rates of diagnosis. We created a patient information video about Oxford Health NHS Foundation Trust Memory Clinics, to inform and empower those awaiting assessment and to promote early diagnosis. Fourteen people (patients, carers, and staff) were approached prior to developing the video to ascertain their views on the themes the video should cover. The video consisted of unscripted interviews with patients, carers, and staff. We surveyed participants and new patients attending memory clinic to get feedback on the video and to assess patients' level of understanding and confidence about a memory assessment before and after watching the video. The video content was refined based on this feedback and a final version was produced. Patient feedback demonstrated that confidence and understanding increased after watching the video. Although this study is limited by its small sample size and lack of access to those with undiagnosed dementia, feedback suggested that the video empowered and reassured those awaiting assessment and could be used as a tool to reduce barriers to early diagnosis. Patients and carers involved in making the video found it a therapeutic activity in itself.

  12. Testing breast cancer serum biomarkers for early detection and prognosis in pre-diagnosis samples

    Science.gov (United States)

    Kazarian, Anna; Blyuss, Oleg; Metodieva, Gergana; Gentry-Maharaj, Aleksandra; Ryan, Andy; Kiseleva, Elena M; Prytomanova, Olga M; Jacobs, Ian J; Widschwendter, Martin; Menon, Usha; Timms, John F

    2017-01-01

    Background: Breast cancer is a leading cause of morbidity and mortality worldwide. Although mammography screening is available, there is an ongoing interest in improved early detection and prognosis. Herein, we have analysed a combination of serological biomarkers in a case–control cohort of sera taken before diagnosis. Methods: This nested case–control study within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) used serum samples from 239 women who subsequently developed breast cancer and 239 matched cancer-free controls. Sera were screened by ELISA for 9 candidate markers. Univariate and multivariate analyses were performed to examine associations with clinico-pathological features and between case controls in different time groups before diagnosis. Results: Significant associations with clinico-pathological features related to prognosis were found for several candidates (CA15-3, HSP90A and PAI-1). However, there were no consistent differences between cases and controls for any candidate in the lead up to diagnosis. Whilst combination models outperformed single markers, there was no increase in performance towards diagnosis. Conclusions: This study using unique pre-diagnosis samples shows that CA15-3, HSP90A and PAI-1 have potential as early prognostic markers and warrant further investigation. However, none of the candidates or combinations would be useful for screening. PMID:28081538

  13. [The method for early diagnosis of the gastric cancer based metabolomics research].

    Science.gov (United States)

    Furina, R R; Ryzhkov, V L; Mitrakova, N N; Koptina, A V; Safiullin, I K; Lychagin, K A; Eroshkin, P R

    2014-01-01

    This paper deals with the questions of the usage of metabolomics research results in the diagnosis of gastric cancer. The central idea metabolomics is to identify the specific biomarkers in a biological sample used in a diagnostics this disease. The volatile organic compounds--metabolites isolated from the urine samples from patients are considered as biomarkers. The paper also describes main methods of separation and identification of volatile organic compounds (gas chromatography, mass spectrometry) applied in metabolomics. The paper presents some results of laboratory research aimed at the detection of biomarkers of gastric cancer. The presented material will be of some help in solving the problems of early diagnosis of this disease.

  14. Individualized peri-operative fluid therapy facilitating early-phase recovery after liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Guo-Qing Jiang; Ping Chen; Dou-Sheng Bai; Jing-Wang Tan; Hao Su; Min-Hao Peng

    2012-01-01

    AIM:To investigate the correlation between peri-operative fluid therapy and early-phase recovery after liver transplantation (LT) by retrospectively reviewing 102 consecutive recipients.METHODS:Based on whether or not the patients had pulmonary complications,the patients were categorized into non-pulmonary and pulmonary groups.Twentyeight peri-operative variables were analyzed in both groups to screen for the factors related to the occurrence of early pulmonary complications.RESULTS:The starting hemoglobin (Hb) value,an intra-operative transfusion > 100 mL/kg,and a fluid balance ≤-14 mL/kg on the first day and the second or third day post-operatively were significant factors for early pulmonary complications.The extubation time,time to initial passage of flatus,or intensive care unit length of stay were significantly prolonged in patients who had not received an intra-operative transfusion ≤100 mL/kg or a fluid balance ≤-14 mL/kg on the first day and the second or the third day post-operatively.Moreover,these patients had poorer results in arterial blood gas analysis.CONCLUSION:It is important to offer a precise and individualized fluid therapy during the peri-operative period to the patients undergoing LT for cirrhosis-associated hepatocellular carcinoma.

  15. Osteoclastogenesis in Local Alveolar Bone in Early Decortication-Facilitated Orthodontic Tooth Movement

    Science.gov (United States)

    Liu, Chang; Jiang, Yu-Xi; Qu, Hong; Li, Cui-Ying; Jiang, Jiu-Hui

    2016-01-01

    Objective In the current study, we aimed to investigate the effects of alveolar decortication on local bone remodeling, and to explore the possible mechanism by which decortication facilitates tooth movement. Materials and Methods Forty rabbits were included in the experiment. The left mandible was subjected to decortication-facilitated orthodontics, and the right mandible underwent traditional orthodontics as a control. The animals were sacrificed on the days 1, 3, 5, 7 and 14, after undergoing orthodontic procedures. Tooth movement was measured by Micro-CT, and the local periodontal tissues were investigated using H&E, Masson's trichrome and tartrate-resistant acid phosphatase (TRAP) staining. The mRNA levels of genes related to bone remodeling in the alveolar bone were analyzed using real-time PCR. Result On days 3, 5, 7 and 14, tooth movement was statistically accelerated by decortication (P < 0.05) and was accompanied by increased hyperemia. Despite the lack of new bone formation in both groups, more osteoclasts were noted in the decorticated group, with two peak counts (P < 0.05). The first peak count was consistent with the maximum values of ctsk and TRAP expression, and the second peak counts accompanied the maximum nfatc1 and jdp2 expression. The increased fra2 expression and the ratio of rankl/opg also accompanied the second peak counts. Conclusions Following alveolar decortication, osteoclastogenesis was initially induced to a greater degree than the new bone formation which was thought to have caused a regional acceleratory phenomenon (RAP). The amount of steoclastogenesis in the decorticated alveolar bone was found to have two peaks, perhaps due to attenuated local resistance. The first peak count in osteoclasts may have been due to previously existing osteoclast precursors, whereas the second may represent the differentiation of peripheral blood mononuclear cells which came from circulation as the result of hyperemia. PMID:27096621

  16. Significance of arthrosonography for knee joint damage diagnosis in patients with early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    L V Sizova

    2008-01-01

    Full Text Available Objective. To assess significance of arthrosonography in diagnosis of in knee joint changes in patients with early rheumatoid arthritis (RA. Material and methods. 44 patients with early RA aged 19 to 73 years were examined. 29,5% of pts had early RA without primary osteoarthritis (OA, 70,5% had early RA with primary OA. Ultrasonography of knee joints was performed with Diasonics (USA, 1997 by the linear sensor with frequency of 7 MHz. The protocol of ultrasonic examination of knee joints was filled for each pt. Results. Clinical signs of of knee joint synovitis have been revealed in 61,5% of pts with early RA without primary OA, and in 80,6% of pts with early RA with primary OA, ultrasonic - in 100% of pts. Intraarticular knee joint effusion resulted in increase of suprapatellar bursa and lateral recesses size. Extraarticular inflammation was frequently shown by thickening of semymemranous muscles tendons, especially in pts with the early RA with primary OA (p<0,005. Degenerative changes in the group of pts with primary OA were more expressed in early RA and usually accompanied by non-uniform decrease of cartilage thickness and occurrence of osteophytes while cartilage in pts with early RA without primary OA had normal thickness or thickening because of swelling, and osteophytes were absent. Conclusion. Prevalence of knee joint intraarticular and extraarticular inflammatory changes over degenerate changes (symmetric thickening of the synovium, primary increase of the sizes of suprapatellar bursa and lateral recesses because of effusion, thickening of tendons of knee joints at the normal or increased thickness of cartilage because of inflammation can be considered sonographic sign of early RA. In pts with early RA coincided with primary OA these changes were usually found in combination with non-uniform decrease of cartilage thickness. In case of cartilage inflammatory edema, detection of osteophytes allows to confirm presence of OA in pts with

  17. Do diagnosis delays impact receipt of test results? Evidence from the HIV early infant diagnosis program in Uganda.

    Directory of Open Access Journals (Sweden)

    Melissa Latigo Mugambi

    Full Text Available BACKGROUND: There is scant evidence on the association between diagnosis delays and the receipt of test results in HIV Early Infant Diagnosis (EID programs. We determine the association between diagnosis delays and other health care system and patient factors on result receipt. METHODS: We reviewed 703 infant HIV test records for tests performed between January 2008 and February 2009 at a regional referral hospital and level four health center in Uganda. The main outcome was caregiver receipt of the test result. The primary study variable was turnaround time (time between sample collection and result availability at the health facility. Additional variables included clinic entry point, infant age at sample collection, reported HIV status and receipt of antiretroviral prophylaxis for prevention of mother-to-child transmission. We conducted a pooled analysis in addition to separate analyses for each facility. We estimated the relative risk of result receipt using modified Poisson regression with robust standard errors. RESULTS: Overall, the median result turnaround time, was 38 days. 59% of caregivers received infant test results. Caregivers were less likely to receive results at turnaround times greater than 49 days compared to 28 days or fewer (ARR = 0.83; 95% CI = 0.70-0.98. Caregivers were more likely to receive results at the PMTCT clinic (ARR = 1.81; 95% CI = 1.40-2.33 and less likely at the pediatric ward (ARR = 0.54; 95% CI = 0.37-0.81 compared to the immunization clinic. At the level four health center, result receipt was half as likely among infants older than 9 months compared to 3 months and younger (ARR= 0.47; 95% CI = 0.25-0.93. CONCLUSION: In this study setting, we find evidence that longer turnaround times, clinic entry point and age at sample collection may be associated with receipt of infant HIV test results.

  18. {sup 18}F-FDG positron emission tomography in the early diagnosis of enterocolitis: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Kresnik, E.; Gallowitsch, H.J.; Igerc, I.; Kumnig, G.; Gomez, I.; Lind, P. [Nuclear Medicine and Special Endocrinology, PET Centre, General Hospital, St. Veiterstrasse 47, 9020 Klagenfurt (Austria); Mikosch, P.; Alberer, D.; Hebenstreit, A. [Department of Internal Medicine and Gastroenterology, General Hospital, Klagenfurt (Austria); Wuertz, F. [Department of Pathology, General Hospital, Klagenfurt (Austria); Kogler, D.; Gasser, J. [Department of Radiology, General Hospital, Klagenfurt (Austria)

    2002-10-01

    Collagenous and eosinophilic colitis are rare diseases characterised by chronic watery diarrhoea. Radiographic evaluation of the gastrointestinal tract and colonoscopy are usually non-diagnostic since as many as one-third of patients will have minor abnormalities. To date a few investigators have reported increased fluorine-18 fluorodeoxyglucose ({sup 18}F-FDG) uptake on positron emission tomography (PET) in patients with acute enterocolitis, but there have been no reports on the use of {sup 18}F-FDG PET for the diagnosis of collagenous or eosinophilic colitis in an early clinical stage. The aim of this preliminary study was to evaluate the usefulness of {sup 18}F-FDG PET in the early diagnosis of patients with colitis. We investigated five women (mean age 61.2{+-}12.1 years) who had been diagnosed as having colitis in an early clinical stage. In all but one of the patients, the diagnosis of colitis was based on biopsy. Magnetic resonance colonography, ultrasonography and colonoscopy were performed in all but one of the patients. Two women were identified as having collagenous colitis in an early clinical stage. Another two patients had eosinophilic colitis. The morphological imaging methods, magnetic resonance colonography and ultrasonography, yielded no suspicious findings, and the results of colonoscopy similarly showed no abnormalities. One patient had colitis due to bacterial infection. In all patients {sup 18}F-FDG PET showed a pathological increase in tracer uptake in the large bowel, suggestive of colitis. In four of the five patients, colitis was confirmed by histology, and in one, by bacterial analysis. {sup 18}F-FDG PET was able to detect colitis in an early clinical stage, when morphological imaging methods and colonoscopy were non-diagnostic. The early performance of {sup 18}F-FDG PET imaging in patients with possible colitis is encouraging. (orig.)

  19. [Bioethical reflections on ill-considered care due to an early diagnosis of Alzheimer disease].

    Science.gov (United States)

    Buxó, M Jesús; Casado, María

    2014-01-01

    Early diagnosis of Alzheimer disease raises important bioethical issues. In the interval between early disease detection and symptom onset, there is a time in which the patient's autonomy, privacy, and dignity may be undermined by certain healthcare measures or by family care and support. These measures may eventually turn patients into an object of care, preventing them from accepting the disease, developing an identity, and rearranging their living spaces. Every effort should be made to ensure that care does not become compassionate harassment or an invasive act, annulling the patient's autonomy, identity, and self-determination.

  20. 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.

  1. Early diagnosis of pyridoxine-dependent epilepsy: video-EEG monitoring and biochemical and genetic investigation.

    Science.gov (United States)

    Ville, Dorothée; Ginguene, Carole; Marignier, Stéphanie; des Portes, Vincent; de Bellescize, Jullita

    2013-11-01

    Pyridoxine-dependent epilepsy (PDE) is a rare autosomal recessive metabolic disease. A delay of treatment may affect outcome and early initiation of pyridoxine based on effective diagnosis is crucial to ensure good cognitive outcome in neonates. A consensus for the diagnosis of PDE is based on refractive seizures and responsiveness to pyridoxine, however, a growing body of evidence suggests that additional elements should be considered which include biochemical data, genetic screening, and EEG monitoring. We present a case study of a neonate with PDE, who presented with misleading clinical presentation and a novel mutation in the antiquitin (ALDH7A1) gene (A294V), and highlight important aspects in order to consider the definition of diagnosis and management of PDE in the light of more recent data.

  2. Basal cell carcinoma with halo phenomenon in a young female: Significance of dermatoscopy in early diagnosis

    Directory of Open Access Journals (Sweden)

    Pinar Yuksel Basak

    2015-01-01

    Full Text Available Halo phenomenon of nevus may be observed as a circular reaction, although it is unusual around tumors. A 29-year-old woman presented with a pigmented lesion on the cheek since three years. She noted whitening of the skin around the lesion almost after a year following its appearance. Dermatologic examination revealed a pigmented nodular lesion with a hypopigmented halo on the left infraorbital region. The clinical impression was halo nevus, whereas basal cell carcinoma (BCC was considered in dermatoscopic differential diagnosis. The diagnosis was infiltrative-type BCC histopathologically. The persistence of a perilesional halo around an enlarging pigmented lesion should be carefully examined with accompanying dermatoscopic findings even in young patients for early diagnosis of tumoral lesions.

  3. MRI Manifestation and Early Diagnosis of Bone Infarct: A Rare Complication of Steroid Therapy for Pemphigus

    Directory of Open Access Journals (Sweden)

    UC Parashari

    2011-07-01

    Full Text Available The objective of the study was to analyse the magnetic resonance imaging (MRI manifestation of bone infarction and explore the value of such imaging in early diagnosis. In bone infarction, aseptic osteonecrosis occurs in the metaphysis and diaphysis of long bones. The “Double line” sign in MRI is most characteristic of this lesion and is seen as high signal intensity in the inner zone along with lowsignal-intensity line in the outer zone in a T2 weighted image. In clinically suspected patients, MRI can be used for early diagnosis. Here we describe a case of pemphigus resulting from steroid therapy leading to development of bone infarction in the metadiaphyseal region of the femur and tibia.

  4. Early Diagnosis of Cutaneous Mucormycosis Due to Lichtheimia corymbifera After a Traffic Accident.

    Science.gov (United States)

    Tyll, Tomas; Lyskova, Pavlina; Hubka, Vit; Muller, Martin; Zelenka, Lubomir; Curdova, Martina; Tuckova, Inna; Kolarik, Miroslav; Hamal, Petr

    2016-02-01

    A case report of cutaneous mucormycosis and obstacles to early diagnosis is presented. A 38-year-old male was involved in a car accident that led to amputation of both lower limbs. Subsequently, he developed fungal wound infection of the left lower limb stump. The infection was detected very early, although the diagnosis was difficult because only a small area was affected and histopathological examination was initially negative. The infection was proven by microscopy, culture and histopathology. The isolate was identified by sequencing of the rDNA ITS region gene (internal transcribed spacer region of ribosomal DNA) as Lichtheimia corymbifera. Liposomal amphotericin B and surgery were successful in management of the disease.

  5. Does adenosine deaminase activity play a role in the early diagnosis of ectopic pregnancy?

    Science.gov (United States)

    Turkmen, G G; Karçaaltıncaba, D; Isık, H; Fidancı, V; Kaayalp, D; Tımur, H; Batıoglu, S

    2016-01-01

    Early diagnosis of ectopic pregnancy (EP) is important due to life-threatening consequences in the first trimester of pregnancy. In this study we aimed to investigate the role of adenosine deaminase (ADA) activity in the prediction of EP. Forty-one patients with unruptured ectopic pregnancy comprised the case group and forty-two first trimester pregnant women with shown foetal heart beating in ultrasound comprised the control group. The mean ADA level in EP (10.9 ± 3.0 IU/L) was higher than that in control group (9.2 ± 3.6 IU/L) (p = 0.018). Receiver operating characteristics or ROC curve identified ADA value of 10.95 IU/L as optimal threshold for the prediction of EP with 56% sensitivity and 67% specificity. High ADA levels are valuable in the early diagnosis of EP. However more comprehensive studies are required.

  6. The value of serum creatine kinase in early diagnosis of heterotopic ossification.

    Science.gov (United States)

    Sherman, Andrew L; Williams, Joan; Patrick, Lornette; Banovac, Kresimir

    2003-01-01

    Heterotopic ossification (HO) is a complication of spinal cord injury (SCI) characterized by formation of ectopic bone. Early diagnosis is critical, but available diagnostic methods have drawbacks. Serum creatine kinase may be a marker for the development and severity of HO. 18 SCI patients with diagnosed HO based on clinical findings and bone scintigraphy. Serum creatine kinase levels were taken at the time of diagnosis of HO and during subsequent etidronate therapy. Of the 14 patients with normal creatine kinase values, 13 had no evidence of HO on follow-up radiographic examination. Of the 4 patients with elevated creatine kinase, all developed radiographic signs of HO. Elevated serum creatine kinase may be associated with a more aggressive course of HO as well as resistance to etidronate therapy. Further studies are needed to determine whether creatine kinase may serve as a marker for early, active HO.

  7. 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

    -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......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...... demonstrated that it remains a particular challenge to provide a competent diagnostic tool box for low virulent strains of CSFV, e.g. CSFV-Glentorf. Acknowledgements: The authors wish to thank the EU Reference laboratory for Classical Swine Fever, TIHO, Hannover, for kindly supplying the CSFV-Romania, the CSFV...

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Early Diagnosis of Rare Diseases with a Focus on Pulmonary Arterial Hypertension: A Narrative Review

    OpenAIRE

    Bonaguro, Russell

    2015-01-01

    Health outcomes for rare diseases can be greatly affected by timely diagnosis.This paper presents a narrative review of current literature on rare diseases, with a focuson Pulmonary Arterial Hypertension (PAH), to identify needs for early diagnosisinitiatives. The review assessed: what needs to be done, what is currently being done,and what are the approaches or change theories that underlie these initiatives.Literature from online key-word searches included academic articles pertaining todia...

  10. A Case Report of Probable Sporadic Creutzfeldt-Jakob Disease: How to Approach Early Diagnosis?

    OpenAIRE

    Tan, Bowei; Morales Mangual, Carlos; Mahmud, Iftekhar; Tongo, Nosakhare D; Mararenko, Larisa; Kay, Arthur

    2017-01-01

    Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare and fatal spongiform encephalopathy characterized by rapidly progressive dementia and myoclonus. The rarity of this disease and varied initial symptoms make the early diagnosis fairly challenging. Here, we present?a case initially admitted for confusion and bizarre behaviors. She had acute deterioration of mental status, akinetic mutism, and myoclonus jerks four weeks later. Cerebrospinal fluid (CSF) analysis was positive for protein 14-3-3....

  11. ORGANIZATION OF EARLY DIAGNOSIS OF ONCOUROLOGICAL DISEASES IN THE SVERDLOVSK REGION

    Directory of Open Access Journals (Sweden)

    V. N. Zhuravlev

    2014-07-01

    Full Text Available A major focus of this paper is on the organization of specialized urological treatment, by taking into account the Governor's program “Male urological health” in the Sverdlovsk Region. It also shows the great importance of financial support for early diagnosis, timely effective treatment, clinical examination, and better quality of life in the male population of the Sverdlovsk Region. 

  12. Early diagnosis of complex diseases by molecular biomarkers, network biomarkers, and dynamical network biomarkers.

    Science.gov (United States)

    Liu, Rui; Wang, Xiangdong; Aihara, Kazuyuki; Chen, Luonan

    2014-05-01

    Many studies have been carried out for early diagnosis of complex diseases by finding accurate and robust biomarkers specific to respective diseases. In particular, recent rapid advance of high-throughput technologies provides unprecedented rich information to characterize various disease genotypes and phenotypes in a global and also dynamical manner, which significantly accelerates the study of biomarkers from both theoretical and clinical perspectives. Traditionally, molecular biomarkers that distinguish disease samples from normal samples are widely adopted in clinical practices due to their ease of data measurement. However, many of them suffer from low coverage and high false-positive rates or high false-negative rates, which seriously limit their further clinical applications. To overcome those difficulties, network biomarkers (or module biomarkers) attract much attention and also achieve better performance because a network (or subnetwork) is considered to be a more robust form to characterize diseases than individual molecules. But, both molecular biomarkers and network biomarkers mainly distinguish disease samples from normal samples, and they generally cannot ensure to identify predisease samples due to their static nature, thereby lacking ability to early diagnosis. Based on nonlinear dynamical theory and complex network theory, a new concept of dynamical network biomarkers (DNBs, or a dynamical network of biomarkers) has been developed, which is different from traditional static approaches, and the DNB is able to distinguish a predisease state from normal and disease states by even a small number of samples, and therefore has great potential to achieve "real" early diagnosis of complex diseases. In this paper, we comprehensively review the recent advances and developments on molecular biomarkers, network biomarkers, and DNBs in particular, focusing on the biomarkers for early diagnosis of complex diseases considering a small number of samples and high

  13. A plan to facilitate the early career development of minority scholars in the health sciences.

    Science.gov (United States)

    Berget, Rachael J; Reynolds, Charles F; Ricci, Edmund M; Quinn, Sandra C; Mawson, Anthony R; Payton, Marinelle; Thomas, Stephen B

    2010-11-01

    The EXPORT Health Project at the Center for Minority Health, University of Pittsburgh, partnered with the Center of Excellence in Minority Health at Jackson State University to design and present a Summer Research Career Development Institute (SRCDI) in 2005 and 2006. The goal of the SRCDI was to enhance the early academic career survival skills of postdoctoral and junior faculty investigators doing research on minority health disparities. Institute organizers seek to increase the number of minority investigators who are successful in securing faculty appointments and independent funding through federal agencies. The Pittsburgh Jackson State University SRCDI admitted a total of 55 (26 in 2005 and 29 in 2006) outstanding postdoctoral fellows and assistant professors from institutions across the United States. Elements of this model can be exported to other institutions to assist minority faculty in achieving their career goals.

  14. 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 selfesteem, 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.

  15. High-frequency audiometry: a means for early diagnosis of noise-induced hearing loss.

    Science.gov (United States)

    Mehrparvar, Amir H; Mirmohammadi, Seyyed J; Ghoreyshi, Abbas; Mollasadeghi, Abolfazl; Loukzadeh, Ziba

    2011-01-01

    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.

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

    Science.gov (United States)

    Salman, Afan; Lina, Yen; Simon, Christian

    2014-03-01

    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.

  17. 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.

  18. Affective facilitation of early visual cortex during rapid picture presentation at 6 and 15 Hz.

    Science.gov (United States)

    Bekhtereva, Valeria; Müller, Matthias M

    2015-12-01

    The steady-state visual evoked potential (SSVEP), a neurophysiological marker of attentional resource allocation with its generators in early visual cortex, exhibits enhanced amplitude for emotional compared to neutral complex pictures. Emotional cue extraction for complex images is linked to the N1-EPN complex with a peak latency of ∼140-160 ms. We tested whether neural facilitation in early visual cortex with affective pictures requires emotional cue extraction of individual images, even when a stream of images of the same valence category is presented. Images were shown at either 6 Hz (167 ms, allowing for extraction) or 15 Hz (67 ms per image, causing disruption of processing by the following image). Results showed SSVEP amplitude enhancement for emotional compared to neutral images at a presentation rate of 6 Hz but no differences at 15 Hz. This was not due to featural differences between the two valence categories. Results strongly suggest that individual images need to be displayed for sufficient time allowing for emotional cue extraction to drive affective neural modulation in early visual cortex.

  19. 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.

  20. 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

  1. Recognition of Immune Response for the Early Diagnosis and Treatment of Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Adrese M. Kandahari

    2015-01-01

    Full Text Available Osteoarthritis is a common and debilitating joint disease that affects up to 30 million Americans, leading to significant disability, reduction in quality of life, and costing the United States tens of billions of dollars annually. Classically, osteoarthritis has been characterized as a degenerative, wear-and-tear disease, but recent research has identified it as an immunopathological disease on a spectrum between healthy condition and rheumatoid arthritis. A systematic literature review demonstrates that the disease pathogenesis is driven by an early innate immune response which progressively catalyzes degenerative changes that ultimately lead to an altered joint microenvironment. It is feasible to detect this infiltration of cells in the early, and presumably asymptomatic, phase of the disease through noninvasive imaging techniques. This screening can serve to aid clinicians in potentially identifying high-risk patients, hopefully leading to early effective management, vast improvements in quality of life, and significant reductions in disability, morbidity, and cost related to osteoarthritis. Although the diagnosis and treatment of osteoarthritis routinely utilize both invasive and non-invasive strategies, imaging techniques specific to inflammatory cells are not commonly employed for these purposes. This review discusses this paradigm and aims to shift the focus of future osteoarthritis-related research towards early diagnosis of the disease process.

  2. A systematic review of barriers to early presentation and diagnosis with breast cancer among black women

    Science.gov (United States)

    Jones, Claire EL; Maben, Jill; Jack, Ruth H; Davies, Elizabeth A; Forbes, Lindsay JL; Lucas, Grace; Ream, Emma

    2014-01-01

    Objective To explore barriers to early presentation and diagnosis with breast cancer among black women. Design Systematic review. Methods We searched multiple bibliographic databases (January 1991–February 2013) for primary research, published in English, conducted in developed countries and investigating barriers to early presentation and diagnosis with symptomatic breast cancer among black women (≥18 years). Studies were excluded if they did not report separate findings by ethnic group or gender, only reported differences in time to presentation/diagnosis, or reported on interventions and barriers to cancer screening. We followed Cochrane and PRISMA guidance to identify relevant research. Findings were integrated through thematic synthesis. Designs of quantitative studies made meta-analysis impossible. Results We identified 18 studies (6183 participants). Delay was multifactorial, individual and complex. Factors contributing to delay included: poor symptom and risk factor knowledge; fear of detecting breast abnormality; fear of cancer treatments; fear of partner abandonment; embarrassment disclosing symptoms to healthcare professionals; taboo and stigmatism. Presentation appears quicker following disclosure. Influence of fatalism and religiosity on delay is unclear from evidence in these studies. We compared older studies (≥10 years) with newer ones (<10 years) to determine changes over time. In older studies, delaying factors included: inaccessibility of healthcare services; competing priorities and concerns about partner abandonment. Partner abandonment was studied in older studies but not in newer ones. Comparisons of healthy women and cancer populations revealed differences between how people perceive they would behave, and actually behave, on finding breast abnormality. Conclusions Strategies to improve early presentation and diagnosis with breast cancer among black women need to address symptom recognition and interpretation of risk, as well as

  3. [Laparoscopic diagnosis and treatment of early adhesive small bowel obstruction after gynecological surgery].

    Science.gov (United States)

    Timofeev, M E; Breusenko, V G; Shapoval'iants, S G; Fedorov, E D; Larichev, S E; Kretsu, V N

    2015-01-01

    It is presented the results of diagnostic and curative laparoscopic interventions in 33 patients with acute early adhesive small bowel obstruction. Ileus developed after surgical treatment (laparotomy) of different gynecological diseases. Laparoscopy appeared as the most informative diagnostic method to confirm diagnosis in all patients, to estimate state of abdominal cavity and small pelvis organs what can help to determine method of surgical treatment. Contraindications for laparoscopic surgery were identified in 12 (36.4%) patients and conversion to laparotomy was applied in this group. Postoperative complications were diagnosed in 1 (8.3%) patient. 2 (16.6%) patients died. Early adhesive ileus was resolved laparoscopically in 21 (63.6%) of 33 patients. Recurrent acute early adhesive ileus was detected in 1 (4.7%) patient.

  4. Language facilitates event memory in early childhood: Child comprehension, adult-provided linguistic support and delayed recall at 16 months.

    Science.gov (United States)

    Lukowski, Angela F; Phung, Janice N; Milojevich, Helen M

    2015-01-01

    Adult-provided supportive language facilitates memory for the past in preverbal and verbal children. Work conducted with 18-month-olds indicates that children benefit from supportive adult language when tested after a 4-week delay but not when tested immediately after sequence demonstration; moreover, findings reveal that supportive language provided only at test may be more facilitative of recall after a delay relative to supportive language provided only at encoding. In the present study, we examined whether child language comprehension abilities moderated the extent to which preverbal children benefitted from supportive language provided at encoding and test. The findings indicated that child language comprehension and supportive language provided at encoding were unassociated with performance at baseline or immediate imitation; however, the moderating effect of child language comprehension on adult-provided supportive language at encoding and test was observed after a 1-week delay. Correlations revealed continuous associations between general comprehension scores and recall performance after the 1-week delay on sequences presented in the most supportive condition at encoding. Taken together, the presented findings reveal that the complex interplay between language and cognition is established in early childhood, with foundational relations emerging before children are capable of verbally reporting on the past.

  5. Laboratory Risk Indicator for Necrotizing Fasciitis score for early diagnosis of necrotizing fasciitis in Darwin.

    Science.gov (United States)

    Narasimhan, Vignesh; Ooi, Geraldine; Weidlich, Stephanie; Carson, Phillip

    2017-03-15

    Soft tissue infections are a major health burden in the Top End of the Northern Territory of Australia. Necrotizing fasciitis (NF) is associated with mortality rates from 8 to 40%. Early recognition and aggressive surgical debridement are the cornerstones of successful treatment. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, developed by Wong et al., uses six routine biochemical variables to aid early diagnosis. We aim to assess the diagnostic efficacy of the LRINEC score in our population. A retrospective review of patients with NF between 2005 and 2013 was conducted. A time matched cohort of abscesses/cellulitis was selected. Admission bloods were used to calculate the LRINEC score. An intraoperative finding of NF was used as the gold standard definition for comparison. The diagnostic accuracy of the LRINEC score was assessed. Ninety-eight patients with NF and 205 control patients were identified. The area under the receiver operator curve for the LRINEC score in detecting NF was 0.925 (0.890-0.959, P < 0.001). The sensitivity of the LRINEC ≥5 for NF was 76.3%, with a specificity of 93.1%. The positive and negative predictive values were 95.5 and 88.1%, respectively. The positive and negative likelihood ratios were 11 and 0.25. The LRINEC score is a useful, robust, non-invasive and easily calculated scoring system that can be used as an adjunct to early diagnosis of NF. However, a high degree of clinical suspicion remains the most important factor in early diagnosis of NF. © 2017 Royal Australasian College of Surgeons.

  6. Laser-induced fluorescence as a method of early caries diagnosis

    Science.gov (United States)

    Mielczarek, Agnieszka; Wiewior, Piotr

    2001-07-01

    Use of lasers in dentistry dates back 20 years but is still not fully exploited, especially when concerning the hard dental tissues. Over the past many efforts and actions have been involved in testing and developing new methods for caries diagnosis. The implementation of these methods in general dental practice is unfortunately still limited because too little scientific evidence exists to support them. One of the age-old concerns for dentists is that decay is often discovered too late. Dentists commonly use x-ray imaging for early caries detection, but this method cannot reveal decay at a sufficiently early stage to avoid restorative methods. Generally, if a caries lesion si detected by x-ray, the mineral loss within the tooth is normally very high and will need invasive treatment. Several laser based techniques, as also other optical methods of detecting caries lesions at an early stage seem to be very promising. Fluorescence of tooth structure is observed when hard tissues are illuminated using laser light. Decayed areas appear dark and provide a contrast against the healthy background surrounding them, so discriminating sound and carious tissues. The aim of this study was to present the possibilities of using laser induced fluorescence in the diagnosis of early caries lesions. The current state-of-the-art is presented, as well as results of our investigations. In our studies an argon ion laser was used to illuminate the teeth and the fluorescence pictures were captured with a CCD camera and then analyzed. Results confirmed that laser induced fluorescence can be used as a sensitive method of caries diagnosis.

  7. Clinical prediction and diagnosis of neurosyphilis in HIV-infected patients with early Syphilis.

    Science.gov (United States)

    Dumaresq, Jeannot; Langevin, Stéphanie; Gagnon, Simon; Serhir, Bouchra; Deligne, Benoît; Tremblay, Cécile; Tsang, Raymond S W; Fortin, Claude; Coutlée, François; Roger, Michel

    2013-12-01

    The diagnosis of neurosyphilis (NS) is a challenge, especially in HIV-infected patients, and the criteria for deciding when to perform a lumbar puncture (LP) in HIV-infected patients with syphilis are controversial. We retrospectively reviewed demographic, clinical, and laboratory data from 122 cases of HIV-infected patients with documented early syphilis who underwent an LP to rule out NS, and we evaluated 3 laboratory-developed validated real-time PCR assays, the Treponema pallidum particle agglutination (TPPA) assay, the fluorescent treponemal antibody absorption (FTA-ABS) assay, and the line immunoassay INNO-LIA Syphilis, for the diagnosis of NS from cerebrospinal fluid (CSF) samples of these patients. NS was defined by a reactive CSF-VDRL test result and/or a CSF white blood cell (WBC) count of >20 cells/μl. Thirty of the 122 patients (24.6%) had early NS. Headache, visual symptoms, a CD4 cell count of HIV-1 RNA count of ≥50 copies/ml, were associated with NS in multivariate analysis (P = diagnosis of NS, the PCR, FTA-ABS, TPPA, and INNO-LIA assays had sensitivities of 58%, 100%, 68%, and 100%, specificities of 67%, 12%, 49%, and 13%, and negative predictive values of 85%, 100%, 84%, and 100%, respectively. Visual disturbances, headache, uncontrolled HIV-1 viremia, and a CD4 cell count of HIV-infected patients with early syphilis, while blood serum RPR titers were not; therefore, RPR titers should not be used as the sole criterion for deciding whether to perform an LP in early syphilis. When applied to CSF samples, the INNO-LIA Syphilis assay easily helped rule out NS.

  8. Hemorrhagic shock and encephalopathy syndrome – the markers for an early HSES diagnosis

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    Miyaichi Toshinori

    2008-10-01

    Full Text Available Abstract Background The hemorrhagic shock and encephalopathy syndrome (HSES is a devastating disease that affects young children. The outcomes of HSES patients are often fatal or manifesting severe neurological sequelae. We reviewed the markers for an early diagnosis of HSES. Methods We examined the clinical, biological and radiological findings of 8 patients (4 months to 9 years old who met the HSES criteria. Results Although cerebral edema, disseminated intravascular coagulopathy (DIC, and multiple organ failure were seen in all 8 cases during their clinical courses, brain computed tomography (CT scans showed normal or only slight edema in 5 patients upon admission. All 8 patients had normal platelet counts, and none were in shock. However, they all had severe metabolic acidosis, which persisted even after 3 hours (median base excess (BE, -7.6 mmol/L. And at 6 hours after admission (BE, -5.7 mmol/L they required mechanical ventilation. Within 12 hours after admission, fluid resuscitation and vasopressor infusion for hypotension was required. Seven of the patients had elevated liver enzymes and creatine kinase (CK upon admission. Twenty-four hours after admission, all 8 patients needed vasopressor infusion to maintain blood pressure. Conclusion CT scan, platelet count, hemoglobin level and renal function upon admission are not useful for an early diagnosis of HSES. However, the elevated liver enzymes and CK upon admission, hypotension in the early stage after admission with refractory acid-base disturbance to fluid resuscitation and vasopressor infusion are useful markers for an early HSES diagnosis and helpful to indicate starting intensive neurological treatment.

  9. [Application evaluation of multi-parametric MRI in the diagnosis and differential diagnosis of early prostate cancer and prostatitis].

    Science.gov (United States)

    Li, P; Huang, Y; Li, Y; Cai, L; Ji, G H; Zheng, Y; Chen, Z Q

    2016-10-11

    Objective: To evaluate the value of multi-parametric MRI (Mp-MRI) in the diagnosis and differential diagnosis of early prostate cancer(PCa) in the peripheral zone(PZ) and low T2WI signal intensity of prostatitis. Methods: A total of 40 patients with PZ early PCa and 37 with prostatitis of hypointense T2WI signal in PZ were retrospectively analyzed, which were collected from the General Hospital of Ningxia Medical University from Janurary 2009 to June 2015, who underwent T2WI, DWI, and DCE-MRI examination and all patients were confirmed by pathology. All the data was transferred to GE Advanced Workstation AW4.3, the indexes divided into cancerous and prostatitis regions were calculated by Functool2 of signal intensity-time(SI-T) curve and ADC value, to calcuate the time to minimum(Tmax), the whole enhancment degree (SImax). ROC cure was used to determine the cutoff value for PCa detection with the ADC value. Result: On T2WI, 57.5% of PCa (23/40) showed focal nodular homogeneous low signal intensity, 70.3% of prostatitis(26/37) showed diffuse inhomogeneous low signal intensity. DCE-MRI, the distribution of curve types for malignant tumors was type Ⅰ 2.5%(1/40), typeⅡ32.5%(13/40) and type Ⅲ 65.0% (26/40). While the numbers for prostatitis was type Ⅰ 16.2%(6/37) , type Ⅱ 56.8% (21/37) and type Ⅲ 27.0% (10/37)respectively.The patterns of curve types in malignant lesions were different from benign lesions significantly(χ(2) =12.32, P<0.01). The mean values of Tmax, SImax in cancerous and prostatitis regions were (17.96±2.91)s, 1.76%±0.23% and (21.19±3.59)s, 1.53%±0.18%, respectively (t=5.37, 6.10; P<0.01). On DWI, The mean ADC values in cancerous and prostatitis regions were (0.95±0.13)×10(-3) mm(2)/s and (1.12±0.13)×10(-3) mm(2)/s, respectively (t=7.10, P<0.01). According to the ROC analysis, when the cutoff value was 1.01×10(-3) mm(2)/s, the early PCa of diagnostic sensitivity, specificity and accuracy was 79.1%, 72.7% and 76.1% respectively

  10. Early diagnosis of malignant melanoma: Proposal of a working formulation for the management of cutaneous pigmented lesions from the Melanoma Cooperative Group.

    Science.gov (United States)

    Ascierto, Paolo A; Palmieri, Giuseppe; Botti, Gerardo; Satriano, Rocco A; Stanganelli, Ignazio; Bono, Riccardo; Testori, Alessandro; Bosco, Leonardo; Daponte, Antonio; Caracò, Corrado; Chiofalo, Maria Grazia; Melucci, Maria Teresa; Calignano, Rosario; Tatangelo, Fabiana; Cochran, Alistair J; Castello, Giuseppe

    2003-06-01

    Epiluminescence microscopy (ELM) strongly improves the separation of different types of cutaneous pigmented lesions (CPL) and facilitates the early diagnosis of cutaneous melanoma (CM). ELM alone is not 100% accurate in routine diagnosis, and should not be considered the only criterion in the diagnosis of high-risk skin lesions. We have however, demonstrated close agreement between ELM classification criteria and histology in 2,731 cutaneous lesions. In the past five years, our Melanoma Cooperative Group has evaluated 61,000 skin lesions from 30,000 individuals and identified 478 cutaneous melanomas. Most newly diagnosed patients had very early stage melanoma [299 (62%) were Stage I (203 Stage IA and 96 Stage IB), by the American Joint Committee on Cancer (AJCC) criteria]. We have compared data from the patient histories and clinical evaluations with ELM-based morphological patterns to better characterize skin lesions and minimize interpretative problems. From these comparisons, we propose new guidelines for the management of CPL to provide a standard diagnostic and therapeutic approaches and to foster the early identification of lesions at risk for malignant transformation.

  11. Narrow-band imaging in the diagnosis of early esophageal cancer and precancerous lesions

    Institute of Scientific and Technical Information of China (English)

    HUANG Liu-ye; CUI Jun; WU Cheng-rong; LIU Yun-xiang; XU Ning

    2009-01-01

    Background In the recent years,the incidence of esophageal cancer in China has increased.The key point for raising the survival rate is the diagnosis and treatment at an early stage.Narrow-band imaging (NBI) can enhance the contrast of the mucous membrane of the esophagus without staining.This study aimed to explore the value of NBI in the diagnosis of early esophageal cancer and precancerous lesions.Methods The esophagus was examined with ordinary endoscopy and NBI endoscopy.Pit patterns and blood capillary forms were examined with routine magnifying endoscopy and NBI endoscopy.Finally,a 1.2% Lugoul's iodine solution was used to stain the esophageal mucosal surface and a biopsy was taken at all the sites where NBI or iodine staining was positive.NBI and iodine staining scales were compared with pathologic diagnosis,which was considered as the gold standard.Results A total of 90 cases (138 lesions in total) were diagnosed as early esophageal cancer or precancerous lesions:104 lesions (75.4%) were detected with ordinary endoscopy,120 lesions (87.0%) were detected with NBI endoscopy,and 138 lesions (100%) were detected with iodine staining.The lesion detection rate of NBI was significantly lower than that of iodine staining (X2=17.176,P <0.01).However,there was no significant difference between NBI and iodine staining for the diagnosis of high grade intraepithelial neoplasia (X2=1.362,P >0.05),while the detection rate of NBI was significantly lower than that of iodine staining for the diagnosis of low grade intraepithelial neoplasia (X2=13.388,P <0.01).The pit pattern and blood capillary form of eady esophageal cancer and precancerous lesions could be demonstrated clearer with NBI than with ordinary endoscopy.Conclusions NBI can enhance the contrast of the mucous membrane of the esophagus without staining.The combination of NBI and iodine staining can raise the diagnostic rate of early esophageal cancer and precancerous lesions.

  12. Early diagnosis of typhoid fever by nested PCR for flagellin gene of Salmonella enterica serotype Typhi.

    Science.gov (United States)

    Khan, S; Harish, B N; Menezes, G A; Acharya, N S; Parija, S C

    2012-11-01

    Typhoid fever caused by Salmonella Typhi continues to be a major health problem in spite of the use of antibiotics and the development of newer antibacterial drugs. Inability to make an early laboratory diagnosis and resort to empirical therapy, often lead to increased morbidity and mortality in cases of typhoid fever. This study was aimed to optimize a nested PCR for early diagnosis of typhoid fever and using it as a diagnostic tool in culture negative cases of suspected typhoid fever. Eighty patients with clinical diagnosis of typhoid fever and 40 controls were included in the study. The blood samples collected were subjected to culture, Widal and nested PCR targeting the flagellin gene of S. Typhi. The sensitivity of PCR on blood was found to be 100 per cent whereas the specificity was 76.9 per cent. The positive predictive value (PPV) of PCR was calculated to be 76.9 per cent with an accuracy of 86 per cent. None of the 40 control samples gave a positive PCR. Due to its high sensitivity and specificity nested PCR can be used as a useful tool to diagnose clinically suspected, culture negative cases of typhoid fever.

  13. Neglected evidence in idiopathic pulmonary fibrosis and the importance of early diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Vincent Cottin

    2014-03-01

    Full Text Available In idiopathic pulmonary fibrosis (IPF, some facts or concepts based on substantial evidence, whilst implicit for learned subspecialists, have previously been neglected and/or not explicitly formulated or made accessible to a wider audience. IPF is strongly associated with cigarette smoking and is predominantly a disease of ageing. However, its cause(s remain elusive and, thus, it is one of the most challenging diseases for the development of novel effective and safe therapies. With the approval of pirfenidone for patients with mild-to-moderate IPF, an earlier diagnosis of IPF is a prerequisite for earlier treatment and, potentially, improvement of the long-term clinical outcome of this progressive and ultimately fatal disease. An earlier diagnosis may be achieved in IPF by promoting thin-slice chest high-resolution computed tomography screening of interstitial lung disease as a “by-product” of large-scale lung cancer screening strategies in smokers, but other techniques, which have been neglected in the past, are now available. Lung auscultation and early identification of “velcro” crackles has been proposed as a key component of early diagnosis of IPF. An ongoing study is exploring correlations between lung sounds on auscultation obtained using electronic stethoscopes and high-resolution computed tomography patterns.

  14. Inferior Alveolar Nerve Injuries Following Implant Placement - Importance of Early Diagnosis and Treatment: a Systematic Review

    Directory of Open Access Journals (Sweden)

    Ilana Shavit

    2014-12-01

    Full Text Available Objectives: The purpose of this article is to systematically review diagnostic procedures and risk factors associated with inferior alveolar nerve injury following implant placement, to identify the time interval between inferior alveolar nerve injury and its diagnosis after surgical dental implant placement and compare between outcomes of early and delayed diagnosis and treatment given based on case series recorded throughout a period of 10 years. Material and Methods: We performed literature investigation through MEDLINE (PubMed electronic database and manual search through dental journals to find articles concerning inferior alveolar nerve injury following implant placement. The search was restricted to English language articles published during the last 10 years, from December 2004 to March 2014. Results: In total, we found 33 articles related to the topic, of which 27 were excluded due to incompatibility with established inclusion criteria. Six articles were eventually chosen to be suitable. The studies presented diagnostic methods of inferior alveolar nerve sensory deficit, and we carried out an assessment of the proportion of patients diagnosed within different time intervals from the time the injury occurred. Conclusions: Various diagnostic methods have been developed throughout the years for dealing with 1 quite frequent complication in the implantology field - inferior alveolar nerve injury. Concurrently, the importance of early diagnosis and treatment was proved repeatedly. According to the results of the data analysis, a relatively high percentage of the practitioners successfully accomplished this target and achieved good treatment outcomes.

  15. Early diagnosis of kidney transplant rejection and cyclosporin nephrotoxicity by urine cytology.

    Science.gov (United States)

    Kyo, M; Gudat, F; Dalquen, P; Huser, B; Thiel, G; Fujimoto, N; Ichikawa, Y; Fukunishi, T; Nagano, S; Mihatsch, M J

    1992-01-01

    A total of 2000 urine samples from 53 kidney transplant recipients were studied to develop a routine method for the early diagnosis of rejection and cyclosporin (CSA) nephrotoxicity in urine. New-Sternheimer staining and an immunocytochemical technique were used together with classical Papanicolaou staining to differentiate cells in the urine. After cell count and differentiation of second morning urine samples with New-Sternheimer and Papanicolaou stains, immunocytochemistry was performed using antibodies against the following antigens: CD2, CD4, CD8, CD25, CD71 (transferrin receptor), HLA-DR and cytokeratin (Lu-5). Cell counts were obtained for the positively-reacting cells per millilitre of urine. By New-Sternheimer and Papanicolaou staining, CSA nephrotoxicity was characterized by the predominance of proximal tubular cells. During rejection episodes, increased numbers of mononuclear cells and renal epithelial cells were found. Immunocytochemical analysis showed a significant increase in CD2-, CD4-, CD8-, CD25-, CD71-, and HLA-DR-positive epithelial cells and in the ratio HLA-DR/cytokeratin-positive epithelial cells in rejection. CD25-positive cells had the highest sensitivity and specificity for the diagnosis of rejection. Our urine cytology technique proved to be a useful and non-invasive method for the early diagnosis of rejection and CSA nephrotoxicity.

  16. Early diagnosis of rheumatic diseases: an evaluation of the present situation and proposed changes.

    Science.gov (United States)

    Kwiatkowska, Brygida; Raciborski, Filip; Kłak, Anna; Maślińska, Maria; Gryglewicz, Jerzy

    2015-01-01

    Musculoskeletal pain is a very common complaint, affecting 30-40% of the European population. It is estimated that approximately 400,000 Poles suffer from inflammatory rheumatic diseases, such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis, and a vast majority of those affected are working-age individuals. Patients with suspected arthritis require prompt diagnosis and treatment, as any delays may result in irreversible joint destruction and disability. Currently in Poland, the lag time between the onset of symptoms and diagnosis is, on average, as much as 35 weeks. In this paper, we review the current state of specialist rheumatology care in Poland and propose a reorganised care model that includes early diagnosis of inflammatory arthritis. The main goal we wish to achieve with our reorganised model is to enhance access to outpatient specialist rheumatology care for patients with suspected arthritis. We believe that our model should make it possible to considerably reduce the lag time between GP referral and the diagnosis and treatment by a rheumatologist to as little as 3 to 4 weeks. This article provides a proposal of changes that would achieve this goal and is a summary of the report published by the Institute of Rheumatology in September 2014.

  17. Desirability of early identification of Duchenne Muscular Dystrophy (DMD): parent’s experiences of the period prior to diagnosis.

    NARCIS (Netherlands)

    Eilers, R.; Kleinveld, J.H.; Vroom, E.; Westerman, M.J.; Plass, A.M.C.

    2012-01-01

    Duchenne Muscular Dystrophy (DMD), X-linked recessively inherited, is the most common progressive muscular disorder in children. Early diagnosis could offer opportunities for timely initiation of treatment possibilities, genetic counselling, and prevent a long diagnostic quest. Despite the

  18. Desirability of early identification of Duchenne Muscular Dystrophy (DMD): parent’s experiences of the period prior to diagnosis.

    NARCIS (Netherlands)

    Eilers, R.; Kleinveld, J.H.; Vroom, E.; Westerman, M.J.; Plass, A.M.C.

    2012-01-01

    Duchenne Muscular Dystrophy (DMD), X-linked recessively inherited, is the most common progressive muscular disorder in children. Early diagnosis could offer opportunities for timely initiation of treatment possibilities, genetic counselling, and prevent a long diagnostic quest. Despite the availabil

  19. A magnetic-field enriched surface-enhanced resonance Raman spectroscopy strategy towards the early diagnosis of malaria

    Science.gov (United States)

    Yuen, Clement; Liu, Quan

    2012-03-01

    Early malaria diagnosis is important because malaria disease can develop into fatal illness within hours upon the appearance of the first symptom. The low concentration of the diagnosis biomarker, hemozoin, at the early stage of malaria disease makes early diagnosis difficult. In this paper, we present a magnetic field-enriched surface-enhanced resonance Raman spectroscopy (SERRS) strategy for the sensitive detection of β - hematin crystals, which is equivalent to hemozoin in the characteristics of Raman spectrum, by using magnetic nanoparticles. We observe several orders of magnitude enhancement in the SERRS signal of enriched β - hematin in comparison to the Raman signal of β - hematin in the cases of SERRS alone or magnetic enrichment alone, showing the great potential of this method towards early malaria diagnosis.

  20. The Role of Pancreatic Stone Protein in Diagnosis of Early Onset Neonatal Sepsis

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    Anwar A. Rass

    2016-01-01

    Full Text Available Introduction. Early diagnosis and treatment of neonatal sepsis may help decrease neonatal mortality. Aim of the Study. To evaluate the role of pancreatic stone protein as a marker for early onset neonatal sepsis. Methods. A hospital-based prospective study was conducted on 104 (52 uninfected and 52 infected neonates admitted to the Neonatal Intensive Care Unit (NICU of Zagazig University hospitals during the period from April 2014 to April 2015. All newborns were subjected to full history taking, careful neonatal assessment, blood, C-reactive protein (CRP, and serum pancreatic stone protein. Results. Serum PSP levels were significantly higher in the infected group than in the uninfected group. At a cutoff level of PSP 12.96 ng/mL, the sensitivity was 96.2%, the specificity was 88.5%, positive predictive value was 95.8%, negative predictive value was 89.3%, and area under the curve was 0.87. A significant positive correlation between CRP and PSP was found in infected group. Conclusion. The high negative predictive value of PSP (89.3% indicates that the serum PSP level is a good marker for diagnosis of early onset neonatal sepsis and can be used to limit hospital stay and antibiotic use in neonates treated for suspected sepsis.

  1. Humphrey visual field and frequency doubling perimetry in the diagnosis of early glaucoma.

    Directory of Open Access Journals (Sweden)

    Chandrasekhar G

    2003-01-01

    Full Text Available Purpose: To compare Humphrey Visual Field Analyzer (HVF and Frequency Doubling Perimetry (FDP testing in the diagnosis of early glaucoma. Methods: We performed HVF (24-2 standard full threshold and FDP (N-30 evaluations in 34 consecutive patients with early primary glaucoma and 96 normal subjects. Early glaucoma was defined on the basis of disc changes of glaucoma; the mean deviation on white-on-white perimetry had to be no worse than 6 decibels. Glaucomatous optic neuropathy was defined as a combination of cup-disc asymmetry of more than 0.2, notching, excavation, thinning or pallor of superior or inferior neuroretinal rims, retinal nerve fibre layer defects of the wedge or diffuse type and neuroretinal rim haemorrhage. Both the glaucoma patients and normal subjects had vision better than 6/9 with correction. They had no media opacities other than early nuclear sclerosis and no fundus pathology. Further, normal subjects were free of systemic diseases known to affect the retina or optic nerve, The sensitivity and specificity of HVF and FDP were calculated. Results: There were 44 eligible eyes among the 34 subjects. The glaucomatous disc findings included notch (n=8, pallor (n=21, thinning (n=23 and haemorrhage (n=1 of the neuroretinal rim. The sensitivity and the specificity of the HVF were 52.3% and 57.3% respectively. The sensitivity and the specificity of FDP were 65.9% and 61.5% respectively. Conclusion: The difference between FDP and HVF in the diagnosis of early glaucoma is not marked.

  2. [Guidelines for the early diagnosis of lung cancer for primary care physicians].

    Science.gov (United States)

    2016-01-01

    Lung cancer is a serious/medical and social problem. It belongs to the most common cancers. In the past decades, lung cancer has steadily held a leading place in the structure of cancer morbidity and mortality in our country and in the majority of European countries. Cigarette smoking remains to be the major if not only risk factor for lung cancer. Many attempts were previously made to set up systems for the early (timely) lung cancerdetection in risk groups through cytological and radiological examinations. Prophylactic fluorography and X-ray study have long been an important screening procedure in Russia and foreign countries. Recently this procedure has transformed into digital lung radiography. However, there have been no conclusive proofs for its efficiency in the early detection of lung cancer for a few decades. In the past decade, large-scale prospective randomized trials of low-dose computed tomography (CT) have been performed to screen lung cancer. These have shown that this technology can potentially reduce mortality from this disease. This encouraging result has caused a substantial change in the tactics of examining people at high risk for lung cancer. CT has fully replaced linear tomography and all others special X-ray procedures in the verified diagnosis of lung cancer. The indications for pre-examination CT have been considerably expanded in patients with X-ray detected pathology. The tactics for estimating the small lung tissue foci found at CT has been changed. Availability of CT, clear clinical indications for the study, and observance of the standard procedure have become important elements of the entire system for the early identification of lung cancer. These clinical recommendations largely deal just with organizational and methodological issues. The authors hope that the recommendations will serve as a guide for primary care physicians (therapists, pulmonologists,and radiologists) in the early diagnosis of lung cancer and in the optimization

  3. Advances in Bio-Optical Imaging for the Diagnosis of Early Oral Cancer

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    Ivan Keogh

    2011-07-01

    Full Text Available Oral cancer is among the most common malignancies worldwide, therefore early detection and treatment is imperative. The 5-year survival rate has remained at a dismal 50% for the past several decades. The main reason for the poor survival rate is the fact that most of the oral cancers, despite the general accessibility of the oral cavity, are not diagnosed until the advanced stage. Early detection of the oral tumors and its precursor lesions may be the most effective means to improve clinical outcome and cure most patients. One of the emerging technologies is the use of non-invasive in vivo tissue imaging to capture the molecular changes at high-resolution to improve the detection capability of early stage disease. This review will discuss the use of optical probes and highlight the role of optical imaging such as autofluorescence, fluorescence diagnosis (FD, laser confocal endomicroscopy (LCE, surface enhanced Raman spectroscopy (SERS, optical coherence tomography (OCT and confocal reflectance microscopy (CRM in early oral cancer detection. FD is a promising method to differentiate cancerous lesions from benign, thus helping in the determination of adequate resolution of surgical resection margin. LCE offers in vivo cellular imaging of tissue structures from surface to subsurface layers and has demonstrated the potential to be used as a minimally invasive optical biopsy technique for early diagnosis of oral cancer lesions. SERS was able to differentiate between normal and oral cancer patients based on the spectra acquired from saliva of patients. OCT has been used to visualize the detailed histological features of the oral lesions with an imaging depth down to 2–3 mm. CRM is an optical tool to noninvasively image tissue with near histological resolution. These comprehensive diagnostic modalities can also be used to define surgical margin and to provide a direct assessment of the therapeutic effectiveness.

  4. Multiparameter analysis of biomarkers in the laboratory diagnosis of early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Aleksandr Aleksandrovich Novikov

    2013-01-01

    Full Text Available Subjects and methods. 102 patients with early RA (79 women and 23 men; median age 51 years [41 to 62, 25th to 75th percentile]; disease duration 4 months [2.5 to 6.0]; DAS28 5.4 [4.1 to 5.9] were examined. A comparison group consisted of 616 patients including 27 with systemic lupus erythematosus, 15 with Sjö gren’s syndrome, 25 with ankylosing spondyloarthritis; 33 with osteoarthritis, 20 with overlap syndrome, 9, 22, and 168 patients with gouty, psoriatic, and undifferentiated arthritis, respectively; as well as 297 healthy donors matched with the examinees for gender and age. The concentrations of 36 biomarkers were measured by an immunonephelometric method, enzyme immunoassay, and xMAP technology. The values of one variable from others were predicted using a multiple linear regression method (multivariate analysis. Results. The strongest predictors of early RA, such as the concentrations of interleukin-6, C-reactive protein, granulo-cyte-macrophage colony-stimulating factor, interferon-γ (IFN-γ, IFN^-inducible protein, anti-cyclic citrullinated peptide antibodies, were identified and a candidate for MDI was developed for early RA (MIRRA. After thorough validation, MIRRA may be regarded as a precision serological assay for the early diagnosis of RA. Conclusion. The development of MDI having a higher diagnostic precision than routinely used biomarkers is imperative for early RA diagnosis that allows one to initiate active antirheumatic therapy that is able to effectively delay progressive joint injury.

  5. Development of new strategies for early diagnosis of mucormycosis from bench to bedside.

    Science.gov (United States)

    Walsh, Thomas J; Skiada, Anna; Cornely, Oliver A; Roilides, Emmanuel; Ibrahim, Ashraf; Zaoutis, Theoklis; Groll, Andreas; Lortholary, Olivier; Kontoyiannis, Dimitrios P; Petrikkos, George

    2014-12-01

    Early diagnosis and initiation of amphotericin B (AmB) for treatment of mucormycosis increases survival from approximately 40% to 80%. The central objective of a new study of the European Confederation of Medical Mycology (ECMM) and the International Society for Human and Animal Mycology (ISHAM) Zygomycosis Working Group is to improve the clinical and laboratory diagnosis of mucormycosis. The diagnostic tools generated from this study may help to significantly improve survival from mucormycosis worldwide. The study has three major objectives: to conduct a prospective international registration of patients with mucormycosis using a well-established global network of centres; to construct a predictive risk model for patients at risk for mucormycosis; and to establish an international archive of specimens of tissues, fluids, and organisms linked from the patients enrolled into the registry that will be used for development of leading edge molecular, proteomic, metabolic and antigenic systems for mucormycosis.

  6. Toxic scarlet fever complicating cellulitis: early clinical diagnosis is crucial to prevent a fatal outcome.

    Science.gov (United States)

    Lau, S K; Woo, P C; Yuen, K Y

    2004-04-01

    We describe a case of toxic scarlet fever in a healthy adult with streptococcal cellulitis of the right elbow as a result of skin abrasion. The clinical picture mimicked that of drug eruption after treatment of cellulitis with antibiotics. Among the five cases of scarlet fever complicating cellulitis, including the present one, reported in the English literature, four had severe systemic complications and two died. As a result of re-emergence of invasive streptococcal infections, clinicians should be aware of the differential diagnosis of scarlet fever in patients presenting with cellulitis and skin rash. Early clinical diagnosis is crucial to exclude drug eruptions, prompt initiation of antibiotic treatment, and prevention of the potentially fatal outcome.

  7. Early Diagnosis of Clear Cell Kidney Cancer via VHL/HIF Pathway Regulated-Circulating microRNA

    Science.gov (United States)

    2016-05-01

    Award Number: W81XWH-11-1-0715 TITLE: Early Diagnosis of Clear Cell Kidney Cancer via VHL/HIF Pathway -Regulated Circulating microRNA PRINCIPAL...TITLE AND SUBTITLE Sa. CONTRACT NUMBER Early Diagnosis of Clear Cell Kidney Cancer via VHL/HIF Pathway - Regulated Circulating microRNA Sb. GRANT NUMBER...panel of diagnostic miRNAs that are measurable in serum and will be able to identify kidney cancer in its earliest stages. We hypothesized that serum

  8. Computer-aided diagnosis of early knee osteoarthritis based on MRI T2 mapping.

    Science.gov (United States)

    Wu, Yixiao; Yang, Ran; Jia, Sen; Li, Zhanjun; Zhou, Zhiyang; Lou, Ting

    2014-01-01

    This work was aimed at studying the method of computer-aided diagnosis of early knee OA (OA: osteoarthritis). Based on the technique of MRI (MRI: Magnetic Resonance Imaging) T2 Mapping, through computer image processing, feature extraction, calculation and analysis via constructing a classifier, an effective computer-aided diagnosis method for knee OA was created to assist doctors in their accurate, timely and convenient detection of potential risk of OA. In order to evaluate this method, a total of 1380 data from the MRI images of 46 samples of knee joints were collected. These data were then modeled through linear regression on an offline general platform by the use of the ImageJ software, and a map of the physical parameter T2 was reconstructed. After the image processing, the T2 values of ten regions in the WORMS (WORMS: Whole-organ Magnetic Resonance Imaging Score) areas of the articular cartilage were extracted to be used as the eigenvalues in data mining. Then,a RBF (RBF: Radical Basis Function) network classifier was built to classify and identify the collected data. The classifier exhibited a final identification accuracy of 75%, indicating a good result of assisting diagnosis. Since the knee OA classifier constituted by a weights-directly-determined RBF neural network didn't require any iteration, our results demonstrated that the optimal weights, appropriate center and variance could be yielded through simple procedures. Furthermore, the accuracy for both the training samples and the testing samples from the normal group could reach 100%. Finally, the classifier was superior both in time efficiency and classification performance to the frequently used classifiers based on iterative learning. Thus it was suitable to be used as an aid to computer-aided diagnosis of early knee OA.

  9. Towards early in vivo photoacoustic malaria diagnosis with 10,000-fold sensitivity improvement (Conference Presentation)

    Science.gov (United States)

    Carey, Kai A.; Menyaev, Yulian A.; Nedosekin, Dmitry A.; Sarimollaoglu, Mustafa; Galanzha, Ekaterina I.; Stumhofer, Jason S.; Zharov, Vladimir P.

    2017-03-01

    Roughly 0.6 million people die each year from malaria due to lack of early diagnosis and well-timed treatment. Our previous study demonstrated great potential of in vivo photoacoustic (PA) flow cytometry (PAFC) for early diagnosis of deadly diseases with focus on cancer and thromboembolic complications. Here we demonstrate potential of advanced PAFC platforms using new laser, ultrasound transducer array and recording system to detect infected red blood cells (iRBCs) with malaria-associated pigment hemozoin which has a higher PA contrast than blood background. Mature parasites of human infecting species such as P. falciparum characteristically sequester mature iRBCs in the capillary bed and display synchrony in their reproductive cycle. To address this issue prior to clinical application, new PAFC platform was verified in a pre-clinical study using new animal models. Specifically, we used P. chabaudi (a rodent malaria species that mimics the characteristics of the most virulent human counterpart) to estimate the detection sensitivity with immature ring-stage parasites in peripheral blood, compared PA signals from the differing species, and examined the relationship between PA signal amplitudes and level of blood oxygenation. Based on previous successful trials on melanoma patients with melanin as an intrinsic PA marker, which has similar absorption as hemozoin, we believe that after additional malaria-related clinical trials, PAFC with a small 1064 nm laser and wearable a cost-effective, easy-to-use, watch-like, safe PA probe will provide malaria diagnosis in humans at parasitemia levels 10e4 -times lower than the current gold standard of diagnosis, the Giemsa-stained blood smear. It can reduce malaria-related mortality by well-timed treatment, especially in children in malaria-endemic countries.

  10. Absolute pitch: evidence for early cognitive facilitation during passive listening as revealed by reduced P3a amplitudes.

    Science.gov (United States)

    Rogenmoser, Lars; Elmer, Stefan; Jäncke, Lutz

    2015-03-01

    Absolute pitch (AP) is the rare ability to identify or produce different pitches without using reference tones. At least two sequential processing stages are assumed to contribute to this phenomenon. The first recruits a pitch memory mechanism at an early stage of auditory processing, whereas the second is driven by a later cognitive mechanism (pitch labeling). Several investigations have used active tasks, but it is unclear how these two mechanisms contribute to AP during passive listening. The present work investigated the temporal dynamics of tone processing in AP and non-AP (NAP) participants by using EEG. We applied a passive oddball paradigm with between- and within-tone category manipulations and analyzed the MMN reflecting the early stage of auditory processing and the P3a response reflecting the later cognitive mechanism during the second processing stage. Results did not reveal between-group differences in MMN waveforms. By contrast, the P3a response was specifically associated with AP and sensitive to the processing of different pitch types. Specifically, AP participants exhibited smaller P3a amplitudes, especially in between-tone category conditions, and P3a responses correlated significantly with the age of commencement of musical training, suggesting an influence of early musical exposure on AP. Our results reinforce the current opinion that the representation of pitches at the processing level of the auditory-related cortex is comparable among AP and NAP participants, whereas the later processing stage is critical for AP. Results are interpreted as reflecting cognitive facilitation in AP participants, possibly driven by the availability of multiple codes for tones.

  11. [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.

  12. Magnetic resonance imaging applications in early rheumatoid arthritis diagnosis and management.

    Science.gov (United States)

    Troum, Orrin M; Pimienta, Olga; Olech, Ewa

    2012-05-01

    Early diagnosis and treatment have been recognized as essential for improving clinical outcomes in patients with rheumatoid arthritis (RA). Magnetic resonance imaging (MRI) is a sensitive modality that can assess both inflammatory and structural lesions. MRI can assist in following the disease course in patients treated with traditional disease-modifying antirheumatic drugs and biological therapies both in the clinic and in research trials. Therefore, it is anticipated that MRI becomes the diagnostic imaging modality of choice in RA clinical trials while remaining a useful tool for clinicians evaluating patients with RA.

  13. Sjögren-Larsson syndrome: importance of early diagnosis and aggressive physiotherapy.

    Science.gov (United States)

    Kathuria, Sushruta; Arora, Shikha; Ramesh, V

    2012-09-15

    Sjögren-Larsson syndrome (SLS) is a congenital ichthyotic disorder with spasticity. We describe a case of a 5-year-old boy with SLS diagnosed clinically based on congenital ichythosis, quadriplegia, and mental retardation. The child responded well to emollients and antihistamines. His quadriplegia was managed by aggressive physiotherapy and mental retardation by stimulation techniques. After a 3-year follow up, significant improvement was seen in his motor and mental disability. This case highlights the importance of clinical diagnosis and early intervention for such a disabling disorder.

  14. De Garengeot's hernia: the importance of early diagnosis and its complications.

    Science.gov (United States)

    Kagan Coskun, A; Kilbas, Z; Yigit, T; Simsek, A; Harlak, A

    2012-12-01

    De Garengeot's hernia is a rare condition of acute appendicitis in an incarcerated femoral hernia. A 65-year-old woman was admitted to the emergency room with a 3-day history of a painful and non-reducible mass in her right groin. The patient underwent emergency surgery. At exploration, an acute appendicitis in an incarcerated femoral hernia was identified, likely prediagnosed by computed tomography. The postoperative period was uneventful. In De Garengeot's hernia, early diagnosis is important to reduce the morbidity rate. The surgical approach should be designed according to the condition of the patient, the anatomical position of the appendix vermiformis, and the likelihood of complications.

  15. Facilitating HIV testing, care and treatment for orphans and vulnerable children aged five years and younger through community-based early childhood development playcentres in rural Zimbabwe.

    Science.gov (United States)

    Patel, Diana; Matyanga, Priscilla; Nyamundaya, Tichaona; Chimedza, Delia; Webb, Karen; Engelsmann, Barbara

    2012-07-11

    Early diagnosis of children living with HIV is a prerequisite for accessing timely paediatric HIV care and treatment services and for optimizing treatment outcomes. Testing of HIV-exposed infants at 6 weeks and later is part of the national prevention of mother to child transmission (PMTCT) of HIV programme in Zimbabwe, but many opportunities to test infants and children are being missed. Early childhood development (ECD) playcentres can act as an entry point providing multiple health and social services for orphans and vulnerable children (OVC) under 5 years, including facilitating access to HIV treatment and care. Sixteen rural community-based, community-run ECD playcentres were established to provide health, nutritional and psychosocial support for OVC aged 5 years and younger exposed to or living with HIV, coupled with family support groups (FSGs) for their families/caregivers. These centres were located in close proximity to health centres giving access to nurse-led monitoring of 697 OVC and their caregivers. Community mobilisers identified OVC within the community, supported their registration process and followed up defaulters. Records profiling each child's attendance, development and health status (including illness episodes), vaccinations and HIV status were compiled at the playcentres and regularly reviewed, updated and acted upon by nurse supervisors. Through FSGs, community cadres and a range of officers from local services established linkages and built the capacity of parents/caregivers and communities to provide protection, aid psychosocial development and facilitate referral for treatment and support. Available data as of September 2011 for 16 rural centres indicate that 58.8% (n=410) of the 697 children attending the centres were tested for HIV; 18% (n=74) tested positive and were initiated on antibiotic prophylaxis. All those deemed eligible for antiretroviral therapy were commenced on treatment and adherence was monitored. This community

  16. Endoscopic diagnosis of early carcinoma of the esophagus using Lugol's solution.

    Science.gov (United States)

    Sugimachi, K; Kitamura, K; Baba, K; Ikebe, M; Kuwano, H

    1992-01-01

    Small esophageal lesions, particularly intraepithelial cancers, are extremely difficult to detect. We used Lugol's iodine solution with panendoscopic examination to detect the presence and spread of small squamous cell carcinomas of the esophagus. Serial histologic specimens of the surgically removed esophagus from 32 patients with Lugol's combined endoscopic diagnosis of early esophageal carcinoma were examined to determine the correlation between endoscopic and histologic findings. All of the early staged carcinomas clearly remained unstained by Lugol's solution. We believe that the application of Lugol's solution will greatly aid in instances when a suspicious mucosal lesion is noted, when the margin of the lesion is unclear, or when there is suspicion that a mucosal lesion may have been overlooked.

  17. AUTOFLUORESCENCE BRONCHOSCOPY AS A MODALITY FOR EARLY DIAGNOSIS OF LUNG CANCER

    Directory of Open Access Journals (Sweden)

    KAW Nugraha

    2013-03-01

    Full Text Available Lung cancer has become a complicated health problem in the world. In 2005, approximately 172,500 people diagnosed with lung cancer in the United States. In Indonesia, lung cancer ranks fourth highest. Lung cancer is also the most common cause of death from cancer, so we need appropriate early detection modality to reduce the number of deaths from lung cancer. Compared with other modalities that currently available, Autofluorescence Bronchoscopy (AFB seems to have better accuracy in early diagnosis of lung cancer. AFB can be used to evaluate patients with high-grade sputum atypia, evaluating patients with suspected or had suffered from lung cancer, and have a role in follow-up of bronchial high-grade intraepithelial neoplasia.

  18. Early diagnosis of acoustic neuroma by quantitative neurootological and neuroradiological tests

    Energy Technology Data Exchange (ETDEWEB)

    Haid, C.T.

    1983-02-01

    Every patient with unilateral and sensoneural loss of hearing, independent of vertigo anamnesis or X-rays must be further examined by a vestibular test. Between 1974 and 1980, 80 acoustic neuromas could be diagnosed, including 12 early stage neuromas. This relatively high detection quote of small neuromas is due to a special diagnostical program: All 80 patients with acoustic neuroma had a pathological vestibular result. 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 caloric test: 95% of the patients with a neurinoma showed a pathological result in the positional test. So every patient suffering from an unidentified unilateral and sensoneural hearing loss combined with a pathological result in the positional test must be further examined by a cisternomeatography or computerized tomography (using air-insufflation). Every fifth of these patients showed unique hints of an acoustic neuroma in the neuroradiological test.

  19. A case of Kartagener′s syndrome: Importance of early diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Sanjay Gupta

    2013-01-01

    Full Text Available Kartagener′s syndrome is a very rare congenital malformation comprising of a classic triad of sinusitis, situs inversus and bronchiectasis. Primary ciliary dyskinesia is a genetic disorder with manifestations present from early life and this distinguishes it from acquired mucociliary disorders. Approximately one half of patients with primary ciliary dyskinesia have situs inversus and, thus are having Kartagener syndrome. We present a case of 12 year old boy with sinusitis, situs inversus and bronchiectasis. The correct diagnosis of this rare congenital autosomal recessive disorder in early life is important in the overall prognosis of the syndrome, as many of the complications can be prevented if timely management is instituted, as was done in this in this case.

  20. A case of Kartagener′s syndrome: Importance of early diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Sanjay Gupta

    2012-01-01

    Full Text Available Kartagener′s syndrome is a very rare congenital malformation comprising of a classic triad of sinusitis, situs inversus and bronchiectasis. Primary ciliary dyskinesia is a genetic disorder with manifestations present from early life and this distinguishes it from acquired mucociliary disorders. Approximately one half of patients with primary ciliary dyskinesia have situs inversus and, thus are having Kartagener syndrome. We present a case of 12 year old boy with sinusitis, situs inversus and bronchiectasis. The correct diagnosis of this rare congenital autosomal recessive disorder in early life is important in the overall prognosis of the syndrome, as many of the complications can be prevented if timely management is instituted, as was done in this in this case.

  1. The Usefulness of Biological and Neuroimaging Markers for the Diagnosis of Early-Onset Alzheimer's Disease

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    Alessandro Padovani

    2011-01-01

    Full Text Available The recent proposed criteria for Alzheimer's Disease (AD have strongly claimed the usefulness of biological and neuroimaging markers for early identification AD. Cerebrospinal fluid (CSF Tau/Abeta ratio, hippocampal atrophy, posterior cingulate, and neocortical associative area hypometabolism, or amyloid burden evaluated by PiB compound, held the premises to increase diagnostic accuracy in the preclinical disease stages. Despite many efforts to identify subjects at risk of developing AD, less attention has been paid to presenile AD diagnosis. A few data are already available in early onset AD, mainly obtained in cases of monogenic disorder. In this paper, we discuss the current literature on the role of biological and neuroimaging markers in presenile AD.

  2. Guidelines for Screening, Early Diagnosis and Management of Severe Combined Immunodeficiency (SCID) in India.

    Science.gov (United States)

    Madkaikar, Manisha; Aluri, Jahnavi; Gupta, Sudhir

    2016-05-01

    Severe combined immunodeficiency (SCID) is one of the most severe and fatal forms of inherited primary immunodeficiency. Early diagnosis of SCID improves the outcome of life before and after hematopoietic stem cell transplant (HSCT). SCID fulfills the internationally-established criteria for a condition to be screened for at birth. T cell receptor excision circle (TREC) assay is commonly used in western countries as part of newborn blood spot screening (NBS) program as the assay has high sensitivity and specificity to identify SCID infants, allowing early intervention and curative bone marrow (BM) transplantation. In India, the blood spot based screening programs are yet to mature into a full-fledged national program. Moreover, TREC assay, a PCR based test, is not widely available and may cost USD 5-7 per test; thus limiting its applicability for screening newborns in Indian scenario. Most of the SCID patients have lymphopenia at birth and routine evaluation for absolute lymphocyte count (ALC) on cord blood samples can help in pre-symptomatic detection and early intervention for neonates with SCID. Although ALC count lacks the sensitivity and specificity of TREC assay; its lower cost and widespread availability makes it an attractive option for identifying newborns with lymphopenia during the post-partum hospital stay. BCG vaccine and other live attenuated vaccines (e.g., oral polio vaccine) should be withheld in lymphopenic infants until SCID is excluded by clinical and/or immunological work-up. A diagnosis of SCID warrants immediate care to prevent and treat infections and wherever feasible, early stem cell transplantation for disease free survival.

  3. Recommendations for early diagnosis and intervention in autism spectrum disorders: an Italian-Israeli consensus conference.

    Science.gov (United States)

    Zachor, Ditza A; Curatolo, Paolo

    2014-03-01

    On April 2013 experts in the field of autism from Italy and Israel convened in Jerusalem to discuss and finalize clinical recommendations for early diagnosis and intervention in Autism Spectrum Disorders (ASDs). In this paper, we summarize the results of this Italian-Israeli consensus conference. ASDs constitute a class of severe and heterogeneous neurodevelopmental conditions caused by atypical brain development beginning during early prenatal life, reflecting many genetic, neurobiological and environmental influences. The first clinical signs of ASDs begin to be evident in children between 12 and 18 months of age, often after a period of relatively typical postnatal development. Recent longitudinal studies reveal substantial diversity in developmental trajectories through childhood and adolescence. Some intervention approaches have been demonstrated to be effective in improving core symptoms of ASDs, even if the heterogeneity and developmental nature of the disorder make it implausible that only one specific treatment will be best for all children with ASDs. More randomized control trials (RCTs) on early intervention are needed to identify the most effective strategies and provide the most efficient allocation of resources during the critical early intervention time period. Future research should focus on linking biological phenotypes with specific genotypes, thus establishing a foundation for the development of diagnostic screening tools and individualization of treatments. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  4. Evaluation of quantitative sacro-iliac scintigraphy in the early diagnosis of ankylosing spondylitis.

    Science.gov (United States)

    Kjällman, M; Nylén, O; Hansén, M

    1986-01-01

    Over the period 1976-83 the clinical records were studied of 150 patients with the diagnosis of confirmed or possible sacro-iliitis. All these patients had pathologic sacro-iliac indices on quantitative bone scintigraphy. The most recent radiographs of the sacro-iliac joints were examined by two radiologists independently of each other. 103 (68%) patients with a mean duration of symptoms of 6.7 years, had normal radiographs. The frequency of HLA B27 in this group was only 27%, contrary to the expected 90-100% in an ankylosing spondylitis (AS) population. In a follow-up study, 30 patients, who in 1976-79 had normal sacro-iliac joint X-rays, were further investigated. The mean duration of symptoms was 11.3 years. 21 patients (70%) still had normal radiographs of their sacro-iliac joints and the HLA B27 frequency in this group was 28%. Normal radiographs of the sacro-iliac joints, in spite of the long duration of symptoms together with a low frequency of HLA B27, makes the diagnosis of AS most unlikely. This indicates a low specificity for quantitative sacro-iliac scintigraphy in the early diagnosis of AS. In the follow-up study, Calin's screening test for AS was included and was also found to have a low specificity.

  5. Neuroendocrine tumors (carcinoids of the stomach and intestines - early diagnosis and minimally invasive endoscopic procedures

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    Kuryk O.G.

    2014-03-01

    Full Text Available Background. Neuroendocrine tumors of the stomach and intestines are rare diseases. Increasing incidence and complexity of diagnosis of these diseases cause acuteness of the problem. Objective. To evaluate the effectiveness of morphological examination of endoscopic biopsy material for diagnostics of neuroendocrine tumors and for evaluation of completeness of minimally invasive endoscopic surgical interventions (endoscopic mucosal resection and endoscopic submucosal dissection at neuroendocrine tumors. Methods. On the basis of Medical center "Oberig" in 2009 - 2013 in eight cases neuroendocrine tumors were diagnosed: 2 (25 % in the stomach, 2 (25% – in the duodenum, 2 (25% - in the small intestine, 1 (12.5 % - in the ascending colon, 1 (12.5% - in the rectum. Neuroendocrine tumors of stomach and ileum were removed by endoscopic mucosal resection, duodenal bulb and rectum neuroendocrine tumors – by endoscopic submucosal dissection, papillary duodenum, colon and jejunum neuroendocrine tumors – by surgical resection. Results. It was shown, that morphological evaluation of endoscopic mucosal biopsies is effective way to diagnose the neuroendocrine tumors. Conclusion. Endoscopic mucosal resection and endoscopic submucosal dissection allows to get advanced material for morphological diagnosis of neuroendocrine tumors and an adequate method of their removing Citation: Kuryk OG, Yakovenko VO, Bazdyrev VV, Bodnar LV. [Neuroendocrine tumors (carcinoids of the stomach and intestines - early diagnosis and minimally invasive endoscopic procedures]. Morphologia. 2014;8(1:58-64. Ukrainian.

  6. Clinical symptoms and laboratory findings supporting early diagnosis of Crimean-Congo hemorrhagic fever in Iran.

    Science.gov (United States)

    Mostafavi, Ehsan; Pourhossein, Behzad; Chinikar, Sadegh

    2014-07-01

    Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease, which is usually transmitted to humans by tick bites or contact with blood or other infected tissues of livestock. Patients suffering from CCHF demonstrate an extensive spectrum of clinical symptoms. As it can take considerable time from suspecting the disease in hospital until reaching a definitive diagnosis in the laboratory, understanding the clinical symptoms and laboratory findings of CCHF patients is of paramount importance for clinicians. The data were collected from patients who were referred to the Laboratory of Arboviruses and Viral Hemorrhagic Fevers at the Pasteur institute of Iran with a primary diagnosis of CCHF between 1999 and 2012 and were assessed by molecular and serologic tests. Referred patients were divided into two groups: patients with a CCHF positive result and patients with a CCHF negative result. The laboratory and clinical findings of these two groups were then compared. Two-thousand five hundred thirty-six probable cases of CCHF were referred to the laboratory, of which 871 cases (34.3%) were confirmed to be CCHF. Contact with infected humans and animals increased the CCHF infection risk (P important role in patient survival and the application of the findings of this study can prove helpful as a key for early diagnosis.

  7. The MUC gene family: Their role in diagnosis and early detection of pancreatic cancer

    Directory of Open Access Journals (Sweden)

    Löhr Matthias

    2003-01-01

    Full Text Available Abstract The early diagnosis of pancreatic cancer, as well as distinguishing between chronic pancreatitis and malignant pancreatic disease, remains still a clinical problem. Presently, there is no specific tumor marker for diagnosing pancreatic cancer. Mucin-associated marker like CA 19-9 are the most widely available pancreatic cancer tumor marker, but its value as a screening marker is limited by its reduced specificity. Mucins (MUCs are heavily glycosylated, high molecular weight glycoproteins with an aberrant expression profile in various malignancies. This review considers briefly the potential use of the mucin expression pattern in diagnosis of pancreatic neoplasm. The overview will point out the present knowledge about changes in the mucin gene expression in pancreatic intraepithelial neoplasia (PanINs as precursor lesions and in pancreatic adenocarcinoma, compared to normal pancreas and chronic pancreatitis and the potential role for differentiating chronic pancreatitis from pancreatic cancer. Furthermore, the potential use of MUCs in the diagnosis and differentiation of intraductal papillary-mucinous neoplasm's (IPMNs will be discussed.

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

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    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.

  9. The importance of early diagnosis and treatment of kaposiform hemangioendothelioma complicated by Kasabach-Merritt phenomenon

    Science.gov (United States)

    Vivas-Colmenares, Grecia V.; Ramirez-Villar, Gema L.; Bernabeu-Wittel, Jose; Matute de Cardenas, Jose A.; Fernandez-Pineda, Israel

    2015-01-01

    Kaposiform hemangioendothelioma (KHE) is a locally aggressive vascular tumor that may be complicated by Kasabach-Merritt phenomenon (KMP), a profound thrombocytopenia resulting from platelet trapping within a vascular tumor, either KHE or tufted angioma (TA). Typical features also include low fibrinogen and elevated D-dimers. It is well known that KMP is not caused by infantile hemangiomas. Management of vascular tumors complicated by KMP is challenging, and it is common for referral centers to receive patients in critical medical condition after multimodality treatment failure of vascular anomalies. Our aim is to communicate the importance of early diagnosis and treatment of KHE associated with KMP. A full-term male newborn with KHE complicated by KMP is reported. Treatment with vincristine, aspirin and ticlopidine normalized the coagulation parameters within one week, requiring a total of six doses of vincristine, seven months of ticlopidine and 17 months of aspirin. Early diagnosis and treatment of KHE complicated by KMP may allow the administration of fewer doses of vincristine and avoid the use of corticosteroids. PMID:25692091

  10. Early and rapid prenatal diagnosis of monosomy 2q36.1 in trophoblast cells.

    Science.gov (United States)

    Tachdjian, Gérard; Aboura, Azzedine; Brisset, Sophie; Dommergues, Marc; Gajdos, Vincent; Labrune, Philippe

    2006-01-01

    CVS is the earliest procedure for cytogenetic analysis but the quality of metaphases obtained does not allow the characterization of subtle chromosomal anomalies. We report the application interphase fluorescence in situ hybridization for the rapid prenatal diagnosis of a subtle structural chromosome anomaly in trophoblast cells. The foetus was karyotyped because of a paternal complex chromosomal anomaly 46,XY,inv(2)(q14.3q35),ins(10;2)(q25;q36.1q36.1). Fluorescence in situ hybridization analyses were performed on interphase nuclei and metaphase chromosomes from uncultured chorionic villi using bacterial artificial chromosomes specific for the 2q chromosomal region. Direct conventional cytogenetics showed an apparently normal male karyotype, whereas fluorescence in situ hybridization analysis showed a deletion of the chromosomal region 2q36.1 and a paracentric inversion of the chromosome 2q leading to a partial monosomy 2q36.1. This strategy allowed us to offer an early and rapid chromosomal analysis for this couple leading to a better management of the pregnancy. This report demonstrates that interphase fluorescence in situ hybridization can be used in direct CVS for a rapid and early prenatal diagnosis of complex chromosomal rearrangements. 2006 S. Karger AG, Basel

  11. Significance of Nueroelectrophysiological Tests in the Early Diagnosis of Sub-clinical Neuropathay with Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    LI Zhijun; HU Xiaoqing; TANG Nai

    2006-01-01

    To evaluate the application of nueroelectrophysiological tests in early diagnosis of sub-clinical neuropathy in diabetes mellitus (DM), The routine nerve conductive velocity (NCV),F-wave and sympathetic skin response (SSR) were detected in 27 patients with diabetes mellitus but without symptoms and signs of lesions of nerve system. Our results showed that 48.1%, 44.4 %, 51.9 % of the patients were found to have abnormal NCV, F-wave and SSR respectively. The abnormalities were mainly characterized by prolonged latency, reduced velocity and absence of wave-form.There were significant differences between the controls and the DM group (P<0.05). Both the distal and proximal segments of nerves were affected and the distal lesions took place earlier than proximal ones and the changes in low extremities were more severe than those of upper extremities. F-wave can be used as a sensitive indicator for the early diagnosis of peripheral neuropathy and it can help to detect the subclincial lesions. SSR can be used for the evaluation of functional status of autonomic nerves in DM patients.

  12. 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.)

  13. Role of transvaginal contrast-enhanced ultrasound in the early diagnosis of endometrial carcinoma

    Institute of Scientific and Technical Information of China (English)

    LIU Ying; TIAN Jia-wei; XU Yi; CHENG Wen

    2012-01-01

    Background Endometrial carcinoma is one of the most common gynecological malignancies among women.Early diagnosis and correct preoperative evaluation of myometrial invasion are necessary to improve the prognosis.This study aimed to determine whether features and time-intensity curves (TIC) of transvaginal contrast-enhanced ultrasound (CEUS) differ from those of conventional ultrasound for endometrial carcinoma,and to further explore the clinical role of transvaginal CEUS in the early diagnosis of endometrial carcinoma.Methods Forty women with a normal uterus and seventy-nine patients with endometrial carcinoma were examinedby the transvaginal CEUS with SonoVue (Bracco,Imaging B.V,Switzerland).The enhancement patterns and TIC of lesions were analyzed.The results of CEUS were compared with those of conventional ultrasound and pathology.Results In the early and late enhanced stages,the intensity of enhancement of the normal endometrium was always lower than that in the myometrium,and the boundary between normal endometrium and myometrium was clear.A total of 65.8% (52/79) of lesions presented with inhomogeneous enhancement,34.2% (27/79) presented with homogeneous enhancement; 60.8% (48/79) presented with hyperechoic enhancement,27.8% (22/79) presented with isoechoic enhancement,and 11.4% (9/79) presented with hypoechoic enhancement.The average arrival time,time to peak,rise time,half-wash out time of lesions were shorter than of normal endometrium (P <0.05).The average peak intensity,relative rise in intensity,half-wash out intensity of lesions were higher than of normal endometrium (P<0.05).There were 49 (must be and may be present) cases of endometrial carcinoma by ultrasound (US); 24 cases were consistent with pathology results,16 cases were underestimated and 9 cases were overestimated.There were 72 (must be and may be present) cases of endometrial carcinoma by CEUS; 53 cases were consistent with pathology results,12 cases were underestimated and 7

  14. Cardiac troponins I and T: molecular markers for early diagnosis, prognosis, and accurate triaging of patients with acute myocardial infarction.

    Science.gov (United States)

    Tiwari, Ram P; Jain, Anubhav; Khan, Zakir; Kohli, Veena; Bharmal, R N; Kartikeyan, S; Bisen, Prakash S

    2012-12-01

    Acute myocardial infarction (AMI) is the leading cause of death worldwide, with early diagnosis still being difficult. Promising new cardiac biomarkers such as troponins and creatine kinase (CK) isoforms are being studied and integrated into clinical practice for early diagnosis of AMI. The cardiac-specific troponins I and T (cTnI and cTnT) have good sensitivity and specificity as indicators of myocardial necrosis and are superior to CK and its MB isoenzyme (CK-MB) in this regard. Besides being potential biologic markers, cardiac troponins also provide significant prognostic information. The introduction of novel high-sensitivity troponin assays has enabled more sensitive and timely diagnosis or exclusion of acute coronary syndromes. This review summarizes the available information on the potential of troponins and other cardiac markers in early diagnosis and prognosis of AMI, and provides perspectives on future diagnostic approaches to AMI.

  15. Dairy calf pneumonia: Effective treatment depends on early and accurate diagnosis

    Directory of Open Access Journals (Sweden)

    Panousis Nikolaos

    2009-01-01

    Full Text Available Dairy calf pneumonia is one of the most economically important diseases of calves. A delayed diagnosis could result endemic herd problem, prolonged use of antibiotics, high recurrence rate, pulmonary abscessation and ear infections. The key for effective control is the early detection of pneumonia and the accurate diagnosis of the etiologic factor. For the early detection, a respiratory disease score was assigned based on rectal temperature, character of nasal discharge, eye discharge or ear appearance, and presence of a cough. Each clinical sign has a point scale from 0 (normal to 4 (severe. The respiratory disease score is the sum of points from the 4 categories of clinical signs, with increasing values representing progressive severity. The scoring system results in a minimum score of 0 and a maximum score of 12. Calves with score 5 or higher, having at least 2 clinical signs of respiratory disease, are considered sick and have to be treated. For the accurate diagnosis of the etiological agent the best tool in a live calf is bronchoalveolar lavage (BAL fluid collection. Sampling of severely affected animals should be avoided. New acute cases are ideal. BAL is performed in sedated calves using a sterilized, flexible catheter with a 5-cc balloon cuff. The fresh BAL fluid sample is processed within 2 hours of collection or refrigerated until analysis. Part of the sample is used for microbiology and the remaining is submitted for cytology. BAL fluid that yields homogenous (>106 CFU/ml bacterial or positive Mycoplasma bovis culture is considered abnormal. A disproportionate lowering of macrophages (39% provides evidence of an inflammatory response with or without a positive culture. The ideal antibiotic selection would be based on the antibiotic susceptibility pattern of lung pathogens after BAL fluid culture.

  16. Utility of Early MRI in the Diagnosis and Management of Acute Spontaneous Intracerebral Hemorrhage

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    Wijman, Christine A.C.; Venkatasubramanian, Chitra; Bruins, Sara; Fischbein, Nancy; Schwartz, Neil

    2010-01-01

    Background The optimal diagnostic evaluation for spontaneous intracerebral hemorrhage (ICH) remains controversial. In this retrospective study, we assessed the utility of early magnetic resonance imaging (MRI) in ICH diagnosis and management. Methods Eighty-nine (72%) of 123 patients with spontaneous ICH underwent a brain CT and MRI within 30 days of ICH onset. Seventy patients with a mean age of 62 ± 15 years were included. A stroke neurologist and a general neurologist, each blinded to the final diagnosis, independently reviewed the admission data and the initial head CT and then assigned a presumed ICH cause under 1 of 9 categories. ICH cause was potentially modified after subsequent MRI review. The final ‘gold standard’ ICH etiology was determined after review of the complete medical record by an independent investigator. Change in diagnostic category and confidence and the potential impact on patient management were systematically recorded. Results Mean time to MRI was 3 ± 5 days. Final ICH diagnosis was hypertension or cerebral amyloid angiopathy (CAA) in 50% of patients. After MRI review the stroke neurologist changed diagnostic category in 14%, diagnostic confidence in an additional 23% and management in 20%, and the general neurologist did so in 19, 21 and 21% of patients, respectively. MRI yield was highest in ICH secondary to ischemic stroke, CAA, vascular malformations and neoplasms, and did not differ by age, history of hypertension, hematoma location or the presence of intraventricular hemorrhage. Conclusions The results of this study suggest potential additive clinical benefit of early MRI in patients with spontaneous ICH. PMID:20733299

  17. Polymerase Chain Reaction: An Important Tool for Early Diagnosis of Leptospirosis Cases

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    Mullan, Summaiya

    2016-01-01

    Introduction Various diagnostic methods like Microscopic Agglutination Test (MAT), IgM ELISA, Isolation of Leptospira from the clinical specimen, Rapid leptocheck tests etc., are available for diagnosis of leptospirosis. Polymerase Chain Reaction (PCR) is used for diagnosis of various diseases of infectious origin including leptospirosis but there is paucity of data about comparison of PCR with other available method of diagnosis of leptospirosis. Aim The aim of the study was to detect the leptospiral DNA by PCR method and to compare the results of PCR with other available diagnostic methods used for diagnosis of suspected leptospirosis cases in acute phase of illness. Materials and Methods A total of 207 blood samples were obtained from suspected patients of leptospirosis admitted in New Civil Hospital, a tertiary care hospital in South Gujarat, during the period of July 2008 to November 2008. These blood samples were subjected to Rapid leptocheck, IgM ELISA, MAT test to detect (IgG or IgM) antibody level, Leptospira culture and PCR. Results In early phase of the disease, Rapid leptocheck test gave 44% detection, but along with PCR seropositivity reached upto 71%. Detection rate by IgM ELISA was 59% which increased to 80% with PCR. By MAT seropositivity was 57% but combined seropositivity of MAT with PCR was 78%. Sensitivity and specificity of PCR as compared to MAT (Gold standard) was 52% and 79% respectively. Leptospira was not growing in culture. Conclusion In present study, PCR picked up to 50% of cases which were negative by other serological tests so these finding suggest that PCR should be used routinely in acute phase of disease.

  18. A Novel Electrochemical Microfluidic Chip Combined with Multiple Biomarkers for Early Diagnosis of Gastric Cancer

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    Xie, Yao; Zhi, Xiao; Su, Haichuan; Wang, Kan; Yan, Zhen; He, Nongyue; Zhang, Jingpu; Chen, Di; Cui, Daxiang

    2015-12-01

    Early diagnosis is very important to improve the survival rate of patients with gastric cancer and to understand the biology of cancer. In order to meet the clinical demands for early diagnosis of gastric cancer, we developed a disposable easy-to-use electrochemical microfluidic chip combined with multiple antibodies against six kinds of biomarkers (carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), Helicobacter pylori CagA protein (H.P.), P53oncoprotein (P53), pepsinogen I (PG I), and PG-II). The six kinds of biomarkers related to gastric cancer can be detected sensitively and synchronously in a short time. The specially designed three electrodes system enables cross-contamination to be avoided effectively. The linear ranges of detection of the electrochemical microfluidic chip were as follows: 0.37-90 ng mL-1 for CEA, 10.75-172 U mL-1 for CA19-9, 10-160 U L-1 for H.P., 35-560 ng mL-1 for P53, 37.5-600 ng mL-1 for PG I, and 2.5-80 ng mL-1for PG II. This method owns better sensitivity compared with enzyme-linked immunosorbent assay (ELISA) results of 394 specimens of gastric cancer sera. Furthermore, we established a multi-index prediction model based on the six kinds of biomarkers for predicting risk of gastric cancer. In conclusion, the electrochemical microfluidic chip for detecting multiple biomarkers has great potential in applications such as early screening of gastric cancer patients, and therapeutic evaluation, and real-time dynamic monitoring the progress of gastric cancer in near future.

  19. Altered serum microRNAs as biomarkers for the early diagnosis of pulmonary tuberculosis infection

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    Qi Yuhua

    2012-12-01

    Full Text Available Abstract Background Pulmonary tuberculosis (TB is a highly lethal infectious disease and early diagnosis of TB is critical for the control of disease progression. The objective of this study was to profile a panel of serum microRNAs (miRNAs as potential biomarkers for the early diagnosis of pulmonary TB infection. Methods Using TaqMan Low-Density Array (TLDA analysis followed by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR validation, expression levels of miRNAs in serum samples from 30 patients with active tuberculosis and 60 patients with Bordetella pertussis (BP, varicella-zoster virus (VZV and enterovirus (EV were analyzed. Results The Low-Density Array data showed that 97 miRNAs were differentially expressed in pulmonary TB patient sera compared with healthy controls (90 up-regulated and 7 down-regulated. Following qRT-PCR confirmation and receiver operational curve (ROC analysis, three miRNAs (miR-361-5p, miR-889 and miR-576-3p were shown to distinguish TB infected patients from healthy controls and other microbial infections with moderate sensitivity and specificity (area under curve (AUC value range, 0.711-0.848. Multiple logistic regression analysis of a combination of these three miRNAs showed an enhanced ability to discriminate between these two groups with an AUC value of 0.863. Conclusions Our study suggests that altered levels of serum miRNAs have great potential to serve as non-invasive biomarkers for early detection of pulmonary TB infection.

  20. New biomarkers for early diagnosis of Lesch-Nyhan disease revealed by metabolic analysis on a large cohort of patients.

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    Ceballos-Picot, Irène; Le Dantec, Aurélia; Brassier, Anaïs; Jaïs, Jean-Philippe; Ledroit, Morgan; Cahu, Julie; Ea, Hang-Korng; Daignan-Fornier, Bertrand; Pinson, Benoît

    2015-01-23

    Lesch-Nyhan disease is a rare X-linked neurodevelopemental metabolic disorder caused by a wide variety of mutations in the HPRT1 gene leading to a deficiency of the purine recycling enzyme hypoxanthine-guanine phosphoribosyltransferase (HGprt). The residual HGprt activity correlates with the various phenotypes of Lesch-Nyhan (LN) patients and in particular with the different degree of neurobehavioral disturbances. The prevalence of this disease is considered to be underestimated due to large heterogeneity of its clinical symptoms and the difficulty of diagnosing of the less severe forms of the disease. We therefore searched for metabolic changes that would facilitate an early diagnosis and give potential clues on the disease pathogenesis and potential therapeutic approaches. Lesch-Nyhan patients were diagnosed using HGprt enzymatic assay in red blood cells and identification of the causal HPRT1 gene mutations. These patients were subsequently classified into the three main phenotypic subgroups ranging from patients with only hyperuricemia to individuals presenting motor dysfunction, cognitive disability and self-injurious behavior. Metabolites from the three classes of patients were analyzed and quantified by High Performance Ionic Chromatography and biomarkers of HGprt deficiency were then validated by statistical analyses. A cohort of 139 patients, from 112 families, diagnosed using HGprt enzymatic assay in red blood cells, was studied. 98 displayed LN full phenotype (86 families) and 41 (26 families) had attenuated clinical phenotypes. Genotype/phenotype correlations show that LN full phenotype was correlated to genetic alterations resulting in null enzyme function, while variant phenotypes are often associated with missense mutations allowing some residual HGprt activity. Analysis of metabolites extracted from red blood cells from 56 LN patients revealed strong variations specific to HGprt deficiency for six metabolites (AICAR mono- and tri

  1. Heat shock protein 70 acts as a potential biomarker for early diagnosis of heart failure.

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    Li, Zongshi; Song, Yao; Xing, Rui; Yu, Haiyi; Zhang, Youyi; Li, Zijian; Gao, Wei

    2013-01-01

    Early identification for heart failure (HF) may be useful for disease modifying treatment in order to reduce heart disease progression or even to reverse it. In our previous studies, we have revealed a group of heat shock proteins (HSPs) which might be related to neonatal rat cardiomyocyte hypertrophy by proteomic approach. Here, we confirm that HSPs, including HSP27 and HSP70, altered in the early stage of cardiac remodeling in vivo animal model. Furthermore, plasma concentrations of those HSPs and their potential screening value were evaluated at different stages in 222 patient subjects. Plasma HSP27, HSP70 and HSP90 were measured using enzyme-linked immunosorbent assay. Results indicate that HSP70 was positively correlated to the severity (progression) of HF (r = 0.456, p<0.001). The area under the rate of change (ROC) curve was 0.601 (p = 0.017) in patients with stage B HF and 0.835 (p<0.001) in those with stage C HF. However, HSP27 and HSP90 did not display significant changes in any stage of HF in this study. Taken together, plasma concentrations of HSP70 elevated with the progression of HF and might act as a potential screening biomarker for early diagnosis of HF.

  2. Serum-based microRNA signatures in early diagnosis and prognosis prediction of colon cancer.

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    Vychytilova-Faltejskova, Petra; Radova, Lenka; Sachlova, Milana; Kosarova, Zdenka; Slaba, Katerina; Fabian, Pavel; Grolich, Tomas; Prochazka, Vladimir; Kala, Zdenek; Svoboda, Marek; Kiss, Igor; Vyzula, Rostislav; Slaby, Ondrej

    2016-10-01

    Early detection of colorectal cancer is the main prerequisite for successful treatment and reduction of mortality. Circulating microRNAs were previously identified as promising diagnostic, prognostic and predictive biomarkers. The purpose of this study was to identify serum microRNAs enabling early diagnosis and prognosis prediction of colon cancer. In total, serum samples from 427 colon cancer patients and 276 healthy donors were included in three-phase biomarker study. Large-scale microRNA expression profiling was performed using Illumina small RNA sequencing. Diagnostic and prognostic potential of identified microRNAs was validated on independent training and validation sets of samples using RT-qPCR. Fifty-four microRNAs were found to be significantly deregulated in serum of colon cancer patients compared to healthy donors (P colon cancer patients from healthy donors with sensitivity of 89% and specificity of 81% (AUC = 0.922). This panel of microRNAs exhibited high diagnostic performance also when analyzed separately in colon cancer patients in early stages of the disease (T1-4N0M0; AUC = 0.877). Further, a prognostic panel based on the expression of miR-23a-3p and miR-376c-3p independent of TNM stage was established (HR 2.30; 95% CI 1.44-3.66; P colon cancer were identified. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Early Diagnosis of Bladder Exstrophy: Quantitative Assessment of a Low-Inserted Umbilical Cord.

    Science.gov (United States)

    Fishel-Bartal, Michal; Perlman, Sharon; Messing, Baruch; Bardin, Ron; Kivilevitch, Zvi; Achiron, Reuven; Gilboa, Yinon

    2017-09-01

    Bladder exstrophy is a rare severe congenital malformation. Early prenatal diagnosis is scarcely described in the literature. Low insertion of the umbilical cord is a constant anatomic feature of bladder exstrophy. The aim of our study was to assess whether early measurements of the umbilical cord insertion-to-genital tubercle length may serve as quantitative measurements for a low-inserted umbilical cord in cases of bladder exstrophy. The umbilical cord insertion-to-genital tubercle length was prospectively measured in all cases referred for a nonvisualized urinary bladder before 18 weeks' gestation. Final diagnoses were compared with prenatal measurements. Fifteen fetuses were evaluated for a nonvisualized bladder at a mean gestational age of 15.7 weeks (range, 14-17 weeks). Of them, 6 cases were diagnosed with bladder exstrophy, and 9 cases had a normal urinary bladder. All cases with bladder exstrophy had an umbilical cord insertion-to-genital tubercle length below the fifth percentile for gestational age, whereas cases with a normal bladder had a normal measurement. Fetuses with bladder exstrophy have an umbilical cord insertion-to-genital tubercle length below the fifth percentile of the general population. This measurement may serve as a complementary objective sonographic parameter in the prenatal assessment and counseling of cases suspected of having bladder exstrophy during early pregnancy. © 2017 by the American Institute of Ultrasound in Medicine.

  4. Early diagnosis of junior school age children’s posture disorders

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    Razumeiko N.S.

    2015-12-01

    Full Text Available 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 qualified specialists at the beginning and at the end of experiment. For determination of early signs of muscular asymmetry in torso right and left sides of the tested children we used methodic, based on registration of tonic vibration reflex. Results: the pupils’ examination permitted to form a group of 108 persons, who did not have external signs of posture disorders. It was proved that it would be purposeful to take prophylaxis measures at very early stages of imbalance in muscular system’s work. Traditional approach in the form of prophylaxis examination can not give confident information about initial stage of imbalance in muscular system’s work in child’s organism. Conclusions: it was found that imbalance of motor nervous centers reflex excitability on both sides of backbone (if no purposeful prophylaxis measures are taken can result in muscular tonus asymmetry on right and left sides of torso in lumbar spine area.

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

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    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

  6. Following a natural experiment of guideline adaptation and early implementation: a mixed-methods study of facilitation

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    Dogherty Elizabeth J

    2012-02-01

    Full Text Available Abstract Background Facilitation is emerging as an important strategy in the uptake of evidence. However, it is not entirely clear from a practical perspective how facilitation occurs to help move research evidence into nursing practice. The Canadian Partnership Against Cancer, also known as the 'Partnership,' is a Pan-Canadian initiative supporting knowledge translation activity for improved care through guideline use. In this case-series study, five self-identified groups volunteered to use a systematic methodology to adapt existing clinical practice guidelines for Canadian use. With 'Partnership' support, local and external facilitators provided assistance for groups to begin the process by adapting the guidelines and planning for implementation. Methods To gain a more comprehensive understanding of the nature of facilitation, we conducted a mixed-methods study. Specifically, we examined the role and skills of individuals actively engaged in facilitation as well as the actual facilitation activities occurring within the 'Partnership.' The study was driven by and builds upon a focused literature review published in 2010 that examined facilitation as a role and process in achieving evidence-based practice in nursing. An audit tool outlining 46 discrete facilitation activities based on results of this review was used to examine the facilitation noted in the documents (emails, meeting minutes, field notes of three nursing-related cases participating in the 'Partnership' case-series study. To further examine the concept, six facilitators were interviewed about their practical experiences. The case-audit data were analyzed through a simple content analysis and triangulated with participant responses from the focus group interview to understand what occurred as these cases undertook guideline adaptation. Results The analysis of the three cases revealed that almost all of the 46 discrete, practical facilitation activities from the literature were

  7. THE EARLY DIAGNOSIS AND CLINICAL FEATURES OF AXIAL SPONDYLOARTHRITIS AT THE EUROPEAN CONGRESS OF RHEUMATOLOGY 2015

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    E. E. Gubar

    2016-01-01

    Full Text Available The European  League Against Rheumatism (EULAR  Congress (EULAR-15 was held in Rome on 10–13 June 2015. One of the most important  aspects of the Congress was the problem of spondyloarthritis  (SpA. Reports on the pathogenesis of SpA, including a relationship between the inflammatory processes and the mechanisms  of bone proliferation, occupied a prominent place in the program of the Congress. The fundamental  importance  of proinflammatory cytokines, such as interleukin 17 (IL17/IL23, for SpA was the subject of wide speculation. As in previous years, many reports were dedicated to the early diagnosis of SpA, the comparison of different SpA classification criteria, and the progression of non-radiographic axial SpA to ankylosing spondylitis. Much time was devoted to the results of the latest studies visualizing sacroiliitis and spondylitis.

  8. Quantitative ultrasound venous valve movement: early diagnosis of deep vein thrombosis

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    Muhd Suberi, Anis Azwani; Wan Zakaria, Wan Nurshazwani; Tomari, Razali; Ibrahim, Nabilah

    2016-07-01

    The purpose of this paper is to provide an in-depth analysis of computer aided system for the early diagnosis of Deep Vein Thrombosis (DVT). Normally, patients are diagnosed with DVT through ultrasound examination after they have a serious complication. Thus, this study proposes a new approach to reduce the risk of recurrent DVT by tracking the venous valve movement behaviour. Inspired by image processing technology, several image processing methods namely, image enhancement, segmentation and morphological have been implemented to improve the image quality for further tracking procedure. In segmentation, Otsu thresholding provides a significant result in segmenting valve structure. Subsequently, morphological dilation method is able to enhance the region shape of the valve distinctly and precisely. Lastly, image subtraction method is presented and evaluated to track the valve movement. Based on the experimental results the normal range of valve velocity lies within the range of blood flow velocity (Vb) and occasionally may result in higher values.

  9. Application of a Computational Method for the Early Diagnosis of Prostate Cancer Using Proteomic Pattern Recognition

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    Elzenir Montes,

    2016-12-01

    Full Text Available This paper presents a method based on the recognition of proteomic patterns for the early diagnosis of prostate cancer, using computational techniques, applied in the database of SELDI-TOF proteomic patterns. The method is based on classifying the individual as to the portability stage of prostate cancer. To do so, the Independent Component Analysis (ICA technique is used to extract the characteristics, after which are utilized the algorithm of Maximum Relevance and Minimum Redundancy to reduce the computational cost, and finally the Support Vector Machine to obtain the classification. The best result of the method was obtained with a vector of 27 characteristics, achieving accuracy, specificity and sensitivity, respectively of 89.21%, 83.68% and 95.08%.

  10. Signs and senses: diagnosis and prognosis in early medieval pulse and urine texts.

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    Wallis, F

    2000-08-01

    The character of early medieval medical manuscripts makes it difficult to generalize about the nature of medical knowledge in this period. In order to reconstitute one field of medical science, namely diagnosis and prognosis, while avoiding the pitfalls of unjustified generalization, this essay limits itself to reconstructing the understanding of pulse and urine inspection available in a particular place and time: the Italian monastery of Monte Cassino at the end of the first millennium. The available texts reveal little about the rationale behind these bedside techniques; indeed, pulse and urine seem to be signs without any semiotics, any underlying theory. The clue to this paradox is the fact that these texts see pulse and urine as primarily prognostic rather than diagnostic. Prognosis was understood to be analogous to forms of intuition, judgement, revelation, and prophecy that operated outside the logic of causality. Hence a fully rationalized semiotics was not regarded as necessary for effective medical practice.

  11. Combining multifractal analyses of digital mammograms and infrared thermograms to assist in early breast cancer diagnosis

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    Gerasimova-Chechkina, E.; Toner, B.; Marin, Z.; Audit, B.; Roux, S. G.; Argoul, F.; Khalil, A.; Gileva, O.; Naimark, O.; Arneodo, A.

    2016-08-01

    We used a 1D wavelet transform modulus maxima (WTMM) method to analyze the temporal fluctuations of breast skin temperature recorded with an infrared (IR) camera from a panel of patients with breast cancer. This study shows that the multifractal complexity of temperature fluctuations observed in healthy breasts, is lost in the region of the malignant tumor in cancerous breasts. Then, we applied the 2D WTMM method to analyze the spatial fluctuations of breast density in the X-ray mammograms of the same patients. Compared to the correlated roughness fluctuations observed in the healthy areas, some clear loss of correlations is detected in malignant tumor foci. These physiological and architectural changes in the environment of malignant tumors detected in both thermograms and mammograms open new perspectives in computer-aided multifractal methods to assist in early breast cancer diagnosis.

  12. [Pyoderma gangrenosum: spontaneous healing after early diagnosis. Three cases and general review].

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    Viard, R; Scevola, A; Veber, M; Toussoun, G; Delay, E

    2013-04-01

    Pyoderma gangrenosum (PG) is a rare chronic inflammatory skin disease characterized by the recurring development of necrotizing and painful ulcers and therefore, often misinterpreted. This condition can simulate fulminant infection, particularly after surgery. The presentation is often impressive in extensive ulcerations and scarring and lead to significant sequelae. A rapid initial management avoids a dramatic evolution. We report the case of three PG for patients followed for breast reconstruction after breast cancer. PG is a neutrophilic dermatosis that can occur after injuries of varying intensity. Its shape after surgery is a rare disease whose presentation loud and fast pace "infectious" contrasts with the absence of inflammatory lymphangitis or lymphadenopathy. Be aware of prescribing high doses of corticosteroids. These three cases illustrate the importance for early diagnosis and treatment of PG, who can allow spontaneous healing without complex surgery, always feared in this context. Copyright © 2011. Published by Elsevier SAS.

  13. Crystallographic study of PET radiotracers in clinical evaluation for early diagnosis of Alzheimers

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    Angela Altomare

    2014-11-01

    Full Text Available The title compound, C24H25NO3·2CH3OH, which crystallized as a methanol disolvate, has applications as a PET radiotracer in the early diagnosis of Alzheimer's disease. The dihedral angle between the biphenyl rings is 8.2 (2° and the heterocyclic ring adopts a half-chair conformation with the N atom adopting a pyramidal geometry (bond-angle sum = 327.6°. The C atoms of both methoxy groups lie close to the plane of their attached ring [deviations = 0.107 (6 and 0.031 (6 Å]. In the crystal, the components are linked by O—H...O and O—H...N hydrogen bonds, generating [010] chains. C—H...O interactions are also observed.

  14. [Serum iron and serum copper balance in the early diagnosis of metastases of breast cancer].

    Science.gov (United States)

    Wöllgens, P; Kuhne-Velte, H J; Franke-Lompa, C

    1980-02-01

    In a study made in the follow-up clinic on 684 patients with mammary carcinoma it was found that there were 64 cases of local recurrence and 244 cases of distant metastases. In both groups the serum iron and the serum copper balance in blood tests, in relation to the clinical proof of local recurrence and/or distant metastases, was investigated. It was found that there were 43.7% pathological serum iron and serum copper findings with local recurrences and 62.7% with distant metastases. The drift apart tendency of the blood serum values in patients with distant metastases could be proved in 78.7% of the cases and in 77.5% of the cases before any clinical proof. Thus, these observations allow the statement that the blood serum iron and serum copper imbalance in blood tests is of very real value in the early diagnosis of distant metastases.

  15. Neuroimaging markers for the prediction and early diagnosis of Alzheimer’s disease dementia

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    Ewers, Michael; Sperling, Reisa A.; Klunk, William E.; Weiner, Michael W.; Hampel, Harald

    2011-01-01

    Alzheimer’s disease (AD) is a progressive age-related neurodegenerative disease. At the time of clinical manifestation of dementia, significant irreversible brain damage is already present, rendering the diagnosis of AD at early stages of the disease an urgent prerequisite for therapeutic treatment to halt, or at least slow, disease progression. In this Review, we discuss various neuroimaging measures that are proving to have potential value as biomarkers of AD pathology for the detection and prediction of AD before the onset of dementia. Recent studies that have identified AD-like structural and functional brain changes in elderly people who are cognitively within the normal range or who have mild cognitive impairment (MCI) are discussed. A dynamic sequence model of changes that occur in neuroimaging markers during the different disease stages is presented and the predictive value of multimodal neuroimaging for AD dementia is considered. PMID:21696834

  16. Detection of impaired IgG antibody formation facilitates the decision on early immunoglobulin replacement in hypogammaglobulinemic patients

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    Hermann Maximilian Wolf

    2015-02-01

    Full Text Available Hypogammaglobulinemia (serum IgG lower than 2SD below the age-matched mean and clinical symptoms such as increased susceptibility to infection, autoimmune manifestations, granulomatous disease, unexplained polyclonal lymphoproliferation are considered to be diagnostic hallmarks in patients with common variable immunodeficiency (CVID, the most frequent clinically severe primary immunodeficiency syndrome. In the present study we investigated patients with hypogammaglobulinemia and no clinical or immunological signs of defective cell-mediated immunity and differentiated two groups on the basis of their IgG antibody formation capacity against a variety of different antigens (bacterial toxins, polysaccharide antigens, viral antigens. Patients with hypogammaglobulinemia and intact antibody production (HIAP displayed no or only mild susceptibility to infections, while CVID patients showed marked susceptibility to bacterial infections that normalized following initiation of IVIG or SCIG replacement therapy. There was a substantial overlap in IgG serum levels between the asymptomatic HIAP group and the CVID patients examined before immunoglobulin treatment. HIAP patients showed normal levels of switched B memory cells (CD19+CD27+IgD-, while both decreased and normal levels of switched B memory cells could be found in CVID patients. IgG antibody response to a primary antigen, tick borne encephalitis virus (TBEV, was defective in CVID patients, thus confirming their substantial defect in IgG antibody production. Defective IgG antibody production against multiple antigens could also be demonstrated in an adult patient with recurrent infections but normal IgG levels. To facilitate early treatment before recurrent infections may lead to organ damage the antibody formation capacity should be examined in hypogammaglobulinemic patients and the decision to treat should be based on the finding of impaired IgG antibody production.

  17. Cerebrospinal fluid adenosine deaminase activity: A complimentary tool in the early diagnosis of tuberculous meningitis

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    Taori Girdhar M

    2006-03-01

    Full Text Available Abstract Background Tuberculous meningitis (TBM is the commonest form of neurotuberculosis caused by Mycobacterium tuberculosis bacilli (MTB. The diagnosis of TBM is often difficult. A reliable, cost-effective and rapid diagnostic test, which can be performed in any standard pathology laboratory, could be of help in the diagnosis of TBM. In the present study we measured the adenosine deaminase (ADA activity in cerebrospinal fluid (CSF of TBM and non-TBM patients. Method ADA activity in CSF was determined according to a method based on the Berthlot reaction, which is the formation of a colored indophenol complex from ammonia liberated from adenosine, and quantified spectrophotometrically. Results The CSF ADA activity from TBM patients was compared with CSF ADA from non-TBM infectious meningitis patients, and from patients with non-infectious neurological disorders. The mean CSF ADA activity was found to be significantly higher in CSF of TBM patients, 14.31 ± 3.87 (2.99–26.94, mean ± SD with range, than in the CSF from non-TBM infectious meningitis, 9.25 ± 2.14 (4.99–13.96 and from the non-infectious neurological disorders group, 2.71 ± 1.96 (0.00–7.68, P Conclusion This study demonstrated that ADA activity in the CSF of TBM patients, using a cut-off value 11.39 U/L/min, can be useful for the early differential diagnosis of TBM. This test can be performed in any pathology laboratory where more sophisticated methods are not available.

  18. A novel intravital multi-harmonic generation microscope for early diagnosis of oral cancer

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    Cheng, Yu-Hsiang; Lin, Chih-Feng; Shih, Ting-Fang; Sun, Chi-Kuang

    2013-03-01

    Oral cancer is one of the most frequently diagnosed human cancers and leading causes of cancer death all over the world, but the prognosis and overall survival rate are still poor because of delay in diagnosis and lack of early intervention. The failure of early diagnosis is due to insufficiency of proper diagnostic and screening tools and most patients are reluctant to undergo biopsy. Optical virtual biopsy techniques, for imaging cells and tissues at microscopic details capable of differentiating benign from malignant lesions non-invasively, are thus highly desirable. A novel multi-harmonic generation microscope, excited by a 1260 nm Cr:forsterite laser, with second and third harmonic signals demonstrating collagen fiber distribution and cell morphology in a sub-micron resolution, was developed for clinical use. To achieve invivo observation inside the human oral cavity, a small objective probe with a suction capability was carefully designed for patients' comfort and stability. By remotely changing its focus point, the same objective can image the mucosa surface with a low magnification, illuminated by side light-emitting diodes, with a charge-coupled device (CCD) for site location selection before the harmonic generation biopsy was applied. Furthermore, the slow galvanometer mirror and the fast resonant mirror provide a 30 fps frame rate for high-speed real-time observation and the z-motor of this system is triggered at the same rate to provide fast 3D scanning, again ensuring patients' comfort. Focusing on the special cytological and morphological changes of the oral epithelial cells, our preliminary result disclosed excellent consistency with traditional histopathology studies.

  19. A hybrid feature selection approach for the early diagnosis of Alzheimer’s disease

    Science.gov (United States)

    Gallego-Jutglà, Esteve; Solé-Casals, Jordi; Vialatte, François-Benoît; Elgendi, Mohamed; Cichocki, Andrzej; Dauwels, Justin

    2015-02-01

    Objective. Recently, significant advances have been made in the early diagnosis of Alzheimer’s disease (AD) from electroencephalography (EEG). However, choosing suitable measures is a challenging task. Among other measures, frequency relative power (RP) and loss of complexity have been used with promising results. In the present study we investigate the early diagnosis of AD using synchrony measures and frequency RP on EEG signals, examining the changes found in different frequency ranges. Approach. We first explore the use of a single feature for computing the classification rate (CR), looking for the best frequency range. Then, we present a multiple feature classification system that outperforms all previous results using a feature selection strategy. These two approaches are tested in two different databases, one containing mild cognitive impairment (MCI) and healthy subjects (patients age: 71.9 ± 10.2, healthy subjects age: 71.7 ± 8.3), and the other containing Mild AD and healthy subjects (patients age: 77.6 ± 10.0 healthy subjects age: 69.4 ± 11.5). Main results. Using a single feature to compute CRs we achieve a performance of 78.33% for the MCI data set and of 97.56% for Mild AD. Results are clearly improved using the multiple feature classification, where a CR of 95% is found for the MCI data set using 11 features, and 100% for the Mild AD data set using four features. Significance. The new features selection method described in this work may be a reliable tool that could help to design a realistic system that does not require prior knowledge of a patient's status. With that aim, we explore the standardization of features for MCI and Mild AD data sets with promising results.

  20. The role of neuroimaging in the early diagnosis and evaluation of Parkinson's disease.

    Science.gov (United States)

    Seibyl, J; Jennings, D; Tabamo, R; Marek, K

    2005-10-01

    The development of imaging biomarkers which target specific sites in the brain represents a significant advance in neurodegenerative diseases and Parkinson's disease with the promise of new and improved approaches for the early and accurate diagnosis of disease as well as novel ways to monitor patients and assess treatment. The 3 major applications of imaging may play a role in Parkinson's disease include: 1) the use of neuroimaging as a biomarker of disease in order to improve the accuracy, timeliness, and reliability of diagnosis; 2) objective monitoring of the progression of disease to provide a molecular phenotype of Parkinson's disease which may illuminate some of the sources of clinical variability; 3) the evaluation of so-called ''disease-modifying'' treatments designed to retard the progression of disease by interfering with pathways thought implicated in the ongoing neuronal loss or replace dopamine-producing cells. Each of these areas has shown a numbers of critical clinical investigations which have better defined the utility of the imaging tools to these tasks. Nonetheless, current unresolved issues around the clinical role of neuroimaging in monitoring patients over time and validation of quantitative imaging measures of dopaminergic function are immediate issues for the field and the subject of current research efforts and the extension of the lessons learned in Parkinson's to other neurodegenerative diseases including Alzheimer's dementia.

  1. Standardization of fungal polymerase chain reaction for the early diagnosis of invasive fungal infection

    Directory of Open Access Journals (Sweden)

    P Deshpande

    2011-01-01

    Full Text Available Background: An early initiation of antifungal therapy in invasive fungal infections (IFIs is critical in reducing the high mortality rate. Current diagnosis of fungal infection relies on microscopy, culture, antigen, antibody specific tests and histological diagnosis. However, these tests either lack sensitivity or specificity. There is thus the need for a rapid, specific and accurate diagnostic method. Objective: The aim of our study was to establish PCR for the rapid detection of Candida and Aspergillus species in clinical specimens with improved sensitivity and specificity. Materials and Methods: A total of 71 proven cases of IFI (confirmed by culture were collected. A total of 15 healthy, 15 patients suffering from bacterial sepsis and 15 patients with HIV, HBV viral infections were included as controls. Clinical specimens were subjected to a standardized nested amplification to produce Round I (504 bp and Round II (150 bp amplicons. Restriction digestion was performed on these products for further identification. Results: Analytical sensitivity was determined using 10 6 -10 CFU/ml of cell suspension. The lower detection limit of the assay was 10 CFU/ml of blood. This test was 100% sensitive and specific with a positive predictive value of 100% and a negative predictive value of 96.7%. Conclusion: The assay was found to be effective for the rapid detection of Candida and Aspergillus in clinical specimens.

  2. Quality Improvement Interventions for Early HIV Infant Diagnosis in Northeastern Uganda.

    Science.gov (United States)

    Izudi, Jonathan; Akot, Agnes; Kisitu, Grace Paul; Amuge, Pauline; Kekitiinwa, Adeodata

    2016-01-01

    Introduction. Early infant diagnosis (EID) of human immunodeficiency virus (HIV) ensures prompt treatment and infant survival. In Kaabong Hospital, 20% of HIV exposed infants (HEIs) had access to HIV diagnosis by eight weeks. We aimed to improve EID of HIV by deoxyribonucleic acid-polymerase chain reaction (DNA-PCR) testing by eight weeks from 20 to 100% between June 2014 and November 2015. Method. In this quality improvement (QI) project, EID data was reviewed, gaps prioritized using theme matrix selection, root causes analyzed using fishbone tool, and improvement changes were selected using counter measures matrix but implemented using Plan-Do-Study-Act cycle. Root causes of low first DNA-PCR testing included maternal EID ignorance, absent lost mother-baby pairs (LMBP) tracking system, and no EID performance reviews. Health education, Continuous Medical Education (CMEs), and integration of laboratory and EID services were initial improvement changes used. Results. DNA-PCR testing increased from 20 to 100% between June 2014 and July 2015 and was sustained at 100% until February 2016. Two declines, 67% in September 2014 and 75% in June 2015, due to LMBP were addressed using expert clients and peer mothers, respectively. Conclusion. Formation of WIT, laboratory service integration at MBCP, and task shifting along EID cascade improved EID outcomes at 6 weeks.

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

    Science.gov (United States)

    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.

  4. Efficient mining of association rules for the early diagnosis of Alzheimer's disease.

    Science.gov (United States)

    Chaves, R; Górriz, J M; Ramírez, J; Illán, I A; Salas-Gonzalez, D; Gómez-Río, M

    2011-09-21

    In this paper, a novel technique based on association rules (ARs) is presented in order to find relations among activated brain areas in single photon emission computed tomography (SPECT) imaging. In this sense, the aim of this work is to discover associations among attributes which characterize the perfusion patterns of normal subjects and to make use of them for the early diagnosis of Alzheimer's disease (AD). Firstly, voxel-as-feature-based activation estimation methods are used to find the tridimensional activated brain regions of interest (ROIs) for each patient. These ROIs serve as input to secondly mine ARs with a minimum support and confidence among activation blocks by using a set of controls. In this context, support and confidence measures are related to the proportion of functional areas which are singularly and mutually activated across the brain. Finally, we perform image classification by comparing the number of ARs verified by each subject under test to a given threshold that depends on the number of previously mined rules. Several classification experiments were carried out in order to evaluate the proposed methods using a SPECT database that consists of 41 controls (NOR) and 56 AD patients labeled by trained physicians. The proposed methods were validated by means of the leave-one-out cross validation strategy, yielding up to 94.87% classification accuracy, thus outperforming recent developed methods for computer aided diagnosis of AD.

  5. Early molecular diagnosis and detection of Puccinia striiformis f. sp. tritici in China.

    Science.gov (United States)

    Lihua, C; Shichang, X; Ruiming, L; Taiguo, L; Wanquan, C

    2008-05-01

    Wheat stripe (yellow) rust, caused by Puccinia striiformis f. sp. tritici (Pst), is the most important foliar disease on wheat in China. Early molecular diagnosis and detection of stripe rust will provide a useful aid to the accurate forecast and seasonal control of this destructive disease. Our objective was to develop PCR assays for the rapid identification and detection of P. striiformis. The genomic DNA of P. striiformis and P. triticina were amplified by a pair of primers derived from conserved beta-tubulin gene sequence. A 235-bp specific DNA fragment of P. striiformis was isolated and purified. Based on its sequence, another two primer sets were designed successfully to obtain new sequence-characterized amplified region (SCAR) markers of P. striiformis, which could be amplified in all test isolates of P. striiformis, whereas no DNA fragment was obtained in other nontarget wheat pathogens. The detection limit of the primer set YR (f)/YR (r1) was 2.20 pg microl(-1). The new SCAR markers of P. striiformis can also be detected in Pst-infected wheat leaves postinoculated for 2 days. Our assays are significantly faster than the conventional methods used in the identification of P. striiformis. Development of a simple, high-throughput assay kit for the rapid diagnosis and detection of wheat stripe rust would be anticipated in a further study.

  6. Are the Duke criteria really useful for the early bedside diagnosis of infective endocarditis? Results of a prospective multicenter trial.

    Science.gov (United States)

    Cecchi, Enrico; Trinchero, Rita; Imazio, Massimo; Forno, Davide; Dal Conte, Ivano; Lipani, Filippo; Brusca, Antonio; Gnavi, Roberto

    2005-01-01

    To date, no studies have evaluated the usefulness of the Duke vs the modified Duke criteria for the early diagnosis of infective endocarditis (IE), nor is it known whether a probabilistic approach may be useful in establishing an early clinical diagnosis of IE. The aim of this study was (1) to assess and compare the clinical usefulness of the Duke vs the modified Duke criteria for the early diagnosis of IE, and (2) to evaluate the diagnostic utility of a probabilistic approach based on the echocardiographic criterion. From January 2000 to December 2001, 267 consecutive patients with suspected IE were enrolled in a prospective multicenter trial. IE was diagnosed in 147 cases (55%) and rejected in 120 cases (45%). The Duke and the modified Duke criteria had a high similar sensitivity, specificity and accuracy. The time to diagnosis was 8.15 +/- 7.4 days for the Duke criteria and 8.18 +/- 7.1 days for the modified Duke criteria. The time to diagnosis based on a probabilistic approach was shorter than that based on the Duke and the modified Duke criteria (4.96 +/- 7.1 days, for all p < 0.001). Although the Duke and the modified Duke criteria have a very similar sensitivity, specificity and accuracy, the delay in the time to diagnosis may be significant. A probabilistic approach based on clinical suspicion and echocardiographic evidence may be useful for decision-making, whilst awaiting case definition by means of the Duke criteria.

  7. Early infant diagnosis of HIV infection in low-income and middle-income countries: does one size fit all?

    Science.gov (United States)

    Penazzato, Martina; Revill, Paul; Prendergast, Andrew J; Collins, Intira J; Walker, Simon; Elyanu, Peter J; Sculpher, Mark; Gibb, Diana M

    2014-07-01

    Despite expansion of services for prevention of mother-to-child transmission of HIV (PMTCT), about 700 infants acquire HIV every day. Early initiation of antiretroviral therapy for HIV-infected infants reduces mortality but requires diagnosis by virological testing, which is complex, expensive, and inaccessible in many settings. Little cost-effectiveness evidence exists about different strategies to deliver early infant diagnosis services. Cost-effectiveness will vary depending on entry points for testing, underlying prevalences of HIV, PMTCT coverage, treatment availability, programme attrition, and other factors. Appropriate policy responses are therefore context-specific. In most cases, early infant diagnosis should be concentrated at entry points where underlying infant HIV prevalence is highest (eg, malnutrition wards). This strategy contrasts with the tendency at present to test mainly within PMTCT programmes. If testing is undertaken in PMTCT programmes with high coverage, addition of a virological test at birth might have advantages, including greater predictive value, earlier diagnosis, and better infant follow-up. National programme managers should recognise the opportunity costs of the limited resources available, acknowledge the changing scenario of PMTCT scale-up, ensure implementation of provider-initiated testing and counselling, and tailor early infant diagnosis programmes to maximise health gains for children. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2011-07-01

    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.

  9. Early diagnosis of tongue malignancy using laser induced fluorescence spectroscopy technique

    Science.gov (United States)

    Patil, Ajeetkumar; Unnikrishnan V., K.; Ongole, Ravikiran; Pai, Keerthilatha M.; Kartha, V. B.; Chidangil, Santhosh

    2015-07-01

    Oral cancer together with pharyngeal cancer is the sixth most common malignancy reported worldwide and one with high mortality ratio among all malignancies [1]. Worldwide 450,000 new cases are estimated in 2014[2]. About 90% are a type of cancer called squamous cell carcinoma (SCC). SCC of the tongue is the most common oral malignancy accounting for approximately 40% of all oral carcinomas. One of the important factors for successful therapy of any malignancy is early diagnosis. Although considerable progress has been made in understanding the cellular and molecular mechanisms of tumorigenesis, lack of reliable diagnostic methods for early detection leading to delay in therapy is an important factor responsible for the increase in the mortality rate in various types of cancers. Spectroscopy techniques are extremely sensitive for the analysis of biochemical changes in cellular systems. These techniques can provide a valuable information on alterations that occur during the development of cancer. This is especially important in oral cancer, where "tumor detection is complicated by a tendency towards field cancerization, leading to multi-centric lesions" and "current techniques detect malignant change too late" [3], and "biopsies are not representative of the whole premalignant lesion". [4

  10. Spinal cord injury of cervical vertibrae and early diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    陈扬; 李振宇; 等

    1999-01-01

    Objective:To sum up clinical data and CT and MRI examination in 22 patients with spinal cord injury of cervical vertebrae.Methods:CT and MRI examination of the 22 patients with spinal cord injury of cervical vertebrae revealed that 16 patients had spinal comprssion caused by fracture dislocation and protrusion of intervertebral disc,5 suffered from intramedullary hemorrhage and 1 had complete spinal cord injury.A combined modality therapy of intramedullary and extramedullary decompression for spinal cord,skull traction and avoiding reinjury to spinal cord were used. Results:According to Frankel Classification,before operation 3 cases were classified as A degree,2 as B degree,5as C degree,8 as D degree and 4 as Edegree;after operation 2 were classified as A degree,1 as B degree,6 as C degree,6 as D degree and 7 as E degree.Conclusions:Early diagnosis and timely treatmetn,clear mechanism and degree of injury and early selection of effective treatment are very important in raising the rate of curing spinal cord injury.

  11. A nanostructured genosensor for the early diagnosis of systemic arterial hypertension.

    Science.gov (United States)

    Rolim, Thalita; Cancino, Juliana; Zucolotto, Valtencir

    2015-02-01

    The rapid progress of nanomedicine, especially in areas related to medical imaging and diagnostics, has motivated the development of new nanomaterials that can be combined with biological materials for specific medical applications. One such area of research involves the detection of specific DNA sequences for the early diagnosis of genetic diseases, using nanoparticles-containing genosensors. Typical genosensors devices are based on the use of sensing electrodes - biorecognition platforms - containing immobilized capture DNA probes capable of hybridizing with specific target DNA sequences. In this paper we show that upon an appropriate design of the biorecognition platform, efficient sandwich-type genosensors based upon DNA-AuNPs nanocomplexes can be efficiently applied to the detection of a Systemic Arterial Hypertension (SAH) polymorphism located in intron 16 of the Angiotensin-converter enzyme (ACE) gene. Since SAH is intimately related to heart diseases, especially blood hypertension, its early detection is of great biomedical interest. The biorecognition platforms were assembled using mixed self-assembled monolayers (SAMmix), which provided the immobilization of organized architectures with molecular control. Detection of the DNA target sequence at concentrations down to 1 nM was carried out using electrochemical impedance spectroscopy (EIS). We show that the use of EIS combined with specific nanobiocomplexes represents an efficient method for the unambiguous detection of complementary DNA hybridization for preventative nanomedicine applications.

  12. Clinical study of quantitative diagnosis of early cervical cancer based on the classification of acetowhitening kinetics

    Science.gov (United States)

    Wu, Tao; Cheung, Tak-Hong; Yim, So-Fan; Qu, Jianan Y.

    2010-03-01

    A quantitative colposcopic imaging system for the diagnosis of early cervical cancer is evaluated in a clinical study. This imaging technology based on 3-D active stereo vision and motion tracking extracts diagnostic information from the kinetics of acetowhitening process measured from the cervix of human subjects in vivo. Acetowhitening kinetics measured from 137 cervical sites of 57 subjects are analyzed and classified using multivariate statistical algorithms. Cross-validation methods are used to evaluate the performance of the diagnostic algorithms. The results show that an algorithm for screening precancer produced 95% sensitivity (SE) and 96% specificity (SP) for discriminating normal and human papillomavirus (HPV)-infected tissues from cervical intraepithelial neoplasia (CIN) lesions. For a diagnostic algorithm, 91% SE and 90% SP are achieved for discriminating normal tissue, HPV infected tissue, and low-grade CIN lesions from high-grade CIN lesions. The results demonstrate that the quantitative colposcopic imaging system could provide objective screening and diagnostic information for early detection of cervical cancer.

  13. 产后出血的急救%Early diagnosis and treatment of postpartum hemorrhage

    Institute of Scientific and Technical Information of China (English)

    陈锰; 刘兴会

    2013-01-01

    产后出血仍是我国孕产妇死亡的最主要原因,其早期的诊断和及时的救治是提高抢救成功率、降低孕产妇死亡率的关键.本综述主要从产后出血的早期诊断、及时干预及合理转诊对产后出血的急救进行阐述,并根据我国产后出血的诊疗现状,以期帮助产科医务人员对产后出血的诊治有更深一步的认识.%Postpartum hemorrhage is a leading cause of maternal death in China. Early detection and treatment of postpartum hemorrhage play a key role in reducing maternal mortality rate. This review mainly focus on the early diagnosis,effective treatment and transportation of patients with postpartum hemorrhage in China in order to help the obstetric medical staffs to gain a deeper understanding of this life-threatening condition.

  14. Current Challenges in Diabetic Nephropathy: Early Diagnosis and Ways to Improve Outcomes.

    Science.gov (United States)

    Kim, Sang Soo; Kim, Jong Ho; Kim, In Joo

    2016-06-01

    Diabetes is often associated with chronic kidney disease (CKD) and is the primary cause of kidney failure in half of patients who receive dialysis therapy. Given the increasing prevalence of diabetes and its high morbidity and mortality, diabetic nephropathy is a serious drawback in individual patients and a tremendous socioeconomic burden on society. Despite growing concern for the management of diabetic nephropathy, the prevalence of CKD with diabetes is the same today as it was 20 years ago. The current strategy to manage diabetic nephropathy, including the control of hyperglycemia, dyslipidemia, and blood pressure and the wide-spread use of renin-angiotensin-aldosterone system inhibitors, is well established to be beneficial in the early stages of diabetic nephropathy. However, the effects are uncertain in patients with relatively progressed CKD. Therefore, early diagnosis or risk verification is extremely important in order to reduce the individual and socioeconomic burdens associated with diabetic nephropathy by providing appropriate management to prevent the development and progression of this condition. This review focuses on recent research and guidelines regarding risk assessment, advances in medical treatment, and challenges of and future treatments for diabetic nephropathy.

  15. Massively parallel sequencing for early molecular diagnosis in Leber congenital amaurosis.

    Science.gov (United States)

    Coppieters, Frauke; De Wilde, Bram; Lefever, Steve; De Meester, Ellen; De Rocker, Nina; Van Cauwenbergh, Caroline; Pattyn, Filip; Meire, Françoise; Leroy, Bart P; Hellemans, Jan; Vandesompele, Jo; De Baere, Elfride

    2012-06-01

    Leber congenital amaurosis (LCA) is a rare congenital retinal dystrophy associated with 16 genes. Recent breakthroughs in LCA gene therapy offer the first prospect of treating inherited blindness, which requires an unequivocal and early molecular diagnosis. While present genetic tests do not address this due to a tremendous genetic heterogeneity, massively parallel sequencing (MPS) strategies might bring a solution. Here, we developed a comprehensive molecular test for LCA based on targeted MPS of all exons of 16 known LCA genes. We designed a unique and flexible workflow for targeted resequencing of all 236 exons from 16 LCA genes based on quantitative PCR (qPCR) amplicon ligation, shearing, and parallel sequencing of multiple patients on a single lane of a short-read sequencer. Twenty-two prescreened LCA patients were included, five of whom had a known molecular cause. Validation of 107 variations was performed as proof of concept. In addition, the causal genetic defect and a single heterozygous mutation were identified in 3 and 5, respectively, of 17 patients without previously identified mutations. We propose a novel targeted MPS-based approach that is suitable for accurate, fast, and cost-effective early molecular testing in LCA, and easily applicable in other genetic disorders.

  16. Current Challenges in Diabetic Nephropathy: Early Diagnosis and Ways to Improve Outcomes

    Directory of Open Access Journals (Sweden)

    Sang Soo Kim

    2016-06-01

    Full Text Available Diabetes is often associated with chronic kidney disease (CKD and is the primary cause of kidney failure in half of patients who receive dialysis therapy. Given the increasing prevalence of diabetes and its high morbidity and mortality, diabetic nephropathy is a serious drawback in individual patients and a tremendous socioeconomic burden on society. Despite growing concern for the management of diabetic nephropathy, the prevalence of CKD with diabetes is the same today as it was 20 years ago. The current strategy to manage diabetic nephropathy, including the control of hyperglycemia, dyslipidemia, and blood pressure and the wide-spread use of renin-angiotensin-aldosterone system inhibitors, is well established to be beneficial in the early stages of diabetic nephropathy. However, the effects are uncertain in patients with relatively progressed CKD. Therefore, early diagnosis or risk verification is extremely important in order to reduce the individual and socioeconomic burdens associated with diabetic nephropathy by providing appropriate management to prevent the development and progression of this condition. This review focuses on recent research and guidelines regarding risk assessment, advances in medical treatment, and challenges of and future treatments for diabetic nephropathy.

  17. Qualitative and quantitative aspects of the serological diagnosis of early syphilis.

    Science.gov (United States)

    McMillan, A; Young, H

    2008-09-01

    The aim of the present study was to evaluate the use of various serological tests in the diagnosis of early syphilis. The Murex enzyme immunoassay (EIA) test was used for screening; the Venereal Diseases Research Laboratory (VDRL) test, the Treponema pallidum particle agglutination assay (TPPA) and the Mercia antitreponemal IgM EIA were used in all the patients with a positive screening test and in those with suspected syphilis or in known contacts. In 89 cases of primary syphilis, the Murex EIA screening test was positive in 67 (75%) patients, the Mercia IgM EIA in 80 (90%) cases, the VDRL in 60 (67%) cases and the TPPA in 85 (96%) cases. All the tests were positive in 68 patients with secondary syphilis. In 72 cases of early latent syphilis, the Murex EIA screening test was positive in 68 (94%) patients, the Mercia IgM EIA in 50 (69%) cases, the VDRL in 61 (85%) cases and the TPPA in 68 (94%) cases. The Mercia IgM EIA was the only test positive in four (6%) of these cases; these four patients were known contacts. Antibody titres in the VDRL and TPPA increased as the infection progressed.

  18. How Should the Screening Programs be planned for the Early Diagnosis of Breast Cancer

    Directory of Open Access Journals (Sweden)

    Zafer Kilbas

    2012-04-01

    Full Text Available Breast cancer is the most common cancer of women, and it ranks as the second leading cause of cancer death in women. Although breast cancer incidence in western countries is higher than developping countries, very favorable survival rates in the developed countries have been attributed to early detection by screening. Despite screening mammography have been used for a long time, there is not a strong consensus related to when to start?, how frequently to screen?, and when to finish screening. Many factors including the risk stratification of patient, incidence of breast cancer, social and economic status, the availability of mammography and medical team should be considered when creating national screening programs. Today, the most effective way to reduce breast cancer mortality is early diagnosis and treatment. By the help of effective screening programmes and organizations related to breast cancer awareness, downstaging of breast cancer and reduction in mortality rate in community could be possible. [TAF Prev Med Bull 2012; 11(2.000: 225-230

  19. Lipid raft disarrangement as a result of neuropathological progresses: a novel strategy for early diagnosis?

    Science.gov (United States)

    Marin, R; Rojo, J A; Fabelo, N; Fernandez, C E; Diaz, M

    2013-08-15

    Lipid rafts are the preferential site of numerous membrane signaling proteins which are involved in neuronal functioning and survival. These proteins are organized in multiprotein complexes, or signalosomes, in close contact with lipid classes particularly represented in lipid rafts (i.e. cholesterol, sphingolipids and saturated fatty acids), which may contribute to physiological responses leading to neuroprotection. Increasing evidence indicates that alteration of lipid composition in raft structures as a consequence of neuropathologies, such as Alzheimer's disease (AD) and Parkinson's disease (PD), causes a dramatic increase in lipid raft order. These phenomena may correlate with perturbation of signalosome activities, likely contributing to neurodegenerative progression. Interestingly, significant disruption of stable raft microenvironments has been already observed in the first stages of either AD or PD, suggesting that these alterations may represent early events in the neuropathological development. In this regard, the search for biochemical markers, such as specific metabolic products altered in the brain at the first steps of the disease, presently represents an important challenge for early diagnostic strategies. Alterations of these biomarkers may be reflected in either plasma or cerebrospinal fluid, thus representing a potential strategy to predict an accurate diagnosis. We propose that pathologically-linked lipid raft markers may be interesting candidates to be explored at this level, although it has not been studied so far to what extent alteration of different signalosome components may be reflected in peripheral fluids. In this mini-review, we will discuss on relevant aspects of lipid rafts that contribute to the modulation of neuropathological events related to AD and PD. An interesting hypothesis is that anomalies on raft biomarkers measured at peripheral fluids might mirror the lipid raft pathology observed in early stages of AD and PD.

  20. Early diagnosis of Carpal Tunnel Syndrome (CTS in Indian patients by nerve conduction studies

    Directory of Open Access Journals (Sweden)

    Dr. Geetanjali Sharma MD

    2010-07-01

    Full Text Available The present study was carried out for early confirmation of clinically diagnosed patients of Carpal Tunnel Syndrome (CTS by electro-diagnostic tests which included motor conduction, sensory conduction studies and F-wave studies. The aim of the study was early confirmation of clinically suspected patients of CTS by motor and sensory conduction studies of median and ulnar nerves. Eighty subjects of age group 30-50 years (40 clinically suspected patients of CTS, 40 as control group were studied. Motor and Sensory conduction velocities, distal motor and sensory latencies and F wave latencies of median and ulnar nerves were performed using RMS EMG EP Mark –II. Statistically significant (P < 0.001 slowing of motor conduction velocities for both nerves was seen in the CTS group as compared to control group. Decrease in sensory conduction velocity was more pronounced in CTS group as compared to Control group. Statistically significant (P < 0.001 increase in distal motor and sensory latencies was also observed for both median and ulnar nerves in the CTS group as compared to Control group, with more increase in distal motor latency than sensory latency. Increase in F wave latencies of both nerves was seen in the CTS group. Electrophysiological studies confirmed the early diagnosis of CTS with a high degree of sensitivity. Present results confirm selective slowing of sensory & motor conduction within wrist to palm segment in patients of CTS which is attributable to compression by the transverse carpal ligament or to a disease process of the terminal segment.

  1. Clinical Evaluation of Brain Perfusion SPECT with Brodmann Areas Mapping in Early Diagnosis of Alzheimer's Disease.

    Science.gov (United States)

    Valotassiou, Varvara; Papatriantafyllou, John; Sifakis, Nikolaos; Tzavara, Chara; Tsougos, Ioannis; Psimadas, Dimitrios; Fezoulidis, Ioannis; Kapsalaki, Eftychia; Hadjigeorgiou, George; Georgoulias, Panagiotis

    2015-01-01

    Early diagnosis of Alzheimer's disease (AD) based on clinical criteria alone may be problematic, while current and future treatments should be administered earlier in order to be more effective. Thus, various disease biomarkers could be used for early detection of AD. We evaluated brain perfusion with 99mTc-HMPAO single photon emission computed tomography (SPECT) and Brodmann areas (BAs) mapping in mild AD using an automated software (NeuroGam) for the semi-quantitative evaluation of perfusion in BAs and the comparison with the software's normal database. We studied 34 consecutive patients with mild AD: 9 men, 25 women, mean age 70.9 ± 8.1 years, mean Mini-Mental State Examination 22.6 ± 2.5. BAs 25L, 25R, 38L, 38R, 28L, 28R, 36L, and 36R had the lower mean perfusion values, while BAs 31L, 31R, 19R, 18L, 18R, 17L, and 17R had the higher mean values. Compared with healthy subjects of the same age, perfusion values in BAs 25L, 25R, 28R, 28L, 36L, and 36R had the greatest deviations from the healthy sample, while the lowest deviations were found in BAs 32L, 32R, 19R, 24L, 17L, 17R, 18L, and 18R. A percentage of ≥94% of patients had perfusion values more than -2SDs below the mean of healthy subjects in BAs 38R, 38L, 36L, 36R, 23L, 23R, 22L, 44L, 28L, 28R, 25L, and 25R. The corresponding proportion was less than 38% for BAs 11L, 19R, 32L, 32R, 18L, 18R, 24L, and 17R. In conclusion, brain SPECT studies with automated perfusion mapping could be useful as an ancillary tool in daily practice, revealing perfusion impairments in early AD.

  2. Analysis of factors responsible for the image in early stage emphysema and research concerning the diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Hirotaka [Wakayama Medical Coll. (Japan)

    1998-11-01

    To clarify the utility of the CT image to a clinical diagnosis of the early stage emphysema, the relation of CT value to the level of the lung destruction, the change in the lung density and pulmonary function was examined. Experimental pulmonary emphysema model in canine was produced by inhalation of aerosolized papain solution. In this model, the relationship between the destruction in lung tissues and the analysis of CT images was investigated. Changes in the alveolar surface area per unit lung volume well reflected those in mean CT value in the lung parenchyma. Also, it was clarified that the degree of the lung destruction in this model corresponded to that in patients with the early stage emphysema. Mean CT value in the area that formed lowest 5th percentile of the CT value histogram (mCT (5%ile)) was developed to analyze CT images in emphysema. To develop this study, changes of the mCT (5%ile) at the respiratory level from 5% to 95% inspiratory vital capacity (mCT (5%ile (5-95%VC))) was examined. In experimental studies, there was statistical significance between control and emphysema model. In clinical study using 14 patients with emphysema, the mCT (5%ile (5-95%VC)) reflected well the values of pulmonary function tests which indicated air flow limitation such as %pred. FEV 1.0 and MMF. The present studies demonstrated that it might be useful to detect the pathological and functional impairment in the early stage emphysema by using mCT (5%ile (5-95%VC)). (author)

  3. A preliminary clinical report of 2LC reagent for early gastric cancer diagnosis

    Institute of Scientific and Technical Information of China (English)

    Min Li; Xue Zhong Chen; Zhi Xue Lin; Ling Chen

    2000-01-01

    AIM To explore the feasibility of early gastric cancer diagnosis with 2LC reagent, and to establish a grossexploration method for early gastric cancer with the reagent based on the feasibility.METHODS Add 30 mg or 0.3 mL 2LC reagent into 5 mL urinary sample, observe the change of urinary,and analyze the sample on DAO-JIN-UV-260 Ultraviolet-analyzer at 190nm - 700nm, then, record theabsorbance at 490nm. To determine best stage of sample, take some samples on 8:00 pm and 8:00 am,respectively. To select best dosage of 2LC, take the test with different concentrations. To test the effect ofoperation, conduct the experiment in different stages before and after the operation for the patients withgastric cancer. Two parallel samples were taken each time in the whole experiment.RESULTS Red compound produced by some reactions when the 2LC reagent was added into the urinary ofpatients with gastric cancer, and the urine had obvious absorptivity at about 490nm (positive). There was almost no reaction in the urine of other samples (negative). A total of 172 samples were tested, the positiverate of gastric cancer was above 90% in 48 samples before the operation, in which 8 advanced gastric cancerand 9 early stage gastric cancer samples behaved stronger positive reaction. The positive rate of 118 othersamples was less than 10%. The urine taken in the morning was batter than that in the evening. The bestdosage of 2LC was 6 mg/mL for crystal and 0.05 mL/mL for liquid. The test results of gastric cancerpatients with postoperative tumor recrudescence or transfer were positive, and the others were negative.CONCLUSION There is a high feasibility in manipulation simplification, specificity and receptivity of 2LCreagent for early gastric cancer detection, and the characteristics mentioned above will be improved based onthe advanced raw material used and the style of the 2LC reagent. It is an effective gross exploration methodfor early gastric cancer with the 2LC reagent, and can determine

  4. Available Tools to Facilitate Early Patient Access to Medicines in the EU and the USA: Analysis of Conditional Approvals and the Implications for Personalized Medicine.

    Science.gov (United States)

    Leyens, Lada; Richer, Étienne; Melien, Øyvind; Ballensiefen, Wolfgang; Brand, Angela

    2015-01-01

    Scientific knowledge and our understanding of the human body and diseases have limited any possible treatment tailoring to each patient. The technological advances enabling the integration of various data sets (e.g. '-omics', microbiome, epigenetics and environmental exposure) have facilitated a greater understanding of the human body, the molecular basis of disease and all the factors influencing disease onset, progression and response to treatment, thereby ushering in the era of personalized medicine. We evaluate the regulatory approaches available to facilitate early patient access to efficacious and safe compounds in the EU and the USA in order to make more informed recommendations in the future as to the gaps in regulations for early patient access. An in-depth analysis of conditional approvals (EU) and accelerated approvals (USA) is performed based on the publicly available information (European public assessment reports and a summary review of products approved under both programmes). The types of product, indications, time to approval and type of evidence submitted were analysed. Between 2007 and early 2015, 17 products were conditionally approved in the EU and 25 in the USA, most of them in the area of oncology and based on evidence from phase II clinical trial data. Early approval of promising products based on data from early phases of development is already possible in the EU and the USA. Some of the improvements could entail implementing a rolling assessment of evidence in Europe and extending the scope of early dialogues.

  5. [Real-time sonography of the infant hip joint in the early diagnosis of congenital hip dysplasia].

    Science.gov (United States)

    Casser, H R; Forst, R

    1985-01-01

    The ultrasonic examination of infant hip joint means a great advantage in early diagnosis of congenital hip dysplasia. The sonographic type classification by Graf enables the experienced examiner to make up a differentiated diagnostic-therapeutic concept as early as possible. Therapeutic omissions just as well as exaggerated therapeutic measures can be avoided. Consequently the prognosis of hip joint dysplasia is considerably improved by ultrasonic examination of new-born hip joints.

  6. COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF FIVE METHODS FOR EARLY DIAGNOSIS OF OCCLUSAL CARIES LESIONS – in vitro study.

    OpenAIRE

    Mirela Marinova-Takorova; Radostina Anastasova; Vladimir E. Panov

    2014-01-01

    Purpose: The aim of the presented in vitro study was to evaluate the effectiveness of the device DIAGNOcam and the laser fluorescence device DIAGNOdent for early diagnosis of occlusal caries and to compare it with three traditional methods – visual and tactile, dye and radiographic examination. Material and methods: The sample consisted of 60 extracted human teeth. Three clinicians diagnosed independently the presence or absence of early occlusal surface caries with the visible tactile met...

  7. Claves para el diagnóstico precoz del glaucoma (Keys to early diagnosis of glaucoma

    Directory of Open Access Journals (Sweden)

    Molleda-Carbonell José Mª

    2009-03-01

    Full Text Available ResumenEl diagnóstico precoz del glaucoma es un problema en oftalmologíaveterinaria. Basándose en los síntomas clínicos habituales el diagnóstico suele hacerse en un punto en el que la visión ha sufrido un importante deterioro. Basados en el hecho de que el glaucoma es una enfermedad neurodegenerativa del nervio óptico y que sus primeras manifestaciones son degeneración y muerte de las células ganglionares de la retina, degeneración de axones del nervio óptico y por tanto disminución de la capa de fibras nerviosas nerviosas, con aumento de la excavación papilar, disminución del anillo neuro-retniano y desestabilización de la cabeza del nervio óptico, es obvio que el diagnóstico debe de centrarse en detectar, loantes posible, estos cambios. En la actualidad, sin menospreciar latonometría y la gonioscopia se debe profundizar en aquellas técnicas que como la oftalmoscopia de la retina y papila evalúen el daño y progresión del nervio óptico. Así junto al estudio de la progresión de la excavación papilar frente a la disminución del anillo neurorretiniano, es necesario avanzar en el uso de técnicas actuales como la tomografía de coherencia óptica (OCT y el analizador de fibras nerviosas GDX, que detectan daños y su progresión en la capa de fibras nerviosas de la retina incluso antes de que se traduzcan en una pérdida apreciable de la función visual.SummaryEarly diagnosis of glaucoma is a problem in veterinary ophthalmologybecause the diagnosis is based on the clinical sings when there is animportant visual alteration. Two groups of eye conditions have beenproposed in glaucoma. One of them has the common feature aboutprogressive optic neuropaty involving loss of retinal ganglion cells, getting smaller the neuroretinal rim, loss of nerve fibre layer and generalised or focal enlargement of the cup. Only a preventive glaucoma diagnosis can preserve effectively the vision. Early detection is the key to protecting the

  8. Explore the Possibility of Early Clinical Diagnosis of Endocrine Ophthalmopathy Based on Eye Symptoms of Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    V. G. Likhvantseva

    2016-01-01

    Full Text Available Purpose: to study the possibility of early clinical diagnosis of endocrine ophthalmopathy based on ocular symptoms of hyperthyroidism. Patients and methods: we analyzed the prevalence of ocular symptoms of hyperthyroidism in 139 patients (278 orbits with newly diagnosed endocrine ophthalmopathy (group 1, developed on the background of diffuse toxic goiter. The comparison group consisted of 80 patients (160 orbits with newly diagnosed diffuse toxic goiter with no radiographic evidence of endocrine ophthalmopathy (group 2. All patients were examined by an ophthalmologist and endocrinologist. We analyzed the prevalence of ocular symptoms of hyperthyroidism (symptom Dalrymple’, Mobius’, Zenger’, and combinations thereof, often encountered in diffuse toxic goiter, flowing with endocrine ophthalmopathy, and/or lack thereof - in the group of “thyrotoxic exophthalmos”. We took into account the frequency distribution of these clinical signs, and their combinations. We analyzed the clinical sensitivity and specificity of diagnosis based on the three most common symptoms, and their combinations, associated both with thyrotoxicosis and with endocrine ophthalmopathy. Results: Dalrymple’ symptom, is more common in thyrotoxic exophthalmos than with endocrine ophthalmopathy (compared to 100.0% versus 61.9 %, p<0,001. This suggests that Dalrymple’ symptom leads to over diagnosis aspect endocrine ophthalmopathy. It is obvious that it can be used to recognize and thyrotoxic exophthalmos hyperthyroidism, but you cann’t credibly claim based on orbit about the presence of the disease. In this aspect, the greatest practical interest to provide a comparative assessment of the frequency of detection of symptoms of Mobius’ and Zenger’ and their combinations in a population of endocrine ophthalmopathy and in the group of thyrotoxic exophthalmos. Significantly more symptoms Zenger’ and Mobius’ developed with endocrine ophthalmopathy (66,2% and 81

  9. Ensembles of Deep Learning Architectures for the Early Diagnosis of the Alzheimer's Disease.

    Science.gov (United States)

    Ortiz, Andrés; Munilla, Jorge; Górriz, Juan M; Ramírez, Javier

    2016-11-01

    Computer Aided Diagnosis (CAD) constitutes an important tool for the early diagnosis of Alzheimer's Disease (AD), which, in turn, allows the application of treatments that can be simpler and more likely to be effective. This paper explores the construction of classification methods based on deep learning architectures applied on brain regions defined by the Automated Anatomical Labeling (AAL). Gray Matter (GM) images from each brain area have been split into 3D patches according to the regions defined by the AAL atlas and these patches are used to train different deep belief networks. An ensemble of deep belief networks is then composed where the final prediction is determined by a voting scheme. Two deep learning based structures and four different voting schemes are implemented and compared, giving as a result a potent classification architecture where discriminative features are computed in an unsupervised fashion. The resulting method has been evaluated using a large dataset from the Alzheimer's disease Neuroimaging Initiative (ADNI). Classification results assessed by cross-validation prove that the proposed method is not only valid for differentiate between controls (NC) and AD images, but it also provides good performances when tested for the more challenging case of classifying Mild Cognitive Impairment (MCI) Subjects. In particular, the classification architecture provides accuracy values up to 0.90 and AUC of 0.95 for NC/AD classification, 0.84 and AUC of 0.91 for stable MCI/AD classification and 0.83 and AUC of 0.95 for NC/MCI converters classification.

  10. Short-distance sensory stimulation technique in the early diagnosis of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Betül Çevik

    2013-12-01

    Full Text Available Aim. Normal results obtained from nerve conduction studies do not exclude the diagnosis of carpal tunnel syndrome (CTS. We intended to increase diagnostic sensitivity of nerve conduction studies in the early stage CTS by stimulating shorter palm-wrist segment, and excluding distal region outside the entrapment site of the median nerve which is unaffected from pathologic changes. Methods. In this prospective study, 41 patients (66 hands with clinically diagnosed CTS with normal conventional electrophysiologic examinations were stimulated with electrodes placed at 8, 7, 6, 5, 4 cm from the distal wrist crease (DWC on the palm-wrist segment, and the conduction velocities, latencies, and the differential latencies (conduction delay were compared with those of 34 patients (68 hands in the control group. Results. Conduction delay recorded between 4-5, 5-6, 6-7, 7-8 cm. away from DWC of both groups was statistically insignificant (p>0.1, while the conduction velocities and the latencies obtained from the electrodes placed on 4, 5, 6, 7, and 8 cm away from DWC differed statistically significantly between two groups (p<0.001. Conclusion. In electrophysiologic examinations performed to confirm the diagnosis of CTS, assessment of shorter palm-wrist segment, and stimulation of a predetermined location 4 or 5 cm distal to DWC are sufficient to detect a slight and localized conduction delay in the carpal tunnel. This method eliminated slowing-down effect of distal segment on normal nerve conduction velocities yielding higher degrees of (up to 92.4 % sensitivity.

  11. Invasive pulmonary aspergillosis: role of early diagnosis and surgical treatment in patients with acute leukemia

    Directory of Open Access Journals (Sweden)

    Ursavas Ahmet

    2006-07-01

    Full Text Available Abstract Background Aspergillus is a ubiquitous soil-dwelling fungus known to cause significant pulmonary infection in immunocompromised patients. The incidence of aspergillosis has increased during the past two decades and is a frequently lethal complication of acute leukemia patients that occurs following both chemotherapy and bone marrow transplantation. The diagnosis of invasive pulmonary aspergillosis (IPA according to the criteria that are established by European Organization for the Research and Treatment of Cancer and Mycoses Study Group raise difficulties in severely ill patients. Despite established improvements in field of diagnosis (galactomannan antigen, quantitative PCR, real-time PCR for Aspergillus spp., and findings of computed tomography and treatment with new antifungals, it is still a major problem in patients with acute leukemia. However, prompt and effective treatment of IPA is crucial because most patients will need subsequent chemotherapy for underlying hematologic disease as soon as possible. Case presentation We report a 33-year-old male patient with acute promyelocytic leukemia diagnosed in 1993 that developed invasive pulmonary aspergillosis due to A. flavus at relapse in 2003. The patient was successfully treated with liposomal amphotericin B and underwent surgical pulmonary resection. The operative course was uneventful. Conclusion This report emphasizes the clinical picture, applicability of recent advances in diagnostic and therapeutic approaches for IPA. For early identification of a patient infected with IPA, a high index of suspicion and careful clinical and radiological examinations with serial screening for galactomannan should be established. If aspergillosis is suspected, anti-aspergillosis drug should be administered immediately, and if a unique pulmonary lesion remains, surgical resection should be considered to prevent reactivation during consecutive chemotherapy courses and to improve the outcome.

  12. Early diagnosis and treatment of acute or subacute spinal epidural hematoma

    Institute of Scientific and Technical Information of China (English)

    YU Hang-ping; FAN Shun-wu; YANG Hui-lin; TANG Tian-si; ZHOU Feng; ZHAO Xing

    2007-01-01

    postoperative and preoperative scales (u=3.66, P<0.01). Most patients recovered after therapy, but the recovery of patients treated at our hospitals was superior to that of those transferred from community hospitals (t =2.95, P<0.05). Of the patients treated at our hospitals, 4 were cured and 1 was upgraded with scale from A to D, whereas none of those transferred from community hospitals recovered completely,even one remained scale C.Conclusions Physical examination plus MRI is essential to early diagnosis of acute or subacute spinal epidural hematoma. Preventive and curative measures including emergency operation are helpful to the recovery of patients'nerve function.

  13. [Molecular diagnosis as a strategy for differential diagnosis and at early ages of neurofibromatosis type 1 (NF1)].

    Science.gov (United States)

    Gómez, Martha; Batista, Oriana

    2015-10-01

    Neurofibromatosis type 1 (NF1), is a haploinsufficient and multisystemic disease, caused by inherited or sporadic mutations in the NF1 gene. Its incidence is one in 2,500 to 3,000 individuals, it has an autosomal dominant pattern of inheritance, high clinical variability, complete penetrance and age-dependent complications. Neurofibromin is the product of the NF1 gene and is believed to act as a tumor suppressor since the loss of its function has been associated with benign and malignant tumors in neural crest-derived tissues. Only two correlations between clinical phenotype and mutant alleles in the NF1 gene have been observed. The established criteria for disease diagnosis are very efficient in adults and children older than 3 years of age, but not for children under this age. Mutational analysis is therefore recommended to confirm the disease in young children with a negative family history. A pathogenic mutation in the NF1 should be added to the list of diagnostic criteria. Mutational analysis is also recommended for differential diagnosis and for prenatal or pre-implantation genetic diagnosis, taking into consideration the family history and the type of method to be applied. Molecular studies of this disease using different complimentary molecular techniques and bioinformatics tools have characterized NF1 gene mutations at both the DNA and mRNA levels, increasing the mutational spectrum. Consequently, about 1,289 defects have been reported to date, mainly nonsense/missense mutations, deletions and splice site defects.

  14. Implementation of Early Diagnosis and Intervention Guidelines for Cerebral Palsy in a High-Risk Infant Follow-Up Clinic.

    Science.gov (United States)

    Byrne, Rachel; Noritz, Garey; Maitre, Nathalie L

    2017-08-30

    Cerebral palsy is the most common physical disability in childhood, and is mostly diagnosed after age 2 years. Delays in diagnosis can have negative long-term consequences for children and parents. New guidelines for early cerebral palsy diagnosis and intervention were recently published, after systematic review of the evidence by international multidisciplinary experts aiming to decrease age at diagnosis. The current study tested the feasibility of implementing these guidelines in an American clinical setting. We designed a stepwise implementation process in a neonatal intensive care follow-up clinic. Efficacy was tested by comparing 10-month pre- and post-implementation periods. Clinic visit types, cerebral palsy diagnosis, provider competencies and perspectives, and balancing measures were analyzed. Changes to infrastructure, assessments, scheduling algorithms, documentation and supports in diagnosis or counseling were successfully implemented. Number of three- to four-month screening visits increased (255 to 499, P cerebral palsy care guidelines for infants under age 2 years. We demonstrated for the first time in a US clinical setting the feasibility of implementation of international early diagnosis and treatment guidelines for cerebral palsy. This process is adaptable to other settings and underscores the necessity of future research on cerebral palsy treatments in infancy. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. [Serological diagnosis of an infestation caused by the early developmental stages of botfly larvae (Oedemagena tarandi) in reindeer].

    Science.gov (United States)

    Solopov, N V; Kalinina, N G

    1984-01-01

    Undertaken investigations have shown that the antigen prepared from larvae of O. tarandi is diagnostically effective and stricktly specific only to this infection in the reaction of indirect hemagglutination (RIHA). The experiments have proved the possibility of practical use of RIHA as a principal method of early diagnosis of infection of reindeer caused by O. tarandi.

  17. Role of serum procalcitonin level in early diagnosis of bacterial pneumonia in children, a hospital based study

    Directory of Open Access Journals (Sweden)

    Sheikh Mohd Saleem

    2016-05-01

    Conclusions: Serum PCT is an important biomarker for prompt diagnosis of bacterial infection and a sensitive indicator to distinguish bacterial from non-bacterial pneumonia. Evaluating serum PCT levels helps in early use of antibiotic therapy and prognosis of underlying disease. [Int J Res Med Sci 2016; 4(5.000: 1518-1521

  18. The utility of perfusion CT and CT angiography on early diagnosis and the management of vasospasm after subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Samira Zabihyan

    2015-01-01

    Full Text Available Subarachnoid hemorrhage is one of the most important and dangerous neurologic emergencies worldwide. It is characterized by a sudden and severe headache caused most commonly by the rupture of intracranial aneurysm. Cerebral vasospasm is the most important cause of disability and death in whom survived from the first event. Early diagnosis and management of cerebral vasospasm could prevent and reduce its morbidity and mortality. Thus, an ideal technique must be able to detect the vasospasm before the occurrence of neurological deficits. Perfusion computed tomography could assess vascularity of brain including cerebral blood flow, cerebral blood volume, time to peak and mean transit time. For this application, perfusion computed tomography and computed tomography angiography techniques offer significant advantages and can result in early diagnosis of vasospasm. In this review, we discuss the utility of these two techniques and their safety in the diagnosis and the management of vasospasm following subarachnoid hemorrhage.

  19. Herpes Simplex Virus Hepatitis: A Presentation of Multi-Institutional Cases to Promote Early Diagnosis and Management of the Disease

    Directory of Open Access Journals (Sweden)

    Ashwinee Natu

    2017-01-01

    Full Text Available Objective. To compare three cases of Herpes simplex virus (HSV hepatitis to increase early diagnosis of the disease. Case  1. A 23-year-old man with Crohn’s disease and oral HSV. HSV hepatitis was diagnosed clinically and he improved with acyclovir. Case  2. An 18-year-old G1P0 woman with transaminitis. Despite early empiric acyclovir therapy, she died due to fulminant liver failure. Case  3. A 65-year-old woman who developed transaminitis after liver transplant. Diagnosis was confirmed by biopsy and she had resolution of acute liver failure with acyclovir. Conclusion. It is imperative that clinicians be aware of patients at high risk for developing HSV hepatitis to increase timely diagnosis and prevent morbidity and fatality.

  20. Essentiality of early diagnosis of molar incisor hypomineralization in children and review of its clinical presentation, etiology and management.

    Science.gov (United States)

    Garg, Nishita; Jain, Abhay Kumar; Saha, Sonali; Singh, Jaspal

    2012-09-01

    Molar incisor hypomineralization (MIH) is a common developmental condition resulting in enamel defects in first permanent molars and permanent incisors. It presents at eruption of these teeth. One to four molars, and often also the incisors, could be affected. Since first recognized, the condition has been puzzling and interpreted as a distinct phenomenon unlike other enamel disturbances. Early diagnosis is essential since, rapid breakdown of tooth structure may occur, giving rise to acute symptoms and complicated treatment. The purpose of this article is to review MIH and illustrate its diagnosis and clinical management in young children. How to cite this article: Garg N, Jain AK, Saha S, Singh J. Essentiality of Early Diagnosis of Molar Incisor Hypomineralization in Children and Review of its Clinical Presentation, Etiology and Management. Int J Clin Pediatr Dent 2012;5(3):190-196.

  1. Diagnosis and treatment of early bioprosthetic malfunction in the mitral valve position due to thrombus formation.

    Science.gov (United States)

    Butnaru, Adi; Shaheen, Joseph; Tzivoni, Dan; Tauber, Rachel; Bitran, Daniel; Silberman, Shuli

    2013-11-01

    Bioprosthetic valve thrombosis is uncommon and the diagnosis is often elusive and may be confused with valve degeneration. We report our experience with mitral bioprosthetic valve thrombosis and suggest a therapeutic approach. From 2002 to 2011, 149 consecutive patients who underwent mitral valve replacement with a bioprosthesis at a single center were retrospectively screened for clinical or echocardiographic evidence of valve malfunction. Nine were found to have valve thrombus. All 9 patients had their native valve preserved, representing 24% of those with preserved native valves. Five patients (group 1) presented with symptoms of congestive heart failure at 16.4 ± 12.4 months after surgery. Echocardiogram revealed homogenous echo-dense film on the ventricular surface of the bioprosthesis with elevated transvalvular gradient, resembling early degeneration. The first 2 patients underwent reoperation: valve thrombus was found and confirmed by histologic examination. Based on these, the subsequent 3 patients received anticoagulation treatment with complete thrombus resolution: mean mitral gradient decreased from 23 ± 4 to 6 ± 1 mm Hg and tricuspid regurgitation gradient decreased from 83 ± 20 to 49 ± 5 mm Hg. Four patients (group 2) were asymptomatic, but routine echocardiogram showed a discrete mass on the ventricular aspect of the valve: 1 underwent reoperation to replace the valve and 3 received anticoagulation with complete resolution of the echocardiographic findings. In conclusion, bioprosthetic mitral thrombosis occurs in about 6% of cases. In our experience, onset is early, before anticipated valve degeneration. Clinical awareness followed by an initial trial with anticoagulation is warranted. Surgery should be reserved for those who are not responsive or patients in whom the hemodynamic status does not allow delay. Nonresection of the native valve at the initial operation may play a role in the origin of this entity.

  2. [Hearing handicap in childhood--responsibilities of public health, early diagnosis].

    Science.gov (United States)

    Aust, G; Föll, U; Lutt, B; Schaffrath, R

    1989-01-01

    Serious congenital hearing impairment occur in 1 per 1,000 people. Hereditary disease, perinatal complications, and postnatal disease present particular risk factors. Children, who do not hear or are extremely hard of hearing are slow in their language development and thus become retarded in their mental growth if not given appropriate stimulation. The Counseling Center for the hearing impaired was stablished as a multidisciplinary institution of the Health Office of Berlin-Neukölln for early recognition of and therapy for hearing impaired children. The average age at initial diagnosis of children with hearing impairment in the Federal Republic of Germany is between 3.3-3.4 years according to statistics from 1981. An effort should be made, however, to use the time before the completion of the first year of on's life for an optimal early therapy. Statistics from the Counseling Center for the hearing impaired indicate that at the present time all children with distinct hearing impairments, born in the FRG and West-Berlin, are diagnosed before they reach 32 months of age and are then assigned to special education programs. The average age of recognizing hearing impairments is 13.4 months. This favorable, however not optimal result can be attributed to the situation of a metropolis and its population informed by special professional events for target groups including employees of theYouth Health Services, established pediatricians and ENT specialists, teachers, social workers, educators, and also to the model of the "Berlin-Neukölln Counseling Center" which has proven successful over the past 30 years.

  3. Salivary proteomics: A new adjuvant approach to the early diagnosis of familial juvenile systemic lupus erythematosus.

    Science.gov (United States)

    Abrão, Aline Lauria P; Falcao, Denise Pinheiro; de Amorim, Rivadávio Fernandes Batista; Bezerra, Ana Cristina B; Pombeiro, Gilson Augusto N M; Guimarães, Luciano Junqueira; Fregni, Felipe; Silva, Luciano Paulino; da Mota, Licia Maria Henrique

    2016-04-01

    Systemic lupus erythematosus (SLE) is a chronic multisystemic disease characterized by autoimmune inflammatory disturbance. Pleomorphic manifestations are present and a potentially progressive and debilitating course can be detected. SLE rarely manifests before age 5, and its onset peaks is around puberty. Although clinical manifestations, immunological alterations and treatment do not differ between juvenile and adult SLE, children tend to present with a more aggressive disease course than adults. Hence, autoimmune rheumatic diseases are the most common cause of morbidity and mortality in pediatric populations. Blood serum analysis plays an especially important role in the detection and monitoring of autoantibodies in SLE. However, since blood sampling is an uncomfortable procedure, especially in children, novel less invasive techniques and approaches are of utmost importance to evaluate pediatric subjects. In this regard, saliva samples have several advantages, such as: easy access, fast collection, painless and riskless procedure. Saliva has antimicrobial, immunomodulatory and anti-inflammatory properties, as well as several other relevant features. The whole saliva is a complex mixture of major and minor salivary gland secretion, gingival crevicular fluid, transudates plasma protein, keratinocyte products and oral microbiota. This biological fluid reflects the physiological state of the body, including the emotional condition, and endocrine, nutritional and metabolic changes. Therefore, salivary proteomics is becoming increasingly used for the early diagnosis of several diseases such as breast cancer, oral cancer, Sjögren's syndrome, diffuse systemic sclerosis, rheumatoid arthritis, among others. Considering the detection of some potential markers related to SLE in serum and urine, this study aims to conduct an initial evaluation of the possible presence of such biomarkers in saliva. Furthermore, it is expected to track down new salivary proteins that could be

  4. Characterization of newborn's cries for the early diagnosis of various diseases

    Science.gov (United States)

    Kheddache, Yasmina

    The use of newborn cry signals in diagnosis is based on many theories proposed lately. The main objective in these researches is the cry signals modeling and spectrographic analysis. It has been shown that the newborn cry acoustics are linked to particular medical conditions. This thesis is motivated by improvement of the accuracy of pathological cries recognition. This can be performed by the combination of several acoustic parameters from spectrographic analysis and parameters that describe the configuration of vocal tract and vocal folds. Acoustic characteristics representing the vocal tract were widely applied to the classification of the cries. However the usefulness of vocal folds characteristics in the automatic recognition, as well as their effective techniques extraction have not been exploited deeply. In this context, we have performed a qualitative characterization of healthy and pathologic newborns cries using characteristics that have been defined in the literature and which describe vocal tract and vocal folds behavior during the cry. This step allowed us to identify the most relevant features in the differentiation of the studied pathological cries. For the extraction of selected characteristics, we have implemented effective measure methods that avoid the overestimation and underestimation of characteristics. The proposed and used approach for characteristics quantification facilitates the automatic analysis of cries and allows efficient use of these features in the diagnostic system. We also conducted experimental tests for the validation of all proposed approaches in this thesis. The results are suitable and show an improvement of the cry-based pathology recognition. The work presented in this thesis is a collection of three articles published/submitted in various journals. Two other papers published in conferences are presented in the annexes.

  5. Study on the value of detecting early secretory antigenic target-6 in cerebrospinal fluid monocytes by laser scanning confocal microscopy techniques in the early diagnosis of tuberculous meningitis

    Directory of Open Access Journals (Sweden)

    Mei-jie LI

    2016-08-01

    Full Text Available Objective To explore the value of detecting early secretory antigenic target-6 (ESAT-6 in cerebrospinal fluid (CSF monocytes by laser scanning confocal microscopy (LSCM techniques in early diagnosis of tuberculous meningitis (TBM, and to find a more specific method for early diagnosis.  Methods Double immunofluorescence staining was applied to detect ESAT-6, and LSCM was used to observe the dyeing result of CSF monocytes and to analyze three-dimensional images. ESAT-6 positive cells will present red fluorescence cytoplasm and blue fluorescence nuclei, and negative cells present blue fluorescence nuclei while the cytoplasm is not stained.  Results ESAT-6 was mainly expressed with red fluorescence in cytoplasm of CSF monocytes in patients with TBM. Among 35 cases of TBM patients, there were 28 patients (80% ESAT-6 positive, one case (2.86% ESAT-6 positive in the control group, and the difference was statistically significant (χ2 = 42.918, P = 0.000. ESAT-6 sensitivity was 80% and specificity was 97.14%.  Conclusions The detection of ESAT-6 can provide a certain basis for the early diagnosis of TBM and has high specificity. LSCM techniques can realize simultaneously the observation of multiple fluorescence and provide clear tomography and three-dimensional images. The cytological research has been improved to a new level. DOI: 10.3969/j.issn.1672-6731.2016.08.010

  6. C-Reactive Protein (CRP in Early Diagnosis of Neonatal Septicemia

    Directory of Open Access Journals (Sweden)

    Setal B Chauhan

    2012-06-01

    Full Text Available Aim: Early diagnosis of sepsis in the neonate is often difficult because symptoms and signs are usually non-specific. A study was conducted to evaluate C-reactive protein (CRP as a screening tool for neonatal sepsis. Method: The prospective observational study was conducted at NICU, V. S. Hospital, Ahmedabad from January 2008 to June 2009. 75 neonates were included with the age group of first 28days (4week of life (infant age in study, all of which were suspected to have sepsis in clinical settings. All peripheral smear of neonate stained with Giemsa stain were reviewed .CRP performed by semi quantitative latex agglutination method. Positive cultures were the “gold standard” against which the performance of CRP , abnormal white blood cell counts (WBC & absolute neutrophil counts (ANC were compared. Results: Among 75 septic screens, 39 (52% patients had positive cultures. The sensitivity and specificity of CRP 0.6 mg/dL was 92.30% and 85.71% respectively. Abnormal platelet count had the lowest specificity(45% and sensitivity(23.07% among them. Conclusion: CRP assay using semi quantitative latex agglutination method is a valuable adjunct in screening for neonatal sepsis, complementing clinical decision-making. [National J of Med Res 2012; 2(3.000: 276-278

  7. Contrast-enhanced MRI features in the early diagnosis of Juvenile Idiopathic Arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Hemke, Robert; Maas, Mario [University of Amsterdam, Department of Radiology Academic Medical Center, Amsterdam (Netherlands); Kuijpers, Taco W.; Schonenberg-Meinema, Dieneke [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Nusman, Charlotte M. [University of Amsterdam, Department of Radiology Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Rossum, Marion A.J. van; Berg, J.M. van den [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Department of Pediatric Rheumatology, Reade, Amsterdam (Netherlands); Dolman, Koert M. [Department of Pediatric Rheumatology, Reade, Amsterdam (Netherlands); St. Lucas Andreas Hospital, Department of Pediatrics, Amsterdam (Netherlands)

    2015-11-15

    To determine whether clinical, laboratory or Magnetic Resonance Imaging (MRI) measures differentiate Juvenile Idiopathic Arthritis (JIA) from other forms of active childhood arthritis. We prospectively collected data of 80 treatment-naive patients clinically suspected of JIA with active non-infectious arthritis of (at least) one knee for <12 months duration. Upon presentation patients underwent clinical and laboratory assessments and contrast-enhanced MRI. MRI was not used as a diagnostic criterion. Forty-four (55 %) patients were clinically diagnosed with JIA, whereas in 36 (45 %) patients the diagnosis of JIA was discarded on clinical or laboratory findings. MRI-based synovitis was present in 27 (61.4 %) JIA patients and in 7 (19.4 %) non-JIA patients (P < 0.001). Five factors (male gender, physician's global assessment of overall disease activity, joints with limited range of motion, HLA-B27, MRI-based synovitis) were associated with the onset of JIA. In multivariate analysis MRI-based synovitis proved to be independently associated with JIA (OR 6.58, 95 % CI 2.36-18.33). In patients with MRI-based synovitis, the RR of having JIA was 3.16 (95 % CI 1.6-6.4). The presence of MRI-based synovitis is associated with the clinical onset of JIA. Physical examination could be supported by MRI, particularly to contribute in the early differentiation of different forms of non-infectious childhood arthritis. (orig.)

  8. Differential sialylation of serpin A1 in the early diagnosis of Parkinson's disease dementia.

    Directory of Open Access Journals (Sweden)

    Sarah Jesse

    Full Text Available The prevalence of Parkinson's disease (PD increases with age. Up to 50% of PD show cognitive decline in terms of a mild cognitive impairment already in early stages that predict the development of dementia, which can occur in up to 80% of PD patients over the long term, called Parkinson's disease dementia (PDD. So far, diagnosis of PD/PDD is made according to clinical and neuropsychological examinations while laboratory data is only used for exclusion of other diseases. The aim of this study was the identification of possible biomarkers in cerebrospinal fluid (CSF of PD, PDD and controls (CON which predict the development of dementia in PD. For this, a proteomic approach optimized for CSF was performed using 18 clinically well characterized patients in a first step with subsequent validation using 84 patients. Here, we detected differentially sialylated isoforms of Serpin A1 as marker for differentiation of PD versus PDD in CSF. Performing 2D-immunoblots, all PDD patients could be identified correctly (sensitivity 100%. Ten out of 24 PD patients showed Serpin A1 isoforms in a similar pattern like PDD, indicating a specificity of 58% for the test-procedure. In control samples, no additional isoform was detected. On the basis of these results, we conclude that differentially sialylated products of Serpin A1 are an interesting biomarker to indicate the development of a dementia during the course of PD.

  9. Early diagnosis of primary Sjögren's syndrome: EULAR-SS task force clinical recommendations.

    Science.gov (United States)

    Brito-Zerón, Pilar; Theander, Elke; Baldini, Chiara; Seror, Raphaèle; Retamozo, Soledad; Quartuccio, Luca; Bootsma, Hendrika; Bowman, Simon J; Dörner, Thomas; Gottenberg, Jacques-Eric; Mariette, Xavier; Bombardieri, Stefano; de Vita, Salvatore; Mandl, Thomas; Ng, Wan-Fai; Kruize, Aike A; Tzioufas, Athanasios; Vitali, Claudio; Buyon, Jill; Izmirly, Peter; Fox, Robert; Ramos-Casals, Manuel

    2016-01-01

    Sjögren's syndrome (SjS) is a systemic autoimmune disease that mainly affects the exocrine glands, leading to generalized mucosal dryness. However, primary SjS may initially present with non-sicca (systemic) manifestations. When these features appear before the onset of an overt sicca syndrome, we may talk of an underlying 'occult' SjS. The European League Against Rheumatism (EULAR) has promoted and supported an international collaborative study group (EULAR-SS Task Force) aimed at developing consensual recommendations to provide a homogeneous approach to the patient with primary SjS presenting with systemic involvement. This review summarizes the key factors that should be taken into account in the diagnostic approach in a patient with suspected SjS according to the main clinical patterns of presentation, and is especially focused on organ-specific systemic disease presentations, including a consensus set of recommendations in order to reach an early diagnosis. Close collaboration with the different specialties involved through a comprehensive multidisciplinary approach is essential in SjS patients presenting with systemic involvements.

  10. An availability of brain magnetic resonance imaging (MRI) in the early diagnosis of latent hepatic encephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Kuwahara, Noaki; Tanabe, Masako; Fujiwara, Akiko; Minato, Takeshi; Sasaki, Hiromasa [Hiroshima Posts and Telecommunications Hospital (Japan); Higashi, Toshihiro; Tsuji, Takao

    1996-03-01

    Brain MRI was carried out in patients with chronic liver diseases. No abnormal findings were recognized in patients with chronic viral hepatitis, while 59.2% of cirrhotics showed a symmetrically strong signal in basal ganglia on T1 weighted image in MRI. This finding significantly related with lowered Fischer`s ratio of serum amino acid, increased levels of serum phenylalanine, tyrosine and hyaluronic acid, prolonged prothrombin time and decreased platelet counts in the peripheral blood. Overt hepatic encephalopathy was observed in 6 of 34 patients with the strong signal in MRI during follow-up period, while none of patients without that finding developed hepatic encephalopathy. These results have indicated that the strong signal in basal ganglia on MRI appears in cirrhotic patients with severe liver dysfunction, and it is an useful index in the early diagnosis of latent hepatic encephalopathy. An improvement of this MRI finding was not observed by long-term oral administration of branched-chain amino acid. (author).

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

    Directory of Open Access Journals (Sweden)

    Andrea Bassi

    2014-01-01

    Full Text Available 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.

  12. Role of Electrophysiology in the Early Diagnosis and Follow-Up of Diabetic Retinopathy

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    Nicola Pescosolido

    2015-01-01

    Full Text Available Retinopathy is a severe and common complication of diabetes, representing a leading cause of blindness among working-age people in developed countries. It is estimated that the number of people with diabetic retinopathy (DR will increase from 126.6 million in 2011 to 191 million by 2030. The pathology seems to be characterized not only by the involvement of retinal microvessels but also by a real neuropathy of central nervous system, similar to what happens to the peripheral nerves, particularly affected by diabetes. The neurophysiological techniques help to assess retinal and nervous (optic tract function. Electroretinography (ERG and visual evoked potentials (VEP allow a more detailed study of the visual function and of the possible effects that diabetes can have on the visual function. These techniques have an important role both in the clinic and in research: the central nervous system, in fact, has received much less attention than the peripheral one in the study of the complications of diabetes. These techniques are safe, repeatable, quick, and objective. In addition, both the ERG (especially the oscillatory potentials and the flicker-ERG and VEP have proved to be successful tools for the early diagnosis of the disease and, potentially, for the ophthalmologic follow-up of diabetic patients.

  13. APPLICATION VALUE OF MAGNETIC RESONANCE SEQUENCES IN DIAGNOSIS OF EARLY SPINAL METASTATIC TUMOR

    Institute of Scientific and Technical Information of China (English)

    Li-xia Wang; Xiang-quan Kong; He-shui Shi; Ding-xi Liu; Yin Xiong

    2007-01-01

    Objective To investigate the clinical value of different magnetic resonance (MR) pulse sequences in diagnosis of spinal metastatic tumor.Methods Fifteen patients with clinically suspected spinal metastatic tumor were included in this study. These patients were with documented primary tumors. Four MR pulse sequences, T1-weighted spin echo (T1WI SE), T2-weighted fast spin echo (T2WI FSE), short time inversion recovery (STIR), and gradient echo 2-D multi echo data imaging combination (GE Me-2D) were used to detect spinal metastasis.Results Fifteen vertebral bodies were entire involvement, 38 vertebral bodies were section involvement, and totally 53 vertebral bodies were involved. There were 19 focal infections in pedicle of vertebral arch, 15 metastases in spi-nous process and transverse process. Fifty-three vertebral bodies were abnormal in T1WI SE and GE Me-2D, 35 vertebral bodies were found abnormal in T2WI FSE, and 50 vertebral bodies were found abnormal in STIR. The verges of focal signal of involved vertebral bodies were comparatively clear in T1WI SE, comparatively clear or vague in T2WI FSE, vague in STIR, and clear in GE Me-2D.Conclusions GE Me-2D may be the most sensitive technique to detect metastases. So three sequences (T1WI SE, T2WI FSE, GE Me-2D) can demonstrate the early changes of spinal metastasis roundly.

  14. Non-invasive screening for early Alzheimer’s disease diagnosis by a sensitively immunomagnetic biosensor

    Science.gov (United States)

    Li, Shan-Shan; Lin, Chih-Wen; Wei, Kuo-Chen; Huang, Chiung-Yin; Hsu, Po-Hung; Liu, Hao-Li; Lu, Yu-Jen; Lin, Sheng-Chi; Yang, Hung-Wei; Ma, Chen-Chi M.

    2016-04-01

    Amyloid-beta peptide 1–42 (Aβ42) is considered as a reliable biomarker for the early diagnosis of Alzheimer’s disease (AD). Thus, it is urgent to develop a simple and efficient method for the detection of Aβ42. In this work, a reusable biosensor based on magnetic nitrogen-doped graphene (MNG) modified Au electrode for the detection of Aβ42 has been developed. The antibodies of Aβ 1–28 (Aβab) are used as the specific biorecognition element for Aβ42 that were conjugated on the surface of MNG. In the presence of magnetic nanoparticles on MNG, the electrode coating material, the biosensor can be quickly constructed, without requiring an electrode drying process, which reduce the analysis time and is convenient for proceeding to detection. The reusable biosensor with good reproducibility and stability was linear within the range from 5 pg mL‑1 to 800 pg mL‑1, covering the cut-off level of Aβ42 and a detection limit of 5 pg mL‑1 had been achieved. Furthermore, the fabricated biosensor for Aβ42 detection not only improves the detection performance but also reduces the cost and shortens the response time, demonstrating its potential in diagnosing applications.

  15. A Novel Carbon Nanofibers Grown on Glass Microballoons Immunosensor: A Tool for Early Diagnosis of Malaria

    Directory of Open Access Journals (Sweden)

    Emmanuel Gikunoo

    2014-08-01

    Full Text Available This paper presents a novel method for direct detection of Plasmodium falciparum histidine rich protein-2 (PfHRP-2 antigen using carbon nanofiber (CNF forests grown on glass microballoons (NMBs. Secondary antibodies specific to PfHRP-2 densely attached to the CNFs exhibit extraordinary ability for the detection of minute concentrations of Plasmodium species. A sandwich immunoassay protocol was employed, where a glass substrate was used to immobilize primary antibodies at designated capture zones. High signal amplification was obtained in both colorimetric and electrical measurements due to the CNFs through specific binding. As a result, it was possible to detect PfHRP-2 levels as low as 0.025 ng/mL concentration in phosphate buffered saline (PBS using a visual signal within only 1 min of test duration. Lower limits of 0.01 ng/mL was obtained by measuring the electrical resistivity of the capture zone. This method is also highly selective and specific in identifying PfHRP-2 and other Plasmodium species from the same solution. In addition, the stability of the labeling mechanism eliminates the false signals generated by the use of dyes in current malaria rapid diagnostic test kits (MRDTs. Thus, the rapid, sensitive and high signal amplification capabilities of NMBs is a promising tool for early diagnosis of malaria and other infectious diseases.

  16. Environmental PAH exposure and male idiopathic infertility: a review on early life exposures and adult diagnosis.

    Science.gov (United States)

    Madeen, Erin P; Williams, David E

    2017-03-01

    The male reproductive system is acutely and uniquely sensitive to a variety of toxicities, including those induced by environmental pollutants throughout the lifespan. Early life hormonal and morphological development results in several especially sensitive critical windows of toxicity risk associated with lifelong decreased reproductive health and fitness. Male factor infertility can account for over 40% of infertility in couples seeking treatment, and 44% of infertile men are diagnosed with idiopathic male infertility. Human environmental exposures are poorly understood due to limited available data. The latency between maternal and in utero exposure and a diagnosis in adulthood complicates the correlation between environmental exposures and infertility. The results from this review include recommendations for more and region specific monitoring of polycyclic aromatic hydrocarbon (PAH) exposure, longitudinal and clinical cohort considerations of exposure normalization, gene-environment interactions, in utero exposure studies, and controlled mechanistic animal experiments. Additionally, it is recommended that detailed semen analysis and male fertility data be included as endpoints in environmental exposure cohort studies due to the sensitivity of the male reproductive system to environmental pollutants, including PAHs.

  17. Radiographic Follow-Up during Orthodontic Treatment for Early Diagnosis of Sequential Supernumerary Teeth

    Science.gov (United States)

    Suga, Uhana Seifert Guimarães; Terada, Raquel Sano Suga

    2016-01-01

    Most supernumerary teeth are impacted and asymptomatic. Objective. The aim of this paper is to describe two cases of sequential development of supernumerary teeth in the mandibular premolar region, identified during orthodontic treatment. Reports. The first case describes the radiographic follow-up of a female patient that presented a supernumerary tooth at the age of 9 years and 10 months in the right mandibular premolar region, followed by a further supernumerary tooth in the left mandibular premolar region identified at the age of 11 years and 3 months. In the second case, the radiographic follow-up of a male patient demonstrated 3 supernumerary teeth in the premolar region at the age of 16 years. During orthognathic surgery planning at the age of 20 years and 5 months, a supplemental supernumerary tooth was found in the left mandibular region. Conclusion. Considering the late developing of supernumerary premolars, appropriate follow-up with panoramic radiographs of patients with previous experience of supernumerary teeth is essential for early diagnosis of supplemental premolars to prevent possible complications. PMID:27313911

  18. Detection of retinal nerve fiber layer defects on retinal fundus images for early diagnosis of glaucoma

    Science.gov (United States)

    Muramatsu, Chisako; Hayashi, Yoshinori; Sawada, Akira; Hatanaka, Yuji; Hara, Takeshi; Yamamoto, Tetsuya; Fujita, Hiroshi

    2010-01-01

    Retinal nerve fiber layer defect (NFLD) is a major sign of glaucoma, which is the second leading cause of blindness in the world. Early detection of NFLDs is critical for improved prognosis of this progressive, blinding disease. We have investigated a computerized scheme for detection of NFLDs on retinal fundus images. In this study, 162 images, including 81 images with 99 NFLDs, were used. After major blood vessels were removed, the images were transformed so that the curved paths of retinal nerves become approximately straight on the basis of ellipses, and the Gabor filters were applied for enhancement of NFLDs. Bandlike regions darker than the surrounding pixels were detected as candidates of NFLDs. For each candidate, image features were determined and the likelihood of a true NFLD was determined by using the linear discriminant analysis and an artificial neural network (ANN). The sensitivity for detecting the NFLDs was 91% at 1.0 false positive per image by using the ANN. The proposed computerized system for the detection of NFLDs can be useful to physicians in the diagnosis of glaucoma in a mass screening.

  19. Role of Color Doppler Imaging in Early Diagnosis and Prediction of Progression in Glaucoma

    Directory of Open Access Journals (Sweden)

    Fatima Jimenez-Aragon

    2013-01-01

    Full Text Available This longitudinal and prospective study analyzes the ability of orbital blood flow measured by color Doppler imaging (CDI to predict glaucoma progression in patients with glaucoma risk factors. Patients with normal perimetry but having glaucoma risk factors and patients in the initial phase of glaucoma were prospectively included in the study and divided, after a five-year follow-up, into two groups: “Progression” and “No Progression” based on the changes in the Moorfields regression analysis (MRA classification of Heidelberg retina tomograph (HRT. An orbital CDI was performed in all patients and the parameters obtained were correlated with changes in HRT. A logistic discrimination function (LDF was calculated for ophthalmic artery (OA and central retinal artery (CRA parameters. Receiver operating characteristics curves (ROC were used to assess the usefulness of LDFs to predict glaucomatous progression. A total of 71 eyes were included. End-diastolic velocity, time-averaged velocity, and resistive index in the OA and CRA were significantly different (P<0.05 between the Progression and No Progression groups. The area under the ROC curves calculated for both LDFs was of 0.695 (OA and 0.624 (CRA. More studies are needed to evaluate the ability of CDI to perform early diagnosis and to predict progression in glaucoma in eyes.

  20. Can Baropodometric Analysis be a Useful Tool in the Early Diagnosis of Atypical Parkinsonism? Preliminary Findings

    Science.gov (United States)

    Furnari, Anna; Imbesi, Donatella; La Fauci Belponer, Francesca; Militi, David; Gervasi, Giuseppe; Pastura, Concetta; Bramanti, Placido

    2014-01-01

    Objective: The differential diagnosis between atypical parkinsonism and Parkinson’s disease is difficult, especially in the early stage. Severe postural instability, falls, and complex gait impairments are usually confined to the later stage of Parkinson’s disease, while atypical parkinsonism patients may present a severe postural instability with consequent falls in the earlier stages. Methods: We retrospectively studied 20 subjects with parkinsonism using clinical and baropodometric tools to give quantitative and objective data on the postural, balance, and gait disturbances. Results: The statistical analysis between atypical parkinsonism and Parkinson’s disease patients showed a significant difference in the frequency of long lead time parameter, foot area, foot load and speed, and, in particular, atypical parkinsonism patients presented a prevalent long lead time impairment (8/8 patients) when compared with Parkinson’s disease patients. Discussion: Beside significant differences in the clinical features between the Parkinson’s disease and atypical parkinsonism, our study showed that baropodometric investigation may a valuable tool for the definition of postural and motor extrapyramidal abnormalities, permitting an earlier differentiation between atypical parkinsonism and Parkinson’s disease. PMID:24653938

  1. VitalQPlus: a potential screening tool for early diagnosis of COPD

    Directory of Open Access Journals (Sweden)

    Sui CF

    2015-08-01

    /FEV6 <0.75 compared to patients with fewer COPD symptoms (scores <5. Conclusion: With the availability of a simple screening questionnaire and the COPD-6, there is an opportunity easily to make patients more aware of their lung symptoms and to encourage the provision of early treatment. The proposed dual assessment approach, which we termed the VitalQPlus, may play a profound role in the early diagnosis of COPD, which is crucial in improving the clinical management of the disease. Keywords: spirometry, pulmonary function test, chronic obstructive pulmonary disease, airway obstruction

  2. An MRI-based diagnostic framework for early diagnosis of dyslexia

    Energy Technology Data Exchange (ETDEWEB)

    El-Baz, A. [University of Louisville, Bioengineering Department, Louisville, KY (United States); Casanova, M.; Mott, M.; Switala, A. [University of Louisville, Department of Psychiatry and Behavioral Science, Louisville, KY (United States); Gimel' farb, G. [University of Auckland, Computer Science Department, Auckland (New Zealand)

    2008-09-15

    A computer-aided diagnosis (CAD) system for early diagnosis of dyslexia was developed and tested. Dyslexia can severely impair the learning abilities of children so improved diagnostic methods are needed. Neuropathological studies show abnormal anatomy of the cerebral white matter (CWM) in dyslexic brains. We sought to develop an MRI-based macroscopic neuropathological correlate to the minicolumnopathy of dyslexia that relates to cortical connectivity: the gyral window. The brains of dyslexic patients often exhibit decreased gyrifications, so the thickness of gyral CWM for dyslexic subjects is greater than for normal subjects. We developed an MRI-based method for assessment of gyral CWM thickness with automated recognition of abnormal (e.g., dyslexic) brains. In vivo data was collected from 16 right-handed dyslexic men aged 18-40 years, and a group of 14 controls matched for gender, age, educational level, socioeconomic background, handedness and general intelligence. All the subjects were physically healthy and free of history of neurological diseases and head injury. Images were acquired with the same 1.5T MRI scanner (GE, Milwaukee, WI, USA) with voxel resolution 0.9375 x 0.9375 x 1.5 mm using a T1-weighted imaging sequence protocol. The ''ground truth'' diagnosis to evaluate the classification accuracy for each patient was given by the clinicians. The accuracy of diagnosis/classification of both the training and test subjects was evaluated using the Chi-square test at the three confidence levels - 85, 90 and 95% - in order to examine significant differences in the Levy distances. As expected, the 85% confidence level yielded the best results, the system correctly classified 16 out of 16 dyslexic subjects (a 100% accuracy) and 14 out of 14 control subjects (a 100% accuracy). At the 90% confidence level, 16 out of 16 dyslexic subjects were still classified correctly; however, only 13 out of 14 control subjects were correct, bringing the

  3. On the sensitivity of thermophotonic lock-in imaging and polarized Raman spectroscopy to early dental caries diagnosis

    Science.gov (United States)

    Tabatabaei, Nima; Mandelis, Andreas; Dehghany, Mehdi; Michaelian, Kirk H.; Amaechi, Bennet T.

    2012-02-01

    Dental caries is the leading cause of tooth loss, which can promptly be prevented if detected in early stages of progression. Unfortunately, conventional diagnostic modalities currently used in dentistry lack the sensitivity to detect early caries. The authors' intention is to compare the ability of polarized Raman spectroscopy and thermophotonic imaging to make early caries diagnosis. Extracted human teeth with no visible stain or defects were artificially demineralized in accordance to a well-known protocol in dentistry for simulated early caries development at several demineralization stages. Samples were then inspected using polarized Raman spectroscopy and thermophotonic imaging. The sensitivities of these two diagnostic modalities are compared, and the results are verified using transverse micro-radiography. It was found that compared to polarized Raman spectroscopy, thermophotonic imaging exhibits superior sensitivity to very early stages of demineralization.

  4. Applications of a single-molecule detection in early disease diagnosis and enzymatic reaction study

    Energy Technology Data Exchange (ETDEWEB)

    Li, Jiangwei [Iowa State Univ., Ames, IA (United States)

    2008-01-01

    Various single-molecule techniques were utilized for ultra-sensitive early diagnosis of viral DNA and antigen and basic mechanism study of enzymatic reactions. DNA of human papilloma virus (HPV) served as the screening target in a flow system. Alexa Fluor 532 (AF532) labeled single-stranded DNA probes were hybridized to the target HPV-16 DNA in solution. The individual hybridized molecules were imaged with an intensified charge-coupled device (ICCD) in two ways. In the single-color mode, target molecules were detected via fluorescence from hybridized probes only. This system could detect HPV-16 DNA in the presence of human genomic DNA down to 0.7 copy/cell and had a linear dynamic range of over 6 orders of magnitude. In the dual-color mode, fluorescence resonance energy transfer (FRET) was employed to achieve zero false-positive count. We also showed that DNA extracts from Pap test specimens did not interfere with the system. A surface-based method was used to improve the throughput of the flow system. HPV-16 DNA was hybridized to probes on a glass surface and detected with a total internal reflection fluorescence (TIRF) microscope. In the single-probe mode, the whole genome and target DNA were fluorescently labeled before hybridization, and the detection limit is similar to the flow system. In the dual-probe mode, a second probe was introduced. The linear dynamic range covers 1.44-7000 copies/cell, which is typical of early infection to near-cancer stages. The dual-probe method was tested with a crudely prepared sample. Even with reduced hybridization efficiency caused by the interference of cellular materials, we were still able to differentiate infected cells from healthy cells. Detection and quantification of viral antigen with a novel single-molecule immunosorbent assay (SMISA) was achieved. Antigen from human immunodeficiency virus type 1(HIV-1) was chosen to be the target in this study. The target was sandwiched between a monoclonal capture antibody and a

  5. Poor Outcome in a Mitochondrial Neurogastrointestinal Encephalomyopathy Patient with a Novel TYMP Mutation: The Need for Early Diagnosis

    Directory of Open Access Journals (Sweden)

    Mauro Scarpelli

    2012-12-01

    Full Text Available Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE is a devastating autosomal recessive disorder due to mutations in TYMP, which cause loss of function of thymidine phosphorylase (TP, nucleoside accumulation in plasma and tissues and mitochondrial dysfunction. The clinical picture includes progressive gastrointestinal dysmotility, cachexia, ptosis and ophthalmoparesis, peripheral neuropathy and diffuse leukoencephalopathy, which usually lead to death in early adulthood. Therapeutic options are currently available in clinical practice (allogeneic hematopoietic stem cell transplantation and carrier erythrocyte entrapped TP therapy and newer, promising therapies are expected in the near future. However, successful treatment is strictly related to early diagnosis. We report on an incomplete MNGIE phenotype in a young man harboring the novel heterozygote c.199 C>T (Q67X mutation in exon 2, and the previously reported c.866 A>C (E289A mutation in exon 7 in TYMP. The correct diagnosis was achieved many years after the onset of symptoms and unfortunately, the patient died soon after diagnosis because of multiorgan failure due to severe malnutrition and cachexia before any therapeutic option could be tried. To date, early diagnosis is essential to ensure that patients have the opportunity to be treated. MNGIE should be suspected in all patients who present with both gastrointestinal and nervous system involvement, even if the classical complete phenotype is lacking.

  6. 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

    2016-03-01

    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.I n 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.

  7. Use of amplified Mycobacterium tuberculosis direct test (Gen-probe Inc., San Diego, CA, USA in the diagnosis of tubercular synovitis and early arthritis of knee joint

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    Vinay Kumar Aggarwal

    2012-01-01

    Conclusion: AMTDT or Genprobe is a rapid diagnostic test for early diagnosis of tubercular arthritis, but has low sensitivity in knee joint tuberculosis. Nuclear amplification tests are still far from being a single promising alternative to conventional tests in cases of joint tuberculosis. Routine use of arthroscopic biopsies in all suspected cases is helpful in the early diagnosis of knee joint tuberculosis.

  8. Diagnosis, prognosis and classification of early arthritis: results of a systematic review informing the 2016 update of the EULAR recommendations for the management of early arthritis

    Science.gov (United States)

    Hua, Charlotte; Daien, Claire I; Combe, Bernard; Landewe, Robert

    2017-01-01

    Objective To update the evidence pertaining to the diagnosis, prognosis and classification of patients with early arthritis (EA), and to inform the 2016 European League Against Rheumatism (EULAR) recommendations for the management of patients with EA. Methods MEDLINE, EMBASE and Cochrane databases were searched up to October 2015. The first part of the systematic literature review (SLR) involved a search for studies investigating the recognition and referral of EA. The second part involved a search for studies to identify the place of laboratory and imaging tests in establishing a diagnosis and a prognosis in patients with EA. Results Regarding the issue of referral of patients with EA (1643 hits), 4 studies were included. These studies were in support of early referral for patients with EA. Regarding the issue of diagnosis and prognosis of patients with EA (11 435 hits), 88 studies were included, evaluating mainly the value of rheumatoid factor (RF) and anticitrullinated-peptide antibodies (ACPAs). Sensitivity of these antibodies for a RA diagnosis in patients with EA was moderate (40–80%). Specificity was higher, notably for ACPAs (frequently >80%). ACPAs also showed better prognostic performance than RF (negative predictive values around 80%). We confirmed that structural damage on baseline X-rays is predictive of further radiographic progression in patients with EA. Regarding other imaging modalities, data are sparse. Conclusions This SLR highlights the importance of early referral for patients with EA and confirms that RF and mainly ACPAs as well as a search for structural X-rays changes may help in the diagnosis and prognosis of patients with EA. PMID:28155923

  9. [Significance of glucose-6-phosphate isomerase assay in early diagnosis of rheumatoid arthritis].

    Science.gov (United States)

    Xu, J; Liu, J; Zhu, L; Zhang, X W; Li, Z G

    2016-12-18

    To explore the titer of glucose-6-phosphate isomerase (GPI) for early diagnosis of the outpatient with rheumatoid arthritis (RA) in real life, and to analyze its relationship with disease activity. In the study, 1 051 patients with arthritis were collected in the group who had joints tender and swelling, and 90 cases of healthy people as a control group. ELISA method was used to detect the serum level of GPI, and according to clinical features and laboratory test, all the patients including 525 RA patients, the other patients including osteoarthritis (OA), 134 cases of seronegative spine joint disease (SpA), 104 cases of systemic lupus erythematosus (SLE), 31 cases of primary Sjogren syndrome (pSS), 24 cases of gout arthritis (GA), 22 cases of other connective tissue diseases (including polymyalgia rheumatica, dermatomyositis, systemic sclerosis, adult Still disease) and 46 cases of other diseases (including 165 cases of osteoporosis, avascular necrosis of the femoral head, traumatic osteomyelitis, bone and joint disease, juvenile rheumatoid arthritis, tumor). The diagnostic values of GPI were assessed, and the differences between the GPI positive and negative groups of the RA patients in clinical characteristics, disease activity, severity and inflammatory index analyzed. The positive rate of serum GPI in the patients with RA was 55.4%, contrasting to other autoimmune diseases (14.3%) and healthy controls (7.78%)(P<0.001). Compared with the OA and SpA patients, the RA group was increased more significantly, and the difference was statistically significant (P<0.001). The diagnostic value of GPI alone for RA was 0.39 mg/L, the sensitivity was 54.2%, and specificity was 87.3%. The positive rate of GPI in RF negative patients was 36.1%; the positive rate of GPI in anti-CCP antibody negative patients was 34.2%; the positive rate of GPI in RF and anti-CCP antibody negative patients was 24.1%. The level of GPI had positive correlation (P<0.05) with ESR, RF, anti

  10. Early diagnosis of acute renal allograft rejection: efficacy of macrophage migration inhibition test as an immunological diagnosis

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    Orita,Kunzo

    1977-06-01

    Full Text Available 1. Three cases of acute rejection were detected by macrophage migration inhibition tests (MIT conducted directly on seven patients who had received renal allografts. The macrophage migration inhibitory factor (MIF activity was positive in all cases 1-2 days before the appearance of acute rejection. 2. After the administration of a high dose of Solu-Medrol (1g/day for 3 days to suppress the acute rejection, MIF activity recovered to its normal level 3 days later. These findings seem to indicate that MIT yields immunologically useful criteria for the early detection of an acute rejection.

  11. AUTOANTIBODIES TO CIRTULLINATED ANTIGENS FOR DIAGNOSIS AND PREDICTION OF CLINICAL COURSE IN EARLY RHEUMATOID ARTHRITIS

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    I. B. Belyaeva

    2007-01-01

    Full Text Available Abstract. To study the value of antibodies to cirtullinated antigens in diagnosis and their significance in prediction of erosion formation of rheumatoid arthritis (RA, we examined serological status in 129 patients with early RA (ERA and 55 cases of undifferentiated arthritis, lasting less than 12 months. Another group consisted of 39 patients with long-standing rheumatoid arthritis, in whom the disease persisted for > 2 years. Control group included 39 patients with osteoarthrosis and 29 patients with reactive arthritis. The titers of rheumatoid factor (RF, antikeratin antibodies (AKA, antiperinuclear factor (APF and antibodies to cyclic citrullinated peptide (anti-CCP were studied during initial examination and 12 months later. Serial cryosections of rat esophagus and normal human buccal epithelial cells served as substrates for AKA and APF detection. AntiCCPs were revealed by means of DIASTAT technique (Axis Shield, UK.Upon initial observation of the patients with ERA, sensitivity and specificity of anti-CCP was, resp., 63.5% and 97,8%, thus exceeding both parameters for RF (48,8% и 86,7%. Sensitivity of AKA and APF for the same group was 17% and 24 %, with specificity of 97.7%. In RF-seronegative cases of early RA, anti-CCP were detected in 37% with ERA and 42% long-standing RA. In patients with non-differentiated arthritis who developed RA within one year, RF and anti-CCP were found in 12,2% and 45,5%. Following a one-year observation, a statistically significant increase was found in incidence of RF and anti-CCP in ERA patients.Positivity for anti-citrulline antibodies (AKA, APF and anti-CCP in ERA patients were associated with higher levels of CRP, increased HAQ, DAS4, Sharp scores, as compared to the patients who were seronegative. In ERA patients positive for anti-citrulline antibodies, higher frequencies of synovitis and erosive arthritis were detected by means of ultrasound and magnetic resonance imaging. In the patients with ERA

  12. Early diagnosis of bacterial and fungal infection in chronic cholestatic hepatitis B

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    Xiong-Zhi Wu; Dan Chen; Lian-San Zhao; Xiao-Hui Yu; Mei Wei; Yan Zhao; Qing Fang; Qian Xu

    2004-01-01

    AIM: To investigate the early diagnostic methods of bacterial and fungal infection in patients with chronic cholestatic hepatitis B.METHODS: One hundred and one adult in-patients with chronic hepatitis B were studied and divided into 3 groups:direct bilirubin (DBil)/total bilirubin (TBil)≥0.5, without bacterial and fungal infection (group A, n=38); DBil/TBil <0.5, without bacterial and fungal infection (group B, n=23);DBil/TBil≥0.5, with bacterial or fungal infection (group C,n=40). The serum biochemical index and pulse rate were analyzed.RESULTS: Level of TBil, DBil, alkaline phosphatase (ALP)and DBil/ALP in group A increased compared with that in group B. The level of ALP in group C decreased compared with that in group A, whereas the level of TBil, DBil and DBil/ALP increased (ALP: 156±43, 199±68, respectively,P<0.05; TBil: 370±227, 220±206, respectively, P<0.01;DBil: 214±143, 146±136, respectively, P<0.01; DBil/ALP:1.65±1.05, 0.78±0.70, respectively, P<0.001). The level of DBil and infection affected DBil/ALP. Independent of the effect of DBil, infection caused DBil/ALP to rise (P<0.05).The pulse rate in group A decreased compared with that in group B (63.7±6.4, 77.7±11.4, respectively, P<0.001),and the pulse rate in group C increased compared with that in group A (81.2±12.2, 63.7±6.4, respectively, P<0.001).The equation (infection=0.218 pusle rate +1.064 DBil/ALP -16.361), with total accuracy of 85.5%, was obtained from stepwise logistic regression. Pulse rate (≥80/min) and DBil/ALP (≥1.0) were used to screen infection. The sensitivity was 62.5% and 64.7% respectively, and the specificity was 100% and 82.8% respectively.CONCLUSION: Bacterial and fungal infection deteriorate jaundice and increase pulse rate, decrease serum ALP and increase DBil/ALP. Pulse rate, DBil/ALP and the equation (infection=0.218 pusle rate+1.064 DBil/ALP-16.361) are helpful to early diagnosis of bacterial and fungal infection in patients with chronic

  13. Diagnosis value of serum ALP and osteocalcin in early prostate cancer bone metastasis

    Institute of Scientific and Technical Information of China (English)

    Zong-Yong Cheng

    2016-01-01

    Objective:To explore the role and significance of the joint detection of serum alkaline phosphatase (ALP) and osteocalcin in prostate cancer bone metastases.Methods:A total of 87 cases of prostate cancer patients were diagnosed by radionuclide bone imaging, and 51 cases of them were included in the bone metastases group, while the other 36 cases were selected as the non-metastases group. Serum levels of ALP and osteocalcin of all patients were detected. The sensitivity, specificity, accuracy, likelihood ratio and the predictive value of patients in the two groups were analyzed. The sensitivity and specificity of the combined detection of ALP and osteocalcin and their expression levels in different bone metastases degrees were analyzed.Results:Serum ALP and osteocalcin levels of patients in metastases group were higher than those in non-metastases group and normal control group. In non-metastases group, the ALP level was higher than that in normal control group, while its osteocalcin level was lower than that in control group (P<0.05); The sensitivities of ALP and osteocalcin were 77.2% and 70.6%, respectively, and their specificities were 61.1% and 54.6%, respectively. The sensitivity and specificity became 93.3% and 82.33% in combined detection of ALP and osteocalcin, which was significantly higher than the single detection (P<0.05). The expression levels of ALP and osteocalcin increased with the increase of the metastases degrees (P<0.05). Conclusions:Combined detection of ALP and osteocalcin can be used in the early diagnosis of prostate cancer with improved diagnostic efficiency.

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

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    Domenico Galasso

    2013-04-01

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

  15. Magnetic sifters and biochips for early diagnosis and therapy monitoring of cancer

    Science.gov (United States)

    Earhart, Chris

    2008-03-01

    Magnetic nanoparticles conjugated with biomolecules or recognition moieties are finding wide applications in medicine. In this context, we are developing a micromachined magnetic sifter and magnetic nanoparticles aimed for sample preparation applications in early diagnosis of cancer. The microfabricated sifter consisting of arrays of micron sized slits etched through a silicon wafer. A magnetic film is deposited on the wafer, producing high magnetic field gradients, comparable in magnitude to gradients in planar flow devices. As the solution flows through the die, magnetic particles are captured by the magnetic material surrounding the slits. The large number of slits allows for processing of large volumes of liquid, much greater than that of planar microfluidic devices. The sifters can be simply attached to a syringe or tube, resulting in a portable and user-friendly tool for molecular biology. Separation efficiencies of ˜ 50% for one pass through the sifter have been achieved. We have also designed and fabricated several types of magnetic biochips consisting of arrays of giant magnetoresistive (GMR) spin valve detectors with appropriate dimensions, surface chemistry, and microfluidics. An advanced electronic test station has been set up as a demonstration vehicle for the integrated evaluation of our magnetic biochips with commercial and custom magnetic nanoparticle labels for DNA or protein biomarkers. The magnetic biochip is capable of detecting down to 1-30 nanotags. Real-time detection of DNA signatures and protein targets in buffer and serum samples has been successfully performed in our laboratories, suggesting that magnetic biochips hold great promises for molecular diagnostics of cancer and other diseases. In collaboration with Chris M. Earhart, Wei Hu, Robert J. Wilson, Sebastian J. Osterfeld, Robert L. White, Nader Pourmand, and Shan X. Wang @ Stanford University. This work was supported by grants from NIH (1U54CA119367-01) and DARPA/Navy (N00014-02-1-0807).

  16. HPV and oral lesions: preventive possibilities, vaccines and early diagnosis of malignant lesions

    Science.gov (United States)

    TESTI, D.; NARDONE, M.; MELONE, P.; CARDELLI, P.; OTTRIA, L.; ARCURI, C.

    2015-01-01

    SUMMARY The importance of HPV in world healthy is high, in fact high-risk HPV types contribute significantly to viral associated neoplasms. In this article we will analyze vary expression of HPV in oral cavity both benign and malignant, their prevalence and the importance in early diagnosis and prevention. The classical oral lesions associated with human papillomavirus are squamous cell papilloma, condyloma acuminatum, verruca vulgaris and focal epithelial hyperplasia. Overall, HPV types 2, 4, 6, 11, 13 and 32 have been associated with benign oral lesions while HPV types 16 and 18 have been associated with malignant lesions, especially in cancers of the tonsils and elsewhere in the oropharynx. Transmission of the virus can occur with direct contact, genital contact, anal and oral sex; latest studies suggest a salivary transmission and from mother to child during delivery. The number of lifetime sexual partners is an important risk factor for the development of HPV-positive head-neck cancer. Oral/oropharyngeal cancer etiologically associated with HPV having an increased survival and a better prognostic (85%–90% to five years). There is no cure for the virus. There are two commercially available prophylactic vaccines against HPV today: the bivalent (16 and 18) Cervarix® and the tetravalent (6, 11, 16 and 18) Gardasil® and new vaccine Gardasil 9 (6, 11, 16, 18, 31, 33, 45, 52, 58) was approved in the United States. To be effective, such vaccination should start before “sexual puberty”. The vaccine could be an important preventive strategy, in fact the scientific community is in agreement on hypothesis that blocking the contagion it may also limit the distance complications as the oropharyngeal cancer. PMID:27555904

  17. Introducing a Clinical Practice Guideline Using Early CT in the Diagnosis of Scaphoid and Other Fractures

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    Pincus, Steven

    2009-11-01

    Full Text Available Objective: We developed and implemented clinical practice guideline (CPG using computerized tomography (CT as the initial imaging method in the emergency department management of scaphoid fractures. We hypothesized that this CPG would decrease unnecessary immobilization and lead to earlier return to work.Methods: This observational study evaluated implementation of our CPG, which incorporated early wrist CT in patients with “clinical scaphoid fracture”: a mechanism of injury consistent with scaphoid fracture, anatomical snuff box tenderness, and normal initial plain x-rays. Outcome measures were the final diagnosis as determined by orthopaedic review of the clinical and imaging data. Patient outcomes included time to return to work and patient satisfaction as determined by telephone interview at ten days.Results: Eighty patients completed the study protocol in a regional emergency department.In this patient population CT detected 28 fractures in 25 patients, including six scaphoid fractures, five triquetral fractures, four radius fractures, and 13 other related fractures. Fifty-three patients had normal CT. Eight of these patients had significant ongoing pain at follow up and had an MRI, with only two bone bruises identified. The patients with normal CTs avoided prolonged immobilization (mean time in plaster 2.7 days and had no or minimal time off work (mean 1.6 days. Patient satisfaction was an average 4.2/5.Conclusion: This CPG resulted in rapid and accurate management of patients with suspected occult scaphoid injury, minimized unnecessary immobilization and was acceptable to patients.[WestJEM. 2009;10(4:227-232.

  18. Early diagnosis of the urofacial syndrome is essential to prevent irreversible renal failure

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    Francisco A. Nicanor

    2005-10-01

    Full Text Available INTRODUCTION: The urofacial or Ochoa syndrome is a rare disease characterized by the presence of functional obstructive uropathy associated with peculiar facial features when patients attempt to smile or laugh. Unfortunately, many of these patients remain without proper diagnosis or adequate treatment due to lack of recognition of the disease. This can ultimately result in upper tract deterioration and eventual renal failure. We present our experience with this rare syndrome. MATERIALS AND METHODS: We identified 3 patients who presented initially with acute renal failure, urinary tract infection (UTI and severe dysfunctional elimination. All patients were thoroughly evaluated, including screening for spinal cord anomalies, and were subsequently diagnosed with urofacial syndrome. RESULTS: At the outset, the two older patients (aged 4 and 9 years presented with the typical facial features when attempting to smile or laugh. One patient in the newborn period presented with urinary and fecal retention and septicemia and, to our knowledge, represents the youngest case of urofacial syndrome reported so far. All patients were evaluated with ultrasonography, renal scan, voiding cystourethrogram (VCUG and urodynamics. Findings included hydronephrosis and a thick-walled, trabeculated bladder with poor compliance and detrusor hypereflexia respectively in each patient. All were subsequently treated with clean intermittent catheterization (CIC, antibiotic prophylaxis and anticholinergic therapy. One patient required appendicovesicostomy for CIC due to discomfort secondary to a sensate urethra. CONCLUSIONS: Our series demonstrates that early recognition of this rare syndrome is necessary to adequately treat and prevent upper tract deterioration in these unique individuals. Although the urofacial is difficult to diagnose in infants, cognizance must be maintained in order to prevent severe subsequent sequalae.

  19. Application of magnifying narrow-band imaging endoscopy for diagnosis of early gastric cancer and precancerous lesion

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    Zhang Jing

    2011-12-01

    Full Text Available Abstract Background Gastric carcinoma is the second commonest cause of cancer deaths worldwide. Early detection and diagnosis of gastric cancer in the stomach is important for improving the prognosis of gastric cancer. This retrospective study was designed to investigate the value of magnifying narrow-band imaging (NBI in the diagnosis of precancerous lesions and early gastric cancer. Methods This study included 122 patients who were diagnosed with early gastric cancer or precancerous gastric lesions by endoscopy. The patients underwent an examination with conventional endoscopy, magnifying NBI, and magnifying chromoendoscopy. Images resolution was evaluated, and the morphology, pit patterns and blood capillary forms of lesions were analyzed. The presence of gastric carcinoma and high grade intraepithelial neoplasia in the biopsy samples was considered as a positive pathological result, which is used to assess accuracy of endoscopic diagnosis. Results For image resolution, magnifying NBI and magnifying chromoendoscopy were significantly superior to magnifying conventional endoscopy in morphology, pit pattern and blood capillary form (P 1, and VI type of gastric pit pattern were detected in 14 cases, 43 cases, and 17 cases in patients with high grade intraepithelial neoplasia, respectively. V1 and VI type of gastric pit pattern were detected in 9 cases and 39 cases in patients with early gastric cancer, respectively. The presence of irregular minute vessels and variation in the caliber of vessels was found in 109 cases. The accuracy, sensitivity, specificity, false positive rate and false negative rate for diagnosis of early gastric cancer and precancerous gastric lesions were 68.9%, 95.1%, 63.1%, 24.5%, and 32.4% for conventional endoscopy, 93.6%, 92.7%, 94.5%, 5.7%, and 6.9% for magnifying NBI, and 91.3%, 88.6%, 93.2%, 13.2%, and 21.48% for magnifying chromoendoscopy, respectively. Conclusions This study demonstrates that magnifying NBI is

  20. MicroRNA-486 as a Biomarker for Early Diagnosis and Recurrence of Non-Small Cell Lung Cancer.

    Science.gov (United States)

    Li, Wanshuai; Wang, Yong; Zhang, Qi; Tang, Lili; Liu, Xiaoping; Dai, Yunhua; Xiao, Liang; Huang, Shuguang; Chen, Lu; Guo, Zhongmin; Lu, Jim; Yuan, Kai

    2015-01-01

    Non-small cell lung cancer (NSCLC) is a leading cause of cancer death worldwide. Early diagnosis is essential for improvements of prognosis and survival of the patients. Currently, there is no effective biomarker available in clinical settings for early detection of lung cancer. Altered expressions in many cancer types including NSCLC and stable existence in plasma make microRNAs (miRNAs) a group of potentially useful biomarkers for clinical assessments of patients with NSCLC. To evaluate the potential values of miRNAs as blood-based biomarkers for early diagnosis and prognosis in NSCLC patients. Peripheral blood samples from healthy volunteers and early-staged NSCLC patients before and after surgery were collected, and plasma was separated. Expression of ten miRNAs in the plasma and tumor sections of the patients was detected by quantitative real-time polymerase chain reaction. MiRNA (miR)-486 and miR-150 were found to significantly distinguish lung cancer patients from healthy volunteers. Area under curve of miR-486 and miR-150 were 0.926 (sensitivity, 0.909; specificity, 0.818) and 0.752 (sensitivity, 0.818; specificity, 0.818), respectively. In response to therapy, patients with down-regulated miR-486 expression showed prolonged recurrence-free survival than those with un-reduced miR-486 expression (median, unreached vs. 19 months; hazard ratio, 0.1053; 95% confidence interval, 0.01045 to 1.060; P=0.056). The results suggest that miR-486 and miR-150 could be potential blood-based biomarkers for early diagnosis of NSCLC. Monitoring change of miR-486 expression in plasma might be an effective and non-invasive method for recurrence prediction of early-staged NSCLC patients.

  1. Current situation of early diagnosis of breast cancer%乳腺癌早期诊断现状

    Institute of Scientific and Technical Information of China (English)

    张博

    2013-01-01

    The early diagnosis of breast cancer is very important to treatment and prognosis.With the progresses of breast cancer researches,various biomarkers have been introduced,meaningful for early detection of breast cancer and micrometastases.%早期诊断乳腺癌对合理选择治疗方案和改善预后意义重大.随着乳腺癌分子生物水平研究的不断进展,多种生物标志已引入临床,有助于早期发现乳腺癌和微转移.

  2. Union examination of AFP,AFU,AFPL3 and γ-GT in early diagnosis of primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective To explore the significance of union examination of blood serum liver cancer tracers in the early diagnosis of liver cancer. Methods We observed and compared the level of blood serum liver cancer tracers armor embryo protein (AFP),crag algae glycosidase (AFU),armor embryo protein heteroplasmon (AFPL3) and γ-Gu Anxian transferase (γ-GT) in early time for primary liver cancer patients and hepatitis liver cirrhosis patients and those chronic hepatitis B patients who had liver cancer family history. R...

  3. 急性心肌梗死的早期诊断%Early diagnosis of acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    曲燕; 乔宇; 李平; 邵彩凤

    2015-01-01

    通过对急性心肌梗死患者的早期诊断, 从而制定正确的治疗方法.本文就对患者的表述及临床症状、心电图检查诊断患者是否患有心肌梗死, 以提高诊断率, 减少急性心肌梗死患者死亡的风险.%Through the early diagnosis of acute myocardial infarction patients, correct treatment method was set. This paper provided myocardial infarction diagnosis by examination of patients' description, clinical symptoms and electrocardiogram, so as to improve diagnosis rate and reduce mortality risk in acute myocardial infarction patients.

  4. [Role of nerve stimulation at Erb point in early diagnosis of Guillain-Barré syndrome in children].

    Science.gov (United States)

    Sun, Rui-Di; Fu, Bin; Li, Cheng; Kuang, Guang-Tao; Luo, Xiao-Qing; Jiang, Jun

    2015-07-01

    To study the role of proximal nerve stimulation at Erb point in the early diagnosis of Guillain-Barré syndrome (GBS) in children. Thirty-two children who were diagnosed with GBS between October 2013 and December 2014 received neurophysiological examination. Thirty healthy children were used as controls. Compound muscle action potentials and distal motor latency of the median and ulnar nerves were determined and analyzed after nerve stimulation at the wrist, elbow, and Erb point in the two groups. Moreover, F-wave latency of the median nerve and H-reflex latency of the tibial nerve were measured and analyzed in the two groups. The F-wave and H-reflex latencies were significantly longer in the patient group than in the control group (P0.05). The nerve stimulation at Erb point holds promise as a routine examination for the early diagnosis of GBS.

  5. Fiber optic probe enabled by surface-enhanced Raman scattering for early diagnosis of potential acute rejection of kidney transplant

    Science.gov (United States)

    Chi, Jingmao; Chen, Hui; Tolias, Peter; Du, Henry

    2014-06-01

    We have explored the use of a fiber-optic probe with surface-enhanced Raman scattering (SERS) sensing modality for early, noninvasive and, rapid diagnosis of potential renal acute rejection (AR) and other renal graft dysfunction of kidney transplant patients. Multimode silica optical fiber immobilized with colloidal Ag nanoparticles at the distal end was used for SERS measurements of as-collected urine samples at 632.8 nm excitation wavelength. All patients with abnormal renal graft function (3 AR episodes and 2 graft failure episodes) who were clinically diagnosed independently show common unique SERS spectral features in the urines collected just one day after transplant. SERS-based fiber-optic probe has excellent potential to be a bedside tool for early diagnosis of kidney transplant patients for timely medical intervention of patients at high risk of transplant dysfunction.

  6. Child case of spinal epidural abscess with successful conservative treatment following early diagnosis by CT and /sup 67/Ga SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kusunoki, T.; Tsuda, H.; Sumimoto, S.; Kasajima, Y.; Ojima, S.; Honda, M.; Kanao, K.; Hamamoto, T.

    1987-04-01

    Although early diagnosis and treatment of spinal epidural abscess are emphasized in children in view of its prognosis, these are very difficult because of the nonspecific symptoms of the disease. A 6-year-old boy complained of lumbar pain and difficulty in walking. Computed tomography, performed 6 days after the occurrence of complaints, revealed space occupying lesion in the spinal canal and epidural space at the level of L2-S1. Subsequent single photon emission computed tomography (SPECT) with Ga-67 clearly visualized active inflammation resulting from epidural abscess. The patient received intensive chemotherapy alone. Twenty-one days later, Ga-67 uptake disappeared on SPECT images. The finding indicates the usefulness of diagnostic imagings in the early diagnosis and treatment of spinal epidural abscess, thus avoiding surgery, the role of which has been under debate.

  7. Early malnutrition, but not age, modulates in the rat the L-Arginine facilitating effect on cortical spreading depression.

    Science.gov (United States)

    Frazão, Marília Ferreira; Silva de Seixas Maia, Luciana Maria; Guedes, Rubem Carlos Araújo

    2008-12-05

    Nutritional factors acting during brain development can permanently alter brain electrophysiology. L-Arginine is the precursor of nitric oxide synthesis, which can modulate brain function. Here we investigated the effect of early-in-life administration (during postnatal days 7-28) of L-Arginine (300 mg/(kg day)) on cortical spreading depression (CSD), recorded in well-nourished and malnourished (large litters technique) rats aged 30-40 days (young) and 90-110 days (adult). Compared to water-treated controls, well-nourished L-Arginine-treated rats, but not the malnourished ones, displayed higher CSD velocities (Pbrain weights. It is concluded that early L-Arginine treatment long lastingly increased brain CSD-susceptibility and this effect is abolished by early malnutrition.

  8. Usefulness of magnetic resonance imaging of the wrist for the early diagnosis of dialysis-related amyloidosis

    Energy Technology Data Exchange (ETDEWEB)

    Mochizuki, Takahiro; Mitobe, Michihiro; Mifune, Naoko; Takahashi, Motohiro [Kameda General Hospital, Kamogawa, Chiba (Japan)

    1999-01-01

    Dialysis-related amyloidosis (DRA) is a major complication of long-term hemodialysis patients. The onset of arthropathy is frequently preceded by carpal tunnel syndrome, but the early non-invasive diagnosis of DRA remains unclear. {beta}{sub 2}-microglobulin amyloid deposits in joint synovia and soft tissue precede radiological abnormalities. Magnetic resonance imaging (MRI) may play a more important role in the early diagnosis of DRA, because it allows direct visualization of synovitis and deposition of abnormal soft tissue. The purpose of this study was to evaluate the usefulness of MRI of the wrist for the early diagnosis of DRA. The study included 72 patients (male 37, female 35) undergoing hemodialysis from initiation to 20 years. The patients were examined by MR images of synovitis, deposition of abnormal soft tissue and cystic bone lesions at the wrists. Normal MR images of synovia and soft tissue were defined in 6 control subjects (2 normal 4 non-dialysis patients). Synovitis of the carpal bones was found in 23% of the patients at the start of hemodialysis. Deposition of abnormal soft tissue in the carpal canal and cystic bone lesions were detected after 1 and 2 years of hemodialysis, respectively. All findings were increased significantly with an increasing duration of dialysis. Synovitis was present in 90% of the patients with deposition of abnormal soft tissue, and in 80% of the patients with cystic bone lesions. {beta}{sub 2}-microglobulin value was significantly higher in patients with synovitis, deposition of abnormal soft tissue and cystic bone lesions than in patients without these findings. Our experience suggests that synovitis examined by MRI of the wrists is useful for the early diagnosis of DRA. Thereby, intensive follow-up and management of DRA are required in patients with synovitis at the start of hemodialysis. (author)

  9. Integrative Genomic Data Mining for Discovery of Potential Blood-Borne Biomarkers for Early Diagnosis of Cancer

    OpenAIRE

    Yongliang Yang; Pavel Pospisil; Iyer, Lakshmanan K.; S. James Adelstein; Amin I. Kassis

    2008-01-01

    BACKGROUND: With the arrival of the postgenomic era, there is increasing interest in the discovery of biomarkers for the accurate diagnosis, prognosis, and early detection of cancer. Blood-borne cancer markers are favored by clinicians, because blood samples can be obtained and analyzed with relative ease. We have used a combined mining strategy based on an integrated cancer microarray platform, Oncomine, and the biomarker module of the Ingenuity Pathways Analysis (IPA) program to identify po...

  10. Early diagnosis of prostate cancer using free/total prostate specific antigen ratio: a population based screening data

    Institute of Scientific and Technical Information of China (English)

    LingZhang; Guo-YIJi; Xiao-MengLi; Wei-HuaWang; Hong-WenGao; Yu-ZhuoPan; Hong-JunWang; KuwaharaMasaaki; Xue-JianZhao

    2004-01-01

    Aim: To evaluate the use of free/total prostate specific antig enratio (fPSA/tPSA ratio) in improving the early diagnosis of prostate cancer. Methods: The fPSA/tPSA ratio in the serum was analyzed in 187 men with tPSA ranging between 4.0 and 20.0μg/L. Allof them underwent ultrasound guided sextant prostatic biopsy.The results were calculated by SPSS 10.0 software.

  11. Value of joint detecion of multiple biomarkers on early diagnosis of acute kidney injury in critical patients

    Institute of Scientific and Technical Information of China (English)

    许光银

    2014-01-01

    Objective To assess the value of joint detection of serum cysteine proteinase inhibitors C(sCys-C),urinary kidney injury molecule 1(uKIM-1),urinary neutrophil gelatinase-associated lipocalin(uNGAL)and urinary interleukin 18(uIL-18)for early diagnosis of acute kidney injury(AKI)in critically ill patients.Methods A total of256 adult patients who stayed in Intensive Care Unit for

  12. The Early Intervention Readiness Program (EIRP): A Post-ASD Diagnosis Family Support Program

    Science.gov (United States)

    Tolmie, Rhiannon S.; Bruck, Susan; Kerslake, Rachel

    2017-01-01

    A child's diagnosis with autism spectrum disorder (ASD) can be an extremely stressful time for families. Researchers suggest that the period immediately following ASD diagnosis is a key time for professionals to guide families by providing appropriate information about support options. This article describes a family support program, developed by…

  13. A novel Multiple-Marker Method for the Early Diagnosis of Oral Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Jutta Ries

    2009-01-01

    Full Text Available Objective: Melanoma associated antigens-A (MAGE-A expression is highly specific to cancer cells. Thus, they can be the most suitable targets for the diagnosis of malignancy. The aim of this study was to evaluate the sensitivity of multiple MAGE-A expression analysis for the diagnosis of oral squamous cell carcinoma (OSCC.

  14. The significance of opthalmologic evaluation in the early diagnosis of inborn errors of metabolism: the Cretan experience

    Directory of Open Access Journals (Sweden)

    Lionis Christos

    2002-04-01

    Full Text Available Abstract Background The Inborn Errors of Metabolism (IEM are far from the rare systemic diseases that mainly affect the neural tissue. There are very few written reports on ocular findings in subjects with IEM, thus it was interesting to study the frequency of ocular findings in the studied population and explore their contribution to the early diagnosis of IEM. Methods Our study involved the evaluation of IEM suspected cases, which had been identified in a rural population in Crete, Greece. Over a period of 3 years, 125 patients, who fulfilled the inclusion criteria of this study, were examined. Analytical physical examination, detailed laboratory investigation as well as a thorough ocular examination were made. Results A diagnosis of IEM was established in 23 of the 125 patients (18.4%. Ten (43.5% of the diagnosed IEM had ocular findings, while 8 of them (34.8% had findings which were specific for the diagnosed diseases. One patient diagnosed with glycogenosis type 1b presented a rare finding. Of the 102 non-diagnosed patients, 53 (51.96 % presented various ophthalmic findings, some of which could be related to a metabolic disease and therefore may be very helpful in the future. Conclusions The ocular investigation can be extremely useful for raising the suspicion and the establishment of an early diagnosis of IEM. It could also add new findings related to these diseases. The early management of the ocular symptoms can improve the quality of life to these patients.

  15. Genetic Testing Confirmed the Early Diagnosis of X-Linked Hypophosphatemic Rickets in a 7-Month-Old Infant

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    Kok Siong Poon BSc

    2015-08-01

    Full Text Available Loss-of-function mutations in the phosphate regulating gene with homologies to endopeptidases on the X-chromosome (PHEX have been causally associated with X-linked hypophosphatemic rickets (XLHR. The early diagnosis of XLHR in infants is challenging when it is based solely on clinical features and biochemical findings. We report a 7-month-old boy with a family history of hypophosphatemic rickets., who demonstrated early clinical evidence of rickets, although serial biochemical findings could not definitively confirm rickets. A sequencing assay targeting the PHEX gene was first performed on the mother’s DNA to screen for mutations in the 5′UTR, 22 coding exons, and the exon-intron junctions. Targeted mutation analysis and mRNA studies were subsequently performed on the boys’ DNA to investigate the pathogenicity of the identified mutation. Genetic screening of the PHEX gene revealed a novel mutation, c.1080-2A>C, at the splice acceptor site in intron 9. The detection of an aberrant mRNA transcript with skipped (loss of exon 10 establishes its pathogenicity and confirms the diagnosis of XLHR in this infant. Genetic testing of the PHEX gene resulted in early diagnosis of XLHR, thus enabling initiation of therapy and prevention of progressive rachitic changes in the infant.

  16. Homocysteine as a predictive biomarker in early diagnosis of renal failure susceptibility and prognostic diagnosis for end stages renal disease.

    Science.gov (United States)

    Amin, Hatem K; El-Sayed, Mohamed-I Kotb; Leheta, Ola F

    2016-09-01

    Glomerular filtration rate and/or creatinine are not accurate methods for renal failure prediction. This study tested homocysteine (Hcy) as a predictive and prognostic marker for end stage renal disease (ESRD). In total, 176 subjects were recruited and divided into: healthy normal group (108 subjects); mild-to-moderate impaired renal function group (21 patients); severe impaired renal function group (7 patients); and chronic renal failure group (40 patients) who were on regular hemodialysis. Blood samples were collected, and serum was separated for analysis of total Hcy, creatinine, high sensitive C-reactive protein (CRP), serum albumin, and calcium. Data showed that Hcy level was significantly increased from normal-to-mild impairment then significantly decreases from mild impairment until the patient reaches severe impairment while showing significant elevation in the last stage of chronic renal disease. Creatinine level was increased in all stages of kidney impairment in comparison with control. CRP level was showing significant elevation in the last stage. A significant decrease in both albumin and calcium was occurred in all stages of renal impairment. We conclude Hcy in combination with CRP, creatinine, albumin, and calcium can be used as a prognostic marker for ESRD and an early diagnostic marker for the risk of renal failure.

  17. How to improve the early diagnosis of Trypanosoma cruzi infection: relationship between validated conventional diagnosis and quantitative DNA amplification in congenitally infected children.

    Directory of Open Access Journals (Sweden)

    Jacqueline Bua

    Full Text Available BACKGROUND: According to the Chagas congenital transmission guides, the diagnosis of infants, born to Trypanosoma cruzi infected mothers, relies on the detection of parasites by INP micromethod, and/or the persistence of T. cruzi specific antibody titers at 10-12 months of age. METHODOLOGY AND PRINCIPAL FINDINGS: Parasitemia levels were quantified by PCR in T. cruzi-infected children, grouped according to the results of one-year follow-up diagnosis: A Neonates that were diagnosed in the first month after delivery by microscopic blood examination (INP micromethod (n = 19 had a median parasitemia of 1,700 Pe/mL (equivalent amounts of parasite DNA per mL; B Infants that required a second parasitological diagnosis at six months of age (n = 10 showed a median parasitemia of around 20 Pe/mL and 500 Pe/mL at 1 and 6 months old, respectively, and C babies with undetectable parasitemia by three blood microscopic observations but diagnosed by specific anti - T. cruzi serology at around 1 year old, (n = 22, exhibited a parasitemia of around 5 Pe/mL, 800 Pe/mL and 20 Pe/mL 1, 6 and 12 month after delivery, respectively. T. cruzi parasites were isolated by hemoculture from 19 congenitally infected children, 18 of which were genotypified as DTU TcV, (former lineage TcIId and only one as TcI. SIGNIFICANCE: This report is the first to quantify parasitemia levels in more than 50 children congenitally infected with T. cruzi, at three different diagnostic controls during one-year follow-up after delivery. Our results show that the parasite burden in some children (22 out of 51 is below the detection limit of the INP micromethod. As the current trypanocidal treatment proved to be very effective to cure T. cruzi - infected children, more sensitive parasitological methods should be developed to assure an early T. cruzi congenital diagnosis.

  18. "Play Skills" for Shy Children: Development of a "Social Skills Facilitated Play" Early Intervention Program for Extremely Inhibited Preschoolers

    Science.gov (United States)

    Coplan, Robert J.; Schneider, Barry H.; Matheson, Adrienne; Graham, Allison

    2010-01-01

    The aim of the present study was to develop and provide a preliminary evaluation of a social-skills-based early intervention program specifically designed to assist extremely inhibited preschoolers. Participants were a sample of n = 522 extremely inhibited preschool-aged children, who were randomly assigned to either the "Social Skills…

  19. Genetic Identification Is Critical for the Diagnosis of Parkinsonism: A Chinese Pedigree with Early Onset of Parkinsonism.

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    Yang Yang

    Full Text Available A number of hereditary neurological diseases display indistinguishable features at the early disease stage. Parkinsonian symptoms can be found in numerous diseases, making it difficult to get a definitive early diagnosis of primary causes for patients with onset of parkinsonism. The accurate and early diagnosis of the causes of parkinsonian patients is important for effective treatments of these patients.We have identified a Chinese family (82 family members over four generations with 21 affected individuals that manifested the characterized symptoms of parkinsonism and was initially diagnosed as Parkinson's disease. We followed up with the family for two years, during which we carried out clinical observations, Positron Emission Tomography-Computed Tomography neuroimaging analysis, and exome sequencing to correctly diagnose the case.During the two-year follow-up period, we performed comprehensive medical history collection, physical examination, and structural and functional neuroimaging studies of this Chinese family. We found that the patient exhibited progressive deteriorated parkinsonism with Parkinson disease-like neuropathology and also had a good response to the initial levodopa treatment. However, exome sequencing identified a missense mutation, N279K, in exon 10 of MAPT gene, verifying that the early parkinsonian symptoms in this family are caused by the genetic mutation for hereditary frontotemporal lobar dementia.For the inherited parkinsonian patients who even show the neuropathology similar to that in Parkinson's disease and have initial response to levodopa treatment, genetic identification of the molecular basis for the disease is still required for defining the early diagnosis and correct treatment.

  20. Computer-aided detection systems to improve lung cancer early diagnosis: state-of-the-art and challenges

    Science.gov (United States)

    Traverso, A.; Lopez Torres, E.; Fantacci, M. E.; Cerello, P.

    2017-05-01

    Lung cancer is one of the most lethal types of cancer, because its early diagnosis is not good enough. In fact, the detection of pulmonary nodule, potential lung cancers, in Computed Tomography scans is a very challenging and time-consuming task for radiologists. To support radiologists, researchers have developed Computer-Aided Diagnosis (CAD) systems for the automated detection of pulmonary nodules in chest Computed Tomography scans. Despite the high level of technological developments and the proved benefits on the overall detection performance, the usage of Computer-Aided Diagnosis in clinical practice is far from being a common procedure. In this paper we investigate the causes underlying this discrepancy and present a solution to tackle it: the M5L WEB- and Cloud-based on-demand Computer-Aided Diagnosis. In addition, we prove how the combination of traditional imaging processing techniques with state-of-art advanced classification algorithms allows to build a system whose performance could be much larger than any Computer-Aided Diagnosis developed so far. This outcome opens the possibility to use the CAD as clinical decision support for radiologists.

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

    Directory of Open Access Journals (Sweden)

    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

  2. Clinical undernutrition in 2014; pathogenesis, early diagnosis and consequences; undernutrition and trophopathy.

    Science.gov (United States)

    de Ulíbarri Pérez, José Ignacio

    2014-01-13

    amount of risks which could derive from an imbalanced nutritional status. The use of automated systems to predict and control the risk factors during the clinical phase makes it possible to have a more thorough control of the illness from its origins, allowing an early diagnosis and treatment of it.

  3. MAGNETIC-RESONANCE IMAGING FOR EARLY DIAGNOSIS OF COXITIS IN PATIENTS WITH SPONDYLOARTHRITIS

    Directory of Open Access Journals (Sweden)

    Anna Georgievna Bochkova

    2012-01-01

    Full Text Available Objective — to define more precisely the potential of magnetic-resonance imaging (MRI in the early diagnosis of coxitis in patients with spondyloarthritis (SpA. Material and methods. Hip (coxofemoral joint (HJ MRI (in T1 and T2Fat Sat; 1,5 T modes was performed in 60 patients with ankylosing spondilitis (AS and SpA: clinical signs of coxitis were present in 37 patients, while remaining 13 patients without coxitis were included into the control group while 10 healthy subjects without SpA made formed a healthy control group. The following parameters were monitored: pain intensity — by the numeric rating scale (NRS 0—10, distance between the ankles, radiographic changes (RCh by BASRI index, presence of intraar-ticular exudate by US-examination. Active coxitis was defined as pain (during active and/or passive movement and/or pain at rest in hip joint after exclusion of enthezitis-related pelvic or greater trochanteric pain. Results. Cases of AS and SpA aged younger than 20 y.o. predominated in the cohort patients with coxitis (55,2%. Bilateral coxitis was diagnosed in 81% patients. Median (Me of disease duration was 12 [25th; 75th percentiles — 1; 132] months. Pain intensity in hip joint measured by NRS was 3 [2; 5]. RC were not found (BASRI-hip=0 in 20 (29,8% affected joints, 47 joints met the criteria of I—III BASRI-hip stage. RCh were not present in patients without coxitis (BASRI-hip=1 in 9 (28,7% joints. The most prevalent inflammatory changes (ICh in patients with coxitis following MRI data were: exudation in the articular space >7 Ml (54%, bone marrow edema (BME in the acetabular region (39%, cysts of the acetabular roof (32%, capsule thickening (25,5%, BME of the femoral head (13,4%, cysts of the femoral head (10%. There was a significant correlation between pain intensity measured by NRS and prevalence of ICh (Spearman's rank correlation R=-0,29; t=-2,46; p=0,01. BME of the femoral head and/or of the acetabular roof were seen

  4. How to improve the early diagnosis of pancreatic cancer%如何提高胰腺癌的早期诊断率

    Institute of Scientific and Technical Information of China (English)

    张太平; 展翰翔; 赵玉沛

    2009-01-01

    Pancreatic cancer is highly malignant with a poor prognosis. The resectability and prognosis of early pancreatic cancer are much better than the advanced, so early diagnosis is crucial for saving patients' lives. Because the symptoms of pancreatic cancer are non-specific, most of the patients are misdiagnosed as gastrointestinal or hepatobiliary diseases. Early diagnosis rate of pancreatic cancer can be greatly improved by combined application of tumor marker detection, endoscopic ultrasound, computed tomography, positron emission tomo-graphy, and etc. Early screening of high-risk population has been advocated by the experts, and its value in early diagnosis of pancreatic cancer has been confirmed by relevant studies. The colaboration of multiple pancreatic surgery centers in conducting prospective studies and setting gnidlines for the pancreatic cancer diagnosis, and relevant fundamental reseaches should also be emphasized.

  5. Electrophysiological evidence for early perceptual facilitation and efficient categorization of self-related stimuli during an Implicit Association Test measuring neuroticism.

    Science.gov (United States)

    Fleischhauer, Monika; Strobel, Alexander; Diers, Kersten; Enge, Sören

    2014-02-01

    The Implicit Association Test (IAT) is a widely used latency-based categorization task that indirectly measures the strength of automatic associations between target and attribute concepts. So far, little is known about the perceptual and cognitive processes underlying personality IATs. Thus, the present study examined event-related potential indices during the execution of an IAT measuring neuroticism (N  =  70). The IAT effect was strongly modulated by the P1 component indicating early facilitation of relevant visual input and by a P3b-like late positive component reflecting the efficacy of stimulus categorization. Both components covaried, and larger amplitudes led to faster responses. The results suggest a relationship between early perceptual and semantic processes operating at a more automatic, implicit level and later decision-related categorization of self-relevant stimuli contributing to the IAT effect.

  6. Peripheral biomarkers in Autism: secreted amyloid precursor protein-alpha as a probable key player in early diagnosis.

    Science.gov (United States)

    Bailey, Antoinette R; Giunta, Brian N; Obregon, Demian; Nikolic, William V; Tian, Jun; Sanberg, Cyndy D; Sutton, Danielle T; Tan, Jun

    2008-01-01

    Autism is a pervasive developmental disorder characterized by impairments in socialization and communication. There is currently no single molecular marker or laboratory tool capable of diagnosing autism at an early age. The purpose of this study is to explore the plausible use of peripheral biomarkers in the early diagnosis of autism via a sensitive ELISA. Here, we measured plasma secreted amyloid precursor protein alpha (sAPP-alpha) levels in autistic and aged-matched control blood samples and found a significantly increased level of sAPP-alpha in 60% of the known autistic children. We then tested 150 human umbilical cord blood (HUCB) samples and found significantly elevated levels of plasma sAPP-alpha in 10 of 150 samples. As an additional confirmatory measure, we performed Western blot analysis on these samples which consistently showed increased sAPP-alpha levels in autistic children and 10 of 150 HUCB samples; suggesting a group of autistic patients which could be identified in early childhood by levels of sAPP-alpha. While there is need for further studies of this concept, the measurement of sAPP-alpha levels in serum and human umbilical cord blood by ELISA is a potential tool for early diagnosis of autism.

  7. Union examination of AFP, AFU, AFPL3 andγ-GT in early diagnosis of primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    Yuan Shao; Zuo-ren Wang; Lei Shi

    2009-01-01

    Objective To explore the significance of union examination of blood serum liver cancer tracers in the early diagnosis of liver cancer. Methods We observed and compared the level of blood serum liver cancer tracers armor embryo protein (AFP), crag algae glycosidase (AFU), armor embryo protein heteroplasmon (AFPL3) andγ-Gu Anxian transferase (γ-GT) in early time for primary liver cancer patients and hepatitis liver cirrhosis patients and those chronic hepatitis B patients who had liver cancer family history. Results Finally among the 30 patients in the early liver cancer group, 23 were positive with AFP, 20 with AFU, 15 with AFPL3 and 21 with γ-GT. Five were found positive with blood serum AFP, AFPL3, AFU and γ-GT at the same time; 5 with AFP, AFPL3 and γ-GT; 5 with AFP, AFU and AFPL3; 7 with AFP, AFU andγ-GT. By contrast, in the control group, among the 30 hepatitis liver cirrhosis patients and those chronic hepatitis B patients with liver cancer family history, 11 were found positive with AFP, 3 with AFPL3, 12 with AFU and 14 with γ-GT. None of the patients were found positive with union examination of AFP, AFPL3, AFU and γ-GT in the blood serum at the same time. Conclusion The union examination of AFP, AFU, AFPL3 and γ-GT is significant to the early diagnosis of primary liver cancer.

  8. Information fusion diagnosis and early-warning method for monitoring the long-term service safety of high dams

    Institute of Scientific and Technical Information of China (English)

    Xing LIU; Zhong-ru WU; Yang YANG; Jiang HU; Bo XU

    2012-01-01

    Analyzing the service behavior of high dams and establishing early-warning systems for them have become increasingly important in ensuring their long-term service.Current analysis methods used to obtain safety monitoring data are suited only to single survey point data.Unreliable or even paradoxical results are inevitably obtained when processing large amounts of monitoring data,thereby causing difficulty in acquiring precise conclusions.Therefore,we have developed a new method based on multi-source information fusion for conducting a comprehensive analysis of prototype monitoring data of high dams.In addition,we propose the use of decision information entropy analysis for building a diagnosis and early-warning system for the long-term service of high dams.Data metrics reduction is achieved using information fusion at the data level.A Bayesian information fusion is then conducted at the decision level to obtain a comprehensive diagnosis.Early-warning outcomes can be released after sorting analysis results from multi-positions in the dam according to importance.A case study indicates that the new method can effectively handle large amounts of monitoring data from numerous survey points.It can likewise obtain precise real-time results and export comprehensive early-warning outcomes from multi-positions of high dams.

  9. Clinical whole-genome sequencing in severe early-onset epilepsy reveals new genes and improves molecular diagnosis.

    Science.gov (United States)

    Martin, Hilary C; Kim, Grace E; Pagnamenta, Alistair T; Murakami, Yoshiko; Carvill, Gemma L; Meyer, Esther; Copley, Richard R; Rimmer, Andrew; Barcia, Giulia; Fleming, Matthew R; Kronengold, Jack; Brown, Maile R; Hudspith, Karl A; Broxholme, John; Kanapin, Alexander; Cazier, Jean-Baptiste; Kinoshita, Taroh; Nabbout, Rima; Bentley, David; McVean, Gil; Heavin, Sinéad; Zaiwalla, Zenobia; McShane, Tony; Mefford, Heather C; Shears, Deborah; Stewart, Helen; Kurian, Manju A; Scheffer, Ingrid E; Blair, Edward; Donnelly, Peter; Kaczmarek, Leonard K; Taylor, Jenny C

    2014-06-15

    In severe early-onset epilepsy, precise clinical and molecular genetic diagnosis is complex, as many metabolic and electro-physiological processes have been implicated in disease causation. The clinical phenotypes share many features such as complex seizure types and developmental delay. Molecular diagnosis has historically been confined to sequential testing of candidate genes known to be associated with specific sub-phenotypes, but the diagnostic yield of this approach can be low. We conducted whole-genome sequencing (WGS) on six patients with severe early-onset epilepsy who had previously been refractory to molecular diagnosis, and their parents. Four of these patients had a clinical diagnosis of Ohtahara Syndrome (OS) and two patients had severe non-syndromic early-onset epilepsy (NSEOE). In two OS cases, we found de novo non-synonymous mutations in the genes KCNQ2 and SCN2A. In a third OS case, WGS revealed paternal isodisomy for chromosome 9, leading to identification of the causal homozygous missense variant in KCNT1, which produced a substantial increase in potassium channel current. The fourth OS patient had a recessive mutation in PIGQ that led to exon skipping and defective glycophosphatidyl inositol biosynthesis. The two patients with NSEOE had likely pathogenic de novo mutations in CBL and CSNK1G1, respectively. Mutations in these genes were not found among 500 additional individuals with epilepsy. This work reveals two novel genes for OS, KCNT1 and PIGQ. It also uncovers unexpected genetic mechanisms and emphasizes the power of WGS as a clinical tool for making molecular diagnoses, particularly for highly heterogeneous disorders.

  10. Diffusion-weighted Magnetic Resonance Imaging in the Early Diagnosis of Neonatal Adrenoleukodystrophy

    Directory of Open Access Journals (Sweden)

    R Nuri Sener

    2011-01-01

    Full Text Available A newborn baby girl developed seizures right after birth. On the fourth day, the baby was examined using diffusion sequence magnetic resonance imaging (MRI and diagnosed to have neonatal adrenoleukodystrophy. Laboratory findings confirmed the diagnosis. This is the first case of neonatal adrenoleukodystrophy (NALD where diffusion MRI sequence helped in the diagnosis. We find association of NALD with seizures at birth is an extremely rare occurrence, and so far, only one case has been mentioned in the literature.

  11. The role of nailfold videocapillaroscopy in Raynaud’s phenomenon monitoring and early diagnosis of systemic sclerosis

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    E. Alessandri

    2011-06-01

    Full Text Available Several connective tissue diseases, in particular systemic sclerosis (SSc, have Raynaud’s phenomenon (RP as their first clinical manifestation. Primary RP represents a benign condition often observed in otherwise healthy subjects, especially women: it is due to an exaggerated response to the physiological cold-induced vasospasm, whereas the secondary form of RP is typically associated with connective tissue diseases, especially SSc. Nailfold videocapillaroscopy (NVC, particulary after the recent technological advances, is a safe and reliable method to observe the microvascular structure and its early changes, especially during the transition from primary to secondary RP. In case of SSc, by considering validated patterns and scoring systems, NVC is the main tool that rheumatologists can rely on, besides the presence of specific auto-antibodies, to perform a very early diagnosis of the disease. This implies the possibility of early treatment of SSc, with an eye of predicting and preventing its major clinical complications.

  12. Study of Vessel Conditions in Different Categories of Weight for Early-Stage of Deep Vein Thrombosis (DVT Diagnosis

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    Noor Hafizzatul ‘Izzah bt Mat Harun

    2015-02-01

    Full Text Available In this paper, the clinical experiment study is presented to diagnose the Deep Vein Thrombosis (DVT. The diagnosis of DVT is commonly used by monitoring the blood velocity and the present of thrombus in vessel from B-mode ultrasound image associated with the application of Doppler ultrasound. However, the monitoring of those parameters will only be confirmed when someone had already suffered from DVT disease. Thus, this study is to diagnose the early stage of DVT. Since it is difficult to recognize the vessel condition at the early stage of DVT, the evaluation of vein mechanism based on different categories of weight at the early stage of DVT is proposed. The wall displacement and blood flow velocity is considered to be the important parameters to construct a clinical model of DVT risk factor, thereby constitutes an important contribution for predicting probability of Deep Vein Thrombosis (DVT.

  13. Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Perani, Daniela [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, Nuclear Medicine Unit, Milan (Italy); Cerami, Chiara [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, Clinical Neuroscience Department, Milan (Italy); Caminiti, Silvia Paola [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); Santangelo, Roberto; Coppi, Elisabetta; Ferrari, Laura; Magnani, Giuseppe [San Raffaele Hospital, Department of Neurology, Milan (Italy); Pinto, Patrizia [Papa Giovanni XXIII Hospital, Department of Neurology, Bergamo (Italy); Passerini, Gabriella [Servizio di Medicina di Laboratorio OSR, Milan (Italy); Falini, Andrea [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, CERMAC - Department of Neuroradiology, Milan (Italy); Iannaccone, Sandro [San Raffaele Hospital, Clinical Neuroscience Department, Milan (Italy); Cappa, Stefano Francesco [San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); IUSS Pavia, Pavia (Italy); Comi, Giancarlo [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Hospital, Department of Neurology, Milan (Italy); Gianolli, Luigi [San Raffaele Hospital, Nuclear Medicine Unit, Milan (Italy)

    2016-03-15

    The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). We evaluated the supportive role of CSF Aβ{sub 42}, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ{sub 42} ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ{sub 42} ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role. (orig.)

  14. Application of ThinPrep Bronchial Brushing Cytology in the Early Diagnosis of Lung Cancer: A Retrospective Study

    Science.gov (United States)

    Liu, Chaoying; Wen, Zhongmei; Li, Yang; Peng, Liping

    2014-01-01

    The majority of lung cancer patients are diagnosed at advanced stages of disease. This study evaluated the diagnostic value of ThinPrep (TP) bronchial brushing cytology in lung cancer. A total of 595 patients with suspicious lung cancer were enrolled in this study. The bronchial brushing samples were prepared by TP. The data were then compared to histology of lung tissue samples. Histologically, 479 of these 595 patients were diagnosed with lung cancer, including 223 cases of lung squamous cell carcinoma (SCC), 77 cases of lung adenocarcinoma (ADC), and 152 cases of small cell lung carcinoma (SCLC). The TP cytology revealed a total of 460 cases of lung cancer (including 232 SCCs, 91 ADCs, and 108 SCLCs). The TP cytological technique had 87.06% sensitivity and 62.93% specificity in the diagnosis of lung cancer. Specifically, TP cytology confirmed 195 of 223 SCCs, 47 of 77 ADCs, and 94 of 152 SCLCs. The TP cytology showed 87.44% sensitivity and 90.05% specificity for the diagnosis of SCC, with a Matthew's correlation coefficient (MCC) of 0.820; while the sensitivity was reduced to 61.04% and the specificity was 90.93% for the diagnosis of ADC, with a MCC of 0.464. For the diagnosis of SCLC, the sensitivity was 61.84% and the specificity was 96.84%, with a MCC of 0.648. Thus, this study demonstrated the usefulness of TP bronchial brushing cytology in the early diagnosis of lung cancer, especially the early stage of lung SCC. A prospective clinical trial will verify these data before being translated into the clinic. PMID:24759600

  15. Easy probability estimation of the diagnosis of early axial spondyloarthritis by summing up scores.

    Science.gov (United States)

    Feldtkeller, Ernst; Rudwaleit, Martin; Zeidler, Henning

    2013-09-01

    Several sets of criteria for the diagnosis of axial SpA (including non-radiographic axial spondyloarthritis) have been proposed in the literature in which scores were attributed to relevant findings and the diagnosis requests a minimal sum of these scores. To quantitatively estimate the probability of axial SpA, multiplying the likelihood ratios of all relevant findings was proposed by Rudwaleit et al. in 2004. The objective of our proposal is to combine the advantages of both, i.e. to estimate the probability by summing up scores instead of multiplying likelihood ratios. An easy way to estimate the probability of axial spondyloarthritis is to use the logarithms of the likelihood ratios as scores attributed to relevant findings and to use the sum of these scores for the probability estimation. A list of whole-numbered scores for relevant findings is presented, and also threshold sum values necessary for a definite and for a probable diagnosis of axial SpA as well as a threshold below which the diagnosis of axial spondyloarthritis can be excluded. In a diagram, the probability of axial spondyloarthritis is given for sum values between these thresholds. By the method proposed, the advantages of both, the easy summing up of scores and the quantitative calculation of the diagnosis probability, are combined. Our method also makes it easier to estimate which additional tests are necessary to come to a definite diagnosis.

  16. 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 BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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%. CONCLUSIONS/SIGNIFICANCE: 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

  17. COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF FIVE METHODS FOR EARLY DIAGNOSIS OF OCCLUSAL CARIES LESIONS – in vitro study.

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    Mirela Marinova-Takorova

    2014-07-01

    Full Text Available Purpose: The aim of the presented in vitro study was to evaluate the effectiveness of the device DIAGNOcam and the laser fluorescence device DIAGNOdent for early diagnosis of occlusal caries and to compare it with three traditional methods – visual and tactile, dye and radiographic examination. Material and methods: The sample consisted of 60 extracted human teeth. Three clinicians diagnosed independently the presence or absence of early occlusal surface caries with the visible tactile method,DIAGNOcam andDIAGNOdent. Then X-rays were taken and the dentists viewed them separately, without magnification.Fuchsine was applied for 30 sec. and then washed under running water for 20 min. Places where dye was present were registered. Statistical analysis was performed with SPSS package of Windows. Results: The results showed high level of correspondence between the authors for all the diagnostic methods. Concerning different methods applied for caries diagnosis there was a correlation between the methods, but it was diverging for the different methods. No correlation between radiographic exam and data obtained with DIAGNOdent and dye staining was observed. Conclusions: Based on the obtained results we may conclude that the least sensitive method for fissure caries diagnosis was the dye staining, followed by the radiographic exam. The results, obtained by DIAGNOdent and DIAGNOcam were very close, but DIAGNOcams’ data was better correlating with the clinical results.DIAGNOcam procedure can be judged as equivalent in the detection of occlusal dentine lesions when compared to clinical results.

  18. 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.

  19. Possible Patient Early Diagnosis by Ultrasonic Noninvasive Estimation of Thermal Gradients into Tissues Based on Spectral Changes Modeling

    Directory of Open Access Journals (Sweden)

    I. Bazan

    2012-01-01

    Full Text Available To achieve a precise noninvasive temperature estimation, inside patient tissues, would open promising research fields, because its clinic results would provide early-diagnosis tools. In fact, detecting changes of thermal origin in ultrasonic echo spectra could be useful as an early complementary indicator of infections, inflammations, or cancer. But the effective clinic applications to diagnosis of thermometry ultrasonic techniques, proposed previously, require additional research. Before their implementations with ultrasonic probes and real-time electronic and processing systems, rigorous analyses must be still made over transient echotraces acquired from well-controlled biological and computational phantoms, to improve resolutions and evaluate clinic limitations. It must be based on computing improved signal-processing algorithms emulating tissues responses. Some related parameters in echo-traces reflected by semiregular scattering tissues must be carefully quantified to get a precise processing protocols definition. In this paper, approaches for non-invasive spectral ultrasonic detection are analyzed. Extensions of author's innovations for ultrasonic thermometry are shown and applied to computationally modeled echotraces from scattered biological phantoms, attaining high resolution (better than 0.1°C. Computer methods are provided for viability evaluation of thermal estimation from echoes with distinct noise levels, difficult to be interpreted, and its effectiveness is evaluated as possible diagnosis tool in scattered tissues like liver.

  20. Rapid oriented fibril formation of fish scale collagen facilitates early osteoblastic differentiation of human mesenchymal stem cells.

    Science.gov (United States)

    Matsumoto, Rena; Uemura, Toshimasa; Xu, Zhefeng; Yamaguchi, Isamu; Ikoma, Toshiyuki; Tanaka, Junzo

    2015-08-01

    We studied the effect of fibril formation of fish scale collagen on the osteoblastic differentiation of human mesenchymal stem cells (hMSCs). We found that hMSCs adhered easily to tilapia scale collagen, which remarkably accelerated the early stage of osteoblastic differentiation in hMSCs during in vitro cell culture. Osteoblastic markers such as ALP activity, osteopontin, and bone morphogenetic protein 2 were markedly upregulated when the hMSCs were cultured on a tilapia collagen surface, especially in the early osteoblastic differentiation stage. We hypothesized that this phenomenon occurs due to specific fibril formation of tilapia collagen. Thus, we examined the time course of collagen fibril formation using high-speed atomic force microscopy. Moreover, to elucidate the effect of the orientation of fibril formation on the differentiation of hMSCs, we measured ALP activity of hMSCs cultured on two types of tilapia scale collagen membranes with different degrees of fibril formation. The ALP activity in hMSCs cultured on a fibrous collagen membrane was significantly higher than on a non-fibrous collagen membrane even before adding osteoblastic differentiation medium. These results showed that the degree of the fibril formation of tilapia collagen was essential for the osteoblastic differentiation of hMSCs.

  1. Fast access and early ligation of the renal pedicle significantly facilitates retroperitoneal laparoscopic radical nephrectomy procedures: modified laparoscopic radical nephrectomy

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    Yang Qing

    2013-01-01

    Full Text Available Abstract Background The objective of this study was to develop a modified retroperitoneal laparoscopic nephrectomy and compare its results with the previous technique. Methods One hundred retroperitoneal laparoscopic nephrectomies were performed from February 2007 to October 2011. The previous technique was performed in 60 cases (Group 1. The modified technique (n = 40 included fast access to the renal pedicle according to several anatomic landmarks and early ligation of renal vessels (Group 2. The mean operation time, mean blood loss, duration of hospital stay conversion rate and complication rate were compared between the groups. Results No significant differences were detected regarding mean patient age, mean body mass index, and tumor size between the two groups (P >0.05. The mean operation time was 59.5 ± 20.0 and 39.5 ± 17.5 minutes, respectively, in Groups 1 and 2 (P P P >0.05. Conclusions Early ligature using fast access to the renal vessels during retroperitoneal laparoscopic radical nephrectomy contributed to less operation time and intraoperative blood loss compared with the previous technique. In addition, the modified technique permits the procedure to be performed following the principles of open radical nephrectomy.

  2. Early postnatal diagnosis of hereditary spherocytosis by combining light microscopy, acidified glycerol lysis test and eosin-5'-maleimide binding assay.

    Science.gov (United States)

    Andres, Oliver; Eber, Stefan; Speer, Christian P

    2015-12-01

    Exact diagnosis of hereditary spherocytosis (HS) is widely considered unreliable around birth. However, early postnatal diagnosis at the beginning of congenital hemolysis may be essential for managing neonatal anemia and hemolytic icterus, identifying those at high risk for severe hyperbilirubinemia, irreversible kernicterus, or sudden need for red cell transfusion. We analyzed 37 blood samples from neonates or infants up to six weeks of life that had been collected in-house or shipped to our laboratory due to suspected red cell membrane disorder. By combining assessment of red cell morphology, acidified glycerol lysis test (AGLT), and eosin-5'-maleimide (EMA) binding assay, we were able to clearly exclude HS in 22 and confirm HS in 10 patients, of which one had undergone red cell transfusion prior to blood sampling. Assessment of red cell morphology and normal test results allowed diagnosis of infantile pyknocytosis or Heinz body anemia in three neonates. Re-evaluation of five patients with inconsistent results of AGLT and EMA binding led to confirmation of HS in two cases. Automated analysis of hematologic parameters revealed elevated proportion of hyperdense cells to be a highly significant indicator for HS in neonatal infants. We showed that assessment of red cell morphology in combination with AGLT and EMA binding assay is a reliable basis for confirming or rejecting suspected diagnosis of HS even in neonates. Our data underline the necessity for blood sampling and laboratory exploration in suspected red cell membrane or enzyme defects at the earliest occasion.

  3. Post total thyroidectomy hypocalcemia: A novel multi-factorial scoring system to enable its prediction to facilitate an early discharge

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    P V Pradeep

    2013-01-01

    Full Text Available Context: No single factor can predict the occurrence of post total thyroidectomy (TT hypocalcemia. Aims: This study was conducted to look at various factors usually implicated in post TT clinically significant hypocalcemia (CSH and to develop a scoring system using a combination of these factors to predict CSH. Settings and Design: Prospective study, tertiary care center. Materials and Methods: 145 patients, who underwent total thyroidectomy for benign goiters and early carcinoma thyroid ( 3 had 91% sensitivity, 84% specificity with a PPV of 71% and NPV of 95%, whereas score of ≥ 4 had 100% specificity and PPV in predicting CSH. Conclusions: CSH after TT is multi-factorial, and a combination of factors (Hypocalcemia prediction score > 3 can be used to predict it so as to discharge patients within 24 hours after surgery.

  4. Rapid response to intensive treatment for bulimia nervosa and purging disorder: A randomized controlled trial of a CBT intervention to facilitate early behavior change.

    Science.gov (United States)

    MacDonald, Danielle E; McFarlane, Traci L; Dionne, Michelle M; David, Lauren; Olmsted, Marion P

    2017-09-01

    Rapid response to cognitive behavior therapy (CBT) for eating disorders (i.e., rapid and substantial change to key eating disorder behaviors in the initial weeks of treatment) robustly predicts good outcome at end-of-treatment and in follow up. The objective of this study was to determine whether rapid response to day hospital (DH) eating disorder treatment could be facilitated using a brief adjunctive CBT intervention focused on early change. 44 women (average age 27.3 [8.4]; 75% White, 6.3% Black, 6.9% Asian) were randomly assigned to 1 of 2 4-session adjunctive interventions: CBT focused on early change, or motivational interviewing (MI). DH was administered as usual. Outcomes included binge/purge frequency, Eating Disorder Examination-Questionnaire and Difficulties in Emotion Regulation Scale. Intent-to-treat analyses were used. The CBT group had a higher rate of rapid response (95.7%) compared to MI (71.4%; p = .04, V = .33). Those who received CBT also had fewer binge/purge episodes (p = .02) in the first 4 weeks of DH. By end-of-DH, CBT participants made greater improvements on overvaluation of weight and shape (p = .008), and emotion regulation (ps rapid and nonrapid responders (ps > .05). The results of this study demonstrate that rapid response can be clinically facilitated using a CBT intervention that explicitly encourages early change. This provides the foundation for future research investigating whether enhancing rates of rapid response using such an intervention results in improved longer term outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Early diagnosis of neurodegenerative diseases - the long awaited Holy Grail and bottleneck of modern brain research - 19th HUPO BPP workshop: May 22-24, 2013, Dortmund, Germany.

    Science.gov (United States)

    Schrötter, Andreas; Magraoui, Fouzi El; Gröttrup, Bernd; Wiltfang, Jens; Heinsen, Helmut; Marcus, Katrin; Meyer, Helmut E; Grinberg, Lea T; Park, Young Mok

    2013-10-01

    The HUPO Brain Proteome Project (HUPO BPP) held its 19th workshop in Dortmund, Germany, from May 22 to 24, 2013. The focus of the spring workshop was on strategies and developments concerning early diagnosis of neurodegenerative diseases.

  6. Community-Based HIV-1 Early Diagnosis and Risk Behavior Analysis of Men Having Sex with Men in Hong Kong.

    Science.gov (United States)

    Liang, Jianguo; Liu, Li; Cheung, Mandy; Lee, Man-Po; Wang, Haibo; Li, Chun-Ho; Chan, Chun-Chung; Nishiura, Kenji; Tang, Xian; Tan, Zhiwu; Peng, Jie; Cheung, Ka-Wai; Yam, Wing-Cheong; Chen, Zhiwei

    2015-01-01

    The increasing prevalence of HIV-1 among men having sex with men (MSM) calls for an investigation of HIV-1 prevalence and incidence in MSM by early diagnosis to assist with early preventive interventions in Hong Kong. The participants were recruited randomly from MSM communities within a one-year period. Rapid HIV Test (RHT) and real-time dried blood spot (DBS)-based quantitative polymerase chain reaction (DBS-qPCR) were used for the early diagnosis of 474 participants. Risk behavior analysis was performed by studying information obtained from the participants during the study period. The HIV-1 prevalence and incident rates in the studied MSM population were 4.01% (19/474) and 1.47% (7/474), respectively. Three infected participants were found at the acute phase of infection by DBS-qPCR. Only 46.4% (220/474) MSM were using condoms regularly for anal sex. HIV infection significantly correlated with unprotected receptive anal sex and syphilis infection. An increased number of infections was found among foreign MSM in Hong Kong. This study is the first to use DBS-qPCR to identify acutely infected individuals in a community setting and to provide both the prevalence and incident rates of HIV-1 infection among MSM in Hong Kong. The risk analysis provided evidence that behavior intervention strengthening is necessary to fight against the increasing HIV-1 epidemic among MSM in Hong Kong and surrounding regions in Asia.

  7. [Anencephaly at 20 weeks gestation. What is the optimal gestational age for early diagnosis?].

    Science.gov (United States)

    Porath, M; Henrich, W; Schmider, A; Dudenhausen, J W

    2002-01-01

    Anencephaly is a lethal defect resulting from a disturbed closure of the neural tube. Prenatal diagnosis during first-trimester-scan is essential but implies pitfalls. Three findings of anencephaly at 20 weeks gestation are reported. Fetuses with anencephaly are correctly identified at 12 to 13 weeks gestation. Anencephaly occurs in absence of the cranial vault. Ultrasound findings can be normal until onset of ossification has definitely failed. A first trimester scan at 12 to 13 weeks allows reliable diagnosis and active management of anencephaly. At this gestational age fetal anatomy can be screened in detail by transvaginal ultrasound and nuchal translucency can be measured.

  8. Mast cells facilitate local VEGF release as an early event in the pathogenesis of postoperative peritoneal adhesions.

    LENUS (Irish Health Repository)

    Cahill, Ronan A

    2012-02-03

    BACKGROUND: Peritoneal injury sustained at laparotomy may evoke local inflammatory responses that result in adhesion formation. Peritoneal mast cells are likely to initiate this process, whereas vascular permeability\\/endothelial growth factor (VEGF) may facilitate the degree to which subsequent adhesion formation occurs. METHODS: Mast cell deficient mice (WBB6F1-\\/-), along with their mast cell sufficient counterparts (WBB6F1+\\/+), underwent a standardized adhesion-inducing operation (AIS) with subsequent sacrifice and adhesion assessment 14 days later in a blinded fashion. Additional CD-1 and WBB6F1+\\/+, and WBB6F1-\\/- mice were killed 2, 6, 12, and 24 hours after operation for measurement of VEGF by ELISA in systemic serum and peritoneal lavage fluid. Two further groups of CD-1 mice underwent AIS and received either a single perioperative dose of anti-VEGF monoclonal antibody (10 mug\\/mouse) or a similar volume of IgG isotypic antibody and adhesion formation 2 weeks later was evaluated. RESULTS: WBB6F1-\\/- mice had less adhesions then did their WBB6F1+\\/+ counterparts (median [interquartile range] adhesion score 3[3-3] vs 1.5[1-2] respectively; P < .003). Local VEGF release peaked 6 hours after AIS in both WBB6F1+\\/+ and CD-1 mice whereas levels remained at baseline in WBB6F1-\\/- mice. CD-1 mice treated with a single dose of anti-VEGF therapy during operation had less adhesions than controls (2[1.25-2] vs 3[2.25-3], P = .0002). CONCLUSIONS: Mast cells and VEGF are central to the formation of postoperative intra-abdominal adhesions with mast cells being responsible, either directly or indirectly, for VEGF release into the peritoneal cavity after operation. In tandem with the recent clinical success of anti-VEGF monoclonal antibodies in oncologic practice, our observations suggest an intriguing avenue for research and development of anti-adhesion strategy.

  9. Pilot Study on Clinical Effectiveness of Autofluorescence Imaging for Early Gastric Cancer Diagnosis by Less Experienced Endoscopists

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    Kazuhiro Tada

    2011-01-01

    Full Text Available This study aimed to assess and compare effectiveness of Autofluorescence imaging (AFI in diagnosis of early gastric cancer (EGC between experienced and less experienced endoscopists. Fifty selected images (20 neoplastic lesions and 30 benign lesions/areas of both white light endoscopy (WLE and AFI were blindly reviewed by two groups; first consisted of five experienced endoscopists and second included five less experienced endoscopists. Sensitivity, specificity, and accuracy were 70%, 78%, and 75%, respectively, for AFI and 81%, 76%, and 78%, respectively, for WLE in the experienced group. In the less experienced group, sensitivity, specificity and accuracy were 80%, 81% and 80%, respectively, for AFI and 65%, 77%, and 72%, respectively, for WLE. Interobserver variability for the less experienced group was better with AFI than WLE. AFI improved sensitivity of endoscopic diagnosis of neoplastic lesions by less experienced endoscopists, and its use could beneficially enhance the clinical effectiveness of EGC screening.

  10. Acute abdomen in patients with systemic lupus erythematosus and antiphospholipid syndrome: importance of early diagnosis and treatment

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    Alberto Titos-García

    2015-01-01

    Full Text Available Systemic lupus erithematosus (SLE is an autoimmune disease with multiorgan involvement caused principally by vasculitis of small vessels. The gastrointestinal tract is one of the most frequently affected by SLE, with abdominal pain as the most common symptom. An early diagnosis and treatment of lupus enteritis is essential to avoid complications like hemorrhage or perforation, with up to 50 % of mortality rate. However, differential diagnosis sometimes is difficult, especially with other types of gastrointestinal diseases as digestive involvement of antiphospholipid syndrome (APS, moreover when both entities may coexist. We describe the case of a patient with both diseases that was diagnosed with lupus enteritis and treated with steroid therapy; the patient had an excellent response.

  11. 48. The value of CT scan and detection of telomerase activity in biopsy specimens for early diagnosis of lung carcinoma

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To evaluate the diagnostic value of telomerase activity in the specimens of biopsy with bronchoscopy or cutting needle. Methods: Telomerase activity was measured in the biopsy apecimens taken from 52 patients suspected of having early lung cancer by CT scan. The PCR based silver staining telomeric repeat amplification protocol (TRAP) was used for detection of telomerase activity in 22 patients with early lung cancer (T1N0M0). Control study was made on the specimens taken from 24 patients with benign disease (cyst 3, TB 6, pseudtumor 5, pneumonjia 10). Results: The positive rates of telomerase activity were 86.45% (19/22) and 4.2% (1/24) in early lung cancers and benign lesions respectively (P<0.01). It was significantly higher in early lung cancers than in benign disease. All cases were diagnosed with surgical pathology and following for 2 years. Conclusion: Detecting telomerase activity in preoperative bronchoscope and cutting needle biopsy specimens may contribute to diagnosis of early lung cancer.

  12. 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.

  13. How to Improve the Early Diagnosis of Trypanosoma cruzi Infection: Relationship between Validated Conventional Diagnosis and Quantitative DNA Amplification in Congenitally Infected Children

    Science.gov (United States)

    Bua, Jacqueline; Volta, Bibiana J.; Perrone, Alina E.; Scollo, Karenina; Velázquez, Elsa B.; Ruiz, Andres M.; De Rissio, Ana M.

    2013-01-01

    Background According to the Chagas congenital transmission guides, the diagnosis of infants, born to Trypanosoma cruzi infected mothers, relies on the detection of parasites by INP micromethod, and/or the persistence of T. cruzi specific antibody titers at 10–12 months of age. Methodology and Principal Findings Parasitemia levels were quantified by PCR in T. cruzi-infected children, grouped according to the results of one-year follow-up diagnosis: A) Neonates that were diagnosed in the first month after delivery by microscopic blood examination (INP micromethod) (n = 19) had a median parasitemia of 1,700 Pe/mL (equivalent amounts of parasite DNA per mL); B) Infants that required a second parasitological diagnosis at six months of age (n = 10) showed a median parasitemia of around 20 Pe/mL and 500 Pe/mL at 1 and 6 months old, respectively, and C) babies with undetectable parasitemia by three blood microscopic observations but diagnosed by specific anti - T. cruzi serology at around 1 year old, (n = 22), exhibited a parasitemia of around 5 Pe/mL, 800 Pe/mL and 20 Pe/mL 1, 6 and 12 month after delivery, respectively. T. cruzi parasites were isolated by hemoculture from 19 congenitally infected children, 18 of which were genotypified as DTU TcV, (former lineage TcIId) and only one as TcI. Significance This report is the first to quantify parasitemia levels in more than 50 children congenitally infected with T. cruzi, at three different diagnostic controls during one-year follow-up after delivery. Our results show that the parasite burden in some children (22 out of 51) is below the detection limit of the INP micromethod. As the current trypanocidal treatment proved to be very effective to cure T. cruzi - infected children, more sensitive parasitological methods should be developed to assure an early T. cruzi congenital diagnosis. PMID:24147166

  14. Systematic review of the use of dried blood spots for monitoring HIV viral load and for early infant diagnosis.

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    Pieter W Smit

    Full Text Available BACKGROUND: Dried blood spots (DBS have been used as alternative specimens to plasma to increase access to HIV viral load (VL monitoring and early infant diagnosis (EID in remote settings. We systematically reviewed evidence on the performance of DBS compared to plasma for VL monitoring and EID. METHODS AND FINDINGS: Thirteen peer reviewed HIV VL publications and five HIV EID papers were included. Depending on the technology and the viral load distribution in the study population, the percentage of DBS samples that are within 0.5 log of VL in plasma ranged from 52-100%. Because the input sample volume is much smaller in a blood spot, there is a risk of false negatives with DBS. Sensitivity of DBS VL was found to be 78-100% compared to plasma at VL below 1000 copies/ml, but this increased to 100% at a threshold of 5000 copies/ml. Unlike a plasma VL test which measures only cell free HIV RNA, a DBS VL also measures proviral DNA as well as cell-associated RNA, potentially leading to false positive results when using DBS. The systematic review showed that specificity was close to 100% at DBS VL above 5000 copies/ml, and this threshold would be the most reliable for predicting true virologic failure using DBS. For early infant diagnosis, DBS has a sensitivity of 100% compared to fresh whole blood or plasma in all studies. CONCLUSIONS: Although limited data are available for EID, DBS offer a highly sensitive and specific sampling strategy to make viral load monitoring and early infant diagnosis more accessible in remote settings. A standardized approach for sampling, storing, and processing DBS samples would be essential to allow successful implementation. TRIAL REGISTRATION: PROSPERO Registration #: CRD42013003621.

  15. Systematic Review of the Use of Dried Blood Spots for Monitoring HIV Viral Load and for Early Infant Diagnosis

    Science.gov (United States)

    Smit, Pieter W.; Sollis, Kimberly A.; Fiscus, Susan; Ford, Nathan; Vitoria, Marco; Essajee, Shaffiq; Barnett, David; Cheng, Ben; Crowe, Suzanne M.; Denny, Thomas; Landay, Alan; Stevens, Wendy; Habiyambere, Vincent; Perriens, Joseph H.; Peeling, Rosanna W.

    2014-01-01

    Background Dried blood spots (DBS) have been used as alternative specimens to plasma to increase access to HIV viral load (VL) monitoring and early infant diagnosis (EID) in remote settings. We systematically reviewed evidence on the performance of DBS compared to plasma for VL monitoring and EID. Methods and Findings Thirteen peer reviewed HIV VL publications and five HIV EID papers were included. Depending on the technology and the viral load distribution in the study population, the percentage of DBS samples that are within 0.5 log of VL in plasma ranged from 52–100%. Because the input sample volume is much smaller in a blood spot, there is a risk of false negatives with DBS. Sensitivity of DBS VL was found to be 78–100% compared to plasma at VL below 1000 copies/ml, but this increased to 100% at a threshold of 5000 copies/ml. Unlike a plasma VL test which measures only cell free HIV RNA, a DBS VL also measures proviral DNA as well as cell-associated RNA, potentially leading to false positive results when using DBS. The systematic review showed that specificity was close to 100% at DBS VL above 5000 copies/ml, and this threshold would be the most reliable for predicting true virologic failure using DBS. For early infant diagnosis, DBS has a sensitivity of 100% compared to fresh whole blood or plasma in all studies. Conclusions Although limited data are available for EID, DBS offer a highly sensitive and specific sampling strategy to make viral load monitoring and early infant diagnosis more accessible in remote settings. A standardized approach for sampling, storing, and processing DBS samples would be essential to allow successful implementation. Trial Registration PROSPERO Registration #: CRD42013003621. PMID:24603442

  16. Diagnostic Accuracy of Cerebrospinal Fluid Amyloid-beta Isoforms for Early and Differential Dementia Diagnosis

    NARCIS (Netherlands)

    Struyfs, Hanne; Van Broeck, Bianca; Timmers, Maarten; Fransen, Erik; Sleegers, Kristel; Van Broeckhoven, Christine; De Deyn, Peter P.; Streffer, Johannes R.; Mercken, Marc; Engelborghs, Sebastiaan

    2015-01-01

    Background: Overlapping cerebrospinal fluid biomarkers (CSF) levels between Alzheimer's disease (AD) and non-AD patients decrease differential diagnostic accuracy of the AD core CSF biomarkers. Amyloid-beta (A beta) isoforms might improve the AD versus non-AD differential diagnosis. Objective: To de

  17. The New DSM-5 Impairment Criterion: A Challenge to Early Autism Spectrum Disorder Diagnosis?

    Science.gov (United States)

    Zander, Eric; Bölte, Sven

    2015-01-01

    The possible effect of the DSM-5 impairment criterion on diagnosing autism spectrum disorder (ASD) in young children was examined in 127 children aged 20-47 months with a DSM-IV-TR clinical consensus diagnosis of ASD. The composite score of the Vineland Adaptive Behavior Scales (VABS) served as a proxy for the DSM-5 impairment criterion. When…

  18. Early Diagnosis of Intestinal Ischemia Using Urinary and Plasma Fatty Acid Binding Proteins

    NARCIS (Netherlands)

    Thuijls, Geertje; van Wijck, Kim; Grootjans, Joep; Derikx, Joep P. M.; van Bijnen, Annemarie A.; Heineman, Erik; Dejong, Cornelis H. C.; Buurman, Wim A.; Poeze, Martijn

    2011-01-01

    Objective: This study aims at improving diagnosis of intestinal ischemia, by measuring plasma and urinary fatty acid binding protein (FABP) levels. Methods: Fifty consecutive patients suspected of intestinal ischemia were included and blood and urine were sampled at time of suspicion. Plasma and uri

  19. Early diagnosis and minimally invasive treatment of occlusal caries--a clinical approach.

    Science.gov (United States)

    Brostek, Andrew

    2004-01-01

    This report summarizes the clinical experiences and recommendations for use of the KaVo DIAGNOdent laser fluorescence device and of air abrasion (Kinetic cavity preparation). A major diagnostic problem facing clinicians today is the difficulty of achieving accurate occlusal caries diagnosis. Diagnostic accuracy is important because it determines the quality of the treatment decisions made, particularly with regard to the possibility of unnecessary operative intervention. The decrease in incidence of cavitated caries in Western countries, followed by the change in common presentation to non-cavitated caries, has made this accurate diagnosis more difficult. The deficiencies of using traditional methods of occlusal diagnosis are discussed and examined, along with the need for new, more accurate techniques. The use of the new technology of laser fluorescence is explained in detail with a discussion of the advantages and limitations of a commercial device: the KaVo DIAGNOdent. A minimal cavity outline philosophy is suggested for operative intervention, with particular emphasis on the advantages of using Kinetic cavity preparation (KCP) non-rotary method of tooth cutting. It should be noted that treatment options such as operative intervention should never precede adequate diagnosis and the use of preventive treatments such as sealants, should be utilized where indicated.

  20. A Single, Early Magnetic Resonance Imaging Study in the Diagnosis of Multiple Sclerosis

    NARCIS (Netherlands)

    Rovira, Alex; Swanton, Josephine; Tintore, Mar; Huerga, Elena; Barkhof, Fredrick; Filippi, Massimo; Frederiksen, Jette L.; Langkilde, Annika; Miszkiel, Katherine; Polman, Chris; Rovaris, Marco; Sastre-Garriga, Jaume; Miller, David; Montalban, Xavier

    2009-01-01

    Background: A diagnosis of multiple sclerosis in patients who present for the first time with a clinically isolated syndrome (CIS) can be established with brain magnetic resonance imaging (MRI) if the MRI demonstrates demyelinating lesions with dissemination in space (DIS) and dissemination in time

  1. Early pack-off diagnosis in drilling using an adaptive observer and statistical change detection

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens

    2015-01-01

    in the well. A model-based adaptive observer is used to estimate these friction parameters as well as flow rates. Detecting changes to these estimates can then be used for pack-off diagnosis, which due to measurement noise is done using statistical change detection. Isolation of incident type and location...

  2. The New DSM-5 Impairment Criterion: A Challenge to Early Autism Spectrum Disorder Diagnosis?

    Science.gov (United States)

    Zander, Eric; Bölte, Sven

    2015-01-01

    The possible effect of the DSM-5 impairment criterion on diagnosing autism spectrum disorder (ASD) in young children was examined in 127 children aged 20-47 months with a DSM-IV-TR clinical consensus diagnosis of ASD. The composite score of the Vineland Adaptive Behavior Scales (VABS) served as a proxy for the DSM-5 impairment criterion. When…

  3. Non-Invasive Markers for Early Diagnosis and Determination of the Severity of Necrotizing Enterocolitis

    NARCIS (Netherlands)

    Thuijls, Geertje; Derikx, Joep P. M.; van Wijck, Kim; Zimmermann, Luc J. I.; Degraeuwe, Pieter L.; Mulder, Twan L.; Van der Zee, David C.; Brouwers, Hens A. A.; Verhoeven, Bas H.; van Heurn, L. W. Ernest; Kramer, Boris W.; Buurman, Wim A.; Heineman, Erik

    2010-01-01

    Objectives: To improve diagnosis of necrotizing enterocolitis (NEC) by noninvasive markers representing gut wall integrity loss (I-FABP and claudin-3) and gut wall inflammation (calprotectin). Furthermore, the usefulness of I-FABP to predict NEC severity and to screen for NEC was evaluated. Methods:

  4. Non-invasive markers for early diagnosis and determination of the severity of necrotizing enterocolitis.

    NARCIS (Netherlands)

    Thuijls, G.; Derikx, J.P.; Wijck, K. van; Zimmermann, L.J.; Degraeuwe, P.L.J.; Mulder, T.L.; Zee, D.C. van der; Brouwers, H.A.A.; Verhoeven, B.H.; Heurn, L.W.E. van; Kramer, B.W.; Buurman, W.A.; Heineman, E.

    2010-01-01

    OBJECTIVES: To improve diagnosis of necrotizing enterocolitis (NEC) by noninvasive markers representing gut wall integrity loss (I-FABP and claudin-3) and gut wall inflammation (calprotectin). Furthermore, the usefulness of I-FABP to predict NEC severity and to screen for NEC was evaluated. METHODS:

  5. Contribution of a Comparative Western Blot Method to Early Postnatal Diagnosis of Congenital Syphilis.

    Science.gov (United States)

    Marangoni, Antonella; Foschi, Claudio; Capretti, Maria Grazia; Nardini, Paola; Compri, Monica; Corvaglia, Luigi Tommaso; Faldella, Giacomo; Cevenini, Roberto

    2016-05-01

    Serology has a pivotal role in the diagnosis of congenital syphilis (CS), but problems arise because of the passive transfer of IgG antibodies across the placenta. The aim of this study was to assess the diagnostic value of a comparative Western blot (WB) method finalized to match the IgG immunological profiles of mothers and their own babies at birth in order to differentiate between passively transmitted maternal antibodies and antibodies synthesized by the infants against Treponema pallidum Thirty infants born to mothers with unknown or inadequate treatment for syphilis were entered in a retrospective study, conducted at St. Orsola-Malpighi Hospital, Bologna, Italy. All of the infants underwent clinical, instrumental, and laboratory examinations, including IgM WB testing. For the retrospective study, an IgG WB assay was performed by blotting T. pallidum antigens onto nitrocellulose sheets and incubating the strips with serum specimens from mother-child pairs. CS was diagnosed in 11 out of the 30 enrolled infants; 9/11 cases received the definitive diagnosis within the first week of life, whereas the remaining two were diagnosed later because of increasing serological test titers. The use of the comparative IgG WB testing performed with serum samples from mother-child pairs allowed a correct CS diagnosis in 10/11 cases. The CS diagnosis was improved by a strategy combining comparative IgG WB results with IgM WB results, leading to a sensitivity of 100%. The comparative IgG WB test is thus a welcome addition to the conventional laboratory methods used for CS diagnosis, allowing identification and adequate treatment of infected infants and avoiding unnecessary therapy of uninfected newborns. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  6. 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.

  7. Early diagnosis of Carpal Tunnel Syndrome (CTS) in Indian patients by nerve conduction studies

    OpenAIRE

    2010-01-01

    The present study was carried out for early confirmation of clinically diagnosed patients of Carpal Tunnel Syndrome (CTS) by electro-diagnostic tests which included motor conduction, sensory conduction studies and F-wave studies. The aim of the study was early confirmation of clinically suspected patients of CTS by motor and sensory conduction studies of median and ulnar nerves. Eighty subjects of age group 30-50 years (40 clinically suspected patients of CTS, 40 as control group) were studie...

  8. Attach importance to the early diagnosis and treatment of acute coagulation dysfunction after major war trauma

    OpenAIRE

    Li, Jie-Shou; You-sheng LI

    2013-01-01

    Coagulation dysfunction after major war trauma is conventionally attributed to consumption and dilution of coagulation factors. However, recent studies have identified an acute coagulation dysfunction at the early stage after trauma. This coagulation dysfunction due to endogenous coagulation disturbance at the early stage after trauma is called acute traumatic coagulation dysfunction (ATCD), and the patients with ATCD would have an increased complication rate and mortality. Standard coagulati...

  9. Lobar Collapse and Obliteration of Air Bronchogram Allowing Early Diagnosis of Endobronchial Aspergillus Infection following Hematopoietic Stem Cell Transplantation

    Directory of Open Access Journals (Sweden)

    Elizabeth Thompson

    2014-01-01

    Full Text Available Endobronchial fungal infection (EBFI is notoriously difficult to diagnose early since it may present few systemic features and does not cause characteristic parenchymal lesions on lung CT scanning. We report a 9-year-old girl who suffered extended neutropenia following graft failure after haematopoietic stem cell transplantation (HSCT for severe aplastic anaemia. CT scan prior to retransplantation was normal despite persistent cough but lobar collapse was shown on repeat scan 16 days later. The probable diagnosis of EBFI (later proven on bronchoscopy was only suspected when subsequent chest X-ray (CXR demonstrated lack of an air bronchogram in the partially collapsed lung. Early radiological suspicion resulted in multiagent antifungal therapy followed by delayed lobectomy, and led to this being the first reported case of Aspergillus EBFI not to result in respiratory failure.

  10. A Statistical Index for Early Diagnosis of Ventricular Arrhythmia from the Trend Analysis of ECG Phase-portraits

    CERN Document Server

    Cappiello, Grazia; Mazomenos, Evangelos B; Maharatna, Koushik; Koulaouzidis, George; Morgan, John; Puddu, Paolo Emilio

    2016-01-01

    In this paper, we propose a novel statistical index for the early diagnosis of ventricular arrhythmia (VA) using the time delay phase-space reconstruction (PSR) technique, from the electrocardiogram (ECG) signal. Patients with two classes of fatal VA - with preceding ventricular premature beats (VPBs) and with no VPBs have been analysed using extensive simulations. Three subclasses of VA with VPBs viz. ventricular tachycardia (VT), ventricular fibrillation (VF) and VT followed by VF are analyzed using the proposed technique. Measures of descriptive statistics like mean ({\\mu}), standard deviation ({\\sigma}), coefficient of variation (CV = {\\sigma}/{\\mu}), skewness ({\\gamma}) and kurtosis (\\{beta}) in phase-space diagrams are studied for a sliding window of 10 beats of ECG signal using the box-counting technique. Subsequently, a hybrid prediction index which is composed of a weighted sum of CV and kurtosis has been proposed for predicting the impending arrhythmia before its actual occurrence. The early diagnos...

  11. Randomized trial of automated, electronic monitoring to facilitate early detection of sepsis in the intensive care unit*.

    Science.gov (United States)

    Hooper, Michael H; Weavind, Lisa; Wheeler, Arthur P; Martin, Jason B; Gowda, Supriya Srinivasa; Semler, Matthew W; Hayes, Rachel M; Albert, Daniel W; Deane, Norment B; Nian, Hui; Mathe, Janos L; Nadas, Andras; Sztipanovits, Janos; Miller, Anne; Bernard, Gordon R; Rice, Todd W

    2012-07-01

    To determine whether automated identification with physician notification of the systemic inflammatory response syndrome in medical intensive care unit patients expedites early administration of new antibiotics or improvement of other patient outcomes in patients with sepsis. : A prospective randomized, controlled, single center study. Medical intensive care unit of an academic, tertiary care medical center. Four hundred forty-two consecutive patients admitted over a 4-month period who met modified systemic inflammatory response syndrome criteria in a medical intensive care unit. Patients were randomized to monitoring by an electronic "Listening Application" to detect modified (systemic inflammatory response syndrome) criteria vs. usual care. The listening application notified physicians in real time when modified systemic inflammatory response syndrome criteria were detected, but did not provide management recommendations. The median time to new antibiotics was similar between the intervention and usual care groups when comparing among all patients (6.0 hr vs. 6.1 hr, p = .95), patients with sepsis (5.3 hr vs. 5.1 hr; p = .90), patients on antibiotics at enrollment (5.2 hr vs. 7.0 hr, p = .27), or patients not on antibiotics at enrollment (5.2 hr vs. 5.1 hr, p = .85). The amount of fluid administered following detection of modified systemic inflammatory response syndrome criteria was similar between groups whether comparing all patients or only patients who were hypotensive at enrollment. Other clinical outcomes including intensive care unit length of stay, hospital length of stay, and mortality were not shown to be different between patients in the intervention and control groups. Realtime alerts of modified systemic inflammatory response syndrome criteria to physicians in one tertiary care medical intensive care unit were feasible and safe but did not influence measured therapeutic interventions for sepsis or significantly alter clinical outcomes.

  12. Deproteinized bone with VEGF gene transfer to facilitate the repair of early avascular necrosis of femoral head of rabbit

    Institute of Scientific and Technical Information of China (English)

    CAO Kai; HUANG Wei; AN Hong; JIANG Dian-ming; SHU Yong; HAN Zhi-min

    2009-01-01

    Objective: To explore a new method for early avascular necrosis of femoral head (AVNFH) therapy.Methods: Sixty-nine AVNFH New Zealand adult rabbits were randomly divided into three groups with equal number. In Group A, deproteinized bone (DPB) that absorbed with recombinant plasmid pcDNA3.1-hVEGF165 was implanted into the drilled tunnel of necrotic femoral head. In Group B, only DPB was implanted. In Group C, only tunnel was drilled without DPB or plasmid implanted. Femoral head specimens were obtained at postoperative 1, 2, 4, 8, 16 weeks. The expression of VEGF165 and collagen I was detected by immunohistochemistry. Bone formation was detected generally by X-ray. Angiogenesis and the repair of the femoral head were observed histologically.Results: The expression of VEGF 165 could be detected 2 weeks after implantation in Group A, but it was not observed in other groups. The result of collagen I expression had a significantly difference 2, 4 and 8 weeks after operation in Group A from those in other groups (P<0.01).X-ray results indicated that there was more bone formation in Group A than in other groups. The regenerated capillary vessels staining result of necrotic femoral head in Group A was significantly different from those in other groups at postoperative 2 and 4 weeks (P<0.01).Conclusions: Transfection ofhVEGF165 gene enhances local angiogenesis and DPB-VEGF compound improves the repair of necrotic femoral head. Deproteinized bone grafting with VEGF gene transfer provides a potential method for the treatment of osteonecrosis.

  13. Spontaneous Complete Uterine Rupture in a Nonlaboring, Early Third-trimester Uterus: Missed Diagnosis by Ultrasound

    Directory of Open Access Journals (Sweden)

    Luke Dixon

    2013-10-01

    Full Text Available Objective - Describe potential consequences and remedy for not intermittently auscultating fetal heart tones during travel to the imaging department and misdiagnosing a ruptured uterus on ultrasound as a synechiae. Study Design - Retrospective chart review of case. Results - Spontaneous uterine rupture in pregnancy is a rare and catastrophic event. Fetal monitoring is an important component for diagnosis, but fetal heart auscultation is usually discontinued while the patient is receiving imaging. We present a ruptured uterus at 28 weeks with delayed diagnosis secondary to interrupted fetal heart tone auscultation and a misdiagnosis of a rupture as a synechiae resulting in a seriously compromised newborn at delivery. Conclusion - Intermittent fetal heart tone auscultation is a possible method of monitoring when the patient is off continuous fetal monitoring.

  14. [Gallstone ileus as a cause of acute abdomen. Importance of early diagnosis for surgical treatment].

    Science.gov (United States)

    Martín-Pérez, Jesica; Delgado-Plasencia, Luciano; Bravo-Gutiérrez, Alberto; Burillo-Putze, Guillermo; Martínez-Riera, Antonio; Alarcó-Hernández, Antonio; Medina-Arana y, Vicente

    2013-10-01

    Gallstone ileus is an uncommon type of mechanical intestinal obstruction caused by an intraluminal gallstone, and preoperative diagnosis is difficult in the Emergency department. This study is a retrospective analysis of the clinical presentation of 5 patients with gallstone ileus treated between 2000-2010. Clinical features, diagnostic testing, and surgical treatment were analyzed. Five patients were included: 2 cases showed bowel obstruction; 2 patients presented a recurrent gallstone ileus with prior surgical intervention; and one patient presented acute peritonitis due to perforation of an ileal diverticula. In all cases CT confirmed the preoperative diagnosis. In our experience, gallstone ileus may present with clinical features other than intestinal obstruction. In suspicious cases CT may be useful to decrease diagnostic delay, which is associated with more complications.

  15. Barriers and facilitators related to the uptake of four strategies to prevent neonatal early-onset group B haemolytic streptococcus disease: a qualitative study.

    Science.gov (United States)

    Kolkman, Diny G E; Fleuren, Margot A H; Wouters, Maurice G A J; de Groot, Christianne J M; Rijnders, Marlies E B

    2017-05-09

    Actions to prevent early onset disease in neonates are based on different strategies including administering antibiotic prophylaxis during labour in case of 1) maternal GBS colonisation (screening strategy), 2) identified risk factors (risk-based strategy) or 3) a combination of these two conditions (maternal GBS colonisation and identified risk factors: combination strategy and the Dutch guideline). Low adherence to guidelines preventing EOGBS has been reported. Each strategy has drawbacks and clinical outcomes are affected by care providers' and women's adherence. The actual impact of any preventive strategy is the product of efficacy of the strategy and the level of implementation. In order to reduce neonatal death due to EOGBS by developing the optimal guideline, we analysed barriers and facilitators of current used strategies. Focus group and personal interviews with care providers and women were performed. Impeding and enhancing factors in adherence to the preventive strategies were discussed and scored using the Measurement Instrument for Determinants of Innovations (MIDI) and analysed by two independent researchers. Overall, care providers identified 3.6 times more factors that would impede (n = 116) rather than facilitate (n = 32) adherence to the preventive strategies. 28% facilitative factors were reported in relation to the combination strategy and 86% impeding factors in relation to the Dutch guideline. The most preferred strategy was the combination strategy by 74% of the care providers and by 86% of the women. We obtained a detailed understanding of factors that influence adherence to preventive strategies. This insight can be used to develop implementation activities to improve the uptake of new strategies. The trial is registered in the Dutch Trial Register NTR3965 .

  16. Early Diagnosis of Penetrating Cardiac and Pleural Injury by Extended Focused Assessment with Sonography for Trauma

    Science.gov (United States)

    Singaravelu, K. P.; Saya, Rama Prakasha; Pandit, Vinay R.

    2016-01-01

    In India, stab injury is not uncommon, but identifying potential life threatening conditions in the emergency room (ER) and initiating prompt treatment are challenging. This is a case report of a young patient who presented to the ER with assault injury to the chest and shock; timely extended focused assessment with sonography for trauma helped to fast-track the patient to the operating room. A brief review of diagnosis and management of penetrating cardiac injury is presented herewith.

  17. Diagnosis of Late-Stage, Early-Onset, Small-Fiber Polyneuropathy

    Science.gov (United States)

    2016-10-01

    of this research is to 1) develop screening tools for simple diagnosis by using patient-report symptom questionnaire and standardized medical exams, 2...symptom questionnaire and a standardized examination for medical personnel. Subtasks: a) Administer/validate questionnaires /forms (Sept 2016- Mar...products; Nothing to Report Nothing to Report Nothing to Report Nothing to Report  software;  educational aids or curricula;  instruments

  18. Early diagnosis of mycotic keratitis : Predictive value of potassium hydroxide preparation

    Directory of Open Access Journals (Sweden)

    Sharma Savitri

    1998-01-01

    Full Text Available Potassium hydroxide (KOH preparation is an underutilized modality in the diagnosis of mycotic keratitis. We have earlier shown its utility in the diagnosis of Nocardia and Acanthamoeba keratitis. The aim of this study was (i to evaluate the sensitivity, specificity and predictive value of KOH preparation, and (ii to compare its efficacy with other methods of corneal scraping examination, for the diagnosis of mycotic keratitis. The study was conducted in two phases. In phase I, randomized corneal scrapings were examined by KOH, Gram′s stain, and lactophenol cotton blue (LPCB in 91 infectious keratitis subjects. In phase II, 53 corneal scrapings were stained with KOH and calcofluor white (CFW, and viewed with bright field (KOH and fluorescence (CFW microscopy. The KOH and CFW readings were recorded by an observer masked to the clinical findings and culture results. Nineteen scrapings were examined by two masked observers. In 22 culture positive fungal keratitis patients in phase I, the sensitivity of KOH, Gram′s stain, and LPCB methods was 100%, 86.4%, and 77.3%, respectively. In phase II, the specificities of KOH and CFW were identical (83.8%, while the sensitivities were 81.2% and 93.7%, respectively (p = 0.59, in 16 culture positive mycotic keratitis patients. There was no significant difference between the negative and positive predictive values of KOH and CFW. Furthermore, no significant interobserver variability was found in the specificity and sensitivity. The KOH method compares well with other microscopy methods in the diagnosis of keratomycosis and has a definite place in the armamentarium of diagnostic techniques.

  19. Glucocorticoids facilitate the transcription from the human cytomegalovirus major immediate early promoter in glucocorticoid receptor- and nuclear factor-I-like protein-dependent manner

    Energy Technology Data Exchange (ETDEWEB)

    Inoue-Toyoda, Maki [Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575 (Japan); Kato, Kohsuke [Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575 (Japan); Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575 (Japan); Nagata, Kyosuke, E-mail: knagata@md.tsukuba.ac.jp [University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575 (Japan); Yoshikawa, Hiroyuki [Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575 (Japan); Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575 (Japan)

    2015-02-27

    Human cytomegalovirus (HCMV) is a common and usually asymptomatic virus agent in healthy individuals. Initiation of HCMV productive infection depends on expression of the major immediate early (MIE) genes. The transcription of HCMV MIE genes is regulated by a diverse set of transcription factors. It was previously reported that productive HCMV infection is triggered probably by elevation of the plasma hydroxycorticoid level. However, it is poorly understood whether the transcription of MIE genes is directly regulated by glucocorticoid. Here, we found that the dexamethasone (DEX), a synthetic glucocorticoid, facilitates the transcription of HCMV MIE genes through the MIE promoter and enhancer in a glucocorticoid receptor (GR)-dependent manner. By competitive EMSA and reporter assays, we revealed that an NF-I like protein is involved in DEX-mediated transcriptional activation of the MIE promoter. Thus, this study supports a notion that the increased level of hydroxycorticoid in the third trimester of pregnancy reactivates HCMV virus production from the latent state. - Highlights: • DEX facilitates the transcription from the HCMV MIE promoter. • GR is involved in DEX-dependent transcription from the HCMV MIE promoter. • A 17 bp repeat is responsible for the HCMV MIE promoter activation by DEX. • An NF-I-like protein is involved in the HCMV MIE promoter activation by DEX.

  20. Role of the General Surgeon in the Early Diagnosis and Treatment of Charcot Foot.

    Science.gov (United States)

    Sellés Dechent, Rafael; Rueda Alcárcel, Camilo; Primo Romaguera, Vicent; Martínez Caamaño, Asunción; Asencio Arana, Francisco

    2015-05-01

    The Charcot foot (CF) consists of a progressive deterioration of the bones and joints, most common in diabetic patients with advanced neuropathy. The great problem is that can be confused with other processes, delaying the diagnosis and specific treatment. The aim is to analyze the cases of CF diagnosed in our hospital and especially to highlight the role of the general surgeon. Retrospective study of all registered cases diagnosed of CF between the diabetic population of our Department of Health. A review of the literature was performed. From 2008 to 2012, there 7 cases of CF were diagnosed (prevalence 1:710). Two of the patients were diagnosed erroneously of cellulitis. The average time of delay in the diagnosis was 10 weeks (minimum 1, maximum 24). The initial treatment was immobilization of the extremity. Once the edema was eliminated, an offload orthesis was placed according to Sanders's anatomical classification. Evolution was favorable in 5 patients, 1 patient needed amputation, and other one died of acute cardiac pathology. The CF is a more frequent pathology than we believe. The general surgeon is the fundamental prop in the diagnosis and initial treatment. Before the presence of inflammation and edema of the foot in a patient with diabetes and severe neuropathy, once cellulitis, osteomyelitis, and TVP are ruled out, Charcot neuroarthropathy should be considered. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Early-phase thin-slice CT in the diagnosis of small insulinomas.

    Science.gov (United States)

    Ishioka, Hideki; Sata, Naohiro; Ishiguro, Yasunao; Lefor, Alan; Yasuda, Yoshikazu

    2015-01-31

    Insulinomas, which are generally smaller than 2 cm, may be difficult to detect by routine imaging modalities including abdominal ultrasonography, computed tomography, and magnetic resonance imaging. Although preoperative detection of insulinomas is essential for operative planning, it is often challenging due to their small size. While arterial stimulation and venous sampling has been used in patients with insulinomas it has been largely supplanted by early-phase thin-slice computed tomography. We report three patients with insulinomas, which were not detected by routine computed tomography scan, but were successfully imaged using early-phase thin-slice computed tomography. Enucleation was performed in all patients based on preoperative imaging. All three patients had an unremarkable postoperative course. Early-phase thin-slice computed tomography is recommended for the preoperative identification of insulinomas. This non-invasive imaging technique should be considered before performing arterial stimulation and venous sampling.

  2. Fault Early Diagnosis of Rolling Element Bearings Combining Wavelet Filtering and Degree of Cyclostationarity Analysis

    Institute of Scientific and Technical Information of China (English)

    ZHOU Fu-chang; CHEN Jin; HE Jun; BI Guo; LI Fu-cai; ZHANG Gui-cai

    2005-01-01

    The vibration signals of rolling element bearing are produced by a combination of periodic and random processes due to the machine's rotation cycle and interaction with the real world. The combination of such components can give rise to signals, which have periodically time-varying ensemble statistical and are best considered as cyclostationary. When the early fault occurs, the background noise is very heavy, it is difficult to disclose the latent periodic components successfully using cyclostationary analysis alone. In this paper the degree of cyclostationarity is combined with wavelet filtering for detection of rolling element bearing early faults. Using the proposed entropy minimization rule. The parameters of the wavelet filter are optimized. This method is shown to be effective in detecting rolling element bearing early fault when cyclostationary analysis by itself fails.

  3. Neutrophil CD64 combined with PCT, CRP and WBC improves the sensitivity for the early diagnosis of neonatal sepsis.

    Science.gov (United States)

    Yang, Ai-Ping; Liu, Jun; Yue, Lei-He; Wang, Hong-Qi; Yang, Wen-Juan; Yang, Guo-Hui

    2016-02-01

    The aim of this study was to determine whether neutrophil CD64 (nCD64) combined with procalcitonin (PCT), C-reactive protein (CRP) and white blood cell count (WBC) can increase the sensitivity and accuracy of neonatal sepsis diagnosis. The serum levels of nCD64, CRP, PCT and WBC were detected in 60 patients with neonatal sepsis and 60 patients with non-sepsis. Sensitivity, specificity, positive and negative predictive values, receiver operating characteristic (ROC) area under the curve (AUC), and logistic regression analysis were performed to evaluate the diagnostic value of these markers on neonatal sepsis. Serum levels of nCD64, PCT, CRP and WBC were higher in the sepsis group than non-sepsis group (pneonatal sepsis were increased to 95.5%. Except for WBC, the birth weight and gestational age had no effects on the diagnostic value of these serum biomarkers. nCD64 and PCT are better diagnostic biomarkers for early diagnosis of neonatal sepsis as compared to CRP. With the help of optimal cut-off value based on ROC curve and logistic regression analysis, the combination of these biomarkers could improve the sensitivity for the diagnosis of suspected late-onset neonatal sepsis based on common serum biomarkers.

  4. Flow Cytometry as a Diagnostic Tool in the Early Diagnosis of Aggressive Lymphomas Mimicking Life-Threatening Infection

    Directory of Open Access Journals (Sweden)

    Nikolaos J. Tsagarakis

    2011-01-01

    Full Text Available Aggressive lymphomas can present with symptoms mimicking life-threatening infection. Flow cytometry (FC is usually recommended for the classification and staging of lymphomas in patients with organomegaly and atypical cells in effusions and blood, after the exclusion of other possible diagnoses. FC may also have a place in the initial diagnostic investigation of aggressive lymphoma. Three cases are presented here of highly aggressive lymphomas in young adults, which presented with the clinical picture of fever of unknown origin (FUO in patients severely ill. All followed a life-threatening clinical course, and two developed the hemophagocytic syndrome (HPS, but microbiological, immunological, and morphological evaluation and immunohistochemistry (IHC failed to substantiate an early diagnosis. FC was the technique that provided conclusive diagnostic evidence of lymphoma, subsequently verified by IHC. Our experience with these three cases highlights the potential role of FC as an adjunct methodology in the initial assessment of possible highly aggressive lymphoma presenting with the signs and symptoms of life-threatening infection, although the definitive diagnosis should be established by biopsy. In such cases, FC can contribute to the diagnosis of lymphoma, independently of the presence of HPS.

  5. 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.

  6. Clinical validation of surface-enhanced Raman scattering-based immunoassays in the early diagnosis of rheumatoid arthritis.

    Science.gov (United States)

    Chon, Hyangah; Wang, Rui; Lee, Sangyeop; Bang, So-Young; Lee, Hye-Soon; Bae, Sang-Cheol; Hong, Sung Hyun; Yoon, Young Ho; Lim, Dong Woo; deMello, Andrew J; Choo, Jaebum

    2015-11-01

    We assessed the clinical feasibility of conducting immunoassays based on surface-enhanced Raman scattering (SERS) in the early diagnosis of rheumatoid arthritis (RA). An autoantibody against citrullinated peptide (anti-CCP) was used as a biomarker, magnetic beads conjugated with CCP were used as substrates, and the SERS nanotags were comprised of anti-human IgG-conjugated hollow gold nanospheres (HGNs). We were able to determine the anti-CCP serum levels successfully by observing the distinctive Raman intensities corresponding to the SERS nanotags. At high concentrations of anti-CCP (>25 U/mL), the results obtained from the SERS assay confirmed those obtained via an ELISA-based assay. Nevertheless, quantitation via our SERS-based assay is significantly more accurate at low concentrations (25 U/mL) revealed a good correlation between the ELISA and SERS-based assays. However, in the anti-CCP-negative group (n = 43, <25 U/mL), the SERS-based assay was shown to be more reproducible. Accordingly, we suggest that SERS-based assays are novel and potentially useful tools in the early diagnosis of RA.

  7. Comparative study of immunochromatographic assay (IgM) and widal test for early diagnosis of typhoid fever.

    Science.gov (United States)

    Sultana, S; Hossain, M A; Alam, M A; Paul, S K; Kabir, M R; Hoque, S M; Yesmin, T; Habiba, U; Sarkar, S R; Maruf, M A; Halim, P I; Hoque, M R

    2012-10-01

    Typhoid fever is a severe systemic infection endemic in many developing countries, including Bangladesh. Present study evaluated immunochromatographic test (ICT) and Widal test in the early diagnosis of typhoid fever cases. The study was carried out in the department of Microbiology, Mymensingh Medical College, Mymensingh between July, 2010 and June, 2011, including 200 individuals of different age and sex. Of them, 150 were clinically suspected cases of typhoid fever and 50 age-sex matched controls. Among 150 blood samples from the suspected cases 106(70.7%) were positive for IgM of Salmonella typhi by ICT and 67(44.7%) were positive by Widal test. Whereas, among the 50 controls 4(8%) were positive by ICT and 6(12%) were positive by Widal test. The sensitivity, specificity, positive and negative predictive value of the ICT was found as 83.3%, 92.00%, 91.9% and 83.6% respectively. On the other hand corresponding values for Widal test were of 44.4%, 88%, 80% and 59.5% respectively. Thus, The ICT (IgM) is better alternative to Widal test for early and accurate diagnosis of typhoid fever. The ICT (IgM) is rapid, easy to perform, applicable for field use and highly sensitive and specific for detection of antibodies in patients with typhoid fever.

  8. Clinical practice guideline for the prevention, early detection, diagnosis, management and follow up of type 2 diabetes mellitus in adults.

    Science.gov (United States)

    Aschner, Pablo M; Muñoz, Oscar Mauricio; Girón, Diana; García, Olga Milena; Fernández-Ávila, Daniel Gerardo; Casas, Luz Ángela; Bohórquez, Luisa Fernanda; Arango T, Clara María; Carvajal, Liliana; Ramírez, Doris Amanda; Sarmiento, Juan Guillermo; Colon, Cristian Alejandro; Correa G, Néstor Fabián; Alarcón R, Pilar; Bustamante S, Álvaro Andrés

    2016-06-30

    In Colombia, diabetes mellitus is a public health program for those responsible for creating and implementing strategies for prevention, diagnosis, treatment, and follow-up that are applicable at all care levels, with the objective of establishing early and sustained control of diabetes. A clinical practice guide has been developed following the broad outline of the methodological guide from the Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations taken into account in formulating them. In general terms, what is proposed here is a screening process using the Finnish Diabetes Risk Score questionnaire adapted to the Colombian population, which enables early diagnosis of the illness, and an algorithm for determining initial treatment that can be generalized to most patients with diabetes mellitus type 2 and that is simple to apply in a primary care context. In addition, several recommendations have been made to scale up pharmacological treatment in those patients that do not achieve the objectives or fail to maintain them during initial treatment. These recommendations also take into account the evolution of weight and the individualization of glycemic control goals for special populations. Finally, recommendations have been made for opportune detection of micro- and macrovascular complications of diabetes.

  9. Clinical practice guideline for the prevention, early detection, diagnosis, management and follow up of type 2 diabetes mellitus in adults

    Science.gov (United States)

    Muñoz, Oscar Mauricio; Girón, Diana; García, Olga Milena; Fernández-Ávila, Daniel Gerardo; Casas, Luz Ángela; Bohórquez, Luisa Fernanda; Arango T, Clara María; Carvajal, Liliana; Ramírez, Doris Amanda; Sarmiento, Juan Guillermo; Colon, Cristian Alejandro; Correa G, Néstor Fabián; Alarcón R, Pilar; Bustamante S, Álvaro Andrés

    2016-01-01

    In Colombia, diabetes mellitus is a public health program for those responsible for creating and implementing strategies for prevention, diagnosis, treatment, and follow-up that are applicable at all care levels, with the objective of establishing early and sustained control of diabetes. A clinical practice guide has been developed following the broad outline of the methodological guide from the Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations taken into account in formulating them. In general terms, what is proposed here is a screening process using the Finnish Diabetes Risk Score questionnaire adapted to the Colombian population, which enables early diagnosis of the illness, and an algorithm for determining initial treatment that can be generalized to most patients with diabetes mellitus type 2 and that is simple to apply in a primary care context. In addition, several recommendations have been made to scale up pharmacological treatment in those patients that do not achieve the objectives or fail to maintain them during initial treatment. These recommendations also take into account the evolution of weight and the individualization of glycemic control goals for special populations. Finally, recommendations have been made for opportune detection of micro- and macrovascular complications of diabetes. PMID:27546934

  10. Breast Cancer: subgroups specific blood-biomarkers for early / predictive diagnosis and personalized treatment — EDRN Public Portal

    Science.gov (United States)

    Breast-conserving lumpectomy followed by radiation therapy has been shown to be an alternative strategy, competitive to mastectomy, in preventing mortality caused by breast cancer. However, besides negative short-term effects (blood flow disturbances, painful erythema, etc.) breast irradiation causes severe long-term side-effects (leucopenia, anemia, breast edema, fibrosis, increase of angiosarcoma, leukemia, myelodysplastic syndromes). Therefore, the identification of individual susceptibility to radiation and improved patient-specific radiotherapy planning are highly desirable for personalised treatment in breast cancer. Why early and predictive diagnosis is crucial for long-term outcomes of breast cancer? Breast cancer is the most common cause of cancer death among women with an average incidence rate of 10-12 per 100 women. In 2005, breast cancer led to 502,000 deaths worldwide. Advanced stages of breast cancer lead to the development of metastasis predominantly in the lymph nodes, bone, lung, skin, brain, and liver. Although breast-MRI is currently the most sensitive diagnostic tool for breast imaging, its specificity is limited resulting in a negative impact for surgical management in approximately 9 % of cases. Early diagnosis has been demonstrated to be highly beneficial, enabling significantly enhanced therapy efficiency and possibly full recovery.

  11. Charcot stage 0: A review and consideratons for making the correct diagnosis early.

    Science.gov (United States)

    Holmes, Crystal; Schmidt, Brian; Munson, Michael; Wrobel, James S

    2015-01-01

    Charcot neuropathic osteoarthropathy (CN) is a rare disease (NIDDK, NIH Summary Report Charcot Workshop, 2008) that causes significant morbidity and mortality for affected patients. The disease can result in severe deformities of the foot and ankle that contribute to the development of ulcerations and amputations. Medical advances have failed to find ways to stop the progression of the disease. However, it is known that early detection of the CN has a substantial impact on patient outcomes. CN in the earliest stage is very difficult to recognize and differentiate from other similar presenting diseases. We intend to outline clinical considerations practitioners can use when evaluating a patient with early stage suspected CN.

  12. [The diagnosis, treatment and prevention of early stages of cerebral blood flow insufficiency].

    Science.gov (United States)

    Martynov, Iu S; Girich, T I; Kuntsevich, G I; Sokov, E L; Malkova, E V; Borisova, N F; Nozdriukhina, N V; Shuvakhina, N A

    1998-01-01

    Biomicroscopy of bulbar conjuctiva as well as oencephalography were quite informative for discovery of subclinical manifestations of disorders of cerebral circulation (DCC). That conclusion resulted from the observation of 133 patients with early forms of vascular pathology of brain. Besides, to find the early signs, it was also worth while to perform some biochemical studies (coagulogram, studies of both rheologic properties and lipids of blood). In order to establish discirculatory encephalopathy it was also expedient to use ultrasonic dopplerography and electroencephalography. Efficiency of some medical-prophylactic measures (normalization of the diet, weight, muscular activity, administration of antiatherosclerotic drugs) that prevented the progression of aorta's stenosis was also demonstrated.

  13. Early diagnosis of Werner’s syndrome using exome-wide sequencing in a single, atypical patient

    Directory of Open Access Journals (Sweden)

    Eleanor eRaffan

    2011-03-01

    Full Text Available Genetic diagnosis of inherited metabolic disease is conventionally achieved through syndrome recognition and targeted gene sequencing, but many patients receive no specific diagnosis. Next generation sequencing allied to capture of expressed sequences from genomic DNA now offers a powerful new diagnostic approach. Barriers to routine diagnostic use include cost, and the complexity of interpreting results arising from simultaneous identification of large numbers of variants. We applied exome-wide sequencing to an individual, 16 year old daughter of consanguineous parents with a novel syndrome of short stature, severe insulin resistance, ptosis and microcephaly. Pulldown of expressed sequences from genomic DNA followed by massively parallel sequencing was undertaken. Single nucleotide variants (SNVs were called using SAMtools prior to filtering based on sequence quality and existence in control genomes and exomes. Of 485 genetic variants predicted to alter protein sequence and absent from control data, 24 were homozygous in the patient. One mutation – the p.Arg732X mutation in the WRN gene – has previously been reported in Werner’s syndrome (WS. On re-evaluation of the patient several early features of WS were detected including loss of fat from the extremities and frontal hair thinning. Lymphoblastoid cells from the proband exhibited a defective decatenation checkpoint, consistent with loss of WRN activity. We have thus diagnosed WS some 15 years earlier than average, permitting aggressive prophylactic therapy and screening for WS complications, illustrating the potential of exome-wide sequencing to achieve early diagnosis and change management of rare autosomal recessive disease, even in individual patients of consanguineous parentage with apparently novel syndromes.

  14. The PredictAD project: development of novel biomarkers and analysis software for early diagnosis of the Alzheimer's disease.

    Science.gov (United States)

    Antila, Kari; Lötjönen, Jyrki; Thurfjell, Lennart; Laine, Jarmo; Massimini, Marcello; Rueckert, Daniel; Zubarev, Roman A; Orešič, Matej; van Gils, Mark; Mattila, Jussi; Hviid Simonsen, Anja; Waldemar, Gunhild; Soininen, Hilkka

    2013-04-01

    Alzheimer's disease (AD) is the most common cause of dementia affecting 36 million people worldwide. As the demographic transition in the developed countries progresses towards older population, the worsening ratio of workers per retirees and the growing number of patients with age-related illnesses such as AD will challenge the current healthcare systems and national economies. For these reasons AD has been identified as a health priority, and various methods for diagnosis and many candidates for therapies are under intense research. Even though there is currently no cure for AD, its effects can be managed. Today the significance of early and precise diagnosis of AD is emphasized in order to minimize its irreversible effects on the nervous system. When new drugs and therapies enter the market it is also vital to effectively identify the right candidates to benefit from these. The main objective of the PredictAD project was to find and integrate efficient biomarkers from heterogeneous patient data to make early diagnosis and to monitor the progress of AD in a more efficient, reliable and objective manner. The project focused on discovering biomarkers from biomolecular data, electrophysiological measurements of the brain and structural, functional and molecular brain images. We also designed and built a statistical model and a framework for exploiting these biomarkers with other available patient history and background data. We were able to discover several potential novel biomarker candidates and implement the framework in software. The results are currently used in several research projects, licensed to commercial use and being tested for clinical use in several trials.

  15. Early diagnosis and follow-up of aortitis with [{sup 18}F]FDG PET and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Meller, J.; Siefker, U.; Sahlmann, C.O.; Lehmann, K.; Conrad, M. [Department of Nuclear Medicine, Georg August University, Robert Koch-Strasse 40, 37075, Goettingen (Germany); Strutz, F.; Scheel, A. [Department of Nephrology and Rheumatology, Georg August University, Goettingen (Germany); Vosshenrich, R. [Department of Radiology, Georg August University, Goettingen (Germany)

    2003-05-01

    The aim of this prospective study was to compare fluorine-18 fluorodeoxyglucose ([{sup 18}F]FDG) positron emission tomography (PET) with magnetic resonance imaging (MRI) in patients with early aortitis, at the time of initial diagnosis and during immunosuppressive therapy. The study population consisted of 15 patients (nine females and six males; median age 62 years, range 26-76 years) who presented with fever of unknown origin or an elevated erythrocyte sedimentation rate or elevated C-reactive protein and who showed pathological aortic [{sup 18}F]FDG uptake. Fourteen of these patients had features of early giant cell arteritis (GCA), while one had features of early Takayasu arteritis. During follow-up, seven PET scans were performed in six patients with GCA 4-30 months (median 19 months) after starting immunosuppressive medication. The results of [{sup 18}F]FDG imaging were compared with the results of MRI at initial evaluation and during follow-up and with the clinical findings. At baseline, abnormal [{sup 18}F]FDG uptake was present in 59/104 (56%) of the vascular regions studied in 15 patients. Seven follow-up PET studies were performed in six patients. Of 30 regions with initial pathological uptake in these patients, 24 (80%) showed normalisation of uptake during follow-up. Normalisation of [{sup 18}F]FDG uptake correlated with clinical improvement and with normalisation of the laboratory findings. All except one of the patients with positive aortic [{sup 18}F]FDG uptake were investigated with MRI and MRA. Thirteen of these 14 patients showed inflammation in at least one vascular region. Of 76 vascular regions studied, 41 (53%) showed vasculitis on MRI. Of 76 vascular regions studied with both PET and MRI, 47 were concordantly positive or negative on both modalities, 11 were positive on MRI only and 18 were positive on PET only. MRI was performed during follow-up in six patients: of 17 regions with inflammatory changes, 15 regions remained unchanged and two

  16. Prognostic characteristics of asthma diagnosis in early childhood in clinical practice

    NARCIS (Netherlands)

    Wever-Hess, J; Kouwenberg, JM; Duiverman, EJ; Hermans, J; Wever, AMJ

    A registration study from clinical practice was set up to assess the prognostic value of symptoms and laboratory data at first visit for doctor-diagnosed 'asthma' in early childhood. A total of 419 children aged 0-4 y, who were newly referred to the outpatient department of the Juliana Children's

  17. Sports and Marfan Syndrome: Awareness and Early Diagnosis Can Prevent Sudden Death.

    Science.gov (United States)

    Salim, Mubadda A.; Alpert, Bruce S.

    2001-01-01

    Physicians who work with athletes play an important role in preventing sudden death related to physical activity in people who have Marfan syndrome. Flagging those who have the physical stigmata and listening for certain cardiac auscultation sounds are early diagnostic keys that can help prevent deaths. People with Marfan syndrome should be…

  18. Prognostic characteristics of asthma diagnosis in early childhood in clinical practice

    NARCIS (Netherlands)

    Wever-Hess, J; Kouwenberg, JM; Duiverman, EJ; Hermans, J; Wever, AMJ

    1999-01-01

    A registration study from clinical practice was set up to assess the prognostic value of symptoms and laboratory data at first visit for doctor-diagnosed 'asthma' in early childhood. A total of 419 children aged 0-4 y, who were newly referred to the outpatient department of the Juliana Children's Ho

  19. Early infant diagnosis of HIV in three regions in Tanzania; successes and challenges

    DEFF Research Database (Denmark)

    Chiduo, Mercy G.; Mmbando, Bruno M.; Theilgaard, Zarah P.;

    2013-01-01

    The study showed an increase in testing of HIV exposed infants within the three years, there is large variations of HIV prevalence among the regions. Challenges like; sample turnaround time and LTFU must be overcome before this can translate into the intended goal of early initiation of lifelong ...

  20. [Specific learning disabilities and psychopathological aspects: the importance of early diagnosis].

    Science.gov (United States)

    Chiappedi, M; Zoppello, M; Rossi, R; Scarabello, E M; Piazza, F

    2007-06-01

    The case of a couple of monozygotic twins, for whom the diagnosis of Specific Learning Disabilities was made when they were 14.5 years old, even if reading and writing difficulties had been present since the beginning of primary school, is described. The consultation had been required due to difficulties in relating with same age boys, with social withdrawal and depressive traits, leaving in second place school difficulties; clinical suspect has led to extend the evaluation to include the neuropsychological aspects and so to reach the diagnosis. The differences in terms of adaptive modalities facing the discomfort, probably based on temperament differences, and neuropsychological disorder (low grade dyslexia for one twin, dis-orthography and low-to-medium grade dyslexia for the other one) are discussed. The acquired awareness of being intelligent has permitted the boys to look back in a new way to the school failures they had collected through years; namely, understanding that their difficulties reflected a specific neuropsychological deficit has permitted to reconsider their own past history with a consequent modification of the ''beliefs'' about their abilities. This all has led as a consequence to an increase of life quality (with an improved school and relational adaptation), without cancelling but instead supporting the research of on individuality based on temperament differences. This was possible in spite of the evident delay in reaching the diagnosis and the consequent accumulation of frustration and inadequacy experiences for many years; it's therefore demonstrated the importance of a global evaluation of patients with anamnesis of difficulties in learning to read and write, also in order to treat the possible psychopathological aspects of the clinical picture, which can be the result of a sense of helplessness.

  1. Application of nanophotosensitizers (aluminum phthalocyanine nanoparticles) for early diagnosis and prevention of inflammatory diseases

    Science.gov (United States)

    Kuznetsova, J. O.; Makarov, V. I.

    2016-08-01

    This paper deals with a possibility of new types of photosensitizers application - Aluminum Phthalocyanine nanoparticles (nAlPc) in clinical practice for diagnosis, prevention and therapy of inflammatory diseases in dentistry and traumatology. It was detected that the aluminum phthalocyanine (AlPc) fluoresces in the nanoparticle form in the presence of pathologic microflora or inflammation process. It will make possible to detect the local accumulation of pathological microflora on the enamel surface and also for diagnostics and treatment of inflammatory diseases. Experimental studies of interaction of NP-AlPc with tooth enamel and with biological joint tissue at arthrosis are presented.

  2. DNA Hypermethylation Patterns Detected in Serum as a Tool for Early Breast Cancer Diagnosis

    Science.gov (United States)

    2009-09-01

    renal [37], ovarian [38], colorectal [39], cervical 165 [40], lung [41–43], liver [44], and breast [32–34, 37, 38, 166 45]. Studies in lung cancer have...patterns of RASSF1A, p16 , and p15 172 (using DNA from 200 ll of serum) as much as 9 years 173 prior to diagnosis. 174 DNA methylation and breast cancer ...193) RARb2 CDH1 ESR1 BRCA1 CCND2 p16 TWIST 26% 80% 84% 41% 11% 14% 59% Not calculated (at least 84%) Cancer Causes Control 123 Journal : Large 10552

  3. Lung Cancer Early Diagnosis Using Some Data Mining Classification Techniques: A Survey

    Directory of Open Access Journals (Sweden)

    Thangaraju P

    2014-06-01

    Full Text Available Data mining is the process of analyzing data from different perspectives and summarizing it into useful information. Data mining is primarily used to this requirement thus finding its applications in diverse fields such as retail, financial, communication, marketing organizations and medicine. Data Mining plays an important role in healthcare organization because with the growth of population and dangerous deadly diseases like Cancer, SARS, Leprosy, HIV etc, Lung cancer is one of the most dangerous disease. This survey for appropriate medical image mining, Data Preprocessing, Feature Extraction, rule generation and classification, it provides basic framework for further improvement in medical diagnosis.

  4. Early pack-off diagnosis in drilling using an adaptive observer and statistical change detection

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens

    2015-01-01

    in the well. A model-based adaptive observer is used to estimate these friction parameters as well as flow rates. Detecting changes to these estimates can then be used for pack-off diagnosis, which due to measurement noise is done using statistical change detection. Isolation of incident type and location...... is done using a multivariate generalized likelihood ratio test, determining the change direction of the estimated mean values. The method is tested on simulated data from the commercial high-fidelity multi-phase simulator OLGA, where three different pack-offs at different locations and with different...

  5. [Progress in the early diagnosis of cancer of the colon and rectum].

    Science.gov (United States)

    Canessa, N; Roset, J; Boffi, A; Ferrara, J B; Galano, A; Albertengo, J C

    1978-09-01

    Our experience with the air contrast examination in the cancer of colon and rectum diagnoses is showed. The colaboration among radiologist, endoscopist, pathologist and surgeon is important. In the large bowel tumors diagnosis, the radiologic and endoscopic prodedures should be evaluated together. The double colonic contrast has showed in our experience, better results than with the barium enema. Over 31 patients with both studies, we obtained 13 false negatives (with barium enema, doing then the double colonic contrast became positive 12 (92.4%).

  6. Is There Such a Diagnosis as an Early Onset Unipolar Depression?

    Directory of Open Access Journals (Sweden)

    Berta Ferreira

    2014-10-01

    Full Text Available According to Kraepelin, melancholia was part of manic-depressive psychosis. In the 60s however, other authors (Angst, 1966; Perris, 1966; Winokur, 1967 questioned this concept by considering unipolar depression a clinical entity, separated from bipolar disorders. Using strict bipolar disorders criteria, some prospective studies have shown a diagnosis switch from unipolar to bipolar disorders in up to 50% of the cases (Caryell, 1995; Goldberg, 2001; Angst, 2005. The existence of unipolar depression as a clinical entity is discussed, taking in consideration the “minor” bipolar symptoms that occur during the course of affective disorders.

  7. Lung Cancer Early Diagnosis Using Some Data Mining Classification Techniques: A Survey

    Directory of Open Access Journals (Sweden)

    Thangaraju P

    2015-11-01

    Full Text Available  Data mining is the process of analyzing data from different perspectives and summarizing it into useful information. Data mining is primarily used to this requirement thus finding its applications in diverse fields such as retail, financial, communication, marketing organizations and medicine. Data Mining plays an important role in healthcare organization because with the growth of population and dangerous deadly diseases like Cancer, SARS, Leprosy, HIV etc, Lung cancer is one of the most dangerous disease. This survey for appropriate medical image mining, Data Preprocessing, Feature Extraction, rule generation and classification, it provides basic framework for further improvement in medical diagnosis.

  8. Early diagnosis of testicular tumor using Tc-/sub 99m/ pertechnetate scrotal imaging

    Energy Technology Data Exchange (ETDEWEB)

    Donoghue, G.D.; Prezio, J.A.; Ricci, P.E.

    1983-12-01

    Two patients who originally presented with clinical symptoms of epididymo-orchitis, with compatible findings on the Tc-/sub 99m/ pertechnetate scrotal images, had temporary remission of their symptoms with antibiotic therapy. After two months, both patients had repeat scrotal images, because of persistent testicular enlargement. Both now demonstrated a ''cold spot'' in the otherwise increased activity on the affected side. Both patients underwent orchiectomy; patient 1 had a tissue diagnosis of malignant mixed germ cell tumor and patient 2 showed teratocarcinoma.

  9. EARLY DIAGNOSIS AND MANAGEMENT OF NEUROMYELITIS OPTICA PREVENTS RELAPSES AND LIMITS VISUAL DISABILITY

    Directory of Open Access Journals (Sweden)

    Satya Srinivas

    2015-03-01

    Full Text Available Neuromyelitis optica (NMO or devics disease was considered as a variant of Multiple sclerosis, w ith recent advances in investigations and with better understanding of etiopathogenesis, NMO is a distinct immune mediated, largely relapsing, inflammatory , demyelinating disease of central nervous system. NMO most commonly i nvolves the optic nerves and spinal cord. Relapsing and monophasic are two var iants of NMO , as relapsing NMO is a rapidly disabling disease, prompt diagnosis of the type from the monophasic, helps in the management as well as decreasing the motor and visual morbidity

  10. The role and reliability of rapid bedside diagnostic test in early diagnosis and treatment of bacterial meningitis.

    Science.gov (United States)

    Kumar, Arun; Debata, Pradeep Kumar; Ranjan, Amitabh; Gaind, Rajani

    2015-04-01

    To evaluate the role and reliability of rapid bedside diagnostic test in early diagnosis and treatment of bacterial meningitis in children using reagent strips. This prospective, single blinded study was conducted in the Department of Pediatrics of VMMC & Safdarjung Hospital, New Delhi in collaboration with the Department of Microbiology of VMMC & Safdarjung Hospital, New Delhi, over a period of 15 mo (August 2009 to Nov 2010). Seventy-five children aged 3 mo to 12 y admitted in the pediatric ward with suspected diagnosis of acute meningitis were included. All enroled patients underwent lumbar puncture. CSF samples were taken and divided in 2 parts for laboratory evaluation and rapid strip analysis. The sensitivity, specificity, positive predictive value and the negative predictive values of the reagent strips for the diagnosis of bacterial meningitis were calculated. Accuracy of the reagent strips was established using kappa statistics. Latex agglutination for antigen detection and microbiological culture were also done. Highly significant association was observed between CSF examination in routine laboratory method and dipstick method. The number of laboratory values that correlated were- for cells 71(94.63%), for protein 68 (90.67%), for glucose 68(90.67%) out of total 75 cases. The sensitivity and specificity of reagent strip in diagnosing acute bacterial meningitis were 96.7% and 97.8% respectively. The positive predictive and negative predictive values of reagent strip in diagnosing acute bacterial meningitis were 96.7% and 97.8% respectively. Staphylococcus aureus was found to be the most common organism isolated (50%). Thus reagent strip analysis is a very rapid, reliable and effective method for diagnosis of acute bacterial meningitis in children. Staphylococcus aureus was the most common organism isolated.

  11. Significance of Cystatin C for Early Diagnosis of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography.

    Science.gov (United States)

    Wang, Mian; Zhang, Li; Yue, Rongzheng; You, Guiying; Zeng, Rui

    2016-08-22

    BACKGROUND Contrast-induced nephropathy is acute kidney injury caused by contrast medium exposure. Serum creatinine is the clinical diagnostic standard, but it does not yield quick results. The serum level of cystatin C is stable and it can reflect renal function sensitively. The study aimed to assess the usefulness of cystatin C for early diagnosis of contrast-induced nephropathy in patients undergoing coronary angiography. MATERIAL AND METHODS We included 300 patients who underwent CAG. According to the sCr at 48 h, patients were divided into 2 groups: CIN group and non-CIN group. Their demographics and basal renal function were recorded. Changes in sCr, Cys C, and e GFR were compared at the same time. ROC analysis was used to assess the sensitivity and specificity of Cys C in the early diagnosis of CIN. RESULTS Comparison of basal renal function and serum level of Cys C showed no significant differences between the 2 groups. Serum level of Cys C increased significantly at 24 h (p<0.001), and sCr increased significantly at 48 h. ROC analysis showed that the AUC of the change in Cys C between baseline and 24 h was 0.936 (95% CI: 0.879-0.992, p=0.000) and the optimum cut-off level was 0.26 mg/L (sensitivity=89.7% and specificity=95.6%). CONCLUSIONS The concentration change of Cys C is better than sCr as a biomarker in the early detection of CIN.

  12. Identification of Apo-A1 as a biomarker for early diagnosis of bladder transitional cell carcinoma

    Directory of Open Access Journals (Sweden)

    Wang Shixin

    2011-04-01

    Full Text Available Abstract Background Bladder transitional cell carcinoma (BTCC is the fourth most frequent neoplasia in men, clinically characterized by high recurrent rates and poor prognosis. Availability of urinary tumor biomarkers represents a convenient alternative for early detection and disease surveillance because of its direct contact with the tumor and sample accessibility. Results We tested urine samples from healthy volunteers and patients with low malignant or aggressive BTCC to identify potential biomarkers for early detection of BTCC by two-dimensional electrophoresis (2-DE coupled with mass spectrometry (MS and bioinformatics analysis. We observed increased expression of five proteins, including fibrinogen (Fb, lactate dehydrogenase B (LDHB, apolipoprotein-A1 (Apo-A1, clusterin (CLU and haptoglobin (Hp, which were increased in urine samples of patients with low malignant or aggressive bladder cancer. Further analysis of urine samples of aggressive BTCC showed significant increase in Apo-A1 expression compared to low malignant BTCC. Apo-A1 level was measured quantitatively using enzyme-linked immunosorbent assay (ELISA and was suggested to provide diagnostic utility to distinguish patients with bladder cancer from controls at 18.22 ng/ml, and distinguish patients with low malignant BTCC from patients with aggressive BTCC in two-tie grading system at 29.86 ng/ml respectively. Further validation assay showed that Apo-A1 could be used as a biomarker to diagnosis BTCC with a sensitivity and specificity of 91.6% and 85.7% respectively, and classify BTCC in two-tie grading system with a sensitivity and specificity of 83.7% and 89.7% respectively. Conclusion Taken together, our findings suggest Apo-A1 could be a potential biomarker related with early diagnosis and classification in two-tie grading system for bladder cancer.

  13. Functional brain imaging in the dementias: role in early detection, differential diagnosis, and longitudinal studies

    Energy Technology Data Exchange (ETDEWEB)

    Devous, M.D. Sr. [Nuclear Medicine Center and Department of Radiology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX (United States)

    2002-12-01

    This review considers the role of functional brain imaging techniques in the dementias. The substantial assistance that especially single-photon emission tomography and positron emission tomography can play in the initial diagnosis of dementia and in the differential diagnosis of the specific dementing disorder is discussed. These techniques alone essentially match the sensitivity and specificity of clinical diagnoses in distinguishing Alzheimer's dementia (AD) from age-matched controls, from frontal lobe dementia and vascular dementia, and even from Lewy body dementia. Newer analytic techniques such as voxel-based correlational analyses and discriminant function analyses enhance the power of such differential diagnoses. Functional brain imaging techniques can also significantly assist in patient screening for clinical trials. The correlation of the observed deficits with specific patterns of cognitive abnormalities permits enhanced patient management and treatment planning and improved longitudinal assessment of outcome. It is also noteworthy that the classic abnormalities of temporoparietal and posterior cingulate hypoperfusion or hypometabolism appear to be present prior to symptom onset. These abnormalities predict progression to AD in the presence of the earliest of symptoms, and are present even in cognitively normal but at-risk subjects, with a severity proportional to the risk status. Even greater predictive ability for progression to AD is obtained by combining measures of perfusion or metabolism with risk factors, tau protein levels, hippocampal N-Acetyl aspartate concentrations, or hippocampal volume measures. (orig.)

  14. Application of conditionally replicating adenoviruses in tumor early diagnosis technology, gene-radiation therapy and chemotherapy.

    Science.gov (United States)

    Li, Shun; Ou, Mengting; Wang, Guixue; Tang, Liling

    2016-10-01

    Conditionally replicating adenoviruses (CRAds), or known as replication-selective adenoviruses, were discovered as oncolytic gene vectors several years ago. They have a strong ability of scavenging tumor and lesser toxicity to normal tissue. CRAds not only have a tumor-killing ability but also can combine with gene therapy, radiotherapy, and chemotherapy to induce tumor cell apoptosis. In this paper, we review the structure of CRAds and CRAd vectors and summarize the current application of CRAds in tumor detection as well as in radiotherapy and suicide gene-mediating chemotherapy. We also propose further research strategies that can improve the application value of CRAds, including enhancing tumor destruction effect, further reducing toxic effect, reducing immunogenicity, constructing CRAds that can target tumor stem cells, and trying to use mesenchymal stem cells (MSCs) as the carriers for oncolytic adenoviruses. As their importance to cancer diagnosis, gene-radiation, and chemotherapy, CRAds may play a considerable role in clinical diagnosis and various cancer treatments in the future.

  15. Serological monitoring of antibodies for an early diagnosis ofaspergillosis in captive penguins

    Directory of Open Access Journals (Sweden)

    Ângela L. Cabana

    2015-06-01

    Full Text Available Abstract: This study aimed to evaluate the efficacy of detection of anti-Aspergillus fumigatus antibodies in captive penguins by double radial agar gel immunodiffusion (AGID for the aspergillosis diagnosis. We included 134 Magellanic penguins (Spheniscus magellanicus in rehabilitation at the Center for Recovery of Marine Animals (CRAM / FURG. All of them were monitored by AGID weekly until its final destination (death or release, totalizing 660 serum samples studied. All animals were clinically accompanied and post-mortem examinations was performed in penguins that died during the studied period. A total of 28% (37/134 of the penguins died, 89.2% (33/37 due to aspergillosis, 11% (4/37 by other causes and 97 were released. From the 33 animals with proven aspergillosis, 21 presented anti- A. fumigatus antibodies by AGID, being the average interval between death and positive AGID 16.4 days. Twelve animals with negative serology died of aspergillosis. The sensitivity and specificity rates were 63.6% and 95% respectively, and the positive and negative predictive values were 80.7% and 88.9% respectively. These data demonstrate that the serological monitoring for detection of antibodies by AGID can be an important tool for the diagnosis of aspergillosis in penguins.

  16. Serum beta-2-Microglobulin level: A parameter for early diagnosis of renal allograft rejection

    Directory of Open Access Journals (Sweden)

    Rezai A

    1994-05-01

    Full Text Available For monitoring of renal transplant function, serum B2m was evaluated in 23 recipients. According to clinical diagnosis the patients were in four groups: 1 Successful renal transplant; the mean concentration of SB2m pretransplantation was 73.1±26.1 mg/L but decreased to nearly normal level (4.43±1.17 mg/L within 24-48h and then reached to 3.1 mg/L duting 20 days after transplantation. 2 Renal dysfunction (except rejection; the maximum changes of SB2m was 1.1 mg/L/day and no significant changes of SB2m were found between this group and group 1. 3 Accelerated and acute rejection; during immunological rejection crisis, SB2m level increased and after response to antirejection therapy decreased. The daily changes of SB2m allowed to diffrentiate renal dysfunction fom rejection in 84% of cases. Moreover according to SB2m fluctuation levels, SB2m had a prognostic pattern for acute rejection due to significant differences between the level of SB2m on the day of clinical diagnosis of rejection and 4 days previously (P<0.025, and also 2 days before rejection (P<0.025, while this pattern was not found for serum creatinin and BUN.