78 FR 69839 - DOE/NSF High Energy Physics Advisory Panel

Science.gov (United States)

2013-11-21

... DEPARTMENT OF ENERGY DOE/NSF High Energy Physics Advisory Panel AGENCY: Department of Energy.../NSF High Energy Physics Advisory Panel (HEPAP). The Federal Advisory Committee Act (Pub. L. 92-463, 86... CONTACT: John Kogut, Executive Secretary; High Energy Physics Advisory Panel; U.S. Department of Energy...

75 FR 57463 - DOE/NSF High Energy Physics Advisory Panel

Science.gov (United States)

2010-09-21

... DEPARTMENT OF ENERGY DOE/NSF High Energy Physics Advisory Panel AGENCY: Department of Energy.../NSF High Energy Physics Advisory Panel (HEPAP). Federal Advisory Committee Act (Pub. L. 92-463, 86... Secretary; High Energy Physics Advisory Panel; U.S. Department of Energy; SC-25/ Germantown Building, 1000...

77 FR 4027 - DOE/NSF High Energy Physics Advisory Panel

Science.gov (United States)

2012-01-26

... DEPARTMENT OF ENERGY DOE/NSF High Energy Physics Advisory Panel AGENCY: Department of Energy.../NSF High Energy Physics Advisory Panel (HEPAP). The Federal Advisory Committee Act (Pub. L. 92-463, 86... Secretary; High Energy Physics Advisory Panel; U.S. Department of Energy; SC-25/ Germantown Building, 1000...

76 FR 41234 - DOE/NSF High Energy Physics Advisory Panel

Science.gov (United States)

2011-07-13

... DEPARTMENT OF ENERGY DOE/NSF High Energy Physics Advisory Panel AGENCY: Department of Energy.../NSF High Energy Physics Advisory Panel (HEPAP). The Federal Advisory Committee Act (Pub. L. 92-463, 86... Secretary; High Energy Physics Advisory Panel; U.S. Department of Energy; SC-25/ Germantown Building, 1000...

76 FR 8358 - DOE/NSF High Energy Physics Advisory Panel

Science.gov (United States)

2011-02-14

... DEPARTMENT OF ENERGY DOE/NSF High Energy Physics Advisory Panel AGENCY: Department of Energy.../NSF High Energy Physics Advisory Panel (HEPAP). Federal Advisory Committee Act (Pub. L. 92-463, 86... Secretary; High Energy Physics Advisory Panel; U.S. Department of Energy; SC-25/ Germantown Building, 1000...

Extracellular Gd-CA: Differences in prevalence of NSF

International Nuclear Information System (INIS)

Thomsen, Henrik S.; Marckmann, Peter

2008-01-01

Until recently it was believed that extracellular gadolinium-based contrast agents were safe for both the kidneys and all other organs within the dose range up to 0.3 mmol/kg body weight. However, in 2006, it was demonstrated that some gadolinium-based contrast agents may trig the development of nephrogenic systemic fibrosis, a generalized fibrotic disorder, in renal failure patients. As no prospective studies can be performed we must rely on retrospective data. From those data it is obvious that the prevalence of NSF is significantly higher after the unstable agent gadodiamide than after any other gadolinium-based agent (3-7% versus 0-1% per injection) in patients with reduced renal function. Prevalence after exposure to two gadodiamide injections is as high as 36% in patients with chronic kidney disease (CKD) stage 5. No report of NSF after the most stable agents has been reported in the peer-reviewed literature documenting that there is a difference between the various agents regarding triggering NSF

45 CFR 689.5 - Initial NSF handling of misconduct matters.

Science.gov (United States)

2010-10-01

... regulation. (c) If OIG determines that alleged research misconduct involves potential civil or criminal... FOUNDATION RESEARCH MISCONDUCT § 689.5 Initial NSF handling of misconduct matters. (a) NSF staff who learn of... awardee institution of the alleged research misconduct and encourage it to undertake an inquiry; (2) Defer...

Cugini's syndrome: its clinical history and diagnosis

Directory of Open Access Journals (Sweden)

Laura Gasbarrone

2013-09-01

Full Text Available INTRODUCTION: This article deals with the description and diagnosis of a new nosographic syndrome, which received the eponym of "Cugini's syndrome" by the name of the Author who discovered its clinical picture. This syndrome is characterized by the binomial: "minimal target organ damage associated to monitoring prehypertension". CLINICAL HISTORY AND DIAGNOSIS: Between the years 1997 and 2002, the Author published a series of investigations regarding some office normotensives who inexplicably showed incipient signs of target organ damage (TOD. Investigated via ambulatory (A blood (B pressure (P monitoring (M, these subjects were surprisingly found not to be hypertensive. Neverthless, the office normotensives with TOD exibited the daily mean level of their systolic (S and diastolic (D BP (DML SBP/DBP significantly more elevated as compared to true normotensives. Because of these ABPM findings, the Author realized that the investigated subjects were false normotensives whose TOD was associated with a monitoring prehypertension (ABPM-diagnosable prehypertension alias monitoring prehypertension alias masked prehypertension. The year after the last Cugini's investigation, the INC-7 Reports introduced the term: "prehypertension" in its classification of arterial hypertension, as an office sphygmomanometric condition in between office normotension and office hypertension. The ABPM cut-off upper limits for a differential diagnosis between monitoring normotension, prehypertension and hypertension are reported, as calculated by the Author in its collection of ABPMs. The eponym of "Cugini's syndrome" was assigned in 2007 and confirmed in 2009. CONCLUSIVE REMARKS: The monitoring prehypertension is a further condition of discrepancy between office sphygmomanometry and ABPM, as per a masked prehypertension, whose diagnosis has to be immediately diagnosed, for preventing the onset of a TOD. There are reported the present investigations dealing with the possible

From the NSF: The National Science Foundation’s Investments in Broadening Participation in Science, Technology, Engineering, and Mathematics Education through Research and Capacity Building

Science.gov (United States)

James, Sylvia M.; Singer, Susan R.

2016-01-01

The National Science Foundation (NSF) has a long history of investment in broadening participation (BP) in science, technology, engineering, and mathematics (STEM) education. A review of past NSF BP efforts provides insights into how the portfolio of programs and activities has evolved and the broad array of innovative strategies that has been used to increase the participation of groups underrepresented in STEM, including women, minorities, and persons with disabilities. While many are familiar with these long-standing programmatic efforts, BP is also a key component of NSF’s strategic plans, has been highlighted in National Science Board reports, and is the focus of ongoing outreach efforts. The majority of familiar BP programs, such as the Louis Stokes Alliances for Minority Participation (now 25 years old), are housed in the Directorate for Education and Human Resources. However, fellowship programs such as the Graduate Research Fellowships and Postdoctoral Research Fellowships under the Directorate for Biological Sciences (and parallel directorates in other STEM disciplines) are frequently used to address underrepresentation in STEM disciplines. The FY2016 and FY2017 budget requests incorporate funding for NSF INCLUDES, a new cross-agency BP initiative that will build on prior successes while addressing national BP challenges. NSF INCLUDES invites the use of innovative approaches for taking evidence-based best practices to scale, ushering in a new era in NSF BP advancement. PMID:27587853

Effect of criminal defendant's history of childhood sexual abuse and personality disorder diagnosis on juror decision making.

Science.gov (United States)

Butler, Ebony; Jacquin, Kristine

2014-08-01

This study investigated whether a defendant's history of childhood sexual abuse (CSA) and/or personality disorder (PD) diagnosis affected juror decision making in a child sexual abuse trial. The PDs in the study were borderline PD and antisocial PD. Participants were 385 college students, 121 men and 264 women, who read a summary of a mock criminal trial and then made various juror decisions. Trial summaries were prepared by the principal investigator and were all uniform in content, length and detail. For the trial, both the defendant's gender and victim's gender were specified. The defendant was male, and the alleged victim was female. When the verdict was assessed, the results yielded that when the defendant's CSA history was presented, juror guilt ratings were higher than when there was no history of CSA. Similarly, when the defendant had a PD diagnosis, there were higher guilt ratings than when there was no PD diagnosis. CSA history and PD diagnosis were significant predictors of guilt ratings, suggesting that jurors perceive defendants more negatively if they have either been sexually abused as a child or have borderline or antisocial PD. Copyright © 2014 John Wiley & Sons, Ltd.

NSF-Sponsored Biological and Chemical Oceanography Data Management Office

Science.gov (United States)

Allison, M. D.; Chandler, C. L.; Copley, N.; Galvarino, C.; Gegg, S. R.; Glover, D. M.; Groman, R. C.; Wiebe, P. H.; Work, T. T.; Biological; Chemical Oceanography Data Management Office

2010-12-01

Ocean biogeochemistry and marine ecosystem research projects are inherently interdisciplinary and benefit from improved access to well-documented data. Improved data sharing practices are important to the continued exploration of research themes that are a central focus of the ocean science community and are essential to interdisciplinary and international collaborations that address complex, global research themes. In 2006, the National Science Foundation Division of Ocean Sciences (NSF OCE) funded the Biological and Chemical Oceanography Data Management Office (BCO-DMO) to serve the data management requirements of scientific investigators funded by the National Science Foundation’s Biological and Chemical Oceanography Sections. BCO-DMO staff members work with investigators to manage marine biogeochemical, ecological, and oceanographic data and information developed in the course of scientific research. These valuable data sets are documented, stored, disseminated, and protected over short and intermediate time frames. One of the goals of the BCO-DMO is to facilitate regional, national, and international data and information exchange through improved data discovery, access, display, downloading, and interoperability. In May 2010, NSF released a statement to the effect that in October 2010, it is planning to require that all proposals include a data management plan in the form of a two-page supplementary document. The data management plan would be an element of the merit review process. NSF has long been committed to making data from NSF-funded research publicly available and the new policy will strengthen this commitment. BCO-DMO is poised to assist in creating the data management plans and in ultimately serving the data and information resulting from NSF OCE funded research. We will present an overview of the data management system capabilities including: geospatial and text-based data discovery and access systems; recent enhancements to data search tools; data

Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods.

Science.gov (United States)

Rodriguez, C; Van Broeck, J; Taminiau, B; Delmée, M; Daube, G

2016-08-01

Recognised as the leading cause of nosocomial antibiotic-associated diarrhoea, the incidence of Clostridium difficile infection (CDI) remains high despite efforts to improve prevention and reduce the spread of the bacterium in healthcare settings. In the last decade, many studies have focused on the epidemiology and rapid diagnosis of CDI. In addition, different typing methods have been developed for epidemiological studies. This review explores the history of C. difficile and the current scope of the infection. The variety of available laboratory tests for CDI diagnosis and strain typing methods are also examined. Copyright © 2016 Elsevier Ltd. All rights reserved.

CAREER opportunities at the Condensed Matter Physics Program, NSF/DMR

Science.gov (United States)

Durakiewicz, Tomasz

The Faculty Early Career Development (CAREER) Program is a Foundation-wide activity, offering prestigious awards in support of junior faculty. Awards are expected to build the careers of teacher-scholars through outstanding research, excellent education and the integration of education and research. Condensed Matter Physics Program receives between 35 and 45 CAREER proposals each year, in areas related to fundamental research of phenomena exhibited by condensed matter systems. Proposal processing, merit review process, funding levels and success rates will be discussed in the presentation. NSF encourages submission of CAREER proposals from junior faculty members from CAREER-eligible organizations and encourages women, members of underrepresented minority groups, and persons with disabilities to apply. NSF/DMR/CMP homepage: https://www.nsf.gov/funding/pgm_summ.jsp?pims_id=5666

NSF Support for Physics at the Undergraduate Level: A View from Inside

Science.gov (United States)

McBride, Duncan

2015-03-01

NSF has supported a wide range of projects in physics that involve undergraduate students. These projects include NSF research grants in which undergraduates participate; Research Experiences for Undergraduates (REU) centers and supplements; and education grants that range from upper-division labs that may include research, to curriculum development for upper- and lower-level courses and labs, to courses for non-majors, to Physics Education Research (PER). The NSF Divisions of Physics, Materials Research, and Astronomy provide most of the disciplinary research support, with some from other parts of NSF. I recently retired as the permanent physicist in NSF's Division of Undergraduate Education (DUE), which supports the education grants. I was responsible for a majority of DUE's physics grants and was involved with others overseen by a series of physics rotators. There I worked in programs entitled Instrumentation and Laboratory Improvement (ILI); Course and Curriculum Development (CCD); Course, Curriculum, and Laboratory Improvement (CCLI); Transforming Undergraduate STEM Education (TUES); and Improving Undergraduate STEM Education (IUSE). NSF support has enabled physics Principal Investigators to change and improve substantially the way physics is taught and the way students learn physics. The most important changes are increased undergraduate participation in physics research; more teaching using interactive engagement methods in classes; and growth of PER as a legitimate field of physics research as well as outcomes from PER that guide physics teaching. In turn these have led, along with other factors, to students who are better-prepared for graduate school and work, and to increases in the number of undergraduate physics majors. In addition, students in disciplines that physics directly supports, notably engineering and chemistry, and increasingly biology, are better and more broadly prepared to use their physics education in these fields. I will describe NSF

45 CFR 680.11 - Staff involvement with NSF proposals and awards.

Science.gov (United States)

2010-10-01

... teaching careers to spend a year or two at NSF and then return to research and teaching, usually at the... SCIENCE FOUNDATION NATIONAL SCIENCE FOUNDATION RULES OF PRACTICE AND STATUTORY CONFLICT-OF-INTEREST EXEMPTIONS Rules of Practice for the National Science Foundation § 680.11 Staff involvement with NSF...

From the NSF: The National Science Foundation's Investments in Broadening Participation in Science, Technology, Engineering, and Mathematics Education through Research and Capacity Building.

Science.gov (United States)

James, Sylvia M; Singer, Susan R

The National Science Foundation (NSF) has a long history of investment in broadening participation (BP) in science, technology, engineering, and mathematics (STEM) education. A review of past NSF BP efforts provides insights into how the portfolio of programs and activities has evolved and the broad array of innovative strategies that has been used to increase the participation of groups underrepresented in STEM, including women, minorities, and persons with disabilities. While many are familiar with these long-standing programmatic efforts, BP is also a key component of NSF's strategic plans, has been highlighted in National Science Board reports, and is the focus of ongoing outreach efforts. The majority of familiar BP programs, such as the Louis Stokes Alliances for Minority Participation (now 25 years old), are housed in the Directorate for Education and Human Resources. However, fellowship programs such as the Graduate Research Fellowships and Postdoctoral Research Fellowships under the Directorate for Biological Sciences (and parallel directorates in other STEM disciplines) are frequently used to address underrepresentation in STEM disciplines. The FY2016 and FY2017 budget requests incorporate funding for NSF INCLUDES, a new cross-agency BP initiative that will build on prior successes while addressing national BP challenges. NSF INCLUDES invites the use of innovative approaches for taking evidence-based best practices to scale, ushering in a new era in NSF BP advancement. © 2016 S. M. James and S. R. Singer. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Linking the GLOBE Program With NASA and NSF Large-Scale Experiments

Science.gov (United States)

Filmer, P. E.

2005-12-01

NASA and the NSF, the sponsoring Federal agencies for the GLOBE Program, are seeking the participation of science teams who are working at the cutting edge of Earth systems science in large integrated Earth systems science programs. Connecting the GLOBE concept and structure with NASA and NSF's leading Earth systems science programs will give GLOBE schools and students access to top scientists, and expose them to programs that have been designated as scientific priorities. Students, teachers, parents, and their communities will be able to see how scientists of many disciplines work together to learn about the Earth system. The GLOBE solicitation released by the NSF targets partnerships between GLOBE and NSF/NASA-funded integrated Earth systems science programs. This presentation will focus on the goals and requirements of the NSF solicitation. Proponents will be expected to provide ways for the GLOBE community to interact with a group of scientists from their science programs as part of a wider joint Earth systems science educational strategy (the sponsoring agencies', GLOBE's, and the proposing programs'). Teams proposing to this solicitation must demonstrate: - A focus on direct connections with major NSF Geosciences and/or Polar Programs and/or NASA Earth-Sun research programs that are related to Earth systems science; - A demonstrable benefit to GLOBE and to NSF Geosciences and/or Polar Programs or NASA Earth-Sun education goals (providing access to program researchers and data, working with GLOBE in setting up campaigns where possible, using tested GLOBE or non-GLOBE protocols to the greatest extent possible, actively participating in the wider GLOBE community including schools, among other goals); - An international component; - How the existing educational efforts of the large science program will coordinate with GLOBE; - An Earth systems science education focus, rather than a GLOBE protocol-support focus; - A rigorous evaluation and assessment component

HIV Positive Diagnosis During Pregnancy Increases Risk of IPV Postpartum Among Women with No History of IPV in Their Relationship.

Science.gov (United States)

Groves, Allison K; Reyes, H Luz McNaughton; Moodley, Dhayendre; Maman, Suzanne

2017-07-24

There has been limited study of whether and for whom physical intimate partner violence (IPV) is a consequence of an HIV-positive diagnosis. Per the diathesis stress model, the consequences of HIV infection may be worse for women with a history of IPV. We hypothesize that the positive association between HIV diagnosis in pregnancy and postpartum IPV will be exacerbated for women with a history of IPV. Data come from a prospective cohort study with 1015 participants who completed a baseline antenatal and 9-month postpartum visit. Using logistic regression analyses, we found a statistically significant interaction between HIV diagnosis, history of IPV and postpartum IPV (AOR: 0.40, 95% CI 0.17-0.96). The findings were in the opposite direction as expected: HIV-diagnosis was not associated with IPV for women with a history of IPV (AOR: 2.17, 95% CI 1.06, 4.42). However, HIV-positive women without a history of IPV faced more than two times the risk of incident postpartum IPV than HIV-negative women (AOR: 2.17, 95% CI 1.06, 4.42). Interventions to reduce incident and ongoing IPV during the perinatal period are needed.

Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests

Science.gov (United States)

Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-01-01

Objective To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Design Prospective diagnostic study. Settings Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Participants Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Interventions Not applicable. Main outcome measures History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians’ composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Results Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0–92.5). Combining a history of trauma during a pivot with a “popping” sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6–17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8–31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR

Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests.

Science.gov (United States)

Décary, Simon; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-01-01

To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Prospective diagnostic study. Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Not applicable. History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians' composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0-92.5). Combining a history of trauma during a pivot with a "popping" sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6-17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8-31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03-0.24). Diagnostic clusters combining history elements and physical

21st Century Kinematics : The 2012 NSF Workshop

CERN Document Server

2013-01-01

21st Century Kinematics focuses on algebraic problems in the analysis and synthesis of mechanisms and robots, compliant mechanisms, cable-driven systems and protein kinematics. The specialist contributors provide the background for a series of presentations at the 2012 NSF Workshop. The text shows how the analysis and design of innovative mechanical systems yield increasingly complex systems of polynomials, characteristic of those systems. In doing so, takes advantage of increasingly sophisticated computational tools developed for numerical algebraic geometry and demonstrates the now routine derivation of polynomial systems dwarfing the landmark problems of even the recent past. The 21st Century Kinematics workshop echoes the NSF-supported 1963 Yale Mechanisms Teachers Conference that taught a generation of university educators the fundamental principles of kinematic theory. As such these proceedings will be provide admirable supporting theory for a graduate course in modern kinematics and should be of consid...

NSF Obligations for Top 200 Institutions by Fiscal Year

Data.gov (United States)

National Science Foundation — An text/xml file containing FY 2001 through FY 2015 National Science Foundation (NSF) obligations by institution for the top 200 recipients defined in terms of total...

Association of parental history of type 2 diabetes with age, lifestyle, anthropometric factors, and clinical severity at type 2 diabetes diagnosis

DEFF Research Database (Denmark)

Svensson, Elisabeth; Berencsi, Klara; Sander, Simone

2016-01-01

in Type 2 Diabetes cohort. We examined the prevalence ratios (PR) of demographic, lifestyle, anthropometric, and clinical factors according to parental history, using Poisson regression adjusting for age and gender. RESULTS: Of 2825 T2D patients, 34% (n = 964) had a parental history of T2D. Parental......BACKGROUND: We investigated whether parental history of type 2 diabetes mellitus (T2D) is associated with age, lifestyle, anthropometric factors, and clinical severity at the time of T2D diagnosis. METHODS: We conducted a cross-sectional study based on the Danish Centre for Strategic Research...... history was associated with younger age at diagnosis [adjusted (a)PR 1.66, 95% confidence interval: 1.19, 2.31) for age

Nephrogenic systemic fibrosis (NSF) and gadolinium-based contrast ...

African Journals Online (AJOL)

Nephrogenic systemic fibrosis (NSF), unknown before March 1997 and first described in 2000, is a systemic disorder characterised by widespread tissue fibrosis. The first known case occurred in 1997, after the use of gadolinium-based contrast agents (GBCAs) at high doses in patients with renal failure had become routine.

The development of a standardised diet history tool to support the diagnosis of food allergy

NARCIS (Netherlands)

Skypala, Isabel J.; Venter, Carina; Meyer, Rosan; deJong, Nicolette W.; Fox, Adam T.; Groetch, Marion; Oude Elberink, J. N.; Sprikkelman, Aline; Diamandi, Louiza; Vlieg-Boerstra, Berber J.

2015-01-01

The disparity between reported and diagnosed food allergy makes robust diagnosis imperative. The allergy-focussed history is an important starting point, but published literature on its efficacy is sparse. Using a structured approach to connect symptoms, suspected foods and dietary intake, a

Feelings of Women With Strong Family Histories Who Subsequent to Their Breast Cancer Diagnosis Tested BRCA Positive.

Science.gov (United States)

Joseph, Meera; Rab, Faiza; Panabaker, Karen; Nisker, Jeff

2015-05-01

Family physicians in Canada as reported in several studies do not recognize the importance of family history in relation to breast/ovarian cancer and thus Canadian women with strong family histories continue to develop early-onset breast cancer without the knowledge of or ability to make choices regarding increased surveillance or preventative strategies. This study explored the feelings of women who learned about their hereditary risk only after their diagnosis younger than 52 years and who eventually tested positive for a BRCA gene mutation. Thirty-four such women were mailed an invitation to participate in this research including a letter of information, consent form, and discussion prompts for their written narrative response. Rigorous mixed method analyses were performed using Charmaz-based qualitative analyses as well as quantitative analyses. Thirteen women (38.2%) responded with narratives for qualitative analysis from which 4 themes were coconstructed as follows: I, types of emotions; II, emotional response; III, coping with emotions; and IV, advice to women at similar risk. Women felt they should have learned about their hereditary risk from their family physician and through public education before their diagnosis. Although not experienced at the time of diagnosis, anger, frustration, and regret were experienced after receiving their BRCA results. These emotions arose from our research participants' lack of opportunity for prior genetic counseling and testing opportunity for genetic counseling and testing. With increased public and physician education, it is hoped that women with significant family histories of breast/ovarian cancer will be identified before diagnosis and given options regarding cancer surveillance and risk reduction strategies.

Diagnosis, natural history, and management in vascular Ehlers-Danlos syndrome.

Science.gov (United States)

Byers, Peter H; Belmont, John; Black, James; De Backer, Julie; Frank, Michael; Jeunemaitre, Xavier; Johnson, Diana; Pepin, Melanie; Robert, Leema; Sanders, Lynn; Wheeldon, Nigel

2017-03-01

Vascular Ehlers Danlos syndrome (vEDS) is an uncommon genetic disorders characterized by arterial aneurysm, dissection and rupture, bowel rupture, and rupture of the gravid uterus. The frequency is estimated as 1/50,000-1/200,000 and results from pathogenic variants in COL3A1, which encodes the chains of type III procollagen, a major protein in vessel walls and hollow organs. Initial diagnosis depends on the recognitions of clinical features, including family history. Management is complex and requires multiple specialists who can respond to and manage the major complications. A summary of recommendations for management include: Identify causative variants in COL3A1 prior to application of diagnosis, modulate life style to minimize injury, risk of vessel/organ rupture, identify and create care team, provide individual plans for emergency care ("vascular EDS passport") with diagnosis and management plan for use when traveling, centralize management at centers of excellence (experience) when feasible, maintain blood pressure in the normal range and treat hypertension aggressively, surveillance of vascular tree by doppler ultrasound, CTA (low radiation alternatives) or MRA if feasible on an annual basis. These recommendations represent a consensus of an international group of specialists with a broad aggregate experience in the care of individuals with vascular EDS that will need to be assessed on a regular basis as new information develops. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

NSF's Perspective on Space Weather Research for Building Forecasting Capabilities

Science.gov (United States)

Bisi, M. M.; Pulkkinen, A. A.; Bisi, M. M.; Pulkkinen, A. A.; Webb, D. F.; Oughton, E. J.; Azeem, S. I.

2017-12-01

Space weather research at the National Science Foundation (NSF) is focused on scientific discovery and on deepening knowledge of the Sun-Geospace system. The process of maturation of knowledge base is a requirement for the development of improved space weather forecast models and for the accurate assessment of potential mitigation strategies. Progress in space weather forecasting requires advancing in-depth understanding of the underlying physical processes, developing better instrumentation and measurement techniques, and capturing the advancements in understanding in large-scale physics based models that span the entire chain of events from the Sun to the Earth. This presentation will provide an overview of current and planned programs pertaining to space weather research at NSF and discuss the recommendations of the Geospace Section portfolio review panel within the context of space weather forecasting capabilities.

Was Queen Victoria depressed? 1. Natural history and differential diagnosis of presenting problem.

Science.gov (United States)

Powles, W E; Alexander, M G

1987-02-01

For some years we have speculated as to whether Queen Victoria suffered a definable psychiatric illness in her notorious and prolonged seclusion after the Prince Consort's death. We here summarize criteria for grief and depression from three authorities. Against these, we examine the natural history of the Queen's bereavement and restitution. We find that her suffering and her portrayal of the role of widow were related to her personal style and were culturally accepted. Her self-esteem, ego functions, and object relatedness were preserved. While some clinicians might favour a diagnosis of Dysthymic Disorder, we find the evidence strongly in favour of an intense, prolonged, normal human grief (Uncomplicated Bereavement of DSM III) coloured by a romantic and histrionic personal style. Intensity and duration do not, in this case, establish a diagnosis of depression.

The NSF Cybersecurity Center of Excellence: Translating Identity Management and Cybersecurity into Scientific Collaboration

Science.gov (United States)

Welch, V.

2016-12-01

Scientists care deeply about their collaborations: who is a member, who can access, produce, and correct data, and manager instruments critical to their science missions. The communities of cybersecurity and identity management professionals develop tools to support collaborations and the undertaking of trustworthy science, but there are large cultural and linguistic gaps between these communities and the scientists they service. The National Science Foundation has recently funded a NSF Cybersecurity Center of Excellence to help its community of projects by providing leadership and addressing the challenges of trustworthy science. A key goal of this NSF Center has been translating between the goals of the science community into requirements and risks understood by identity management and cybersecurity communities. This talk will give an update on the Center's efforts and other services it provides to the NSF community to bridge these cultures.

Global nanotechnology development from 1991 to 2012: patents, scientific publications, and effect of NSF funding

Energy Technology Data Exchange (ETDEWEB)

Chen, Hsinchun [The University of Arizona, Department of Management Information Systems (United States); Roco, Mihail C. [National Science Foundation (United States); Son, Jaebong; Jiang, Shan, E-mail: jiangs@email.arizona.edu; Larson, Catherine A.; Gao, Qiang [The University of Arizona, Department of Management Information Systems (United States)

2013-09-15

In a relatively short interval for an emerging technology, nanotechnology has made a significant economic impact in numerous sectors including semiconductor manufacturing, catalysts, medicine, agriculture, and energy production. A part of the United States (US) government investment in basic research has been realized in the last two decades through the National Science Foundation (NSF), beginning with the nanoparticle research initiative in 1991 and continuing with support from the National Nanotechnology Initiative after fiscal year 2001. This paper has two main goals: (a) present a longitudinal analysis of the global nanotechnology development as reflected in the United States Patent and Trade Office (USPTO) patents and Web of Science (WoS) publications in nanoscale science and engineering (NSE) for the interval 1991-2012; and (b) identify the effect of basic research funded by NSF on both indicators. The interval has been separated into three parts for comparison purposes: 1991-2000, 2001-2010, and 2011-2012. The global trends of patents and scientific publications are presented. Bibliometric analysis, topic analysis, and citation network analysis methods are used to rank countries, institutions, technology subfields, and inventors contributing to nanotechnology development. We then, examined how these entities were affected by NSF funding and how they evolved over the past two decades. Results show that dedicated NSF funding used to support nanotechnology R and D was followed by an increased number of relevant patents and scientific publications, a greater diversity of technology topics, and a significant increase of citations. The NSF played important roles in the inventor community and served as a major contributor to numerous nanotechnology subfields.

77 FR 64799 - DOE/NSF High Energy Physics Advisory Panel

Science.gov (United States)

2012-10-23

... DEPARTMENT OF ENERGY DOE/NSF High Energy Physics Advisory Panel AGENCY: Department of Energy... Physics Advisory Panel (HEPAP). Federal Advisory Committee Act (Pub. L. 92-463, 86 Stat. 770) requires... Kogut, Executive Secretary; High Energy Physics Advisory Panel; U.S. Department of Energy; SC-25...

78 FR 46330 - DOE/NSF High Energy Physics Advisory Panel

Science.gov (United States)

2013-07-31

... DEPARTMENT OF ENERGY DOE/NSF High Energy Physics Advisory Panel AGENCY: Office of Science... High Energy Physics Advisory Panel (HEPAP). Federal Advisory Committee Act (Pub. L. 92-463, 86 Stat... CONTACT: John Kogut, Executive Secretary; High Energy Physics Advisory Panel; U.S. Department of Energy...

Advancing Capabilities for Understanding the Earth System Through Intelligent Systems, the NSF Perspective

Science.gov (United States)

Gil, Y.; Zanzerkia, E. E.; Munoz-Avila, H.

2015-12-01

The National Science Foundation (NSF) Directorate for Geosciences (GEO) and Directorate for Computer and Information Science (CISE) acknowledge the significant scientific challenges required to understand the fundamental processes of the Earth system, within the atmospheric and geospace, Earth, ocean and polar sciences, and across those boundaries. A broad view of the opportunities and directions for GEO are described in the report "Dynamic Earth: GEO imperative and Frontiers 2015-2020." Many of the aspects of geosciences research, highlighted both in this document and other community grand challenges, pose novel problems for researchers in intelligent systems. Geosciences research will require solutions for data-intensive science, advanced computational capabilities, and transformative concepts for visualizing, using, analyzing and understanding geo phenomena and data. Opportunities for the scientific community to engage in addressing these challenges are available and being developed through NSF's portfolio of investments and activities. The NSF-wide initiative, Cyberinfrastructure Framework for 21st Century Science and Engineering (CIF21), looks to accelerate research and education through new capabilities in data, computation, software and other aspects of cyberinfrastructure. EarthCube, a joint program between GEO and the Advanced Cyberinfrastructure Division, aims to create a well-connected and facile environment to share data and knowledge in an open, transparent, and inclusive manner, thus accelerating our ability to understand and predict the Earth system. EarthCube's mission opens an opportunity for collaborative research on novel information systems enhancing and supporting geosciences research efforts. NSF encourages true, collaborative partnerships between scientists in computer sciences and the geosciences to meet these challenges.

Using curriculum vitae to compare some impacts of NSF research grants with research center funding

OpenAIRE

Monica Gaughan; Barry Bozeman

2002-01-01

While traditional grants remain central in US federal support of academic scientists and engineers, the role of multidisciplinary NSF Centers is growing. Little is known about how funding through these Centers affects scientific output or (as is an NSF aim) increases academic collaboration with industry. This paper tests the use of CVs to examine how Center funding affects researchers' publication rates and their obtaining industry grants. Copyright , Beech Tree Publishing.

78 FR 12043 - DOE/NSF High Energy Physics Advisory Panel

Science.gov (United States)

2013-02-21

... DEPARTMENT OF ENERGY DOE/NSF High Energy Physics Advisory Panel AGENCY: Office of Science... High Energy Physics Advisory Panel (HEPAP). The Federal Advisory Committee Act (Pub. L. 92-463, 86 Stat... INFORMATION CONTACT: John Kogut, Executive Secretary; High Energy Physics Advisory Panel; U.S. Department of...

77 FR 33449 - DOE/NSF High Energy Physics Advisory Panel

Science.gov (United States)

2012-06-06

... DEPARTMENT OF ENERGY DOE/NSF High Energy Physics Advisory Panel AGENCY: Office of Science... High Energy Physics Advisory Panel (HEPAP). The Federal Advisory Committee Act (Pub. L. 92-463, 86 Stat..., Executive Secretary; High Energy Physics Advisory Panel; U.S. Department of Energy; SC-25/ Germantown...

Global nanotechnology development from 1991 to 2012: patents, scientific publications, and effect of NSF funding

International Nuclear Information System (INIS)

Chen, Hsinchun; Roco, Mihail C.; Son, Jaebong; Jiang, Shan; Larson, Catherine A.; Gao, Qiang

2013-01-01

In a relatively short interval for an emerging technology, nanotechnology has made a significant economic impact in numerous sectors including semiconductor manufacturing, catalysts, medicine, agriculture, and energy production. A part of the United States (US) government investment in basic research has been realized in the last two decades through the National Science Foundation (NSF), beginning with the nanoparticle research initiative in 1991 and continuing with support from the National Nanotechnology Initiative after fiscal year 2001. This paper has two main goals: (a) present a longitudinal analysis of the global nanotechnology development as reflected in the United States Patent and Trade Office (USPTO) patents and Web of Science (WoS) publications in nanoscale science and engineering (NSE) for the interval 1991–2012; and (b) identify the effect of basic research funded by NSF on both indicators. The interval has been separated into three parts for comparison purposes: 1991–2000, 2001–2010, and 2011–2012. The global trends of patents and scientific publications are presented. Bibliometric analysis, topic analysis, and citation network analysis methods are used to rank countries, institutions, technology subfields, and inventors contributing to nanotechnology development. We then, examined how these entities were affected by NSF funding and how they evolved over the past two decades. Results show that dedicated NSF funding used to support nanotechnology R and D was followed by an increased number of relevant patents and scientific publications, a greater diversity of technology topics, and a significant increase of citations. The NSF played important roles in the inventor community and served as a major contributor to numerous nanotechnology subfields

Trauma history is associated with prior suicide attempt history in hospitalized patients with major depressive disorder.

Science.gov (United States)

Brown, Lily A; Armey, Michael A; Sejourne, Corinne; Miller, Ivan W; Weinstock, Lauren M

2016-09-30

Although the relationships between PTSD, abuse history, and suicidal behaviors are well-established in military and outpatient samples, little data is available on this relationship in inpatient samples. This study examines the relationships between these variables and related demographic and clinical correlates in a sample of psychiatric inpatients with a diagnosis of major depressive disorder using electronic medical record (EMR) data. Controlling for relevant demographic and clinical variables, PTSD diagnosis and history of abuse were both significantly associated with history of suicide attempt, but in a combined model, only history of abuse remained as a significant predictor. Whereas history of abuse was associated with a history multiple suicide attempts, PTSD diagnosis was not. Both insurance status and gender acted as significant moderators of the relationship between history of abuse and history of suicide attempt, with males and those with public/no insurance having greater associations with history of suicide attempts when an abuse history was present. These data indicate the importance of documentation of PTSD, abuse history, and history of suicide attempts. The results also suggest that in the presence of an abuse history or PTSD diagnosis, additional time spent on safety and aftercare planning following hospital discharge may be indicated. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The SC State NSF PAARE Program

Science.gov (United States)

Walter, Donald; Ajello, Marco; Brittain, Sean; Cash, Jennifer; Fogle, Bryan; Hartmann, Dieter; Ho, Shirley; Howell, Steve; King, Jeremy; Leising, Mark; Smith, Daniel

2018-01-01

We report on the activities of our NSF PAARE program during Year 3 of the project. Our partnership under this award includes South Carolina State University (a Historically Black College/University), Clemson University (a Ph.D. granting institution) and individual investigators at NASA Ames and elsewhere. Our partnership with the Citizen CATE Experiment and involvement in the total solar eclipse which passed through our campus on August 21, 2017, will be discussed. The PAARE project continues to strengthen our partnership with Clemson. We are close to completing a memorandum of agreement between the two institutions that will allow for the seamless transfer of an undergraduate from SC State to Clemson’s graduate program in physics and astronomy. Additionally, we have worked together under the Citizen CATE project and through other research activities. SC State is a member of the National Astronomy Consortium (NAC) and participates through its faculty and undergraduates, one of whom (Wesley Red) is reporting on his summer internship at this conference. We also served as the state coordinator for South Carolina for the Citizen CATE Experiment. The August 21st path of totality crossed through our campus and the campus of our partner Clemson University. Additional colleges, universities and citizen scientist groups partnered with us to provide 7 sites of coverage across South Carolina from the foothills of the Appalachian mountains to the Atlantic Ocean near the site of departure of the shadow from the continental U.S. Support for this work includes our NSF PAARE award AST-1358913 as well as resources and support provided by Clemson University and the National Optical Astronomy Observatory. CATE work has been supported by NASA SMD award NNX16AB92A to the National Solar Observatory. Additional details can be found at: http://physics.scsu.edu

Congenital neutropenia in the era of genomics: classification, diagnosis, and natural history.

Science.gov (United States)

Donadieu, Jean; Beaupain, Blandine; Fenneteau, Odile; Bellanné-Chantelot, Christine

2017-11-01

This review focuses on the classification, diagnosis and natural history of congenital neutropenia (CN). CN encompasses a number of genetic disorders with chronic neutropenia and, for some, affecting other organ systems, such as the pancreas, central nervous system, heart, bone and skin. To date, 24 distinct genes have been associated with CN. The number of genes involved makes gene screening difficult. This can be solved by next-generation sequencing (NGS) of targeted gene panels. One of the major complications of CN is spontaneous leukaemia, which is preceded by clonal somatic evolution, and can be screened by a targeted NGS panel focused on somatic events. © 2017 John Wiley & Sons Ltd.

[Value of history and clinical and laboratory data for the diagnosis of dehydration due to acute diarrhea in children younger than 5 years].

Science.gov (United States)

Pruvost, Isabelle; Dubos, François; Aurel, Marie; Hue, Valérie; Martinot, Alain

2008-04-01

Acute diarrhea is frequent, costly because of the number of hospital admissions required, and sometimes serious, even fatal to children in France. The clinical diagnosis of dehydration is difficult, but essential to determine management. To summarize the published data on the value of clinical history, clinical signs and laboratory results for diagnosing dehydration during acute diarrhea in young (1 month-5 years) non-malnourished children. Four databases (Medline, INIST, Ovid, and Cochrane) were searched through November 2006, with the key words "dehydration" subcategories "diagnosis, or etiology, or history", "diarrhea" subcategory "diagnosis", and age limits "infant or preschool child". We selected the articles and reviews that included as an endpoint for dehydration "weight gain > 5% after recovery" (the gold standard). Thirteen studies were selected. No single clinical history item, clinical sign or laboratory value was sufficient to discriminate between children with and without dehydration. The reproducibility of clinical signs varied substantially between studies. Persistent skin folds and signs of vasoconstriction contributed the most information, with good specificity but sensitivity dehydration. No dehydration scale has been validated. None of the studies selected had a very high level of proof (level 1 and 2); neither signs nor scores have been validated internally or externally because of the low number of subjects. The diagnosis of dehydration due to acute diarrhea in young children depends on the number of signs present, since no individual element of clinical history, clinical picture or laboratory tests distinguished dehydration. Other studies are necessary.

Family History of Early Infant Death Correlates with Earlier Age at Diagnosis But Not Shorter Time to Diagnosis for Severe Combined Immunodeficiency

Directory of Open Access Journals (Sweden)

Anderson Dik Wai Luk

2017-07-01

Full Text Available BackgroundSevere combined immunodeficiency (SCID is fatal unless treated with hematopoietic stem cell transplant. Delay in diagnosis is common without newborn screening. Family history of infant death due to infection or known SCID (FH has been associated with earlier diagnosis.ObjectiveThe aim of this study was to identify the clinical features that affect age at diagnosis (AD and time to the diagnosis of SCID.MethodsFrom 2005 to 2016, 147 SCID patients were referred to the Asian Primary Immunodeficiency Network. Patients with genetic diagnosis, age at presentation (AP, and AD were selected for study.ResultsA total of 88 different SCID gene mutations were identified in 94 patients, including 49 IL2RG mutations, 12 RAG1 mutations, 8 RAG2 mutations, 7 JAK3 mutations, 4 DCLRE1C mutations, 4 IL7R mutations, 2 RFXANK mutations, and 2 ADA mutations. A total of 29 mutations were previously unreported. Eighty-three of the 94 patients fulfilled the selection criteria. Their median AD was 4 months, and the time to diagnosis was 2 months. The commonest SCID was X-linked (n = 57. A total of 29 patients had a positive FH. Candidiasis (n = 27 and bacillus Calmette–Guérin (BCG vaccine infection (n = 19 were the commonest infections. The median age for candidiasis and BCG infection documented were 3 months and 4 months, respectively. The median absolute lymphocyte count (ALC was 1.05 × 109/L with over 88% patients below 3 × 109/L. Positive FH was associated with earlier AP by 1 month (p = 0.002 and diagnosis by 2 months (p = 0.008, but not shorter time to diagnosis (p = 0.494. Candidiasis was associated with later AD by 2 months (p = 0.008 and longer time to diagnosis by 0.55 months (p = 0.003. BCG infections were not associated with age or time to diagnosis.ConclusionFH was useful to aid earlier diagnosis but was overlooked by clinicians and not by parents. Similarly, typical clinical features of

The design of a switchyard for the NSF isotope separator

International Nuclear Information System (INIS)

Malcolm, I.C.; Grant, I.S.

1982-01-01

In examining design requirements for the optics of the NSF isotope separator, first-order considerations, voltage requirements, second-order considerations, and shim coil design are discussed. The results are given of a computer study of the system comprising of quadrupole triplet, magnetic and electrostatic sectors. The effects of the accuracy in the fabrication of the electrostatic sector are considered. (U.K.)

Dr. Tulga Ersal at NSF Workshop Accessible Remote Testbeds ART'15

Science.gov (United States)

Event Archives Dr. Tulga Ersal at NSF Workshop Accessible Remote Testbeds ART'15 On November 12th, Dr Workshop on Accessible Remote Testbeds (ART'15) at Georgia Tech. From the event website: The rationale behind the ART'15 workshop is that remote-access testbeds could, if done right, significantly change how

Development of a Consensus Standard for School Equipment: NSF/NSSEA 380

Science.gov (United States)

Breitner, Ashlee

2011-01-01

For many years, the school supplies and equipment industry has investigated methods to ensure product safety and compliance across all its product categories. In early 2010, NSF International and the National School Supply and Equipment Association (NSSEA) came together to develop quality standards for products and equipment designed for use in…

NSF Lower Atmospheric Observing Facilities (LAOF) in support of science and education

Science.gov (United States)

Baeuerle, B.; Rockwell, A.

2012-12-01

Researchers, students and teachers who want to understand and describe the Earth System require high quality observations of the atmosphere, ocean, and biosphere. Making these observations requires state-of-the-art instruments and systems, often carried on highly capable research platforms. To support this need of the geosciences community, the National Science Foundation's (NSF) Division of Atmospheric and Geospace Sciences (AGS) provides multi-user national facilities through its Lower Atmospheric Observing Facilities (LAOF) Program at no cost to the investigator. These facilities, which include research aircraft, radars, lidars, and surface and sounding systems, receive NSF financial support and are eligible for deployment funding. The facilities are managed and operated by five LAOF partner organizations: the National Center for Atmospheric Research (NCAR); Colorado State University (CSU); the University of Wyoming (UWY); the Center for Severe Weather Research (CSWR); and the Center for Interdisciplinary Remotely-Piloted Aircraft Studies (CIRPAS). These observational facilities are available on a competitive basis to all qualified researchers from US universities, requiring the platforms and associated services to carry out various research objectives. The deployment of all facilities is driven by scientific merit, capabilities of a specific facility to carry out the proposed observations, and scheduling for the requested time. The process for considering requests and setting priorities is determined on the basis of the complexity of a field campaign. The poster will describe available observing facilities and associated services, and explain the request process researchers have to follow to secure access to these platforms for scientific as well as educational deployments. NSF/NCAR GV Aircraft

Differential diagnosis and recovery of acute bilateral foot drop in a patient with a history of low back pain: A case report.

Science.gov (United States)

Lomaglio, Melanie; Canale, Bob

2017-06-01

Acute bilateral foot drop is rare and may be due to peripheral or central lesions. The purpose of this case report was to describe the differential diagnosis and recovery of a patient with low back pain (LBP) that awoke with bilateral foot drop. A 39-year-old man with a history of LBP awoke with a steppage gait pattern. Spinal imaging and tapping were negative for sinister pathologies. A subsequent history taken by the physical therapist uncovered that the patient had previously taken a narcotic and slept in a kneeling position to relieve his LBP. Strength and sensory testing revealed isolated impairments in the fibular nerve distribution, and bilateral fibular palsy was suspected and later confirmed with electrophysiological studies. Surgical fibular nerve decompression was performed, and the patient underwent physical therapy. Five months later the patient demonstrated antigravity strength and a partial return of sensation. By 17 months, his Lower Extremity Functional Scale had improved from 17/80 to 78/80, revealing a near complete recovery. The patient's history of LBP was a "red herring" that delayed the diagnosis and caused undue stress to the patient. This case stresses the importance of a thorough history and clinical examination.

Awareness about past diagnosis and treatment history: nationwide survey of childhood cancer survivors and their parents.

Science.gov (United States)

Ahn, Eunmi; Park, Hyeon Jin; Baek, Hee Jo; Hwang, Pyoung Han; Lee, Young Ho; Park, Byung-Kiu; Kim, Young So; Shim, Hye-Young; Shin, Dongwook; Yang, Hyung Kook; Park, Jong Hyock; Park, Kyung Duk

2017-10-01

To assess the awareness of past medical history and long-term care issues of childhood cancer survivors (CCS) in Korea. A nationwide survey was conducted on CCS and their parents in 10 regional cancer centers in Korea. Answers regarding cancer diagnosis and treatment history were compared with the treatment summary and categorized into three ('specific,' 'general,' and 'no') or two ('yes' and 'no') groups. Out of 343 contacts, 293 dyads completed the survey, and 281 dyads were analyzed. Awareness of cancer diagnosis was mostly specific for parents (76.5%) and CCS (35.2%). Awareness of anti-cancer treatment exposure was mostly general (84.6% for surgery, 67.9% for chemotherapy, and 53.9% for hematopoietic stem cell transplantation) rather than specific. In particular, more than half of the parents were not aware of the exposure to cardiotoxic agents (72.9%) or radiation therapy (56.3%). Providing information about long-term side effects and prevention of secondary cancer was significantly correlated only with more concern and more follow-up visits (P ≤ 0.001, respectively), without correlation with more specific awareness of exposure to cardiotoxic agents or radiation. Most of the parents of CCS were not aware of treatment-related risk factors necessary for long-term care. Providing information was significantly correlated with more concern and more follow-up visits, without improving corresponding knowledge about their past medical history. Effort aimed towards improving awareness about risk factors, the manner of providing information, and the patient referral system within which we use this information is warranted. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

LRRK2 phosphorylates pre-synaptic N-ethylmaleimide sensitive fusion (NSF) protein enhancing its ATPase activity and SNARE complex disassembling rate.

Science.gov (United States)

Belluzzi, Elisa; Gonnelli, Adriano; Cirnaru, Maria-Daniela; Marte, Antonella; Plotegher, Nicoletta; Russo, Isabella; Civiero, Laura; Cogo, Susanna; Carrion, Maria Perèz; Franchin, Cinzia; Arrigoni, Giorgio; Beltramini, Mariano; Bubacco, Luigi; Onofri, Franco; Piccoli, Giovanni; Greggio, Elisa

2016-01-13

Lrrk2, a gene linked to Parkinson's disease, encodes a large scaffolding protein with kinase and GTPase activities implicated in vesicle and cytoskeletal-related processes. At the presynaptic site, LRRK2 associates with synaptic vesicles through interaction with a panel of presynaptic proteins. Here, we show that LRRK2 kinase activity influences the dynamics of synaptic vesicle fusion. We therefore investigated whether LRRK2 phosphorylates component(s) of the exo/endocytosis machinery. We have previously observed that LRRK2 interacts with NSF, a hexameric AAA+ ATPase that couples ATP hydrolysis to the disassembling of SNARE proteins allowing them to enter another fusion cycle during synaptic exocytosis. Here, we demonstrate that NSF is a substrate of LRRK2 kinase activity. LRRK2 phosphorylates full-length NSF at threonine 645 in the ATP binding pocket of D2 domain. Functionally, NSF phosphorylated by LRRK2 displays enhanced ATPase activity and increased rate of SNARE complex disassembling. Substitution of threonine 645 with alanine abrogates LRRK2-mediated increased ATPase activity. Given that the most common Parkinson's disease LRRK2 G2019S mutation displays increased kinase activity, our results suggest that mutant LRRK2 may impair synaptic vesicle dynamics via aberrant phosphorylation of NSF.

NSF- and SNARE-mediated membrane fusion is required for nuclear envelope formation and completion of nuclear pore complex assembly in Xenopus laevis egg extracts.

Science.gov (United States)

Baur, Tina; Ramadan, Kristijan; Schlundt, Andreas; Kartenbeck, Jürgen; Meyer, Hemmo H

2007-08-15

Despite the progress in understanding nuclear envelope (NE) reformation after mitosis, it has remained unclear what drives the required membrane fusion and how exactly this is coordinated with nuclear pore complex (NPC) assembly. Here, we show that, like other intracellular fusion reactions, NE fusion in Xenopus laevis egg extracts is mediated by SNARE proteins that require activation by NSF. Antibodies against Xenopus NSF, depletion of NSF or the dominant-negative NSF(E329Q) variant specifically inhibited NE formation. Staging experiments further revealed that NSF was required until sealing of the envelope was completed. Moreover, excess exogenous alpha-SNAP that blocks SNARE function prevented membrane fusion and caused accumulation of non-flattened vesicles on the chromatin surface. Under these conditions, the nucleoporins Nup107 and gp210 were fully recruited, whereas assembly of FxFG-repeat-containing nucleoporins was blocked. Together, we define NSF- and SNARE-mediated membrane fusion events as essential steps during NE formation downstream of Nup107 recruitment, and upstream of membrane flattening and completion of NPC assembly.

Genetic modifiers of comatose mutations in Drosophila: insights into neuronal NSF (N-ethylmaleimide-sensitive fusion factor) functions.

Science.gov (United States)

Sanyal, Subhabrata; Krishnan, K S

2012-09-01

By the middle of the 20th century, development of powerful genetic approaches had ensured that the fruit fly would remain a model organism of choice for genetic and developmental studies. But in the 1970s, a few pioneering groups turned their attention to the prospect of using the fly for neurophysiological experiments. They proposed that in a poikilothermic organism such as Drosophila, temperature-sensitive or "ts" mutations in proteins that controlled nerve function would translate to a "ts" paralytic phenotype. This was by no means an obvious or even a likely assumption. However, following directed screens these groups soon reported dramatic demonstrations of reversible ts paralysis in fly mutants. Resultantly, these "simple" experiments led to the isolation of a number of conditional mutations including shibire, paralytic, and comatose. All have since been cloned and have enabled deep mechanistic insights into synaptic transmission and nerve conduction. comatose (comt) mutations, for example, were found to map to missense changes in dNSF1, a neuron-specific fly homolog of mammalian NSF (N-ethylmaleimide-sensitive fusion factor). Studies on comt were also some of the first to discriminate between nuanced models of NSF function during presynaptic transmitter release that have since been borne out by experiments in multiple preparations. Here, the authors present an overview of NSF function as it is understood today, with an emphasis on contributions from Drosophila beginning with experiments carried out by Obaid Siddiqi in the Benzer laboratory. The authors also outline initial results from a genetic screen for phenotypic modifiers of comt that hold the promise of further elucidating NSF function at the synapse. Over the years, the neuromuscular system of Drosophila has served as a uniquely accessible model to unravel mechanisms underlying synaptic transmission. To this day, ts paralysis remains one of the most emphatic demonstrations of nerve function in an

Food allergy diagnosis in patients with elimination diet history. Preliminary report

Directory of Open Access Journals (Sweden)

Elsy Maureen Navarrete-Rodríguez

2014-09-01

Full Text Available Background: Food allergy diagnosis is performed by a double blind placebo controlled challenge; however, in a lot of patients, it is only based on clinical history, skin prick tests, or parents’ perception. There is a high frequency of elimination diets without an adequate approach. Objective: To analyze the results of diagnostic tests in a group of children with elimination diet-based on suspected food allergy and verify such studies with double blind placebo-controlled test challenge. Material and method: An observational, analytical and prospective study was done in a group of patients with elimination diet for suspected food allergy. We performed prick test, Prick-to-Prick test and patch test and the positive ones were verified by double-blind placebo-controlled challenge. Results: Fourty-three patients were included within a total of 1,935 tests. Both approach for immediate and late sensitivity had not statistically significant relationship between a positive test and the elimination of food. Until now, we had 4 (8% positive challenges out of 50. Conclusion: The frequency of allergy proved by double-blind placebo-controlled test in 50 challenges was of 8% (4/50, thus, in the preliminary report we found a high frequency of elimination diets without adequate support. It is very important that food allergy diagnosis is accurate and based on an appropriate approach; since the implementation of an elimination diet in pediatric population can have a negative influence on their growth and development.

NSF-RANN Trace Contaminants Program directory

International Nuclear Information System (INIS)

Purnell, P.A.; Smith, S.K.; Wilkes, C.F.

1976-10-01

This directory is designed to aid effective communication throughout the National Science Foundation's Trace Contaminants Program, Research Applied to National Needs. The majority of the participants in the Program are represented by name, address, telephone number, and a very brief description of research interest. The directory has five major divisions to facilitate its use. Section I contains a listing of the program managers associated with the NSF-RANN Trace Contaminants Program. Section II lists the principal investigators, co-principal investigators, and coordinators of each of the research grants in the Program. Section III lists the personnel by individual projects. Section IV contains a total alphabetic listing complete with project titles and Section V contains a keyword index. This directory is maintained by the Toxic Materials Information Center as part of the Environmental Resource Center of the Information Center Complex, Information Division, Oak Ridge National Laboratory

NRAO Response to NSF Senior Review of Astronomy Facilities

Science.gov (United States)

2006-11-01

The National Science Foundation's (NSF) Astronomy Senior Review Committee report (pdf file), released today, made major recommendations for restructuring the NSF's ground-based astronomy efforts, including significant changes for the National Radio Astronomy Observatory (NRAO). The committee's report urged that leadership in radio astronomy, including millimeter- and submillimeter-wave observatories, "remain centered at NRAO as it is, by far, the largest radio astronomy organization in the world." The report praised the record of management of NRAO and the scientific capabilities of the Atacama Large Millimeter/submillimeter Array (ALMA), the Expanded Very Large Array (EVLA), the Robert C. Byrd Green Bank Telescope (GBT), and the Very Long Baseline Array (VLBA). However, the report also recommended that some reductions and changes occur at the NRAO by 2011. Specifically, the report recommended that: (a) VLBA operations make a transition to a significant reliance on international funding or risk closure; (b) GBT operations costs be reduced; and (c) NRAO scientific staff costs be reduced. "The Senior Review Committee had the very difficult task of reconciling the needs of current facilities and funding new facilities for the future of astronomy. We appreciate their efforts and look forward to working with the NSF to ensure that the valuable and unique research capabilities of our NRAO telescopes continue to serve the astronomical community," said Dr. Fred K.Y. Lo, NRAO Director. The VLBA provides the greatest angular resolution, or ability to see fine detail, of any telescope in the world, greatly exceeding the capabilities of the Hubble Space Telescope and the future Square Kilometre Array. The committee recognized that, "if the VLBA is closed, a unique capability would likely be lost for decades." "The VLBA is used by scientists from around the world because of its unique capabilities. It has produced landmark research milestones and the committee recognized in its

Small vessel vasculitis History, classification, etiology, histopathology, clinic, diagnosis and treatment

International Nuclear Information System (INIS)

Iglesias Gamarra, Antonio; Matteson, Eric L; Restrepo, Jose Felix

2007-01-01

Small-vessel vasculitis is a convenient descriptor for a wide range of diseases characterized by vascular inflammation of the venules, capillaries, and/or arterioles with pleomorphic clinical manifestations. The classical clinical phenotype is leucocytoclastic vasculitis with palpable purpura, but manifestations vary widely depending upon the organs involved. Histopathologic examination in leucocytoclastic vasculitis reveals angiocentric segmental inflammation, fibrinoid necrosis, and a neutrophilic infiltrate around the blood vessel walls with erythrocyte extravasation. The etiology of small-vessel vasculitis is unknown in many cases, but in others, drugs, post viral syndromes, malignancy, primary vasculitis such as microscopic polyarteritis, and connective tissue disorders are associated, The diagnosis of small- vessel vasculitis relies on a thorough history and physical examination, as well as relevant antibody testing including antinuclear antibody and anti neutrophil cytoplasmic antibody, hepatitis B and C serologies, assessment of complement, immunoglobulins, blood count, serum creatinine liver function tests, urinalysis, radiographic imaging and biopsy. The treatment is based primarily on corticosteroid and immunosuppressive agents

[Definition of the Diagnosis Osteomyelitis-Osteomyelitis Diagnosis Score (ODS)].

Science.gov (United States)

Schmidt, H G K; Tiemann, A H; Braunschweig, R; Diefenbeck, M; Bühler, M; Abitzsch, D; Haustedt, N; Walter, G; Schoop, R; Heppert, V; Hofmann, G O; Glombitza, M; Grimme, C; Gerlach, U-J; Flesch, I

2011-08-01

The disease "osteomyelitis" is characterised by different symptoms and parameters. Decisive roles in the development of the disease are played by the causative bacteria, the route of infection and the individual defense mechanisms of the host. The diagnosis is based on different symptoms and findings from the clinical history, clinical symptoms, laboratory results, diagnostic imaging, microbiological and histopathological analyses. While different osteomyelitis classifications have been published, there is to the best of our knowledge no score that gives information how sure the diagnosis "osteomyelitis" is in general. For any scientific study of a disease a valid definition is essential. We have developed a special osteomyelitis diagnosis score for the reliable classification of clinical, laboratory and technical findings. The score is based on five diagnostic procedures: 1) clinical history and risk factors, 2) clinical examination and laboratory results, 3) diagnostic imaging (ultrasound, radiology, CT, MRI, nuclear medicine and hybrid methods), 4) microbiology, and 5) histopathology. Each diagnostic procedure is related to many individual findings, which are weighted by a score system, in order to achieve a relevant value for each assessment. If the sum of the five diagnostic criteria is 18 or more points, the diagnosis of osteomyelitis can be viewed as "safe" (diagnosis class A). Between 8-17 points the diagnosis is "probable" (diagnosis class B). Less than 8 points means that the diagnosis is "possible, but unlikely" (class C diagnosis). Since each parameter can score six points at a maximum, a reliable diagnosis can only be achieved if at least 3 parameters are scored with 6 points. The osteomyelitis diagnosis score should help to avoid the false description of a clinical presentation as "osteomyelitis". A safe diagnosis is essential for the aetiology, treatment and outcome studies of osteomyelitis. © Georg Thieme Verlag KG Stuttgart · New York.

Report on a Boston University Conference December 7-8, 2012 on "How Can the History and Philosophy of Science Contribute to Contemporary US Science Teaching?"

Science.gov (United States)

Garik, Peter; Benétreau-Dupin, Yann

2014-01-01

This is an editorial report on the outcomes of an international conference sponsored by a grant from the National Science Foundation (NSF) (REESE-1205273) to the School of Education at Boston University and the Center for Philosophy and History of Science at Boston University for a conference titled: "How Can the History and Philosophy of…

The Arctic Cooperative Data and Information System: Data Management Support for the NSF Arctic Research Program (Invited)

Science.gov (United States)

Moore, J.; Serreze, M. C.; Middleton, D.; Ramamurthy, M. K.; Yarmey, L.

2013-12-01

The NSF funds the Advanced Cooperative Arctic Data and Information System (ACADIS), url: (http://www.aoncadis.org/). It serves the growing and increasingly diverse data management needs of NSF's arctic research community. The ACADIS investigator team combines experienced data managers, curators and software engineers from the NSIDC, UCAR and NCAR. ACADIS fosters scientific synthesis and discovery by providing a secure long-term data archive to NSF investigators. The system provides discovery and access to arctic related data from this and other archives. This paper updates the technical components of ACADIS, the implementation of best practices, the value of ACADIS to the community and the major challenges facing this archive for the future in handling the diverse data coming from NSF Arctic investigators. ACADIS provides sustainable data management, data stewardship services and leadership for the NSF Arctic research community through open data sharing, adherence to best practices and standards, capitalizing on appropriate evolving technologies, community support and engagement. ACADIS leverages other pertinent projects, capitalizing on appropriate emerging technologies and participating in emerging cyberinfrastructure initiatives. The key elements of ACADIS user services to the NSF Arctic community include: data and metadata upload; support for datasets with special requirements; metadata and documentation generation; interoperability and initiatives with other archives; and science support to investigators and the community. Providing a self-service data publishing platform requiring minimal curation oversight while maintaining rich metadata for discovery, access and preservation is challenging. Implementing metadata standards are a first step towards consistent content. The ACADIS Gateway and ADE offer users choices for data discovery and access with the clear objective of increasing discovery and use of all Arctic data especially for analysis activities

History of stress-related health changes: a cue to pursue a diagnosis of latent primary adrenal insufficiency.

Science.gov (United States)

Yamamoto, Toshihide

2014-01-01

Routine delays in the diagnosis of primary adrenal insufficiency (PAI) are well known and conceivably attributable to the absence of cues, other than anti-adrenal autoantibodies, to pursue subclinical PAI. Subclinical PAI is latent unless the afflicted patient encounters stress such as an acute illness, surgery, psychosocial burden, etc. It remains to be demonstrated whether a history of stress-related health changes is a useful cue to pursue a diagnosis of latent PAI. The patients were selected for a history of recurrent symptoms, i.e., gastrointestinal symptoms, fatigue, or lassitude, aggravated by stress and alleviated by the removal of stress, and signs, i.e., weight loss, hypotension, and hyperpigmentation. As the early morning cortisol levels were low or low-normal and the adrenocorticotropic hormone (ACTH) levels were within the reference ranges, provocation tests, i.e., insulin-induced hypoglycemia tests and low-dose (1 μg) corticotropin tests (LDTs), were used to estimate the hypothalamus-pituitary-adrenal (HPA) axis status. Patients with the HPA axis dysfunction on two provocation tests were supplemented with physiologic doses of glucocorticoids (GCs). The effects of GC supplementation on stress-related health changes were observed. The ACTH levels after insulin-induced hypoglycemia were higher and the cortisol levels were lower in the patients than in the control subjects. The cortisol levels in the patients were increased less significantly by LDT than those observed in the control subjects. Stress-related health changes ceased to recur and signs, i.e., a low body weight, hypotension, and hyperpigmentation, were ameliorated following GC supplementation. A history of stress-related health changes is useful as a cue to pursue latent PAI in patients with low or low-normal early morning cortisol levels.

"Teaching Physics as one of the humanities": The history of (harvard) project Physics, 1961-1970

Science.gov (United States)

Meshoulam, David

In the United States after World War II, science had come to occupy a central place in the minds of policy makers, scientists, and the public. Negotiating different views between these groups proved a difficult task and spilled into debates over the role and scope of science education. To examine this process, this dissertation traces the history of Harvard Project Physics (HPP), a high-school physics curriculum from the 1960s that incorporated a humanistic and historical approach to teaching science. The narrative begins with the rise of General Education in the 1940s. Under the leadership of Harvard president James Conant, faculty at Harvard developed several Natural Science courses that connected science to history as a way to teach students about science and its relationship to culture. By the late 1950s this historical approach faced resistance from scientists who viewed it as misrepresenting their disciplines and called for students to learn specialized subject matter. With the support of the National Science Foundation (NSF), in the early 1960s scientists' vision of science education emerged in high-school classrooms across the country. By the mid 1960s, with the passage of the Civil Rights Act, the Elementary and Secondary Education Act, and the Daddario Amendment to the NSF, the political and education landscape began to change. These laws transformed the goals of two of the NSF and the Office of Education (USOE). These organizations faced demands to work together to develop projects that would speak to domestic concerns over equity and diversity. Their first joint educational venture was HPP. In order to succeed, HPP had to speak to the needs of disciplinary-minded scientists at the NSF, equity-minded educators at the USOE, and results-focused politicians in Congress. This work argues that HPP succeeded because it met the needs of these various stakeholders regarding the roles of science and education in American society.

Management and Stewardship of Airborne Observational Data for the NSF/NCAR HIAPER (GV) and NSF/NCAR C-130 at the National Center for Atmospheric Research (NCAR) Earth Observing Laboratory (EOL)

Science.gov (United States)

Aquino, J.

2014-12-01

The National Science Foundation (NSF) provides the National Center for Atmospheric Research (NCAR) Earth Observing Laboratory (EOL) funding for the operation, maintenance and upgrade of two research aircraft: the NSF/NCAR High-performance Instrumented Airborne Platform for Environmental Research (HIAPER) Gulfstream V and the NSF/NCAR Hercules C-130. A suite of in-situ and remote sensing airborne instruments housed at the EOL Research Aviation Facility (RAF) provide a basic set of measurements that are typically deployed on most airborne field campaigns. In addition, instruments to address more specific research requirements are provided by collaborating participants from universities, industry, NASA, NOAA or other agencies. The data collected are an important legacy of these field campaigns. A comprehensive metadata database and integrated cyber-infrastructure, along with a robust data workflow that begins during the field phase and extends to long-term archival (current aircraft data holdings go back to 1967), assures that: all data and associated software are safeguarded throughout the data handling process; community standards of practice for data stewardship and software version control are followed; simple and timely community access to collected data and associated software tools are provided; and the quality of the collected data is preserved, with the ultimate goal of supporting research and the reproducibility of published results. The components of this data system to be presented include: robust, searchable web access to data holdings; reliable, redundant data storage; web-based tools and scripts for efficient creation, maintenance and update of data holdings; access to supplemental data and documentation; storage of data in standardized data formats; comprehensive metadata collection; mature version control; human-discernable storage practices; and procedures to inform users of changes. In addition, lessons learned, shortcomings, and desired upgrades

Cryptosporidium sebagai Indikator Biologi dan Indeks Nsf-Wqi untuk Mengevaluasi Kualitas Air (Studi Kasus: Hulu Sungai Citarum, Kabupaten Bandung

Directory of Open Access Journals (Sweden)

Tastaptyani Kurnia Nufutomo

2017-11-01

Full Text Available Kualitas air yang menurun di Hulu Sungai Citarum dapat disebabkan oleh banyak faktor. Faktor-faktor tersebut dapat diketahui dari parameter fisika, kimia dan biologi. Parameter biologi yang digunakan untuk mengevaluasi kualitas air adalah  mikroorganisme patogen yang menimbulkan penyakit di sistem pencernaan seperti diare akut, yaitu Coliform dan Cryptosporidium. Tujuan penelitian ini adalah untuk mengetahui status kualitas air di Hulu Sungai Citarum dengan indeks kualitas air NSF-WQI, mengetahui hubungan dan pengaruh parameter fisik dan kimia air terhadap parameter biologi, menentukan faktor utama dari parameter air yang paling berpengaruh dan mengetahui hubungan serta pengaruh faktor utama tersebut terhadap Cryptosporidium. Metode yang digunakan adalah  mengambil sampel di tiap stasiun dengan composite, mengidentifikasi dan analisis Coliform dengan MPN dan identifikasi Crytosporidium dengan Ziehl Neelsen staining, kemudian menganalisis parameter kimia dan fisika dengan indeks NSF-WQI, lalu data tersebut diolah menggunakan metode statistik PCA. Hasil pengukuran kualitas air berdasarkan NSF-WQI adalah kualitas air di Hulu Sungai Citarum termasuk kategori buruk dan medium. Keberadaan Cryptosporidium di Hulu Sungai Citarum disebabkan oleh 2 (dua faktor utama, yaitu faktor pertama terdiri dari DO, turbiditas, NO2, NH4 dan total Colifom, sedangkan faktor kedua terdiri dari TSS, COD dan PO4. Kedua faktor tersebut tidak signifikan dengan keberadaan Cryptosporidium di Hulu Sungai Citarum. Kata kunci: Cryptosporidium, Hulu Sungai Citarum, Indeks NSF-WQI, Kualitas Air

Nephrogenic systemic fibrosis: history and epidemiology

DEFF Research Database (Denmark)

Thomsen, Henrik S

2009-01-01

Nephrogenic systemic fibrosis (NSF) is a new disease; the first case was diagnosed in 1997. It took 9 years before an association between NSF and gadolinium-based contrast agents (Gd-CAs) was identified. Gadolinium has several advantages for use in relation to enhanced MRI, but it is also a toxic...... that the real number of patients who have NSF has not been accurately totaled; the disease seems to be underdiagnosed for various reasons....

The Value of History, Physical Examination, and Radiographic Findings in the Diagnosis of Symptomatic Meniscal Tear among Middle-Age Subjects with Knee Pain

Science.gov (United States)

Katz, Jeffrey N.; Smith, Savannah R.; Yang, Heidi Y.; Martin, Scott D.; Wright, John; Donnell-Fink, Laurel A.; Losina, Elena

2016-01-01

Objective To evaluate the utility of clinical history, radiographic and physical exam findings in the diagnosis of symptomatic meniscal tear (SMT) in patients over age 45, in whom concomitant osteoarthritis is prevalent. Methods In a cross-sectional study of patients from two orthopedic surgeons’ clinics we assessed clinical history, physical examination and radiographic findings in patients over 45 with knee pain. The orthopedic surgeons rated their confidence that subjects’ symptoms were due to MT; we defined the diagnosis of SMT as at least 70% confidence. We used logistic regression to identify factors independently associated with diagnosis of SMT and we used the regression results to construct an index of the likelihood of SMT. Results In 174 participants, six findings were associated independently with the expert clinician having ≥70% confidence that symptoms were due to MT: localized pain, ability to fully bend the knee, pain duration <1 year, lack of varus alignment, lack of pes planus, and absence of joint space narrowing on radiographs. The index identified a low risk group with 3% likelihood of SMT. Conclusion While clinicians traditionally rely upon mechanical symptoms in this diagnostic setting, our findings did not support the conclusion that mechanical symptoms were associated with the expert’s confidence that symptoms were due to MT. An index that includes history of localized pain, full flexion, duration <1 year, pes planus, varus alignment, and joint space narrowing can be used to stratify patients according to their risk of SMT and it identifies a subgroup with very low risk. PMID:27390312

The diagnosis of psychopathy between psychiatry, Adlerian psychology and policy

OpenAIRE

Kölch, Michael

2010-01-01

The thesis analyses the beginning of child and adolescent psychiatric services in Berlin be-tween 1918 and 1935. Using methods of history of sciences, social history, and history of institutions the conceptualisation of the “psychopathy” as a specific diagnosis for children with behaviour problems was examined. This diagnosis was the core diagnosis for the devel-opment of early psychiatry for children. By this theoretical concept of “psychopathy” the vari-ous scientific models about psychiatr...

Aerodynamic instability: A case history

Science.gov (United States)

Eisenmann, R. C.

1985-01-01

The identification, diagnosis, and final correction of complex machinery malfunctions typically require the correlation of many parameters such as mechanical construction, process influence, maintenance history, and vibration response characteristics. The progression is reviewed of field testing, diagnosis, and final correction of a specific machinery instability problem. The case history presented addresses a unique low frequency instability problem on a high pressure barrel compressor. The malfunction was eventually diagnosed as a fluidic mechanism that manifested as an aerodynamic disturbance to the rotor assembly.

Cost-effectiveness analysis of main diagnosis tools in women with overactive bladder. Clinical history, micturition diary and urodynamic study.

Science.gov (United States)

López-Fando, L; Carracedo, D; Jiménez, M; Gómez de Vicente, J M; Martínez, L; Gómez-Cañizo, C; Gómez, V; Burgos, F J

2015-01-01

The aim of the present clinical research is to analyze, in the light of the best scientific evidence, the performance and the cost of the main diagnostic tools for overactive bladder (OAB). It is an exploratory transversal study in which 199 women diagnosed of OAB between 2006 and 2008 were selected and underwent to following prospective analyses: physical examination, urine analysis, micturition diary (MD) and urodynamic study (UDS). A percentage of 80% was assumed as highly sensitive and a diagnostic difference among tests of 10% would be considered clinically relevant. Tests' sensitivity for diagnosis of OAB was statistically established by two ways: isolated and combined. Besides, the direct and indirect costs of these tests performance were conducted. Cost-effectiveness study of clinical history (CH), MD and US for the diagnosis of OAB was performed. Overall sensitivity for OAB diagnosis is low for the 3 tests used in isolated way, whilst the combination of any two tests shows good overall sensitivity. The combination of CH and MD has appeared as the most cost-effective alternative to OAB diagnosis. For OAB diagnosis, CH-DM combination shows the same sensitivity than the association of either of them with the UDS, but unlike to these, it shows the lowest cost. Copyright © 2013 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Low Rate of Prenatal Diagnosis among Neonates with Critical Aortic Stenosis: Insight into the Natural History In Utero (Aortic Stenosis)

Science.gov (United States)

Freud, Lindsay R.; Moon-Grady, Anita; Escobar-Diaz, Maria C.; Gotteiner, Nina L.; Young, Luciana T.; McElhinney, Doff B.; Tworetzky, Wayne

2014-01-01

Objectives To better understand the natural history and spectrum of fetal aortic stenosis (AS), we aimed to 1) determine the prenatal diagnosis rate of neonates with critical AS and a biventricular (BV) outcome; and 2) describe the findings at fetal echocardiography in prenatally diagnosed patients. Methods A multi-center, retrospective study was performed from 2000 to 2013. Neonates with critical AS who were discharged with a BV outcome were included. The prenatal diagnosis rate was compared to that reported for hypoplastic left heart syndrome (HLHS). Fetal echocardiographic findings in prenatally diagnosed patients were reviewed. Results Only 10 of 117 neonates (8.5%) with critical AS and a BV outcome were diagnosed prenatally, a rate significantly lower than that for HLHS in the contemporary era (82%; p<0.0001). Of the 10 patients diagnosed prenatally, all developed LV dysfunction by a median gestational age of 33 weeks (range, 28–35). When present, Doppler abnormalities such as retrograde flow in the aortic arch (n=2), monophasic mitral inflow (n=2), and left to right flow across the foramen ovale (n=8) developed late in gestation (median 33 weeks). Conclusion The prenatal diagnosis rate among neonates with critical AS and a BV outcome is very low, likely due to a relatively normal 4-chamber view in mid-gestation with development of significant obstruction in the 3rd trimester. This natural history contrasts with that of severe mid-gestation AS with evolving HLHS and suggests that the timing in gestation of significant AS has an important impact on subsequent left heart growth in utero. PMID:25251721

Gerbode defect: A comprehensive review of its history, anatomy, embryology, pathophysiology, diagnosis, and treatment

Directory of Open Access Journals (Sweden)

Erfanul Saker

2017-10-01

Full Text Available The purpose of this paper is to survey the literature on Gerbode defect and provide an overview of its history, anatomy, development, pathophysiology, diagnosis, and treatment options. The available literature on this topic, including case reports, was thoroughly reviewed. Gerbode defect is defined as abnormal shunting between the left ventricle and right atrium resulting from either a congenital defect or prior cardiac insults. The pathophysiology underlying the development of Gerbode defect is a disease process that injures the atrioventricular septum and leads to the abnormal shunting of blood. Although the most prevalent cause of Gerbode defect has historically been congenital, an increasing trend towards acquired cases has recently been reported owing to improved diagnostic capabilities and a greater number of invasive cardiac procedures. In conclusion, Gerbode defect is an increasingly recognized condition that warrants further study.

78 FR 58569 - Notice of Meeting; NSF Synchrotron Subcommittee of the Advisory Committee for Mathematical and...

Science.gov (United States)

2013-09-24

... report findings--Murray Gibson, Northeastern University 2. Importance of materials research facilities...--Patricia Dehmer, DOE 3. Biology/biomaterials talk--importance of materials research facilities--Pupa... Materials Research on its facilities portfolio including the role it and NSF should play in synchrotron...

NSF-RANN Trace Contaminants Program directory. [Personnel directory

Energy Technology Data Exchange (ETDEWEB)

Purnell, P.A.; Smith, S.K.; Wilkes, C.F.

1976-10-01

This directory is designed to aid effective communication throughout the National Science Foundation's Trace Contaminants Program, Research Applied to National Needs. The majority of the participants in the Program are represented by name, address, telephone number, and a very brief description of research interest. The directory has five major divisions to facilitate its use. Section I contains a listing of the program managers associated with the NSF-RANN Trace Contaminants Program. Section II lists the principal investigators, co-principal investigators, and coordinators of each of the research grants in the Program. Section III lists the personnel by individual projects. Section IV contains a total alphabetic listing complete with project titles and Section V contains a keyword index. This directory is maintained by the Toxic Materials Information Center as part of the Environmental Resource Center of the Information Center Complex, Information Division, Oak Ridge National Laboratory.

Update on the NSF PAARE Program at SC State

Science.gov (United States)

Walter, Donald K.; Ajello, Marco; Brittain, Sean D.; Cash, Jennifer; Hartmann, Dieter; Ho, Shirley; Howell, Steve B.; King, Jeremy R.; Leising, Mark D.; Smith, Daniel M.

2017-01-01

We report on results from our NSF PAARE program during Year 2 of the project. Our partnership under this PAARE award includes South Carolina State University (a Historically Black College/University), Clemson University (a Ph.D. granting institution) as well as individual investigators at NASA Ames and Carnegie Mellon University. Our recent work on variable and peculiar stars, work with the Kepler Observatory and our educational products in cosmology for non-STEM majors will be presented. We have successfully piloted sharing our teaching resources by offering an upper-level astrophysics course taught at Clemson via video conferencing , allowing a graduating senior from SC State to take a course not available through his home institution. Additionally, we are working on a memorandum of agreement between the two institutions that will allow for the seamless transfer of an undergraduate from SC State to Clemson’s graduate program in physics and astronomy. Our curriculum work includes new web-based cosmology activities and laboratory experiments. SC State undergraduates are reporting at this conference on their work with the light curves of semiregular variables using Kepler data. Additionally, we are heavily involved in the Citizen CATE Experiment. A PAARE scholarship student from SC State and the PAARE PI traveled to Indonesia for the March 2016 solar eclipse. Their results are also being presented elsewhere at this conference (see Myles McKay’s poster). Support for this work includes our NSF PAARE award AST-1358913 as well as resources and support provided by Clemson University and the National Optical Astronomy Observatory. Additional support has been provided by the South Carolina Space Grant Consortium and from NASA to SC State under awards NNX11AB82G and NNX13AC24G. CATE work has been supported by NASA SMD award NNX16AB92A to the National Solar Observatory. Additional details can be found at: http://physics.scsu.edu

ESO and NSF Sign Agreement on ALMA

Science.gov (United States)

2003-02-01

Green Light for World's Most Powerful Radio Observatory On February 25, 2003, the European Southern Observatory (ESO) and the US National Science Foundation (NSF) are signing a historic agreement to construct and operate the world's largest and most powerful radio telescope, operating at millimeter and sub-millimeter wavelength. The Director General of ESO, Dr. Catherine Cesarsky, and the Director of the NSF, Dr. Rita Colwell, act for their respective organizations. Known as the Atacama Large Millimeter Array (ALMA), the future facility will encompass sixty-four interconnected 12-meter antennae at a unique, high-altitude site at Chajnantor in the Atacama region of northern Chile. ALMA is a joint project between Europe and North America. In Europe, ESO is leading on behalf of its ten member countries and Spain. In North America, the NSF also acts for the National Research Council of Canada and executes the project through the National Radio Astronomy Observatory (NRAO) operated by Associated Universities, Inc. (AUI). The conclusion of the ESO-NSF Agreement now gives the final green light for the ALMA project. The total cost of approximately 650 million Euro (or US Dollars) is shared equally between the two partners. Dr. Cesarsky is excited: "This agreement signifies the start of a great project of contemporary astronomy and astrophysics. Representing Europe, and in collaboration with many laboratories and institutes on this continent, we together look forward towards wonderful research projects. With ALMA we may learn how the earliest galaxies in the Universe really looked like, to mention but one of the many eagerly awaited opportunities with this marvellous facility". "With this agreement, we usher in a new age of research in astronomy" says Dr. Colwell. "By working together in this truly global partnership, the international astronomy community will be able to ensure the research capabilities needed to meet the long-term demands of our scientific enterprise, and

Year 4 Of The NSF-funded PAARE Project At SC State

Science.gov (United States)

Walter, Donald K.; Brittain, S. D.; Cash, J. L.; Hartmann, D. H.; Howell, S. B.; King, J. R.; Leising, M. D.; Mayo, E. A.; Mighell, K. J.; Smith, D. M.

2012-01-01

We summarize the progress made through Year 4 of "A Partnership in Observational and Computational Astronomy (POCA)". This NSF-funded project is part of the "Partnerships in Astronomy and Astrophysics Research and Education (PAARE)" program. Our partnership includes South Carolina State University (a Historically Black College/University), Clemson University (a Ph.D. granting institution) and the National Optical Astronomy Observatory. Fellowships provided by POCA as well as recruitment efforts on the national level have resulted in enrolling a total of four underrepresented minorities into the Ph.D. program in astronomy at Clemson. We report on the success and challenges to recruiting students into the undergraduate physics major with astronomy option at SC State. Our summer REU program under POCA includes underrepresented students from across the country conducting research at each of our three institutions. Examples are given of our inquiry-based, laboratory exercises and web- based activities related to cosmology that have been developed with PAARE funding. We discuss our ground-based photometric and spectroscopic study of RV Tauri and Semi-Regular variables which has been expanded to include successful Cycle 2 Kepler observations of a dozen of these objects reported elsewhere at this conference (see D.K. Walter, et.al.). Support for the POCA project is provided by the NSF PAARE program to South Carolina State University under award AST-0750814 as well as resources and support provided by Clemson University and the National Optical Astronomy Observatory. Support for the Kepler observations is provided by NASA to South Carolina State University under award NNX11AB82G.

Geoscience Workforce Development at UNAVCO: Leveraging the NSF GAGE Facility

Science.gov (United States)

Morris, A. R.; Charlevoix, D. J.; Miller, M.

2013-12-01

Global economic development demands that the United States remain competitive in the STEM fields, and developing a forward-looking and well-trained geoscience workforce is imperative. According to the Bureau of Labor Statistics, the geosciences will experience a growth of 19% by 2016. Fifty percent of the current geoscience workforce is within 10-15 years of retirement, and as a result, the U.S. is facing a gap between the supply of prepared geoscientists and the demand for well-trained labor. Barring aggressive intervention, the imbalance in the geoscience workforce will continue to grow, leaving the increased demand unmet. UNAVCO, Inc. is well situated to prepare undergraduate students for placement in geoscience technical positions and advanced graduate study. UNAVCO is a university-governed consortium facilitating research and education in the geosciences and in addition UNAVCO manages the NSF Geodesy Advancing Geosciences and EarthScope (GAGE) facility. The GAGE facility supports many facets of geoscience research including instrumentation and infrastructure, data analysis, cyberinfrastructure, and broader impacts. UNAVCO supports the Research Experiences in the Solid Earth Sciences for Students (RESESS), an NSF-funded multiyear geoscience research internship, community support, and professional development program. The primary goal of the RESESS program is to increase the number of historically underrepresented students entering graduate school in the geosciences. RESESS has met with high success in the first 9 years of the program, as more than 75% of RESESS alumni are currently in Master's and PhD programs across the U.S. Building upon the successes of RESESS, UNAVCO is launching a comprehensive workforce development program that will network underrepresented groups in the geosciences to research and opportunities throughout the geosciences. This presentation will focus on the successes of the RESESS program and plans to expand on this success with broader

Rhazes, a genius physician in diagnosis and treatment of kidney calculi in medical history.

Science.gov (United States)

Changizi Ashtiyani, Saeed; Cyrus, Ali

2010-04-01

Abu Bakr Mohammad Ibn Zakariya Razi, known in the west as Rhazes (865 to 925 AD), was born in the ancient city of Rayy, near Tehran, Iran. He was a renowned physician in medical history and not only followed Hippocrates and Galen, but also greatly extended the analytical approach of his predecessors. Based on the existing documents, he was known as the most distinguished character in the world of medicine up to the 17th century. A great number of innovations and pioneering works in the medical science have been recorded in the name of Rhazes. His fundamental works in urology as part of his research in the realm of medicine have remained unknown. Pathophysiology of the urinary tract, venereal diseases, and kidney and bladder calculi are among his main interests in this field. He also purposed and developed methods for diagnosis and treatment of kidney calculi for the first time in medical history. He also presented a very exact and precise description of neuropathic bladder followed by vertebral fracture. He advanced urine analysis and studied function and diseases of the kidneys. Rhazes recommendations for the prevention of calculi are quite scientific and practical and in accordance with current recommendations to avoid hypercalciuria and increased saturation of urine. Rhazes was not only one of the most important Persian physician-philosophers of his era, but for centuries, his writings became fundamental teaching texts in European medical schools. Some important aspects of his contributions to medicine are reviewed.

Supporting "The Best and Brightest" in Science and Engineering: NSF Graduate Research Fellowships

OpenAIRE

Richard B. Freeman; Tanwin Chang; Hanley Chiang

2005-01-01

The National Science Foundation's (NSF) Graduate Research Fellowship (GRF) is a highly prestigious award for science and engineering (S&E) graduate students. This paper uses data from 1952 to 2004 on the population of over 200,000 applicants to the GRF to examine the determinants of the number and characteristics of applicants and the characteristics of awardees. In the early years of the program, GRF awards went largely to physical science and mathematics students and disproportionately to w...

Epidemiology and natural history of vestibular schwannomas

DEFF Research Database (Denmark)

Stangerup, Sven-Eric; Caye-Thomasen, Per

2012-01-01

This article describes various epidemiologic trends for vestibular schwannomas over the last 35 years, including a brief note on terminology. Additionally, it provides information on the natural history of tumor growth and hearing level following the diagnosis of a vestibular schwannoma. A treatm......This article describes various epidemiologic trends for vestibular schwannomas over the last 35 years, including a brief note on terminology. Additionally, it provides information on the natural history of tumor growth and hearing level following the diagnosis of a vestibular schwannoma...

Weight Changes following the Diagnosis of Type 2 Diabetes

DEFF Research Database (Denmark)

Olivarius, Niels de Fine; Siersma, Volkert Dirk; Køster-Rasmussen, Rasmus

2015-01-01

Aims: The association between recent and more distant weight changes before and after the diagnosis of type 2 diabetes has been little researched. The aim of this study is to determine the influence of patients’ weight history before diabetes diagnosis on the observed 6-year weight changes after...... diagnosis. Methods: A clinical cohort study combined with self-reported past weight history. In total 885 patients aged ≥40 years and newly diagnosed with clinical type 2 diabetes were included. Body weight was measured immediately after diabetes diagnosis and again at the 6-year follow up examination...... weight change after diagnosis. Conclusions: During the first on average 5.7 years after diagnosis of type 2 diabetes, patients generally follow a course of declining average weight, and these weight developments are related primarily to recent weight changes, body mass index, and age, but not to the more...

Impostor Syndrome, a Reparative History

OpenAIRE

Simmons, D

2016-01-01

This is an attempt to insert the stories we tell about fear and shame into a history of twentieth-century psychology and its obsession with achievement and modernization. It is an attempt to write an affective history of achievement at the turn of the millennium - and to make this feeling history. Impostor Syndrome is a pop-psychological diagnosis, employed to explain the low presence of women in STEM fields, business and academic administration and ’thought leadership’ in the pubic sphere. T...

Measurements on the NSF injector and analysing magnets

International Nuclear Information System (INIS)

Armitage, S.A.; Barker, D.; Eastham, D.A.; Kivlin, F.J.; Tait, N.R.S.

1979-08-01

Two 90 0 uniform field magnets are to be installed in the Nuclear Structure Facility (NSF). Their purpose and design are summarized. The effects of various field errors on the performance of a 90 0 double focusing magnet were investigated using a beam optics programme. The results were used to draw up the specification for the magnets. Subsequent checks were made on the angles β of the effective field boundaries with and without the field clamps in place and of the uniformity of the field along the beam orbit in the orbit plane. Checks were also made on radial uniformity in the orbit plane. In order to ensure reliability of calibration of the magnetic field in terms of the field at the NMR probe, reproducibility of field distributions for various excitation cycles was studied. Finally the performance of the magnets was checked directly using high quality α-sources located at the object point, detecting the image at the image point using a position sensitive surface barrier detector. The results of studies on the inflector magnet have been published. (author)

US Global Change Research Program Distributed Cost Budget Interagency Funds Transfer from DOE to NSF

Energy Technology Data Exchange (ETDEWEB)

Uhle, Maria [National Science Foundation (NSF), Washington, DC (United States)

2016-09-22

These funds were transferred from DOE to NSF as DOE's contribution to the U.S. Global Change Research Program in support of 4 internationalnactivities/programs as approved by the U.S. Global Change Research Program on 14 March 2014. The programs are the International Geosphere-Biosphere Programme, the DIVERSITAS programme, and the World Climate Research Program. All program awards ended as of 09-23-2015.

Proceedings: Joint DOE/NSF Workshop on flow of particulates and fluids

Energy Technology Data Exchange (ETDEWEB)

1993-12-31

These proceedings are the result of the Fifth DOR-NSF Workshop on fundamental research in the area of particulate two-phase flow and granular flow. The present collection of twenty contributions from universities and national laboratories is based on research projects sponsored by either the Department of Energy or the National Science Foundation. These papers illustrate some of the latest advances in theory, simulations, and experiments. The papers from the Workshop held September 29--October 1, 1993 have been separated into three basic areas: experiments, theory, and numerical simulations. A list of attendees at the workshop is included at the end of the proceedings. Selected papers have been indexed separately for inclusion in the Energy Science and Technology Database.

Thoracic splenosis as a differential diagnosis of juxtapleural nodules

Directory of Open Access Journals (Sweden)

B. Lopes

2014-01-01

Full Text Available Thoracic splenosis is rare and consists of ectopic implantation of splenic tissue into the chest after concomitant thoracic and abdominal trauma with diaphragm injury. It occurs in about 18% of cases of splenic ruptures. In almost all cases, diagnosis is given incidentally once patients are usually asymptomatic. Thoracic splenosis should be considered as a differential diagnosis in all patients with history of trauma presenting with juxtapleural nodules in chest computed tomography. However, malignant conditions should be ruled out firstly. Biopsy is not essential for the diagnosis once nuclear medicine can confirm splenosis in patients with pertinent history of trauma and suggestive tomographic image. We present a typical case of thoracic splenosis whose diagnosis was made by nuclear medicine and no invasive procedures were required.

Diagnosis of pediatric urinary tract infections

Directory of Open Access Journals (Sweden)

Jeng-Daw Tsai

2016-09-01

Full Text Available Urinary tract infection (UTI is the second common infection in children. The diagnosis of UTI in infants and children can be difficult. Good history taking and physical examination are corner stones of good care of UTI. In addition, this article reviewed current evident on the methods of urine specimen collection and various diagnostic criteria to reach the diagnosis of UTI. Asian Guideline for UTI in children is highlighted to increase consensus of the diagnosis of UTI.

Diagnosis of pediatric urinary tract infections

OpenAIRE

Jeng-Daw Tsai; Chun-Chen Lin; Stephan S. Yang

2016-01-01

Urinary tract infection (UTI) is the second common infection in children. The diagnosis of UTI in infants and children can be difficult. Good history taking and physical examination are corner stones of good care of UTI. In addition, this article reviewed current evident on the methods of urine specimen collection and various diagnostic criteria to reach the diagnosis of UTI. Asian Guideline for UTI in children is highlighted to increase consensus of the diagnosis of UTI.

A genomic and transcriptomic approach for a differential diagnosis between primary and secondary ovarian carcinomas in patients with a previous history of breast cancer

International Nuclear Information System (INIS)

Meyniel, Jean-Philippe; Alran, Séverine; Rapinat, Audrey; Gentien, David; Roman-Roman, Sergio; Mignot, Laurent; Sastre-Garau, Xavier; Cottu, Paul H; Decraene, Charles; Stern, Marc-Henri; Couturier, Jérôme; Lebigot, Ingrid; Nicolas, André; Weber, Nina; Fourchotte, Virginie

2010-01-01

The distinction between primary and secondary ovarian tumors may be challenging for pathologists. The purpose of the present work was to develop genomic and transcriptomic tools to further refine the pathological diagnosis of ovarian tumors after a previous history of breast cancer. Sixteen paired breast-ovary tumors from patients with a former diagnosis of breast cancer were collected. The genomic profiles of paired tumors were analyzed using the Affymetrix GeneChip ® Mapping 50 K Xba Array or Genome-Wide Human SNP Array 6.0 (for one pair), and the data were normalized with ITALICS (ITerative and Alternative normaLIzation and Copy number calling for affymetrix Snp arrays) algorithm or Partek Genomic Suite, respectively. The transcriptome of paired samples was analyzed using Affymetrix GeneChip ® Human Genome U133 Plus 2.0 Arrays, and the data were normalized with gc-Robust Multi-array Average (gcRMA) algorithm. A hierarchical clustering of these samples was performed, combined with a dataset of well-identified primary and secondary ovarian tumors. In 12 of the 16 paired tumors analyzed, the comparison of genomic profiles confirmed the pathological diagnosis of primary ovarian tumor (n = 5) or metastasis of breast cancer (n = 7). Among four cases with uncertain pathological diagnosis, genomic profiles were clearly distinct between the ovarian and breast tumors in two pairs, thus indicating primary ovarian carcinomas, and showed common patterns in the two others, indicating metastases from breast cancer. In all pairs, the result of the transcriptomic analysis was concordant with that of the genomic analysis. In patients with ovarian carcinoma and a previous history of breast cancer, SNP array analysis can be used to distinguish primary and secondary ovarian tumors. Transcriptomic analysis may be used when primary breast tissue specimen is not available

Spondylolysis and spondylolisthesis in children and adolescents: I. Diagnosis, natural history, and nonsurgical management.

Science.gov (United States)

Cavalier, Ralph; Herman, Martin J; Cheung, Emilie V; Pizzutillo, Peter D

2006-07-01

Spondylolysis and spondylolisthesis are often diagnosed in children presenting with low back pain. Spondylolysis refers to a defect of the vertebral pars interarticularis. Spondylolisthesis is the forward translation of one vertebral segment over the one beneath it. Isthmic spondylolysis, isthmic spondylolisthesis, and stress reactions involving the pars interarticularis are the most common forms seen in children. Typical presentation is characterized by a history of activity-related low back pain and the presence of painful spinal mobility and hamstring tightness without radiculopathy. Plain radiography, computed tomography, and single-photon emission computed tomography are useful for establishing the diagnosis. Symptomatic stress reactions of the pars interarticularis or adjacent vertebral structures are best treated with immobilization of the spine and activity restriction. Spondylolysis often responds to brief periods of activity restriction, immobilization, and physiotherapy. Low-grade spondylolisthesis (50% translation) responds much less reliably to nonsurgical treatment. The growing child may need to be followed clinically and radiographically through skeletal maturity. When pain persists despite nonsurgical interventions, when progressive vertebral displacement increases, or in the presence of progressive neurologic deficits, surgical intervention is appropriate.

Young woman with a four-year history of epilepsy and progressive focal cortical atrophy — What is the diagnosis?

Directory of Open Access Journals (Sweden)

S. Pati

2014-01-01

Full Text Available The pathogenesis of disease progression in drug-refractory epilepsy is poorly understood. We report the case of a young woman with a four-year history of epilepsy that progressed rapidly as evidenced by the development of progressive focal cortical atrophy. She underwent biopsy that showed perinatal ischemia and a prominent inflammatory response, including T-cell infiltration and microglial activation. There was no consensus reached on the final diagnosis although the hypothesis of dual pathology (adult variant of Rasmussen's encephalitis and perinatal stroke was considered. The possible role of inflammation in the progression of epilepsy caused by a “static” lesion (perinatal stroke is discussed.

History of psychiatry

Science.gov (United States)

Shorter, Edward

2013-01-01

Purpose of review The present review examines recent contributions to the evolving field of historical writing in psychiatry. Recent findings Interest in the history of psychiatry continues to grow, with an increasing emphasis on topics of current interest such as the history of psychopharmacology, electroconvulsive therapy, and the interplay between psychiatry and society. The scope of historical writing in psychiatry as of 2007 is as broad and varied as the discipline itself. Summary More than in other medical specialties such as cardiology or nephrology, treatment and diagnosis in psychiatry are affected by trends in the surrounding culture and society. Studying the history of the discipline provides insights into possible alternatives to the current crop of patent-protected remedies and trend-driven diagnoses. PMID:18852567

Advances in Psychiatric Diagnosis: Past, Present, and Future

Directory of Open Access Journals (Sweden)

Carol S. North

2017-04-01

Full Text Available This editorial examines controversies identified by the articles in this special issue, which explore psychopathology in the broad history of the classification of selected psychiatric disorders and syndromes over time through current American criteria. Psychiatric diagnosis has a long history of scientific investigation and application, with periods of rapid change, instability, and heated controversy associated with it. The articles in this issue examine the history of psychiatric nomenclature and explore current and future directions in psychiatric diagnosis through the various versions of accepted diagnostic criteria and accompanying research literature addressing the criteria. The articles seek to guide readers in appreciating the complexities of psychiatric diagnosis as the field of psychiatry pushes forward toward future advancements in diagnosis. Despite efforts of many scientists to advance a diagnostic classification system that incorporates neuroscience and genetics, it has been argued that it may be premature to attempt to move to a biologically-based classification system, because psychiatric disorders cannot yet be fully distinguished by any specific biological markers. For now, the symptom-based criteria that the field has been using continue to serve many essential purposes, including selection of the most effective treatment, communication about disease with colleagues, education about psychiatric illness, and support for ongoing research.

The U.S. NSF Ocean Observatories Initiative: A Modern Virtual Observatory

Science.gov (United States)

Orcutt, John; Vernon, Frank; Peach, Cheryl; Arrott, Matthew; Graybeal, John; Farcas, Claudiu; Farcas, Emilia; Krueger, Ingolf; Meisinger, Michael; Chave, Alan

2010-05-01

The NSF Ocean Observatories Initiative (OOI) began a five-year construction period in October 2009. The Consortium on Ocean Leadership (COL) manages the overall program with Implementing Organizations for Coastal/Global Scale Nodes (CGSN) at Woods Hole, Oregon State and Scripps; the Regional Cabled Network (RCN) at U of Washington and Cyberinfrastructure (CI) at UCSD and more than ten subcontractors. The NSF has made a commitment to support the observatory operations and maintenance for a 30-year period; a minimal period of time to measure physical, chemical and biological data over a length of time possibly sufficient to measure secular changes associated with climate and geodesy. The CI component is a substantial departure from previous approaches to data distribution and management. These innovations include the availability of data in near-real-time with latencies of seconds, open access to all data, analysis of the data stream for detection and modeling, use of the derived knowledge to modify the network with minimal or no human interaction and maintenance of data provenance through time as new versions of the data are created through QA/QC processes. The network architecture is designed to be scalable so that addition of new sensors is straightforward and inexpensive with costs increasing linearly at worst. Rather than building new computer infrastructure (disk farms and computer clusters), we are presently exploiting Amazon's Extensible Computing Cloud (EC2) and Simple Storage System (S3) to reduce long-term commitments to hardware and maintenance in order to minimize operations and maintenance costs. The OOI CI is actively partnering with other organizations (e.g. NOAA's IOOS) to integrate existing data systems using many of the same technologies to improve broad access to existing and planned observing systems, including those that provide critical climate data. Because seasonal and annual variability of most measureable parameters is so large, the

Calibration and Field Deployment of the NSF G-V VCSEL Hygrometer

Science.gov (United States)

DiGangi, J. P.; O'Brien, A.; Diao, M.; Hamm, C.; Zhang, Q.; Beaton, S. P.; Zondlo, M. A.

2012-12-01

Cloud formation and dynamics have a significant influence on the Earth's radiative forcing budget, which illustrates the importance of clouds with respect to global climate. Therefore, an accurate understanding of the microscale processes dictating cloud formation is crucial for accurate computer modeling of global climate change. A critical tool for understanding these processes from an airborne platform is an instrument capable of measuring water vapor with both high accuracy and time, thus spatial, resolution. Our work focuses on an open-path, compact, vertical-cavity surface-emitting laser (VCSEL) absorption-based hygrometer, capable of 25 Hz temporal resolution, deployed on the NSF/NCAR Gulfstream-V aircraft platform. The open path nature of our instrument also helps to minimize sampling artifacts. We will discuss our efforts toward achieving within 5% accuracy over 5 orders of magnitude of water vapor concentrations. This involves an intercomparison of five independent calibration methods: ice surface saturators using an oil temperature bath, solvent slush baths (e.g. chloroform/LN2, water/ice), a research-grade frost point hygrometer, static pressure experiments, and Pt catalyzed hydrogen gas. This wide variety of available tools allows us to accurately constrain the calibrant water vapor concentrations both before and after the VCSEL hygrometer sampling chamber. For example, the mixing ratio as measured by research-grade frost point hygrometer after the VCSEL hygrometer agreed within 2% of the mixing ration expected from the water/ice bubbler source before the VCSEL over the temperature range -50°C to 20°C. Finally, due to the compact nature of our instrument, we are able to perform these calibrations simultaneously at the same temperatures (-80°C to 30°C) and pressures (150 mbar to 760 mbar) as sampled ambient air during a flight. This higher accuracy can significantly influence the science utilizing this data, which we will illustrate using

Continuation of lithium after a diagnosis of chronic kidney disease

DEFF Research Database (Denmark)

Kessing, L V; Feldt-Rasmussen, B; Andersen, P K

2017-01-01

OBJECTIVE: To investigate whether continued lithium or anticonvulsant treatment after a first diagnosis of chronic kidney disease (CKD) was associated with progression to irreversible end-stage kidney disease. METHODS: Nationwide cohort study including all individuals in Denmark in a period from...... 1995 to 2012 with a diagnosis of CKD and (i) a history of lithium treatment (N = 754, among whom 238 patients had a diagnosis of bipolar disorder) or (ii) a history of anticonvulsant treatment (N = 5.004, among whom 199 patients had a diagnosis of bipolar disorder). End-stage CKD was defined as chronic...... dialysis or renal transplantation. RESULTS: Continuing lithium (HR = 0.58 (95% CI: 0.37-0.90) and continuing anticonvulsants (HR = 0.53 (95% CI: 0.44-0.64) were associated with decreased rates of end-stage CKD. In the subcohorts of patients with a diagnosis of bipolar disorder, continuing lithium...

Diagnostic accuracy of the Thessaly test, standardised clinical history and other clinical examination tests (Apley's, McMurray's and joint line tenderness) for meniscal tears in comparison with magnetic resonance imaging diagnosis.

Science.gov (United States)

Blyth, Mark; Anthony, Iain; Francq, Bernard; Brooksbank, Katriona; Downie, Paul; Powell, Andrew; Jones, Bryn; MacLean, Angus; McConnachie, Alex; Norrie, John

2015-08-01

Reliable non-invasive diagnosis of meniscal tears is difficult. Magnetic resonance imaging (MRI) is often used but is expensive and incidental findings are problematic. There are a number of physical examination tests for the diagnosis of meniscal tears that are simple, cheap and non-invasive. To determine the diagnostic accuracy of the Thessaly test and to determine if the Thessaly test (alone or in combination with other physical tests) can obviate the need for further investigation by MRI or arthroscopy for patients with a suspected meniscal tear. Single-centre prospective diagnostic accuracy study. Although the study was performed in a secondary care setting, it was designed to replicate the results that would have been achieved in a primary care setting. Two cohorts of patients were recruited: patients with knee pathology (n = 292) and a control cohort with no knee pathology (n = 75). Sensitivity, specificity and diagnostic accuracy of the Thessaly test in determining the presence of meniscal tears. Participants were assessed by both a primary care clinician and a musculoskeletal clinician. Both clinicians performed the Thessaly test, McMurray's test, Apley's test, joint line tenderness test and took a standardised clinical history from the patient. The Thessaly test had a sensitivity of 0.66, a specificity of 0.39 and a diagnostic accuracy of 54% when utilised by primary care clinicians. This compared with a sensitivity of 0.62, a specificity of 0.55 and diagnostic accuracy of 59% when used by musculoskeletal clinicians. The diagnostics accuracy of the other tests when used by primary care clinicians was 54% for McMurray's test, 53% for Apley's test, 54% for the joint line tenderness test and 55% for clinical history. For primary care clinicians, age and past history of osteoarthritis were both significant predictors of MRI diagnosis of meniscal tears. For musculoskeletal clinicians age and a positive diagnosis of meniscal tears on clinical history

[Cystic fibrosis--initial diagnosis in a 39-year-old patient].

Science.gov (United States)

Bargon, J; Rickmann, J; Jacobi, V; Straub, R; Arnemann, J; Wagner, T O

2000-12-15

Cystic fibrosis is the most common hereditary disorder among Caucasians. Most of the patients are diagnosed as children. However, some cases are going undiagnosed into adulthood and are then often misdiagnosed because the non-pediatricians do not know cystic fibrosis very well and do not consider this diagnosis in adult patients. We present the medical history of a woman, who was diagnosed with cystic fibrosis at the age of 39 years, although she had suffered from bronchiectasis, pancreatic insufficiency and liver cirrhosis since many years. Her medical history was long with some diagnosis, but because of her age nobody considered the final diagnosis. In adult patients with bronchiectasis, liver cirrhosis and pancreatic insufficiency in combination or with only one of these symptoms, cystic fibrosis should be included into the differential diagnosis.

Year-Long Peer Mentoring Activity to Enhance the Retention of Freshmen STEM Students in a NSF Scholarship Program

Science.gov (United States)

Cutright, Teresa J.; Evans, Edward

2016-01-01

The last year of a National Science Foundation (NSF) funded scholarship program was used to provide pseudo-formal peer mentoring activities to engineering, mathematics, and science undergraduates. A one-credit class was used to afford time for peer mentors and mentees to interact. During the fall semester, seniors augmented each week's topics with…

Evaluation of NSF's Program of Grants and Vertical Integration of Research and Education in the Mathematical Sciences (VIGRE)

Science.gov (United States)

National Academies Press, 2009

2009-01-01

In 1998, the National Science Foundation (NSF) launched a program of Grants for Vertical Integration of Research and Education in the Mathematical Sciences (VIGRE). These grants were designed for institutions with PhD-granting departments in the mathematical sciences, for the purpose of developing high-quality education programs, at all levels,…

Cheating and sports: history, diagnosis and treatment.

Science.gov (United States)

Kamis, Danielle; Newmark, Thomas; Begel, Daniel; Glick, Ira D

2016-12-01

This paper focuses on "cheating" in modern day athletics from youth through professional sports. We briefly summarize a history of cheating in the sports world. We examine the current role cheating plays in sports as well as its causes including, psychodynamic issues, the development of personality disorders and how personality traits become pathological resulting in deception, dishonesty, and underhandedness. We describe management and treatment including psychotherapeutic intervention as well as medication. Finally we discuss a systems approach involving outreach to coaches, families, and related sports organizations (like FIFA, WADA, etc) or the professional leagues which have institutional control and partial influence on the athlete.

Diagnosis of diabetes insipidus observed in Swiss Duroc boars.

Science.gov (United States)

Grahofer, Alexander; Wiedemar, Natalie; Gurtner, Corinne; Drögemüller, Cord; Nathues, Heiko

2016-01-29

Diabetes insipidus (DI) is a rare disease in humans and animals, which is caused by the lack of production, malfunction or dysfunction of the distal nephron to the antidiuretic effect of the antidiuretic hormone (ADH). Diagnosis requires a thorough medical history, clinical examination and further laboratory confirmation. This case report describes the appearance of DI in five Duroc boars in Switzerland. Two purebred intact Duroc boars at the age of 8 months and 1.5 years, respectively, with a history of polyuric and polydipsic symptoms had been referred to the Swine Clinic in Berne. Based on the case history, the results of clinical examination and the analysis of blood and urine, a tentative diagnosis of DI was concluded. Finally, the diagnosis was confirmed by findings from a modified water deprivation test, macroscopic examinations and histopathology. Following the diagnosis, three genes known to be involved in inherited DI in humans were analyzed in order to explore a possible genetic background of the affected boars. The etiology of DI in pigs is supposed to be the same as in humans, although this disease has never been described in pigs before. Thus, although occurring only on rare occasions, DI should be considered as a differential diagnosis in pigs with polyuria and polydipsia. It seems that a modified water deprivation test may be a helpful tool for confirming a diagnosis in pigs. Since hereditary forms of DI have been described in humans, the occurrence of DI in pigs should be considered in breeding programs although we were not able to identify a disease associated mutation.

Accuracy of family history of cancer : clinical genetic implications

NARCIS (Netherlands)

Sijmons, RH; Boonstra, AE; Reefhuis, J; Hordijk-Hos, JM; de Walle, HEK; Oosterwijk, JC; Cornel, MC

Family medical history is the cornerstone of clinical genetic diagnosis and management in cases of familial cancer. The soundness of medical decisions can be compromised if reports by the family on affected relatives are inaccurate. Although very time consuming, family medical histories are

Photoelastic examination of borosilicate glass discs used in the insulating legs for the NSF tandem

International Nuclear Information System (INIS)

Acton, W.J.; Cundy, D.

1981-04-01

The results are presented of a photoelastic stress analysis carried out to establish the effect of re-annealing borosilicate glass discs used in the insulating legs of the 30 MV tandem van de Graaff accelerator of the NSF. The results show that re-annealing of the glass discs has no measurable effect on reducing the high stress at inclusions and re-emphasise the need to exercise great care in selecting suitable discs for use in the insulating legs. (U.K.)

Building A Drought Science Learning Community: Education and Engagement in an NSF CAREER Grant

Science.gov (United States)

Quiring, S. M.

2011-12-01

This paper describes the education and engagement plan of the NSF CAREER award that I received in 2011 (Role of Soil Moisture in Seasonal to Interannual Climate Variability in the U.S. Great Plains; NSF Award #1056796). A key component of this plan is the development of a Drought Science Learning Community. A learning community is a program of courses and activities, which may include social and academic activities outside the classroom, that form a single program of instruction. Learning communities serve to increase faculty-student and student-student interaction, improve active and collaborative learning, and develop curricular coherence. The goal of a learning community is to encourage integration of learning across courses and to involve students with one of the grand challenges facing society. Students will be recruited from a Freshman Year Seminar (FYS) that I teach every Fall. Students who belong to the learning community will participate in the Water Management and Hydrological Sciences Seminar Series, relevant field trips, and monthly brown bag lunch meetings where students and faculty will discuss their current research projects and recently published scientific articles. Students who participate in learning community activities will benefit from a common intellectual experience that will help them to develop linkages between courses, regular interactions with faculty mentors, and the opportunity to contribute to faculty research. All students will be encouraged to complete an undergraduate thesis as the capstone experience of their participation in the learning community. In addition to describing the organization of the education and engagement plan, I will also discuss expected outcomes, best practices and lessons learned.

Exploration of NSF-ATE Projects Approaches in the Integration of Technology and Engineering Education at the K-12 Levels

Science.gov (United States)

Strobel, Johannes; Mendoza Díaz, Noemi V.

2012-01-01

Access to post-secondary education, specifically in the technical, two-year institution area, is a topic of growing interest in the country. Funding agencies, such as NSF, via the Advanced Technological Education Program (ATE), are supporting initiatives and research aimed at increasing the number of technicians and engineers and improving…

Diagnosis of Hymenoptera venom allergy

NARCIS (Netherlands)

Bilo, BM; Rueff, F; Mosbech, H; Bonifazi, F; Oude Elberink, JNG

2005-01-01

The purpose of diagnostic procedure is to classify a sting reaction by history, identify the underlying pathogenetic mechanism, and identify the offending insect. Diagnosis of Hymenoptera venom allergy thus forms the basis for the treatment. In the central and northern Europe vespid (mainly Vespula

Are we there yet? An NSF-CAREER sponsored field program as a vehicle for engaging high school students in geology

Science.gov (United States)

Frank, T. D.

2011-12-01

Many students graduate from high school having never been exposed to the geosciences. The idea of a career in the geosciences is therefore often not on the radar when students embark on university studies. History on the Rocks, a field-based summer program developed as part of a NSF-CAREER grant and offered annually since 2008, is designed to expose high school students to geology through hands-on experiences. The program focuses on interpreting the sedimentary rock record, the major archive of Earth history. Following a day of introductory exercises in the lab, participants travel to world-class geologic sites around Nebraska and collect evidence that allows them to interpret environment and climate at the time of deposition. They use their data to consider how climate change, sea level, and catastrophic events leave their imprints on the rock record and to reconstruct Nebraska's geologic history. In 2008, 12 high school science teachers from districts across Nebraska, incuding the Santee Nation district, enrolled in the program. Teachers developed a set of lesson plans related to their field experience. They posted the plans online and now routinely use them in their home schools, thereby exposing their students to geology. Subsequent programs have been held for groups of high school students drawn from rural and urban regions throughout the state. Working with students raised some unforeseen issues related to accident liability and parental concern about students working in remote areas. These problems were solved by offering the program through existing, well-known entities, including Girls Inc., a nonprofit organization that empowers girls from low-income families in urban settings (i.e., Omaha), and the 4H Youth Development Extension Office at the University of Nebraska-Lincoln (UNL). Both groups are eager to provide students with the opportunity to visit a university and explore careers. Convincing inner-city students, who generally came to the program with

Cornell's LEPP, CHESS research labs expected to get $124 million in NSF funding for elementary particle and X-ray research

CERN Multimedia

2003-01-01

"Cornell University will be awarded up to $124 million over the next five years by the National Science Foundation (NSF) to support research at the Laboratory for Elementary-Particle Physics (LEPP) and the Cornell High Energy Synchrotron Source (CHESS), a national user facility" (1 page).

Hepatosplenic Candidiasis Without Prior Documented Candidemia: An Underrecognized Diagnosis?

Science.gov (United States)

van Prehn, Joffrey; Menke-van der Houven van Oordt, C Willemien; de Rooij, Madelon L; Meijer, Ellen; Bomers, Marije K; van Dijk, Karin

2017-08-01

Patients with a history of chemotherapy or stem cell transplantation (SCT) and prolonged neutropenia are at risk for hepatic and/or splenic seeding of Candida . In our experience, hepatosplenic candidiasis (HSC) without documented candidemia often remains unrecognized. We describe three cases of HSC without documented candidemia and the challenges in establishing the diagnosis and adequately treating this condition. The first patient had a history of SCT for treatment of breast cancer and was scheduled for hemihepatectomy for suspected liver metastasis. A second opinion at our institute resulted in the diagnosis of hepatic candidiasis without prior documented candidemia, for which she was treated successfully with fluconazole. The second case demonstrates the limitations of (blood and tissue) cultures and the value of molecular methods to confirm the diagnosis. Case 3 illustrates treatment challenges, with ongoing dissemination and insufficient source control despite months of antifungal therapy, eventually resulting in a splenectomy. A structured literature search was performed for articles describing any patient with HSC and documented blood culture results. Thirty articles were available for extraction of data on candidemia and HSC. Seventy percent (131/187) of patients with HSC did not have documented candidemia. The majority of HSC events were described in hematologic patients, although some cases were described in patients with solid tumors treated with SCT ( n  = 1) or chemotherapy and a history of leukopenia ( n  = 2). Current guidelines and practices for diagnosis and treatment are described. Clinicians should be aware that HSC most often occurs without documented candidemia. In case of persistent or unexplained fever or lesions in the liver and/or spleen, a history of neutropenia should place disseminated candidiasis in the differential diagnosis. HSC is not limited to hematological patients and may occur in patients with solid tumors treated with

Impostor Syndrome, a Reparative History

Directory of Open Access Journals (Sweden)

Dana Simmons

2016-08-01

Full Text Available This is an attempt to insert the stories we tell about fear and shame into a history of twentieth-century psychology and its obsession with achievement and modernization. It is an attempt to write an affective history of achievement at the turn of the millennium - and to make this feeling history. Impostor Syndrome is a pop-psychological diagnosis, employed to explain the low presence of women in STEM fields, business and academic administration and ’thought leadership’ in the pubic sphere. The article follows the intellectual lineage of two precursors of Impostor Syndrome, Fear of Success and the Impostor Phenomenon. It argues that the grouping of gender/ race/ success/ affect was a keystone of twentieth-century American psychology and development theory. The history of this feeling has consequences for thinking about situated knowledge, realism and epistemic justice.

Radiological diagnosis of fractures

International Nuclear Information System (INIS)

Finlay, D.B.L.; Allen, M.J.

1984-01-01

This book is about radiology of fractures. While it contains sections of clinical features it is not intended that readers should rely entirely upon these for the diagnosis and management of the injured patient. As in the diagnosis and treatment of all medical problems, fracture management must be carried out in a logical step-by-step fashion - namely, history, examination, investigation, differential diagnosis, diagnosis and then treatment. Each section deals with a specific anatomical area and begins with line drawings of the normal radiographs demonstrating the anatomy. Accessory views that may be requested, and the indications for these, are included. Any radiological pitfalls for the area in general are then described. The fractures in adults are then examined in turn, their radiological features described, and any pitfalls in their diagnosis discussed. A brief note of important clinical findings is included. A brief mention is made of pediatric fractures which are of significance and their differences to the adult pattern indicated. Although fractures can be classified into types with different characteristics, in life every fracture is individual. Fractures by and large follow common patterns, but many have variations

Diagnostic accuracy of self-report and subjective history in the diagnosis of low back pain with non-specific lower extremity symptoms: A systematic review.

Science.gov (United States)

Shultz, Susan; Averell, Kristina; Eickelman, Angela; Sanker, Holly; Donaldson, Megan Burrowbridge

2015-02-01

Subjective history questions/self-report items are commonly used to triage the patient with low back pain and related leg symptoms. However the value of the history taking process for decision-making to identify common classifications/diagnosis for patients presenting with low back related leg pain (LBRLP) have not been considered. The purpose of this study was to investigate the diagnostic accuracy of self-report items/history-taking questions used to identify patients with LBRLP. Eligible studies included: 1)subjects with low back pain AND related lower extremity pain, 2)details of subjective examination/self-report items, 3)cohort, prospective/longitudinal studies, and randomized control trials, 4)use of statistical reporting, 5)an acceptable reference standard. Quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2. A synthesis of history items that met the threshold for at least a small shift in the likelihood of the condition with a +LR ≥ 2 or -LR ≤ 0.5 were reported. Conditions commonly reported in the literature: lumbar spinal stenosis, lumbosacral nerve root compression/radiculopathy, disc herniation and neurophysiological low back pain ± leg pain. Eleven studies met the inclusion criteria. This is the first systematic review of diagnostic accuracy studies that examined only the history-taking items for their ability to identify LBRLP conditions. Clustering key items may provide a more precise clinical picture necessary to detect and treat a patient's presentation. History questions formed within the interview and their contributing value for decision-making remain understudied. There is a need for better designs to determine a more accurate diagnostic power to identify conditions with LBRLP. Copyright © 2014 Elsevier Ltd. All rights reserved.

Functional vision loss: a diagnosis of exclusion.

Science.gov (United States)

Villegas, Rex B; Ilsen, Pauline F

2007-10-01

Most cases of visual acuity or visual field loss can be attributed to ocular pathology or ocular manifestations of systemic pathology. They can also occasionally be attributed to nonpathologic processes or malingering. Functional vision loss is any decrease in vision the origin of which cannot be attributed to a pathologic or structural abnormality. Two cases of functional vision loss are described. In the first, a 58-year-old man presented for a baseline eye examination for enrollment in a vision rehabilitation program. He reported bilateral blindness since a motor vehicle accident with head trauma 4 years prior. Entering visual acuity was "no light perception" in each eye. Ocular health examination was normal and the patient made frequent eye contact with the examiners. He was referred for neuroimaging and electrophysiologic testing. The second case was a 49-year-old man who presented with a long history of intermittent monocular diplopia. His medical history was significant for psycho-medical evaluations and a diagnosis of factitious disorder. Entering uncorrected visual acuities were 20/20 in each eye, but visual field testing found constriction. No abnormalities were found that could account for the monocular diplopia or visual field deficit. A diagnosis of functional vision loss secondary to factitious disorder was made. Functional vision loss is a diagnosis of exclusion. In the event of reduced vision in the context of a normal ocular health examination, all other pathology must be ruled out before making the diagnosis of functional vision loss. Evaluation must include auxiliary ophthalmologic testing, neuroimaging of the visual pathway, review of the medical history and lifestyle, and psychiatric evaluation. Comanagement with a psychiatrist is essential for patients with functional vision loss.

Does the medical diagnosis of occupational asthma coincide with the legal diagnosis?

Science.gov (United States)

Çelebi Sözener, Zeynep; Aydın, Ömür; Demirel, Yavuz Selim; Soyyiğit, Şadan; Çerçi, Pamir; Kendirlinan, Reşat; Bavbek, Sevim; Çelik, Gülfem Elif; Misirligil, Zeynep; Sin, Betül Ayşe; Keleşoğlu, Arif; Mungan, Dilşad

2017-11-01

The incidence of occupational asthma (OA) is increasing worldwide. In this study, we first aimed to document the rate of diagnosis of OA among patients who were referred to our clinic from the Social Security Institution and the factors that affected diagnosis; secondly, we aimed to assess the consistency of the medical and legal diagnoses. The study involved 132 consecutive patients who were referred to our clinic for the evaluation of OA between 2010 and 2015. Detailed workplace history, the tools used in the diagnosis such as peak expiratory flow (PEF) monitoring and bronchial provocation tests, and the final medical diagnosis were recorded from case files. Asthma was diagnosed in 75% (n = 99) of the patients. Among them, 22.2% were diagnosed as having OA. The diagnosis was confirmed by serial PEF measurements, non-specific bronchial hyperreactivity assessment or both of the tests both at work and off-work periods. OA diagnosis was mostly established in active workers (72.7%). The legal diagnosis period was completed in 54.5% of these 22 patients, and 50% (n = 11) were officially diagnosed as having OA with a 91.6% concordance with medical diagnosis. This study verifies the importance of diagnosing asthma correctly as a first step in the evaluation of OA. Diagnostic tests other than specific provocation tests could be preferential in patients who still work in the same field. We believe that cooperation with the patient's occupational physician and adequate recognition of the work environment will improve the consistency of legal and medical diagnoses.

Family history influences the early onset of hepatocellular carcinoma

Institute of Scientific and Technical Information of China (English)

Chung-Hwa Park; Seung-Hee Jeong; Hyeon-Woo Yim; Jin Dong Kim; Si Hyun Bae; Jong Young Choi; Seung Kew Yoon

2012-01-01

AIM:To evaluate the relationship between a positive family history of primary liver cancer and hepatocellular carcinoma (HCC) development in Korean HCC patients.METHODS:We studied a total of 2242 patients diagnosed with HCC between January 1990 and July 2008,whose family history of primary liver cancer was clearly described in the medical records.RESULTS:Of the 2242 patients,165 (7.4％) had a positive family history of HCC and 2077 (92.6％) did not.The male to female ratio was 3.6:1,and the major causes of HCC were chronic hepatitis B virus (HBV) infection in 75.1％,chronic hepatitis C virus infection in 13.2％ and alcohol in 3.1％.The median ages at diagnosis in the positive-and negative-history groups were 52 years (range:29-79 years) and 57 years (range:18-89 years),respectively (P ＜ 0.0001).Furthermore,among 1713 HCC patients with HBV infection,the number of patients under 45 years of age out of 136 patients with positive family history was 26 (19.1％),whereas those out of 1577 patients with negative family history was 197 (12.5％),suggesting that a positive family history may be associated with earlier development of HCC in the Korean population (P =0.0028).CONCLUSION:More intensive surveillance maybe recommended to those with a positive family history of HCC for earlier diagnosis and proper management especially when HBV infection is present.

Diagnosis of bone metastasis from thyroid carcinoma: a multidisciplinary approach

International Nuclear Information System (INIS)

Bechsgaard, Thor; Lelkaitis, Giedrius; Jensen, Karl E; Ewertsen, Caroline

2015-01-01

Sarcomas are rare tumors originating from soft tissue or bone. Diagnosis and treatment of sarcomas should be performed at specialized sarcoma centers, where patients are evaluated at a multidisciplinary tumor conference. We present a case where sarcoma was suspected from magnetic resonance imaging (MRI), but histology revealed a metastasis from thyroid carcinoma, although the patient had no previous history of thyroid malignancy and resection of the thyroid gland was without malignancy. Ultrasound-guided biopsy was possible due to cortical destruction and the multidisciplinary approach with re-evaluation of previous pathology and a thorough patient history enabled a final diagnosis

Cyberinfrastructure for the NSF Ocean Observatories Initiative

Science.gov (United States)

Orcutt, J. A.; Vernon, F. L.; Arrott, M.; Chave, A.; Krueger, I.; Schofield, O.; Glenn, S.; Peach, C.; Nayak, A.

2007-12-01

The Internet today is vastly different than the Internet that we knew even five years ago and the changes that will be evident five years from now, when the NSF Ocean Observatories Initiative (OOI) prototype has been installed, are nearly unpredictable. Much of this progress is based on the exponential growth in capabilities of consumer electronics and information technology; the reality of this exponential behavior is rarely appreciated. For example, the number of transistors on a square cm of silicon will continue to double every 18 months, the density of disk storage will double every year, and network bandwidth will double every eight months. Today's desktop 2TB RAID will be 64TB and the 10Gbps Regional Scale Network fiber optical connection will be running at 1.8Tbps. The same exponential behavior characterizes the future of genome sequencing. The first two sequences of composites of individuals' genes cost tens of millions of dollars in 2001. Dr. Craig Venter just published a more accurate complete human genome (his own) at a cost on the order of 100,000. The J. Craig Venter Institute has provided support for the X Prize for Genomics offering 10M to the first successful sequencing of a human genome for $1,000. It's anticipated that the prize will be won within five years. Major advances in technology that are broadly viewed as disruptive or revolutionary rather than evolutionary will often depend upon the exploitation of exponential expansions in capability. Applications of these ideas to the OOI will be discussed. Specifically, the agile ability to scale cyberinfrastructure commensurate with the exponential growth of sensors, networks and computational capability and demand will be described.

Monitoring the consequences of decreased ozone protection: The NSF ultraviolet radiation monitoring network

International Nuclear Information System (INIS)

Anon.

1993-01-01

The effects of decreased protection from ultraviolet radiation are as troubling as the continuing depletion of stratospheric ozone. Evidence exists to clearly link ozone depletion to changes in the antarctic marine environment. Results of two 1992 papers are summarized here. Enhanced exposure to mid-range UV radiation was found to be affecting marine ecosystems with a recorded 6-12 percent reduction in primary productivity directly related to the ozone layer depletion. In another experiment, a model was developed indicating that the ozone hole could reduce near-surface photosynthesis by as much as 12-15 percent. The NSF UV monitoring system in place for these and other experiments uses a spectroradiometer, making hourly, high-resolution measurements of the distribution of UV surface irradiance

Preparing Scientists for Scientific Careers: Broader Impacts from an NSF CAREER Award

Science.gov (United States)

Crosby, Alfred

2008-03-01

The scientific focus of my NSF CAREER Award is the impact of patterns, topographical and surface chemical in design, on the adhesion of soft polymer interfaces. Although this topic has provided a strong foundation for the mentoring and training of graduate students, the primary broader impacts of my award have focused on the development of ``soft'' skills in graduate and post-doctoral researchers in STEM disciplines. I have developed a course on ``Scientific and Engineering Management,'' which provides an open forum for students to explore the skills that, in many ways, define successful careers for many scientists. Topics include: leadership, proposal writing, group management, communication in diverse environments, and ethics. In this presentation, I highlight the primary phases of this program, how it meshes with scientific goals, and general statements about the mission of education outreach within STEM disciplines.

Approaches to the diagnosis and management of patients with a history of nonsteroidal anti-inflammatory drug-related urticaria and angioedema.

Science.gov (United States)

Kowalski, Marek L; Woessner, Katharine; Sanak, Marek

2015-08-01

Nonsteroidal anti-inflammatory drug (NSAID)-induced urticarial and angioedema reactions are among the most commonly encountered drug hypersensitivity reactions in clinical practice. Three major clinical phenotypes of NSAID-induced acute skin reactions manifesting with angioedema, urticaria, or both have been distinguished: NSAID-exacerbated cutaneous disease, nonsteroidal anti-inflammatory drug-induced urticaria/angioedema (NIUA), and single NSAID-induced urticaria and angioedema. In some patients clinical history alone might be sufficient to establish the diagnosis of a specific type of NSAID hypersensitivity, whereas in other cases oral provocation challenges are necessary to confirm the diagnosis. Moreover, classification of the type of cutaneous reaction is critical for proper management. For example, in patients with single NSAID-induced reactions, chemically nonrelated COX-1 inhibitors can be safely used. However, there is cross-reactivity between the NSAIDs in patients with NSAID-exacerbated cutaneous disease and NIUA, and thus only use of selective COX-2 inhibitors can replace the culprit drug if the chronic treatment is necessary, although aspirin desensitization will allow for chronic treatment with NSAIDs in some patients with NIUA. In this review we present a practical clinical approach to the patient with NSAID-induced urticaria and angioedema. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Obsessive-Compulsive Disorder with Suicide Obsessions in a First Responder without Previous Diagnosis of OCD or History of Suicide Attempts.

Science.gov (United States)

Rachamallu, Vivekananda; Song, Michael M; Liu, Haiying; Giles, Charles L; McMahon, Terry

2017-01-01

Obsessive-compulsive disorder (OCD) is a distressing and often debilitating disorder characterized by obsessions, compulsions, or both that are time-consuming and cause impairment in social, occupational, or other areas of functioning. There are many published studies reporting higher risk of suicidality in OCD patients, as well as studies describing increased risk of suicidality in OCD patients with other comorbid psychiatric conditions such as major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). Existing case reports on OCD with suicide as the obsessive component describe patients with long standing diagnosis of OCD with suicidal ideations or previous suicide attempts. This report describes the case of a 28-year-old male, who works as a first responder, who presented with new onset symptoms characteristic of MDD and PTSD, with no past history of OCD or suicidality who developed OCD with suicidal obsessions. Differentiating between suicidal ideation in the context of other psychiatric illnesses and suicidal obsessions in OCD is critical to ensuring accurate diagnosis and timely provision of most appropriate treatment. The combination of exposure and response prevention therapy and pharmacotherapy with sertraline and olanzapine was effective in helping the patient manage the anxiety and distress stemming from the patient's OCD with suicidal obsession.

Opportunities for Funding at NSF

Science.gov (United States)

Kafafi, Zakya H.

2009-03-01

lead to a better quality of life and improved economic development for people all over the world will also be given. As science is becoming increasingly global, DMR is particularly interested in preparing students to be agile thinkers in this universal environment and in forging collaborations and cooperation among scientists and engineers around the world. Free movement of knowledge without any obstacles can only be achieved through a more coordinated approach for international collaboration. Following the presentation there will be a question-and-answer period. For additional information, visit the DMR Web page at www.nsf.gov/materials

Increasing Access for Economically Disadvantaged Students: The NSF/CSEM & S-STEM Programs at Louisiana State University

Science.gov (United States)

Wilson, Zakiya S.; Iyengar, Sitharama S.; Pang, Su-Seng; Warner, Isiah M.; Luces, Candace A.

2012-10-01

Increasing college degree attainment for students from disadvantaged backgrounds is a prominent component of numerous state and federal legislation focused on higher education. In 1999, the National Science Foundation (NSF) instituted the "Computer Science, Engineering, and Mathematics Scholarships" (CSEMS) program; this initiative was designed to provide greater access and support to academically talented students from economically disadvantaged backgrounds. Originally intended to provide financial support to lower income students, this NSF program also advocated that additional professional development and advising would be strategies to increase undergraduate persistence to graduation. This innovative program for economically disadvantaged students was extended in 2004 to include students from other disciplines including the physical and life sciences as well as the technology fields, and the new name of the program was Scholarships for Science, Technology, Engineering and Mathematics (S-STEM). The implementation of these two programs in Louisiana State University (LSU) has shown significant and measurable success since 2000, making LSU a Model University in providing support to economically disadvantaged students within the STEM disciplines. The achievement of these programs is evidenced by the graduation rates of its participants. This report provides details on the educational model employed through the CSEMS/S-STEM projects at LSU and provides a path to success for increasing student retention rates in STEM disciplines. While the LSU's experience is presented as a case study, the potential relevance of this innovative mentoring program in conjunction with the financial support system is discussed in detail.

Skin-deep diagnosis: affective bias and zebra retreat complicating the diagnosis of systemic sclerosis.

Science.gov (United States)

Miller, Chad S

2013-01-01

Nearly half of medical errors can be attributed to an error of clinical reasoning or decision making. It is estimated that the correct diagnosis is missed or delayed in between 5% and 14% of acute hospital admissions. Through understanding why and how physicians make these errors, it is hoped that strategies can be developed to decrease the number of these errors. In the present case, a patient presented with dyspnea, gastrointestinal symptoms and weight loss; the diagnosis was initially missed when the treating physicians took mental short cuts and used heuristics as in this case. Heuristics have an inherent bias that can lead to faulty reasoning or conclusions, especially in complex or difficult cases. Affective bias, which is the overinvolvement of emotion in clinical decision making, limited the available information for diagnosis because of the hesitancy to acquire a full history and perform a complete physical examination in this patient. Zebra retreat, another type of bias, is when a rare diagnosis figures prominently on the differential diagnosis but the physician retreats for various reasons. Zebra retreat also factored in the delayed diagnosis. Through the description of these clinical reasoning errors in an actual case, it is hoped that future errors can be prevented or inspiration for additional research in this area will develop.

Overview of diagnosis and management of paediatric headache. Part I: diagnosis.

Science.gov (United States)

Ozge, Aynur; Termine, Cristiano; Antonaci, Fabio; Natriashvili, Sophia; Guidetti, Vincenzo; Wöber-Bingöl, Ciçek

2011-02-01

Headache is the most common somatic complaint in children and adolescents. The evaluation should include detailed history of children and adolescents completed by detailed general and neurological examinations. Moreover, the possible role of psychological factors, life events and excessively stressful lifestyle in influencing recurrent headache need to be checked. The choice of laboratory tests rests on the differential diagnosis suggested by the history, the character and temporal pattern of the headache, and the physical and neurological examinations. Subjects who have any signs or symptoms of focal/progressive neurological disturbances should be investigated by neuroimaging techniques. The electroencephalogram and other neurophysiological examinations are of limited value in the routine evaluation of headaches. In a primary headache disorder, headache itself is the illness and headache is not attributed to any other disorder (e.g. migraine, tension-type headache, cluster headache and other trigeminal autonomic cephalgias). In secondary headache disorders, headache is the symptom of identifiable structural, metabolic or other abnormality. Red flags include the first or worst headache ever in the life, recent headache onset, increasing severity or frequency, occipital location, awakening from sleep because of headache, headache occurring exclusively in the morning associated with severe vomiting and headache associated with straining. Thus, the differential diagnosis between primary and secondary headaches rests mainly on clinical criteria. A thorough evaluation of headache in children and adolescents is necessary to make the correct diagnosis and initiate treatment, bearing in mind that children with headache are more likely to experience psychosocial adversity and to grow up with an excess of both headache and other physical and psychiatric symptoms and this creates an important healthcare problem for their future life.

[Clinical diagnosis of dyslexia].

Science.gov (United States)

Martínez Hermosillo, A; Balderas Gil, A

1980-01-01

In 5 years of experience at the Instituto Nacional de la Comunicacion Humana, 302 clinical histories showed the diagnosis of dyslexia. The following parameters were studied: age, sex, heredofamilial history, gestation, psychomotor development, clinical picture, examination of the language (type, reading, spontaneous writing, dictation, mathematic concepts), laterality, scholarship, scholar failures, psychological study. The following results were obtained: Dyslexia was more important or frequent between 5 to 8.9 years of age. Males predominated 3:1. The heredofamilial history was important. Dyslexia prevailed in products of the first gestations. A high disturbance was found in the psychomotor development of a large percent of dyslexic patients. Examination of language was also important. Dyslexia was more frequent in right-handed patients. Scholar failures in one or more instances were found. The psychological study must be done. If dyslexia is diagnosed on time, it may be prevented and all unwanted sequelae may be avoided.

Sun protection practices among offspring of women with personal or family history of skin cancer.

Science.gov (United States)

Geller, Alan C; Brooks, Daniel R; Colditz, Graham A; Koh, Howard K; Frazier, A Lindsay

2006-04-01

Family history of skin cancer is an important determinant of skin cancer risk for offspring. No previous study of the effect of personal or family history of skin cancer on the sun protection behaviors of the offspring has been published. A retrospective study was conducted of the sun protection behaviors of the adolescent participants in the Growing Up Today Study (GUTS), who were offspring of mothers from the Nurses Health Study II. Adolescents' surveys were matched with their mothers' reports of a personal or family history of skin cancer and compared with adolescents whose mothers did not report a personal or family history of skin cancer. The outcome measures were (1) occurrence of frequent sunburns during the past summer, (2) use of a tanning bed during the past year, and (3) routine use of sunscreen. Frequent sunburns were defined as the report of > or = 3 sunburns during the past summer. We compared those who reported having used a tanning bed in the past year at least once with those who reported no tanning bed use in the past year. Routine use of sunscreen was defined as a respondent who replied that he or she "always" or "often" used sunscreen with sun protection factor of 15 or more when he or she was outside for > 15 minutes on a sunny day during the past summer. General estimating equations were used to calculate odds ratios and 95% confidence intervals adjusted for gender, age, color of untanned skin, and number of friends who were tanned. We also conducted an additional analysis restricted to children whose mothers had received a diagnosis of skin cancer in which we assessed sun protection behaviors according to the child's age and mother's age at the time of the mother's diagnosis and the number of years that had passed since the diagnosis of the mother's skin cancer. In 1999, 9943 children reported their sun protection behaviors; 8697 of their mothers had not received a diagnosis of skin cancer or reported a family history of melanoma, 463

Emphysematous and xanthogranulomatous pyelonephritis: rare diagnosis

Directory of Open Access Journals (Sweden)

Lya Duarte Ramos

Full Text Available Pyelonephritis is a pyogenic infection of renal parenchyma that involves the renal pelvis. It is generally of easy diagnosis. The present case report aims to describe two different manifestations of this infection: xanthogranulomatous pyelonephritis and emphysematous pyelonephritis, which have poor prognosis and require a more effective treatment. The two cases were women in the fiftieth and sixtieth decade of life, with diabetes mellitus and history of weight loss. The diagnosis of the renal infection was established through computed tomography and the treatment was based in surgical procedure, with favorable outcome.

High-Resolution Digitization of the Film Archive of SPRI/NSF/TUD Radar Sounding of the Antarctic Ice Sheet

Science.gov (United States)

Schroeder, D. M.; Dowdeswell, J. A.; Mackie, E. J.; Vega, K. I.; Emmons, J. R.; Winstein, K.; Bingham, R. G.; Benham, T. J.

2017-12-01

The airborne radio echo sounding data collected during the SPRI/NSF/TUD surveys of the Antarctic Ice Sheet in the late nineteen sixties and early seventies were recorded on a combination of 35mm and super-8 mm black-and-white optical film. These data represent the oldest extant continent-scale geophysical observations of ice thickness, internal layering and conditions beneath the Antarctic Ice Sheet. As such, when compared with modern radar sounding observations, they offer a unique opportunity to investigate temporal changes in ice sheet conditions across half a century. However, the storage of these data on film, paper-prints, and scans of those prints have made such comparison at the full radiometric and geometric resolution of the data difficult. To address this challenge, we utilized a state-of-the-art high-resolution Hollywood film scanning system to digitize the entire SPRI/NSF/TUD optical film archive. This has resulted in over two million digital images with information at the full spatial and brightness-level resolution of the original film. We present the process and results of this scanning as well as the current progress in formatting, registering, and positioning these data for release and use by the wider radio glaciological community. We also discuss the glaciological insights enabled by this effort.

Application of water quality indices NSF, DINIUS and BMWP to Ayura Creek, Antioquia, Colombia

International Nuclear Information System (INIS)

Gonzalez Melendez, Viky; Caicedo Quintero, Orlando; Aguirre Ramirez, Nestor

2013-01-01

This investigation evaluates the quality of water in the creek The Ayura (municipality of Envigado, Antioquia, Colombia), through application of the National Sanitation Foundation (NSF) and Dinius quality indexes, and the biotic index BMWP/Col. the estimate of these indexes was conducted with data collected in three sites and three moments. Physicochemical and microbiological variables were determinate; we also performed a qualitative and quantitative sampling of aquatic macroinvertebrates. Using this methodology the behavior of physical-chemical and biological community in the different sites was studied. The physicochemical and aquatic macroinvertebrate indexes results showed that site 1 provides a good quality of water and the sites 2 and 3 a middle deteriorated water quality.

Creep-Fatigue Failure Diagnosis

Science.gov (United States)

Holdsworth, Stuart

2015-01-01

Failure diagnosis invariably involves consideration of both associated material condition and the results of a mechanical analysis of prior operating history. This Review focuses on these aspects with particular reference to creep-fatigue failure diagnosis. Creep-fatigue cracking can be due to a spectrum of loading conditions ranging from pure cyclic to mainly steady loading with infrequent off-load transients. These require a range of mechanical analysis approaches, a number of which are reviewed. The microstructural information revealing material condition can vary with alloy class. In practice, the detail of the consequent cracking mechanism(s) can be camouflaged by oxidation at high temperatures, although the presence of oxide on fracture surfaces can be used to date events leading to failure. Routine laboratory specimen post-test examination is strongly recommended to characterise the detail of deformation and damage accumulation under known and well-controlled loading conditions to improve the effectiveness and efficiency of failure diagnosis. PMID:28793676

To tell or not to tell the diagnosis of schizophrenia.

OpenAIRE

Donnelly, P

1989-01-01

Some patients with schizophrenia are not told their diagnosis. The moral, clinical and practical issues involved in telling or not telling the patient are discussed. In some cases a relative is told the diagnosis but not the patient. The implications for the family and clinical outcome are outlined. A case history illustrating some of these issues is presented.

Laboratory Diagnosis of Congenital Toxoplasmosis

Science.gov (United States)

Pomares, Christelle

2016-01-01

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

International perspective on nanotechnology papers, patents, and NSF awards (2000-2016)

Science.gov (United States)

Zhu, Hongyi; Jiang, Shan; Chen, Hsinchun; Roco, Mihail C.

2017-11-01

This paper presents the development of nanotechnology between 2000 and 2016 as reflected in the Web of Science papers, United States Patent and Trademark Office (USPTO), World International Property Organization (WIPO) patents, and National Science Foundation (NSF) awards, with a special reference to the United States (US), European Union (EU27), P.R. China, Japan, and South Korea. The field of nanotechnology is branching out into novel scientific and technology platforms, and it is increasingly difficult to separate foundational nanoscale components from divergent application areas. The average global growth rate has been sustained at about 15% for both papers and patents in the selected interval. The growth rates among regions are non-uniform. P.R. China and South Korea have increased faster in both the numbers and quality of their scientific publications, and currently P.R. China has the largest volume of nanotechnology publications and South Korea the most publications per capita in the field of nanotechnology. The US, EU27, and Japan are maintaining leadership in the upstream, better cited, conceptual components of nanotechnology research and development.

Gynecomastia in two young men with histories of prolonged use of anabolic androgenic steroids

OpenAIRE

Orlandi, M.A.; Venegoni, E.; Pagani, C.

2010-01-01

The aim of this report is to highlight the risk of anabolic androgenic steroid-induced gynecomastia in young men involved in nonagonistic sports and the role of ultrasonography in its diagnosis. The authors describe two cases of gynecomastia in nonprofessional weight lifters with histories of AAS use. In both cases, the diagnosis was based on patient history and clinical findings, but the sonographic examination confirmed the clinical suspicion and excluded the presence of other types of dise...

Lessons learned from family history in ocular genetics.

Science.gov (United States)

Marino, Meghan J

2015-07-01

Given the vast genetic and phenotypic heterogeneity seen in ocular genetic disorders, considering a patient's clinical phenotype in the context of the family history is essential. Clinicians can improve patient care by appropriately incorporating a patient's family history into their evaluation. Obtaining, reviewing, and accurately interpreting the pedigree are skills geneticists and genetic counselors possess. However, with the field of ophthalmic genetics vastly growing, it is becoming essential for ophthalmologists to understand the utility of the pedigree and develop their abilities in eliciting this information. By not considering a patient's clinical history in the context of the family history, diagnoses can be missed or inaccurate. The purpose of this review is to inform ophthalmologists on the importance of the family history and highlight how the pedigree can aid in establishing an accurate genetic diagnosis. This review also provides to ophthalmologists helpful tips on eliciting and interpreting a patient's family history.

Tickborne infectious diseases: diagnosis and management

National Research Council Canada - National Science Library

Cunha, Burke A

2000-01-01

... to particular flora and fauna. The purpose of Tickborne Infectious Diseases: Diagnosis and Management is to condense in a single book different approaches and paradigms of tickborne infectious diseases. Three chapters are devoted to background information, including the natural history of ticks, the diagnostic procedures of tickborne diseases, and the new tick-transm...

Shell shock, trauma, and the First World War: the making of a diagnosis and its histories.

Science.gov (United States)

Loughran, Tracey

2012-01-01

During the First World War, thousands of soldiers were treated for "shell shock," a condition which encompassed a range of physical and psychological symptoms. Shell shock has most often been located within a "genealogy of trauma," and identified as an important marker in the gradual recognition of the psychological afflictions caused by combat. In recent years, shell shock has increasingly been viewed as a powerful emblem of the suffering of war. This article, which focuses on Britain, extends scholarly analyses which question characterizations of shell shock as an early form of post-traumatic stress disorder. It also considers some of the methodological problems raised by recasting shell shock as a wartime medical construction rather than an essentially timeless manifestation of trauma. It argues that shell shock must be analyzed as a diagnosis shaped by a specific set of contemporary concerns, knowledges, and practices. Such an analysis challenges accepted understandings of what shell shock "meant" in the First World War, and also offers new perspectives on the role of shell shock in shaping the emergence of psychology and psychiatry in the early part of the twentieth century. The article also considers what relation, if any, might exist between intellectual and other histories, literary approaches, and perceptions of trauma as timeless and unchanging.

ENVIRONMENTAL TECHNOLOGY VERIFICATION: JOINT (NSF-EPA) VERIFICATION STATEMENT AND REPORT HYDRO COMPLIANCE MANAGEMENT, INC. HYDRO-KLEEN FILTRATION SYSTEM, 03/07/WQPC-SWP, SEPTEMBER 2003

Science.gov (United States)

Verification testing of the Hydro-Kleen(TM) Filtration System, a catch-basin filter designed to reduce hydrocarbon, sediment, and metals contamination from surface water flows, was conducted at NSF International in Ann Arbor, Michigan. A Hydro-Kleen(TM) system was fitted into a ...

History before diagnosis in childhood craniopharyngioma : associations with initial presentation and long-term prognosis

NARCIS (Netherlands)

Hoffmann, Anika; Boekhoff, Svenja; Gebhardt, Ursel; Sterkenburg, Anthe S.; Daubenbuechel, Anna M. M.; Eveslage, Maria; Mueller, Hermann L.

2015-01-01

Objective: Childhood craniopharyngiomas (CP) are often diagnosed after a long duration of history (DOH). Tumor size, hypothalamic involvement (HI), and obesity are associated with reduced overall survival (OS) and functional capacity (FC). The effect of DOH and specific symptoms in history on

Unmet needs for analyzing biological big data: A survey of 704 NSF principal investigators.

Science.gov (United States)

Barone, Lindsay; Williams, Jason; Micklos, David

2017-10-01

In a 2016 survey of 704 National Science Foundation (NSF) Biological Sciences Directorate principal investigators (BIO PIs), nearly 90% indicated they are currently or will soon be analyzing large data sets. BIO PIs considered a range of computational needs important to their work, including high performance computing (HPC), bioinformatics support, multistep workflows, updated analysis software, and the ability to store, share, and publish data. Previous studies in the United States and Canada emphasized infrastructure needs. However, BIO PIs said the most pressing unmet needs are training in data integration, data management, and scaling analyses for HPC-acknowledging that data science skills will be required to build a deeper understanding of life. This portends a growing data knowledge gap in biology and challenges institutions and funding agencies to redouble their support for computational training in biology.

Reliability of the information about the history of diagnosis and treatment of hypertension. Differences in regard to sex, age, and educational level. The pró-saúde study

Directory of Open Access Journals (Sweden)

Faerstein Eduardo

2001-01-01

Full Text Available OBJECTIVE: To assess the intraobserver reliability of the information about the history of diagnosis and treatment of hypertension. METHODS: A multidimensional health questionnaire, which was filled out by the interviewees, was applied twice with an interval of 2 weeks, in July '99, to 192 employees of the University of the State of Rio de Janeiro (UERJ, stratified by sex, age, and educational level. The intraobserver reliability of the answers provided was estimated by the kappa statistic and by the coefficient of intraclass correlation (CICC. RESULTS: The general kappa (k statistic was 0.75 (95% CI=0.73-0.77. Reliability was higher among females (k=0.88, 95% CI=0.85-0.91 than among males (k=0.62, 95% CI=0.59-0.65.The reliability was higher among individuals 40 years of age or older (k=0.79; 95% CI=0.73-0.84 than those from 18 to 39 years (k=0.52; 95% CI=0.45-0.57. Finally, the kappa statistic was higher among individuals with a university educational level (k=0.86; 95% CI=0.81-0.91 than among those with high school educational level (k=0.61; 95% CI=0.53-0.70 or those with middle school educational level (k=0.68; 95% CI=0.64-0.72. The coefficient of intraclass correlation estimated by the intraobserver agreement in regard to age at the time of the diagnosis of hypertension was 0.74. A perfect agreement between the 2 answers (k=1.00 was observed for 22 interviewees who reported prior prescription of antihypertensive medication. CONCLUSION: In the population studied, estimates of the reliability of the history of medical diagnosis of hypertension and its treatment ranged from substantial to almost perfect reliability.

Validity and underrecording of diagnosis of COPD in the Danish National Patient Registry

DEFF Research Database (Denmark)

Thomsen, Reimar W; Lange, Peter; Hellquist, Birthe

2011-01-01

, and for 1546 patients with a discharge diagnosis of either pneumonia or respiratory failure but no COPD diagnosis. Presence of COPD was assessed based on medical history, clinical symptoms and findings, and spirometry results. RESULTS: The overall positive predictive value for COPD was 92% (95% confidence...

Bone health history in breast cancer patients on aromatase inhibitors.

Directory of Open Access Journals (Sweden)

Marilyn L Kwan

Full Text Available A cross-sectional study was performed to assess bone health history among aromatase inhibitor (AI users before breast cancer (BC diagnosis, which may impact fracture risk after AI therapy and choice of initial hormonal therapy. A total of 2,157 invasive BC patients initially treated with an AI were identified from a prospective cohort study at Kaiser Permanente Northern California (KPNC. Data on demographic and lifestyle factors were obtained from in-person interviews, and bone health history and clinical data from KPNC clinical databases. The prevalence of osteoporosis and fractures in postmenopausal AI users was assessed, compared with 325 postmenopausal TAM users. The associations of bone health history with demographic and lifestyle factors in AI users were also examined. Among all initial AI users, 11.2% had a prior history of osteoporosis, 16.3% had a prior history of any fracture, and 4.6% had a prior history of major fracture. Postmenopausal women who were taking TAM as their initial hormonal therapy had significantly higher prevalence of prior osteoporosis than postmenopausal AI users (21.5% vs. 11.8%, p<0.0001. Among initial AI users, the associations of history of osteoporosis and fracture in BC patients with demographic and lifestyle factors were, in general, consistent with those known in healthy older women. This study is one of the first to characterize AI users and risk factors for bone morbidity before BC diagnosis. In the future, this study will examine lifestyle, molecular, and genetic risk factors for AI-induced fractures.

Diagnostic value of history taking in reflex syncope

NARCIS (Netherlands)

Colman, N.; Nahm, K.; van Dijk, J. G.; Reitsma, J. B.; Wieling, W.; Kaufmann, H.

2004-01-01

The medical history, in combination with the physical examination and a 12-lead electrocardiogram, plays a key role in the diagnosis and risk stratification of patients with syncope. However, diagnostic clinical criteria are not uniformly applied. In older studies, the diagnostic criteria for

Methods of rapid diagnosis for the etiology of meningitis in adults

Science.gov (United States)

Bahr, Nathan C; Boulware, David R

2014-01-01

Infectious meningitis may be due to bacterial, mycobacterial, fungal or viral agents. Diagnosis of meningitis must take into account numerous items of patient history and symptomatology along with regional epidemiology and basic cerebrospinal fluid testing (protein, etc.) to allow the clinician to stratify the likelihood of etiology possibilities and rationally select additional diagnostic tests. Culture is the mainstay for diagnosis in many cases, but technology is evolving to provide more rapid, reliable diagnosis. The cryptococcal antigen lateral flow assay (Immuno-Mycologics) has revolutionized diagnosis of cryptococcosis and automated nucleic acid amplification assays hold promise for improving diagnosis of bacterial and mycobacterial meningitis. This review will focus on a holistic approach to diagnosis of meningitis as well as recent technological advances. PMID:25402579

Family history and risk of breast cancer: an analysis accounting for family structure.

Science.gov (United States)

Brewer, Hannah R; Jones, Michael E; Schoemaker, Minouk J; Ashworth, Alan; Swerdlow, Anthony J

2017-08-01

Family history is an important risk factor for breast cancer incidence, but the parameters conventionally used to categorize it are based solely on numbers and/or ages of breast cancer cases in the family and take no account of the size and age-structure of the woman's family. Using data from the Generations Study, a cohort of over 113,000 women from the general UK population, we analyzed breast cancer risk in relation to first-degree family history using a family history score (FHS) that takes account of the expected number of family cases based on the family's age-structure and national cancer incidence rates. Breast cancer risk increased significantly (P trend  history was that combining FHS and age of relative at diagnosis. A family history score based on expected as well as observed breast cancers in a family can give greater risk discrimination on breast cancer incidence than conventional parameters based solely on cases in affected relatives. Our modeling suggests that a yet stronger predictor of risk might be a combination of this score and age at diagnosis in relatives.

Sustaining professional development gains after the NSF-CCLI grant ends

Science.gov (United States)

Grove, K.; Dekens, P. S.; Dempsey, D. P.

2012-12-01

At San Francisco State University we aimed to transform our freshman-level courses in geology, oceanography, and meteorology using funding from a NSF-CCLI grant—"Creating an academic community to foster curiosity and discovery in introductory Geoscience classes" (2010-2012). In addition to creating a new laboratory space and new laboratory materials, we focused on the professional development of graduate teaching assistants (GTAs) and other departmental instructors. Previously, GTAs were given little support to gain teaching skills and present interesting labs, and there was little communication among the various instructors of the introductory courses. We aimed to change the tenor of the department by infusing discussions about effective teaching practices into the daily academic lives of faculty and GTAs and by creating institutional structures to ensure that innovations continued beyond the life of the NSF grant. We entitled this function of the department a Teaching and Learning Community (TLC). An essential element of the TLC, and the institutionalization of project activities, was to create a new graduate seminar course—"Our Dynamic Classroom"—that is offered every semester. This course was created to provide a mechanism for instructors to meet each week to discuss aspects of teaching pedagogy and to share classroom experiences. Each week a GTA or faculty member leads the discussion. Typical weekly topics include: what is inquiry-based learning, understanding students' misconceptions, teaching quantitative skills, what is the affective domain, improving students' writing skills. In response to participant feedback, the course now focuses more on the needs of specific instructors teaching specific courses. For example, in Spring 2012, seminar participants identified several issues GTAs were encountering, such as students failing to read instructions for labs before executing them, and some members of small collaborative groups not actively participating

Validity of Combining History Elements and Physical Examination Tests to Diagnose Patellofemoral Pain.

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Décary, Simon; Frémont, Pierre; Pelletier, Bruno; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-04-01

To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude patellofemoral pain (PFP). Prospective diagnostic study. Orthopedic outpatient clinics, family medicine clinics, and community-dwelling. Consecutive patients (N=279) consulting one of the participating orthopedic surgeons (n=3) or sport medicine physicians (n=2) for any knee complaint. Not applicable. History elements and physical examination tests were obtained by a trained physiotherapist blinded to the reference standard: a composite diagnosis including both physical examination tests and imaging results interpretation performed by an expert physician. Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of PFP, and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios with associated 95% confidence intervals (CIs) were calculated. Two hundred seventy-nine participants were evaluated, and 75 had a diagnosis of PFP (26.9%). Different combinations of history elements and physical examination tests including the age of participants, knee pain location, difficulty descending stairs, patellar facet palpation, and passive knee extension range of motion were associated with a diagnosis of PFP and used in clusters to accurately discriminate between individuals with PFP and individuals without PFP. Two diagnostic clusters developed to confirm the presence of PFP yielded a positive likelihood ratio of 8.7 (95% CI, 5.2-14.6) and 3 clusters to exclude PFP yielded a negative likelihood ratio of .12 (95% CI, .06-.27). Diagnostic clusters combining common history elements and physical examination tests that can accurately diagnose or exclude PFP compared to various knee

Clinical and histological findings in nephrogenic systemic fibrosis

International Nuclear Information System (INIS)

Cowper, Shawn E.; Rabach, Morgan; Girardi, Michael

2008-01-01

Nephrogenic systemic fibrosis (NSF) is a relative newcomer to the world of medicine. NSF was introduced just over 10 years ago as nephrogenic fibrosing dermopathy, but with further investigation, its systemic nature was determined. The strict adherence to a definition requiring both clinical and pathological concordance has allowed for careful separation of this entity from other fibrosing disorders, leading eventually to the realization that gadolinium-based contrast agents were closely associated with its onset. As planned prospective studies get underway, it is of paramount importance that researchers and clinicians realize that NSF remains a very challenging diagnosis, and that both clinical and histopathological criteria must be employed to reach the most accurate diagnosis possible

Banquet Talk: The Fallen Sky: An Intimate History of Shooting Stars

Science.gov (United States)

Cokinos, Chris

2010-10-01

Christopher Cokinos will read from his book The Fallen Sky: An Intimate History of Shooting Stars, which blends folklore, history, science and memoir in an exploration--literal and metaphoric--of the passions that drive meteorite hunters. From Kansas to Greenland, from Utah to Antarctica, Cokinos crossed the globe to follow in the footsteps of such famed meteorite hunters and scientists as Robert Peary, Harvey Nininger and Eugene Shoemaker. Cokinos himself hunted meteorites as part of the NSF-funded Antarctic Search for Meteorites expedition in 2003-2004. Seed Magazine said this of his book: ``When Cokinos isn't chronicling the solar system's origins or recounting obsessive tales of explorers trekking to the ends of the Earth in pursuit of exotic rocks from the sky, he's telling the reader about the dissolution of his first marriage or his struggles with depression. But this unflinching introspection sets the stage for Cokinos' transformation, as he delves deeper into his subject and grasps the profound links between shooting stars and life here on Earth.'' Cokinos teaches at Utah State University, is the author of Hope Is the Thing with Feathers, also from Tarcher/Penguin, and has had work in the New York Times, the Los Angeles Times, the American Scholar and elsewhere.

My brief history

CERN Document Server

Hawking, Stephen

2013-01-01

My Brief History recounts Stephen Hawking’s improbable journey, from his postwar London boyhood to his years of international acclaim and celebrity. Lavishly illustrated with rarely seen photographs, this concise, witty, and candid account introduces readers to a Hawking rarely glimpsed in previous books: the inquisitive schoolboy whose classmates nicknamed him Einstein; the jokester who once placed a bet with a colleague over the existence of a particular black hole; and the young husband and father struggling to gain a foothold in the world of physics and cosmology. Writing with characteristic humility and humor, Hawking opens up about the challenges that confronted him following his diagnosis of ALS at age twenty-one. Tracing his development as a thinker, he explains how the prospect of an early death urged him onward through numerous intellectual breakthroughs, and talks about the genesis of his masterpiece A Brief History of Time—one of the iconic books of the twentieth century.

Family history of cancer predicts endometrial cancer risk independently of Lynch Syndrome: Implications for genetic counselling.

Science.gov (United States)

Johnatty, Sharon E; Tan, Yen Y; Buchanan, Daniel D; Bowman, Michael; Walters, Rhiannon J; Obermair, Andreas; Quinn, Michael A; Blomfield, Penelope B; Brand, Alison; Leung, Yee; Oehler, Martin K; Kirk, Judy A; O'Mara, Tracy A; Webb, Penelope M; Spurdle, Amanda B

2017-11-01

To determine endometrial cancer (EC) risk according to family cancer history, including assessment by degree of relatedness, type of and age at cancer diagnosis of relatives. Self-reported family cancer history was available for 1353 EC patients and 628 controls. Logistic regression was used to quantify the association between EC and cancer diagnosis in ≥1 first or second degree relative, and to assess whether level of risk differed by degree of relationship and/or relative's age at diagnosis. Risk was also evaluated for family history of up to three cancers from known familial syndromes (Lynch, Cowden, hereditary breast and ovarian cancer) overall, by histological subtype and, for a subset of 678 patients, by EC tumor mismatch repair (MMR) gene expression. Report of EC in ≥1 first- or second-degree relative was associated with significantly increased risk of EC (P=3.8×10 -7 ), independent of lifestyle risk factors. There was a trend in increasing EC risk with closer relatedness and younger age at EC diagnosis in relatives (P Trend =4.43×10 -6 ), and with increasing numbers of Lynch cancers in relatives (P Trend ≤0.0001). EC risk associated with family history did not differ by proband tumor MMR status, or histological subtype. Reported EC in first- or second-degree relatives remained associated with EC risk after conservative correction for potential misreported family history (OR 2.0; 95% CI, 1.24-3.37, P=0.004). The strongest predictor of EC risk was closer relatedness and younger EC diagnosis age in ≥1 relative. Associations remained significant irrespective of proband MMR status, and after excluding MMR pathogenic variant carriers, indicating that Lynch syndrome genes do not fully explain familial EC risk. Copyright © 2017 Elsevier Inc. All rights reserved.

Positron emission tomography in the diagnosis of variant angina

NARCIS (Netherlands)

Jessurun, GAJ; Meeder, JG; Tio, RA

The diagnosis of coronary vasospasm in chronic vasospastic angina is established by the history of typical nocturnal angina pectoris with rapid relief after sublingual nitroglycerin, concomitant ST-segment elevation on the electrocardiogram and a recent normal coronary angiogram, True vasospasm may

Structural analysis of wind turbine rotors for NSF-NASA Mod-0 wind power system

Science.gov (United States)

Spera, D. A.

1976-01-01

Preliminary estimates are presented of vibratory loads and stresses in hingeless and teetering rotors for the proposed NSF-NASA Mod-0 wind power system. Preliminary blade design utilizes a tapered tubular aluminum spar which supports nonstructural aluminum ribs and skin and is joined to the rotor hub by a steel shank tube. Stresses in the shank of the blade are calculated for static, rated, and overload operating conditions. Blade vibrations were limited to the fundamental flapping modes, which were elastic cantilever bending for hingeless rotor blades and rigid-body rotation for teetering rotor blades. The MOSTAB-C computer code was used to calculate aerodynamic and mechanical loads. The teetering rotor has substantial advantages over the hingeless rotor with respect to shank stresses, fatigue life, and tower loading. The hingeless rotor analyzed does not appear to be structurally stable during overloads.

Unmet needs for analyzing biological big data: A survey of 704 NSF principal investigators.

Directory of Open Access Journals (Sweden)

Lindsay Barone

2017-10-01

Full Text Available In a 2016 survey of 704 National Science Foundation (NSF Biological Sciences Directorate principal investigators (BIO PIs, nearly 90% indicated they are currently or will soon be analyzing large data sets. BIO PIs considered a range of computational needs important to their work, including high performance computing (HPC, bioinformatics support, multistep workflows, updated analysis software, and the ability to store, share, and publish data. Previous studies in the United States and Canada emphasized infrastructure needs. However, BIO PIs said the most pressing unmet needs are training in data integration, data management, and scaling analyses for HPC-acknowledging that data science skills will be required to build a deeper understanding of life. This portends a growing data knowledge gap in biology and challenges institutions and funding agencies to redouble their support for computational training in biology.

Breast Cancer Profile among Patients with a History of Chemoprevention

Directory of Open Access Journals (Sweden)

Freya R. Schnabel

2016-01-01

Full Text Available Purpose. This study identifies women with breast cancer who utilized chemoprevention agents prior to diagnosis and describes their patterns of disease. Methods. Our database was queried retrospectively for patients with breast cancer who reported prior use of chemoprevention. Patients were divided into primary (no history of breast cancer and secondary (previous history of breast cancer groups and compared to patients who never took chemoprevention. Results. 135 (6% of 2430 women used chemoprevention. In the primary chemoprevention group (n = 18, 1%, 39% had completed >5 years of treatment, and fully 50% were on treatment at time of diagnosis. These patients were overwhelmingly diagnosed with ER/PR positive cancers (88%/65% and were diagnosed with equal percentages (44% of IDC and DCIS. 117 (87% used secondary chemoprevention. Patients in this group were diagnosed with earlier stage disease and had lower rates of ER/PR-positivity (73%/65% than the nonchemoprevention group (84%/72%. In the secondary group, 24% were on chemoprevention at time of diagnosis; 73% had completed >5 years of treatment. Conclusions. The majority of patients who used primary chemoprevention had not completed treatment prior to diagnosis, suggesting that the timing of initiation and compliance to prevention strategies are important in defining the pattern of disease in these patients.

Improving Science Teacher Preparation through the APS PhysTEC and NSF Noyce Programs

Science.gov (United States)

Williams, Tasha; Tyler, Micheal; van Duzor, Andrea; Sabella, Mel

2013-03-01

Central to the recruitment of students into science teaching at a school like CSU, is a focus on the professional nature of teaching. The purpose of this focus is twofold: it serves to change student perceptions about teaching and it prepares students to become teachers who value continued professional development and value the science education research literature. The Noyce and PhysTEC programs at CSU place the professional nature of teaching front and center by involving students in education research projects, paid internships, attendance at conferences, and participation in a new Teacher Immersion Institute and a Science Education Journal Reading Class. This poster will focus on specific components of our teacher preparation program that were developed through these two programs. In addition we will describe how these new components provide students with diverse experiences in the teaching of science to students in the urban school district. Supported by the NSF Noyce Program (0833251) and the APS PhysTEC Program.

Classification and Differential Diagnosis of Oral and Maxillofacial Pain.

Science.gov (United States)

Scrivani, Steven J; Spierings, Egilius L H

2016-08-01

Pain in the orofacial region is a common presenting symptom. The majority of symptoms are related to dental disease and the cause can readily be established, the problem dealt with, and the pain eliminated. However, pain may persist and defy attempts at treatment. Intractable oral or facial pain can be diagnostically challenging. To make a definitive diagnosis and initiate proper treatment, a rigorous protocol for evaluation includes a thorough history and an appropriate comprehensive clinical examination and diagnostic testing, including chief complaint, history of present illness, medical history, physical examination, diagnostic studies, including imaging, and psychosocial evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

Hemichorea, parkinson's disease or somatoform disorder? A hard differential diagnosis

Directory of Open Access Journals (Sweden)

David Gonçalves Nordon

2010-12-01

Full Text Available ABSTRACT: The diagnosis of movement disorders can be quite complex, as its causes may be both organic and psychogenic. We present the case of a 62 year old woman, with a 12 year old history of movement disorder, whose treatment has been insufficient and possibly inadequate, and her diagnosis has been doubtful and not yet defined. We discuss our diagnostic methods and empirical treatments, looking for the best for our patient.

New technologies in diagnosis of preinvasive cervical lesions

Directory of Open Access Journals (Sweden)

I. P. Aminodova

2015-01-01

Full Text Available Results of efficiency assessment of different diagnosis for preinvasive cervical lesions are represented in the article. During investigation the retrospective analysis of 353 patient histories of women with cervical intraepithelial neoplasia (primary and recurrent, who have been observed in Ivanovskiy regional oncological dispensary from 2002 to 2011, was performed. The accuracy rates of diagnosis of cervical intraepithelial neoplasia for one or several methods including cytological study, colposcopy and fluorescence cystoscopy were compared. Fluorescence diagnosis was performed with drug fotoditazin (LLC «VETA-GRAND», marketing authorisation №LS 001246 at dose of 1,0 mg/kg body weight. The final diagnosis was determined by results of histological study. The accuracy of cytological study accounted for 67,5–80,7%. Using colposcopy the exact diagnosis was determined in 67,9–74,4% of cases. Combination of cytological study with colposcopy improved the accuracy of diagnosis up to 82.1–88.9%. The superior results were for concurrent use of cytological study with colposcopy and fluorescence diagnosis – in such case the diagnosis was correct in 92,0–96,7% of patients. The analysis of results showed that using all methods of diagnosis the accuracy of diagnosis for recurrent cervical intraepithelial neoplasia was lower than for primary lesions. The decrease of diagnosis accuracy is probably related to previous diagnosis and therapeutic manipulations on cervix. Thus, multimodal diagnosis investigation with methods of fluorescence spectroscopy allows to improve accuracy of diagnosis for preinvasive cervical lesions. 

Delayed diagnosis of lymphogranuloma venereum-associated colitis in a man first suspected to have rectal cancer.

Science.gov (United States)

Bancil, Aaron S; Alexakis, Christopher; Pollok, Richard

2016-01-01

Lymphogranuloma venereum-associated colitis is a diagnosis that should not be missed. The following case represents the importance of a thorough history, including the importance of the sexual history to prevent the misdiagnosis of these patients.

Natural history of Duchenne muscular dystrophy

Directory of Open Access Journals (Sweden)

Qing KE

2015-05-01

Full Text Available Duchenne muscular dystrophy (DMD is X-linked recessive hereditary disease. DMD gene mutations result in dystrophin deficiency, which causes not only muscle movement disorders but also scoliosis, cognitive dysfunction, urinary tract diseases, respiratory diseases and heart diseases. Most patients die in early adult for respiratory and circulatory failure. Early multidisciplinary therapies will significantly delay disease progression and improve patients' quality of life. However, DMD diagnosis and treatment exist significantly time delay now. In this study, we review the natural history of DMD, including motor, cognitive, respiratory and heart function, for improving DMD early recognition, diagnosis and treatment, so as to benefit DMD patients. DOI: 10.3969/j.issn.1672-6731.2015.05.004

Posttraumatic stress disorder: a history and a critique.

Science.gov (United States)

Andreasen, Nancy C

2010-10-01

Although posttraumatic stress disorder (PTSD) is sometimes considered to be a relatively new diagnosis, as the name first appeared in 1980, the concept of the disorder has a very long history. That history has often been linked to the history of war, but the disorder has also been frequently described in civilian settings involving natural disasters, mass catastrophes, and serious accidental injuries. The diagnosis first appeared in the official nomenclature when Diagnostic and Statistical Manual of Mental Disorders (DSM)-I was published in 1952 under the name gross stress reaction. It was omitted, however, in the next edition in 1968, after a long period of relative peace. When DSM-III was developed in the mid-1980s the recent occurrence of the Vietnam War provoked a more thorough examination of the disorder. PTSD was defined as a stress disorder that is a final common pathway occurring as a consequence of many different types of stressors, including both combat and civilian stress. The definition of PTSD has filled an important niche in clinical psychiatry. Its definition continues to raise important questions about the relationship between a stressor, the individual experiencing it, and the characteristic symptoms. © 2010 Association for Research in Nervous and Mental Disease.

High accuracy of family history of melanoma in Danish melanoma cases.

Science.gov (United States)

Wadt, Karin A W; Drzewiecki, Krzysztof T; Gerdes, Anne-Marie

2015-12-01

The incidence of melanoma in Denmark has immensely increased over the last 10 years making Denmark a high risk country for melanoma. In the last two decades multiple public campaigns have sought to increase the awareness of melanoma. Family history of melanoma is a known major risk factor but previous studies have shown that self-reported family history of melanoma is highly inaccurate. These studies are 15 years old and we wanted to examine if a higher awareness of melanoma has increased the accuracy of self-reported family history of melanoma. We examined the family history of 181 melanoma probands who reported 199 cases of melanoma in relatives, of which 135 cases where in first degree relatives. We confirmed the diagnosis of melanoma in 77% of all relatives, and in 83% of first degree relatives. In 181 probands we validated the negative family history of melanoma in 748 first degree relatives and found only 1 case of melanoma which was not reported in a 3 case melanoma family. Melanoma patients in Denmark report family history of melanoma in first and second degree relatives with a high level of accuracy with a true positive predictive value between 77 and 87%. In 99% of probands reporting a negative family history of melanoma in first degree relatives this information is correct. In clinical practice we recommend that melanoma diagnosis in relatives should be verified if possible, but even unverified reported melanoma cases in relatives should be included in the indication of genetic testing and assessment of melanoma risk in the family.

Evaluation of medical record quality and communication skills among pediatric interns after standardized parent training history-taking in China.

Science.gov (United States)

Yu, Mu Xue; Jiang, Xiao Yun; Li, Yi Juan; Shen, Zhen Yu; Zhuang, Si Qi; Gu, Yu Fen

2018-02-01

The effect of using standardized parent training history-taking on the quality of medical records and communication skills among pediatric interns was determined. Fifth-year interns who were undertaking a pediatric clinical practice rotation were randomized to intervention and control groups. All of the pediatric interns received history-taking training by lecture and bedside teaching. The pediatric interns in the intervention group also received standardized parent history-taking training. The following two outcome measures were used: the scores of medical records, which were written by the pediatric interns after history-taking from real parents of pediatric patients; and the communication assessment tool (CAT) assessed by real parents. The general information, history of present illness (HPI), past medical history, personal history, family history, diagnosis, diagnostic analysis, and differential diagnosis scores in the intervention group were significantly higher than the control group (p history-taking is effective in improving the quality of medical records by pediatric interns. Standardized parent training history-taking is a superior teaching tool for clinical reasoning ability, as well as communication skills in clinical pediatric practice.

An Analysis of NSF Geosciences Research Experience for Undergraduate Site Programs from 2009 through 2011

Science.gov (United States)

Rom, E. L.; Patino, L. C.; Weiler, S.; Sanchez, S. C.; Colon, Y.; Antell, L.

2011-12-01

The Research Experience for Undergraduate (REU) Program at the U.S. National Science Foundation (NSF) provides U.S. undergraduate students from any college or university the opportunity to conduct research at a different institution and gain a better understanding of research career pathways. The Geosciences REU Sites foster research opportunities in areas closely aligned with geoscience programs, particularly those related to earth, atmospheric and ocean sciences. The aim of this paper is to provide an overview of the Geosciences REU Site programs run in 2009 through 2011. A survey requesting information on recruitment methods, student demographics, enrichment activities, and fields of research was sent to the Principal Investigators of each of the active REU Sites. Over 70% of the surveys were returned with the requested information from about 50 to 60 sites each year. The internet is the most widely used mechanism to recruit participants, with personal communication as the second most important recruiting tool. The admissions rate for REU Sites in Geosciences varies from less than 10% to 50%, with the majority of participants being rising seniors and juniors. Many of the participants come from non-PhD granting institutions. Among the participants, gender distribution varies by discipline, with ocean sciences having a large majority of women and earth sciences having a majority of men. Regarding ethnic diversity, the REU Sites reflect the difficulty of attracting diverse students into Geosciences as a discipline; a large majority of participants are Caucasian and Asian students. Furthermore, participants from minority-serving institutions and community colleges constitute a small percentage of those taking part in these research experiences. The enrichment activities are very similar across the REU Sites, and mimic activities common to the scientific community, including intellectual exchange of ideas (lab meetings, seminars, and professional meetings

Missed diagnosis of an unusual case of impacted esophageal foreign body

Directory of Open Access Journals (Sweden)

Abu Taiub Mohammed Mohiuddin Chowdhury

2015-01-01

Full Text Available Accidental foreign body or food particle impaction in the esophagus causing partial or complete obstruction of the esophageal lumen is not uncommon. Most of this presents with remarkable history and acute or related symptoms that lead to diagnosis. Here, we present an unusual clinically misleading case of impacted food object in the esophageal lumen causing partial obstruction that mimic the diagnosis of esophageal and other associated pathologies.

Diagnosis and conservative management of female stress urinary incontinence

Directory of Open Access Journals (Sweden)

Anil Krishna Dass

2013-05-01

Full Text Available Urinary incontinence affects 17–45% of women worldwide and stress urinary incontinence is responsible for 48% of all cases. Detailed history, physical examination and investigations are crucial to identify the diagnosis underlying the incontinence symptoms to select effective therapy. Although mid-urethral sling procedures are considered to be ‘gold standard’ treatment of SUI, conservative treatment with pelvic floor muscle training and lifestyle modification is still the first line of management. This article discusses the diagnosis and conservative management of female SUI.

Professional Development for Graduate Students through Internships at Federal Labs: an NSF/USGS Collaboration

Science.gov (United States)

Snow, E.; Jones, E.; Patino, L. C.; Wasserman, E.; Isern, A. R.; Davies, T.

2016-12-01

In 2013 the White House initiated an effort to coordinate STEM education initiatives across federal agencies. This idea spawned several important collaborations, one of which is a set of National Science Foundation programs designed to place graduate students in federal labs for 2-12 months of their Ph.D. training. The Graduate Research Internship Program (GRIP) and the Graduate Student Preparedness program (GSP) each have the goal of exposing PhD students to the federal work environment while expanding their research tools and mentoring networks. Students apply for supplementary support to their Graduate Research Fellowship (GRIP) or their advisor's NSF award (GSP). These programs are available at several federal agencies; the USGS is one partner. At the U.S. Geological Survey, scientists propose projects, which students can find online by searching USGS GRIP, or students and USGS scientists can work together to develop a research project. At NSF, projects are evaluated on both the scientific merit and the professional development opportunities they afford the student. The career development extends beyond the science (new techniques, data, mentors) into the professional activity of writing the proposal, managing the budget, and working in a new and different environment. The USGS currently has 18 GRIP scholars, including Madeline Foster-Martinez, a UC Berkeley student who spent her summer as a GRIP fellow at the USGS Pacific Coastal and Marine Science Center working with USGS scientist Jessica Lacy. Madeline's Ph.D. work is on salt marshes and she has studied geomorphology, accretion, and gas transport using a variety of research methods. Her GRIP fellowship allowed her to apply new data-gathering tools to the question of sediment delivery to the marsh, and build and test a model for sediment delivery along marsh edges. In addition, she gained professional skills by collaborating with a new team of scientists, running a large-scale field deployment, and

Diagnosis of Allergic and Nonallergic Food Intolerance in Children

Directory of Open Access Journals (Sweden)

A. A. Cheburkin

2013-01-01

Full Text Available Because the incorrect food avoidance affects quality of life and nutrition, especially in children, there is possible harm in over-diagnosing food allergy. The approach to the proper diagnosis of food allergy and nonallergic intolerance requires consideration of the medical history, tests for food-specific IgE antibodies, skin puncture tests. Pediatrist must appreciate that a positive test for food-specific IgE or skin puncture test primarily denotes sensitization and may not confirm clinical allergy. Food elimination diet or oral food challenge is required for diagnosis confirmation. Additional procedures may be needed, depending on the differential diagnosis of IgE mediated or non-IgE mediated food intolerance.

Ataque de nervios and history of childhood trauma.

Science.gov (United States)

Schechter, D S; Marshall, R; Salmán, E; Goetz, D; Davies, S; Liebowitz, M R

2000-07-01

Ataque de nervios is a common, self-labeled Hispanic folk diagnosis. It typically describes episodic, dramatic outbursts of negative emotion in response to a stressor, sometimes involving destructive behavior. Dissociation and affective dysregulation during such episodes suggested a link to childhood trauma. We therefore assessed psychiatric diagnoses, history of ataque, and childhood trauma in treatment-seeking Hispanic outpatients (N = 70). Significantly more subjects with an anxiety or affective disorder plus ataque reported a history of physical abuse, sexual abuse, and/or or a substance-abusing caretaker than those with psychiatric disorder but no ataque. In some Hispanic individuals, ataque may represent a culturally sanctioned expression of extreme affect dysregulation associated with childhood trauma. Patients with ataque de nervios should receive a thorough traumatic history assessment.

The validity of the family history method for identifying Alzheimer disease.

Science.gov (United States)

Li, G; Aryan, M; Silverman, J M; Haroutunian, V; Perl, D P; Birstein, S; Lantz, M; Marin, D B; Mohs, R C; Davis, K L

1997-05-01

To examine the validity of the family history method for identifying Alzheimer disease (AD) by comparing family history and neuropathological diagnoses. Seventy-seven former residents of the Jewish Home and Hospital for the Aged, New York, NY, with neuropathological evaluations on record were blindly assessed for the presence of dementia and, if present, the type of dementia through family informants by telephone interviews. The Alzheimer's Disease Risk Questionnaire was used to collect demographic information and screen for possible dementia. If dementia was suspected, the Dementia Questionnaire was administered to assess the course and type of dementia, i.e., primary progressive dementia (PPD, likely AD), multiple infarct dementia, mixed dementia (i.e., PPD and multiple infarct dementia), and other dementias based on the modified Diagnostic and Statistical Manual of Mental Disorders, Third Edition, criteria. Sixty (77.9%) of 77 elderly subjects were classified as having dementia and 17 (22.1%) were without dementia by family history evaluation. Of the 60 elderly subjects with dementia, 57 (95%) were found at autopsy to have had neuropathological changes related to dementia. The sensitivity of the family history diagnosis for dementia with related neuropathological change was 0.84 (57 of 68) and the specificity was 0.67 (6 of 9). Using family history information to differentiate the type of dementia, the sensitivity for definite or probable AD (with or without another condition) was 0.69 (36 of 51) and the specificity was 0.73 (19 of 26). The majority (9 of 15) of patients testing false negative for PPD had a history of stroke associated with onset of memory changes, excluding a diagnosis of PPD. Identifying dementia, in general, and AD, in particular, has an acceptable sensitivity and specificity. As is true for direct clinical diagnosis, the major issue associated with misclassifying AD in a family history assessment is the masking effects of a coexisting non

Building a Community of Scholars: One University's Story of Students Engaged in Learning Science, Mathematics, and Engineering through a NSF S-STEM Grant--Part II

Science.gov (United States)

Kalevitch, Maria; Maurer, Cheryl; Badger, Paul; Holdan, Greg; Sirinterlikci, Arif

2015-01-01

The School of Engineering, Mathematics, and Science (SEMS) at Robert Morris University (RMU) was awarded a five-year grant from the National Science Foundation (NSF) to fund scholarships to 21 academically talented but financially challenged students majoring in the disciplines of science, technology, engineering, and mathematics (STEM). Each…

Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity.

Science.gov (United States)

Elli, Luca; Branchi, Federica; Tomba, Carolina; Villalta, Danilo; Norsa, Lorenzo; Ferretti, Francesca; Roncoroni, Leda; Bardella, Maria Teresa

2015-06-21

Cereal crops and cereal consumption have had a vital role in Mankind's history. In the recent years gluten ingestion has been linked with a range of clinical disorders. Gluten-related disorders have gradually emerged as an epidemiologically relevant phenomenon with an estimated global prevalence around 5%. Celiac disease, wheat allergy and non-celiac gluten sensitivity represent different gluten-related disorders. Similar clinical manifestations can be observed in these disorders, yet there are peculiar pathogenetic pathways involved in their development. Celiac disease and wheat allergy have been extensively studied, while non-celiac gluten sensitivity is a relatively novel clinical entity, believed to be closely related to other gastrointestinal functional syndromes. The diagnosis of celiac disease and wheat allergy is based on a combination of findings from the patient's clinical history and specific tests, including serology and duodenal biopsies in case of celiac disease, or laboratory and functional assays for wheat allergy. On the other hand, non-celiac gluten sensitivity is still mainly a diagnosis of exclusion, in the absence of clear-cut diagnostic criteria. A multimodal pragmatic approach combining findings from the clinical history, symptoms, serological and histological tests is required in order to reach an accurate diagnosis. A thorough knowledge of the differences and overlap in clinical presentation among gluten-related disorders, and between them and other gastrointestinal disorders, will help clinicians in the process of differential diagnosis.

Social support and delays seeking care after HIV diagnosis, North Carolina, 2000-2006.

Science.gov (United States)

McCoy, Sandra I; Strauss, Ronald P; MacDonald, Pia D M; Leone, Peter A; Eron, Joseph J; Miller, William C

2009-09-01

Many adults in the USA enter primary care late in the course of HIV infection, countering the clinical benefits of timely HIV services and missing opportunities for risk reduction. Our objective was to determine if perceived social support was associated with delay entering care after an HIV diagnosis. Two hundred and sixteen patients receiving primary care at a large, university-based HIV outpatient clinic in North Carolina were included in the study. Dimensions of functional social support (emotional/informational, tangible, affectionate, and positive social interaction) were quantified with a modified Medical Outcomes Study Social Support Scale and included in proportional hazards models to determine their effect on delays seeking care. The median delay between diagnosis and entry to primary care was 5.9 months. Levels of social support were high but only positive social interaction was moderately associated with delayed presentation in adjusted models. The effect of low perceived positive social interaction on the time to initiation of primary care differed by history of alcoholism (no history of alcoholism, hazard ratio (HR): 1.43, 95% confidence interval (CI): 0.88, 2.34; history of alcoholism, HR: 0.71, 95% CI: 0.40, 1.28). Ensuring timely access to HIV care remains a challenge in the southeastern USA. Affectionate, tangible, and emotional/informational social support were not associated with the time from diagnosis to care. The presence of positive social interaction may be an important factor influencing care-seeking behavior after diagnosis.

Current Concepts in the Diagnosis of Primary Open Angle Glaucoma

African Journals Online (AJOL)

RESULTS: The Preferred Practice Pattern Committee of the American Academy of Ophthalmology recommends that the comprehensive initial glaucoma evaluation (history and physical examination) includes comprehensive adult eye evaluation with special attention to those factors that specifically bear on the diagnosis ...

Lifetime interpersonal violence and self-reported chlamydia trachomatis diagnosis among California women.

Science.gov (United States)

Alvarez, Jennifer; Pavao, Joanne; Mack, Katelyn P; Chow, Joan M; Baumrind, Nikki; Kimerling, Rachel

2009-01-01

To examine the relationship between cumulative exposure to various types of interpersonal violence throughout the life span and self-reported history of Chlamydia trachomatis (CT) diagnosis in a population-based sample of California women. This was a cross-sectional analysis of a population-based survey of California women aged 18-44 years (n = 3521). Participants reported their experience of multiple types of interpersonal violence: physical or sexual abuse in childhood or adulthood and intimate partner violence (IPV) in the past 12 months. Current posttraumatic stress disorder (PTSD) and depressive symptoms were also reported. Separate logistic regression models assessed the association between experiencing each type of interpersonal violence, as well as women's cumulative exposure to violence, and past CT diagnosis, adjusting for age, race/ethnicity, and poverty, as well as mental health problems. Six percent of women reported a past diagnosis of CT, and 40.8% reported experiencing at least one type of interpersonal violence in their lifetime. All types of violence were significantly associated with higher odds of having a past CT diagnosis even after controlling for sociodemographics. Women who reported experiencing four or more types of violence experiences had over five times the odds of reporting a lifetime CT diagnosis compared with women who never experienced interpersonal violence (adjusted odds ratio = 5.71, 95% CI 3.27-9.58). Current PTSD and depressive symptoms did not significantly affect the relationship between a woman's cumulative experience of violence and her risk of past CT diagnosis. There is a robust association between experiencing multiple forms of violence and having been diagnosed with CT. Women who seek treatment for sexually transmitted diseases (STDs), such as CT, should be assessed for their lifetime history of violence, especially violence in their current intimate relationships. Sexual risk reduction counseling may also be important

[The Classification of Headache: Important Aspects of Patient's History and Clinical Diagnostic].

Science.gov (United States)

Kamm, Katharina; Ruscheweyh, Ruth; Eren, Ozan; Straube, Andreas

2017-03-01

Headache disorders are the most occuring symptoms in human population. Basis for a successful therapy of headaches is a definite diagnosis, which needs in turn valid criteria for the graduation of headaches. Corresponding to the classification of the International Headache Society (IHS) especially relevant questions about patient's history and clinical examination lead to a diagnosis. © Georg Thieme Verlag KG Stuttgart · New York.

Difficulties with Prenatal Diagnosis of the Walker-Warburg Syndrome

International Nuclear Information System (INIS)

Low, A.S.C.; Lee, S.L.; Tan, A.S.A.; Chan, D.K.L.; Chan, L.L.

2005-01-01

We describe a postnatally diagnosed case of Walker-Warburg syndrome - a form of congenital muscular dystrophy with lissencephaly and eye abnormalities. We reviewed the literature to highlight its clinico-radiological diagnostic features and discuss the difficulties encountered with prenatal diagnosis, especially in cases with no positive family history. An increased awareness of this rare but lethal condition, and a high index of suspicion during routine antenatal ultrasound, could prompt further advanced fetal ultrasonography and magnetic resonance imaging, and aid in timely prenatal diagnosis, management, and counseling. Brain/brainstem, congenital, magnetic resonance imaging, obstetrics, pediatrics, ultrasound

Difficulties with Prenatal Diagnosis of the Walker-Warburg Syndrome

Energy Technology Data Exchange (ETDEWEB)

Low, A.S.C.; Lee, S.L.; Tan, A.S.A.; Chan, D.K.L.; Chan, L.L. [Singapore General Hospital (Singapore). Depts. of Diagnostic Radiology, Obstetrics and Gynecology and Neonatology

2005-10-01

We describe a postnatally diagnosed case of Walker-Warburg syndrome - a form of congenital muscular dystrophy with lissencephaly and eye abnormalities. We reviewed the literature to highlight its clinico-radiological diagnostic features and discuss the difficulties encountered with prenatal diagnosis, especially in cases with no positive family history. An increased awareness of this rare but lethal condition, and a high index of suspicion during routine antenatal ultrasound, could prompt further advanced fetal ultrasonography and magnetic resonance imaging, and aid in timely prenatal diagnosis, management, and counseling. Brain/brainstem, congenital, magnetic resonance imaging, obstetrics, pediatrics, ultrasound.

Learning disabilities: definitions, epidemiology, diagnosis, and intervention strategies.

Science.gov (United States)

Lagae, Lieven

2008-12-01

Learning problems occur in about 5% of school-aged children. Learning disabilities are specific and life-long but present with different school problems at different ages, depending on such factors as age, medical history, family history, and intelligence quotient. Proper individualized diagnosis and treatment plans are necessary to remediate these problems and to offer adequate coping strategies. Many children who have learning problems can be classified into one of two major categories: the dyslexia group or the nonverbal learning disability group. The role of the medical professional is important to guide parents in the diagnostic and therapeutic process.

Breastfeeding and the prevention of breast cancer: a retrospective review of clinical histories.

Science.gov (United States)

González-Jiménez, Emilio; García, Pedro A; Aguilar, María José; Padilla, Carlos A; Álvarez, Judit

2014-09-01

To evaluate at what age parous and nonparous women were diagnosed with breast cancer. Factors taken into account for parous women were whether they had breastfed their children, and if so, the length of the lactation period. Other factors considered for both groups were obesity, family histories of cancer, smoking habits and alcohol consumption. Breast cancer is the most common form of cancer in younger women in Western countries. Its growing incidence as well as the increasingly early age of diagnosis led us to carefully analyse its possible causes and the preventive measures to be taken. This is a particularly important goal in epidemiological research. A retrospective study of the clinical histories of patients diagnosed with breast cancer at the San Cecilio University Hospital in Granada (Spain). In this study, we analysed 504 medical records of female patients, 19-91 years of age, who had been diagnosed and treated for breast cancer from 2004-2009 at the San Cecilio University Hospital in Granada (Spain). Relevant data (age of diagnosis, period of lactation, family history of cancer, obesity, alcohol consumption and smoking habits) were collected from the clinical histories of each patient and analysed. A conditional inference tree was used to relate the age of diagnosis to smoking habits and the length of the lactation period. The conditional inference tree identified significant differences between the age of the patients at breast cancer diagnosis, smoking habits (p cancer. Our study concluded that breastfeeding for over six months not only provides children with numerous health benefits, but also protects mothers from breast cancer when the mothers are nonsmokers. Nurses play a crucial role in encouraging new mothers to breastfeed their children, and this helps to prevent breast cancer. © 2013 John Wiley & Sons Ltd.

IMAGING AS AN AID TO THE DIAGNOSIS OF ACUTE APPENDICITIS

Directory of Open Access Journals (Sweden)

Lionel I Wijesuriya

2007-01-01

Full Text Available Acute appendicitis has been known as a disease entity for well over a century but a confident diagnosis before surgeryin all patients suspected of the condition is still not possible. Timely diagnosis is essential to minimise morbidity due topossible perforation of the inflamed organ in the event treatment is delayed; so much so that surgeons often preferredto operate at the slightest suspicion of the diagnosis in the past. This resulted in the removal of many normal appendixes.When the diagnosis of appendicitis is clear from the history and clinical examination, then no further investigation isnecessary and prompt surgical treatment is appropriate. Where there is doubt about the diagnosis however it is advisableto resort to imaging studies such as abdominal ultrasound or computed tomography to clear such suspicions beforesubjecting the patient to an appendicectomy. These studies would also help avoid delays in surgery in deservingpatients.

What Lies Behind NSF Astronomer Demographics? Subjectivities of Women, Minorities and Foreign-born Astronomers within Meshworks of Big Science Astronomy

Science.gov (United States)

Guillen, Reynal; Gu, D.; Holbrook, J.; Murillo, L. F.; Traweek, S.

2011-01-01

Our current research focuses on the trajectory of scientists working with large-scale databases in astronomy, following them as they strategically build their careers, digital infrastructures, and make their epistemological commitments. We look specifically at how gender, ethnicity, nationality intersect in the process of subject formation in astronomy, as well as in the process of enrolling partners for the construction of instruments, design and implementation of large-scale databases. Work once figured as merely technical support, such assembling data catalogs, or as graphic design, generating pleasing images for public support, has been repositioned at the core of the field. Some have argued that such databases enable a new kind of scientific inquiry based on data exploration, such as the "fourth paradigm" or "data-driven" science. Our preliminary findings based on oral history interviews and ethnography provide insights into meshworks of women, African-American, "Hispanic," Asian-American and foreign-born astronomers. Our preliminary data suggest African-American men are more successful in sustaining astronomy careers than Chicano and Asian-American men. A distinctive theme in our data is the glocal character of meshworks available to and created by foreign-born women astronomers working at US facilities. Other data show that the proportion of Asian to Asian American and foreign-born Latina/o to Chicana/o astronomers is approximately equal. Futhermore, Asians and Latinas/os are represented in significantly greater numbers than Asian Americans and Chicanas/os. Among professional astronomers in the US, each ethnic minority group is numbered on the order of tens, not hundreds. Project support is provided by the NSF EAGER program to University of California, Los Angeles under award 0956589.

CT Diagnosis of Appendicitis

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Christopher Libby

2017-01-01

Full Text Available History of present illness: A 19-year-old male with no previous medical history presented with 7/10 non-radiating, constant, sharp, periumbilical pain associated with nausea, and four episodes of vomiting. He was seen at urgent care where his labs showed a WBC of 16,000/mcL. He was subsequently sent to the emergency department (ED for concern of appendicitis. Of note, his pain worsened with bumps during the drive to the ED. After arriving to the ED the pain migrated to the right lower quadrant. Computed tomography (CT revealed acute appendicitis and the patient was admitted to the surgery service and taken to the operating room (OR for an appendectomy. Significant findings: The CT abdomen/pelvis with IV contrast shows a dilated appendix (see red outline with thickened, hyperenhancing wall (see blue outline best visualized in the axial and coronal planes. Discussion: Appendicitis is a common diagnosis in the emergency department in patients presenting with abdominal pain, occurring most frequently in young adults with a peak incidence in those aged 10-19.1 Failure to quickly diagnose acute appendicitis can result in perforation rates as high as 80 percent.2 While the diagnosis of appendicitis can be made clinically, CT is a non-invasive modality that improves the detection of appendicitis with sensitivities of 88–100%, specificities of 91–99%, positive predictive values of 92–98%, negative predictive values of 95–100%, and accuracies of 94–98%.3-8 The major advantage of CT over both clinical exam and ultrasound is the ability of the radiologist to exclude acute appendicitis if the appendix appears normal. However, CT carries the risks associated with ionizing radiation. While previously there was some debate on the best choice for type of CT scan and use of IV and oral contrast, recent studies have shown that CT abdomen/pelvis with IV contrast alone is sufficient for diagnosis of appendicitis.9, 10

Ultrasonography in Early Diagnosis of Heterotopic Ossification

Directory of Open Access Journals (Sweden)

Shan-Hui Lin

2014-12-01

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

Diagnostic Validity of Combining History Elements and Physical Examination Tests for Traumatic and Degenerative Symptomatic Meniscal Tears.

Science.gov (United States)

Décary, Simon; Fallaha, Michel; Frémont, Pierre; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie E; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2017-10-27

The current approach to the clinical diagnosis of traumatic and degenerative symptomatic meniscal tears (SMTs) proposes combining history elements and physical examination tests without systematic prescription of imaging investigations, yet the evidence to support this diagnostic approach is scarce. To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude traumatic and degenerative SMT compared with other knee disorders. Prospective diagnostic accuracy study. Patients were recruited from 2 orthopedic clinics, 2 family medicine clinics, and from a university community. A total of 279 consecutive patients who underwent consultation for a new knee complaint. Each patient was assessed independently by 2 evaluators. History elements and standardized physical examination tests performed by a physiotherapist were compared with the reference standard: an expert physicians' composite diagnosis including a clinical examination and confirmatory magnetic resonance imaging. Participating expert physicians were orthopedic surgeons (n = 3) or sport medicine physicians (n = 2). Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of SMT and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures were calculated including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CIs). Eighty patients had a diagnosis of SMT (28.7%), including 35 traumatic tears and 45 degenerative tears. The combination a history of trauma during a pivot, medial knee pain location, and a positive medial joint line tenderness test was able to diagnose (LR+ = 8.9; 95% CI 6.1-13.1) or exclude (LR- = 0.10; 95% CI 0.03-0.28) a traumatic SMT. Combining a history of

Hypothyroidism After a Cancer Diagnosis: Etiology, Diagnosis, Complications, and Management

Science.gov (United States)

Carter, Yvette; Sippel, Rebecca S.

2014-01-01

Hypothyroidism is a common disease that is easily treated in the majority of cases, when readily diagnosed; however, presentation of an aggregate of its symptoms is often clinically overlooked or attributed to another disease and can potentially be lethal. Already prevalent in older women, its occurrence in younger patients is rising as a result of radiation therapy, radioactive iodine therapy, and newer antineoplastic agents used to manage various malignancies. The presence of nonspecific constitutional symptoms and neuropsychiatric complaints in cancer patients can be attributed to a myriad of other diagnoses and therapies. Thyroid dysfunction can be easily overlooked in cancer patients because of the complexity of cancer’s clinical picture, particularly in the pediatric population. Underdiagnosis can have important consequences for the management of both hypothyroidism and the malignancy. At minimum, quality of life is adversely affected. Untreated hypothyroidism can lead to heart failure, psychosis, and coma and can reduce the effectiveness of potentially life-saving cancer therapies, whereas iatrogenic causes can provoke atrial fibrillation and osteoporosis. Consequently, the diagnosis and treatment of hypothyroidism in cancer patients are pertinent. We summarize the history, epidemiology, pathophysiology, clinical diagnosis, and management of hypothyroidism in cancer patients. PMID:24309982

Hypothyroidism after a cancer diagnosis: etiology, diagnosis, complications, and management.

Science.gov (United States)

Carter, Yvette; Sippel, Rebecca S; Chen, Herbert

2014-01-01

Hypothyroidism is a common disease that is easily treated in the majority of cases, when readily diagnosed; however, presentation of an aggregate of its symptoms is often clinically overlooked or attributed to another disease and can potentially be lethal. Already prevalent in older women, its occurrence in younger patients is rising as a result of radiation therapy, radioactive iodine therapy, and newer antineoplastic agents used to manage various malignancies. The presence of nonspecific constitutional symptoms and neuropsychiatric complaints in cancer patients can be attributed to a myriad of other diagnoses and therapies. Thyroid dysfunction can be easily overlooked in cancer patients because of the complexity of cancer's clinical picture, particularly in the pediatric population. Underdiagnosis can have important consequences for the management of both hypothyroidism and the malignancy. At minimum, quality of life is adversely affected. Untreated hypothyroidism can lead to heart failure, psychosis, and coma and can reduce the effectiveness of potentially life-saving cancer therapies, whereas iatrogenic causes can provoke atrial fibrillation and osteoporosis. Consequently, the diagnosis and treatment of hypothyroidism in cancer patients are pertinent. We summarize the history, epidemiology, pathophysiology, clinical diagnosis, and management of hypothyroidism in cancer patients.

Absence of family history and phenotype-genotype correlation in pediatric Brugada syndrome: more burden to bear in clinical and genetic diagnosis.

Science.gov (United States)

Daimi, Houria; Khelil, Amel Haj; Ben Hamda, Khaldoun; Aranega, Amelia; Chibani, Jemni B E; Franco, Diego

2015-06-01

Brugada syndrome (BrS) is an autosomal-dominant genetic cardiac disorder caused in 18-30 % of the cases by SCN5A gene mutations and manifested by an atypical right bundle block pattern with ST segment elevation and T wave inversion in the right precordial leads. The syndrome is usually detected after puberty. The identification of BrS in pediatric patients is thus a rare occurrence, and most of the reported cases are unmasked after febrile episodes. Usually, having a family history of sudden death represents the first reason to perform an ECG in febrile children. However, this practice makes the sporadic cases of cardiac disease and specially the asymptomatic ones excluded from this diagnosis. Here, we report a sporadic case of a 2-month-old male patient presented with vaccination-related fever and ventricular tachycardia associated with short breathing, palpitation and cold sweating. ECG changes were consistent with type 1 BrS. SCN5A gene analysis of the proband and his family revealed a set of mutations and polymorphisms differentially distributed among family members, however, without any clear genotype-phenotype correlation. Based on our findings, we think that genetic testing should be pursued as a routine practice in symptomatic and asymptomatic pediatric cases of BrS, with or without family history of sudden cardiac death. Similarly, our study suggests that pediatrician should be encouraged to perform an ECG profiling in suspicious febrile children and quickly manage fever since it is the most important factor unmasking BrS in children.

Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity

Science.gov (United States)

Elli, Luca; Branchi, Federica; Tomba, Carolina; Villalta, Danilo; Norsa, Lorenzo; Ferretti, Francesca; Roncoroni, Leda; Bardella, Maria Teresa

2015-01-01

Cereal crops and cereal consumption have had a vital role in Mankind’s history. In the recent years gluten ingestion has been linked with a range of clinical disorders. Gluten-related disorders have gradually emerged as an epidemiologically relevant phenomenon with an estimated global prevalence around 5%. Celiac disease, wheat allergy and non-celiac gluten sensitivity represent different gluten-related disorders. Similar clinical manifestations can be observed in these disorders, yet there are peculiar pathogenetic pathways involved in their development. Celiac disease and wheat allergy have been extensively studied, while non-celiac gluten sensitivity is a relatively novel clinical entity, believed to be closely related to other gastrointestinal functional syndromes. The diagnosis of celiac disease and wheat allergy is based on a combination of findings from the patient’s clinical history and specific tests, including serology and duodenal biopsies in case of celiac disease, or laboratory and functional assays for wheat allergy. On the other hand, non-celiac gluten sensitivity is still mainly a diagnosis of exclusion, in the absence of clear-cut diagnostic criteria. A multimodal pragmatic approach combining findings from the clinical history, symptoms, serological and histological tests is required in order to reach an accurate diagnosis. A thorough knowledge of the differences and overlap in clinical presentation among gluten-related disorders, and between them and other gastrointestinal disorders, will help clinicians in the process of differential diagnosis. PMID:26109797

Lipoma arborescens: diagnosis and image

International Nuclear Information System (INIS)

Goncalves, Marcela; Len, Claudio Arnaldo; Terreri, Maria Teresa Ramos Ascencao; Fernandes, Artur da Rocha Correa; Hilario, Maria Odete Esteves

2004-01-01

Lipoma arborescens is an intraarticular lesion of unknown etiology, consisting of a chronic villous fat proliferation of the synovial membrane. The disease has occasionally been associated with diabetes mellitus, degenerative diseases, juvenile rheumatoid arthritis and also rheumatoid arthritis. The diagnosis relies on magnetic resonance imaging evaluation and synovial biopsy. We report a case of a 8-year-old girl with a two year history of bilateral swelling of the knees and elbows. The patient had improvement of the arthritis after starting treatment with conventional drugs. (author)

Cerebral metastasis masquerading as cerebritis: A case of misguiding history and radiological surprise!

Directory of Open Access Journals (Sweden)

Ashish Kumar

2013-01-01

Full Text Available Cerebral metastases usually have a characteristic radiological appearance. They can be differentiated rather easily from any infective etiology. Similarly, positive medical history also guides the neurosurgeon towards the possible diagnosis and adds to the diagnostic armamentarium. However, occasionally, similarities on imaging may be encountered where even history could lead us in the wrong direction and tends to bias the clinician. We report a case of a 40-year-old female with a history of mastoidectomy for otitis media presenting to us with a space occupying lesion in the right parietal region, which was thought pre-operatively as an abscess along with the cerebritis. Surprisingly, the histopathology proved it to be a metastatic adenocarcinoma. Hence, a ring enhancing lesion may be a high grade neoplasm/metastasis/abscess, significant gyral enhancement; a feature of cerebritis is not linked with a neoplastic etiology more often. This may lead to delayed diagnosis, incorrect prognostication and treatment in patients having coincidental suggestive history of infection. We review the literature and highlight the key points helping to differentiate an infective from a neoplastic pathology which may look similar at times.

Caffeine dependence in combination with a family history of alcoholism as a predictor of continued use of caffeine during pregnancy.

Science.gov (United States)

Svikis, Dace S; Berger, Nathan; Haug, Nancy A; Griffiths, Roland R

2005-12-01

The purpose of the study was to examine whether caffeine dependence and a family history of alcoholism are associated with continued use of caffeine during pregnancy. Forty-four women seeking obstetrical care in an office-based practice completed questionnaires and provided saliva samples at three prenatal visits occurring 2-3, 3-4, and 7 months postconception. On visit 1, the patients received the physician's instructions to stop using caffeine. Structured interviews were used to assign a diagnosis of caffeine dependence (lifetime) and to identify family history of alcoholism. Outcome measures included self-reported levels of caffeine use and saliva caffeine levels at the three prenatal visits. Although most women eliminated or substantially reduced their caffeine consumption between pregnancy awareness and prenatal visit 1, those with a lifetime diagnosis of caffeine dependence and a family history of alcoholism had higher levels of caffeine use and lower rates of abstinence throughout pregnancy. Saliva caffeine levels confirmed these effects. Withdrawal symptoms, functional impairment, and craving were cited as reasons they failed to eliminate or cut back on caffeine use. Fifty percent of the women with both a lifetime diagnosis of caffeine dependence and a family history of alcoholism continued to use caffeine in amounts (>300 mg/day) greater than those considered safe during pregnancy, compared to none of the women without caffeine dependence and a family history of alcoholism. Women with a lifetime diagnosis of caffeine dependence and a family history of alcoholism also reported higher rates of past cigarette smoking and problematic alcohol use. Caffeine-dependent women with a family history of alcoholism were not able to follow their physician's advice to reduce or eliminate caffeine consumption during pregnancy, despite their wanting to do so. This subgroup may require more intensive intervention to ensure caffeine abstinence and may be at greater risk for

The genus Architeuthis was erected, without giving any diagnosis ...

African Journals Online (AJOL)

spamer

The genus Architeuthis was erected, without giving any diagnosis, by Steenstrup in 1857 for a specimen stranded on the Danish coast in 1853. In 1880, Verrill gave the first description of the genus. Pfeffer (1912) related this history and also mentioned that traditional narratives and illustrations of the 16th century had.

Noninvasive Prenatal Diagnosis of Hypohidrotic Ectodermal Dysplasia by Tooth Germ Sonography.

Science.gov (United States)

Wünsche, S; Jüngert, J; Faschingbauer, F; Mommsen, H; Goecke, T; Schwanitz, K; Stepan, H; Schneider, H

2015-08-01

Hypohidrotic ectodermal dysplasia, a potentially life-threatening heritable disorder, may be recognized already in utero by characteristic features such as oligodontia and mandibular hypoplasia. As therapeutic options and prognosis depend on the time point of diagnosis, early recognition was attempted during routine prenatal ultrasound examinations. Fetuses of nine pregnant women (one triplet and eight singleton pregnancies) with family histories of hypohidrotic ectodermal dysplasia were investigated by sonography between the 20th and 24th week of gestation. In 4 male and 2 female fetuses reduced amounts of tooth germs were detected, whereas 5 fetal subjects showed the normal amount. Three-dimensional ultrasound evaluation revealed mandibular hypoplasia in 5 of the 6 fetuses with oligodontia. Molecular genetic analysis and/or clinical findings after birth confirmed the prenatal sonographic diagnosis in each subject. In subjects with a family history of hypohidrotic ectodermal dysplasia, the diagnosis of this rare condition can be established noninvasively by sonography in the second trimester of pregnancy. Early recognition of the disorder may help to prevent dangerous hyperthermic episodes in infancy and may allow timely therapeutic interventions. © Georg Thieme Verlag KG Stuttgart · New York.

[Diagnosis and differential diagnosis of bronchial asthma].

Science.gov (United States)

Gillissen, A; Bauer, T; Richter, F; Leonhardt, P

2001-11-01

Asthma and COPD (chronic obstructive pulmonary disease) are the most important obstructive pulmonary diseases. Patient's history and physical evaluation give major hints of the underlying disease. Further diagnostic measures comprise lung function analysis including spirometry, plethysmography and--in severe cases--blood gas analysis. Bronchial hyperreactivity may be quantified with an unspecific inhalative provocation test. In many cases allergic diseases are accompanied by asthma. Thus, allergy tests--particularly skin prick tests--have to be carried out. To further define an underlying allergy, in some cases even specific inhalative provocation tests have to be performed. X-ray of the thorax and other imaging techniques, detailed blood analysis, further diagnosis of the upper respiratory tract and the cardiac system may have to be carried out a) to quantify the effects of a severe form of asthma or COPD on other organs, and b) for differential diagnostic examinations.

Hereditary spherocytosis: Consequences of delayed diagnosis

Directory of Open Access Journals (Sweden)

Sarah C Steward

2014-08-01

Full Text Available Objective: To determine whether patients with undiagnosed hereditary spherocytosis hospitalized for transfusions might have avoided hospitalization via earlier diagnosis. Study design: Charts of all (N = 30 patients with hereditary spherocytosis seen in pediatric hematology at West Virginia University-Charleston were reviewed. Family and transfusion history and presence of neonatal jaundice were recorded. Complete blood count and reticulocyte values during infancy were available for 20 of 30 patients, while baseline steady-state values were available for all 30. Results: Transfusions were given to 22 patients; 12 of 14 with an aplastic crisis were undiagnosed. In 10 of 12, the severity of anemia led to hospitalization (3 to intensive care. All 10 had prior mean corpuscular hemoglobin concentration and/or red cell distribution width elevations and a history of neonatal jaundice; 7 of 10 had a positive family history. Conclusions: Undiagnosed hereditary spherocytosis may lead to inpatient transfusions for severe anemia. Earlier detection of hereditary spherocytosis is easily achievable and may reduce hospitalizations via closer monitoring.

Irritant-Induced Paradoxical Vocal Fold Motion Disorder: Diagnosis and Management.

Science.gov (United States)

Marcinow, Anna M; Thompson, Jennifer; Forrest, L Arick; deSilva, Brad W

2015-12-01

To review our experience with the diagnosis and treatment of irritant-induced paradoxical vocal fold motion disorder (IPVFMD). Retrospective chart review. Tertiary academic referral center. Thirty-four cases that met IPVFMD criteria and 76 cases of non-IPVFMD were selected from a database of patients with paradoxical vocal fold motion disorder-the diagnosis of which was made on the basis of flexible fiberoptic laryngoscopy and augmented by an odor challenge. Clinical charts were reviewed to document history of environmental allergies, pulmonary disease, gastroesophageal reflux, psychiatric disorder, fibromyalgia, tobacco use, alcohol use, dysphonia, cough, dysphagia, and treatment outcomes. There were no statistical differences between the IPVFMD and non-IPVFMD groups. Of the patients who were assigned and attended laryngeal control therapy, 13 (65%) reported improvement of symptoms. Symptom improvement increased to 100% in those patients who attended at least 2 laryngeal control therapy sessions. IPVFMD should be considered in patients presenting with respiratory symptoms after irritant exposure. Sensitivity of diagnosis can be improved via a standardized approach consisting of a careful history and physical examination, including laryngoscopy in the presence of triggers. Laryngeal control therapy is a well-tolerated and effective method of managing IPVFMD. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Delayed diagnosis in pediatric headache: an outpatient Italian survey.

Science.gov (United States)

Colombo, Bruno; Dalla Libera, Dacia; De Feo, Donatella; Pavan, Giulia; Annovazzi, Pietro Osvaldo; Comi, Giancarlo

2011-09-01

The aim of this prospective study is to assess the time lapse between the onset of recurring headache and the correct diagnosis in a cohort of pediatric patients attending an Italian children's headache center for the first time. One hundred and one patients and parents, referred to the Pediatric Headache Centre of San Raffaele Hospital in Milan, Italy, underwent a semi-structured interview to ascertain features of headache since onset (clinical and family history, presence of childhood periodic syndromes, previously undergone instrumental exams and specialists' examinations before the correct diagnosis, past and current treatment). All patients were evaluated by expert neurologists and their headache was classified according to the International Classification of Headache Disorders II (2004). The median time delay from the onset of the first episode of recurrent headache to definite diagnosis was 20 months (interquartile range 12 to 36 months). A correlation with younger age and a more delayed headache diagnosis was found (r Spearman = 0.25; P = .039). An association between diagnostic delay and positive family history (median 24 months [12 to 48] vs 12 [6 to 24]; P = .014) or female gender (median 18 months [12 to 42] vs. 12 [5 to 30]; P trend = .070) was also evident. Notably, 76 out of 101 patients referred to our Center received an appropriate diagnosis according to International Classification of Headache Disorders II at the time of our visit only. Of note, up to 21% of this group were previously misdiagnosed (for epilepsy 43%, sinusitis 38%, or other diseases 19%), a fact that contributed to a longer time of clinical assessment (median 39 months) before reaching a correct diagnosis. The other group of 80 patients (79%) did not receive a specific diagnosis and treatment, and were not studied until their symptom became chronic and disabling. Pediatric headache is still under-diagnosed and not adequately considered as a health problem in the

Diagnosis of chronic active hepatitis in a miniature schnauzer.

Science.gov (United States)

Hendrix, Alana D

2004-09-01

A 12-year-old male castrated miniature schnauzer was presented with a history of abdominal distension. Serum biochemical analysis and abdominal ultrasonography indicated hepatic disease. A wedge biopsy provided a diagnosis of chronic active hepatitis. A therapeutic regime was initiated to improve the quality of life and slow the progression of this disease is described.

Diagnosis of chronic active hepatitis in a miniature schnauzer

OpenAIRE

Hendrix, Alana D.

2004-01-01

A 12-year-old male castrated miniature schnauzer was presented with a history of abdominal distension. Serum biochemical analysis and abdominal ultrasonography indicated hepatic disease. A wedge biopsy provided a diagnosis of chronic active hepatitis. A therapeutic regime was initiated to improve the quality of life and slow the progression of this disease is described.

Magnetic resonance spectroscopic diagnosis of acute alcohol ingestion with hidden history

International Nuclear Information System (INIS)

Pungavkar, S.A.; Joshi, V.; Patkar, D.P.; Lawande, M.; Gadani, S.; Shah-Mehta, N.

2006-01-01

Parenchymal changes within the brain in chronic alcoholics are well known, and specific MRI and MR spectroscopy findings have been described. However, recent alcohol ingestion goes undetected on routine MRI because of lack of specific parenchymal changes in the acute setting. Magnetic resonance spectroscopy can detect the presence of ethanol as a metabolite in the brain accurately and can provide valuable information regarding acute ingestion of alcohol. This may be useful especially in cases where history of alcohol ingestion is withheld. Copyright (2006) Blackwell Science Pty Ltd

Challenges in diagnosis and counseling of a family with two ...

African Journals Online (AJOL)

... of specific investigations, metabolic specialized labs and the deficiency of documentation. In this case report, we present the challenges that we met in diagnosis and counseling of a family with both Tay–Sachs and maple syrup urine disease depending mainly on history, clinical data and a few diagnostic investigations.

FETOMATERNAL HAEMORRHAGE – DIFFERENTIAL DIAGNOSIS – CASE REPORT

Directory of Open Access Journals (Sweden)

Jadranka Domazet-Fink

2002-07-01

Full Text Available Background. There are several different causes for fetomaternal haemorrhage. Sinusoidal pattern, which is relatively characteristic for fetal anaemia, may in its final stages completely disappear. Differential diagnosis of silent trace of cardiotocogram with late decelerations is quite difficult to solve.Case report. A case of unusual injury of a pregnant woman is described. The injury led to fetomaternal haemorrhage. Typical sinusoidal pattern cardiotocogram was not seen and the differential diagnosis was hard to determine. Because of prompt intervention and efficient postnatal therapy the child and mother are both well. The dilemmas in regards to differential diagnosis are being discussed.Conclusions. It is important to be very careful in history taking even if the situation is urgent. If there is no explanation for pathological cardiotocogram, decision must be made according to pregnant woman’s wishes. Kleihauer-Betke test, which is easy to perform and gives much information, is described.

Leucocyte esterase in the rapid diagnosis of paediatric septic arthritis.

LENUS (Irish Health Repository)

Kelly, E G

2013-02-01

Septic arthritis may affect any age group but is more common in the paediatric population. Infection is generally bacterial in nature. Prompt diagnosis is crucial, as delayed treatment is associated with lifelong joint dysfunction. A clinical history and application of Kocher\\'s criteria may indicate that there is a septic arthritis. However, definitive diagnosis is made on culture of septic synovial fluid. The culture process can take over 24h for the initial culture to yield bacterial colonies. Leucocyte esterase is released by leucocytes at the site of an infection. We hypothesise that leucocyte esterase can be utilized in the rapid diagnosis of septic arthritis and shorten the time to decisive treatment whilst simultaneously decreasing unnecessary treatment of non-septic joints.

Plain X-ray diagnosis of the acute abdomen: A surgical handbook with notes on clinical presentation and differential diagnosis

International Nuclear Information System (INIS)

Gough, M.H.; Gear, M.W.; Daar, A.S.

1985-01-01

Taken in conjunction with a history and clinical examination, the plain X-ray film may provide invaluable help in reaching or confirming a diagnosis in the patient with an acute abdomen. Designed for the casualty officer or trainee surgeon, this clinical handbook is a practical guide to the interpretation of the plain abdominal X-ray. The format of the first edition has been retained, providing typical examples of X-rays of the conditions which present as abdominal emergencies. Each X-ray is accompanied by a legend in four sections: the characteristic radiological signs demonstrated in the film; the differential diagnosis suggested by the X-ray; the presenting signs and symptoms of the condition under discussion; and a list of possible clinical differential diagnoses

A positive diagnosis of functional (psychogenic) tics.

Science.gov (United States)

Demartini, B; Ricciardi, L; Parees, I; Ganos, C; Bhatia, K P; Edwards, M J

2015-03-01

Functional tics, also called psychogenic tics or pseudo-tics, are difficult to diagnose because of the lack of diagnostic criteria and their clinical similarities to organic tics. The aim of the present study was to report a case series of patients with documented functional tics and to describe their clinical characteristics, risk factors and psychiatric comorbidity. Also clinical tips are suggested which might help the differential diagnosis in clinical practice. Eleven patients (mean age at onset 37.2, SD 13.5; three females) were included with a documented or clinically established diagnosis of functional tics, according to consultant neurologists who have specific expertise in functional movement disorders or in tic disorders. Adult onset, absent family history of tics, inability to suppress the movements, lack of premonitory sensations, absence of pali-, echo- and copro-phenomena, presence of blocking tics, the lack of the typical rostrocaudal tic distribution and the coexistence of other functional movement disorders were common in our patients. Our data suggest that functional tics can be differentiated from organic tics on clinical grounds, although it is also accepted that this distinction can be difficult in certain cases. Clinical clues from history and examination described here might help to identify patients with functional tics. © 2014 EAN.

Diagnosis of intestinal and extra intestinal amoebiasis

International Nuclear Information System (INIS)

Lopez, Myriam Consuelo; Quiroz, Damian Arnoldo; Pinilla, Analida Elizabeth

2007-01-01

during the XXth and the beginning of the XXIst century in updating the diagnosis of amoebiasis and accepting the hypothesis of the complex Entamoeba histolytic / Entamoeba dispar proposed by Brumpt in 1925. In Colombia, given the progress made in the diagnostic techniques, as well as the determination of Gal/GalNAc lectine in the feces, the prevalence of E. histolytic between 0.6%-1.4%. However, for the diagnosis of intestinal amoebiasis direct test without being able to define the species. On the other hand, the most important clinical picture of extra-intestinal amoebiasis is liver abscess; to make that diagnosis the clinical history the context is analyzed, including the clinical history, epidemiological aspects, imaging studies and IgG antibodies against histolytic. The histopathology of the colon lesions continues to be valid for the differential diagnosis with other etiologies. The advent of the new molecular biology tests, will be a helpful diagnosis tool in this pathology.

Interstitial cystitis/bladder pain syndrome: diagnosis and management.

Science.gov (United States)

Offiah, I; McMahon, S B; O'Reilly, B A

2013-08-01

The bladder pain syndrome (BPS) is a spectrum of urological symptoms characterised by bladder pain with typical cystoscopic features. Diagnosis and management of this syndrome may be difficult. There is no evidence-based management approach for the diagnosis or treatment of BPS. The objective of this study was to critically review and summarise the evidence relating to the diagnosis and treatment of the bladder pain syndrome. A review of published data on the diagnosis and treatment of the BPS was performed. Our search was limited to English-language articles, on the "diagnosis", and "management" or "treatment" of "interstitial cystitis" and the "bladder pain syndrome" in "humans." Frequency, urgency and pain on bladder filling are the most common symptoms of BPS. All urodynamic volumes are reduced in patients with BPS. Associated conditions include psychological distress, depression, history of sexual assault, irritable bowel syndrome and fibromyalgia. Cystoscopy remains the test for definitive diagnosis, with visualisation of haemorrhage on cystoreduction. A multidisciplinary treatment approach is essential in the management of this condition. Orally administered amitriptyline is an efficacious medical treatment for BPS. Intravesical hyaluronic acid and local anaesthetic, with/without hydrodistension are among new treatment strategies. Sacral or pudendal neuromodulation is effective, minimally invasive and safe. Surgery is reserved for refractory cases. There remains a paucity of evidence for the diagnosis and treatment of BPS. We encountered significant heterogeneity in the assessment of symptoms, duration of treatment and follow up of patients in our literature review.

Use of computed tomography in the diagnosis of a cerebral abscess in a goat

International Nuclear Information System (INIS)

Gerros, T.C.; Mattoon, J.S.; Snyder, S.P.

1998-01-01

A 7-month-old La Mancha doe was presented with a right head tilt and ventral strabismus while circling to the left, History and physical examination led to a tentative diagnosis of a cerebral abscess. Computed tomography revealed a large, complex mass with ring enhancement in the left cerebral hemisphere, supporting the diagnosis. Postmortem examination confirmed the cerebral abscess. Bacterial cultures yielded heavy growth of Actinomyces pyogenes

Guidelines for the diagnosis and monitoring of silicosis.

Science.gov (United States)

Fernández Álvarez, Ramón; Martínez González, Cristina; Quero Martínez, Aida; Blanco Pérez, José Jesús; Carazo Fernández, Luis; Prieto Fernández, Amador

2015-02-01

Silicosis is one of the occupational respiratory diseases most commonly encountered in our setting. It is caused by inhalation of crystalline silica that triggers a fibrotic response in the lung parenchyma. It presents as diffuse interstitial disease and clinical expression ranges from asymptomatic forms to chronic respiratory failure. Diagnosis is based on clinical history and radiological findings. There is no effective treatment, and once diagnosed, the patient must avoid all sources of occupational exposure. In these guidelines, the clinical, radiological and functional aspects of silicosis are reviewed, and strategies for diagnosis, monitoring and classification of patients are proposed, along with recommendations regarding the occupational implications of this disease. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

A Clinician's Guide to the Diagnosis and Management of Gallbladder Volvulus.

Science.gov (United States)

Pottorf, Brian J; Alfaro, Leonardo; Hollis, Harris W

2013-01-01

Gallbladder volvulus (GV), or torsion of the gallbladder, is an uncommon surgical emergency. This article reviews the world literature related to GV. We examine the history of gallbladder torsion and highlight the critical constellation of presenting signs and symptoms, which guide the acute care physician and surgeon to accurate and timely diagnosis of GV before surgical intervention. A comprehensive review of all published cases of GV was performed using the National Library of Medicine (PubMed) database. Lists of typical symptoms and clinical presentations are provided to allow clinicians to establish an accurate preoperative diagnosis. GV is frequently undiagnosed before surgical intervention. However, clinical presentation and associated radiographic findings can lead to an accurate diagnosis if the clinician is aware of this uncommon condition. When the diagnosis has been established before operative intervention, expeditious laparoscopic cholecystectomy can be performed safely. Delays in diagnosis may mandate open cholecystectomy if laparoscopic extraction is contraindicated because of undesirable sequelae of gallbladder necrosis, specifically perforation, bilious peritonitis, and hemodynamic instability.

Computed tomography in the diagnosis of steroidal hepatopathy in a dog: case report

Energy Technology Data Exchange (ETDEWEB)

Oliveira, D.C; Costa, L.A.V.S.; Lopes, B.F.; Lanis, A.B.; Borlini, D.C.; Costa, F.S., E-mail: danielcapucho@gmail.co [Universidade Federal do Espirito Santo (UFES), Vitroria, ES (Brazil). Dept. de Medicina Veterinaria; Maia Junior, J.A. [Centro de Escolas de Formacao de Tecnicos em Radiologia, Vila Velha, ES (Brazil)

2011-02-15

It is reported a case of an eight-year-old Yorkshire Terrier dog, with a history of prolonged use of prednisone in a dosage of 1mg/kg of body weight each 24 hours during two years. The helical computed tomography revealed hepatomegaly associated to a hyper attenuation of the parenchyma, with a radiodensity value of 82.55 Hounsfield units (HU). The spleen presented a mean radiodensity of 57.17HU, and a radiodensity difference of 25.38HU was observed between the two organs. Based on the history and findings of imaging technique, it was determined the presumptive diagnosis of steroidal hepatopathy compatible with accumulation of hepatic glycogen. It was concluded that computed tomography enabled the characterization of hepatic injury and the presumed diagnosis of steroidal hepatopathy. (author)

Computed tomography in the diagnosis of steroidal hepatopathy in a dog: case report

International Nuclear Information System (INIS)

Oliveira, D.C; Costa, L.A.V.S.; Lopes, B.F.; Lanis, A.B.; Borlini, D.C.; Costa, F.S.

2011-01-01

It is reported a case of an eight-year-old Yorkshire Terrier dog, with a history of prolonged use of prednisone in a dosage of 1mg/kg of body weight each 24 hours during two years. The helical computed tomography revealed hepatomegaly associated to a hyper attenuation of the parenchyma, with a radiodensity value of 82.55 Hounsfield units (HU). The spleen presented a mean radiodensity of 57.17HU, and a radiodensity difference of 25.38HU was observed between the two organs. Based on the history and findings of imaging technique, it was determined the presumptive diagnosis of steroidal hepatopathy compatible with accumulation of hepatic glycogen. It was concluded that computed tomography enabled the characterization of hepatic injury and the presumed diagnosis of steroidal hepatopathy. (author)

Computed tomography in the diagnosis of steroidal hepatopathy in a dog: case report

Directory of Open Access Journals (Sweden)

D.C Oliveira

2011-02-01

Full Text Available It is reported a case of an eight-year-old Yorkshire Terrier dog, with a history of prolonged use of prednisone in a dosage of 1mg/kg of body weight each 24 hours during two years. The helical computed tomography revealed hepatomegaly associated to a hyperattenuation of the parenchyma, with a radiodensity value of 82.55 Hounsfield units (HU. The spleen presented a mean radiodensity of 57.17HU, and a radiodensity difference of 25.38HU was observed between the two organs. Based on the history and findings of imaging technique, it was determined the presumptive diagnosis of steroidal hepatopathy compatible with accumulation of hepatic glycogen. It was concluded that computed tomography enabled the characterization of hepatic injury and the presumed diagnosis of steroidal hepatopathy

Parental history of psychiatric diagnoses and unipolar depression: a Danish National Register-based cohort study.

Science.gov (United States)

Musliner, K L; Trabjerg, B B; Waltoft, B L; Laursen, T M; Mortensen, P B; Zandi, P P; Munk-Olsen, T

2015-10-01

Depression is known to run in families, but the effects of parental history of other psychiatric diagnoses on depression rates are less well studied. Few studies have examined the impact of parental psychopathology on depression rates in older age groups. We established a population-based cohort including all individuals born in Denmark after 1954 and alive on their 10th birthday (N = 29 76 264). Exposure variables were maternal and paternal history of schizophrenia, bipolar disorder, depression, anxiety or 'other' psychiatric diagnoses. Incidence rate ratios (IRRs) were estimated using Poisson regressions. Parental history of any psychiatric diagnosis increased incidence rates of outpatient (maternal: IRR 1.88, p history. IRRs for parental history of non-affective disorders remained relatively stable across age groups, while IRRs for parental affective disorders (unipolar or bipolar) decreased with age from 2.29-3.96 in the youngest age group to 1.53-1.90 in the oldest group. IRR estimates for all parental diagnoses were similar among individuals aged ⩾41 years (IRR range 1.51-1.90). Parental history of any psychiatric diagnosis is associated with increased incidence rates of unipolar depression. In younger age groups, parental history of affective diagnoses is more strongly associated with rates of unipolar depression than non-affective diagnoses; however, this distinction disappears after age 40, suggesting that parental psychopathology in general, rather than any one disorder, confers risk for depression in middle life.

The value of electrocardiography for differential diagnosis in wide QRS complex tachycardia.

Science.gov (United States)

Sousa, Pedro A; Pereira, Salomé; Candeias, Rui; de Jesus, Ilídio

2014-03-01

Correct diagnosis in wide QRS complex tachycardia remains a challenge. Differential diagnosis between ventricular and supraventricular tachycardia has important therapeutic and prognostic implications, and although data from clinical history and physical examination may suggest a particular origin, it is the 12-lead surface electrocardiogram that usually enables this differentiation. Since 1978, various electrocardiographic criteria have been proposed for the differential diagnosis of wide complex tachycardias, particularly the presence of atrioventricular dissociation, and the axis, duration and morphology of QRS complexes. Despite the wide variety of criteria, diagnosis is still often difficult, and errors can have serious consequences. To reduce such errors, several differential diagnosis algorithms have been proposed since 1991. However, in a small percentage of wide QRS tachycardias the diagnosis remains uncertain and in these the wisest decision is to treat them as ventricular tachycardias. The authors' objective was to review the main electrocardiographic criteria and differential diagnosis algorithms of wide QRS tachycardia. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Attitudes in Patients with Autosomal Dominant Polycystic Kidney Disease Toward Prenatal Diagnosis and Preimplantation Genetic Diagnosis.

Science.gov (United States)

Swift, Oscar; Vilar, Enric; Rahman, Belinda; Side, Lucy; Gale, Daniel P

2016-12-01

No recommendations currently exist regarding implementation of both prenatal diagnosis and preimplantation genetic diagnosis (PGD) for autosomal dominant polycystic kidney disease (ADPKD). This study evaluated attitudes in ADPKD patients with either chronic kidney disease (CKD) stages I-IV or end-stage renal failure (ESRF) toward prenatal diagnosis and PGD. Ninety-six ADPKD patients were recruited from an outpatient clinic, wards, and dialysis units. Thirty-eight patients had ESRF and 58 had CKD stages I-IV. Participants were given an information sheet on prenatal diagnosis and PGD and subsequently completed a questionnaire. The median age of participants was 51.5 years. Seventeen percent of ADPKD patients with CKD and 18% of ADPKD patients with ESRF would consider prenatal diagnosis and termination of pregnancy for ADPKD. Fifty percent with CKD would have opted for PGD (or might consider it in the future) were it available and funded by the UK National Health Service, compared to 63% in the ESRF group (p = 0.33). Sixty-nine percent in the CKD group and 68% in the ESRF group believed that PGD should be offered to other patients. There was a spectrum of attitudes among this cohort. A proportion of patients believe that PGD should be made available to prospective parents with this disease. The discrepancy between the low proportion (17% CKD, 18% ESRF) who would consider prenatal diagnosis and termination of pregnancy and the higher number who hypothetically express an intention or wish to access PGD (50% CKD and 63% ESRF) indicates far greater acceptability for diagnostic methods that occur before embryo implantation. It is not known how the development of methods to identify patients whose renal function is likely to decline rapidly and treatments altering the natural history of ADPKD will affect these attitudes.

Case Report: CT diagnosis of thymic remnant cyst/thymopharyngeal duct cyst

International Nuclear Information System (INIS)

Daga, Bipin V; Chaudhary, VA; Dhamangaokar, VB

2009-01-01

A 4-year-old boy presented with history of left anterolateral neck swelling since birth. He was clinically diagnosed to have a branchial cleft cyst. A CT scan revealed findings suggestive of a thymic remnant cyst. The lesion was excised and the diagnosis was confirmed by histopathology

Unexplained weight loss in an elderly patient. Delayed diagnosis of thyrotoxicosis

International Nuclear Information System (INIS)

Weiss, R.J.

1989-01-01

Because the presenting symptoms of hyperthyroidism are often misleading in elderly patients, diagnosis depends on a high degree of clinical suspicion. The presence of unexplained weight loss, atrial fibrillation, or heart failure (especially in a patient without a history of heart problems) justifies testing for thyrotoxicosis

Unexplained weight loss in an elderly patient. Delayed diagnosis of thyrotoxicosis

Energy Technology Data Exchange (ETDEWEB)

Weiss, R.J. (Medical College of Pennsylvania, Philadelphia (USA))

1989-11-01

Because the presenting symptoms of hyperthyroidism are often misleading in elderly patients, diagnosis depends on a high degree of clinical suspicion. The presence of unexplained weight loss, atrial fibrillation, or heart failure (especially in a patient without a history of heart problems) justifies testing for thyrotoxicosis.

The University of Minnesota Morris - N.S.F. REU Program: Twenty years of encouraging women to participate in the Geological Sciences

Science.gov (United States)

Cotter, J. F.

2009-12-01

The goal of the UMM - REU program is to nurture the development of women in the geological sciences. Women are historically under-represented in the geological sciences. This program introduces undergraduate women to research project design and independent data collection and analysis designed to increase student’s scientific skills, introduce them to new fields of study, and to develop academic/professional confidence. In so doing, the program tries to encourage students to continue their education at the graduate level and/or to pursue a career in the Geosciences. The program was first proposed in 1988 and was run during the summers of 1989, '90, '91, '94, '95, '97, ’99, 2000, 05, 07, and 09 (in 1996 and 1998 a similar program was run at Gustavus Adolphus College). The focus of the program is field and laboratory research to determine the origin and history of glacial deposits in west-central Minnesota and the late Paleozoic Glacial deposits of the Parana Basin, Brazil. Much of the success of the program can be attributed to developing student “ownership” of their individual projects, their particular REU group, and the UMM-REU program overall. Research projects are selected and designed by the participants. Frequently considered are: research subject, location of field area and geologic techniques employed. Both project ownership and team building is encouraged by participant led weekly visits to field areas and frequent group discussions of research problems, successes and major gaffes. Additional team building activities include: 1) living in the same on-campus apartments and Brazilian B&B, 2) organized social activities, 3) international travel and working with Brazilian (women) students, 4) readings and discussions on "women in geology”, 5) shared strategies and concerns for career choices and; 6) participation in the "Friends of UMM-REU" conference (an "informal" presentation of results). Finally, an emphasis is placed on the utilization of the

Small vessel vasculitis History, classification, etiology, histopathology, clinic, diagnosis and treatment; Vasculitis de pequenos vasos. Historia, clasificacion, etiologia, histopatologia, clinica, diagnostico y tratamiento

Energy Technology Data Exchange (ETDEWEB)

Iglesias Gamarra, Antonio; Matteson, Eric L; Restrepo, Jose Felix

2007-07-01

Small-vessel vasculitis is a convenient descriptor for a wide range of diseases characterized by vascular inflammation of the venules, capillaries, and/or arterioles with pleomorphic clinical manifestations. The classical clinical phenotype is leucocytoclastic vasculitis with palpable purpura, but manifestations vary widely depending upon the organs involved. Histopathologic examination in leucocytoclastic vasculitis reveals angiocentric segmental inflammation, fibrinoid necrosis, and a neutrophilic infiltrate around the blood vessel walls with erythrocyte extravasation. The etiology of small-vessel vasculitis is unknown in many cases, but in others, drugs, post viral syndromes, malignancy, primary vasculitis such as microscopic polyarteritis, and connective tissue disorders are associated, The diagnosis of small- vessel vasculitis relies on a thorough history and physical examination, as well as relevant antibody testing including antinuclear antibody and anti neutrophil cytoplasmic antibody, hepatitis B and C serologies, assessment of complement, immunoglobulins, blood count, serum creatinine liver function tests, urinalysis, radiographic imaging and biopsy. The treatment is based primarily on corticosteroid and immunosuppressive agents.

Predictors of pretreatment CA125 at ovarian cancer diagnosis

DEFF Research Database (Denmark)

Babic, Ana; Cramer, Daniel W; Kelemen, Linda E

2017-01-01

PURPOSE: Cancer antigen 125 (CA125) is a glycoprotein expressed by epithelial cells of several normal tissue types and overexpressed by several epithelial cancers. Serum CA125 levels are mostly used as an aid in the diagnosis of ovarian cancer patients, to monitor response to treatment and detect...... in CA125 between studies and linear regression to estimate the association between epidemiologic factors and tumor characteristics and pretreatment CA125 levels. RESULTS: In age-adjusted models, older age, history of pregnancy, history of tubal ligation, family history of breast cancer, and family...... cancer recurrence. Besides tumor characteristics, CA125 levels are also influenced by several epidemiologic factors, such as age, parity, and oral contraceptive use. Identifying factors that influence CA125 levels in ovarian cancer patients could aid in the interpretation of CA125 values for individuals...

Importance of updating family cancer history in childhood cancer survivors.

Science.gov (United States)

Russo, Selena; Warby, Meera; Tucker, Katherine M; Wakefield, Claire E; Cohn, Richard J

2017-10-01

Estimates of the number of childhood cancers with a genetic basis range from 5-8.5% found in germline samples to 29% based on clinical criteria. Family history-taking practice is a fundamental first step in detecting at risk individuals and families. This study focused on Li-Fraumeni Syndrome (LFS), a highly penetrant cancer syndrome. Reported family history in a cohort of 648 of cancer survivor cohort (CCS) was examined. Eligible CCS were: (i) aged up to 14 years at diagnosis; (ii) more than 5 years postdiagnosis; (iii) treated for a childhood cancer at the study hospitals in NSW, Australia; (iv) in remission for more than 3 years. CCS completed self-administered questionnaires. Medical records confirmed diagnosis and treatment-related information. Our findings reveal an increased cancer risk among sibling and relatives of CCS. 91% of siblings diagnosed with cancer were diagnosed under the age of 40 and about 30% diagnosed under the aged of 15 revealing a 5- (RR = 5.1; 95% CI, 3.3-7.9) and 44-fold (RR = 44.6; 95% CI, 18.4-108.3) increased risked of cancer compared with the Australian population, respectively. About 2% of CCS reported that they had been diagnosed with a genetic cancer syndrome. However, 11% of survivors described a family history pattern which met Chompret criteria for screening for TP53 mutations associated with LFS. Our data suggests that familial cancer predispositions may be initially overlooked. Aperiodic and accurate ascertainment of family cancer history of childhood cancer patients and survivors is therefore recommended.

Progress in diagnosis of breast cancer: Advances in radiology technology

Directory of Open Access Journals (Sweden)

J Mari Beth Linder

2015-01-01

Full Text Available Breast cancer is the leading cause of cancer in females between the ages of 15 and 54, and the second leading cause of cancer death in women in the United States. Diagnosis begins with detection by breast examination (clinical breast exam or breast self-exam or by radiologic studies, like mammography. Many advances in the diagnosis of breast cancer have taken place in recent years. This article will review the history of radiologic advances in the diagnosis of breast cancer. Use of technological advancements in digital breast tomosynthesis, magnetic resonance imaging, and ultrasound in breast cancer diagnosis will be presented. Advantages and disadvantages of these diagnostic interventions when compared to older, traditional X-ray films will be discussed. It is important for all nurses, including radiology and oncology nurses, to be well informed about these varied diagnostic modalities, and appreciate the fact that advances in radiologic imaging technologies can yield improved outcomes for breast cancer patients.

Splenosis: a diagnosis to be considered

Directory of Open Access Journals (Sweden)

Jorge C. Ribeiro

2006-12-01

Full Text Available The term splenosis applies to the autotransplanted splenic tissue resulting from seeding in the context of past splenic trauma or surgery. We report a 42-year-old man with a history of splenectomy observed for an incidentally found retrovesical mass thought to be an ectopic testicle. The abdominal laparotomy revealed multiple focuses of pelvic splenosis. As splenosis can be diagnosed through specific imaging studies one should always consider it in differential diagnosis of a mass discovered years after splenic surgery or trauma.

Fall in C-Peptide During First 2 Years From Diagnosis

Science.gov (United States)

Greenbaum, Carla J.; Beam, Craig A.; Boulware, David; Gitelman, Stephen E.; Gottlieb, Peter A.; Herold, Kevan C.; Lachin, John M.; McGee, Paula; Palmer, Jerry P.; Pescovitz, Mark D.; Krause-Steinrauf, Heidi; Skyler, Jay S.; Sosenko, Jay M.

2012-01-01

Interpretation of clinical trials to alter the decline in β-cell function after diagnosis of type 1 diabetes depends on a robust understanding of the natural history of disease. Combining data from the Type 1 Diabetes TrialNet studies, we describe the natural history of β-cell function from shortly after diagnosis through 2 years post study randomization, assess the degree of variability between patients, and investigate factors that may be related to C-peptide preservation or loss. We found that 93% of individuals have detectable C-peptide 2 years from diagnosis. In 11% of subjects, there was no significant fall from baseline by 2 years. There was a biphasic decline in C-peptide; the C-peptide slope was −0.0245 pmol/mL/month (95% CI −0.0271 to −0.0215) through the first 12 months and −0.0079 (−0.0113 to −0.0050) from 12 to 24 months (P < 0.001). This pattern of fall in C-peptide over time has implications for understanding trial results in which effects of therapy are most pronounced early and raises the possibility that there are time-dependent differences in pathophysiology. The robust data on the C-peptide obtained under clinical trial conditions should be used in planning and interpretation of clinical trials. PMID:22688329

Peritoneal lymphomatosis confounded by prior history of colon cancer: a case report

International Nuclear Information System (INIS)

Kim, Yun Gi; Baek, Ji Yeon; Kim, Sun Young; Lee, Dong Hyeon; Park, Weon Seo; Kwon, Youngmee; Kim, Min Ju; Kang, Jeehoon; Lee, Joo Myung

2011-01-01

It is well known that carcinomas of the gastrointestinal tract are frequently associated with peritoneal carcinomatosis. In contrast to that entity extensive involvement of the peritoneal cavity with malignant lymphoma is rare. This is the first case reporting coexistence of peritoneal lymphomatosis and a previous history of colon cancer, which is a highly challenging clinical situation. If not aware of this unusual condition medical history, radiologic finding and laboratory data alone can lead to wrong diagnosis as in this case

Foreign body in the knee with no history of trauma

Directory of Open Access Journals (Sweden)

Jesudoss Prabhakaran

2015-01-01

Full Text Available Foreign bodies in the knee joint are not uncommon. We report a case of sewing needle that migrated and embedded inside the knee with no history of trauma. Searching for any small foreign body in the knee joint is not easy in either open or arthroscopic procedures. In this case, the surgery was made by open method avoiding arthroscopy due to technical reasons. We emphasize careful history taking, clinical examination and, preferably, an open procedure for migrating tiny foreign bodies to facilitate accurate diagnosis, superior visualization and easier instrumentation to remove embedded foreign bodies in the knee.

Differential diagnosis of adrenocorticotropic hormone-independent Cushing syndrome: role of adrenal venous sampling.

Science.gov (United States)

Martins, Raquel G; Agrawal, Reshma; Berney, Daniel M; Reznek, Rodney; Matson, Matthew; Grossman, Ashley B; Druce, Maralyn R

2012-01-01

To outline the potential role for adrenal venous sampling in the diagnosis and management of adrenocorticotropic hormone (ACTH)-independent Cushing syndrome (CS). We present a case description and discuss the management of a 59-year-old woman with an 8-year history of weight gain, centripetal obesity, a round plethoric face, skin thinning, easy bruising, hirsutism, and progressive muscle weakness. The patient reported a prior personal history of asthma, type 2 diabetes mellitus, hypertension, dyslipidemia, and bilateral leg ulcers, but she denied having any personal or family history of endocrinopathy and was not taking any corticosteroid medication. Elevated midnight serum cortisol, failure to suppress cortisol levels with a low-dose dexamethasone suppression test, and undetectable plasma ACTH all indicated ACTH-independent CS. Additional investigations including dynamic tests and adrenal imaging were supported by adrenal venous sampling in order to make a diagnosis and formulate a management plan. She was ultimately noted to have bilateral functioning adrenal nodules (adenoma and adenolipoma) and underwent successful bilateral laparoscopic adrenalectomy, with postoperative glucocorticoid and mineralocorticoid replacement. Adrenal venous sampling may be an important step in the differential diagnosis of CS and localization of the source of cortisol excess. It may distinguish pheochromocytoma or benign nonfunctioning adrenal nodules from cortisol-secreting adenomas and may avoid unnecessary bilateral adrenalectomy. It can also ensure that the correct operation is completed, if required, and thus avoid the increased morbidity and mortality associated with repeated surgical interventions.

Clinical diagnosis and computer analysis of headache symptoms.

OpenAIRE

Drummond, P D; Lance, J W

1984-01-01

The headache histories obtained from clinical interviews of 600 patients were analysed by computer to see whether patients could be separated systematically into clinical categories and to see whether sets of symptoms commonly reported together differed in distribution among the categories. The computer classification procedure assigned 537 patients to the same category as their clinical diagnosis, the majority of discrepancies between clinical and computer classifications involving common mi...

Challenges in diagnosis and counseling of a family with two recessive neurometabolic disorders

Directory of Open Access Journals (Sweden)

Heba S. Abd-Elkhalek

2016-07-01

In this case report, we present the challenges that we met in diagnosis and counseling of a family with both Tay–Sachs and maple syrup urine disease depending mainly on history, clinical data and a few diagnostic investigations.

Chroni - an Android Application for Geochronologists to Access Archived Sample Analyses from the NSF-Funded Geochron.Org Data Repository.

Science.gov (United States)

Nettles, J. J.; Bowring, J. F.

2014-12-01

NSF requires data management plans as part of funding proposals and geochronologists, among other scientists, are archiving their data and results to the public cloud archives managed by the NSF-funded Integrated Earth Data Applications, or IEDA. GeoChron is a database for geochronology housed within IEDA. The software application U-Pb_Redux developed at the Cyber Infrastructure Research and Development Lab for the Earth Sciences (CIRDLES.org) at the College of Charleston provides seamless connectivity to GeoChron for uranium-lead (U-Pb) geochronologists to automatically upload and retrieve their data and results. U-Pb_Redux also manages publication-quality documents including report tables and graphs. CHRONI is a lightweight mobile application for Android devices that provides easy access to these archived data and results. With CHRONI, U-Pb geochronologists can view archived data and analyses downloaded from the Geochron database, or any other location, in a customizable format. CHRONI uses the same extensible markup language (XML) schema and documents used by U-Pb_Redux and GeoChron. Report Settings are special XML files that can be customized in U-Pb_Redux, stored in the cloud, and then accessed and used in CHRONI to create the same customized data display on the mobile device. In addition to providing geologists effortless and mobile access to archived data and analyses, CHRONI allows users to manage their GeoChron credentials, quickly download private and public files via a specified IEDA International Geo Sample Number (IGSN) or URL, and view specialized graphics associated with particular IGSNs. Future versions of CHRONI will be developed to support iOS compatible devices. CHRONI is an open source project under the Apache 2 license and is hosted at https://github.com/CIRDLES/CHRONI. We encourage community participation in its continued development.

The NSF Undergraduate ALFALFA Team: Partnering with Arecibo Observatory to Offer Undergraduate and Faculty Extragalactic Radio Astronomy Research Opportunities

Science.gov (United States)

Ribaudo, Joseph; Koopmann, Rebecca A.; Haynes, Martha P.; Balonek, Thomas J.; Cannon, John M.; Coble, Kimberly A.; Craig, David W.; Denn, Grant R.; Durbala, Adriana; Finn, Rose; Hallenbeck, Gregory L.; Hoffman, G. Lyle; Lebron, Mayra E.; Miller, Brendan P.; Crone-Odekon, Mary; O'Donoghue, Aileen A.; Olowin, Ronald Paul; Pantoja, Carmen; Pisano, Daniel J.; Rosenberg, Jessica L.; Troischt, Parker; Venkatesan, Aparna; Wilcots, Eric M.; ALFALFA Team

2017-01-01

The NSF-sponsored Undergraduate ALFALFA (Arecibo Legacy Fast ALFA) Team (UAT) is a consortium of 20 institutions across the US and Puerto Rico, founded to promote undergraduate research and faculty development within the extragalactic ALFALFA HI blind survey project and follow-up programs. The objective of the UAT is to provide opportunities for its members to develop expertise in the technical aspects of observational radio spectroscopy, its associated data analysis, and the motivating science. Partnering with Arecibo Observatory, the UAT has worked with more than 280 undergraduates and 26 faculty to date, offering 8 workshops onsite at Arecibo (148 undergraduates), observing runs at Arecibo (69 undergraduates), remote observing runs on campus, undergraduate research projects based on Arecibo science (120 academic year and 185 summer projects), and presentation of results at national meetings such as the AAS (at AAS229: Ball et al., Collova et al., Davis et al., Miazzo et al., Ruvolo et al, Singer et al., Cannon et al., Craig et al., Koopmann et al., O'Donoghue et al.). 40% of the students and 45% of the faculty participants have been women and members of underrepresented groups. More than 90% of student alumni are attending graduate school and/or pursuing a career in STEM. 42% of those pursuing graduate degrees in Physics or Astronomy are women.In this presentation, we summarize the UAT program and the current research efforts of UAT members based on Arecibo science, including multiwavelength followup observations of ALFALFA sources, the UAT Collaborative Groups Project, the Survey of HI in Extremely Low-mass Dwarfs (SHIELD), and the Arecibo Pisces-Perseus Supercluster Survey (APPSS). This work has been supported by NSF grants AST-0724918/0902211, AST-075267/0903394, AST-0725380, AST-121105, and AST-1637339.

Relationship of family history and outcome after breast conservation therapy in women with ductal carcinoma in situ of the breast

International Nuclear Information System (INIS)

Harris, Eleanor E.R.; Schultz, Delray J.; Peters, Christopher A.; Solin, Lawrence J.

2000-01-01

Purpose: The purpose of this study was to evaluate the relationship between a family history of breast or ovarian cancer and outcome after breast-conserving surgery and radiation in women presenting with an initial diagnosis of ductal carcinoma in situ (DCIS) of the breast. Methods and Materials: A total of 146 consecutive women with a pathologic diagnosis of ductal carcinoma in situ as their first diagnosis of any breast cancer were identified; 28 (19%) had a positive family history of breast or ovarian cancer in a first-degree relative, 27 (19%) had a positive family history in a second-degree relative, and 91 (62%) had no family history. Pathologic, clinical, and treatment factors, and clinical outcomes for each family history group were compared. Cosmesis and complications were recorded at each follow-up. Patients were treated between 1978 and 1995, and the median follow-up was 7.1 years. Results: Patients with a positive family history in a first- or second-degree relative each had an 8% incidence of local failure at 10 years, while the negative family history group demonstrated a 16% local failure rate (p = 0.33). Overall survival at 10 years for patients with a positive family history in a first- or second-degree relative was 100% and for those with a negative family history was 91% (p = 0.08). The negative family history group had a higher median age that may account for the difference in overall survival. Cause-specific survival (CSS) was 97%, 100%, and 99%, respectively, at 10 years (p = 0.25). There were no differences in the cosmetic results or complication rates between women with a positive or negative family history. Conclusion: We have shown that a family history of breast and/or ovarian cancer is not associated with an adverse outcome for women treated with breast conservation therapy for DCIS. Local recurrence, cause-specific survival, overall survival, cosmesis, and complication rates were comparable to that of similarly treated women with

Space-Time Analysis of Testicular Cancer Clusters Using Residential Histories: A Case-Control Study in Denmark

Science.gov (United States)

Sloan, Chantel D.; Nordsborg, Rikke B.; Jacquez, Geoffrey M.; Raaschou-Nielsen, Ole; Meliker, Jaymie R.

2015-01-01

Though the etiology is largely unknown, testicular cancer incidence has seen recent significant increases in northern Europe and throughout many Western regions. The most common cancer in males under age 40, age period cohort models have posited exposures in the in utero environment or in early childhood as possible causes of increased risk of testicular cancer. Some of these factors may be tied to geography through being associated with behavioral, cultural, sociodemographic or built environment characteristics. If so, this could result in detectable geographic clusters of cases that could lead to hypotheses regarding environmental targets for intervention. Given a latency period between exposure to an environmental carcinogen and testicular cancer diagnosis, mobility histories are beneficial for spatial cluster analyses. Nearest-neighbor based Q-statistics allow for the incorporation of changes in residency in spatial disease cluster detection. Using these methods, a space-time cluster analysis was conducted on a population-wide case-control population selected from the Danish Cancer Registry with mobility histories since 1971 extracted from the Danish Civil Registration System. Cases (N=3297) were diagnosed between 1991 and 2003, and two sets of controls (N=3297 for each set) matched on sex and date of birth were included in the study. We also examined spatial patterns in maternal residential history for those cases and controls born in 1971 or later (N= 589 case-control pairs). Several small clusters were detected when aligning individuals by year prior to diagnosis, age at diagnosis and calendar year of diagnosis. However, the largest of these clusters contained only 2 statistically significant individuals at their center, and were not replicated in SaTScan spatial-only analyses which are less susceptible to multiple testing bias. We found little evidence of local clusters in residential histories of testicular cancer cases in this Danish population. PMID

Space-time analysis of testicular cancer clusters using residential histories: a case-control study in Denmark.

Directory of Open Access Journals (Sweden)

Chantel D Sloan

Full Text Available Though the etiology is largely unknown, testicular cancer incidence has seen recent significant increases in northern Europe and throughout many Western regions. The most common cancer in males under age 40, age period cohort models have posited exposures in the in utero environment or in early childhood as possible causes of increased risk of testicular cancer. Some of these factors may be tied to geography through being associated with behavioral, cultural, sociodemographic or built environment characteristics. If so, this could result in detectable geographic clusters of cases that could lead to hypotheses regarding environmental targets for intervention. Given a latency period between exposure to an environmental carcinogen and testicular cancer diagnosis, mobility histories are beneficial for spatial cluster analyses. Nearest-neighbor based Q-statistics allow for the incorporation of changes in residency in spatial disease cluster detection. Using these methods, a space-time cluster analysis was conducted on a population-wide case-control population selected from the Danish Cancer Registry with mobility histories since 1971 extracted from the Danish Civil Registration System. Cases (N=3297 were diagnosed between 1991 and 2003, and two sets of controls (N=3297 for each set matched on sex and date of birth were included in the study. We also examined spatial patterns in maternal residential history for those cases and controls born in 1971 or later (N= 589 case-control pairs. Several small clusters were detected when aligning individuals by year prior to diagnosis, age at diagnosis and calendar year of diagnosis. However, the largest of these clusters contained only 2 statistically significant individuals at their center, and were not replicated in SaTScan spatial-only analyses which are less susceptible to multiple testing bias. We found little evidence of local clusters in residential histories of testicular cancer cases in this Danish

Space-time analysis of testicular cancer clusters using residential histories: a case-control study in Denmark.

Science.gov (United States)

Sloan, Chantel D; Nordsborg, Rikke B; Jacquez, Geoffrey M; Raaschou-Nielsen, Ole; Meliker, Jaymie R

2015-01-01

Though the etiology is largely unknown, testicular cancer incidence has seen recent significant increases in northern Europe and throughout many Western regions. The most common cancer in males under age 40, age period cohort models have posited exposures in the in utero environment or in early childhood as possible causes of increased risk of testicular cancer. Some of these factors may be tied to geography through being associated with behavioral, cultural, sociodemographic or built environment characteristics. If so, this could result in detectable geographic clusters of cases that could lead to hypotheses regarding environmental targets for intervention. Given a latency period between exposure to an environmental carcinogen and testicular cancer diagnosis, mobility histories are beneficial for spatial cluster analyses. Nearest-neighbor based Q-statistics allow for the incorporation of changes in residency in spatial disease cluster detection. Using these methods, a space-time cluster analysis was conducted on a population-wide case-control population selected from the Danish Cancer Registry with mobility histories since 1971 extracted from the Danish Civil Registration System. Cases (N=3297) were diagnosed between 1991 and 2003, and two sets of controls (N=3297 for each set) matched on sex and date of birth were included in the study. We also examined spatial patterns in maternal residential history for those cases and controls born in 1971 or later (N= 589 case-control pairs). Several small clusters were detected when aligning individuals by year prior to diagnosis, age at diagnosis and calendar year of diagnosis. However, the largest of these clusters contained only 2 statistically significant individuals at their center, and were not replicated in SaTScan spatial-only analyses which are less susceptible to multiple testing bias. We found little evidence of local clusters in residential histories of testicular cancer cases in this Danish population.

Diagnosis of multiple system atrophy.

Science.gov (United States)

Palma, Jose-Alberto; Norcliffe-Kaufmann, Lucy; Kaufmann, Horacio

2018-05-01

Multiple system atrophy (MSA) may be difficult to distinguish clinically from other disorders, particularly in the early stages of the disease. An autonomic-only presentation can be indistinguishable from pure autonomic failure. Patients presenting with parkinsonism may be misdiagnosed as having Parkinson disease. Patients presenting with the cerebellar phenotype of MSA can mimic other adult-onset ataxias due to alcohol, chemotherapeutic agents, lead, lithium, and toluene, or vitamin E deficiency, as well as paraneoplastic, autoimmune, or genetic ataxias. A careful medical history and meticulous neurological examination remain the cornerstone for the accurate diagnosis of MSA. Ancillary investigations are helpful to support the diagnosis, rule out potential mimics, and define therapeutic strategies. This review summarizes diagnostic investigations useful in the differential diagnosis of patients with suspected MSA. Currently used techniques include structural and functional brain imaging, cardiac sympathetic imaging, cardiovascular autonomic testing, olfactory testing, sleep study, urological evaluation, and dysphagia and cognitive assessments. Despite advances in the diagnostic tools for MSA in recent years and the availability of consensus criteria for clinical diagnosis, the diagnostic accuracy of MSA remains sub-optimal. As other diagnostic tools emerge, including skin biopsy, retinal biomarkers, blood and cerebrospinal fluid biomarkers, and advanced genetic testing, a more accurate and earlier recognition of MSA should be possible, even in the prodromal stages. This has important implications as misdiagnosis can result in inappropriate treatment, patient and family distress, and erroneous eligibility for clinical trials of disease-modifying drugs. Copyright © 2017 Elsevier B.V. All rights reserved.

Importance of ultrasonographic study in the diagnosis of the neoplasia of pancreas

International Nuclear Information System (INIS)

Salomon, M.; Rodriguez, Z.; Diaz, J.A.; Fong, A.

1988-01-01

Thirty clinical histories of patients discharged from hospital, with diagnosis of neoplasia of the pancreas, were reviewed. The patients were assisted at the ''saturnino Lora'' Teaching Provincial Hospital, Santiago de Cuba, from January 1983 to June 1985. Remarkable effectiveness of abdominal ultrasonographic study for the diagnosis of this affection was demonstrated at its correlation with other complementary examinations, such as radiographic and laparoscopic examinations, besides surgical findings and verification with histopathologic diagnosis. The tumor was more frequently located in the head of the pancreas and echogenicity and dilation of biliary and choledocus ducts were its main ultrasonographic characteristics. Adenocarcinoma was the prevailing histologic type. These findings agree with those related in the reviewed literature

Nonorganic hearing loss in children: audiometry, clinical characteristics, biographical history and recovery of hearing thresholds.

Science.gov (United States)

Schmidt, Claus-Michael; am Zehnhoff-Dinnesen, Antoinette; Matulat, Peter; Knief, Arne; Rosslau, Ken; Deuster, Dirk

2013-07-01

The term "nonorganic hearing loss" (NOHL) (pseudohypacusis, functional or psychogenic hearing loss) describes a hearing loss without a detectable corresponding pathology in the auditory system. It is characterized by a discrepancy between elevated pure tone audiometry thresholds and normal speech discrimination. The recommended audiological management of NOHL in children comprises history taking, diagnosis, and counseling. According to the literature, prognosis depends on the severity of the patient's school and/or personal problems. Routine referral to a child psychiatrist is discussed as being controversial. The clinical history of 34 children with NOHL was retrospectively evaluated. In 15 children, follow up audiometry was performed. Results of biographical history, subjective and objective audiometry, additional speech and language assessment, psychological investigations and follow up audiometry are presented and discussed. The prevalence of NOHL was 1.8% in children with suspected hearing loss. Mean age at diagnosis was 10.8 years. Girls were twice as often affected as boys. Patient history showed a high prevalence of emotional and school problems. Pre-existing organic hearing loss can be worsened by nonorganic causes. Children with a fast recovery of hearing thresholds (n=6) showed a high rate (4/6) of family, social and emotional problems. In children with continuous threshold elevation (n=9), biographical history showed no recognizable or obvious family, social or emotional problems; learning disability (4/9) was the most frequently presented characteristic. Due to advances in objective audiometry, the diagnosis of NOHL is less challenging than management and counseling. Considering the high frequency of personal and school problems, a multidisciplinary setting is helpful. On the basis of our results, drawing conclusions from hearing threshold recovery on the severity of underlying psychic problems seems inappropriate. As a consequence, a referral to a

Importance of Video-EEG Monitoring in the Diagnosis of Epilepsy in a Psychiatric Patient

Directory of Open Access Journals (Sweden)

Batool F. Kirmani

2013-01-01

Full Text Available Epilepsy is a chronic medical condition which is disabling to both patients and caregivers. The differential diagnosis of epilepsy includes psychogenic nonepileptic spells or “pseudoseizures.” Epilepsy is due to abnormal electrical activity in the brain, and pseudoseizure is a form of conversion disorder. The brain waves remain normal in pseudoseizures. The problem arises when a patient with significant psychiatric history presents with seizures. Pseudoseizures become high on the differential diagnosis without extensive work up. This is a case of woman with significant psychiatric issues which resulted in a delay in the diagnosis of epilepsy.

Earth's Climate History from Glaciers and Ice Cores

Science.gov (United States)

Thompson, Lonnie

2013-03-01

Glaciers serve both as recorders and early indicators of climate change. Over the past 35 years our research team has recovered climatic and environmental histories from ice cores drilled in both Polar Regions and from low to mid-latitude, high-elevation ice fields. Those ice core -derived proxy records extending back 25,000 years have made it possible to compare glacial stage conditions in the Tropics with those in the Polar Regions. High-resolution records of δ18O (in part a temperature proxy) demonstrate that the current warming at high elevations in the mid- to lower latitudes is unprecedented for the last two millennia, although at many sites the early Holocene was warmer than today. Remarkable similarities between changes in the highland and coastal cultures of Peru and regional climate variability, especially precipitation, imply a strong connection between prehistoric human activities and regional climate. Ice cores retrieved from shrinking glaciers around the world confirm their continuous existence for periods ranging from hundreds to thousands of years, suggesting that current climatological conditions in those regions today are different from those under which these ice fields originated and have been sustained. The ongoing widespread melting of high-elevation glaciers and ice caps, particularly in low to middle latitudes, provides strong evidence that a large-scale, pervasive and, in some cases, rapid change in Earth's climate system is underway. Observations of glacier shrinkage during the 20th and 21st century girdle the globe from the South American Andes, the Himalayas, Kilimanjaro (Tanzania, Africa) and glaciers near Puncak Jaya, Indonesia (New Guinea). The history and fate of these ice caps, told through the adventure, beauty and the scientific evidence from some of world's most remote mountain tops, provide a global perspective for contemporary climate. NSF Paleoclimate Program

If You Listen, the Patient Will Tell You the Diagnosis

Science.gov (United States)

Holmes, Frederick

2007-01-01

Since the time of Hippocrates, professors in medical schools have been telling their students to listen to patients. Medical students and young doctors all come to realize that the medical history, the patient's account of his or her own illness, is the best source of information with which to make an accurate diagnosis. The physical examination,…

Concussion diagnosis and management

Science.gov (United States)

Mann, Aneetinder; Tator, Charles H.; Carson, James D.

2017-01-01

Abstract Objective To assess the knowledge of, attitudes toward, and learning needs for concussion diagnosis and management among family medicine residents. Design E-mail survey. Setting University of Toronto in Ontario. Participants Family medicine residents (N = 348). Main outcome measures To describe relationships between awareness of concussion management and lifestyle, education background, and residency placement, t tests and 2 tests were used as appropriate. Linear regression was used to compare self-reported concussion knowledge with knowledge scores. Thematic analysis was used to interpret answers to the qualitative question asking residents to describe challenges they foresee physicians facing when diagnosing and managing concussion. Results The residents who responded (n = 73, response rate 21%) correctly answered an average of 5.2 questions out of 9 (58%) regarding the diagnosis and management of concussion. Postgraduate year, sex, personal history of concussion, and clinical exposure to concussion were not significant factors in predicting the number of correct answers. Several misconceptions and knowledge gaps were revealed. Of residents who responded, 71% did not recognize chronic traumatic encephalopathy and only 63% recognized second-impact syndrome as consequences of repetitive concussions. Moreover, 32% of residents did not think that every individual with a concussion should see a physician as part of management. Knowledge scores did not predict self-reported concussion knowledge. Thematic analysis revealed 4 themes related to the challenges of concussion diagnosis and management: the nonspecificity and vagueness of symptoms, lack of formal diagnostic criteria, patient compliance with management, and counseling patients with respect to return to play, work, or learning. Conclusion We found substantial gaps in knowledge surrounding concussion diagnosis and management among family medicine residents. This lack of knowledge should be addressed at

Dissecting the assembly and star formation history of disks and bulges in nearby spirals using the VENGA IFU survey

Science.gov (United States)

Carrillo, Andreia Jessica; Jogee, Shardha; Kaplan, Kyle; Weinzirl, Tim; Blanc, Guillermo A.

2017-06-01

Integral field spectroscopy of nearby galaxies provides a powerful and unparalleled tool for studying how galaxies assemble the different components -- the bulge, bar, and disk-- that define the Hubble sequence. We explore the assembly and star formation history of these components using galaxies in the VIRUS-P Exploration of Nearby Galaxies (VENGA) survey of 30 nearby spiral galaxies. Compared to other integral field spectroscopy studies of spirals, our study benefits from high spatial sampling and resolution (typically a few 100 pc), large coverage from the bulge to the outer disk, broad wavelength range (3600-6800 A), and medium spectral resolution (120 km/s at 5000 A). In this poster, we present the methodology and data illustrating the exquisite, high-quality, spatially-resolved spectra out to large radii, and the distribution, kinematics, and metallicity of stars and ionized gas. We discuss the next steps in deriving the star formation history (SFH) of bulge, bar, and disk components, and elucidating their assembly pathway by comparing their SFH and structural properties to theoretical models of galaxy evolution. This project is supported by the NSF grants AST-1614798 and AST-1413652.

Paternal history of mental illness associated with posttraumatic stress disorder among veterans.

Science.gov (United States)

Shepherd-Banigan, Megan; Kelley, Michelle L; Katon, Jodie G; Curry, John F; Goldstein, Karen M; Brancu, Mira; Wagner, H Ryan; Fecteau, Teresa E; Van Houtven, Courtney H

2017-10-01

This study examined the association between parent and family reported history of non-PTSD mental illness (MI), PTSD specifically, and substance use problems, and participant clinical diagnosis of PTSD. Participants were drawn from the US Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC) Post-Deployment Mental Health (PDMH) study (n = 3191), an ongoing multi-site cohort study of US Afghanistan and Iraq conflict era veterans. Participants who recalled a father history of PTSD had a 26-percentage point higher likelihood of meeting criteria for PTSD; while participants reporting any family history of PTSD had a 15-percentage point higher probability of endorsing symptoms consistent with PTSD. Mother history of substance use problems was associated with Veteran current PTSD, but results were sensitive to model specification. Current PTSD was not associated with family/parent history of non-PTSD mental illness, mother history of PTSD, or family/father history of substance use problems. Family history of PTSD may increase PTSD risk among veterans exposed to trauma, particularly when a father history is reported. Knowledge of family history could improve clinical decision-making for trauma-exposed individuals and allow for more effective targeting of programs and clinical services. Published by Elsevier B.V.

Bohmian histories and decoherent histories

International Nuclear Information System (INIS)

Hartle, James B.

2004-01-01

The predictions of the Bohmian and the decoherent (or consistent) histories formulations of the quantum mechanics of a closed system are compared for histories--sequences of alternatives at a series of times. For certain kinds of histories, Bohmian mechanics and decoherent histories may both be formulated in the same mathematical framework within which they can be compared. In that framework, Bohmian mechanics and decoherent histories represent a given history by different operators. Their predictions for the probabilities of histories of a closed system therefore generally differ. However, in an idealized model of measurement, the predictions of Bohmian mechanics and decoherent histories coincide for the probabilities of records of measurement outcomes. The formulations are thus difficult to distinguish experimentally. They may differ in their accounts of the past history of the Universe in quantum cosmology

Delayed radiographic diagnosis of osteoid osteoma in the lumbar spine

International Nuclear Information System (INIS)

Louis-Ugbo, J.; Reddy, A.S.; Heller, J.G.

1998-01-01

Study design: Case report and literature review. Objectives: Describe a case of delayed diagnosis of osteoid osteoma of the spine due to misinterpretation of initial imaging studies within two months of onset of pain, and discuss the relevant imaging characteristics and their pitfalls. Summary of background data. Several cases of delayed diagnosis have been previously reported. Only one false negative bone scan has been reported; however other imaging modalities established the diagnosis. In our patient, all of the imaging modalities were initially interpreted as negative hence the delay in diagnosis. Methods: History, physical examination and imaging studies (x-rays, bone scan, MRI) of the patient were employed to evaluate the differential diagnosis of low back pain and sciatica in a 16 yr old. Repeat bone scan and CT scan were done six months after onset of symptoms because of persistent clinical suspicion of osteoid osteoma. Results: The repeat bone scan and CT scan confirmed-the diagnosis missed, during the first round of imaging. An osteoid osteoma of the L5 pedicle was removed without incident. Conclusion: Technetium bone scans remain the main stay of early diagnosis of osteoid osteoma when plain films and other imaging modalities are normal. However, when faced with persistent unexplained musculoskeletal pain in an adolescent, further follow-up and diagnostic efforts are indicated; possibly repeating a bone scan if initially interpreted as negative. (author)

How to make a cost-efficient and reliable diagnosis in equine dermatology?

NARCIS (Netherlands)

Sloet van Oldruitenborgh-Oosterbaan, M.M.

2012-01-01

To make a diagnosis in skin disease it is important to establish the signalment of the patient and to obtain an comprehensive anamnesis (history). Many skin conditions are presented initially at an advanced stage and many have had some (or more) attempts at treatment. A thorough

Report on the SNL/NSF International Workshop on Joint Mechanics, Arlington, Virginia, 16-18 October 2006.

Energy Technology Data Exchange (ETDEWEB)

Ewins, David J. (Imperial College, London England, UK); Bergman, Lawrence A. (University of Illinois, Urbana, IL); Segalman, Daniel Joseph

2007-11-01

The NSF/SNL joint mechanics workshop, held in Arlington, Virginia, 16-18 October, 2006, attempted to assess the current state of the art for modeling joint mechanics for the purpose of structural dynamics calculation, to identify the underlying physics issues that must be addressed to advance the field, and to propose a path forward. Distinguished participants from several countries representing research communities that focus on very different length and time scales identified multiple challenges in bridging those scales. Additionally, two complementary points of view were developed for addressing those challenges. The first approach - the 'bottom-up' perspective - attempts to bridge scales by starting from the smallest length scale and working up. The other approach starts at the length scale of application and attempts to deduce mechanics at smaller length scales through reconciliation with laboratory observation. Because interface physics is a limiting element of predictive simulation in defense and transportation, this issue will be of continuing importance for the foreseeable future.

Reflex syncope: Diagnosis and treatment

Directory of Open Access Journals (Sweden)

Richard Sutton

2017-12-01

Full Text Available For the diagnosis of reflex syncope, diligent history-building with the patient and a witness is required. In the Emergency Department (ED, the assessment of syncope is a challenge which may be addressed by an ED Observation Unit or by a referral to a Syncope Unit. Hospital admission is necessary for those with life-threatening cardiac conditions although risk stratification remains an unsolved problem. Other patients may be investigated with less urgency by carotid sinus massage (>40 years, tilt testing, and electrocardiogram loop recorder insertion resulting in a clear cause for syncope. Management includes, in general terms, patient education, avoidance of circumstances in which syncope is likely, increase in fluid and salt consumption, and physical counter-pressure maneuvers. In older patients, those that will benefit from cardiac pacing are now well defined. In all patients, the benefit of drug therapy is often disappointing and there remains no ideal drug. A role for catheter ablation may emerge for the highly symptomatic reflex syncope patient. Keywords: Cardiac pacing, Catheter ablation, Diagnosis, Drugs, Management, Reflex syncope

The natural history of anencephaly.

LENUS (Irish Health Repository)

Obeidi, Nidaa

2012-01-31

OBJECTIVE: Early elective termination of pregnancy is the most common outcome of a diagnosis of anencephaly in developed countries. Experience and expertise with management of ongoing pregnancies is limited. We aimed to investigate the natural history of these pregnancies from diagnosis to delivery and to determine timing of death. METHOD: A retrospective review of cases of anencephaly diagnosed between 2003 and 2009 in tertiary-referral university teaching hospitals in Cork. RESULTS: The majority of cases (25\\/26; 96%) were diagnosed prenatally at a median gestation of 21(+2) weeks (range 13(+4)-32(+4)). The median maternal age was 30 years (range 17-41) and 50% were primigravidae. Seven pregnancies were complicated by polyhydramnios and four deliveries were complicated by shoulder dystocia. The median gestation at delivery was 35 weeks (range 22(+5)-42(+6)); 69% of labours were induced at a median gestation of 34 weeks. Six women (6\\/26; 23%) had a pre-labour intrauterine fetal death and nine women (9\\/26; 35%) had an intrapartum fetal death. Median neonatal survival time was 55 min (range 10 min to 8 days). Six parents donated neonatal organs for transplantation. CONCLUSION: This study provides useful information for health professionals caring for patients with a diagnosis of anencephaly. The majority of these infants die prior to delivery but short-term survival is possible.

History taking in TB patients at Likuni mission hospital in Malawi ...

African Journals Online (AJOL)

In the file audit for patients diagnosed and treated at Likuni Mission Hospital from January to July 1997 the results show unsystematic recording of patient history. Out of 88 case notes reviewed none contained patients' events before diagnosis was made. 34% had no duration of symptoms recorded and 19% had no ...

[Differential diagnosis between borderline personality disorder and bipolar disorder].

Science.gov (United States)

Herbst, Luis

2010-01-01

The relationship between bipolar disorder and borderline personality disorder remains controversial since in both conditions there are overlapping and similar symptomatic dimensions. Symptomatic dimensions suitable to subserve differential diagnosis are: mood, mood variability mode, and personal and family history. Characteristics of psychotic symptoms may also be useful in the differentiation. On the other hand, anxiety symptoms, neuropsychological profiles, neuro-imaging procedures and biomarkers seem not to contribute to differentiate between both diseases. The presentation of nonsuicidal self mutilation behavior can offer some differences between bipolar and borderline personality disorders, but both can coexist in clinical comorbid forms and do not significantly contribute to the differential diagnosis. Differential diagnosis is complicated by the fact that a low percentage of patients can experience comorbidity of both conditions. In this work we review all these issues, and particularly emphasize the importance of sitematically take into account the patient background, the course that follows his or her disorder, together with the outcome in response to medical decisions.

Cellular Blue Nevus Diagnosed following Excision of Melanoma: A Challenge in Diagnosis

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Nives Jonjić

2016-01-01

Full Text Available A case of a 41-year-old woman with a history of nodular melanoma (NM, associated with an indurated dome-shaped blue-black nodule with a diameter of 1.2 cm in the gluteal region, is presented. Clinical diagnosis of the lesion, present from birth, was blue nevus. Recently, the nodule has been showing a mild enlargement and thus complete resection was performed. Histological analysis revealed a pigmented lesion with an expansive pattern of extension into the dermis and the subcutaneous adipose tissue. The lesion displayed an alveolar pattern as well as a pigmented dendritic cell pattern. The histology was consistent with cellular blue nevus (CBN; however, the history of NM which was excised one year earlier, as well as the clinical information about the slow growing lesion, included a differential diagnosis of CBN, borderline melanocytic tumor, and malignant blue nevus. Additional immunohistochemical (HMB-45, p16, and Ki-67 and molecular (BRAF V600E mutation analyses were performed on both lesions: the CBN-like and the previously excised NM. Along with lesion history and histological analyses, p16 staining and BRAF were useful diagnostic tools for confirming the benign nature of CBN in this case.

The diagnosis of tuberculosis in dialysis patients

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Hela Jebali

2017-01-01

Full Text Available The incidence of tuberculosis (TB is high in patients undergoing chronic dialysis than it is in the general population. The diagnosis of TB is often difficult and extrapulmonary involvement is predominant. This study investigates the spectrum of clinical presentations and outcome in dialysis patients during a nine-year period. TB was diagnosed in 41 patients. Anti-TB drugs, adverse effects of therapy, and outcome were noted. Thirty-eight patients (92.6% were on hemodialysis and three were on peritoneal dialysis (7.3%. The mean age at diagnosis was 50.8 years and the male/female ratio was 1.16. Four patients had a history of pulmonary TB. Extrapulmonary involvement was observed in 32 (78 % patients. The bacteriological confirmation was made in 41.46% and histological confirmation was made in 26.83%, and in the rest, the diagnosis was retained on the criterion presumption. Nineteen patients (46.34% developed adverse effects of antitubercular drugs. Eight patients (19.51% died during the study from TB or adverse effects of treatment. Low urea reduction ratio and female sex were associated with poor prognosis in our study. The clinical manifestations of TB in patients on dialysis are quite nonspecific, making timely diagnosis difficult, and delaying the initiation of curative treatment, which is a major determinant of the outcome.

Emergency Medicine Evaluation of Community-Acquired Pneumonia: History, Examination, Imaging and Laboratory Assessment, and Risk Scores.

Science.gov (United States)

Long, Brit; Long, Drew; Koyfman, Alex

2017-11-01

Pneumonia is a common infection, accounting for approximately one million hospitalizations in the United States annually. This potentially life-threatening disease is commonly diagnosed based on history, physical examination, and chest radiograph. To investigate emergency medicine evaluation of community-acquired pneumonia including history, physical examination, imaging, and the use of risk scores in patient assessment. Pneumonia is the number one cause of death from infectious disease. The condition is broken into several categories, the most common being community-acquired pneumonia. Diagnosis centers on history, physical examination, and chest radiograph. However, all are unreliable when used alone, and misdiagnosis occurs in up to one-third of patients. Chest radiograph has a sensitivity of 46-77%, and biomarkers including white blood cell count, procalcitonin, and C-reactive protein provide little benefit in diagnosis. Biomarkers may assist admitting teams, but require further study for use in the emergency department. Ultrasound has shown utility in correctly identifying pneumonia. Clinical gestalt demonstrates greater ability to diagnose pneumonia. Clinical scores including Pneumonia Severity Index (PSI); Confusion, blood Urea nitrogen, Respiratory rate, Blood pressure, age 65 score (CURB-65); and several others may be helpful for disposition, but should supplement, not replace, clinical judgment. Patient socioeconomic status must be considered in disposition decisions. The diagnosis of pneumonia requires clinical gestalt using a combination of history and physical examination. Chest radiograph may be negative, particularly in patients presenting early in disease course and elderly patients. Clinical scores can supplement clinical gestalt and assist in disposition when used appropriately. Published by Elsevier Inc.

My brief history. 2. ed.

International Nuclear Information System (INIS)

Hawking, Stephen

2015-01-01

For the first time, Stephen Hawking turns his gaze inward for a revealing look at his own life and intellectual evolution. My Brief History recounts Stephen Hawking's improbable journey, from his post-war London boyhood to his years of international acclaim and celebrity. Illustrated with rarely seen photographs, this concise, witty and candid account introduces readers to the inquisitive schoolboy whose classmates nicknamed him 'Einstein'; the jokester who once placed a bet with a colleague over the existence of a black hole; and the young husband and father striving to gain a foothold in the world of academia. Writing with humility and humour, Hawking opens up about the challenges that confronted him following his diagnosis of ALS aged twenty-one. Tracing his development as a thinker, he explains how the prospect of an early death urged him onward through numerous intellectual breakthroughs, and talks about the genesis of his masterpiece A Brief History of Time - one of the iconic books of the twentieth century.

Acute lead intoxication in a female battery worker: Diagnosis and management

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Hadjichristodoulou Christos

2010-07-01

Full Text Available Abstract Lead is a significant occupational and environmental hazard. Battery industry is one of the settings related to lead intoxication. Published information on the use of oral chelating agents for the treatment of anaemia in the context of acute lead intoxication is limited. The patient was a 33 year immigrant female worker in a battery manufacture for 3 months. She complained for malaise that has been developed over the past two weeks. Pallor of skin and conjunctiva was the only sign found in physical examination. The blood test on admission revealed normochromic anaemia. Endoscopic investigation of the gastrointestinal system was negative for bleeding. The bone marrow biopsy was unrevealing. At baseline no attention has been paid to patient's occupational history. Afterwards the patient's occupational history has been re-evaluated and she has been screened for lead intoxication. The increased levels of the lead related biomarkers of exposure and effect confirmed the diagnosis. The patient received an oral chelating agent and an improvement in clinical picture, and levels of haematological and lead related biochemical parameters have been recorded. No side effect and no rebound effect were observed. This case report emphasizes the importance of the occupational history in the context of the differential diagnosis. Moreover, this report indicates that lead remains a significant occupational hazard especially in the small scale battery industry

Acute lead intoxication in a female battery worker: Diagnosis and management.

Science.gov (United States)

Dounias, George; Rachiotis, George; Hadjichristodoulou, Christos

2010-07-07

Lead is a significant occupational and environmental hazard. Battery industry is one of the settings related to lead intoxication. Published information on the use of oral chelating agents for the treatment of anaemia in the context of acute lead intoxication is limited. The patient was a 33 year immigrant female worker in a battery manufacture for 3 months. She complained for malaise that has been developed over the past two weeks. Pallor of skin and conjunctiva was the only sign found in physical examination. The blood test on admission revealed normochromic anaemia. Endoscopic investigation of the gastrointestinal system was negative for bleeding. The bone marrow biopsy was unrevealing.At baseline no attention has been paid to patient's occupational history. Afterwards the patient's occupational history has been re-evaluated and she has been screened for lead intoxication. The increased levels of the lead related biomarkers of exposure and effect confirmed the diagnosis. The patient received an oral chelating agent and an improvement in clinical picture, and levels of haematological and lead related biochemical parameters have been recorded. No side effect and no rebound effect were observed. This case report emphasizes the importance of the occupational history in the context of the differential diagnosis. Moreover, this report indicates that lead remains a significant occupational hazard especially in the small scale battery industry.

Tree analysis modeling of the associations between PHQ-9 depressive symptoms and doctor diagnosis of depression in primary care.

Science.gov (United States)

Chin, Weng-Yee; Wan, Eric Yuk Fai; Dowrick, Christopher; Arroll, Bruce; Lam, Cindy Lo Kuen

2018-04-26

The aim of this study was to explore the relationship between patient self-reported Patient Health Questionnaire-9 (PHQ-9) symptoms and doctor diagnosis of depression using a tree analysis approach. This was a secondary analysis on a dataset obtained from 10 179 adult primary care patients and 59 primary care physicians (PCPs) across Hong Kong. Patients completed a waiting room survey collecting data on socio-demographics and the PHQ-9. Blinded doctors documented whether they thought the patient had depression. Data were analyzed using multiple logistic regression and conditional inference decision tree modeling. PCPs diagnosed 594 patients with depression. Logistic regression identified gender, age, employment status, past history of depression, family history of mental illness and recent doctor visit as factors associated with a depression diagnosis. Tree analyses revealed different pathways of association between PHQ-9 symptoms and depression diagnosis for patients with and without past depression. The PHQ-9 symptom model revealed low mood, sense of worthlessness, fatigue, sleep disturbance and functional impairment as early classifiers. The PHQ-9 total score model revealed cut-off scores of >12 and >15 were most frequently associated with depression diagnoses in patients with and without past depression. A past history of depression is the most significant factor associated with the diagnosis of depression. PCPs appear to utilize a hypothetical-deductive problem-solving approach incorporating pre-test probability, with different associated factors for patients with and without past depression. Diagnostic thresholds may be too low for patients with past depression and too high for those without, potentially leading to over and under diagnosis of depression.

Clinical and diagnosis characteristics of breast cancers in women with a history of radiotherapy in the first 30years of life: A French multicentre cohort study.

Science.gov (United States)

Demoor-Goldschmidt, C; Supiot, S; Oberlin, O; Helfre, S; Vigneron, C; Brillaud-Meflah, V; Bernier, V; Laprie, A; Ducassou, A; Claude, L; Mahé, M A; de Vathaire, F

2017-08-01

Irradiation (>3Gy) to the breast or axillae before 30years of age increases the risk of secondary breast cancer (SBC). The purpose of this article is to describe the clinical characteristics of SBC and the way of diagnosis in young women (before the age of national screening) in France who had received previous radiotherapy for a childhood or a young adulthood cancer. This retrospective, multicentre study reviewed the medical records of women with SBC before the age of the national screening who had received irradiation (≥3Gy) on part or all of the breast before 30years of age, for any type of tumour except BC. A total of 121 SBC were detected in 104 women with previous radiotherapy. Twenty percent of SBC were detected during regular breast screening and 16% of the women had a regular radiological follow-up. Our results points out that the main proportion of childhood cancer survivors did not benefit from the recommended breast cancer screening. This result is comparable to other previously published studies in other countries. A national screening programme is necessary and should take into account the patient's age, family history, personal medical history and previous radiotherapy to reduce the number of SBC diagnosed at an advanced stage. Copyright © 2017. Published by Elsevier B.V.

Attention-Deficit/Hyperactivity Disorder (ADHD): Interaction between socioeconomic status and parental history of ADHD determines prevalence.

Science.gov (United States)

Rowland, Andrew S; Skipper, Betty J; Rabiner, David L; Qeadan, Fares; Campbell, Richard A; Naftel, A Jack; Umbach, David M

2018-03-01

Many studies have reported a higher prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) among disadvantaged populations, but few have considered how parental history of ADHD might modify that relationship. We evaluated whether the prevalence of ADHD varies by socioeconomic status (SES) and parental history of ADHD in a population-sample of elementary school children age 6-14 years. We screened all children in grades 1-5 in 17 schools in one North Carolina (U.S.) county for ADHD using teacher rating scales and 1,160 parent interviews, including an ADHD structured interview (DISC). We combined parent and teacher ratings to determine DSM-IV ADHD status. Data analysis was restricted to 967 children with information about parental history of ADHD. SES was measured by family income and respondent education. We found an interaction between family income and parental history of ADHD diagnosis (p = .016). The SES gradient was stronger in families without a parental history and weaker among children with a parental history. Among children without a parental history of ADHD diagnosis, low income children had 6.2 times the odds of ADHD (95% CI 3.4-11.3) as high income children after adjusting for covariates. Among children with a parental history, all had over 10 times the odds of ADHD as high income children without a parental history but the SES gradient between high and low income children was less pronounced [odds ratio (OR) = 1.4, 95% CI 0.6-3.5]. Socioeconomic status and parental history of ADHD are each strong risk factors for ADHD that interact to determine prevalence. More research is needed to dissect the components of SES that contribute to risk of ADHD. Future ADHD research should evaluate whether the strength of other environmental risk factors vary by parental history. Early identification and interventions for children with low SES or parental histories of ADHD should be explored. © 2017 Association for Child and Adolescent Mental Health.

a comparison of accuracy of clinical tests and mri in the diagnosis of ...

African Journals Online (AJOL)

Methods: Between January 2011 and December 2015, 147 consecutive patients with previous history of knee injury ... Results: There was a wide variance between clinical diagnosis and MRI reportage for meniscal tears. ..... Musculoskeletal injuries associated with ... (MRI) in the management of knee disorders in a sports.

Radiological diagnosis of periventricular and subcortical leukomalacia

Energy Technology Data Exchange (ETDEWEB)

Taboada, D.; Alonso, A.; Olague, R.; Mulas, F.; Andres, V.

1980-08-01

Nine newborn infants with histories of perinatal asphyxia are presented. The pneumoencephalographic findings which led to the diagnosis are typical and constant. They include marked subcortical atrophy with rounded, dilated, and undisplaced lateral ventricles. Cystography with 3 cc of air demonstrated multiple subcortical and paraventricular cavities, without communication with the ventricular system, but with the typical honeycomb appearance of paraventricular and subcortical leukomalacia described in postmortem findings. The CT findings are typical, and provide the location of the cavities as well as their density.

History of the mammography and its impact in morbi-mortality due to breast cancer

International Nuclear Information System (INIS)

Oliva, Marcia; Sartori, Eugenia; Gotta, Cesar

2004-01-01

On this historical article the authors offer a bibliographic revision of the evolution of breast radiological diagnosis over time, and analyze its stages and the impact on the reduction of morbidity and mortality due to breast cancer. The evolution of breast pathology diagnosis started several centuries ago but made rapid progress since the development of the X-rays (Salomon 1913). The appearance of the mammographic technique (Leborgne 1958, Gross 1966) is paramount in the history of the diagnosis and prevention of breast pathology. After the generalization and systematization of its use, it became the first method for an effective prevention and an early detection of breast cancer. (author)

Basic pattern in CT of the lung and differential diagnosis

International Nuclear Information System (INIS)

Jacobi, V.; Thalhammer, A.

2006-01-01

Infectious, physical, chemical or other noxae elicit a limited number of reactions in lung tissue. As in the case of other organs and tissues, lung tissue has specific reactions that are often more indicative of the particular organ than the harmful agent. The resulting radiological features are usually ambiguous and therefore prevent definitive diagnosis. This complicates etiological categorization of the disease. Pathognomonic findings are rare. The same noxa can yield different radiographic features and clinical pictures for different patients. A diagnosis is generally not comprised of a single radiographic feature, but rather of a combination of a plurality of features. Although the number of possible diagnoses can be limited via radiological means, a final diagnosis is determined in conjunction with the medical history, the clinical picture, as well as lab and histopathological values. This article defines the most common pulmonary changes and also discusses differential diagnostic criteria. (orig.)

Ischemic or toxic injury: A challenging diagnosis and treatment of drug-induced stenosis of the sigmoid colon.

Science.gov (United States)

Zhang, Zong-Ming; Lin, Xiang-Chun; Ma, Li; Jin, An-Qin; Lin, Fang-Cai; Liu, Zhuo; Liu, Li-Min; Zhang, Chong; Zhang, Na; Huo, Li-Juan; Jiang, Xue-Liang; Kang, Feng; Qin, Hong-Jun; Li, Qiu-Yang; Yu, Hong-Wei; Deng, Hai; Zhu, Ming-Wen; Liu, Zi-Xu; Wan, Bai-Jiang; Yang, Hai-Yan; Liao, Jia-Hong; Luo, Xu; Li, You-Wei; Wei, Wen-Ping; Song, Meng-Meng; Zhao, Yue; Shi, Xue-Ying; Lu, Zhao-Hui

2017-06-07

A 48-year-old woman was admitted with 15-mo history of abdominal pain, diarrhea and hematochezia, and 5-mo history of defecation difficulty. She had been successively admitted to nine hospitals, with an initial diagnosis of inflammatory bowel disease with stenotic sigmoid colon. Findings from computed tomography virtual colonoscopy, radiography with meglumine diatrizoate, endoscopic balloon dilatation, metallic stent implantation and later overall colonoscopy, coupled with the newfound knowledge of compound Qingdai pill-taking, led to a subsequent diagnosis of ischemic or toxic bowel disease with sigmoid colon stenosis. The patient was successfully treated by laparoscopic sigmoid colectomy, and postoperative pathological examination revealed ischemic or toxic injury of the sigmoid colon, providing a final diagnosis of drug-induced sigmoid colon stenosis. This case highlights that adequate awareness of drug-induced colon stenosis has a decisive role in avoiding misdiagnosis and mistreatment. The diagnostic and therapeutic experiences learnt from this case suggest that endoscopic balloon expansion and colonic metallic stent implantation as bridge treatments were demonstrated as crucial for the differential diagnosis of benign colonic stenosis. Skillful surgical technique and appropriate perioperative management helped to ensure the safety of our patient in subsequent surgery after long-term use of glucocorticoids.

Early prenatal diagnosis of ischiopagus conjoined twins

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Ahmet Mete Ergenoğlu

2014-03-01

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

Diagnosis and perioperative management of ruptured AAA mimicking symptomatic groin hernia

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Holger Jan Klein

2016-01-01

Conclusion: Computed Tomography Angiography (CTA remains the recommended diagnostic tool—for both safe diagnosis of the ruptured aneurysm and precise preoperative planning. Endovascular aortic repair of the RAAA—if feasible—is the treatment of choice. This rare form of RAAA manifestation should call physicians attention—especially in patients with known abdominal aortic aneurysms in their preceding medical history.

A review of serological tests used in the diagnosis of Brucellosis ...

African Journals Online (AJOL)

Brucellosis is of serious economic importance in livestock and in humans. There are batteries of serological tests developed and in use for the diagnosis of brucellosis in human and livestock Brief history, merits and demerits of some of these test are enumerated in this review. The purpose of the review is to bring together in ...

Differential diagnosis of CNS angiostrongyliasis: a short review.

Science.gov (United States)

Senthong, Vichai; Chindaprasirt, Jarin; Sawanyawisuth, Kittisak

2013-06-01

The diagnostic criterion for eosinophilic meningitis (EOM) is the identification of an absolute count of 10 eosinophils per ml or more than 10% of the total white blood cells in the cerebrospinal fluid (CSF) in the proper clinical context. The most common cause of EOM is Angiostrongylus cantonensis infection, termed meningitic angiostrongyliasis (MA). Neurognathostomiasis (NG) is the main parasitic disease in the differential diagnosis of meningitic angiostrongyliasis. This short review is based on articles published on Medline between 2000 and 2012 related to EOM. There are three main approaches that can be used to differentiate between MA and NG, involving clinical factors, history of larval exposure, and serological tests. MA patients presented with acute severe headache but without neurological deficit, combined with a history of eating uncooked snails or slugs. NG patients always presented with motor weakness, migratory swelling, radicular pain and had history of eating uncooked poultry or fish. Specific antigenic bands in immunoblot tests are helpful tools to differentiate the two diseases. Other causes of eosinophilic meningitis are neurocysticercosis, cerebral paragonimiasis, Toxoplasma canis, Baylisascaris, tuberculous meningitis, and cryptococcal meningitis.

A review of American psychiatry through its diagnoses: the history and development of the Diagnostic and Statistical Manual of Mental Disorders.

Science.gov (United States)

Fischer, Bernard A

2012-12-01

The history of the Diagnostic and Statistical Manual of Mental Disorders (DSM) reflects the larger history of American psychiatry. As the field anticipates DSM-5, it is useful to take stock of this history and consider not only how diagnosis impacts our understanding of mental illness but also how contemporary thought influences diagnosis. Before the DSM, the field was disjointed. The publication of the first American diagnostic manual, the precursor of the DSM, mirrored society's interest in organized record keeping and prevention rather than treatment of mental illness. The first and second editions of DSM brought a common language to diagnosis and were largely the work of outpatient and academic psychiatrists rather than those based in large state hospitals. The third edition of the DSM saw the shift in American psychiatry's leadership from the eminent clinician to the researcher, whereas the fourth edition reflected the rise of "evidence-based medicine." DSM-5 will likewise represent the current status of the field-not only with regard to science but also reflecting the place of American psychiatry in medicine today.

Evaluation of the first seizure patient: Key points in the history and physical examination.

Science.gov (United States)

Nowacki, Tomasz A; Jirsch, Jeffrey D

2017-07-01

This review will present the history and physical examination as the launching point of the first seizure evaluation, from the initial characterization of the event, to the exclusion of alternative diagnoses, and then to the determination of specific acute or remote causes. Clinical features that may distinguish seizures from alternative diagnoses are discussed in detail, followed by a discussion of acute and remote first seizure etiologies. This review article is based on a discretionary selection of English language articles retrieved by a literature search in the PubMed database, and the authors' clinical experience. The first seizure is a dramatic event with often profound implications for patients and family members. The initial clinical evaluation focuses on an accurate description of the spell to confirm the diagnosis, along with careful scrutiny for previously unrecognized seizures that would change the diagnosis more definitively to one of epilepsy. The first seizure evaluation rests primarily on the clinical history, and to a lesser extent, the physical examination. Even in the era of digital EEG recording and neuroimaging, the initial clinical evaluation remains essential for the diagnosis, treatment, and prognostication of the first seizure. Copyright © 2016. Published by Elsevier Ltd.

Diagnosis of Swimming Induced Pulmonary Edema—A Review

Science.gov (United States)

Grünig, Hannes; Nikolaidis, Pantelis T.; Moon, Richard E.; Knechtle, Beat

2017-01-01

Swimming induced pulmonary edema (SIPE) is a complication that can occur during exercise with the possibility of misdiagnosis and can quickly become life threatening; however, medical literature infrequently describes SIPE. Therefore, the aim of this review was to analyse all individual cases diagnosed with SIPE as reported in scientific sources, with an emphasis on the diagnostic pathways and the key facts resulting in its diagnosis. Due to a multifactorial and complicated pathophysiology, the diagnosis could be difficult. Based on the actual literature, we try to point out important findings regarding history, conditions, clinical findings, and diagnostic testing helping to confirm the diagnosis of SIPE. Thirty-eight cases from seventeen articles reporting the diagnosis of SIPE were selected. We found remarkable differences in the individual described diagnostic pathways. A total of 100% of the cases suffered from an acute onset of breathing problems, occasionally accompanied by hemoptysis. A total of 73% showed initial hypoxemia. In most of the cases (89%), an initial chest X-Ray or chest CT was available, of which one-third (71%) showed radiological signs of pulmonary edema. The majority of the cases (82%) experienced a rapid resolution of symptoms within 48 h, the diagnostic hallmark of SIPE. Due to a foreseeable increase in participation in swimming competitions and endurance competitions with a swimming component, diagnosis of SIPE will be important, especially for medical teams caring for these athletes. PMID:28912730

EFFECTIVENESS OF CT IN DIAGNOSIS OF PROPTOSIS

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Vikas Agrawal

2017-07-01

Full Text Available BACKGROUND Orbit is a pyramidal shaped anatomical space bound by orbital bones whose apex is continued posteriorly as the optic canal and rectangular base opens into the face. Though a series of canal, fissures and foramina communicate with extra orbital compartment, it is a closed compartment with broad opening anteriorly. Orbit contains the eye ball, extra ocular muscles, vascular elements, nerves, lacrimal gland and connective tissue. Proptosis is defined as an abnormal protrusion of the eyeball. MATERIALS AND METHODS Total 32 patients referred from various departments mainly from ophthalmology and medicine with history and clinical features suggestive of proptosis were evaluated in our department and after proper history taking and clinical examination, Computed Tomography (CT scan and histopathological diagnosis was done. RESULTS The age of the patients ranged from 1-55 years. Mass lesions (46.87% were the most common cause of proptosis followed by inflammatory lesions (37.5%. Trauma, vascular lesions and congenital conditions were infrequent causes of proptosis. Unilateral proptosis was more frequent (84.37% than bilateral proptosis (15.62% and thyroid ophthalmopathy accounted for 60% of bilateral proptosis cases. CONCLUSION Mass lesions were the most common cause of proptosis followed by inflammatory lesions. CT scanning should be the chief investigation in evaluation of lesions causing proptosis. It is the most useful in detecting, characterising and determining the extent of disease process. The overall accuracy of CT scan in diagnosis of proptosis was 96.87%.

A Clinician’s Guide to the Diagnosis and Management of Gallbladder Volvulus

Science.gov (United States)

Pottorf, Brian J; Alfaro, Leonardo; Hollis, Harris W

2013-01-01

Introduction: Gallbladder volvulus (GV), or torsion of the gallbladder, is an uncommon surgical emergency. This article reviews the world literature related to GV. We examine the history of gallbladder torsion and highlight the critical constellation of presenting signs and symptoms, which guide the acute care physician and surgeon to accurate and timely diagnosis of GV before surgical intervention. Methods: A comprehensive review of all published cases of GV was performed using the National Library of Medicine (PubMed) database. Results: Lists of typical symptoms and clinical presentations are provided to allow clinicians to establish an accurate preoperative diagnosis. Conclusion: GV is frequently undiagnosed before surgical intervention. However, clinical presentation and associated radiographic findings can lead to an accurate diagnosis if the clinician is aware of this uncommon condition. When the diagnosis has been established before operative intervention, expeditious laparoscopic cholecystectomy can be performed safely. Delays in diagnosis may mandate open cholecystectomy if laparoscopic extraction is contraindicated because of undesirable sequelae of gallbladder necrosis, specifically perforation, bilious peritonitis, and hemodynamic instability. PMID:23704849

Longitudinal histories as predictors of future diagnoses of domestic abuse: modelling study

Science.gov (United States)

Kohane, Isaac S; Mandl, Kenneth D

2009-01-01

Objective To determine whether longitudinal data in patients’ historical records, commonly available in electronic health record systems, can be used to predict a patient’s future risk of receiving a diagnosis of domestic abuse. Design Bayesian models, known as intelligent histories, used to predict a patient’s risk of receiving a future diagnosis of abuse, based on the patient’s diagnostic history. Retrospective evaluation of the model’s predictions using an independent testing set. Setting A state-wide claims database covering six years of inpatient admissions to hospital, admissions for observation, and encounters in emergency departments. Population All patients aged over 18 who had at least four years between their earliest and latest visits recorded in the database (561 216 patients). Main outcome measures Timeliness of detection, sensitivity, specificity, positive predictive values, and area under the ROC curve. Results 1.04% (5829) of the patients met the narrow case definition for abuse, while 3.44% (19 303) met the broader case definition for abuse. The model achieved sensitive, specific (area under the ROC curve of 0.88), and early (10-30 months in advance, on average) prediction of patients’ future risk of receiving a diagnosis of abuse. Analysis of model parameters showed important differences between sexes in the risks associated with certain diagnoses. Conclusions Commonly available longitudinal diagnostic data can be useful for predicting a patient’s future risk of receiving a diagnosis of abuse. This modelling approach could serve as the basis for an early warning system to help doctors identify high risk patients for further screening. PMID:19789406

A negative bone scan leads to an unusual diagnosis

International Nuclear Information System (INIS)

O'Brien, L.

1998-01-01

Full text: A bone scan looking for osteomyelitis or a more sinister pathology was performed on a 7-year-old boy with Von Willebrand''s disease. He presented with symptoms of pain in the left groin and a lump, although there had been no history of direct trauma, and an X-ray report stating that there was an irregular ill-defined area of bony destruction seen in the lower aspect of the left ischium. Blood pool images of the pelvis were acquired soon after an injection of MDP and three hours later a whole body bone scan was done. Results of the bone scan showed that the radiolucent lesion in the left ilium seen on the plain radiographs was not metabolically active on the technetium MDP study. Features compatible with a response to an intraosseous or sub-periosteal haematoma were seen when reviewing the original X-rays and, as there was a spontaneous resolution of the patient''s symptoms, this was considered to be the diagnosis. This study shows that a negative bone scan, which rules out an active bone lesion, is of value in making a diagnosis when used in conjunction with X-rays and a knowledge of the patient''s history

Evaluation of Outcome- Prenatal Diagnosis Indication and Results Suitability in Families Referred to our Laboratory For Prenatal Diagnosis

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Ayşegül Türkyılmaz

2007-01-01

Full Text Available Since our aim is to establish the importance, necessity and concept of prenatal diagnosis in our region and supply routine service at a stage which we admit as a transitional period for application, all of the materials of amniocentesis, cordocentesis and corion villi sample referred to laboratories were evaluated without refusal.When we examined prenatal diagnoses of these specimens, we found Down Risk (according to triple test result in 164 specimens (%34, fetal anomaly risk in 122 (%25, advanced age in 69 (%14 poor-obstetric anamnesis in 27(%5, Down Syndrome- infant history in 20 (%4, family request in 17, and habitual abortus (%3 etc. in specimens. Lymphocyte Culture prepared in duplicate for each specimen and chromosome were obtained from total of ten slides for each specimen. Slides were stained with Giemsa Banding Technic (GTG Banding. Total (10x481 4810 slides were evaluated for diagnosis.There were no false positive and false negative results.

Medial tibial stress syndrome can be diagnosed reliably using history and physical examination

NARCIS (Netherlands)

Winters, M.; Bakker, E. W. P.; Moen, M. H.; Barten, C. C.; Teeuwen, R.; Weir, A.

2017-01-01

The majority of sporting injuries are clinically diagnosed using history and physical examination as the cornerstone. There are no studies supporting the reliability of making a clinical diagnosis of medial tibial stress syndrome (MTSS). Our aim was to assess if MTSS can be diagnosed reliably, using

Plain radiographic findings of lung cancer with delayed diagnosis

International Nuclear Information System (INIS)

Choe, Kyu Ok; Chung, Jin Ill

1994-01-01

In Korea, Lung cancer is the Second most common prevailing malignancy among male population next to stomach cancer. Although CT scan and MRI is widely used in the staging of lung cancer, plain chest x-ray still plays an important role in screening and diagnosis. Our intention was to review the confusing radiographic features which result in delayed diagnosis of lung cancer. Of the 160 patients with lung cancer evaluated by us, 62 patients(39%) with delayed diagnosis and average diagnostic duration of 5.1 months compared with 2.1 months for those without delay. We reviewed the plain chest x-ray findings of those 62 patients. The diagnosis of lung cancer was delayed more than half of the cases under the impression of intrathoracic tuberculosis. Upon reviewing the roentgenologic findings in patients with diagnostic delay, central type appeared as a small hilar or mediastinal mass with or without obstructive pneumonia. Peripheral type appeared as an ill-defined pulmonary module, a nodule hidden by overlapping structures, or as a lung cancer associated with pulmonary tuberculosis. Some cases were misinterpreted as extranodal spread of malignancy. To solve above mentioned problems, we recommend proper understanding of natural history of lung cancer, incorporation of high kVp technique in chest radiographs, routine acquisition of lateral chest radiograph to increase diagnostic accuracy, and appropriate use of CT scan in cases of difficult diagnosis

History of music therapy treatment interventions for children with autism.

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Reschke-Hernández, Alaine E

2011-01-01

The purpose of this paper is to provide a systematic review of the history of music therapy research and treatment of children with autism. Understanding such history is important in order to improve clinical efficacy and inform future research. This paper includes a history of autism diagnosis, reviews strengths and limitations of music therapy practice with children with autism from 1940-2009, and suggests direction for future music therapy research and clinical practice with this population. Literature was limited to the English language and obtained with the following search terms: autism, autistic, (early) infantile autism, child, therapeutic music, musical therapy, and music therapy. Table of contents from music therapy journals were searched, and reference lists from obtained articles were perused for additional articles. This historical review focused primarily on journal articles, however, books and book chapters that appeared to hold particular historical significance were also included.

[Pica diagnosis during pregnancy and micronutrient dificiency in Argentine women].

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Poy, M S; Weisstaub, A; Iglesias, C; Fernández, S; Portela, Ma L; López, L B

2012-01-01

To evaluate by biochemical parameters iron and zinc nutritional status in women with and without pica diagnosis during pregnancy. During puerperium 109 women were evaluated at Fiorito Hospital, Argentina. Pica diagnosis was made in 42 women while 67 did not refer the practice. Fasting blood samples were obtained and analyzed in a hematology analyzer for values of red blood cells, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and hematocrit. Serum zinc and erythrocyte zinc was analyzed by atomic absorption spectrophotometry. Substances consumed during pica practice were: earth, ice, brick, paper, desinfectant and dog food. Women with pica diagnosis had higher a rate of family history of pica and personal antecedents of pica in childhood (OR: 15.9). Sociodemographic and anthropometric characteristics and neonatal birth weight were similar between both groups, although women with pica diagnosis had lower values in mean corpuscular volume (p = 0,008), mean corpuscular hemoglobin (p = 0,009) and erythrocyte zinc (0,008). Applying a logistic regression model, erythrocyte zinc was the only biochemical indicator associated with pica practice (p = 0,028). At puerperium, women with pica during pregnancy could have lower levels in biochemical parameters for iron and zinc status so we suggest that early diagnosis of pica could help to identify micronutrient deficient.

The effective and preventive factors of taking patients\\' history from the viewpoint of the students of Birjand Medical School in 2010-2011

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Z. Khazaee

2013-06-01

Full Text Available Introduction: Taking patients' history and doing physical examinations help physicians to diagnose correctly and treat accordingly. There are several factors which may affect the quality of taking patients' history. This study aims to assess determinants of taking patients' history from the viewpoint of the students of Birjand Medical School. Methods: This descriptive study was carried out in 2010-2011 on all 137 medical trainees and interns studying at Birjand Medical School. To determine the students’ attitudes towards history taking and to evaluate their performance a questionnaire and a check-list were used, respectively. The data analyzed using SPSS software. Descriptive-deductive statistics (T-test were applied on the data. Results: The average score of the motivational factors was more than the preventive factors. Among the motivational factors, the statement “taking patient history is a basis of proper diagnosis and treatment” (3.58 and among the preventive factors the statement “taking patient history just to evade responsibility”(2.57had the highest scores. Moreover, there was a significant difference between the performance of trainees and interns in taking and recording patients’ history (P<0.005. Conclusion: Although the students held a positive attitude toward taking patients' history, they didn’t have satisfactory performance in recording disease symptoms, diagnosis and treatment plans this entails more attention. Observation of trainers on the process of history taking may help.

Safety of pregnancy following breast cancer diagnosis: a meta-analysis of 14 studies

DEFF Research Database (Denmark)

Azim, Hatem A; Santoro, Luigi; Pavlidis, Nicholas

2011-01-01

Due to the rising trend of delaying pregnancy to later in life, more women are diagnosed with breast cancer before completing their families. Therefore, enquiry into the feasibility and safety of pregnancy following breast cancer diagnosis is on the rise. Available evidence suggests that women...... with a history of breast cancer are frequently advised against future conception for fear that pregnancy could adversely affect their breast cancer outcome. Hence, we conducted a meta-analysis to understand the effect of pregnancy on overall survival of women with a history of breast cancer....

Safety of pregnancy following breast cancer diagnosis: a meta-analysis of 14 studies

DEFF Research Database (Denmark)

Azim, Hatem A; Santoro, Luigi; Pavlidis, Nicholas

2011-01-01

with a history of breast cancer are frequently advised against future conception for fear that pregnancy could adversely affect their breast cancer outcome. Hence, we conducted a meta-analysis to understand the effect of pregnancy on overall survival of women with a history of breast cancer.......Due to the rising trend of delaying pregnancy to later in life, more women are diagnosed with breast cancer before completing their families. Therefore, enquiry into the feasibility and safety of pregnancy following breast cancer diagnosis is on the rise. Available evidence suggests that women...

Headache and facial pain: differential diagnosis and treatment.

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Bernstein, Jonathan A; Fox, Roger W; Martin, Vincent T; Lockey, Richard F

2013-01-01

Headaches affect 90% of the population sometime during their life. Most are benign and fleeting, some are serious and life-threatening, and others require ongoing medical consultation and treatment. A careful history and physical is necessary to establish a differential diagnosis and to guide the choice of testing to make an accurate diagnosis. The most common types of headaches are discussed in this review. They are divided into primary and secondary headache disorders as classified by the International Headache Society. Primary headache disorders include migraine without and with aura, cluster and tension-type headaches. Secondary headaches are those that occur as a result of some other disorder and include brain tumors, rhinosinusitis, diseases of intracranial and extracranial vasculature, and temporomandibular joint disease. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo

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Muhammed Dagkiran

2015-12-01

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

Clinical lesson: eosinophilic oesophagitis, a new diagnosis to swallow

OpenAIRE

Lamb, C A; Kanakala, V; Stirling, R W; Attwood, S E A

2010-01-01

Eosinophilic oesophagitis (EoE) is a recently described condition that has gained increasing recognition over the past 5 years. Despite this, many clinicians remain unaware of EoE, often leading to diagnostic delay and therefore significant morbidity. The diagnosis of EoE should be considered in any patient with a history of intermittent or continuous dysphagia, or oesophageal food impaction. It should be strongly suspected in young patients, particularly men, presenting with dysphagia and a ...

Diagnosis and Management of Upper Gastrointestinal Neuroendocrine Tumors

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Jun Liong Chin

2017-11-01

Full Text Available Upper gastrointestinal neuroendocrine tumors (NETs are rare tumors which are increasingly recognised by practising endoscopists. After confirmation by endoscopic biopsies of these focal lesions, many questions may arise. As NETs are less frequently encountered compared to other malignancies or gastrointestinal pathology, many endoscopists may not fully understand the natural history, diagnosis and management of these tumors. In this review, we aim to update the practising endoscopist on the key clinical features and management of patients with upper gastrointestinal NET.

Differential diagnosis

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Abdallah Adra

2016-09-01

Full Text Available Abnormal uterine bleeding may be acute or chronic accounting for up to 30% of outpatient visits to gynecologists. Hyperprolactinemia is one of the most common endocrine disorders associated with ovulatory dysfunction that results in menstrual irregularities. Prior to initiating treatment, the various causes (physiologic, pathologic, pharmacologic, or idiopathic of hyperprolactinemia must be elucidated. Prolactin is a stress hormone that increases in response to stressful conditions; therefore, while collecting samples it is necessary to reduce venipuncture stress. A thorough patient history and physical examination will help to identify the cause and to direct therapy. Imaging results must always be assessed along with a patient’s clinical history and biochemical parameters when a pituitary tumor is suspected. Magnetic resonance imaging is the method of choice for the diagnosis of microprolactinomas and macroprolactinomas in both initial assessment and follow-up. Several drugs may cause a significant increase in serum prolactin concentration. If clinically feasible, the drug should be discontinued; if this is not possible, it should be substituted with a drug of similar action that does not cause hyperprolactinemia. Prolactinomas are the most common cause of pituitary adenomas affecting women of fertile age leading to significant elevations in prolactin that warrant treatment. Idiopathic hyperprolactinemia may be observed in the presence of elevated serum prolactin levels and in the absence of any other recognized cause of increased prolactin secretion. Dopamine agonists are the mainstay of therapy in prolactinomas and symptomatic idiopathic hyperprolactinemia because they normalize serum prolactin, effectively shrink prolactinomas and normalize gonadal function (i.e. menstruation.

Changes in Mothers' Experiences of Receiving an Autism Diagnosis: A Contextualized Case Study

Science.gov (United States)

Hornstein, Shana

2011-01-01

Autism has a unique history. The definition has broadened and changed over time, from an emotional disturbance with psychogenic origins to a neurodevelopmental disability with suspected environmental and genetic origins. Diagnosis occurs later than children born with obvious disabilities such as cerebral palsy or Down syndrome, but earlier than…

Slow-growing labyrinthine masses: contribution of MRI to diagnosis, follow-up and treatment

International Nuclear Information System (INIS)

Deux, J.F.; Marsot-Dupuch, K.; Tubiana, J.M.; Tran Ba Huy, P.; Sterkers, J.M.

1998-01-01

We report the use of MRI in the diagnosis, follow-up and therapeutic management of three cases of intralabyrinthine Schwannoma. The diagnosis was based on the history and initial and follow-up MRI findings. The main feature suggesting the diagnosis was a nodular intralabyrinthine mass of low signal intensity on T2-weighted images, and high or isointense signal on T1-weighted images (relative to cerebrospinal fluid), which showed contrast enhancement. Follow-up imaging showed growth of the tumour in one patient. One patient underwent surgery for severe tinnitus. To detect these lesions, MRI should be focussed on the inner ear, using thin-section T2-weighted and T1-weighted images before and after contrast medium. MRI allowed informed surgical planning. (orig.) (orig.)

Early diagnosis of the Spondyloarthropathies

International Nuclear Information System (INIS)

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

2005-01-01

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

Dioctophyma renale in a dog: clinical diagnosis and surgical treatment.

Science.gov (United States)

Ferreira, Vivian Lindmayer; Medeiros, Fábio Pestana; July, José Roberto; Raso, Tânia Freitas

2010-02-26

This study reports a case of parasitism by the giant kidney worm, Dioctophyma renale, diagnosed in the right kidney of a domestic dog. An adult female German Shepherd was attended with clinical history of prostration and hyporexia. The hemogram showed changes compatible with an inflammatory process, for that reason, an abdominal ultrasound was requested. Ultrasound image suggested the presence of D. renale in the right kidney. The diagnosis was confirmed after urinalysis due to the presence of dioctophymas ova in the urinary sediment. Surgical treatment was made and the animal had an excellent recovery after the nephrectomy was performed. Generally, in almost all cases, parasitism by D. renale in domestic dogs is a necropsy finding, nevertheless imaging techniques as sonography and laboratorial exams as urinalysis have been proven to be important tools to achieve diagnosis. The purpose of this study is to report a case of parasitism by D. renale where diagnosis and treatment were made in time to allow the patient's recovery.

Uncovering History for Future History Teachers

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Fischer, Fritz

2010-01-01

The art of history teaching is at a crossroads. Recent scholarship focuses on the need to change the teaching of history so students can better learn history, and insists that history teachers must move beyond traditional structures and methods of teaching in order to improve their students' abilities to think with history. This article presents…

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

Science.gov (United States)

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

2017-11-01

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

[Diagnosis and treatment of pediatric anismus].

Science.gov (United States)

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

2006-11-01

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

Differential diagnosis of nongap metabolic acidosis: value of a systematic approach.

Science.gov (United States)

Kraut, Jeffrey A; Madias, Nicolaos E

2012-04-01

Nongap metabolic acidosis is a common form of both acute and chronic metabolic acidosis. Because derangements in renal acid-base regulation are a common cause of nongap metabolic acidosis, studies to evaluate renal acidification often serve as the mainstay of differential diagnosis. However, in many cases, information obtained from the history and physical examination, evaluation of the electrolyte pattern (to determine if a nongap acidosis alone or a combined nongap and high anion gap metabolic acidosis is present), and examination of the serum potassium concentration (to characterize the disorder as hyperkalemic or hypokalemic in nature) is sufficient to make a presumptive diagnosis without more sophisticated studies. If this information proves insufficient, indirect estimates or direct measurement of urinary NH(4)(+) concentration, measurement of urine pH, and assessment of urinary HCO(3)(-) excretion can help in establishing the diagnosis. This review summarizes current information concerning the pathophysiology of this electrolyte pattern and the value and limitations of all of the diagnostic studies available. It also provides a systematic and cost-effective approach to the differential diagnosis of nongap metabolic acidosis.

NSF-Sponsored Summit on the Future of Undergraduate Geoscience Education: outcomes

Science.gov (United States)

Mosher, S.

2014-12-01

The NSF-sponsored Summit on the Future of Undergraduate Geoscience Education made major progress toward developing a collective community vision for the geosciences. A broad spectrum of the geoscience education community, ~200 educators from research universities/four and two year colleges, focused on preparation of undergraduates for graduate school and future geoscience careers, pedagogy, use of technology, broadening participation/retention of underrepresented groups, and preparation of K-12 science teachers. Participants agreed that key concepts, competencies and skills learned throughout the curriculum were more important than specific courses. Concepts included understanding Earth as complex, dynamic system, deep time, evolution of life, natural resources, energy, hazards, hydrogeology, surface processes, Earth materials and structure, and climate change. Skills/competencies included ability to think spatially and temporally, reason inductively and deductively, make and use indirect observations, engage in complex open, coupled systems thinking, and work with uncertainty, non-uniqueness, and incompleteness, as well as critical thinking, problem solving, communication, and ability to think like a scientist and continue to learn. Successful ways of developing these include collaborative, integrative projects involving teams, interdisciplinary projects, fieldwork and research experiences, as well as flipped classrooms and integration and interactive use of technology, including visualization, simulation, modeling and analysis of real data. Wider adoption of proven, effective best practices is our communities' main pedagogical challenge, and we focused on identifying implementation barriers. Preparation of future teachers in introductory and general geoscience courses by incorporating Next Generation Science Standards and using other sciences/math to solve real world geoscience problems should help increase diversity and number of future geoscientists and

Institutional transformation: An analysis of change initiatives at NSF ADVANCE institutions

Science.gov (United States)

Plummer, Ellen W.

The purpose of this study was to examine how institutional culture promoted or impeded the implementation of round one and two NSF ADVANCE initiatives designed to improve academic climates for women in science and engineering. This study was conducted in two phases. In phase one, 35 participants from 18 institutions were interviewed to answer three research questions. Participants identified a policy, process, or program designed to improve academic cultures for women in science and engineering fields. Participants also identified strategies that promoted the implementation of these efforts, and discussed factors that impeded these efforts. In phase two, site visits were conducted at two institutions to answer a fourth research question. How did institutional culture shape the design and implementation of faculty search processes? Policies, processes, and programs were implemented by participants at the institutional, departmental, and individual levels and included family friendly and dual career policies at the institutional level, improved departmental faculty search and climate improvement processes, and mentoring programs and training for department heads at the individual level. Communication and leadership strategies were key to the successful implementation of policies, processes, and programs designed to achieve institutional transformation. Communication strategies involved shaping change messages to reach varied audiences often with the argument that change efforts would improve the climate for everyone not just women faculty members. Administrative and faculty leaders from multiple levels proved important to change efforts. Institutional Transformation Institutional culture shaped initiatives to improve faculty search processes. Faculty leaders in both settings used data to persuade faculty members of the need for change. At one site, data that included national availability information was critical to advancing the change agenda. At the other site

Who is looking for an internship and successful in obtaining one? Examining application data from REU programs funded through NSF GEO

Science.gov (United States)

Hubenthal, M.; Kelly, M.

2017-12-01

The Directorate for Geosciences (GEO) at the National Science Foundation (NSF) is currently funding 60 Research Experiences for Undergraduate (REU) sites. Each site offers opportunities for 8 to 12 undergraduates to participate in research within solid earth, oceans, atmospheric and cryosphere sciences. Because applicant data is collected at individual REU sites, the exact number of unique applicants to all REU sites, and the demographics of this national applicant pool has not been previously reported. While some sites do provide some of this information to NSF in annual reports, obtaining and combining such data is problematic because the percentage of individuals that apply to multiple programs is unknown and generally believed anecdotally to be high, especially for students traditionally underrepresented in the geosciences. Understanding both the scale and makeup of the national applicant pool is important for several reasons. First, very little is known about how the supply and geographic location of slots in REU programs compares to the demand from undergraduate STEM majors interested in research experiences. Second, research into internship programs and their role in the career development process are limited by a lack of baseline data that includes both successful and unsuccessful internship applicants across the various sub-disciplines of the Earth sciences. Finally, designing and refining efforts to engage underrepresented populations in STEM research, and measuring the impact of such efforts is difficult without baseline data for comparison. We will present aggregate application data from up to 20 GEO REU funded programs. These programs represent Oceans, Atmospheres and Earth Science research areas and includes over a thousand applicants. Preliminary analysis suggests the number of unique applicants in the pool is higher than anecdotally predicted. Similarly, unique applicants from underrepresented communities also appears higher than anticipated.

Phenomenology, psychiatric comorbidity and family history in referred preschool children with obsessive-compulsive disorder

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Coskun Murat

2012-11-01

Full Text Available Abstract Objective The study aimed to investigate phenomenology, psychiatric comorbidity, and family history of obsessive-compulsive disorder (OCD in a clinical sample of normally developing preschool children with OCD. Method Subjects in this study were recruited from a clinical sample of preschool children (under 72 months of age who were referred to a university clinic. Subjects with a normal developmental history and significant impairment related to OCD symptoms were included in the study. Children’s Yale-Brown Obsessive-Compulsive Scale was used to assess OCD symptoms. Each subject was assessed for comorbid DSM-IV psychiatric disorders using a semi-structured interview. Parents were evaluated for lifetime history of OCD in individual sessions. Results Fifteen boys and ten girls (age range: 28 to 69 months; 54.12±9.08 months were included. Mean age of onset of OCD was 35.64±13.42 months. All subjects received at least one comorbid diagnosis. The most frequent comorbid disorders were non-OCD anxiety disorders (n=17; 68.0%, attention-deficit hyperactivity disorder (ADHD (n=15; 60.0%, oppositional defiant disorder (ODD (n=12; 48.0%, and tic disorders (n=6; 24.0%. Mean number of comorbid disorders was 3.65 and 2.35 for boys and girls, respectively. At least one parent received lifetime OCD diagnosis in 68 percent of the subjects. Conclusions The results indicated that OCD in referred preschool children is more common in males, highly comorbid with other psychiatric disorders, and associated with high rates of family history of OCD. Given the high rates of comorbidity and family history, OCD should be considered in referred preschool children with disruptive behavior disorders and/or with family history of OCD.

Age-dependent decline of beta-cell function in type 1 diabetes after diagnosis: a multi-centre longitudinal study

DEFF Research Database (Denmark)

Barker, A.; Lauria, A.; Schloot, N.

2014-01-01

C-peptide secretion is currently the only available clinical biomarker to measure residual β-cell function in type 1 diabetes. However, the natural history of C-peptide decline after diagnosis can vary considerably dependent upon several variables. We investigated the shape of C-peptide decline...... over time from type 1 diabetes onset in relation to age at diagnosis, HbA1c levels and insulin dose....

Parkinsonian syndroms: Clinical phenotype, differential diagnosis and disease progression

International Nuclear Information System (INIS)

Storch, A.

2002-01-01

Parkinsonian syndromes include idiopathic Parkinson's disease (IPD), other neurodegenerative diseases with parkinsonism, the so-called atypical parkinsonian syndromes, and symptomatic parkinsonian syndromes, such as Wilson's disease. IPD is the most frequent disease with parkinsonism as the main clinical feature and is responsible for approx. 80% of all parkinsonian syndromes. Atypical parkinsonian syndromes are the most important differential diagnoses of IPD. The two most frequent types are multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). For clinical diagnosis it is essential to take a careful medical history and to examine the patients physically in regular intervals. However, various clinico-pathological studies have shown that approx. 25% of patients with clinical diagnosis of IPD may have other causes of parkinsonism. Selected technical investigations, in particular functional imaging of the central dopaminergic system using PET or SPECT, may help to make clinical diagnosis more secure. This paper reviews the clinical features and diagnostic findings in diseases with parkinsonism and summarises the difficulties in establishing early and differential diagnoses. (orig.) [de

A knowledge based system for plant diagnosis

International Nuclear Information System (INIS)

Motoda, H.; Yamada, N.; Yoshida, K.

1984-01-01

A knowledge based system for plant diagnosis is proposed in which both event-oriented and function-oriented knowledge are used. For the proposed system to be of practical use, these two types of knowledge are represented by mutually nested four frames, i.e. the component, causality, criteriality, and simulator frames, and production rules. The system provides fast inference capability for use as both a production system and a formal reasoning system, with uncertainty of knowledge taken into account in the former. Event-oriented knowledge is used in both diagnosis and guidance and function-oriented knowledge, in diagnosis only. The inference capability required is forward chaining in the former and resolution in the latter. The causality frame guides in the use of event-oriented knowledge, whereas the criteriality frame does so for function-oriented knowledge. Feedback nature of the plant requires the best first search algorithm that uses histories in the resolution process. The inference program is written in Lisp and the plant simulator and the process I/O control programs in Fortran. Fast data transfer between these two languages is realized by enhancing the memory management capability of Lisp to control the numerical data in the global memory. Simulation applications to a BWR plant demonstrated its diagnostic capability

Diagnosis and Management of Iridocorneal Endothelial Syndrome

Science.gov (United States)

Sacchetti, Marta; Mantelli, Flavio; Macchi, Ilaria; Ambrosio, Oriella; Rama, Paolo

2015-01-01

The iridocorneal endothelial (ICE) syndrome is a rare ocular disorder that includes a group of conditions characterized by structural and proliferative abnormalities of the corneal endothelium, the anterior chamber angle, and the iris. Common clinical features include corneal edema, secondary glaucoma, iris atrophy, and pupillary anomalies, ranging from distortion to polycoria. The main subtypes of this syndrome are the progressive iris atrophy, the Cogan-Reese syndrome, and the Chandler syndrome. ICE syndrome is usually diagnosed in women in the adult age. Clinical history and complete eye examination including tonometry and gonioscopy are necessary to reach a diagnosis. Imaging techniques, such as in vivo confocal microscopy and ultrasound biomicroscopy, are used to confirm the diagnosis by revealing the presence of “ICE-cells” on the corneal endothelium and the structural changes of the anterior chamber angle. An early diagnosis is helpful to better manage the most challenging complications such as secondary glaucoma and corneal edema. Treatment of ICE-related glaucoma often requires glaucoma filtering surgery with antifibrotic agents and the use of glaucoma drainage implants should be considered early in the management of these patients. Visual impairment and pain associated with corneal edema can be successfully managed with endothelial keratoplasty. PMID:26451377

Diagnosis and treatment of orofacial pain in a patient with unserviceable complete dentures: A clinical report.

Science.gov (United States)

Selecman, Audrey M; Ahuja, Swati A

2018-02-08

An ill-fitting complete denture has the potential to create pain and discomfort as well as conceal or confound the diagnosis of other primary sources of orofacial pain such as trigeminal neuralgia. Guidelines of the American Academy of Orofacial Pain offer an evidence-based approach for the assessment, diagnosis, and management of orofacial pain. A complete and accurate differential diagnosis is paramount to the success of treatment as well as to the circumvention of unnecessary therapy. The purpose of this clinical report was to emphasize an evidence-based approach to the diagnosis and treatment of orofacial pain in a patient with edentulism and a history of prolonged denture wear. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

The reversed halo sign: update and differential diagnosis

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Godoy, M C B; Viswanathan, C; Marchiori, E; Truong, M T; Benveniste, M F; Rossi, S; Marom, E M

2012-01-01

The reversed halo sign is characterised by a central ground-glass opacity surrounded by denser air–space consolidation in the shape of a crescent or a ring. It was first described on high-resolution CT as being specific for cryptogenic organising pneumonia. Since then, the reversed halo sign has been reported in association with a wide range of pulmonary diseases, including invasive pulmonary fungal infections, paracoccidioidomycosis, pneumocystis pneumonia, tuberculosis, community-acquired pneumonia, lymphomatoid granulomatosis, Wegener granulomatosis, lipoid pneumonia and sarcoidosis. It is also seen in pulmonary neoplasms and infarction, and following radiation therapy and radiofrequency ablation of pulmonary malignancies. In this article, we present the spectrum of neoplastic and non-neoplastic diseases that may show the reversed halo sign and offer helpful clues for assisting in the differential diagnosis. By integrating the patient's clinical history with the presence of the reversed halo sign and other accompanying radiological findings, the radiologist should be able to narrow the differential diagnosis substantially, and may be able to provide a presumptive final diagnosis, which may obviate the need for biopsy in selected cases, especially in the immunosuppressed population. PMID:22553298

Neuroradiolological diagnosis and follow-up of brain tumors

International Nuclear Information System (INIS)

Kummer, R. von

1997-01-01

Primary tumors of the brain and cerebral metastases cause considerable morbidity and mortality. To assess the chance for cure and to develop a valid concept of treatment, the exact assessment of the tumor's location, of the tumor's borders and malignancy is essential. Today, neuroradiological examination mainly with magnetic resonance imaging (MRI) allows an almost histological diagnosis and description of the tumor's extent. MRI is as well useful for studying the patient's short- and long-term follow-up clinical course. This is illustrated by 3 case histories. (orig.)

Contributions of scintigraphy and sonography to the diagnosis of traumatic splenic lesions in children

International Nuclear Information System (INIS)

Soucy, J.P.; Danais, S.; Filiatrault, D.; Lamoureux, J.; Lamoureux, F.

1984-01-01

20 children who were sent to the Nuclear Medicine and Sonography services for evaluation of the spleen in the context of a history of abdominal trauma were studied. All but one of the children were treated conservately, the exception having had on emergency renal procedure performed for renal rupture. The working diagnosis, based on the clinical that of splenic trauma in all cases. The result show a sensitivity of 90% (2 false negatives) for scintigraphy, and of 30% (14 false negatives) for sonography for the non-invasive diagnosis of splenic trauma in children [fr

Contributions of scintigraphy and sonography to the diagnosis of traumatic splenic lesions in children

Energy Technology Data Exchange (ETDEWEB)

Soucy, J.P.; Danais, S.; Filiatrault, D.; Lamoureux, J.; Lamoureux, F. (Hopital Sainte-Justine, Montreal (Canada))

1984-01-01

20 children who were sent to the Nuclear Medicine and Sonography services for evaluation of the spleen in the context of a history of abdominal trauma were studied. All but one of the children were treated conservately, the exception having had on emergency renal procedure performed for renal rupture. The working diagnosis, based on the clinical, was that of splenic trauma in all cases. The results show a sensitivity of 90% (2 false negatives) for scintigraphy, and of 30% (14 false negatives) for sonography for the non-invasive diagnosis of splenic trauma in children.

ETIOLOGY, PATHOGENESIS AND CLINICAL DIAGNOSIS OF PEYRONIE’S DISEASE

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Тарас Валерьевич Шатылко

2017-03-01

Full Text Available Peyronie’s disease remains an understudied progressing disease being  one of the relevant problems of modern urology and andrology. This condition may cause erectile dysfunction in men of fertile age and its negative impact on sexual function adversely affects patients’ quality of life. This article reviews epidemiology, pathophysiology and specifics of recording history and clinical diagnosis of Peyronie’s disease, that includes questionnaires, physical examination, evaluation of erectile function and penile deformity.

Wolfram Syndrome: Diagnosis, Management, and Treatment.

Science.gov (United States)

Urano, Fumihiko

2016-01-01

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

Late diagnosis of testicular germ cell tumors and its impact on prognosis

International Nuclear Information System (INIS)

Puskacova, J.; Kolenova, A.; Mocna, A.; Cechvalova, A.; Kaiserova, E.; Molcan, J.

2015-01-01

Introduction: Testicular tumors in children and adolescents are rare diseases with very good prognosis. Biological characteristics of germ cell tumors depends on the type of histology, stage and age at the time of diagnosis. Case report: 14 years old boy was urgently admitted to the hospital because of hemoptysis. Chest X ray showed round shaped lesions bilaterally. Surprisingly, extremely enlarged left testicle was found. Ultrasound confirmed tumor in left testicle, tumor markers were elevated and dissemination in lungs, retroperitoneal lymph nodes and CNS as well, was present. Despite three chemotherapeutic regimens the patient died 8 months from the diagnosis. Conclusions: Testicular tumors in adolescent boys are usually diagnosed in advanced stage after several months history of continuous enlargement. Whole body examination of patients and self examination of testicles in pubertal boys could lead to earlier diagnosis and improve the chance to cure. (author)

Diagnosis and laparoscopic management of a rare endometriosis-related peritoneal mass with rapid growth in early pregnancy.

Science.gov (United States)

Di Donato, Nadine; Facchini, Chiara; Leggieri, Concetta; Caprara, Giacomo; Seracchioli, Renato

2015-08-01

Herein is described the diagnosis, clinical management and laparoscopic removal of a rapid growing retro-uterine mass in a pregnant woman. After laparoscopic removal of the pelvic mass, diagnosis of peritoneal endometriotic cyst was made on histology. The patient was asymptomatic and no history of endometriosis was reported. The laparoscopic management of the peritoneal mass was safe and effective and to our knowledge this is the first case report describing a decidualized endometriotic lesion in the absence of a pre-pregnancy endometriosis diagnosis. © 2015 The Authors Journal of Obstetrics and Gynaecology Research © 2015 Japan Society of Obstetrics and Gynecology.

Early Diagnosis of Avascular Necrosis of Bone Following Renal Transplantation By Bone Scan

International Nuclear Information System (INIS)

Shin, Hyun Ho; Kim, Han Su; Ihn, Chun Gyoo; Kim, Myung Jae

1982-01-01

Avascular necrosis of bone has become a well-recognized complication of renal transplantation. While preexisting metabolic bone disease, especially hyperparathyroidism, and metabolic disturbances induced by steroids have been implicated as etiological factors, the pathogenesis is controversial. The diagnosis of avascular necrosis of bone had been based on a history of joint pain and radiographic demonstration of bone necrosis. Recently the bone scan using 99m Tc-methylene diphosphonate is helpful in determining the early stage of bone necrosis. We report two cases of avascular necrosis of femur head, of which diagnosis was made by the bone scan using 99m Tc-methylene diphosphonate.

Risk factors for pancreatic cancer and early diagnosis of pancreatic cancer

International Nuclear Information System (INIS)

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

2008-01-01

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

Impact of smoking on the age at diagnosis of upper tract urothelial carcinoma: Subanalysis of the Japanese Urological Association multi-institutional national database.

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Miyazaki, Jun; Nishiyama, Hiroyuki; Fujimoto, Hiroyuki; Ohyama, Chikara; Koie, Takuya; Hinotsu, Shiro; Kikuchi, Eiji; Sakura, Mizuaki; Inokuchi, Junichi; Hara, Tomohiko

2015-11-01

To examine the influence of smoking history on the diagnosis and other tumor characteristics of upper tract urothelial carcinoma in Japan. A total of 1509 patients with upper tract urothelial carcinoma who were diagnosed in 2005 from 348 Japanese institutions were registered using the multi-institutional national database of the Japanese Urological Association and included in this analysis. Clinical data of the patients were collected in 2011. The associations between the patients' self-reported smoking history and their age at the diagnosis of upper tract urothelial carcinoma, sex, pathological T stage and tumor grade were analyzed. The mean age at the diagnosis of upper tract urothelial carcinoma was approximately 5 years earlier for the 238 current smokers than for the 618 current non-smokers (P smokers, the age at diagnosis for the smoking ≥ 20 cigarettes per day group was 6.5 years lower than that of the perspective of both healthcare and medical economies. © 2015 The Japanese Urological Association.

HNPCC (Lynch Syndrome): Differential Diagnosis, Molecular Genetics and Management - a Review

Science.gov (United States)

2003-01-01

HNPCC (Lynch syndrome) is the most common form of hereditary colorectal cancer (CRC), wherein it accounts for between 2-7 percent of the total CRC burden. When considering the large number of extracolonic cancers integral to the syndrome, namely carcinoma of the endometrium, ovary, stomach, hepatobiliary system, pancreas, small bowel, brain tumors, and upper uroepithelial tract, these estimates of its frequency are likely to be conservative. The diagnosis is based upon its natural history in concert with a comprehensive cancer family history inclusive of all anatomic sites. In order for surveillance and management to be effective and, indeed, lifesaving, among these high-risk patients, the linchpin to cancer control would be the physician, who must be knowledgeable about hereditary cancer syndromes, their molecular and medical genetics, genetic counseling, and, most importantly, the natural history of the disorders, so that the entirety of this knowledge can be melded to highly-targeted management.

A sexually transmitted disease: History of AIDS through philately.

Science.gov (United States)

Vatanoğlu, Emine Elif; Ataman, Ahmet Doğan

2011-01-01

AIDS has become the new plague; a disease that is not only physically and psychologically debilitating, but culturally and socially devastating as well. Like the plague, AIDS has caused fear, prejudice and even panic in society. Although there are remarkable improvements in the diagnosis and treatment of the disease, AIDS continues its grim passage around the globe. After a slight downturn in the early 1990's, it then returned with a vengeance. By the end of the 20(th) century, AIDS was reliably estimated to have caused over 20 million deaths throughout the world. At the same time, 40 million people were estimated to be HIV positive. This paper provides an overview of the history of AIDS, including the discovery and its progress in the world through philately. Philately is the study of stamps and postal history and other related items. Philately involves more than just stamp collecting, it contains the study of the design and educational impact of a philatelic material. We have presented AIDS stamps produced world-wide to emphasize the history of AIDS.

Golden Trail: Retrieving the Data History that Matters from a Comprehensive Provenance Repository

Directory of Open Access Journals (Sweden)

Paolo Missier

2012-03-01

Full Text Available Experimental science can be thought of as the exploration of a large research space, in search of a few valuable results. While it is this “Golden Data” that gets published, the history of the exploration is often as valuable to the scientists as some of its outcomes. We envision an e-research infrastructure that is capable of systematically and automatically recording such history – an assumption that holds today for a number of workflow management systems routinely used in e-science. In keeping with our gold rush metaphor, the provenance of a valuable result is a “Golden Trail”. Logically, this represents a detailed account of how the Golden Data was arrived at, and technically it is a sub-graph in the much larger graph of provenance traces that collectively tell the story of the entire research (or of some of it.In this paper we describe a model and architecture for a repository dedicated to storing provenance traces and selectively retrieving Golden Trails from it. As traces from multiple experiments over long periods of time are accommodated, the trails may be sub-graphs of one trace, or they may be the logical representation of a virtual experiment obtained by joining together traces that share common data.The project has been carried out within the Provenance Working Group of the Data Observation Network for Earth (DataONE NSF project. Ultimately, our longer-term plan is to integrate the provenance repository into the data preservation architecture currently being developed by DataONE.

Juvenile Papillomatosis of the Breast in a Pre-Pubertal Girl: An Uncommon Diagnosis.

Science.gov (United States)

Kafadar, Mehmet Tolga; Anadolulu, Zeynep; Anadolulu, Ali İhsan; Tarini, Emine Zeynep

2018-01-01

Juvenile papillomatosis of the breast represents a rare benign proliferative disorder that affects women younger than thirty years of age. Although it is a localized lesion, it does not have well-demarcated margins. These patients tend to have a strong family history for cancer. As it has similar clinical presentation with that of a fibroadenoma, it usually receives the diagnosis of the latter in the preoperative period. Nonetheless, it has distinct microscopic features such as ductal papillomatosis and cysts that are helpful in the diagnosis. In this article, a case of juvenile papillomatosis diagnosed in a young girl who presented due to a mass of the breast was presented. For the fairly rare case, a total mass excision was performed with preserved breast tissue. The exact diagnosis was made by postoperative histopathological examination.

Slow-growing labyrinthine masses: contribution of MRI to diagnosis, follow-up and treatment

Energy Technology Data Exchange (ETDEWEB)

Deux, J F; Marsot-Dupuch, K; Tubiana, J M [Hopital Saint-Antoine, Paris (France). Service de Radiology; Ouayoun, M; Meyer, B [Service d` ORL, Hopital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, F-75012 Paris (France); Tran Ba Huy, P [Service d` ORL, Hopital Lariboisiere, 2 rue Ambroise Pare, F-75010 Paris (France); Sterkers, J M

1998-10-01

We report the use of MRI in the diagnosis, follow-up and therapeutic management of three cases of intralabyrinthine Schwannoma. The diagnosis was based on the history and initial and follow-up MRI findings. The main feature suggesting the diagnosis was a nodular intralabyrinthine mass of low signal intensity on T2-weighted images, and high or isointense signal on T1-weighted images (relative to cerebrospinal fluid), which showed contrast enhancement. Follow-up imaging showed growth of the tumour in one patient. One patient underwent surgery for severe tinnitus. To detect these lesions, MRI should be focussed on the inner ear, using thin-section T2-weighted and T1-weighted images before and after contrast medium. MRI allowed informed surgical planning. (orig.) (orig.) With 3 figs., 1 tab., 21 refs.

Assessment of Risk of Violent Behavior in Female Psychiatric Patients with a Criminal History

Directory of Open Access Journals (Sweden)

Makurina A.P.,

2014-11-01

Full Text Available We present the results of study of illegal actions predictors in individuals with mental disorders and discuss the specific features of female criminality. On a sample of 69 patients with a diagnosis of organic mental disorder and schizophrenia, with criminal histories, we applied clinical and psychological hermeneutic analysis, used questionnaires to determine the self-assessments of patients, self-control diagnosis, self-regulation style features, diagnosis of aggression and hostility, coping strategies, destructive attitudes in interpersonal relationships. It made possible to identify clinical, social and pathopsychological factors of aggressive behavior in forensic patients. These individual psychological characteristics of mentally ill women will improve the prognosis of their aggressive behavior, implement differentiated preventive measures in the hospital and to establish appropriate intervention programs

History and Physical Examination for Shoulder Instability.

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Haley, Col Chad A

2017-09-01

Glenohumeral instability frequently occurs in young active individuals especially those engaged in athletic and military activities. With advanced imaging and arthroscopic evaluation, our understanding of the injury patterns associated with instability has significantly improved. The majority of instability results from a traumatic anterior event which presents with common findings in the history, examination, and imaging studies. As such, a comprehensive evaluation of the patient is important to correctly diagnose the instability patterns and thus provide appropriate treatment intervention. With the correct diagnosis and improved surgical techniques, the majority of patients with instability can return to preinjury levels.

Bedside Ultrasound for the Diagnosis of Small Bowel Obstruction

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Alexander Anshus

2017-09-01

Full Text Available History of present illness: An elderly female with no history of prior abdominal surgeries presented to the emergency department (ED with acute onset of abdominal pain and distention. Upon arrival, she began having large volume bilious emesis. While waiting for a computed tomography (CT scan of her abdomen and pelvis, a point of care ultrasound (POCUS was performed which showed evidence of a small bowel obstruction (SBO. The patient had a nasogastric tube placed that put out over two liters of bilious contents. A subsequent CT scan confirmed the diagnosis of SBO from a left inguinal hernia and the patient was admitted to the surgical service. Significant findings: The POCUS utilizing the low frequency curvilinear probe demonstrates fluid-filled, dilated bowel loops greater than 2.5cm with to-and-fro peristalsis, and thickened bowel walls greater than 3mm, concerning for SBO. Discussion: Gastrointestinal obstruction is a common diagnosis in the ED, accounting for approximately 15% of all ED visits for acute abdominal pain.1 SBO accounts for approximately 80% of all obstructions.2 In the diagnosis of SBO, studies show that abdominal x-rays have a sensitivity of 66-77% and specificity of 50-57%,3 CT scans have a sensitivity of 92% and specificity of 93%,4 and ultrasound has a sensitivity of 88% and specificity of 96%.5 While CT scan remains a widely accepted modality for diagnosing SBO, ultrasound is more cost effective, well tolerated, does not involve ionizing radiation, and can be done in a timely manner at the patient’s bedside. Ultrasound can also identify transition points as well as distinguish between functional and mechanical obstruction.6 In addition to SBO, ultrasound can be used to diagnose external hernias, intussusception, tumors, superior mesenteric artery (SMA syndrome, foreign bodies, bezoars, and ascariasis.7

[Differential diagnosis of abdominal pain].

Science.gov (United States)

Frei, Pascal

2015-09-02

Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain.

MRI diagnosis of meningovascular neurosyphilis

International Nuclear Information System (INIS)

Chen Shuang; Qian Jianguo; Feng Xiaoyuan

2005-01-01

Objective: To evaluate the value and limitation of MRI in the diagnosis of meningovascular neurosyphilis. Methods: Five cases of neurosyphilis confirmed by clinical history/laboratory were examined with MRI (3 plain MRI, 2 enhanced MRI). The results of blood and CSF TPPA/RPR were positive and HIV was negative. Results: Abnormal signals were demonstrated in the temporal lobe in 3 cases, and infarction was revealed in the basal ganglion and periventricular white matter in another 2 cases. There was no marked contrast enhancement in the 2 cases. Conclusion: Meningovascular neurosyphilis has no characteristic features on MRI, but MRI is an effective method in delineating the size, range, and characters of neurosyphilis, and it is also an useful modality to follow-up after antibiotic therapy. (authors)

CLINICAL FEATURES AND PATTERN OF FRACTURES AT THE TIME OF DIAGNOSIS OF OSTEOGENESIS IMPERFECTA IN CHILDREN.

Science.gov (United States)

Brizola, Evelise; Zambrano, Marina Bauer; Pinheiro, Bruna de Souza; Vanz, Ana Paula; Félix, Têmis Maria

2017-01-01

To characterize the fracture pattern and the clinical history at the time of diagnosis of osteogenesis imperfecta. In this retrospective study, all patients with osteogenesis imperfecta, of both genders, aged 0-18 years, who were treated between 2002 and 2014 were included. Medical records were assessed to collect clinical data, including the presence of blue sclerae, dentinogenesis imperfecta, positive familial history of osteogenesis imperfecta, and the site of the fractures. In addition, radiographic findings at the time of the diagnosis were reviewed. Seventy-six patients (42 females) were included in the study. Individuals' age ranged from 0 to 114 months, with a median (interquartile range) age of 38 (6-96) months. Blue sclerae were present in 93.4% of patients, dentinogenesis imperfecta was observed in 27.6% of patients, and wormian bones in 29.4% of them. The number of fractures at diagnosis ranged from 0 to 17, with a median of 3 (2-8) fractures. Forty (57%) patients had fractures of the upper and lower extremities, and 9 patients also had spinal fractures. The diagnosis was performed at birth in 85.7% of patients with type 3, and 39.3% of those with type 4/5 of the disorder. Osteogenesis imperfecta is a genetic disorder with distinctive clinical features such as bone fragility, recurrent fractures, blue sclerae, and dentinogenesis imperfecta. It is important to know how to identify these characteristics in order to facilitate the diagnosis, optimize the treatment, and differentiate osteogenesis imperfecta from other disorders that also can lead to fractures.

Film reading in the East Midlands Breast Screening Programme – Are we missing opportunities for earlier diagnosis?

International Nuclear Information System (INIS)

Jenkins, J.; Murphy, A.E.; Edmondson-Jones, M.; Sibbering, D.M.; Turnbull, A.E.

2014-01-01

Aim: To assess whether there are any significant differences in the film-reading histories of interval or screen-detected cancers, and whether this affects stage at diagnosis. Materials and methods: The rates of screen-detected and interval cancers (overall and by radiological categorization) were observed from 268,067 women screened in the East Midlands Breast Screening Programme over 2004–2007 to assess whether there were differences in incidence based on previous film-reading history. Cancers detected at the subsequent screen and film-reading history were analysed to assess whether this affected stage at diagnosis. Analysis undertaken involved cancer detection rates, confidence intervals, and chi-square tests with Monte Carlo simulation. Results: Rates of interval cancers were similar in all groups where at least one reader had indicated recall to assessment (6.1–7.7/1000) and were significantly higher in comparison to women whose previous film-reading outcome was unanimous routine rescreen (2.9/1000; p < 0.001). Four point one percent of interval cancers with no previous recall outcomes were false negatives, which was significantly lower compared to the groups where at least one reader had indicated recall (10.9%; p = 0.005). Cancers detected at the subsequent screen demonstrated no significant difference in prognosis dependent on previous film-reading history (p = 0.503). Conclusion: The prognosis of screen-detected cancers was similar and few cancers were false negatives regardless of film-reading history at the previous screen

Prostate cancer risk prediction based on complete prostate cancer family history.

Science.gov (United States)

Albright, Frederick; Stephenson, Robert A; Agarwal, Neeraj; Teerlink, Craig C; Lowrance, William T; Farnham, James M; Albright, Lisa A Cannon

2015-03-01

Prostate cancer (PC) relative risks (RRs) are typically estimated based on status of close relatives or presence of any affected relatives. This study provides RR estimates using extensive and specific PC family history. A retrospective population-based study was undertaken to estimate RRs for PC based on complete family history of PC. A total of 635,443 males, all with ancestral genealogy data, were analyzed. RRs for PC were determined based upon PC rates estimated from males with no PC family history (without PC in first, second, or third degree relatives). RRs were determined for a variety of constellations, for example, number of first through third degree relatives; named (grandfather, father, uncle, cousins, brothers); maternal, paternal relationships, and age of onset. In the 635,443 males analyzed, 18,105 had PC. First-degree RRs ranged from 2.46 (=1 first-degree relative affected, CI = 2.39-2.53) to 7.65 (=4 first-degree relatives affected, CI = 6.28-9.23). Second-degree RRs for probands with 0 affected first-degree relatives ranged from 1.51 (≥1 second-degree relative affected, CI = 1.47-1.56) to 3.09 (≥5 second-degree relatives affected, CI = 2.32-4.03). Third-degree RRs with 0 affected first- and 0 affected second-degree relatives ranged from 1.15 (≥1 affected third-degree relative, CI = 1.12-1.19) to 1.50 (≥5 affected third-degree relatives, CI = 1.35-1.66). RRs based on age at diagnosis were higher for earlier age at diagnoses; for example, RR = 5.54 for ≥1 first-degree relative diagnosed before age 50 years (CI = 1.12-1.19) and RR = 1.78 for >1 second-degree relative diagnosed before age 50 years, CI = 1.33, 2.33. RRs for equivalent maternal versus paternal family history were not significantly different. A more complete PC family history using close and distant relatives and age at diagnosis results in a wider range of estimates of individual RR that are potentially more accurate than RRs estimated

The psychosocial impact of serological diagnosis of asymptomatic herpes simplex virus type 2 infection.

Science.gov (United States)

Rosenthal, S L; Zimet, G D; Leichliter, J S; Stanberry, L R; Fife, K H; Tu, W; Bernstein, D I

2006-04-01

To evaluate the impact of a positive herpes simplex virus type 2 (HSV-2) serological test on psychosocial functioning among people with no known history of genital herpes. Individuals (age 14-30 years) without a history of genital herpes were recruited from an urban university setting and sexually transmitted diseases (STD), primary care, and adolescent clinics. Participants completed a questionnaire addressing psychological functioning, psychosocial adjustment, and perceived quality of sex and were offered free HSV-2 antibody testing. 33 HSV-2 positive people and 60 HSV-2 negative people demographically matched from the same source of recruitment were re-evaluated at a 3 month follow up visit. HSV-2 positive participants also completed a genital herpes quality of life (GHQOL) measure. Of the 33 who were HSV-2 seropositive, four did not recall their diagnosis. In comparing those who were HSV-2 positive with those who were negative, repeated measures analysis of variance indicated there were no significant differences over time on any of the measures. None the less, many HSV-2 positive individuals indicated that the diagnosis had a notable impact on their quality of life. Also, among the HSV-2 positive people, lower GHQOL at the 3 month follow up was predicted by higher interpersonal sensitivity (r = -0.44, p<0.05), lower social support (r = 0.40, p<0.05), and quality of sex (r = 0.62, p<0.01) at baseline. A diagnosis of asymptomatic HSV-2 infection does not appear to cause significant lasting psychological difficulties. Those for whom the diagnosis had the greatest impact were interpersonally vulnerable before the diagnosis. These results suggest that assessment of interpersonal distress may be important to include as part of pretest and post-test counselling.

Factors influencing diagnosis delay of advanced breast cancer in Moroccan women.

Science.gov (United States)

Maghous, A; Rais, F; Ahid, S; Benhmidou, N; Bellahamou, K; Loughlimi, H; Marnouche, E; Elmajjaoui, S; Elkacemi, H; Kebdani, T; Benjaafar, N

2016-06-07

Delay in the diagnosis of breast cancer in symptomatic women of 3 months or more is associated with advanced stage and low survival. We conducted this study to learn more about the extent and reasons behind diagnosis delay of advanced breast cancer in Moroccan women. A group of patients with advanced breast cancer were interviewed at the National Institute of Oncology in Rabat during the period from February to December 2014. Diagnosis delay was devised into patient delay and system delay. Patient delay was defined as time from first symptoms until first medical consultation. System delay was defined as time from first presentation to a health care provider until definite diagnosis or treatment. Prospective information and clinical data were collected on a form during an interview with each patient and from medical records. In all, 137 patients were interviewed. The mean age of women was 48.3 ± 10.4 years. The median of consultation time was 6[4,12] months and the median of diagnosis time was 1[1,3] months. Diagnosis delay was associated to a personal reason in 96 (70.1 %) patients and to a medical reason in 19 (13.9 %) patients. A number of factors predicted diagnosis delay: symptoms were not considered serious in 66 (55.9 %) patients; traditional therapy was applied in 15 (12.7 %) patients and fear of cancer diagnosis and/or treatment in 14 (11.9 %) patients. A use of traditional methods was significantly associated with rural residence and far away from basic health center (p = 0.000). Paradoxically, a family history of breast cancer was significantly higher in who report a fear of cancer diagnosis and/or treatment to diagnosis delay (p Diagnosis delay is very serious problem in Morocco. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer information in our populations and training of general practitioners to reduce advanced breast cancer by

The ESPGHAN Revised Porto Criteria for the Diagnosis of Inflammatory Bowel Disease in Children and Adolescents

DEFF Research Database (Denmark)

Levine, Arie; Koletzko, Sibylle; Turner, Dan

2014-01-01

The diagnosis of pediatric-onset IBD (PIBD) can be challenging in choosing the most informative diagnostic tests and correctly classifying PIBD into its different subtypes. Recent advances in our understanding of the natural history and phenotype of PIBD, increasing availability of serological an...

Preoperative Diagnosis of Adult Intussusception Caused by Small Bowel Lipoma

Directory of Open Access Journals (Sweden)

Hiroaki Shiba

2009-11-01

Full Text Available Adult intussusception is rare, accounting for only 5% of all intussusceptions, for which preoperative diagnosis is difficult. We herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma. A 33-year-old man was admitted to our hospital with three weeks history of colicky epigastric pain. Computed tomography revealed thickening of the ileal wall suggestive of intussusception. Colonoscopy revealed an ileocolic intussusception. Barium enema for reduction of ileocolic intussusception demonstrated a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve. The intussusception was reduced, and the patient underwent partial resection of the ileum encompassing the small bowel tumor. Histological findings confirmed the diagnosis of lipoma of the small bowel. The patient made a satisfactory recovery and remains well.

[Laypersons can seek help from their Facebook friends regarding medical diagnosis].

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Folkestad, Lars; Brodersen, Jacob Broder; Hallas, Peter; Brabrand, Mikkel

2011-12-05

In contrast to Internet search engines, social media on the Internet such as Facebook, Twitter, etc. reach a large number of people, who are ready to help answering questions. This type of information aggregation has been dubbed "crowdsourcing" i.e. outsourcing a task to a large group of people or community (a crowd) through an open call. Our aim was to explore whether laypersons via Facebook friends could crowd source their way to a medical diagnosis based on a brief medical history, posted as a status update on Facebook. The participants posted a brief case story on their Facebook profile and asked their "Facebook friends" to come up with possible diagnoses. The correct diagnosis was suggested in five of the six case stories, and the correct diagnosis was made after a median of ten minutes. The quality of the responses varied from relevant differential diagnoses to very silly diagnostic suggestions. Based on this study, we believe that laypersons can use his or her "Facebook friends" to identify the need to see a doctor for their symptoms rather than relying on them to give them a specific diagnosis for their symptoms.

HNPCC (Lynch Syndrome: Differential Diagnosis, Molecular Genetics and Management - a Review

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Lynch Henry T

2003-12-01

Full Text Available Abstract HNPCC (Lynch syndrome is the most common form of hereditary colorectal cancer (CRC, wherein it accounts for between 2-7 percent of the total CRC burden. When considering the large number of extracolonic cancers integral to the syndrome, namely carcinoma of the endometrium, ovary, stomach, hepatobiliary system, pancreas, small bowel, brain tumors, and upper uroepithelial tract, these estimates of its frequency are likely to be conservative. The diagnosis is based upon its natural history in concert with a comprehensive cancer family history inclusive of all anatomic sites. In order for surveillance and management to be effective and, indeed, lifesaving, among these high-risk patients, the linchpin to cancer control would be the physician, who must be knowledgeable about hereditary cancer syndromes, their molecular and medical genetics, genetic counseling, and, most importantly, the natural history of the disorders, so that the entirety of this knowledge can be melded to highly-targeted management.

History or histories of socio-economic rights?

DEFF Research Database (Denmark)

Christiansen, Christian O.

2016-01-01

The German historian Reinhart Koselleck was once described as a partisan for histories in the plural (as opposed to history in the singular). His point was that history has many different layers, logics, and temporalities and that the modernist idea of one, overarching history with one direction ......) at work in the histories and dynamics of socio-economic rights. More specifically, I propose a list of eight important variables that may help explain the dynamics of the histories of socio-economic rights - their failures as well as their successes....... (telos) – be it towards progress or decline – was inadequate for the multi-faceted geographies, rhythms and dynamics of life. In these reflections on a two-days research workshop in Paris, I argue that Koselleck’s point also applies to the field of the history of socio-economic rights. Instead of writing...... the history of socio-economic rights, I would propose thinking about the histories of socio-economic rights. There are three main reasons for this: the non-teleological histories of socioeconomic rights; the distinctiveness between different socio-economic rights; and the complexity (multiple variables...

Clinical presentation of retinoblastoma in Alexandria: A step toward earlier diagnosis.

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Soliman, Sameh E; Eldomiaty, Wesam; Goweida, Mohamed B; Dowidar, Amgad

2017-01-01

To evaluate the clinical presentation of retinoblastoma in Alexandria, Egypt, correlate the timing of accurate diagnosis with the presence of advanced disease and identify causes of delayed presentation. Retrospective noncomparative single institution study reviews demographic and clinical data of all new children with retinoblastoma presenting to Alexandria Main University ocular oncology clinic (OOC) from January 2012 to June 2014. Diagnosis time was from initial parental complaint to retinoblastoma diagnosis and referral time was from retinoblastoma diagnosis to presentation to the Alexandria OCC. Delayed Diagnosis and referral were counted if >2 weeks. Advanced presentation is defined as clinical TNMH (8th edition) staging of cT2 or cT3 (international intraocular retinoblastoma classification group D or E) in at least one eye or the presence of extra-ocular disease (cT4). Seventy eyes of 47 children were eligible: 52% unilateral, 7% with family history and 96% presented with leukocorea. Sixty-four percent of children had advanced intraocular disease and none had extra-ocular disease. Delayed presentation occurred in 58% of children and was significantly associated with advanced disease in both unilaterally and bilaterally affected children (p = 0.003, 0.002 respectively). The delay in diagnosis was more in unilateral cases while the delay in referral was more in bilateral cases. The main cause of delayed presentation in unilateral retinoblastoma was misdiagnosis (30%) while parental shopping for second medical opinion (30%) was the main cause in bilateral children. Delayed diagnosis is a problem affecting retinoblastoma management. Better medical education and training, health education and earlier screening are recommended to achieve earlier diagnosis.

Diagnostic delay in malignant pleural mesothelioma due to physicians fixation on history with non-exposure to asbestos

DEFF Research Database (Denmark)

Madsen, Poul Henning; Laursen, Christian B.; Davidsen, Jesper Rømhild

2013-01-01

To establish the diagnosis of virtually any disease, the clinician must combine a variety of information. Often emphasised in this context is thorough medical history-taking including information on exposure to factors leading to or being associated with the disease in question. Continuous...... assessment of all available information is of utmost importance, as fixation on single details can be misguiding with inappropriate consequences in both the diagnostic and therapeutic approach. This case report presents how an atypical medical history led to a delay in the diagnosis of malignant pleural...... mesothelioma due to a low a priori likelihood of the disease because of non-exposure to asbestos. We highlight the fact that postrationalisation and attempts to renew a diagnostic approach must be carried out each time diagnostic dilemmas emerge, and when some or all diagnostic clues disagree....

The natural history of Perthes' disease.

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Terjesen, Terje; Wiig, Ola; Svenningsen, Svein

2010-12-01

The prognosis in Perthes' disease varies considerably according to certain risk factors, but there is no concensus regarding the relative importance of these factors. We assessed the natural history of the disease and defined prognostic factors of value in deciding the proper treatment. During the 5-year period 1996-2000, a nationwide study on Perthes' disease was performed in Norway. 425 patients were registered. The present study involved the 212 children (mean age 5.1 years, 77% boys) who were affected unilaterally and who had been treated with physiotherapy only (which is considered not to change the natural history). They were followed by taking radiographs at the time of diagnosis and after 1, 3, and 5 years. At the 5-year follow-up, the outcome was evaluated according to a modification of the Stulberg classification: good (spherical femoral head), fair (ovoid femoral head), and poor (flat femoral head). The 5-year radiographic results were strongly dependent on 4 risk factors: age 6 years or more at diagnosis, total femoral head necrosis, height of the lateral pillar of the epiphysis less than 50% of normal height, and femoral head cover less than 80%. As the number of risk factors increased from 0 to 4, the proportion of patients with good radiographic 5-year outcome decreased from 79% to 0% and the proportion with poor outcome increased from 3% to 91%. Most children under 6 years of age do not need any special treatment. In older children, no special treatment is indicated if the whole femoral head is not necrotic and the femoral head cover is > 80%. In the most severe forms of the disease (i.e. more than 2 risk factors), surgical containment treatment seems advisable.

The definition and natural history of severe exacerbation of hepatitis B

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GUO Wei

2014-10-01

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

Diagnosis of functional (psychogenic paresis and weakness

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Savkov V.S.

2018-03-01

Full Text Available Functional (conversion neurological symptoms represent one of the most common situations faced by neurologists in their everyday practice. Among them, acute or subacute functional weakness may mimic very prevalent conditions such as stroke or traumatic injury. In the diagnosis of functional weakness, although elements of the history are helpful, physical signs are often of crucial importance in the diagnosis and positive signs are as important as absence of signs of disease. Hence, accurate and reliable positive signs of functional weakness are valuable for obtaining timely diagnosis and treatment, making it possible to avoid unnecessary or invasive tests and procedures up to thrombolysis. Functional weakness commonly presents as weakness of an entire limb, paraparesis, or hemiparesis, with observable or demonstrable inconsistencies and non-anatomic accompaniments. Documentation of limb movements during sleep, the arm drop test, the Babinski’s trunk-thigh test, Hoover tests, the Sonoo abductor test, and various dynamometer tests can provide useful bedside diagnostic information on functional weakness. We therefore present here a brief overview of the positive neurological signs of functional weakness available, both in the lower and in the upper limbs; but none should be used in isolation and must be interpreted in the overall context of the presentation. It should be borne in mind that a patient may have both a functional and an organic disorder.

History of trauma and posttraumatic disorders in literature.

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Kucmin, Tomasz; Kucmin, Adriana; Nogalski, Adam; Sojczuk, Sebastian; Jojczuk, Mariusz

2016-01-01

In 1980 a third edition of Diagnostic and Statistical Manual of Mental Disorders (DSM) brought diagnostic criteria for a new diagnosis - posttraumatic stress disorder (PTSD). This disorder is a result of highly intensive stressor and in many cases leads to sever psychiatric distress. Despite relatively recent introduction of PTSD as a new diagnosis, this disorder was excessively described in scientific papers as well as in fiction novels. Analysis of those descriptions across ages allows for the conclusion that character and type of stressors has changed, however, people's reactions to highly intensive stressors are basically similar. First descriptions are found in notes of Egyptian physicians and then in papers of Homer, Herodotus and Plutarch. In consecutive parts of this paper, the authors present history of posttraumatic stress disorder describing contribution of Polish authors - Kepiński and Szymusik. Presented historical perspective of posttraumatic stress disorder allows for better understanding of reasons for introducing PTSD into classifications as well as controversies related to it.

Radiographer's impact on improving clinical decision-making, patient care and patient diagnosis: a pilot study

International Nuclear Information System (INIS)

Lam, Daniel; Egan, Ingrid; Baird, Marilyn

2004-01-01

This pilot study attempts to quantify the benefits of a documented radiographic clinical history through the use of the clinical history template form designed by Egan and Baird. Six radiographers completed the clinical history template for 40 patients and four radiologists included the recorded information as part of their reporting process. A focus discussion group was held between the radiographers to ascertain the level of satisfaction and benefits encountered with the use of the template form. A questionnaire was designed for the radiologists to complete regarding the usefulness of the template form with respect to the radiological reporting process. Results/Discussion: 15 cases for which the form was used demonstrated a direct benefit in respect to improved radiographic clinical decision-making. Radiographers agreed the template form aided the establishment of a stronger radiographer-patient relationship during the radiographic examination. Two radiologists agreed the form aided in establishing a radiological diagnosis and suggested the form be implemented as part of the standard departmental protocol. Despite the small sample size, there is evidence the form aided radiographic decision-making and assisted in the establishment of an accurate radiological diagnosis. The overall consensus amongst radiographers was that it enhanced radiographer-patient communication and improved the level of patient care. Copyright (2004) Australian Institute of Radiography

Early Diagnosis of Avascular Necrosis of Bone Following Renal Transplantation By Bone Scan

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Shin, Hyun Ho; Kim, Han Su; Ihn, Chun Gyoo; Kim, Myung Jae [Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

1982-09-15

Avascular necrosis of bone has become a well-recognized complication of renal transplantation. While preexisting metabolic bone disease, especially hyperparathyroidism, and metabolic disturbances induced by steroids have been implicated as etiological factors, the pathogenesis is controversial. The diagnosis of avascular necrosis of bone had been based on a history of joint pain and radiographic demonstration of bone necrosis. Recently the bone scan using {sup 99m}Tc-methylene diphosphonate is helpful in determining the early stage of bone necrosis. We report two cases of avascular necrosis of femur head, of which diagnosis was made by the bone scan using {sup 99m}Tc-methylene diphosphonate.

History of thyroid disease and survival of ovarian cancer patients: results from the Ovarian Cancer Association Consortium, a brief report.

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Minlikeeva, Albina N; Freudenheim, Jo L; Cannioto, Rikki A; Eng, Kevin H; Szender, J Brian; Mayor, Paul; Etter, John L; Cramer, Daniel W; Diergaarde, Brenda; Doherty, Jennifer A; Dörk, Thilo; Edwards, Robert; deFazio, Anna; Friel, Grace; Goodman, Marc T; Hillemanns, Peter; Høgdall, Estrid; Jensen, Allan; Jordan, Susan J; Karlan, Beth Y; Kjær, Susanne K; Klapdor, Rüdiger; Matsuo, Keitaro; Mizuno, Mika; Nagle, Christina M; Odunsi, Kunle; Paddock, Lisa; Rossing, Mary Anne; Schildkraut, Joellen M; Schmalfeldt, Barbara; Segal, Brahm H; Starbuck, Kristen; Terry, Kathryn L; Webb, Penelope M; Zsiros, Emese; Ness, Roberta B; Modugno, Francesmary; Bandera, Elisa V; Chang-Claude, Jenny; Moysich, Kirsten B

2017-09-26

Findings from in vitro studies suggest that increased exposure to thyroid hormones can influence progression of ovarian tumours. However, epidemiologic evidence on this topic is limited. We pooled data from 11 studies from the Ovarian Cancer Association Consortium. Using multivariate Cox proportional hazards models, we estimated associations between hyper- and hypothyroidism and medications prescribed for these conditions with 5-year all-cause survival among women diagnosed with invasive ovarian cancer. Overall, there was a nonsignificant association with history of hyperthyroidism (n=160 cases) and mortality (HR=1.22; 95% CI=0.97-1.53). Furthermore, diagnosis of hyperthyroidism within the 5 years before ovarian cancer diagnosis was associated with an increased risk of death (HR=1.94; 95% CI=1.19-3.18). A more modest association was observed with history of hypothyroidism (n=624 cases) and mortality (HR=1.16; 95% CI=1.03-1.31). Neither duration of hypothyroidism nor use of thyroid medications was associated with survival. In this large study of women with ovarian cancer, we found that recent history of hyperthyroidism and overall history of hypothyroidism were associated with worse 5-year survival.

Importance of spontaneous nystagmus detection in the differential diagnosis of acute vertigo.

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Pavlin-Premrl, Davor; Waterston, John; McGuigan, Sean; Infeld, Bernard; Sultana, Ron; O'Sullivan, Richard; Gerraty, Richard P

2015-03-01

Vertigo is a common cause of emergency department attendance. Detection of spontaneous nystagmus may be a useful sign in distinguishing vestibular neuritis from other vestibular diagnoses. We aimed to assess the contribution of spontaneous nystagmus in the diagnosis of acute vertigo. We enrolled consecutive consenting patients arriving at a single emergency department with acute vertigo. There was no declared protocol for the emergency department staff. A standardized history and examination was conducted by the investigators. Observation for spontaneous nystagmus, its response to visual fixation, and testing the vestibulo-ocular reflex with the horizontal head impulse test were the chief examination components. MRI was obtained within 24 hours. Clinical criteria and MRI were used to reach the final diagnosis. The investigators' physical findings and final neurological diagnosis were compared with the initial emergency department examination findings and the referral diagnosis. There were 28 patients, 15 with vestibular neuritis, six with benign paroxysmal positional vertigo, one with stroke, suspected clinically, and three with migraine. In three the diagnosis remained uncertain. Spontaneous nystagmus was seen in all 15 patients with vestibular neuritis, fixation-suppressed in eight of 11 tested for this. The head impulse test was positive in 12 of 15 with vestibular neuritis. The emergency department referral diagnosis was correct in six of 23 patients. The ability to detect spontaneous nystagmus is useful in vestibular diagnosis, both in support of a diagnosis of vestibular neuritis and in avoiding false positive diagnoses of benign paroxysmal positional vertigo. Copyright © 2014 Elsevier Ltd. All rights reserved.

Malignant Mesothelioma of Spermatic Cord in an Elderly Man With a History of Asbestos Exposure.

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D'Antonio, Antonio; Mastella, Federica; Colucci, Angelo; Silvestre, Gianmarco

2016-01-01

We report a case of malignant mesothelioma of the spermatic cord in 80-year-old man presented with retained testis, hydrocele, and right inguinal mass. The patient had a long history of asbestos exposure as a railway worker. The patient was submitted to inguinal radical orchiectomy. One year after surgery, the patient is alive without signs of disease. Malignant mesothelioma of spermatic cord is a very rare disease, but this diagnosis should be suspected in patient with a history of asbestos exposure. Copyright © 2015 Elsevier Inc. All rights reserved.

Prenatal diagnosis of spinal muscular atrophy in Chinese by genetic analysis of fetal cells

Institute of Scientific and Technical Information of China (English)

WU Ting; DING Xin-sheng; LI Wen-lei; YAO Juan; DENG Xiao-xuan

2005-01-01

Background Spinal muscular atrophy (SMA) is an autosomal recessive disease characterized by degeneration of anterior horn cells of the spinal cord.The survival motor neuron gene is SMA-determining gene deleted in approximately 95% of SMA patients.This study was undertaken to predict prenatal SMA efficiently and rapidly in families with previously affected child.Methods Prenatal diagnosis was made in 8 fetuses with a family history of SMA.Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) were used for the detection of the survival motor neuron gene.Results The survival motor neuron gene was not found in 6 fetuses, ruling out the diagnosis of SMA.Two fetuses were detected positive and the pregnancies were terminated.Conclusion Our method is effective and convenient in prenatal diagnosis of SMA.

Chronic pancreatitis: diagnosis, classification, and new genetic developments.

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Etemad, B; Whitcomb, D C

2001-02-01

The utilization of recent advances in molecular and genomic technologies and progress in pancreatic imaging techniques provided remarkable insight into genetic, environmental, immunologic, and pathobiological factors leading to chronic pancreatitis. Translation of these advances into clinical practice demands a reassessment of current approaches to diagnosis, classification, and staging. We conclude that an adequate pancreatic biopsy must be the gold standard against which all diagnostic approaches are judged. Although computed tomography remains the initial test of choice for the diagnosis of chronic pancreatitis, the roles of endoscopic retrograde pancreatography, endoscopic ultrasonography, and magnetic resonance imaging are considered. Once chronic pancreatitis is diagnosed, proper classification becomes important. Major predisposing risk factors to chronic pancreatitis may be categorized as either (1) toxic-metabolic, (2) idiopathic, (3) genetic, (4) autoimmune, (5) recurrent and severe acute pancreatitis, or (6) obstructive (TIGAR-O system). After classification, staging of pancreatic function, injury, and fibrosis becomes the next major concern. Further research is needed to determine the clinical and natural history of chronic pancreatitis developing in the context of various risk factors. New methods are needed for early diagnosis of chronic pancreatitis, and new therapies are needed to determine whether interventions will delay or prevent the progression of the irreversible damage characterizing end-stage chronic pancreatitis.

Clinical diagnosis versus autopsy diagnosis in head trauma

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Velnic Andreea-Alexandra

2017-12-01

Full Text Available The correct and complete diagnosis is essential for the adequate care and the favourable clinical evolution of the patients with head trauma. Purpose: To identify the error rate in the clinical diagnosis of head injuries as shown in comparison with the autopsy diagnosis and to identify the most common sources of error. Material and method: We performed a retrospective study based on data from the medical files and the autopsy reports of patients with head trauma who died in the hospital and underwent forensic autopsy. We collected: demographic data, clinical and laboratory data and autopsy findings. To quantify the concordance rate between the clinical diagnosis of death and the autopsy diagnosis we used a 4 classes classification, which ranged from 100% concordance (C1 to total discordance (C4 and two classes of partial discordance: C2 (partial discordance in favour of the clinical diagnosis- missing injuries in the autopsy reports and C3 (partial discordance in favor of the necroptic diagnosis- missing injuries in the medical files. Data were analyzed with SPSS version 20.0. Results: We analyzed 194 cases of death due to head injuries. We found a total concordance between the clinical death diagnosis and autopsy diagnosis in 30.4% of cases and at least one discrepancy in 69.6% of cases. Increasing the duration of hospitalization directly correlates with the amount of the imaging investigations and these in turn correlates with an increased rate of diagnosis concordance. Among the patients with stage 3 coma who associated a spinal cord injury, we found a partial diagnosis discordance in 50% of cases and a total discordance in 50% of cases, possibly due to the need for conducting emergency imaging investigation and the need for surgical treatment. In cases with partial and total discordant diagnosis, at least one lesion was omitted in 45.1% of the cases. The most commonly omitted injuries in C2 cases were subdural hematoma, intracerebral

a History of Funding for WOMEN’S Programs at the National Science Foundation: from Individual Powre Approaches to the Advance of Institutional Approaches

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Rosser, Sue V.; Lane, Eliesh O'neil

The biennial reports on women, minorities, and persons with disabilities produced by the National Science Foundation (NSF) because of congressional mandate laid the statistical foundation for NSF initiatives to redress the underrepresentation of these groups. Programs established in the 1980s such as Research Opportunities for Women, Visiting Professorships for Women, Graduate Fellowships for Women, and Career Advancement Awards provided support to individual women for their research. In the 1990s, the NSF also began to focus on systemic initiatives, creating the Program for Women and Girls, although it continued to address the problem through support of individual researchers in the newly created Professional Opportunities for Women in Research and Education (POWRE) initiative. The responses from more than 400 awardees during the 4 years of POWRE provide insights into the current issues these women perceive surrounding their grants, funding, and interactions with NSF bureaucracy and staff members. The results of the POWRE survey support the institutional, systemic thrust of the NSF’s new ADVANCE initiative to attempt to solve problems such as balancing career and family that cannot be addressed solely by supporting research projects of individual female scientists and engineers.

The early history of x-ray diagnosis with emphasis on the contributions of physics 1895-1915

International Nuclear Information System (INIS)

Mould, R.F.

1995-01-01

The contribution of physics to the development of X-ray diagnosis was vital in the early years of this century following Rontgen's discovery 1895-1915. The sections are presented in a logical order beginning with the discovery of X-rays, followed by X-ray tube technology to the advent of the hot cathode Coolidge tube, with the third and final section covering diagnostic radiology physics. It has been compiled from personal research over 35 years in libraries worldwide, drawing on textbooks, journals, popular magazines, newspapers, X-ray company catalogues and museum exhibits. I have included a certain amount of anecdotal information, because after all, much of the early commentaries were indeed anecdotal - and make very interesting reading. Finally it is commented that although this review is devoted to X-ray diagnosis, X-ray therapy should not be forgotten, and readers are referred to another review by the author on early therapeutic advances. (Author)

Autism, an overwhelming condition: history, etiopathogenesis, types, diagnosis, therapy and prognosis.

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Amihăesei, Ioana Cristina; Stefanachi, Elena

2013-01-01

Autism is defined as a neurologic developmental disorder affecting brain and behavior, becoming usually apparent before 3 years of age, with stable evolution and no remission. No neurologic morphologic abnormality was associated with the disease. Several types of disease being described, autism is part of a larger spectrum known as autism spectrum disorders (ASD), or pervasive developmental disorders (PDD). The disease was first described long before it was defined and it has received its modern name. Main cause in the development of autism is considered to be genetic, up to 90 %. However, environmental factors could be incriminated, sometimes. The five types included in ASD are: Asperger syndrome, pervasive developmental disorder-not otherwise specified (PDD-NOS), typical autism, Rett syndrome and childhood disintegrative disorder (CDD). The classical triad of symptoms includes: social interaction impairments, communication impairments and repetitive, stereotype behavior. Diagnosis is based on interview of the parents and specialized observation of the suspected children. Main tools used in therapy are the family and the educational system. Well established, specialized programs of therapy were developed in time. Prognosis of autism is severe, since no cure is possible; nevertheless spontaneous recoveries do occur, in some cases.

Diagnosis of esophageal disorders in carnivorous animals

International Nuclear Information System (INIS)

Fenyves, B.; Korodi, P.

1997-01-01

The esophagus serves to carry food, water and saliva from the pharynx to the stomach. Interruption of this function results in severe consequences for the animal, and complications of the esophageal disorders (e.g. pneumonia, mediastinitis, pleuritis, pyothorax, pneumothorax) can cause similarly serious problems. Clinical signs of esophageal disorders are similar to that of other gastrointestinal diseases. Diagnosis (based on the patient's medical history and clinical signs) is confirmed by supplementary examination. Radiology, possibly including contrast studies, is the primary in the home practice in consequence of the limited financial possibilities. The article reviews radiology, complications, prognosis and some treatment methods of esophageal disorders

Fine needle aspiration diagnosis of a spontaneously infarcted fibroadenoma mimicking carcinoma: a case report.

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Arora, Rajan; Abou-Bakr, Amany; Al Taleb, Ahmed

2013-02-01

Spontaneous infarction of fibroadenoma is an extremely rare complication in a nonpregnant/nonlactating female undergoing first-time aspiration. It can be misdiagnosed as carcinoma in all aspects of triple approach used for evaluation of patients with breast lesions. A 37-year-old woman presented to the outpatient surgical clinic with a 6-month history of a breast lump that was slowly increasing in size and had become painful during the past month. There was no history of any trauma or fine needle aspiration, and she was not pregnant or lactating. Mammogram and ultrasound revealed a 2.9-cm heterogenous hypoechoic suspicious lesion. No lymph nodes were detected in the axilla. Fine needle aspiration cytology was performed, and a diagnosis of benign breast lesion with features of infarction was rendered on cytology. The lump was excised surgically, and a histological diagnosis of infarcted fibroadenoma was made. Careful and diligent search for preserved benign epithelial cells on smears is the key to recognize this entity and avoid serious therapeutic implications.

Family History in Patients with Bipolar Disorder.

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Özdemir, Osman; Coşkun, Salih; Aktan Mutlu, Elif; Özdemir, Pınar Güzel; Atli, Abdullah; Yilmaz, Ekrem; Keskin, Sıddık

2016-09-01

In this study, we aimed to better understand the genetic transmission of bipolar disorder by examining the family history of patients. Sixty-three patients with bipolar disorder and their families were included. The final sample comprised 156 bipolar patients and their family members. An inclusion criterion was the presence of bipolar disorder history in the family. The diagnosis of other family members was confirmed by analyzing their files, hospital records, and by calling them to the hospital. Sixty-five patients were women (41.6%) and 91 were men (58.3%) (ratio of men/women: 1.40). When analyzing the results in terms of the transition of disease from the mother's or father's side, similar results were obtained: 25 patients were from the mother's side and 25 patients were from the father's side in 63 cases. The results of our study support the fact that a significant relationship exists between the degree of kinship and the heritability of bipolar disorder and, furthermore, that the effect of the maternal and paternal sides is similar on the transmission of genetic susceptibility.

Adapting and Bending the Portal to the Public: Evaluation of an NSF-Funded Science Communication Model for UNAVCO's Geoscience Summer Internships

Science.gov (United States)

Dutilly, E.; Charlevoix, D. J.; Bartel, B. A.

2017-12-01

UNAVCO is a National Science Foundation (NSF) facility specializing in geodesy. As part of its education and outreach work, it operates annual summer internships. In 2016, UNAVCO joined the Portal to the Public (PoP) network and the PoP model was adapted and bent to provide science communication professional development for summer interns. PoP is one way that UNAVCO invests in and trains future generations of geoscientists. The NSF-funded PoP initiative and its network, PoPNet, is a premier outreach framework connecting scientists and public audiences for over a decade. PoPNet is a network of sixty organizations committed to using the PoP method to engage the public in face-to-face interactions with practicing scientists. The PoP initiative provides professional development to scientists focused on best practices in science communication, helps them to develop an interactive exhibit consistent with their current research, and offers them a venue for interacting with the public. No other evaluation work to date has examined how summer internships can uptake the PoP model. This presentation focuses on evaluation findings from two cohorts of summer interns across two years. Three primary domains were assessed: how demographic composition across cohorts required changes to the original PoP framework, which of the PoP professional development trainings were valued (or not) by interns, and changes to intern knowledge, attitudes, and abilities to communicate science. Analyses via surveys and interviews revealed that level of intern geoscience knowledge was a major factor in deciding the focus of the work, specifically whether to create new hands-on exhibits or use existing ones. Regarding the use of PoP trainings, there was no obvious pattern in what interns preferred. Most growth and learning for interns occurred during and after the outreach activity. Results of this evaluation can be used to inform other applications of the PoP approach in summer internships.

Congenital Midline Cervical Cleft: Diagnosis, Pathologic Findings, and Early Stage Treatment

OpenAIRE

Sinopidis, Xenophon; Kourea, Helen P.; Panagidis, Antonios; Alexopoulos, Vasileios; Tzifas, Sotirios; Dimitriou, Gabriel; Georgiou, George

2012-01-01

Congenital midline cervical cleft is a very uncommon malformation of the anterior neck, with less than 100 cases reported in medical literature. Herein we present a case of a female neonate with this anomaly. A detailed description of the macroscopic and microscopic characteristics is performed. As it is derived from the natural history of the lesion, prompt clinical diagnosis, and operative treatment during early infancy predispose to a better aesthetic and functional prognosis.

Differential Diagnosis of Nongap Metabolic Acidosis: Value of a Systematic Approach

OpenAIRE

Kraut, Jeffrey A.; Madias, Nicolaos E.

2012-01-01

Nongap metabolic acidosis is a common form of both acute and chronic metabolic acidosis. Because derangements in renal acid-base regulation are a common cause of nongap metabolic acidosis, studies to evaluate renal acidification often serve as the mainstay of differential diagnosis. However, in many cases, information obtained from the history and physical examination, evaluation of the electrolyte pattern (to determine if a nongap acidosis alone or a combined nongap and high anion gap metabo...

Report on a Boston University Conference December 7-8, 2012 on How Can the History and Philosophy of Science Contribute to Contemporary US Science Teaching?

Science.gov (United States)

Garik, Peter; Benétreau-Dupin, Yann

2014-09-01

This is an editorial report on the outcomes of an international conference sponsored by a grant from the National Science Foundation (NSF) (REESE-1205273) to the School of Education at Boston University and the Center for Philosophy and History of Science at Boston University for a conference titled: How Can the History and Philosophy of Science Contribute to Contemporary US Science Teaching? The presentations of the conference speakers and the reports of the working groups are reviewed. Multiple themes emerged for K-16 education from the perspective of the history and philosophy of science. Key ones were that: students need to understand that central to science is argumentation, criticism, and analysis; students should be educated to appreciate science as part of our culture; students should be educated to be science literate; what is meant by the nature of science as discussed in much of the science education literature must be broadened to accommodate a science literacy that includes preparation for socioscientific issues; teaching for science literacy requires the development of new assessment tools; and, it is difficult to change what science teachers do in their classrooms. The principal conclusions drawn by the editors are that: to prepare students to be citizens in a participatory democracy, science education must be embedded in a liberal arts education; science teachers alone cannot be expected to prepare students to be scientifically literate; and, to educate students for scientific literacy will require a new curriculum that is coordinated across the humanities, history/social studies, and science classrooms.

Personal history of rosacea and risk of incident cancer among women in the US.

Science.gov (United States)

Li, W-Q; Zhang, M; Danby, F W; Han, J; Qureshi, A A

2015-07-28

Rosacea is an inflammatory skin disease. We examined the association between personal history of rosacea and risk of incident cancers. A total of 75 088 whites were included from the Nurses' Health Study II (1991-2011). Information on clinician-diagnosed rosacea and diagnosis year was collected in 2005. All cancers other than basal cell carcinoma (BCC) were confirmed. During 1 447 205 person-years, we identified 5194 cases with internal malignancies and 5788 with skin cancers. We did not observe significant associations between personal history of rosacea and internal malignancies, except for thyroid cancer (hazard ratio (HR)=1.59, 95% confidence interval (CI)=1.07-2.36). Among skin cancers, personal history of rosacea was associated with an elevated risk of BCC (HR=1.50, 95% CI=1.35-1.67). We suggest possible associations between personal history of rosacea and an increased risk of thyroid cancer and BCC. Further studies are warranted to replicate our findings and to explore the underlying mechanisms.

Abdominal aortic aneurysms do not develop more aggressively among patients with a positive family history of the disease

DEFF Research Database (Denmark)

Mejnert Jørgensen, Trine; Wemmelund, Holger; Green, Anders

Title: Abdominal aortic aneurysms no not develop more aggressively among patients with a positive family history of the disease Authors: Trine M. M. Joergensen, Holger Wemmelund, Anders Green, Jes Lindholt, Kim Houlind. Introduction: It is well known, that a family history of abdominal aortic...... aneurysm (AAA) strongly increases the risk of developing AAA, but it is still uncertain whether familial AAA’s develops differently than non-familial AAA’s. Objectives: To investigate whether familial AAA’s develop more aggressively than non-familial AAA’s by looking at growth rate, risk of surgery...... and rupture, as well as the size of the aneurysm at the time of diagnosis and the patient´s age at the time of operation, rupture and diagnosis. Design: Observational retrospective longitudinal study Materials: 318 patients (273 men and 45 women) with AAA diagnosed between 1996-2008 in Jutland, Denmark...

ISSLS Prize Winner: Consensus on the Clinical Diagnosis of Lumbar Spinal Stenosis: Results of an International Delphi Study.

Science.gov (United States)

Tomkins-Lane, Christy; Melloh, Markus; Lurie, Jon; Smuck, Matt; Battié, Michele C; Freeman, Brian; Samartzis, Dino; Hu, Richard; Barz, Thomas; Stuber, Kent; Schneider, Michael; Haig, Andrew; Schizas, Constantin; Cheung, Jason Pui Yin; Mannion, Anne F; Staub, Lukas; Comer, Christine; Macedo, Luciana; Ahn, Sang-Ho; Takahashi, Kazuhisa; Sandella, Danielle

2016-08-01

Delphi. The aim of this study was to obtain an expert consensus on which history factors are most important in the clinical diagnosis of lumbar spinal stenosis (LSS). LSS is a poorly defined clinical syndrome. Criteria for defining LSS are needed and should be informed by the experience of expert clinicians. Phase 1 (Delphi Items): 20 members of the International Taskforce on the Diagnosis and Management of LSS confirmed a list of 14 history items. An online survey was developed that permits specialists to express the logical order in which they consider the items, and the level of certainty ascertained from the questions. Phase 2 (Delphi Study) Round 1: Survey distributed to members of the International Society for the Study of the Lumbar Spine. Round 2: Meeting of 9 members of Taskforce where consensus was reached on a final list of 10 items. Round 3: Final survey was distributed internationally. Phase 3: Final Taskforce consensus meeting. A total of 279 clinicians from 29 different countries, with a mean of 19 (±SD: 12) years in practice participated. The six top items were "leg or buttock pain while walking," "flex forward to relieve symptoms," "feel relief when using a shopping cart or bicycle," "motor or sensory disturbance while walking," "normal and symmetric foot pulses," "lower extremity weakness," and "low back pain." Significant change in certainty ceased after six questions at 80% (P < .05). This is the first study to reach an international consensus on the clinical diagnosis of LSS, and suggests that within six questions clinicians are 80% certain of diagnosis. We propose a consensus-based set of "seven history items" that can act as a pragmatic criterion for defining LSS in both clinical and research settings, which in the long term may lead to more cost-effective treatment, improved health care utilization, and enhanced patient outcomes. 2.

Hematological and biochemical indicators for the early diagnosis of dengue viral infection

International Nuclear Information System (INIS)

Butt, N.; Abbasi, A.; Sheikh, Q.H.

2008-01-01

To determine the haematological and biochemical indicators for the early diagnosis of dengue viral infection. Patients presenting with a fever of less than 2 weeks duration, generalized morbiliform rash and bleeding manifestations were included. Clinical history was recorded and patients were placed on fluid and haematological support. Diagnosis was established by Polymerase Chain Reaction (PCR) for dengue virus or detection of dengue virus specific IgM and IgG. One hundred and four patients met the inclusion criteria during the study period. Sixty six patients had clinical and haematological features suggestive of grade I Dengue Hemorrhagic Fever (DHF); 34 patients had grade II DHF and 4 had grade III DHF out of whom 3 progressed to grade IV DHF. All the patients presented with fever followed by generalized morbiliform rash (81.73%), vomiting (79.8%), abdominal pain (65.38%), backache (62.5%), depression (60.6%) and mucosal bleeding manifestations (34.6%). Clinically, conjunctival infection was present in 93 patients (89.4%), hepatomegaly 59 (56.7%), lymphadenopathy in 17 (16.3%), splenomegaly in 13 (12.5%), pleural effusion in 11 (10.5%) and ascites in 8 (7.6%). Common laboratory findings were thrombocytopenia in 100% patients, leucopenia in 55 (52.8%), raised hematocrit in 52 (50%), and elevated aminotransferases, gamma GT in 100 (96%) patients. The overall mortality was 2.88%. In this series clinical history and examination supported by the triad of thrombocytopenia, raised hematocrit and elevated liver enzymes was sufficient for the early diagnosis of dengue hemorrhagic fever without waiting for dengue serology. (author)

Family history of type 2 diabetes and prevalence of metabolic syndrome in adult Asian Indians.

Science.gov (United States)

Das, Mithun; Pal, Susil; Ghosh, Arnab

2012-04-01

Our objective was to test the association between familial risk of type 2 diabetes mellitus (T2DM) and the prevalence of metabolic syndrome (MS) in adult Asian Indians. A total of 448 adult (>30 years) individuals (257 males and 191 females) participated in the study. Familial risk of T2DM was classified into three groups viz., 1=both parents affected; 2=parent and/or siblings affected and 3=none or no family history for T2DM. Anthropometric measures, blood pressures, fasting blood glucose and metabolic profiles were studied using standard techniques. MS was defined accordingly. The prevalence of MS phenotypes was estimated and compared among the three familial risk strata. Individuals with a history of both parents affected from diabetes had significantly higher (Pfamily history of T2DM. Significant difference was also noticed between individuals with and without MS according to the family history of diabetes (Pfamily history of T2DM. Family history of T2DM had significant effect on individuals with MS as compared to their counterparts (individuals having no family history of T2DM). It therefore seems reasonable to argue that family history of T2DM could be useful as a predictive tool for early diagnosis and prevention of MS in Asian Indian population.

Diagnosis of ischemic vertebral collapse using selective spinal angiography

International Nuclear Information System (INIS)

Stojanovic, J.; Kovac, V.

1981-01-01

During the year of 1980 we observed 3 patients with a vertebral collapse of indistinct origin. As there was no recent trauma in the past history, selective spinal angiography (SSA) was used to clarify the diagnosis. In each of the three cases we found evident rarefaction, in some places even an occlusion of the arteries of the adjacent affected vertebra. On the bases of this finding we concluded that this might be an ischemic vertebral collapse, an entity which had been under discussion long ago but not exactly confirmed so far. (orig.) [de

A Rare Cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception.

Science.gov (United States)

Sertkaya, Mehmet; Emre, Arif; Pircanoglu, Eyüp Mehmet; Yazar, Fatih Mehmet; Tepe, Murat; Cengiz, Emrah; Isler, Ali; Vicdan, Halit

2016-01-01

Intussusception in adults is very rarely seen, and this cause acute abdomen. A computed tomography (CT) scan, clinical suspicion, history, and a physical examination are important for the diagnosis. We present two cases of colonic intussusceptions induced by lipoma. The cases had similar locations, diagnoses, and management. Both lipomas were located close to the cecum in the ascending colon, and a right segmental colon resection was performed in both cases. The follow-up of both cases was uneventful. Although benign lesions can cause colonic intussusception, the high incidence of malignancy in colonic lesions should always be considered. Therefore, oncologic surgical procedures should be applied. The definitive diagnosis can be made by histopathology. Sertkaya M, Emre A, Pircanoglu EM, Yazar FM, Tepe M, Cengiz E, Isler A, Vicdan H. A Rare cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception. Euroasian J Hepato-Gastroenterol 2016;6(2):179-182.

Undergraduate Research as a Process for STEM Teaching and Learning Systemic Change: Lessons Learned from the Council on Undergraduate Research NSF CCLI and TUES Projects

Science.gov (United States)

Ambos, E. L.; Havholm, K. G.; Malachowski, M.; Osborn, J.; Karukstis, K.

2013-12-01

For more than seven years, the Council on Undergraduate Research (CUR), the primary organization supporting programs, services, and advocacy for undergraduate research, has been working with support from the NSF's Division of Undergraduate Education (DUE) to enhance, sustain, and institutionalize undergraduate research in diverse STEM disciplines and higher education settings. The Council on Undergraduate Research comprises more than 9000 individual and 670 institutional members within a divisional structure that includes geosciences, as well as 11 other thematic areas. Through its most recent grant: 'Transformational Learning through Undergraduate Research: Comprehensive Support for Faculty, Institutions, State Systems and Consortia' (NSF DUE CCLI III Award #09-20275), CUR has been collaborating with six higher education systems, each selected after a rigorous national application process in 2010 and 2011. These six systems, which collectively represent 79 individual institutions, are the Council of Public Liberal Arts Colleges (COPLAC), University of Wisconsin System (UWS), California State University System (CSU), City University of New York (CUNY), Great Lakes Colleges Association (GLCA), and Pennsylvania State System of Higher Education (PASSHE). The more than 350 participants of faculty and senior-level administrators from the six systems are engaged in shared multi-faceted and multi-year professional development experiences. Teams from each system attended customized institutes facilitated by CUR experts in 2011-2012, during which the teams developed specific action plans focused on institutionalizing undergraduate research on their campus and within their system. The systems were reconvened as a group a year after the first institute, to chart progress toward achieving their goals. Based on interviews and surveys with participants, campus teams are making substantial progress toward implementation of robust undergraduate research programs, and are making

Neonatal periventricular leukomalacia: real-time sonographic diagnosis with CT correlation

International Nuclear Information System (INIS)

Chow, P.P.; Horgan, J.G.; Taylor, K.J.W.

1985-01-01

The utility of real-time sonography in the diagnosis of neonatal periventricular leukomalacia (PVL) has been described only recently. Six cases are reported of PVL diagnosed by serial real-time scanning. The sonographic findings were correlated with the computed tomographic findings and the clinical history. In five of six infants in whom scanning was performed, characteristic multiseptated periventricular cavitations developed 2-3 weeks after birth or later. A transition from normal to increased periventricular echogenicity was often observed before the development of the periventricular cavitations in nonhemorrhagic PVL. The parenchymal abnormality demonstrated by sonography correlated well with an abnormal neurologic outcome. It is suggested that serial real-time scanning be performed in neonates whose history suggests the possibility of hypoxic-ischemic brain injury. Nonspecific predictors of PVL include seizures, apnea, disturbed mental status, abnormal muscle tone, and leg weakness

Can Social History Variables Predict Prison Inmates’ Risk for Latent Tuberculosis Infection?

Directory of Open Access Journals (Sweden)

Tyler E. Weant

2012-01-01

Full Text Available Improved screening and treatment of latent tuberculosis infection (LTBI in correctional facilities may improve TB control. The Ohio Department of Rehabilitation and Correction (ODRC consists of 32 prisons. Inmates are screened upon entry to ODRC and yearly thereafter. The objective of the study was to determine if social history factors such as tobacco, alcohol, and drug use are significant predictors of LTBI and treatment outcomes. We reviewed the medical charts of inmates and randomly selected age-matched controls at one ODRC facility for 2009. We used a conditional logistic regression to assess associations between selected social history variables and LTBI diagnosis. Eighty-nine inmates with a history of LTBI and 88 controls were identified. No social history variable was a significant predictor of LTBI. Medical comorbidities such as asthma, rheumatoid arthritis, and hepatitis C were significantly higher in inmates with LTBI. 84% of inmates diagnosed with LTBI had either completed or were on treatment. Annual TB screening may not be cost-effective in all inmate populations. Identification of factors to help target screening populations at risk for TB is critical. Social history variables did not predict LTBI in our inmate population. Additional studies are needed to identify inmates for the targeted TB testing.

An Interdisciplinary Approach to the Diagnosis and Management of a Complex Case of Postencephalitic Behavioral Disorder.

Science.gov (United States)

Fialkov, M. Jerome; And Others

1983-01-01

The diagnosis and treatment of a 13-year-old female who manifested postencephalitic behavioral syndrome 9 years after an acute measles infection are described, along with the history of the case. The case illustrates that an interdisciplinary approach using a single-case experimental design can be clinically effective. (SEW)

Surveillance of women with a personal history of breast cancer by tumour subtype.

Science.gov (United States)

Benveniste, A P; Dryden, M J; Bedrosian, I; Morrow, P K; Bassett, R L; Yang, W

2017-03-01

To determine if the rate and timing of a second breast cancer event (SBCE) in women with a personal history of breast cancer varies by disease subtype or breast imaging method. A retrospective review was performed of women with a SBCE from January 2006 to December 2010 at a single institution. Data analysed included oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) status of the primary and second breast cancers; mammographic and ultrasound (US) features from SBCE; and the time interval between both events. Of 207 patients diagnosed with a SBCE, the median age at first diagnosis was 50.6 years, range 24.8 to 80.2; at second diagnosis was 56.2 years, range 25.8 to 87.9. Eleven percent of SBCE were diagnosed >10 years after the primary cancer diagnosis. The median time between the first and second diagnosis for ER-positive patients was 2.7 years (range 0.7-17.4 years); and 1.9 years for ER-negative patients, (range 0.4-23.4 years; pbreast cancer (TNBC) had a shorter time between diagnoses than others (p=0.0003). At 3, 5, and 10 years, 85%, 92%, and 97% of ER-negative and 54%, 81%, and 95% of ER-positive tumours, respectively, had recurred. ER-negative tumours and TNBC were more likely to be visible at US. There may be a role for customised imaging surveillance of women with a personal history of breast cancer (PHBC) after 10 years. Further studies are necessary to determine if US may be valuable in the surveillance of patients with ER-negative and TNBC tumours. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Endocrine emergencies in critically ill patients: Challenges in diagnosis and management

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Sukhminder Jit Singh Bajwa

2012-01-01

Full Text Available Endocrine emergencies pose unique challenges for the attending intensivist while managing critically ill patients. Besides taking care of primary disease state, one has to divert an equal attention to the possible associated endocrinopathies also. One of the common reasons for inability to timely diagnose an endocrinal failure in critically ill patients being the dominance of other severe systemic diseases and their clinical presentation. The timely diagnosis and administration of therapeutic interventions for these endocrine disorders can improve the outcome in critically ill patients. The timely diagnosis and administration of timely therapeutics in common endocrine disorders like severe thyroid disease, acute adrenal insufficiency and diabetic ketoacidosis significantly influence the outcome and prognosis. Careful evaluation of clinical history and a high degree of suspicion are the corner stone to diagnose such problems. Aggressive management of the patient is equally important as the complications are devastating and can prove highly fatal. The present article is an attempt to review some of the common endocrine emergencies in intensive care unit and the challenges associated with their diagnosis and management.

Gaucher Disease: The Metabolic Defect, Pathophysiology, Phenotypes And Natural History

Science.gov (United States)

Baris, Hagit N.; Cohen, Ian J.; Mistry, Pramod K.

2015-01-01

Gaucher disease (GD), a prototype lysosomal storage disorder, results from inherited deficiency of lysosomal glucocerebrosidase due to biallelic mutations in GBA. The result is widespread accumulation of macrophages engorged with predominantly lysosomal glucocerebroside. A complex multisystem phenotype arises involving the liver, spleen, bone marrow and occasionally the lungs in type 1 Gaucher disease; in neuronopathic fulminant type 2 and chronic type 3 disease there is in addition progressive neurodegenerative disease. Manifestations of Gaucher disease type 1 (GD1) include hepatosplenomegaly, cytopenia, a complex pattern of bone involvement with avascular osteonecrosis (AVN), osteoporosis, fractures and lytic lesions. Enzyme replacement therapy became the standard of care in 1991, and this has transformed the natural history of GD1. This article reviews the clinical phenotypes of GD, diagnosis, pathophysiology and its natural history. A subsequent chapter discusses the treatment options. PMID:25345088

破坏性心境失调障碍的诊断与治疗的思考%The history, diagnosis and treatment of disrupitve mood dysregulaiton disorder

Institute of Scientific and Technical Information of China (English)

陈俊; 汪作为; 方贻儒

2016-01-01

Summary:Disruptive mood dysregulation disorder was newly included as a diagnostic category in Diagnostic and statistical manual of mental disorders fifth edition (DSM-5), but the knowledge about it in the clinical practice field is still limited. Therefore, the aim of the present article is to introduce this diagnositc category’s history, key points of diagnosis, treatment and its impact on clinical pracitce for clinical reference.%概述：美国精神障碍诊断与统计分册第5版新增一个诊断类别为破坏性心境失调障碍，但是临床实践中对此认识仍然较为有限。因此，本文就该诊断类别的由来、诊断要点、治疗以及对临床实践的启示作一介绍，供临床参考。

[Accuracy of placenta accreta prenatal diagnosis by ultrasound and MRI in a high-risk population].

Science.gov (United States)

Daney de Marcillac, F; Molière, S; Pinton, A; Weingertner, A-S; Fritz, G; Viville, B; Roedlich, M-N; Gaudineau, A; Sananes, N; Favre, R; Nisand, I; Langer, B

2016-02-01

Main objective was to compare accuracy of ultrasonography and MRI for antenatal diagnosis of placenta accreta. Secondary objectives were to specify the most common sonographic and RMI signs associated with diagnosis of placenta accreta. This retrospective study used data collected from all potential cases of placenta accreta (patients with an anterior placenta praevia with history of scarred uterus) admitted from 01/2010 to 12/2014 in a level III maternity unit in Strasbourg, France. High-risk patients beneficiated antenatally from ultrasonography and MRI. Sonographic signs registered were: abnormal placental lacunae, increased vascularity on color Doppler, absence of the retroplacental clear space, interrupted bladder line. MRI signs registered were: abnormal uterine bulging, intraplacental bands of low signal intensity on T2-weighted images, increased vascularity, heterogeneous signal of the placenta on T2-weighed, interrupted bladder line, protrusion of the placenta into the cervix. Diagnosis of placenta accreta was confirmed histologically after hysterectomy or clinically in case of successful conservative treatment. Twenty-two potential cases of placenta accreta were referred to our center and underwent both ultrasonography and MRI. All cases of placenta accreta had a placenta praevia associated with history of scarred uterus. Sensibility and specificity for ultrasonography were, respectively, 0.92 and 0.67, for MRI 0.84 and 0.78 without significant difference (p>0.05). The most relevant signs associated with diagnosis of placenta accreta in ultrasonography were increased vascularity on color Doppler (sensibility 0.85/specificity 0.78), abnormal placental lacunae (sensibility 0.92/specificity 0.55) and loss of retroplacental clear space (sensibility 0.76/specificity 1.0). The most relevant signs in MRI were: abnormal uterine bulging (sensitivity 0.92/specificity 0.89), dark intraplacental bands on T2-weighted images (sensitivity 0.83/specificity 0.80) or

Prenatal diagnosis of Neu-Laxova syndrome: a case report

Directory of Open Access Journals (Sweden)

Polat Ibrahim

2002-02-01

Full Text Available Abstract Background Neu-Laxova syndrome is a rare congenital abnormality involving multiple systems. We report a case of Neu-Laxova syndrome (NLS diagnosed prenatally by ultrasound examination. Case presentation A 29-year-old gravida 3, para 2 woman was first seen in our antenatal clinic at 38 weeks' pregnancy. Except for the consanguinity and two previous abnormal stillborn babies her medical history was unremarkable. On ultrasound examination microcephaly, flat forehead, micrognathia, intrauterine growth restriction, generalized edema of the skin, hypoplastic chest, excessive soft tissue deposition of hands and feet, joint contractures and a penis without scrotal sacs were detected. She delivered a 2000 g male fetus. He died five minutes after delivery. Postmortem examination confirmed the diagnosis of Neu-Laxova syndrome. Conclusion Because of the autosomal recessive inheritance of Neu-Laxova syndrome genetic counseling and early-serial ultrasound examination should be performed at risk families. Early diagnosis of the disease may offer termination of the pregnancy as an option.

Hypothalamic amenorrhea: from diagnosis to therapeutical approach.

Science.gov (United States)

Genazzani, A D; Chierchia, E; Santagni, S; Rattighieri, E; Farinetti, A; Lanzoni, C

2010-05-01

Among secondary amenorrheas, hypothalamic amenorrhea (HA) is the one with no evidence of endocrine/systemic causal factors. HA is mainly related to various stressors affecting neuroendocrine control of the reproductive axis. In clinical practice, HA is mainly associated with metabolic, physical, or psychological stress. Stress is the adaptive response of our body through all its homeostatic systems, to external and/or internal stimuli that activate specific and nonspecific physiological pathways. HA occurs generally after severe stressed conditions/situations such as dieting, heavy training, or intense emotional events, all situations that can induce amenorrhea with or without body weight loss and HA is a secondary amenorrhea with a diagnosis of exclusion. In fact, the diagnosis is essentially based on a good anamnestic investigation. It has to be investigated using the clinical history of the patient: occurrence of menarche, menstrual cyclicity, time and modality of amenorrhea, and it has to be excluded any endocrine disease or any metabolic (i.e., diabetes) and systemic disorders. It is necessary to identify any stressed situation induced by loss, family or working problems, weight loss or eating disorders, or physical training or agonist activity. Peculiar, though not specific, endocrine investigations might be proposed but no absolute parameter can be proposed since HA is greatly dependent from individual response to stressors and/or the adaptive response to stress. This chapter aims to give insights into diagnosis and putative therapeutic strategies. Copyright 2010 Elsevier Masson SAS. All rights reserved.

Outcome of retrospective and prospective multicenter cooperative clinical studies of spinal lipoma aiming for elucidating its natural history and for planning its treatment, and usefulness of neuroendoscope in its diagnosis and surgery assistance

International Nuclear Information System (INIS)

Suzuki, Michiyasu; Nomura, Sadahiro; Oi, Shizuo; Mori, Hiroshi; Nonaka, Yuichiro; Tamogami, Ryo; Khasawneh, Nidal; Jianxin, Du

2008-01-01

The rate of manifestation of spinal lipoma (SL) is essentially unknown and propriety of its treatment is still controversial. Started in 2006 a prospective study by 7 facilities (COE-SB Top 7) to elucidate the natural history by such a mean as seeing the age distribution in SL manifestation, and to find applicable factors for conducting prophylactic surgery by such evaluation as improvable symptoms and surgical complication. Facilities also retrospectively summarized their outcomes of surgery and of conservative follow-up in the past 5 years. Further, evaluated was the usefulness of neuroendoscopic observation and assistance in diagnosis and operation, because diagnosis for predicting the neurological prognosis is often difficult by preoperative MRI alone and is changeable by surgical findings due to complex SL structures. This paper is a report describing tentative results of the prospective study above in the first 1 year, of the retrospective one and of the endoscopic utility. Subjects were 45 patients (21 cases, <1 year after birth; asymptomatic, 29 and symptomatic, 16) in the prospective study and 261 patients (asymptomatic, 159 and symptomatic, 102) in the retrospective. The endoscope used was an Oi-Samii Handy Pro type. Neurological symptom was assessed by Spina Befida Neurological Scale (1992). Patients were classified according to Embryo-pathogenetic and Surgico-anatomical Classification of Spina Bifida (2002). Results were: the prevalence was 15% at birth and increased afterwards; prognosis post surgery was poor in transitional SL; symptomatic improvement by operation was small; operative complication was scarce; and endoscope was conceivably useful for diagnosis and operative assistance. (R.T.)

The Cosmic History of Black Hole Accretion from Chandra X-ray Stacking

Science.gov (United States)

Treister, Ezequiel; Urry, C.; Schawinski, K.; Lee, N.; Natarajan, P.; Volonteri, M.; Sanders, D. B.

2012-05-01

In order to fully understand galaxy formation we need to know when in the cosmic history are black holes growing more intensively, in what type of galaxies this growth is happening and what fraction of these sources are invisible at most wavelengths due to obscuration. We take advantage of the rich multi-wavelength data available in the Chandra Deep Field South (CDF-S), including the 4 Msec Chandra observations (the deepest X-ray data to date), in order to measure the amount of black hole accretion as a function of cosmic history, from z 0 to z 6. We obtain stacked rest-frame X-ray spectra for samples of galaxies binned in terms of their IR luminosity, stellar mass and other galaxy properties. We find that the AGN fraction and their typical luminosities, and thus black hole accretion rates, increase with IR luminosity and stellar mass. The integrated intensity at high energies indicates that a significant fraction of the total black hole growth, 22%, occurs in heavily-obscured systems that are not individually detected in even the deepest X-ray observations. We find evidence for a strong connection between significant black hole growth events and major galaxy mergers from z 0 to z 3, while less spectacular but longer accretion episodes are most likely due to other (stochastic) processes. E.T. and K.S. gratefully acknowledges the support provided by NASA through Chandra Postdoctoral Fellowship Award Numbers PF8-90055 and PF9-00069, respectively issued by the Chandra X-ray Observatory Center. E.T. also thanks support by NASA through Chandra Award SP1-12005X Center of Excellence in Astrophysics and Associated Technologies (PFB 06). C. M. Urry acknowledges support from NSF Grants AST-0407295, AST-0449678, AST-0807570, and Yale University.

Delayed Diagnosis of Gorlin-Goltz Syndrome: The Importance of the Multidisciplinary Approach.

Science.gov (United States)

Figueira, Jéssica Araújo; Batista, Fábio Roberto de Souza; Rosso, Karina; Veltrini, Vanessa Cristina; Pavan, Angelo José

2018-03-08

Gorlin-Goltz syndrome (GGS), also known as nevoid basal cell carcinoma syndrome, is an autosomal dominant inherited disorder with high penetrance and variable expressivity. The classic triad originally described by Gorlin and Goltz in 1960 is composed of multiple nevoid basal cell carcinomas (NBCCs), odontogenic keratocysts (OKCs) in the jaws and bifid ribs. in 1977, this triad was modified by Rayner et al, and to GGS diagnosis, the OKCs had to appear in combination with calcification of the cerebellar falx or palmar and plantar pits. It may occur that although GGS syndrome is a well-known condition, only the specific symptom could be observed by different specialists. Therefore, the patient cannot be placed in an always complex clinical panel. The authors introduce an example in this report. In the present case, the patient had NBCCs, OKCs, and probably other signs of GGS since 1998, and has been treated for this conditions separated, without a diagnosis of a syndromic condition. A 54-year-old white woman was referred to the oral medicine service due to cyst located in the right mandibular body. She had history of skin cancer and undergone surgeries and radiotherapies for the lesions treatment, scars on the skin face due to the lesions removed, and a new ulcerated lesion on the back of was diagnosed. In addition, the patient presented frontal and parietal bossing leading to increased cranial circumference, hypertelorism, strabismus, broad base, and mandibular prognathism. To the image examination, skull radiography revealed calcification of the falx cerebri; on chest X-ray bifid rib was observed and spine radiography showed vertebral osteophytes. Panoramic radiograph showed a well-defined bilocular radiolucent image located in posterior and anterior mandibular region. The whole elements induced us to investigate the patient's past medical history, which revealed that since 1998 had the diagnosis of NBCC and OKC. A multidisciplinary approach becomes necessary for

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

Directory of Open Access Journals (Sweden)

Toktam Beheshtian

2015-05-01

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

Becoming the denigrated other: Group relations perspectives on initial reactions to a bipolar disorder diagnosis

Directory of Open Access Journals (Sweden)

Susan G. Goldberg

2012-09-01

Full Text Available The initial reactions to a bipolar disorder diagnosis of research participants in a small, qualitative study consisted of astonishment, dread of being mad, and extremely negative associations. All had prior mental health diagnoses, including episodes of severe depression (all but one and alcoholism (one. All participants reported mental health histories prediagnosis and most had spent years contending with mental health labels, medications, symptoms, and hospitalizations. In addition, most participants were highly educated health professionals, quite familiar with the behaviors that the medical system considered to comprise bipolar disorder. Their negative associations to the initial bipolar disorder diagnosis, therefore, appeared inconsistent with their mental health histories and professional knowledge. This article contextualizes these initial reactions of shock and distress and proposes interpretations of these findings from societal and psychodynamic group relations perspectives. The participants’ initial negative reactions are conceptualized as involving the terror of being transported from the group of normal people into the group of mad or crazy people, i.e., people with mental illnesses, who may constitute a societal denigrated other.

Examining the Role of Antisocial Personality Disorder in Intimate Partner Violence Among Substance Use Disorder Treatment Seekers With Clinically Significant Trauma Histories.

Science.gov (United States)

Dykstra, Rita E; Schumacher, Julie A; Mota, Natalie; Coffey, Scott F

2015-08-01

This study examined the associations among posttraumatic stress disorder (PTSD) symptom severity, antisocial personality disorder (ASPD) diagnosis, and intimate partner violence (IPV) in a sample of 145 substance abuse treatment-seeking men and women with positive trauma histories; sex was examined as a moderator. ASPD diagnosis significantly predicted both verbal and physical aggression; sex moderated the association between ASPD diagnosis and physical violence. PTSD symptom severity significantly predicted engaging in verbal, but not physical, aggression. Overall, these results suggest that an ASPD diagnosis may be an important risk factor for engaging in IPV among women seeking treatment for a substance use disorder. © The Author(s) 2015.

Lipoma arborescens: diagnosis and image; Lipoma arborescens: diagnostico e imagem

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Goncalves, Marcela; Len, Claudio Arnaldo; Terreri, Maria Teresa Ramos Ascencao [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Setor de Reumatologia Pediatrica; Fernandes, Artur da Rocha Correa [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem; Hilario, Maria Odete Esteves [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Alergia, Imunologia e Reumatologia]. E-mail: odetehilario@terra.com.br

2004-08-01

Lipoma arborescens is an intraarticular lesion of unknown etiology, consisting of a chronic villous fat proliferation of the synovial membrane. The disease has occasionally been associated with diabetes mellitus, degenerative diseases, juvenile rheumatoid arthritis and also rheumatoid arthritis. The diagnosis relies on magnetic resonance imaging evaluation and synovial biopsy. We report a case of a 8-year-old girl with a two year history of bilateral swelling of the knees and elbows. The patient had improvement of the arthritis after starting treatment with conventional drugs. (author)

When is facial paralysis Bell palsy? Current diagnosis and treatment.

Science.gov (United States)

Ahmed, Anwar

2005-05-01

Bell palsy is largely a diagnosis of exclusion, but certain features in the history and physical examination help distinguish it from facial paralysis due to other conditions: eg, abrupt onset with complete, unilateral facial weakness at 24 to 72 hours, and, on the affected side, numbness or pain around the ear, a reduction in taste, and hypersensitivity to sounds. Corticosteroids and antivirals given within 10 days of onset have been shown to help. But Bell palsy resolves spontaneously without treatment in most patients within 6 months.

Large granular lymphocyte leukemia: natural history and response to treatment.

LENUS (Irish Health Repository)

Fortune, Anne F

2012-02-01

Large granular lymphocyte leukemia (T-LGL) is an indolent T lymphoproliferative disorder that was difficult to diagnose with certainty until clonality testing of the T cell receptor gene became routinely available. We studied the natural history and response to treatment in 25 consecutive patients with T-LGL diagnosed between 2004 and 2008 in which the diagnosis was confirmed by molecular analysis, to define an effective treatment algorithm. The median age at diagnosis was 61 years (range 27-78), with a male to female ratio of 1:1.8 and presenting features of fatigue (n = 13), recurrent infections (n = 9), and\\/or abnormal blood counts (n = 5). Thirteen patients with symptomatic disease were treated as follows: pentostatin (nine patients), cyclosporine (six patients), methotrexate (three patients), and alemtuzumab in two patients in whom pentostatin was ineffective. Pentostatin was the single most effective therapy, with a response rate of 75% and minimal toxicity. The overall survival (OS) and progression-free survival (PFS) 37 months from diagnosis were 80% and 52%, respectively. Treatment of T-LGL should be reserved for patients with symptomatic disease, but in this series, pentostatin treatment was less toxic and more effective than cyclosporine or methotrexate.

Infezioni da H.pylori. Diagnosi: il ruolo del gastroenterologo

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Claudia Guatti Zuliani

2003-09-01

Full Text Available Diagnosis of H. pylori infection: the role of gastroenterologist Helicobacter pylori (H. pylori infection can be diagnosed by invasive techniques requiring endoscopy and biopsy (histological examination, rapid urease test, culture and by non invasive techniques (serology, urea breath test, detection of H. pylori antigen stool specimen.At present, no single test can be absolutely relied upon to detect colonization by H. pylori and a combination of two tests is recommended if feasible.Nevertheless, in routine dayto- day clinical practice H. pylori diagnosis is often by a single test and consequently the choice of the more suitable test is even more important. Choosing among them is not easy, and several issues need to be considered, such as the clinical situation, (i.e. present symptoms and past medical history, age of patients, if it is first diagnosis or follow-up after treatment.., sensitivity and specificity of the test, the cost-effectiveness of the testing strategy, the availability of the test, the local expertise . Since the “Ideal test” is not relied, the gastroenterologist or clinician as well, has the important role of deciding which test to employ. A good knowledge of advantages and vantages of each test is so necessary to make the best choose as possible.

Imaging diagnosis of Granulocytic Sarcoma in the skull base

International Nuclear Information System (INIS)

Zheng Shaoyan; Xie Jiming; Yang Zhiyun; Zhou Zhou; Li Shurong

2010-01-01

Objective: To improve the understanding and imaging diagnosis of granulocytic sarcoma in the skull base. Methods: Three cases of granulocytic sarcomas in the skull base are reported. The clinical features and imaging findings were analyzed. Results: The three cases occurred in children with acute myeloid leukemia. Two patients presented with oculomotor paralysis before the diagnosis of leukemia, the third patient with history of leukemia presented with headache. Diffuse infiltration of basal skull bone marrow and extracranial soft tissue masses were shown on MRI. The signal intensities of the masses were similar to that of gray matter on T 1 WI and T 2 WI with marked contrast enhancement. The soft tissue masses were located in the para-sellar region and surrounded the lateral wall of the maxillary sinus in one case. The soft tissue mass of the second case infiltrated the orbital cavity, cavernous sinus and oculomotor nerve. Tumor infiltrating the meninges, cranial nerves and paranasal sinuses was seen in the third patient. Conclusion: Cranial nerve paralysis can be the presenting symptom of basal skull granulocytic sarcoma in children. Granulocytic sarcoma should be considered in the different diagnosis when diffuse abnormal signal intensities in the basal skull bone marrow with solitary or multiple soft tissue masses are shown on MRI. (authors)

Nephrolithiasis and hematuria--sometimes a stony road to diagnosis.

Science.gov (United States)

Sellin, L; Quack, I; Weiner, S M; Waldherr, R; Henning, B; Hofebauer, S; Rump, L C

2005-08-01

We report a case of a young man with a history of kidney stones. Occurrence of gross hematuria several months after the extracorporeal shock wave, lithotripsy (ESWL) treatment lead to hospitalization. By ultrasound and abdominal CT scan, the urologist could exclude post-renal causes of the gross hematuria and acute renal failure. After transfer to a department of nephrology hemodialysis was started, an immediate kidney biopsy was performed and prednisolone was administered on the same day. The kidney biopsy revealed an anti-glomerular basement membrane (GBM) disease. The renal function did not recover and the patient remained on hemodialysis. In the literature it has been hypothesized that ESWL-treated patients are prone to develop anti-GBM disease by liberation of glomerular basement antigen through the ESWL high energy shock waves. An additional hypothesis considering the higher susceptibility for anti-GBM disease among certain HLA-tissue types is discussed with regard to our case. Unfortunately, the prolonged track to diagnosis and delayed immunosuppressive treatment could not prevent poor clinical outcome. Although anti-GBM disease is a rather rare disease, it should be included as a differential diagnosis for hematuria--especially months after ESWL treatment. Otherwise early diagnosis may be missed and as in our patient immunosuppressive treatment will remain unsuccessful to recover renal function.

Hereditary angioedema with C1 inhibitor deficiency: delay in diagnosis in Europe.

Science.gov (United States)

Zanichelli, Andrea; Magerl, Markus; Longhurst, Hilary; Fabien, Vincent; Maurer, Marcus

2013-08-12

Hereditary angioedema (HAE) is a rare, debilitating, and potentially life-threatening disease characterized by recurrent edema attacks. Important advances in HAE treatment have been made, including the development of new therapies for treating or preventing attacks. Nevertheless, the disease is still frequently misdiagnosed and inappropriately treated, potentially exposing patients with laryngeal attacks to the risk of asphyxiation. The Icatibant Outcome Survey (IOS) is an international, observational study that documents the clinical outcome of HAE patients eligible for treatment with icatibant. Patient ages at first symptoms and at diagnosis were recorded at enrolment, and the delay between first symptoms and diagnosis was calculated. The median [range] diagnostic delay in HAE type I and II patients across eight countries was 8.5 years [0-62.0]. The median delay in diagnosis was longer for HAE type II versus type I (21 versus 8 years, respectively), although this did not quite reach statistical significance. Although it can be difficult to differentiate HAE symptoms from those of more common angioedema sub-types (e.g. idiopathic or acquired angioedema), our results show that HAE type I and II patients have an unacceptable delay in diagnosis, even those with a family history of the disease. Raising physician awareness of this disabling and potentially fatal disease may lead to a more accurate diagnosis and timely treatment.

Cosmic growth history and expansion history

International Nuclear Information System (INIS)

Linder, Eric V.

2005-01-01

The cosmic expansion history tests the dynamics of the global evolution of the universe and its energy density contents, while the cosmic growth history tests the evolution of the inhomogeneous part of the energy density. Precision comparison of the two histories can distinguish the nature of the physics responsible for the accelerating cosmic expansion: an additional smooth component--dark energy--or a modification of the gravitational field equations. With the aid of a new fitting formula for linear perturbation growth accurate to 0.05%-0.2%, we separate out the growth dependence on the expansion history and introduce a new growth index parameter γ that quantifies the gravitational modification

A rare diagnosis of a focal liver lesion

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Alberto Del Prato

2015-03-01

Full Text Available Splenosis can be considered as a benign condition due to the presence of heterotopic splenic tissue in abdomen, thorax and pelvis because of a massive splenic trauma or surgery. Here we report the case of a patient with an unknown hepatic mass, chronic hepatitis C, liver cirrhosis and a previous splenectomy after abdominal trauma. In our case lesion could not be clearly defined by ultrasound, computed tomography and magnetic resonance. Classical features of malignancy were not demonstrated at computed tomography, while at magnetic resonance imaging the differential diagnosis of the lesion appeared quite difficult and debate. Then an ultrasound-guided biopsy demonstrated the liver mass in left hepatic lobe consisted of splenic tissue and some millimetric accessory spleens in the left upper quadrant. So the possibility of an intra-hepatic splenosis should be taken into account in patients with an unknown liver mass and a history of previous abdominal trauma, followed by splenectomy. The conclusive diagnosis of intra-hepatic splenosis was given by ultrasound-guided biopsy.

At the Interface: Academic History, School History and the Philosophy of History

Science.gov (United States)

Retz, Tyson

2016-01-01

How history is learnt and taught must to some extent be shaped by conceptions of what history is. Historians tend to conceptualize what something is by investigating what it has been and what it has meant in different contexts. This article explains how a debate in the philosophy of history between positivism and intentionalism provided the…

Potential of nano-silver fluoride for tooth enamel caries prevention

Science.gov (United States)

Silva, Amitis V. C.; Mota, Cláudia C. B. O.; Teixeira, Joás. A.; Lins, Emery C.; Gomes, Anderson S. L.; Rosenblatt, Aronita

2018-02-01

This ex vivo study evaluated the efficiency of nano-silver fluoride (NSF) to enamel remineralization of deciduous teeth submitted to a high cariogenic challenge. 33 specimens of sound enamel were distributed into three groups: treated with sodium fluoride, with NSF, and deionized water. All specimens were submitted to microhardness test before chemical caries induction; post-induction of caries; and post-cariogenic challenge. The high cariogenic challenge was carried out in 14 daily cycles. There was no significant statistical difference (p=0.958) of enamel microhardness between NSFtreated and NaF-treated specimens. However, it presented significant difference between water-treated specimens and both NSF-treated and NaF-treated specimens (p=0.003).Furthermore, optical coherence tomography was employed for caries diagnosis, as it can be used in clinical environment.

The history, hotspots, and trends of electrocardiogram.

Science.gov (United States)

Yang, Xiang-Lin; Liu, Guo-Zhen; Tong, Yun-Hai; Yan, Hong; Xu, Zhi; Chen, Qi; Liu, Xiang; Zhang, Hong-Hao; Wang, Hong-Bo; Tan, Shao-Hua

2015-07-01

The electrocardiogram (ECG) has broad applications in clinical diagnosis and prognosis of cardiovascular disease. Many researchers have contributed to its progressive development. To commemorate those pioneers, and to better study and promote the use of ECG, we reviewed and present here a systematic introduction about the history, hotspots, and trends of ECG. In the historical part, information including the invention, improvement, and extensive applications of ECG, such as in long QT syndrome (LQTS), angina, and myocardial infarction (MI), are chronologically presented. New technologies and applications from the 1990s are also introduced. In the second part, we use the bibliometric analysis method to analyze the hotspots in the field of ECG-related research. By using total citations and year-specific total citations as our main criteria, four key hotspots in ECG-related research were identified from 11 articles, including atrial fibrillation, LQTS, angina and MI, and heart rate variability. Recent studies in those four areas are also reported. In the final part, we discuss the future trends concerning ECG-related research. The authors believe that improvement of the ECG instrumentation, big data mining for ECG, and the accuracy of diagnosis and application will be areas of continuous concern.

Hypertrophic pachymeningitis: Current criteria for diagnosis and differentiation (Clinical case and review of literature

Directory of Open Access Journals (Sweden)

E. G. Mendelevich

2015-01-01

Full Text Available The paper describes a 44-year-old male patient with an about 6-year history of hypertrophic pachymeningitis. The major clinical symptoms were characterized by headache, exophthalmos, and blindness in one eye. The data for differential diagnosis of the disease are given. The current literature on the clinical manifestations of hypertrophic pachymeningitis, its differential diagnosis, and the results of magnetic resonance imaging (MRI is reviewed. Diagnostic difficulties at the stage of a clinical observation are due to the nonspecificity of neurological manifestations and the need for a comprehensive examination to detect a somatic disease. MRI can diagnose the disease-specific phenomenon of damage to the meninges, which calls for further careful differentiation. Clinicians must be familiar with alternative differential diagnosis, as a rapid specific therapeutic approach will help avoid long-term or irreversible neurological complications.

History and National Development | Oyeranmi | Journal of History ...

African Journals Online (AJOL)

Volumes of works have been written on the subject of the relevance of history to national development in Nigeria. To „.non historians.. history teaches no particular skill “since the primary focus of history is the past... Does history still serve any purpose especially in the 21st century? What are those values embedded in ...

Diagnosis of 20 cases with chronic radiation syndrome

International Nuclear Information System (INIS)

Zhang, Hongshou; Shen, Zhezhong; Wen Zhigen; Xie, Xiaoping; Ni, Jinxian

1984-01-01

Twenty cases with chronic radiation syndrome were diagnosed in our department during 1957-1980. All except one were radiologists, and eight of them had worked in radiological departments for over 20 years. Owing to the use of out-dated x-ray machines as well as radium sources without adequate protection, all these cases were apparently overexposed to radiation. They presented following signs and symptoms of chronic radiation syndrome: excitability, palpitation, fatigue, general weakness, loss of weight, oversweating accompanied by tendency of lowered metabolism, peripheral blood cell changes, and chromosome aberrations. The diagnosis of this syndrome was based on definitive professional and over-exposure history, clinical picture and abnormal laboratory findings. (author)

Hand-arm vibration syndrome: A rarely seen diagnosis.

Science.gov (United States)

Campbell, Rebecca A; Janko, Matthew R; Hacker, Robert I

2017-06-01

Hand-arm vibration syndrome (HAVS) is a collection of sensory, vascular, and musculoskeletal symptoms caused by repetitive trauma from vibration. This case report demonstrates how to diagnose HAVS on the basis of history, physical examination, and vascular imaging and its treatment options. A 41-year-old man who regularly used vibrating tools presented with nonhealing wounds on his right thumb and third digit. Arteriography revealed occlusions of multiple arteries in his hand with formation of collaterals. We diagnosed HAVS, and his wounds healed after several weeks with appropriate treatment. HAVS is a debilitating condition with often irreversible vascular damage, requiring early diagnosis and treatment.

Hand-arm vibration syndrome: A rarely seen diagnosis

Directory of Open Access Journals (Sweden)

Rebecca A. Campbell, BA

2017-06-01

Full Text Available Hand-arm vibration syndrome (HAVS is a collection of sensory, vascular, and musculoskeletal symptoms caused by repetitive trauma from vibration. This case report demonstrates how to diagnose HAVS on the basis of history, physical examination, and vascular imaging and its treatment options. A 41-year-old man who regularly used vibrating tools presented with nonhealing wounds on his right thumb and third digit. Arteriography revealed occlusions of multiple arteries in his hand with formation of collaterals. We diagnosed HAVS, and his wounds healed after several weeks with appropriate treatment. HAVS is a debilitating condition with often irreversible vascular damage, requiring early diagnosis and treatment.

Evidence against roles for phorbol binding protein Munc13-1, ADAM adaptor Eve-1, or vesicle trafficking phosphoproteins Munc18 or NSF as phospho-state-sensitive modulators of phorbol/PKC-activated Alzheimer APP ectodomain shedding

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Lovestone Simon

2007-12-01

Full Text Available Abstract Background Shedding of the Alzheimer amyloid precursor protein (APP ectodomain can be accelerated by phorbol esters, compounds that act via protein kinase C (PKC or through unconventional phorbol-binding proteins such as Munc13-1. We have previously demonstrated that application of phorbol esters or purified PKC potentiates budding of APP-bearing secretory vesicles at the trans-Golgi network (TGN and toward the plasma membrane where APP becomes a substrate for enzymes responsible for shedding, known collectively as α-secretase(s. However, molecular identification of the presumptive "phospho-state-sensitive modulators of ectodomain shedding" (PMES responsible for regulated shedding has been challenging. Here, we examined the effects on APP ectodomain shedding of four phorbol-sensitive proteins involved in regulation of vesicular membrane trafficking of APP: Munc13-1, Munc18, NSF, and Eve-1. Results Overexpression of either phorbol-sensitive wildtype Munc13-1 or phorbol-insensitive Munc13-1 H567K resulted in increased basal APP ectodomain shedding. However, in contrast to the report of Roßner et al (2004, phorbol ester-dependent APP ectodomain shedding from cells overexpressing APP and Munc13-1 wildtype was indistinguishable from that observed following application of phorbol to cells overexpressing APP and Munc13-1 H567K mutant. This pattern of similar effects on basal and stimulated APP shedding was also observed for Munc18 and NSF. Eve-1, an ADAM adaptor protein reported to be essential for PKC-regulated shedding of pro-EGF, was found to play no obvious role in regulated shedding of sAPPα. Conclusion Our results indicate that, in the HEK293 system, Munc13-1, Munc18, NSF, and EVE-1 fail to meet essential criteria for identity as PMES for APP.

Evidence against roles for phorbol binding protein Munc13-1, ADAM adaptor Eve-1, or vesicle trafficking phosphoproteins Munc18 or NSF as phospho-state-sensitive modulators of phorbol/PKC-activated Alzheimer APP ectodomain shedding.

Science.gov (United States)

Ikin, Annat F; Causevic, Mirsada; Pedrini, Steve; Benson, Lyndsey S; Buxbaum, Joseph D; Suzuki, Toshiharu; Lovestone, Simon; Higashiyama, Shigeki; Mustelin, Tomas; Burgoyne, Robert D; Gandy, Sam

2007-12-09

Shedding of the Alzheimer amyloid precursor protein (APP) ectodomain can be accelerated by phorbol esters, compounds that act via protein kinase C (PKC) or through unconventional phorbol-binding proteins such as Munc13-1. We have previously demonstrated that application of phorbol esters or purified PKC potentiates budding of APP-bearing secretory vesicles at the trans-Golgi network (TGN) and toward the plasma membrane where APP becomes a substrate for enzymes responsible for shedding, known collectively as alpha-secretase(s). However, molecular identification of the presumptive "phospho-state-sensitive modulators of ectodomain shedding" (PMES) responsible for regulated shedding has been challenging. Here, we examined the effects on APP ectodomain shedding of four phorbol-sensitive proteins involved in regulation of vesicular membrane trafficking of APP: Munc13-1, Munc18, NSF, and Eve-1. Overexpression of either phorbol-sensitive wildtype Munc13-1 or phorbol-insensitive Munc13-1 H567K resulted in increased basal APP ectodomain shedding. However, in contrast to the report of Rossner et al (2004), phorbol ester-dependent APP ectodomain shedding from cells overexpressing APP and Munc13-1 wildtype was indistinguishable from that observed following application of phorbol to cells overexpressing APP and Munc13-1 H567K mutant. This pattern of similar effects on basal and stimulated APP shedding was also observed for Munc18 and NSF. Eve-1, an ADAM adaptor protein reported to be essential for PKC-regulated shedding of pro-EGF, was found to play no obvious role in regulated shedding of sAPPalpha. Our results indicate that, in the HEK293 system, Munc13-1, Munc18, NSF, and EVE-1 fail to meet essential criteria for identity as PMES for APP.

Clinical Features of Hereditary and Mast Cell-mediated Angioedema Focusing on the Differential Diagnosis in Japanese Patients.

Science.gov (United States)

Ohsawa, Isao; Honda, Daisuke; Hisada, Atsuko; Inoshita, Hiroyuki; Onda-Tsueshita, Kisara; Mano, Satoshi; Sato, Nobuyuki; Nakamura, Yuya; Shimizu, Tatsuo; Gotoh, Hiromichi; Goto, Yoshikazu; Suzuki, Yusuke; Tomino, Yasuhiko

2018-02-01

Objective The present study was designed to identify the clinical characteristics that permit the differential diagnosis of hereditary angioedema (HAE) and mast cell-mediated angioedema (Mast-AE) during the first consultation. Methods The medical histories and laboratory data of 46 patients with HAE and 41 patients with Mast-AE were compared. Results The average age of onset in the HAE group (19.8±9.0 years) was significantly lower than that in the Mast-AE group (35.2±12.0 years). The incidence of familial angioedema (AE) in the HAE group (73.9%) was significantly higher than that in the Mast-AE group (9.7%). The frequency of history of AE in the extremities, larynx, or gastrointestinal tract was significantly higher in the HAE group. The frequency of AE episodes of the lips and eyelids was significantly lower in the HAE group. The serum C4 concentration and CH50 titer were lower than the normal limit in 91.3% and 45.6% of the patients in the HAE group, respectively; in Mast-AE group the serum C4 concentration and CH50 titer were significantly lower than the normal limit in 4.8% and 0% of the patients, the difference between the two groups was statistically significant. A C1-inhibitor (C1-INH) activity level of <50% was observed in all of the HAE patients, but none of the Mast-AE patients. The mean serum IgE titer in the HAE group (120.8±130.5 IU/mL) was significantly lower than that in the Mast-AE group (262.2±314.9 IU/mL). Conclusion The parameters within the patients' medical histories, such as the age at the onset of AE, a family history of AE, and the locations of past AE episodes are critical for the successful diagnosis of the disease. Measurements of the C4 and C1-INH activity are very useful for differential diagnosis of HAE from Mast-AE.

My brief history. 2. ed.; Meine kurze Geschichte

Energy Technology Data Exchange (ETDEWEB)

Hawking, Stephen

2015-11-01

For the first time, Stephen Hawking turns his gaze inward for a revealing look at his own life and intellectual evolution. My Brief History recounts Stephen Hawking's improbable journey, from his post-war London boyhood to his years of international acclaim and celebrity. Illustrated with rarely seen photographs, this concise, witty and candid account introduces readers to the inquisitive schoolboy whose classmates nicknamed him 'Einstein'; the jokester who once placed a bet with a colleague over the existence of a black hole; and the young husband and father striving to gain a foothold in the world of academia. Writing with humility and humour, Hawking opens up about the challenges that confronted him following his diagnosis of ALS aged twenty-one. Tracing his development as a thinker, he explains how the prospect of an early death urged him onward through numerous intellectual breakthroughs, and talks about the genesis of his masterpiece A Brief History of Time - one of the iconic books of the twentieth century.

The history of neurosurgical treatment of sports concussion.

Science.gov (United States)

Stone, James L; Patel, Vimal; Bailes, Julian E

2014-10-01

Concussion has a long and interesting history spanning at least the 5 millennia of written medical record and closely mirrors the development of surgery and neurosurgery. Not surprisingly, much of the past and present experimental head injury and concussion work has been performed within neurosurgically driven laboratories or by several surgically oriented neurologists. This historical review chronicles the key aspects of neurosurgical involvement in sports concussion as related to the diagnosis, treatment, mitigation, and prevention of injury using the example of American football. In addition, we briefly trace the developments that led to our current understanding of the biomechanical and neurophysiological basis of concussion.

Natural history of cerebral dot-like cavernomas

International Nuclear Information System (INIS)

Nikoubashman, O.; Wiesmann, M.; Tournier-Lasserve, E.; Mankad, K.; Bourgeois, M.; Brunelle, F.; Sainte-Rose, C.; Wiesmann, M.; Zerah, M.; Di Rocco, F.

2013-01-01

Aim: To elucidate the natural history of dot-like or “black spot” cavernomas. Materials and methods: Data of 18 children with black spot cavernomas were analysed retrospectively. Results: Eleven boys and seven girls presented 187 black spot cavernomas during a mean observation period of 5.5 years. Mean and median age at diagnosis of the 187 cavernomas was 9.6 years. There were 70 de novo black spot cavernomas. Boys presented significantly more cavernomas than girls. There were three KRIT1 mutation carriers and four PDCD10 mutation carriers. Children with a PDCD10 mutation presented significantly more lesions than those children with a KRIT1 mutation (mean number of lesions per patient: 23.3 versus 3.3, respectively). There were 10 radiological haemorrhagic events caused by 10 black spot lesions. Two of these events were symptomatic. The haemorrhage rate of black spot cavernomas was 0.7% per lesion-year. Conclusions: A mean bleeding rate of 0.7% per lesion-year is lower than the overall haemorrhage rates provided in the literature. Nonetheless, black spot cavernomas are not purely benign lesions. Furthermore, genetic mutations may play a role in the natural history of black spot cavernomas

BRCA1 status in Pakistani breast cancer patients with moderate family history

International Nuclear Information System (INIS)

Moatter, T.; Pervez, S.; Khan, S.; Azam, I.

2011-01-01

Objective: To determine BRCA1 status in breast carcinoma patients of Pakistani origin. Study Design: Observational study. Place and Duration of Study: The Oncology Clinics of the Aga Khan University Hospital, Karachi, between May 2005 and December 2009. Methodology: Fifty three breast cancer patients based on clinical and laboratory diagnosis were recruited for this study. Moderate family history was defined as having a close relative (mother, daughter, sister) diagnosed with breast cancer under 45 years. Peripheral blood samples were collected from each patient in a 5 ml tube containing EDTA as anticoagulant. Subsequent to DNA extraction, mutational analysis of BRCA1 exons 2, 5, 6, 16, 20 and 22 was carried out using single strand conformation polymorphism (SSCP) assay while protein truncation test (PTT) was used to examine mutations in exon 11. All BRCA1 sequence variants were confirmed by DNA sequencing. Results: Twenty-three patients were diagnosed with early onset breast cancer, 30 patients had moderate family history. At the time of diagnosis, the median age of enrolled patients was 39 years (range 24-65 years). Out of 53 patients, analyzed by SSCP assay, mobility shift was detected in exon 6, 16 and 20 of three patients, whereas one patient was tested positive for mutation in exon 11 by PTT assays. All patients with BRCA1 mutations were further confirmed by DNA sequencing analysis. In exon 16 c.4837A > G was confirmed, which is a common polymorphism reported in several populations including Asians. Moreover, mutations in exon 6 (c.271T > G), exon 20 (c.5231 del G) and exon 11 (c.1123 T > G) were reported first time in the Pakistani population. Several BRCA1 mutations were observed in Pakistani breast cancer patients with moderate family history. Therefore, mutation-based genetic counselling for patients with moderate family history can facilitate management, if one first or second degree relative or early onset disease is apparent. (author)

The ASM-NSF Biology Scholars Program: An Evidence-Based Model for Faculty Development

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Amy L. Chang

2016-05-01

Full Text Available The American Society for Microbiology (ASM established its ASM-NSF (National Science Foundation Biology Scholars Program (BSP to promote undergraduate education reform by 1 supporting biologists to implement evidence-based teaching practices, 2 engaging life science professional societies to facilitate biologists’ leadership in scholarly teaching within the discipline, and 3 participating in a teaching community that fosters disciplinary-level science, technology, engineering, and mathematics (STEM reform. Since 2005, the program has utilized year-long residency training to provide a continuum of learning and practice centered on principles from the scholarship of teaching and learning (SoTL to more than 270 participants (“scholars” from biology and multiple other disciplines. Additionally, the program has recruited 11 life science professional societies to support faculty development in SoTL and discipline-based education research (DBER. To identify the BSP’s long-term outcomes and impacts, ASM engaged an external evaluator to conduct a study of the program’s 2010­–2014 scholars (n = 127 and society partners. The study methods included online surveys, focus groups, participant observation, and analysis of various documents. Study participants indicate that the program achieved its proposed goals relative to scholarship, professional society impact, leadership, community, and faculty professional development. Although participants also identified barriers that hindered elements of their BSP participation, findings suggest that the program was essential to their development as faculty and provides evidence of the BSP as a model for other societies seeking to advance undergraduate science education reform. The BSP is the longest-standing faculty development program sponsored by a collective group of life science societies. This collaboration promotes success across a fragmented system of more than 80 societies representing the life

The ASM-NSF Biology Scholars Program: An Evidence-Based Model for Faculty Development.

Science.gov (United States)

Chang, Amy L; Pribbenow, Christine M

2016-05-01

The American Society for Microbiology (ASM) established its ASM-NSF (National Science Foundation) Biology Scholars Program (BSP) to promote undergraduate education reform by 1) supporting biologists to implement evidence-based teaching practices, 2) engaging life science professional societies to facilitate biologists' leadership in scholarly teaching within the discipline, and 3) participating in a teaching community that fosters disciplinary-level science, technology, engineering, and mathematics (STEM) reform. Since 2005, the program has utilized year-long residency training to provide a continuum of learning and practice centered on principles from the scholarship of teaching and learning (SoTL) to more than 270 participants ("scholars") from biology and multiple other disciplines. Additionally, the program has recruited 11 life science professional societies to support faculty development in SoTL and discipline-based education research (DBER). To identify the BSP's long-term outcomes and impacts, ASM engaged an external evaluator to conduct a study of the program's 2010-2014 scholars (n = 127) and society partners. The study methods included online surveys, focus groups, participant observation, and analysis of various documents. Study participants indicate that the program achieved its proposed goals relative to scholarship, professional society impact, leadership, community, and faculty professional development. Although participants also identified barriers that hindered elements of their BSP participation, findings suggest that the program was essential to their development as faculty and provides evidence of the BSP as a model for other societies seeking to advance undergraduate science education reform. The BSP is the longest-standing faculty development program sponsored by a collective group of life science societies. This collaboration promotes success across a fragmented system of more than 80 societies representing the life sciences and helps

12 December 2012 - US NSF Physics Division Acting Director D. Caldwell signing the guest book with Adviser for the US R. Voss and Head of International Relations F. Pauss; CMS Collaboration Spokesperson J. Incandela and ATLAS Deputy Spokesperson A. Lankford present.

CERN Multimedia

Samuel Morier-Genoud

2012-01-01

12 December 2012 - US NSF Physics Division Acting Director D. Caldwell signing the guest book with Adviser for the US R. Voss and Head of International Relations F. Pauss; CMS Collaboration Spokesperson J. Incandela and ATLAS Deputy Spokesperson A. Lankford present.

Antemortem diagnosis of hydrocephalus in two Congo African grey parrots (Psittacus erithacus erithacus) by means of computed tomography.

Science.gov (United States)

Thurber, Mary I; Mans, Christoph; Fazio, Constance; Waller, Ken; Rylander, Helena; Pinkerton, Marie E

2015-04-01

A 7-year-old and a 10-year-old Congo African grey parrot (Psittacus erithacus erithacus; parrots 1 and 2, respectively) were evaluated because of neurologic deficits. Parrot 1 had an 8- to 9-month history of lethargy and anorexia, with a recent history of a suspected seizure. Parrot 2 had a 6-month history of decreased activity and vocalizing, with an extended history of excessive water intake; a water deprivation test ruled out diabetes insipidus, and psychogenic polydipsia was suspected. Both birds had ophthalmologic asymmetry, with anisocoria detected in parrot 1 and unilateral blindness in parrot 2. Metal gastrointestinal foreign bodies were observed on whole-body radiographs of both birds, but blood lead concentrations were below the range indicated for lead toxicosis. Findings on CT of the head were consistent with hydrocephalus in both cases. Parrot 1 received supportive care and died 3 months after the diagnosis of hydrocephalus. Parrot 2 was treated with omeprazole and prednisolone for 10 days without any improvement in neurologic deficits; euthanasia was elected, and hydrocephalus was confirmed on necropsy. No underlying or concurrent disease was identified. Hydrocephalus should be considered a differential diagnosis for parrots evaluated because of CNS signs. Computed tomography was an excellent screening tool to diagnose hydrocephalus in these patients. Compared with MRI, CT is more frequently available and offers reduced scanning times, reduced cost, and less concern for interference from metallic foreign bodies.

Diagnosis of penicillin allergy revisited: the value of case history, skin testing, specific IgE and prolonged challenge.

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Hjortlund, J; Mortz, C G; Skov, P S; Bindslev-Jensen, C

2013-08-01

Skin testing in duplicate, correlation between case history of immediate and nonimmediate reactions and challenge outcome and prolonged oral treatment with penicillin in the diagnostic evaluation of allergic reactions to β-lactam antibiotics, mimicking real-life situations, have only been addressed in few studies. A total of 342 patients suspected of having β-lactam allergy were investigated according to the European Network for Drug Allergy (ENDA) guidelines and patients found to be negative in the ENDA program were supplemented with a 7-day oral treatment with penicillin. Skin testing with penicillins was performed in duplicate. Patients with case histories of reactions to other β-lactams were also subsequently challenged with the culprit drug. Nineteen patients were IgE-sensitized to penicillin. Then, intracutaneous tests (ICTs) were performed, in which 35 patients tested positive for allergy, 21 with delayed and 14 with immediate reactions. Only three patients tested positive for the major (PPL) and/or minor (MDM) penicillin determinants, all being positive for penicillin G in ICT. The remaining 291 patients were challenged with penicillin: 10 tested positive in single-dose challenge and 23 tested positive in the 7-day challenge. A total of 17 of 78 patients with a negative penicillin challenge tested positive during challenges with other β-lactams. We found no correlation between case histories of immediate and nonimmediate reactions and reaction time during challenge. The data suggest that case history is often insufficient to discriminate between immediate reactors and nonimmediate reactors. A 7-day challenge with the culprit β-lactam may yield more positive reactions than the accepted one- or 2-day challenge. Interpretation of skin testing should be made with caution. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Concise History of Asperger Syndrome: the short reign of a troublesome diagnosis

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Bernardo eBarahona-Correa

2016-01-01

Full Text Available First described in 1944 by Hans Asperger, it was not before 1994 that Asperger Syndrome (AS was included in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, only to disappear in the Manual’s 5th edition in 2013. During its brief existence as a diagnostic entity, AS aroused immense interest and controversy. Similar to patients with autism, AS patients show deficits in social interaction, inappropriate communication skills, and interest restriction, but also display a rich variety of subtle clinical characteristics that for many distinguish AS from autism. However, difficulties operationalising diagnostic criteria and differentiating AS from autism ultimately led to its merging into the unifying category of Autistic Spectrum Disorders. Here we briefly review the short history of this fascinating condition.

Dysuria in the Emergency Department: Missed Diagnosis of Chlamydia trachomatis

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Morgan D. Wilbanks

2014-03-01

Full Text Available Introduction: The clinical presentation of genital Chlamydia trachomatis infection (chlamydia in women is often indistinguishable from a urinary tract infection. While merited in the setting of dysuria, emergency department (ED clinicians do not routinely test for chlamydia in women. The primary aim of our study was to evaluate the frequency of chlamydia testing among women presenting to the ED with dysuria. Methods: We conducted a retrospective chart review of women 19-25 years of age presenting with dysuria to an urban ED and who had been coded with urinary tract infection (UTI as their primary diagnosis (ICD-9 599.0 from October 2005 to March 2011. We excluded women who were pregnant, had underlying anatomical or neurological urinary system pathology, had continuation of symptoms from UTI or a sexually transmitted infection (STI diagnosed elsewhere, or were already on antibiotics for a UTI or STI. We identified the rates of sexual history screening, pelvic examination and chlamydia assay testing and evaluated predictors using univariate and multivariate analyses. Results: Of 280 women with dysuria and a UTI diagnosis, 17% were asked about their sexual history, with 94% reporting recent sexual activity. Pelvic examination was performed in 23%. We were unable to determine the overall chlamydia prevalence as only 20% of women in the cohort were tested. Among the 20% of women tested for chlamydia infection, 21% tested positive. Only 42% of chlamydia-positive women were prescribed treatment effective for chlamydia (azithromycin or doxycycline at their visit; the remaining were prescribed UTI treatment not effective against chlamydia. Predictors of sexual history screening included vaginal bleeding (OR 5.4, 95% CI=1.5 to 19.6 and discharge (OR 2.8, 95% CI=1.1 to 6.9. Predictors of a pelvic examination being performed included having a complaint of vaginal discharge (OR 11.8, 95% CI=4.2 to 32.9, a sexual history performed (OR 2.5, 95% CI=1.1 to 5

Swan ganz catheter for diagnosis of transient central diabetes insipidus after mitral valve replacement

International Nuclear Information System (INIS)

Sarwar, I.; Sinha, L.M.; Younus, A.

2012-01-01

Transient Diabetes Insipidus (DI) occurring in a patient undergoing open heart surgery is a rare occurrence. In this case report, we are presenting a 30 years old female patient with past history of stroke who underwent redo mitral valve replacement developed polyuria. The diagnosis of hypovolemia was made with the help of swan ganz catheter. The patient responded to desmopressin and completely recovered seven days after surgery. It is possible that transient cerebral ischemia given her history of Stroke resulted in the dysfunction of osmotic receptors in the hypothalamus or hypothalamus - pituitary axis during Cardiopulmonary Bypass (CPB). Therefore, we concluded that central DI is a probable cause of polyuria after CPB. (author)

Cybersecurity Implications for Industry, Academia, and Parents: A Qualitative Case Study in NSF STEM Education

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Stevenson, Gregory V.

Rationale: Former President Barack Obama's 3.9 trillion for the 2015 fiscal year budget request included a 2.9 billion investment in Science, Technology, Engineering and Math (STEM) education. Research then showed that the national spending for cybersecurity has exceeded $10.7 billion in the 2015 fiscal year. Nonetheless, the number of cyberattacks has risen year after year since 2012, potentially due to the lack of education and training in cybersecurity. Methodology: A qualitative case study research was conducted to explore and investigate the lived professional experiences of experts from San Antonio Texas whose efforts were aligned to increase the number of qualified cybersecurity professionals. To qualify the organizational needs for cybersecurity professionals, the study gathered expert opinions by surveying human resource managers pertaining to the needs of cybersecurity education. To refine and further validate data collection efforts, the study involved researcher observations and a survey of a narrow cohort to perform analytic induction to eliminate bias and exhaust the exploratory research (Maxwell, 2005). Result: The findings of the case study will: 1) help augment the importance of cybersecurity education in pre-kindergarten through 12th grade, 2) be utilized as a single guide for school leaders in the process of developing cybersecurity education strategies, and 3) in the longer term, be used by the National Sciences Foundation (NSF) as an effective model to institute cybersecurity education practices nationwide and thereby reduce the existing trouble of the nation by criminal cyber actors.

Intra-articular osteoid osteoma as a differential diagnosis of diffuse mono-articular joint pain.

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Rolvien, Tim; Zustin, Jozef; Mussawy, Haider; Schmidt, Tobias; Pogoda, Pia; Ueblacker, Peter

2016-11-04

The aim of this retrospective study was to investigate the frequency of intra-articular osteoid osteoma (iaOO) in a large study cohort and to demonstrate its clinical relevance as an important differential diagnosis of non-specific mono-articular joint pain. We searched the registry for bone tumours of the University Medical Centre Hamburg-Eppendorf for osteoid osteomas in the last 42 years. Herein, we present three selected iaOO which were detected in the three major weight-bearing joints. Computed tomography (CT) or magnetic resonance imaging (MRI) scans were performed for initial diagnosis. Out of a total of 367 osteoid osteomas, 19 (5.2 %) tumours were localized intra-articularly. In all three presented tumours, a history of severe mono-articular pain was reported; however, the mean time to correct diagnosis was delayed to 20.7 months. Clearly, the nidus seen in CT and MRI images in combination with inconsistent salicylate-responsive nocturnal pain led to the diagnosis of iaOO. Rarely, osteoid osteoma can occur in an intra-articular location. In cases of diffuse mono-articular pain, iaOO should be considered both in large and smaller joints to avoid delays in diagnosis and therapy of this benign bone tumour.

Diagnosis and management of Silver-Russell syndrome: first international consensus statement.

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Wakeling, Emma L; Brioude, Frédéric; Lokulo-Sodipe, Oluwakemi; O'Connell, Susan M; Salem, Jennifer; Bliek, Jet; Canton, Ana P M; Chrzanowska, Krystyna H; Davies, Justin H; Dias, Renuka P; Dubern, Béatrice; Elbracht, Miriam; Giabicani, Eloise; Grimberg, Adda; Grønskov, Karen; Hokken-Koelega, Anita C S; Jorge, Alexander A; Kagami, Masayo; Linglart, Agnes; Maghnie, Mohamad; Mohnike, Klaus; Monk, David; Moore, Gudrun E; Murray, Philip G; Ogata, Tsutomu; Petit, Isabelle Oliver; Russo, Silvia; Said, Edith; Toumba, Meropi; Tümer, Zeynep; Binder, Gerhard; Eggermann, Thomas; Harbison, Madeleine D; Temple, I Karen; Mackay, Deborah J G; Netchine, Irène

2017-02-01

This Consensus Statement summarizes recommendations for clinical diagnosis, investigation and management of patients with Silver-Russell syndrome (SRS), an imprinting disorder that causes prenatal and postnatal growth retardation. Considerable overlap exists between the care of individuals born small for gestational age and those with SRS. However, many specific management issues exist and evidence from controlled trials remains limited. SRS is primarily a clinical diagnosis; however, molecular testing enables confirmation of the clinical diagnosis and defines the subtype. A 'normal' result from a molecular test does not exclude the diagnosis of SRS. The management of children with SRS requires an experienced, multidisciplinary approach. Specific issues include growth failure, severe feeding difficulties, gastrointestinal problems, hypoglycaemia, body asymmetry, scoliosis, motor and speech delay and psychosocial challenges. An early emphasis on adequate nutritional status is important, with awareness that rapid postnatal weight gain might lead to subsequent increased risk of metabolic disorders. The benefits of treating patients with SRS with growth hormone include improved body composition, motor development and appetite, reduced risk of hypoglycaemia and increased height. Clinicians should be aware of possible premature adrenarche, fairly early and rapid central puberty and insulin resistance. Treatment with gonadotropin-releasing hormone analogues can delay progression of central puberty and preserve adult height potential. Long-term follow up is essential to determine the natural history and optimal management in adulthood.

Myxedema coma: diagnosis and treatment.

Science.gov (United States)

Wall, C R

2000-12-01

Myxedema coma, the extreme manifestation of hypothyroidism, is an uncommon but potentially lethal condition. Patients with hypothyroidism may exhibit a number of physiologic alterations to compensate for the lack of thyroid hormone. If these homeostatic mechanisms are overwhelmed by factors such as infection, the patient may decompensate into myxedema coma. Patients with hypothyroidism typically have a history of fatigue, weight gain, constipation and cold intolerance. Physicians should include hypothyroidism in the differential diagnosis of every patient with hyponatremia. Patients with suspected myxedema coma should be admitted to an intensive care unit for vigorous pulmonary and cardiovascular support. Most authorities recommend treatment with intravenous levothyroxine (T4) as opposed to intravenous liothyronine (T3). Hydrocortisone should be administered until coexisting adrenal insufficiency is ruled out. Family physicians are in an important position to prevent myxedema coma by maintaining a high level of suspicion for hypothyroidism.

Fault Diagnosis Method of Polymerization Kettle Equipment Based on Rough Sets and BP Neural Network

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Shu-zhi Gao

2013-01-01

Full Text Available Polyvinyl chloride (PVC polymerizing production process is a typical complex controlled object, with complexity features, such as nonlinear, multivariable, strong coupling, and large time-delay. Aiming at the real-time fault diagnosis and optimized monitoring requirements of the large-scale key polymerization equipment of PVC production process, a real-time fault diagnosis strategy is proposed based on rough sets theory with the improved discernibility matrix and BP neural networks. The improved discernibility matrix is adopted to reduct the attributes of rough sets in order to decrease the input dimensionality of fault characteristics effectively. Levenberg-Marquardt BP neural network is trained to diagnose the polymerize faults according to the reducted decision table, which realizes the nonlinear mapping from fault symptom set to polymerize fault set. Simulation experiments are carried out combining with the industry history datum to show the effectiveness of the proposed rough set neural networks fault diagnosis method. The proposed strategy greatly increased the accuracy rate and efficiency of the polymerization fault diagnosis system.

Lung cancer stage at diagnosis: Individual associations in the prospective VITamins and lifestyle (VITAL cohort

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Au David H

2011-06-01

Full Text Available Abstract Background Lung cancer is the leading cause of cancer death in the United States. Identifying factors associated with stage of diagnosis can improve our understanding of biologic and behavioral pathways of lung cancer development and detection. We used data from a prospective cohort study to evaluate associations of demographic, health history, and health behaviors with early versus late stage at diagnosis of non-small cell lung cancer (NSCLC. Methods We calculated odds ratios (ORs for the association of patient-level characteristics with advanced stage of diagnosis for NSCLC. The OR's were then adjusted for age, gender, race/ethnicity, smoking status, income, education, chronic obstructive pulmonary disease, and a comorbidity index. Results We identified 612 cases of NSCLC among 77,719 adults, aged 50 to 76 years from Washington State recruited in 2000-2002, with followup through December 2007. In univariate analyses, subjects who quit smoking Conclusions Smoking status, education, and a screening activity were associated with stage at diagnosis of NSCLC. These results may guide future studies of the underlying mechanisms that influence how NSCLC is detected and diagnosed.

Asthma history, job type and job changes among US nurses.

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Dumas, Orianne; Varraso, Raphaëlle; Zock, Jan Paul; Henneberger, Paul K; Speizer, Frank E; Wiley, Aleta S; Le Moual, Nicole; Camargo, Carlos A

2015-07-01

Nurses are at increased risk of occupational asthma, an observation that may be related to disinfectants exposure. Whether asthma history influences job type or job changes among nurses is unknown. We investigated this issue in a large cohort of nurses. The Nurses' Health Study II is a prospective study of US female nurses enrolled in 1989 (ages 24-44 years). Job status and asthma were assessed in biennial (1989-2011) and asthma-specific questionnaires (1998, 2003). Associations between asthma history at baseline (diagnosis before 1989, n=5311) and job type at baseline were evaluated by multinomial logistic regression. The relations of asthma history and severity during follow-up to subsequent job changes were evaluated by Cox models. The analytic cohort included 98 048 nurses. Compared with nurses in education/administration (likely low disinfectant exposure jobs), women with asthma history at baseline were less often employed in jobs with likely high disinfectant exposure, such as operating rooms (odds ratio 0.73 (95% CI 0.63 to 0.86)) and emergency room/inpatient units (0.89 (0.82 to 0.97)). During a 22-year follow-up, nurses with a baseline history of asthma were more likely to move to jobs with lower exposure to disinfectants (HR 1.13 (1.07 to 1.18)), especially among those with more severe asthma (HR for mild persistent: 1.13; moderate persistent 1.26; severe persistent: 1.50, compared with intermittent asthma, p trend: 0.004). Asthma history was associated with baseline job type and subsequent job changes among nurses. This may partly reflect avoidance of tasks involving disinfectant use, and may introduce bias in cross-sectional studies on disinfectant exposure and asthma in nurses. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Chlamydia trachomatis infection in mother and child; the importance of a complete history and efficient interdisciplinary communication].

Science.gov (United States)

Naafs, Jolanda C; Kleinhout, Mirjam Y

2016-01-01

General practitioners and paediatricians are frequently confronted with coughing infants. The age of the infant, the history of both mother and child, as well as the current maternal condition may provide important diagnostic information. A 4-week-old male infant was referred to the paediatrician with a persistent cough. He was admitted to hospital with dyspnoea and need for supplemental oxygen. Meanwhile, his mother was admitted with unexplained abdominal pain and elevated laboratory inflammation markers. Her history revealed an ectopic pregnancy. The infant's condition, for which the initial differential diagnosis was viral bronchiolitis or whooping cough, deteriorated. His medical history revealed a purulent conjunctivitis. Chlamydia trachomatis PCR turned out to be positive in both mother and child. C. trachomatis pneumonia is a common, yet often overlooked cause of cough in infants. This clinical lesson emphasises the importance of a complete history and efficient communication between medical specialists.

Challenges in Internet Addiction Disorder: Is a Diagnosis Feasible or Not?

Science.gov (United States)

Musetti, Alessandro; Cattivelli, Roberto; Giacobbi, Marco; Zuglian, Pablo; Ceccarini, Martina; Capelli, Francesca; Pietrabissa, Giada; Castelnuovo, Gianluca

2016-01-01

An important international discussion began because of some pioneer studies carried out by Young (a) on the internet addiction disorder (IAD). In the fifth and most recent version of the Diagnostic, and Statistical Manual of Mental Disorders (DSM) there is no mention of this disorder and among researchers there are basically two opposite positions. Those who are in favor of a specific diagnosis and those who are claiming the importance of specific criteria characterizing this behavior and the precise role it has in the patient's life. The aim of the present paper is to answer the question whether it is possible or not to formulate diagnoses of internet-related disorders. We revised literature on the history of diagnostic criteria, on neurocognitive evidence, on the topic debate and on IAD instrumental measures. We found that the disorder was not univocally defined and that the construct was somehow too broad and generic to be explicative for a diagnosis. Indeed, the models are borrowed from other addiction pathologies and they are often formulated before the development of internet as intended in current society. In conclusion, we think we need a more innovative, integrated and comprehensive model for an IAD diagnosis.

[(99)Tc(m)N-NOET dual-phase SPECT in differential diagnosis of benign and malignant lung tumors].

Science.gov (United States)

Liu, Haiyan; Li, Sijin; Yang, Suyun; Wu, Zhifang

2014-01-01

To investigate the value of (99)Tc(m)N-NOET dual-phase SPECT in differential diagnosis of benign and malignant lung tumors. CT scan, early (20 to 30 min) and delayed (2 h) imaging of NOET SPECT were performed on 61 patients suspected of lung lesions before operation. The results were compared with the pathological findings. All cases were not treated with radiotherapy, chemotherapy or surgery before checks. Moreover, all patients had pathological diagnosis. To determine the value in differential diagnosis of tumors by analyzing the tumor uptake and excretion of (99)Tc(m)N-NOET, and the results were compared with that of CT. The value of early T/N ratio (ER) in the malignant (G1) and benign (G2) groups was 1.25 ± 0.15 and 1.09 ± 0.11 (P 0.05). The ER, DR and RI of NOET SPECT in the malignant patients were not significantly correlated with TNM staging, pathological types, tumor diameter, cavity in the lung tumor mass, history of smoking, tumor size and patient gender (P > 0.05). The sensitivity of NOET dual-phase SPECT and CT in the differential diagnosis of benign and malignant lung tumors was 94.1% vs. 90.2%, specificity was 70.0% vs. 80.0% , positive predictive value (PPV) was 94.1% vs. 95.8%, negative predictive value (NPV) was 70.0% vs. 61.5 %, and accuracy was 90.2%. vs. 88.5% (P > 0.05 for all). (99)Tc(m)N- NOET dual-phase SPECT could be used in differential diagnosis of benign and malignant lung tumors, with no significant differences compared with the efficacy of CT imaging. The semiquantitative indexes (ER, DR and RI) of NOET SPECT can also be used in differential diagnosis of benign and malignant lung tumors, and are not significantly correlated with TNM staging, pathological types, tumor diameter, cavity of the lung tumor mass, history of smoking, tumor size and patient gender.

History and physical examination of hip injuries in elderly adults.

Science.gov (United States)

Hamedan Al Maqbali, Mohammed Abdullah

2014-01-01

Hip fracture is the most common injury occurring to elderly people and is associated with restrictions of the activities of the patients themselves. The discovery of a hip fracture can be the beginning of a complex journey of care, from initial diagnosis, through operational procedures to rehabilitation. The patient's history and physical examination form the basis of the diagnosis and monitoring of elderly patients with hip problems and dictate the appropriate treatment strategy to be implemented. The aim of this study is to discuss the different diagnoses of hip pain in a case study of an elderly woman who initially complained of pain in her right knee following a fall at home. It shows that musculoskeletal physical examination determined the management of the hip fracture that was found to be present. In addition, the aim of this article is to review diagnostic tests such as radiographs and recommend appropriate management and treatment of hip fractures in elderly patients.

Fascioliasis - a contribution to the differential diagnosis of focal liver lesions

Energy Technology Data Exchange (ETDEWEB)

Schleppi, V.; Neufang, O.; Scheerer, W.; Lossnitzer, K.

1987-02-01

The case of a 60 years old patient with a rare parasitosis, fascioliasis hepatica, is presented. The clinical, parasitologic, radiologic and histologic findings are discussed with reference to the literature. The diagnosis was established by examination of the faeces of the patient. The radiologic examinations document the extent of the organic involvement, in the presented case that of the liver. The finding of circumscribed hypodense liver lesions can be decisive for the further diagnostic proceedings only in the light of an appropriate history and typical laboratory findings.

How well do second-year students learn physical diagnosis? Observational study of an objective structured clinical examination (OSCE

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Simon Steven R

2002-01-01

Full Text Available Abstract Background Little is known about using the Objective Structured Clinical Examination (OSCE in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Methods Cross-sectional study at Harvard Medical School, 1997–1999, for 489 second-year students. Results Average total OSCE score was 57% (range 39–75%. Among clinical skills, students scored highest on patient interaction (72%, followed by examination technique (65%, abnormality identification (62%, history-taking (60%, patient presentation (60%, physical examination knowledge (47%, and differential diagnosis (40% (p Conclusions Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.

PRIMIPARA POST PARTUM DEPRESSION DIAGNOSIS AND TREATMENT

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Esha Pradnyana

2013-02-01

Full Text Available Pregnancy and the first child birth is an influential complex event for a mother, which is where everything including phsycal and psyological aspects. This change can make mother psyological disorder, that can lead into depression after childbearing that call post childbearing depression or post partum depression. A wide review at 59 study make a result that 13% among primipara can suffer post partum depression 12 weeks after childbearing. Estabilishmet of this diagnosis, besides from history and symptoms, and can be supported through test Edinburgh Postnatal Depression Scale( EPDS . Patient with post partum depression, given treatment with antidepressant drug. Breastfeeding is not only to reduce stress for the mother, but also reduce the level of stress on a baby when his mother suffered depression

Diagnosis of toxic alcohols: limitations of present methods.

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Kraut, Jeffrey A

2015-01-01

Methanol, ethylene glycol, diethylene glycol, and propylene glycol intoxications are associated with cellular dysfunction and an increased risk of death. Adverse effects can develop quickly; thus, there is a need for methods for rapidly detecting their presence. To examine the value and limitations of present methods to diagnose patients with possible toxic alcohol exposure. I searched MEDLINE for articles published between 1969 and 2014 using the terms: toxic alcohols, serum osmolality, serum osmol gap, serum anion gap, metabolic acidosis, methanol, ethylene glycol, diethylene glycol, propylene glycol, and fomepizole. Each article was reviewed for additional references. The diagnosis of toxic alcohol exposure is often made on the basis of this history and physical findings along with an increase in the serum osmol and anion gaps. However, an increase in the osmol and/or anion gaps is not always present. Definitive detection in blood requires gas or liquid chromatography, laborious and expensive procedures which are not always available. Newer methods including a qualitative colorimetric test for detection of all alcohols or enzymatic tests for a specific alcohol might allow for more rapid diagnosis. Exposure to toxic alcohols is associated with cellular dysfunction and increased risk of death. Treatment, if initiated early, can markedly improve outcome, but present methods of diagnosis including changes in serum osmol and anion gap, and use of gas or liquid chromatography have important limitations. Development of more rapid and effective tests for detection of these intoxications is essential for optimal care of patients.

Brokering technologies to realize the hydrology scenario in NSF BCube

Science.gov (United States)

Boldrini, Enrico; Easton, Zachary; Fuka, Daniel; Pearlman, Jay; Nativi, Stefano

2015-04-01

In the National Science Foundation (NSF) BCube project an international team composed of cyber infrastructure experts, geoscientists, social scientists and educators are working together to explore the use of brokering technologies, initially focusing on four domains: hydrology, oceans, polar, and weather. In the hydrology domain, environmental models are fundamental to understand the behaviour of hydrological systems. A specific model usually requires datasets coming from different disciplines for its initialization (e.g. elevation models from Earth observation, weather data from Atmospheric sciences, etc.). Scientific datasets are usually available on heterogeneous publishing services, such as inventory and access services (e.g. OGC Web Coverage Service, THREDDS Data Server, etc.). Indeed, datasets are published according to different protocols, moreover they usually come in different formats, resolutions, Coordinate Reference Systems (CRSs): in short different grid environments depending on the original data and the publishing service processing capabilities. Scientists can thus be impeded by the burden of discovery, access and normalize the desired datasets to the grid environment required by the model. These technological tasks of course divert scientists from their main, scientific goals. The use of GI-axe brokering framework has been experimented in a hydrology scenario where scientists needed to compare a particular hydrological model with two different input datasets (digital elevation models): - the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) dataset, v.2. - the Shuttle Radar Topography Mission (SRTM) dataset, v.3. These datasets were published by means of Hyrax Server technology, which can provide NetCDF files at their original resolution and CRS. Scientists had their model running on ArcGIS, so the main goal was to import the datasets using the available ArcPy library and have EPSG:4326 with the same resolution grid as the

Specific features of the clinical and laboratory diagnosis of Lesch—Nyhan syndrome and current therapy options

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M. I. Yablonskaya

2015-01-01

Full Text Available The rare hereditary diseases encountered in the practice of pediatricians, pediatric neurologists, and geneticists include Lesch—Nyhan syndrome associated with purine metabolic disorders caused by mutations in the HPRT1 gene encoding the enzyme hypoxanthine-guanine phosphoribosyltransferase (HGPRT. HGPRT deficiency gives rise to hyperuricemia, hyperuricemic nephropathy, and a CNS lesion reminiscent of dystonic or hyperkinetic infantile cerebral paralysis concurrent with a propensity to have autoaggressive behavior. The diagnosis is based on a range of history data, characteristic neurological symptoms, the detection of high blood and urine uric acid levels, and the identification of pathogenic mutagens in the HPRT1 gene. Early diagnosis contributes to timely therapy and assists in medical genetic counseling. The paper describes a clinical case of a boy with Lesch-Nyhan syndrome and elucidates the problems of diagnosis and treatment of this disease.

Laypersons can seek help from their Facebook friends regarding medical diagnosis

DEFF Research Database (Denmark)

Folkestad, Lars; Brodersen, Jacob Broder; Hallas, Peter

2011-01-01

INTRODUCTION: In contrast to Internet search engines, social media on the Internet such as Facebook, Twitter, etc. reach a large number of people, who are ready to help answering questions. This type of information aggregation has been dubbed "crowdsourcing" i.e. outsourcing a task to a large group...... of people or community (a crowd) through an open call. Our aim was to explore whether laypersons via Facebook friends could crowd source their way to a medical diagnosis based on a brief medical history, posted as a status update on Facebook. MATERIAL AND METHODS: The participants posted a brief case story...... to very silly diagnostic suggestions. CONCLUSION: Based on this study, we believe that laypersons can use his or her »Facebook friends" to identify the need to see a doctor for their symptoms rather than relying on them to give them a specific diagnosis for their symptoms....

Strategy for the diagnosis of thyroid disorders in the developing countries

International Nuclear Information System (INIS)

Poshyachinda, M.

1992-01-01

Thyroid disorders may manifest as abnormalities of anatomy of function of the gland. Most of them can be diagnosed after a careful clinical history and physical examination. Nevertheless, laboratory evaluation is important for an accurate diagnosis before embarking on treatment. There is also a small but a significant fraction of thyroid diseases that can be diagnosed only on the basis of laboratory findings. Often a diagnosis of thyroid disease may need more than a single test. Hence, it is essential to select appropriate tests for thyroid patients by their reliability, precision and overall cost. Many thyroid function tests are nuclear techniques and this trend is not likely to change in near future. Radionuclides that are commonly used in the evaluation of thyroid disorders include iodine-131 ( 131 I), iodine-123 ( 123 I), iodine-125 ( 125 I) and technetium-99m ( 99 TC m -TcO4)

The impact of a cervical spine diagnosis on the careers of National Football League athletes.

Science.gov (United States)

Schroeder, Gregory D; Lynch, T Sean; Gibbs, Daniel B; Chow, Ian; LaBelle, Mark W; Patel, Alpesh A; Savage, Jason W; Nuber, Gordon W; Hsu, Wellington K

2014-05-20

Cohort study. To determine the effect of cervical spine pathology on athletes entering the National Football League. The association of symptomatic cervical spine pathology with American football athletes has been described; however, it is unknown how preexisting cervical spine pathology affects career performance of a National Football League player. The medical evaluations and imaging reports of American football athletes from 2003 to 2011 during the combine were evaluated. Athletes with a cervical spine diagnosis were matched to controls and career statistics were compiled. Of a total of 2965 evaluated athletes, 143 players met the inclusion criteria. Athletes who attended the National Football League combine without a cervical spine diagnosis were more likely to be drafted than those with a diagnosis (P = 0.001). Players with a cervical spine diagnosis had a decreased total games played (P = 0.01). There was no difference in the number of games started (P = 0.08) or performance score (P = 0.38). In 10 athletes with a sagittal canal diameter of less than 10 mm, there was no difference in years, games played, games started, or performance score (P > 0.24). No neurological injury occurred during their careers. In 7 players who were drafted with a history of cervical spine surgery (4 anterior cervical discectomy and fusion, 2 foraminotomy, and 1 suboccipital craniectomy with a C1 laminectomy), there was no difference in career longevity or performance when compared with matched controls. This study suggests that athletes with preexisting cervical spine pathology were less likely to be drafted than controls. Players with preexisting cervical spine pathology demonstrated a shorter career than those without; however, statistically based performance and numbers of games started were not different. Players with cervical spinal stenosis and those with a history of previous surgery demonstrated no difference in performance-based outcomes and no reports of neurological

Necrotizing fasciitis of the lower extremity: a case report and current concept of diagnosis and management.

LENUS (Irish Health Repository)

Naqvi, G A

2012-02-01

Necrotizing fasciitis is a severe soft tissue infection characterized by rapidly progressing necrosis, involving subcutaneous tissues. This rare condition carries high mortality rate and require prompt diagnosis and urgent treatment with radical debridement and antibiotics. We describe a case of 21-year old man who presented with the history of trivial injury to the knee. Initially he was admitted and treated for septic arthritis but later was diagnosed as necrotizing fasciitis which was successfully treated with no ill effects what so ever from this devastating condition. This rare condition has been reported in literature but still early diagnosis, which is a key for successful treatment, remains a challenge.

Histories electromagnetism

International Nuclear Information System (INIS)

Burch, Aidan

2004-01-01

Working within the HPO (History Projection Operator) Consistent Histories formalism, we follow the work of Savvidou on (scalar) field theory [J. Math. Phys. 43, 3053 (2002)] and that of Savvidou and Anastopoulos on (first-class) constrained systems [Class. Quantum Gravt. 17, 2463 (2000)] to write a histories theory (both classical and quantum) of Electromagnetism. We focus particularly on the foliation-dependence of the histories phase space/Hilbert space and the action thereon of the two Poincare groups that arise in histories field theory. We quantize in the spirit of the Dirac scheme for constrained systems

Diagnostic accuracy of history, physical examination, and bedside ultrasound for diagnosis of extremity fractures in the emergency department: a systematic review.

Science.gov (United States)

Joshi, Nikita; Lira, Alena; Mehta, Ninfa; Paladino, Lorenzo; Sinert, Richard

2013-01-01

Understanding history, physical examination, and ultrasonography (US) to diagnose extremity fractures compared with radiography has potential benefits of decreasing radiation exposure, costs, and pain and improving emergency department (ED) resource management and triage time. The authors performed two electronic searches using PubMed and EMBASE databases for studies published between 1965 to 2012 using a strategy based on the inclusion of any patient presenting with extremity injuries suspicious for fracture who had history and physical examination and a separate search for US performed by an emergency physician (EP) with subsequent radiography. The primary outcome was operating characteristics of ED history, physical examination, and US in diagnosing radiologically proven extremity fractures. The methodologic quality of the studies was assessed using the quality assessment of studies of diagnostic accuracy tool (QUADAS-2). Nine studies met the inclusion criteria for history and physical examination, while eight studies met the inclusion criteria for US. There was significant heterogeneity in the studies that prevented data pooling. Data were organized into subgroups based on anatomic fracture locations, but heterogeneity within the subgroups also prevented data pooling. The prevalence of fracture varied among the studies from 22% to 70%. Upper extremity physical examination tests have positive likelihood ratios (LRs) ranging from 1.2 to infinity and negative LRs ranging from 0 to 0.8. US sensitivities varied between 85% and 100%, specificities varied between 73% and 100%, positive LRs varied between 3.2 and 56.1, and negative LRs varied between 0 and 0.2. Compared with radiography, EP US is an accurate diagnostic test to rule in or rule out extremity fractures. The diagnostic accuracy for history and physical examination are inconclusive. Future research is needed to understand the accuracy of ED US when combined with history and physical examination for upper

Prenatal diagnosis of hypomethylation at KvDMR1 and Beckwith–Wiedemann syndrome in a pregnancy conceived by intracytoplasmic sperm injection and in vitro fertilization and embryo transfer

Directory of Open Access Journals (Sweden)

Chih-Ping Chen

2014-03-01

Conclusion: In case of prenatally detected omphalocele associated with an obstetric history of assisted reproductive technology, a differential diagnosis of BWS should be considered. Methylation assays such as MS-MLPA and methylation-specific polymerase chain reaction using uncultured amniocytes are useful for rapid diagnosis of BWS under such circumstances.

Point-of-care Ultrasound for the Diagnosis of Ectopic Pregnancy

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Ahmed Farhat

2017-09-01

Full Text Available History of present illness: A 31-year-old female presented to the Emergency Department by ambulance with severe abdominal pain and presyncope. On exam, the patient was hypotensive with suprapubic tenderness. Though the patient denied being pregnant, her labs showed a beta human chorionic gonadotropin (hCG of 38,000 mIU/ml. A bedside transabdominal pelvic ultrasound revealed an ectopic pregnancy and the patient was taken to the operating room for an emergent right salpingectomy. Significant findings: The transabdominal pelvic ultrasound shows an empty uterus (annotated with free fluid and a right sided extrauterine gestational sac representing an ectopic pregnancy (red arrow. Discussion: Ectopic pregnancy is the leading cause of mortality in the first trimester of pregnancy making prompt diagnosis critical.1 Risk factors including history of previous ectopic pregnancy,2 pelvic inflammatory disease,2 increased age,3 and smoking4 can raise suspicion of an ectopic pregnancy. However, the absence of risk factors does not exclude ectopic pregnancy from the differential. Any sexually active female with abdominal pain following a period of amenorrhea should be suspected of an ectopic until proven otherwise. One third of all pregnant women experience abdominal pain and/or vaginal bleeding and 9% of women with an ectopic are asymptomatic. Thus, history alone is insufficient to make the diagnosis.5 In early pregnancy, ectopic pregnancies share the same symptoms as normal pregnancies, including a missed menstrual period, fatigue, and nausea. The first classical signs of an ectopic pregnancy are vaginal bleeding, dizziness, and lower abdominal and/or pelvic pain usually 6 to 8 weeks after a missed menstrual period.5 A meta-analysis of studies on pelvic ultrasonography demonstrated a sensitivity of 99.3% and a negative predictive value of 99.6% for diagnosing ectopic pregnancy and therefore should be utilized as a first-line diagnostic tool for emergency

Point-of-care Ultrasound for the Diagnosis of a Gluteal Abscess

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Kevin Roy

2018-01-01

Full Text Available History of present illness: A 57-year-old male with a history of intravenous drug use presented to the emergency department with four days of progressively worsening pain and swelling to his left buttock after injecting heroin subcutaneously (i.e., “skin popping”. Labs were significant for a white blood cell count (WBC of 26,700/mm3. Using the high frequency, linear probe, a point-of-care ultrasound (POCUS was performed and revealed a large soft tissue abscess. Significant findings: POCUS reveals a large, hypoechoic soft tissue abscess with debris and tracks extending to the bottom of the image. Furthermore, when compressed, movement of the abscess contents is appreciated. There is also superficial cobble-stoning consistent with overlying cellulitis and soft tissue edema. Discussion: In the United States, there are over 14 million outpatient visits per year related to soft tissue infections, with nearly one-third being seen in the emergency department.1,2 22%-65% of intravenous drug users experience abscesses and cellulitis.3 Soft tissue abscesses are commonly encountered in the emergency department and the diagnosis is often made by history and physical exam.5 However, imaging modalities are more accurate than physical exam alone. When comparing ultrasound to physical exam in the diagnosis of soft tissue abscesses, one study suggests that ultrasound has a sensitivity and specificity of 96% and 87%, respectively. The sensitivity and specificity of the physical exam is 84% and 60%, respectively.4 Another study comparing computed tomography (CT to ultrasound in the diagnosis of abscesses found ultrasound to have a sensitivity and specificity of 96.7% and 85.7%, respectively, while the overall sensitivity and specificity of CT was 76.7% and 91.4%, respectively. Ultrasound was superior in overall image detail ratings and demonstrated more visible detail within the abscess cavity. 5 When utilizing POCUS to evaluate for an abscess, look for an

Malrotation and midgut volvulus: a historical review and current controversies in diagnosis and management

International Nuclear Information System (INIS)

Lampl, Brooke; Berdon, Walter E.; Levin, Terry L.; Cowles, Robert A.

2009-01-01

The complex and sometimes controversial subject of malrotation and midgut volvulus is reviewed commencing with the 19th-century Bohemian anatomist, Vaclav Treitz, who described the suspensory muscle anchoring of the duodenal-jejunal junction in the left upper quadrant, and continuing with William Ladd, the 20th-century American ''father of pediatric surgery'' who pioneered the surgical treatment of midgut volvulus. In this review, we present the interesting history of malrotation and discuss the current radiologic and surgical controversies surrounding its diagnosis and treatment. In the symptomatic patient with malrotation and possible midgut volvulus, prompt diagnosis is critical. The clinical examination and plain film are often confusing, and delayed diagnosis can lead to significant morbidity and death. Despite recent intense interest in the position of the mesenteric vessels on US and CT scans, the upper gastrointestinal series remains the fastest and most accurate method of demonstrating duodenal obstruction, the position of the ligament of Treitz, and, if the contrast agent is followed distally, cecal malposition. Controversy exists over the management of asymptomatic patients with malrotation in whom the diagnosis is made incidentally during evaluation for nonspecific complaints, prior to reflux surgery, and in those with heterotaxy syndromes. (orig.)

[A family history of renal lithiasis in children diagnosed of urinary tract infection by Escherichia coli].

Science.gov (United States)

García Nieto, Víctor; Sotoca Fernández, Jorge; O'Hagan, Monica; Arango Sancho, Pedro; Luis Yanes, Maria Isabel

2018-04-01

Urinary tract infections (UTI) caused by Escherichia coli (E. coli) are common in patients with idiopathic hypercalciuria. As both UTI and hypercalciuria (prelithiasis) have a genetic basis, we wanted to know whether the family history of urolithiasis is more common in children with UTIs caused by E. coli. Secondarily, we wondered if the renal scars are more common in children with prelithiasis. Ambispective study with collected data from 104 patients (40 male, 64 female) followed after having been diagnosed of UTI by E. coli at least once. These patients were asked about the existence of urolithiasis in relatives. The calcium and citrate urinary elimination was qunatified in 80 children. In the total sample, family history was positive for urolithiasis in a significantly higher frequency in those children (n=71; 68.3%) than in the control population in our area (29.7%; previously published data). Prelithiasis frequency in children with UTI was 47.5% (38/80). An association was observed between the diagnosis of prelithiasis both with family history of urolithiasis (P=.030) and the diagnosis of vesicoureteral reflux (P=.034). Children who developed renal scarring had an increased risk of prelithiasis (OR 5.3; P=.033). The frequency of family history of urolithiasis in children with UTI caused by E. coli is very high. Based on our results we hypothesize that the predisposition to lithiasis can involve a constitutively altered defense to E. coli and, therefore, a greater possibility for renal scars. Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Hemophilia Diagnosis

Science.gov (United States)

... and the severity. Families With a History of Hemophilia Any family history of bleeding, such as following ... for hemophilia . Families With No Previous History of Hemophilia About one-third of babies who are diagnosed ...

BSACI guideline for the diagnosis and management of cow's milk allergy.

Science.gov (United States)

Luyt, D; Ball, H; Makwana, N; Green, M R; Bravin, K; Nasser, S M; Clark, A T

2014-01-01

This guideline advises on the management of patients with cow's milk allergy. Cow's milk allergy presents in the first year of life with estimated population prevalence between 2% and 3%. The clinical manifestations of cow's milk allergy are very variable in type and severity making it the most difficult food allergy to diagnose. A careful age- and disease-specific history with relevant allergy tests including detection of milk-specific IgE (by skin prick test or serum assay), diagnostic elimination diet, and oral challenge will aid in diagnosis in most cases. Treatment is advice on cow's milk avoidance and suitable substitute milks. Cow's milk allergy often resolves. Reintroduction can be achieved by the graded exposure, either at home or supervised in hospital depending on severity, using a milk ladder. Where cow's milk allergy persists, novel treatment options may include oral tolerance induction, although most authors do not currently recommend it for routine clinical practice. Cow's milk allergy must be distinguished from primary lactose intolerance. This guideline was prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and is intended for clinicians in secondary and tertiary care. The recommendations are evidence based, but where evidence is lacking the panel of experts in the committee reached consensus. Grades of recommendation are shown throughout. The document encompasses epidemiology, natural history, clinical presentations, diagnosis, and treatment. © 2014 John Wiley & Sons Ltd.

BLINCK?A diagnostic algorithm for skin cancer diagnosis combining clinical features with dermatoscopy findings

OpenAIRE

Bourne, Peter; Rosendahl, Cliff; Keir, Jeff; Cameron, Alan

2012-01-01

Background: Deciding whether a skin lesion requires biopsy to exclude skin cancer is often challenging for primary care clinicians in Australia. There are several published algorithms designed to assist with the diagnosis of skin cancer but apart from the clinical ABCD rule, these algorithms only evaluate the dermatoscopic features of a lesion. Objectives: The BLINCK algorithm explores the effect of combining clinical history and examination with fundamental dermatoscopic assessment in primar...

The lymphocyte transformation test for the diagnosis of drug allergy: sensitivity and specificity.

Science.gov (United States)

Nyfeler, B; Pichler, W J

1997-02-01

The diagnosis of a drug allergy is mainly based upon a very detailed history and the clinical findings. In addition, several in vitro or in vivo tests can be performed to demonstrate a sensitization to a certain drug. One of the in vitro tests is the lymphocyte transformation test (LTT), which can reveal a sensitization of T-cells by an enhanced proliferative response of peripheral blood mononuclear cells to a certain drug. To evaluate the sensitivity and specificity of the LTT, 923 case histories of patients with suspected drug allergy in whom a LTT was performed were retrospectively analysed. Based on the history and provocation tests, the probability (P) of a drug allergy was estimated to be > 0.9, 0.5-0.9, 0.1-0.5 or 0.9) had a positive LTT, which indicates a sensitivity of 78%. If allergies to betalactam-antibiotics were analysed separately, the sensitivity was 74.4%. Fifteen of 102 patients where a classical drug allergy could be excluded (P sensitization could be demonstrated as well (i.e. hen's egg lysozyme, 7/7). In 632 of the 923 cases, skin tests were also performed (scratch and/or epicutaneous), for which we found a lower sensitivity than for the LTT (64%), while the specificity was the same (85%). Although our data are somewhat biased by the high number of penicillin allergies and cannot be generalized to drug allergies caused by other compounds, we conclude that the LTT is a useful diagnostic test in drug allergies, able to support the diagnosis of a drug allergy and to pinpoint the relevant drug.

Prenatal diagnosis of sirenomelia in the first trimester: A case report.

Science.gov (United States)

Ceylan, Yasin; Doğan, Yasemin; Özkan Özdemir, Sebiha; Yücesoy, Gülseren

2016-03-01

Sirenomelia or "mermaid syndrome" is a rare congenital syndrome characterized by the anomalous development of the caudal region of the body. We present a case of sirenomelia diagnosed in the first trimester using two-dimensional and three-dimensional ultrasonographic examination. A nulliparous woman aged thirty years was referred to our perinatology unit for evaluation because of oligohydramnios at 12 weeks of gestation. Her medical history was unremarkable. There was no family history of genetic abnormalities. We identified a single lower extremity and severe oligohydramnios, which are characteristics of sirenomelia. Sirenomelia, a developmental defect involving the caudal region of the body, is associated with several internal visceral anomalies. Sirenomelia is fatal in most cases due to the characteristic pulmonary hypoplasia and renal agenesia. Prenatal diagnosis of sirenomelia may be difficult in the second or third trimester because of the severe oligohydramnios; it should be easier to diagnose sirenomelia in the first trimester.

Persistent severe hypokalemia: Gitelman syndrome and differential diagnosis

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Christine Zomer Dal Molin

Full Text Available Abstract The main causes of hypokalemia are usually evident in the clinical history of patients, with previous episodes of vomiting, diarrhea or diuretic use. However, in some patients the cause of hypokalemia can become a challenge. In such cases, two major components of the investigation must be performed: assessment of urinary excretion potassium and the acid-base status. This article presents a case report of a patient with severe persistent hypokalemia, complementary laboratory tests indicated that's it was hypomagnesaemia and hypocalciuria associated with metabolic alkalosis, and increase of thyroid hormones. Thyrotoxic periodic paralysis was included in the differential diagnosis, but evolved into euthyroid state, persisting with severe hypokalemia, which led to be diagnosed as Gitelman syndrome.

Clinical Implications for the Timely Diagnosis of Mycobacterium marinum in the Age of Biologic Therapy: A Case Report and Review of the Literature

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Chris J. Lata

2017-01-01

Full Text Available Mycobacterium marinum infections typically present as cutaneous nodular lesions with a sporotrichoid lymphatic spread on extensor surfaces of extremities. The natural history of this infection can be altered if the host is immunosuppressed, leading to disseminated presentations. A detailed exposure history and high degree of suspicion for this indolent pathogen are often required for the correct diagnosis of this disease. We present a case of a 67-year-old male misdiagnosed with seronegative rheumatoid arthritis presenting with rheumatic nodules. Initiation of chronic immunosuppressant therapy including biologic monoclonal antibodies resulted in the exacerbation of initially localized disease to broadly disseminated lymphatic, joint, and myotendinous granulomatous disease and led to delay in the correct diagnosis. Cessation of immunosuppressants, with a prolonged course of antimicrobial therapy and multiple surgical debridements were required for cure.

Uroscopy by Hippocrates and Theophilus: prognosis versus diagnosis.

Science.gov (United States)

Kouba, Erik; Wallen, Eric M; Pruthi, Raj S

2007-01-01

In antiquity the visual examination of urine (uroscopy) is well documented. Uroscopy gradually evolved from a prognostic indicator to a diagnostic tool. Comparison of the uses of uroscopy by Hippocrates (400 BC) and Theophilus (700 AD) illustrates this transformation. We reviewed medical and historical literature as well as the translated works of Hippocrates. Although Hippocrates was one of the first physicians to use urine to interpret human body functioning, urine was mainly used as a means for prognosis and prediction of outcomes of illness. In his text De Urinis Theophilus introduced an innovative doctrine and used uroscopy for diagnosis of illnesses. In this respect uroscopy became a paradigm for later diagnostic strategies and is considered an important milestone in the history of clinical diagnosis. Hippocrates' writings displayed uroscopy used in examination of illness. However, he considered it in the context for accurate prognoses. Theophilus treated uroscopy in a sophisticated objective manner and attempted to use uroscopy in an orderly, systemic method to accurately diagnose illness. It was through these approaches to uroscopy that Theophilus became one of the physicians who contributed to the birth of medieval medical studies.

Diagnosis and management of asthma in older adults.

LENUS (Irish Health Repository)

Chotirmall, Sanjay Haresh

2009-05-01

Despite comprehensive guidelines established by the European Global Initiative for Asthma and the U.S. National Asthma Education and Prevention Program on the diagnosis and management of asthma, its mortality in older adults continues to rise. Diagnostic and therapeutic problems contribute to older patients being inadequately treated. The diagnosis of asthma rests on the history and characteristic pulmonary function testing (PFT) with the demonstration of reversible airway obstruction, but there are unique problems in performing this test in older patients and in its interpretation. This review aims to address the difficulties in performing and interpreting PFT in older patients because of the effects of age-related changes in lung function on respiratory physiology. The concept of "airway remodeling" resulting in "fixed obstructive" PFT and the relevance of atopy in older people with asthma are assessed. There are certain therapeutic issues unique to older patients with asthma, including the increased probability of adverse effects in the setting of multiple comorbidities and issues surrounding effective drug delivery. The use of beta 2-agonist, anticholinergic, corticosteroid, and anti-immunoglobulin E treatments are discussed in the context of these therapeutic issues.

Family history of colorectal cancer in first-degree relatives and metachronous colorectal adenoma.

Science.gov (United States)

Jacobs, Elizabeth T; Gupta, Samir; Baron, John A; Cross, Amanda J; Lieberman, David A; Murphy, Gwen; Martínez, María Elena

2018-02-20

Little is known about the relationship between having a first-degree relative (FDR) with colorectal cancer (CRC) and risk for metachronous colorectal adenoma (CRA) following polypectomy. We pooled data from seven prospective studies of 7697 patients with previously resected CRAs to quantify the relationship between having a FDR with CRC and risk for metachronous adenoma. Compared with having no family history of CRC, a positive family history in any FDR was significantly associated with increased odds of developing any metachronous CRA (OR = 1.14; 95% CI = 1.01-1.29). Higher odds of CRA were observed among individuals with an affected mother (OR = 1.27; 95% CI = 1.05-1.53) or sibling (OR = 1.34; 95% CI = 1.11-1.62) as compared with those without, whereas no association was shown for individuals with an affected father. Odds of having a metachronous CRA increased with number of affected FDRs, with ORs (95% CIs) of 1.07 (0.93-1.23) for one relative and 1.39 (1.02-1.91) for two or more. Younger age of diagnosis of a sibling was associated with higher odds of metachronous CRA, with ORs (95% CIs) of 1.66 (1.08-2.56) for diagnosis at 65 years (p-trend = 0.008). Although limited by sample size, results for advanced metachronous CRA were similar to those for any metachronous CRA. A family history of CRC is related to a modestly increased odds of metachronous CRA. Future research should explore whether having a FDR with CRC, particularly at a young age, should have a role in risk stratification for surveillance colonoscopy.

Herpetic esophagitis: a diagnosis to remember

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Marina Pinheiro

2016-02-01

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

Enteropathic Spondyloarthritis: From Diagnosis to Treatment

Directory of Open Access Journals (Sweden)

Rosario Peluso

2013-01-01

Full Text Available Enteropathic arthritis (EA is a spondyloarthritis (SpA which occurs in patients with inflammatory bowel diseases (IBDs and other gastrointestinal diseases. Diagnosis is generally established on the medical history and physical examination. It was, generally, made according to the European Spondyloarthropathy Study Group (ESSG criteria. Rheumatic manifestations are the most frequent extraintestinal findings of IBD with a prevalence between 17% and 39%, and IBD is associated, less frequently, with other rheumatic disease such as rheumatoid arthritis, Sjogren syndrome, Takayasu arteritis, and fibromyalgia. Although the pathogenesis of EA has not been plainly clarified, the most popular theory supposes that joint inflammation occurs in genetically predisposed subjects with bacterial gut infections, provided an important evidence for a possible relationship between inflammation of the gut mucosa and arthritis. The management of patients with EA requires an active cooperation between the gastroenterologist and rheumatologist.

Non-operative diagnosis - effect on repeat-operation rates in the UK breast screening programme

International Nuclear Information System (INIS)

Wallis, M.G.; Cheung, S.; Kearins, O.; Lawrence, G.M.

2009-01-01

Non-operative diagnosis rates in the UK breast screening programme have improved dramatically from 48.8% in 1994/95 (only nine units achieved the then minimum standard of 70%) to 94% in 2005/06 (only seven units failed to achieve the target of 90%). Preoperative and operative history of all 120,550 women diagnosed with screen-detected breast cancer in the UK between April 1994 and March 2006 was derived from different national databases. In 2005/06, 2,790 (17.8%) of the 15,688 women having surgery needed two or more operations. In 2001/02 (non-operative diagnosis rate 87%), the re-operation rate was 23.8% (2,377 of 9,969). Extrapolation backwards to 1994/95 (non-operative diagnosis rate 48.8%) suggests a re-operation rate of 62%. Analysis over the 4 years from April 2002 (n=34,198) demonstrates that 4,089 (12%) women with a correct non-operative diagnosis of invasive disease required additional surgery compared to 1,166 (48%) of women who were under-staged (diagnosed as non-invasive based on core biopsy, but actually suffering from invasive disease). Failure to achieve a non-operative diagnosis of invasive disease (n=1,542) or non-invasive disease (n=2,247) resulted in re-operation rates of 65 and 43% respectively. Given the impact of not having a diagnosis pre-operatively, or of under-staging invasive carcinoma, it seems timely to introduce more sophisticated standards. (orig.)

Avoiding Pitfalls in Molecular Genetic Testing: Case Studies of High-Resolution Array Comparative Genomic Hybridization Testing in the Definitive Diagnosis of Mowat-Wilson Syndrome

OpenAIRE

Kluk, Michael Joseph; An, Yu; James, Philip; Coulter, David; Harris, David; Wu, Bai-Lin; Shen, Yiping

2011-01-01

The molecular testing options available for the diagnosis of genetic disorders are numerous and include a variety of different assay platforms. The consultative input of molecular pathologists and cytogeneticists, working closely with the ordering clinicians, is often important for definitive diagnosis. Herein, we describe two patients who had long histories of unexplained signs and symptoms with a high clinical suspicion of an underlying genetic etiology. Initial molecular testing in both ca...

HE4 in the Differential Diagnosis of a Pelvic Mass: A Case Report

Directory of Open Access Journals (Sweden)

Luigi Frati

2011-01-01

Full Text Available Neoplasms of the ovary present an increasing challenge to the physician. Neoplastic ovarian cysts can resemble endometriomas in ultrasound imaging and need to be carefully considered in the differential diagnosis. We report the case of a woman with a strong family history of hereditary breast and ovarian cancer, who presented with a pelvic mass. The young girl refused oncogenetic counseling and genetic testing, even though she had a 50% a priori probability of being a BRCA1 mutation carrier. Pelvic magnetic resonance imaging (MRI and a comparative analysis of the serum concentration of HE-4 and CA125 biomarkers provided accuracy and sensitivity in the diagnosis of a benign ovarian pathology. Based on this experience, we propose that the sensitivity of a screening program based on a HE4 and CA125 assay and MRI in high risk patients with mutations in the BRCA1 and BRCA2 genes may be considered a useful pre-operative tool for the differential diagnosis of pelvic masses.

Assessment of Residential History Generation Using a Public-Record Database

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David C. Wheeler

2015-09-01

Full Text Available In studies of disease with potential environmental risk factors, residential location is often used as a surrogate for unknown environmental exposures or as a basis for assigning environmental exposures. These studies most typically use the residential location at the time of diagnosis due to ease of collection. However, previous residential locations may be more useful for risk analysis because of population mobility and disease latency. When residential histories have not been collected in a study, it may be possible to generate them through public-record databases. In this study, we evaluated the ability of a public-records database from LexisNexis to provide residential histories for subjects in a geographically diverse cohort study. We calculated 11 performance metrics comparing study-collected addresses and two address retrieval services from LexisNexis. We found 77% and 90% match rates for city and state and 72% and 87% detailed address match rates with the basic and enhanced services, respectively. The enhanced LexisNexis service covered 86% of the time at residential addresses recorded in the study. The mean match rate for detailed address matches varied spatially over states. The results suggest that public record databases can be useful for reconstructing residential histories for subjects in epidemiologic studies.

Pitfalls in the diagnosis of biallelic PMS2 mutations.

Science.gov (United States)

Antelo, Marina; Milito, Daniela; Rhees, Jennifer; Roca, Enrique; Barugel, Miguel; Cuatrecasas, Miriam; Moreira, Leticia; Leoz, Maria Liz; Carballal, Sabela; Ocaña, Teresa; Pellisé, Maria; Castells, Antoni; Boland, C Richard; Goel, Ajay; Balaguer, Francesc

2015-09-01

Constitutional Mismatch Repair Deficiency (CMMR-D) syndrome is an inherited childhood cancer syndrome due to bi-allelic mutations in one of the four DNA mismatch repair genes involved in Lynch syndrome. The tumor spectrum of this syndrome includes hematological, brain and Lynch syndrome associated malignancies, with an increased risk of synchronous and metachronous cancers, and signs of Neurofibromatosis type-1 syndrome such as café-au-lait macules during the first three decades of life. Here, we report the first Argentinian patient with CMMR-D syndrome, focusing on her history of cancer and gastrointestinal manifestations, and the challenging molecular algorithm to finally reach her diagnosis.

Fascioliasis - a contribution to the differential diagnosis of focal liver lesions

International Nuclear Information System (INIS)

Schleppi, V.; Neufang, O.; Scheerer, W.; Lossnitzer, K.

1987-01-01

The case of a 60 years old patient with a rare parasitosis, fascioliasis hepatica, is presented. The clinical, parasitologic, radiologic and histologic findings are discussed with reference to the literature. The diagnosis was established by examination of the faeces of the patient. The radiologic examinations document the extent of the organic involvement, in the presented case that of the liver. The finding of circumscribed hypodense liver lesions can be decisive for the further diagnostic proceedings only in the light of an appropriate history and typical laboratory findings. (orig.) [de

Molecular markers in the epidemiology and diagnosis of coccidioidomycosis.

Science.gov (United States)

Duarte-Escalante, Esperanza; Frías-De-León, María Guadalupe; Zúñiga, Gerardo; Martínez-Herrera, Erick; Acosta-Altamirano, Gustavo; Reyes-Montes, María Del Rocío

2014-01-01

The prevalence of coccidioidomycosis in endemic areas has been observed to increase daily. To understand the causes of the spread of the disease and design strategies for fungal detection in clinical and environmental samples, scientists have resorted to molecular tools that allow fungal detection in a natural environment, reliable identification in clinical cases and the study of biological characteristics, such as reproductive and genetic structure, demographic history and diversification. We conducted a review of the most important molecular markers in the epidemiology of Coccidioides spp. and the diagnosis of coccidioidomycosis. A literature search was performed for scientific publications concerning the application of molecular tools for the epidemiology and diagnosis of coccidioidomycosis. The use of molecular markers in the epidemiological study and diagnosis of coccidioidomycosis has allowed for the typing of Coccidioides spp. isolates, improved understanding of their mode of reproduction, genetic variation and speciation and resulted in the development specific, rapid and sensitive strategies for detecting the fungus in environmental and clinical samples. Molecular markers have revealed genetic variability in Coccidioides spp. This finding influences changes in the epidemiology of coccidioidomycosis, such as the emergence of more virulent or antifungal resistant genotypes. Furthermore, the molecular markers currently used to identify Coccidioides immitis and Coccidioides posadasii are specific and sensitive. However, they must be validated to determine their application in diagnosis. This manuscript is part of the series of works presented at the "V International Workshop: Molecular genetic approaches to the study of human pathogenic fungi" (Oaxaca, Mexico, 2012). Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

Diagnosis and Change or Change and Diagnosis.

Science.gov (United States)

Cammann, Cortlandt

Organizational consultation is often viewed as a four-stage process: entry, diagnosis, intervention, and evaluation. A fifth stage, preparation of organizations to conduct diagnosis and change, is frequently neglected. In the preparation stage, organizational consultants must deal with resistance by creating conditions for the consideration of the…