WorldWideScience

Sample records for prevention diagnosis prognosis

  1. Accident diagnosis, recovery, and prognosis aid

    International Nuclear Information System (INIS)

    Touchton, R.A.

    1987-01-01

    This paper describes an investigation that was conducted to assess and demonstrate the feasibility of using artificial intelligence (AI) techniques to develop an expert system serving as a nuclear plant accident diagnosis, recovery, and prognosis aid. This effort was sponsored under a contract with the Department of Energy as a part of their Small Business Innovation Research Program. The interest in such a system is based upon on-going industry and regulatory commitment to improved nuclear plant performance and safety

  2. Diagnosis and prognosis of primary breast cancer

    International Nuclear Information System (INIS)

    Robertson, J. F. R.; Evans, A. J.

    1997-01-01

    The diagnosis of breast cancer should be made in the context of a multidisciplinary team: preoperative diagnosis can be made in over 90 % of patients with symptomatic and screen-detected cancers. A preoperative diagnosis allows patients the opportunity to come to terms with the diagnosis of breast cancer and to consider their treatment options before progressing to therapeutic surgery. Surgery remains the primary therapeutic treatment for operable breast cancer with radiotherapy and systemic therapies as adjuvant treatments. Surgery in addition provides pathological specimens from which important prognostic information may be obtained. The traditional TNM classification in itself is no longer sufficient although there is still c considerable prognostic information to be gained in staging patients. Markers of tumour biology provide prognostic data independent of TNM staging. Both need to be considered in any overall assessment of patient prognosis

  3. Accident Diagnosis and Prognosis Aide (ADPA)

    International Nuclear Information System (INIS)

    Gunter, A.D.; Touchton, R.A.

    1987-01-01

    This presentation provides a demonstration of a prototypical expert system developed by Technology Applications, Inc. (TAI) under a contract with the Department of Energy as a part of their Small Business Innovation Research Program. The Accident Diagnosis and Prognosis Aide (ADPA) Demonstration Prototype is a working scale model of a real-time expert system which: Diagnoses an accident situation (as well as a number of underlying failures, events, and conditions deduced along the way). Calculates the change in the likelihood of core damage as a function of the events and failures diagnosed. Dynamically generates a recovery procedure tailored to the specific plant state at hand

  4. An Integrated Model-Based Distributed Diagnosis and Prognosis Framework

    Data.gov (United States)

    National Aeronautics and Space Administration — Diagnosis and prognosis are necessary tasks for system reconfiguration and fault-adaptive control in complex systems. Diagnosis consists of detec- tion, isolation...

  5. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Overview Research Cancer Screening Cancer Screening Overview Screening Tests Research Diagnosis and Staging Symptoms Diagnosis Staging Prognosis ... Cancer Prevention Overview Screening Cancer Screening Overview Screening Tests Diagnosis & Staging Symptoms Diagnosis Staging Prognosis Treatment Types ...

  6. Integrated fatigue damage diagnosis and prognosis under uncertainties

    Data.gov (United States)

    National Aeronautics and Space Administration — An integrated fatigue damage diagnosis and prognosis framework is proposed in this paper. The proposed methodology integrates a Lamb wave-based damage detection...

  7. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... and Prevention Risk Factors Genetics Cancer Prevention Overview Research Cancer Screening Cancer Screening Overview Screening Tests Research Diagnosis and Staging Symptoms Diagnosis Staging Prognosis Questions ...

  8. Alcoholism: diagnosis, prognosis, epidemiology, and burden of the disease.

    Science.gov (United States)

    Beresford, Thomas P; Wongngamnit, Narin; Temple, Benjamin A

    2014-01-01

    To the clinician, alcoholism can appear as an amorphous entity that is confusing with respect to diagnosis, treatment prognosis, and the role of the health professional, despite its high incidence and associated morbidities and mortality when unrecognized or untreated. This chapter focuses on the clinical application of current knowledge, with the aim of being useful to the practitioner in working directly with patients for whom alcoholism may or may not be an already identified problem. It briefly reviews large-scale studies and then focuses on diagnosis and prognosis assessment and decision making. Also considered are current controversies in nomenclature and the chapter ends with an economic perspective with respect to healthcare and cost to society. As the introductory chapter, the goal is to provide a context of the scope of alcoholism and attendant problems for the rest of the chapters. © 2014 Elsevier B.V. All rights reserved.

  9. Venous and arterial thromboembolism : prevention and prognosis

    NARCIS (Netherlands)

    Pasha, Sharif Mohammed

    2015-01-01

    This thesis is a journey in the vascular medicine. Chapter 1 is a general introduction. Chapter 2 is a meta-analysis on the diagnosis of pulmonary embolism on the emergency ward. Chapter 3 is a meta-analysis on the occurence of contrast induced nephropathy in patients suspected for pulmonary

  10. MicroRNAs in Testicular Cancer Diagnosis and Prognosis.

    Science.gov (United States)

    Ling, Hui; Krassnig, Lisa; Bullock, Marc D; Pichler, Martin

    2016-02-01

    Testicular cancer processes a unique and clear miRNA expression signature. This differentiates testicular cancer from most other cancer types, which are usually more ambiguous when assigning miRNA patterns. As such, testicular cancer may represent a unique cancer type in which miRNAs find their use as biomarkers for cancer diagnosis and prognosis, with a potential to surpass the current available markers usually with low sensitivity. In this review, we present literature findings on miRNAs associated with testicular cancer, and discuss their potential diagnostic and prognostic values, as well as their potential as indicators of drug response in patients with testicular cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. [Delirium in patients with neurological diseases: diagnosis, management and prognosis].

    Science.gov (United States)

    Hüfner, K; Sperner-Unterweger, B

    2014-04-01

    Delirium is a common acute neuropsychiatric syndrome. It is characterized by concurrent disturbances of consciousness and attention, perception, reasoning, memory, emotionality, the sleep-wake cycle as well as psychomotor symptoms. Delirium caused by alcohol or medication withdrawal is not the subject of the current review. Specific predisposing and precipitating factors have been identified in delirium which converge in a common final pathway of global brain dysfunction. The major predisposing factors are older age, cognitive impairment or dementia, sensory deficits, multimorbidity and polypharmacy. Delirium is always caused by one or more underlying pathologies which need to be identified. In neurology both primary triggers of delirium, such as stroke or epileptic seizures and also secondary triggers, such as metabolic factors or medication side effects play a major role. Nonpharmacological interventions are important in the prevention of delirium and lead to an improvement in prognosis. Delirium is associated with increased mortality and in the long term the development of cognitive deficits and functional impairment.

  12. 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.

  13. Acute Kidney Injury: Epidemiology, Diagnosis, Prognosis, and Future Directions

    Directory of Open Access Journals (Sweden)

    Joana Briosa Neves

    2015-07-01

    Full Text Available Acute kidney injury (AKI is a common problem highly associated with hospitalisation. AKI is the cause of harmful short-term consequences: longer hospital stays, greater disability after discharge, and greater risk of in-hospital mortality, as well as adverse long-term outcomes, such as progression to chronic kidney disease, development of cardiovascular disease, and increased risk of long-term mortality. The concept of AKI has changed since the introduction of the ‘Risk, Injury, Failure, Loss of kidney function, End-stage kidney disease’ (RIFLE classification. More recently, the ‘Kidney Disease Improving Global Outcomes’ (KDIGO classification appears to have provided increased diagnostic sensitivity and outcome-prediction capability. Novel biomarkers and further research on the role of the immune system in AKI may help improve the diagnosis, severity, outcome evaluation, and treatment of the condition. In this review we describe the epidemiology, diagnosis, and prognosis of AKI, as well as possible future directions for its clinical management.

  14. An Integrated Framework for Model-Based Distributed Diagnosis and Prognosis

    Data.gov (United States)

    National Aeronautics and Space Administration — Diagnosis and prognosis are necessary tasks for system re- configuration and fault-adaptive control in complex systems. Diagnosis consists of detection, isolation...

  15. Canine mast cell tumors: diagnosis, treatment, and prognosis

    Directory of Open Access Journals (Sweden)

    Garrett LD

    2014-08-01

    Full Text Available Laura D Garrett Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, IL, USA Abstract: Mast cell tumors (MCTs are the most common malignant skin cancer in dogs, and significant variability exists in their biological behavior. Most MCTs are cured with appropriate local therapy, but a subset shows malignant behavior with the potential to spread to lymph nodes, liver, spleen, and other areas and to thus become a systemic cancer. Because of this variable behavior, it is difficult to predict how any individual tumor is going to behave. The variability thus creates uncertainty in deciding what a particular dog's prognosis is, whether staging tests to assess for metastasis are needed, and even what treatments will be necessary for best outcome. In addition to controversies over the potential for development of systemic disease, or diffuse metastasis, controversies also exist over what treatment is needed to best attain local control of these tumors. This article will briefly discuss the diagnosis of MCTs in dogs and will summarize the literature in regards to the controversial topics surrounding the more aggressive form of this disease, with recommendations made based on published studies. Keywords: mitotic index, mastocytosis, tyrosine kinase inhibitor, histologic grade

  16. Diagnosis-Driven Prognosis for Decision Making, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — One cannot build a system-level Prognosis and Health Management (PHM) solution by cobbling together a bunch of existing prognostic techniques; it will have a very...

  17. Breaking bad news: Effects of forecasting diagnosis and framing prognosis.

    Science.gov (United States)

    Porensky, Emily K; Carpenter, Brian D

    2016-01-01

    Research to support guidelines for breaking bad news is lacking. This study used an experimental paradigm to test two communication strategies, forecasting bad news and framing prognosis, in the context of cancer. In a 2×2 design, 128 participants received bad news in a hypothetical consultation. A videotaped physician presented diagnostic and prognostic information, varying warning (warning shot vs. no warning), and framing (positive vs. negative). Effects on psychological distress, recall accuracy, and subjective interpretations of the news were assessed. Warning was not associated with lower psychological distress or improved recall. Individuals who heard a positively-framed prognosis had significantly less psychological distress, rated their prognosis better, and were more hopeful than those who heard a negatively-framed prognosis. However, they also showed a trend toward reduced accuracy in recalling prognostic statistics. Results contribute to a growing body of literature exploring optimal approaches for communicating bad news in health care. Although research in clinical settings is needed to bolster results, findings suggest that when providers use positive framing to reduce distress about prognosis, they should also consider ways to overcome potential reductions in recall accuracy, such as repeating statistical information or supplementing with written information. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Using data mining techniques for diagnosis and prognosis of cancer disease

    OpenAIRE

    Kharya, Shweta

    2012-01-01

    Breast cancer is one of the leading cancers for women in developed countries including India. It is the second most common cause of cancer death in women. The high incidence of breast cancer in women has increased significantly in the last years. In this paper we have discussed various data mining approaches that have been utilized for breast cancer diagnosis and prognosis. Breast Cancer Diagnosis is distinguishing of benign from malignant breast lumps and Breast Cancer Prognosis predicts whe...

  19. Noninvasive imaging of hepatocellular carcinoma: From diagnosis to prognosis

    Science.gov (United States)

    Jiang, Han-Yu; Chen, Jie; Xia, Chun-Chao; Cao, Li-Kun; Duan, Ting; Song, Bin

    2018-01-01

    Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a major public health problem worldwide. Hepatocarcinogenesis is a complex multistep process at molecular, cellular, and histologic levels with key alterations that can be revealed by noninvasive imaging modalities. Therefore, imaging techniques play pivotal roles in the detection, characterization, staging, surveillance, and prognosis evaluation of HCC. Currently, ultrasound is the first-line imaging modality for screening and surveillance purposes. While based on conclusive enhancement patterns comprising arterial phase hyperenhancement and portal venous and/or delayed phase wash-out, contrast enhanced dynamic computed tomography and magnetic resonance imaging (MRI) are the diagnostic tools for HCC without requirements for histopathologic confirmation. Functional MRI techniques, including diffusion-weighted imaging, MRI with hepatobiliary contrast agents, perfusion imaging, and magnetic resonance elastography, show promise in providing further important information regarding tumor biological behaviors. In addition, evaluation of tumor imaging characteristics, including nodule size, margin, number, vascular invasion, and growth patterns, allows preoperative prediction of tumor microvascular invasion and patient prognosis. Therefore, the aim of this article is to review the current state-of-the-art and recent advances in the comprehensive noninvasive imaging evaluation of HCC. We also provide the basic key concepts of HCC development and an overview of the current practice guidelines. PMID:29904242

  20. Feature Hepatitis: Hepatitis Symptoms, Diagnosis, Treatment & Prevention

    Science.gov (United States)

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

  1. analysis, diagnosis and prognosis of leprosy utilizing fuzzy classifier

    African Journals Online (AJOL)

    TRIPPLEJO2K2

    expert system eliminates uncertainty and imprecision associated with the diagnosis of Leprosy. .... learns by observing how people regulate real systems, Leondes (2010). ... not a thing at the same time, Zadeh (1965). ... Microsoft Windows XP Professional Operating System, .... Systems, Advances in Soft Computing. Series” ...

  2. Using an Agent-oriented Framework for Supervision, Diagnosis and Prognosis Applications in Advanced Automation Environments

    DEFF Research Database (Denmark)

    Thunem, Harald P-J; Thunem, Atoosa P-J; Lind, Morten

    2011-01-01

    This paper demonstrates how a generic agent-oriented framework can be used in advanced automation environments, for systems analysis in general and supervision, diagnosis and prognosis purposes in particular. The framework’s background and main application areas are briefly described. Next......-oriented supervision, diagnosis and prognosis purposes are equally explained. Finally, the paper sums up by also addressing plans for further enhancement and in that respect integration with other tailor-made tools for joint treatment of various modeling and analysis activities upon advanced automation environments....

  3. Diagnosis, prognosis and disease management using in situ hybridization

    International Nuclear Information System (INIS)

    Kucheria, K.; Talwar, R.

    2002-01-01

    The year 2001 saw unveiling of anatomy of the human genome with sequencing of 90% of the euchromatic region. But the ultimate goal of the Human Genome Project to delineate the positions of all genes is yet to be achieved. In Situ Hybridization (ISH) is one of the methods that help in localizing genes on chromosomes. The present study aimed to use radioactive- and fluorescent-labeled probes for screening various congenital anomalies (sex chromosomal and autosomal), for prenatal diagnosis and cancer genetics. Standard techniques were used for hybridization with radioactively and fluorescent labeled probes. Sex chromosome aneuploidies (XXY, XO, XXX, XYY etc.) were analyzed using centromeric probes for chromosomes X and Y. The cases with ambiguous genitalia were further analyzed using probe specific for the sex-determining region (SRY) on the Y chromosome. Suspected cases of Down syndrome were analyzed using probe specific for centromeric region of chromosome 21 to confirm trisomy 21. Prenatal diagnosis included screening aneuploidies of chromosomes 13, 18, 21, X and Y on uncultured cells and metaphases obtained from amniotic fluid and chorionic villi samplings. Gene alterations were also studied in Retinoblastoma patients, Chronic Myeloid Leukemia (CML) and Acute Promyelocytic Leukemia (APML) using probes specific for Rb1, bcr/abl and PML/RARα genes respectively. Response to therapy was assessed by evaluating minimal residual disease (MRD) in leukemia patients. Attempts were also made to analyze cells obtained from buccal mucosa and bladder epithelium that could facilitate rapid screening of sex chromosome anomalies and bladder cancer without painful invasive techniques. Prenatal diagnosis using ISH on uncultured cells could provide an accurate and rapid result. These results of prenatal diagnosis were in conformation with results of conventional cytogenetics obtained after long-term cultures. Molecular rearrangements that could not be detected with conventional

  4. Prenatal diagnosis and prognosis of triple X syndrome: 47, XXX.

    Science.gov (United States)

    Ben Hamouda, H; Mkacher, N; Elghezal, H; Bannour, H; Kamoun, M; Soua, H; Saad, A; Souissi, M M; Sfar, M T

    2009-11-01

    Triple X syndrome is a relatively common sex chromosomal abnormality occurring in 0,1% of live-born female infants. Most of these infants have a normal phenotype and only a few cases with 47, XXX karyotype have congenital malformations. We report three cases of triple X syndrome that were diagnosed prenatally by genetic amniocentesis for advanced maternal age and have been observed from birth to age of 3 to 12 years. A description of their growth and development is presented. The birth weight was normal in all patients and one of them had facial dysmorphism with right microphtalmia and auricular septal defect. During the first 2 years of life, the neuromotor development of these infants was not distinguishable from chromosomally normal children. By 3 years of age, two patients have a moderate developmental delay in speech and language. One girl 12-year-old had normal schooling. The diagnosis of the triple X syndrome can be never made because clinical demonstrations are not rather important to arouse the demand of a karyotype. Prenatal diagnosis is often made in front of the advanced maternal age. Expectant parents must be counseled as to the significance of this 47, XXX karyotype and prognostic information must be given.

  5. Biomarkers in the Diagnosis and Prognosis of Alzheimer's Disease.

    Science.gov (United States)

    Schaffer, Cole; Sarad, Nakia; DeCrumpe, Ashton; Goswami, Disha; Herrmann, Sara; Morales, Jose; Patel, Parth; Osborne, Jim

    2015-10-01

    Alzheimer's disease (AD) is a neurodegenerative disease that inhibits cognitive functions and has no cure. This report reviews the current diagnostic standards for AD with an emphasis on early diagnosis using the cerebrospinal fluid (CSF) biomarkers amyloid-beta, t-tau, and p-tau and fluorodeoxyglucose positron emission tomography imaging. Abnormal levels of these CSF biomarkers and decreased cerebral uptake of glucose have recently been used in the early diagnosis of AD in experimental studies. These promising biomarkers can be measured using immunoassays performed in singleplex or multiplex formats. Although presently, there are no Food and Drug Administration-approved in vitro diagnostics (IVDs) for early detection of AD, a multiplex immunoassay measuring a panel of promising AD biomarkers in CSF may be a likely IVD candidate for the clinical AD diagnostic market. Specifically, the INNO-BIA AlzBio3 immunoassay kit, performed using bead arrays on the xMAP Luminex analyzer, allows simultaneous quantification of amyloid-beta, t-tau, and p-tau biomarkers. AD biomarkers can also be screened using enzyme-linked immunosorbent assays that are offered as laboratory-developed tests. © 2014 Society for Laboratory Automation and Screening.

  6. Prognosis of intervertebral disc loss from diagnosis of degenerative disc disease

    Science.gov (United States)

    Li, S.; Lin, A.; Tay, K.; Romano, W.; Osman, Said

    2015-03-01

    Degenerative Disc Disease (DDD) is one of the most common causes of low back pain, and is a major factor in limiting the quality of life of an individual usually as they enter older stages of life, the disc degeneration reduces the shock absorption available which in turn causes pain. Disc loss is one of the central processes in the pathogenesis of DDD. In this study, we investigated whether the image texture features quantified from magnetic resonance imaging (MRI) could be appropriate markers for diagnosis of DDD and prognosis of inter-vertebral disc loss. The main objective is to use simple image based biomarkers to perform prognosis of spinal diseases using non-invasive procedures. Our results from 65 subjects proved the higher success rates of the combination marker compared to the individual markers and in the future, we will extend the study to other spine regions to allow prognosis and diagnosis of DDD for a wider region.

  7. CEA A BIOCHEMICAL MARKER FOR DIAGNOSIS AND PROGNOSIS OF GASTROINTESTINAL CANCER

    OpenAIRE

    Prathibha; Vishnu Datt

    2016-01-01

    Serum tumor markers (TM) are widely used for diagnosis and monitoring of treatment of cancer. Carcinoembryonic Antigen (CEA) is one of the most widely investigated tumor markers in gastrointestinal (GI) cancers. Estimation of circulating tumor markers is a non- invasive quantitative method. Serum levels of CEA were studied for diagnosis and prognosis of gastrointestinal malignancies. 140 subjects were undertaken out of which 35 normal and remaining 105 were GI cancer patients. Ser...

  8. The endo-perio problem in dental practice: diagnosis and prognosis.

    Science.gov (United States)

    Christie, W H; Holthuis, A F

    1990-11-01

    The relationships between endodontics and periodontics are explored. Diagnosis, prognosis, and treatment planning are discussed for the primary endodontic lesion and the primary endodontic lesion with secondary periodontal involvement. These endodontic lesions are compared with primary periodontal lesions and primary periodontal lesions with secondary endodontic participation. The "true" combined lesion is also reviewed. Clinical photographs and radiographs are used to illustrate specific aspects.

  9. Twin-twin transfusion syndrome - diagnosis and prognosis

    Directory of Open Access Journals (Sweden)

    Hajrić-Egić Amira

    2003-01-01

    Full Text Available Twin-twin transfusion syndrome is a serious complication of monozygotic, monochorionic, diamniotic twins resulting from transplacental vascular communications. In this syndrome blood is thought to be shunted from one twin - donor,who develops anaemia,growth retardation and oligoamnios, to the other twin - recipient,who becomes plethoric,macrosomic and develops polyhydroamnios. The incidence of twin-twin transfusion syndrome ranges from 5-15% of all twin pregnancies. If this condition develops in the second trimester, it is usually associated with spontaneous abortion and death of one or both fetuses before viability. Developing the syndrome in the third trimester has better perinatal outcome. Mortality rates ranging from 56%-100%, depending on gestational age and severity of the syndrome. The ultrasound criterias for diagnosis, in this study,were the presence of twins of the same sex with discordant growth, with oligohydroamnios in one twin sac and polyhydroamnios in the other one, one placenta and thin membrane between twins. The present study shows clinical course of 14 cases and value of Doppler ultrasound to analyze the usefulness of umbilical artery blood flow velocimetry for predicting the risk of twin-twin transfusion syndrome. 14 twin pregnancies with twin-twin transfusion syndrome were diagnosed during the last four years period and prospectivelly followed. 9 cases were diagnosed before the completion od 28 weeks of gestation.The mean gestational age was 21,6_+4,2 weeks at diagnosis and 23,2+_3,6 weeks at delivery. 5 cases were diagnosed after 28 weeks of gestation. The mean gestational age in this group was 29,6+_2,1 weeks at diagnosis and 33+_3,3 weeks at delivery. The survival rate in this study was 29%(8/28.9 cases ended in spontaneous abortion between 18th and 27th weeks of pregnancy (table 1 and 5 in premature labor (table 2.There were 7 intrauterine death (5 at admission and 2 few days after admission and 13 neonatal deaths

  10. Quantitative diagnosis and prognosis framework for concrete degradation due to alkali-silica reaction

    Science.gov (United States)

    Mahadevan, Sankaran; Neal, Kyle; Nath, Paromita; Bao, Yanqing; Cai, Guowei; Orme, Peter; Adams, Douglas; Agarwal, Vivek

    2017-02-01

    This research is seeking to develop a probabilistic framework for health diagnosis and prognosis of aging concrete structures in nuclear power plants that are subjected to physical, chemical, environment, and mechanical degradation. The proposed framework consists of four elements: monitoring, data analytics, uncertainty quantification, and prognosis. The current work focuses on degradation caused by ASR (alkali-silica reaction). Controlled concrete specimens with reactive aggregate are prepared to develop accelerated ASR degradation. Different monitoring techniques — infrared thermography, digital image correlation (DIC), mechanical deformation measurements, nonlinear impact resonance acoustic spectroscopy (NIRAS), and vibro-acoustic modulation (VAM) — are studied for ASR diagnosis of the specimens. Both DIC and mechanical measurements record the specimen deformation caused by ASR gel expansion. Thermography is used to compare the thermal response of pristine and damaged concrete specimens and generate a 2-D map of the damage (i.e., ASR gel and cracked area), thus facilitating localization and quantification of damage. NIRAS and VAM are two separate vibration-based techniques that detect nonlinear changes in dynamic properties caused by the damage. The diagnosis results from multiple techniques are then fused using a Bayesian network, which also helps to quantify the uncertainty in the diagnosis. Prognosis of ASR degradation is then performed based on the current state of degradation obtained from diagnosis, by using a coupled thermo-hydro-mechanical-chemical (THMC) model for ASR degradation. This comprehensive approach of monitoring, data analytics, and uncertainty-quantified diagnosis and prognosis will facilitate the development of a quantitative, risk informed framework that will support continuous assessment and risk management of structural health and performance.

  11. HIV / AIDS: Symptoms, Diagnosis, Prevention and Treatment

    Science.gov (United States)

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

  12. Implications of microRNAs in Colorectal Cancer Development, Diagnosis, Prognosis and Therapeutics

    Directory of Open Access Journals (Sweden)

    Haiyan eZhai

    2011-11-01

    Full Text Available MicroRNAs (miRNAs are a class of non-coding small RNAs with critical regulatory functions as post-transcriptional regulators. Due to the fundamental importance and broad impact of miRNAs on multiple genes and pathways, dysregulated miRNAs have been associated with human diseases, including cancer. Colorectal cancer (CRC is among the most deadly diseases, and miRNAs offer a new frontier for target discovery and novel biomarkers for both diagnosis and prognosis. In this review, we summarize the recent advancement of miRNA research in CRC, in particular, the roles of miRNAs in colorectal cancer stem cells, EMT, chemoresistance, therapeutics, diagnosis and prognosis.

  13. Circulating tumour DNA methylation markers for diagnosis and prognosis of hepatocellular carcinoma

    Science.gov (United States)

    Xu, Rui-Hua; Wei, Wei; Krawczyk, Michal; Wang, Wenqiu; Luo, Huiyan; Flagg, Ken; Yi, Shaohua; Shi, William; Quan, Qingli; Li, Kang; Zheng, Lianghong; Zhang, Heng; Caughey, Bennett A.; Zhao, Qi; Hou, Jiayi; Zhang, Runze; Xu, Yanxin; Cai, Huimin; Li, Gen; Hou, Rui; Zhong, Zheng; Lin, Danni; Fu, Xin; Zhu, Jie; Duan, Yaou; Yu, Meixing; Ying, Binwu; Zhang, Wengeng; Wang, Juan; Zhang, Edward; Zhang, Charlotte; Li, Oulan; Guo, Rongping; Carter, Hannah; Zhu, Jian-Kang; Hao, Xiaoke; Zhang, Kang

    2017-11-01

    An effective blood-based method for the diagnosis and prognosis of hepatocellular carcinoma (HCC) has not yet been developed. Circulating tumour DNA (ctDNA) carrying cancer-specific genetic and epigenetic aberrations may enable a noninvasive `liquid biopsy' for diagnosis and monitoring of cancer. Here, we identified an HCC-specific methylation marker panel by comparing HCC tissue and normal blood leukocytes and showed that methylation profiles of HCC tumour DNA and matched plasma ctDNA are highly correlated. Using cfDNA samples from a large cohort of 1,098 HCC patients and 835 normal controls, we constructed a diagnostic prediction model that showed high diagnostic specificity and sensitivity (P < 0.001) and was highly correlated with tumour burden, treatment response, and stage. Additionally, we constructed a prognostic prediction model that effectively predicted prognosis and survival (P < 0.001). Together, these findings demonstrate in a large clinical cohort the utility of ctDNA methylation markers in the diagnosis, surveillance, and prognosis of HCC.

  14. Exercise thallium-201 scintigraphy in the diagnosis and prognosis of coronary artery disease

    International Nuclear Information System (INIS)

    Kotler, T.S.; Diamond, G.A.

    1990-01-01

    The objective of this study is to determine the discriminant accuracy of exercise thallium-201 myocardial perfusion scintigraphy for the diagnosis and prognosis of patients with known or suspected coronary artery disease. This is a survey of the National Library of Medicine MEDLINE database. The key medical subject headings used were coronary disease, myocardial infarction, radionuclide imaging, and thallium. A total of 122 retrieved studies were considered relevant and were reviewed in depth. Only studies reporting both the sensitivity and specificity of thallium scintigraphy were analyzed. Discriminant accuracy for diagnosis and prognosis was summarized in terms of pooled sensitivity and specificity. Exercise thallium scintigraphy is useful in the noninvasive diagnosis of coronary artery disease, especially in patients with abnormal resting electrocardiograms, restricted exercise tolerance, and intermediate probability of having disease at the time of testing as well as of defining the prognosis of patients with known or suspected coronary artery disease, especially in those with previous myocardial infarction. Because of various shortcomings in the published record, however, the marginal discriminant accuracy and cost effectiveness of thallium scintigraphy compared with conventional clinical assessment and exercise electrocardiography remain controversial. 193 references

  15. A Bayesian least squares support vector machines based framework for fault diagnosis and failure prognosis

    Science.gov (United States)

    Khawaja, Taimoor Saleem

    A high-belief low-overhead Prognostics and Health Management (PHM) system is desired for online real-time monitoring of complex non-linear systems operating in a complex (possibly non-Gaussian) noise environment. This thesis presents a Bayesian Least Squares Support Vector Machine (LS-SVM) based framework for fault diagnosis and failure prognosis in nonlinear non-Gaussian systems. The methodology assumes the availability of real-time process measurements, definition of a set of fault indicators and the existence of empirical knowledge (or historical data) to characterize both nominal and abnormal operating conditions. An efficient yet powerful Least Squares Support Vector Machine (LS-SVM) algorithm, set within a Bayesian Inference framework, not only allows for the development of real-time algorithms for diagnosis and prognosis but also provides a solid theoretical framework to address key concepts related to classification for diagnosis and regression modeling for prognosis. SVM machines are founded on the principle of Structural Risk Minimization (SRM) which tends to find a good trade-off between low empirical risk and small capacity. The key features in SVM are the use of non-linear kernels, the absence of local minima, the sparseness of the solution and the capacity control obtained by optimizing the margin. The Bayesian Inference framework linked with LS-SVMs allows a probabilistic interpretation of the results for diagnosis and prognosis. Additional levels of inference provide the much coveted features of adaptability and tunability of the modeling parameters. The two main modules considered in this research are fault diagnosis and failure prognosis. With the goal of designing an efficient and reliable fault diagnosis scheme, a novel Anomaly Detector is suggested based on the LS-SVM machines. The proposed scheme uses only baseline data to construct a 1-class LS-SVM machine which, when presented with online data is able to distinguish between normal behavior

  16. [Prognosis and progression of cognitive impairment. Preventive measures].

    Science.gov (United States)

    López Mongil, Rosa; López Trigo, José Antonio

    2016-06-01

    Because of the substantial increase in population ageing, age-related processes, such as dementia and Alzheimer disease (AD), are becoming highly prevalent. The course of this disease, including preprodromic phases, lasts at least 20 years. The presence of comorbidities, especially those of vascular origin, can trigger and aggravate disease progression. On the other hand, cognitive reserve, the absence or control of comorbid factors and healthy lifestyles can protect or modify -in the sense of slow down- disease progression. Knowledge of the phases of AD and their functional impact on affected individuals helps to identify the average prognosis and, in particular, to establish and predict care plans based on the individual's needs. Copyright © 2016 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Diagnosis, treatment, clinical course, and prognosis of childhood-onset craniopharyngioma patients.

    Science.gov (United States)

    Müller, Hermann L

    2017-12-01

    For decades gross-total resection was the preferred treatment option in childhood-onset craniopharyngioma, assuming that radical strategies at the time of initial diagnosis and treatment would result in cure. Recent reports on long-term prognosis, novel treatment approaches, and molecular genetics provide new insights into more risk-adapted treatment strategies in order to prevent sequelae such as hypothalamic syndrome. A search for original articles published between 2000 and 2016 was performed in PubMed, Science Citation Index Expanded, EMBASE and Scopus. The search terms used were "craniopharyngioma", "hypothalamus", "pituitary", "obesity", "irradiation", and "neurosurgery". The clinical, neuroradiological and surgical definition of hypothalamic involvement is a fundamental factor related to postoperative poor outcome, progressive obesity and neuropsychological impairment after surgical removal. There is a need to change the previous "gold-standard" objective of a primary radical tumor removal in all cases by the new paradigm of a limited resection plus focused radiotherapy in patients with hypothalamic lesions. Hypothalamic involvement and treatment-related hypothalamic lesions are associated with the highest risk of postoperative sequelae. Three dimensional intensity modulated proton beam radiotherapy has potential advantage of over photon beam methods to focus and limit the radiation effects to optic and hypothalamic structures. Preclinical, in vivo mouse models of craniopharyngioma have potential advantage to investigate molecular pathways deregulated in the tumor and to test the use of specific drugs. As expertise has been shown to have impact on post-treatment morbidity, medical societies should establish criteria of adequate professional expertise for the treatment of craniopharyngioma.

  18. Screening and preventive diagnosis with radiological imaging

    Energy Technology Data Exchange (ETDEWEB)

    Reiser, M.F. [University Hospitals - Grosshadern and Innenstadt (Germany). Dept. of Clinical Radiology; Kaick, G. van [Deutsches Krebsforschungszentrum, Heidelberg (Germany); Fink, C.; Schoenberg, S.O. (eds.) [Univ. Hospital Mannheim (Germany). Dept. of Clinical Radiology

    2008-07-01

    Continuous technical developments have improved the potential of organ-based radiological diagnostics and have now also led to the use of dedicated whole-body examinations in the field of screening and preventive diagnosis. This book aims to provide clinicians with a broad understanding of screening and preventive diagnosis using radiological imaging. The first part of the book is dedicated to the fundamentals of screening and preventive diagnosis, and comprises chapters on epidemiology and pathology, technical and organizational aspects of radiological screening, legal and ethical issues, and cost-benefit analysis. The second part of the book discusses in depth the most important practical examples of radiological screening and surveillance, both for unselected populations and for individual risk groups. (orig.)

  19. Screening and preventive diagnosis with radiological imaging

    International Nuclear Information System (INIS)

    Reiser, M.F.; Fink, C.; Schoenberg, S.O.

    2008-01-01

    Continuous technical developments have improved the potential of organ-based radiological diagnostics and have now also led to the use of dedicated whole-body examinations in the field of screening and preventive diagnosis. This book aims to provide clinicians with a broad understanding of screening and preventive diagnosis using radiological imaging. The first part of the book is dedicated to the fundamentals of screening and preventive diagnosis, and comprises chapters on epidemiology and pathology, technical and organizational aspects of radiological screening, legal and ethical issues, and cost-benefit analysis. The second part of the book discusses in depth the most important practical examples of radiological screening and surveillance, both for unselected populations and for individual risk groups. (orig.)

  20. [Use of micro RNAs in the diagnosis and prognosis of colorectal cancer (CCR)].

    Science.gov (United States)

    Arredondo-Valdez, Abril Reneé; Wence-Chavez, Laura; Rosales-Reynoso, Mónica Alejandra

    2016-01-01

    The aim of this review is to present a general overview about the importance of micro RNAs (miRNAs) in colorectal carcinoma. First, we focused on the mechanisms whereby the miRNAs regulate the expression of target genes, and how an altered regulation of them is associated with several types of cancer, including colorectal carcinoma. Later, examples of some miRNAs that have been associated with cancer development and how the expression patterns of specific miRNAs can be used as potential biomarkers for prognosis, diagnosis and therapeutic outcome in colorectal carcinoma are addressed. Finally, several polymorphisms presents in the miRNAs that have been associated to risk and prognosis in colorectal carcinoma are described.

  1. State Dementia Plans and the Alzheimer's Disease Movement: Framing Diagnosis, Prognosis, and Motivation.

    Science.gov (United States)

    Arbogast, Charlotte E; Welleford, E Ayn; Netting, F Ellen

    2017-07-01

    An interpretive analysis of 38 state dementia plans compares similarities and differences in diagnostic framing (problem identification/trends/issues), prognosis framing (addressing the problem), and motivational framing (calls for action) across plans. In framing diagnosis, only 6 plans used dementia alone in their titles. In framing prognosis and the subsequent call to action, state plans were consistent in their dire prognostications about the progressive and fatal consequences of the disease with a primary focus on the cost. Motivational language mirrored that of the Alzheimer's Disease (AD) Movement, from raising awareness to using inflammatory words to incite action. The language used set up the frame for clinical interventions that may not distinguish between types of dementia and could undercut the provision of person-centered care, shifts the victimization focus from persons with AD to caregivers and ultimately the state, and may subintentionally reflect cultural biases.

  2. Gastric cancer in young people under 30 years of age: worse prognosis, or delay in diagnosis?

    International Nuclear Information System (INIS)

    López-Basave, Horacio Noé; Morales-Vásquez, Flavia; Ruiz-Molina, Juan Manuel; Ñamendys-Silva, Silvio A; Vela-Sarmiento, Itzel; Ruan, Javier Melchor; Rosciano, Alejandro E Padilla; Calderillo-Ruiz, German; Díaz-Romero, Consuelo; Herrera-Gómez, Angel; Meneses-García, Abelardo A

    2013-01-01

    Gastric cancer is an aggressive disease with nonspecific early symptoms. Its incidence and prognosis in young patients has shown considerable variability. Our objective was to retrospectively study patients from our institution aged <30 years with gastric carcinoma. The study was undertaken to describe the experience of gastric cancer in this population, and to demonstrate its specific clinical and pathological characteristics. We reviewed the cases of histologically confirmed gastric cancer between 1985 and 2006 at the Instituto Nacional de Cancerología of Mexico (INCan); emphasis in our review was placed on clinical presentation, diagnostic and therapeutic intervention, pathology, and the results. Thirty cases of gastric carcinoma were reviewed. The patients’ median age was 27 years (range, 18–30 years) and the male:female ratio was 1:1. Gastric cancer exhibits different behavior in patients aged, 30 years, but delay in diagnosis and the tumor’s behavior appear to be the most important factors in prognosis of the disease

  3. 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)

  4. Diagnosis, Prevention and Management of Postoperative ...

    African Journals Online (AJOL)

    Diagnosis, Prevention and Management of Postoperative Pulmonary Edema. ... period or it can be negative pressure pulmonary edema (NPPE). NPPE is an important clinical entity in immediate post.extubation period and occurs due to acute upper airway obstruction and creation of acute negative intrathoracic pressure.

  5. Application of monitoring, diagnosis, and prognosis in thermal performance analysis for nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyeong Min; Heo, Gyun Young [Kyung Hee University, Yongin (Korea, Republic of); Na, Man Gyun [Chosun University, Gwangju (Korea, Republic of)

    2014-12-15

    As condition-based maintenance (CBM) has risen as a new trend, there has been an active movement to apply information technology for effective implementation of CBM in power plants. This motivation is widespread in operations and maintenance, including monitoring, diagnosis, prognosis, and decision-making on asset management. Thermal efficiency analysis in nuclear power plants (NPPs) is a longstanding concern being updated with new methodologies in an advanced IT environment. It is also a prominent way to differentiate competitiveness in terms of operations and maintenance costs. Although thermal performance tests implemented using industrial codes and standards can provide officially trustworthy results, they are essentially resource-consuming and maybe even a hind-sighted technique rather than a foresighted one, considering their periodicity. Therefore, if more accurate performance monitoring can be achieved using advanced data analysis techniques, we can expect more optimized operations and maintenance. This paper proposes a framework and describes associated methodologies for in-situ thermal performance analysis, which differs from conventional performance monitoring. The methodologies are effective for monitoring, diagnosis, and prognosis in pursuit of CBM. Our enabling techniques cover the intelligent removal of random and systematic errors, deviation detection between a best condition and a currently measured condition, degradation diagnosis using a structured knowledge base, and prognosis for decision-making about maintenance tasks. We also discuss how our new methods can be incorporated with existing performance tests. We provide guidance and directions for developers and end-users interested in in-situ thermal performance management, particularly in NPPs with large steam turbines.

  6. Application of monitoring, diagnosis, and prognosis in thermal performance analysis for nuclear power plants

    International Nuclear Information System (INIS)

    Kim, Hyeong Min; Heo, Gyun Young; Na, Man Gyun

    2014-01-01

    As condition-based maintenance (CBM) has risen as a new trend, there has been an active movement to apply information technology for effective implementation of CBM in power plants. This motivation is widespread in operations and maintenance, including monitoring, diagnosis, prognosis, and decision-making on asset management. Thermal efficiency analysis in nuclear power plants (NPPs) is a longstanding concern being updated with new methodologies in an advanced IT environment. It is also a prominent way to differentiate competitiveness in terms of operations and maintenance costs. Although thermal performance tests implemented using industrial codes and standards can provide officially trustworthy results, they are essentially resource-consuming and maybe even a hind-sighted technique rather than a foresighted one, considering their periodicity. Therefore, if more accurate performance monitoring can be achieved using advanced data analysis techniques, we can expect more optimized operations and maintenance. This paper proposes a framework and describes associated methodologies for in-situ thermal performance analysis, which differs from conventional performance monitoring. The methodologies are effective for monitoring, diagnosis, and prognosis in pursuit of CBM. Our enabling techniques cover the intelligent removal of random and systematic errors, deviation detection between a best condition and a currently measured condition, degradation diagnosis using a structured knowledge base, and prognosis for decision-making about maintenance tasks. We also discuss how our new methods can be incorporated with existing performance tests. We provide guidance and directions for developers and end-users interested in in-situ thermal performance management, particularly in NPPs with large steam turbines.

  7. Diagnosis and prognosis of Ostheoarthritis by texture analysis using sparse linear models

    DEFF Research Database (Denmark)

    Marques, Joselene; Clemmensen, Line Katrine Harder; Dam, Erik

    We present a texture analysis methodology that combines uncommitted machine-learning techniques and sparse feature transformation methods in a fully automatic framework. We compare the performances of a partial least squares (PLS) forward feature selection strategy to a hard threshold sparse PLS...... algorithm and a sparse linear discriminant model. The texture analysis framework was applied to diagnosis of knee osteoarthritis (OA) and prognosis of cartilage loss. For this investigation, a generic texture feature bank was extracted from magnetic resonance images of tibial knee bone. The features were...... used as input to the sparse algorithms, which dened the best features to retain in the model. To cope with the limited number of samples, the data was evaluated using 10 fold cross validation (CV). The diagnosis evaluation using sparse PLS reached a generalization area-under-the-ROC curve (AUC) of 0...

  8. CEA A BIOCHEMICAL MARKER FOR DIAGNOSIS AND PROGNOSIS OF GASTROINTESTINAL CANCER

    Directory of Open Access Journals (Sweden)

    Prathibha

    2016-02-01

    Full Text Available Serum tumor markers (TM are widely used for diagnosis and monitoring of treatment of cancer. Carcinoembryonic Antigen (CEA is one of the most widely investigated tumor markers in gastrointestinal (GI cancers. Estimation of circulating tumor markers is a non- invasive quantitative method. Serum levels of CEA were studied for diagnosis and prognosis of gastrointestinal malignancies. 140 subjects were undertaken out of which 35 normal and remaining 105 were GI cancer patients. Serum levels of CEA were analyzed by Enzyme Linked Immunosorbent Assay (ELISA. Result of serum CEA levels of the GI cancer patients and normal subjects were analyzed statistically. It was observed that there was significant increase in (P <0.01 in CEA levels of oesophagus, stomach and colon cancer patients as compared to normal subjects. The levels of CEA decreased significantly after the surgery but the decrease in levels of CEA was not up to the levels as normal control subjects.

  9. Endometrial cancer, types, prognosis, female hormones and antihormones

    DEFF Research Database (Denmark)

    Ulrich, L S G

    2011-01-01

    . Prognosis is also dependent on tumor differentiation and stage, and treatment should be adjusted accordingly. In this paper, the different types of endometrial cancer, staging, prognosis, diagnosis, prevention, treatment and their relationship to estrogen and other female hormones are reviewed....

  10. Model-Based Diagnosis and Prognosis of a Water Recycling System

    Science.gov (United States)

    Roychoudhury, Indranil; Hafiychuk, Vasyl; Goebel, Kai Frank

    2013-01-01

    A water recycling system (WRS) deployed at NASA Ames Research Center s Sustainability Base (an energy efficient office building that integrates some novel technologies developed for space applications) will serve as a testbed for long duration testing of next generation spacecraft water recycling systems for future human spaceflight missions. This system cleans graywater (waste water collected from sinks and showers) and recycles it into clean water. Like all engineered systems, the WRS is prone to standard degradation due to regular use, as well as other faults. Diagnostic and prognostic applications will be deployed on the WRS to ensure its safe, efficient, and correct operation. The diagnostic and prognostic results can be used to enable condition-based maintenance to avoid unplanned outages, and perhaps extend the useful life of the WRS. Diagnosis involves detecting when a fault occurs, isolating the root cause of the fault, and identifying the extent of damage. Prognosis involves predicting when the system will reach its end of life irrespective of whether an abnormal condition is present or not. In this paper, first, we develop a physics model of both nominal and faulty system behavior of the WRS. Then, we apply an integrated model-based diagnosis and prognosis framework to the simulation model of the WRS for several different fault scenarios to detect, isolate, and identify faults, and predict the end of life in each fault scenario, and present the experimental results.

  11. Critical Appraisal of the Quality of Evidence Addressing the Diagnosis, Prognosis, and Management of Peripheral Artery Disease in Patients With Diabetic Foot Ulceration.

    Science.gov (United States)

    Ali, Stephen R; Ozdemir, Baris A; Hinchliffe, Robert J

    2018-06-13

    There is a paucity of robust evidence on prevention and management of diabetic foot ulcers (DFUs) to inform treatment. This study appraises the current quality of the evidence addressing diagnosis, prognosis, and management of peripheral artery disease (PAD) in patients with DFUs using a newly devised 21 point scoring (TOPS) disease specific research appraisal tool published by the International Working Group on the Diabetic Foot (IWGDF) and European Wound Management Association. The 2015 IWGDF guidance on diagnosis, prognosis, and management of PAD in patients with DFUs was used to identify studies pertaining to prevention and management. Two reviewers assessed these articles against TOPS, which examines study design, conduct, and outcome reporting. The overall median score was 8 (3-12/21). The median design total score was 2 (0-4/11). The median conduct total score was 2 (1-4/6). The median outcomes total score was 3 (1-4/4). There was improvement with time in overall total (Spearman Rho 0.39, p = .0005), design total (0.35, p = .0023), and outcomes total (0.35, p = .0002), but not conduct total (-0.03, p = .8132) scores. Although this analysis revealed an improvement over time in the overall calibre of studies, the present quality remains poor on which to inform the diagnosis, management, and prognosis of patients with PAD and diabetic foot ulceration. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

  12. Deep vein thrombosis: diagnosis, treatment, and prevention

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, W.P.; Youngswick, F.D.

    Deep vein thrombosis (DVT) is a dangerous complication that may present after elective foot surgery. Because of the frequency with which DVT occurs in the elderly patient, as well as in the podiatric surgical population, the podiatrist should be acquainted with this entity. A review of the diagnosis, treatment, prevention, and the role of podiatry in the management of DVT is discussed in this paper.

  13. Clinical algorithms for the diagnosis and prognosis of interstitial lung disease in systemic sclerosis.

    Science.gov (United States)

    Hax, Vanessa; Bredemeier, Markus; Didonet Moro, Ana Laura; Pavan, Thaís Rohde; Vieira, Marcelo Vasconcellos; Pitrez, Eduardo Hennemann; da Silva Chakr, Rafael Mendonça; Xavier, Ricardo Machado

    2017-10-01

    Interstitial lung disease (ILD) is currently the primary cause of death in systemic sclerosis (SSc). Thoracic high-resolution computed tomography (HRCT) is considered the gold standard for diagnosis. Recent studies have proposed several clinical algorithms to predict the diagnosis and prognosis of SSc-ILD. To test the clinical algorithms to predict the presence and prognosis of SSc-ILD and to evaluate the association of extent of ILD with mortality in a cohort of SSc patients. Retrospective cohort study, including 177 SSc patients assessed by clinical evaluation, laboratory tests, pulmonary function tests, and HRCT. Three clinical algorithms, combining lung auscultation, chest radiography, and percentage predicted forced vital capacity (FVC), were applied for the diagnosis of different extents of ILD on HRCT. Univariate and multivariate Cox proportional models were used to analyze the association of algorithms and the extent of ILD on HRCT with the risk of death using hazard ratios (HR). The prevalence of ILD on HRCT was 57.1% and 79 patients died (44.6%) in a median follow-up of 11.1 years. For identification of ILD with extent ≥10% and ≥20% on HRCT, all algorithms presented a high sensitivity (>89%) and a very low negative likelihood ratio (algorithms, especially the algorithm C (HR = 3.47, 95% CI: 1.62-7.42), which identified the presence of ILD based on crackles on lung auscultation, findings on chest X-ray, or FVC 20% on HRCT or, in indeterminate cases, FVC algorithms had a good diagnostic performance for extents of SSc-ILD on HRCT with clinical and prognostic relevance (≥10% and ≥20%), and were also strongly related to mortality. Non-HRCT-based algorithms could be useful when HRCT is not available. This is the first study to replicate the prognostic algorithm proposed by Goh et al. in a developing country. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Fernell E

    2013-02-01

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

  15. [Early diagnosis and prognosis evaluation of Bell palsy with blink reflex ].

    Science.gov (United States)

    Xie, Dan-dan; Li, Xiao-song; Liu, Yuan-yuan

    2014-11-01

    To determine the value of blink reflex in early diagnosis and prognosis evaluation of Bell palsy. Blink reflex and facial nerve conduction were examined in 58 patients with Bell palsy within one week after symptom onset. The patients without response of R1 , R2 and R2 ' waves were classified as complete efferent retardarce (Group A, 30 cases), and those with response of R1 , R2 and R2 ' waves were classified as incomplete efferent anomalies (Group B, 28 cases). The clinical outcomes after three months of systemic therapy were evaluated using the House-Blackmann (H-B) scale. Efferent anomalies of blink reflex occurred in ail of the 58 patients. Abnormal results of facial nerve conduction appeared in 23 (39. 7%) patients. The three months therapy was effective in 93% patients in Group B and 70% patients in Group A (PBell palsy.

  16. Tumor markers for diagnosis, monitoring of recurrence and prognosis in patients with upper gastrointestinal tract cancer.

    Science.gov (United States)

    Jing, Jie-Xian; Wang, Yan; Xu, Xiao-Qin; Sun, Ting; Tian, Bao-Guo; Du, Li-Li; Zhao, Xian-Wen; Han, Cun-Zhi

    2014-01-01

    To evaluate the value of combined detection of serum CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS for the clinical diagnosis of upper gastrointestinal tract (GIT) cancer and to analyze the efficacy of these tumor markers (TMs) in evaluating curative effects and prognosis. A total of 573 patients with upper GIT cancer between January 2004 and December 2007 were enrolled in this study. Serum levels of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were examined preoperatively and every 3 months postoperatively by ELISA. The sensitivity of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were 26.8%, 36.2%, 42.9%, 2.84%, 25.4%, 34.6%, 34.2% and 30.9%, respectively. The combined detection of CEA+CA199+CA242+CA724 had higher sensitivity and specificity in gastric cancer (GC) and cardiac cancer, while CEA+CA199+CA242+SCC was the best combination of diagnosis for esophageal cancer (EC). Elevation of preoperative CEA, CA19-9 and CA24-2, SCC and CA72-4 was significantly associated with pathological types (pCEA, CA19-9, CA24-2, CA72-4 and SCC decreased obviously 3 months after operations. When metastasis and recurrence occurred, the levels of TMs significantly increased. On multivariate analysis, high preoperative CA72-4, CA24-2 and SCC served as prognostic factors for cardiac carcinoma, GC and EC, respectively. combined detection of CEA+CA199+CA242+SCC proved to be the most economic and practical strategy in diagnosis of EC; CEA+CA199+CA242+CA724 proved to be a better evaluation indicator for cardiac cancer and GC. CEA and CA19-9, CA24-2, CA72-4 and SCC, examined postoperatively during follow-up, were useful to find early tumor recurrence and metastasis, and evaluate prognosis. AFP, TPA and TPS have no significant value in diagnosis of patients with upper GIT cancer.

  17. Novel Biomarker Proteins in Chronic Lymphocytic Leukemia: Impact on Diagnosis, Prognosis and Treatment.

    Directory of Open Access Journals (Sweden)

    Lee Admoni-Elisha

    Full Text Available In many cancers, cells undergo re-programming of metabolism, cell survival and anti-apoptotic defense strategies, with the proteins mediating this reprogramming representing potential biomarkers. Here, we searched for novel biomarker proteins in chronic lymphocytic leukemia (CLL that can impact diagnosis, treatment and prognosis by comparing the protein expression profiles of peripheral blood mononuclear cells from CLL patients and healthy donors using specific antibodies, mass spectrometry and binary logistic regression analyses and other bioinformatics tools. Mass spectrometry (LC-HR-MS/MS analysis identified 1,360 proteins whose expression levels were modified in CLL-derived lymphocytes. Some of these proteins were previously connected to different cancer types, including CLL, while four other highly expressed proteins were not previously reported to be associated with cancer, and here, for the first time, DDX46 and AK3 are linked to CLL. Down-regulation expression of two of these proteins resulted in cell growth inhibition. High DDX46 expression levels were associated with shorter survival of CLL patients and thus can serve as a prognosis marker. The proteins with modified expression include proteins involved in RNA splicing and translation and particularly mitochondrial proteins involved in apoptosis and metabolism. Thus, we focused on several metabolism- and apoptosis-modulating proteins, particularly on the voltage-dependent anion channel 1 (VDAC1, regulating both metabolism and apoptosis. Expression levels of Bcl-2, VDAC1, MAVS, AIF and SMAC/Diablo were markedly increased in CLL-derived lymphocytes. VDAC1 levels were highly correlated with the amount of CLL-cancerous CD19+/CD5+ cells and with the levels of all other apoptosis-modulating proteins tested. Binary logistic regression analysis demonstrated the ability to predict probability of disease with over 90% accuracy. Finally, based on the changes in the levels of several proteins in

  18. Cytogenetic as an Important Tool for Diagnosis and Prognosis for Patients with Hypocellular Primary Myelodysplastic Syndrome

    Directory of Open Access Journals (Sweden)

    Daiane Corrêa de Souza

    2014-01-01

    Full Text Available We analyzed cytogenetically 105 patients with hypocellular primary MDS and their clinical implications. The main chromosomal abnormalities found were del(5q/−5, del(6q/+6, del(7q/−7, del(11q, and del(17p. Pediatric patients had a higher frequency of abnormal karyotypes compared with adult patients (P < 0,05. From our patients, 18% showed evolution of the disease. The chromosomal abnormalities presented in the diagnosis of patients who evolved to AML included numerical (−7, +8 and structural del(6q, del(7q, i(7q, t(7;9, i(9q, and del(11q abnormalities and complex karyotypes. Although the frequency of evolution from hypocellular MDS to AML is low, our results suggest that some chromosomal alterations may play a critical role during this process. We applied the IPSS in our patients because this score system has been proved to be useful for predicting evolution of disease. When we considered the patients according to group 1 (intermediate-1 and group 2 (intermediate-2 and high risk, we showed that group 2 had a high association with respect to the frequency of abnormal karyotypes (P < 0,0001, evolution of disease (P < 0,0001, and mortality (P < 0,001. In fact, the cytogenetic analysis for patients with hypocellular primary MDS is an important tool for diagnosis, prognosis, in clinical decision-making and in follow-up.

  19. MicroRNA: a new and promising potential biomarker for diagnosis and prognosis of ovarian cancer

    International Nuclear Information System (INIS)

    Pal, Manish K.; Jaiswar, Shyam P.; Dwivedi, Vinaya N.; Tripathi, Amit K.; Dwivedi, Ashish; Sankhwar, Pushplata

    2015-01-01

    Epithelial ovarian cancer (EOC) is the leading cause of death among all gynecological malignancies. Despite the technological and medical advances over the past four decades, such as the development of several biological markers (mRNA and proteins biomarkers), the mortality rate of ovarian cancer remains a challenge because of its late diagnosis, which is specifically attributed to low specificities and sensitivities. Under this compulsive scenario, recent advances in expression biology have shifted in identifying and developing specific and sensitive biomarkers, such as microRNAs (miRNAs) for cancer diagnosis and prognosis. MiRNAs are a novel class of small non-coding RNAs that deregulate gene expression at the posttranscriptional level, either by translational repression or by mRNA degradation. These mechanisms may be involved in a complex cascade of cellular events associated with the pathophysiology of many types of cancer. MiRNAs are easily detectable in tissue and blood samples of cancer patients. Therefore, miRNAs hold good promise as potential biomarkers in ovarian cancer. In this review, we attempted to provide a comprehensive profile of key miRNAs involved in ovarian carcinoma to establish miRNAs as more reliable non-invasive clinical biomarkers for early detection of ovarian cancer compared with protein and DNA biomarkers

  20. Age at diagnosis in women with non-metastatic breast cancer: Is it related to prognosis?

    International Nuclear Information System (INIS)

    Alieldin, N.H.; Abo-Elazm, O.M.; Bilal, D.; Ibrahim, A.S.; Salem, S.E.; Gouda, E.; Elmongy, M.

    2014-01-01

    Objective: Primary objective was to verify whether breast cancer patients aged less than 40 years at diagnosis have poorer prognosis than older patients. Secondary to assess prognostic factors influencing disease free survival. Methods: 941 women were diagnosed with non-metastatic breast cancer at NCI, Cairo in 2003. Epidemiologic, clinico-pathological characteristics, treatment modalities and disease free survival were compared among the two age groups. Prognostic factors were evaluated for association with disease-free survival. Results: One hundred-eighty-one patients (19.2%) were younger than 40 years and 760 (80.8%) were older. Older women presented with higher rates of comorbidities and younger women presented with more hormone non-responsive tumors. Young women presented with larger tumors pT4 = 13.8% compared to 8.6% in older women, yet not significant. Young women were treated with more conservative surgery, more adjuvant chemotherapy and radiotherapy while older women with more radical mastectomies and more hormonal treatment. Recurrence rates were significantly higher among young women 44,2% compared to 34.5% in older women. Five year disease free survival in young women was 38.9% ± 4.6% compared to 48.6% ± 2.5% with adjusted hazard ratio of 1.22 95% Cl (0.91-1.64),p = 0.19. Multivariate analyses identified positive axillary lymph nodes (pN2-pN3), larger tumor size (pT3-pT4), hypertension, lobular carcinoma type and lack of adjuvant systemic treatment as independent factors associated with poor DFS. Conclusion: Young women were not found to have poorer prognosis, yet they presented with more ER negative tumors. Most of women presented with advanced stage and young women had higher recurrence rates.

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

    Directory of Open Access Journals (Sweden)

    Xiang-yao WANG

    2016-04-01

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

  2. Diagnosis and prognosis of the source term by the French Safety Institut during an emergency on a PWR

    International Nuclear Information System (INIS)

    Chauliac, C.; Janot, L.; Jouzier, A.; Rague, B.

    1992-01-01

    The French approach for the diagnosis and the prognosis of the source term during an accident on a PWR is presented and the tools which have been developed to implement this approach at the Institute for Nuclear Protection and Safety (IPSN) are described. (author). 2 refs, 3 figs

  3. Information about diagnosis and prognosis related to anxiety and depression in children with cancer aged 8-16 years

    NARCIS (Netherlands)

    Last, B. F.; van Veldhuizen, A. M.

    1996-01-01

    The aim of this study was to test the hypothesis that being openly informed about the diagnosis and prognosis benefits the emotional well-being of children with cancer. A stratified sample of 56 children with cancer aged 8-16 years and their parents participated. The parents were interviewed about

  4. Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD): The TRIPOD Statement.

    Science.gov (United States)

    Collins, Gary S; Reitsma, Johannes B; Altman, Douglas G; Moons, Karel G M

    2015-06-01

    Prediction models are developed to aid health care providers in estimating the probability or risk that a specific disease or condition is present (diagnostic models) or that a specific event will occur in the future (prognostic models), to inform their decision making. However, the overwhelming evidence shows that the quality of reporting of prediction model studies is poor. Only with full and clear reporting of information on all aspects of a prediction model can risk of bias and potential usefulness of prediction models be adequately assessed. The Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) Initiative developed a set of recommendations for the reporting of studies developing, validating, or updating a prediction model, whether for diagnostic or prognostic purposes. This article describes how the TRIPOD Statement was developed. An extensive list of items based on a review of the literature was created, which was reduced after a Web-based survey and revised during a 3-day meeting in June 2011 with methodologists, health care professionals, and journal editors. The list was refined during several meetings of the steering group and in e-mail discussions with the wider group of TRIPOD contributors. The resulting TRIPOD Statement is a checklist of 22 items, deemed essential for transparent reporting of a prediction model study. The TRIPOD Statement aims to improve the transparency of the reporting of a prediction model study regardless of the study methods used. The TRIPOD Statement is best used in conjunction with the TRIPOD explanation and elaboration document. To aid the editorial process and readers of prediction model studies, it is recommended that authors include a completed checklist in their submission (also available at www.tripod-statement.org). The Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) Initiative developed a set of recommendations

  5. From big data to diagnosis and prognosis: gene expression signatures in liver hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Hong Yang

    2017-03-01

    Full Text Available Background Liver hepatocellular carcinoma accounts for the overwhelming majority of primary liver cancers and its belated diagnosis and poor prognosis call for novel biomarkers to be discovered, which, in the era of big data, innovative bioinformatics and computational techniques can prove to be highly helpful in. Methods Big data aggregated from The Cancer Genome Atlas and Natural Language Processing were integrated to generate differentially expressed genes. Relevant signaling pathways of differentially expressed genes went through Gene Ontology enrichment analysis, Kyoto Encyclopedia of Genes and Genomes and Panther pathway enrichment analysis and protein-protein interaction network. The pathway ranked high in the enrichment analysis was further investigated, and selected genes with top priority were evaluated and assessed in terms of their diagnostic and prognostic values. Results A list of 389 genes was generated by overlapping genes from The Cancer Genome Atlas and Natural Language Processing. Three pathways demonstrated top priorities, and the one with specific associations with cancers, ‘pathways in cancer,’ was analyzed with its four highlighted genes, namely, BIRC5, E2F1, CCNE1, and CDKN2A, which were validated using Oncomine. The detection pool composed of the four genes presented satisfactory diagnostic power with an outstanding integrated AUC of 0.990 (95% CI [0.982–0.998], P < 0.001, sensitivity: 96.0%, specificity: 96.5%. BIRC5 (P = 0.021 and CCNE1 (P = 0.027 were associated with poor prognosis, while CDKN2A (P = 0.066 and E2F1 (P = 0.088 demonstrated no statistically significant differences. Discussion The study illustrates liver hepatocellular carcinoma gene signatures, related pathways and networks from the perspective of big data, featuring the cancer-specific pathway with priority, ‘pathways in cancer.’ The detection pool of the four highlighted genes, namely BIRC5, E2F1, CCNE1 and CDKN2A, should be

  6. Milk Fistula: Diagnosis, Prevention, and Treatment.

    Science.gov (United States)

    Larson, Kelsey E; Valente, Stephanie A

    2016-01-01

    Milk fistula is an uncommon condition which occurs when there is an abnormal connection that forms between the skin surface and the duct in the breast of a lactating woman, resulting in spontaneous and often constant drainage of milk from this path of least resistance. A milk fistula is usually a complication that results from a needle biopsy or surgical intervention in a lactating patient. Here, the authors present an unusual case of a spontaneous milk fistula which developed from an abscess in the breast of a lactating woman. The patient initially presented to the office with a large open wound on her breast, formed from skin breakdown, within which milk was pooling. She was treated with local wound care and cessation of breastfeeding, with appropriate healing of the wound and closure of the fistula with 6 weeks. Diagnosis, prevention, and treatment of milk fistula were reviewed. © 2015 Wiley Periodicals, Inc.

  7. Galectin-3: a new biomarker for the diagnosis, analysis and prognosis of acute and chronic heart failure.

    Science.gov (United States)

    Hrynchyshyn, Nataliya; Jourdain, Patrick; Desnos, Michel; Diebold, Benoit; Funck, François

    2013-10-01

    Heart failure constitutes an important medical, social and economic problem. The prevalence of heart failure is estimated as 2-3% of the adult population and increases with age, despite the scientific progress of the past decade, especially the emergence of natriuretic peptides, which have been widely used as reliable markers for diagnostic and prognostic evaluation. Identification of new reliable markers for diagnosis, analysis, prognosis of mortality and prevention of hospitalization is still necessary. Galectin-3 is a soluble β-galactoside-binding protein secreted by activated macrophages. Its main action is to bind to and activate the fibroblasts that form collagen and scar tissue, leading to progressive cardiac fibrosis. Numerous experimental studies have shown the important role of galectin-3 in cardiac remodelling due to fibrosis, independent of the fibrosis aetiology. Galectin-3 is significantly increased in chronic heart failure (acute or non-acute onset), independent of aetiology. Some clinical studies have confirmed the predictive value of galectin-3 in all-cause mortality in patients with heart failure. In our review, we aim to analyse the role of galectin-3 in the development of heart failure, its value in screening and clinical decision making and its possible predictive application in follow-up as a "routine" test in an addition to established biomarkers, such as B-type natriuretic peptide and N-terminal prohormone of B-type natriuretic peptide. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  8. Brain networks predict metabolism, diagnosis and prognosis at the bedside in disorders of consciousness.

    Science.gov (United States)

    Chennu, Srivas; Annen, Jitka; Wannez, Sarah; Thibaut, Aurore; Chatelle, Camille; Cassol, Helena; Martens, Géraldine; Schnakers, Caroline; Gosseries, Olivia; Menon, David; Laureys, Steven

    2017-08-01

    Recent advances in functional neuroimaging have demonstrated novel potential for informing diagnosis and prognosis in the unresponsive wakeful syndrome and minimally conscious states. However, these technologies come with considerable expense and difficulty, limiting the possibility of wider clinical application in patients. Here, we show that high density electroencephalography, collected from 104 patients measured at rest, can provide valuable information about brain connectivity that correlates with behaviour and functional neuroimaging. Using graph theory, we visualize and quantify spectral connectivity estimated from electroencephalography as a dense brain network. Our findings demonstrate that key quantitative metrics of these networks correlate with the continuum of behavioural recovery in patients, ranging from those diagnosed as unresponsive, through those who have emerged from minimally conscious, to the fully conscious locked-in syndrome. In particular, a network metric indexing the presence of densely interconnected central hubs of connectivity discriminated behavioural consciousness with accuracy comparable to that achieved by expert assessment with positron emission tomography. We also show that this metric correlates strongly with brain metabolism. Further, with classification analysis, we predict the behavioural diagnosis, brain metabolism and 1-year clinical outcome of individual patients. Finally, we demonstrate that assessments of brain networks show robust connectivity in patients diagnosed as unresponsive by clinical consensus, but later rediagnosed as minimally conscious with the Coma Recovery Scale-Revised. Classification analysis of their brain network identified each of these misdiagnosed patients as minimally conscious, corroborating their behavioural diagnoses. If deployed at the bedside in the clinical context, such network measurements could complement systematic behavioural assessment and help reduce the high misdiagnosis rate reported

  9. Germ Cell Proteins in Melanoma: Prognosis, Diagnosis, Treatment, and Theories on Expression

    International Nuclear Information System (INIS)

    Rosa, A. M.; Dabas, N.; Byrnes, D. M.; Eller, M. S.; Grichnik, J. M.; Grichnik, J M.; Grichnik, J M.

    2012-01-01

    Germ cell protein expression in melanoma has been shown to correlate with malignancy, severity of disease and to serve as an immunologic target for therapy. However, very little is known about the role that germ cell proteins play in cancer development. Unique germ cell pathways include those involved in immortalization, genetic evolution, and energy metabolism. There is an ever increasing recognition that within tumors there is a subpopulation of cells with stem-cell-like characteristics that play a role in driving tumor genesis. Stem cell and germ cell biology is intertwined. Given the enormous potential and known expression of germ cell proteins in melanoma, it is possible that they represent a largely untapped resource that may play a fundamental role in tumor development and progression. The purpose of this paper is to provide an update on the current value of germ cell protein expression in melanoma diagnosis, prognosis, and therapy, as well as to review critical germ cell pathways and discuss the potential roles these pathways may play in malignant transformation

  10. The epigenetics of prostate cancer diagnosis and prognosis: update on clinical applications.

    Science.gov (United States)

    Blute, Michael L; Damaschke, Nathan A; Jarrard, David F

    2015-01-01

    There is a major deficit in our ability to detect and predict the clinical behavior of prostate cancer (PCa). Epigenetic changes are associated with PCa development and progression. This review will focus on recent results in the clinical application of diagnostic and prognostic epigenetic markers. The development of high throughput technology has seen an enormous increase in the discovery of new markers that encompass epigenetic changes including those in DNA methylation and histone modifications. Application of these findings to urine and other biofluids, but also cancer and noncancerous prostate tissue, has resulted in new biomarkers. There has been a recent commercial development of a DNA methylation-based assay for identifying PCa risk from normal biopsy tissue. Other biomarkers are currently in the validation phase and encompass combinations of multiple genes. Epigenetic changes improve the specificity and sensitivity of PCa diagnosis and have the potential to help determine clinical prognosis. Additional studies will not only provide new and better biomarker candidates, but also have the potential to inform new therapeutic strategies given the reversibility of these processes.

  11. Polycystic echinococcosis in the state of Acre, Brazil: contribution to patient diagnosis, treatment and prognosis

    Science.gov (United States)

    de Siqueira, Nilton Ghiotti; de Siqueira, Cláudia Maria Villar Maziero; Rodrigues-Silva, Rosângela; Soares, Manoel do Carmo P; Póvoa, Marinete Marins

    2013-01-01

    The lack of knowledge regarding polycystic hydatid disease results in delayed or even incorrect diagnosis. The lack of systematic information regarding treatment also makes it difficult to assess the results and prognosis in patients with peritoneal and hepatic lesions caused by Echinococcus vogeli. Here we describe the clinical features of patients, propose a radiological classification protocol and describe a therapeutic option for the treatment of hydatid disease that previously had only been used for cases of cystic echinococcosis (Echinococcus granulosus). A prospective cohort study was initiated in 1999 and by 2009 the study included 60 patients. These patients were classified according to the PNM classification (parasite lesion, neighbouring organ invasion and metastases) and placed in one of three therapeutic modalities: (i) chemotherapy with albendazole at a dose of 10 mg/kg/day, (ii) surgical removal of cysts or (iii) percutaneous puncture of the cysts via puncture, aspiration, injection and re-aspiration (PAIR). The results were stratified according to therapeutic outcome: "cure", "clinical improvement", "no improvement", "death" or "no information". The PNM classification was useful in indicating the appropriate therapy in cases of polycystic hydatid disease. In conclusion, surgical therapy produced the best clinical results of all the therapies studied based on "cure" and "clinical improvement" outcomes. The use of PAIR for treatment requires additional study. PMID:23903966

  12. A Single Imaging Modality in the Diagnosis, Severity, and Prognosis of Pulmonary Embolism

    Directory of Open Access Journals (Sweden)

    Hadice Selimoglu Sen

    2014-01-01

    Full Text Available Introduction. This study aimed to investigate the currency of computerized tomography pulmonary angiography-based parameters as pulmonary artery obstruction index (PAOI, as well as right ventricular diameters for pulmonary embolism (PE risk evaluation and prediction of mortality and intensive care unit (ICU requirement. Materials and Methods. The study retrospectively enrolled 203 patients hospitalized with acute PE. PAOI was calculated according to Qanadli score. Results. Forty-three patients (23.9% were hospitalized in the ICU. Nineteen patients (10.6% died during the 30-day follow-up period. The optimal cutoff value of PAOI for PE 30th day mortality and ICU requirement were found as 36.5% in ROC curve analysis. The pulmonary artery systolic pressure had a significant positive correlation with right/left ventricular diameter ratio (r=0.531, P<0.001, PAOI (r=0.296, P<0.001, and pulmonary artery diameter (r=0.659, P<0.001. The patients with PAOI values higher than 36.5% have a 5.7-times increased risk of death. Conclusion. PAOI is a fast and promising parameter for risk assessment in patients with acute PE. With greater education of clinicians in this radiological scoring, a rapid assessment for diagnosis, clinical risk evaluation, and prognosis may be possible in emergency services without the need for echocardiography.

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

    Science.gov (United States)

    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.

  14. Data-driven technology for engineering systems health management design approach, feature construction, fault diagnosis, prognosis, fusion and decisions

    CERN Document Server

    Niu, Gang

    2017-01-01

    This book introduces condition-based maintenance (CBM)/data-driven prognostics and health management (PHM) in detail, first explaining the PHM design approach from a systems engineering perspective, then summarizing and elaborating on the data-driven methodology for feature construction, as well as feature-based fault diagnosis and prognosis. The book includes a wealth of illustrations and tables to help explain the algorithms, as well as practical examples showing how to use this tool to solve situations for which analytic solutions are poorly suited. It equips readers to apply the concepts discussed in order to analyze and solve a variety of problems in PHM system design, feature construction, fault diagnosis and prognosis.

  15. Genomic aberrations in spitzoid tumours and their implications for diagnosis, prognosis and therapy

    Science.gov (United States)

    Wiesner, Thomas; Kutzner, Heinz; Cerroni, Lorenzo; Mihm, Martin J.; Busam, Klaus J.; Murali, Rajmohan

    2016-01-01

    techniques, such as array comparative genomic hybridisation (CGH) or fluorescence in situ hybridisation (FISH), are capable of accurately classifying histologically benign and malignant Spitz tumours, but are not very helpful in the diagnosis of ambiguous melanocytic lesions. Nevertheless, we expect that progress in our understanding of tumour genomics and progression will refine the classification of melanocytic tumours in the near future. By integrating clinical, pathological, and genetic criteria, distinct tumour subsets will be defined within the heterogeneous group of Spitz tumours, which will eventually lead to improvements in diagnosis, prognosis and therapy. PMID:27020384

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

    Science.gov (United States)

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

    2018-04-01

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

  17. Support vector data description for fusion of multiple health indicators for enhancing gearbox fault diagnosis and prognosis

    International Nuclear Information System (INIS)

    Wang, Dong; Tse, Peter W; Guo, Wei; Miao, Qiang

    2011-01-01

    A novel method for enhancing gearbox fault diagnosis and prognosis is developed by fusion of multiple health indicators through support vector data description. First, the Comblet transform is used to identify gear residual error signals from the raw signal. Second, based on the observation of gear residual error signals, a total of 11 gear health indicators are identified, and are categorized into two types of indicators. The first and second types of indicators are for fault diagnosis and prognosis, respectively. The first type has six indicators, which are sensitive to impulsive signals triggered by anomalous impacts. The second type has five indicators, which are suitable for tracking degradation of faults. Third, through the support vector data description, the first six health indicators are fused into type one indicators for fault diagnosis. The remaining five indicators are fused into type two indicators for fault prognosis. Finally, a Gaussian kernel is designed to enhance the performance of type one and two indicators by optimal range of width size. The effectiveness of the proposed method is validated through experiments. The new method has been proven to be superior to methods that use unfused indicators individually

  18. Free light chains of immunoglobulins in the diagnosis and prognosis of multiple myeloma

    Directory of Open Access Journals (Sweden)

    N. V. Lyubimova

    2017-01-01

    Full Text Available Background: Analysis of free light chains of immunoglobulins (FLC in the serum is an effective method in the diagnosis of multiple myeloma. Plasma cells produce two types of FLC: κand λ-FLC. FLC, which are not incorporated into monoclonal intact immunoglobulins, are released into circulation, and then are filtered and reabsorbed in kidneys depending on their molecular weight. Circulating FLC commonly form homodimers, known as Bence-Jones protein, which is a biomarker of Bence-Jones multiple myeloma. According to the international guidelines, the ratio κ/λ FLC is an important diagnostic criterion of multiple myeloma. Aim: To evaluate the diagnostic and prognostic value of serum FLC in multiple myeloma patients. Materials and methods: We examined 118 patients with multiple myeloma, admitted to the Department of Hemoblastosis Chemotherapy of N.N. Blokhin Russian Cancer Research Center from 2010 to 2016, and 68 healthy men and women. Serum concentrations of FLC were measured with an immunoturbidimetric method using the test-system Freelite Human Lambda and Freelite Human Kappa (Binding Site Inc.. Results: The levels of monoclonal κor λ-FLC in patients with G-, A-myeloma and Bence-Jones multiple myeloma were significantly higher than those in the control group (p < 0.005. The diagnostic sensitivity of quantification of FLC and their ratio was 87.3% and 89.8%, and in combination with the use of immune electrophoresis it was close to 100%. Analysis of progression free survival and overall survival showed significant differences (p < 0.04 between the groups of patients according their κ/λ FLC ratio. The basal value of κ/λ FLC ratio of less than 0.04 and more than 140 was a  predictor of unfavorable outcome. Conclusion: The inclusion of the determination of serum FLC into the assessment plan of patients with suspected monoclonal gammapathy makes it possible to increase diagnostic sensitivity of the available methods for paraprotein

  19. The clinical pathological features, diagnosis, treatment and prognosis of small intestine primary malignant tumors.

    Science.gov (United States)

    Guo, Xiaochuan; Mao, Zhiyuan; Su, Dan; Jiang, Zhaocai; Bai, Li

    2014-04-01

    The aim of the study was to describe and analyze the clinicopathological features and diagnosis of Chinese patients with small intestine primary malignant tumors and to explore the best therapy to small bowel adenocarcinoma (SBA). More than 26,000 patients with digestive tract malignant tumors received treatment in PLA hospital from 2000 to 2011, and among them, there were 887 patients who had small intestine primary malignant tumors, and 666 of 887 patients had the completed basic clinical documents. We retrospectively analyzed the correlation between clinical and pathological features of the 666 patients and analyzed the survival and prognosis of 173 SBA patients with follow-up data. Both the number of patients with primary malignant tumors of the small intestine and the number of patients who received chemotherapy showed an increasing trend. The ratio of male to female was 1.58:1. The male patients significantly exceed the female patients with tumors of non-ampullary duodenum, jejunum and duodenal ampulla; and most of the patients are over 60 years of age. For patients burdened with either of the pathological types of tumors, the males exceeded the females, but there was no significant difference. Abdominal pain was the main clinical manifestation for patients with tumors of non-ampullary duodenum, jejunum and ileum, and the most common clinical manifestations were jaundice and abdominal pain for patients with ampullary duodenal tumors, adenocarcinoma, neuroendocrine tumors and sarcoma. In addition, patients with stromal tumors were prone to gastrointestinal bleeding. Gastrointestinal endoscopy was the most common examinational procedure. Patients under 60 years of age were prone to surgery and chemotherapy after surgery, and patients over 60 years of age were prone to supportive treatment and chemotherapy without surgery. The medium overall survival of patients who received surgery without chemotherapy, chemotherapy after surgery, chemotherapy without surgery

  20. Diabetes Part 1. Definition, Diagnosis and Prevention

    African Journals Online (AJOL)

    Skoludek_R

    increasing obesity and a steady year on year rise in the incidence of type 1 ... its under-diagnosis and under-treatment leads to rapid death in T1DM and to unnecessary suffering and ... 80% of the time), T1DM presents in childhood with.

  1. [Prenatal diagnosis of a right thoracic congenital ectopic kidney with a diaphragmatic hernia: a combination with a good prognosis].

    Science.gov (United States)

    Cessans, C; Pharamin, J; Crouzet, K; Kessler, S; Puget, C; Bouali, O; Galinier, P; Marcoux, M-O

    2015-11-01

    Ectopic intrathoracic kidney is a rare congenital anomaly, usually asymptomatic. This anomaly is sometimes associated with a diaphragmatic hernia. Few cases of this combination have been described, often in the absence of a prenatal diagnosis. We report on the case of a female newborn infant who was diagnosed with an ectopic intrathoracic right kidney and a diaphragmatic hernia upon 33 weeks of gestation. The patient underwent surgery on the first day of life and the respiratory and renal outcomes were simple. We review the literature and discuss the seemingly good prognosis of this combination. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Role of inflammatory marker YKL-40 in the diagnosis, prognosis and cause of cardiovascular and liver diseases

    DEFF Research Database (Denmark)

    Kjaergaard, A.D.; Johansen, Julia Sidenius; Bojesen, Stig Egil

    2016-01-01

    This review summarizes present evidence for the role of YKL-40 in the diagnosis, prognosis and cause of cardiovascular and alcoholic liver disease. The question of whether YKL-40 is merely a marker or a causal factor in the development of cardiovascular and liver disease is addressed, with emphasis...... of cardiovascular and alcoholic liver disease, thus suggesting that plasma YKL-40 does not play a causal role in the development of these diseases. Despite this, plasma YKL-40 levels may play a role in disease progression after diagnosis, and inhibition of YKL-40 activity might be a novel therapy in some...... rather than a drug and placebo, and like a blinded trial, it allows inference about causality. Moreover, the review also covers background on the molecular biology and functions of YKL-40, YKL-40 levels in healthy individuals and reference range, and the role of YKL-40 as a biomarker of cardiovascular...

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

    Science.gov (United States)

    Shukla, Hem D

    2017-10-25

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

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

    Directory of Open Access Journals (Sweden)

    Hem D. Shukla

    2017-10-01

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

  5. Current problems of prevention diagnosis and treatment of radiation sickness

    International Nuclear Information System (INIS)

    Gus'kova, A.K.

    1986-01-01

    Causes of increasing interest to the problems of prevention, diagnosis and treatment of radiation sickness are presented. On the basis of recent publications some new aspects as quantitative criteria in radiobiology, organization problems of medical aid at radiation incidents estimation of efficiency of preventive medicine and radiation sickness therapy, theoretical development of radiotherapy of different organs et al., are characterized

  6. Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies.

    Science.gov (United States)

    Saha, Manish; Allon, Michael

    2017-02-07

    Given the high comorbidity in patients on hemodialysis and the complexity of the dialysis treatment, it is remarkable how rarely a life-threatening complication occurs during dialysis. The low rate of dialysis emergencies can be attributed to numerous safety features in modern dialysis machines; meticulous treatment and testing of the dialysate solution to prevent exposure to trace elements, toxins, and pathogens; adherence to detailed treatment protocols; and extensive training of dialysis staff to handle medical emergencies. Most hemodialysis emergencies can be attributed to human error. A smaller number are due to rare idiosyncratic reactions. In this review, we highlight major emergencies that may occur during hemodialysis treatments, describe their pathogenesis, offer measures to minimize them, and provide specific interventions to prevent catastrophic consequences on the rare occasions when such emergencies arise. These emergencies include dialysis disequilibrium syndrome, venous air embolism, hemolysis, venous needle dislodgement, vascular access hemorrhage, major allergic reactions to the dialyzer or treatment medications, and disruption or contamination of the dialysis water system. Finally, we describe root cause analysis after a dialysis emergency has occurred to prevent a future recurrence. Copyright © 2017 by the American Society of Nephrology.

  7. Elevated C-reactive protein in the diagnosis, prognosis, and cause of cancer

    DEFF Research Database (Denmark)

    Allin, Kristine H; Nordestgaard, Børge G

    2011-01-01

    The aim of this review is to summarize present evidence of an association between circulating levels of C-reactive protein (CRP) and cancer risk, and to evaluate whether elevated circulating CRP levels cause cancer. Additionally, the review provides background information on the acute......-phase response, chronic inflammation, the molecular biology, function and measurement of CRP, circulating levels of CRP in health and disease, the principle of Mendelian randomization, the association between circulating levels of CRP and cancer prognosis, and cancer biomarkers. In the Copenhagen General...... increased risk of death from breast cancer compared to patients with CRP levels...

  8. The Young Brain and Concussion: Imaging as a Biomarker for Diagnosis and Prognosis

    Science.gov (United States)

    Toledo, E.; Lebel, A.; Becerra, L.; Minster, A.; Linnman, C; Maleki, N; Dodick, D.W.; Borsook, D.

    2012-01-01

    Concussion (mild traumatic brain injury (mTBI)) is a significant pediatric public health concern. Despite increased awareness, a comprehensive understanding of the acute and chronic effects of concussion on central nervous system structure and function remains incomplete. Here we review the definition, epidemiology, and sequelae of concussion within the developing brain, during childhood and adolescence, with current data derived from studies of pathophysiology and neuroimaging. These findings may contribute to a better understanding of the neurological consequences of traumatic brain injuries, which in turn, may lead to the development of brain biomarkers to improve identification, management and prognosis of pediatric patients suffering from concussion. PMID:22476089

  9. An Integrated Framework for Model-Based Distributed Diagnosis and Prognosis

    Science.gov (United States)

    2012-09-01

    0 : t) denotes all measurements observed up to time t. The goal of prognosis is to determine the end of (use- ful) life ( EOL ) of a system, and/or its...remaining useful life (RUL). For a given fault, f , using the fault estimate, p(xf (t),θf (t)|y(0 : t)), a probability distribution of EOL , p(EOLf (tP...is stochas- tic, EOL /RUL are random variables and we represent them by probability distributions. The acceptable behavior of the system is expressed

  10. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Prognosis Questions to Ask about Your Diagnosis Research Understanding Cancer Prognosis Oncologist Anthony L. Back, M.D., a national expert on doctor-patient communications, talks with one of his patients about what ...

  11. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... during a certain period of time after diagnosis. Disease-free survival This statistic is the percentage of ... discuss cancer prognosis (the likely course of the disease). Learn key points about prognosis and how to ...

  12. Hepatorenal syndrome: diagnosis, treatment and prevention

    DEFF Research Database (Denmark)

    Israelsen, Mads Egerod; Gluud, Lise Lotte; Bendtsen, Flemming

    2014-01-01

    Cirrhosis, ascites and renal impairment are associated with high morbidity and mortality. The hepatorenal syndrome (HRS) is a type of renal failure that affects patients with cirrhosis and ascites. This paper provides an update on evidence-based interventions in HRS. A number of factors can...... precipitate HRS. The monitoring, prevention, early detection, and correct treatment of these are essential. Terlipressin combined with albumin is the first-line treatment of type 1 HRS. In type 2 HRS with refractory ascites, liver transplantation and TIPS should be considered....

  13. The effect of silicone implants on the diagnosis, prognosis, and treatment of breast cancer.

    Science.gov (United States)

    Handel, Neal

    2007-12-01

    Because of the prevalence of breast cancer, many augmented women eventually will develop the disease. This article reviews what is known about the effect of implants on the detection, prognosis, and treatment of carcinoma of the breast. Observations were made on 4082 breast cancer patients (3953 nonaugmented and 129 augmented) treated over a 23-year time span. Findings in the two groups were compared and differences analyzed statistically. Mammograms of all women with palpable lesions were reviewed to assess mammographic sensitivity in patients with and without implants. Cosmetic outcomes in augmented patients treated with breast conservation therapy were reviewed. Augmented patients presented more frequently with palpable lesions, invasive tumors, axillary nodal metastases, and false-negative mammograms. However, there was no significant difference in stage of disease, tumor size, recurrence rates, or survival between the two groups. Augmented patients treated with breast conservation therapy often experienced poor cosmetic results and frequently required reoperation. Despite the diminished sensitivity of mammography in women with implants, augmented and nonaugmented patients are diagnosed at a similar stage of disease and have a comparable prognosis. Implants may impair mammography but appear to facilitate tumor detection on physical examination. Magnetic resonance imaging and breast ultrasound may be useful adjuncts, but conventional mammography remains the most reliable tool for diagnosing early breast cancer in augmented patients. Breast implants do not interfere with mastectomy or breast reconstruction but may compromise the outcome of breast conservation therapy.

  14. The prognosis of surgically treated congenital hydronephrosis after diagnosis in utero

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Mortensen, T; Diemer, Henrik

    1985-01-01

    Nine patients with a prenatal ultrasonic diagnosis of unilateral ureteropelvic junction obstruction underwent pyeloplasty in early neonatal life. Based on radiological and renographical assessment of the results, immediate postnatal intervention had no demonstrable advantage over those subjects i...

  15. Nanotechnology in dentistry: prevention, diagnosis, and therapy.

    Science.gov (United States)

    Abou Neel, Ensanya Ali; Bozec, Laurent; Perez, Roman A; Kim, Hae-Won; Knowles, Jonathan C

    2015-01-01

    Nanotechnology has rapidly expanded into all areas of science; it offers significant alternative ways to solve scientific and medical questions and problems. In dentistry, nanotechnology has been exploited in the development of restorative materials with some significant success. This review discusses nanointerfaces that could compromise the longevity of dental restorations, and how nanotechnolgy has been employed to modify them for providing long-term successful restorations. It also focuses on some challenging areas in dentistry, eg, oral biofilm and cancers, and how nanotechnology overcomes these challenges. The recent advances in nanodentistry and innovations in oral health-related diagnostic, preventive, and therapeutic methods required to maintain and obtain perfect oral health, have been discussed. The recent advances in nanotechnology could hold promise in bringing a paradigm shift in dental field. Although there are numerous complex therapies being developed to treat many diseases, their clinical use requires careful consideration of the expense of synthesis and implementation.

  16. Nanotechnology in dentistry: prevention, diagnosis, and therapy

    Science.gov (United States)

    Abou Neel, Ensanya Ali; Bozec, Laurent; Perez, Roman A; Kim, Hae-Won; Knowles, Jonathan C

    2015-01-01

    Nanotechnology has rapidly expanded into all areas of science; it offers significant alternative ways to solve scientific and medical questions and problems. In dentistry, nanotechnology has been exploited in the development of restorative materials with some significant success. This review discusses nanointerfaces that could compromise the longevity of dental restorations, and how nanotechnolgy has been employed to modify them for providing long-term successful restorations. It also focuses on some challenging areas in dentistry, eg, oral biofilm and cancers, and how nanotechnology overcomes these challenges. The recent advances in nanodentistry and innovations in oral health-related diagnostic, preventive, and therapeutic methods required to maintain and obtain perfect oral health, have been discussed. The recent advances in nanotechnology could hold promise in bringing a paradigm shift in dental field. Although there are numerous complex therapies being developed to treat many diseases, their clinical use requires careful consideration of the expense of synthesis and implementation. PMID:26504385

  17. Herpes Genitalis: Diagnosis, Treatment and Prevention

    Science.gov (United States)

    Sauerbrei, A.

    2016-01-01

    Herpes genitalis is caused by the herpes simplex virus type 1 or type 2 and can manifest as primary or recurrent infection. It is one of the most common sexually transmitted infections and due to associated physical and psychological morbidity it constitutes a considerable, often underestimated medical problem. In addition to providing the reader with basic knowledge of the pathogen and clinical presentation of herpes genitalis, this review article discusses important aspects of the laboratory diagnostics, antiviral therapy and prophylaxis. The article is aimed at all health-care workers managing patients with herpes genitalis and attempts to improve the often suboptimal counselling, targeted use of laboratory diagnostics, treatment and preventive measures provided to patients. PMID:28017972

  18. Remarks about the prognosis in case of antenatal diagnosis of gastroschisis.

    Science.gov (United States)

    Poulain, P; Milon, J; Frémont, B; Proudhon, J F; Odent, S; Babut, J M; Le Marec, B; Grall, J Y; Giraud, J R

    1994-05-18

    We report our experience of 15 cases of gastroschisis which occurred between 1981 and 1993. All but one were diagnosed antenatally by ultrasound between 16 and 32 weeks of pregnancy. We made a termination of the pregnancy in 3 cases, for multiple malformations in 2 cases and one case of very early premature rupture of the membranes (PROM). When checked (11 cases), the karyotype was normal. We made a cesarean section in 11 cases: the indication was a complication for 6 (fetal distress, PROM, polyhydramnios, large dilatation of the gut). We noted growth retardation in 7 newborns and prematurity in 5/12 (mean gestational age of 36.8 weeks). The preoperative study of the gut noted 5 cases with intestinal damage and one case of complete necrosis of the gut. The global prognosis is not as good as usual, with a perinatal mortality of 41.6% (5/12). We discuss this latter point and examine the literature.

  19. Problems of genetic diagnosis: serological markers in the prognosis of the development of human speed abilities

    Directory of Open Access Journals (Sweden)

    Serhiyenko Leonid Prokopovich

    2011-10-01

    Full Text Available The article deals with the study of correlation between blood groups system AB0 and Rh with the peculiarities of the development of human speed abilities. Complex of genetic markers is defined. It is possible to use this complex in the individual prognosis of the development of human motor abilities. With 0(I and A(II blood groups and Rh+ have a high inclination to the physical development. Better identify trends in the phenotypic expression of high-speed abilities in people with 0(I and A(II blood groups in comparison with people with the AB(IV and B(III blood group. The pattern of decreasing susceptibility to the development of high-speed abilities as follows: 0(I>A(II>B(III>AB (IV. It is established that a complex system of genetic markers AB0 and Rh blood has no gender differences.

  20. Nanotechnology in dentistry: prevention, diagnosis, and therapy

    Directory of Open Access Journals (Sweden)

    Abou Neel EA

    2015-10-01

    Full Text Available Ensanya Ali Abou Neel,1–3 Laurent Bozec,3 Roman A Perez,4,5 Hae-Won Kim,4–6 Jonathan C Knowles3,5 1Division of Biomaterials, Operative Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 2Biomaterials Department, Faculty of Dentistry, Tanta University, Tanta, Egypt; 3UCL Eastman Dental Institute, Biomaterials and Tissue Engineering, London, UK; 4Institute of Tissue Regenerative Engineering (ITREN, 5Department of Nanobiomedical Science and BK21 Plus NBM Global Research Center for Regenerative Medicine, 6Department of Biomaterials Science, College of Dentistry, Dankook University, Cheonan, Republic of Korea Abstract: Nanotechnology has rapidly expanded into all areas of science; it offers significant alternative ways to solve scientific and medical questions and problems. In dentistry, nanotechnology has been exploited in the development of restorative materials with some significant success. This review discusses nanointerfaces that could compromise the longevity of dental restorations, and how nanotechnolgy has been employed to modify them for providing long-term successful restorations. It also focuses on some challenging areas in dentistry, eg, oral biofilm and cancers, and how nanotechnology overcomes these challenges. The recent advances in nanodentistry and innovations in oral health-related diagnostic, preventive, and therapeutic methods required to maintain and obtain perfect oral health, have been discussed. The recent advances in nanotechnology could hold promise in bringing a paradigm shift in dental field. Although there are numerous complex therapies being developed to treat many diseases, their clinical use requires careful consideration of the expense of synthesis and implementation. Keywords: nanotechnology, nanointerfaces, biofilm-related oral diseases, tissue engineering, drug delivery, toxicity

  1. Roentgenologic diagnosis of perforation of the alimentary tract in neonates and a study of the pathogenesis and the prognosis

    International Nuclear Information System (INIS)

    Zhou Shaoyi; Liu Liwei

    2003-01-01

    Objective: To study the X-ray manifestations of alimentary tract perforation in neonates and investigate the pathogenesis and the prognosis. Methods: In total 65 cases of alimentary tract perforation in neonates were retrospectively studied, including the X-ray manifestations and the pathology. Results: Pneumo-peritoneum was revealed in 59 cases out of 65, including sever pneumo-peritoneum in 19 cases, moderate in 20 cases and mild in 20 cases. Free air was revealed in the sub-diaphragmatic regions in 55 cases. The following manifestations indicated pneumo-peritoneum: football sign (25 cases), falciform ligament sign (36 cases) and pencil-drawing sign (27 cases). Other findings included the absence of the gastric bulb revealed in 11 cases, increased distance between the bowel loops in 28, widen separation of the intestinal wall and the adjacent air filled loop in 34, air-containing bowel wall in 11, and feces air mixture within peripheral loops in 8 case. The primary affection included: defects of gastric musculature (11 cases), congenital malformation of small intestine (11 cases), Hirschsprung disease (8 cases), atresia of the anus (2 cases), meconium peritonitis (5 cases), NEC (24 cases), and other causes (4 cases). Conclusion: In the diagnosis of alimentary tract's perforation in neonates, Roentgenography is still the most important examination and the first choice of imaging. It also helps evaluating the pathogenesis and the prognosis of those disorders

  2. Serum tumor markers in chronic kidney disease: as clinical tool in diagnosis, treatment and prognosis of cancers.

    Science.gov (United States)

    Amiri, Fateme Shamekhi

    2016-01-01

    Cancer is singled out as the biggest cause of death in the world, predicted to reach 13.1 million cancer-related deaths by the year 2030. Although there are no specific tumor markers used in cancer screening, some markers can be used to assist in making a diagnosis and determining a prognosis. They can be used to follow in cases where the diagnosis is cancer through monitoring of the disease recurrence and/or evaluating the response to therapy. These markers are not specific as the number increases in multiple cases of cancer. Some markers are positive in a single type of cancer; others are detectable in more than one type. An ideal tumor marker should be highly sensitive, specific, and reliable with high prognostic value. Other characteristics of an ideal tumor marker are organ specificity and correlation of it with tumor stages. However, none of the tumor markers reported to date has all these characteristics. Influence of different stages of chronic kidney function on serum tumor markers is variable. Furthermore, hemodialysis, peritoneal dialysis, and kidney transplantation affect on tumor markers differently. Sometimes, no study has been found in the literature review. Combined serum tumor markers may also be valuable. This literature review points the role of serum tumor markers in screening, diagnosis, and follow-up of cancer patients in chronic kidney disease patients and renal allograft recipients. In addition, impact of chronic kidney disease and kidney transplantation on different serum tumor markers is briefly explored.

  3. Serum miRNAs as Biomarkers for the Diagnosis and Prognosis of Thyroid Cancer: A Comprehensive Review of the Literature.

    Science.gov (United States)

    Mahmoudian-Sani, Mohammad-Reza; Mehri-Ghahfarrokhi, Ameneh; Asadi-Samani, Majid; Mobini, Gholam-Reza

    2017-07-01

    Thyroid cancer is the most common endocrine malignancy and accounts for 1% of cancers. In recent years, there has been much interest in the feasibility of using miRNAs or miRNA panels as biomarkers for the diagnosis of thyroid cancer. miRNAs are noncoding RNAs with 21-23 nucleotides that are highly conserved during evolution. They have been proposed as regulators of gene expression, apoptosis, cancer, and cell growth and differentiation. The Directory of Open Access Journals (DOAJ), Google Scholar, PubMed (NLM), LISTA (EBSCO), and Web of Science were searched. The serum level of miRNAs (miRNA-375, 34a, 145b, 221, 222, 155, Let-7, 181b) can be used as molecular markers for the diagnosis and prognosis of thyroid cancer in the serum samples of patients with thyroid glands. Given that most common methods for the screening of thyroid cancer cannot detect the disease in its early stages, identifying miRNAs that are released in the bloodstream during the gradual progression of the disease is considered a key method in the early diagnosis of thyroid cancers.

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  5. Industrial Process Monitoring in the Big Data/Industry 4.0 Era: from Detection, to Diagnosis, to Prognosis

    Directory of Open Access Journals (Sweden)

    Marco S. Reis

    2017-06-01

    Full Text Available We provide a critical outlook of the evolution of Industrial Process Monitoring (IPM since its introduction almost 100 years ago. Several evolution trends that have been structuring IPM developments over this extended period of time are briefly referred, with more focus on data-driven approaches. We also argue that, besides such trends, the research focus has also evolved. The initial period was centred on optimizing IPM detection performance. More recently, root cause analysis and diagnosis gained importance and a variety of approaches were proposed to expand IPM with this new and important monitoring dimension. We believe that, in the future, the emphasis will be to bring yet another dimension to IPM: prognosis. Some perspectives are put forward in this regard, including the strong interplay of the Process and Maintenance departments, hitherto managed as separated silos.

  6. Synergistic combination of systems for structural health monitoring and earthquake early warning for structural health prognosis and diagnosis

    Science.gov (United States)

    Wu, Stephen; Beck, James L.

    2012-04-01

    Earthquake early warning (EEW) systems are currently operating nationwide in Japan and are in beta-testing in California. Such a system detects an earthquake initiation using online signals from a seismic sensor network and broadcasts a warning of the predicted location and magnitude a few seconds to a minute or so before an earthquake hits a site. Such a system can be used synergistically with installed structural health monitoring (SHM) systems to enhance pre-event prognosis and post-event diagnosis of structural health. For pre-event prognosis, the EEW system information can be used to make probabilistic predictions of the anticipated damage to a structure using seismic loss estimation methodologies from performance-based earthquake engineering. These predictions can support decision-making regarding the activation of appropriate mitigation systems, such as stopping traffic from entering a bridge that has a predicted high probability of damage. Since the time between warning and arrival of the strong shaking is very short, probabilistic predictions must be rapidly calculated and the decision making automated for the mitigation actions. For post-event diagnosis, the SHM sensor data can be used in Bayesian updating of the probabilistic damage predictions with the EEW predictions as a prior. Appropriate Bayesian methods for SHM have been published. In this paper, we use pre-trained surrogate models (or emulators) based on machine learning methods to make fast damage and loss predictions that are then used in a cost-benefit decision framework for activation of a mitigation measure. A simple illustrative example of an infrastructure application is presented.

  7. Optimization of nonlinear, non-Gaussian Bayesian filtering for diagnosis and prognosis of monotonic degradation processes

    Science.gov (United States)

    Corbetta, Matteo; Sbarufatti, Claudio; Giglio, Marco; Todd, Michael D.

    2018-05-01

    The present work critically analyzes the probabilistic definition of dynamic state-space models subject to Bayesian filters used for monitoring and predicting monotonic degradation processes. The study focuses on the selection of the random process, often called process noise, which is a key perturbation source in the evolution equation of particle filtering. Despite the large number of applications of particle filtering predicting structural degradation, the adequacy of the picked process noise has not been investigated. This paper reviews existing process noise models that are typically embedded in particle filters dedicated to monitoring and predicting structural damage caused by fatigue, which is monotonic in nature. The analysis emphasizes that existing formulations of the process noise can jeopardize the performance of the filter in terms of state estimation and remaining life prediction (i.e., damage prognosis). This paper subsequently proposes an optimal and unbiased process noise model and a list of requirements that the stochastic model must satisfy to guarantee high prognostic performance. These requirements are useful for future and further implementations of particle filtering for monotonic system dynamics. The validity of the new process noise formulation is assessed against experimental fatigue crack growth data from a full-scale aeronautical structure using dedicated performance metrics.

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

    Directory of Open Access Journals (Sweden)

    Elder JH

    2017-08-01

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

  9. The utility of preoperative acth/cortisol ratio for the diagnosis and prognosis of cushing's disease

    Directory of Open Access Journals (Sweden)

    Alev Selek

    2018-01-01

    Full Text Available Purpose: Cushing's syndrome (CS is a rare disease having diagnostic difficulties. Many diagnostic tests have been defined but none of these are diagnostic alone. Determination of the cause is another problem which sometimes requires more sophisticated and invasive procedures. Therefore, we aimed to evaluate the utility of pretreatment plasma adrenocorticotropic hormone (ACTH/cortisol ratios in patients with confirmed endogenous CS for the diagnosis and differential diagnosis of CS. Materials and Methods: This retrospective evaluation included 145 patients with the diagnosis of CS, 119 patients with Cushing's disease (CD, and 26 patients with ACTH-independent CS (AICS, in a university hospital. Furthermore, 114 individuals in whom CS diagnosis was excluded with at least one negative screening test were enrolled to the study as control group. The clinical, laboratory, imaging, postsurgical pathologic records and also clinical follow-up data of all patients were evaluated. Results: The median basal ACTH/cortisol ratio of the patients with CD was significantly higher than AICS and controls. A cutoff ACTH/cortisol ratio >2.5 was found to be diagnostic for CD with 82% specificity and 63% sensitivity. Among CD group, patients with recurrent disease had higher preoperative ACTH levels and ACTH/cortisol ratio than patients with sustained remission. Furthermore, these patients had more invasive, atypical, and larger tumors. Conclusion: An ACTH/cortisol ratio >2.5 would be beneficial to diagnose CD together with other diagnostic tests. It is a simple test with no additional cost. Higher ratios might be related with larger, invasive, and atypical adenoma and also might be helpful to predict recurrence.

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

    Science.gov (United States)

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

    2017-01-01

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

  11. High specificity of spot urinary free metanephrines in diagnosis and prognosis of pheochromocytomas and paragangliomas by HPLC with electrochemical detection.

    Science.gov (United States)

    Zuo, Ming; Zhen, Qianna; Zhang, Xiaoqing; Zou, Wenbi; Yang, Xiangchun; Tian, Gang; Shi, Zhenghu; Li, Qifu; Ding, Min

    2018-03-01

    The metanephrines (MNs) in plasma and urine were proposed as biomarkers for the diagnosis of pheochromocytomas and paragangliomas (PPGLs). However, plasma free MNs and 24h urinary fractionated MNs were not satisfactory enough in specificity for the diagnosis of PPGLs. Moreover, the collection of 24h urine was inconvenient. This work examined the diagnostic and prognostic efficiency of free MNs in spot urine for PPGLs. We measured free MNs concentration in spot urine and plasma of 28 PPGLs patients and 155 control subjects by HPLC with electrochemical detection. Postoperative free MNs levels in spot urine and plasma of 14 PPGLs patients were also determined. Creatinine (Cr) concentration was used for the correction of urine volume. The specificity of spot urinary free MNs/Cr in the diagnosis of PPGLs was significantly higher than that of plasma free MNs [normetanephrine (NMN), 98.7% (95.4%-99.8%) vs 93.0% (87.4%-96.6%); metanephrine (MN), 93.6% (88.5%-96.9%) vs 84.5% (77.5%-90.0%)]. Meanwhile, the positive likelihood ratios for spot urinary free NMN/Cr and MN/Cr were 69.21 and 13.29, compared with 12.68 and 5.30 for plasma free NMN and MN, respectively. For the PPGLs patients underwent surgery, the plasma free MNs level appeared an abnormal elevation and yielded false-positive results for some patients. Our findings were validated in an independent cohort, resulting in the specificity of 100% for both urinary free NMN/Cr and MN/Cr, and 97.3% and 83.8% for plasma free NMN and MN, respectively. Spot urinary free MNs/Cr, superior to plasma free MNs, presented a promising biomarker for the diagnosis and prognosis of PPGLs. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Combination of IL-6, IL-10, and MCP-1 with traditional serum tumor markers in lung cancer diagnosis and prognosis.

    Science.gov (United States)

    Pan, Y W; Zhou, Z G; Wang, M; Dong, J Q; Du, K P; Li, S; Liu, Y L; Lv, P J; Gao, J B

    2016-11-03

    Early detection and treatment is critically important for lung cancer patients. Inflammatory mediators such as IL-6, IL-10, and MCP-1 participate in lung cancer regulation. CEA, CA125, and ProGRP are commonly used serum tumor markers for lung cancer. In this study, we assessed the sensitivity and specificity of CEA, CA125, and ProGRP when used in combination with IL-6, IL-10, and MCP in lung cancer diagnosis. Serum from three different groups (healthy controls, individuals with high risk for lung cancer, and lung cancer patients) was collected. Electrochemiluminescence was used to detect expressions of CEA, CA125, and ProGRP; ELISA was used to examine serum levels of IL-6, IL-10, and MCP-1. Specificity and sensitivity of single as well as combination markers in lung cancer diagnosis were determined. Results indicated that CEA, CA125, ProGRP, and MCP-1 were significantly up-regulated in lung cancer patients as compared to those in controls and high risk individuals. Higher IL-6 and IL-10 levels were observed in both lung cancer patients and high-risk individuals as compared to those in controls. Highest sensitivity (95.2%) in cancer diagnosis was achieved when all six markers were used. This was followed by a combination of IL-6, IL-10, CEA, CA125, and ProGRP (92.6%). The most sensitive (88.6%). Four-marker combination was composed of IL-6, CEA, CA125, and ProGRP. As the combined usage of CEA, CA125, ProGRP, IL-6, IL-10, and MCP-1 significantly improved sensitivity of lung cancer detection; this biomarker arrangement may be beneficial for early diagnosis, treatment, and prognosis of lung cancer.

  13. Does Diagnosis of Hypertension Prevent Stroke? A Preliminary ...

    African Journals Online (AJOL)

    Introduction: The present study was designed to determine the relative frequency of previously diagnosed and undiagnosed hypertension in first stroke in order to evaluate if previous diagnosis of hypertension can prevent stroke. Patients and Methods: One hundred and twenty nine first stroke patients presenting at the ...

  14. Urinary Tract Infections in Pregnancy - Diagnosis, Treatment and Prevention

    OpenAIRE

    Figueiredo, A; Gomes, G; Campos, A

    2012-01-01

    Objectives: Literature review of classification, epidemiology, pathophysiology, microbiology, clinical presentation, diagnosis, complications, treatment and prevention of urinary tract infections (UTI) in pregnancy. Data Sources and Review Methods: Bibliographic research in Medline, through PubMed and Medscape, of systematic reviews, observational studies, clinical guidelines, meta-analyses and randomized controlled trials published between January 1992 and December 2010. Results: Asymp...

  15. Diagnosis, treatment and prevention of HIV/AIDS | Lyamuya ...

    African Journals Online (AJOL)

    Diagnosis, treatment and prevention of HIV/AIDS. E Lyamuya. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

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

    Directory of Open Access Journals (Sweden)

    Ricardo Nitrini

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

  17. Diagnosis and prognosis of anomalous origin of the left coronary artery from the pulmonary artery

    DEFF Research Database (Denmark)

    Holst, Line Marie Broksø; Helvind, Morten; Andersen, Henrik Ørbæk

    2015-01-01

    , sweating or failure to thrive; two adults were asymptomatic and one adult presented with cardiac arrest. Six infants had moderate to severe mitral valve regurgitation and five of these patients had preoperative moderate to severely reduced left ventricular function. Nine patients underwent surgical repair...... from February 2004 to January 2014. RESULTS: Ten patients presented with the diagnosis of ALCAPA. A total of seven infants and three adults underwent surgical repair in our Department of Thoracic Surgery, Rigshospitalet, Denmark. The seven infants presented with symptoms of heart failure: dyspnoea...

  18. Paraneoplastic syndrome in urothelial carcinoma of the kidney: difficulty in diagnosis and deterioration in prognosis

    Directory of Open Access Journals (Sweden)

    I. E. Mamaev

    2015-01-01

    Full Text Available Paraneoplastic syndrome is not a common concomitance of urothelial tumors. The literature describes a few tens of clinical cases in which urothelial cancer has become a cause of marked nonspecific tumor-associated reactions, associated with the presence of the tumor. Bladder tumors are at stake in all cases. The given clinical observation describes paraneoplastic manifestations in high-grade urothelial carcinoma of the kidney. It demonstrates difficulties in differential diagnosis and gives a retrospective estimate of diagnostic and therapeutic tactics.

  19. Bone metastases of differentiated thyroid cancer: the importance of early diagnosis and {sup 131}I therapy on prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Zanotti-Fregonara, P. [CEA, DSV, I2BM, SHFJ, UMNRC, Orsay (France); Rubello, D. [Santa Maria Misericordia Hosp, Rovigo (Italy); Hindie, E. [Hop StLouis, Paris (France)

    2008-07-01

    Complete text of publication follows: Distant metastases are found at diagnosis or during follow-up in 10%-15% of patients with differentiated thyroid cancer. Bone is the second most commonly involved site. Patients with bone metastases, whether isolated or associated with lung metastases, have a markedly poor prognosis. Ten-year survival rates range from 13% to 21%. Given such poor prognosis, the use of {sup 131}I therapy has been questioned. However, it might well be that poor prognosis of bone metastases can be overcome if {sup 131}I therapy is delivered at an early stage, when tumor burden is small, as previously demonstrated for pulmonary metastases. A review of a large series of patients showed that only rarely were bone metastases diagnosed at an early stage. Among 109 patients with bone metastases reported by Bernier et al., only 4 had both radioiodine uptake and a negative standard radiography examination. Similarly, Durante et al. reported that only 8 of 115 patients had negative radiography findings at presentation. Prognosis may improve if bone metastases are detected earlier. In a recent study, bone metastases were first detected by {sup 131}I scanning in 8 of 16 patients, when complementary radiologic studies were negative. Six of these patients showed an excellent response to {sup 131}I therapy. Today, the nuclear medicine community is well armed for this challenge toward earlier diagnosis. Postsurgery thyroid remnant ablation is more widely used. The {sup 131}I whole body scan associated with thyroid remnant ablation after thyroidectomy has a major role in early diagnosis of functioning distant metastases at a time when complementary imaging techniques (CT, MRI, bone scanning) are often still showing negative findings. Early diagnosis of specific {sup 131}I-avid bone foci will be improved with the advent and generalization of SPECT/CT. When early diagnosis is achieved, repeated {sup 131}I therapy can be effective by targeting not only visible

  20. Bone metastases of differentiated thyroid cancer: the importance of early diagnosis and 131I therapy on prognosis

    International Nuclear Information System (INIS)

    Zanotti-Fregonara, P.; Rubello, D.; Hindie, E.

    2008-01-01

    Complete text of publication follows: Distant metastases are found at diagnosis or during follow-up in 10%-15% of patients with differentiated thyroid cancer. Bone is the second most commonly involved site. Patients with bone metastases, whether isolated or associated with lung metastases, have a markedly poor prognosis. Ten-year survival rates range from 13% to 21%. Given such poor prognosis, the use of 131 I therapy has been questioned. However, it might well be that poor prognosis of bone metastases can be overcome if 131 I therapy is delivered at an early stage, when tumor burden is small, as previously demonstrated for pulmonary metastases. A review of a large series of patients showed that only rarely were bone metastases diagnosed at an early stage. Among 109 patients with bone metastases reported by Bernier et al., only 4 had both radioiodine uptake and a negative standard radiography examination. Similarly, Durante et al. reported that only 8 of 115 patients had negative radiography findings at presentation. Prognosis may improve if bone metastases are detected earlier. In a recent study, bone metastases were first detected by 131 I scanning in 8 of 16 patients, when complementary radiologic studies were negative. Six of these patients showed an excellent response to 131 I therapy. Today, the nuclear medicine community is well armed for this challenge toward earlier diagnosis. Postsurgery thyroid remnant ablation is more widely used. The 131 I whole body scan associated with thyroid remnant ablation after thyroidectomy has a major role in early diagnosis of functioning distant metastases at a time when complementary imaging techniques (CT, MRI, bone scanning) are often still showing negative findings. Early diagnosis of specific 131 I-avid bone foci will be improved with the advent and generalization of SPECT/CT. When early diagnosis is achieved, repeated 131 I therapy can be effective by targeting not only visible metastases but also those still too small

  1. Implementation of Segmentation Methods for the Diagnosis and Prognosis of Mild Cognitive Impairment and Alzheimer Disease

    International Nuclear Information System (INIS)

    Matoug, S; Abdel-Dayem, A

    2012-01-01

    Alzheimer's disease (AD) is the most common form of dementia affecting seniors age 65 and over. When AD is suspected, the diagnosis is usually confirmed with behavioural assessments and cognitive tests, often followed by a brain scan. Advanced medical imaging is a good tool to predict conversion from prodromal stages (mild cognitive impairment) to Alzheimer's disease. Since volumetric MRI can detect changes in the size of brain regions, measuring those regions that atrophy during the progress of Alzheimer's disease can help the neurologist in his diagnostic. In the present investigation, we present an automatic tool that reads volumetric MRI and performs 2-dimensional (volume slices) and volumetric segmentation methods in order to segment gray matter, white matter and cerebrospinal fluid (CSF). We used the MRI data sets database from the Open Access Series of Imaging Studies (OASIS).

  2. SPET in cardiology. Diagnosis, prognosis and management of patients with coronary artery disease

    International Nuclear Information System (INIS)

    Tamaki, N.; Morita, K.

    2005-01-01

    Stress myocardial perfusion imaging has been considered as a most valuable means for diagnosis and treatment strategy in patients with suspected and known coronary artery disease. 99m TC perfusion imaging agents provide excellent myocardial perfusion images. In addition, greater photon flux from the tracer permits simultaneous assessment of regional perfusion and function with use ECG-gated acquisition. Gated SPET imaging technique has a potential for higher diagnostic accuracy for diagnosis of coronary artery disease and assessment of the disease severity. In addition, radionuclide imaging plays an important role to differentiate reversible ischemic myocardium which may improve LV function after revascularization from irreversible scar in patients with history of myocardial infraction. While FDG-PET is considered as a most reliable means for myocardial assessment, SPET imaging has been widely used for the viability assessment, with gaining higher accuracy for predicting reversible ischemia. Recently a variety of new radiopharmaceutical agents have been introduced to probe myocardial function 'in vivo' ( 123 I)BMIPP, a branched fatty acid analog, has been used for metabolic imaging using SPET. Less uptake of BMIPP than perfusion is often observed in the ischemic myocardium. Such a perfusion metabolic mismatch which seems to be similarly observed in FDG-PET is identified in the stunned or hibernating myocardium with regional dysfunctions. Severe ischemia is identified as reduced BMIPP uptake at rest, suggesting its role as an ischemic memory imaging. These new techniques will provide insights into new pathological states in the ischemic heart disease and enable to select optimal treatment of these patients

  3. Candidate biomarkers for the diagnosis and prognosis of drug-induced liver injury: An international collaborative effort.

    Science.gov (United States)

    Church, Rachel J; Kullak-Ublick, Gerd A; Aubrecht, Jiri; Bonkovsky, Herbert L; Chalasani, Naga; Fontana, Robert J; Goepfert, Jens C; Hackman, Frances; King, Nicholas M P; Kirby, Simon; Kirby, Patrick; Marcinak, John; Ormarsdottir, Sif; Schomaker, Shelli J; Schuppe-Koistinen, Ina; Wolenski, Francis; Arber, Nadir; Merz, Michael; Sauer, John-Michael; Andrade, Raul J; van Bömmel, Florian; Poynard, Thierry; Watkins, Paul B

    2018-01-22

    Current blood biomarkers are suboptimal in detecting drug-induced liver injury (DILI) and predicting its outcome. We sought to characterize the natural variabilty and performance characteristics of fourteen promising DILI biomarker candidates. Serum or plasma from multiple cohorts of healthy volunteers (n=192 and =81), subjects who safely took potentially hepatotoxic drugs without adverse effects (n=55 and =92) and DILI patients (n=98, =28, and =143) were assayed for microRNA-122 (miR-122), glutamate dehydrogenase (GLDH), total keratin 18 (K18), caspase cleaved K18 (ccK18), glutathione S-transferase alpha (GSTα), alpha fetoprotein (AFP), arginase-1 (ARG1), osteopontin (OPN), sorbitol dehydrogenase (SDH), fatty acid binding protein (FABP1), cadherin-5 (CDH5), macrophage colony stimulating factor receptor (MCSFR), paraoxonase 1 (PON1, normalized to prothrombin protein), and leucocyte cell-derived chemotaxin-2 (LECT2). Most candidate biomarkers were significantly altered in DILI cases compared to healthy volunteers. GLDH correlated more closely with gold standard alanine aminotransferase (ALT) than miR-122 and there was a surprisingly wide inter- and intra-individual variability of miR-122 levels among the healthy volunteers. Serum K18, OPN, and MCSFR levels were most strongly associated with liver-related death or transplant within 6 months of DILI-onset. Prediction of prognosis among DILI patients using Model for End-stage Liver Disease (MELD) was improved by incorporation of K18 and MCSFR levels. GLDH appears to be more useful than miR-122 in identifying DILI patients. K18, OPN and MCSFR are promising candidates for prediction of prognosis during an acute DILI event. Serial assessment of these biomarkers in large prospective studies will help further delineate their role in DILI diagnosis and management. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

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

    Directory of Open Access Journals (Sweden)

    K.A. Kalashnikova

    2016-05-01

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

  5. The role of procalcitonin as a guide for the diagnosis, prognosis, and decision of antibiotic therapy for lower respiratory tract infections

    Directory of Open Access Journals (Sweden)

    Amal Abd El-Azeem

    2013-10-01

    Conclusion: Serum PCT level could be used as a novel marker of lower respiratory tract bacterial infections for diagnosis, prognosis and follow up of therapy. This reduces side-effects of an unnecessary antibiotic use, lowers costs, and in the long-term, leads to diminishing drug resistance.

  6. HbA1c for diagnosis and prognosis of gestational diabetes mellitus.

    Science.gov (United States)

    Kwon, Soon Sung; Kwon, Ja-Young; Park, Yong-Won; Kim, Young-Han; Lim, Jong-Baeck

    2015-10-01

    HbA1c is a widely used marker in diagnosing type 2 diabetes mellitus (DM), but its clinical utility in diagnosing gestational diabetes mellitus (GDM) is not established. Here, we evaluated the clinical usefulness of HbA1c in diagnosing GDM and predicting the risk of future type 2 DM development among GDM patients. This retrospective, cross-sectional study included 321 subjects who underwent 100-g oral glucose tolerance tests (OGTT) during pregnancy. HbA1c and other variables were analyzed to evaluate their diagnostic performance for GDM. To evaluate the clinical usefulness of HbA1c in predicting future type 2 DM development, we classified GDM subjects who had more than 3 months of follow-up data into two subgroups: those who developed postpartum type 2 DM (PDM) and those who did not. HbA1c was significantly higher in the GDM group than in the normal control group. With the 100-g OGTT as reference, HbA1c showed 91.3% sensitivity and 62% specificity at a cut-off value of 5.05% (32 mmol/mol) for GDM diagnosis. At a cut-off value of 5.25% (34 mmol/mol), sensitivity was 73.6% and specificity was 77.2%. HbA1c levels during pregnancy were higher in those with PDM than in those without PDM (5.91 [41 mmol/mol] vs. 5.44% [36 mmol/mol], p<0.001). The prognostic value of HbA1c for PDM was evaluated by ROC curve analysis, with sensitivity of 78.6% and specificity of 72.5% at a cut-off value of 5.55% (37 mmol/mol). HbA1c showed high sensitivity with relatively low specificity for diagnosis of GDM in pregnant women and was a potential predictor of PDM. HbA1c may be able to be used as a simple and less invasive alternative screening test for OGTT in GDM patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Takotsubo Cardiomyopathy in Intensive Care Unit: Prevention, Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Hannah Masoud

    2016-01-01

    Full Text Available Accurate diagnosis of Takotsubo Cardiomyopathy has substantial prognostic implications in an intensive care unit, given its increased mortality risk and association with life-threatening complications. This report seeks to discuss diagnostic modalities that can be useful in accurately differentiating Takotsubo Cardiomyopathy from Acute Coronary Syndrome, and also briefly discuss prevention and management of this cardiomyopathy in an intensive care unit. For critically ill Takotsubo patients, intensive clinicians can consider establishment of diagnosis by specific electrocardiograph changes, distinctive marked release of cardiac enzymes, characteristic echocardiograph findings, as well as invasive coronary angiography or noninvasive cardiac magnetic imaging.

  8. Improving diagnosis, prognosis and prediction by using biomarkers in CRC patients (Review).

    Science.gov (United States)

    Nikolouzakis, Taxiarchis Konstantinos; Vassilopoulou, Loukia; Fragkiadaki, Persefoni; Mariolis Sapsakos, Theodoros; Papadakis, Georgios Z; Spandidos, Demetrios A; Tsatsakis, Aristides M; Tsiaoussis, John

    2018-06-01

    Colorectal cancer (CRC) is among the most common cancers. In fact, it is placed in the third place among the most diagnosed cancer in men, after lung and prostate cancer, and in the second one for the most diagnosed cancer in women, following breast cancer. Moreover, its high mortality rates classifies it among the leading causes of cancer‑related death worldwide. Thus, in order to help clinicians to optimize their practice, it is crucial to introduce more effective tools that will improve not only early diagnosis, but also prediction of the most likely progression of the disease and response to chemotherapy. In that way, they will be able to decrease both morbidity and mortality of their patients. In accordance with that, colon cancer research has described numerous biomarkers for diagnostic, prognostic and predictive purposes that either alone or as part of a panel would help improve patient's clinical management. This review aims to describe the most accepted biomarkers among those proposed for use in CRC divided based on the clinical specimen that is examined (tissue, faeces or blood) along with their restrictions. Lastly, new insight in CRC monitoring will be discussed presenting promising emerging biomarkers (telomerase activity, telomere length and micronuclei frequency).

  9. Melanotic Schwannomas Are Rarely Seen Pigmented Tumors with Unpredictable Prognosis and Challenging Diagnosis.

    Science.gov (United States)

    Keskin, Elif; Ekmekci, Sumeyye; Oztekin, Ozgur; Diniz, Gulden

    2017-01-01

    Melanotic Schwannoma (MS) is rarely seen and potentially malignant neoplasm that is categorized as a variant of Schwannoma. MS most frequently involves intracranial structures followed by posterior nerve roots in the spinal canal. Approximately 50% of the cases with MS have psammomatous calcifications and this type of MS is related to Carney complex with autosomal dominant inheritance. Most cases of MS are benign, though 10% of them are malignant with metastatic potential. MS mimics melanoma and the differential diagnosis should be made excluding other melanin producing neoplasms especially melanoma. Case 1 . A 42-year-old hypertensive male presented for checkup. He had a well-defined extraspinal oval lesion measuring 3.5 × 2.5 cm near right adrenal. Case 2 . A 22-year-old female presented with neurofibromatosis-2, bilateral acoustic schwannomas and café au lait lesions on sacrococcygeal region. She had an intradural extramedullary lesion measuring 6.1 × 2.0 cm at L1-2 level. MS is a rare neoplasm composed of Schwann cells and melanin pigment. These tumors are usually benign but they may become aggressive. The biologic behavior of MS is difficult to predict; the patients have to be followed up for a longer period due to its malignant potential.

  10. Cervical spine injury. Diagnosis, prognosis and management; Trauma der Halswirbelsaeule. Diagnose, Prognose und Management

    Energy Technology Data Exchange (ETDEWEB)

    Schueller-Weidekamm, C. [AKH, Medizinische Universitaet Wien (Austria). Abteilung fuer Neuroradiologie und Muskuloskelettale Radiologie

    2008-05-15

    Cervical spine injuries are a common occurrence in multi-trauma patients and should be taken into account when planning further clinical management. This review describes in detail upper and lower cervical spine injuries and introduces the sub-axial injury classification (SLIC) that is based on three components: injury morphology, integrity of the discoligamentous complex and the neurologic status of the patient. If the total SLIC score is <3, non-surgical treatment is recommended. If the total is {>=}5, operative treatment is indicated as such a score is associated with instability and probably neurologic deficits. The precise diagnosis of the radiologist, which would include the SLIC classification, should facilitate clinical decision-making about further management. (orig.) [German] Halswirbelsaeulenverletzungen sind bei polytraumatisierten Patienten haeufig und sollten beim klinischen Management des Patienten beruecksichtigt werden. Verletzungen der oberen Halswirbelsaeule werden als Sonderformen eingeteilt. Die subaxialen Verletzungen koennen nach der SLIC-Klassifikation ('sub-axial injury classification') gescort werden, die auf der Morphologie der Verletzung, dem diskoligamentaeren Komplex und dem neurologischen Status basiert. Bei einem Score <3 wird ein konservatives Management empfohlen. Bei einem Score {>=}5 sollte eine operative Versorgung der Halswirbelsaeule vorgenommen werden, da die Verletzung eine Instabilitaet und moeglicherweise auch ein neurologisches Defizit verursacht. Anhand einer praezisen Diagnose des Radiologen unter Beruecksichtigung der SLIC-Klassifikation sollte dem Kliniker die Entscheidung fuer das weitere Management erleichtert werden. (orig.)

  11. Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

    Science.gov (United States)

    2014-01-01

    Lichen planus (LP) is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations. PMID:24672362

  12. Importance of brain perfusion SPECT in the diagnosis and prognosis of migraine

    International Nuclear Information System (INIS)

    Colmenter, L.F.; Paz-Araviche, V.; Celedon-Arrieta, P.; Mora, E.; Tavares, A.

    2002-01-01

    Aim: The objective of this investigation was to establish the usefulness of ECD-99mTc brain perfusion SPECT in the evaluation of the diagnosis of functional alterations of Vascular Headaches of migrainous origin and to determine the changes in regional cerebral blood flow (FSCr) during the headache phase. Material and Methods: A population of 21 female patients, 5 controls, of the same age and sex, aged between 20 and 76 years, with clinical evidence of headache with or without aura, with a duration of 8 to 72 hours, pulsating pain, associated to nausea, photophobia, phonophobia, that does not resolve with common analgesics and characterized by increase of the pain with physical activity. Brain perfusion SPECT was practiced on them at the moment of crisis, independent of the presence of aura or pain, and without crisis. ECD-99mTc was administered at a dose of 925 to 1110 MBq. Images were analyzed by the semi quantification method. Results: SPECT detected 13 hypo-captures on the 16 patients studied. With an 81% sensitivity and 100% specificity, with a precision value of 86%. Analysis through X Binomial Aleatory Variable showed a precision of 90% (p= < 0,023) for the isotopic test, with a significance level of 5%. Conclusions: The results of this study confirm that brain SPECT is a neuroimaging technique capable of identifying migrainous patients, being able to reevaluate the type of hypo perfusion that each patient has, during crisis or out of crisis, and correlate the cortical perfusion deficits and the deterioration of neuropsychological functions

  13. Diagnosis, treatment and prognosis of small bowel volvulus in adults: A monocentric summary of a rare small intestinal obstruction.

    Directory of Open Access Journals (Sweden)

    Xiaohang Li

    Full Text Available Small bowel volvulus is a rare disease, which is also challenging to diagnose. The aims of this study were to characterize the clinical and radiological features associated with small bowel volvulus and treatment and to identify risk factors for associated small bowel necrosis.Patients with small bowel volvulus who underwent operations from January 2001 to December 2015 at the First Affiliated Hospital of China Medical University (Shenyang, China were reviewed. Clinical, surgical and postsurgical data were registered and analyzed.Thirty-one patients were included for analysis. Fifteen patients were female (48.4%, with an average age of 47.7 years (18-79 years. The clinical signs and symptoms were unspecific and resembled intestinal obstruction. Clinical examination revealed abdominal distension and/or diffuse tenderness with or without signs of peritonitis. The use of CT scans, X-rays or ultrasound did not differ significantly between patients. In 9 of 20 patients that received abdominal CT scans, "whirlpool sign" on the CT scan was present. Secondary small bowel volvulus was present in 58.1% of patients, and causes included bands (3, adhesion (7, congenital anomalies (7 and stromal tumor (1. Out of the 31 patients, 15 with gangrenous small bowel had to undergo intestinal resection. Intestinal gangrene was present with higher neutrophils count (p<0.0001 and the presence of bloody ascites (p = 0.004. Three patients died of septic shock (9.68%, and the recurrence rate was 3.23%.To complete an early and accurate diagnosis, a CT scan plus physical exam seems to be the best plan. After diagnosis, an urgent laparotomy must be performed to avoid intestinal necrosis and perforation. After surgery, more than 90% of the patients can expect to have a favorable prognosis.

  14. Diagnosis, treatment and prognosis of small bowel volvulus in adults: A monocentric summary of a rare small intestinal obstruction.

    Science.gov (United States)

    Li, Xiaohang; Zhang, Jialin; Li, Baifeng; Yi, Dehui; Zhang, Chengshuo; Sun, Ning; Lv, Wu; Jiao, Ao

    2017-01-01

    Small bowel volvulus is a rare disease, which is also challenging to diagnose. The aims of this study were to characterize the clinical and radiological features associated with small bowel volvulus and treatment and to identify risk factors for associated small bowel necrosis. Patients with small bowel volvulus who underwent operations from January 2001 to December 2015 at the First Affiliated Hospital of China Medical University (Shenyang, China) were reviewed. Clinical, surgical and postsurgical data were registered and analyzed. Thirty-one patients were included for analysis. Fifteen patients were female (48.4%), with an average age of 47.7 years (18-79 years). The clinical signs and symptoms were unspecific and resembled intestinal obstruction. Clinical examination revealed abdominal distension and/or diffuse tenderness with or without signs of peritonitis. The use of CT scans, X-rays or ultrasound did not differ significantly between patients. In 9 of 20 patients that received abdominal CT scans, "whirlpool sign" on the CT scan was present. Secondary small bowel volvulus was present in 58.1% of patients, and causes included bands (3), adhesion (7), congenital anomalies (7) and stromal tumor (1). Out of the 31 patients, 15 with gangrenous small bowel had to undergo intestinal resection. Intestinal gangrene was present with higher neutrophils count (p<0.0001) and the presence of bloody ascites (p = 0.004). Three patients died of septic shock (9.68%), and the recurrence rate was 3.23%. To complete an early and accurate diagnosis, a CT scan plus physical exam seems to be the best plan. After diagnosis, an urgent laparotomy must be performed to avoid intestinal necrosis and perforation. After surgery, more than 90% of the patients can expect to have a favorable prognosis.

  15. MicroRNAs as New Biomarkers for Diagnosis and Prognosis, and as Potential Therapeutic Targets in Acute Myeloid Leukemia

    Science.gov (United States)

    Trino, Stefania; Caivano, Antonella; Laurenzana, Ilaria; Tagliaferri, Daniela; Falco, Geppino; Del Vecchio, Luigi; Musto, Pellegrino; De Luca, Luciana

    2018-01-01

    Acute myeloid leukemias (AML) are clonal disorders of hematopoietic progenitor cells which are characterized by relevant heterogeneity in terms of phenotypic, genotypic, and clinical features. Among the genetic aberrations that control disease development there are microRNAs (miRNAs). miRNAs are small non-coding RNAs that regulate, at post-transcriptional level, translation and stability of mRNAs. It is now established that deregulated miRNA expression is a prominent feature in AML. Functional studies have shown that miRNAs play an important role in AML pathogenesis and miRNA expression signatures are associated with chemotherapy response and clinical outcome. In this review we summarized miRNA signature in AML with different cytogenetic, molecular and clinical characteristics. Moreover, we reviewed the miRNA regulatory network in AML pathogenesis and we discussed the potential use of cellular and circulating miRNAs as biomarkers for diagnosis and prognosis and as therapeutic targets. PMID:29401684

  16. Plant Lectins Targeting O-Glycans at the Cell Surface as Tools for Cancer Diagnosis, Prognosis and Therapy

    Science.gov (United States)

    Poiroux, Guillaume; Barre, Annick; van Damme, Els J. M.; Benoist, Hervé; Rougé, Pierre

    2017-01-01

    Aberrant O-glycans expressed at the surface of cancer cells consist of membrane-tethered glycoproteins (T and Tn antigens) and glycolipids (Lewis a, Lewis x and Forssman antigens). All of these O-glycans have been identified as glyco-markers of interest for the diagnosis and the prognosis of cancer diseases. These epitopes are specifically detected using T/Tn-specific lectins isolated from various plants such as jacalin from Artocarpus integrifola, and fungi such as the Agaricus bisporus lectin. These lectins accommodate T/Tn antigens at the monosaccharide-binding site; residues located in the surrounding extended binding-site of the lectins often participate in the binding of more extended epitopes. Depending on the shape and size of the extended carbohydrate-binding site, their fine sugar-binding specificity towards complex O-glycans readily differs from one lectin to another, resulting in a great diversity in their sugar-recognition capacity. T/Tn-specific lectins have been extensively used for the histochemical detection of cancer cells in biopsies and for the follow up of the cancer progression and evolution. T/Tn-specific lectins also induce a caspase-dependent apoptosis in cancer cells, often associated with a more or less severe inhibition of proliferation. Moreover, they provide another potential source of molecules adapted to the building of photosensitizer-conjugates allowing a specific targeting to cancer cells, for the photodynamic treatment of tumors. PMID:28598369

  17. Circulating mRNAs and miRNAs as candidate markers for the diagnosis and prognosis of prostate cancer

    DEFF Research Database (Denmark)

    Souza, Marilesia Ferreira de; Kuasne, Hellen; Barros-Filho, Mateus de Camargo

    2017-01-01

    Circulating nucleic acids are found in free form in body fluids and may serve as minimally invasive tools for cancer diagnosis and prognosis. Only a few studies have investigated the potential application of circulating mRNAs and microRNAs (miRNAs) in prostate cancer (PCa). The Cancer Genome Atlas......RNA expression revealed eleven genes and eight miRNAs which were validated by RT-qPCR in plasma samples from 102 untreated PCa patients and 50 cancer-free individuals. Two genes, OR51E2 and SIM2, and two miRNAs, miR-200c and miR-200b, showed significant association with PCa. Expression levels...... of these transcripts distinguished PCa patients from controls (67% sensitivity and 75% specificity). PCa patients and controls with prostate-specific antigen (PSA) ≤ 4.0 ng/mL were discriminated based on OR51E2 and SIM2 expression levels. The miR-200c expression showed association with Gleason score and miR-200b...

  18. Integration of Breast Cancer Secretomes with Clinical Data Elucidates Potential Serum Markers for Disease Detection, Diagnosis, and Prognosis.

    Science.gov (United States)

    Ziegler, Yvonne S; Moresco, James J; Yates, John R; Nardulli, Ann M

    2016-01-01

    Cancer cells secrete factors that influence adjacent cell behavior and can lead to enhanced proliferation and metastasis. To better understand the role of these factors in oncogenesis and disease progression, estrogen and progesterone receptor positive MCF-7 cells, triple negative breast cancer MDA-MB-231, DT22, and DT28 cells, and MCF-10A non-transformed mammary epithelial cells were grown in 3D cultures. A special emphasis was placed on triple negative breast cancer since these tumors are highly aggressive and no targeted treatments are currently available. The breast cancer cells secreted factors of variable potency that stimulated proliferation of the relatively quiescent MCF-10A cells. The conditioned medium from each cell line was subjected to mass spectrometry analysis and a variety of secreted proteins were identified including glycolytic enzymes, proteases, protease inhibitors, extracellular matrix proteins, and insulin-like growth factor binding proteins. An investigation of the secretome from each cell line yielded clues about strategies used for breast cancer proliferation and metastasis. Some of the proteins we identified may be useful in the development of a serum-based test for breast cancer detection, diagnosis, prognosis, and monitoring.

  19. Candidiasis: predisposing factors, prevention, diagnosis and alternative treatment.

    Science.gov (United States)

    Martins, Natália; Ferreira, Isabel C F R; Barros, Lillian; Silva, Sónia; Henriques, Mariana

    2014-06-01

    Candidiasis is the most common opportunistic yeast infection. Candida species and other microorganisms are involved in this complicated fungal infection, but Candida albicans continues to be the most prevalent. In the past two decades, it has been observed an abnormal overgrowth in the gastrointestinal, urinary and respiratory tracts, not only in immunocompromised patients, but also related to nosocomial infections and even in healthy individuals. There is a widely variety of causal factors that contribute to yeast infection which means that candidiasis is a good example of a multifactorial syndrome. Due to rapid increase in the incidence in these infections, this is the subject of numerous studies. Recently, the focus of attention is the treatment and, above all, the prevention of those complications. The diagnosis of candidiasis could become quite complicated. Prevention is the most effective "treatment," much more than eradication of the yeast with antifungal agents. There are several aspects to consider in the daily routine that can provide a strength protection. However, a therapeutic approach is necessary when the infection is established, and therefore, other alternatives should be explored. This review provides an overview on predisposition factors, prevention and diagnosis of candidiasis, highlighting alternative approaches for candidiasis treatment.

  20. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement. The TRIPOD Group.

    Science.gov (United States)

    Collins, Gary S; Reitsma, Johannes B; Altman, Douglas G; Moons, Karel G M

    2015-01-13

    Prediction models are developed to aid health care providers in estimating the probability or risk that a specific disease or condition is present (diagnostic models) or that a specific event will occur in the future (prognostic models), to inform their decision making. However, the overwhelming evidence shows that the quality of reporting of prediction model studies is poor. Only with full and clear reporting of information on all aspects of a prediction model can risk of bias and potential usefulness of prediction models be adequately assessed. The Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) Initiative developed a set of recommendations for the reporting of studies developing, validating, or updating a prediction model, whether for diagnostic or prognostic purposes. This article describes how the TRIPOD Statement was developed. An extensive list of items based on a review of the literature was created, which was reduced after a Web-based survey and revised during a 3-day meeting in June 2011 with methodologists, health care professionals, and journal editors. The list was refined during several meetings of the steering group and in e-mail discussions with the wider group of TRIPOD contributors. The resulting TRIPOD Statement is a checklist of 22 items, deemed essential for transparent reporting of a prediction model study. The TRIPOD Statement aims to improve the transparency of the reporting of a prediction model study regardless of the study methods used. The TRIPOD Statement is best used in conjunction with the TRIPOD explanation and elaboration document. To aid the editorial process and readers of prediction model studies, it is recommended that authors include a completed checklist in their submission (also available at www.tripod-statement.org). © 2015 The Authors.

  1. Diagnosis, prevention and management of postoperative pulmonary edema.

    Science.gov (United States)

    Bajwa, Sj Singh; Kulshrestha, A

    2012-07-01

    Postoperative pulmonary edema is a well-known postoperative complication caused as a result of numerous etiological factors which can be easily detected by a careful surveillance during postoperative period. However, there are no preoperative and intraoperative criteria which can successfully establish the possibilities for development of postoperative pulmonary edema. The aims were to review the possible etiologic and diagnostic challenges in timely detection of postoperative pulmonary edema and to discuss the various management strategies for prevention of this postoperative complication so as to decrease morbidity and mortality. The various search engines for preparation of this manuscript were used which included Entrez (including Pubmed and Pubmed Central), NIH.gov, Medknow.com, Medscape.com, WebMD.com, Scopus, Science Direct, MedHelp.org, yahoo.com and google.com. Manual search was carried out and various text books and journals of anesthesia and critical care medicine were also searched. From the information gathered, it was observed that postoperative cardiogenic pulmonary edema in patients with serious cardiovascular diseases is most common followed by noncardiogenic pulmonary edema which can be due to fluid overload in the postoperative period or it can be negative pressure pulmonary edema (NPPE). NPPE is an important clinical entity in immediate post-extubation period and occurs due to acute upper airway obstruction and creation of acute negative intrathoracic pressure. NPPE carries a good prognosis if promptly diagnosed and appropriately treated with or without mechanical ventilation.

  2. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Questions to Ask about Your Diagnosis Research Understanding Cancer Prognosis Oncologist Anthony L. Back, M.D., a ... for provider care teams (PDF-210KB). Understanding Your Cancer Prognosis Video View this video on YouTube. Three ...

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

    Directory of Open Access Journals (Sweden)

    Jiahua Ju

    2014-03-01

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

  4. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Research Cancer Treatment Types of Cancer Treatment Side Effects Clinical Trials Information A to Z List of ... Diagnosis Staging Prognosis Treatment Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping ...

  5. Psychosocial risks in university education teachers: Diagnosis and prevention

    Directory of Open Access Journals (Sweden)

    María Matilde García

    2016-12-01

    Full Text Available The aim of this study is to assess the psychosocial risks of university teachers and identify enhancement areas for a healthy organization in a sample of 621 teachers from the University of A Coruña, Spain. To achieve this aim, the Copenhagen Psychosocial Questionnaire (CoPsoQ adapted to the Spanish population (ISTAS21 Method was applied. The results showed an unfavorable situation for psychosocial health in five dimensions: high psychological demands, low esteem, high double presence, low social support, and high job insecurity. In contrast, a favorable situation for health is the dimension active work and development opportunities. It was also found that there is not a single profile of university teacher in psychosocial risk. To conclude, a diagnosis of psychosocial risks of university teachers is made and, in that scenario, some risk prevention strategies at university level are proposed.

  6. Canine angiostrongylosis: recent advances in diagnosis, prevention, and treatment

    Directory of Open Access Journals (Sweden)

    Di Cesare A

    2014-12-01

    Full Text Available Angela Di Cesare, Donato Traversa Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy Abstract: Angiostrongylus vasorum is a parasitic nematode affecting the heart and pulmonary arteries of wild (eg, foxes and domestic canids. The parasite has an indirect life cycle in which slugs and snails act as intermediate hosts. In the last few years the parasite has spread outside the traditional endemic foci, and there is a rise of documented cases of canine angiostrongylosis across Europe. Angiostrongylus vasorum causes cardiopulmonary disorders and coagulopathies, along with different nonspecific clinical signs. Fatal infections are frequently reported. Given the severity of the infection and the recent geographic spreading of the parasite, this article reviews and discusses the current knowledge of A. vasorum, with a special focus on recent insights on diagnosis, prevention, and treatment of dog angiostrongylosis. Keywords: Angiostrongylus vasorum, dog, epidemiology, diagnostic approaches, control, therapy

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

    Directory of Open Access Journals (Sweden)

    S. A. Perepelitsa

    2012-01-01

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

  8. Gender, histology, and time of diagnosis are important factors for prognosis: analysis of 1499 never-smokers with advanced non-small cell lung cancer in Japan.

    Science.gov (United States)

    Kawaguchi, Tomoya; Takada, Minoru; Kubo, Akihito; Matsumura, Akihide; Fukai, Shimao; Tamura, Atsuhisa; Saito, Ryusei; Kawahara, Masaaki; Maruyama, Yosihito

    2010-07-01

    There has been a growing interest in lung cancer in never-smokers. Utilizing a database from the National Hospital Study Group for Lung Cancer, information for never-smokers and ever-smokers with advanced non-small cell lung cancer was obtained from 1990 to 2005, including clinicopathologic characteristics, chemotherapy response, and survival data. Time of diagnosis was classified into two periods: 1990-1999 and 2000-2005. Multivariate analysis was performed using the Cox regression and logistic regression method, including gender, age, performance status, histology, stage, and period of diagnosis. There were 1499 never-smokers and 3455 ever-smokers with advanced stage IIIB and IV diseases who received cytotoxic chemotherapy. Never-smokers generally included more females, were younger, with better performance status and more adenocarcinoma diagnosed (p time of diagnosis are important factors for prognosis in these patients.

  9. Optimal diagnosis, prevention, and management of periprosthetic joint infection

    Directory of Open Access Journals (Sweden)

    Tafer N

    2015-01-01

    Full Text Available Nathalie Tafer,1 Wilson Belaieff,1 Céline Cuérel,1 Matthieu Zingg,1 Pierre Hoffmeyer,1 Ilker Uçkay1,2 1Orthopedic Surgery Department, 2Division of Infectious Diseases, University of Geneva Hospitals and Medical School, Geneva, Switzerland Abstract: The pace of the aging population is steadily rising worldwide with a parallel increase in the demand for joint replacement procedures. With the increasing number of patients undergoing arthroplasty, there is also an increased risk for arthroplasty infection that may lead to severe complications, poorer outcome, and substantial extra costs for health care systems. Current rates of prosthetic joint infection are not dramatically different from the 1960s or 1970s, but some general principles are now better defined, and their management has been studied extensively during the past decades, thus resulting in a change in clinical practice. The purpose of this review is to summarize important principles of prosthetic joint infection to guide the clinician and to contribute to the optimal diagnosis, prevention, and management of periprosthetic joint infections. Keywords: arthroplasty infection, antibiotic therapy, biofilm, surgery, prevention

  10. A structured review of spinal stiffness as a kinesiological outcome of manipulation: its measurement and utility in diagnosis, prognosis and treatment decision-making.

    Science.gov (United States)

    Snodgrass, Suzanne J; Haskins, Robin; Rivett, Darren A

    2012-10-01

    To review and discuss the methods used for measuring spinal stiffness and factors associated with stiffness, how stiffness is used in diagnosis, prognosis, and treatment decision-making and the effects of manipulative techniques on stiffness. A systematic search of MEDLINE, EMBASE, CINAHL, AMED and ICL databases was conducted. Included studies addressed one of four constructs related to stiffness: measurement, diagnosis, prognosis and/or treatment decision-making, and the effects of manipulation on stiffness. Spinal stiffness was defined as the relationship between force and displacement. One hundred and four studies are discussed in this review, with the majority of studies focused on the measurement of stiffness, most often in asymptomatic persons. Eight studies investigated spinal stiffness in diagnosis, providing limited evidence that practitioner-judged stiffness is associated with radiographic findings of sagittal rotational mobility. Fifteen studies investigated spinal stiffness in prognosis or treatment decision-making, providing limited evidence that spinal stiffness is unlikely to independently predict patient outcomes, though stiffness may influence a practitioner's application of non-thrust manipulative techniques. Nine studies investigating the effects of manipulative techniques on spinal stiffness provide very limited evidence that there is no change in spinal stiffness following thrust or non-thrust manipulation in asymptomatic individuals and non-thrust techniques in symptomatic persons, with only one study supporting an immediate, but not sustained, stiffness decrease following thrust manipulation in symptomatic individuals. The existing limited evidence does not support an association between spinal stiffness and manipulative treatment outcomes. There is a need for additional research investigating the effects of manipulation on spinal stiffness in persons with spinal pain. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2013-02-01

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

  12. Food Allergies: Symptoms, Diagnosis, Prevention and Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... this page please turn Javascript on. Feature: Food Allergies Food Allergies: Symptoms, Diagnosis, Prevention and Treatment Past Issues / Spring ... treatments only ease the symptoms. Preventing a food allergy reaction There are no drugs or treatments available ...

  13. Diagnosis, injury and prevention of internal radiation exposure

    International Nuclear Information System (INIS)

    Tatsuzaki, Hideo

    2012-01-01

    Radiation exposure is classified into three categories: external exposure, surface contamination, and internal exposure (also called internal contamination). Internal exposure is an exposure by the ionizing radiation emitted from radioactive materials taken into a human body. Uptake of radioactive materials can go through inhalation, ingestion, or wound contamination. Not like external exposure, alpha ray or beta ray, which has a limited penetration, is also important in internal exposure. Diagnosis of internal exposure is based on measurement and dose assessment in addition to the history taking. Two methods, direct measurement and/or bioassay (indirect measurement), are used for the measurement. These measurements provide information of radioactive materials in the body at the time of the measurement. The exposure dose to the body needs to be calculated in a process of dose assessment, based on the results of these measurements and history of intake, either acute intake or chronic intake. Another method, measurement of environmental samples or food stuff, is also used for dose assessment. For internal exposure, radiation dose to the body is expressed as committed effective dose or committed equivalent dose, which are accumulation of dose over a defined period. Radioactive materials taken into body are transferred among many body components depending on the type of radionuclide or chemicals etc. Some radioactive materials concentrate in a specific organ. Symptoms and signs depend on the distribution of the radioactive materials in the body. Monitoring the concentration in air or foods is conducted in order to control human activities and foods and consequently reduce the amount of intake to human bodies as a preventive measure. Prevention of internal exposure is also conducted by protective gears such as full face masks. Iodine prophylaxis could be used against radioactive iodine intake. Stable iodine, mostly potassium iodide, could be taken into the thyroid and

  14. The value of determination of blood cardiac troponin T, IL-8 and TNF-α contents for the diagnosis and prognosis assessment in patients with viral myocarditis

    International Nuclear Information System (INIS)

    Tao Qian; Zhou Xuanyan; Li Enjie

    2006-01-01

    Objective: To investigate the value of determination of blood cardiac troponin T (cTnT), IL-8 and TNF-α contents for the diagnosis and prognosis assessment in patients with viral myocarditis (VMC). Methods: Plasma cTnT (with immuno-infiltration method) and serum IL - 8, TNF ( with ELISA) contents were measured in 86 patients with VMC at different stages ( 1 months, 6 months), and 30 controls. Results: The positive rates of blood cTnT, IL-8 and TNF-α in acute VMC patients were significantly higher than those in patients with history less than 6 months as well as with history more than 6 months and the controls group (P 0.05). The cure rate in patients with positive cTnT was significantly lower than that in patients with negative cTnT both at 1 months and 6 months (P<0.005). Conclusion: Blood cTnT, IL-8 and TNF-α are sensitive and specific predictors for diagnosis and prognosis assessment in patients with VMC. (authors)

  15. An unfortunate case of acquired hemochromatosis: a case report review of the clinical presentation, diagnosis, management, and prognosis

    Directory of Open Access Journals (Sweden)

    Tariq A

    2016-12-01

    Full Text Available Anam Tariq,1 Kevin Westra,2 Arben Santo3 1Department of Internal Medicine, Pinnacle Health Internal Medicine, 2Department of Gastroenterology, Harrisburg Gastroenterology, Harrisburg, PA, 3Department of Pathology, Virginia College of Osteopathic Medicine-Virginia Tech, Blacksburg, VA, USA Background: While blood transfusions are commonly used for prophylaxis and treatment for acute chest syndromes and strokes in sickle cell patients, accumulation of excess iron resulting in secondary hemochromatosis remains a rare disease. Chelation is the mainstay for preventing and treating iron overload to deter potential end-organ damages; it is rare when therapy fails. Case report: A 52-year-old African American woman with chronic anemia secondary to sickle cell anemia and history of multiple blood transfusions presented with elevated serum ferritin (8000 ng/mL and bilirubin (16.8 mg/dL. She had no previous personal or family history of liver disease. A magnetic resonance cholangiopancreatography (MRCP and a liver biopsy confirmed the secondary hemochromatosis with marked fibrosis and 4+ iron deposits, but since she was therapeutically on deferasirox, her treatment regimen involved only closer monitoring. Her hemochromatosis led to readmission within a year for rapid progression of cardiac and hepatic failure. Conclusion: Since chronically transfused sickle cell patients are at a significantly higher risk of mortality due to the secondary hemochromatosis and end-stage organ damage, knowledge of prophylactic iron chelation is important. Minimizing unnecessary transfusions should be strongly emphasized to reduce the sequelae as iron burden remains a threat. The effectiveness of iron-chelating therapy is best monitored via periodic magnetic resonance imaging, liver transaminases, bilirubin, creatinine, ferritin, and cardiac function tests. Despite the prophylactic treatment and quarterly blood work, in this case the initial presentation did not correlate with

  16. Corneal allograft rejection: Risk factors, diagnosis, prevention, and treatment

    Directory of Open Access Journals (Sweden)

    Dua Harminder

    1999-01-01

    Full Text Available Recent advances in corneal graft technology, including donor tissue retrieval, storage and surgical techniques, have greatly improved the clinical outcome of corneal grafts. Despite these advances, immune mediated corneal graft rejection remains the single most important cause of corneal graft failure. Several host factors have been identified as conferring a "high risk" status to the host. These include: more than two quadrant vascularisation, with associated lymphatics, which augment the afferent and efferent arc of the immune response; herpes simplex keratitis; uveitis; silicone oil keratopathy; previous failed (rejected grafts; "hot eyes"; young recipient age; and multiple surgical procedures at the time of grafting. Large grafts, by virtue of being closer to the host limbus, with its complement of vessels and antigen-presenting Langerhans cells, also are more susceptible to rejection. The diagnosis of graft rejection is entirely clinical and in its early stages the clinical signs could be subtle. Graft rejection is largely mediated by the major histocompatibility antigens, minor antigens and perhaps blood group ABO antigens and some cornea-specific antigens. Just as rejection is mediated by active immune mediated events, the lack of rejection (tolerance is also sustained by active immune regulatory mechanisms. The anterior chamber associated immune deviation (ACAID and probably, conjunctiva associated lymphoid tissue (CALT induced mucosal tolerance, besides others, play an important role. Although graft rejection can lead to graft failure, most rejections can be readily controlled if appropriate management is commenced at the proper time. Topical steroids are the mainstay of graft rejection management. In the high-risk situations however, systemic steroids, and other immunosuppressive drugs such as cyclosporin and tacrolimus (FK506 are of proven benefit, both for treatment and prevention of rejection.

  17. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Cancer Diagnosis Research Cancer Prevention Research Screening & Early Detection Cancer Treatment Research Cancer & Public Health Cancer Health ... Genomics Causes of Cancer Diagnosis Prevention Screening & Early Detection Treatment Cancer & Public Health Cancer Health Disparities Childhood ...

  18. Time interval between infective endocarditis first symptoms and diagnosis: relationship to infective endocarditis characteristics, microorganisms and prognosis.

    Science.gov (United States)

    N'Guyen, Yohan; Duval, Xavier; Revest, Matthieu; Saada, Matthieu; Erpelding, Marie-Line; Selton-Suty, Christine; Bouchiat, Coralie; Delahaye, François; Chirouze, Catherine; Alla, François; Strady, Christophe; Hoen, Bruno

    2017-03-01

    To analyze the characteristics and outcome of infective endocarditis (IE) according to the time interval between IE first symptoms and diagnosis. Among the IE cases of a French population-based epidemiological survey, patients having early-diagnosed IE (diagnosis of IE within 1 month of first symptoms) were compared with those having late-diagnosed IE (diagnosis of IE more than 1 month after first symptoms). Among the 486 definite-IE, 124 (25%) had late-diagnosed IE whereas others had early-diagnosed IE. Early-diagnosed IE were independently associated with female gender (OR = 1.8; 95% CI [1.0-3.0]), prosthetic valve (OR= 2.6; 95% CI [1.4-5.0]) and staphylococci as causative pathogen (OR = 3.7; 95% CI [2.2-6.2]). Cardiac surgery theoretical indication rates were not different between early and late-diagnosed IE (56.3% vs 58.9%), whereas valve surgery performance was lower in early-diagnosed IE (41% vs 53%; p = .03). In-hospital mortality rates were higher in early-diagnosed IE than in late-diagnosed IE (25.1% vs 16.1%; p endocarditis, which time interval between first symptoms and diagnosis was less than one month, were mainly due to Staphylococcus aureus in France. Staphylococcus aureus infective endocarditis were associated with septic shock, transient ischemic attack or stroke and higher mortality rates than infective endocarditis due to other bacteria or infective endocarditis, which time interval between first symptoms and diagnosis was more than one month. Infective endocarditis, which time interval between first symptoms and diagnosis was more than one month, were accounting for one quarter of all infective endocarditis in our study and were associated with vertebral osteomyelitis and a higher rate of cardiac surgery performed for hemodynamic indication than other infective endocarditis.

  19. [The Spanish Society of Paediatric Infectious Diseases guidelines on the prevention, diagnosis and treatment of neonatal herpes simplex infections].

    Science.gov (United States)

    2018-02-13

    Neonatal herpes simplex virus infections are rare, but are associated with significant morbidity and mortality. Most newborns acquire herpes simplex virus infection in the peripartum period. For peripartum transmission to occur, women must be shedding the virus in their genital tracts symptomatically or asymptomatically around the time of delivery. There are evidence-based interventions in pregnancy to prevent the transmission to the newborn. Caesarean section should be performed in the presence of herpetic lesions, and antiviral prophylaxis in the last weeks of pregnancy is recommended to suppress genital tract herpes simplex virus at the time of delivery. The diagnosis and early treatment of neonatal herpes simplex virus infections require a high index of suspicion, especially in the absence of skin lesions. It is recommended to rule out herpes simplex virus infections in those newborns with mucocutaneous lesions, central nervous system involvement, or septic appearance. The prognosis of newborns with skin, eye, and/or mouth disease in the high-dose acyclovir era is very good. Antiviral treatment not only improves mortality rates in disseminated and central nervous system disease, but also improves the rates of long-term neurodevelopmental impairment in the cases of disseminated disease. Interestingly, a 6-month suppressive course of oral acyclovir following the acute infection has improved the neurodevelopmental prognosis in patients with CNS involvement. Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Guidelines for the diagnosis, prevention and treatment of osteoporosis

    OpenAIRE

    M. Rossini; G. Rini; R. Nuti; S. Minisola; S. Migliaccio; C. Mereu; L. Masi; C. Marcocci; E. Mannarino; G. Luisetto; G.C. Isaia; S. Gonnelli; S. Giannini; B. Frediani; E. Fiore

    2011-01-01

    The guidelines for the osteoporosis management were first drafted by a working group and then critically evaluated by the board of SIOMMMS. The most relevant points are: Definition: Osteoporosis is defined as a quantitative and qualitative deterioration of bone tissue leading to increased risk of fracture. Postmenopausal and senile osteoporosis are defined as primitive. Diagnosis: The cornerstone for the diagnosis of osteoporosis is the measurement of bone mineral density (BMD) by DXA (dual-e...

  1. Instrumentation needs and data management by the French protection and nuclear safety institute for the diagnosis and prognosis of the release during an emergency on a PWR

    International Nuclear Information System (INIS)

    Rague, B.; Janot, L.; Jouzier, A.

    1992-01-01

    IPSN in conjunction with EDF has been developing for the last years an approach for the diagnosis and prognosis of the Source Term during an accident on a PWR. Intended for the off-site emergency teams, this methodology is implemented with dedicated manual and computerized tools within the frame of the SESAME project. It is necessary to have access during the accident to various information dealing with the state of the plant. These information needs and the various means available to pick up data from the plant are described in this paper. Emphasis is given on the analysis of data that is needed to avoid any failure in the assessment of the state of the safety barriers and functions. This analysis deals with: the quality of the information depending on the environmental conditions and on the availability of the supply systems, the cross-check between measurements of same type, the cross-check between measurements of different types

  2. Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting

    International Nuclear Information System (INIS)

    Perani, Daniela; Cerami, Chiara; Caminiti, Silvia Paola; Santangelo, Roberto; Coppi, Elisabetta; Ferrari, Laura; Magnani, Giuseppe; Pinto, Patrizia; Passerini, Gabriella; Falini, Andrea; Iannaccone, Sandro; Cappa, Stefano Francesco; Comi, Giancarlo; Gianolli, Luigi

    2016-01-01

    The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). We evaluated the supportive role of CSF Aβ 42 , t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ 42 ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ 42 ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role. (orig.)

  3. Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Perani, Daniela [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, Nuclear Medicine Unit, Milan (Italy); Cerami, Chiara [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, Clinical Neuroscience Department, Milan (Italy); Caminiti, Silvia Paola [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); Santangelo, Roberto; Coppi, Elisabetta; Ferrari, Laura; Magnani, Giuseppe [San Raffaele Hospital, Department of Neurology, Milan (Italy); Pinto, Patrizia [Papa Giovanni XXIII Hospital, Department of Neurology, Bergamo (Italy); Passerini, Gabriella [Servizio di Medicina di Laboratorio OSR, Milan (Italy); Falini, Andrea [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, CERMAC - Department of Neuroradiology, Milan (Italy); Iannaccone, Sandro [San Raffaele Hospital, Clinical Neuroscience Department, Milan (Italy); Cappa, Stefano Francesco [San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); IUSS Pavia, Pavia (Italy); Comi, Giancarlo [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Hospital, Department of Neurology, Milan (Italy); Gianolli, Luigi [San Raffaele Hospital, Nuclear Medicine Unit, Milan (Italy)

    2016-03-15

    The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). We evaluated the supportive role of CSF Aβ{sub 42}, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ{sub 42} ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ{sub 42} ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role. (orig.)

  4. Preventing gatekeeping delays in the diagnosis of rare diseases

    NARCIS (Netherlands)

    de Vries, E.; Fransen, L.; van den Aker, M.; Meijboom, B.R.

    2018-01-01

    GPs acting as gatekeepers render a healthcare system easily accessible as well as affordable. However, gatekeeping can have an important drawback: it may hamper timely diagnosis and treatment of patients suffering from a rare disease (incidence <1:2000),1 especially if patients present with common

  5. THE INFECTIVE ENDOCARDITIS (PREVENTION, DIAGNOSIS CRITERIA AND TREATMENT: KEY POINTS 2010

    Directory of Open Access Journals (Sweden)

    A. A. Demin

    2010-01-01

    Full Text Available Key positions of Guidelines on the prevention, diagnosis, and treatment of infective endocarditis issued by the Task Force of ESC in 2009 are explained in the comments. Recent opinions on these items are presented.

  6. Elevated Serum ADA Activity as a Marker for Diagnosis and Prognosis of Visceral Leishmaniasis and Post Kala-Azar Dermal Leishmaniasis in Indian Patients

    Science.gov (United States)

    Vijayamahantesh; Amit, Ajay; Dikhit, Manas R.; Pandey, Raj K.; Singh, Kuljit; Mishra, Ritesh; Das, V. N. R; Das, Pradeep; Bimal, Sanjiva

    2016-01-01

    Serum adenosine deaminase (ADA) activity increases in diseases where cellular immunity is involved. Since cell-mediated immune responses play a paramount role in the pathogenesis and healing of the visceral leishmaniasis, therefore, the present study was undertaken to evaluate the serum ADA activity in different pathological conditions. Adenosine deaminase was determined in sera of active visceral leishmaniasis (VL) patients (n = 39), active postkala-azar dermal leishmaniasis (PKDL) cases (n = 34) at the point of diagnosis and after treatment stages along with healthy controls (n = 30), endemic healthy subjects (n = 34) and endemic asymptomatic subjects (n = 34).Our in-vitro result revealed that monocytes secrete significant ADA level in response to Leishmania donovani (L.donovani) stimulation. The serum ADA activity in active VL and PKDL subjects were found to be significantly higher than that of respective treated cases and healthy controls. We also observed a marginal number (17.6%) of endemic asymptomatic subjects showed elevated serum ADA activity. Further, the ADA activity in PKDL was found to be decreased gradually during the different phases of treatment. Interestingly, 2 out of 32 treated VL cases found to have high serum ADA activity during follow up period were relapsed within few days. These results suggest the possibility of ADA as a marker of clinical pathogenesis and can be used as a surrogate marker in the diagnosis and prognosis of VL and PKDL. PMID:27186641

  7. Elevated Serum ADA Activity as a Marker for Diagnosis and Prognosis of Visceral Leishmaniasis and Post Kala-Azar Dermal Leishmaniasis in Indian Patients.

    Science.gov (United States)

    Vijayamahantesh; Amit, Ajay; Dikhit, Manas R; Pandey, Raj K; Singh, Kuljit; Mishra, Ritesh; Das, V N R; Das, Pradeep; Bimal, Sanjiva

    2016-01-01

    Serum adenosine deaminase (ADA) activity increases in diseases where cellular immunity is involved. Since cell-mediated immune responses play a paramount role in the pathogenesis and healing of the visceral leishmaniasis, therefore, the present study was undertaken to evaluate the serum ADA activity in different pathological conditions. Adenosine deaminase was determined in sera of active visceral leishmaniasis (VL) patients (n = 39), active postkala-azar dermal leishmaniasis (PKDL) cases (n = 34) at the point of diagnosis and after treatment stages along with healthy controls (n = 30), endemic healthy subjects (n = 34) and endemic asymptomatic subjects (n = 34).Our in-vitro result revealed that monocytes secrete significant ADA level in response to Leishmania donovani (L.donovani) stimulation. The serum ADA activity in active VL and PKDL subjects were found to be significantly higher than that of respective treated cases and healthy controls. We also observed a marginal number (17.6%) of endemic asymptomatic subjects showed elevated serum ADA activity. Further, the ADA activity in PKDL was found to be decreased gradually during the different phases of treatment. Interestingly, 2 out of 32 treated VL cases found to have high serum ADA activity during follow up period were relapsed within few days. These results suggest the possibility of ADA as a marker of clinical pathogenesis and can be used as a surrogate marker in the diagnosis and prognosis of VL and PKDL.

  8. Assessing significance of peripheral blood indicators for differential diagnosis and prognosis of thrombotic complications in polycythemia vera and secondary erythrocytosis

    Directory of Open Access Journals (Sweden)

    Kostiukevych O.M.

    2014-03-01

    Full Text Available The aim of the study – determining of changes in peripheral blood (PB in patients with secondary erythrocytosis (SE and polycythemia vera (PV, detection of discriminatory parameters levels of PB indicators and analyzing of their operating characteristics for differentiation of erythrocytosis and predicting of thrombotic events in patients with PV. Materials and methods. The material for the study was the results of clinical trials of 210 patients with erythrocytosis who underwent differential diagnosis between PV and SE. Results and discussion. The optimal threshold for differential diagnosis of red blood cells content between PV and SE is >6.08•1012/ L, the diagnostic value of the marker equals to the level of a good diagnostic marker (AUC=0.82; 95% CI=0.77-0.87, p 57.5% with its capacity – 0.72 (0.66-0.78, p 8.9•109/L, and the boundary of marker is consistent with a good level of efficiency (AUC=0.79, 95% CI=0.72-0.84, p287•109 /L" to differentiate erythrocytosis is 0.90 (0.86-0.94, p 55%" and "WBC >12.3•109 /L", according to the AUC (AUC=0.65; 95% CI=0.52-0.79, p=0.021 and AUC=0.66; 95% CI=0.55-0.77, p=0.003, respectively, corresponds to the average power level. Conclusion. Hemoglobin has not confirmed its value for the differential diagnosis between PV and SE. Using other parameters of PB with the aim of differentiating PV and SE is rational, but their discriminatory power levels greatly depend on the group erythrocytosis. In our cohort were obtained the following most appropriate criteria for inclusion of patients in the group of patients with PV: "WBC >8.9•109/L", "red blood cells >6.08•1012/L" and "hematocrit >57.5%". The most significant marker of general clinical blood test to differentiate between PV and SE is "platelets >287•109/L". Hematocrit over 55% and WBC over 12.3•109/L are valuable prognostic markers of thrombosis in PV patients, but their use is appropriate only in a cohort of patients with PV without

  9. Low Serum Complement C3 Levels at Diagnosis of Renal ANCA-Associated Vasculitis Is Associated with Poor Prognosis.

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    Jean-François Augusto

    Full Text Available Recent studies have demonstrated the key role of the complement alternative pathway (cAP in the pathophysiology of experimental ANCA-associated vasculitis (AAV. However, in human AAV the role of cAP has not been extensively explored. In the present work, we analysed circulating serum C3 levels measured at AAV onset and their relation to outcomes.We conducted a retrospective observational cohort study including 45 consecutive patients with AAV diagnosed between 2000 and 2014 with serum C3 measurement at diagnosis, before immunosuppressive treatment initiation. Two groups were defined according to the median serum C3 level value: the low C3 group (C3<120 mg/dL and the high C3 level group (C3≥120 mg/dL. Patient and renal survivals, association between C3 level and renal pathology were analysed.Serum complement C3 concentration remained in the normal range [78-184 mg/dL]. Compared with the high C3 level, the patients in the low C3 level group had lower complement C4 concentrations (P = 0.008 and lower eGFR (P = 0.002 at diagnosis. The low C3 level group had poorer patient and death-censored renal survivals, compared with the high C3 level group (P = 0.047 and P = 0.001, respectively. We observed a significant negative correlation between C3 levels and the percentage of glomeruli affected by cellular crescent (P = 0.017, r = -0.407. According to the Berden et al renal histologic classification, patients in the crescentic/mixed category had low C3 levels more frequently (P<0.01. Interestingly, we observed that when patients with the crescentic/mixed histologic form were analysed according to C3 level, long term renal survival was significantly greater in the high C3 level group than in the low C3 level group (100% vs 40.7% at 6 years, p = 0.046. No relationship between serum C4 and renal outcome was observed.A Low C3 serum level in AAV patients at diagnosis is associated with worse long-term patient and renal survival.

  10. Guidelines for the diagnosis, prevention and treatment of osteoporosis

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    M. Rossini

    2011-06-01

    Full Text Available The guidelines for the osteoporosis management were first drafted by a working group and then critically evaluated by the board of SIOMMMS. The most relevant points are: Definition: Osteoporosis is defined as a quantitative and qualitative deterioration of bone tissue leading to increased risk of fracture. Postmenopausal and senile osteoporosis are defined as primitive. Diagnosis: The cornerstone for the diagnosis of osteoporosis is the measurement of bone mineral density (BMD by DXA (dual-energy X-ray absortiometry at the femoral neck with T-score values -2.5 is usually not justified. Pharmacological intervention: The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk. This is the case only when the risk of fracture is rather high. FRAX™ is recognized as a useful tool for easily estimate the long-term fracture risk. SIOMMMS with these guidelines is committed to validate and further develop this diagnostic tool.

  11. Understanding Cancer Prognosis

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    Full Text Available ... Your Diagnosis Research Understanding Cancer Prognosis Oncologist Anthony L. Back, M.D., a national expert on doctor- ... Centered Approach View this video on YouTube. Anthony L. Back, M.D., coaches other oncologists about how ...

  12. Orthopedic Health: Joint Health and Care: Prevention, Symptoms, Diagnosis & Treatment

    Science.gov (United States)

    ... version of this page please turn Javascript on. Prevention Regular exercise, a balanced diet, and a healthful weight can help you reduce your risk of developing osteoarthritis, especially in the hips and knees, or suffering sports injuries. Exercise helps bone density, improves muscle strength and ...

  13. Dietary supplement use and colorectal tumors : from prevention to diagnosis

    NARCIS (Netherlands)

    Bröring, R.C.

    2015-01-01

    Background: Expert guidelines formulated by the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) advised no use of dietary supplements for cancer prevention. However, it is unclear whether those recommendations also apply to populations at

  14. Beyond HbA1c and glucose: the role of nontraditional glycemic markers in diabetes diagnosis, prognosis, and management

    Science.gov (United States)

    Parrinello, Christina M.; Selvin, Elizabeth

    2014-01-01

    Fasting glucose and hemoglobin A1c (HbA1c) are the standard measures for diagnosis and monitoring of diabetes. There has been recent interest in nontraditional markers of hyperglycemia, including fructosamine, glycated albumin and 1,5-anhydroglucitol (1,5-AG), as alternatives or adjuncts to standard measures. There is a growing literature linking these nontraditional markers with microvascular and macrovascular complications. Fructosamine and glycated albumin have also been shown to improve identification of persons with diabetes. However, long-term prospective studies with clinical outcomes are lacking. Some modern laboratory assays for fructosamine, glycated albumin and 1,5-AG have excellent performance. Expanded use of these tests has the potential to improve diabetes care as these measures may overcome limitations of HbA1c in certain patients, complement traditional measures by providing additional information on shorter-term glycemic control, and improve risk stratification for diabetes and its complications. Nonetheless, studies are needed to demonstrate if their routine use will benefit patients and improve outcomes. PMID:25249070

  15. Importance of Clinical and Laboratory Findings in the Diagnosis and Surgical Prognosis of Patients with Constrictive Pericarditis

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    Fábio Fernandes

    2017-10-01

    Full Text Available Abstract Background: International studies have reported the value of the clinical profile and laboratory findings in the diagnosis of constrictive pericarditis. However, Brazilian population data are scarce. Objective: To assess the clinical characteristics, sensitivity of imaging tests and factors related to the death of patients with constrictive pericarditis undergoing pericardiectomy. Methods: Patients with constrictive pericarditis surgically confirmed were retrospectively assessed regarding their clinical and laboratory variables. Two methods were used: transthoracic echocardiography and cardiac magnetic resonance imaging. Mortality predictors were determined by use of univariate analysis with Cox proportional hazards model and hazard ratio. All tests were two-tailed, and an alpha error ≤ 5% was considered statically significant. Results: We studied 84 patients (mean age, 44 ± 17.9 years; 67% male. Signs and symptoms of predominantly right heart failure were present with jugular venous distention, edema and ascites in 89%, 89% and 62% of the cases, respectively. Idiopathic etiology was present in 69.1%, followed by tuberculosis (21%. Despite the advanced heart failure degree, low BNP levels (median, 157 pg/mL were found. The diagnostic sensitivities for constriction of echocardiography and magnetic resonance imaging were 53.6% and 95.9%, respectively. There were 9 deaths (10.7%, and the risk factors were: anemia, BNP and C reactive protein levels, pulmonary hypertension >55 mm Hg, and atrial fibrillation. Conclusions: Magnetic resonance imaging had better diagnostic sensitivity. Clinical, laboratory and imaging markers were associated with death.

  16. Understanding Cancer Prognosis

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    Full Text Available ... CANCER Live Chat Publications Dictionary Menu Contact Dictionary Search About Cancer Causes and Prevention Risk Factors Genetics ... Legislative Resources Recent Public Laws Careers Visitor Information Search Search Home About Cancer Diagnosis and Staging Diagnosis ...

  17. The detection of hTERC amplification using fluorescence in situ hybridization in the diagnosis and prognosis of cervical intraepithelial neoplasia: a case control study

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    Yin Geping

    2012-08-01

    Full Text Available Abstract Background Currently the routine non-invasive screening methods for cervical intraepithelial neoplasia (CIN and cervical cancer are Thinprep cytology test (TCT and human papillomavirus testing. However, both methods are limited by the high false positive and false negative rates and lack of association with patients’ prognosis, especially for the early detection of pro-malignant CIN. The aim of the study was to investigate the role of genomic amplification of human telomerase gene (hTERC in the diagnosis and prognosis of CIN. Methods The study group consisted of specimens of exfoliated cervical cells from 151 patients, including 27 with CIN I, 54 with CIN II/III, 17 with carcinoma in situ, and 28 with invasive squamous carcinoma, as well as 25 patients who were at 2-year follow-up after either Loop Electrosurgical Excision treatment (n = 11 or radical surgery (n = 14. hTERC amplification was detected by dual-color interphase fluorescence in situ hybridization (FISH, and the results were compared with TCT and histologic examination. The final diagnosis was determined by the pathological examination. The control group consisted of specimens of exfoliated cervical cells from 40 normal women. Results The percentage of cervical exfoliated cells with positive hTERC amplification and incidence rates of hTERC amplification were 9.2% ± 4.6% and 44.4% (12/27 respectively in patients with CIN I; 16.0% ± 14.4% and 85.1% (46/54 in patients with CIN II/III; 19.7% ± 13.3% and 88.3% (15 /17 in patients with carcinoma in situ; 47.0% ± 25.2% and 100% (28/28in patients with invasive squamous carcinoma. There was statistically significant difference between the control and study group (P Conclusion The detection of genomic amplification of hTERC using FISH is a non-invasive and effective approach for CIN.

  18. Low oxytocin and melatonin levels and their possible role in the diagnosis and prognosis in Iraqi autistic children

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    Abdulamir, Haidar A.; Abdul-Rasheed, Omar F.; Abdulghani, Emad A.

    2016-01-01

    Objectives: To test the possible association between oxytocin and melatonin levels with the severity of social and cognitive dysfunctions, and to study the correlation between these parameters in children with autism. Methods: A case-control study was carried out in the Department of Chemistry and Biochemistry, College of Medicine, Al-Nahrain University, Baghdad, Iraq. The study was performed on 60 male autistic patients recruited from the Pediatric Department of Al-Sader General Hospital, Baghdad, Iraq between November 2014 and April 2015. The levels of oxytocin and melatonin were measured in the serum of these autistic male patients, and categorized as mild, moderate, and severe (20 patients each), and was compared with 26 age- and gender-matched control subjects. Results: The data indicated that the levels of oxytocin (44.72 ± 36.1 µIU/mL) and melatonin in patients (23.08 ± 10.41 pg/mL) were significantly lower (pautistic patients with oxytocin (59.22 ± 27.32 µIU/mL) and melatonin (27.55 ± 14.71 pg/mL). These 2 parameters showed a significant positive correlation with each other in moderate (r=0.513; p=0.021), and severe patients (r=0.598; p=0.005). Conclusion: Receiver operating characteristic analysis revealed that oxytocin can be considered as a good diagnostic marker in severe autistic patients while melatonin can be considered as a good diagnostic marker in all autistic subgroups. This study proves the possibility of using oxytocin and melatonin in the diagnosis, and as markers of autism severity. PMID:26739971

  19. Diagnosis, prevention, and management of canine hip dysplasia: a review

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    Schachner ER

    2015-05-01

    Full Text Available Emma R Schachner, Mandi J Lopez Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA Abstract: Canine hip dysplasia (CHD is a polygenic and multifactorial developmental disorder characterized by coxofemoral (hip joint laxity, degeneration, and osteoarthritis (OA. Current diagnostic techniques are largely subjective measures of joint conformation performed at different stages of development. Recently, measures on three-dimensional images generated from computed tomography scans predicted the development of OA associated with CHD. Continued refinement of similar imaging methods may improve diagnostic imaging techniques to identify dogs predisposed to degenerative hip joint changes. By current consensus, joint changes consistent with CHD are influenced by genetic predisposition as well as environmental and biomechanical factors; however, despite decades of work, the relative contributions of each to the development and extent of CHD signs remain elusive. Similarly, despite considerable effort to decipher the genetic underpinnings of CHD for selective breeding programs, relevant genetic loci remain equivocal. As such, prevention of CHD within domestic canine populations is marginally successful. Conservative management is often employed to manage signs of CHD, with lifelong maintenance of body mass as one of the most promising methods. Surgical intervention is often employed to prevent joint changes or restore joint function, but there are no gold standards for either goal. To date, all CHD phenotypes are considered as a single entity in spite of recognized differences in expression and response to environmental conditions and treatment. Identification of distinct CHD phenotypes and targeting evidence-based conservative and invasive treatments for each may significantly advance prevention and management of a prevalent, debilitating condition in canine companions. Keywords: canine

  20.  DNA microarray-based gene expression profiling in diagnosis, assessing prognosis and predicting response to therapy in colorectal cancer

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    Przemysław Kwiatkowski

    2012-06-01

    Full Text Available  Colorectal cancer is the most common cancer of the gastrointestinal tract. It is considered as a biological model of a certain type of cancerogenesis process in which progression from an early to late stage adenoma and cancer is accompanied by distinct genetic alterations.Clinical and pathological parameters commonly used in clinical practice are often insufficient to determine groups of patients suitable for personalized treatment. Moreover, reliable molecular markers with high prognostic value have not yet been determined. Molecular studies using DNA-based microarrays have identified numerous genes involved in cell proliferation and differentiation during the process of cancerogenesis. Assessment of the genetic profile of colorectal cancer using the microarray technique might be a useful tool in determining the groups of patients with different clinical outcomes who would benefit from additional personalized treatment.The main objective of this study was to present the current state of knowledge on the practical application of gene profiling techniques using microarrays for determining diagnosis, prognosis and response to treatment in colorectal cancer.

  1. Enterobacteriaceae infection – diagnosis, antibiotic resistance and prevention

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    Anna Jarząb

    2011-01-01

    Full Text Available Intestinal infections caused by rod-shaped bacteria of the [i]Enterobacteriaceae[/i] genus are one of the major health hazards in countries where sanitation standards are low. [i]Strains[/i] of [i]Shigella,[/i] [i]Salmonella, Escherichia[/i] and [i]Yersinia [/i]are responsible for diarrhea, severe bacillary dysentery, typhoid, other intestinal diseases, as well as genitourinary tract and blood infections. According to the WHO there are 4.5 billion cases every year, of which 1.9 million end in death. This makes intestinal infections third in terms of human disease mortality. In this work we discuss methods of pathogen identification, the mechanism of host-pathogen interaction, and the nature of the ¬host’s immunological response. Due to rising drug resistance we discuss the importance of better pathogen detection, vaccine design and the use of vaccines as a preventive measure against intestinal infections. Special attention is paid to OMP38, a protein isolated from [i]S. flexneri[/i] 3a outer membrane. Since it is known that this protein has good immunogenic properties, it can be used as an antigen or carrier for conjugate vaccines.

  2. Applicative Value of Serum CA19-9, CEA, CA125 and CA242 in Diagnosis and Prognosis for Patients with Pancreatic Cancer Treated by Concurrent Chemoradiotherapy.

    Science.gov (United States)

    Gu, Yu-Lei; Lan, Chao; Pei, Hui; Yang, Shuang-Ning; Liu, Yan-Fen; Xiao, Li-Li

    2015-01-01

    To evaluate the application value of serum CA19-9, CEA, CA125 and CA242 in diagnosis and prognosis of pancreatic cancer cases treated with concurrent chemotherapy. 52 patients with pancreatic cancer, 40 with benign pancreatic diseases and 40 healthy people were selected. The electrochemiluminescence immunoassay method was used for detecting levels of CA19-9, CEA and CA125, and a CanAg CA242 enzyme linked immunoassay kit for assessing the level of CA242. The Kaplan-Meier method was used for analyzing the prognostic factors of patients with pancreatic cancer. The Cox proportional hazard model was applied for analyzing the hazard ratio (HR) and 95% confidential interval (CI) for survival time of patients with pancreatic cancer. The levels of serum CA19-9, CEA, CA125 and CA242 in patients with pancreatic cancer were significantly higher than those in patients with benign pancreatic diseases and healthy people (PCEA. The specificity of CA242 is the highest, followed by CA125, CEA and CA19-9. The sensitivity and specificity of joint detection of serum CA19-9, CEA, CA125and CA242 were 90.4% and 93.8%, obviously higher than single detection of those markers in diagnosis of pancreatic cancer. The median survival time of 52 patients with pancreatic cancer was 10 months (95% CI7.389~12.611).. Patients with the increasing level of serum CA19-9, CEA, CA125, CA242 had shorter survival times (P=0.047. 0.043, 0.0041, 0.029). COX regression analysis showed that CA19-9 was an independent prognostic factor for patients with pancreatic cancer (P=0.001, 95%CI 2.591~38.243). The detection of serum tumor markers (CA19.9, CEA, CA125 and CA242) is conducive to the early diagnosis of pancreatic cancer and joint detection of tumor markers helps improve the diagnostic efficiency. Moreover, CA19-9 is an independent prognostic factor for patients with pancreatic cancer.

  3. Current opinion and consensus statement regarding the diagnosis, prognosis, and treatment of patients with essential thrombocythemia: a survey of the Spanish Group of Ph-negative Myeloproliferative Neoplasms (GEMFIN) using the Delphi method.

    Science.gov (United States)

    Besses, C; Hernández-Boluda, J C; Pérez Encinas, M; Raya, J M; Hernández-Rivas, J M; Jiménez Velasco, A; Martínez Lopez, J; Vicente, V; Burgaleta, C

    2016-04-01

    The current consensus on the diagnosis, prognosis, and treatment of essential thrombocythemia (ET) is based on experts' recommendations. However, several aspects of the diagnosis of, prognosis of, and therapy for ET are still controversial. The Delphi method was employed with an expert panel of members of the Spanish Group of Ph-negative Myeloproliferative Neoplasms in order to identify the degree of agreement on the diagnosis, prognosis, and treatment of ET. Nine leading experts selected a total of 41 clinical hematologists with well-known expertise in ET. An electronic questionnaire was used to collect the questions rated in a four-step scale. The questions were grouped into four blocks: diagnosis, risk stratification, goals of therapy, and treatment strategy. After the first round consisting of 80 questions, a second round including 14 additional questions focused on the recommendations advocated by experts of the European LeukemiaNet in 2011 was analyzed. The median and mean values for the first and second rounds were calculated. A summary of the conclusions considered as the most representative of each block of questions is presented. The Delphi method is a powerful instrument to address the current approaches and controversies surrounding ET.

  4. Understanding Cancer Prognosis

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    Full Text Available ... Cancer Biology Research Cancer Genomics Research Research on Causes of Cancer Cancer Diagnosis Research Cancer Prevention Research Screening & Early ... Scientists NCI Research Areas Cancer Biology Cancer Genomics Causes of Cancer Diagnosis Prevention Screening & Early Detection Treatment Cancer & Public ...

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

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    Gregorio Katz

    2008-01-01

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

  6. Can Exosomes Induced by Breast Involution Be Markers for the Poor Prognosis and Prevention of Postpartum Breast Cancer

    Science.gov (United States)

    2015-07-01

    estrone, estradiol, estriol, progesterone, and 17- hydroxyprogesterone in human pregnancy. I. Normal pregnancy, American journal of obstetrics and...Marchbanks PA: Reproductive history and mortality after breast cancer diagnosis, Obstet Gynecol 2004, 104:146-154 17. Stensheim H, Moller B, van Dijk T

  7. Diagnosis and Prognosis of Sciatica

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    A.J.H. Verwoerd (Annemieke)

    2015-01-01

    markdownabstract__Abstract__ Sciatica is one of the most common lumbar spine disorders with a life time incidence of 12 to 40%. The most common cause of sciatica is a herniated disc. Sciatica is associated with significant morbidity. Back problems rank, certainly in the industrialized countries,

  8. Macrophage Inhibitory Cytokine-1 (MIC-1 as A Biomarker for Diagnosis 
and Prognosis of Stage I-II Non-small Cell Lung Cancer

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    Yuning LIU

    2016-04-01

    Full Text Available Background and objective Increased macrophage inhibitory cytokine-1 (MIC-1, member of transforming growth factor-β (TGF-β superfamily, was found in patients serum with epithelial tumors. Therefore, our aim was to delineate the diagnostic and prognostic value of serum MIC-1 in patients with stage I-II non-small cell lung cancer (NSCLC. Methods A total of 152 consecutive patients with stage I–II NSCLC were prospectively enrolled and underwent follow up after total resection of tumor. Serum MIC-1 level was detected in lung cancer patients by ELISA, 48 benign pulmonary disease patients and 105 healthy controls, and was correlated with clinical features and prognosis of patients. Results The level of MIC-1 of NSCLC patients was significantly higher than that of controls (P<0.001 and benign pulmonary disease patients (P<0.001. A threshold of 1,000 pg/mL could be used to diagnose early-stage NSCLC with 70.4% sensitivity and 99.0% specificity. The level of MIC-1 was associated with elder age (P=0.001, female (P=0.03 and T2 (P=0.022. A threshold of 1,465 pg/mL could identify patients with early poor outcome with 72.2% sensitivity and 66.1% specificity. The overall 3-year survival rate in patients with high level of MIC-1 (≥1,465 pg/mL was significantly lower than that of patients with low MIC-1 level (77.6% vs 94.8%. Multivariable Cox regression revealed that a high level of MIC-1 was an independent risk factor for compromised overall survival (HR=3.37, 95%CI: 1.09-10.42, P=0.035. Conclusion High level of serum MIC-1 could be served as a potential biomarker for diagnosis and poorer outcome in patients with early-stage NSCLC.

  9. The clinical role of microRNA-21 as a promising biomarker in the diagnosis and prognosis of colorectal cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Peng, Qiliang; Zhang, Xueli; Min, Ming; Zou, Li; Shen, Peipei; Zhu, Yaqun

    2017-07-04

    This systematic analysis aimed to investigate the value of microRNA-21 (miR-21) in colorectal cancer for multiple purposes, including diagnosis and prognosis, as well as its predictive power in combination biomarkers. Fifty-seven eligible studies were included in our meta-analysis, including 25 studies for diagnostic meta-analysis and 32 for prognostic meta-analysis. For the diagnostic meta-analysis of miR-21 alone, the overall pooled results for sensitivity, specificity, and area under the curve (AUC) were 0.64 (95% CI: 0.53-0.74), 0.85 (0.79-0.90), and 0.85 (0.81-0.87), respectively. Circulating samples presented corresponding values of 0.72 (0.63-0.79), 0.84 (0.78-0.89), and 0.86 (0.83-0.89), respectively. For the diagnostic meta-analysis of miR-21-related combination biomarkers, the above three parameters were 0.79 (0.69-0.86), 0.79 (0.68-0.87), and 0.86 (0.83-0.89), respectively. Notably, subgroup analysis suggested that miRNA combination markers in circulation exhibited high predictive power, with sensitivity of 0.85 (0.70-0.93), specificity of 0.86 (0.77-0.92), and AUC of 0.92 (0.89-0.94). For the prognostic meta-analysis, patients with higher expression of miR-21 had significant shorter disease-free survival [DFS; pooled hazard ratio (HR): 1.60; 95% CI: 1.20-2.15] and overall survival (OS; 1.54; 1.27-1.86). The combined HR in tissues for DFS and OS were 1.76 (1.31-2.36) and 1.58 (1.30-1.93), respectively. Our comprehensive systematic review revealed that circulating miR-21 may be suitable as a diagnostic biomarker, while tissue miR-21 could be a prognostic marker for colorectal cancer. In addition, miRNA combination biomarkers may provide a new approach for clinical application.

  10. Potential Role of Circulating MiR-21 in the Diagnosis and Prognosis of Digestive System Cancer: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Yin, Chengqiang; Zhou, Xiaoying; Dang, Yini; Yan, Jin; Zhang, Guoxin

    2015-12-01

    Recent evidences indicate that circulating microRNAs (miRNAs) exhibit aberrant expression in the plasma of patients suffering from cancer compared to normal individuals, suggesting that it may be a useful noninvasion diagnostic method. MiR-21 plays crucial roles in carcinogenesis and can be served as a biomarker for the detection of various cancers. Therefore, the aim of this meta-analysis is to assess the potential role of miR-21 for digestive system cancer. By searching the PubMed, Embase, and Web of Science for publications concerning the diagnostic value of miR-21 for digestive system cancer, total of 23 publications were included in this meta-analysis. Receiver operating characteristic curves (ROC) were used to check the overall test performance. For prognostic meta-analysis, pooled hazard ratios (HRs) of circulating miR-21 for survival were calculated. Totally 23 eligible publications were included in this meta-analysis (15 articles for diagnosis and 8 articles for prognosis). For diagnostic meta-analysis, the summary estimates revealed that the pooled sensitivity and specificity were 0.76 (95% CI = 0.70-0.82) and 0.84 (95% CI = 0.78-0.89). Besides, the area under the summary ROC curve (AUC) is 0.87. For prognostic meta-analysis, the pooled HR of higher miR-21 expression in circulation was 1.94 (95% CI = 0.99-3.82, P = 0.055), which indicated higher miR-21 expression could be likely to predict poorer survival in digestive system cancer. The subgroup analysis implied the higher expression of miR-21 was correlated with worse overall survival in the Asian population in digestive system cancer (HR = 2.41, 95% CI = 1.21-4.77, P = 0.012). The current evidence suggests circulating miR-21 may be suitable to be a diagnostic and prognostic biomarker for digestive system cancer in the Asians.

  11. Preventing delayed diagnosis of cancer: clinicians’ views on main problems and solutions

    Science.gov (United States)

    Car, Lorainne Tudor; Papachristou, Nikolaos; Urch, Catherine; Majeed, Azeem; El–Khatib, Mona; Aylin, Paul; Atun, Rifat; Car, Josip; Vincent, Charles

    2016-01-01

    Background Delayed diagnosis is a major contributing factor to the UK’s lower cancer survival compared to many European countries. In the UK, there is a significant national variation in early cancer diagnosis. Healthcare providers can offer an insight into local priorities for timely cancer diagnosis. In this study, we aimed to identify the main problems and solutions relating to delay cancer diagnosis according to cancer care clinicians. Methods We developed and implemented a new priority–setting approach called PRIORITIZE and invited North West London cancer care clinicians to identify and prioritize main causes for and solutions to delayed diagnosis of cancer care. Results Clinicians identified a number of concrete problems and solutions relating to delayed diagnosis of cancer. Raising public awareness, patient education as well as better access to specialist care and diagnostic testing were seen as the highest priorities. The identified suggestions focused mostly on the delays during referrals from primary to secondary care. Conclusions Many identified priorities were feasible, affordable and converged around common themes such as public awareness, care continuity and length of consultation. As a timely, proactive and scalable priority–setting approach, PRIORITZE could be implemented as a routine preventative system for determining patient safety issues by frontline staff. PMID:28028437

  12. Onfalocele: Prognóstico Fetal em 51 Casos com Diagnóstico Pré-Natal Omphalocele: Fetal Prognosis in 51 Cases with Prenatal Diagnosis

    Directory of Open Access Journals (Sweden)

    Samir Aldalla Mustafá

    2001-02-01

    Full Text Available Objetivo: avaliar o prognóstico fetal dos casos de onfalocele com diagnóstico pré-natal. Métodos: foram analisados 51 casos de onfalocele com diagnóstico pré-natal e divididos em 3 grupos: grupo 1, onfalocele isolada; grupo 2, onfalocele com malformações estruturais associadas e cariótipo normal; grupo 3, onfalocele associada à cromossomopatia. As análises foram realizadas em relação à sobrevida geral e pós-correção cirúrgica, considerando as malformações associadas, idade gestacional no parto, peso no nascimento e tamanho da onfalocele. Resultados: o grupo 1 correspondeu a 21% (n = 11, o grupo 2 a 55% (n = 28 e o grupo 3 a 24% (n = 12. Todos os casos do grupo 3 evoluíram para óbito, e a cromossomopatia mais freqüente foi a trissomia do 18. A sobrevida foi de 80% no grupo 1 e de 25% no grupo 2. Dezesseis casos foram submetidos à correção cirúrgica (10 isoladas e 6 associadas e 81% sobreviveram (8 isoladas e 5 associadas. A mediana do peso no nascimento dos sobreviventes pós-correção cirúrgica foi 3.140 g e dos que morreram foi de 2.000 g (p = 0,148 e a idade gestacional do parto foi de 37 e de 36 semanas (p = 0,836, respectivamente. A relação das circunferências onfalocele/abdominal diminuiu com a idade gestacional, 0,88 entre 25-29 semanas e 0,65 entre 30-35 semanas (p = 0,043. Não foi observada diferença significativa no tamanho da onfalocele nos 3 grupos (p = 0,988 e influência deste prognóstico pós-correção cirúrgica (p = 0,553. Conclusão: a sobrevida geral e pós-correção cirúrgica foi de 25 e 81%, respectivamente. As malformações associadas representam o principal fator prognóstico das onfaloceles com diagnóstico pré-natal, visto que se associam com prematuridade e baixo peso.Purpose: to evaluate the prognosis of fetal omphalocele after prenatal diagnosis. Methods: fifty-one cases with prenatal diagnosis of fetal omphalocele were divided into three groups: group 1, isolated omphalocele

  13. Understanding Cancer Prognosis

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  14. Understanding Cancer Prognosis

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    Full Text Available ... Types Recurrent Cancer Common Cancer Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver ... Genomics Research Research on Causes of Cancer Cancer Diagnosis Research Cancer Prevention Research Screening & Early Detection Cancer ...

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    Full Text Available ... Cancer Research Common Cancer Types Recurrent Cancer Common Cancer Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer ... Genomics Research Research on Causes of Cancer Cancer Diagnosis Research Cancer Prevention Research Screening & Early Detection Cancer ...

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  1. Diagnosis and prevention of overtraining syndrome: an opinion on education strategies

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    Kreher JB

    2016-09-01

    Full Text Available Jeffrey B Kreher Department of Orthopaedics, Division of Pediatric Orthopaedics, Massachusetts General Hospital and Massachusetts General Hospital for Children, Boston, MA, USA Abstract: Overtraining syndrome is a condition of maladapted physiology in the setting of excessive exercise without adequate rest. The exact etiology and pathogenesis are unknown and being investigated. Symptoms are multisystem in nature and often representative of underlying hormonal, immunologic, neurologic, and psychologic disturbances. Unfortunately, systematic review of the literature does not clearly direct diagnosis, management, or prevention. However, given the severity of symptoms and impairment to quality of life, prevention of overtraining syndrome should be considered by all who interact with endurance athletes. This article will provide suggestions for management of at-risk athletes despite absence of validated diagnostic tests and preventative measures. Keywords: overreaching, unexplained underperformance, burnout, muscle failure syndrome

  2. Diagnosis, management and prevention of ischemic stroke for non-neurologists

    Directory of Open Access Journals (Sweden)

    Kavian Ghandehari

    2011-07-01

    Full Text Available Background: Stroke is the third common cause of disability and death. Diagnosis of stroke is based on its clinical manifestations and/or observation of infarct in the neuroimaging. Standard battery of diagnostic investigations and classification criteria is required for detection of stroke etiology. Materials and Method: This review article deals with the diagnosis and management of brain infarction particularly in our country and is provided for non-neurologists. Using online scientific search engines and in some parts referring to laboratory archives constituted base of this review article.Results: Acute stroke management is almost similar in its various etiologies. Neuroprotective drugs have little value in acute stroke management. At present time, a few Iranian medical centers have infrastructure of thrombolysis therapy. Prevention of stroke is based on the detection and control of its risk factors. Aspirin, 80 mg per day is the most common drug for stroke prevention. Co-administration of aspirin 80 mg/d and Dipyridamole 200-400 mg/d increases the preventive effects of aspirin. Clopidogrel 75 mg/d is the stroke preventive drug of choice in patients with peptic ulcer and coronary artery disease. Co-administration of aspirin and clopidogrel is more effective in stroke prevention but has more hemorrhagic complications. Using warfarin for stroke prevention is suggested only in patients who have facilities for repetitive coagulation tests. Carotid endarterectomy is indicated in symptomatic patients with more than 70% stenosis of extracranial internal carotid artery, if performed only by vascular surgeons experienced in carotid surgery.Conclusion: Many stroke patients are managed by general practitioners and non-neurologists, e.g. internists, cardiologists and neurosurgeons. This review article provides continuous medical education according to Iranian medical curriculum

  3. Maternal and fetal cytomegalovirus infection: diagnosis, management, and prevention [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Robert F. Pass

    2018-03-01

    Full Text Available Congenital cytomegalovirus infection is a major cause of central nervous system and sensory impairments that affect cognition, motor function, hearing, language development, vestibular function, and vision. Although the importance of congenital cytomegalovirus infection is readily evident, the vast majority of maternal and fetal infections are not identified, even in developed countries. Multiple studies of prenatal cytomegalovirus infections have produced a body of knowledge that can inform the clinical approach to suspected or proven maternal and fetal infection. Reliable diagnosis of cytomegalovirus infection during pregnancy and accurate diagnosis of fetal infection are a reality. Approaches to preventing the transmission of cytomegalovirus from mother to fetus and to the treatment of fetal infection are being studied. There is evidence that public health approaches based on hygiene can dramatically reduce the rate of primary maternal cytomegalovirus infections during pregnancy. This review will consider the epidemiology of congenital cytomegalovirus infection, the diagnosis and management of primary infection during pregnancy, and approaches to preventing maternal infection.

  4. Diagnosis System for Diabetic Retinopathy and Glaucoma Screening to Prevent Vision Loss

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    Siva Sundhara Raja DHANUSHKODI

    2014-03-01

    Full Text Available Aim: Diabetic retinopathy (DR and glaucoma are two most common retinal disorders that are major causes of blindness in diabetic patients. DR caused in retinal images due to the damage in retinal blood vessels, which leads to the formation of hemorrhages spread over the entire region of retina. Glaucoma is caused due to hypertension in diabetic patients. Both DR and glaucoma affects the vision loss in diabetic patients. Hence, a computer aided development of diagnosis system for Diabetic retinopathy and Glaucoma screening is proposed in this paper to prevent vision loss. Method: The diagnosis system of DR consists of two stages namely detection and segmentation of fovea and hemorrhages. The diagnosis system of glaucoma screening consists of three stages namely blood vessel segmentation, Extraction of optic disc (OD and optic cup (OC region and determination of rim area between OD and OC. Results: The specificity and accuracy for hemorrhages detection is found to be 98.47% and 98.09% respectively. The accuracy for OD detection is found to be 99.3%. This outperforms state-of-the-art methods. Conclusion: In this paper, the diagnosis system is developed to classify the DR and glaucoma screening in to mild, moderate and severe respectively.

  5. Prenatal diagnosis and prevention of toxoplasmosis in pregnant women in Northern Vietnam: study protocol.

    Science.gov (United States)

    Smit, G Suzanne A; Vu, Thi Lam Binh; Do, Trung Dung; Speybroeck, Niko; Devleesschauwer, Brecht; Padalko, Elizaveta; Roets, Ellen; Dorny, Pierre

    2017-05-25

    In Vietnam, no systematic prenatal toxoplasmosis screening is in place, and only few studies have assessed the prevalence and importance of this zoonotic parasite infection. In addition, no studies have been conducted to assess the risk factors associated with toxoplasmosis. This study protocol was developed to determine the seroprevalence of toxoplasmosis in pregnant women in Hanoi and Thai Binh, Northern Vietnam, and to evaluate the association with risk factors and congenital toxoplasmosis. The protocol was developed in a way that it could potentially evolve into a countrywide prenatal diagnosis and prevention program, with the main focus on primary prevention. The collaborating gynaecologists will invite eligible pregnant women attending antenatal care for the first time to participate in the study. At first consult, information about toxoplasmosis and its prevention will be provided. All participants will be asked to fill in a questionnaire, which is designed to analyse socio-demographic and biologically plausible risk factors associated with toxoplasmosis, and blood samples will be collected to determine the seroprevalence of toxoplasmosis in pregnant women. In case there is suspicion of a primary infection during pregnancy, the concerned women will be followed-up by the gynaecologists according to a predefined protocol. Every participant will be informed on her serological status, risk factors and prevention measures and is offered appropriate medical information and medical follow-up if required. The hypothesis is that congenital toxoplasmosis is an important but currently under-diagnosed public health problem in Vietnam. This study can strengthen sustainable control of toxoplasmosis in Vietnam, provide a protocol for prenatal diagnosis, boost overall awareness, improve the knowledge about toxoplasmosis prevention and can be essential for evidence-based health policy.

  6. Application of nanophotosensitizers (aluminum phthalocyanine nanoparticles) for early diagnosis and prevention of inflammatory diseases

    Science.gov (United States)

    Kuznetsova, J. O.; Makarov, V. I.

    2016-08-01

    This paper deals with a possibility of new types of photosensitizers application - Aluminum Phthalocyanine nanoparticles (nAlPc) in clinical practice for diagnosis, prevention and therapy of inflammatory diseases in dentistry and traumatology. It was detected that the aluminum phthalocyanine (AlPc) fluoresces in the nanoparticle form in the presence of pathologic microflora or inflammation process. It will make possible to detect the local accumulation of pathological microflora on the enamel surface and also for diagnostics and treatment of inflammatory diseases. Experimental studies of interaction of NP-AlPc with tooth enamel and with biological joint tissue at arthrosis are presented.

  7. Application of nanophotosensitizers (aluminum phthalocyanine nanoparticles) for early diagnosis and prevention of inflammatory diseases

    International Nuclear Information System (INIS)

    Kuznetsova, J O; Makarov, V I

    2016-01-01

    This paper deals with a possibility of new types of photosensitizers application - Aluminum Phthalocyanine nanoparticles (nAlPc) in clinical practice for diagnosis, prevention and therapy of inflammatory diseases in dentistry and traumatology. It was detected that the aluminum phthalocyanine (AlPc) fluoresces in the nanoparticle form in the presence of pathologic microflora or inflammation process. It will make possible to detect the local accumulation of pathological microflora on the enamel surface and also for diagnostics and treatment of inflammatory diseases. Experimental studies of interaction of NP-AlPc with tooth enamel and with biological joint tissue at arthrosis are presented. (paper)

  8. Metabolomics in plants and humans: applications in the prevention and diagnosis of diseases.

    Science.gov (United States)

    Gomez-Casati, Diego F; Zanor, Maria I; Busi, María V

    2013-01-01

    In the recent years, there has been an increase in the number of metabolomic approaches used, in parallel with proteomic and functional genomic studies. The wide variety of chemical types of metabolites available has also accelerated the use of different techniques in the investigation of the metabolome. At present, metabolomics is applied to investigate several human diseases, to improve their diagnosis and prevention, and to design better therapeutic strategies. In addition, metabolomic studies are also being carried out in areas such as toxicology and pharmacology, crop breeding, and plant biotechnology. In this review, we emphasize the use and application of metabolomics in human diseases and plant research to improve human health.

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

    Science.gov (United States)

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

    2016-04-26

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

  10. Understanding Cancer Prognosis

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    Full Text Available ... disease will go for you is called prognosis. It can be hard to understand what prognosis means ... prognosis include: The type of cancer and where it is in your body The stage of the ...

  11. [Ischemic origin of diabetic foot disease. Epidemiology, difficulties of diagnosis, options for prevention and revascularization].

    Science.gov (United States)

    Kolossváry, Endre; Bánsághi, Zoltán; Szabó, Gábor Viktor; Járai, Zoltán; Farkas, Katalin

    2017-02-01

    "Diabetic foot" as definition covers a multifactorial clinical condition. According to the recent epidemiological data, the role of lower limb ischemia is getting more influential over other pathological causes, like neuropathy, infections and bone or soft tissue deformity. In diabetes, vascular disease leads to increased risk for leg ulcers and minor or major amputations. The traditional diagnostic tools for recognition of peripheral arterial disease have limited value because of diabetes specific clinical manifestations. Available vascular centers with special expertise and diagnostic tools are the prerequisite for efficient diagnosis supporting timely recognition of peripheral arterial disease. In course of treatment of diabetic foot with ischemic origin, beyond effective medical treatment revascularization (open vascular surgery or endovascular procedures) has paramount importance for prevention of limb loss. Vascular teams of vascular specialists, vascular surgeons and interventional radiologist in dedicated centers in multidisciplinary cooperation with other professions represent public health issue in effective prevention. Orv. Hetil., 2017, 158(6), 203-211.

  12. Preventing the transmission of mitochondrial DNA disorders using prenatal or preimplantation genetic diagnosis.

    Science.gov (United States)

    Smeets, Hubert J M; Sallevelt, Suzanne C E H; Dreesen, Jos C F M; de Die-Smulders, Christine E M; de Coo, Irenaeus F M

    2015-09-01

    Mitochondrial disorders are among the most common inborn errors of metabolism; at least 15% are caused by mitochondrial DNA (mtDNA) mutations, which occur de novo or are maternally inherited. For familial heteroplasmic mtDNA mutations, the mitochondrial bottleneck defines the mtDNA mutation load in offspring, with an often high or unpredictable recurrence risk. Oocyte donation is a safe option to prevent the transmission of mtDNA disease, but the offspring resulting from oocyte donation are genetically related only to the father. Prenatal diagnosis (PND) is technically possible but usually not applicable because of limitations in predicting the phenotype. For de novo mtDNA point mutations, recurrence risks are low and PND can be offered to provide reassurance regarding fetal health. PND is also the best option for female carriers with low-level mutations demonstrating skewing to 0% or 100%. A fairly new option for preventing the transmission of mtDNA diseases is preimplantation genetic diagnosis (PGD), in which embryos with a mutant load below a mutation-specific or general expression threshold of 18% can be transferred. PGD is currently the best reproductive option for familial heteroplasmic mtDNA point mutations. Nuclear genome transfer and genome editing techniques are currently being investigated and might offer additional reproductive options for specific mtDNA disease cases. © 2015 New York Academy of Sciences.

  13. Outcomes of a Cross-Disciplinary Concussion Prevention and Diagnosis Workshop Series

    Directory of Open Access Journals (Sweden)

    Patrick Drane

    2018-02-01

    Full Text Available This paper reports the outcomes of a series of two Concussion Research Workshops held in Lowell, MA, USA. The workshop examined the state-of-the-art in concussion research, research challenges and the future directions of research within the following three core topic areas: (A Concussion Prevention Techniques & Technology, (B Concussion Diagnosis, and (C Treatment of Concussions. Concussions are a form of traumatic brain injury caused by an impact and are a growing concern among athletes and those who are involved with sports. Recent years have led to increasing awareness and research related to concussions with limited definitive understanding of the specific mechanism and pathology. Technology is beginning to take on an important role in the prevention, diagnosis and treatment of concussions. Currently, sensors provide data about the impact and the athlete. However, sensors and better protective equipment can enable an effective monitoring and thus protection of athletes. Only when a more definitive understanding of the injury mechanism is achieved, can sensors and protective equipment design contribute to effective monitoring and protection of athletes.

  14. Survey of physicians' approach to food allergy, Part 2: Allergens, diagnosis, treatment, and prevention.

    Science.gov (United States)

    Wilson, Brian G; Cruz, Narlito V; Fiocchi, Alessandro; Bahna, Sami L

    2008-03-01

    Food allergy (FA) practice varies widely. To report differences between allergists and nonallergists regarding diagnosis, treatment, and prevention of FA. A 2-page questionnaire was mailed to 3,000 allergists and 4,000 nonallergists. We previously published the findings on prevalence and manifestations. Herein, we report the findings on food allergens, diagnosis, treatment, and prevention. Responses were received from 584 (19.5%) of the allergists and 77 (1.9%) of the nonallergists. Because of the nonallergists' low response rate, descriptive comparisons were made without emphasis on statistical significance. Allergists and nonallergists differed in their rankings of the 5 most common food allergens. Nonallergists differed markedly from allergists in the diagnostic methods, using more leukocytotoxic tests (10.9% vs 0.3%), specific IgG4 tests (33.8% vs 6.0%), and intradermal tests (40.0% vs 9.5%), but fewer percutaneous skin tests (44.7% vs 98.9%), specific IgE tests (73.4% vs 97.8%), and challenges (61.1% vs 87.6%). They also differed in their use of open, single-blind, and double-blind challenge tests. Allergists were more likely to rely on elimination of proven food allergens and less likely to use conventional elimination diets, rotation diets, and sublingual or subcutaneous hyposensitization. Allergists were more likely to recommend a diet regimen during pregnancy (76.7% vs 35.3%) and lactation (91.1% vs 72.9%), breastfeeding (93.6% vs 84.3%), hydrolysate formulas (83.5% vs 64.3%), and withholding solids until the age of 6 months (89.4% vs 70.0%). Differences were noted between nonallergists and allergists regarding causes, diagnostic methods, treatment, and prevention of FA, indicating the need for more education in this area.

  15. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy.

    Science.gov (United States)

    Rawlinson, William D; Boppana, Suresh B; Fowler, Karen B; Kimberlin, David W; Lazzarotto, Tiziana; Alain, Sophie; Daly, Kate; Doutré, Sara; Gibson, Laura; Giles, Michelle L; Greenlee, Janelle; Hamilton, Stuart T; Harrison, Gail J; Hui, Lisa; Jones, Cheryl A; Palasanthiran, Pamela; Schleiss, Mark R; Shand, Antonia W; van Zuylen, Wendy J

    2017-06-01

    Congenital cytomegalovirus is the most frequent, yet under-recognised, infectious cause of newborn malformation in developed countries. Despite its clinical and public health importance, questions remain regarding the best diagnostic methods for identifying maternal and neonatal infection, and regarding optimal prevention and therapeutic strategies for infected mothers and neonates. The absence of guidelines impairs global efforts to decrease the effect of congenital cytomegalovirus. Data in the literature suggest that congenital cytomegalovirus infection remains a research priority, but data are yet to be translated into clinical practice. An informal International Congenital Cytomegalovirus Recommendations Group was convened in 2015 to address these questions and to provide recommendations for prevention, diagnosis, and treatment. On the basis of consensus discussions and a review of the literature, we do not support universal screening of mothers and the routine use of cytomegalovirus immunoglobulin for prophylaxis or treatment of infected mothers. However, treatment guidelines for infected neonates were recommended. Consideration must be given to universal neonatal screening for cytomegalovirus to facilitate early detection and intervention for sensorineural hearing loss and developmental delay, where appropriate. The group agreed that education and prevention strategies for mothers were beneficial, and that recommendations will need continual updating as further data become available. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Significance of diagnosis of liver metastases from colorectal cancer by angio helical CT and intermittent hepatic arterial infusion chemotherapy after hepatic resection in terms of prognosis

    International Nuclear Information System (INIS)

    Hatsuse, Kazuo; Aoki, Hideki; Murayama, Michinori

    1997-01-01

    Seventy five cases had undergone hepatic resection for liver metastases from colorectal cancer from 1979 to 1994. Computed tomography during hepatic angiography (angio CT) was tried in 27 cases. At first, we compared detection ratios of angio CT for liver metastase to those of ultrasonography, conventional CT, and operative ultrasonography on these 27 cases. Next, the prognosis of seventy five cases was examined. They were divided into three groups; the HX group 29 cases with only hepatic resection; the HX+AP group of 19 cases with intermittent hepatic arterial infusion chemotherapy after hepatic resection; the angio CT group of 27 cases selected for hepatic resection by angio CT, followed by the same infusion chemotherapy as that given to the HX+AP group. Fifty metastases were diagnosed histopathologically in twenty seven cases that underwent hepatic resection after angio CT. Detection ratios for small metastases 1.0 cm or smaller in diameter were 8.3% with ultrasonography, 25% with CT, 75% with angio CT, and 50% with operative ultrasonography. Detection ratios of angio CT were superior to those of ultrasonography and CT. Recurrence rates of the remnant liver were significantly low and survival rates were significantly superior in the angio CT group compared to the other two groups (p<0.02). The prognosis with and without intermittent hepatic arterial infusion chemotherapy after hepatic resection were significantly different (p<0.03). The above data suggest that improvement of detection ratios for liver metastases by angio CT, and probably concomitant intermittent hepatic infusion chemotherapy contribute to decreased remnant liver recurrence and an increased survival rate. (author)

  17. SGLT2 Inhibitor-associated Diabetic Ketoacidosis: Clinical Review and Recommendations for Prevention and Diagnosis.

    Science.gov (United States)

    Goldenberg, Ronald M; Berard, Lori D; Cheng, Alice Y Y; Gilbert, Jeremy D; Verma, Subodh; Woo, Vincent C; Yale, Jean-François

    2016-12-01

    Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the newest class of antihyperglycemic agents available on the market. Regulator warnings and concerns regarding the risk of developing diabetic ketoacidosis (DKA), however, have dampened enthusiasm for the class despite the combined glycemic, blood pressure, and occasional weight benefits of SGLT2 inhibitors. With the goal of improving patient safety, a cross-Canada expert panel and writing group were convened to review the evidence to-date on reported SGLT2 inhibitor-related DKA incidents and to offer recommendations for preventing and recognizing patients with SGLT2 inhibitor-associated DKA. Reports covering DKA events in subjects taking SGLT2 inhibitors that were published in PubMed, presented at professional conferences, or in the public domain from January 2013 to mid-August 2016 were reviewed by the group independently and collectively. Practical recommendations for diagnosis and prevention were established by the panel. DKA is rarely associated with SGLT2 inhibitor therapy. Patients with SGLT2 inhibitor-associated DKA may be euglycemic (plasma glucose level SGLT2 inhibitor-associated DKA may be prevented by withholding SGLT2 inhibitors when precipitants develop, avoiding insulin omission or inappropriate insulin dose reduction, and by following sick day protocols as recommended. Preventive strategies should help avoid SGLT2 inhibitor-associated DKA. All SGLT2 inhibitor-treated patients presenting with signs or symptoms of DKA should be suspected to have DKA and be investigated for DKA, especially euglycemic patients. If DKA is diagnosed, SGLT2 inhibitor treatment should be stopped, and the DKA should be treated with a traditional treatment protocol. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  18. Latent M. tuberculosis infection--pathogenesis, diagnosis, treatment and prevention strategies.

    Science.gov (United States)

    Druszczyńska, Magdalena; Kowalewicz-Kulbat, Magdalena; Fol, Marek; Włodarczyk, Marcin; Rudnicka, Wiesława

    2012-01-01

    One third of the earths population is infected with Mycobacterium tuberculosis (Mtb), but only 5-10% of the infected individuals develop active tuberculosis (TB) over their lifetime. The remaining 90-95% stay healthy and are called latently infected individuals. They are the biggest reservoir of the tubercle bacilli and identifying the cases of latent TB is a part of the global plan of TB control. From the clinical point of view detection of latent TB infections (LTBI) in individuals with the highest active TB risk including cases of HIV infection, autoimmune inflammatory diseases or cancer, is a priority. This review summarizes the recent findings in the pathogenesis of latent TB, its diagnosis, treatment and prevention.

  19. Enhancing quality practice for prevention and diagnosis of urinary tract infection during inpatient spinal cord rehabilitation.

    Science.gov (United States)

    Alavinia, Seyed Mohammad; Omidvar, Maryam; Farahani, Farnoosh; Bayley, Mark; Zee, Joana; Craven, Beverley Catharine

    2017-11-01

    To reduce the incidence of Urinary Tract Infection (UTI) in subacute SCI individuals admitted for tertiary inpatient rehabilitation. A quality improvement team was assembled to improve UTI prevention/diagnosis. To plan data collection, UTI-related factors were mapped in an Ishikawa (fishbone) driver diagram. Data including patient demographics, presence and frequency of signs and/or symptoms of UTI and antibiotic initiation from August to December 2015 were recorded. Sensitivity, Specificity, Positive and Negative Predictive Values (PPV, NPV), and Likelihood Ratios (LR) were calculated for each sign and symptom. Tertiary SCI Rehabilitation Results: Among 55 inpatients with subacute SCI who had signs/symptoms prompting urine culture and sensitivity (C&S), 32 (58.18%) were diagnosed with a UTI. The most frequent symptoms were foul smelling urine (41%), change in urine color (31%), and incontinence (25%), and the most common sign was fever (34%). Most UTIs (81%) occurred among individuals using Clean Intermittent Catheterization (CIC), with 46% of catheterizations performed by nurses. Foul smelling urine had the highest sensitivity (0.50, 95% CI: 0.31-0.69), and new incontinence had the highest specificity (0.88, 95% CI: 0.69-0.97) for UTI diagnosis. The highest PPV belonged to the cloudy urine (0.71, 95% CI: 0.42-0.92). The combination of cloudy and foul smelling urine increased the PPV to 78% (95% CI: (0.40-0.97). The concurrent presence of cloudy and foul smelling urine is predicted of UTI diagnosis inpatients tertiary setting. SCI inpatients are susceptible to UTI when learning CIC technique from nurses.

  20. The Role of Environmental Design in Cancer Prevention, Diagnosis, Treatment, and Survivorship: A Systematic Literature Review.

    Science.gov (United States)

    Gharaveis, Arsalan; Kazem-Zadeh, Mahshad

    2018-01-01

    The purpose of this literature review is to provide a better understanding of the impact that environmental design can have on the process of cancer prevention, diagnosis, treatment, and survivorship. Cancer is considered a chronic disease in the United States, and more than 1.6 million new cases are diagnosed annually. New strategies of cancer care propose patient-centered services to achieve the best outcome, and researchers have found that environmental design can be an important part of improving this care. Searches were conducted in the PubMed and Google Scholar databases as well as in specific healthcare design journals such as Health Environments Research & Design, Environmental Psychology, and Environment and Behavior. The criteria for articles included in the review were (a) English-language articles related to facility design, which addressed (b) the topics of built environment in relation to cancer diagnosis, treatment, and survivorship, and were (c) published in peer-reviewed journals between 2000 and 2017. Finally, 10 articles were selected, and the contents were analyzed. The selected articles demonstrate that environmental design is one of the critical factors for success throughout the whole continuum of cancer care from diagnosis to end-of-treatment. Some of the specific conclusions from the review are that "neighborhood-oriented" design strategies can be beneficial (by providing accessibility to all facilities along the patient's path), that access to nature for patients, staff, and visitors alike is associated with better outcomes, and that provisions for natural lighting and noise reduction are associated with cancer patients' well-being.

  1. Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis - 2018 update.

    Science.gov (United States)

    Rodrigues, A M; Canhão, H; Marques, A; Ambrósio, C; Borges, J; Coelho, P; Costa, L; Fernandes, S; Gonçalves, I; Gonçalves, M; Guerra, M; Marques, M L; Pimenta, S; Pinto, P; Sequeira, G; Simões, E; Teixeira, L; Vaz, C; Vieira-Sousa, E; Vieira, R; Alvarenga, F; Araújo, F; Barcelos, A; Barcelos, F; Barros, R; Bernardes, M; Canas da Silva, J; Cordeiro, A; Costa, M; Cunha-Miranda, L; Cruz, M; Duarte, A C; Duarte, C; Faustino, A; Figueiredo, G; Fonseca, J E; Furtado, C; Gomes, J; Lopes, C; Mourão, A F; Oliveira, M; Pimentel-Santos, F M; Ribeiro, A; Sampaio da Nóvoa, T; Santiago, M; Silva, C; Silva-Dinis, A; Sousa, S; Tavares-Costa, J; Terroso, G; Vilar, A; Branco, J C; Tavares, V; Romeu, J C; da Silva, Jap

    2018-01-01

    Advances in osteoporosis (OP)case definition, treatment options, optimal therapy duration and pharmacoeconomic evidence in the national context motivated the Portuguese Society of Rheumatology (SPR) to update the Portuguese recommendations for the diagnosis and management of osteoporosis published in 2007. SPR bone diseases' working group organized meetings involving 55 participants (rheumatologists, rheumatology fellows and one OP specialist nurse) to debate and develop the document. First, the working group selected 11 pertinent clinical questions for the diagnosis and management of osteoporosis in standard clinical practice. Then, each question was investigated through literature review and draft recommendations were built through consensus. When insufficient evidence was available, recommendations were based on experts' opinion and on good clinical practice. At two national meetings, the recommendations were discussed and updated. A draft of the recommendations full text was submitted to critical review among the working group and suggestions were incorporated. A final version was circulated among all Portuguese rheumatologists before publication and the level of agreement was anonymously assessed using an online survey. The 2018 SPR recommendations provide comprehensive guidance on osteoporosis prevention, diagnosis, fracture risk assessment, pharmacological treatment initiation, therapy options and duration of treatment, based on the best available evidence. They attained desirable agreement among Portuguese rheumatologists. As more evidence becomes available, periodic revisions will be performed. Target audience and patient population: The target audience for these guidelines includes all clinicians. The target patient population includes adult Portuguese people. Intended use: These recommendations provide general guidance for typical cases. They may not be appropriate in all situations - clinicians are encouraged to consider this information together with

  2. Focus on prevention, diagnosis and treatment of hypertension in children and adolescents

    Science.gov (United States)

    2013-01-01

    The European Society of Hypertension has recently published its recommendations on prevention, diagnosis and treatment of high blood pressure in children and adolescents. Taking this contribution as a starting point the Study Group of Hypertension of the Italian Society of Pediatrics together with the Italian Society of Hypertension has conducted a reappraisal of the most recent literature on this subject. The present review does not claim to be an exhaustive description of hypertension in the pediatric population but intends to provide Pediatricians with practical and updated indications in order to guide them in this often unappreciated problem. This document pays particular attention to the primary hypertension which represents a growing problem in children and adolescents. Subjects at elevated risk of hypertension are those overweight, with low birth weight and presenting a family history of hypertension. However, also children who do not present these risk factors may have elevated blood pressure levels. In pediatric age diagnosis of hypertension or high normal blood pressure is made with repeated office blood pressure measurements that show values exceeding the reference values. Blood pressure should be monitored at least once a year with adequate methods and instrumentation and the observed values have to be interpreted according to the most updated nomograms that are adjusted for children’s gender, age and height. Currently other available methods such as ambulatory blood pressure monitoring and home blood pressure measurement are not yet adequately validated for use as diagnostic instruments. To diagnose primary hypertension it is necessary to exclude secondary forms. The probability of facing a secondary form of hypertension is inversely proportional to the child’s age and directly proportional to blood pressure levels. Medical history, clinical data and blood tests may guide the differential diagnosis of primary versus secondary forms. The prevention

  3. Primary prevention of hemoglobinopathies by prenatal diagnosis and selective pregnancy termination in a Muslim country: Oman

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    Suha Mustafa Hassan

    2014-11-01

    Full Text Available Hemoglobinopathies (HBP are the most common genetic disorder in Oman and are in need of prevention programs due to the high incidence of β-thalassemia major and sickle cell disease. Prenatal diagnosis (PD and selective pregnancy termination is shown to be the most effective prevention tool for the control of HBP. However, PD is not available in Oman thus far because abortion is subject to religious, cultural and ethical issues. We have examined the attitude of a number of Omani HBP carrier couples towards prenatal diagnosis and selective abortion. We have interviewed 35 couples at risk visiting the main premarital clinic in Muscat between Jan 2011 and Jan 2012. Couples were interviewed using a pre-structured questionnaire. The majority would have accepted prenatal diagnosis (94% if the service would be available in the country but pregnancy termination was greatly influenced by religious values. 血红蛋白病(HBP)是一种在阿曼最常见的遗传性疾病,由于其高发的B型地中海贫血症及镰状细胞症,相关的预防措施对于这一国家来说,相当重要。产前诊断(PD)和选择性终止妊娠被证实是针对管控血红蛋白病(HBP)的最有效方法。然而,由于受到宗教、文化和伦理抵制堕胎的影响,产前诊断(PD)并不能在该国得以应用。我们对该国一部分血红蛋白病患夫妇做了一项关于产前诊断的意向调查。2011年一月至2012年一月,我们在马斯喀特(阿曼首都)的一家婚前诊所对35对夫妇做了相关的采访调查。调查的问卷是事先设置好的。大部分(94%)夫妇表示接受产前诊断如果相应的措施能得到广泛的普及,但是他们对于选择性终止妊娠的态度受到了其宗教价值观的极大影响。

  4. A population based study of variations in operation rates for breast cancer, of comorbidity and prognosis at diagnosis: failure to operate for early breast cancer in older women.

    Science.gov (United States)

    Bates, T; Evans, T; Lagord, C; Monypenny, I; Kearins, O; Lawrence, G

    2014-10-01

    Older women are less likely to have surgery for operable breast cancer. This population-based study examines operation rates by age and identifies groups which present with early or late disease. 37 000 cancer registrations for 2007 were combined with Hospital Episode Statistics comorbidity data for England. Operation rates were examined by age, ethnicity, deprivation, comorbidity, screen-detection, tumour size, grade and nodal status. Early and late presentation were correlated with Nottingham Prognostic Index (NPI) groups and tumour size. The proportion of women not having surgery increased from 7-10% at ages 35-69 to 82% from age 90. From age 70, the proportion not having surgery rose by an average of 3.1% per year of age. Women with a Charlson Comorbidity Index score of ≥1 (which increased with age), with tumours >50 mm or who were node positive, were less likely to have surgery. Although women aged 70-79 were more likely to have larger tumours, their tumours were also more likely to have an excellent or good NPI (p ethnic groups (p ethnic groups presented with more advanced tumours. Older women had larger tumours which were otherwise of good prognosis, and this would not account for the failure to operate which may in part be related to comorbidity in this age group. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Comparison of computed tomography and endoscopy in the diagnosis and grading of esophageal varices; value of computed tomography for predict prognosis of chronic liver disease

    International Nuclear Information System (INIS)

    Ko, Gi Young; Park, Cheol Min; Lee, Jin Seong; Hyun, Chang Dong; Lee, Moon Gyu; Auh, Yong Ho; Kim, Hae Ryun

    1996-01-01

    To evaluate the sensitivity and specificity of conventional CT of abdomen in the detection of esophageal varices, and to correlate CT grade of esophageal varices with prognosis and risk for bleeding. Both CT and endoscopy were performed in 100 patients. Endoscopy revealed that while 54 patients had varices, 46 did not. CT criteria of variceal grading were follows;(1) wallthickening of more than 5 mm or irregular wall contour(grade 1):(2) intraluminal protruding tubular structures with contrast enhancement(grade II);(3) confluent varices in the wall of esophagus or multiplied paraesophageal collaterals(gradeIII). CT were reviewed by three radiologists without reference to clinical and endoscopic data. Sensitivity and specificity of CT in the detection of esophageal varices were 80%, retrospectively. CT and endoscopic grades agreed with each other in 68% of patients, and there was high correlation between CT and endoscopy. (Gamma statistics, p=0.828). No history or endoscopic evidence of variceal bleeding was present on grade I, but there was a high incidence on grade II(35%) and on grade III(50%)(MH Chi-Square, Ridit scores=50.561, p=0.000). Abdominal CT is useful in the detection of esophageal varices, and can predict the risk factors of bleeding in patients with chronic liver diseases

  6. The biology, prevention, diagnosis and treatment of dental caries: scientific advances in the United States.

    Science.gov (United States)

    Zero, Domenick T; Fontana, Margherita; Martínez-Mier, E Angeles; Ferreira-Zandoná, Andréa; Ando, Masatoshi; González-Cabezas, Carlos; Bayne, Stephen

    2009-09-01

    Scientific advances in cariology in the past 150 years have led to the understanding that dental caries is a chronic, dietomicrobial, site-specific disease caused by a shift from protective factors favoring tooth remineralization to destructive factors leading to demineralization. Epidemiologic data indicate that caries has changed in the last century; it now is distributed unequally in the U.S. population. People who are minorities, homeless, migrants, children with disabilities and of lower socioeconomic status suffer from the highest prevalence and severity of dental caries. Scientific advances have led to improvements in the prevention, diagnosis and treatment of dental caries, but there is a need for new diagnostic tools and treatment methods. and Future management of dental caries requires early detection and risk assessment if the profession is to achieve timely and cost-effective prevention and treatment for those who need it most. Dental professionals look forward to the day when people of all ages and backgrounds view dental caries as a disease of the past.

  7. Technology for Diagnosis, Treatment, and Prevention of Cardiometabolic Disease in India.

    Science.gov (United States)

    Hameed, Safraj Shahul; Rawal, Ishita; Soni, Deepa; Ajay, Vamadevan S; Goenka, Shifalika; Prabhakaran, Dorairaj

    2016-01-01

    Cardiometabolic diseases (CMD) are a major cause of mortality, morbidity and disability worldwide. Among Indians, CMD onset is at a much younger age and is prevalent in all sections of the society. Prevention, control and management of CMD and its risk factors is a major public health challenge, and alternative approaches need to be explored and integrated into public health programs. Advancements in the fields of computers, electronics, telecommunication and medicine have resulted in the rapid development of health-related technology. In this paper we provide an overview of the major technological advances in diagnosis, treatment and prevention within the field of CMD in the last few decades. This non-exhaustive review focuses on the most promising technologies that the authors feel might be of relevance in the Indian context. Some of the techniques detailed include advances in imaging and mobile phone technology, surgical techniques, electronic health records, Nano medicine, telemedicine and decision support systems. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Congenital cytomegalovirus infection in pregnancy: a review of prevalence, clinical features, diagnosis and prevention.

    Science.gov (United States)

    Naing, Zin W; Scott, Gillian M; Shand, Antonia; Hamilton, Stuart T; van Zuylen, Wendy J; Basha, James; Hall, Beverly; Craig, Maria E; Rawlinson, William D

    2016-02-01

    Human cytomegalovirus (CMV) is under-recognised, despite being the leading infectious cause of congenital malformation, affecting ~0.3% of Australian live births. Approximately 11% of infants born with congenital CMV infection are symptomatic, resulting in clinical manifestations, including jaundice, hepatosplenomegaly, petechiae, microcephaly, intrauterine growth restriction and death. Congenital CMV infection may cause severe long-term sequelae, including progressive sensorineural hearing loss and developmental delay in 40-58% of symptomatic neonates, and ~14% of initially asymptomatic infected neonates. Up to 50% of maternal CMV infections have nonspecific clinical manifestations, and most remain undetected unless specific serological testing is undertaken. The combination of serology tests for CMV-specific IgM, IgG and IgG avidity provide improved distinction between primary and secondary maternal infections. In pregnancies with confirmed primary maternal CMV infection, amniocentesis with CMV-PCR performed on amniotic fluid, undertaken after 21-22 weeks gestation, may determine whether maternofetal virus transmission has occurred. Ultrasound and, to a lesser extent, magnetic resonance imaging are valuable tools to assess fetal structural and growth abnormalities, although the absence of fetal abnormalities does not exclude fetal damage. Diagnosis of congenital CMV infection at birth or in the first 3 weeks of an infant's life is crucial, as this should prompt interventions for prevention of delayed-onset hearing loss and neurodevelopmental delay in affected infants. Prevention strategies should also target mothers because increased awareness and hygiene measures may reduce maternal infection. Recognition of the importance of CMV in pregnancy and in neonates is increasingly needed, particularly as therapeutic and preventive interventions expand for this serious problem. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  9. Contribution of magnetic resonance imaging to the diagnosis and prognosis of Marchiafava-Bignami disease. Report of a case with a favorable outcome

    International Nuclear Information System (INIS)

    Martinez, J.Y.; Vincenti Rouquette, I.; Debourdeau, P.; Saissy, J.M.

    1997-01-01

    A patient with a history of chronic alcohol abuse and metal disorders developed a coma due to Marchiafava-Bignami disease. A computed tomography study of the brain was normal, whereas magnetic resonance imaging disclosed a solitary circumscribed lesion in the middle part of the corpus callosum, generating a hypointense signal on T1 images and a hyperintense signal on T2 images. The outcome was favorable. A previous magnetic resonance imaging study done after the onset of the mental disorders was normal, supporting a diagnosis of acute regressive rather than mixed Marchiafava-Bignami disease. (authors)

  10. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... treatments being used today. Still, your doctor may tell you that you have a good prognosis if ... to respond well to treatment. Or, he may tell you that you have a poor prognosis if ...

  11. Understanding Your Cancer Prognosis

    Science.gov (United States)

    Understanding Your Cancer Prognosis is the main video in the NCI Prognosis Video Series, which offers the perspectives of three cancer patients and their doctor, an oncologist who is also a national expert in doctor-patient communication.

  12. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... doctor may tell you that you have a good prognosis if statistics suggest that your cancer is ... about how to discuss prognosis with their patients. Good communication, he says, is part of providing good ...

  13. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Understanding Cancer Prognosis Oncologist Anthony L. Back, M.D., a national expert on doctor-patient communications, talks with one of his patients about what she'd like to know of her prognosis. Credit: National ...

  14. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... your situation is in the best position to discuss your prognosis and explain what the statistics may ... situation best is in the best position to discuss your prognosis. Survival statistics most often come from ...

  15. PECULIARITIES OF ARTERIAL HYPERTENSION DIAGNOSIS AND SECONDARY PREVENTION ACCORDING TO PHYSICIANS INTERVIEWING

    Directory of Open Access Journals (Sweden)

    N. S. Oganisyan

    2006-01-01

    Full Text Available Aim. To reveal peculiarities of arterial hypertension (AH diagnosis and therapy and their matching with international and national guidelines on AH. Material and Methods. An interview among Moscow physicians dealing with hypertensive patients was conducted in April-June 2005. Interview was taken with specially worked out forms containing 15 questions about hypertensive patient management. 102 physicians took part in interviewing, among them 65 internists and 37 cardiologists. Among interviewed physicians 56 ones were from outpatient clinics, 19 - from diagnostic centers, 14 - from hospitals, 5 - from commercial medical centers, 4 - from research center and 3 physicians had private practice.  Results. 80,4% of interviewed physicians correctly determined the main goals of AH therapy. 16% of doctors did not indicate blood pressure level below 140/90 mm Hg as target level of secondary prevention. Mainly antihypertensive therapy was presented by four classes of medicines, their shares were as follow: ACE inhibitors - 35%, beta-blockers – 28%, diuretics – 26% and calcium antagonists – 10%. Other classes of antihypertensive medicines (antagonists of angiotensin-II receptors, central acting medicines made about 1% of share. When choosing original medicine among several suggested trade marks, only 22% of doctors defined the medicine correctly. Original medicines made only 29,4% prescriptions in real medical practice. Conclusion. Real practice of AH diagnosis and therapy considerably differs from international and national guidelines on AH. It is possibly related with lack of appropriate knowledge among physicians as well as problems in public health service.   

  16. Long-Term Clinical Outcomes and Factors That Predict Poor Prognosis in Athletes After a Diagnosis of Acute Spondylolysis: A Retrospective Review With Telephone Follow-up.

    Science.gov (United States)

    Selhorst, Mitchell; Fischer, Anastasia; Graft, Kristine; Ravindran, Reno; Peters, Eric; Rodenberg, Richard; MacDonald, James

    2016-12-01

    Study Design Retrospective review with telephone follow-up. Background Acute spondylolytic injuries have a dramatic impact on the young athlete. Excellent short-term clinical outcomes have been observed, but not enough is known about long-term clinical outcomes. Objectives (1) To report long-term clinical outcomes for patients diagnosed with acute spondylolysis, and (2) to assess the prognostic ability of retrospective variables for long-term outcomes. Methods Patients from 2010 through 2013 were retrospectively reviewed to identify patients and to obtain demographic, baseline, and short-term outcomes. Long-term follow-up data were collected by telephone from patients diagnosed with acute spondylolysis to assess recurrence rate of low back pain, perceived outcome, pain, and functional ability. Patients were categorized as having a good or poor long-term outcome based on these measures. Logistic regression analysis was performed to assess the prognostic ability of the retrospective variables for long-term outcomes 3.4 years (range, 1.5-5.6 years) after treatment. Results One hundred twenty-one (71.6%) patients completed the follow-up questionnaire (48 female; mean age at baseline, 14.4 years). At follow-up, 81 (66.9%) patients were able to maintain their same or a higher level of sport. Recurrence of significant symptoms was reported by 55 (45.5%) patients, with 41 (33.9%) requiring medical treatment. The final logistic regression model revealed that female sex, adverse reaction during care, and multilevel injury were significant predictors of poor long-term outcome (R 2 = 0.22). Conclusion Although excellent short-term outcomes were noted, 42% of patients reported a poor outcome at long-term follow-up. Female sex, multilevel injury, and experiencing an adverse reaction during care were significant predictors of poor long-term clinical outcome for patients diagnosed with acute spondylolysis. Level of Evidence Prognosis, level 4. Registered January 15, 2015 at www

  17. [POP-Q indication points, Aa and Ba, involve in diagnosis and prognosis of occult stress urinary incontinence complicated with pelvic organ prolapse].

    Science.gov (United States)

    Liu, Cheng; Wu, Wenying; Yang, Qing; Hu, Ming; Zhao, Yang; Hong, Li

    2015-06-01

    To investigate the correlation between pelvic organ prolapse quantitation (POP-Q) indication points and the incidence of occult stress urinary incontinence (OSUI) and its impact on prognosis. Retrospective study medical records of 93 patients with pelvic organ prolapse (POP) staged at III-IV, of which underwent pelvic reconstruction operations with Prolift system from Jan. 2007 to Sept. 2012. None of these patients had clinical manifestations of stress urinary incontinence (SUI) before surgery, and in which 44 patients were included in study group (POP complicated with OSUI) because they were identified with OSUI, another 49 patients as control group (simple POP). Follow-up and collecting datas including POP-Q, stress test, urodynamic recordings, incidence of de novo SUI, statistic analyzing by logistic regression and receiver operating characteristic curve (ROC). (1) The study group had a much higher incidence of 30% (13/44) on de novo SUI than that of control group (4%, 2/49; P < 0.01). (2) Vaginal delivery (OR = 5.327, 95% CI: 1.120-25.347), constipation (OR = 5.789, 95% CI: 1.492-22.459), preoperative OSUI (OR = 13.695, 95% CI: 2.980-62.944), anterior vaginal wall prolapse (OR = 6.115, 95% CI: 1.231-30.379) were identified as dependent risk factors for de novo SUI by logistic regression analysis. (3) For POP patients that complicated with OSUI, we chose a cutoff value of +1.5 cm for Aa point as the threshold to predicting incidence of de novo SUI according to ROC curve, area under the curve (AUC) was 0.889 (P < 0.05), the sensitivity reached 88.9% and specificity was 73.9%. According to ROC curve of Ba point, a cutoff value of +2.5 cm was chosen as the threshold to predicting incidence of de novo SUI post-operation, it had a sensitivity of 66.7% and specificity of 82.6%, AUC was 0.766 (P < 0.05). Pre-operative OSUI is a dependent risk factor of de novo SUI for advanced POP patients. Aa and Ba points are correlated with preoperative OSUI, and it is worthy to be

  18. O médico frente ao diagnóstico e prognóstico do câncer avançado The physician when facing diagnosis and prognosis of advanced cancer

    Directory of Open Access Journals (Sweden)

    Etelvino de Souza Trindade

    2007-02-01

    Full Text Available OBJETIVO: Avaliar a postura de médicos frente à informação do diagnóstico e prognóstico de câncer aos pacientes, familiares ou ambos, incluindo uma análise bioética do conflito verificado entre beneficência, respeito à autonomia do paciente e paternalismo. MÉTODOS: Foram entrevistados 38 médicos responsáveis por pacientes com neoplasias malignas em um hospital terciário. O questionário foi dividido em duas partes. Uma com dados gerais do entrevistado e outra com perguntas específicas sobre a transmissão das informações ao paciente e também avaliação da compreensão do médico sobre beneficência. RESULTADOS: Embora 97,4% dos médicos em geral informem o diagnóstico aos seus pacientes, nos casos de doença terminal, 50% se valem da família como apoio. Com relação à informação sobre prognóstico fatal, os que comunicam somente à família foram 63,1%, enquanto 31,6% preferem passar a informação diretamente ao paciente. O estudo mostrou que os profissionais confundem beneficência com paternalismo. CONCLUSÃO: Os médicos têm o hábito de informar o diagnóstico aos seus pacientes. Na impossibilidade de recursos curativos, as atitudes tornam-se conflitantes no que concerne aos princípios da beneficência e autonomia. O número de médicos que acreditam no paternalismo como forma de beneficência é ainda significativo. A atitude paternalista emerge principalmente quando os recursos terapêuticos tornam-se não resolutivos.Biotechnological scientific progress has brought about some misunderstanding between advances and ethical decisions. The relationship physician-patient when facing seriously ill patients has been altered. OBJECTIVE: To evaluate the physician's attitude when facing disclosure to patient, family or both of cancer diagnosis and prognosis including also a bioethical analysis about the conflicts between beneficence, respect for patient autonomy and paternalism. METHODS: Thirty-eight physicians

  19. Role of diagnosis of dyslipidemia in primary and secondary vascular prevention in a neurology department.

    Science.gov (United States)

    Horváth, Eszter; Vadasdi, Károly; Vastagh, Ildikó; Folyovich, András

    2010-03-30

    Lipids have important functions in the human body, but high serum cholesterol level is an important risk factor for cardiovascular and cerebrovascular diseases. Prevention of stroke includes modifying risk factors, like dyslipidemias. Based on this theory, we examined in practice the possible role of a public care neurology and stroke department with a large patient turnover in vascular risk screening with regard to the diagnosis of hyperlipidemia. We reviewed all the medical records (irrespective of disease group;) of patients hospitalized in 2007 at Department of Neurclogy and Stroke Center of Szent János Hospital of the Municipality of the City of Budapest. Patients included in the study were classified into three groups: (1) those admitted with acute stroke; (2) those with a history of acute stroke, but without evidence of a novel cerebrovascular event; (3) no history and evidence of cerebrovascular disease during hospitalization. Our data show that 17.6% of patients was diagnosed with hyperlipidemia during hospital care, and another 18.5% was known to have elevated cholesterol levels. Altogether, 36.1% of the 1438 patients evaluated had hyper ipidemia. Known hypercholesterolemia was 18.4% in patierts admitted for acute stroke, 26.9% in patients formerly (but not currently) treated for cerebrovascular disease, and 13.6% in the third group. Newly diagnosed elevated cholesterol levels had highest rate (22.6%) in former stroke patierts (currently treated for other diseases); 20.4% in patients with acute stroke, and 13.2% in the third group. In the first two groups, the number of patients newly diagnosed with elevated serum cholesterol almost equaled to those with already known hypercholesterolemia. Based on our data, neurology departments have an important role in diagnosing hyperlipidemia and vascular prevention.

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

    Science.gov (United States)

    Testi, D; Nardone, M; Melone, P; Cardelli, P; Ottria, L; Arcuri, C

    2015-01-01

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

  1. Finger tapping and verbal fluency post-tap test improvement in INPH: its value in differential diagnosis and shunt-treatment outcomes prognosis.

    Science.gov (United States)

    Liouta, Evangelia; Gatzonis, Stylianos; Kalamatianos, Theodosis; Kalyvas, Aristotelis; Koutsarnakis, Christos; Liakos, Faidon; Anagnostopoulos, Christos; Komaitis, Spyridon; Giakoumettis, Dimitris; Stranjalis, George

    2017-12-01

    Idiopathic normal pressure hydrocephalus (INPH) diagnosis is challenging as it can be mimicked by other neurological conditions, such as neurodegenerative dementia and motor syndromes. Additionally, outcomes after lumbar puncture (LP) tap test and shunt treatment may vary due to the lack of a common protocol in INPH assessment. The present study aimed to assess whether a post-LP test amelioration of frontal cognitive dysfunctions, characterizing this syndrome, can differentiate INPH from similar neurological conditions and whether this improvement can predict INPH post-shunt outcomes. Seventy-one consecutive patients referred for INPH suspicion and LP testing, were enrolled. According to the consensus guidelines criteria, 29 patients were diagnosed as INPH and 42 were assigned an alternative diagnosis (INPH-like group) after reviewing clinical, neuropsychological and imaging data, and before LP results. A comprehensive neuropsychological assessment for frontal executive, upper extremity fine motor functions, aphasias, apraxias, agnosias and gait evaluation were administered at baseline. Executive, fine motor functions and gait were re-examined post-LP test in all patients and post-shunt placement in INPH patients. Of the INPH patients, 86.2% showed cognitive amelioration in the post-LP test; in addition, all but one (97%) presented with neurocognitive and gait improvement post-shunt. Verbal phonological fluency and finger tapping task post-LP improvement predicted positive clinical outcome post-shunt. None of the INPH-like group presented with neurocognitive improvement post-LP. Post-LP amelioration of verbal fluency and finger tapping deficits can differentiate INPH from similar disorders and predict positive post-shunt clinical outcome in INPH. This becomes of great importance when gait assessment is difficult to perform in clinical practice.

  2. The utility of the macro-aggregated albumin lung perfusion scan in the diagnosis and prognosis of hepatopulmonary syndrome in cirrhotic patients candidates for liver transplantation

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    Israel Grilo

    Full Text Available Background: The macro-aggregated albumin lung perfusion scan (99mTc-MAA is a diagnostic method for hepatopulmonary syndrome (HPS. Aim: To determine the sensitivity of 99mTc-MAA in diagnosing HPS, to establish the utility of 99mTc-MAA in determining the influence of HPS on hypoxemia in patients with concomitant pulmonary disease and to determine the correlation between 99mTc-MAA values and other respiratory parameters. Methods: Data from 115 cirrhotic patients who were eligible for liver transplantation (LT were prospectively analyzed. A transthoracic contrast echocardiography and 99mTc-MAA were performed in 85 patients, and 74 patients were diagnosed with HPS. Results: The overall sensitivity of 99mTc-MAA for the diagnosis of HPS was 18.9% (14/74 in all of the HPS cases and 66.7% (4/6 in the severe to very severe cases. In HPS patients who did not have lung disease, the degree of brain uptake of 99mTc-MAA was correlated with the alveolar-arterial oxygen gradient (A-a PO2 (r = 0.32, p < 0.05 and estimated oxygen shunt (r = 0.41, p < 0.05 and inversely correlated with partial pressure of arterial oxygen (PaO2 while breathing 100% O2 (r = -0.43, p < 0.05. The 99mTc-MAA was positive in 20.6% (7/36 of the patients with HPS and lung disease. The brain uptake of 99mTc-MAA was not associated with mortality and normalized in all cases six months after LT. Conclusions: The 99mTc-MAA is a low sensitivity test for the diagnosis of HPS that can be useful in patients who have concomitant lung disease and in severe to very severe cases of HPS. It was not related to mortality, and brain uptake normalized after LT.

  3. 8C.01: SFLT-1 AND PLGF MEASUREMENTS AND THEIR RATIO FOR THE DIAGNOSIS AND PROGNOSIS OF PREECLAMPSIA IN A HIGH-RISK COHORT.

    Science.gov (United States)

    Saleh, L; Verdonk, K; Danser, A H J; Steegers, E A P; Russcher, H; van den Meiracker, A H; Visser, W

    2015-06-01

    The soluble Fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio has been introduced as a biomarker for diagnosing preeclampsia (PE) and the prediction of adverse pregnancy outcome. In a cohort of pregnant women with PE or at high risk of PE, the additive value of the sFlt-1/PlGF ratio for diagnosing PE and prediction of adverse pregnancy outcomes was investigated. From September 2011 until August 2013 patients with suspected or confirmed clinical PE were recruited at the Erasmus MC. At time of admission, blood for measurement of sFlt-1 and PlGF was obtained. A sFlt-1/PlGF ratio of >85 was considered suggestive for PE. Clinical characteristics and pregnancy outcomes were retrieved from medical records. The clinical diagnosis of PE was made based on the ISSHP criteria, whereas the fullPIERS definition was used for the rating of adverse pregnancy outcomes. A total of 96 patients were included. Of the patients, 53 (55%) met the clinical criteria of PE at time of blood sampling. In 11% of these patients (n = 6) the ratio was 85 (false positive), resulting in positive and negative predictive values of 89% and 86% respectively. Three patients without clinical PE, but with a positive ratio, developed superimposed PE and 2 developed an adverse pregnancy outcome. In 2 of the 6 patients with clinical PE but a negative ratio, an adverse pregnancy outcome was encountered. Using a binary regression model with adjustment for gestational age < 34 weeks, clinical PE was associated with a 9 times increased risk for an adverse outcome, while this was 29 times for an elevated ratio (P = 0.036). The additive value of an increased ratio for diagnosing PE is limited since most patients with clinical PE also have a positive ratio. An elevated ratio is superior to the clinical diagnosis of PE for predicting an adverse pregnancy outcome.

  4. National Guidelines «Acute Kidney Injury: Basic Principles of the Diagnosis, Prevention and Treatment (2015» Part I

    Directory of Open Access Journals (Sweden)

    A.V. Smirnov

    2016-04-01

    Full Text Available The main problems of acute kidney injury (AKI are considered. The necessity of introduction of the AKI concept into the practice of national health care is justified. Specific recommendations for the diagnosis, monitoring, prevention and treatment of this dangerous condition are given.

  5. [Guidelines for diagnosis, treatment and prevention of infections in cancer patients 2013].

    Science.gov (United States)

    2014-01-01

    Cancer patients pose an increased risk of infectious complications due to their underlying disease and its treatment. The present guidelines, developed by the Commission of Infections in the Immunocompromised Host of the Argentine Society of Infectious Diseases are an updated version of those published in 2008. For the elaboration of these guidelines, both the scientific evidence and the local experience were thoroughly evaluated. This Consensus includes an overview of the risk factors and the epidemiology of infections in both adult and pediatric cancer patients. It deals with the management of the febrile neutropenic patient, the risk categorization, the initial empirical therapy in the multiresistant era and its subsequent management. It includes a section dedicated to the antifungal empirical and directed therapy as well as the diagnosis and treatment of the most frequent fungal infections. Prevention strategies, both general and for high-risk patients, including those receiving biologic response modifiers, are herein shown. These guidelines should be applied in conjunction with a careful clinical evaluation and taking into account local epidemiological factors. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  6. Prevention of Lysosomal Storage Diseases and Derivation of Mutant Stem Cell Lines by Preimplantation Genetic Diagnosis

    Science.gov (United States)

    Altarescu, Gheona; Beeri, Rachel; Eiges, Rachel; Epsztejn-Litman, Silvina; Eldar-Geva, Talia; Elstein, Deborah; Zimran, Ari; Margalioth, Ehud J.; Levy-Lahad, Ephrat; Renbaum, Paul

    2012-01-01

    Preimplantation genetic diagnosis (PGD) allows birth of unaffected children for couples at risk for a genetic disorder. We present the strategy and outcome of PGD for four lysosomal storage disorders (LSD): Tay-Sachs disease (TSD), Gaucher disease (GD), Fabry disease (FD), and Hunter syndrome (HS), and subsequent development of stem cell lines. For each disease, we developed a family-specific fluorescent multiplex single-cell PCR protocol that included the familial mutation and informative markers surrounding the mutation. Embryo biopsy and PGD analysis were performed on either oocytes (polar bodies one and two) or on single blastomeres from a six-cell embryo. We treated twenty families carrying mutations in these lysosomal storage disorders, including 3 couples requiring simultaneous analysis for two disorders (TSD/GD, TSD/balanced Robertsonian translocation 45XYder(21;14), and HS/oculocutaneus albinism). These analyses led to an overall pregnancy rate/embryo transfer of 38% and the birth of 20 unaffected children from 17 families. We have found that PGD for lysosomal disorders is a safe and effective method to prevent birth of affected children. In addition, by using mutant embryos for the derivation of stem cell lines, we have successfully established GD and HS hESC lines for use as valuable models in LSD research. PMID:23320174

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

    Directory of Open Access Journals (Sweden)

    A. E. Khramov

    2015-01-01

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

  8. Antibodies to SS-A/Ro-52kD and centromere in autoimmune liver disease: a clue to diagnosis and prognosis of primary biliary cirrhosis.

    Science.gov (United States)

    Granito, A; Muratori, P; Muratori, L; Pappas, G; Cassani, F; Worthington, J; Ferri, S; Quarneti, C; Cipriano, V; de Molo, C; Lenzi, M; Chapman, R W; Bianchi, F B

    2007-09-15

    Primary biliary cirrhosis (PBC) may be associated with various rheumatological disorders. To investigate the frequency and significance of 'rheumatological' antinuclear antibodies in the field of autoimmune chronic liver disease, with special regard to PBC. We studied 105 patients with PBC, 162 autoimmune liver disease controls (type 1 and 2 autoimmune hepatitis, primary sclerosing cholangitis), 30 systemic lupus erythematosus and 50 blood donors. Sera were tested for the presence of antibodies to extractable nuclear antigens (anti-ENA) by counterimmunoelectrophoresis, enzyme-linked and immunoblot (IB) assay, and for the presence of anti-centromere antibodies (ACA) by indirect immunofluorescence on HEp-2 cells and IB. The overall prevalence of IB-detected anti-ENA in PBC (30%) was higher than in type 1 autoimmune hepatitis (2.5%, P < 0.0001), type 2 autoimmune hepatitis (0%, P < 0.0001) and primary sclerosing cholangitis (11.5%, P = 0.006) and lower than in systemic lupus erythematosus (53%, P = 0.03). The most frequent anti-ENA reactivity in PBC was anti-SSA/Ro-52kD (28%). ACA were detected by IB in 21% PBC patients and never in the other subjects (P < 0.0001). Anti-SS-A/Ro/52kD positive PBC patients had at the time of diagnosis a more advanced histological stage (P = 0.01) and higher serum levels of bilirubin (P = 0.01) and IgM (P = 0.03) compared with negative ones. In the autoimmune liver disease setting, anti-SS-A/Ro-52kD and ACA have a high specificity for PBC and can thus be of diagnostic relevance in anti-mitochondrial antibodies negative cases. If confirmed in further studies with adequate follow-up, anti-SS-A/Ro-52kD antibodies might identify PBC patients with a more advanced and active disease.

  9. Examining the potential clinical value of curcumin in the prevention and diagnosis of Alzheimer's disease.

    Science.gov (United States)

    Goozee, K G; Shah, T M; Sohrabi, H R; Rainey-Smith, S R; Brown, B; Verdile, G; Martins, R N

    2016-02-14

    Curcumin derived from turmeric is well documented for its anti-carcinogenic, antioxidant and anti-inflammatory properties. Recent studies show that curcumin also possesses neuroprotective and cognitive-enhancing properties that may help delay or prevent neurodegenerative diseases, including Alzheimer's disease (AD). Currently, clinical diagnosis of AD is onerous, and it is primarily based on the exclusion of other causes of dementia. In addition, phase III clinical trials of potential treatments have mostly failed, leaving disease-modifying interventions elusive. AD can be characterised neuropathologically by the deposition of extracellular β amyloid (Aβ) plaques and intracellular accumulation of tau-containing neurofibrillary tangles. Disruptions in Aβ metabolism/clearance contribute to AD pathogenesis. In vitro studies have shown that Aβ metabolism is altered by curcumin, and animal studies report that curcumin may influence brain function and the development of dementia, because of its antioxidant and anti-inflammatory properties, as well as its ability to influence Aβ metabolism. However, clinical studies of curcumin have revealed limited effects to date, most likely because of curcumin's relatively low solubility and bioavailability, and because of selection of cohorts with diagnosed AD, in whom there is already major neuropathology. However, the fresh approach of targeting early AD pathology (by treating healthy, pre-clinical and mild cognitive impairment-stage cohorts) combined with new curcumin formulations that increase bioavailability is renewing optimism concerning curcumin-based therapy. The aim of this paper is to review the current evidence supporting an association between curcumin and modulation of AD pathology, including in vitro and in vivo studies. We also review the use of curcumin in emerging retinal imaging technology, as a fluorochrome for AD diagnostics.

  10. ACE-I Angioedema: Accurate Clinical Diagnosis May Prevent Epinephrine-Induced Harm

    Directory of Open Access Journals (Sweden)

    R. Mason Curtis

    2016-06-01

    Full Text Available Introduction: Upper airway angioedema is a life-threatening emergency department (ED presentation with increasing incidence. Angiotensin-converting enzyme inhibitor induced angioedema (AAE is a non-mast cell mediated etiology of angioedema. Accurate diagnosis by clinical examination can optimize patient management and reduce morbidity from inappropriate treatment with epinephrine. The aim of this study is to describe the incidence of angioedema subtypes and the management of AAE. We evaluate the appropriateness of treatments and highlight preventable iatrogenic morbidity. Methods: We conducted a retrospective chart review of consecutive angioedema patients presenting to two tertiary care EDs between July 2007 and March 2012. Results: Of 1,702 medical records screened, 527 were included. The cause of angioedema was identified in 48.8% (n=257 of cases. The most common identifiable etiology was AAE (33.1%, n=85, with a 60.0% male predominance. The most common AAE management strategies included diphenhydramine (63.5%, n=54, corticosteroids (50.6%, n=43 and ranitidine (31.8%, n=27. Epinephrine was administered in 21.2% (n=18 of AAE patients, five of whom received repeated doses. Four AAE patients required admission (4.7% and one required endotracheal intubation. Epinephrine induced morbidity in two patients, causing myocardial ischemia or dysrhythmia shortly after administration. Conclusion: AAE is the most common identifiable etiology of angioedema and can be accurately diagnosed by physical examination. It is easily confused with anaphylaxis and mismanaged with antihistamines, corticosteroids and epinephrine. There is little physiologic rationale for epinephrine use in AAE and much risk. Improved clinical differentiation of mast cell and non-mast cell mediated angioedema can optimize patient management.

  11. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... our information on Coping With Cancer helpful. Understanding Statistics About Survival Doctors estimate prognosis by using statistics that researchers have collected over many years about ...

  12. [Efficiency of early diagnosis and prevention of chronic obstructive pulmonary disease in industrial workers (prospective observation results)].

    Science.gov (United States)

    Bobrov, S V; Shpagina, L A; Kuznetsova, G V; Burganova, M R

    2011-01-01

    Examination of workers engaged into major industrial enterprises of Novosibirsk demonstrated high prevalence of bronchial obstruction in individuals contacting industrial aerosol. The workers with long length of service proved high level of tobacco addiction and marked psychologic dependence on smoking. Based on the data obtained, the authors specified a program for early diagnosis and prevention of occupational bronchitis among the workers of major industrial enterprises.

  13. Understanding Cancer Prognosis

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    Full Text Available ... talk about, even for doctors. Many Factors Can Affect Your Prognosis Some of the factors that affect prognosis include: The type of cancer and where ... at the National Institutes of Health FOLLOW US Facebook Twitter Instagram YouTube Google+ LinkedIn GovDelivery RSS CONTACT ...

  14. Understanding Cancer Prognosis

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    Full Text Available ... hard to talk about, even for doctors. Many Factors Can Affect Your Prognosis Some of the factors that affect prognosis include: The type of cancer ... that cancer will come back later. For this reason, doctors cannot say for sure that you are ...

  15. Understanding Cancer Prognosis

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    Full Text Available ... D., a national expert on doctor-patient communications, talks with one of his patients about what she'd like to ... how to discuss cancer prognosis (the likely course of the disease). Learn key points about prognosis and how to talk about it, and gain valuable insight from the ...

  16. Gastrointestinal Stromal Tumor: Diagnosis and Prognosis

    International Nuclear Information System (INIS)

    Martin, M. T.; Olmedilla, P.; Gonzalez, S.; Oliver, J. M.

    2003-01-01

    Gastrointestinal stromal tumors (GIST) are mesenquimal tumors derived from cell precursors. They have the capacity for myogenic and neurogenic differentiation and are characterized by expression of KIT protein /tyrosine kinase growth factor). Clinically, they exhibit various biological behaviors. We present 8 cases of GIST, describing both their radiological manifestation through computerized tomography (CT) and most accepted criteria for benignity and malignancy. We also describe the response of one meta statically diagnosed tumor to tyrosine kinase inhibitor. (Author) 9 refs

  17. Severe aortic stenosis: diagnosis, treatment and prognosis

    NARCIS (Netherlands)

    M.W.A. van Geldorp (Martijn)

    2013-01-01

    textabstractDegenerative aortic stenosis is the most common valvular heart disease in developed countries. The prevalence of severe aortic stenosis increases with age from 1% in people below 65 years of age to nearly 6% in people over the age of 85. Since the population life expectancy continues to

  18. Sports and Marfan Syndrome: Awareness and Early Diagnosis Can Prevent Sudden Death.

    Science.gov (United States)

    Salim, Mubadda A.; Alpert, Bruce S.

    2001-01-01

    Physicians who work with athletes play an important role in preventing sudden death related to physical activity in people who have Marfan syndrome. Flagging those who have the physical stigmata and listening for certain cardiac auscultation sounds are early diagnostic keys that can help prevent deaths. People with Marfan syndrome should be…

  19. Factors Influencing Suicidal Tendencies of Patients with Diagnosis of Attempted Suicide in Medical History and Potential Prevention of Relapse Prevention.

    Science.gov (United States)

    Kotrbová, Kvetoslava; Dóci, Ivan; Hamplová, Lidmila; Dvořák, Vít; Selingerová, Šárka; Růžičková, Veronika; Chmelařová, Šárka

    2017-12-01

    consumption is the highest-risk factor in connection with relapsing suicide. In case of psychiatric patients with attempted suicide in their medical history, all verified preventive and therapeutic procedures that can contribute to prevention of relapses should be used within follow-up professional care. Specific approach of the closest social environment, medical literacy of the population and state safety measures are important. Copyright© by the National Institute of Public Health, Prague 2017

  20. Neonatal adrenal hemorrhage manifesting as acute scrotum: timely diagnosis prevents unnecessary surgery.

    Science.gov (United States)

    Avolio, Luigi; Fusillo, Mario; Ferrari, Giovanna; Chiara, Alberto; Bragheri, Romano

    2002-04-01

    Neonatal adrenal hemorrhage presenting as scrotal swelling has been reported in 17 cases, with unnecessary surgical exploration in 7. We report 2 new cases, emphasizing the knowledge of this clinical association and the role of ultrasonography in the differential diagnosis for this specific condition and in all cases of neonatal acute scrotum.

  1. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease, GOLD Executive Summary

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Hurd, Suzanne S; Agusti, Alvar G

    2013-01-01

    Chronic obstructive pulmonary disease (COPD) is a global health problem and since 2001 the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published its strategy document for the diagnosis and management of COPD. This executive summary presents the main contents of the second 5...

  2. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... your cancer and knowing what to expect can help you and your loved ones make decisions. Some ... what the statistics may mean. If you need help coping with your prognosis, you may find our ...

  3. Understanding Cancer Prognosis

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    Full Text Available ... Recurrent Cancer Common Cancer Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung ... need for different kinds of information about her colorectal cancer prognosis. Diving Out of the Dark View this ...

  4. Understanding Cancer Prognosis

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    Full Text Available ... to know more, the doctor who knows the most about your situation is in the best position ... statistics may be used to estimate prognosis. The most commonly used statistics include: Cancer-specific survival This ...

  5. Understanding Cancer Prognosis

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    Full Text Available ... Cancer Common Cancer Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer ... need for different kinds of information about her colorectal cancer prognosis. Diving Out of the Dark View ...

  6. Understanding Cancer Prognosis

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    Full Text Available ... treatment Seeking Information About Your Prognosis Is a Personal Decision When you have cancer, you and your ... think they are too impersonal to be of value to you. It is up to you to ...

  7. Understanding Cancer Prognosis

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    Full Text Available ... Cancer Common Cancer Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung ... need for different kinds of information about her colorectal cancer prognosis. Diving Out of the Dark View this ...

  8. Understanding Cancer Prognosis

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    Full Text Available ... of survival. The estimate of how the disease will go for you is called prognosis. It can ... they cannot be used to predict exactly what will happen to you. Everyone is different. Treatments and ...

  9. Understanding Cancer Prognosis

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    Full Text Available ... M.D., a national expert on doctor-patient communications, talks with one of his patients about what ... how to discuss prognosis with their patients. Good communication, he says, is part of providing good care. ...

  10. Understanding Cancer Prognosis

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  11. Understanding Cancer Prognosis

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    Full Text Available ... that cancer will come back later. For this reason, doctors cannot say for sure that you are ... about how to discuss prognosis with their patients. Good communication, he says, is part of providing good ...

  12. Understanding Cancer Prognosis

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    Full Text Available ... Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training at NCI (Intramural) Resources for ... Staging Prognosis Questions to Ask ... This statistic is another method used to estimate cancer-specific survival that does ...

  13. Understanding Cancer Prognosis

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  14. Understanding Cancer Prognosis

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  15. Understanding Cancer Prognosis

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  16. Understanding Cancer Prognosis

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  17. Understanding Cancer Prognosis

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  18. Understanding Cancer Prognosis

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  19. Understanding your cancer prognosis

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    ... about: Treatment Palliative care Personal matters such as finances Knowing what to expect may make it easier ... treatment. www.cancer.net/navigating-cancer-care/cancer-basics/understanding-statistics-used-guide-prognosis-and-evaluate-treatment . ...

  20. Understanding Cancer Prognosis

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    Full Text Available ... Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training at NCI (Intramural) Funding for ... Staging Prognosis Questions to Ask about ... This statistic is another method used to estimate cancer-specific survival that does ...

  1. Understanding Cancer Prognosis

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    Full Text Available ... Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training at NCI (Intramural) Resources for ... Staging Prognosis Questions to Ask about ... This statistic is another method used to estimate cancer-specific survival that does ...

  2. Understanding Cancer Prognosis

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    Full Text Available ... hard to talk about, even for doctors. Many Factors Can Affect Your Prognosis Some of the factors ... Services Website Linking U.S. Department of Health and Human Services National Institutes of Health National Cancer Institute ...

  3. Understanding Cancer Prognosis

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  4. Understanding Cancer Prognosis

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    Full Text Available ... 2 years, 5 years, etc., with 5 years being the time period most often used. Cancer-specific ... a prognosis may not be based on treatments being used today. Still, your doctor may tell you ...

  5. Guideline for the prevention, diagnosis and management of cryptococcal meningitis among HIV-infected persons: 2013 update

    Directory of Open Access Journals (Sweden)

    The Southern African HIV Clinicians Society

    2013-06-01

    Full Text Available Six years after the first Society guidelines were published, cryptococcal meningitis (CM remains an important cause of morbidity and mortality among HIV-infected adults in South Africa. Several important developments have spurred the  publication of updated guidelines to manage this common fungal opportunistic infection. Recommendations described here include: (1 screening and pre-emptive treatment; (2 laboratory diagnosis and monitoring; (3 management of a first episode of CM; (4 amphotericin B deoxycholate toxicity prevention, monitoring and management; (5 timing of antiretroviral therapy among patients with CM; (6 management of raised intracranial pressure; (7 management of relapse episodes of CM.

  6. Herpes simplex virus infection in pregnancy and in neonate: status of art of epidemiology, diagnosis, therapy and prevention

    Directory of Open Access Journals (Sweden)

    Barucca Valentina

    2009-04-01

    Full Text Available Abstract Herpes simplex virus (HSV infection is one of the most common viral sexually transmitted diseases worldwide. The first time infection of the mother may lead to severe illness in pregnancy and may be associated with virus transmission from mother to foetus/newborn. Since the incidence of this sexually transmitted infection continues to rise and because the greatest incidence of herpes simplex virus infections occur in women of reproductive age, the risk of maternal transmission of the virus to the foetus or neonate has become a major health concern. On these purposes the Authors of this review looked for the medical literature and pertinent publications to define the status of art regarding the epidemiology, the diagnosis, the therapy and the prevention of HSV in pregnant women and neonate. Special emphasis is placed upon the importance of genital herpes simplex virus infection in pregnancy and on the its prevention to avoid neonatal HSV infections.

  7. Systemic and Disease-Specific Risk Factors in Vascular Dementia: Diagnosis and Prevention

    Directory of Open Access Journals (Sweden)

    Efraim Jaul

    2017-10-01

    Full Text Available In order to prevent the onset of vascular dementia (VaD in aging individuals, it is critical to detect clinically relevant vascular and systemic pathophysiological changes to signal the onset of its preceding prodromal stages. Identifying behavioral and neurobiological markers that are highly sensitive to VaD classification vs. other dementias is likely to assist in developing novel preventive treatment strategies that could delay the onset of disruptive psychomotor symptoms, decrease hospitalizations, and increase the quality of life in clinically-high-risk aging individuals. In light of empirical diagnostic and clinical findings associated with VaD pathophysiology, the current investigation will suggest a few clinically-validated biomarker measures of prodromal VaD cognitive impairments that are correlated with vascular symptomology, and VaD endophenotypes in non-demented aging people. In prodromal VaD individuals, distinguishing VaD from other dementias (e.g., Alzheimer's disease could facilitate specific early preventive interventions that significantly delay more severe cognitive deterioration or indirectly suppress the onset of dementia with vascular etiology. Importantly, the authors conclude that primary prevention strategies should examine aging individuals by employing comprehensive geriatric assessment approach, taking into account their medical history, and longitudinally noting their vascular, systemic, cognitive, behavioral, and clinical functional status. Secondary prevention strategies may include monitoring chronic medication as well as promoting programs that facilitate social interaction and every-day activities.

  8. Malaria Prevention by New Technology: Vectored Delivery of Antibody Genes

    Science.gov (United States)

    2016-10-01

    to a product, scientific advance, or research tool that makes a meaningful contribution toward the understanding, prevention, diagnosis , prognosis...organizations Gary Ketner Ph.D. P.I. 6 person-months Design of experiments, analysis and interpretation of data, organizational tasks 50% of support from

  9. Recommendations for the diagnosis, treatment and prevention of the pneumonia acquired in the community in adults

    International Nuclear Information System (INIS)

    2003-01-01

    The pneumonia acquired in the community in adults, is the acute infection of the pulmonary parenchyma that is developed away from the hospital environment, it is manifested in the first 48 hours from the entrance to the hospital or after seven days of having left. The supplement includes clinical square, epidemiology, etiology classification, diagnostic, treatment and prevention among others

  10. Uveal melanoma: Estimating prognosis

    Directory of Open Access Journals (Sweden)

    Swathi Kaliki

    2015-01-01

    Full Text Available Uveal melanoma is the most common primary malignant tumor of the eye in adults, predominantly found in Caucasians. Local tumor control of uveal melanoma is excellent, yet this malignancy is associated with relatively high mortality secondary to metastasis. Various clinical, histopathological, cytogenetic features and gene expression features help in estimating the prognosis of uveal melanoma. The clinical features associated with poor prognosis in patients with uveal melanoma include older age at presentation, male gender, larger tumor basal diameter and thickness, ciliary body location, diffuse tumor configuration, association with ocular/oculodermal melanocytosis, extraocular tumor extension, and advanced tumor staging by American Joint Committee on Cancer classification. Histopathological features suggestive of poor prognosis include epithelioid cell type, high mitotic activity, higher values of mean diameter of ten largest nucleoli, higher microvascular density, extravascular matrix patterns, tumor-infiltrating lymphocytes, tumor-infiltrating macrophages, higher expression of insulin-like growth factor-1 receptor, and higher expression of human leukocyte antigen Class I and II. Monosomy 3, 1p loss, 6q loss, and 8q and those classified as Class II by gene expression are predictive of poor prognosis of uveal melanoma. In this review, we discuss the prognostic factors of uveal melanoma. A database search was performed on PubMed, using the terms "uvea," "iris," "ciliary body," "choroid," "melanoma," "uveal melanoma" and "prognosis," "metastasis," "genetic testing," "gene expression profiling." Relevant English language articles were extracted, reviewed, and referenced appropriately.

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

    Science.gov (United States)

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

    1990-04-15

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

  12. Clinical practice guidelines for prevention, diagnosis and management of early and delayed-onset ocular injuries due to mustard gas exposure

    Directory of Open Access Journals (Sweden)

    Zhale Rajavi

    2017-01-01

    Conclusion: Considering the lack of CPGs for the prevention, diagnosis, and management of mustard gas-induced keratitis, these recommendations would be useful to prevent the serious ocular complications of mustard gas and standardize eye care services to the affected individuals.

  13. Beals syndrome (congenital contractural arachnodactyly in children: Clinical symptoms, diagnosis, treatment, and prevention

    Directory of Open Access Journals (Sweden)

    A. N. Semyachkina

    2016-01-01

    Full Text Available The paper deals with a rare monogenic connective tissue disease from a group of fibrillinopathies with autosomal dominant inheritance — Beals syndrome caused by a mutation in the FBN2 gene. Attention is drawn to the high phenotypic similarity of this disease and Marfan syndrome (FBN1 gene mutation, which is associated with the almost complete identity of two proteins: fibrillin 1 and fibrillin 2.The paper describes a clinical case of a child with Beals syndrome and the typical manifestations of the disease: asthenic constitution, arachnodactyly of the hands and feet, congenital contractures of the large and small joints, chest deformity, kyphoscoliosis, talpes, and crushed ears. The investigators made a differential diagnosis with other connective tissue diseases, such as Marfan syndrome, Stickler syndrome, Ehlers–Danlos syndrome, homocystenuria, and arthrogryposis. DNA diagnosis verified the Beals syndrome in the proband. Exon 28 in the FBN2 gene showed the previously undescribed missense mutation of c.3719G>A, resulting in the amino acid substitution of cysteine for tyrosine (p.Cys1240Tyr in the structure of the protein fibrillin 2. A de novo mutation occurred. There is evidence for its pathogenicity in the development of the clinical symptoms of the disease. The problems of effective medical genetic counseling in this family are discussed. 

  14. Glaucoma: Biological Trabecular and Neuroretinal Pathology with Perspectives of Therapy Innovation and Preventive Diagnosis

    Directory of Open Access Journals (Sweden)

    Raffaele Nuzzi

    2017-09-01

    Full Text Available Glaucoma is a common degenerative disease affecting retinal ganglion cells (RGC and optic nerve axons, with progressive and chronic course. It is one of the most important reasons of social blindness in industrialized countries. Glaucoma can lead to the development of irreversible visual field loss, if not treated. Diagnosis may be difficult due to lack of symptoms in early stages of disease. In many cases, when patients arrive at clinical evaluation, a severe neuronal damage may have already occurred. In recent years, newer perspective in glaucoma treatment have emerged. The current research is focusing on finding newer drugs and associations or better delivery systems in order to improve the pharmacological treatment and patient compliance. Moreover, the application of various stem cell types with restorative and neuroprotective intent may be found appealing (intravitreal autologous cellular therapy. Advances are made also in terms of parasurgical treatment, characterized by various laser types and techniques. Moreover, recent research has led to the development of central and peripheral retinal rehabilitation (featuring residing cells reactivation and replacement of defective elements, as well as innovations in diagnosis through more specific and refined methods and inexpensive tests.

  15. Safety and health in forest harvesting operations. Diagnosis and preventive actions. A review.

    OpenAIRE

    P. Albizu-Urionabarrenetxea; E. Tolosana-Esteban; E. Roman-Jordan

    2013-01-01

    Aim of study: to review the present state of the art in relation to the main labour risks and the most relevant results of recent studies evaluating the safety and health conditions of the forest harvesting work and better ways to reduce accidents.Area of study: It focuses mainly on developed Countries, where the general concern about work risks prevention, together with the complex idiosyncrasy of forest work in forest harvesting operations, has led to a growing interest from the forest scie...

  16. Understanding Cancer Prognosis

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    Full Text Available ... Menu Contact Dictionary Search About Cancer Causes and Prevention Risk Factors Genetics Cancer Prevention Overview Research Cancer Screening ... What Is Cancer Cancer Statistics Cancer Disparities Causes & Prevention Risk Factors Genetics Cancer Prevention Overview Screening Cancer Screening ...

  17. Understanding Cancer Prognosis

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    Full Text Available ... Contact Dictionary Search About Cancer Causes and Prevention Risk Factors Genetics Cancer Prevention Overview Research Cancer Screening ... Is Cancer Cancer Statistics Cancer Disparities Causes & Prevention Risk Factors Genetics Cancer Prevention Overview Screening Cancer Screening ...

  18. Understanding Cancer Prognosis

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    Full Text Available ... Contact Dictionary Search About Cancer Causes and Prevention Risk Factors Genetics Cancer Prevention Overview Research Cancer Screening Cancer ... Is Cancer Cancer Statistics Cancer Disparities Causes & Prevention Risk Factors Genetics Cancer Prevention Overview Screening Cancer Screening Overview ...

  19. Understanding Cancer Prognosis

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    Full Text Available ... Search About Cancer Causes and Prevention Risk Factors Genetics Cancer Prevention Overview Research Cancer Screening Cancer Screening ... Cancer Statistics Cancer Disparities Causes & Prevention Risk Factors Genetics Cancer Prevention Overview Screening Cancer Screening Overview Screening ...

  20. Venous thromboembolism: the prevailing approach to diagnosis, prevention and treatment among Internal Medicine practitioners.

    Science.gov (United States)

    Markel, Arie; Gavish, Israel; Kfir, Hila; Rimbrot, Sofia

    2017-02-01

    Venous thromboembolism (VTE) is the third most common cause of death and the leading cause of sudden death in hospitalized medical patients. Despite the existence of guidelines for prevention and treatment of this disorder, their implementation in everyday life is not always accomplished. We performed a survey among directors of Internal Medicine departments in our country in order to evaluate their attitude and approach to this issue. A questionnaire with pertinent questions regarding prevention and treatment of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE) was sent to each one of the directors of Internal Medicine Departments around the country. Sixty-nine out of 97 (71%) of the Internal Medicine departments directors responded the questionnaire. We found that several of the current guidelines were followed in a reasonable way. On the other hand, heterogeneity of responses was also present and the performance of current guidelines was imperfectly followed, and showed to be deficient in several aspects. An effort should be done in order to reemphasize and put in effect current guidelines for the prevention and treatment of VTE among hospitalists and Internal Medicine practitioners.

  1. Risk of breast cancer after a diagnosis of ovarian cancer in BRCA mutation carriers: Is preventive mastectomy warranted?

    Science.gov (United States)

    McGee, Jacob; Giannakeas, Vasily; Karlan, Beth; Lubinski, Jan; Gronwald, Jacek; Rosen, Barry; McLaughlin, John; Risch, Harvey; Sun, Ping; Foulkes, William D; Neuhausen, Susan L; Kotsopoulos, Joanne; Narod, Steven A

    2017-05-01

    Preventive breast surgery and MRI screening are offered to unaffected BRCA mutation carriers. The clinical benefit of these two modalities has not been evaluated among mutation carriers with a history of ovarian cancer. Thus, we sought to determine whether or not BRCA mutation carriers with ovarian cancer would benefit from preventive mastectomy or from MRI screening. First, the annual mortality rate for ovarian cancer patients was estimated for a cohort of 178 BRCA mutation carriers from Ontario, Canada. Next, the actuarial risk of developing breast cancer was estimated using an international registry of 509 BRCA mutation carriers with ovarian cancer. A series of simulations was conducted to evaluate the reduction in the probability of death (from all causes) associated with mastectomy and with MRI-based breast surveillance. Cox proportional hazards models were used to evaluate the impacts of mastectomy and MRI screening on breast cancer incidence as well as on all-cause mortality. Twenty (3.9%) of the 509 patients developed breast cancer within ten years following ovarian cancer diagnosis. The actuarial risk of developing breast cancer at ten years post-diagnosis, conditional on survival from ovarian cancer and other causes of mortality was 7.8%. Based on our simulation results, among all BRCA mutation-carrying patients diagnosed with stage III/IV ovarian cancer at age 50, the chance of dying before age 80 was reduced by less than 1% with MRI and by less than 2% with mastectomy. Greater improvements in survival with MRI or mastectomy were observed for women who had already survived 10years after ovarian cancer, and for women with stage I or II ovarian cancer. Among BRCA mutation-carrying ovarian cancer patients without a personal history of breast cancer, neither preventive mastectomy nor MRI screening is warranted, except for those who have survived ovarian cancer without recurrence for ten years and for those with early stage ovarian cancer. Copyright © 2017

  2. Rapid-prenatal diagnosis through fluorescence in situ hybridization for preventing aneuploidy related birth defects.

    Science.gov (United States)

    Fauzdar, Ashish; Chowdhry, Mohit; Makroo, R N; Mishra, Manoj; Srivastava, Priyanka; Tyagi, Richa; Bhadauria, Preeti; Kaul, Anita

    2013-01-01

    Women with high-risk pregnancies are offered prenatal diagnosis through amniocentesis for cytogenetic analysis of fetal cells. The aim of this study was to evaluate the effectiveness of the rapid fluorescence in situ hybridization (FISH) technique for detecting numerical aberrations of chromosomes 13, 21, 18, X and Y in high-risk pregnancies in an Indian scenario. A total of 163 samples were received for a FISH and/or a full karyotype for prenatal diagnosis from high-risk pregnancies. In 116 samples both conventional culture techniques for getting karyotype through G-banding techniques were applied in conjunction to FISH test using the AneuVysion kit (Abbott Molecular, Inc.), following standard recommended protocol to compare the both the techniques in our setup. Out of 116 patients, we got 96 normal for the five major chromosome abnormality and seven patients were found to be abnormal (04 trisomy 21, 02 monosomy X, and 01 trisomy 13) and all the FISH results correlated with conventional cytogenetics. To summarize the results of total 163 patients for the major chromosomal abnormalities analyzed by both/or cytogenetics and FISH there were 140 (86%) normal, 9 (6%) cases were abnormal and another 4 (2.5%) cases were suspicious mosaic and 10 (6%) cases of culture failure. The diagnostic detection rate with FISH in 116 patients was 97.5%. There were no false-positive and false-negative autosomal or sex chromosomal results, within our established criteria for reporting FISH signals. Rapid FISH is a reliable and prompt method for detecting numerical chromosomal aberrations and has now been implemented as a routine diagnostic procedure for detection of fetal aneuploidy in India.

  3. Oral diagnosis and treatment planning: part 5. Preventive and treatment planning for dental caries.

    Science.gov (United States)

    Yip, K; Smales, R

    2012-09-01

    The practice of operative dentistry continues to evolve, to reflect the many changes occurring in society and in dental diseases and conditions. However, the belief that all questionable and early carious lesions should be restored still persists. This belief is largely based upon the concept that the removal of all carious tissue followed by meticulous restoration of the tooth is the treatment of choice for dental caries. Yet restorations are not permanent and do not cure caries, as the causes remain. On the other hand, preventive measures can remove or partially remove the causes, thereby reducing the risks for future caries recurrence at the same site or elsewhere in the mouth.

  4. [FEDERAL CLINICAL RECOMMENDATIONS IN DIAGNOSIS, TREATMENT AND PREVENTION OF HEARING LOSS DUE TO NOISE].

    Science.gov (United States)

    Adeninskaya, E E; Bukhtiarov, I V; Bushmanov, A Iu; Dayhes, N A; Denisov, E I; Izmerov, N F; Mazitova, N N; Pankova, V B; Preobrazhenskaya, E A; Prokopenko, L V; Simonova, N I; Tavartkiladze, G A; Fedina, I N

    2016-01-01

    Noise induced hearing loss is a slowly developing hearing impairment, caused by occupational exposure to excessive noise levels, constitutes a lesion of the auditory analyzer and clinically manifested as chronic bilateral sensorineural hearing loss. Currently, there is not a treatment that provide a cure of sensorineural hearing loss. Regular, individually tailored treatment should be directed to the pathogenic mechanisms and specific clinical symptoms of hearing loss, as well as the prevention of complications. We recommend using non-drug therapies that can improve blood flow in labyrinth, tissue and cellular metabolism.

  5. Safety and health in forest harvesting operations. Diagnosis and preventive actions. A review

    Energy Technology Data Exchange (ETDEWEB)

    Albizu-Urionabarrenetxea, P. M.; Tolosana-Esteban, E.; Roman-Jordan, E.

    2013-07-01

    Aim of study: to review the present state of the art in relation to the main labour risks and the most relevant results of recent studies evaluating the safety and health conditions of the forest harvesting work and better ways to reduce accidents. Area of study: It focuses mainly on developed Countries, where the general concern about work risks prevention, together with the complex idiosyncrasy of forest work in forest harvesting operations, has led to a growing interest from the forest scientific and technical community. Material and Methods: The main bibliographic and Internet references have been identified using common reference analysis tools. Their conclusions and recommendations have been comprehensively summarized. Main results: Collection of the principal references and their most important conclusions relating to the main accident risk factors, their causes and consequences, the means used towards their prevention, both instrumental as well as in the aspects of training and business management, besides the influence of the growing mechanization of logging operations on those risks. Research highlights: Accident risk is higher in forest harvesting than in most other work sectors, and the main risk factors such as experience, age, seasonality, training, protective equipment, mechanization degree, etc. have been identified and studied. The paper summarizes some relevant results, one of the principal being that the proper entrepreneurial risk management is a key factor leading to the success in minimizing labour risks. (Author)

  6. Understanding Cancer Prognosis

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    Full Text Available ... to you. Everyone is different. Treatments and how people respond to treatment can differ greatly. Also, it takes years to see the benefit of new treatments and ways of finding cancer. So, the statistics your doctor uses to make a prognosis may not be based ...

  7. Understanding Cancer Prognosis

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  8. Understanding Cancer Prognosis

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    Full Text Available ... you received. Video Series This video series offers the perspectives of three cancer patients and their doctor. The ... Three cancer patients and their doctor share their perspectives on how to discuss cancer prognosis (the likely course of the disease). Learn key points ...

  9. Understanding Cancer Prognosis

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    Full Text Available ... Your Cancer Prognosis Video View this video on YouTube. Three cancer patients and their doctor share their ... One Couple's Creative Response View this video on YouTube. Vanessa, an artist, and her husband Roy discover ...

  10. Symposium summary and prognosis

    International Nuclear Information System (INIS)

    Bjorken, J.D.

    1975-11-01

    The summary of the symposium on high energy physics experiments includes phenomena at low energies, the foundations of physics (considered to be mainly gravitation and quantum electrodynamics), standards of reference used for interpretation of experimental data, the new physics, particle proliferation, theoretical development, and a prognosis for the future

  11. Prognosis of dementia

    NARCIS (Netherlands)

    van de Vorst, IE

    2016-01-01

    Background: In this thesis, we focused on the prognosis of patients with dementia who visited a hospital (inpatient or day clinic care) in the Netherlands. So far, absolute mortality risks for dementia were lacking in the Netherlands, whereas these risks have been available for years for cancer or

  12. Understanding Cancer Prognosis

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    Full Text Available ... control. Whatever your doctor tells you, keep in mind that a prognosis is an educated guess. Your ... Website Cancer.gov en español Multimedia Publications Site Map Digital Standards for NCI Websites POLICIES Accessibility Comment ...

  13. Understanding Cancer Prognosis

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    Full Text Available ... a link to this page included, e.g., “Understanding Cancer Prognosis was originally published by the National Cancer Institute.” Please note that blog posts that are written by individuals from outside the government may be owned by the writer, and graphics ...

  14. [Prevention, diagnosis and treatment of perioperative complications of bariatric and metabolic surgery].

    Science.gov (United States)

    Wu, Haifu; Zhong, Ming; Zhou, Di; Shi, Chenye; Jiao, Heng; Wu, Wei; Chang, Xinxia; Cang, Jing; Bian, Hua

    2017-04-25

    Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy. The treatment of pulmonary artery embolism includes remittance of pulmonary arterial hypertension, anticoagulation, thrombolysis, operative thrombectomy, interventional therapy and extracorporeal membrane oxygenation (ECMO). Hemorrhage is a rarely occurred but relatively serious complication after bariatric surgery. The primary cause of anastomotic bleeding after laparoscopic gastric bypass is incomplete hemostasis or weak laparoscopic repair. The common bleeding site in laparoscopic sleeve gastrectomy is gastric stump and close to partes pylorica, and the bleeding may be induced by malformation and weak repair technique. Patients with hemodynamic instability caused by active bleeding or excessive bleeding should timely received surgical treatment. Anastomotic fistula in gastric bypass can be divided into gastrointestinal anastomotic fistula and jejunum-jejunum anastomotic fistula. The treatment of postoperative anastomotic fistula should vary with each individual, and conservative treatment or operative treatment should be adopted. Anastomotic stenosis is mainly related to the operative techniques. Stenosis after sleeve gastrectomy often occurs in gastric angle, and the treatment methods include balloon dilatation and stent implantation, and surgical

  15. [Utilization patterns of prevention and early diagnosis for cancer in women].

    Science.gov (United States)

    Torres-Mejía, Gabriela; Ortega-Olvera, Carolina; Ángeles-Llerenas, Angélica; Villalobos-Hernández, Aremis Litai; Salmerón-Castro, Jorge; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

    2013-01-01

    To estimate the utilization patterns of cancer prevention programs in women during the period 2000-2012 in Mexican women who participated in three national surveys. We analyzed data from the ENSA 2000, ENSANUT 2006 and ENSANUT 2012 that are representative of the Mexican population. Prevalences were obtained, trend tests and Poisson regression were used to determine the possibility of having more coverage. The coverage of Papanicolaou use in the last 12 months in 2012 was 45.5%, HPV testing in the last four years was 11.9% and mammography use in the past two years was 29.4% and 17.2% in women aged 50-69 years and 40-49 years, respectively. Although there was an increase in the coverage of screening programs, there should be a boost in the service quality and universal coverage.

  16. [Prevention and Treatment of Common Acute Adverse Effects With Antipsychotic Use in Adults With Schizophrenia Diagnosis].

    Science.gov (United States)

    Arenas Borrero, Álvaro Enrique; Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana Patricia; Vélez Traslaviña, Ángela; Castro Díaz, Sergio Mario; Jaramillo González, Luis Eduardo; García Valencia, Jenny

    2014-01-01

    To determine the most adequate strategies for the prevention and treatment of the acute adverse effects of the use of antipsychotics. A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. A systematic literature search was carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. The non-pharmacological interventions such as nutritional counseling by a nutritionist, exercise and psychotherapy are effective in preventing weight gain with the use of antipsychotics. (Kg Weight reduction in DM of -3.05 (-4.16, -1.94)). The antipsychotic change from olanzapine to aripiprazole showed weight loss and decreased BMI (decreased weight in KG DM -3.21 (-9.03, -2.61). The use of beta blockers was ineffective in reducing akathisia induced by antipsychotic; using as outcome the 50% reduction of symptoms of akathisia comparing beta-blockers with placebo RR was 1.4 (0.59, 1.83). It is recommended to make psychotherapeutic accompaniment and nutrition management of overweight for patients with weight gain. If these alternatives are ineffective is suggested to change the antipsychotic or consider starting metformin. For the management of drug-induced akathisia it is recommended to decrease the dose of the drug and the addition of lorazepam. It is recommended using 5mg biperiden IM or trihexyphenidyl 5mg orally in case of secondary acute dystonia and for the treatment of antipsychotic-induced parkinsonism to decrease the dose of antipsychotic or consider using 2 - 4mg/day of biperiden or diphenhydramine 50mg once daily. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  17. A Review of the Centers for Disease Control and Prevention's Guidelines for the Clinical Laboratory Diagnosis of Lyme Disease.

    Science.gov (United States)

    Miraglia, Caterina M

    2016-12-01

    The purpose of this paper is to review information regarding the current guidelines for the clinical laboratory diagnosis of Lyme disease as set forth by the Centers for Disease Control and Prevention (CDC) to chiropractic physicians and to discuss the clinical utility of this testing. The CDC's website was reviewed to determine what their current recommendations are for the clinical laboratory testing of Lyme disease. The CDC's established guidelines recommend the use of a 2-tiered serologic testing algorithm for the evaluation of patients with suspected Lyme disease. This review provides doctors of chiropractic with information to remain current with the CDC's recommended guidelines for Lyme disease testing because patients may present to their office with the associated signs and symptoms of Lyme disease.

  18. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary.

    Science.gov (United States)

    Vogelmeier, Claus F; Criner, Gerard J; Martinez, Fernando J; Anzueto, Antonio; Barnes, Peter J; Bourbeau, Jean; Celli, Bartolome R; Chen, Rongchang; Decramer, Marc; Fabbri, Leonardo M; Frith, Peter; Halpin, David M G; López Varela, M Victorina; Nishimura, Masaharu; Roche, Nicolas; Rodriguez-Roisin, Roberto; Sin, Don D; Singh, Dave; Stockley, Robert; Vestbo, Jørgen; Wedzicha, Jadwiga A; Agusti, Alvar

    2017-03-01

    This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD (GOLD) 2017 Report focuses primarily on the revised and novel parts of the document. The most significant changes include: 1) the assessment of chronic obstructive pulmonary disease has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; 2) for each of the groups A to D, escalation strategies for pharmacological treatments are proposed; 3) the concept of de-escalation of therapy is introduced in the treatment assessment scheme; 4) nonpharmacologic therapies are comprehensively presented and; 5) the importance of comorbid conditions in managing COPD is reviewed. Copyright ©2017 the American Thoracic Society. Published with permission from the American Thoracic Society. Design and branding are copyright ©ERS 2017.

  19. Role of Brush Biopsy and DNA Cytometry for Prevention, Diagnosis, Therapy, and Followup Care of Oral Cancer

    Directory of Open Access Journals (Sweden)

    Alfred Böcking

    2011-01-01

    Full Text Available Late diagnosis resulting in late treatment and locoregional failure after surgery are the main causes of death in patients with oral squamous cell carcinomas (SCCs. Actually, exfoliative cytology is increasingly used for early detection of oral cancer and has been the subject of intense research over the last five years. Significant advances have been made both in relation to screening and evaluation of precursor lesions. As this noninvasive procedure is well tolerated by patients, more lesions may be screened and thus more oral cancers may be found in early, curable stages. Moreover, the additional use of DNA image cytometry is a reasonable tool for the assessment of the resection margins of SCC. DNA image cytometry could help to find the appropriate treatment option for the patients. Finally, diagnostic DNA image cytometry is an accurate method and has internationally been standardized. In conclusion, DNA image cytometry has increasing impact on the prevention, diagnostic, and therapeutical considerations in head and neck SCC.

  20. Understanding Cancer Prognosis

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    Full Text Available ... Recent Public Laws Careers Visitor Information Search Search Home About Cancer Diagnosis and Staging Diagnosis and Staging ... If you want treatment How to best take care of yourself and manage treatment side effects How ...

  1. Regorafenib-associated hand-foot skin reaction: practical advice on diagnosis, prevention, and management.

    Science.gov (United States)

    McLellan, B; Ciardiello, F; Lacouture, M E; Segaert, S; Van Cutsem, E

    2015-10-01

    Regorafenib is an orally available, small-molecule multikinase inhibitor with international marketing authorizations for use in colorectal cancer and gastrointestinal stromal tumors. In clinical trials, regorafenib showed a consistent and predictable adverse-event profile, with hand-foot skin reaction (HFSR) among the most clinically significant toxicities. This review summarizes the clinical characteristics of regorafenib-related HFSR and provides practical advice on HFSR management to enable health care professionals to recognize, pre-empt, and effectively manage the symptoms, thereby allowing patients to remain on active therapy for as long as possible. This review is based on a systematic literature search of the PubMed database (using synonyms of HFSR, regorafenib, and skin toxicities associated with targeted therapies or cytotoxic chemotherapy). However, as this search identified very few articles, the authors also use their clinical experience as oncologists and dermatologists managing patients with treatment-related HFSR to provide recommendations on recognition and management of HFSR in regorafenib-treated patients. Regorafenib-related HFSR is similar to that seen with other multikinase inhibitors (e.g. sorafenib, sunitinib, cabozantinib, axitinib, and pazopanib) but differs from the hand-foot syndrome seen with cytotoxic chemotherapies (e.g. fluoropyrimidines, anthracyclines, and taxanes). There have been no controlled trials of symptomatic management of regorafenib-related HFSR, and limited good-quality evidence from randomized clinical trials of effective interventions for HFSR associated with other targeted therapies. Recommendations on prevention and management of regorafenib-related HFSR in this review are therefore based on the expert opinion of the authors (dermatologists and oncologists with expertise in the management of treatment-related skin toxicities and oncologists involved in clinical trials of regorafenib) and tried-and-tested empirical

  2. Regorafenib-associated hand–foot skin reaction: practical advice on diagnosis, prevention, and management

    Science.gov (United States)

    McLellan, B.; Ciardiello, F.; Lacouture, M. E.; Segaert, S.; Van Cutsem, E.

    2015-01-01

    Background Regorafenib is an orally available, small-molecule multikinase inhibitor with international marketing authorizations for use in colorectal cancer and gastrointestinal stromal tumors. In clinical trials, regorafenib showed a consistent and predictable adverse-event profile, with hand–foot skin reaction (HFSR) among the most clinically significant toxicities. This review summarizes the clinical characteristics of regorafenib-related HFSR and provides practical advice on HFSR management to enable health care professionals to recognize, pre-empt, and effectively manage the symptoms, thereby allowing patients to remain on active therapy for as long as possible. Design This review is based on a systematic literature search of the PubMed database (using synonyms of HFSR, regorafenib, and skin toxicities associated with targeted therapies or cytotoxic chemotherapy). However, as this search identified very few articles, the authors also use their clinical experience as oncologists and dermatologists managing patients with treatment-related HFSR to provide recommendations on recognition and management of HFSR in regorafenib-treated patients. Results Regorafenib-related HFSR is similar to that seen with other multikinase inhibitors (e.g. sorafenib, sunitinib, cabozantinib, axitinib, and pazopanib) but differs from the hand–foot syndrome seen with cytotoxic chemotherapies (e.g. fluoropyrimidines, anthracyclines, and taxanes). There have been no controlled trials of symptomatic management of regorafenib-related HFSR, and limited good-quality evidence from randomized clinical trials of effective interventions for HFSR associated with other targeted therapies. Recommendations on prevention and management of regorafenib-related HFSR in this review are therefore based on the expert opinion of the authors (dermatologists and oncologists with expertise in the management of treatment-related skin toxicities and oncologists involved in clinical trials of regorafenib) and

  3. Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention.

    Science.gov (United States)

    Saunders, John B; Hao, Wei; Long, Jiang; King, Daniel L; Mann, Karl; Fauth-Bühler, Mira; Rumpf, Hans-Jürgen; Bowden-Jones, Henrietta; Rahimi-Movaghar, Afarin; Chung, Thomas; Chan, Elda; Bahar, Norharlina; Achab, Sophia; Lee, Hae Kook; Potenza, Marc; Petry, Nancy; Spritzer, Daniel; Ambekar, Atul; Derevensky, Jeffrey; Griffiths, Mark D; Pontes, Halley M; Kuss, Daria; Higuchi, Susumu; Mihara, Satoko; Assangangkornchai, Sawitri; Sharma, Manoj; Kashef, Ahmad El; Ip, Patrick; Farrell, Michael; Scafato, Emanuele; Carragher, Natacha; Poznyak, Vladimir

    2017-09-01

    Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%-15% among young people in several Asian countries and of 1%-10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11.

  4. Canine parvoviral enteritis: an update on the clinical diagnosis, treatment, and prevention

    Directory of Open Access Journals (Sweden)

    Mylonakis ME

    2016-07-01

    Full Text Available Mathios E Mylonakis, Iris Kalli, Timoleon S Rallis Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece  Abstract: Canine parvovirus type 2 is the cause of a highly contagious acute enteritis associated with high morbidity and mortality, with very low survival rates in untreated dogs. Although severe clinical disease typically occurs in dogs younger than 6 months of age, adults with insufficient immunity may potentially be affected. In this article, the current state of knowledge is reviewed regarding the diagnostic aspects of parvoviral enteritis, with special emphasis placed on the clinical relevance of the detection of viral antigens in the feces, detection of viral antibodies in the serum, or the polymerase chain reaction-based amplification of the viral DNA in the feces. In addition, the components of the supportive and symptomatic treatment aiming to optimize the outcome of the disease in the clinical setting are thoroughly reviewed. Immunization guidelines for the prevention of the disease are also updated. Keywords: dog, parvovirus type 2, acute enteritis, treatment, vaccination

  5. [RELEVANT PRINCIPLES IN THE DIAGNOSIS, TREATMENT, AND PREVENTION OF TOXOPLASMOSIS DURING PREGNANCY].

    Science.gov (United States)

    Merzlova, N B; Serova, I A; Yagodina, A Yu

    2015-01-01

    A retrospective survey of the prevalence of TORCH infections among pregnant women was performed in the perinatal center, M. A. Tverye Military Sanitary Unit Nine (Perm), in June 2010 to December 2013. The survey covered 2060 women: they were all examined for cytomegalovirus, herpes simplex virus, and Toxoplasma. Antibodies to Toxoplasma gondii were detected in 28.68% (591/2060); 98.62% were found to have antibodies to herpes simplex; antibodies to cytomegalovirus were identified in 87.13% (1795/2060). Acute maternal toxoplasmosis was diagnosed by seroconversion or determination of IgM anti-Toxoplasma gondii antibodies, in the presence of a low avidity index and a four-fold increase in antibody titers, by simultaneously studying paired serum samples obtained at a 2-week interval. To confirm fetal infection, amniotic fluid PCR examination should be performed after 18 weeks' gestation. No consensus of opinion as to the principles of treatment for toxoplasmosis in pregnant women makes relevant the long-term results of antibacterial and antiprotozoal treatment cycles varying in duration and intensity. The prevention of acute toxoplasmosis in pregnant women ensures the principle of a mother's personal responsibility for infection safety of a newborn infant, which is informationally provided in health and safety fundamentals course and pregravid preparation schools.

  6. Reproductive prognosis in endometriosis

    DEFF Research Database (Denmark)

    Hjordt Hansen, Maj V; Dalsgaard, Torur; Hartwell, Dorthe

    2014-01-01

    OBJECTIVE: To assess the reproductive long-term prognosis of women with and without endometriosis, to explore changes over time, and to quantify the contribution of artificial reproductive techniques. DESIGN: Cohort study. SETTING: Denmark 1977-2009. SAMPLE: Data retrieved from four national...... registries. Among 15-49-year-old women during the period 1977-82, 24 667 were diagnosed with endometriosis and 98 668 (1:4) women without endometriosis were age-matched. METHODS: To assess long-term reproductive prognosis, all pregnancy outcomes were identified among the women with and without endometriosis...... until the end of 2009. To explore changes over time, the endometriosis cohorts were followed for 15 years from the years 1980, 1986, 1992 and 1998, with the corresponding control cohorts. All pregnancy outcomes were categorized into naturally or artificially conceived pregnancies. MAIN OUTCOME MEASURES...

  7. Prevention and diagnosis of ventilator-associated pneumonia: a survey on current practices in Southern Spanish ICUs.

    Science.gov (United States)

    Sierra, Rafael; Benítez, Encarnación; León, Cristóbal; Rello, Jordi

    2005-09-01

    To assess the implementation of selected ventilator-associated pneumonia (VAP) prevention strategies, and to learn how VAP is diagnosed in the ICUs of Southern Spain. Multicentric survey. The ICUs of 32 hospitals of the public health-care system of Southern Spain. Directors of ICUs. None. Twenty-eight ICUs (87.5%) returned completed questionnaires. Ventilator circuits were changed every 72 h or longer in 75% of ICUs. Use of heat and moisture exchangers and open endotracheal suction systems were reported in 96% of ICUs. Subglottic secretion drainage was never used, and 57% of ICUs checked endotracheal tube cuff pressure at least daily. Semi-recumbent position was common (93%), and 67.5% of ICUs used frequently noninvasive ventilation. Continuous enteral feeding was reported in all ICUs. Sedative infusions were usually interrupted every day in 11% of ICUs. Seventy-five percent of ICUs had specific guidelines for antibiotic therapy of VAP, but rotation of antibiotics was uncommon (11%). Twenty-nine percent of ICUs diagnosed VAP without microbiological confirmation. The most used technique for microbiologic diagnosis was qualitative culture of endotracheal aspirates (42.8%). The centers with a larger structural complexity reported using VAP therapy guidelines more frequently than the smaller centers, but they did not utilized bronchoscopic techniques for diagnosing VAP. Common prevention and diagnostic procedures in clinical practice, including large teaching institutions, significantly differed from evidence-based recommendations and reports by research groups of excellence. In addition, our study suggests that clinical practice for preventing and diagnosing VAP is variable and many opportunities exist to improve the care of patients receiving mechanical ventilation.

  8. Traditional Chinese medicine and new concepts of predictive, preventive and personalized medicine in diagnosis and treatment of suboptimal health.

    Science.gov (United States)

    Wang, Wei; Russell, Alyce; Yan, Yuxiang

    2014-02-13

    The premise of disease-related phenotypes is the definition of the counterpart normality in medical sciences. Contrary to clinical practices that can be carefully planned according to clinical needs, heterogeneity and uncontrollability is the essence of humans in carrying out health studies. Full characterization of consistent phenotypes that define the general population is the basis to individual difference normalization in personalized medicine. Self-claimed normal status may not represent health because asymptomatic subjects may carry chronic diseases at their early stage, such as cancer, diabetes mellitus and atherosclerosis. Currently, treatments for non-communicable chronic diseases (NCD) are implemented after disease onset, which is a very much delayed approach from the perspective of predictive, preventive and personalized medicine (PPPM). A NCD pandemic will develop and be accompanied by increased global economic burden for healthcare systems throughout both developed and developing countries. This paper examples the characterization of the suboptimal health status (SHS) which represents a new PPPM challenge in a population with ambiguous health complaints such as general weakness, unexplained medical syndrome (UMS), chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), post-viral fatigue syndrome (PVFS) and chronic fatigue immune dysfunction syndrome (CFIDS). We applied clinical informatic approaches and developed a questionnaire-suboptimal health status questionnaire-25 (SHSQ-25) for measuring SHS. The validity and reliability of this approach were evaluated in a small pilot study and then in a cross-sectional study of 3,405 participants in China. We found a correlation between SHS and systolic blood pressure, diastolic blood pressure, plasma glucose, total cholesterol and high-density lipoprotein (HDL) cholesterol among men, and a correlation between SHS and systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides

  9. Understanding Cancer Prognosis

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    Full Text Available Skip to content Español 1-800-4-CANCER Live Chat Publications Dictionary Menu Contact Dictionary Search About Cancer Causes and Prevention Risk Factors Genetics Cancer Prevention Overview Research Cancer ...

  10. Understanding Cancer Prognosis

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    Full Text Available ... Understanding Cancer What Is Cancer? Cancer Statistics Cancer Disparities Understanding Cancer What Is Cancer Cancer Statistics Cancer Disparities Causes & Prevention Risk Factors Genetics Cancer Prevention Overview ...

  11. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

    NARCIS (Netherlands)

    Hooton, Thomas M.; Bradley, Suzanne F.; Cardenas, Diana D.; Colgan, Richard; Geerlings, Suzanne E.; Rice, James C.; Saint, Sanjay; Schaeffer, Anthony J.; Tambayh, Paul A.; Tenke, Peter; Nicolle, Lindsay E.

    2010-01-01

    Guidelines for the diagnosis, prevention, and management of persons with catheter-associated urinary tract infection (CA-UTI), both symptomatic and asymptomatic, were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence-based guidelines encompass diagnostic

  12. Contribution of the private sector healthcare service providers to malaria diagnosis in a prevention of re-introduction setting.

    Science.gov (United States)

    Fernando, Sumadhya Deepika; Dharmawardana, Priyani; Epasinghe, Geethanee; Senanayake, Niroshana; Rodrigo, Chaturaka; Premaratne, Risintha; Wickremasinghe, Rajitha

    2016-10-18

    Sri Lanka is currently in the prevention of re-introduction phase of malaria. The engagement of the private sector health care institutions in malaria surveillance is important. The purpose of the study was to determine the number of diagnostic tests carried out, the number of positive cases identified and the referral system for diagnosis in the private sector and to estimate the costs involved. This prospective study of private sector laboratories within the Colombo District of Sri Lanka was carried out over a 6-month period in 2015. The management of registered private sector laboratories was contacted individually and the purpose of the study was explained. A reporting format was developed and introduced for monthly reporting. Forty-one laboratories were eligible to be included in the study and 28 participated by reporting data on a monthly basis. Excluding blood bank samples and routine testing for foreign employment, malaria diagnostic tests were carried out on 973 individuals during the 6-month period and nine malaria cases were identified. In 2015, a total of 36 malaria cases were reported from Sri Lanka. Of these, 24 (67 %) were diagnosed in the Colombo District and 50 % of them were diagnosed in private hospitals. An equal number of cases were diagnosed from the private sector and government sector in the Colombo District in 2015. The private sector being a major contributor in the detection of imported malaria cases in the country should be actively engaged in the national malaria surveillance system.

  13. 2018 International Olympic Committee Consensus Statement on Prevention, Diagnosis, and Management of Pediatric Anterior Cruciate Ligament Injuries

    Science.gov (United States)

    Ardern, Clare L.; Ekås, Guri; Grindem, Hege; Moksnes, Håvard; Anderson, Allen F.; Chotel, Franck; Cohen, Moises; Forssblad, Magnus; Ganley, Theodore J.; Feller, Julian A.; Karlsson, Jón; Kocher, Mininder S.; LaPrade, Robert F.; McNamee, Mike; Mandelbaum, Bert; Micheli, Lyle; Mohtadi, Nicholas G.H.; Reider, Bruce; Roe, Justin P.; Seil, Romain; Siebold, Rainer; Silvers-Granelli, Holly J.; Soligard, Torbjørn; Witvrouw, Erik; Engebretsen, Lars

    2018-01-01

    In October 2017, the International Olympic Committee hosted an international expert group of physical therapists and orthopaedic surgeons who specialize in treating and researching pediatric anterior cruciate ligament (ACL) injuries. The purpose of this meeting was to provide a comprehensive, evidence-informed summary to support the clinician and help children with ACL injury and their parents/guardians make the best possible decisions. Representatives from the following societies attended: American Orthopaedic Society for Sports Medicine; European Paediatric Orthopaedic Society; European Society for Sports Traumatology, Knee Surgery, and Arthroscopy; International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine; Pediatric Orthopaedic Society of North America; and Sociedad Latinoamericana de Artroscopia, Rodilla, y Deporte. Physical therapists and orthopaedic surgeons with clinical and research experience in the field and an ethics expert with substantial experience in the area of sports injuries also participated. This consensus statement addresses 6 fundamental clinical questions regarding the prevention, diagnosis, and management of pediatric ACL injuries. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision making with children and the potential long-term ramifications of the injury. PMID:29594177

  14. 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries

    Science.gov (United States)

    Ekås, Guri Ranum; Grindem, Hege; Moksnes, Håvard; Anderson, Allen F; Chotel, Franck; Cohen, Moises; Forssblad, Magnus; Ganley, Theodore J; Feller, Julian A; Karlsson, Jón; Kocher, Minider S; LaPrade, Robert F; McNamee, Michael; Mandelbaum, Bert; Micheli, Lyle; Mohtadi, Nicholas; Reider, Bruce; Roe, Justin; Seil, Romain; Siebold, Rainer; Witvrouw, Erik; Engebretsen, Lars

    2018-01-01

    In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions. PMID:29478021

  15. Vital prognosis after hospitalization for COPD

    DEFF Research Database (Denmark)

    Vestbo, J; Prescott, E; Lange, P

    1998-01-01

    STUDY AIM: To examine survival after admission due to chronic obstructive pulmonary disease (COPD) in a population sample over a time span of 15 years. DESIGN: Linkage between a prospective population cohort and register information on hospitalization and mortality. SETTING: The Copenhagen City...... Heart Study (CCHS). PARTICIPANTS: A total of 267 men and 220 women who had participated in the CCHS and who were hospitalized with a discharge diagnosis of COPD (ICD-8 491-2). MAIN RESULTS: The crude 5-yr survival rate after a COPD admission was 45% (37% for men and 52% for women). Mortality risk...... associated with prognosis. Survival after admission due to COPD did not change significantly over time. CONCLUSION: Compared to previous studies of COPD patients, the present study indicates that prognosis after hospital admission remains virtually unchanged over the last decades. FEV1 is still the strongest...

  16. Understanding Cancer Prognosis

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    Full Text Available ... decide how much information you want. If you do decide you want to know more, the doctor ... of time after diagnosis compared to people who do not have cancer. Overall survival This is the ...

  17. Understanding Cancer Prognosis

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    Full Text Available ... a certain period of time after diagnosis. Disease-free survival This statistic is the percentage of patients ... treatment. Other names for this statistic are recurrence-free or progression-free survival. Because statistics are based ...

  18. Understanding Cancer Prognosis

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    Full Text Available ... body The cancer’s grade, which refers to how abnormal the cancer cells look under a microscope. Grade ... during a certain period of time after diagnosis. Disease-free survival This statistic is the percentage of ...

  19. Understanding Cancer Prognosis

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    Full Text Available ... Proposal NCI Congressional Justification NCI Budget Fact Book Careers at NCI Visitor Information Legislative Activities Hearings & Testimonies ... Committees of Interest Legislative Resources Recent Public Laws Careers Visitor Information Search Search Home About Cancer Diagnosis ...

  20. Understanding Cancer Prognosis

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    Full Text Available ... Justification NCI Budget Fact Book Careers at NCI Visitor Information Legislative Activities Hearings & Testimonies Current Congress Legislative ... of Interest Legislative Resources Recent Public Laws Careers Visitor Information Search Search Home About Cancer Diagnosis and ...

  1. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  2. Understanding Cancer Prognosis

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    Full Text Available ... from their cancer during a certain period of time after diagnosis. The period of time may be 1 year, 2 years, 5 years, etc., with 5 years being the time period most often used. Cancer-specific survival is ...

  3. From Prenatal to Preimplantation Genetic Diagnosis of β-Thalassemia. Prevention Model in 8748 Cases: 40 Years of Single Center Experience

    Directory of Open Access Journals (Sweden)

    Giovanni Monni

    2018-02-01

    Full Text Available The incidence of β-thalassemia in Sardinia is high and β-39 is the most common mutation. The prevention campaign started in 1977 and was performed in a single center (Microcitemico Hospital, Cagliari, Sardinia, Italy. It was based on educational programs, population screening by hematological and molecular identification of the carriers. Prenatal and pre-implantation diagnosis was offered to couples at risk. 8564 fetal diagnosis procedures using different invasive approaches and analysis techniques were performed in the last 40 years. Trans-abdominal chorionic villous sampling was preferred due to lower complication risks and early diagnosis. Chorionic villous DNA was analyzed by PCR technique. 2138 fetuses affected by β-thalassemia were diagnosed. Women opted for termination of the pregnancy (TOP in 98.2% of these cases. Pre-implantation genetic diagnosis (PGD was proposed to couples at risk to avoid TOP. A total of 184 PGD were performed. Initially, the procedure was exclusively offered to infertile couples, according to the law in force. The success rate of pregnancies increased from 11.1% to 30.8% when, crucial law changes were enacted, and PGD was offered to fertile women as well. Forty years of β-thalassemia prevention programs in Sardinia have demonstrated the important decrease of this severe genetic disorder.

  4. From Prenatal to Preimplantation Genetic Diagnosis of β-Thalassemia. Prevention Model in 8748 Cases: 40 Years of Single Center Experience.

    Science.gov (United States)

    Monni, Giovanni; Peddes, Cristina; Iuculano, Ambra; Ibba, Rosa Maria

    2018-02-20

    The incidence of β-thalassemia in Sardinia is high and β-39 is the most common mutation. The prevention campaign started in 1977 and was performed in a single center (Microcitemico Hospital, Cagliari, Sardinia, Italy). It was based on educational programs, population screening by hematological and molecular identification of the carriers. Prenatal and pre-implantation diagnosis was offered to couples at risk. 8564 fetal diagnosis procedures using different invasive approaches and analysis techniques were performed in the last 40 years. Trans-abdominal chorionic villous sampling was preferred due to lower complication risks and early diagnosis. Chorionic villous DNA was analyzed by PCR technique. 2138 fetuses affected by β-thalassemia were diagnosed. Women opted for termination of the pregnancy (TOP) in 98.2% of these cases. Pre-implantation genetic diagnosis (PGD) was proposed to couples at risk to avoid TOP. A total of 184 PGD were performed. Initially, the procedure was exclusively offered to infertile couples, according to the law in force. The success rate of pregnancies increased from 11.1% to 30.8% when, crucial law changes were enacted, and PGD was offered to fertile women as well. Forty years of β-thalassemia prevention programs in Sardinia have demonstrated the important decrease of this severe genetic disorder.

  5. EUROPAEM EMF Guideline 2016 for the prevention, diagnosis and treatment of EMF-related health problems and illnesses.

    Science.gov (United States)

    Belyaev, Igor; Dean, Amy; Eger, Horst; Hubmann, Gerhard; Jandrisovits, Reinhold; Kern, Markus; Kundi, Michael; Moshammer, Hanns; Lercher, Piero; Müller, Kurt; Oberfeld, Gerd; Ohnsorge, Peter; Pelzmann, Peter; Scheingraber, Claus; Thill, Roby

    2016-09-01

    , the emerging electromagnetic hypersensitivity (EHS) is more and more recognized by health authorities, disability administrators and case workers, politicians, as well as courts of law. We recommend treating EHS clinically as part of the group of chronic multisystem illnesses (CMI), but still recognizing that the underlying cause remains the environment. In the beginning, EHS symptoms occur only occasionally, but over time they may increase in frequency and severity. Common EHS symptoms include headaches, concentration difficulties, sleep problems, depression, a lack of energy, fatigue, and flu-like symptoms. A comprehensive medical history, which should include all symptoms and their occurrences in spatial and temporal terms and in the context of EMF exposures, is the key to making the diagnosis. The EMF exposure is usually assessed by EMF measurements at home and at work. Certain types of EMF exposure can be assessed by asking about common EMF sources. It is very important to take the individual susceptibility into account. The primary method of treatment should mainly focus on the prevention or reduction of EMF exposure, that is, reducing or eliminating all sources of high EMF exposure at home and at the workplace. The reduction of EMF exposure should also be extended to public spaces such as schools, hospitals, public transport, and libraries to enable persons with EHS an unhindered use (accessibility measure). If a detrimental EMF exposure is reduced sufficiently, the body has a chance to recover and EHS symptoms will be reduced or even disappear. Many examples have shown that such measures can prove effective. To increase the effectiveness of the treatment, the broad range of other environmental factors that contribute to the total body burden should also be addressed. Anything that supports homeostasis will increase a person's resilience against disease and thus against the adverse effects of EMF exposure. There is increasing evidence that EMF exposure has a

  6. EUROPAEM EMF Guideline 2015 for the prevention, diagnosis and treatment of EMF-related health problems and illnesses.

    Science.gov (United States)

    Belyaev, Igor; Dean, Amy; Eger, Horst; Hubmann, Gerhard; Jandrisovits, Reinhold; Johansson, Olle; Kern, Markus; Kundi, Michael; Lercher, Piero; Mosgöller, Wilhelm; Moshammer, Hanns; Müller, Kurt; Oberfeld, Gerd; Ohnsorge, Peter; Pelzmann, Peter; Scheingraber, Claus; Thill, Roby

    2015-01-01

    environment. In the beginning, EHS symptoms often occur only occasionally, but over time they may increase in frequency and severity. Common EHS symptoms include headaches, concentration difficulties, sleeping problems, depression, lack of energy, fatigue and flu-like symptoms. A comprehensive medical history, which should include all symptoms and their occurrences in spatial and temporal terms and in the context of EMF exposures, is the key to the diagnosis. The EMF exposure can be assessed by asking for typical sources like Wi-Fi access points, routers and clients, cordless and mobile phones and measurements at home and at work. It is very important to take the individual susceptibility into account. The primary method of treatment should mainly focus on the prevention or reduction of EMF exposure, that is, reducing or eliminating all sources of EMF at home and in the workplace. The reduction of EMF exposure should also be extended to public spaces such as schools, hospitals, public transport, and libraries to enable persons with EHS an unhindered use (accessibility measure). If a detrimental EMF exposure is reduced sufficiently, the body has a chance to recover and EHS symptoms will be reduced or even disappear. Many examples have shown that such measures can prove effective. Also the survival rate of children with leukemia depends on ELF magnetic field exposure at home. To increase the effectiveness of the treatment, the broad range of other environmental factors that contribute to the total body burden should also be addressed. Anything that supports a balanced homeostasis will increase a person's resilience against disease and thus against the adverse effects of EMF exposure. There is increasing evidence that EMF exposure has a major impact on the oxidative and nitrosative regulation capacity in affected individuals. This concept also may explain why the level of susceptibility to EMF can change and why the number of symptoms reported in the context of EMF exposures is

  7. Understanding Cancer Prognosis

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    Full Text Available Skip to content Español 1-800-4-CANCER Live Chat Publications Dictionary Menu Contact Dictionary Search About Cancer Causes and Prevention Risk Factors ... MORE INFORMATION About This Website Cancer.gov en español Multimedia Publications Site Map Digital Standards for NCI ...

  8. Understanding Cancer Prognosis

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    Full Text Available ... Español 1-800-4-CANCER Live Chat Publications Dictionary Menu Contact Dictionary Search About Cancer Causes and Prevention Risk Factors ... Managing Cancer Care Finding Health Care Services Costs & Medical Information Advance Directives Using Trusted Resources Understanding Cancer ...

  9. Transforaminal Epidural Steroid Injections Followed by Mechanical Diagnosis and Therapy to Prevent Surgery for Lumbar Disc Herniation

    NARCIS (Netherlands)

    van Helvoirt, H.; Apeldoorn, A.T.; Ostelo, R.W.J.G.; Knol, D.L.; Arts, M.P.; Kamper, S.J.; van Tulder, M.W.

    2014-01-01

    Study Design: Prospective cohort study. Objective: To report the clinical course of patients with MRI-confirmed lumbar disc herniation-related radicular noncentralizing pain who received transforaminal epidural steroid injections (TESIs) and mechanical diagnosis and therapy (MDT). Summary of

  10. Prognosis of Cyclic Vomiting Syndrome

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2016-03-01

    Full Text Available Investigators from Teikyo University School of Medicine, Tokyo, Japan, evaluated the clinical features, prognosis, and prophylaxis of cyclic vomiting syndrome and the relationship between the syndrome and levels of adrenocorticotropic/antidiuretic hormones (ACTH/ADH.

  11. Providing clinicians and patients with actual prognosis: cancer in the context of competing causes of death.

    Science.gov (United States)

    Howlader, Nadia; Mariotto, Angela B; Woloshin, Steven; Schwartz, Lisa M

    2014-11-01

    To isolate progress against cancer from changes in competing causes of death, population cancer registries have traditionally reported cancer prognosis (net measures). But clinicians and cancer patients generally want to understand actual prognosis (crude measures): the chance of surviving, dying from the specific cancer and from competing causes of death in a given time period. To compare cancer and actual prognosis in the United States for four leading cancers-lung, breast, prostate, and colon-by age, comorbidity, and cancer stage and to provide templates to help patients, clinicians, and researchers understand actual prognosis. Using population-based registry data from the Surveillance, Epidemiology, and End Results (SEER) Program, we calculated cancer prognosis (relative survival) and actual prognosis (five-year overall survival and the "crude" probability of dying from cancer and competing causes) for three important prognostic determinants (age, comorbidity [Charlson-score from 2012 SEER-Medicare linkage dataset] and cancer stage at diagnosis). For younger, healthier, and earlier stage cancer patients, cancer and actual prognosis estimates were quite similar. For older and sicker patients, these prognosis estimates differed substantially. For example, the five-year overall survival for an 85-year-old patient with colorectal cancer is 54% (cancer prognosis) versus 22% (actual prognosis)-the difference reflecting the patient's substantial chance of dying from competing causes. The corresponding five-year chances of dying from the patient's cancer are 46% versus 37%. Although age and comorbidity lowered actual prognosis, stage at diagnosis was the most powerful factor: The five-year chance of colon cancer death was 10% for localized stage and 83% for distant stage. Both cancer and actual prognosis measures are important. Cancer registries should routinely report both cancer and actual prognosis to help clinicians and researchers understand the difference between

  12. Real-time monitoring, prognosis, and resilient control for wind turbine systems

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Zhiwei; Sheng, Shuangwen

    2018-02-01

    This special issue aims to provide a platform for academic and industrial communities to report recent results and emerging research in real-time monitoring, fault diagnosis, prognosis, and resilient control and design of wind turbine systems. After a strict peer-review process, 20 papers were selected, which represent the most recent progress of the real-time monitoring, diagnosis, prognosis, and resilient control methods/techniques in wind turbine systems.

  13. MSCT在主动脉壁内血肿诊断和转归中的应用%Application of multi-slice spiral CT in diagnosis and prognosis of aortic artery intramural hematoma

    Institute of Scientific and Technical Information of China (English)

    黄源义; 谢欢; 邬正宏; 刘四斌

    2011-01-01

    Objective To investigate the applied value of multi-slice spiral CT in diagnosis and prognoses of aortic artery intramural hematoma(IMH). Methods 11 patients with IMH underwent plain CT scan and CT angiography with 16-slice spiral CT of GE. Endovascular stent for the treatment in 3 cases and conservative treatment in 8 cases was performed. All patients were followed-up twice or 4 times for 15 - 210 days(mean 112. 5 days). Results 3 cases with Stanford A and 8 cases with Stanford B IMH were diagnosed. The main CT findings were as follows: Crescent or circular thickening(>5 mm)of aortic wall with higher density or isodensi-ty without intimal flap as well as true and false lumen in 11 cases;atherosclerosis in 7 cases;intimal calcification ingression in 4 cases; intimal leakages in 3 cases;penetrating ulcer in 3 cases. The hematomas in 7 cases were completely absorbed,incomplete absorbed in 2 cases,while 2 cases were transformed to dissecting aneurysm. Conclusion MSCT is a significant method in diagnosis and follow-ing-up of IMH, and can provide important informations for clinical treatment.%目的 探讨MSCT在主动脉壁内血肿(IMH)诊断和转归中的应用价值.方法 采用GE 16排螺旋CT对11例IMH行平扫和CTA扫描.3例行腔内支架隔绝术,8例保守治疗.所有病例治疗后随访2~4次,随访时间15~210 d(平均112.5 d).结果 A型IMH 3例,B 型IMH 8例.MSCT主要征象为:11例主动脉壁新月形或环形增厚>5 mm,呈等密度或高密度,无内膜片撕裂及真、假两腔形成;主动脉粥样硬化7例;内膜钙化内移4例;内膜渗漏3例;穿透性溃疡3例.7例完全吸收,2例部分吸收,2例进展成夹层动脉瘤.结论 MSCT能对IMH作出明确的诊断,并可作为IMH随访的重要检查手段,对临床治疗有重要的指导意义.

  14. Prevention and diagnosis of invasive fungal disease in high-risk patients within an integrative care pathway.

    Science.gov (United States)

    Barnes, Rosemary A; Stocking, Kate; Bowden, Sarah; Poynton, Matthew H; White, P Lewis

    2013-09-01

    The aim of this study was to assess the clinical utility of enhanced diagnostics on the management of invasive fungal disease in high risk patients within an integrated care pathway and to audit compliance and efficacy of antifungal prophylaxis. A cohort of 549 high risk haematology and stem-cell transplant recipients was followed over a 5 year period. The routine standard of care involved the use of antimould prophylaxis and a neutropenic care pathway utilizing twice weekly antigen and PCR testing. Prophylaxis with itraconazole was poorly tolerated and therapeutic levels could not be maintained. Antigen testing and PCR showed good clinical utility in the management of invasive aspergilosis with high sensitivity (98%) and negative predictive value (99.6%) when both tests were used together, allowing a diagnosis IA to be excluded and obviating the need for empirical antifungal agents. When used serially, multiple positive PCR and antigen test results enabled accurate diagnosis of IA with a specificity of 95% and a positive likelihood ratio of 11. Biomarkers preceded clinical signs in 85% of proven and probable invasive disease. The combination of both tests showed optimum clinical utility for the diagnosis and management of IA in this high risk group. Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  15. Towards in silico prognosis using big data

    Directory of Open Access Journals (Sweden)

    Ohs Nicholas

    2016-09-01

    Full Text Available Clinical diagnosis and prognosis usually rely on few or even single measurements despite clinical big data being available. This limits the exploration of complex diseases such as adolescent idiopathic scoliosis (AIS where the associated low bone mass remains unexplained. Observed low physical activity and increased RANKL/OPG, however, both indicate a mechanobiological cause. To deepen disease understanding, we propose an in silico prognosis approach using clinical big data, i.e. medical images, serum markers, questionnaires and live style data from mobile monitoring devices and explore the role of inadequate physical activity in a first AIS prototype. It employs a cellular automaton (CA to represent the medical image, micro-finite element analysis to calculate loading, and a Boolean network to integrate the other biomarkers. Medical images of the distal tibia, physical activity scores, and vitamin D and PTH levels were integrated as measured clinically while the time development of bone density and RANKL/OPG was observed. Simulation of an AIS patient with normal physical activity and patient-specific vitamin D and PTH levels showed minor changes in bone density whereas the simulation of the same AIS patient but with reduced physical activity led to low density. Both showed unchanged RANKL/OPG and considerable cortical resorption. We conclude that our integrative in silico approach allows to account for a variety of clinical big data to study complex diseases.

  16. Improving outcomes in cancer diagnosis, prevention and control: barriers, facilitators and the need for health literacy in Ibadan Nigeria.

    Science.gov (United States)

    Adedimeji, Adebola A; Lounsbury, David; Popoola, Oluwafemi; Asuzu, Chioma; Lawal, Akinmayowa; Oladoyin, V; Crifase, Cassandra; Agalliu, Ilir; Shankar, Viswanathan; Adebiyi, Akindele

    2017-10-01

    Cancers constitute a significant public health problem in Nigeria. Breast, cervix and prostate cancers are leading causes of cancer-related deaths. Changing diets, lifestyles, HIV/AIDS and macro-structural factors contribute to cancer morbidity and mortality. Poor health information linking cancer risk to individual behaviors, environmental pollutants and structural barriers undermine prevention/control efforts. Studies suggest increasing health literacy and empowering individuals to take preventive action will improve outcomes and mitigate impact on a weak health system. We obtained qualitative data from 80 men, women, and young adults in 11 focus groups to assess beliefs, risk-perceptions, preventive behaviors and perceptions of barriers and facilitators to cancer control in Ibadan, Nigeria and conducted thematic analysis. Participants demonstrated awareness of cancers and mentioned several risk factors related to individual behaviors and the environment. Nonetheless, myths and misconceptions as well as micro, meso and macro level barriers impede prevention and control efforts. Developing and implementing comprehensive context-relevant health literacy interventions in community settings are urgently needed.Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  17. Acute rheumatic fever and rheumatic heart disease--priorities in prevention, diagnosis and management. A report of the CSANZ Indigenous Cardiovascular Health Conference, Alice Springs 2011.

    Science.gov (United States)

    Rémond, M G W; Wheaton, G R; Walsh, W F; Prior, D L; Maguire, G P

    2012-10-01

    Three priority areas in the prevention, diagnosis and management of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) were identified and discussed in detail: 1. Echocardiography and screening/diagnosis of RHD – Given the existing uncertainty it remains premature to advocate for or to incorporate echocardiographic screening for RHD into Australian clinical practice. Further research is currently being undertaken to evaluate the potential for echocardiography screening. 2. Secondary prophylaxis – Secondary prophylaxis (long acting benzathine penicillin injections) must be seen as a priority. Systems-based approaches are necessary with a focus on the development and evaluation of primary health care-based or led strategies incorporating effective health information management systems. Better/novel systems of delivery of prophylactic medications should be investigated. 3. Management of advanced RHD – National centres of excellence for the diagnosis, assessment and surgical management of RHD are required. Early referral for surgical input is necessary with multidisciplinary care and team-based decision making that includes patient, family, and local health providers. There is a need for a national RHD surgical register and research strategy for the assessment, intervention and long-term outcome of surgery and other interventions for RHD. Copyright © 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  18. The Indian National Association for Study of the Liver (INASL) Consensus on Prevention, Diagnosis and Management of Hepatocellular Carcinoma in India: The Puri Recommendations.

    Science.gov (United States)

    Kumar, Ashish; Acharya, Subrat K; Singh, Shivaram P; Saraswat, Vivek A; Arora, Anil; Duseja, Ajay; Goenka, Mahesh K; Jain, Deepali; Kar, Premashish; Kumar, Manoj; Kumaran, Vinay; Mohandas, Kunisshery M; Panda, Dipanjan; Paul, Shashi B; Ramachandran, Jeyamani; Ramesh, Hariharan; Rao, Padaki N; Shah, Samir R; Sharma, Hanish; Thandassery, Ragesh B

    2014-08-01

    Hepatocellular carcinoma (HCC) is one of the major causes of morbidity, mortality and healthcare expenditure in patients with chronic liver disease. There are no consensus guidelines on diagnosis and management of HCC in India. The Indian National Association for Study of the Liver (INASL) set up a Task-Force on HCC in 2011, with a mandate to develop consensus guidelines for diagnosis and management of HCC, relevant to disease patterns and clinical practices in India. The Task-Force first identified various contentious issues on various aspects of HCC and these issues were allotted to individual members of the Task-Force who reviewed them in detail. The Task-Force used the Oxford Center for Evidence Based Medicine-Levels of Evidence of 2009 for developing an evidence-based approach. A 2-day round table discussion was held on 9th and 10th February, 2013 at Puri, Odisha, to discuss, debate, and finalize the consensus statements. The members of the Task-Force reviewed and discussed the existing literature at this meeting and formulated the INASL consensus statements for each of the issues. We present here the INASL consensus guidelines (The Puri Recommendations) on prevention, diagnosis and management of HCC in India.

  19. Neuroblastoma: biology, prognosis, and treatment

    NARCIS (Netherlands)

    Park, Julie R.; Eggert, Angelika; Caron, Huib

    2010-01-01

    Neuroblastoma, a neoplasm of the sympathetic nervous system, is the second most common extracranial malignant tumor of childhood and the most common solid tumor of infancy. Neuroblastoma is a heterogeneous malignancy with prognosis ranging from near uniform survival to high risk for fatal demise.

  20. Neuroblastoma: biology, prognosis, and treatment

    NARCIS (Netherlands)

    Park, Julie R.; Eggert, Angelika; Caron, Huib

    2008-01-01

    Neuroblastoma, a neoplasm of the sympathetic nervous system, is the second most common extracranial malignant tumor of childhood and the most common solid tumor of infancy. Neuroblastoma is a heterogeneous malignancy with prognosis ranging from near uniform survival to high risk for fatal demise.

  1. Long-term prediction of prostate cancer diagnosis and death using PSA and obesity related anthropometrics at early middle age: data from the malmö preventive project.

    Science.gov (United States)

    Assel, Melissa J; Gerdtsson, Axel; Thorek, Daniel L J; Carlsson, Sigrid V; Malm, Johan; Scardino, Peter T; Vickers, Andrew; Lilja, Hans; Ulmert, David

    2018-01-19

    To evaluate whether anthropometric parameters add to PSA measurements in middle-aged men for risk assessment of prostate cancer (PCa) diagnosis and death. After adjusting for PSA, both BMI and weight were significantly associated with an increased risk of PCa death with the odds of a death corresponding to a 10 kg/m2 or 10 kg increase being 1.58 (95% CI 1.10, 2.28; p = 0.013) and 1.14 (95% CI 1.02, 1.26; p = 0.016) times greater, respectively. AUCs did not meaningfully increase with the addition of weight or BMI to prediction models including PSA. In 1974 to 1986, 22,444 Swedish men aged 44 to 50 enrolled in Malmö Preventive Project, Sweden, and provided blood samples and anthropometric data. Rates of PSA screening in the cohort were very low. Documentation of PCa diagnosis and disease-specific death up to 2014 was retrieved through national registries. Among men with anthropometric measurements available at baseline, a total of 1692 men diagnosed with PCa were matched to 4190 controls, and 464 men who died of disease were matched to 1390 controls. Multivariable conditional logistic regression was used to determine whether diagnosis or death from PCa were associated with weight and body mass index (BMI) at adulthood after adjusting for PSA. Men with higher BMI and weight at early middle age have an increased risk of PCa diagnosis and death after adjusting for PSA. However, in a multi-variable numerical statistical model, BMI and weight do not importantly improve the predictive accuracy of PSA. Risk-stratification of screening should be based on PSA without reference to anthropometrics.

  2. Diagnosis of osteoporosis in rural Arctic Greenland: a clinical case using plain chest radiography for secondary prevention and consideration of tools for primary prevention in remote areas.

    Science.gov (United States)

    Fleischer, Inuuteq; Schæbel, Louise K; Albertsen, Nadja; Sørensen, Vibeke N; Andersen, Stig

    2017-01-01

    Osteoporosis is a frequent disease in many populations. The hallmark is fragility fractures, which are harbingers of future fractures, disability, mortality and cost on society. The occurrence increases with age, low vitamin D level and smoking. Smoking rates are high, vitamin D is low and life expectancy is rising steeply in Greenland, as is the need for focus on osteoporosis. We report a case that uses a simple and readily available tool to diagnose osteoporosis at the hospital in Sisimiut, a town of 5000 inhabitants on the west coast of Greenland. A 51-year-old Inuit woman was seen due to lower back pain. No trauma could be recalled. Laboratory results showed a low vitamin D level and normal S-calcium, S-phosphate, S-parathyroid hormone, S-thyrotropin, erythrocyte sedimentation rate, S-creatinine and hemoglobin. The lateral chest radiograph demonstrated a reduction of anterior height of the seventh and ninth thoracic vertebral bodies of 50% and 40% respectively. Chest radiographs are frequently done in the towns along the vast coastline of Greenland, the world's largest island. They are transferred to the hospital in the capital city Nuuk using existing tele-technology, and specialist evaluations are given in electronic records available at the coastal hospitals. Effective therapies for osteoporosis are available and the identification of vertebral fractures that merit treatment may prevent future fractures, morbidity and mortality. Fragility fractures are frequent in old age and the steep rise in life expectancy and in the number of old people in Greenland emphasize the need for a focus on management of osteoporosis. Geography provides a diagnostic challenge to rural and remote areas that can be overcome by the use of lateral chest radiographs as it relies on facilities readily available. Clinical risk assessment tools with high specificity may support further osteoporosis risk prediction in remote Arctic societies.

  3. DIAGNOSIS AND PREVENTION OF CARDIOTOXICITY IN PATIENTS WITH BREAST CANCER FROM THE STANDPOINT OF AN ONCOLOGIST AND A CARDIOLOGIST

    Directory of Open Access Journals (Sweden)

    T. Yu. Semiglazova

    2017-01-01

    Full Text Available Knowledge of anthracycline antibiotics’ (AAs pathogenesis and main risk factors allowed to develop various methods of prevention and early detection of cardiotoxicity as well as to create several guidelines on decreasing the risk of its development. Traditional AAs are a crucial option in treatment of metastatic breast cancer including their repeated prescription. However, their application is significantly limited by various manifestations of toxicity, especially cumulative cardiotoxicity. The most promising is use of pegylated liposomal pharmaceutical formulations of AAs. Among these formulations, pegylated liposomal doxorubicin almost fully lacks anthracycline cardiotoxicity because due to its unique formulation it accumulates almost exclusively in tumor tissue.

  4. Expression of XPG protein in the development, progression and prognosis of gastric cancer.

    Directory of Open Access Journals (Sweden)

    Na Deng

    Full Text Available BACKGROUND: Xeroderma pigmentosum group G (XPG plays a critical role in preventing cells from oxidative DNA damage. This study aimed to investigate XPG protein expression in different gastric tissues and in patients with diverse prognoses, thus providing insights into its role in the development, progression and prognosis of gastric cancer (GC. METHODS: A total of 176 GC, 131 adjacent non-tumour tissues, 53 atrophic gastritis (AG and 49 superficial gastritis (SG samples were included. Immunohistochemical staining was used to detect XPG protein expression. RESULTS: XPG expression was significantly higher in GC tissues compared with adjacent non-tumour tissues. In the progressive disease sequence SG→AG→GC, XPG expression was significantly higher in AG and GC compared with SG. Analysis of clinicopathological parameters and survival in GC patients demonstrated a significant association between XPG expression level and depth of tumour invasion, macroscopic type, Lauren's classification, smoking, Helicobacter pylori infection and family history. Cox multivariate survival analysis indicated that patients with positive XPG expression had significantly longer overall survival (P = 0.020, HR = 0.394, 95%CI 0.179-0.866, especially in aged younger than 60 years (P = 0.027, HR = 0.361, 95%CI 0.147-0.888 and male patients (P = 0.002, HR = 0.209, 95%CI 0.077-0.571. CONCLUSIONS: This study demonstrated that XPG protein expression was related to the development, progression and prognosis of GC, and might thus serve as a potential biomarker for its diagnosis and prognosis.

  5. Impact of serum SP-A and SP-D levels on comparison and prognosis of idiopathic pulmonary fibrosis

    OpenAIRE

    Wang, Kai; Ju, Qing; Cao, Jing; Tang, Wenze; Zhang, Jian

    2017-01-01

    Abstract Background and objective: Idiopathic pulmonary fibrosis (IPF) has a poor prognosis in general; however, it is heterogeneous to detect relative biomarkers for predicting the disease progression. Serum biomarkers can be conveniently collected to detect and help to differentially diagnose IPF and predict IPF prognosis. This meta-analysis aimed to evaluate the use of serum surfactant proteins A and D (SP-A and SP-D) for differential diagnosis and prognosis of IPF. Methods: Relevant artic...

  6. High HIV incidence in men who have sex with men following an early syphilis diagnosis: is there room for pre-exposure prophylaxis as a prevention strategy?

    Science.gov (United States)

    Girometti, Nicolò; Gutierrez, Angela; Nwokolo, Nneka; McOwan, Alan; Whitlock, Gary

    2017-08-01

    HIV pre-exposure prophylaxis (PrEP) is becoming a pivotal strategy for HIV prevention. Understanding the impact of risk factors for HIV transmission to identify those at highest risk would favour the implementation of PrEP, currently limited by costs. In this service evaluation, we estimated the incidence of bacterial STIs in men who have sex with men (MSM) diagnosed with early syphilis attending a London sexual health clinic according to their HIV status. In addition, we estimated the incidence of HIV infection in HIV-negative MSM, following a diagnosis of early syphilis. We undertook a retrospective case note review of all MSM patients diagnosed with early syphilis between January and June 2014. A number of sexual health screens and diagnoses of chlamydia, gonorrhoea and HIV were prospectively analysed following the syphilis diagnosis. 206 MSM were diagnosed with early syphilis. 110 (53%) were HIV-negative at baseline, 96 (47%) were HIV-positive. Only age (37 vs 32 years, p=0.0005) was significantly different according to HIV status of MSM at baseline. In HIV-negative versus HIV-positive MSM, incidence of rectal chlamydia infection at follow-up was 27 cases vs 50/100 person-years of follow-up (PYFU) (p=0.0039), 33 vs 66/100 PYFU (p=0.0044) for rectal gonorrhoea and 10 vs 26/100 PYFU (p=0.0044) for syphilis reinfection, respectively. Total follow-up for 110 HIV-negative MSM was 144 person-years. HIV incidence was 8.3/100 PYFU (CI 4.2 to 14). A diagnosis of early syphilis carries a high risk of consequent HIV seroconversion and should warrant prioritised access to prevention measures such as PrEP and regular STI screening to prevent HIV transmission. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Thrombocytopenia in leukemia: Pathogenesis and prognosis.

    Science.gov (United States)

    Shahrabi, Saeid; Behzad, Masumeh Maleki; Jaseb, Kaveh; Saki, Najmaldin

    2018-02-20

    Leukemias, a heterogeneous group of hematological disorders, are characterized by ineffective hematopoiesis and morphologic abnormalities of hematopoietic cells. Thrombocytopenia is a common problem among leukemia types that can lead to hemorrhagic complications in patients. The purpose of this review article is to identify the conditions associated with the incidence of thrombocytopenia in leukemias. It can be stated that although translocations have been considered responsible for this complication in many studies, other factors such as bone marrow failure, genes polymorphism, a mutation in some transcription factors, and the adverse effects of treatment could be associated with pathogenesis and poor prognosis of thrombocytopenia in leukemias. Considering the importance of thrombocytopenia in leukemias, it is hoped that the recognition of risk factors increasing the incidence of this complication in leukemic patients would be useful for prevention and treatment of this disorder.

  8. Scabies: Prevention and Control

    Science.gov (United States)

    ... Information Scabies FAQs Workplace FAQs Epidemiology & Risk Factors Biology Disease Diagnosis Treatment Prevention & Control Resources for Health Professionals Medications Institutional Settings Prevention ...

  9. Preimplantation genetic diagnosis as a strategy to prevent having a child born with an heritable eye disease.

    Science.gov (United States)

    Yahalom, Claudia; Macarov, Michal; Lazer-Derbeko, Galit; Altarescu, Gheona; Imbar, Tal; Hyman, Jordana H; Eldar-Geva, Talia; Blumenfeld, Anat

    2018-05-21

    In developed countries, genetically inherited eye diseases are responsible for a high percentage of childhood visual impairment. We aim to report our experience using preimplantation genetic diagnostics (PGD) in order to avoid transmitting a genetic form of eye disease associated with childhood visual impairment and ocular cancer. Retrospective case series of women who underwent in vitro fertilization (IVF) and PGD due to a familial history of inherited eye disease and/or ocular cancer, in order to avoid having a child affected with the known familial disease. Each family underwent genetic testing in order to identify the underlying disease-causing mutation. IVF and PGD treatment were performed; unaffected embryos were implanted in their respective mothers. Thirty-five unrelated mothers underwent PGD, and the following hereditary conditions were identified in their families: albinism (10 families); retinitis pigmentosa (7 families); retinoblastoma (4 families); blue cone monochromatism, achromatopsia, and aniridia (2 families each); and Hermansky-Pudlak syndrome, Leber congenital amaurosis, Norrie disease, papillorenal syndrome, primary congenital cataract, congenital glaucoma, Usher syndrome type 1F, and microphthalmia with coloboma (1 family each). Following a total of 88 PGD cycles, 18 healthy (i.e., unaffected) children were born. Our findings underscore the importance an ophthalmologist plays in informing patients regarding the options now available for using prenatal and preimplantation genetic diagnosis to avoid having a child with a potentially devastating genetic form of eye disease or ocular cancer. This strategy is highly relevant, particularly given the limited options currently available for treating these conditions.

  10. Transforaminal epidural steroid injections followed by mechanical diagnosis and therapy to prevent surgery for lumbar disc herniation.

    Science.gov (United States)

    van Helvoirt, Hans; Apeldoorn, Adri T; Ostelo, Raymond W; Knol, Dirk L; Arts, Mark P; Kamper, Steven J; van Tulder, Maurits W

    2014-07-01

    Prospective cohort study. To report the clinical course of patients with MRI-confirmed lumbar disc herniation-related radicular noncentralizing pain who received transforaminal epidural steroid injections (TESIs) and mechanical diagnosis and therapy (MDT). Noncentralizing symptoms in patients with lumbar disc herniation are associated with poor outcome. Commonly used treatments for these patients include TESIs and MDT. No study has evaluated the outcome of combining both strategies. Consecutive candidates for herniated lumbar disc surgery with noncentralizing chronic pain were eligible. Patients received TESIs followed by MDT. The primary outcomes were pain severity in the leg, disability (Roland-Morris Disability Questionnaire for Sciatica), and global perceived effect (GPE). Outcomes were measured at baseline, discharge, and 12 months. Linear mixed-models and McNemar's tests were used to analyze outcome data. Sixty-nine patients receive TESIs. After TESIs, symptoms were resolved completely in 11 patients (16%). In these patients, symptom resolution was maintained at 12 months. A second subgroup of 32 patients (46%) reported significantly less pain after TESIs and showed centralization with MDT reassessment (significant reductions in leg pain and disability [P TESIs but still showed noncentralization with MDT reassessment (significant reductions in leg pain and disability [P TESIs and received an operative intervention. The results indicate that a course of TESIs followed by MDT may be able to avoid surgery in a substantial proportion of candidates for herniated lumbar disc surgery. Wiley Periodicals, Inc.

  11. Prognosis

    DEFF Research Database (Denmark)

    Myers, Jonathan; Brawner, Clinton A; Haykowsky, Mark J F

    2015-01-01

    Patients with heart failure (HF) were once discouraged from participating in exercise programs because of concerns regarding safety and the potential for harm to an already damaged myocardium. However, studies over the last 3 decades have provided extensive insights into both the health outcome b...

  12. Prognosis and submandibular gland function

    International Nuclear Information System (INIS)

    Ino, Chiyonori; Yamashita, Toshio; Hanaoka, Mako; Kumazawa, Tadami

    1984-01-01

    Submandibular gland function was tested with sup(99m)Tc-pertechnetate scan 10 days and 3-4 weeks after the onset Bell's palsy, and the results and prognoses were correlated. In the first report we divided the cases into groups A, B and C, and this time group D classified in S.S.R. was poor. Groups A and D can be differentiated by submandibular gland scan within 10 days after the onset; that is to say, the prognosis of more than half the cases can be determined in this early phase. Especially, it is noticeable that group D showing the poor prognosis is differentiated within 10 days after the onset. This method was compared with other tests of facial palsy. Four to five weeks after the onset all tests were of equal accuracy in predicting the prognosis of each group. Within 10 days after the onset, however, submandibular gland scan seems to be more useful than the other tests. (author)

  13. Hypertension Canada's 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension.

    Science.gov (United States)

    Leung, Alexander A; Nerenberg, Kara; Daskalopoulou, Stella S; McBrien, Kerry; Zarnke, Kelly B; Dasgupta, Kaberi; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain; Bolli, Peter; Tremblay, Guy; McLean, Donna; Tobe, Sheldon W; Ruzicka, Marcel; Burns, Kevin D; Vallée, Michel; Prasad, G V Ramesh; Lebel, Marcel; Feldman, Ross D; Selby, Peter; Pipe, Andrew; Schiffrin, Ernesto L; McFarlane, Philip A; Oh, Paul; Hegele, Robert A; Khara, Milan; Wilson, Thomas W; Penner, S Brian; Burgess, Ellen; Herman, Robert J; Bacon, Simon L; Rabkin, Simon W; Gilbert, Richard E; Campbell, Tavis S; Grover, Steven; Honos, George; Lindsay, Patrice; Hill, Michael D; Coutts, Shelagh B; Gubitz, Gord; Campbell, Norman R C; Moe, Gordon W; Howlett, Jonathan G; Boulanger, Jean-Martin; Prebtani, Ally; Larochelle, Pierre; Leiter, Lawrence A; Jones, Charlotte; Ogilvie, Richard I; Woo, Vincent; Kaczorowski, Janusz; Trudeau, Luc; Petrella, Robert J; Hiremath, Swapnil; Drouin, Denis; Lavoie, Kim L; Hamet, Pavel; Fodor, George; Grégoire, Jean C; Lewanczuk, Richard; Dresser, George K; Sharma, Mukul; Reid, Debra; Lear, Scott A; Moullec, Gregory; Gupta, Milan; Magee, Laura A; Logan, Alexander G; Harris, Kevin C; Dionne, Janis; Fournier, Anne; Benoit, Geneviève; Feber, Janusz; Poirier, Luc; Padwal, Raj S; Rabi, Doreen M

    2016-05-01

    Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force provides annually updated, evidence-based recommendations to guide the diagnosis, assessment, prevention, and treatment of hypertension. This year, we present 4 new recommendations, as well as revisions to 2 previous recommendations. In the diagnosis and assessment of hypertension, automated office blood pressure, taken without patient-health provider interaction, is now recommended as the preferred method of measuring in-office blood pressure. Also, although a serum lipid panel remains part of the routine laboratory testing for patients with hypertension, fasting and nonfasting collections are now considered acceptable. For individuals with secondary hypertension arising from primary hyperaldosteronism, adrenal vein sampling is recommended for those who are candidates for potential adrenalectomy. With respect to the treatment of hypertension, a new recommendation that has been added is for increasing dietary potassium to reduce blood pressure in those who are not at high risk for hyperkalemia. Furthermore, in selected high-risk patients, intensive blood pressure reduction to a target systolic blood pressure ≤ 120 mm Hg should be considered to decrease the risk of cardiovascular events. Finally, in hypertensive individuals with uncomplicated, stable angina pectoris, either a β-blocker or calcium channel blocker may be considered for initial therapy. The specific evidence and rationale underlying each of these recommendations are discussed. Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force will continue to provide annual updates. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  14. Early diagnosis of congenital vascular malformation as a condition to rapid prevention of complications – case study

    Directory of Open Access Journals (Sweden)

    Dominika Jaguś

    2017-06-01

    Full Text Available Klippel–Trénaunay syndrome is a rare congenital condition characterised by a triad of symptoms: capillary-lymphatic-venous malformations, varicose veins and venous malformations as well as soft tissue and skeletal hypertrophy of the affected limb. In this article, we present a case of a 5-year-old boy with extensive vascular malformations of the lower limbs and the buttock region. In this case, manifestation of all three symptoms was gradual. At the age of 4 years, the patient was admitted to the Department of Imaging Diagnostics for further diagnosis, where the triad characteristic for Klippel–Trénaunay syndrome and popliteal vein agenesis were diagnosed. Currently, a multidisciplinary team takes care of the boy in the Children’s Memorial Health Institute. Early and accurate diagnosis allows for rapid prevention of complications associated with Klippel–Trénaunay syndrome and enables patient-tailored treatment.

  15. Diagnosis-Driven Prognosis for Decision Making, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — In Phase II, the QSI-Vanderbilt team seeks to develop a system-level diagnostics and prognostic process that incorporates a "sense and respond capability," which...

  16. Diagnosis and prognosis of brain tumors in clinical trials

    OpenAIRE

    Gorlia, Thierry

    2013-01-01

    textabstractAccording to the Central Brain Registry Of The United States (CBTRUS) statistical report (February 2012) the incidence rate of all primary non malignant and malignant brain and central nervous system tumors is 19.89 cases per 100.000 (11.58 for non-malignant tumors and 7.31 for malignant tumors). Malignant brain tumors account for only 1% to 2% of all adult cancers. As a comparison, in 2012, the incidence of women breast cancer was 121.2 (per 100.000). Tumors of neuroepithelial ti...

  17. The Three Mile Island accident. Diagnosis and prognosis

    International Nuclear Information System (INIS)

    Toth, L.M.; Malinauskas, A.P.; Eidam, G.R.; Burton, H.M.

    1986-01-01

    The Three Mile Island accident occurred on March 29, 1979. The decision to hold a symposium on the TMI accident aftermath was reached when it was realized that enough information had been gathered during the past 6 years to provide a fairly complete picture of the damage and of the activities required for eventual recovery. The symposium was organized into three sessions: the first dealt with a description of the accident, the second focused on the chemical aspects involved, and the third addressed the strategy and progress made toward recovery. The symposium was intended to focus on these three subjects and leave the environmental considerations to future meetings and reports. Although it might appear shortsighted to exclude the environmental impact, the exclusion was considered necessary in order to maintain the focus we sought

  18. Extracellular Matrix Biomarkers for Diagnosis, Prognosis, Imaging, and Targeting

    Science.gov (United States)

    2015-09-01

    collaboration with the Lindquist lab. Funding Support: Please see previously provided other support and changes noted below. Name: Doris Tabassum ...Project: Doris Tabassum has generated cell line models of heterogeneity with different metastatic capability. Additional funds from Dr. Polyak’s grants

  19. Endothelial Progenitor Cells for Diagnosis and Prognosis in Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Caterina Oriana Aragona

    2016-01-01

    Full Text Available Objective. To identify, evaluate, and synthesize evidence on the predictive power of circulating endothelial progenitor cells (EPCs in cardiovascular disease, through a systematic review of quantitative studies. Data Sources. MEDLINE was searched using keywords related to “endothelial progenitor cells” and “endothelium” and, for the different categories, respectively, “smoking”; “blood pressure”; “diabetes mellitus” or “insulin resistance”; “dyslipidemia”; “aging” or “elderly”; “angina pectoris” or “myocardial infarction”; “stroke” or “cerebrovascular disease”; “homocysteine”; “C-reactive protein”; “vitamin D”. Study Selection. Database hits were evaluated against explicit inclusion criteria. From 927 database hits, 43 quantitative studies were included. Data Syntheses. EPC count has been suggested for cardiovascular risk estimation in the clinical practice, since it is currently accepted that EPCs can work as proangiogenic support cells, maintaining their importance as regenerative/reparative potential, and also as prognostic markers. Conclusions. EPCs showed an important role in identifying cardiovascular risk conditions, and to suggest their evaluation as predictor of outcomes appears to be reasonable in different defined clinical settings. Due to their capability of proliferation, circulation, and the development of functional progeny, great interest has been directed to therapeutic use of progenitor cells in atherosclerotic diseases. This trial is registered with registration number: Prospero CRD42015023717.

  20. Diagnosis and prognosis of acute hamstring injuries in athletes

    NARCIS (Netherlands)

    Kerkhoffs, Gino M. M. J.; van Es, Nick; Wieldraaijer, Thijs; Sierevelt, Inger N.; Ekstrand, Jan; van Dijk, C. Niek

    2013-01-01

    Identification of the most relevant diagnostic and prognostic factors of physical examination and imaging of hamstring injuries in (elite) athletes. A literature search was conducted in MEDLINE and EMBASE for articles between 1950 and April 2011. A survey was distributed among the members of the

  1. Distributed Diagnosis, Prognosis and Recovery for Complex Systems, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Complex space systems such as lunar habitats generate huge amounts of data. For example, the International Space Station (ISS) has over 250,000 individually...

  2. Developments in diagnosis and prognosis of superficial bladder cancer.

    NARCIS (Netherlands)

    Moonen, P.M.J.

    2007-01-01

    Non-muscle invasive bladder encompasses the relatively innocent low risk tumours, but also the potentially lethal high risk tumours. Low risk tumours have a high chance of recurrence, but high risk tumours have both a high risk of recurrence and progression. Progression to muscle-invasive disease

  3. Heart failure in geriatric outpatients: diagnosis, prognosis and treatment

    NARCIS (Netherlands)

    Oudejans-Mooijaart, I.

    2012-01-01

    The ageing of the population and improved survival following acute cardiac events have led to an increased prevalence of heart failure (HF), especially in the elderly. Establishing the presence of HF based only on signs and symptoms is often inaccurate. Additional investigations (e.g.

  4. Diagnosis and prognosis of brain tumors in clinical trials

    NARCIS (Netherlands)

    T.S. Gorlia (Thierry)

    2013-01-01

    textabstractAccording to the Central Brain Registry Of The United States (CBTRUS) statistical report (February 2012) the incidence rate of all primary non malignant and malignant brain and central nervous system tumors is 19.89 cases per 100.000 (11.58 for non-malignant tumors and 7.31 for malignant

  5. Prognosis of patients with transected melanomas.

    Science.gov (United States)

    Martires, Kathryn J; Nandi, Tina; Honda, Kord; Cooper, Kevin D; Bordeaux, Jeremy S

    2013-04-01

    The management of melanoma is directly related to Breslow's depth. Biopsying melanomas in a fashion that transects the deep margin precludes an accurate measurement of the true depth. To examine the prognosis of melanomas transected along the deep margins, as well as cases where no residual melanoma was seen on re-excision after transection. Records from a cohort of patients at one institution were examined from 1996 through 2007. Patients were considered to have "transected" melanomas if tumor cells were present on the deep margin of the biopsy. Overall survival was determined. Seven hundred fourteen patients were examined. 171 (24%) of all melanomas were transected. 101(59%) of those lacked tumor cells on re-excision. Patients with transected melanomas were older (OR = 1.03, p < .001), and had higher Breslow's depths (OR = 1.21, p < .001) than those without transected tumors. Those with no residual melanoma after transection were younger (OR = 0.98, p = .010) and more likely to have no lymph node involvement (OR = 2.23, p = .037). Neither transection (p = .760), nor lack of residual melanoma on re-excision after transection (p = .793) influenced survival. A high number of melanomas are transected at diagnosis, many of which lack visible tumor. The original Breslow's depth of transected melanomas without residual tumor on re-excision accurately predicts survival and prognosis. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  6. [Antiphospholipid syndrome and pregnancy: Obstetrical prognosis according to the type of APS].

    Science.gov (United States)

    Delesalle, C; de Vienne, C; Le Hello, C; Verspyck, E; Dreyfus, M

    2015-05-01

    The objective of our study was to compare treatment-based obstetrical outcomes in women with either thrombotic or obstetrical antiphospholipid syndrome (APS). This was a historical cohort study conducted between 1998 and 2009 in 23 patients who had a total of 83 pregnancies. The syndrome was diagnosed using the 2006 Sapporo criteria. Thirty-one of these 83 pregnancies were valid before the diagnosis was made. A live infant was born in 22% of them, the infant being small for gestational age in 26% of cases. The fetus died in utero in a further 26% of cases. Pregnancies were subdivided into 2 groups depending on whether the initial event leading to APS diagnosis was obstetrical or thrombotic. Treatment (aspirin and low molecular weight heparin) was based on this classification: the latter was given in a curative dose for thrombotic events, in a preventive dose for obstetrical events. No fetal loss was observed when treatment was administered according to the protocol. Nevertheless, 20% of the pregnancies with obstetrical APS were complicated by smallness for gestational age and only 38% of the infants were live births. More than 87% of the thrombotic forms treated were free of complications and led to birth of a living child. Appropriate treatment appears to improve the prognosis for pregnancies in patients with APS. These patients are nevertheless at increased risk of an obstetrical event and require close monitoring, especially in obstetrical manifestations, which appear to have a poorer prognosis. Multidisciplinary follow-up by an experienced team is essential. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  7. Comparing corporal punishment and children's exposure to violence between caregivers: Towards better diagnosis and prevention of intrafamilial physical abuse of children.

    Science.gov (United States)

    Ribeiro, Cristina Silveira; Coelho, Luís; Magalhães, Teresa

    2016-02-01

    Any intervention involving child victims of intrafamilial abuse must take the alleged underlying motives for the abuse into account. The aim of this study is to further our understanding of intrafamilial physical abuse of children, by comparing its various aspects while considering the alleged underlying motives. A preliminary sample of 1656 cases of alleged physical abuse in the northern region of Portugal was analysed, with two main motives being identified: corporal punishment (CP) (G1 = 927) and exposure to violence between caregivers (EVC) (G2 = 308). Statistically significant differences were found between the two motives (p < 0.05) for the following variables: (1) age of the alleged victims, (2) sex of the alleged abuser, (3) risk factors affecting the alleged abuser, (4) abuser/victim relationship, (5) injury-producing mechanism, (6) time between last abuse and forensic medical examination and (7) location of injuries. Evidence-based knowledge of these differences may help in accurate diagnosis by doctors (particularly forensic physicians) and prevention of this type of violence through support strategies (including tertiary prevention strategies). Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  8. A Review of Prevention, Diagnosis and Treatment of Relative Energy Deficiency in Sport (RED-S) in Artistic (Synchronized) Swimming.

    Science.gov (United States)

    Robertson, Sherry; Mountjoy, Margo

    2018-05-03

    The syndrome Relative Energy Deficiency in Sport (RED-S) is a clinical entity characterized by low energy availability (LEA), which can negatively affect the health and performance of both male and female athletes. The underlying mechanism of RED-S is an inadequacy of dietary energy to support optimal health and performance. This syndrome refers to impaired physiological function including metabolic rate, menstrual function, bone health, immunity, protein synthesis, and cardiovascular health, with psychological consequences which can either precede (through restrictive dietary habits) or result from RED-S. The term RED-S extends beyond the condition termed the "Female Athlete Triad". Formerly known as synchronized swimming, artistic swimming is an Olympic sport requiring a high level of fitness as well as technical skill and artistry. The risk of RED-S is high in artistic swimming as it is an aesthetic, judged sport with an emphasis on a lean physique. RED-S is of significant concern in the sport of artistic swimming because of the potential negative effects on physical and mental health as well as consequences on athletic performance. This paper reviews health and performance consequences associated with LEA resulting in RED-S in artistic swimming. Medical and nutritional considerations specific to artistic swimming are reviewed and methods to help detect and manage RED-S are discussed. Prevention and management of RED-S in this athlete population should be a priority for coaches and the sport medicine professionals working with artistic swimming athletes should utilize the RED-S CAT, a Clinical Assessment Tool for screening and managing RED-S.

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

    Science.gov (United States)

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

    2016-11-01

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

  10. Long-Term Prognosis of Ischemic Stroke in Young Adults

    OpenAIRE

    Varona, Jose F.

    2010-01-01

    There is limited information about long-term prognosis of ischemic stroke in young adults. Giving the potentially negative impact in physical, social, and emotional aspects of an ischemic stroke in young people, providing early accurate long-term prognostic information is very important in this clinical setting. Moreover, detection of factors associated with bad outcomes (death, recurrence, moderate-to-severe disability) help physicians in optimizing secondary prevention strategies. The prese...

  11. Probabilistic Prognosis of Non-Planar Fatigue Crack Growth

    Science.gov (United States)

    Leser, Patrick E.; Newman, John A.; Warner, James E.; Leser, William P.; Hochhalter, Jacob D.; Yuan, Fuh-Gwo

    2016-01-01

    Quantifying the uncertainty in model parameters for the purpose of damage prognosis can be accomplished utilizing Bayesian inference and damage diagnosis data from sources such as non-destructive evaluation or structural health monitoring. The number of samples required to solve the Bayesian inverse problem through common sampling techniques (e.g., Markov chain Monte Carlo) renders high-fidelity finite element-based damage growth models unusable due to prohibitive computation times. However, these types of models are often the only option when attempting to model complex damage growth in real-world structures. Here, a recently developed high-fidelity crack growth model is used which, when compared to finite element-based modeling, has demonstrated reductions in computation times of three orders of magnitude through the use of surrogate models and machine learning. The model is flexible in that only the expensive computation of the crack driving forces is replaced by the surrogate models, leaving the remaining parameters accessible for uncertainty quantification. A probabilistic prognosis framework incorporating this model is developed and demonstrated for non-planar crack growth in a modified, edge-notched, aluminum tensile specimen. Predictions of remaining useful life are made over time for five updates of the damage diagnosis data, and prognostic metrics are utilized to evaluate the performance of the prognostic framework. Challenges specific to the probabilistic prognosis of non-planar fatigue crack growth are highlighted and discussed in the context of the experimental results.

  12. Fertility prognosis for infertile couples

    DEFF Research Database (Denmark)

    Bostofte, E; Bagger, P; Michael, A

    1993-01-01

    OBJECTIVE: To develop a fertility prognosis model for infertile couples. DESIGN: Prospective follow-up study. PARTICIPANTS: In the period November 30, 1977 to June 1, 1985, 321 consecutive couples were investigated for infertility at Hvidovre University Hospital. Investigation of the female...... MEASURE: The Cox regression model was used to predict the time required to conceive based on informations provided by fertility investigations. RESULTS: Three of 16 prognostic variables (the period of infertility, the female infertility factor, and the P-test) possess significant prognostic information...

  13. [Hindfoot valgus. Diagnosis and therapy of flatfoot].

    Science.gov (United States)

    Radl, R; Fuhrmann, G; Maafe, M; Krifter, R-M

    2012-04-01

    The clinical finding of flatfoot is characterized by a flattening of the medial longitudinal arch and valgus deformity of the hindfoot. The differential diagnosis of flatfoot is the physiological, flexible, contracted flatfoot, which occurs as a congenital or acquired deformity. Congenital flatfoot deformity requires early intensive therapy, while a flexible flatfoot in children has a good prognosis and conservative treatment usually leads to a stable and sufficient load-bearing foot. Severe flatfoot in children can be corrected successfully by simple, minimally invasive procedures. In adults with symptomatic flatfoot, which usually occurs due to an insufficiency of the tendon of the tibialis posterior, conservative therapy with insoles, shoe modifications and physiotherapeutic measures can lead to significant improvement, otherwise surgical correction is recommended. Early, stage-appropriate therapy helps to prevent an impending decompensation of the hindfoot.

  14. [THE RESULTS OF IMPLEMENTATION OF THE INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT LOAN PROJECT "PREVENTION, DIAGNOSIS, AND TREATMENT OF TUBERCULOSIS AND AIDS", A "TUBERCULOSIS" COMPONENT].

    Science.gov (United States)

    2010-01-01

    Due to the implementation of the International Bank for Reconstruction and Development (IBRD) loan project "Prevention, diagnosis, treatment of tuberculosis and AIDS", a "Tuberculosis" component that is an addition to the national tuberculosis control program in 15 subjects of the Russian Federation, followed up by the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences, the 2005-2008 measures stipulated by the Project have caused substantial changes in the organization of tuberculosis control: implementation of Orders Nos. 109, 50, and 690 and supervision of their implementation; modernization of the laboratories of the general medical network and antituberbulosis service (404 kits have been delivered for clinical diagnostic laboratories and 12 for bacteriological laboratories, including BACTEC 960 that has been provided in 6 areas); 91 training seminars have been held at the federal and regional levels; 1492 medical workers have been trained in the detection, diagnosis, and treatment of patients with tuberculosis; 8 manuals and guidelines have been prepared and sent to all areas. In the period 2005-2008, the tuberculosis morbidity and mortality rates in the followed-up areas reduced by 1.2 and 18.6%, respectively. The analysis of patient cohorts in 2007 and 2005 revealed that the therapeutic efficiency evaluated from sputum smear microscopy increased by 16.3%; there were reductions in the proportion of patients having ineffective chemotherapy (from 16.1 to 11.1%), patients who died from tuberculosis (from 11.6 to 9.9%), and those who interrupted therapy ahead of time (from 11.8 to 7.8%). Implementation of the IBR project has contributed to the improvement of the national strategy and the enhancement of the efficiency of tuberculosis control.

  15. [Early diagnosis of human immunodeficiency virus-1 in infants: The prevention of mother-to-child transmission program in Equatorial Guinea].

    Science.gov (United States)

    Prieto-Tato, Luis Manuel; Vargas, Antonio; Álvarez, Patrícia; Avedillo, Pedro; Nzi, Eugenia; Abad, Carlota; Guillén, Sara; Fernández-McPhee, Carolina; Ramos, José Tomás; Holguín, África; Rojo, Pablo; Obiang, Jacinta

    2016-11-01

    Great efforts have been made in the last few years in order to implement the prevention of mother-to-child transmission (PMTCT) program in Equatorial Guinea (GQ). The aim of this study was to evaluate the rates of mother-to-child HIV transmission based on an HIV early infant diagnosis (EID) program. A prospective observational study was performed in the Regional Hospital of Bata and Primary Health Care Centre Maria Rafols, Bata, GQ. Epidemiological, clinical, and microbiological characteristics of HIV-1-infected mothers and their exposed infants were recorded. Dried blood spots (DBS) for HIV-1 EID were collected from November 2012 to December 2013. HIV-1 genome was detected using Siemens VERSANT HIV-1 RNA 1.0 kPCR assay. Sixty nine pairs of women and infants were included. Sixty women (88.2%) had WHO clinical stage 1. Forty seven women (69.2%) were on antiretroviral treatment during pregnancy. Forty five infants (66.1%) received postnatal antiretroviral prophylaxis. Age at first DBS analysis was 2.4 months (IQR 1.2-4.9). One infant died before a HIV-1 diagnosis could be ruled out. Two infants were HIV-1 infected and started HAART before any symptoms were observed. The rate of HIV-1 transmission observed was 2.9% (95%CI 0.2-10.5). The PMTCT rate was evaluated for the first time in GQ based on EID. EID is the key for early initiation of antiretroviral therapy and to reduce the mortality associated with HIV infection. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  16. [Field investigation of occupational disease diagnosis in Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014: an analysis of 136 cases].

    Science.gov (United States)

    Fan, C Y; Li, X D; Wen, W; Wang, Y Y; Zhang, Y; Lang, L

    2016-04-20

    To investigate the characteristics of 136 patients with occupational diseases, to summarize key techniques used in field investigation, and to provide a scientific basis for the development of standard operating procedures for field investigation of occupational disease diagnosis. Field investigation and routine data analysis were performed to analyze the cases diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from January 2009 to December 2014. A total of 136 cases of occupational diseases were diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014, and there were 66 cases of leukemia, 18 cases of suspected occupational benzene poisoning, 12 cases of suspected occupational handarm vibration disease, and 11 cases of suspected pneumoconiosis. Of all these patients, 41.91% were engaged in at least three types of work, 70.59% were exposed to at least three types of chemicals, 25.74% experienced changes in technical processes and chemicals, and 47.06% had disputes on the chemicals they were exposed to during verification by both parties. Occupational hazard factors were detected. Most samples (358)were used to measure benzene concentration in workplace air, among which 11.7% had a benzene concentration of >6.00 mg/m(3)(exceeding standard), 13.41% had a benzene concentration of 3.26~6.00 mg/m(3), 75.42% had a benzene concentration ofoccupational hand-arm vibration disease, suspected pneumoconiosis, and suspected occupational noiseinduced hearing loss had high overstandard rates (100%, 93.8%, and 83.3%, respectively). Field investigation of occupational disease diagnosis reveals large numbers of cases of leukemia, suspected occupational benzene poisoning, suspected occupational hand-arm vibration disease, and suspected pneumoconiosis. The key aspects of field investigation include confirmation of the history of occupational exposure, identification of occupational hazard

  17. A genetic programming approach to oral cancer prognosis

    Directory of Open Access Journals (Sweden)

    Mei Sze Tan

    2016-09-01

    Full Text Available Background The potential of genetic programming (GP on various fields has been attained in recent years. In bio-medical field, many researches in GP are focused on the recognition of cancerous cells and also on gene expression profiling data. In this research, the aim is to study the performance of GP on the survival prediction of a small sample size of oral cancer prognosis dataset, which is the first study in the field of oral cancer prognosis. Method GP is applied on an oral cancer dataset that contains 31 cases collected from the Malaysia Oral Cancer Database and Tissue Bank System (MOCDTBS. The feature subsets that is automatically selected through GP were noted and the influences of this subset on the results of GP were recorded. In addition, a comparison between the GP performance and that of the Support Vector Machine (SVM and logistic regression (LR are also done in order to verify the predictive capabilities of the GP. Result The result shows that GP performed the best (average accuracy of 83.87% and average AUROC of 0.8341 when the features selected are smoking, drinking, chewing, histological differentiation of SCC, and oncogene p63. In addition, based on the comparison results, we found that the GP outperformed the SVM and LR in oral cancer prognosis. Discussion Some of the features in the dataset are found to be statistically co-related. This is because the accuracy of the GP prediction drops when one of the feature in the best feature subset is excluded. Thus, GP provides an automatic feature selection function, which chooses features that are highly correlated to the prognosis of oral cancer. This makes GP an ideal prediction model for cancer clinical and genomic data that can be used to aid physicians in their decision making stage of diagnosis or prognosis.

  18. A genetic programming approach to oral cancer prognosis.

    Science.gov (United States)

    Tan, Mei Sze; Tan, Jing Wei; Chang, Siow-Wee; Yap, Hwa Jen; Abdul Kareem, Sameem; Zain, Rosnah Binti

    2016-01-01

    The potential of genetic programming (GP) on various fields has been attained in recent years. In bio-medical field, many researches in GP are focused on the recognition of cancerous cells and also on gene expression profiling data. In this research, the aim is to study the performance of GP on the survival prediction of a small sample size of oral cancer prognosis dataset, which is the first study in the field of oral cancer prognosis. GP is applied on an oral cancer dataset that contains 31 cases collected from the Malaysia Oral Cancer Database and Tissue Bank System (MOCDTBS). The feature subsets that is automatically selected through GP were noted and the influences of this subset on the results of GP were recorded. In addition, a comparison between the GP performance and that of the Support Vector Machine (SVM) and logistic regression (LR) are also done in order to verify the predictive capabilities of the GP. The result shows that GP performed the best (average accuracy of 83.87% and average AUROC of 0.8341) when the features selected are smoking, drinking, chewing, histological differentiation of SCC, and oncogene p63. In addition, based on the comparison results, we found that the GP outperformed the SVM and LR in oral cancer prognosis. Some of the features in the dataset are found to be statistically co-related. This is because the accuracy of the GP prediction drops when one of the feature in the best feature subset is excluded. Thus, GP provides an automatic feature selection function, which chooses features that are highly correlated to the prognosis of oral cancer. This makes GP an ideal prediction model for cancer clinical and genomic data that can be used to aid physicians in their decision making stage of diagnosis or prognosis.

  19. Etiology, Localization and Prognosis in Cerebellar Infarctions

    Directory of Open Access Journals (Sweden)

    Yavuz Yücel

    2006-01-01

    Full Text Available Cerebrovasculer disease are the most frequent disease of the brain. Cerebellar infarct remains % 1.5-4.2 of these diseases. Etiological factors, lesion localization, symptoms and findings and relationship with prognosis of our patients with cerebellar infarct were investigated in our study. For this purpose, 32 patients were evaluated who were admitted to the Dicle University Medical School Department of Neurology in 1995-2001 hospitalized with the diagnosis of clinically and radiological confirmed cerebellar infarction.All of patients in the study group, 21 (%65.6 were male and 11 (%34.3 female. Age of overall patients ranged between 40 and 75 years with a mean of 57.8±10.2 years. Atherothrombotic infarct was the most frequent reason at the etiologic clinical classification. The most frequently found localization was the posterior inferior cerebellar artery infarct (%50. The leading two risk factors were hypertension (%78.1 and cigarette smoking (%50. The most common sign and symptoms were vertigo (%93.7, vomiting (%75, headache (%68.7 and cerebellar dysfunction findings (%50. The mean duration of hospitalization was 16.3±7.6 days. Overall mortality rate was found to be % 6.2. Finally, the most remarkable risk factors at cerebellar infarct patients are hypertension and atherosclerosis at etiology. We are considering that, controlling of these factors will reduce the appearance frequency of cerebellar infarcts.

  20. Pediatric Hypothyroidism: Diagnosis and Treatment.

    Science.gov (United States)

    Wassner, Ari J

    2017-08-01

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

  1. Cutaneous epidermoid carcinoma (spinocellular carcinoma): clinical practice recommendations for diagnosis and therapy. Full report

    International Nuclear Information System (INIS)

    Martin, Ludovic; Bonerandi, Jean-Jacques; Brugneaux, Julie; Beauvillain, Claude; Chassagne, Jean-Francois; Clavere, Pierre; Grolleau, Jean-Louis; Grossin, Maggy; Sei, Jean-Francois; Caquant, Ludovic; Chaussade, Veronique; Desouches, Christophe; Garnier, Francois; Jourdain, Alain; Lemonnier, Jean-Yves; Maillard, Herve; Ortonne, Nicolas; Rio, Emmanuel; Simon, Etienne

    2009-01-01

    This guide aims at providing practitioners taking into care patients presenting a cutaneous cancer with recommendations based on scientific evidences or expert agreements. More precisely, the objectives are to clarify the terminology used to describe the different forms of cutaneous epidermoid carcinoma (CEC) and of their precursors (actinic keratosis, Bowen's disease), to propose a prognosis classification of CECs adapted to the previously identified prognosis factors, to optimise the diagnosis and therapy of actinic keratosis and Bowen's disease according to recent publications, and to recall the principles of a primary prevention of CECs and of their precursors, and of screening of high risk individuals. Thus, the different parts of this report address the following issues: anatomic-clinical forms and epidemiology of CECs and of their precursors, prognosis factors of CECs, means of treatment of CECs and of their precursors (medical, physical, surgical, radiation-based, and chemical treatments). Radiotherapy notably comprises external radiotherapy and interstitial brachytherapy. Indications for radiotherapy are discussed with respect to existing guides and to the clinical situation. The authors address the care of CECs and of their precursors (prevention, screening and clinical diagnosis, care of invasive CECs, keratoacanthoma treatment). They finally discuss quality criteria aimed at practice improvement, and perspectives regarding the evolution of this guide and studies to be performed

  2. Establishing and prioritizing research questions for the prevention, diagnosis and treatment of hair loss (excluding alopecia areata): the Hair Loss Priority Setting Partnership.

    Science.gov (United States)

    Macbeth, A; Tomlinson, J; Messenger, A; Moore-Millar, K; Michaelides, C; Shipman, A; Kassim, J; Brockley, J; Szczecinska, W; Farrant, P; Robinson, R; Rodgers, J; Chambers, J; Upadhyaya, S; Harries, M

    2018-02-01

    Hair and scalp problems are common. Unfortunately, many uncertainties exist around the most effective management and treatment strategies for these disorders. To identify uncertainties in hair-loss management, prevention, diagnosis and treatment that are important to both people with hair loss and healthcare professionals. A Hair Loss Priority Setting Partnership was established between patients, their carers and relatives, and healthcare professionals to identify the most important uncertainties in hair loss. The methodology of the James Lind Alliance was followed to ensure a balanced, inclusive and transparent process. In total, 2747 treatment uncertainties were submitted by 912 participants; following exclusions 884 uncertainties relating to hair loss (excluding alopecia areata) were analysed. Questions were combined into 'indicative uncertainties' following a structured format. A series of ranking exercises further reduced this list to a top 25 that was taken to a final prioritization workshop where the top 10 priorities were agreed. We present the top 10 research priorities for hair loss (excluding alopecia areata) to guide researchers and funding bodies to support studies important to both patients and clinicians. © 2017 British Association of Dermatologists.

  3. Regulation of epigenetic traits of the glutathione S-transferase P1 gene:From detoxification towards cancer prevention and diagnosis

    Directory of Open Access Journals (Sweden)

    Marc eDiederich

    2014-07-01

    Full Text Available Glutathione S-transferases (GSTs are phase II drug detoxifying enzymes that play an essential role in maintenance of cell integrity and protection against DNA damage by catalyzing the conjugation of glutathione to a wide variety of exo- and endogenous electrophilic substrates. GSTP1, the gene encoding the pi­class GST is frequently inactivated by acquired somatic CpG island promoter hypermethylation in multiple cancer subtypes including prostate, breast, liver and blood cancers. Epigenetically mediated GSTP1 silencing is associated with enhanced cancer susceptibility by decreasing its caretaker gene function, which tends to promote neoplastic transformation allowing the cell to acquire additional alterations. Thus, this epigenetic alteration is now considered as a cancer biomarker but could as well play a driving role in multistep cancer development especially well documented in prostate cancer development.The present review discusses application of epigenetic alterations affecting GSTP1 in cancer medicine used alone or in combination with other biomarkers for cancer detection and diagnosis as well as for future targeted preventive and therapeutic interventions including by dietary agents.

  4. Early diagnosis of osteomyelitis occurred in the jaws

    International Nuclear Information System (INIS)

    Choi, Eun Sook; Na, Seung Mog; Lee, Un Gyeong; Koh, Kwang Joon

    1994-01-01

    Early diagnosis and treatment of osteomyelitis provide good prognosis and prevent severe complications. Therefore, it is important to early diagnose and treat before the bony changes are observed in conventional radiograms. Authors experienced three cases of early osteomyelitis, and scintigrams were useful to differentiate them from other diseases. The purpose of this report was to aid in the early diagnosis and treatment of osteomyelitis occurred in the jaws. The characteristic features were as follows: 1. In clinical examination, the patients complained mild pain and localized swelling in the jaws. 2. In radiographic findings, the conventional radiograms showed relatively mild bony change in the jaws. 3. The more severe periosteal reactions were observed in radiograms in children than in adult patient. 4. It showed marked increased uptake of radioisotopes in all scintigrams. 5. The three phase bone scanning were helpful to differentiate osteomyelitis from soft tissue diseases.

  5. TBI Symptoms, Diagnosis, Treatment, Prevention

    Science.gov (United States)

    ... lightheadedness, dizziness, blurred vision, ringing in the ears, bad taste in the mouth, fatigue (including changed sleep patterns), behavior or mood swings, trouble with memory and concentration. Moderate or severe: As above, but headache worsens ...

  6. [Ambulatory blood pressure monitoring for hypertension diagnosis?

    Science.gov (United States)

    Gijón Conde, T; Banegas, J R

    2017-01-01

    The early and accurate diagnosis of hypertension is essential given its importance in the development of cardiovascular disease. The boundaries between normal blood pressure (BP) and hypertension are arbitrary and based on the benefits of treating exceeding those of not treating. Conventional BP measurement at the clinic only offers information of a particular time and presents multiple biases dependent on inherent variability of BP and measurement technique itself. Multiple studies have demonstrated the prognosis superiority in the development of cardiovascular disease of ambulatory blood pressure monitoring (ABPM), allows detection of white coat hypertension, avoiding overdiagnosis and overtreatment, and the detection of patients with masked hypertension who are at risk of underdetection and undertreatment. ABPM also assess nightime BP and circadian variability, providing additional prognostic value. ABPM is recognized in the diagnosis of hypertension in 2011 British NICE Guidelines, very argued at the 2013 European Society of Hypertension guidelines, and recommended in the US Preventive Services Task Force in 2015, 2016 Canadian Guidelines and the 2016 Spanish Program of Preventive Activities and Health Promotion (PAPPS). Its generalization is likely to be only a matter of time. Copyright © 2017 Sociedad Española de Hipertension-Liga Española para la Lucha de la Hipertensión Arterial (SEH-LELHA). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. The influence of body mass index and age on C-peptide at the diagnosis of type 1 diabetes in children who participated in the diabetes prevention trial-type 1.

    Science.gov (United States)

    Sosenko, Jay M; Geyer, Susan; Skyler, Jay S; Rafkin, Lisa E; Ismail, Heba M; Libman, Ingrid M; Liu, Yuk-Fun; DiMeglio, Linda A; Evans-Molina, Carmella; Palmer, Jerry P

    2018-05-01

    The extent of influence of BMI and age on C-peptide at the diagnosis of type 1 diabetes (T1D) is unknown. We thus studied the impact of body mass index Z-scores (BMIZ) and age on C-peptide measures at and soon after the diagnosis of T1D. Data from Diabetes Prevention Trial-Type 1 (DPT-1) participants C-peptide measures with BMIZ and age in 2 cohorts: oral glucose tolerance tests (OGTTs) at diagnosis (n = 99) and mixed meal tolerance tests (MMTTs) C-peptide from OGTTs (n = 99) at diagnosis and MMTTs (n = 80) after diagnosis were positively associated with BMIZ and age (P C-peptide measures. In an example, 2 individuals with identical AUC C-peptide values had an approximate 5-fold difference in values after adjustments for BMIZ and age. The association between fasting glucose and C-peptide decreased markedly when fasting C-peptide values were adjusted (r = 0.30, P C-peptide measures are strongly and independently related to BMIZ and age at and soon after the diagnosis of T1D. Adjustments for BMIZ and age cause substantial changes in C-peptide values, and impact the association between glycemia and C-peptide. Such adjustments can improve assessments of β-cell impairment at diagnosis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Sleep impairment and prognosis of acute myocardial infarction

    DEFF Research Database (Denmark)

    Clark, Alice; Lange, Theis; Hallqvist, Johan

    2014-01-01

    STUDY OBJECTIVES: Impaired sleep is an established risk factor for the development of cardiovascular disease, whereas less is known about how impaired sleep affects cardiovascular prognosis. The aim of this study is to determine how different aspects of impaired sleep affect the risk of case fata...... assessment that could benefit secondary cardiovascular prevention. CITATION: Clark A, Lange T, Hallqvist J, Jennum P, Rod NH. Sleep impairment and prognosis of acute myocardial infarction: a prospective cohort study. SLEEP 2014;37(5):851-858....... registries. In women, disturbed sleep showed a consistently higher risk of long-term cardiovascular events: AMI (hazard ratio [HR] = 1.69; 95% confidence interval [CI] 0.95-3.00), stroke (HR = 2.61; 95% CI: 1.19-5.76), and heart failure (HR = 2.43; 95% CI: 1.18-4.97), whereas no clear effect of impaired...

  9. The Value of PCT, WBC and hs-CRP Tests in the Diagnosis and Prognosis of Children with Pneumonia%小儿肺炎中PCT、WBC、hs-CRP检测对疾病诊断及预后判断价值分析

    Institute of Scientific and Technical Information of China (English)

    夏兰兰; 李敬

    2017-01-01

    目的 分析小儿肺炎中PCT、WBC、hs-CRP检测对疾病诊断及预后的判断价值.方法 选取2015年5月至2016年4月在本院住院治疗的肺炎患儿120例作为观察组,健康儿童65例作为对照组.检测治疗前后患儿及健康儿童血清PCT、WBC、hs-CRP的变化.结果 治疗前,细菌感染组WBC数量(15.5±3.4)×109/L、hs-CRP水平(19.8±2.6) mg/L和PCT水平(21.9±2.1)ng/mL均明显高于非细菌感染组(6.8 ±2.3)×109/L、(4.5±2.3)mg/L、(4.7±1.8) ng/mL和健康对照组(8.1 ±1.4)×109/L、(3.5±1.2) mg/L、(1.8±0.5) ng/mL,且差异具有统计学意义(P<0.05).而非细菌感染组和健康对照组的WBC、hs-CRP和PCT结果差异无统计学意义(P>0.05);治疗后,细菌感染组WBC数量(7.3±1.4)×109/L、hs-CRP水平(5.1 ± 1.2) mg/L和PCT水平(2.3 ± 1.2) ng/mL均明显低于治疗前,差异具有统计学意义(P<0.05);WBC、hs-CRP、PCT联合检测的灵敏性95.2%、特异性93.0%、准确度93.3%显著高于WBC、hs-CRP、PCT单独检测,差异具有统计学意义(P<0.05).结论 在小儿肺炎治疗过程中,动态监测患儿血清的WBC、hs-CRP、PCT的变化,并结合临床,有助于诊疗和判断患儿疾病愈后的情况,具有显著的临床意义,值得推广应用.%Objective To estimate the value of PCT,WBC and hs-CRP tests in the diagnosis and prognosis of children with pneumonia.Methods 120 cases with pneumonia in children were selected from May 2015 to April 2016 in our hospital as the observation group,65 cases of healthy children as the control group.Changes of serum PCT,WBC and hs-CRP tests in children and healthy children before and after treatment were mearued.Results Before treatment,bacterial infection group have WBC count (15.5 ± 3.4) × 109/L,hs-CRP levels (19.8±2.6) mg/L and PCT level (21.9 ±2.1) ng/mL,which were significantly higher than those in non bacterial infection group (6.8 ±2.3) × 109/L,(4.5 ±2.3) mg/L,(4.7 ± 1.8) ng/mL and healthy control group (+ 8.1

  10. Symptoms, location and prognosis of pulmonary embolism

    Directory of Open Access Journals (Sweden)

    M.T. García-Sanz

    2014-07-01

    Full Text Available Background and objective: Pulmonary embolism (PE is a common disease with variable symptoms and high overall mortality. The clinical relevance of the extent of PE is still debatable, and the role of anticoagulation in patients with subsegmental involvement has been contested. Our objective is to describe the clinical details of patients with PE in our hospital and to analyze their prognosis based on the extent of the disease. Materials and methods: Retrospective study of 313 patients diagnosed with PE by chest computed tomography (CT scan at the Hospital Complex of Pontevedra in Spain for six years. Predictors of mortality were determined by multivariate analysis. Results: Women accounted for 56% of patients, and patient median age was 70 years (interquartile range 53–78 years. Subsegmental PE accounted for 7% of all cases; these patients were younger and had lower comorbidity; they reported chest pain more often, performed better in blood gas analysis and none of them had proximal deep vein thrombosis (DVT. Patients with subsegmental PE had a higher survival rate. Factors independently associated with mortality were cancer diagnosis and higher comorbidity. Conclusions: Patients with subsegmental PE clinically differ from those with more proximal PE. Underlying diseases have more influence on the prognosis than the extent of the disease. Resumo: Contexto e objectivo: A embolia pulmonar (PE é uma doença comum com sintomas variáveis e uma elevada taxa de mortalidade global. A relevância clínica da extensão da PE é ainda fonte de debate, e o papel da anticoagulação em pacientes com envolvimento de sub-segmentos foi contestado. O nosso objectivo é descrever os dados clínicos de doentes com PE no nosso hospital e analisar o seu prognóstico, com base na extensão da doença. Materiais e métodos: Estudo retrospectivo de 313 doentes, diagnosticados com PE, através de uma tomografia computadorizada de t

  11. Radiotherapy in breast cancer and its prognosis

    International Nuclear Information System (INIS)

    Mitter, Mihir

    1980-01-01

    Various aspects of breast cancer are discussed. These include clinical staging, histological grading, site of growth, frequency and lactation, immunological response and prognosis, and survival of untreated cases. Importance of early detection is emphasised and prognosis after radiotherapy alone or in combination with surgery is briefly discussed. (M.G.B.)

  12. Pediatric melanoma: incidence, treatment, and prognosis

    Directory of Open Access Journals (Sweden)

    Saiyed FK

    2017-04-01

    Full Text Available Faiez K Saiyed,1 Emma C Hamilton,1 Mary T Austin,1,2 1Department of Pediatric Surgery, McGovern Medical School, 2Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: The purpose of this review is to outline recent advancements in diagnosis, treatment, and prevention of pediatric melanoma. Despite the recent decline in incidence, it continues to be the deadliest form of skin cancer in children and adolescents. Pediatric melanoma presents differently from adult melanoma; thus, the traditional asymmetry, border irregularity, color variegation, diameter >6 mm, and evolution (ABCDE criteria have been modified to include features unique to pediatric melanoma (amelanotic, bleeding/bump, color uniformity, de novo/any diameter, evolution of mole. Surgical and medical management of pediatric melanoma continues to derive guidelines from adult melanoma treatment. However, more drug trials are being conducted to determine the specific impact of drug combinations on pediatric patients. Alongside medical and surgical treatment, prevention is a central component of battling the incidence, as ultraviolet (UV-related mutations play a central role in the vast majority of pediatric melanoma cases. Aggressive prevention measures targeting sun safety and tanning bed usage have shown positive sun-safety behavior trends, as well as the potential to decrease melanomas that manifest later in life. As research into the field of pediatric melanoma continues to expand, a prevention paradigm needs to continue on a community-wide level. Keywords: melanoma, pediatric, adolescent, childhood

  13. Diagnosis and treatment of ampullary tumors

    Directory of Open Access Journals (Sweden)

    YIN Tao

    2017-02-01

    Full Text Available Ampullary tumors mainly manifest as obstructive jaundice and ampullary mass in clinical practice and are difficult to be identified in early stage due to a complex structure of the anatomical site, a deep location, and hidden symptoms. Sometimes a qualitative diagnosis cannot be made. Based on the experience in the treatment of ampullary tumors for many years in our center, this article summarizes the features of ampullary tumors from the aspects of clinical manifestations, diagnosis, treatment, and prognosis, especially the issues regarding imaging evaluation of ampullary tumors, selection of surgical procedure, and prognosis. An early diagnosis is the key to the treatment of ampullary tumors, and early identification and treatment of lesions have great impacts on patients′ prognosis. Accurate preoperative imaging evaluation, a professional diagnosis and treatment team, accurate preoperative and intraoperative pathological analysis, and implementation of reasonable therapeutic strategy are the key to patients′ recovery.

  14. Recomendaciones para la prevención, diagnóstico y tratamiento de LA EPOC en la Argentina Guidelines for COPD prevention, diagnosis and treatment in Argentina

    Directory of Open Access Journals (Sweden)

    Juan Carlos Figueroa Casas

    2012-08-01

    .Since morbidity, mortality and socioeconomic costs from Chronic Obstructive Pulmonary Disease (COPD are widely increasing, a group of respiratory medicine specialists was summoned by the AAMR to update basic knowledge on COPD and to issue recommendations for its prevention, diagnosis and treatment. The authors review the definition of COPD together with current knowledge on pathophysiology. Clinical presentation, functional evaluation and imaging are summarized. Early diagnosis through pulmonary function tests -mainly spirometry- and the role of smoking cessation are stressed. Smoking cessation strategies are described as well as pharmacological and non-pharmacological treatment. Long acting bronchodilators are considered the first pharmacological option for treatment due to its effectiveness and patient compliance. Inhaled corticosteroids are indicated in combination with long-acting bronchodilators in patients who present persistent airway obstruction associated with frequent exacerbations since they reduce their number although further studies are needed to confirm their cost/benefit. Annual influenza vaccination is recommended in all patients. In the non-pharmacological section, surgery for emphysema is suggested in very specific cases. Respiratory rehabilitation is a useful tool for patients with daily activities limitation. Long-term oxygen therapy at home improves survival in patients with severe chronic hypoxemia. Non-invasive home ventilation in chronic patients has limited indications in specific subgroups. Acute exacerbations should be aggressively treated with bronchodilators, oxygen, antibiotics, corticosteroids and eventually mechanical ventilation, as invasive as not invasive respiratory support. The importance of public education as well as of individual patients and their families is deemed essential in the prevention and treatment of the disease.

  15. Quantifying prognosis with risk predictions.

    Science.gov (United States)

    Pace, Nathan L; Eberhart, Leopold H J; Kranke, Peter R

    2012-01-01

    Prognosis is a forecast, based on present observations in a patient, of their probable outcome from disease, surgery and so on. Research methods for the development of risk probabilities may not be familiar to some anaesthesiologists. We briefly describe methods for identifying risk factors and risk scores. A probability prediction rule assigns a risk probability to a patient for the occurrence of a specific event. Probability reflects the continuum between absolute certainty (Pi = 1) and certified impossibility (Pi = 0). Biomarkers and clinical covariates that modify risk are known as risk factors. The Pi as modified by risk factors can be estimated by identifying the risk factors and their weighting; these are usually obtained by stepwise logistic regression. The accuracy of probabilistic predictors can be separated into the concepts of 'overall performance', 'discrimination' and 'calibration'. Overall performance is the mathematical distance between predictions and outcomes. Discrimination is the ability of the predictor to rank order observations with different outcomes. Calibration is the correctness of prediction probabilities on an absolute scale. Statistical methods include the Brier score, coefficient of determination (Nagelkerke R2), C-statistic and regression calibration. External validation is the comparison of the actual outcomes to the predicted outcomes in a new and independent patient sample. External validation uses the statistical methods of overall performance, discrimination and calibration and is uniformly recommended before acceptance of the prediction model. Evidence from randomised controlled clinical trials should be obtained to show the effectiveness of risk scores for altering patient management and patient outcomes.

  16. Prevalence and prognosis of Alzheimer's disease at the mild cognitive impairment stage

    NARCIS (Netherlands)

    Vos, S.J.B.; Verhey, F.; Frolich, L.; Kornhuber, J.; Wiltfang, J.; Maier, W.; Peters, O.; Ruther, E.; Nobili, F.; Morbelli, S.; Frisoni, G. B.; Drzezga, A.; Didic, M.; van Berckel, B.N.M.; Simmons, A.; Soininen, H.; Kloszewska, I.; Mecocci, P.; Tsolaki, M.; Vellas, B.; Lovestone, S.; Muscio, C.; Herukka, S.K.; Salmon, E.; Bastin, C.; Wallin, A.; Nordlund, A.; de Mendonca, A.; Silva, D.; Santana, I.; Lemos, R.; Engelborghs, S.; Van der Mussele, S.; Freund-Levi, Y.; Wallin, A.K.; Hampel, H.; van der Flier, W.M.; Scheltens, P.; Visser, P.J.

    2015-01-01

    Three sets of research criteria are available for diagnosis of Alzheimer's disease in subjects with mild cognitive impairment: the International Working Group-1, International Working Group-2, and National Institute of Aging-Alzheimer Association criteria. We compared the prevalence and prognosis of

  17. Risk stratification in upper gastrointestinal bleeding; prediction, prevention and prognosis

    NARCIS (Netherlands)

    de Groot, N.L.

    2013-01-01

    In the first part of this thesis we developed a novel prediction score for predicting upper gastrointestinal (GI) bleeding in both NSAID and low-dose aspirin users. Both for NSAIDs and low-dose aspirin use risk scores were developed by identifying the five most dominant predictors. The risk of upper

  18. Molecular analysis for diagnosis of Marfan syndrome and Marfan-associated disorders

    Institute of Scientific and Technical Information of China (English)

    GAO Ling-gen; YAO Xiu-ping; ZHANG Lin; HUI Ru-tai; ZHOU Xian-liang

    2011-01-01

    Marfan syndrome is a systemic disorder of connective tissue, caused by mutations in the FBN1, TGFBR1 or TGFBR2 genes. This syndrome is characterized by involvement of three major systems, skeletal, ocular, and cardiovascular. The continuing improvements in molecular biology and increasing availability of molecular diagnosis in clinical practice allow recognition of Marfan syndrome in patients with incomplete phenotypes. Additionally, molecular analyses could also be used for preimplantation genetic diagnosis. The identification of a mutation allows for early diagnosis, prognosis, genetic counseling, preventive management of carriers and reassurance for unaffected relatives. The importance of knowing in advance the location of the putative family mutation is highlighted by its straightforward application to prenatal and postnatal screening.

  19. Central venous catheter-related infections in hematology and oncology: 2012 updated guidelines on diagnosis, management and prevention by the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology.

    Science.gov (United States)

    Hentrich, M; Schalk, E; Schmidt-Hieber, M; Chaberny, I; Mousset, S; Buchheidt, D; Ruhnke, M; Penack, O; Salwender, H; Wolf, H-H; Christopeit, M; Neumann, S; Maschmeyer, G; Karthaus, M

    2014-05-01

    Cancer patients are at increased risk for central venous catheter-related infections (CRIs). Thus, a comprehensive, practical and evidence-based guideline on CRI in patients with malignancies is warranted. A panel of experts by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) has developed a guideline on CRI in cancer patients. Literature searches of the PubMed, Medline and Cochrane databases were carried out and consensus discussions were held. Recommendations on diagnosis, management and prevention of CRI in cancer patients are made, and the strength of the recommendation and the level of evidence are presented. This guideline is an evidence-based approach to the diagnosis, management and prevention of CRI in cancer patients.

  20. Novel Biomarker for Prognosis, Treatment Response

    Science.gov (United States)

    An NCI Cancer Currents blog about a study of a new type of cancer biomarker that measures the extent of chromosomal instability as a way to potentially predict patient prognosis and help guide cancer treatment choices.

  1. Machinery prognostics and prognosis oriented maintenance management

    CERN Document Server

    Yan, Jihong

    2014-01-01

    This book gives a complete presentatin of the basic essentials of machinery prognostics and prognosis oriented maintenance management, and takes a look at the cutting-edge discipline of intelligent failure prognosis technologies for condition-based maintenance.  Latest research results and application methods are introduced for signal processing, reliability moelling, deterioration evaluation, residual life prediction and maintenance-optimization as well as applications of these methods.

  2. Toxoplasmosis: Prevention and Control

    Science.gov (United States)

    ... Toxoplasmosis FAQs Toxoplasmosis & Pregnancy FAQs Epidemiology & Risk Factors Biology Disease Diagnosis Treatment Prevention & Control Resources for Health Professionals Publications Printable Resources Additional ...

  3. Radionuclide imaging in diagnosis and therapy of the diabetic foot

    International Nuclear Information System (INIS)

    Zhu Cansheng

    2000-01-01

    Early and accurate diagnosis of angiopathy or infection of the diabetic foot is the key to the successful management. Radionuclide imaging is very useful in detecting diabetic microangiopathy, assessing the prognosis of foot ulcers, and diagnosing the osteomyelitis

  4. Measles diagnosis at the Subcarpathian region: yesterday, today, tomorrow

    OpenAIRE

    R.M. Savchuk; N.I. Sidneva; T.B. Djus; L.Y. Pogorila; A.M. Stepanovich

    2017-01-01

    The article deals with the results of the epidemiological analysis of measles rate in Ivano-Frankivsk region, laboratory diagnosis, studying of the specific immune resistance and prognosis of morbidity for 2017–2018.

  5. Measles diagnosis at the Subcarpathian region: yesterday, today, tomorrow

    Directory of Open Access Journals (Sweden)

    R.M. Savchuk

    2017-11-01

    Full Text Available The article deals with the results of the epidemiological analysis of measles rate in Ivano-Frankivsk region, laboratory diagnosis, studying of the specific immune resistance and prognosis of morbidity for 2017–2018.

  6. Diagnosis and treatment of chronic thromboembolic pulmonary hypertension in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Charles Marinus; Mellemkjær, Søren; Nielsen-Kudsk, Jens Erik

    2016-01-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is an important differential diagnosis in patients with unexplained dyspnoea. CTEPH is under-recognized and carries a poor prognosis without treatment. Surgical pulmonary endarterectomy is the preferred treatment for the majority of patients...

  7. CT classification and clinical prognosis of cerebral infarction in the area of middle cerebral artery

    International Nuclear Information System (INIS)

    Konno, Jyoji

    1983-01-01

    Computerized tomographies (CT) were repeatedly scanned on 70 patients with cerebral infarction in the middle cerebral artery. Low density area (LDA) was measured with HounFsfield's Unit (HU) and studied on the progressive changes. Classification of LDA was attempted and studied on correlation with mass effect, contrast enhancement, angiographical findings, clinical symptoms and prognosis. It was considered that important points of diagnosis of cerebral infarction were timing of examination of CT and determination of LDA with HUF. It was also thought that CT classification of LDA was usefull to estimate prognosis of the patients with cerebral infarction. (author)

  8. Prognosis of ocular syphilis in patients infected with HIV in the antiretroviral therapy era.

    Science.gov (United States)

    Tsuboi, Motoyuki; Nishijima, Takeshi; Yashiro, Shigeko; Teruya, Katsuji; Kikuchi, Yoshimi; Katai, Naomichi; Oka, Shinichi; Gatanaga, Hiroyuki

    2016-12-01

    To describe the clinical course and prognosis of ocular syphilis in patients infected with HIV-1 in the antiretroviral therapy (ART) era. We conducted a single-centre retrospective chart review of ocular syphilis in patients infected with HIV-1 diagnosed between August 1997 and July 2015. The prognosis of best-corrected visual acuity (BCVA) was analysed. The study subjects were 30 eyes of 20 men who had sex with men (MSM) (median age, 41). Loss of vision and posterior uveitis were the most common ocular clinical features (43%) and location of inflammation at presentation (50%), respectively. The median baseline BCVA was 0.4 (IQR 0.2-1.2), including three eyes with hand motion. BCVA≤0.4 at diagnosis was significantly associated with posterior uveitis or panuveitis (p=0.044). Seventy-five per cent were treated with intravenous benzylpenicillin and 53% were diagnosed with neurosyphilis. After treatment (median follow-up: 21 months), BCVA improved in 89% of the eyes, including all eyes with hand motion, to a median BCVA of 1.2 (IQR 0.8-1.2). Kaplan-Meier analysis showed that >28 days of ocular symptoms before diagnosis was the only factor associated with poor prognosis of BCVA. Three patients (15%) developed recurrence after treatment. The prognosis of BCVA in HIV-infected patients with ocular syphilis in the ART era was favourable after proper treatment. Having >28 days of ocular symptoms before diagnosis was associated with poor prognosis. Changes in visual acuity in HIV-infected MSM should prompt an immediate assessment for ocular syphilis as delays in diagnosis and therapy can lead to irreversible visual loss. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Canine Leishmaniosis: tools for diagnosis in veterinary practice in Colombia

    Directory of Open Access Journals (Sweden)

    Víctor Acero P

    2015-09-01

    Full Text Available The objective of this article is to perform a critical analysis and guide veterinarians in the management of canine Leishmaniosis. A systematic literature review was performed between 2005 and 2014 including scientific papers which take into account experiences and reports of: pathogenesis, diagnosis, clinical presentation, treatment, vaccination, prevention and control strategies. We discuss the different aspects of VL management and aspects that should be taken into account depending on the country, after a patient is suspected or confirmed as positive, including the possibility of euthanasia. We describe the different clinical manifestations of the disease, diagnosis, signs and treatment of canine leishmaniosis. Canine leishmaniosis is present in different parts of the country, therefore it must be considered as a possible differential diagnosis in the veterinary clinic, in patients with dermatological and systemic signs that are compatible with various diseases. In Colombia, the patients diagnosed with cutaneous leishmaniasis could be treated and have a favorable prognosis, whereas in canines with diagnosis of visceral leishmaniasis euthanasia should be considered because of the public health implications.

  10. Summary of the findings of the International Collaboration on Mild Traumatic Brain Injury Prognosis

    DEFF Research Database (Denmark)

    Donovan, J.; Cancelliere, C.; Cassidy, J. D.

    2014-01-01

    In 2004, the WHO Collaborating Centre for Neurotrauma, Prevention, Management and Rehabilitation Task Force published the first large systematic review and best evidence synthesis on the clinical course and prognosis for recovery after MTBI. Ten years later, the International Collaboration on Mil...

  11. Sarcopenia in COPD: relationship with COPD severity and prognosis

    Science.gov (United States)

    Costa, Tatiana Munhoz da Rocha Lemos; Costa, Fabio Marcelo; Moreira, Carolina Aguiar; Rabelo, Leda Maria; Boguszewski, César Luiz; Borba, Victória Zeghbi Cochenski

    2015-01-01

    Objective: To evaluate the prevalence of sarcopenia in COPD patients, as well as to determine whether sarcopenia correlates with the severity and prognosis of COPD. Methods: A cross-sectional study with COPD patients followed at the pulmonary outpatient clinic of our institution. The patients underwent dual-energy X-ray absorptiometry. The diagnosis of sarcopenia was made on the basis of the skeletal muscle index, defined as appendicular lean mass/height2 only for low-weight subjects and adjusted for fat mass in normal/overweight subjects. Disease severity (COPD stage) was evaluated with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The degree of obstruction and prognosis were determined by the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index. Results: We recruited 91 patients (50 females), with a mean age of 67.4 ± 8.7 years and a mean BMI of 25.8 ± 6.1 kg/m2. Sarcopenia was observed in 36 (39.6%) of the patients, with no differences related to gender, age, or smoking status. Sarcopenia was not associated with the GOLD stage or with FEV1 (used as an indicator of the degree of obstruction). The BMI, percentage of body fat, and total lean mass were lower in the patients with sarcopenia than in those without (p < 0.001). Sarcopenia was more prevalent among the patients in BODE quartile 3 or 4 than among those in BODE quartile 1 or 2 (p = 0.009). The multivariate analysis showed that the BODE quartile was significantly associated with sarcopenia, regardless of age, gender, smoking status, and GOLD stage. Conclusions: In COPD patients, sarcopenia appears to be associated with unfavorable changes in body composition and with a poor prognosis. PMID:26578132

  12. Cardiorenal Syndrome: Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    O.O. Melnyk

    2017-02-01

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

  13. Prognosis of ischemic heart disease based on pyrophosphate scan of myocardium

    Energy Technology Data Exchange (ETDEWEB)

    Duska, F [Karlova Univ., Hradec Kralove (Czechoslovakia). Lekarska Fakulta

    1982-11-01

    A brief survey is given of the present knowledge of the problems, based on literary data. Pyrophosphate myocardial scan is an important examination in establishing the diagnosis of acute myocardial infarction and some other myocardial diseases. Apart from this, it is of great importance in determining the prognosis. In the early phase of the disease, an apparently worse prognosis is found in patients with extensive lesion, and in those with an infarction intensively accumulating the radiopharmaceutical. In a certain number of infarctions, scintigraphic examination is positive over several months; usually the radiopharmaceutical disappears within two weeks. Patients with long-persisting positivity have a markedly worse prognosis. On the basis of early and late heart scan, it is thus possible to estimate the future fate of patients w+th ischemic heart disease. Large and long-persisting lesions serve as a warning for the physician.

  14. Clinical prognosis of patients with diagnosed chronic solvent intoxication

    Energy Technology Data Exchange (ETDEWEB)

    Juntunen, J; Antti-Poika, M; Tola, S; Partanen, T

    1982-05-01

    The clinical symptoms and signs of 80 patients with chronic organic solvent intoxication were evaluated after 3-9 years (mean 5.8 years) of follow-up. Thirty-one of the patients had slight clinical neurological signs at the time of diagnosis while the rest of the patients had only neurophysiological or psychological disturbances. The most common subjective symptoms were headache, tiredness and memory disturbances. Of the clinical signs, disturbances occurred frequently in cerebellar functions, gait and station and fine motorics. In addition, psycho-organic alteration and neurasthenic signs were often found. After the follow-up clinical signs of impairment in the nervous system were present in 42 cases. At the group level, the subjective symptoms decreased during the follow-up but the objective clinical signs increased and worsened. Only the prognosis of disturbances in gait and station correlated with the duration and intensity of exposure. The present results emphasize the great difficulties arising in occupational neurology regarding chronic organic solvent intoxications. No clear-cut clinical picture exists and reliable estimation of prognosis in general cannot be made on the basis of the present knowledge.

  15. Early diagnosis of Gorlin-Goltz syndrome: case report.

    Science.gov (United States)

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

    2011-01-25

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

  16. Early diagnosis of Gorlin-Goltz syndrome: case report

    Directory of Open Access Journals (Sweden)

    Trento Cleverson L

    2011-01-01

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

  17. [Catatonia de novo, report on a case: immediate vital prognosis and psychiatric prognosis in longer term].

    Science.gov (United States)

    Patry, L; Guillem, E; Pontonnier, F; Ferreri, M

    2003-01-01

    by benzodiazepine (clorazepate 20 mg i.v.) did not lead to any improvement. The organic investigations were completed with cerebral MRI and the ruling out of a Wilson's disease. Convulsive therapy was then decided. It proved dramatically effective from the first attempt; 4 shocks were carried out before the patient's relatives ask for her discharge from hospital. The patient revealed she had experienced low delirium during her catatonic state. The clinical picture that followed showed retardation with anxiety. She was scared with fear both for the other patients and the nursing team. She kept distant and expressed few affects. The treatment at the time of discharge was olanzapine 10 mg per os. She was discharged with a diagnosis of catatonia but with no specific psychiatric etiological diagnosis associated. She discontinued her follow-up a few weeks later. After one year, we had no information about her. Catatonia has now become rare but remains a problem for clinicians. We reviewed data concerning short term vital prognosis and psychiatric long term prognosis in catatonia. Lethal catatonia is associated with acute onset, both marked psychomotor and neurovegetative symptoms. In the light of literature, there is no proband clinical criterion during the episode that is of relevant diagnostic value to ascertain the psychiatric etiology.

  18. Biomarkers, Natural Course and Prognosis.

    Science.gov (United States)

    Arenillas, Juan F; López-Cancio, Elena; Wong, Ka Sing

    2016-01-01

    Increasing our knowledge about intracranial atherosclerosis (ICAS) natural history and prognostic factors is essential to improve its preventive therapy and thus reduce the dramatic clinical consequences caused by this entity. ICAS is characterized by a chronic and progressive course until it becomes symptomatic, mostly through complication of an unstable intracranial atherosclerotic plaque. Population-based studies in healthy subjects have shown that the prevalence of asymptomatic ICAS is higher in Asian than in Caucasian populations. In both settings, asymptomatic ICAS is associated with classical vascular risk factors and with the metabolic syndrome, and it is burdened with an increasing risk of having incident stroke and cognitive impairment. When it reaches its symptomatic stage, ICAS is a dynamic and aggressive condition, and affected patients are at high risk of having recurrent stroke and other major vascular events. The Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis (SAMMPRIS) trial has recently shown a robust impact of intensive medical therapy reducing the risk of clinical recurrence of symptomatic ICAS. However, even under best medical therapy and degree of risk factor control, symptomatic ICAS-related recurrence risk continues to be the highest among all stroke etiologic subtypes. The second part of the chapter reviews the current understanding of prognostic factors that may help discriminate the high-risk ICAS patients, divided into local factors (vulnerable ICAS plaque) and systemic factors (vulnerable ICAS patient). Regarding research on local factors, high-resolution magnetic resonance imaging (HRMRI) is an emerging technique that allows in vivo evaluation of intracranial arterial wall, which is displacing our research focus from intracranial stenosis degree towards intracranial atherosclerotic plaque composition and activity. Characterization of the vulnerable ICAS patient may be improved with biomarker research. The

  19. Does age affect prognosis in salivary gland carcinoma patients?

    DEFF Research Database (Denmark)

    Bjørndal, Kristine; Larsen, Stine R; Therkildsen, Marianne H

    2016-01-01

    in the young group were WHO performance status 0 and in disease stage I + II, and they presented with significantly more histological low grade tumors. In multivariate analysis, chronological age seemed to be of no prognostic significance to salivary gland carcinoma patients as opposed to performance status......, disease stage and histological grade. CONCLUSIONS: Salivary gland carcinoma patients over the age of 70 years have a poor prognosis compared to younger patients, which can be explained by higher disease stages, more histological high grade subtypes and a poorer performance status at the time of diagnosis.......AIM: To compare incidence, histology, treatment modalities, disease stages, and outcome in elderly patients (≥70 years) compared to younger (

  20. Concurrent new drug prescriptions and prognosis of early breast cancer

    DEFF Research Database (Denmark)

    Cronin-Fenton, Deirdre; Lash, Timothy L; Ahern, Thomas P

    2018-01-01

    Breast Cancer Group (DBCG) clinical database provides high-quality prospectively collected data on breast cancer diagnosis, treatment, and routine follow-up for breast cancer recurrence. Individual-level linkage of DBCG data to other population-based and medical registries in Denmark, including......BACKGROUND: Myriad reports suggest that frequently used prescription drugs alter the viability of breast cancer cells in pre-clinical studies. Routine use of these drugs, therefore, may impact breast cancer prognosis, and could have important implications for public health. METHODS: The Danish...... the Danish National Prescription Registry, has facilitated large population-based pharmacoepidemiology studies. A unique advantage of using DBCG data for such studies is the ability to investigate the association of drugs with breast cancer recurrence rather than breast cancer mortality - which may...

  1. Radiation-induced neuropathies: collateral damage of improved cancer prognosis

    International Nuclear Information System (INIS)

    Pradat, Pierre-Francois; Maisonobe, Thierry; Psimaras, Dimitri; Lenglet, Timothee; Porcher, Raphael; Lefaix, J.L.; Delenian, S.

    2012-01-01

    Because of the improvement of cancer prognosis, long-term damages of treatments become a medical and public health problem. Among the iatrogenic complications, neurological impairment is crucial to consider since motor disability and pain have a considerable impact on quality of life of long cancer survivors. However, radiation-induced neuropathies have not been the focus of great attention. The objective of this paper is to provide an updated review about the radiation-induced lesions of the peripheral nerve system. Radiation-induced neuropathies are characterized by their heterogeneity in both symptoms and disease course. Signs and symptoms depend on the affected structures of the peripheral nerve system (nerve roots, nerve plexus or nerve trunks). Early-onset complications are often transient and late complications are usually progressive and associated with a poor prognosis. The most frequent and well known is delayed radiation-induced brachial plexopathy, which may follow breast cancer irradiation. Radiation-induced lumbosacral radiculoplexopathy is characterized by pure or predominant lower motor neuron signs. They can be misdiagnosed, confused with amyotrophic lateral sclerosis (ALS) or with leptomeningeal metastases since nodular MRI enhancement of the nerve roots of the cauda equina and increased cerebrospinal fluid protein content can be observed. In the absence of specific markers of the link with radiotherapy, the diagnosis of post-radiation neuropathy may be difficult. Recently, a posteriori conformal radiotherapy with 3D dosimetric reconstitution has been developed to link a precise anatomical site to unexpected excess irradiation. The importance of early diagnosis of radiation-induced neuropathies is underscored by the emergence of new disease-modifying treatments. Although the pathophysiology is not fully understood, it is already possible to target radiation-induced fibrosis but also associated factors such as ischemia, oxidative stress and

  2. Hypoxic-ischemic encefalopathy: Clinical course and prognosis

    Directory of Open Access Journals (Sweden)

    Ćosić-Cerovac Nataša

    2003-01-01

    Full Text Available Background. Establishing the value of neurological examination, and additional diagnostic methods (ultrasonography and magnetic resonance imaging of the brain in the diagnosis and prognosis of hypoxic-ischemic encephalopathy and its treatment, tracking the clinical course, and making the prognosis of neurological development in newborn infants with hypoxic-ischemic encefalopathy. Methods. The group of 40 term newborn infants with suspected intrauterine asphyxia was examined. All the infants were prospectivelly followed untill the 3rd year of age at the Clinic for Neurology and Psychiatry for Children and Youth in order to estimate their neurological development and to diagnose the occurence of persistent neurological disorders. All the infants were analyzed by their gestational age and Apgar score in the 1st and the 5th minute of life. They were all examined neurologically and by ultrasonography in the first week of life and, repeatedly, at the age of 1, 3, 6, 9, 12, 18, as well as in the 24th month of life. They were treated by the standard methods for this disease. Finally, all the infants were examined neurologically and by magnetic resonance imaging of the brain in their 3rd year of age. On the basis of neurological finding infants were devided into 3 groups: infants with normal neurological finding, infants with mild neurological symptomatology, and infants with severe neurological disorders. Results. It was shown that neurological finding, ultrasonography and magnetic resonance imaging of the brain positively correlated with the later neurological development of the infants with hypoxic-ischemic encephalopathy. Conclusion. Only the combined use of these techniques had full diagnostic and prognostic significance emphasizing that the integrative approach was very important in the diagnosis of brain lesions in infants.

  3. Risk stratification in secondary cardiovascular prevention.

    Science.gov (United States)

    Lazzeroni, Davide; Coruzzi, Paolo

    2018-02-19

    Worldwide, more than 7 million people experience acute myocardial infarction (AMI) every year (1), and although substantial reduction in mortality has been obtained in recent decades, one-year mortality rates are still in the range of 10%. Among patients who survive AMI, 20% suffer a second cardiovascular event in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of AMI (2). Despite the evidence that lifestyle changes and risk factors management strongly improve long-term prognosis, preventive care post-AMI remains sub-optimal. Cross-sectional data from the serially conducted EUROASPIRE surveys in patients with established ischemic heart disease (IHD) and people at high cardiovascular risk have demonstrated a high prevalence of unhealthy lifestyle, modifiable risk factors and inadequate use of drug therapies to achieve blood pressure and lipid goals (3). Secondary prevention programmes, defined as the level of preventive care focusing on early risk stratification, are highly recommended in all IHD patients, to restore quality of life, maintain or improve functional capacity and prevent recurrence.

  4. Biomarkers and Prognosis in Malignant Lymphomas

    NARCIS (Netherlands)

    Hagenbeek, Anton; Gascoyne, Randy D.; Dreyling, Martin; Kluin, Philip; Engert, Andreas; Salles, Gilles

    2009-01-01

    Approximately 100 hematologists and pathologists from Europe, the United States, and Canada participated in the workshop Biomarkers and Prognosis in Malignant Lymphomas, held in Mandelieu, France,April 11-13, 2008, under the leadership of Anton Hagenbeek, Randy Gascoyne, and Gilles Salles.

  5. Diagnosis, prevention and correction of boundary states, psychosomatic disorders in the personnel of the Kombinat industrial association under chronic stress conditions

    International Nuclear Information System (INIS)

    Tabachnikov, S.I.; Aleksandrovskij, Yu.A.; Shcherbina, E.A.; Roslyakov, V.S.; Cherenkov, V.N.; Bero, M.P.; Mukhamadieva, R.A.; Rymar', I.B.; Polonskij, V.G.; Dubritij, L.S.

    1989-01-01

    Dynamics of different psychogenetic impacts on the great number of people turned out under hazardous conditions for life was presented. Psychogenetic disorders in the personnel and human population following the Chernobyl' accident were studied. Personnel taking part in the emergency response and having no signs of radiation disease were found to have nervous-mental adaptation disorders at all stages of accident. Combination of measures on the preventive and therapeutic-reabilitative procedures was presented. Obtained results have shown that the proposed preventive and psychotherapeutic measures are the most effective and effications ones under chronic stress conditions. tab. 1

  6. Echocardiography diagnosis of myocardial infarction complications

    Directory of Open Access Journals (Sweden)

    N.D. Oryshchyn

    2016-03-01

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

  7. Sarcopenia Impairs Prognosis of Patients with Hepatocellular Carcinoma: The Role of Liver Functional Reserve and Tumor-Related Factors in Loss of Skeletal Muscle Volume.

    Science.gov (United States)

    Imai, Kenji; Takai, Koji; Watanabe, Satoshi; Hanai, Tatsunori; Suetsugu, Atsushi; Shiraki, Makoto; Shimizu, Masahito

    2017-09-22

    Sarcopenia impairs survival in patients with hepatocellular carcinoma (HCC). This study aimed to clarify the factors that contribute to decreased skeletal muscle volume in patients with HCC. The third lumbar vertebra skeletal muscle index (L3 SMI) in 351 consecutive patients with HCC was calculated to identify sarcopenia. Sarcopenia was defined as an L3 SMI value ≤ 29.0 cm²/m² for women and ≤ 36.0 cm²/m² for men. The factors affecting L3 SMI were analyzed by multiple linear regression analysis and tree-based models. Of the 351 HCC patients, 33 were diagnosed as having sarcopenia and showed poor prognosis compared with non-sarcopenia patients ( p = 0.007). However, this significant difference disappeared after the adjustments for age, sex, Child-Pugh score, maximum tumor size, tumor number, and the degree of portal vein invasion by propensity score matching analysis. Multiple linear regression analysis showed that age ( p = 0.015) and sex ( p < 0.0001) were significantly correlated with a decrease in L3 SMI. Tree-based models revealed that sex (female) is the most significant factor that affects L3 SMI. In male patients, L3 SMI was decreased by aging, increased Child-Pugh score (≥56 years), and enlarged tumor size (<56 years). Maintaining liver functional reserve and early diagnosis and therapy for HCC are vital to prevent skeletal muscle depletion and improve the prognosis of patients with HCC.

  8. Methodological issues and research recommendations for prognosis after mild traumatic brain injury

    DEFF Research Database (Denmark)

    Kristman, Vicki L; Borg, Jörgen; Godbolt, Alison K

    2014-01-01

    methodological concerns and knowledge gaps in the literature. Here we report and make recommendations on how to avoid methodological flaws found in prognostic studies of MTBI. Additionally, we discuss issues of MTBI definition and identify topic areas in need of further research to advance the understanding......, Prevention, Management and Rehabilitation Task Force on the prognosis of MTBI. Of 299 relevant studies, 101 were accepted as scientifically admissible. The methodological quality of the research literature on MTBI prognosis has not improved since the 2002 Task Force report. There are still many...... of prognosis after MTBI. Priority research areas include but are not limited to the use of confirmatory designs, studies of measurement validity, focus on the elderly, attention to litigation/compensation issues, the development of validated clinical prediction rules, the use of MTBI populations other than...

  9. Case-based reasoning combined with statistics for diagnostics and prognosis

    International Nuclear Information System (INIS)

    Olsson, T; Funk, P

    2012-01-01

    Many approaches used for diagnostics today are based on a precise model. This excludes diagnostics of many complex types of machinery that cannot be modelled and simulated easily or without great effort. Our aim is to show that by including human experience it is possible to diagnose complex machinery when there is no or limited models or simulations available. This also enables diagnostics in a dynamic application where conditions change and new cases are often added. In fact every new solved case increases the diagnostic power of the system. We present a number of successful projects where we have used feature extraction together with case-based reasoning to diagnose faults in industrial robots, welding, cutting machinery and we also present our latest project for diagnosing transmissions by combining Case-Based Reasoning (CBR) with statistics. We view the fault diagnosis process as three consecutive steps. In the first step, sensor fault signals from machines and/or input from human operators are collected. Then, the second step consists of extracting relevant fault features. In the final diagnosis/prognosis step, status and faults are identified and classified. We view prognosis as a special case of diagnosis where the prognosis module predicts a stream of future features.

  10. Long term prognosis of patients with cystic fibrosis in relation to early detection by neonatal screening and treatment in a cystic fibrosis centre

    NARCIS (Netherlands)

    Dankert-Roelse, J E; te Meerman, G J

    BACKGROUND: A study was undertaken to evaluate whether an early diagnosis by neonatal screening may improve the long term prognosis of patients with cystic fibrosis and to assess the influence of expert management started immediately after the diagnosis. METHODS: Comparative clinical follow up in

  11. [Impact of postoperative pathological features of esophageal squamous cell carcinoma on the prognosis].

    Science.gov (United States)

    Xu, Lei; Li, Yin; Sun, Haibo; Zheng, Yan; Wang, Zongfei; Chen, Xiankai

    2017-12-25

    Esophageal cancer is located in the 8th position of the incidence of malignant tumors and the 6th most common cause of cancer-related mortality in the world, while China has the highest incidence and mortality of esophageal cancer. Esophageal squamous cell carcinoma (ESCC), the predominant histologic type of esophageal cancer in China, accounts for about 90%. Despite recent improvement of surgical techniques and philosophy, however, the prognosis of ESCC patients treated with surgery is still poor, and 5-year survival remains unsatisfactorily low. So far, the pathogenesis of esophageal squamous cell carcinoma is still unclear, and effective prevention is also out of the question. To find the main factors affecting the prognosis of esophageal squamous cell carcinoma, and to improve the survival of patients, are the main directions of all scholars. Postoperative pathology of esophageal squamous cell carcinoma is considered to be one of the most important predictors of prognosis. Currently, the evaluation of postoperative esophageal prognosis mainly depends on TNM staging, but some criteria of its specific content and staging remains controversial. In this paper recent domestic and foreign related researches and clinical trials reports are collected, and the postoperative pathological features affecting esophageal squamous cell carcinoma prognosis were reviewed.

  12. Autism: Diagnosis

    Science.gov (United States)

    ... Information Publications Awards Partners Contact Us ¿Qué es Autismo? Donate Home What is Autism? What is Autism? ... Information Publications Awards Partners Contact Us ¿Qué es Autismo? Diagnosis Home / What is Autism? / Diagnosis Expand Medical ...

  13. Prognosis after percutaneous coronary intervention in patients with psoriasis

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Lindhardsen, Jesper; Gislason, Gunnar

    2012-01-01

    and severe psoriasis, respectively. Patients with severe psoriasis were less likely to receive secondary prevention pharmacotherapy with betablockers, statins and platelet inhibitors. CONCLUSION: This first study of the prognosis following PCI in patients with psoriasis demonstrated an increased risk of all...... population undergoing first-time PCI in the period 2002--09. Cox regression models, controlling for age, gender, socioeconomic status, pharmacological treatment, and comorbidity were used to assess the risk of 1) all-cause mortality and 2) a composite endpoint of death, myocardial infarction, and stroke......-cause mortality and of a composite of death, myocardial infarction and stroke, respectively, in patients with severe psoriasis compared to patients without psoriasis. Further studies of this novel association are needed....

  14. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Munck, L K; Andersen, J R

    1985-01-01

    The irritable bowel syndrome is the commonest diagnosis in gastroenterological clinics, although diagnostic criteria and investigatory programs vary. To elucidate the diagnostic safety and prognosis of the syndrome, a retrospective study was conducted. One hundred and twelve consecutive patients...... with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were...

  15. Rectal malignant melanoma mistaken for thrombotic hemorrhoids - rare tumor with poor prognosis

    International Nuclear Information System (INIS)

    Kovacova, E.; Hvizdakova, A.; Vyskocil, M.; Kinova, S.; Sesovsky, V.; Kobzova, D.; Palkovic, M.

    2011-01-01

    Rectal malignant melanoma originates in the melanocytes of the anorectal area. Represent less than 1 % of all melanomas, and 4 % of all malignant tumors of the rectum and anus. The most common clinical manifestation is bleeding, the clinical examination may be mistaken for benign lesions or hemorrhoids. Given the rarity of the diagnosis are not well-defined therapeutic procedures. Prognosis for patient is poor. The authors present a case of 70-year old patient with rectal melanoma diagnosed at an advanced stage of disease, initially with diagnosis a thrombotic hemorrhoid. (author)

  16. Critical Discussion of Essentials of Diagnosis and Recording in Periodontics.

    Science.gov (United States)

    Ellen, Richard P.

    1994-01-01

    Issues to be addressed before writing standards of care for the diagnosis of adult periodontal disease are discussed. These include considerations in screening and examination; arriving at diagnosis and prognosis, informing the patient, and referral; monitoring outcomes using diagnostic signs and tests; and new technology for and approaches to…

  17. Prognosis of synchronous bilateral breast cancer

    DEFF Research Database (Denmark)

    Holm, Marianne; Tjønneland, Anne; Balslev, Eva

    2014-01-01

    Currently, no consistent evidence-based guidelines for the management of synchronous bilateral breast cancer (SBBC) exist and it is uncertain how presenting with SBBC affects patients' prognosis. We conducted a review of studies analyzing the association between SBBC and prognosis. The studies...... that reported adjusted effect measures were included in meta-analyses of effect of bilaterality on breast cancer mortality. From 57 initially identified records 17 studies from 11 different countries including 8,050 SBBC patients were included. The quality of the studies varied but was generally low with small...... sample sizes, and lack of consistent, detailed histo-pathological information. When doing meta-analysis on the subgroup of studies that provided adjusted effect estimates on breast cancer mortality (nine studies including 3,631 SBBC cases), we found that bilaterality in itself had a negative impact...

  18. Energy prognosis services come of age

    International Nuclear Information System (INIS)

    Girsberger, H.; Schneiter, F.

    2005-01-01

    This article describes how good load-prognosis systems can help avoid the expenses incurred by the purchase of expensive supplementary energy. The possibilities offered to electricity utilities are discussed that arise from being able to delegate the tasks of load-modelling and load-management to external mathematical experts. The advantages for the utilities in being able to concentrate on their core business are discussed. A load prognosis system is described that uses several mathematical algorithms. The advantages offered by such a service are stressed, such as, for example, the integration of the collective know-how gained over the course of several projects. The methods and data used and the quality of the results obtained are discussed

  19. 2016 Expert consensus document on prevention, diagnosis and treatment of short-term peripheral venous catheter-related infections in adults

    Directory of Open Access Journals (Sweden)

    Josep A. Capdevila

    2016-07-01

    Full Text Available The use of endovascular catheters is a routine practice in secondary and tertiary care level hospitals. The short-term use of peripheral catheters has been found to be associated with the risk of nosocomial bacteraemia, resulting in morbidity and mortality. Staphylococcus aureus is mostly associated with peripheral catheter insertion. This Consensus Document has been prepared by a panel of experts of the Spanish Society of Cardiovascular Infections, in cooperation with experts from the Spanish Society of Internal Medicine, Spanish Society of Chemotherapy, and the Spanish Society of Thoracic-Cardiovascular Surgery, and aims to define and establish guidelines for the management of short duration peripheral vascular catheters. The document addresses the indications for insertion, catheter maintenance, registering, diagnosis and treatment of infection, indications for removal, as well as placing an emphasis on continuous education as a drive toward quality. Implementation of these guidelines will allow uniformity in use, thus minimizing the risk of infections and their complications.

  20. Outcome, comorbidity and prognosis in anorexia nervosa.

    Science.gov (United States)

    Jagielska, Gabriela; Kacperska, Iwona

    2017-04-30

    Anorexia nervosa (AN) is a relatively common disorder, especially in adolescent and young adult women. The lifetime prevalence of AN in females ranges from 1.2 to 2.2%. The prevalence in males is 10-times lower. The condition is associated with a high risk of chronic course and poor prognosis in terms of treatment and the risk of death. Longer follow-up periods seemed to correspond with increased improvement rates and increased mortality. Onset of the disorder during adolescence is associated with better prognosis. It is reported that as much as 70% to over 80% of patients in this age group achieve remission. Worse outcomes are observed in patients who required hospitalization and in adults. Recent studies indicate improved prognosis for cure and lower mortality rates than previously reported. However, the recovery can take several years and AN is associated with high risk of developing other psychiatric disorders during the patients' lifetime, even after recovery from AN (mainly: affective disorders, anxiety disorders, obsessive-compulsive disorders, substance abuse disorders). Studies indicate that bulimic symptoms often occur in the course of anorexia nervosa (especially within 2-3 years from the onset of AN). The authors present a review of literature on the course, comorbidity, mortality, and prognostic factors in AN. Better knowledge of the course of anorexia can contribute to more realistic expectations of the pace of symptomatic improvement, as well as to a creation of therapeutic programs which are better adapted to the needs of the patients.

  1. Prognosis, proof and priorities in dietetic practice

    NARCIS (Netherlands)

    Iestra, J.A.

    2006-01-01

    The Dutch prevention policy document 2004-2007 expresses the need for more disease prevention interventions in the curative domain of health care. In hospitals the dietician is traditionally involved in preventive activities. The recent focus on prevention provides an opportunity to reflect on what

  2. Revisiting 'Respiratory Function in Emphysema in Relation to Prognosis'

    Directory of Open Access Journals (Sweden)

    David V Bates

    2000-01-01

    Full Text Available BACKGROUND: The 1956 paper by DV Bates, JMS Knott and RV Christie, "Respiratory function in emphysema in relation to prognosis" Quart J Med 1956;97:137-157 is largely reprinted with a commentary by the first author, Dr David Bates. Although the pathology of emphysema was well recognized at the time, the clinical diagnosis and assessment of its severity were known to be imprecise; physiological measurements assessing and following the clinical course had not been established. The study aimed to follow systematically a group of patients, selected by clinical criteria using standardized clinical and physiological techniques, over four years and correlate physiological and clinical changes in relation to prognosis and eventually to postmortem findings. Fifty-nine patients were recruited to an emphysema clinic at St Bartholomew's Hospital, London, England. Inclusion criteria were dyspnea without other causes and no cor pulmonale present. Patients' symptoms were assessed by a standardized questionnaire, and measurements were taken of lung volumes, maximal ventilatory volume, carbon monoxide diffusing capacity at rest, exercise and oxygen saturation by oximetry.  During the four years of the study, 17 patients died (actuarial expected - four and 13 presented with signs of pulmonary heart failure. All postmortem examinations (n=9 showed advanced emphysema. A seasonal variation in dyspnea was established (the period included the infamous 1952 London smog. Four patients improved, and the remainder were unchanged or deteriorated. Close relationships were shown between dyspnea and function results, particularly for the diffusing capacity of lungs for carbon monoxide (DLCO. A comparison among a group of patients with chronic bronchitis without dyspnea showed that the DLCO discriminated between them. A loss of the normal increase in DLCO during exercise was shown in emphysema.

  3. Applications of Machine Learning in Cancer Prediction and Prognosis

    Directory of Open Access Journals (Sweden)

    Joseph A. Cruz

    2006-01-01

    Full Text Available Machine learning is a branch of artificial intelligence that employs a variety of statistical, probabilistic and optimization techniques that allows computers to “learn” from past examples and to detect hard-to-discern patterns from large, noisy or complex data sets. This capability is particularly well-suited to medical applications, especially those that depend on complex proteomic and genomic measurements. As a result, machine learning is frequently used in cancer diagnosis and detection. More recently machine learning has been applied to cancer prognosis and prediction. This latter approach is particularly interesting as it is part of a growing trend towards personalized, predictive medicine. In assembling this review we conducted a broad survey of the different types of machine learning methods being used, the types of data being integrated and the performance of these methods in cancer prediction and prognosis. A number of trends are noted, including a growing dependence on protein biomarkers and microarray data, a strong bias towards applications in prostate and breast cancer, and a heavy reliance on “older” technologies such artificial neural networks (ANNs instead of more recently developed or more easily interpretable machine learning methods. A number of published studies also appear to lack an appropriate level of validation or testing. Among the better designed and validated studies it is clear that machine learning methods can be used to substantially (15-25% improve the accuracy of predicting cancer susceptibility, recurrence and mortality. At a more fundamental level, it is also evident that machine learning is also helping to improve our basic understanding of cancer development and progression.

  4. Applications of machine learning in cancer prediction and prognosis.

    Science.gov (United States)

    Cruz, Joseph A; Wishart, David S

    2007-02-11

    Machine learning is a branch of artificial intelligence that employs a variety of statistical, probabilistic and optimization techniques that allows computers to "learn" from past examples and to detect hard-to-discern patterns from large, noisy or complex data sets. This capability is particularly well-suited to medical applications, especially those that depend on complex proteomic and genomic measurements. As a result, machine learning is frequently used in cancer diagnosis and detection. More recently machine learning has been applied to cancer prognosis and prediction. This latter approach is particularly interesting as it is part of a growing trend towards personalized, predictive medicine. In assembling this review we conducted a broad survey of the different types of machine learning methods being used, the types of data being integrated and the performance of these methods in cancer prediction and prognosis. A number of trends are noted, including a growing dependence on protein biomarkers and microarray data, a strong bias towards applications in prostate and breast cancer, and a heavy reliance on "older" technologies such artificial neural networks (ANNs) instead of more recently developed or more easily interpretable machine learning methods. A number of published studies also appear to lack an appropriate level of validation or testing. Among the better designed and validated studies it is clear that machine learning methods can be used to substantially (15-25%) improve the accuracy of predicting cancer susceptibility, recurrence and mortality. At a more fundamental level, it is also evident that machine learning is also helping to improve our basic understanding of cancer development and progression.

  5. Methodological issues and research recommendations for prognosis after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis.

    Science.gov (United States)

    Kristman, Vicki L; Borg, Jörgen; Godbolt, Alison K; Salmi, L Rachid; Cancelliere, Carol; Carroll, Linda J; Holm, Lena W; Nygren-de Boussard, Catharina; Hartvigsen, Jan; Abara, Uko; Donovan, James; Cassidy, J David

    2014-03-01

    The International Collaboration on Mild Traumatic Brain Injury (MTBI) Prognosis performed a comprehensive search and critical review of the literature from 2001 to 2012 to update the 2002 best-evidence synthesis conducted by the World Health Organization Collaborating Centre for Neurotrauma, Prevention, Management and Rehabilitation Task Force on the prognosis of MTBI. Of 299 relevant studies, 101 were accepted as scientifically admissible. The methodological quality of the research literature on MTBI prognosis has not improved since the 2002 Task Force report. There are still many methodological concerns and knowledge gaps in the literature. Here we report and make recommendations on how to avoid methodological flaws found in prognostic studies of MTBI. Additionally, we discuss issues of MTBI definition and identify topic areas in need of further research to advance the understanding of prognosis after MTBI. Priority research areas include but are not limited to the use of confirmatory designs, studies of measurement validity, focus on the elderly, attention to litigation/compensation issues, the development of validated clinical prediction rules, the use of MTBI populations other than hospital admissions, continued research on the effects of repeated concussions, longer follow-up times with more measurement periods in longitudinal studies, an assessment of the differences between adults and children, and an account for reverse causality and differential recall bias. Well-conducted studies in these areas will aid our understanding of MTBI prognosis and assist clinicians in educating and treating their patients with MTBI. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine.

    Science.gov (United States)

    Meeusen, Romain; Duclos, Martine; Foster, Carl; Fry, Andrew; Gleeson, Michael; Nieman, David; Raglin, John; Rietjens, Gerard; Steinacker, Jürgen; Urhausen, Axel

    2013-01-01

    Successful training not only must involve overload but also must avoid the combination of excessive overload plus inadequate recovery. Athletes can experience short-term performance decrement without severe psychological or lasting other negative symptoms. This functional overreaching will eventually lead to an improvement in performance after recovery. When athletes do not sufficiently respect the balance between training and recovery, nonfunctional overreaching (NFOR) can occur. The distinction between NFOR and overtraining syndrome (OTS) is very difficult and will depend on the clinical outcome and exclusion diagnosis. The athlete will often show the same clinical, hormonal, and other signs and symptoms. A keyword in the recognition of OTS might be "prolonged maladaptation" not only of the athlete but also of several biological, neurochemical, and hormonal regulation mechanisms. It is generally thought that symptoms of OTS, such as fatigue, performance decline, and mood disturbances, are more severe than those of NFOR. However, there is no scientific evidence to either confirm or refute this suggestion. One approach to understanding the etiology of OTS involves the exclusion of organic diseases or infections and factors such as dietary caloric restriction (negative energy balance) and insufficient carbohydrate and/or protein intake, iron deficiency, magnesium deficiency, allergies, and others together with identification of initiating events or triggers. In this article, we provide the recent status of possible markers for the detection of OTS. Currently, several markers (hormones, performance tests, psychological tests, and biochemical and immune markers) are used, but none of them meet all the criteria to make their use generally accepted.

  7. ECIL guidelines for the prevention, diagnosis and treatment of BK polyomavirus-associated haemorrhagic cystitis in haematopoietic stem cell transplant recipients.

    Science.gov (United States)

    Cesaro, Simone; Dalianis, Tina; Hanssen Rinaldo, Christine; Koskenvuo, Minna; Pegoraro, Anna; Einsele, Hermann; Cordonnier, Catherine; Hirsch, Hans H

    2018-01-01

    To define guidelines for BK polyomavirus (BKPyV)-associated haemorrhagic cystitis (BKPyV-HC) after paediatric and adult HSCT. Review of English literature and evidence-based recommendations by expert consensus. BKPyV-HC occurs in 8%-25% of paediatric and 7%-54% of adult recipients undergoing allogeneic HSCT. Diagnosis requires the triad of cystitis, macro-haematuria and high urine BKPyV loads >7 log10 copies/mL, and exclusion of other relevant aetiologies. BKPyV viraemia is frequent and may serve as a more specific semiquantitative follow-up marker. No randomized controlled trials are available to inform antiviral prophylaxis or treatment. However, hyper-hydration and/or bladder irrigation showed limited prophylactic value. Fluoroquinolones are not effective for prophylaxis or treatment, but rather increase antibiotic resistance. Hyperbaric oxygen or fibrin glue is marginally effective based on small case series from correspondingly equipped centres. Although cidofovir has been reported to improve and/or reduce BKPyV viraemia or viruria, the current data do not support its regular use. BKPyV-HC remains a disabling unmet clinical need in HSCT that requires novel approaches supported by proper clinical trials. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Fully integrated e-services for prevention, diagnosis, and treatment of sexually transmitted infections: results of a 4-county study in California.

    Science.gov (United States)

    Spielberg, Freya; Levy, Vivian; Lensing, Shelly; Chattopadhyay, Ishita; Venkatasubramanian, Lalitha; Acevedo, Nincoshka; Wolff, Peter; Callabresi, Debra; Philip, Susan; Lopez, Teresa P; Padian, Nancy; Blake, Diane R; Gaydos, Charlotte A

    2014-12-01

    We examined the acceptability, feasibility, and cost of a fully integrated online system (eSTI) for sexually transmitted infection (STI) testing, treatment, and linkage to care with 4 Northern California health departments. In April 2012, we implemented the eSTI system, which provided education; testing of self-collected vaginal swabs for chlamydia, gonorrhea, and trichomoniasis; e-prescriptions; e-partner notification; and data integration with clinic electronic health records. We analyzed feasibility, acceptability, and cost measures. During a 3-month period, 217 women aged 18 to 30 years enrolled; 67% returned the kit. Of these, 92% viewed their results online. STI prevalence was 5.6% (chlamydia and trichomoniasis). All participants with STIs received treatment either the same day at a pharmacy (62%) or within 7 days at a clinic (38%). Among participants completing follow-up surveys, 99% would recommend the online eSTI system to a friend, and 95% preferred it over clinic-based testing within a study. The fully integrated eSTI system has the potential to increase diagnosis and treatment of STIs with higher patient satisfaction at a potentially lower cost.

  9. BMI and breast cancer prognosis benefit: mammography screening reveals differences between normal weight and overweight women.

    Science.gov (United States)

    Crispo, Anna; Grimaldi, Maria; D'Aiuto, Massimiliano; Rinaldo, Massimo; Capasso, Immacolata; Amore, Alfonso; D'Aiuto, Giuseppe; Giudice, Aldo; Ciliberto, Gennaro; Montella, Maurizio

    2015-02-01

    Few studies are available on the potential impact of body weight on breast cancer prognosis in screen-detected patients. Moreover, it is not known whether body mass index (BMI) could have a different prognostic impact in screen-detected versus symptomatic breast cancer patients. To investigate these unsolved issues, we carried out a retrospective study evaluating the effect of BMI on breast cancer prognosis in screen-detected vs symptomatic breast cancer patients. We conducted a follow-up study on 448 women diagnosed with incident, histologically-confirmed breast cancer. Patients were categorized according to their BMI as normal weight, overweight and obese. Disease free survival (DFS), overall survival (OS), and BMI curves were compared according to mode of cancer detection. Among screen-detected patients, higher BMI was associated with a significant lower DFS, whereas no significant difference was observed among symptomatic patients. OS showed similar results. In the multivariate analysis adjusting for age, education, tumor size, nodal status, estrogen receptor (ER), progesterone receptor (PR) and menopausal status, the risk for high level of BMI among screen-detected patients did not reach the statistical significance for either recurrence or survival. Our study highlights the potential impact of high bodyweight in breast cancer prognosis, the findings confirm that obesity plays a role in women breast cancer prognosis independently from diagnosis mode. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Necrotizing fasciitis: strategies for diagnosis and management.

    Science.gov (United States)

    Taviloglu, Korhan; Yanar, Hakan

    2007-08-07

    Necrotizing fasciitis (NF) is uncommon and difficult to diagnose, and it cause progressive morbidity until the infectious process is diagnosed and treated medically and surgically. The literature addressed NF contains confusing information, inaccurate bacteriologic data, and antiquated antibiotic therapy. A delay in diagnosis is associated with a grave prognosis and increased mortality. The main goal of the clinician must be to establish the diagnosis and initially treat the patient within the standard of care. This review is planned as a guide for the clinician in making an early diagnosis of NF and initiating effective medical and surgical therapy.

  11. Necrotizing fasciitis: strategies for diagnosis and management

    Directory of Open Access Journals (Sweden)

    Yanar Hakan

    2007-08-01

    Full Text Available Abstract Necrotizing fasciitis (NF is uncommon and difficult to diagnose, and it cause progressive morbidity until the infectious process is diagnosed and treated medically and surgically. The literature addressed NF contains confusing information, inaccurate bacteriologic data, and antiquated antibiotic therapy. A delay in diagnosis is associated with a grave prognosis and increased mortality. The main goal of the clinician must be to establish the diagnosis and initially treat the patient within the standard of care. This review is planned as a guide for the clinician in making an early diagnosis of NF and initiating effective medical and surgical therapy.

  12. Fungal Diseases: Ringworm Risk & Prevention

    Science.gov (United States)

    ... Testing Treatment & Outcomes Health Professionals Statistics More Resources Candidiasis Candida infections of the mouth, throat, and esophagus Vaginal candidiasis Invasive candidiasis Definition Symptoms Risk & Prevention Sources Diagnosis ...

  13. Community abortion incomplete abortion common cause diagnosis and prevention measures%社区人工流产术中人流不全常见原因、诊断及防治措施

    Institute of Scientific and Technical Information of China (English)

    姜美芳

    2015-01-01

    目的:分析社区人工流产术后人流不全的常见原因、诊断方法与防治措施。方法:收治人工流产不全患者59例,回顾分析其临床资料,同时实施钳刮术、清宫术,或让患者服用药物。结果:人流不全患者均治疗成功,成功率100%。结论:人流不全的原因具有多样化的特点,对于人流不全患者需要及时诊断与治疗。%Objective:To analyze the community abortion incomplete abortion common cause diagnosis and prevention measures. Methods:59 patients with incomplete abortion were selected.We retrospective analyzed clinical data,while implementing curettage, curettage,or let the patients taking the drug.Results:Incomplete abortion patients were treated successfully,and the success rate of 100%.Conclusion:The reason for incomplete abortion has a variety of features,for incomplete abortion patients require prompt diagnosis and treatment.

  14. Diagnosis and Management of Uncomplicated Chlamydia trachomatis Infections in Adolescents and Adults: Summary of Evidence Reviewed for the 2015 Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines.

    Science.gov (United States)

    Geisler, William M

    2015-12-15

    In preparation for the 2015 Centers for Disease Control and Prevention (CDC) Sexually Transmitted Diseases (STD) Treatment Guidelines, the CDC convened an advisory group in 2013 to examine recent abstracts and published literature addressing the epidemiology, diagnosis, and management of STDs. This article summarizes the key questions, evidence, and recommendations for the diagnosis and management of uncomplicated Chlamydia trachomatis (CT) infection in adolescents and adults that were considered in development of the 2015 CDC STD Treatment Guidelines. The evidence reviewed primarily focused on CT infection risk factors in women, clinical significance of oropharyngeal CT detection, acceptability and performance of CT testing on self-collected specimens in men, performance of CT point-of-care tests, efficacy of recommended and investigational CT infection treatments, and timing of test of cure following CT infection treatment in pregnant women. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  15. A missed injury leading to delayed diagnosis and postoperative infection of an unstable thoracic spine fracture - case report of a potentially preventable complication

    Directory of Open Access Journals (Sweden)

    Stahel Philip F

    2011-10-01

    Full Text Available Abstract Background Patients suffering from polytrauma often present with altered mental status and have varying levels of examinability. This makes evaluation difficult. Physicians are often required to rely on advanced imaging techniques to make prompt and accurate diagnoses. Occasionally, injury detection on advanced imaging studies can be challenging given the subtle findings associated with certain conditions, such as diffuse idiopathic skeletal hyperostosis (DISH. Delayed or missed diagnoses in the setting of spinal fracture can lead to catastrophic neurological injury. Case presentation A man struck by a motor vehicle suffered multiple traumatic injuries including numerous rib fractures, a mechanically unstable pelvic fracture, and also had suspicion for an aortic injury. Unfortunately, the upper thoracic segment (T1-5 was only visualized with axial images based on the electronic data. Several days later, a contrast CT scan obtained to check the status of suspected aortic injury revealed T3-T4 subluxation indicative of an unstable extension-type fracture in the setting of DISH. Due to the missed injury and delay in diagnosis, surgery was not performed until eight days after the injury. At surgery, the patient was found to have left T3-T4 facet joint infection as well as infected hematoma surrounding a left T4 transverse process fracture and a traumatic T4 costo-transverse joint fracture-subluxation. Despite presence of infection, an instrumented posterior spinal fusion from T1-T6 was performed and the patient recovered well after antibiotic treatment. Conclusion A T3-T4 unstable DISH extension-type fracture was initially missed in a polytrauma patient due to inadequate imaging acquisition, which caused a delay in treatment and bacterial seeding of fracture hematoma. Complete imaging is especially needed in obtunded patients that cannot be thoroughly examined.

  16. SERS-Based Prognosis of Kidney Transplant Outcome

    Science.gov (United States)

    Chi, Jingmao

    Kidney transplant is the predominant procedure of all organ transplants around the world. The number of patients on the waiting list for a kidney is growing rapidly, yet the number of donations does not keep up with the fast-growing need. This thesis focuses on the surface-enhanced Raman scattering (SERS) analysis of urine samples for prognosis of kidney transplant outcome, which can potentially let patients have a more timely treatment as well as expand the organ pool for transplant. We have observed unique SERS spectral features from urine samples of kidney transplant recipients that have strong associations with the kidney acute rejection (AR) based on the analysis of urine one day after the transplant. Our ability to provide an early prognosis of transplant outcome is a significant advance over the current gold standard of clinical diagnosis, which occurs weeks or months after the surgical procedure. The SERS analysis has also been applied to urine samples from deceased kidney donors. Excellent classification ability was achieved when the enhanced PCA-LDA analysis was used to classify and identify urine samples from different cases. The sensitivity of the acute tubular necrosis (ATN) class is more than 90%, which can indicate the usable kidneys in the high failure risk category. This analysis can help clinicians identify usable kidneys which would be discarded using conventional clinic methods as high failure risk. To investigate the biomarkers that cause the unique SERS features, an HPLC-SERS-MS approach was established. The high-performance liquid chromatography (HPLC) was used to separate the urinary components to reduce the sample complexity. The mass spectrometry (MS) was used to determine the formulas and the structures of the biomarkers. The presence of 1-methyl-2-pyrrolidone (NMP) and adenine in urine samples were confirmed by both MS and SERS analysis. Succinylmonocholine, a metabolite of suxamethonium, has a potential to be the biomarker that causes

  17. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report.

    Science.gov (United States)

    Levey, Andrew S; de Jong, Paul E; Coresh, Josef; El Nahas, Meguid; Astor, Brad C; Matsushita, Kunihiro; Gansevoort, Ron T; Kasiske, Bertram L; Eckardt, Kai-Uwe

    2011-07-01

    The definition and classification for chronic kidney disease was proposed by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) in 2002 and endorsed by the Kidney Disease: Improving Global Outcomes (KDIGO) in 2004. This framework promoted increased attention to chronic kidney disease in clinical practice, research and public health, but has also generated debate. It was the position of KDIGO and KDOQI that the definition and classification should reflect patient prognosis and that an analysis of outcomes would answer key questions underlying the debate. KDIGO initiated a collaborative meta-analysis and sponsored a Controversies Conference in October 2009 to examine the relationship of estimated glomerular filtration rate (GFR) and albuminuria to mortality and kidney outcomes. On the basis of analyses in 45 cohorts that included 1,555,332 participants from general, high-risk, and kidney disease populations, conference attendees agreed to retain the current definition for chronic kidney disease of a GFR 30 mg/g, and to modify the classification by adding albuminuria stage, subdivision of stage 3, and emphasizing clinical diagnosis. Prognosis could then be assigned based on the clinical diagnosis, stage, and other key factors relevant to specific outcomes. KDIGO has now convened a workgroup to develop a global clinical practice guideline for the definition, classification, and prognosis of chronic kidney disease.

  18. Primary Neuroendocrine Carcinoma of Thymus Caused Cushing Syndrome: 
Surgical Treatment and Prognosis Analysis

    Directory of Open Access Journals (Sweden)

    Li LI

    2015-07-01

    Full Text Available Background and objective Primary neuroendocrine carcinoma of thymus (pNECT is a rare thymic neoplasm. Some pNECTs could produce an adrenocorticotropic hormone and cause Cushing syndrome (CS. The aim os this study is to discuss the diagnostic technique and surgical management of pNECT-caused CS and analyze prognosis factors to improve the clinical experience of the disease. Methods The outcome of surgery and follow-up of 14 cases (eight males and six females of pNECT-caused CS were retrospectively analyzed from November 1987 to June 2013. Result The median age of the patients was 29, and the median duration of the disease was four months (1 month-44 months. All cases exhibited clinical evidence for the diagnosis of CS, and thoracic computed tomography (CT was used to detect thymic tumors. Surgical treatment significantly decreased the concentration of both serum cortisol and adrenocorticotropic hormone (P<0.01 but caused one death in the perioperative period. With multidisciplinary therapy, the median survival was 38 months. Conclusion pNECT-caused CS is a rare disease with aggressive characteristics and unclear prognosis. Early diagnosis and therapy is a challenge for clinicians. Thoracic CT is important for disease location and preoperative evaluation and should be routinely applied to all CS patients to allow early surgery and improved prognosis.

  19. [Primary Neuroendocrine Carcinoma of Thymus Caused Cushing Syndrome: Surgical Treatment and Prognosis Analysis].

    Science.gov (United States)

    Li, Li; Chen, Yeye; Li, Shanqing; Liu, Hongsheng; Huang, Cheng; Qin, Yingzhi

    2015-07-01

    Primary neuroendocrine carcinoma of thymus (pNECT) is a rare thymic neoplasm. Some pNECTs could produce an adrenocorticotropic hormone and cause Cushing syndrome (CS). The aim os this study is to discuss the diagnostic technique and surgical management of pNECT-caused CS and analyze prognosis factors to improve the clinical experience of the disease. The outcome of surgery and follow-up of 14 cases (eight males and six females) of pNECT-caused CS were retrospectively analyzed from November 1987 to June 2013. The median age of the patients was 29, and the median duration of the disease was four months (1 month-44 months). All cases exhibited clinical evidence for the diagnosis of CS, and thoracic computed tomography (CT) was used to detect thymic tumors. Surgical treatment significantly decreased the concentration of both serum cortisol and adrenocorticotropic hormone (Pdisease with aggressive characteristics and unclear prognosis. Early diagnosis and therapy is a challenge for clinicians. Thoracic CT is important for disease location and preoperative evaluation and should be routinely applied to all CS patients to allow early surgery and improved prognosis.

  20. Prognosis following cancer surgery during holiday periods.

    Science.gov (United States)

    Lagergren, Jesper; Mattsson, Fredrik; Lagergren, Pernilla

    2017-11-15

    Surgery is the mainstay curative treatment in most cancer. We aimed to test the new hypothesis that cancer surgery performed during holiday periods is associated with worse long-term prognosis than for non-holiday periods. This nationwide Swedish population-based cohort study included 228,927 patients during 1997-2014 who underwent elective resectional surgery for a cancer where the annual number of resections was over 100. The 16 eligible cancer sites were grouped into 10 cancer groups. The exposure, holiday periods, was classified as wide (14-weeks) or narrow (7-weeks). Surgery conducted inside versus outside holiday periods was compared regarding overall disease-specific (main outcome) and overall all-cause (secondary outcome) mortality. Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age, sex, comorbidity, hospital volume, calendar period and tumor stage. Surgery conducted during wide and narrow holiday periods were associated with increased HRs of disease-specific mortality for cancer of the breast (HR 1.08, 95% CI 1.03-1.13 and HR 1.06, 95% CI 1.01-1.12) and possibly of cancer of the liver-pancreas-bile ducts (HR 1.09, 95% CI 0.99-1.20 and HR 1.12, 95% CI 0.99-1.26). Sub-groups with cancer of the colon-rectum, head-and-neck, prostate, kidney-urine bladder and thyroid also experienced statistically significantly worse prognosis following surgery conducted during holiday periods. No influence of surgery during holiday was detected for cancer of the esophagus-stomach, lung or ovary-uterus. All-cause HRs were similar to the disease-specific HRs. The prognosis following cancer surgery might not be fully maintained during holiday periods for all cancer sites. © 2017 UICC.

  1. Breast. cancer. Prognosis factors - preliminar study

    International Nuclear Information System (INIS)

    Rotstein, S.; Fonseca, N.M.

    1984-01-01

    A preliminar study of prognosis factors in 8 cases of breast cancer is made. Are used as parameters the dimension, the localization and the nuclear differentiation degree (gN) of the primary tumor, the vascular invasion and the axillary histologic status (pN) and the sinus histiocytosis phenomenon. Among the studied factors, have special importance the presence of vascular invasion and the negative sinus histiocytosis (minimal or absent sinus histiocytosis). Both phenomena are considered as an expression of potential systemic disease, independent of the clinical stage. Consequently the use of chemotherapy in the surgery complementation is preconized, to a best control of the disease. (author)

  2. [Short-term prognosis of transient ischemic attacks. Mexican multicenter stroke registry].

    Science.gov (United States)

    Arauz, Antonio; Cantú, Carlos; Ruiz-Sandoval, José Luis; Villarreal-Careaga, Jorge; Barinagarrementeria, Fernando; Murillo-Bonilla, Luis; Fernández, José Antonio; Torres, Bertha; León, Carolina; Rodríguez-Leyva, Idelfonso; Rangel-Guerra, Ricardo

    2006-01-01

    There are no data on Mexican population referring to frequency and prognosis of transient ischemic attacks (TIA). The purpose of the present study was to: (1) estimate the prevalence, vascular risk factors and short-term outcome in patients with TIA included in the first Mexican registry of cerebrovascular disease, and (2) analyze the acute care provided in these patients. This national registry of cerebrovascular diseases is a multicenter, observational, and hospital-based registry that was conducted from November 2002 to October 2004. The registry was developed to improve our knowledge in Mexico regarding risk factors profile, outcome, current diagnostic and treatment strategies, and short-term follow-up in patients with acute cerebral ischemia. Standardized data assessment was used by all centers which included information on demographics, pre-hospital events (including stroke onset and arrival to hospital), emergency department triage and workup. Short-term outcome was evaluated at day 30. Of this registry, TIA cases were selected and associated risk factors, clinical characteristics, diagnosis and treatment were analyzed. During the study time period, 2,000 patients were enrolled; 97 (5%) with diagnosis of TIA; 51 women and 46 men, mean age 69.3 +/- 11.4 years. Among these 97 patients; 51 (52.6%) were admitted to the hospital for evaluation. The main risk factors were; age > or = 65 years in 74%, hypertension in 64%, diabetes in 45%, and dislipidemia in 36% and obesity in 31%. The affected arterial territory was carotid TIA in 74% and vertebrobasilar in 26%. TIA was attributed to atherosclerosis in 63% of the patients, cardioembolism in 17%, and small vessels disease in 5%. At 30 days follow-up; three patients died during the initial evaluation (two secondary to cardiac arrhythmia, and one secondary to pneumonia). Among 14 of the 94 survivors (14.9%) we documented an early stroke recurrence, including cerebral infarction in nine patients (9.6%) and new TIA in

  3. Diagnosis and Treatment of Neurocysticercosis

    Directory of Open Access Journals (Sweden)

    Christina M. Coyle

    2009-01-01

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

  4. [Breast cancer: histological prognosis from biopsy material].

    Science.gov (United States)

    Veith, F; Picco, C

    1977-01-01

    Two histological factors to be taken into consideration for prognosis in pretreatment schedules of breast cancer have been studied on a group of 352 cases treated by non-mutilating therapeutics at the Fondation Curie between 1960 and 1970. The tumour material the slides of which we have reexamined "blindly", i.e. ignoring the evolution of the case had been obtained mostly by drill-biopsy. Histological groups and types have been determined following an analytical classification for computer purpose. The degree of malignancy was calculated with the method of Scarff-Bloom-Richardson. The analyzed data have been memorized on computer and then confronted with the elements of the T.N.M. classification and the survival of the patients involved. It appeared that if drill-biopsie have been performed correctly the histological type may be defined in eighty percent of cases. And it is likewise possible to calculate the histological grade of malignancy for each mammary cancer. With such a material the value for prognosis by means of the Scarff-Bloom-Richardson method still remains if applied only to adenocarcinoma of the "common infiltrating type".

  5. Big-Data-Based Thermal Runaway Prognosis of Battery Systems for Electric Vehicles

    Directory of Open Access Journals (Sweden)

    Jichao Hong

    2017-07-01

    Full Text Available A thermal runaway prognosis scheme for battery systems in electric vehicles is proposed based on the big data platform and entropy method. It realizes the diagnosis and prognosis of thermal runaway simultaneously, which is caused by the temperature fault through monitoring battery temperature during vehicular operations. A vast quantity of real-time voltage monitoring data is derived from the National Service and Management Center for Electric Vehicles (NSMC-EV in Beijing. Furthermore, a thermal security management strategy for thermal runaway is presented under the Z-score approach. The abnormity coefficient is introduced to present real-time precautions of temperature abnormity. The results illustrated that the proposed method can accurately forecast both the time and location of the temperature fault within battery packs. The presented method is flexible in all disorder systems and possesses widespread application potential in not only electric vehicles, but also other areas with complex abnormal fluctuating environments.

  6. Serum biomarkers for the early diagnosis of TIA: The MIND-TIA study protocol.

    Science.gov (United States)

    Dolmans, L Servaas; Rutten, Frans H; El Bartelink, Marie-Louise; Seppenwoolde, Gerdien; van Delft, Sanne; Kappelle, L Jaap; Hoes, Arno W

    2015-07-28

    A Transient Ischaemic Attack (TIA) bears a high risk of a subsequent ischaemic stroke. Adequate diagnosis of a TIA should be followed immediately by the start of appropriate preventive therapy, including antiplatelets. The diagnosis of a TIA based on symptoms and signs only is notoriously difficult and biomarkers of brain ischaemia might improve the recognition, and target management and prognosis of TIA patients. Our aim is to quantify the added diagnostic value of serum biomarkers of brain ischaemia in patients suspected of TIA. a cross-sectional diagnostic accuracy study with an additional six month follow-up period. 350 patients suspected of TIA in the primary care setting. Patients suspected of a TIA will be recruited by at least 200 general practitioners (GPs) in the catchment area of seven TIA outpatient clinics willing to participate in the study. In all patients a blood sample will be drawn as soon as possible after the patient has contacted the GP, but at least within 72 h after onset of symptoms. Participants will be referred by the GP to the regional TIA outpatient clinic for additional investigations, including brain imaging. The 'definite' diagnosis (reference standard) will be made by a panel consisting of three experienced neurologists who will use all available diagnostic information and the clinical information obtained during the outpatient clinic assessment, and a six month follow-up period. The diagnostic accuracy, and value in addition to signs and symptoms of candidate serum biomarkers will be assessed in terms of discrimination with C statistics, and calibration with plots. We aim to include 350 suspected cases, with 250 patients with indeed definite TIA (or minor stroke) according to the panel. We hope to find novel biomarkers that will enable a rapid and accurate diagnosis of TIA. This would largely improve the management and prognosis of such patients. ClinicalTrials.gov Identifier NCT01954329.

  7. [Gender Aspects in Gastrointestinal Tumours and Their Prognosis in Regard to Multimodal Treatment Concepts].

    Science.gov (United States)

    Seeland, U; Heger, U; Heise, K; Ott, K

    2015-06-01

    Systematic analyses of gender effects in gastrointestinal malignancies are currently lacking, partly because sex and gender have not been used as stratification criteria in major studies on the topic. It is, however, indisputable that gastrointestinal tumours differ in risk factors, incidence and prognosis between the genders. This review summarises the most important findings on differences related to biological sex and sociocultural gender and discusses anatomic specifics with immediate significance for surgical interventions. Epidemiological differences in upper gastrointestinal malignancies are most prominent in regard to histological subtypes, directly affecting diagnostics, therapy, and prognosis. Women have a better prognosis in many of these tumour subtypes. For colorectal carcinoma, sex hormones, specifically oestrogens, appear to play a distinct role in tumourigenesis. Histopathological analysis of the expression of oestrogen receptor beta (ERβ) in the tumour tissue has attracted interest since it was shown that women with low ERβ expression have a better prognosis than men with comparable ERβ status. Data on the higher incidence of right-sided colon carcinoma and non-polypoid neoplasms in women could lead to improved screening programmes. Men and women cite differing reasons for avoidance of screening colonoscopies, thus gender specific approaches could improve colon cancer prevention programmes. Data on differing bioavailability of 5-fluorouracil between the genders are useful to minimise adverse effects of chemotherapy and should be accounted for in dosage. Further systematic analysis of gender effects on gastrointestinal tumours is warranted and would be a substantial step towards personalised oncological surgery. Georg Thieme Verlag KG Stuttgart · New York.

  8. Tumor size and prognosis in patients with Wilms tumor

    Directory of Open Access Journals (Sweden)

    Valentina Oliveira Provenzi

    2015-03-01

    Full Text Available OBJECTIVE: Investigate the relationship of the tumor volume after preoperative chemotherapy (TVAPQ and before preoperative chemotherapy (TVBPQ with overall survival at two and at five years, and lifetime. METHODS: Our sample consisted of consecutive patients evaluated in the period from 1989 to 2009 in an Onco-Hematology Service. Clinical, histological and volumetric data were collected from the medical records. For analysis, chi-square, Kaplan-Meier, log-rank and Cox regression tests were used. RESULTS: The sample consisted of 32 patients, 53.1% were male with a median age at diagnosis of 43 months. There was a significant association between TVAPQ>500mL and the difference between the TVBPQ and TVAPQ (p=0.015 and histologic types of risk (p=0.008. It was also verified an association between the difference between the TVBPQ and TVAPQ and the predominant stromal tumor (p=0.037. When assessing the TVAPQ of all patients, without a cutoff, there was an association of the variable with lifetime (p=0.013, i.e., for each increase of 10mL in TVAPQ there was an average increase of 2% in the risk of death. CONCLUSIONS: Although our results indicate that the TVAPQ could be considered alone as a predictor of poor prognosis regardless of the cutoff suggested in the literature, more studies are needed to replace the histology and staging by tumor size as best prognostic variable.

  9. Immunophenotypes and Immune Markers Associated with Acute Promyelocytic Leukemia Prognosis

    Directory of Open Access Journals (Sweden)

    Fang Xu

    2014-01-01

    Full Text Available CD2+, CD34+, and CD56+ immunophenotypes are associated with poor prognoses of acute promyelocytic leukemia (APL. The present study aimed to explore the role of APL immunophenotypes and immune markers as prognostic predictors on clinical outcomes. A total of 132 patients with de novo APL were retrospectively analyzed. Immunophenotypes were determined by flow cytometry. Clinical features, complete remission (CR, relapse, and five-year overall survival (OS rate were assessed and subjected to multivariate analyses. The CD13+CD33+HLA-DR-CD34− immunophenotype was commonly observed in patients with APL. Positive rates for other APL immune markers including cMPO, CD117, CD64, and CD9 were 68.7%, 26%, 78.4%, and 96.6%, respectively. When compared with patients with CD2− APL, patients with CD2+ APL had a significantly higher incidence of early death (50% versus 15.7%; P=0.016, lower CR rate (50% versus 91.1%; P=0.042, and lower five-year OS rate (41.7% versus 74.2%; P=0.018. White blood cell (WBC count before treatment was found to be the only independent risk factor of early death, CR failure, and five-year mortality rate. Flow cytometric immunophenotype analysis can facilitate prompt APL diagnosis. Multivariate analysis has demonstrated that WBC count before treatment is the only known independent risk factor that predicts prognosis for APL in this study population.

  10. Oral tumors in dogs and cats. II. Prognosis and treatment

    International Nuclear Information System (INIS)

    Dhaliwal, R.S.; Kitchell, B.E.; Marretta, S.M.

    1998-01-01

    Small size and rostral location generally are positive prognostic factors for all types of oral tumors.:Standard treatment modalities for oral tumors include surgery, radiation therapy, intralesional matrix cisplatin, photodynamic therapy, and chemotherapy, Investigational therapeutic regimens, such as immunotherapy and gene therapy are not:yet widely available to practicing veterinarians. Surgery and radiation therapy are the-treatments of-choice for oral tumors because these neoplasms are locally aggressive and rarely metastasize. The advent of radical,surgical techniques coupled: with the use of radiation therapy has dramatically: improved survival Fates for dogs with oral tumors. When considered for oral tumors, chemotherapy is always palliative therapy because a complete cure cannot be anticipated with chemotherapy alone. However, using concurrent chemotherapy (as a radiation Sensitizer) and radiation therapy is gaining a lot of interest in clinical research. Part I of this two-part presentation discussed clinical Signs,diagnosis, and histologic types of various oral tumors; Part II reviews prognosis and treatment

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

    Science.gov (United States)

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

    2016-12-01

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

  12. Energieprognostik auf dem Pruefstand. Energy prognosis on the test bench

    Energy Technology Data Exchange (ETDEWEB)

    Haerter, M [ed.

    1988-01-01

    Does an energy prognosis reveal more about its author, than about the future of energy The fact that there is a lot of scepticism toward extremely varying and often diametrally opposed forecasts on the area of energy suggested to look at the 'psychology of forecasts and prognosis'. Representatives of the fields involved were invited to Schloss Haigerloch in 1986 in order to analyse the influence of the environment on the result of a prognosis. Linking up with this subject the GEE-prognosis-workshop held in 1987 looked into the fundamental question of 'Progress in prognostication'. Three recent studies which were supplemented by a historic study on deviations between prognosis and the actual facts, were presented at the workshop. They supplied a comparative evaluation of national and international energy prognostications. Papers from both meetings are contained in this volume providing a survey on the state of energy prognosis. (orig.).

  13. Anthrax: Diagnosis

    Science.gov (United States)

    ... Diagnosis Language: English (US) Español (Spanish) Recommend on Facebook Tweet Share Compartir Doctors in the United States rarely see a patient with anthrax. CDC Guidance and case definitions are available to help doctors diagnose anthrax, take ...

  14. Clinicopathologic and gene expression parameters predict liver cancer prognosis

    International Nuclear Information System (INIS)

    Hao, Ke; Zhong, Hua; Greenawalt, Danielle; Ferguson, Mark D; Ng, Irene O; Sham, Pak C; Poon, Ronnie T; Molony, Cliona; Schadt, Eric E; Dai, Hongyue; Luk, John M; Lamb, John; Zhang, Chunsheng; Xie, Tao; Wang, Kai; Zhang, Bin; Chudin, Eugene; Lee, Nikki P; Mao, Mao

    2011-01-01

    The prognosis of hepatocellular carcinoma (HCC) varies following surgical resection and the large variation remains largely unexplained. Studies have revealed the ability of clinicopathologic parameters and gene expression to predict HCC prognosis. However, there has been little systematic effort to compare the performance of these two types of predictors or combine them in a comprehensive model. Tumor and adjacent non-tumor liver tissues were collected from 272 ethnic Chinese HCC patients who received curative surgery. We combined clinicopathologic parameters and gene expression data (from both tissue types) in predicting HCC prognosis. Cross-validation and independent studies were employed to assess prediction. HCC prognosis was significantly associated with six clinicopathologic parameters, which can partition the patients into good- and poor-prognosis groups. Within each group, gene expression data further divide patients into distinct prognostic subgroups. Our predictive genes significantly overlap with previously published gene sets predictive of prognosis. Moreover, the predictive genes were enriched for genes that underwent normal-to-tumor gene network transformation. Previously documented liver eSNPs underlying the HCC predictive gene signatures were enriched for SNPs that associated with HCC prognosis, providing support that these genes are involved in key processes of tumorigenesis. When applied individually, clinicopathologic parameters and gene expression offered similar predictive power for HCC prognosis. In contrast, a combination of the two types of data dramatically improved the power to predict HCC prognosis. Our results also provided a framework for understanding the impact of gene expression on the processes of tumorigenesis and clinical outcome

  15. Guidelines on the radiological diagnosis of the more common primary skeletal tumors

    International Nuclear Information System (INIS)

    Nemiro, J.; Riza, J.

    2002-01-01

    The rate of the skeletal tumors ia as high as 10% among skeletal disorders and the future of patients often depends on the early diagnosis of them. Radiological methods, such as X-ray examinations, conventional tomography, and computed tomography as well as magnetic resonance imaging (MRI) are very helpful in their diagnosis. Useful additional information may be obtained by using selective angiography and radionuclide diagnosis. The main objectives of the radiological diagnosis of skeletal tumors include: 1) possibly early detection of the signs of tumor itself; 2) specification of its location and of the involvement of bone and surrounding tissues; 3) evaluating of its nature (benign / malignant) and also making of the preventive prognosis and outlining of an adequate treatment for it; 4) determination of its nosologic status. Main conclusions: 1) the majority of skeletal tumors present a sufficiently well-defined radiological information to make the determination of their nature and nosologic status possible; systemic clinical signs are more of a signaling value; 2) classical X-ray examination provides a sufficiently objective basic information about skeletal tumors, which may be used as the basis for a purposeful employment of computed tomography and MRI which appear to be very promising methods in this field. (authors)

  16. Contribuição da citometria de fluxo para o diagnóstico e prognóstico das síndromes mielodisplásicas The application of flow cytometric analysis of bone marrow cells for the diagnosis and prognosis of myelodysplastic syndromes

    Directory of Open Access Journals (Sweden)

    Irene Lorand-Metze

    2006-09-01

    Full Text Available O diagnóstico das síndromes mielodisplásicas (SMD é baseado nos achados de citopenias no sangue periférico, na morfologia (atipias das células hemopoiéticas na medula óssea e no cariótipo. Em uma proporção considerável de casos, porém, o grau de atipias encontrado é discreto e sujeito a interpretações subjetivas. Além disso, alterações citogenéticas são encontradas apenas em 30%-80% dos casos. A citometria de fluxo multiparamétrica é uma técnica rápida, reproduzível e relativamente barata, capaz de objetivar alterações funcionais do clone SMD na maioria dos casos, o que permite o diagnóstico diferencial com patologias não-clonais que cursam com citopenias periféricas. Várias alterações têm sido descritas na expressão de antígenos ligados a linhagem e maturação celular nas três séries hemopoiéticas. Protocolos de três ou quatro cores analisando-se as séries eritroblástica, mielomonocítica e blastos têm sido propostos e conseguem resolver o diagnóstico diferencial em praticamente todos os casos. A citometria de fluxo também é útil para o acompanhamento dos pacientes, já que a progressão do clone neoplásico é acompanhada por um aumento do número de alterações fenotípicas e de células CD34+ além da diminuição de marcadores pró-apoptóticos.The diagnosis of MDS is based on the presence of peripheral cytopenias together with cell atypias in bone marrow precursors and cytogenetic abnormalities. However, in several cases, the cell atypias are discrete, and/or the karyotype is normal, precluding a clear-cut diagnosis. Multiparametric flow cytometry is a fast, reproducible and relatively inexpensive technique, which is able to disclose changes in the expression of lineage and maturation related antigens. Several of such abnormalities have been described in MDS. Three or four-color protocols have been used to analyze erythroblasts, granulocytes, monocytes and blasts, permitting, in most of the

  17. Long-Term Prognosis of Plantar Fasciitis

    DEFF Research Database (Denmark)

    Hansen, Liselotte; Krogh, Thøger Persson; Ellingsen, Torkell

    2018-01-01

    , exercise-induced symptoms, bilateral heel pain, fascia thickness, and presence of a heel spur) could predict long-term outcomes, (3) to assess the long-term ultrasound (US) development in the fascia, and (4) to assess whether US-guided corticosteroid injections induce atrophy of the heel fat pad. Study....... The risk was significantly greater for women (P heel...... regardless of symptoms and had no impact on prognosis, and neither did the presence of a heel spur. Only 24% of asymptomatic patients had a normal fascia on US at long-term follow-up. A US-guided corticosteroid injection did not cause atrophy of the heel fat pad. Our observational study did not allow us...

  18. Survival pathological prognosis factors in breast cancer

    International Nuclear Information System (INIS)

    Gonzalez-Longoria Boada, Lourdes B.

    2012-01-01

    A descriptive and longitudinal study of 273 women with breast cancer belonging to Granma province was carried out from 2003 to 2004, in order to analyze the survival of this female population, reason why the method of Kaplan Meier was used for the calculation of the mentioned variable and the Log Rank test was used for the comparison of curves. Patients with higher survival at 5 years were those who had tumors of 2 cm or less (87.5%), histological grade I (90.3%), nuclear grade I (88.3%), as well as the absence of vascular, lymphatic or lymph node invasion (with 80.6; 74.9 and 6.1% respectively). Also, tumor size, histological and nuclear grade, nodal status, as well as lymphatic and vascular invasion constituted prognosis factors, which favored the individualization of therapeutic behaviors

  19. [Laron syndrome: Presentation, treatment and prognosis].

    Science.gov (United States)

    Latrech, Hanane; Polak, Michel

    2016-01-01

    Laron syndrome is a rare cause of short stature due to an abnormality of growth hormone receptor (GHR). It is characterized by poor phenotype-genotype correlation and geographic predilection essentially in the Mediterranean rim, the Middle East and Indian subcontinent. This syndrome corresponds to an endogenous and exogenous complete insensitivity of GH and manifests by early hypoglycemia, an extremely severe short stature and dysmorphic features contrasting with high levels of circulating GH. To date, treatment with recombinant IGF1 is the only treatment option that has improved the terrible prognosis in these patients but does not actually realize the conditions for genuine replacement therapy. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. Prognosis of ventricular fibrillation in hospital

    DEFF Research Database (Denmark)

    Jensen, G V; Torp-Pedersen, C; Køber, L

    1992-01-01

    In a retrospective study of 520 patients with in-hospital ventricular fibrillation 421 (81%) had acute myocardial infarction (MI), 66 (13%) had ischaemic heart disease (IHD) without MI, 33 (6%) had no signs of IHD. The in-hospital mortality of these three groups was 51%, 52%, and 27%, respectively...... (P = 0.01). Logistic regression analysis demonstrated that heart failure and cardiogenic shock were significant risk factors for in-hospital death among patients with IHD. Among discharged patients 1 and 5 years survival was 78% and 51% for patients with MI, 63% and 25% for patients with IHD, 67...... with known IHD suffering in-hospital VF without AMI have a very poor short- and long-term prognosis. These patients need extensive cardiac examination....